10 Levels Of Intimacy In Today’s Communication
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Fixing health care on the back of a napkin - Or not.
I love the guys at digital roam's "back of the napkin" blog. Their mission is to visualize issues and to eliminate jargon and technobabble so that the average person can make sense of complex issues. And that's a great mission.
But with all the talk about health reform lately, I am concerned that there are an awful lot of people trying to simplify the problem. And it just isn't simple. The back of the napkin gang has gotten one thing very right: That health reform isn't about health reform anymore; it's about health insurance reform.
Full disclosure; I work for an insurance company. It'll be no surprise to you that I think my company does a lot of good and adds a lot of value for a lot of people. I wouldn't work there otherwise. And there are clearly things that need to be reformed in the insurance (payor's) part of the healthcare equation just as there are on the parts of the doctors and patients (the napkins address the docs and payors in their analysis, but not-so-much on the patients). But the picture above shows how the back-of-the-napkin guys have simplified an issue so much that they have fundamentally changed reality. I'm going to assume that this is an error rather than a subtle way of using their bully pulpit to support their own viewpoint. But insurance didn't "jump between me and my doctor" to ration care. Your employer told your insurance company what it was willing to pay for. And that's just one, obvious example.
There's a quotation on this subject that I really like, and I wish I could remember who said it: "For every complex problem, there is a simple solution. And it's wrong."
That's where we are here. Both in the health reform "debate" [read: propaganda wars] and in the (presumably well-intentioned) back of the napkin summary, we're dumbing down a complex problem to the point where we're not actually educating anybody on anything.
excerpt from "Echo Beach," one of the stories collected in "Binding Energy"
... and also a great Martha and the Muffins song
It’s always the last day of the world at Echo Beach. From fifteen miles up, the horizon is visibly bowed. The sun hangs swollen above an oily sea. The coastal range ripples up from the water’s edge, bunching together in wattles like the neck of a lizard. Scintilla flash from the ruins of a port city half engulfed.
The lounge is quiet, but it will start filling up soon. At a table in the middle of the room, an old man plays chess with an automaton. Every now and then, he reaches across the table and slaps the thing on the side of its metal head.
Near one of the large windows, a lanky, barrel-chested man drinks alone. Coal black skin, melanin-enhanced, tangle of blonde dreads. Circa 22C, a mod from one of the Martian arcologies. Clearly pre-Plague. Close enough to home for me that I want to say something to him, warn him. But what could I say?
A couple sits at the bar leaning toward one another, their heads touching. It’s difficult to say whether they are accelerated canines or regressed humans, but there is something very dog-like in their focused attention to one another. An aura of benign stupidity hangs about them like sweet incense.
The digital clock above the holo fireplace reads 4:22:00. As I watch, the numbers dissolve and re-form: 4:21:59.
I check my console, pour a shot of absinthe and a pony of pomegranate juice, set them on a tray, and send it floating toward the Martian.
I walk down the length of the bar to the couple.
“Get you anything else?”
The man looks up at me with watery eyes.
“No, thank you,” he says.
“I don’t think so,” the woman says at the same time. They look at each other and bark soft laughter. They lean their heads together again.
I decide to leave the old man and the bot alone. As I turn my back I hear a thump as he smacks it again.
I wipe down the bar, check my stock. Vodka from Ganymede, gin from Hotpoint, malts from Scotland. Scotland. I remember jagged green hills, black rock thrusting into a gray sky, mounds of rubble dotting a fractal coastline testament to the mercurial nature of power. I stood amidst the ruins of the Castle Duncan as a piper wailed defiance and loss to the cradle of the ocean. There was a small suitcase open in front of him. Tourists threw coins.
I wonder if there’s anything left of Scotland now, here at the end of Time. It’s a stupid thought, of course. The continents have shifted, the seas have climbed and receded a dozen times. North America is an archipelago stretching from pole to equator; Fiji is the leading edge of a megacontinent; the treasures of continental Europe lie beneath a cold, green sea.
The world-face changes, the abstract constructions of Man linger ghostlike. If I were to travel to the global coordinates occupied by Castle Duncan circa 20C, could I still hear the echoes of pipes in the salt air? Does Gaia remember?
The Gate hums quietly. Laughter echoes up from the Foyer. Heads emerge from the spiral staircase set in the floor at the far end of the lounge away from the windows. Party of four; two men, two women. Definitely post-Diaspora; I can’t place them on the Continuum. Definitely wealthy. They wear their entitlement like a badge.
One of them men catches sight of me, nudges his companions, and they all drift in my direction.
He says something to me in a liquid trill. A voice whispers in my ear: Give us your best table.
Arrogant bastard. I gesture at the nearly empty room.
“Have your finest pleasure,” I say, hoping that the odd phrasing will confuse his chip.
He gives me a strange look and gestures his companions toward the windows. They are selectively polarized; you can look directly at the sun’s disk. Structures writhe across its face. Precursor flares erupt like Medusa tangles from its troubled edge.
After a few minutes they sit down. I pretend to be busy with something behind the bar. The man clears his throat several times, finally gestures me over.
I grab a very dirty rag from the bin under the bar and carry it conspicuously as I walk over to them. I wipe down their table, leaving a greasy film.
“What can I get for you?” I ask. His companions ignore me.
His voice is water running over smooth stones. There is a sibilant whisper in my ear.
Do you have beer?
Moron. This is a bar, for Christ’s sake.
“Beer. Let me think.” I cup my chin in my fist, scratch my head. “I don’t ... no, wait. Beer. Yes, I think so. Four beers?”
“You’re very rude,” the man says, in halting System Anglo.
“It’s the end of the world, Holmes. You can sue me.”
I go back to the bar, pour a pitcher and set it on a tray with four glasses. I send it toward them a little too quickly and a foamy tongue spills down the side of the pitcher.
The Gate hums again. It’s almost inaudible, a subsonic rumble I feel in my feet. Business is picking up. The clock reads 3:37.
By 1:30 Echo Beach is packed. Ice-miners from the Belt, circa 24C, very heavy drinkers. A clutch of avian poets from Deneb IV, post-Diaspora. An accelerated goat with a bell around his neck. He doesn’t smell accelerated. Even though the place is S.R.O., there are empty seats on either side of him at the bar. He’s guzzling buttermilk and eating pickled onions like jelly beans.
It’s almost time for a visit from the Lhosa. I send a couple of bus trays weaving between the tables and wipe down the bar. Everything looks pretty good. At 1:05, the air next to me crackles like old paper and a humaniform outline begins to gather substance.
But it doesn’t quite coalesce. It never does. The Lhosa projects in as a hologram from some other place and time. Never in person, never via the Gate. Its manifestation is always a translucent cartoon-like rendering of a 20C Hollywood B.E.M. – bulbous forehead cradled by a delicate tracery of bone, veiny tributaries branching beneath the skin. Huge eyes, black pupils surrounded by bloody sclera. It’s wearing a jumpsuit with thin, pointy lapels. An elaborate raygun hangs holstered at its side.
I suspect that its appearance in this form is a concession to my kitschy 20C notion of alienness. I have no idea what the Lhosa actually looks like, whether it is a singular entity of unimaginable power, a representative of a vastly superior race of beings, or the fin-de-monde equivalent of a street punk working a three card Monty hustle on Lenox Avenue.
excerpt from "Burn Rate"
Ross, Doctor Bob, and Peter waited in the reception area for their contact to show up. He was twenty minutes late and Peter had already asked the receptionist twice to make sure the guy knew they had arrived. They were in Building 7, Level 3: a single cell of the huge organism called Business Systems, Inc. It was hard to crack a place like BS, but once you were in, you were pretty much set.
Peter had set up a meeting to introduce the company, talk about a trial deployment, maybe get some services revenue. Peter would be the pitch man. Doctor Bob was there for technical credibility. Ross came along to keep an eye on Peter. They were dressed in full corporate regalia: dark suits, cream shirts, navy ties bearing innocuous, forgettable patterns. Peter looked like he’d stepped off a GQ cover. Doctor Bob looked like he’d stepped off a fourteen-hour plane flight. Ross had spent a couple of years on Wall Street after getting his MBA where the basic, daily uniform was suit and tie, so he was comfortable and figured he probably looked okay.
Peter scored this prospect as a 6 out of 7 on his pipeline report. Ross thought he was smoking crack, but was willing to give him the benefit of the doubt, at least for awhile.
A sweaty balding man in his late twenties wearing a Marine World t-shirt pushed through the frosted glass door. Behind him, in a room the size of an airplane hangar, a sea of cubicles awash in bright fluorescent light, their perfect geometry like an Escher painting.
“Are you the guys from Tesseract?”
Peter stepped forward.
“You must be Fritz – we spoke on the phone. Peter Magdalen.” He gestured in the direction of his colleagues. “Ross Williamson, our CEO. Dr. Robert Sanskrit, CTO.”
Hands where shaken, business cards exchanged. Fritz led them into the giant room. The opposite wall was impossibly far away. They made their way along the side of the cube farm, past copy rooms, break rooms, the occasional glass-walled private office.
Finally, Fritz punched a code into a keypad next to a door and let them into a conference room with a long, fake wood table and a PC projector hanging from the ceiling.
“I’ll let you get set up,” Fritz said, and backed out of the room.
Doctor Bob positioned himself strategically near a whiteboard. Peter stood with his hands at his sides, wearing a deer-in-headlights expression.
“Peter. How’s it going?” Ross asked.
Peter blinked, looked at Ross.
“Fine.” He began setting up his laptop. The team from BS began shuffling in. Not a gray head among them, Ross noted. He’d have to have a talk with Peter about qualifying prospects.
More introductions. The business card conga line. Someone came in with an armful of Evians. Peter fired up the projector and stood up.
“T-t-tesseract T-t-technologies is th-th-th-the lead-leading p-p-p-provider of ---“
It was painful to watch. His ivy-league features crumpled like paper; his eyes bulged, a beached fish gasping for air. Explosive gasp and fine spray of spittle when he finally managed to eject a syllable.
Fritz looked like he watching a traffic accident unfold in slow motion. The rest of the BS guys were trying not to look at each other.
Ross slipped his cell phone out of its holster, held it under the table, tapped out KILL ME, and sent the message to Doctor Bob.
Doctor Bob’s phone beeped. He flipped it open, looked at it and coughed into his fist, muffling a laugh.
Ross wanted to step in and shut Peter up, at least get in a few complete sentences before the BS guys told them to fuck off and bark at the moon. But there was no way to do it without pulling the rug completely out from under him and making them all look like chumps.
Peter’s third slide was a ducky-horsy architecture diagram: the Tesseract component model in a typical deployment scenario. Doctor Bob saw an opening, stood up, and began an impromptu whiteboard talk. Peter looked annoyed. Everyone else in the room seemed to sigh as one with relief.
Doctor Bob gave great whiteboard. He had a Ph.D. from Harvard (in Philosophy, but everybody assumed it was in something technical) and had been crawling around the Valley, building software for one company after another, since the Visicalc days. He’d dropped two fortunes betting on technology trends that suffered from poor timing: pen computing and “push.” Tesseract was the second company Ross had been in with him, and Ross trusted him completely.
Doctor Bob lobbed a softball to Ross about business models, and they riffed back and forth for a bit. Peter stood at the front of the room with his hands in his pockets, squinting in the projector’s glare.
Finally, it was over. More handshakes. The obligatory “next steps” bullshit that nobody believed.
Fritz walked them back to the reception area. His pudgy face held an unmistakable expression of relief as he badged himself back into the big room.
They rode back to the East Bay in silence. Halfway across the San Mateo Bridge, Ross couldn’t stand it any more and put on a Morphine CD.
He pulled in front of a Starbucks near the office.
“Post mortem,” he said, and they all filed out.
They got themselves coffee and carbs and took a table in the back. The ambient music was vintage Leo Kottke, which Ross thought was pretty cool until he realized that it was a cut from a Starbucks-brand compilation CD called Groovy Guitar Sounds on display next to the register.
Doctor Bob sat back, sipping his latte. Ross looked at Peter, waiting.
“I thought that went pretty well,” Peter said.
Ross grimaced. “I don’t know, Peter, I thought we pretty much got our asses kicked.”
Doctor Bob leaned forward. “Man, that’s some stutter you’ve got there, dude.”
“What are you talking about?”
Ross and Doctor Bob looked at each other. Doctor Bob shrugged.
“Well,” Ross said. “You – I’ve never noticed it before, maybe it’s just a public speaking thing. You definitely have this, well, it’s a stutter.”
Peter looked at Doctor Bob, who nodded. Peter shook his head.
“Bullshit. I don’t stutter. Am I stuttering now?”
“No,” Ross said. “You’re not. But –“
“Well, how bad is it?”
“It’s bad, man,” Doctor Bob said.
Peter raised his voice. “Bad? What do you mean, bad?”
Several of the other patrons looked up from their coffee drinks.
“T-t-t-tesseract T-t-technologies t-t-tops th-the ch-ch-charts,” Doctor Bob said, in a fairly passable imitation.
“You son of a bitch,” Peter said. He stood up, pushed his chair in with a loud crash, and stalked out.
Ross and Doctor Bob stared at the door for about thirty seconds.
“You’re fired,” Ross said, finally.
“B-b-b-bummer,” Doctor Bob said.
Ross unclipped his phone, said “Gina” into the handset, and held it to his ear.
“Gina, Ross. Listen, cancel Peter’s badge, okay? Yeah … Well, he kind of quit and I kind of fired him. Yeah … Oh, and listen … if he calls and you see it’s him from caller i.d., answer with a stutter … Yeah, you know … T-t-t-tesseract T-t-t-technologies, c-c-can I help you? … Right, he’ll think it’s really funny. Oh, and tell him if he wants his last paycheck he’d better return his fucking laptop … Right, thanks.”
Doctor Bob looked at him, one eyebrow slightly raised.
“What? She can handle it.”
“So,” Doctor Bob said. “Who hired that asshole?”
“Don’t start with me. Four years at Oracle, Wharton MBA -- his references checked out.” He took a sip of coffee. “Although … the last guy I talked to, I kind of wondered why it sounded like he couldn’t stop laughing.”
“So we need a sales guy,” Bob said.
“Well, what we need is a sale.”
“How much runway do we have?”
“Our burn rate’s about seventy K a month, we’ve got maybe twenty K a month coming in, and we’ve got maybe a hundred in the bank. Do the math, man – it’s not looking good. Two months. I finally heard from my guy at Sierra. Not the schmuck -- his partner, Tryggvason. Turns out he skied off a mountain in Switzerland and he’s been laid up in a clinic getting wired back together. He e-mailed me, said he’s still interested. I know that game, though – he’s gonna circle around like a fucking vulture until we’re up against the wall so he can ratchet down the valuation. Then, just when we’re about to miss payroll, a term sheet magically appears. Fucking bloodsucking cocksuckers.”
“Don’t hold back, man. Tell me what you really think.”
Ross bit his lip, took a sip of coffee.
“I don’t think we can go back to Heaven for a bridge without at least a letter of intent from a marquee customer. I’m gonna try, but I don’t think they’ll bite.” Heaven was the angel investor fund that had provided Tesseract’s seed round, along with a hundred K from Ross and fifty from Doctor Bob. “It’s just timing, man – sales cycles are so fucking long these days. Lori’ll kill me, but I can probably pull a couple hundred K out of the house, buy us a few months, maybe more if we cut the Posse back.”
“You don’t want to do that.”
Ross shrugged. “What’s the worst that could happen?”
“You lose your house, your wife comes to her senses and dumps you, and we lose the company.”
“Hmm. Yeah, that would pretty much suck. I don’t see a lot of options, though.”
It Depends, An Ode to the Systems Architect
-- Dan Marcus (with apologies to John Vorhaus and his excellent book “Killer Poker”)
Architecture is a challenge built on techno trends
And many tough decision upon which a system bends.
So when I’m asked for my advice by strangers and by friends,
I look them squarely in the eye and answer, “It depends!”
Depends on what app server’s hot,
What the last SVP bought,
The foresnics of this system’s rot,
And other stuff that I forgot.
This project’s benediction --
Is it real or is it fiction?
I can take no firm position.
I am not a geek magician
Blesed with techno-precognition.
So I have no ammunition
For your big Enterprise mission.
I am just a politician
Who, waffling, contends:
“It’s architecture – it depends!”
Depends on who’s been talking smack,
Who has lots and lots of cash,
On who’s been drinking sour mash
Or maybe even smoking crack.
You want to know if you should build a data access bus
Or buy a turnkey product to ameliorate your fuss
But if you ask me what a systems guru recommends,
I’ll look you squarely in the eye and answer, “It depends!”
Depends on what’s your IDE,
Your build procedures currently
And what the process wonks defend.
Let’s just say it all depends.
Those Accenture guys will never leave! Their project never ends!
That code they wrote! I’d like to kill them! Them and all their friends!
You want me to clean up their mess, your disbelief suspends,
I’ll look you squarely in the eye and answer, “It depends!”
Will this pig scale?
It all depends!
This framework hale?
Depends!
Dot NET the Holy Grail?
Depends!
Executives in jail?
Depends!
Maintainable?
It just depends!
Explainable?
Depends!
Production ready?
Well, I’ll tell you
That in my best projection
Based on thorough and professional
Analysis and code dissection,
Testing that’s regressional,
Interviews confessional,
Demos very sleek,
With ducky-horsey Visio,
And Power Point technique,
And thirty six page writeup
Which to reputation lends
I’ll look you boldly in the eye
And tell you, “It depends!”
Went to Tartine for the first time.
Arguably the best bakery in the city of San Francisco . Jenny and I went a bit overboard. We had a chocolate croissant each (made with my favorite Valrhona chocolate). She also had an almond creme croissant, and I had a veggie quiche and puffy gougere with gruyere cheese, cracked black pepper and thyme. Plus two regular coffees. Yes, there were leftovers.
Look at that crazy line outside the door! It took us a good 25 min. to get our orders in.
