“Hi, Jaded Julie. Mack copied me on his exchange of Christmas notes with his friends, Ernie and Susan. You might find them interesting. Here’s the note that Ernie and Susan sent to him:
‘Christmas Day is just about done where you are, and the grandchildren here are already winding down - all the Santa gifts are opened and being played with. But we wanted to wish you a very merry Christmas and lift you up with a prayer that 2011 will be a year of much more peace - for you in particular and for all of us in general.’”
“It sounds like a classical, peaceful American Christmas, Curmudge.”
“This is Mack’s response:
‘Dear Ernie and Susan,
Christmas has been pretty nice. Today was a nice, quiet day. Just got a cold so spent a few hours napping at the house. The whole camp has had it; I'm like the last one to get it. Just got back from screening a detainee tonight. Christmas Eve was a little more exciting. I was eating lunch when one of my medics ran in the chow hall and told me we had traumas coming. Apparently one of the good Afghanis in a nearby village was the victim of a Taliban motorcycle drive-by. Shot in the chest, head and leg. His cousin brought him to right outside our FOB, with the guy in the back of a minivan. Stokes, one of my medics, and I took the little ambulance and had a hair-raising ride to the gate. Blood everywhere. The van was outside the gate on the highway since they couldn't come in. We drove through the gate onto the highway, usually a no-no since the Ford has no armor (and we were in T-shirts!!) The Ford does have a siren loud enough to peel paint, however.
I had the Afghanis in the van lay the guy by the side of the road and I did a "cric", which is a surgical airway where I cut a hole in his throat and put in a breathing tube, right there on the road. Fortunately no snipers. We put the guy in our ambulance and took him back to the aid station. Unfortunately he died; had a pulse of something like 29 when we got him on the table, but I think we got some I/O points with the local population for trying.
We had a beautiful candlelight Christmas Eve service in the chapel (tent) last night. I played the piano for it like I do for most of the church services.
Today Major General Terry (RC South Commander) flew in to visit everyone for Christmas. We enjoyed meeting him very much.
Anyway, I'm guessing you guys had a pretty nice Christmas Eve service at church. Feel free to read this letter at Sunday School if you want, so they know we had a good Christmas as well. Stay in touch and God bless. -----Mack.’”
“Curmudge, the FOB (Forward Operating Base) must be a fortified island of relative safety amid a sea of anarchy. So why am I shuddering? Maybe if I put on a warmer sweater…”
Wednesday, December 29, 2010
Tuesday, December 14, 2010
Afghanistan ER
“Good morning, Jaded Julie. You may be interested in the news bulletin (below) that I saw on the Web yesterday:
‘Six American soldiers were killed and more than a dozen American and Afghan troops were wounded on Sunday morning when a van packed with explosives was detonated at a new jointly operated outpost in southern Afghanistan. The soldiers were inside a small mud-walled building near the village of Sangsar, north of the Arghandab River, when the bomber drove up to one of the walls and exploded his charge around 9 a.m. The explosion blasted a hole in the thick wall, causing the roof to collapse on the soldiers inside. Others quickly arrived and clawed and pulled at the waist-deep rubble to free the buried troops. The building had been occupied by the Americans and Afghans for only a few days, an American official said, and was beside a narrow road. It was not immediately clear how the van managed to get so close without being challenged or stopped.’”
“Doesn’t sound good, Curmudge. We’ve heard about mud-walled buildings before. Did you send a note to Mack asking about it?”
“I did, and here is his reply:
‘Yes, that suicide bomber was for us. It occurred on Sunday morning at a small outpost, happened to one of our platoons, one that I have been out with a number of times and been at the exact same type of outpost with. Good I wasn't killed in a blast, but frustrating that I wasn't close enough to do anything to help. I was sent out there quite quickly by the command, but when I got there, all the dead and worst injured had been already evacuated. They were just digging through the rubble; I took care of a couple of Afghan Army folks. I've been busy checking out the remaining folks here, also there is a huge emotional toll since 6 guys were killed like that. Been busy, up until 0200 last night just talking to distraught guys.
Jim Slone, my PA, has gone on leave, so I can't really leave the Aid Station on base to go on missions, since we have to have at least one care provider on hand.’”
“My feelings are a mixture of thankfulness and rage, Curmudge.”
“Mine also, Julie. Mack said that with winter coming on, the Taliban chiefs will sit at home by the fire in the security of Pakistan and send out the young jihadis to become martyrs. I guess he’s right.”
‘Six American soldiers were killed and more than a dozen American and Afghan troops were wounded on Sunday morning when a van packed with explosives was detonated at a new jointly operated outpost in southern Afghanistan. The soldiers were inside a small mud-walled building near the village of Sangsar, north of the Arghandab River, when the bomber drove up to one of the walls and exploded his charge around 9 a.m. The explosion blasted a hole in the thick wall, causing the roof to collapse on the soldiers inside. Others quickly arrived and clawed and pulled at the waist-deep rubble to free the buried troops. The building had been occupied by the Americans and Afghans for only a few days, an American official said, and was beside a narrow road. It was not immediately clear how the van managed to get so close without being challenged or stopped.’”
“Doesn’t sound good, Curmudge. We’ve heard about mud-walled buildings before. Did you send a note to Mack asking about it?”
“I did, and here is his reply:
‘Yes, that suicide bomber was for us. It occurred on Sunday morning at a small outpost, happened to one of our platoons, one that I have been out with a number of times and been at the exact same type of outpost with. Good I wasn't killed in a blast, but frustrating that I wasn't close enough to do anything to help. I was sent out there quite quickly by the command, but when I got there, all the dead and worst injured had been already evacuated. They were just digging through the rubble; I took care of a couple of Afghan Army folks. I've been busy checking out the remaining folks here, also there is a huge emotional toll since 6 guys were killed like that. Been busy, up until 0200 last night just talking to distraught guys.
Jim Slone, my PA, has gone on leave, so I can't really leave the Aid Station on base to go on missions, since we have to have at least one care provider on hand.’”
“My feelings are a mixture of thankfulness and rage, Curmudge.”
“Mine also, Julie. Mack said that with winter coming on, the Taliban chiefs will sit at home by the fire in the security of Pakistan and send out the young jihadis to become martyrs. I guess he’s right.”
Tuesday, November 30, 2010
Afghanistan ER
“Here’s Mack’s latest note, Julie. I’ll read it to you:
‘We did have a huge Thanksgiving dinner. I literally ate too much. Our mission that you mentioned was successful in that we accomplished what we set out to do. We went into one of the worst Taliban areas, found improvised explosive and burned and blew it up. We also found a Taliban Aid Station and burned it down. The real sad thing was that the other platoon was moving and an Afghani soldier moved off the cleared path and stepped on an IED, blew both his legs off, also injured an interpreter. Some of our guys were carrying him to the helicopter and the enemy apparently had a buried remote-controlled IED ready. When the stretcher bearers passed over it, they blew it up, killing two of our guys, injuring several more, and of course killing the Afghan guy on the stretcher. I was six hundred meters away with the other platoon and couldn't go help them since all the ground between us was not cleared and likely seeded with plenty more explosive devices. It was extraordinarily frustrating to not be able to help. Everyone was furious and despondent at the end of an otherwise tactically very successful mission. Memorial service was yesterday.
We are in our new Aid Station, which was just completed. It is beautiful and three times as large as our old one in the old stone Afghan building. The new place is by the helicopter landing zone; can be windy at times. Also too close to the trash burn pit, and I am lobbying hard to get the burn pit moved. Anyway, after I got back from the mission I pretty much just slept all day while the medics moved everything from the old building (none of them were out on the mission like I was). It was sometimes exhausting out in the field, climbing over the stone walls in the grape fields with full packs, weapons, etc.’”
“Golly, Curmudge, it must be awfully depressing for the troops and for the folks back home at Fort Campbell for the battalion to be losing at least two soldiers per week to IEDs.”
“Julie, I seem to recall reading about medieval times when battles were stopped to allow the wounded to be removed from the field. I guess now we are fighting an even more primitive civilization.”
“Civilization? Aren’t these the guys who condemn women to death by stoning?”
‘We did have a huge Thanksgiving dinner. I literally ate too much. Our mission that you mentioned was successful in that we accomplished what we set out to do. We went into one of the worst Taliban areas, found improvised explosive and burned and blew it up. We also found a Taliban Aid Station and burned it down. The real sad thing was that the other platoon was moving and an Afghani soldier moved off the cleared path and stepped on an IED, blew both his legs off, also injured an interpreter. Some of our guys were carrying him to the helicopter and the enemy apparently had a buried remote-controlled IED ready. When the stretcher bearers passed over it, they blew it up, killing two of our guys, injuring several more, and of course killing the Afghan guy on the stretcher. I was six hundred meters away with the other platoon and couldn't go help them since all the ground between us was not cleared and likely seeded with plenty more explosive devices. It was extraordinarily frustrating to not be able to help. Everyone was furious and despondent at the end of an otherwise tactically very successful mission. Memorial service was yesterday.
We are in our new Aid Station, which was just completed. It is beautiful and three times as large as our old one in the old stone Afghan building. The new place is by the helicopter landing zone; can be windy at times. Also too close to the trash burn pit, and I am lobbying hard to get the burn pit moved. Anyway, after I got back from the mission I pretty much just slept all day while the medics moved everything from the old building (none of them were out on the mission like I was). It was sometimes exhausting out in the field, climbing over the stone walls in the grape fields with full packs, weapons, etc.’”
“Golly, Curmudge, it must be awfully depressing for the troops and for the folks back home at Fort Campbell for the battalion to be losing at least two soldiers per week to IEDs.”
“Julie, I seem to recall reading about medieval times when battles were stopped to allow the wounded to be removed from the field. I guess now we are fighting an even more primitive civilization.”
“Civilization? Aren’t these the guys who condemn women to death by stoning?”
Monday, November 22, 2010
Afghanistan ER
“Another note from Mack. It’s rather short:
‘Pretty busy over here; lost some guys to a suicide bomber in the field. These were guys I had just been on the same mission with for 6 days. Then I went back in to check up on things at the aid station. Next day, guys I was just walking with out there were blown to bits by a s_ _ _-a_ _ with an explosive vest. Also three injured. I can't stand the fact that I was with them; then the moment I leave to go back here to work, this thing happens. Memorial service tomorrow.’”
“Do you have any comments, Curmudge?”
“Nothing that isn’t profane, Julie.”
‘Pretty busy over here; lost some guys to a suicide bomber in the field. These were guys I had just been on the same mission with for 6 days. Then I went back in to check up on things at the aid station. Next day, guys I was just walking with out there were blown to bits by a s_ _ _-a_ _ with an explosive vest. Also three injured. I can't stand the fact that I was with them; then the moment I leave to go back here to work, this thing happens. Memorial service tomorrow.’”
“Do you have any comments, Curmudge?”
“Nothing that isn’t profane, Julie.”
Wednesday, November 17, 2010
Afghanistan ER
“Well, Curmudge, after spending the past couple of days thinking about Mack’s letter in our last posting, do you feel any better?”
“I don’t feel better, Jaded Julie, but I understand better. Mack is living out his belief that wounded soldiers should receive the best medical care available at the point of injury. And he has determined that he will be available. As long as he has a good PA back in the aid station, Mack will practice battlefield medicine literally in the field. He may be setting a new standard for infantry battalion surgeons.”
“I can just hear the platoon sergeant announcing, ‘Listen up, guys. I have some good news and some bad news. The good news is that the doc is going with us on this mission. The bad news is that that means our platoon has the toughest assignment and we are the most likely to sustain casualties.’”
“Let’s hope the good news outweighs the bad and that the bad news doesn’t actually occur.”
“But Curmudge, isn’t a physician too valuable to go out into the field like Mack does?”
“I’m sure, Julie, that every parent feels that way about their 20-year old rifleman son.”
“Mack said that he and the medics carry M-4’s and act like riflemen until someone is wounded. I thought that medical personnel were noncombatants and had red crosses on their helmets.”
“That was another war, Julie. To the Taliban, a red cross—especially a cross—would look just like a bull’s-eye.”
“Curmudge, wouldn’t a physician feel out of his element in the field carrying a rifle along with his aid bag?”
“That might be true for a lot of docs, but not Mack. When he first went on active duty in the mid-1980’s, he was an infantry platoon leader. That was before a lot of today’s young soldiers were born.”
“Finally Curmudge, do you still get that knot in the pit of your stomach when you read notes from Mack?”
“It’s there all the time, Julie, and it will remain there for the next several months.”
“I don’t feel better, Jaded Julie, but I understand better. Mack is living out his belief that wounded soldiers should receive the best medical care available at the point of injury. And he has determined that he will be available. As long as he has a good PA back in the aid station, Mack will practice battlefield medicine literally in the field. He may be setting a new standard for infantry battalion surgeons.”
“I can just hear the platoon sergeant announcing, ‘Listen up, guys. I have some good news and some bad news. The good news is that the doc is going with us on this mission. The bad news is that that means our platoon has the toughest assignment and we are the most likely to sustain casualties.’”
“Let’s hope the good news outweighs the bad and that the bad news doesn’t actually occur.”
“But Curmudge, isn’t a physician too valuable to go out into the field like Mack does?”
“I’m sure, Julie, that every parent feels that way about their 20-year old rifleman son.”
“Mack said that he and the medics carry M-4’s and act like riflemen until someone is wounded. I thought that medical personnel were noncombatants and had red crosses on their helmets.”
“That was another war, Julie. To the Taliban, a red cross—especially a cross—would look just like a bull’s-eye.”
“Curmudge, wouldn’t a physician feel out of his element in the field carrying a rifle along with his aid bag?”
“That might be true for a lot of docs, but not Mack. When he first went on active duty in the mid-1980’s, he was an infantry platoon leader. That was before a lot of today’s young soldiers were born.”
“Finally Curmudge, do you still get that knot in the pit of your stomach when you read notes from Mack?”
“It’s there all the time, Julie, and it will remain there for the next several months.”
Monday, November 15, 2010
Afghanistan ER
“Curmudge, a few weeks ago, on October 11, you shared a note from Mack describing injuries that he and the troops sustained from improvised explosive devices (IEDs).”
“Right, Julie. It brought the war in Afghanistan awfully close to home. He recently provided more details about the mission in a letter to an old friend from Appleton. Mack sent me a copy; I’ll read part of it:
‘Dear Joe,
The last 5 months have been quite an adventure. It would take quite a while to detail everything, and I can tell you stories on end if you are interested. I will tell you about the mission where the IED attack happened. To start with, I am a ‘battalion surgeon’ in an infantry battalion. The term ‘surgeon’ in this case, means the chief medical officer for a military unit as opposed to being a surgeon who takes out gall bladders, etc. As you know, my specialty is Emergency Medicine, i.e. working in an ER.
I have gone on all the major offensives/missions. What happens is I usually go with whichever platoon or company looks like they will encounter the most resistance and have the greatest potential for casualties. I carry an M-4 (it's a shortened M-16 with a collapsible stock like the riflemen carry) and function pretty much like a rifleman the way the medics do until something happens. There is a combat medic in each platoon and I "plus up" the given platoon in these situations.
This particular mission was a Clear and Hold, where we move through the countryside, clearing houses/ compounds to ensure no enemy there and identify/destroy any IEDs that are found. The second evening we were settling down to eat a meal and sleep when the radio call came in that one of the guys in the next platoon over had stepped on an IED and had lost a leg. I ran with the company commander who was with our platoon up to the area where they were, (a grape field). The guy was pretty messed up, one leg gone, open pelvic fracture, severe rectal and pelvic injuries. The medics and I got the guy stabilized and we called in a helicopter to fly him out. We were somewhat shaken up by what had happened to him. I went back to my platoon and we went to sleep. The next morning we were to move to a new compound (Afghani houses, or compounds are mud-walled courtyards with individual rooms built into the walls as opposed to the whole building having a roof like an American house), and we packed up and moved to the place. It had been searched to ensure no bombs were rigged or anything. We had just moved inside when the first bomb went off. It was about 15 feet from me, but it was inside the foyer and I was just around a corner so that protected me from shrapnel. In the explosion guys were thrown through the air, lots of smoke, etc. and lots of confusion. I was checking out the guy who landed right in front of me; then people started shouting that someone was badly injured. I yelled that everybody who could walk should go toward the walls and bring the badly injured to the middle.
We were working on this guy who had shrapnel to his face, legs, etc, left middle finger partly blown off, fragments in right elbow, etc. in the middle of the courtyard when the second bomb went off along the wall. My medic and I fell across the guy to keep the dirt chunks/ fragments, etc from falling on him, then got him wrapped up to fly out. Because of the concussion there was an increasing number of people vomiting, losing balance, etc. I sent out 5 on the first helo, then 12 on the next one. We sent out some more on a convoy that brought the battalion commander to the scene later. By this time the platoon was not really combat effective, so the rest of us flew out late that night on a Blackhawk. My medics at the base camp with my PA checked the remainder of the people out including me. I just had a headache and jaw ache the next day, then pretty much felt back to normal aided by my pounding max doses of Tylenol. My parents did get a call the next morning from Fort Campbell saying I had had a mild ‘TBI’, but fortunately I had e-mailed my dad late the night before so he know I was still coherent.
I hope that wasn't too laborious a read. This week has been somewhat difficult as we lost two guys who were killed outright by IEDs. My PA and my medics and I were in the Aid Station three nights ago when the locals brought in two girls (age 4 and 7) who had been badly burned in a gasoline explosion. Apparently the parents had bought what they thought was diesel fuel but turned out to be gasoline for their heater. When they filled it and lit it, Boom! Burns about 80-90% of bodies. We intubated the kids, dressed the burns, and flew them out. Apparently they both died the next day, judged by the hospital to be not survivable burns, changed to comfort care only.
I should be home next spring/summer and certainly plan to stop to see you the next time I'm in Wisconsin.
Take care---Mack’”
“What’s the lesson, Curmudge? It sounds as if the good guys took it on the chin.”
“Julie, when I read this, my only feeling is the knot growing in the pit of my stomach. Let’s think about Mack’s letter and talk more about it in a few days.”
“Right, Julie. It brought the war in Afghanistan awfully close to home. He recently provided more details about the mission in a letter to an old friend from Appleton. Mack sent me a copy; I’ll read part of it:
‘Dear Joe,
The last 5 months have been quite an adventure. It would take quite a while to detail everything, and I can tell you stories on end if you are interested. I will tell you about the mission where the IED attack happened. To start with, I am a ‘battalion surgeon’ in an infantry battalion. The term ‘surgeon’ in this case, means the chief medical officer for a military unit as opposed to being a surgeon who takes out gall bladders, etc. As you know, my specialty is Emergency Medicine, i.e. working in an ER.
I have gone on all the major offensives/missions. What happens is I usually go with whichever platoon or company looks like they will encounter the most resistance and have the greatest potential for casualties. I carry an M-4 (it's a shortened M-16 with a collapsible stock like the riflemen carry) and function pretty much like a rifleman the way the medics do until something happens. There is a combat medic in each platoon and I "plus up" the given platoon in these situations.
This particular mission was a Clear and Hold, where we move through the countryside, clearing houses/ compounds to ensure no enemy there and identify/destroy any IEDs that are found. The second evening we were settling down to eat a meal and sleep when the radio call came in that one of the guys in the next platoon over had stepped on an IED and had lost a leg. I ran with the company commander who was with our platoon up to the area where they were, (a grape field). The guy was pretty messed up, one leg gone, open pelvic fracture, severe rectal and pelvic injuries. The medics and I got the guy stabilized and we called in a helicopter to fly him out. We were somewhat shaken up by what had happened to him. I went back to my platoon and we went to sleep. The next morning we were to move to a new compound (Afghani houses, or compounds are mud-walled courtyards with individual rooms built into the walls as opposed to the whole building having a roof like an American house), and we packed up and moved to the place. It had been searched to ensure no bombs were rigged or anything. We had just moved inside when the first bomb went off. It was about 15 feet from me, but it was inside the foyer and I was just around a corner so that protected me from shrapnel. In the explosion guys were thrown through the air, lots of smoke, etc. and lots of confusion. I was checking out the guy who landed right in front of me; then people started shouting that someone was badly injured. I yelled that everybody who could walk should go toward the walls and bring the badly injured to the middle.
We were working on this guy who had shrapnel to his face, legs, etc, left middle finger partly blown off, fragments in right elbow, etc. in the middle of the courtyard when the second bomb went off along the wall. My medic and I fell across the guy to keep the dirt chunks/ fragments, etc from falling on him, then got him wrapped up to fly out. Because of the concussion there was an increasing number of people vomiting, losing balance, etc. I sent out 5 on the first helo, then 12 on the next one. We sent out some more on a convoy that brought the battalion commander to the scene later. By this time the platoon was not really combat effective, so the rest of us flew out late that night on a Blackhawk. My medics at the base camp with my PA checked the remainder of the people out including me. I just had a headache and jaw ache the next day, then pretty much felt back to normal aided by my pounding max doses of Tylenol. My parents did get a call the next morning from Fort Campbell saying I had had a mild ‘TBI’, but fortunately I had e-mailed my dad late the night before so he know I was still coherent.
I hope that wasn't too laborious a read. This week has been somewhat difficult as we lost two guys who were killed outright by IEDs. My PA and my medics and I were in the Aid Station three nights ago when the locals brought in two girls (age 4 and 7) who had been badly burned in a gasoline explosion. Apparently the parents had bought what they thought was diesel fuel but turned out to be gasoline for their heater. When they filled it and lit it, Boom! Burns about 80-90% of bodies. We intubated the kids, dressed the burns, and flew them out. Apparently they both died the next day, judged by the hospital to be not survivable burns, changed to comfort care only.
I should be home next spring/summer and certainly plan to stop to see you the next time I'm in Wisconsin.
Take care---Mack’”
“What’s the lesson, Curmudge? It sounds as if the good guys took it on the chin.”
“Julie, when I read this, my only feeling is the knot growing in the pit of my stomach. Let’s think about Mack’s letter and talk more about it in a few days.”
Monday, October 18, 2010
Afghanistan ER
“Hey, Curmudge, has Mack recovered from the concussion he received from the IED blasts?”
“His email notes seem pretty normal, Jaded Julie. A few headaches, but none of the more serious symptoms that one expects from traumatic brain injuries. He has been back ‘home’ at the forward operating base (FOB) for the past few days, but living there is not especially easy.”
“I understand that the Americans share the FOB with British and Afghan soldiers, and that the sanitary conditions are not the best.”
“Here’s what he says, Julie, in his latest note:
‘Do you really think I haven't been ‘encouraging’ these people to improve the Porta-Potties? We've been doing everything we can, including trying to restrict as many as we can for US and British use only. This was determined to be ‘discriminatory’ to the ANA, so they are back to dive-bombing the latrines. They actually stand up on the toilet seats and let it go, and if things don't quite fall into the hole, oh well. The struggle is ongoing.’”
“Do you recall, Curmudge, our writing about sanitation in Third World countries back on March 3? If 40% of the world’s population don’t have any toilet facilities, there are a lot of people out there who might not know how to use them if they had them.”
“And a couple of years ago on May 8, 2008 in Kaizen Curmudgeon we talked about how a leadership culture change sometimes involves learning things that seem unnatural, like potty training for young children. So there in Afghanistan the culture change is more than like potty training, it is potty training.”
“His email notes seem pretty normal, Jaded Julie. A few headaches, but none of the more serious symptoms that one expects from traumatic brain injuries. He has been back ‘home’ at the forward operating base (FOB) for the past few days, but living there is not especially easy.”
“I understand that the Americans share the FOB with British and Afghan soldiers, and that the sanitary conditions are not the best.”
“Here’s what he says, Julie, in his latest note:
‘Do you really think I haven't been ‘encouraging’ these people to improve the Porta-Potties? We've been doing everything we can, including trying to restrict as many as we can for US and British use only. This was determined to be ‘discriminatory’ to the ANA, so they are back to dive-bombing the latrines. They actually stand up on the toilet seats and let it go, and if things don't quite fall into the hole, oh well. The struggle is ongoing.’”
“Do you recall, Curmudge, our writing about sanitation in Third World countries back on March 3? If 40% of the world’s population don’t have any toilet facilities, there are a lot of people out there who might not know how to use them if they had them.”
“And a couple of years ago on May 8, 2008 in Kaizen Curmudgeon we talked about how a leadership culture change sometimes involves learning things that seem unnatural, like potty training for young children. So there in Afghanistan the culture change is more than like potty training, it is potty training.”
Monday, October 11, 2010
Afghanistan ER
“Another note from Mack, Jaded Julie. I am at a loss for words, so I’ll just read his:
‘Hi, everyone,
This weekend was quite eventful. I was in a double IED blast. We were in a compound and there were two houseborne IEDs that went off, first one about 15 feet away from me; then while we were taking care of the guy hurt worst in that one, a second bomb went off. I just got done being checked out in the Aid Station at Howz-E-Madad. Only a little sore, have a mandatory 24 hour rest period that we do for soldiers who have been in IED or bomb attacks as part of the mTBI (mild traumatic brain injury) policy for prevention of worsening, etc.
I had been on this patrol mission since Thursday. Last night a guy stepped on an IED, lost his leg but also had terrible pelvic injuries; we did all we could do for him, (treating him in a grape field). He had two surgeries today, I think, and is on a flight to Germany. I already had a pretty depleted Aid Bag today when the IEDs blew up; now it's completely trashed as are my clothes and everything. I still have someone's blood on me; it took forever to get everyone flown out and I finally got a helicopter ride back here about 10 PM or so. I am going to leave the bloody stuff in front of the house and go take a shower.
Take care and stay in touch----Mack’
After reading this, I sent him a note suggesting that this might be a good time to revisit the concept of a board-certified physician going on patrols.”
“You can already guess his reply, Curmudge. He will probably say that the horrible wounds suffered by the troops make it all the more essential that he be there. If it hadn’t been for Mack and his medics, the soldier who lost his leg would have died right there in the grape vineyard.”
‘Hi, everyone,
This weekend was quite eventful. I was in a double IED blast. We were in a compound and there were two houseborne IEDs that went off, first one about 15 feet away from me; then while we were taking care of the guy hurt worst in that one, a second bomb went off. I just got done being checked out in the Aid Station at Howz-E-Madad. Only a little sore, have a mandatory 24 hour rest period that we do for soldiers who have been in IED or bomb attacks as part of the mTBI (mild traumatic brain injury) policy for prevention of worsening, etc.
I had been on this patrol mission since Thursday. Last night a guy stepped on an IED, lost his leg but also had terrible pelvic injuries; we did all we could do for him, (treating him in a grape field). He had two surgeries today, I think, and is on a flight to Germany. I already had a pretty depleted Aid Bag today when the IEDs blew up; now it's completely trashed as are my clothes and everything. I still have someone's blood on me; it took forever to get everyone flown out and I finally got a helicopter ride back here about 10 PM or so. I am going to leave the bloody stuff in front of the house and go take a shower.
Take care and stay in touch----Mack’
After reading this, I sent him a note suggesting that this might be a good time to revisit the concept of a board-certified physician going on patrols.”
“You can already guess his reply, Curmudge. He will probably say that the horrible wounds suffered by the troops make it all the more essential that he be there. If it hadn’t been for Mack and his medics, the soldier who lost his leg would have died right there in the grape vineyard.”
Monday, October 4, 2010
Afghanistan ER
“Hey, Curmudge, it looks as if you have another note from Mack.”
“It’s pretty short, Julie, and is mostly a thank-you note to his brother. Here, I’ll read it to you:
‘Thanks so much for the last package. I've been doing a lot of field time with this big thing you've probably seen in the news.... Would've been downright unhealthy without all the wet wipes, toilet paper, Gatorade, and of course, the cookies for morale and a break from just straight MRE's (field rations). Very interesting and slightly precarious last several days. Last night I was on the ground 400 meters from a kinetic strike (F-16 making two runs dropping a two-thousand pound bomb each time). Most terrifying explosion I've ever experienced and I think the rest of the group felt pretty much the same.’”
“Not anything about emergency medicine in this one, Curmudge. Let’s assume that’s good news.”
“As much as I appreciate getting these notes, they always leave me a bit shaken. At least this time it was the enemy on the receiving end. Nevertheless, I’m reminded of how much danger the troops—even the medical personnel—are in.”
“It’s pretty short, Julie, and is mostly a thank-you note to his brother. Here, I’ll read it to you:
‘Thanks so much for the last package. I've been doing a lot of field time with this big thing you've probably seen in the news.... Would've been downright unhealthy without all the wet wipes, toilet paper, Gatorade, and of course, the cookies for morale and a break from just straight MRE's (field rations). Very interesting and slightly precarious last several days. Last night I was on the ground 400 meters from a kinetic strike (F-16 making two runs dropping a two-thousand pound bomb each time). Most terrifying explosion I've ever experienced and I think the rest of the group felt pretty much the same.’”
“Not anything about emergency medicine in this one, Curmudge. Let’s assume that’s good news.”
“As much as I appreciate getting these notes, they always leave me a bit shaken. At least this time it was the enemy on the receiving end. Nevertheless, I’m reminded of how much danger the troops—even the medical personnel—are in.”
Friday, September 24, 2010
Afghanistan ER
“Hey, Julie, Mack has been ‘out of the office’ for several days and just sent this note:
‘I was just on a 10 day mission. Was projected to be pretty dangerous with lots of casualties, but didn't turn out too bad. I did have one scary patient where I put in a chest tube in a partially-built guard tower. Whole thing was pretty exhausting. I did wade across the Argandab River during our "push." You should look that one up, since this is apparently a pretty notable river here.
We have another mission coming up very soon, (sooner than I would have wanted for rest purposes). By the way, please send another roll of duct tape (not for medical use).’”
“I think I understand what an Afghanistan emergency room is, Curmudge. It’s any place where a wounded soldier needs the urgent care of a physician.”
“Perhaps Mack’s team should adopt the motto, ‘The best of care anywhere. Literally, anywhere.'”
‘I was just on a 10 day mission. Was projected to be pretty dangerous with lots of casualties, but didn't turn out too bad. I did have one scary patient where I put in a chest tube in a partially-built guard tower. Whole thing was pretty exhausting. I did wade across the Argandab River during our "push." You should look that one up, since this is apparently a pretty notable river here.
We have another mission coming up very soon, (sooner than I would have wanted for rest purposes). By the way, please send another roll of duct tape (not for medical use).’”
“I think I understand what an Afghanistan emergency room is, Curmudge. It’s any place where a wounded soldier needs the urgent care of a physician.”
“Perhaps Mack’s team should adopt the motto, ‘The best of care anywhere. Literally, anywhere.'”
Wednesday, September 15, 2010
Afghanistan ER
“Hey, Curmudge, I see that Mack copied you on another email to his friends. It appears that he only writes to them when something exciting has happened.”
“Exciting isn’t the right word, Jaded Julie. This time it was tragic. I’ll read part of what he wrote:
‘Hi, everyone,
Hope your Labor Day holiday was good. Ours over here got pretty tumultuous. We were sitting down to a special Labor Day dinner they had in the mess tent when the word came that incoming (fire) was expected. I had to leave half my dinner behind as everyone had to go to bunkers, etc. A mortar hit a Hesco (barrier wall) and bounced into a bunker. It blew up at head height right in the middle of a group of American contractors that worked with us. It was the worst mass-casualty event I've ever been involved with. People lying all over the place with terrible head injuries gurgling blood etc. Two died within the hour, then one more died the next morning at the hospital where we had flown him. (I tried as much as I could to help him.) Several more still in bad condition. It's taken a couple of days to just clean the blood off ourselves and the equipment. Still getting more incoming, lots of time in body armor. Our morale is very good, including mine (so far). I have a tiny ‘cottage’ that one of my medics and I built so I don’t have to sleep in a tent all winter. I’ll try to send a picture of it. I can say that I own property in Afghanistan, albeit in an unsafe neighborhood. Anyway, we’ve got a burned baby coming in. Gotta go--Mack.’”
“Curmudge, it sounds as if on Labor Day the term ‘triage’ reverted back to its original meaning.”
“The training of the whole medical team undoubtedly kicked in; but after things settled down, all of them—Mack, his PA, and especially the young enlisted medics—must have realized what an emotional experience their first mass-casualty event had been.”
“Exciting isn’t the right word, Jaded Julie. This time it was tragic. I’ll read part of what he wrote:
‘Hi, everyone,
Hope your Labor Day holiday was good. Ours over here got pretty tumultuous. We were sitting down to a special Labor Day dinner they had in the mess tent when the word came that incoming (fire) was expected. I had to leave half my dinner behind as everyone had to go to bunkers, etc. A mortar hit a Hesco (barrier wall) and bounced into a bunker. It blew up at head height right in the middle of a group of American contractors that worked with us. It was the worst mass-casualty event I've ever been involved with. People lying all over the place with terrible head injuries gurgling blood etc. Two died within the hour, then one more died the next morning at the hospital where we had flown him. (I tried as much as I could to help him.) Several more still in bad condition. It's taken a couple of days to just clean the blood off ourselves and the equipment. Still getting more incoming, lots of time in body armor. Our morale is very good, including mine (so far). I have a tiny ‘cottage’ that one of my medics and I built so I don’t have to sleep in a tent all winter. I’ll try to send a picture of it. I can say that I own property in Afghanistan, albeit in an unsafe neighborhood. Anyway, we’ve got a burned baby coming in. Gotta go--Mack.’”
“Curmudge, it sounds as if on Labor Day the term ‘triage’ reverted back to its original meaning.”
“The training of the whole medical team undoubtedly kicked in; but after things settled down, all of them—Mack, his PA, and especially the young enlisted medics—must have realized what an emotional experience their first mass-casualty event had been.”
Wednesday, August 11, 2010
Afghanistan ER
“Hey Curmudge. I see that you received a note from Mack.”
“Right Jaded Julie. He copied me on an email sent to several of his friends here in the States.”
“I understand that he is a battalion surgeon in Afghanistan.”
“That’s his title. Actually he is an emergency medicine physician. Would you like me to read part of his note? Here it is:
‘Just wanted to say hi. Pretty exciting last several days. My medics and I have taken care of a lot of people, 49 traumas in 2 months. Mostly Afghanis, (Military and civilians including kids). Took care of a 5 year-old boy with gunshot wound to head, very serious, flew him out stable. We've saved a lot of lives. Yesterday I was on a patrol and we got ambushed and had half-hour firefight. No one of us hurt. The Kiowas (helicopters) came in to shoot them up. I played guitar in the chapel service last Sunday…’“
“One question, Curmudge. What was a board-certified physician doing on a patrol?”
“It must have been a slow day back at the battalion aid station. He undoubtedly left his PA in charge.”
“Curmudge, is there a lesson in this story?”
“I hope so, Julie. There in the midst of a war and a dusty, almost Biblical setting, they are achieving the basic goal of medicine everywhere. As Mack said, ‘We’ve saved a lot of lives.’”
“Right Jaded Julie. He copied me on an email sent to several of his friends here in the States.”
“I understand that he is a battalion surgeon in Afghanistan.”
“That’s his title. Actually he is an emergency medicine physician. Would you like me to read part of his note? Here it is:
‘Just wanted to say hi. Pretty exciting last several days. My medics and I have taken care of a lot of people, 49 traumas in 2 months. Mostly Afghanis, (Military and civilians including kids). Took care of a 5 year-old boy with gunshot wound to head, very serious, flew him out stable. We've saved a lot of lives. Yesterday I was on a patrol and we got ambushed and had half-hour firefight. No one of us hurt. The Kiowas (helicopters) came in to shoot them up. I played guitar in the chapel service last Sunday…’“
“One question, Curmudge. What was a board-certified physician doing on a patrol?”
“It must have been a slow day back at the battalion aid station. He undoubtedly left his PA in charge.”
“Curmudge, is there a lesson in this story?”
“I hope so, Julie. There in the midst of a war and a dusty, almost Biblical setting, they are achieving the basic goal of medicine everywhere. As Mack said, ‘We’ve saved a lot of lives.’”
Wednesday, April 14, 2010
When Education Becomes Indoctrination
“Curmudge, our topic for today looks rather ominous. Perhaps we should start with an example. Our last discussion ended with the males of the village acquiring enough education to build systems for providing clean water and basic sanitation. Then what?”
“In their madrasa the boys undoubtedly learn reading and writing. However, if their teacher is an Islamic radical, he may also be indoctrinating them with the belief that the United States is the ‘Great Satan’ that must be destroyed by people achieving ‘martyrdom.’”
“So Curmudge, in our eyes these so-called ‘martyrs’ become murderers and suicide bombers by blowing themselves and innocent people to bits. It doesn’t do much good for these people to grow up with clean water and sanitation if their ultimate desire is to be dead before they’re old enough to grow a beard.”
“It’s even worse, Jaded Julie, when a whole nation becomes indoctrinated. Sixty-five years ago (I was 11 years old) American civilians viewed Japanese kamikaze pilots as a small group of deranged zealots willing to crash their planes onto American ships off Okinawa. Only slightly later did we learn that the whole Japanese nation had been brain-washed into believing that Americans were a sub-human race to be resisted unto death. This was clearly demonstrated by Okinawan civilians jumping to their death off high cliffs before the advancing Americans.”
“I can understand the history, Curmudge, but their psychology blows my mind. I hope the Islamic terrorists possess the only remaining vestige of such a warped mindset.”
“Unfortunately it’s not true, Julie. The modern-day North Koreans have been propagandized in much the same way as the World War II Japanese. The North Korean educational system teaches a belief in the unique moral superiority of the Korean race (1); Americans are depicted as an inherently evil race and sketched as jackals with paws and snouts.”
“Golly Curmudge, that would seem unbelievable except that it has been pounded into the minds of North Korean children for the past forty years.”
“There’s more. ‘They are also told that the South Korean masses, for all their material comfort, are ashamed of being under the thumb of the Yankees and yearn to live under Kim Jong-Il.’ The propaganda apparatus continues to assure the North Korean people that their economic sacrifices (over a million starved to death in the 1990’s) are essential to support their ‘military first’ regime and protect them from the Yankees.”
“If we didn’t know authoritatively that all this is the truth, it would seem like some sort of diabolical fairy tale. How will this situation end?”
“For our purpose, Julie, we can conclude that education can be a force for good; but when it becomes propaganda, it can become unspeakably evil. History is full of additional examples. For North Korea, the end game is a total unknown. Watch out for further writings by B. R. Myers to keep up to date on the situation (2). However if you want to sleep well at night, read medieval novels by Ken Follett.”
(1) Myers, B.R. The Cleanest Race: How North Koreans See Themselves—and Why It Matters. Available from Amazon.com. See also review by William Alexander.
(2) Myers, B.R. North Korea on the Edge. http://online.wsj.com/article/SB10001424052748704100604575145672974954144.html?KEYWORDS=BR+Myers
“In their madrasa the boys undoubtedly learn reading and writing. However, if their teacher is an Islamic radical, he may also be indoctrinating them with the belief that the United States is the ‘Great Satan’ that must be destroyed by people achieving ‘martyrdom.’”
“So Curmudge, in our eyes these so-called ‘martyrs’ become murderers and suicide bombers by blowing themselves and innocent people to bits. It doesn’t do much good for these people to grow up with clean water and sanitation if their ultimate desire is to be dead before they’re old enough to grow a beard.”
“It’s even worse, Jaded Julie, when a whole nation becomes indoctrinated. Sixty-five years ago (I was 11 years old) American civilians viewed Japanese kamikaze pilots as a small group of deranged zealots willing to crash their planes onto American ships off Okinawa. Only slightly later did we learn that the whole Japanese nation had been brain-washed into believing that Americans were a sub-human race to be resisted unto death. This was clearly demonstrated by Okinawan civilians jumping to their death off high cliffs before the advancing Americans.”
“I can understand the history, Curmudge, but their psychology blows my mind. I hope the Islamic terrorists possess the only remaining vestige of such a warped mindset.”
“Unfortunately it’s not true, Julie. The modern-day North Koreans have been propagandized in much the same way as the World War II Japanese. The North Korean educational system teaches a belief in the unique moral superiority of the Korean race (1); Americans are depicted as an inherently evil race and sketched as jackals with paws and snouts.”
“Golly Curmudge, that would seem unbelievable except that it has been pounded into the minds of North Korean children for the past forty years.”
“There’s more. ‘They are also told that the South Korean masses, for all their material comfort, are ashamed of being under the thumb of the Yankees and yearn to live under Kim Jong-Il.’ The propaganda apparatus continues to assure the North Korean people that their economic sacrifices (over a million starved to death in the 1990’s) are essential to support their ‘military first’ regime and protect them from the Yankees.”
“If we didn’t know authoritatively that all this is the truth, it would seem like some sort of diabolical fairy tale. How will this situation end?”
“For our purpose, Julie, we can conclude that education can be a force for good; but when it becomes propaganda, it can become unspeakably evil. History is full of additional examples. For North Korea, the end game is a total unknown. Watch out for further writings by B. R. Myers to keep up to date on the situation (2). However if you want to sleep well at night, read medieval novels by Ken Follett.”
(1) Myers, B.R. The Cleanest Race: How North Koreans See Themselves—and Why It Matters. Available from Amazon.com. See also review by William Alexander.
(2) Myers, B.R. North Korea on the Edge. http://online.wsj.com/article/SB10001424052748704100604575145672974954144.html?KEYWORDS=BR+Myers
Wednesday, April 7, 2010
Will education be the key to the Third World's health problems?
“Curmudge, it’s hard for me to forget about the problems of that Third World country that was our imaginary destination a few weeks ago. Wouldn’t the people’s lives be better if they could somehow get an education?”
“Jaded Julie, it depends on their culture and ultimately, on their government. With their hanging latrine, the people we visited were already one rung up on the sanitation ladder. I’m sure you recall that 2.6 billion people don’t even have a basic latrine, and many of those folks might not even appreciate the value of one. So the first step in education would be to put sanitation in the mindset of the populace.”
“What about formal education like reading and writing?”
“The dominant belief in some cultures is that women should not be educated. So in those locations at least half of their intellectual capital is wasted. Fortunately those children who are able to attend school will eventually be able to interact with their government and nongovernmental organizations (NGOs) to learn about developing clean water systems and basic sanitary facilities.”
“So, Curmudge, how might they obtain clean water?”
“It depends on the locale. They might dig a well or collect rainwater. Even in the U.S., my mother and her sisters used water from the rain barrel to wash their hair; it was softer than the spring water that they drank. Surface water in the Third World would have to be purified to make it safe. That could be done inexpensively by filtration through a ceramic cone or treatment with Clorox or similar chemicals. A solar still should be adequate to produce drinking water for a small family.”
“What about sanitation? There must be something for undeveloped countries that is better than that hanging latrine that we saw.”
“There are several systems, Julie, including composting pit latrines and their commercial version, the Ecosan waterless toilet. We needn’t discuss operational details other than to say that they are simple and should be inexpensive. I’ve seen these, fitted with solar panels, in national parks in the U.S.”
“We’ve done it, Curmudge. We’ve solved the water and sanitation problems of the Third World, at least theoretically. So everyone should live happily ever after.”
“It’s not necessarily so, Jaded Julie. Governments or ethnic groups can come along and turn everything we’ve said on its head. We’ll talk about that next time. You won’t like the story.”
“Jaded Julie, it depends on their culture and ultimately, on their government. With their hanging latrine, the people we visited were already one rung up on the sanitation ladder. I’m sure you recall that 2.6 billion people don’t even have a basic latrine, and many of those folks might not even appreciate the value of one. So the first step in education would be to put sanitation in the mindset of the populace.”
“What about formal education like reading and writing?”
“The dominant belief in some cultures is that women should not be educated. So in those locations at least half of their intellectual capital is wasted. Fortunately those children who are able to attend school will eventually be able to interact with their government and nongovernmental organizations (NGOs) to learn about developing clean water systems and basic sanitary facilities.”
“So, Curmudge, how might they obtain clean water?”
“It depends on the locale. They might dig a well or collect rainwater. Even in the U.S., my mother and her sisters used water from the rain barrel to wash their hair; it was softer than the spring water that they drank. Surface water in the Third World would have to be purified to make it safe. That could be done inexpensively by filtration through a ceramic cone or treatment with Clorox or similar chemicals. A solar still should be adequate to produce drinking water for a small family.”
“What about sanitation? There must be something for undeveloped countries that is better than that hanging latrine that we saw.”
“There are several systems, Julie, including composting pit latrines and their commercial version, the Ecosan waterless toilet. We needn’t discuss operational details other than to say that they are simple and should be inexpensive. I’ve seen these, fitted with solar panels, in national parks in the U.S.”
“We’ve done it, Curmudge. We’ve solved the water and sanitation problems of the Third World, at least theoretically. So everyone should live happily ever after.”
“It’s not necessarily so, Jaded Julie. Governments or ethnic groups can come along and turn everything we’ve said on its head. We’ll talk about that next time. You won’t like the story.”
Wednesday, March 31, 2010
Governments and Health in the Third World
“Curmudge, do you recall our imaginary visit a few weeks ago to that Third World village where the people had such poor health and sanitation? I suspect that those people’s sorry situation is duplicated in many locations throughout the Third World. What’s the root cause of their plight?”
“In my opinion, Jaded Julie, the root cause is poor government. I’ve heard it said that in the U.S. one gets rich and then goes into politics; in the Third World one goes into politics and then gets rich. In these countries, graft is rampant. When the developed world sends (lends?) money to Third World countries, it often ends up in the pockets of the leaders and their cronies. These folks don’t seem to believe that a government should exist for the benefit of its people.”
“Citizens of Third World countries often do quite well if they are able to emigrate to a developed country. What is their country of origin lacking that prevents their ‘pulling themselves up by their bootstraps’ back home?”
“For the most part, the countries of the world that are the most poverty ridden are those without democratic governments that foster free markets. This is documented by studies published by the World Bank. At the bottom of the ease-of-business scale are those little countries of Africa that would be difficult to find even on an up-to-date map. The vast majority of the populations of these same countries live in poverty.”
“That must mean, Curmudge, that the countries in which the citizens prosper are those in which it is easy to do business.”
“Exactly. At the top of the ease-of-doing-business scale are Singapore, New Zealand, Hong Kong, and the U.S. in that order. The World Bank’s criteria include: starting a business, dealing with licenses, hiring and firing workers, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts, and closing a business. We know intuitively that most of these conditions are favorable in the countries of the developed world.”
“I saw you reading an article by Steve Forbes in which he elaborated on some of these criteria.”
“According to Forbes, the rule of law that we enjoy in the U.S. is essential. Commercial contracts must be respected by everyone, including government bureaucrats, and government cannot seize your property or nationalize your business. ‘Low tax rates on income, profits and capital gains foster more risk-taking and higher growth, bringing about a richer economy with a higher standard of living—along with higher government revenues.’”
“Curmudge, some people don’t believe what Forbes said about lower tax rates bringing a higher standard of living and, at the same time, higher government revenues.”
“Forbes’ statement is undoubtedly based on the Laffer curve. Although it is somewhat controversial, the political philosophy of those who totally reject it appears to have blinded them to the realities of history. Speaking of history, the concept of the Laffer curve has been around since the 14th century.”
“So back to those impoverished folks in the Third World village we visited a few weeks ago. We could help that single village by sending our own resources, but what can be done to assist the whole poverty-ridden nation?”
“If the source of poverty is despotic leadership, Julie, one solution might be regime change. The feasibility of that depends on the relative strength and determination of the regime and of the people. Peaceful change came to the former Soviet–bloc countries in 1989-90 because virtually all of the citizens participated in peaceful demonstrations that the communist leaders were unwilling to suppress violently. Elsewhere, regime change has not occurred because despotic leaders were willing to put down unrest irrespective of the cost.”
“I have the feeling that today’s discussion might end on a discouraging word, Curmudge. If they don’t get a democratic, somewhat benevolent government, the folks we visited may have to put up with their polluted water and hanging toilet for a long time.”
“They are not the only people with concerns, Julie. Even people in developed countries have to work hard to keep their standard of living from being eroded by their government. To quote Thomas Paine, ‘The greatest tyrannies are always perpetrated in the name of the noblest causes.’"
“In my opinion, Jaded Julie, the root cause is poor government. I’ve heard it said that in the U.S. one gets rich and then goes into politics; in the Third World one goes into politics and then gets rich. In these countries, graft is rampant. When the developed world sends (lends?) money to Third World countries, it often ends up in the pockets of the leaders and their cronies. These folks don’t seem to believe that a government should exist for the benefit of its people.”
“Citizens of Third World countries often do quite well if they are able to emigrate to a developed country. What is their country of origin lacking that prevents their ‘pulling themselves up by their bootstraps’ back home?”
“For the most part, the countries of the world that are the most poverty ridden are those without democratic governments that foster free markets. This is documented by studies published by the World Bank. At the bottom of the ease-of-business scale are those little countries of Africa that would be difficult to find even on an up-to-date map. The vast majority of the populations of these same countries live in poverty.”
“That must mean, Curmudge, that the countries in which the citizens prosper are those in which it is easy to do business.”
“Exactly. At the top of the ease-of-doing-business scale are Singapore, New Zealand, Hong Kong, and the U.S. in that order. The World Bank’s criteria include: starting a business, dealing with licenses, hiring and firing workers, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts, and closing a business. We know intuitively that most of these conditions are favorable in the countries of the developed world.”
“I saw you reading an article by Steve Forbes in which he elaborated on some of these criteria.”
“According to Forbes, the rule of law that we enjoy in the U.S. is essential. Commercial contracts must be respected by everyone, including government bureaucrats, and government cannot seize your property or nationalize your business. ‘Low tax rates on income, profits and capital gains foster more risk-taking and higher growth, bringing about a richer economy with a higher standard of living—along with higher government revenues.’”
“Curmudge, some people don’t believe what Forbes said about lower tax rates bringing a higher standard of living and, at the same time, higher government revenues.”
“Forbes’ statement is undoubtedly based on the Laffer curve. Although it is somewhat controversial, the political philosophy of those who totally reject it appears to have blinded them to the realities of history. Speaking of history, the concept of the Laffer curve has been around since the 14th century.”
“So back to those impoverished folks in the Third World village we visited a few weeks ago. We could help that single village by sending our own resources, but what can be done to assist the whole poverty-ridden nation?”
“If the source of poverty is despotic leadership, Julie, one solution might be regime change. The feasibility of that depends on the relative strength and determination of the regime and of the people. Peaceful change came to the former Soviet–bloc countries in 1989-90 because virtually all of the citizens participated in peaceful demonstrations that the communist leaders were unwilling to suppress violently. Elsewhere, regime change has not occurred because despotic leaders were willing to put down unrest irrespective of the cost.”
“I have the feeling that today’s discussion might end on a discouraging word, Curmudge. If they don’t get a democratic, somewhat benevolent government, the folks we visited may have to put up with their polluted water and hanging toilet for a long time.”
“They are not the only people with concerns, Julie. Even people in developed countries have to work hard to keep their standard of living from being eroded by their government. To quote Thomas Paine, ‘The greatest tyrannies are always perpetrated in the name of the noblest causes.’"
Thursday, March 25, 2010
Cultures--Bad and Good
“Curmudge, I believe that you’ve felt that one of the best aspects of the Lean culture was its respect for people.”
“Right, Jaded Julie. Although I always enjoyed my work, I now realize that I often worked in a poor cultural environment. I guess I was just stoic and didn’t know any better. Fortunately, there were other places where the culture was extraordinary.”
“We can learn from experiences that were bad as well as from those that were good. Let’s start with the bad ones. Can you give some examples?”
“The company’s culture was great until the founders retired. The new CEO was from Chicago, so he moved corporate headquarters there (at great expense). As I recall, the building had five stories; the top floor was for the exclusive use of the top executives and their administrative assistants. Whenever I met with my boss, her assistant would escort me from the third floor; the elevator door wouldn’t open at the fifth floor for mere peasants. When one stepped out of the elevator, you faced a life-size stylized horse which likely cost much more than a real one. If the horse could have talked, it would have announced, ‘You are now in executive country.’ The art work on my boss’s office walls was exquisite. It had to be because it was inspected periodically by the ‘picture police.’”
“To say the least, the corporate culture doesn’t sound very egalitarian. You once told me that it wasn’t so much the executive floor that bothered you; it was the political stratification that seemed to be palpable throughout the whole building.”
“That’s for sure, Julie. Corporate royalty had an executive dining room on the top floor and a garage beneath the building for their company-owned cars. Fortunately, some of the perquisites trickled down to the lower floors. Managers had offices with a window, and directors had corner offices. Others, like me, had cubicles in the middle of a big room. I was grateful that because my regular location was here in the Fox Valley, I only visited corporate headquarters occasionally for meetings.”
“Although the whole situation sounds pretty dismal, were there other aspects of the culture that really got your goat?”
“There sure were. Another location of the company had layoffs that occurred in waves. During one of these periods, when the P.A. system summoned a person to report to Human Resources, it usually meant that his job had been eliminated. In addition, when I read the company’s annual report, I learned that they paid more for the executives’ golf club memberships than they paid me in salary. I remain perplexed at the top-level executives’ apparent disinterest in how the company’s venomous culture impacted the rest of their employees.”
“Wow, Curmudge! Your experience with medieval management must have been a real downer.”
“There are more examples, but perhaps not quite as egregious. Many years ago in a different organization, a new president was hired from a university in the South. Despite the organization’s extraordinary culture, he made no attempt to understand it or to build upon it. It was his way or the highway, and most staff members—including me—chose the highway.”
“I hope, Curmudge, that these truly bad experiences were matched by some that were truly good.”
“We’ll talk about those soon in Kaizen Curmudgeon, Julie.”
“Right, Jaded Julie. Although I always enjoyed my work, I now realize that I often worked in a poor cultural environment. I guess I was just stoic and didn’t know any better. Fortunately, there were other places where the culture was extraordinary.”
“We can learn from experiences that were bad as well as from those that were good. Let’s start with the bad ones. Can you give some examples?”
“The company’s culture was great until the founders retired. The new CEO was from Chicago, so he moved corporate headquarters there (at great expense). As I recall, the building had five stories; the top floor was for the exclusive use of the top executives and their administrative assistants. Whenever I met with my boss, her assistant would escort me from the third floor; the elevator door wouldn’t open at the fifth floor for mere peasants. When one stepped out of the elevator, you faced a life-size stylized horse which likely cost much more than a real one. If the horse could have talked, it would have announced, ‘You are now in executive country.’ The art work on my boss’s office walls was exquisite. It had to be because it was inspected periodically by the ‘picture police.’”
“To say the least, the corporate culture doesn’t sound very egalitarian. You once told me that it wasn’t so much the executive floor that bothered you; it was the political stratification that seemed to be palpable throughout the whole building.”
“That’s for sure, Julie. Corporate royalty had an executive dining room on the top floor and a garage beneath the building for their company-owned cars. Fortunately, some of the perquisites trickled down to the lower floors. Managers had offices with a window, and directors had corner offices. Others, like me, had cubicles in the middle of a big room. I was grateful that because my regular location was here in the Fox Valley, I only visited corporate headquarters occasionally for meetings.”
“Although the whole situation sounds pretty dismal, were there other aspects of the culture that really got your goat?”
“There sure were. Another location of the company had layoffs that occurred in waves. During one of these periods, when the P.A. system summoned a person to report to Human Resources, it usually meant that his job had been eliminated. In addition, when I read the company’s annual report, I learned that they paid more for the executives’ golf club memberships than they paid me in salary. I remain perplexed at the top-level executives’ apparent disinterest in how the company’s venomous culture impacted the rest of their employees.”
“Wow, Curmudge! Your experience with medieval management must have been a real downer.”
“There are more examples, but perhaps not quite as egregious. Many years ago in a different organization, a new president was hired from a university in the South. Despite the organization’s extraordinary culture, he made no attempt to understand it or to build upon it. It was his way or the highway, and most staff members—including me—chose the highway.”
“I hope, Curmudge, that these truly bad experiences were matched by some that were truly good.”
“We’ll talk about those soon in Kaizen Curmudgeon, Julie.”
Thursday, March 11, 2010
Return to the Third World
“Jaded Julie, I’m certain that you recall the unpleasant details of our imaginary trip to the third world last week. Remember those local people who were staring at us as we were inspecting their hanging latrine? They sure didn’t look very happy.”
“All of the details were unpleasant, Curmudge. Maybe those folks thought that we were going to add to the overcrowding in their primitive toilet. No need to worry. I’d suffer extreme constipation before I’d use that grubby thing.”
“That assumes, of course, that you didn’t have diarrhea, which you would have gotten within a few hours after drinking the local water. But what I also noticed was that many of the locals appeared to be in poor health.”
“You’re right, Curmudge. Some of the children had distended bellies, and I saw a woman with a grotesquely enlarged leg. She looked as if she were part elephant.”
“That’s why they call her disease elephantiasis, Julie. You must have cut class the day they covered tropical diseases in nursing school. Actually, there may have been several of the locals who weren’t able to come down to peer at the visitors from far away. They were bed-ridden because they were too ill with malaria or AIDS.”
“I’m becoming convinced that life is extremely fragile in undeveloped countries.”
(2) Global Network for Neglected Tropical Diseases. http://globalnetwork.org/
“All of the details were unpleasant, Curmudge. Maybe those folks thought that we were going to add to the overcrowding in their primitive toilet. No need to worry. I’d suffer extreme constipation before I’d use that grubby thing.”
“That assumes, of course, that you didn’t have diarrhea, which you would have gotten within a few hours after drinking the local water. But what I also noticed was that many of the locals appeared to be in poor health.”
“You’re right, Curmudge. Some of the children had distended bellies, and I saw a woman with a grotesquely enlarged leg. She looked as if she were part elephant.”
“That’s why they call her disease elephantiasis, Julie. You must have cut class the day they covered tropical diseases in nursing school. Actually, there may have been several of the locals who weren’t able to come down to peer at the visitors from far away. They were bed-ridden because they were too ill with malaria or AIDS.”
“I’m becoming convinced that life is extremely fragile in undeveloped countries.”
“Here are some data on the top five diseases that show just how fragile it is (1):
Lower respiratory infections (pneumonia, etc.): Over 4 million deaths per year.
HIV/AIDS: Over 3 million deaths from AIDS in 2004. 39.4 million infected with HIV.
Malaria: Between 1 and 5 million deaths per year. 300-500 million cases per year.
Diarrhea: 2.2 million deaths per year. 4 billion people infected per year.
Tuberculosis: 2 million deaths per year. 2 billion people are infected.”
“I’ve read the list. The next five are measles, whooping cough, tetanus, meningitis, and syphilis. Then there are the so-called 13 neglected tropical diseases (NTDs) that infect 1.4 billion people worldwide (2). The most common of these is roundworm; that’s what gave distended bellies to the kids we saw. Elephantiasis (I just looked it up), snail fever, and river blindness are on this list. So Curmudge, why aren’t people in the industrialized world more concerned about these people and their diseases?”
“My speculation, Julie, is that people are very insular by nature. We read about the problems of our own world every day, and those are the ones we are concerned about. If we perceive a personal threat from our immediate surroundings, we’ll cling to that belief as strongly as if it were a religion. Dogma usually trumps objective science.”
“If that’s the case, we’re apt to become preoccupied with the first threat that someone puts into our head.”
“That seems likely, Julie. Skeptics probably sleep better at night, and realists do everything in their power to solve real problems like those we’ve seen in the Third World.”
“Specifically Curmudge, what can we do?”
“As you said last week, everybody should revisit their priorities. Senior citizens can open their checkbooks, and as a nurse, Jaded Julie, you would be a great asset on the mission trip from Affinity to Peru next fall.”
(1) Top killer diseases in the developing world.
http://www.alertnet.org/topkillerdiseases.htm(2) Global Network for Neglected Tropical Diseases. http://globalnetwork.org/
Wednesday, March 3, 2010
A Trip to the Third World
“Jaded Julie, please name the most serious environmental problem you can think of.”
“That’s easy, Curmudge. Global warming. At least that’s what everybody says.”
“Who is ‘everybody’?”
“The newspapers. The politicians. Well…everybody.”
“I’d like you to take an imaginary trip with me to a rural area of a third world country. Will you go?”
“As old as you are, I knew it was going to be imaginary. Okay, let’s go.”
“We’re here. That shack over there is where you’ll be staying.”
“Wow, it’s hot! What’s that horrible odor? It smells like a sewage treatment plant with a power failure. I hope those mosquitoes buzzing around my head aren’t carrying malaria. And if my ‘luxury villa’ (shack) has only one room, where’s the bathroom?”
“The ‘hanging latrine’ is right over there (1). It’s an outhouse with a rag door on 4-foot high stilts. There’s no seat, but there is a ditch underneath. It doesn’t flush, but in the monsoon season the rain carries everything farther down the ditch. One walks up a rickety sloping ladder to get to it; if you lose your balance on the way up, the result will be—to say the least—memorable. Oh, and by the way, you’ll be sharing this ‘facility’ with those 500 people who are staring at us, and you’ll share your one-room ‘villa’ with seven of them.”
“Where’s the toilet paper?”
“Don’t ask.”
“And where do I wash my hands?”
“In that stream over there; see where the ditch runs into it. It’s the same place you’ll get water for cooking and drinking. I hope you brought your own soap. Or if you want somewhat cleaner water, there’s a well five miles down the road.”
“Please, Curmudge, get me out of here! I’ve seen (and smelled) enough.”
“We’re back home, Julie. Appleton never looked or smelled better. After experiencing our imaginary trip, you may be interested in these statistics (2):
· 40 per cent of the world’s population do not have access to a basic latrine. That’s 2.6 billion people who don’t even have a bucket or box (3).
· Up to 80 per cent of illnesses and five million deaths per year in the developing world are related to sanitation and water.
· 4,500 children die every day from diarrheal illnesses.
· Every year more than 3.5 million children do not live to celebrate their fifth birthday because of diarrhea and pneumonia.”
“Curmudge, I couldn’t stand spending a day in the place we just visited, yet those people must spend their whole lifetime there. I’d better revisit my earlier thought about global warming. Let’s see…the world’s leaders—even those from developing nations—are talking about spending billions of dollars per year on an uncertain solution to an uncertain problem that might occur at an uncertain time in the future. Contrast that with spending orders of magnitude less money on known solutions to the known problems of dirty water and inadequate sanitation that will kill 4,500 children today. The everybodies that I mentioned earlier need to re-think their priorities. I have certainly changed mine.”
“Jaded Julie, you are indeed a gem.”
(1) WaterAid The State of the Worlds Toilets 2007.
http://www.wateraid.org/documents/the_state_of_the_worlds_toilets_2007_1.pdf
(2) Dickson, B. and Salmon, B. Looking Back at International Year of Sanitation.
http://www.theepochtimes.com/n2/index2.php?option=com_content&task=view&id=9791&pop=1&page=0&Itemid=1
(3) George, R. Nowhere to Go. The Rotarian—January 2010.
http://www.rotary.org/en/MediaAndNews/TheRotarian/Pages/toilets1001.aspx
“That’s easy, Curmudge. Global warming. At least that’s what everybody says.”
“Who is ‘everybody’?”
“The newspapers. The politicians. Well…everybody.”
“I’d like you to take an imaginary trip with me to a rural area of a third world country. Will you go?”
“As old as you are, I knew it was going to be imaginary. Okay, let’s go.”
“We’re here. That shack over there is where you’ll be staying.”
“Wow, it’s hot! What’s that horrible odor? It smells like a sewage treatment plant with a power failure. I hope those mosquitoes buzzing around my head aren’t carrying malaria. And if my ‘luxury villa’ (shack) has only one room, where’s the bathroom?”
“The ‘hanging latrine’ is right over there (1). It’s an outhouse with a rag door on 4-foot high stilts. There’s no seat, but there is a ditch underneath. It doesn’t flush, but in the monsoon season the rain carries everything farther down the ditch. One walks up a rickety sloping ladder to get to it; if you lose your balance on the way up, the result will be—to say the least—memorable. Oh, and by the way, you’ll be sharing this ‘facility’ with those 500 people who are staring at us, and you’ll share your one-room ‘villa’ with seven of them.”
“Where’s the toilet paper?”
“Don’t ask.”
“And where do I wash my hands?”
“In that stream over there; see where the ditch runs into it. It’s the same place you’ll get water for cooking and drinking. I hope you brought your own soap. Or if you want somewhat cleaner water, there’s a well five miles down the road.”
“Please, Curmudge, get me out of here! I’ve seen (and smelled) enough.”
“We’re back home, Julie. Appleton never looked or smelled better. After experiencing our imaginary trip, you may be interested in these statistics (2):
· 40 per cent of the world’s population do not have access to a basic latrine. That’s 2.6 billion people who don’t even have a bucket or box (3).
· Up to 80 per cent of illnesses and five million deaths per year in the developing world are related to sanitation and water.
· 4,500 children die every day from diarrheal illnesses.
· Every year more than 3.5 million children do not live to celebrate their fifth birthday because of diarrhea and pneumonia.”
“Curmudge, I couldn’t stand spending a day in the place we just visited, yet those people must spend their whole lifetime there. I’d better revisit my earlier thought about global warming. Let’s see…the world’s leaders—even those from developing nations—are talking about spending billions of dollars per year on an uncertain solution to an uncertain problem that might occur at an uncertain time in the future. Contrast that with spending orders of magnitude less money on known solutions to the known problems of dirty water and inadequate sanitation that will kill 4,500 children today. The everybodies that I mentioned earlier need to re-think their priorities. I have certainly changed mine.”
“Jaded Julie, you are indeed a gem.”
(1) WaterAid The State of the Worlds Toilets 2007.
http://www.wateraid.org/documents/the_state_of_the_worlds_toilets_2007_1.pdf
(2) Dickson, B. and Salmon, B. Looking Back at International Year of Sanitation.
http://www.theepochtimes.com/n2/index2.php?option=com_content&task=view&id=9791&pop=1&page=0&Itemid=1
(3) George, R. Nowhere to Go. The Rotarian—January 2010.
http://www.rotary.org/en/MediaAndNews/TheRotarian/Pages/toilets1001.aspx
Wednesday, February 24, 2010
600 Years into the Future
(A continuation of our earlier posting, 600 Years Ago)
“It stretches my belief, Curmudge. You can foresee 600 years into the future?”
“No way, Jaded Julie. I can’t even see tomorrow on the calendar without my trifocals. We’re actually going to consider what’s going on today with an eye toward 600 years in the future. We’ll use the same assumptions as last time, with an average global temperature rise of 0.7 degrees C. per 100 years. Once again the wizard…”
“…the wizard? I thought he was put into a dungeon in 1410.”
“Same guy. His sentence was 600 years. Wizards have a long life expectancy, and they are very persistent. As I was saying, once again the wizard successfully peddled his global warming story to the world leaders; and their response was similar to what it had been in 1410. They held international meetings, (almost) reached agreements, and pledged (sort of) great sums of money to help developing nations.”
“The advent of the airplane certainly made it easier to attend those international meetings.”
“But it all went bust. The pseudo-agreements depended on countries acting contrary to their own economic interests. Money for developing nations, as with previous ‘foreign aid,’ would have gone into their leaders’ Swiss bank accounts. International scientific efforts were confounded by politics and vested interests, and the wizard was exposed as a pretender.”
“Curmudge, there must be a better way.”
“There is, Jaded Julie, and it is called capitalism. First let’s consider its opposite, socialism, which has been proven to be a total failure (the Soviet Union), or an opiate of the people (Western Europe). Characteristics of socialism include confiscatory taxation and centralized planning made by political appointees or bureaucrats with de facto tenure. The results of socialism are high unemployment, little opportunity for initiative and personal growth, and a passive citizenry totally dependent on the government for their welfare.”
“That doesn’t sound like a good way to solve a problem like global warming, assuming it is a problem. So how might this be approached in a capitalistic society?”
“Julie, I thought you’d never ask. To begin with, decisions made by millions of informed citizens, thinking critically for and about themselves, should be better than those made by a few powerful bureaucrats. If given respect and the opportunity to make things better, able citizens will gain an understanding of climate change and will devise ways to adapt to it or possibly avert it.”
“Hey, Curmudge, you just spoke of respect for people and making things better. That’s Lean; we finally got there!”
“Government should allow those with ability to succeed or fail depending on their own creativity and initiative. Equal opportunity doesn’t guarantee equal outcomes. If governments had always discouraged inventors and entrepreneurs, we’d still be living in 1410. In their normal mode of operation, governments only redistribute the pie; entrepreneurs make the pie bigger.”
“With that as an introduction, Curmudge, how are capitalism and Lean going to give us a better outcome from global warming?”
“Because they are betting their own money and are not depending on political favoritism, individuals should not be taken in by boondoggles. A smart entrepreneur will not develop a solution until he is certain there is a problem. As time passes and new information becomes available, he will be continuously refocusing his efforts. That is Lean-type continuous improvement on a long time scale.”
“If there really is global warming, and our best knowledge says we can’t control it, how will capitalism respond?”
“It’s pretty simple. Ariens will make more lawnmowers and fewer snow blowers. There may be more skin cancer, so more dermatologists will learn how to do Mohs surgery. We’ll adapt, and we might live longer.”
“Finally, Curmudge, why did we title this posting 600 Years into the Future? We talked mostly about the present.”
“Well, Jaded Julie, it seemed like a logical successor to our earlier posting, 600 Years Ago. Besides, a title is the author’s prerogative. I don’t recall there being a tornado in Gone with the Wind.”
“It stretches my belief, Curmudge. You can foresee 600 years into the future?”
“No way, Jaded Julie. I can’t even see tomorrow on the calendar without my trifocals. We’re actually going to consider what’s going on today with an eye toward 600 years in the future. We’ll use the same assumptions as last time, with an average global temperature rise of 0.7 degrees C. per 100 years. Once again the wizard…”
“…the wizard? I thought he was put into a dungeon in 1410.”
“Same guy. His sentence was 600 years. Wizards have a long life expectancy, and they are very persistent. As I was saying, once again the wizard successfully peddled his global warming story to the world leaders; and their response was similar to what it had been in 1410. They held international meetings, (almost) reached agreements, and pledged (sort of) great sums of money to help developing nations.”
“The advent of the airplane certainly made it easier to attend those international meetings.”
“But it all went bust. The pseudo-agreements depended on countries acting contrary to their own economic interests. Money for developing nations, as with previous ‘foreign aid,’ would have gone into their leaders’ Swiss bank accounts. International scientific efforts were confounded by politics and vested interests, and the wizard was exposed as a pretender.”
“Curmudge, there must be a better way.”
“There is, Jaded Julie, and it is called capitalism. First let’s consider its opposite, socialism, which has been proven to be a total failure (the Soviet Union), or an opiate of the people (Western Europe). Characteristics of socialism include confiscatory taxation and centralized planning made by political appointees or bureaucrats with de facto tenure. The results of socialism are high unemployment, little opportunity for initiative and personal growth, and a passive citizenry totally dependent on the government for their welfare.”
“That doesn’t sound like a good way to solve a problem like global warming, assuming it is a problem. So how might this be approached in a capitalistic society?”
“Julie, I thought you’d never ask. To begin with, decisions made by millions of informed citizens, thinking critically for and about themselves, should be better than those made by a few powerful bureaucrats. If given respect and the opportunity to make things better, able citizens will gain an understanding of climate change and will devise ways to adapt to it or possibly avert it.”
“Hey, Curmudge, you just spoke of respect for people and making things better. That’s Lean; we finally got there!”
“Government should allow those with ability to succeed or fail depending on their own creativity and initiative. Equal opportunity doesn’t guarantee equal outcomes. If governments had always discouraged inventors and entrepreneurs, we’d still be living in 1410. In their normal mode of operation, governments only redistribute the pie; entrepreneurs make the pie bigger.”
“With that as an introduction, Curmudge, how are capitalism and Lean going to give us a better outcome from global warming?”
“Because they are betting their own money and are not depending on political favoritism, individuals should not be taken in by boondoggles. A smart entrepreneur will not develop a solution until he is certain there is a problem. As time passes and new information becomes available, he will be continuously refocusing his efforts. That is Lean-type continuous improvement on a long time scale.”
“If there really is global warming, and our best knowledge says we can’t control it, how will capitalism respond?”
“It’s pretty simple. Ariens will make more lawnmowers and fewer snow blowers. There may be more skin cancer, so more dermatologists will learn how to do Mohs surgery. We’ll adapt, and we might live longer.”
“Finally, Curmudge, why did we title this posting 600 Years into the Future? We talked mostly about the present.”
“Well, Jaded Julie, it seemed like a logical successor to our earlier posting, 600 Years Ago. Besides, a title is the author’s prerogative. I don’t recall there being a tornado in Gone with the Wind.”
Wednesday, February 17, 2010
600 Years Ago
“Today, Jaded Julie, we’re going to do some thinking outside of the box.”
“That shouldn’t be hard, Curmudge. You are outside of the box.”
“We’ll begin by making some assumptions for which there has been some evidence in recent years (1). Let’s assume that the earth’s average temperature has been rising linearly at 0.7 degrees Celsius per 100 years and that a total increase of four degrees C. converts the earth into a jungle. At 0.7 degrees per century, that would require 570 years. For simplicity, let’s round it off to 600 years and begin our story in the year 1410, i.e., 600 years ago.”
“I’m with you, Curmudge. Beam me down, Scottie.”
“Life was not easy in 1410. While the kings lived like kings, the common people in the country eked out a living in agriculture and those in the cities built cathedrals. Along came an all-knowing (so he thought) wizard who convinced the Pope and all the world’s kings, czars, and caliphs that we were faced with the future tragedy of global warming. (He was wrong. In 1410 we were actually at the end of the Medieval Warm Period.) Further, the wizard proposed that global warming could be averted by stopping the growth of the burning of fossil fuels, at that time coal and peat. The world’s leaders agreed with the wizard and decreed that his proposal be implemented.”
“I think I see what’s coming, Curmudge. The growth of a civilization parallels its energy use. If additional coal could not be mined, the development of civilization would have been arrested at 1410. I shudder at the thought; it would have been ‘Groundhog Day’ forever.”
”Worse than that, Julie. Without coal for steam engines, the Industrial Revolution could not have occurred, and our life expectancy would still be around 40 years. Even the printing press might not have been invented. In fact, most of the inventions created after 1410 would not have happened.”
“Things like cars, airplanes, computers, modern sanitation and health care, nuclear power, space flight, and Krispy Kreme donuts.”
“One bright spot, Julie. When the would-be wizard’s forecast did not materialize, he was probably thrown into a dungeon.”
“Is there a lesson in this, Curmudge?”
“Sure. World leaders should be wary of purported wizards; and if they do believe the wizard, they should not be taken in by recommendations of global, draconian measures. And finally, if the wizard is proven wrong, burn him at the stake.”
“Wow! The hot seat would seem fitting for someone who built his reputation on ‘warming.’ By the way, we didn’t mention Lean once in this story, and that’s supposed to be the subject of this blog.”
“Of course we didn’t, Julie. In 1410 Lean hadn’t been invented yet. But hang in there; Lean will be in our next conversation.”
(1) Plass, G.N. Carbon dioxide and the climate. Reprint of author’s 1956 article in American Scientist 98 (1) 58-67 (January-February 2010)
http://www.americanscientist.org/issues/feature/2010/1/carbon-dioxide-and-the-climate/1
“That shouldn’t be hard, Curmudge. You are outside of the box.”
“We’ll begin by making some assumptions for which there has been some evidence in recent years (1). Let’s assume that the earth’s average temperature has been rising linearly at 0.7 degrees Celsius per 100 years and that a total increase of four degrees C. converts the earth into a jungle. At 0.7 degrees per century, that would require 570 years. For simplicity, let’s round it off to 600 years and begin our story in the year 1410, i.e., 600 years ago.”
“I’m with you, Curmudge. Beam me down, Scottie.”
“Life was not easy in 1410. While the kings lived like kings, the common people in the country eked out a living in agriculture and those in the cities built cathedrals. Along came an all-knowing (so he thought) wizard who convinced the Pope and all the world’s kings, czars, and caliphs that we were faced with the future tragedy of global warming. (He was wrong. In 1410 we were actually at the end of the Medieval Warm Period.) Further, the wizard proposed that global warming could be averted by stopping the growth of the burning of fossil fuels, at that time coal and peat. The world’s leaders agreed with the wizard and decreed that his proposal be implemented.”
“I think I see what’s coming, Curmudge. The growth of a civilization parallels its energy use. If additional coal could not be mined, the development of civilization would have been arrested at 1410. I shudder at the thought; it would have been ‘Groundhog Day’ forever.”
”Worse than that, Julie. Without coal for steam engines, the Industrial Revolution could not have occurred, and our life expectancy would still be around 40 years. Even the printing press might not have been invented. In fact, most of the inventions created after 1410 would not have happened.”
“Things like cars, airplanes, computers, modern sanitation and health care, nuclear power, space flight, and Krispy Kreme donuts.”
“One bright spot, Julie. When the would-be wizard’s forecast did not materialize, he was probably thrown into a dungeon.”
“Is there a lesson in this, Curmudge?”
“Sure. World leaders should be wary of purported wizards; and if they do believe the wizard, they should not be taken in by recommendations of global, draconian measures. And finally, if the wizard is proven wrong, burn him at the stake.”
“Wow! The hot seat would seem fitting for someone who built his reputation on ‘warming.’ By the way, we didn’t mention Lean once in this story, and that’s supposed to be the subject of this blog.”
“Of course we didn’t, Julie. In 1410 Lean hadn’t been invented yet. But hang in there; Lean will be in our next conversation.”
(1) Plass, G.N. Carbon dioxide and the climate. Reprint of author’s 1956 article in American Scientist 98 (1) 58-67 (January-February 2010)
http://www.americanscientist.org/issues/feature/2010/1/carbon-dioxide-and-the-climate/1
Wednesday, February 10, 2010
Peer-Reviewed Publications
(This is the continuation of a series of postings introduced on January 22, 2010.)
“Curmudge, the term ‘peer-reviewed’ has been in the news a lot during the past few months. This might be one of those extremely rare blog topics about which you know something. Would you be so kind as to enlighten me, or is this a subject—like differential equations—that you have totally forgotten?”
“I would be delighted to share my recollections, Jaded Julie. Because I had manuscripts peer reviewed between 1961 and 2002 and did a bit of reviewing myself, much of it has become hardwired.”
“Please give it a try, Old Guy. Let’s start by looking at the process from the author’s standpoint and how he or she decides what is publishable.”
“The critical guideline in this whole process, Julie, is integrity. If data from an experiment or series of experiments provides the basis for a finding or story heretofore unknown to the world or to others in your discipline, it is a candidate for publication. But one can’t cherry-pick his data. If some of the data don’t fit your story, they can’t simply be ignored; they can only be rejected if they are statistical outliers.”
“I can appreciate the importance of integrity. Doesn’t everyone have some element of vested interest in his research?”
“Vested interest comes in many flavors, Julie. Late in one’s career, the author’s delight in contributing to knowledge would represent the low end of the vested interest scale. At the far end of the scale is current work in atmospheric science. It seems that in that discipline one’s findings impact multimillion-dollar technological ventures, politics, and the fate of the industrialized world. The higher one goes on the vested interest scale, the greater the temptation to compromise one’s integrity.”
“So back to the guy in the lab. The author writes his paper, including data to support his hypothesis (remember, no fudging or cherry-picking) and enough experimental detail to permit someone to duplicate the work, and sends it off to a journal for publication, right?”
“Exactly. Often he must wait many months—up to a year—for the peer review process to transpire.”
“Am I correct, Curmudge, that publication in a peer-reviewed journal has traditionally been the ‘gold standard’ for scientific knowledge?”
“You are essentially correct, Jaded Julie. Remember, however, that the ultimate tests are (1) one’s work must be independently reproducible by someone else, and (2) any forecasts must turn out to be true. Nevertheless, despite all of its warts and blemishes and potential for hanky-panky, the peer review process has worked pretty well. Because my area was not highly controversial and was populated by a limited number of scientists, peer review was not very onerous for either authors or reviewers.”
“Curmudge, what’s that ‘potential for hanky-panky’ that you mentioned earlier?”
“Here’s an example. Consider a topic about which there are two schools of thought and in which editors and reviewers have a vested interest. Remember that peer review is a single-blind process in which the reviewers know the author but not vice-versa.”
“I think I can see what’s coming, Curmudge. If the editor’s position on the topic is ’A’ and the author is advocating position ‘B’, the editor can reject the paper out of hand or send it to reviewers that share position ‘A’ who will recommend rejection. I feel sorry for the poor author. He’s been shot down, but he doesn’t know by whom. And potential reviewers who are interested in position ‘B’ may wonder why they never receive any manuscripts to review. ”
“That’s it, Julie. If the author can’t find another journal whose reviewers will at least consider evidence of position ‘B’, he and position ‘B’ are effectively suppressed. This would appear to be ‘political’ science, i.e., science for the purpose of politics or vested interests. My speculation is that this might represent the untimely and unjustified demise of traditional peer review.”
“So how do we summarize the lessons of these last four postings?”
“It’s pretty simple, Julie. Be wary of politicians talking about science, of people confusing effect with cause, of scientists with a vested interest using complex mathematical models that can’t be experimentally verified, and of researchers who suppress publication of findings that don’t agree with their own.”
“Curmudge, the term ‘peer-reviewed’ has been in the news a lot during the past few months. This might be one of those extremely rare blog topics about which you know something. Would you be so kind as to enlighten me, or is this a subject—like differential equations—that you have totally forgotten?”
“I would be delighted to share my recollections, Jaded Julie. Because I had manuscripts peer reviewed between 1961 and 2002 and did a bit of reviewing myself, much of it has become hardwired.”
“Please give it a try, Old Guy. Let’s start by looking at the process from the author’s standpoint and how he or she decides what is publishable.”
“The critical guideline in this whole process, Julie, is integrity. If data from an experiment or series of experiments provides the basis for a finding or story heretofore unknown to the world or to others in your discipline, it is a candidate for publication. But one can’t cherry-pick his data. If some of the data don’t fit your story, they can’t simply be ignored; they can only be rejected if they are statistical outliers.”
“I can appreciate the importance of integrity. Doesn’t everyone have some element of vested interest in his research?”
“Vested interest comes in many flavors, Julie. Late in one’s career, the author’s delight in contributing to knowledge would represent the low end of the vested interest scale. At the far end of the scale is current work in atmospheric science. It seems that in that discipline one’s findings impact multimillion-dollar technological ventures, politics, and the fate of the industrialized world. The higher one goes on the vested interest scale, the greater the temptation to compromise one’s integrity.”
“So back to the guy in the lab. The author writes his paper, including data to support his hypothesis (remember, no fudging or cherry-picking) and enough experimental detail to permit someone to duplicate the work, and sends it off to a journal for publication, right?”
“Exactly. Often he must wait many months—up to a year—for the peer review process to transpire.”
“Am I correct, Curmudge, that publication in a peer-reviewed journal has traditionally been the ‘gold standard’ for scientific knowledge?”
“You are essentially correct, Jaded Julie. Remember, however, that the ultimate tests are (1) one’s work must be independently reproducible by someone else, and (2) any forecasts must turn out to be true. Nevertheless, despite all of its warts and blemishes and potential for hanky-panky, the peer review process has worked pretty well. Because my area was not highly controversial and was populated by a limited number of scientists, peer review was not very onerous for either authors or reviewers.”
“Curmudge, what’s that ‘potential for hanky-panky’ that you mentioned earlier?”
“Here’s an example. Consider a topic about which there are two schools of thought and in which editors and reviewers have a vested interest. Remember that peer review is a single-blind process in which the reviewers know the author but not vice-versa.”
“I think I can see what’s coming, Curmudge. If the editor’s position on the topic is ’A’ and the author is advocating position ‘B’, the editor can reject the paper out of hand or send it to reviewers that share position ‘A’ who will recommend rejection. I feel sorry for the poor author. He’s been shot down, but he doesn’t know by whom. And potential reviewers who are interested in position ‘B’ may wonder why they never receive any manuscripts to review. ”
“That’s it, Julie. If the author can’t find another journal whose reviewers will at least consider evidence of position ‘B’, he and position ‘B’ are effectively suppressed. This would appear to be ‘political’ science, i.e., science for the purpose of politics or vested interests. My speculation is that this might represent the untimely and unjustified demise of traditional peer review.”
“So how do we summarize the lessons of these last four postings?”
“It’s pretty simple, Julie. Be wary of politicians talking about science, of people confusing effect with cause, of scientists with a vested interest using complex mathematical models that can’t be experimentally verified, and of researchers who suppress publication of findings that don’t agree with their own.”
Wednesday, February 3, 2010
Curmudge and Jaded Julie Talk about Models
(This is the continuation of a series of postings introduced on January 22, 2010.)
“Models, Curmudge? You mean those super-slender gals who look as if they have an eating disorder?”
“No, Jaded Julie. We’re going to talk about mathematical models; these are mathematical depictions of processes. Models were described in our discussions of queuing theory last July. Authors that we cited in Kaizen Curmudgeon a few weeks ago used models to forecast physician income in a medical home. We use value stream maps all the time as visual models to depict processes in the hospital. The equations that I learned in physics classes long ago were models of physical processes; they included statics (e.g., forces on a stationary beam), and dynamics (a ball rolling down an inclined plane).”
“Wow! There must be a model for everything. I’ll bet that the advent of the computer has made it possible to model processes that are more and more complex.”
“That’s for sure. We’ll talk more about that later, but let’s start by considering a very simple example. Our daughter moved to a new house in Madison, so I consulted MapSeek* to learn how to get there. In addition to directions, MapSeek said that our daughter’s house is 104.61 miles from ours and that it would take us 1 hour and 54 minutes to get there. In computing our travel time, MapSeek must have used the model, time equals distance divided by an estimated average speed. Their average speed was 55 mph (104.61 miles ÷ 1.9 hours).”
“I’m with you, Curmudge. Because the MapSeek routing uses Highway 26, their average speed must have been adjusted for slowing down in Rosendale to avoid getting a speeding ticket and perhaps also for the possibility of getting stuck behind a farmer pulling a load of manure on 26, a two-lane highway. But is the best route now using Highway 26 through Rosendale? U.S.-151 is now four lanes all the way from Fond du Lac to Madison. Perhaps we should give this new information to MapSeek so they can adjust their model.”
“That would certainly seem to be the proper thing to do, Julie. But let’s consider this hypothetical case. Suppose the MapSeek people own a coffee shop in Rosendale. They wouldn’t want to change their recommended route and their model because it would hurt their coffee shop’s business. That’s called having a vested interest in their model and the data that go into it. MapSeek would prefer that we shut up about there being a better route; perhaps they might even try to suppress all discussions of alternate ways to go from Appleton to Madison.”
“Hey, that’s not fair! We all depend on MapSeek for the correct information.”
“It’s a sad story, Julie. We can see through what Mapseek might do because it’s hard to color the results from a simple, transparent model based on a classical equation. In addition, Mapseek’s work can be easily tested empirically. But when a bunch of suspect data are poured into a complex computer model that is arcane, abstruse, and tentative, anything can happen. That is especially true when someone has a vested interest in the outcome.”
“(Although Curmudge uses words that are known to only a few people and are hard for the rest of us to understand, I get the picture.) Hey, Curmudge, your story is a parable, isn’t it? May I explain its lesson?”
“Go ahead, but don’t get too specific.”
“Think critically. Be slow to accept the conclusions of investigators attempting to model a complex process when their work is supported—even indirectly—by people with a vested interest in their results.”
*Our apologies to MapQuest for using a name similar to theirs in this totally hypothetical example.
“Models, Curmudge? You mean those super-slender gals who look as if they have an eating disorder?”
“No, Jaded Julie. We’re going to talk about mathematical models; these are mathematical depictions of processes. Models were described in our discussions of queuing theory last July. Authors that we cited in Kaizen Curmudgeon a few weeks ago used models to forecast physician income in a medical home. We use value stream maps all the time as visual models to depict processes in the hospital. The equations that I learned in physics classes long ago were models of physical processes; they included statics (e.g., forces on a stationary beam), and dynamics (a ball rolling down an inclined plane).”
“Wow! There must be a model for everything. I’ll bet that the advent of the computer has made it possible to model processes that are more and more complex.”
“That’s for sure. We’ll talk more about that later, but let’s start by considering a very simple example. Our daughter moved to a new house in Madison, so I consulted MapSeek* to learn how to get there. In addition to directions, MapSeek said that our daughter’s house is 104.61 miles from ours and that it would take us 1 hour and 54 minutes to get there. In computing our travel time, MapSeek must have used the model, time equals distance divided by an estimated average speed. Their average speed was 55 mph (104.61 miles ÷ 1.9 hours).”
“I’m with you, Curmudge. Because the MapSeek routing uses Highway 26, their average speed must have been adjusted for slowing down in Rosendale to avoid getting a speeding ticket and perhaps also for the possibility of getting stuck behind a farmer pulling a load of manure on 26, a two-lane highway. But is the best route now using Highway 26 through Rosendale? U.S.-151 is now four lanes all the way from Fond du Lac to Madison. Perhaps we should give this new information to MapSeek so they can adjust their model.”
“That would certainly seem to be the proper thing to do, Julie. But let’s consider this hypothetical case. Suppose the MapSeek people own a coffee shop in Rosendale. They wouldn’t want to change their recommended route and their model because it would hurt their coffee shop’s business. That’s called having a vested interest in their model and the data that go into it. MapSeek would prefer that we shut up about there being a better route; perhaps they might even try to suppress all discussions of alternate ways to go from Appleton to Madison.”
“Hey, that’s not fair! We all depend on MapSeek for the correct information.”
“It’s a sad story, Julie. We can see through what Mapseek might do because it’s hard to color the results from a simple, transparent model based on a classical equation. In addition, Mapseek’s work can be easily tested empirically. But when a bunch of suspect data are poured into a complex computer model that is arcane, abstruse, and tentative, anything can happen. That is especially true when someone has a vested interest in the outcome.”
“(Although Curmudge uses words that are known to only a few people and are hard for the rest of us to understand, I get the picture.) Hey, Curmudge, your story is a parable, isn’t it? May I explain its lesson?”
“Go ahead, but don’t get too specific.”
“Think critically. Be slow to accept the conclusions of investigators attempting to model a complex process when their work is supported—even indirectly—by people with a vested interest in their results.”
*Our apologies to MapQuest for using a name similar to theirs in this totally hypothetical example.
Wednesday, January 27, 2010
Curmudge and Jaded Julie Talk About Cause and Effect
(This is the continuation of a series of postings introduced on January 22, 2010.)
“Jaded Julie, I’m concerned that many people don’t understand basic science.”
“If basic science means physical chemistry and thermodynamics, I would be concerned that you are concerned. In fact, Curmudge, I would consider you to be an unrealistic zealot.”
“No, Julie. I mean really basic grade-school stuff. Let’s write a play to illustrate a very simple lesson. The time is almost 400 years ago, and the setting is the city of Florence in northern Italy. My character is called Cattivo Uomo, and you will be Spossate Infermiera.”
“Which are, of course, Nasty Man and Jaded Nurse in Italian (actually, the adjective should follow the noun, i.e., uomo cattivo).”
“The curtain has gone up, and you and I are up early watching the sun rise.”
“What a beautiful sunrise, Cattivo.”
“It happens every morning, Spossate, just like clockwork.”
“We would be in big trouble if the sun didn’t go around the earth so regularly. It must come closer in the summer when it gets so warm here. Then the glaciers in the Alps melt back. Thankfully, it gets cooler at night when the sun is around on the other side.”
“Can you think of any other explanation for our days and nights, Spossate?”
“It seems pretty obvious to me that the sun goes around the earth. Everyone sees it rise and set, and that’s what they believe.”
“I’ve heard about another explanation…that the sun stands still at the center of our universe, and that the earth rotates once every 24 hours.”
“Outrageous! Who said that, Cattivo?”
“It was our neighbor, Mr. Galilei. His ideas are gong to get him into a lot of trouble.”
“Our play’s over, Julie. Curtain down. Did it teach you a lesson?”
“I’m shocked that 400 years ago virtually everyone thought that the sun moved around the earth every day, but that was the easiest explanation.”
“We know now that the accepted explanation was false. So what is the lesson that our story teaches?”
“I’ve got it, Curmudge. No matter how evident the effect, it does not prove the cause.”
“Jaded Julie, I’m concerned that many people don’t understand basic science.”
“If basic science means physical chemistry and thermodynamics, I would be concerned that you are concerned. In fact, Curmudge, I would consider you to be an unrealistic zealot.”
“No, Julie. I mean really basic grade-school stuff. Let’s write a play to illustrate a very simple lesson. The time is almost 400 years ago, and the setting is the city of Florence in northern Italy. My character is called Cattivo Uomo, and you will be Spossate Infermiera.”
“Which are, of course, Nasty Man and Jaded Nurse in Italian (actually, the adjective should follow the noun, i.e., uomo cattivo).”
“The curtain has gone up, and you and I are up early watching the sun rise.”
“What a beautiful sunrise, Cattivo.”
“It happens every morning, Spossate, just like clockwork.”
“We would be in big trouble if the sun didn’t go around the earth so regularly. It must come closer in the summer when it gets so warm here. Then the glaciers in the Alps melt back. Thankfully, it gets cooler at night when the sun is around on the other side.”
“Can you think of any other explanation for our days and nights, Spossate?”
“It seems pretty obvious to me that the sun goes around the earth. Everyone sees it rise and set, and that’s what they believe.”
“I’ve heard about another explanation…that the sun stands still at the center of our universe, and that the earth rotates once every 24 hours.”
“Outrageous! Who said that, Cattivo?”
“It was our neighbor, Mr. Galilei. His ideas are gong to get him into a lot of trouble.”
“Our play’s over, Julie. Curtain down. Did it teach you a lesson?”
“I’m shocked that 400 years ago virtually everyone thought that the sun moved around the earth every day, but that was the easiest explanation.”
“We know now that the accepted explanation was false. So what is the lesson that our story teaches?”
“I’ve got it, Curmudge. No matter how evident the effect, it does not prove the cause.”
Friday, January 22, 2010
Curmudgeon and Jaded Julie Read the Newspaper
“Curmudge, I see that you are reading the editorial and opinion pages of the newspaper.”
“It takes less time, Jaded Julie. The regular news pages contain a lot of useless stuff like the latest indiscretions of professional athletes and entertainers, and they often omit information that is truly important. In addition, the ‘news’ sometimes contains ‘spin’ that is hard to detect.”
“Okay, so what’s wrong with spin in the news?”
“If you see the ‘spun’ information again and again, you might eventually believe it. Ultimately, it may become an urban legend (the Brits call it an urban myth) in which you acquire unquestioning faith.”
“That doesn’t sound good, Curmudge, especially if the info is wrong or at least uncertain. So why should this subject be of interest to people working in health care?”
“Virtually no one that I know in health care has time to read the news critically. Perhaps we can provide some guidance to help them avoid getting hoodwinked by what they read. We’ll also give a refresher on the ethics of ‘speaking with data.’”
“How can we do that, Old Guy?”
“In our next few conversations we’ll suggest some cautionary signals that will alert the reader to possible spin. Things like confusion over cause-and-effect and the possible impact of vested interest in reported information. We’ll also mention some less familiar, but in-the-news, topics like mathematical models and peer-reviewed research publications. One story will be a parable, and another will be a play starring you as a tired-out Italian nurse, Spossate Infermiera.”
“Wow! I can hardly wait. But I’ll bet there are some people out there who are so set in their beliefs that they will consider your ideas to be just the ranting of an old man.”
“That’s okay, Julie. My age is my license to rant.”
“I presume that every one of our conversations will have a lesson. Can we add a short lesson to end your tirade for today?”
“Sure, Jaded Julie. Here it is: When a writer quotes a politician who is talking about science, put on your skeptic’s hat.”
“It takes less time, Jaded Julie. The regular news pages contain a lot of useless stuff like the latest indiscretions of professional athletes and entertainers, and they often omit information that is truly important. In addition, the ‘news’ sometimes contains ‘spin’ that is hard to detect.”
“Okay, so what’s wrong with spin in the news?”
“If you see the ‘spun’ information again and again, you might eventually believe it. Ultimately, it may become an urban legend (the Brits call it an urban myth) in which you acquire unquestioning faith.”
“That doesn’t sound good, Curmudge, especially if the info is wrong or at least uncertain. So why should this subject be of interest to people working in health care?”
“Virtually no one that I know in health care has time to read the news critically. Perhaps we can provide some guidance to help them avoid getting hoodwinked by what they read. We’ll also give a refresher on the ethics of ‘speaking with data.’”
“How can we do that, Old Guy?”
“In our next few conversations we’ll suggest some cautionary signals that will alert the reader to possible spin. Things like confusion over cause-and-effect and the possible impact of vested interest in reported information. We’ll also mention some less familiar, but in-the-news, topics like mathematical models and peer-reviewed research publications. One story will be a parable, and another will be a play starring you as a tired-out Italian nurse, Spossate Infermiera.”
“Wow! I can hardly wait. But I’ll bet there are some people out there who are so set in their beliefs that they will consider your ideas to be just the ranting of an old man.”
“That’s okay, Julie. My age is my license to rant.”
“I presume that every one of our conversations will have a lesson. Can we add a short lesson to end your tirade for today?”
“Sure, Jaded Julie. Here it is: When a writer quotes a politician who is talking about science, put on your skeptic’s hat.”
Sunday, January 10, 2010
Curmudgeon's Wastebasket--a Companion to Kaizen Curmudgeon
“It’s a new year, Jaded Julie, and change is in the air.”
“I thought it was just a breeze blowing in from a farm outside of town. So what’s the change, Curmudge?”
“Do you recall our holiday greeting last month? To say the least, it was not all sweetness and light. I was concerned that we might offend someone by referring to Orwell’s book, 1984. There are over 4,000 employees at Affinity, and we dare not offend any of them in a corporate blog like Kaizen Curmudgeon.”
“It sounds as if you are saying that the content of Kaizen Curmudgeon must be plain vanilla, pristine pure, and squeaky clean. But a totally noncontroversial curmudgeon is an oxymoron. I suppose you’ll change your name to Santa Claus and mine to Snow White.”
“No way, Julie. Kaizen Curmudgeon will be unchanged. We’re going to start a personal blog to be a companion to the Kaizen Curmudgeon corporate blog. Let’s call the new blog Curmudgeon’s Wastebasket.”
“Might as well. That’s where the Kaizen Curmudgeon rejects go when we deep-six them, especially if they contain something controversial.”
“What is controversial, Julie, depends on the reader’s outlook. Nevertheless, our intent for Curmudgeon’s Wastebasket is just like that for Kaizen Curmudgeon—to share information with readers that they might not otherwise encounter. Our focus will continue to be Lean, health care, and leadership, but we’ll leave room for other topics—stuff that is so compelling that it demands to be shared.”
“I’m concerned, Curmudge. How will readers know about Curmudgeon’s Wastebasket? Should we publicize it by shouting from the top of the parking ramp? Maybe we could establish a ‘Code Curmudgeon’ to be announced whenever there is a new posting.”
“It shouldn’t be hard. We’ll just put a link in Kaizen Curmudgeon to direct readers to each new posting in Curmudgeon’s Wastebasket.”
“With all of these changes, I hope you are not forgetting about Lean.”
“This is Lean, Julie. We are respecting our readers’ sensitivities and continuously improving our blogging.”
“I’m with you, Curmudge. See you in Curmudgeon’s Wastebasket.”
“I thought it was just a breeze blowing in from a farm outside of town. So what’s the change, Curmudge?”
“Do you recall our holiday greeting last month? To say the least, it was not all sweetness and light. I was concerned that we might offend someone by referring to Orwell’s book, 1984. There are over 4,000 employees at Affinity, and we dare not offend any of them in a corporate blog like Kaizen Curmudgeon.”
“It sounds as if you are saying that the content of Kaizen Curmudgeon must be plain vanilla, pristine pure, and squeaky clean. But a totally noncontroversial curmudgeon is an oxymoron. I suppose you’ll change your name to Santa Claus and mine to Snow White.”
“No way, Julie. Kaizen Curmudgeon will be unchanged. We’re going to start a personal blog to be a companion to the Kaizen Curmudgeon corporate blog. Let’s call the new blog Curmudgeon’s Wastebasket.”
“Might as well. That’s where the Kaizen Curmudgeon rejects go when we deep-six them, especially if they contain something controversial.”
“What is controversial, Julie, depends on the reader’s outlook. Nevertheless, our intent for Curmudgeon’s Wastebasket is just like that for Kaizen Curmudgeon—to share information with readers that they might not otherwise encounter. Our focus will continue to be Lean, health care, and leadership, but we’ll leave room for other topics—stuff that is so compelling that it demands to be shared.”
“I’m concerned, Curmudge. How will readers know about Curmudgeon’s Wastebasket? Should we publicize it by shouting from the top of the parking ramp? Maybe we could establish a ‘Code Curmudgeon’ to be announced whenever there is a new posting.”
“It shouldn’t be hard. We’ll just put a link in Kaizen Curmudgeon to direct readers to each new posting in Curmudgeon’s Wastebasket.”
“With all of these changes, I hope you are not forgetting about Lean.”
“This is Lean, Julie. We are respecting our readers’ sensitivities and continuously improving our blogging.”
“I’m with you, Curmudge. See you in Curmudgeon’s Wastebasket.”
Subscribe to:
Posts (Atom)
