Thursday, December 27, 2012

Thoughts on Steve Jobs

I've been engrossed in the Steve Jobs biography for the past few months. My friend K encouraged me to start listening to "books on CD" during my often lengthy rides to and from work, so I took out the Jobs bio from the library, and the rest is history. It's 20 discs long. I've had to renew it twice, and I'm still not finished with it.

So I've been thinking a lot about Steve Jobs as I've worked my way through this long, long book: what he did right, what he did wrong, what he was like, how he imagined all these new innovations. I wanted to share some of my thoughts about Jobs here.

I think - based on what I heard in his biography - that Steve Jobs was probably a huge (pardon my French) a-hole, and I probably would have hated working with him. He was self-centered, and unaware of how his words and actions affected others around him. He was oddly childlike, not realizing that his bodily odor offended people, acting very emotional and even bursting out crying at inappropriate times.

On the other hand, he was clearly brilliant, and he understood what people wanted and needed before they even realized what they wanted and needed. He trusted his intuition, realizing that if he liked it, others would like it. In a way, he could see the future.

He was a perfectionist. He had a vision of how products should be, and he wouldn't stop changing them until they were perfect. This drove the people he worked with crazy. But in the end, the products were amazing.

He pushed people to do what they didn't believe they could do. I'm sure this was terribly frustrating at the time. Some called this his "reality distortion field." But people often exceeded their own expectations and capabilities under him.

I realized recently that you can see Steve Jobs on YouTube giving some of his famous MacWorld talks and introducing new products that are described in the biography. Watching these really brings the book to life. For example:

...here you can see Jobs introducing the Macintosh in 1984

...in 1998 introducing the iMac


...in 2001  introducing the iPod



...here introducing the iPhone in 2007


and here the iPad in 2010


and here iCloud in 2011


It's kind of amazing to think that I've been alive through this entire digital revolution, from the introduction of personal computers through the digital music revolution (from records to cassette tapes to 8-tracks to CDs and now to MP3s), from rotary phones to push button phones to wireless home phones to cell phones, not to mention the Internet and all that it brings with it. I remember the first PCs becoming available my senior year of college  I remember sending my first emails, and I remember browsing the web when it was just words, no images. I remember agonizing whether I should get a cell phone. And now...

It's all rather amazing, if you look at the arc of it. Or as Jobs would say, "insanely great."



Monday, May 07, 2012

Jersey Shore kills brain cells

I've written about the show Jersey Shore before. J likes this show a lot. My opinion? While watching this show, I can actually feel my brain cells dying.

So now there actually is a spin-off of Jersey Shore called the Paulie D Project. (The show is so successful, there is a spin-off. Good grief.) One of the characters from Jersey Shore, Paulie D, who has hair that defies gravity, is featured.

I was watching an episode today with J. The basic routine is that the group (here, a group of men) a) elaborately gets ready to go out b) goes out to a club c) gets drunk, dances, and meets women d) some of the women come home with the men, and they have sex. The end.

So in this episode, Paulie D. becomes enamored with a woman during step c), and one of his pals notices that she has a ring on her finger. (Paulie does not notice this because he is both drunk and aroused.) Paulie brings her home, and gets ready to go to bed with her. Suddenly, she admits that she's married. So Paulie "does the right thing" and ushers her out of the house.

Good grief.

This is what now passes for ethical behavior. Not sleeping with a strange woman who you just met, because she is married.

I'm feeling my brain cells dying again...

Thursday, May 03, 2012

The unhealthy plate

You probably know by now that I work in public health. My program is currently working on the issue of childhood obesity (and obesity in general).  This picture is what people at the Harvard School of Public Health thinks people should be eating. Overall, I agree with this plan, and I try (try!) to eat this way. I try to serve lots of fruits and veggies, smaller portions of protein, and I don't do really well with the whole grains, but I try. I use healthy oils in my cooking.

The problem is, this is not how most people eat.

My family attended an event last night, and I made an image representing the meal we had. I call it The Unhealthy Plate.  Here it is:

First of all, look at the color. Everything on the unhealthy plate is yellow. We ate chicken breast with gravy, potatoes, corn on the cob, washed it down with soda, and had ice cream and cake for dessert. There wasn't a vegetable or fruit anywhere in sight. I know, technically potatoes and corn are vegetables, but they are starchy vegetables. There were no leafy greens, nothing green at all in fact, nothing red or orange... And it was delicious. But not healthy.

So. Where does this leave us?

Well...there is the ideal. And there is reality. And that's the problem, I think.

Friday, April 20, 2012

Spring = lawn flags and chemicals

It's only April 20th but it's a beautiful spring day, and I just took a fast-ish walk around my neighborhood to get some sun and exercise. Unfortunately, the little yellow lawn flags are back along with the sun, as well as the caustic scent of herbicide. This made me think of Sandra Steingraber's wonderful article Canadian Bylaws; American Lawn Flags which is already 2 years old, but still applies. She writes:
The smell of lawn chemicals is as dependable a harbinger of spring as robins and lilacs. Not in big parts of Canada, where many municipalities and provinces have opted to abolish the cosmetic use of pesticides on the grounds that the links between pesticide exposure and childhood cancer are too troubling to ignore. So, how come we're still using them?
Ironically, one lawn I saw today that had lawn flags also had a poster advertising a childhood brain cancer fundraiser. Um....

In any event, I'm happy to report that some folks in my town are bringing the film A Chemical Reaction to town next week.
A Chemical Reaction, is a 70 minute feature documentary movie that tells the story of one of the most powerful and effective community initiatives in the history of North America.  It started with one lone voice in 1984.  Dr. June Irwin, a dermatologist, noticed a connection between her patients’ health conditions and their exposure to chemical pesticides and herbicides.  With relentless persistence she brought her concerns to town meetings to warn her fellow citizens that the chemicals they were putting on their lawns posed severe health risks and had unknown side effects on the environment.
Maybe it will help.

Sunday, April 15, 2012

Why walk with us?

There are many worthwhile charities vying for your attention this time of year. Charities big and small, local, national, and even international, all want your support and money. In Boston alone there are several charity walks each weekend in the spring, summer and fall. There are several breast cancer walks that want your participation as well. How do you decide which one to support?

Some other breast cancer organizations focus on providing mammograms for women who cannot afford them. Many groups provide money for research, often on new treatments for women who already have breast cancer. MBCC is different. We think that the way to stop breast cancer is to prevent it in the first place. We ask you to join us in this important work by planning to take part in Against the Tide, our annual breast cancer swim/kayak/walk/run event.

Against the Tide has been taking place for 20 years. It has many loyal, concerned supporters. But we need more. We need you.

You have two opportunities to take part in Against the Tide. One event takes place on Sat. June 24th in Hopkinton, MA (near Framingham). The second takes place on Sat. August 18 in Brewster, MA (on Cape Cod). There are many options for participation. You can take part in a 3 mile walk, a 2 mile kayak, a 1 mile swim (competitive or recreational) or a 5K or 10K run (competitive or recreational). This year, we have a new event called an Aquathon: a 1 mile swim followed by a 5K or 10K run. Challenge yourself!

Click here for all the information you need about Against the Tide. We’d love to have you join us for this exciting, empowering day. If you can’t join us, click here and support one of the many individuals or teams who are planning to participate on June 24 or August 18.

Here are the facts: there is strong, growing scientific evidence that many diseases, including breast cancer, are caused at least in part by unregulated, untested chemicals in our environment. MBCC works to educate, to advocate, to make change around environmental causes of breast cancer. We want to see a world free of breast cancer by stopping breast cancer before it starts.

Join us! Swim, kayak, walk or run Against the Tide with MBCC!

Cross-posted at MBCC.org

Saturday, February 04, 2012

D’var on Parashat Beshalach for Sisterhood Shabbat 2012

This week’s Torah portion, Beshalach, tells a story that we all know very well. It is the story of what happens to the Children of Israel right after they leave Egypt, and just before they arrived at the Red Sea. Pharaoh – as we all remember – finally lets the Children of Israel go; but then he changes his mind, and sends soldiers, riding in horse-drawn chariots after them ; Moses holds up his staff and the Sea splits; the Children of Israel cross through; then Moses lowers his staff, and the Egyptian soldiers, horses, and chariots are drowned.

Beshalach includes a famous poem, The Song of the Sea – Shirat Ha’Yam – that we just heard chanted in its beautiful and unique trope. This poem describes all that just happened – nd praises G-d for G-d strength against the Egyptians –one of our most well-known prayers, Mi Chamocah, comes from this poem. Who is like You among powers, God? Who is like You, majestic in holiness, Awesome in praise, doing wonders?

Directly after the song of the sea, the Torah reads: “Miriam the prophetess, Aaron's sister, took the drum in her hand, and all the women followed her with drums and dancing.” Oddly, this is the first time in the Torah that Miriam is called by her name. Earlier, she is referred to in relation to Moses, but never by her actual name. Not only is she called by her name here, she is also called “prophetess” – neviah. This is the first time she is named, and she is called a prophetess. Maybe some other kind of liberation is taking place as well?

The haftarah for Beshalach relates the story of another prophetess – Deborah, from the book of Judges. This story is less well-known, perhaps, than the Torah story. It takes place during the period of the judges, which was approximately 1220-1020 BCE. There were 15 or 16 judges in all, and Deborah was the fourth.

Here is the story: The people of Israel had been oppressed by King Yavin, King of Canaan, and his general Sisera for 20 years. G-d tells Deborah the time has come to fight. Deborah is instructed to call Barak, and tell him that G-d had ordered him to bring 10,000 men to fight a Sisera, and that G-d will deliver Sisera into Barak’s hands. Interestingly, Barak says to Deborah, "If you will go with me, I will go; if not, I will not go." Barak senses that he needs Deborah’s help to win this battle. "Very well, I will go with you," she answered. "However, there will be no glory for you in the course you are taking, for then the Lord will deliver Sisera into the hands of a woman." Interesting. Even 3000 years ago, if you were helped by a woman, it meant less status for you.

Barak and his men attack Sisera’s army, and Sisera flees in fear. All of Sisera’s men are killed. Sisera ends up in the tent of Yael, the wife of a friend of Sisera’s. She welcomes him, gives him food, and he falls asleep. Yael then takes the tent pin and a mallet and kills Sisera. When Barak comes looking for him, Yael informs him that he is “quite dead.”

This story is followed by a poem that Deborah and Barak sing together, the Song of Deborah, recounting the episode I just described, and praising G-d, similar to the Song of the Sea. It is easy to see the parallels between the Torah and Haftarah portions: water, G-d’s salvation, a strong woman, a song or poem.

This portion is perfect for Sisterhood Shabbat because it features strong woman figures – in both the Torah portion (Miriam) and Haftarah portion (Deborah), not to mention Yael and her tent pin.

On the other hand, reading through these portions, it was disturbing to how rarely strong women are featured in the Torah. Or rather, how infrequently women in biblical times were considered to having agency. Yes, we have Sarah, Rebecca, Rachel and Leah doing their thing… but there are few women mentioned actively participating in life in the Torah. Yes, those were different times. Yes the world has changed quite a bit. But what does this mean for us today?

In some ways, we’ve never had it so good. In the not too distant past, women weren’t allowed to be a part of a minyan to say kaddish, women weren’t allowed to have aliyot or to lead services. We have come a long way. Women in the Conservative, Reform, and Reconstructionist movements of Judaism are equal in every way to men. And there is movement toward equality even in Orthodox Judaism. But what does it mean that a parsha featuring two strong women is something that we notice as different? Something that is so rare in the Torah that we say: here is a parsha about strong capable women?

Feminist Letty Cottin Pogrebin, in her book Deborah, Golda, and Me, wrote these words 20 years ago: “The most outrageous false myth in Judaism is that women were not doing anything important….Even if most women were denied the opportunity of study, prayer, leadership and conquest, that doesn’t mean they were not being Jews...They were doing hard work, vital work – G-d’s work – creating Jewish life and nourishing Jewish families. If women had written the Bible, we would know about that work, and that work would be deemed important….”

Just because we can’t read in detail about our female ancestors, doesn’t mean we can’t use our imaginations. To think about the roles they played. And to know that – without them – we wouldn’t be standing here today, leading this special Sisterhood Shabbat, and talking about some biblical women we do know about who were pretty remarkable.

Tuesday, January 31, 2012

Practical

Yitro is one of my favorite Torah portions. The reason is that it depicts one of the things I like most about Judaism: how practical it is.

Here's the story of Yitro in brief: Yitro is Moses' father-in-law. He comes to visit Moses in the desert shortly after the Children of Israel leave Egypt. He sees that the people come to Moses all day long so he can hear their troubles and administer justice. Yitro watches this for a while, and says: "You are working too hard! You can't do this all alone. You are going to burn yourself out! Choose some good men, and have them help you judge the people, and you can handle the most difficult cases."

This is just such a wonderful and practical piece of advice! And so modern!

I am chanting a portion of Torah in a few weeks from Yitro, and I love it! Here is what it says:
Moses took his father-in-law's advice, and did all that he said. He chose capable men from all Israel, and he appointed them as administrators over the people, leaders of thousands, leaders of hundreds, leaders of fifties, and leaders of tens. They administered justice on a regular basis, bringing the difficult cases to Moses, and judging the simple cases by themselves. Moses let his father-in-law depart, and he went away to his homeland.



Saturday, January 21, 2012

Bad timing

So this whole bar mitzvah thing...the timing seems to be off.

This is my problem. When J was a little kid, he loved all the Jewish stuff. He loved Shabbat at preschool. He loved the wine, the candles, the challah... He loved saying the blessings. He loved being the Sabbath King. He loved Chanukah. He loved Purim. He loved the seder at Passover.

So we sent him to Jewish day school because we loved how seamlessly his preschool had moved between our two worlds, the American/secular world and the Jewish world. And he loved kindergarten, and he learned to read English, and then in first grade he learned to read and write Hebrew, and he learned some Hebrew words. He liked the bible stories, and he liked learning the morning prayers. He liked the Hebrew songs and Israeli dances. And we went to temple, and he liked the kids' services. And it continued this way, through about fourth or fifth grade.

But now J is 12-1/2, in sixth grade, in middle school, on the brink of adolescence. Currently, he loves 1) basketball 2) x-box 3) his friends, especially if he is playing either basketball or x-box with them. (And playing basketball on x-box with a friend is the ultimate.) But what he isn't really interested in anymore is school, or Judaism. Those things are, to quote J and all his friends, are "boring."

And now it's time to prepare him for his bar mitzvah. He's not resisting, but he's not really into it, either.

So here we are. Now what do we do? How do we make this meaningful at this time in his life?

Friday, January 13, 2012

Non-adherence and mail orders

I've always been somewhat peeved by the term "non-adherence," as in "the patient is non-adherent to his/her medication." It puts the blame squarely on the patient. It's as if someone is saying: "Why won't you just take your medication? I told you it's good for you! I told you that you need it! What is wrong with you?"

So here's a little story...

I take two medications, one prescribed by my PCP and one prescribed by my oncologist. For some reason, my PCP will not give me a prescription for a year, and insists on giving me a script for 6 months or even 3 months. (This is a medication I've been on for years. It's not like something is going to change.)

My new job has a mail-away drug program, and you can get 3 months of your prescription for a slightly lower cost than ordering it from the local drug store. So the last time I was in to see my PCP, I asked her to send the prescription to the mail-away drug program. She assured me that it would go through quickly and that I'd receive the medication in a few days.

I checked the mail-away drug program's website and my prescription didn't appear there. After about 10 days, I heard from my PCP's office: there had been some problem with getting the mail-away drug program to accept my prescription. They think it has been resolved.

Next, I get an automated call from the mail-away drug program, asking me to confirm my zip code and address. They say that the address in their system and in the PCP's system don't match. I'm starting to realize that my doctor's office probably has my zip code entered incorrectly (there are 2 zip codes in my town and people tend to confuse them). This has caused all this delay.

So now the prescription is on the website, and everything looks okay. Except it hasn't been filled or mailed.

What the hell is going on? And my medication supply is dwindling.

Probably a week later, I get another automated call from the mail-away drug program. There has been a delay in my order (no explanation for the delay). Am I running out of medication? If I am, I should call them.

So by now I really am running out of medication. I call my PCP's office. Since I'm calling about a prescription, they transfer me to the nurse's voice mail. I explain the situation and that I need a refill from the local pharmacy because the mail order one is being delayed. The voice mail says that if you are running out of a prescription, you should call the pharmacy and have them fax a request to the PCP's office.

I call the pharmacy, and they tell me that they can fax a refill request to my PCP's office. So I have them do that. And then I leave another message at my PCP's nurse's voice mail.

Finally, I take my last pill. Now I am starting to get very nervous because if I miss these pills for more than a day, I'll start getting side effects.

I decide to call the mail order drug program. (I don't know why I am protecting them: Medco is the company.) A very polite woman says that my prescription was sent 2 days ago and should arrive soon. I tell her that I am now out of medication. She offers to authorize a "bridge" prescription of my medication, but...my PCP has to authorize it before the drug store will fill it. Also, since I've already run out of medication, do I want counseling?

Counseling? No, I want my prescription. Thank you very much.

I call my PCP's office again. This time I am able to talk to a human being who discovers 2 interesting things while looking at my record: 1) my zip code is incorrect in their system (as I suspected) which caused the delay in the first place with the mail order company, and 2) the nurse did indeed already call the prescription into the local drug store. I am relieved, and plan to pick up the prescription at the drug store when I get home.

When I get home from work, the medication has arrived from the mail order company. I take my pills. All is well with the world.

Or is it?

Why did I have to jump through all these hoops just to get my prescription filled? This is absolutely ridiculous.

So back to where we began: non-adherence. It's easy to see how people get off-track with their medications when you have to deal with #$%@ like this. Sure, some folks probably don't take their medications for other reasons. But I'll bet that a lot of the non-adherence now-a-days is due to ridiculousness like this. It just isn't right.

P.S. As a final nail in the coffin, I just tried to pick up my prescription at the local pharmacy. The emergency prescription that was supposed to hold me over in case my mail-order prescription didn't arrive soon enough? It was denied by the insurance company.