US Gov. Asked Twitter to Delay Maintenance

Via Sullivan, it seems that the State Department asked Twitter to delay scheduled maintenance that would have disabled service today in Iran (i.e., last night here). That's a pretty remarkable step, not necessarily in terms of being an extraordinary measure in itself, but because the move demonstrates the administration's interest in new technology and its role in the current Iranian crisis. Kudos.

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Shepherd Smith, Voice of Reason

It's getting eerie to watch clips of Shepherd Smith speaking with apparent honesty and sensibility against the conservative CW on Fox. Take the following clip, in which he points out that the attack on the Holocaust Memorial Museum reflected an advisory homeland security recently issued which the right flipped out over:



Almost makes me feel bad about forwarding the following to my friends (key words: Jenny Lopez, Curb Job, Blow Job):

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Cyber Attacking the Atlantic?

Just got back from my bachelor party. Due to regional confidentiality agreements, I can only report that it was in a town named "the meadows" by 19th-century Spanish immigrants.

But I'm feverishly reading about the Iranian elections, and came across this post by Andrew Sullivan (who's been all over the story):

The Atlantic is struggling to keep the site up despite what seems to be a digital attack. Please be persistent in trying to reload.

If that's true, it would be a pretty remarkable indicator of where the digital age is heading. Welcome to the 21st century.

UPDATE: Sullivan has reported that their servers were only overloaded -- no "denial of service" attacks. This doesn't surprise me -- whereas I wouldn't put such a thing past a country with very sophisticated state digital infrastructure (say, China), in a place like Iran, where I'd assume most of the techies are liberals, it would have been remarkable.

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Superb Health Care Article

Atul Gawande, a practicing surgeon, has written a brilliant article about healthcare reform for the New Yorker. Its basic thesis: while there are a host of theories about how to reduce the cost of healthcare in the United States, the greatest problem is over-treatment -- the prescription of medications, treatments, tests and surgeries that are redundant, unnecessary, and sometimes harmful.

To research the article, Gawande flew to MacAllen, a rural Texas county that's the most expensive health care market in the United States, despite having average or below-average patient outcomes, and residents who are, on average, as healthy as anywhere else. There's a sharp moment when he sits down with some physicians at a diner to talk it over:

“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

I thought this discussion was fascinating, because it confirmed my little experience discussing the subject with my best friend, a neurosurgeon practicing in Nashville. Back when he was going through medical school, we used to talk about the high cost of medical care, and he always insisted the problem was malpractice suits; insurance against malpractice was bankrupting doctors and forcing them to add extra testing. When I pointed him to studies showing that malpractice awards were dropping even as insurance costs skyrocketed, he shrugged it off. It was the lawyers, plain and simple.

I have a feeling that now, after many more years of practice and experience, he sees things differently (and I'm looking forward to asking him at my bachelor party next week). My guess is that the malpractice canard is a commonly-held but superficial excuse that one would encounter early on in medical education -- especially while interning and doing early rotations. But as doctors gain more experience, they gain a richer, more nuanced understanding that complicates that reassuring but misleading perspective. And that's what is reflected in the exchange above: initially, the doctors offer the comforting excuse that it's the fault of lawyers and court cases -- not their own. But when push comes to shove, they recognize the problem lies closer to home.

Which isn't to say that insurance reform, digitization, universal coverage, prescription cost controls, etc., aren't key to moving forward. But a huge component is getting physicians to recognize that, despite excellent medical skills, their daily decisions contribute incrementally to the national health care problem.

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At a conference: GSLIS Champaign-Urbana

A quick note: I've been at a conference on the digital humanities all week, which explains the paucity of posting. BUT I've been learning some fascinating, exciting, and (I think) revolutionary stuff which I'll be sharing as soon as I get the chance. Tomorrow I fly with The Talented Videographer and a couple of Good Folks out to Miami for some vacay, but I'll post soon.

A link for the conference.

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The Big Easy stole by baby: Absinthe my Sazerac

The Talented Videographer is off to Nawlins for her bachelorette party. In honor of her trip, I wanted a Sazerac (the state drink of LA) but didn't want to pony up the $60 for a bottle of absinthe. So I decided to make my own. And it turns out this is really cheap ($20-$30, depending on base liquor), and really easy.

Believe it or not, wormwood, the key ingredient, is available at the local Fiesta Mart for $2 a quarter oz (I stumbled across it looking for Chamomile for my Pithy Wit). You mix a whole ounce of this stuff in a 750 ml. bottle of 150-proof alcohol (I used Bacardi 151) and leave it for seven days, then strain it through a coffee filter. Add some spices (I used 1 tbs. anise seed, 1 tsp fresh sage, 1 tsp. spearmint, 1/2 tsp. coriander seed and 1/4 tsp. caraway seed, plus a pinch of ground cardamom--make sure to crack the whole seeds in a mortar and pestle or w/ a rolling pin). Let that sit for another four days, then strain again through a coffee filter. Lovely and complex licorice flavor w/ spicy background, a rich green-brown (from the rum coloring) and a very, very nice Sazerac.


The Sazerac:

2 oz. Rye whiskey.
1/2 tsp. absinthe
4 dashes Pechaud bitters
1 sugar cuber or 1 tsp simple syrup.

Pour whiskey over ice and stir in bitters and simple syrup or sugar cube for 20 seconds. In the meantime, pour small measure of absinthe into the serving glass (I like short martini glasses) and swirl it around to coat the glass. Strain mixture into glass, garnish with a lemon twist if you'd like.

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Rockets-Lakers

Can you remember the last time a team was so popular at home it didn't matter if they clinched the semi-final series? Houston is CRAZY IN LOVE with this team.

On a related note, did you catch Aaron Brooks' standup last week? Smokin:

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The Measure of Happiness

There's a startling and moving article by Joshua Wolf Shenk over at The Atlantic that I enjoyed more than anything else I've read in some time. It's about something called the Harvard Study of Adult Development, which has tracked a group of more than a hundred male sophmores from the 1940's until the present day, in order to try and get a sense of what makes people happy, and why. The group included at least one best-selling author and John F. Kennedy (though apparently, his records have been sealed until 2050).

Here's a sample, about the man who's overseen the study for the last fifty years, and what he and others have learned:

Vaillant brings a healthy dose of subtlety to a field that sometimes seems to glide past it. The bookstore shelves are lined with titles that have an almost messianic tone, as in Happier: Learn the Secrets to Daily Joy and Lasting Fulfillment. But what does it mean, really, to be happier? For 30 years, Denmark has topped international happiness surveys. But Danes are hardly a sanguine bunch. Ask an American how it’s going, and you will usually hear “Really good.” Ask a Dane, and you will hear “Det kunne være værre (It could be worse).” “Danes have consistently low (and indubitably realistic) expectations for the year to come,” a team of Danish scholars concluded. “Year after year they are pleasantly surprised to find that not everything is getting more rotten in the state of Denmark.”

Of course, happiness scientists have come up with all kinds of straightforward, and actionable, findings: that money does little to make us happier once our basic needs are met; that marriage and faith lead to happiness (or it could be that happy people are more likely to be married and spiritual); that temperamental “set points” for happiness—a predisposition to stay at a certain level of happiness—account for a large, but not overwhelming, percentage of our well-being. (Fifty percent, says Sonja Lyubomirsky in The How of Happiness. Circumstances account for 10 percent, and the other 40 percent is within our control.) But why do countries with the highest self-reports of subjective well-being also yield the most suicides? How is it that children are often found to be a source of “negative affect” (sadness, anger)—yet people identify children as their greatest source of pleasure?

The most moving take-away, I think, is a discussion of how rich and complicated all of the surveys and tests are as a body. It's not really possible to boil down the quirks and vicissitudes of someone's entire life into an empirical data set with any clear answers. Many start out happy and end in divorce and suicide; some come from poor, broken homes, and end up successful philanthropists and civil rights leaders. And I suspect many more are just Willie Lomans, lost in unextraordinary lives that lack clear-cut plot lines or turns of fortune. It's the kind of article that hits me square in the chest.



Here's a sample of one of the portraits:

After college, you got an advanced degree and began to climb the rungs in your profession. You married a terrific girl, and you two played piano together for fun. You eventually had five kids. Asked about your work in education, you said, “What I am doing is not work; it is fun. I know what real work is like.” Asked at age 25 whether you had “any personal problems or emotional conflicts (including sexual),” you answered, “No … As Plato or some of your psychiatrists might say, I am at present just ‘riding the wave.’” You come across in your files as smart, sensible, and hard-working. “This man has always kept a pleasant face turned toward the world,” Dr. Heath noted after a visit from you in 1949. From your questionnaire that year, he got “a hint … that everything has not been satisfactory” at your job. But you had no complaints. After interviewing you at your 25th reunion, Dr. Vaillant described you as a “solid guy.”

Two years later, at 49, you were running a major institution. The strain showed immediately. Asked for a brief job description, you wrote: “RESPONSIBLE (BLAMED) FOR EVERYTHING.” You added, “No matter what I do … I am wrong … We are just ducks in a shooting gallery. Any duck will do.” On top of your job troubles, your mother had a stroke, and your wife developed cancer. Three years after you started the job, you resigned before you could be fired. You were 52, and you never worked again. (You kept afloat with income from stock in a company you’d done work for, and a pension.)

Seven years later, Dr. Vaillant spoke with you: “He continued to obsess … about his resignation,” he wrote. Four years later, you returned to the subject “in an obsessional way.” Four years later still: “It seemed as if all time had stopped” for you when you resigned. “At times I wondered if there was anybody home,” Dr. Vaillant wrote. Your first wife had died, and you treated your second wife “like a familiar old shoe,” he said.

But you called yourself happy. When you were 74, the questionnaire asked: “Have you ever felt so down in the dumps that nothing could cheer you up?” and gave the options “All of the time, some of the time, none of the time.” You circled “None of the time.” “Have you felt calm and peaceful?” You circled “All of the time.”

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