Some Random Thoughts At The Foot Of Arenal

The Arenal Volcano, from Springs Resort, La Fortuna, Costa Rica

I'm reporting today from The Springs Resort, in the shadow of the Arenal Volcano in central Costa Rica. We are just at the edge of the Rain Forest, and at the beginnings of the rainy season, so you can imaging just how lush and tropical the surroundings are down here. (And by the way, when it rains, IT RAINS!!)

ABC filmed an episode of The Bachelor on the grounds of The Springs, which is how Mrs. Dalai learned of it, and so here we are for Dalai, Jr.'s high school graduation present. Words cannot do this place justice, and the photos on the website don't begin to convey just how wonderful it is. I would place it just below Jade Mountain (another former Bachelor venue) in beauty of the facility and the surroundings. In fact, the view of Arenal is really reminiscent of the Piton in St. Lucia. The service here has been just as good, and by that I mean incredible. 

We even made a new local acquaintance, Señor Gato, although I suspect the next occupants of the room won't appreciate our cultivating his friendship...

For better or worse, there is WiFi in the room, and so I've managed to keep in touch with the outside world.

Let's start with the "for better"...From lifeIMAGE comes word of some tools to ease image exchange from within any other system, which means that if IT cooperates, my PACS could talk to your PACS:

Newton, Mass. – May 29, 2012 – lifeIMAGE announced today it is releasing certain open application programming interfaces (APIs) that can be used by developers of healthcare information technologies (HIT) or imaging devices to enable the secure exchange of medical images and related patient records directly from their software.

The lifeIMAGE network has been used to share over 160,000,000 medical images across diverse healthcare providers representing 40,000 affiliated physicians. lifeIMAGE is the go-to network for on-demand  clinical exchange of imaging exams along with related information such as reports or EKGs. This secure and high-speed network is used by physicians on five continents to collaborate on time sensitive patient cases.

With API integration, more providers will have the ability to tap into the network by enabling their existing systems to securely share imaging information on demand. PACS, EMR, dictation and reporting, CD/DVD writer, visualization, or personal health record (PHR) application vendors can integrate with open APIs to give their end-users the added benefit of a simple workflow for sharing patients’ imaging history.

“Our CD burning systems that have been in place for several years at an academic medical center in the Washington D.C., in addition to other customer sites, are used to publish imaging results to other providers outside their network using the lifeIMAGE cloud service,” said Cyrus Samari, a co-founder of Sorna. “When our customers have an exam that needs to be sent to an outside referring physician, or to the patient, with a single click, they have the option of burning a disc or sending it electronically on the lifeIMAGE network, all from the same interface - automatically.”

Norman Young, President & CEO of ClearCanvas, said “We were founded on the simple belief that medical imaging informatics should be accessible to all.  Now, using a lifeIMAGE open API, users of our FDA-cleared diagnostic viewer will be able to instantaneously share images that are in front of them with any one.”

“Whether it’s a simple CT or a complicated cardiology exam, whether it’s arriving through the door on a CD with a patient or arriving via the cloud, open and secure exchange of patients’ imaging history is key to improving patient care and driving down our country’s healthcare costs, said Hamid Tabatabaie, President & CEO of lifeIMAGE.   “We are eliminating the technological barriers to timely access to information by making our API available to all developers of related software. Now, HIT companies can use the open API to differentiate their services and ensure their users have the power to exchange information on demand.”

“lifeIMAGE recently delivered an API to a large academic medical center to enable their Epic users to upload or view images directly from the applications they use to check patients in or when accessing medical records of patients,” Tabatabaie added.  “A separate API is being used to provide access to employees who use WebMD’s PHR. Employees are able to share imaging content with any physician directly from their PHR, where other important medical history may also be available. ”

Companies that want to use the API can visit lifeIMAGE at the annual SIIM conference in booth #426, or request more information at www.lifeimage.com/api.

Since I won't make it to SCAR SiiM this year, I'll request more information. Does it work with IMPAX?

Which brings us to the "for worse"...

I've heard nothing from Agfa about Western Australia, and I would really like to know their take on the situation. Have I been fed incorrect information? Is the system working perfectly? Or is it such a disaster that no one wants to talk about it? As always, I will gladly post any official (or semi-official) statement from Agfa.

And worse yet, an email trail has been released, courtesy of the GOP, rather clearly outlining the level of Thugocracy under which we must live and function. Did you think the authors of the Affordable Care Act really had your best interest at heart? Ha. The ACA was gleefully crammed down this nation's collective (pun intended) throat by the Obama/Pelosi/Reid axis of evil, and there were any number of back-alley deals, in truth, threats and bribes, to assure the lock-step (goose-step?) cooperation of the drug and insurance industries. Read this from the (Republican-chaired, thank Heaven) House Energy and Commerce Committee:

WASHINGTON, DC – The House Energy and Commerce Oversight and Investigations Subcommittee, chaired by Rep. Cliff Stearns (R-FL), today released a memo and supporting documentation outlining a series of intricate policy negotiations used to craft the health care law, the full details of which have never been released to the public. The memo is part on an ongoing investigation the committee launched more than a year ago to shine light on a process that excluded both the American people and many of their elected representatives. Despite the White House’s unwillingness to make these negotiations transparent, even after the fact, the investigation has uncovered a series of emails and internal documents that paint a much clearer picture of the tools and tactics used by the Obama administration to secure a narrow, partisan victory and see PPACA signed into law...

Documents released by the committee today show major negotiation milestones throughout 2009 as the White House attempted to secure a deal with the interest groups who had been invited to the bargaining table. The materials reflect negotiating tactics used by top White House personnel including threats of public criticism and policy declarations. They also show that PhRMA was assured a “direct line of communication” with the White House, and that the organization was offered private reassurances about the deal remaining intact in spite of congressional concerns.

From the Washington Times:

Top administration officials cut backroom deals with the nation’s top drug companies to win support for President Obama’s health care overhaul, threatening them with steeper taxes if they resisted and promising a better financial deal for the industry if they acquiesced, according to internal documents released Thursday by House Republicans.

In some of the key deals, Mr. Obama agreed to drop his long-standing support for letting Americans buy cheaper foreign prescription drugs — something the pharmaceutical industry vehemently opposed — and the drugmakers promised to mount a public campaign to sell the public on the health care legislation...

The material released by House GOP members provides a rare insider look at the wheeling and dealing on Capitol Hill as Mr. Obama tried to shepherd his bill through Congress, in the face of near-unanimous GOP opposition.

The details emerged as House Republicans released emails it obtained during a yearlong investigation into the closed-door negotiations between the White House and lobbyists for drug companies. House Republicans said those negotiations violated the promises of transparency Mr. Obama made during his 2008 campaign.

“We really have now been able to build a case that there was a sequential, planned, organized strategy for the White House to trade policy for politics, if you will,” said Rep. Michael C. Burgess, Texas Republican. “They were willing to give up on things they thought were sound principles.”

The documents show that former White House Chief of Staff Jim Messina and health care reform point woman Nancy-Ann DeParle told drug company representatives in June 2009 that if they didn’t cooperate on the initiative, Mr. Obama would demand a 15 percent rebate on Medicare drugs and push to remove the tax deduction for direct consumer advertising — items that could cost the industry $100 billion over the next decade.

The threats appeared to work, and the parties met the next month to hammer out a final deal. The drug companies agreed to pay higher Medicaid rebates and a new health care reform fee to raise $80 billion for the legislation, and promised to run positive television ads about it.

In exchange, the White House gave them direct input into the new policies and promised to let them continue to set their own drug prices. Ms. DeParle threw in an extra prize to reward pharmaceutical companies for their cooperation, saying she and other officials decided to reverse the administration’s position on drug importation, which Mr. Obama supported while running for president.

“I made [the] decision, based on how constructive you guys have been, to oppose importation on this bill,” she wrote to Bryant Hall, chief lobbyist for the Pharmaceutical Research and Manufacturers of America(PhRMA).

Administration officials have denied that they negotiated directly with PhRMA, instead saying it was Senate Democrats who brokered the agreement.

But Republicans said their findings contradict the White House and confirm what the GOP has long contended: that the White Housebypassed members of its own party to iron out specific details with the drug companies.

The White House didn’t respond to requests for comment, but congressional Democrats defended the deal-making, saying it was no different from what had been done for major legislation under previous presidents...

PhRMA said the industry’s negotiations with the White House were a normal part of doing business...

Republicans said the investigation punctured a hole in Mr. Obama’s pledges of transparency during the 2008 campaign — including a vow to televise all of the health care negotiations so Americans could see who was lobbying for the drug companies and other big players in the debate.

“When you are supposedly acting in the public’s behalf, when you have promised that this is going to be the central feature of your administration, you darned well better behave that way,” Mr. Burgess said...

Yes, yes, I know. Business as usual in D.C. Except this piece of garbage gives the Socialists Democrats control over our very lives.

I'm presently in a nation with Socialized Medicine, and I've asked around about it. Everyone in Costa Rica pays a 9% tax for their "free" healthcare. However, if you need something beyond the basic, you have to wait (sometimes a year or two) for an appointment, or pay $30 for a primary-care visit outside the "free" system, or have your employer dock you for more insurance, which is a big hardship on most. As my guide Juan Carlo put it, "you might not think $30 is a lot, but for me and my friends, it's impossible."

Americans who believe in the increasingly mis-named Affordable Care Act would do well to heed the examples of the rest of the world. Governmental CONTROL (as opposed to Regulation) does not work very well for any prolonged period of time. Don't even bother to tell me of the few anecdotes you've heard about wonderful "free" care your cousin's friend's uncle received in England. The majority of the care isn't wonderful, and it certainly isn't free. Someone is paying for it, rest assured.

I don't think anyone is particularly surprised by this latest revelation of corruption by our illustrious leaders, both in the Administration and the Pharmaceutical industry. But it should certainly give us pause. The whole welfare state in America, and with that I include Medicare, Medicaid, and Social Security, are little more than governmental thuggery, redistributing wealth in a very small part to those who are truly in need, but also to the cronies of those in power, and to many (the looters or moochers, as Ayn Rand calls them in Atlas Shrugged) who don't need it at all.

Medicine in particular has been corrupted by the unholy alliance of Left-Leaning (and sometimes Right-Leaning too) Government, Big Pharmacy, Big Insurance, and not a few thieving physicians. It has become all about the money, and only tangentially about the health of the patient. Personally, I blame Government most of all (what a surprise...) It has set the rules, and the rest of the louts simply follow them or skirt them in the most barely legal manner possible to their own benefit. Nothing personal, of course.

I've got the answer, but if I told you how to fix this, too many of the above would be on the next flight down to Costa Rica with the express purpose of dropping me into the active C-Crater of Arenal.

In the meantime, I'll be on my porch, appreciating the beauty of Arenal and the flora and fauna around her, sipping on yet another Imperial.

Pura Vida!

"SO" Is, Well, The New "Like," You Know?

So..........................................................................................................
back in 2006, I bemoaned the phenomenon of the overuse of the word "Like". It seemed at the time that everyone below the age of 21, and at least a third of those above, were using the word "like" two, three, even four times in a sentence. Make that in EVERY sentence. Here is an example I provided at the time:

You know LIKE I feel LIKE students LIKE have trouble LIKE selecting LIKE career awareness LIKE experiences.

Happily, this bad habit has faded, although the "Likers" are still out there, but that isn't the end of the story.

My daughter, Dolly, has graced us with her presence this week, coming home from Medical School for the express purpose of studying for her Step I exams. Mrs. Dalai and I are of course glad to provide a peaceful and quiet atmosphere. Dolly does come up for air every so often, but when we actually get the chance to talk to her, we notice a disturbing trend: Every thought is prefaced by "So......" with a long pause. Apparently, "so" is the new "like".  As my quote in the old post mentioned, there seems to be a trend among the young to fill gaps in their speech with nonsense filler words. Or, to give themselves a bit of time to think before actually saying something intelligent, they begin with a place-holder word. Now, President Reagan used the word "well..." for this purpose, but he did it with perhaps a little more skill than our talkers do today.

So...........................................................................
I felt it my duty to break Dolly of the "like" habit, and I did this with some aversion therapy. Every time she said "like" in my presence, I would loudly erupt with the nonsense syllable "ACK!" rather like (sorry) one would do with a dog about to do a nasty on the rug. After about 50 "ACK's", Dolly's "like" addiction was gone.

I find myself having to do the same thing with "So....." But, well, like, it's my duty as a parent to raise her properly, you know?

So.............. somehow, Dolly is staying mostly in her room this trip.

No Mirth In Perth (And Elsewhere in WA)

It has been two years to the day since the publication of my one and only expose', Blunder Down Under, documenting the dismal failure of a huge AGFA IMPAX installation in Western Australia. You would think the problem might be fixed by now. You would be wrong.

My friends Down Under describe week-long outages, about which no one seems to care anymore. There may have been some progress, but very little, and basically nothing much has changed.

Supposedly, the PACS contract is up for tender next year (that's Australian for rebid) but it seems unlikely that those in charge (definitely not the docs) will be motivated to change to another vendor.

I'll quote my closing from the 2010 article:

As the Western Australia upgrade to IMPAX 6.4 is brand new (they had IMPAX 5 before this that at least stayed up most of the time), there is only one entity that has the ability, and the obligation, to fix it, and that is Agfa. So, guys, fix it. Seriously. This is a very bad, very serious, and very dangerous situation. I'm putting out the pubic call to Agfa: Send whatever resources you must, send whomever you must (you can't have my Agfa PACS Goddess, but you can have me if I can help, and not somehow end up mysteriously lost in the Outback), and send them quickly, please. Western Australia needs you now. Get this repaired before your reputation, and possibly patients, are further harmed. Do what you need to do.

This has gone on for well over TWO YEARS, folks. The implications for those purchasing new systems should be clear. Are we listening?

ADDENDUM

I can see that several folks from AGFA have hit this post. Please feel free to comment and explain to everyone what's happening Down Under.

This Is NOT ME, I Promise!!!

Image courtesy of PoorMD.com and DiagnosticImaging.com.

Do visit PoorMD.com for some absolutely hilarious medical cartoons...

Atlas Shrugged: The Trial of Hank Rearden

To continue the uncannily accurate quotes from Ayn Rand's "Atlas Shrugged," we move to the trial of industrialist Hank Rearden, charged with an illegal sale of his miraculous alloy, Rearden Metal. Hank's defense, if you can call it that, is a certainly a lesson for our times:

For a month in advance, the people who filled the courtroom had been told by the press that they would see the man who was a greedy enemy of society; but they had come to see the man who had invented Rearden Metal.

He stood up, when the judges called upon him to do so. He wore a grey suit, he had pale blue eyes and blond hair; it was not the colours that made his figure seem icily implacable, it was the fact that the suit had an expensive simplicity seldom flaunted these days, that it belonged in the sternly luxurious office of a rich corporation, that his bearing came from a civilised era and clashed with the place around him.

The crowd knew from the newspapers that he represented the evil of ruthless wealth; and - as they praised the virtue of chastity, then ran to see any movie that displayed a half-naked female on its posters - so they came to see him; evil, at least, did not have the stale hopelessness of a bromide which none believed and none dared to challenge. They looked at him without admiration - admiration was a feeling they had lost the capacity to experience, long ago; they looked with curiosity and with a dim sense of defiance against those who had told them that it was their duty to hate him.

A few years ago, they would have jeered at his air of self-confident wealth. But today, there was a slate-grey sky in the windows of the courtroom, which promised the first snowstorm of a long, hard winter; the last of the country's oil was vanishing, and the coal mines were not able to keep up with the hysterical scramble for winter supplies. The crowd in the courtroom remembered that this was the case which had cost them the services of Ken Danagger. There were rumours that the output of the Danagger Coal Company had fallen perceptibly within one month; the newspapers said that it was merely a matter of readjustment while Danagger's cousin was reorganising the company he had taken over. Last week, the front pages had carried the story of a catastrophe on the site of a housing project under construction: defective steel girders had collapsed, killing four workmen; the newspapers had not mentioned, but the crowd knew, that the girders had come from Orren Boyle's Associated Steel.

They sat in the courtroom in heavy silence and they looked at the tall, grey figure, not with hope - they were losing the capacity to hope - but with an impassive neutrality spiked by a faint question mark; the question mark was placed over all the pious slogans they had heard for years.

The newspapers had snarled that the cause of the country's troubles, as this case demonstrated, was the selfish greed of rich industrialists; that it was men like Hank Rearden who were to blame for the shrinking diet, the falling temperature and the cracking roofs in the homes of the nation; that if it had not been for men who broke regulations and hampered the government's plans, prosperity would have been achieved long ago; and that a man like Hank Rearden was prompted by nothing but the profit motive. This last was stated without explanation or elaboration, as if the words "profit motive" were the self-evident brand of ultimate evil.

The crowd remembered that these same newspapers, less than two years ago, had screamed that the production of Rearden Metal should be forbidden, because its producer was endangering people's lives for the sake of his greed; they remembered that the man in grey had ridden in the cab of the first engine to run over a track of his own Metal; and that he was now on trial for the greedy crime of withholding from the public a load of the Metal which it had been his greedy crime to offer in the public market.

According to the procedure established by directives, cases of this kind were not tried by a jury, but by a panel of three judges appointed by the Bureau of Economic Planning and National Resources; the procedure, the directives had stated, was to be informal and democratic. The judge's bench had been removed from the old Philadelphia courtroom for this occasion, and replaced by a table on a wooden platform; it gave the room an atmosphere suggesting the kind of meeting where a presiding body puts something over on a mentally retarded membership.

One of the judges, acting as prosecutor, had read the charges.
"You may now offer whatever plea you wish to make in your own defence," he announced. Facing the platform, his voice inflectionless and peculiarly clear, Hank Rearden answered:
"I have no defence."
"Do you --" The judge stumbled; he had not expected it to be that easy. "Do you throw yourself upon the mercy of this court?"
"I do not recognise this court's right to try me."
"What?"
"I do not recognise this court's right to try me."
"But, Mr. Rearden, this is the legally appointed court to try this particular category of crime."
"I do not recognise my action as a crime."
"But you have admitted that you have broken our regulations controlling the sale of your Metal."
"I do not recognise your right to control the sale of my Metal."
"Is it necessary for me to point out that your recognition was not required?"
"No. I am fully aware of it and I am acting accordingly."

He noted the stillness of the room. By the rules of the complicated pretence which all those people played for one another's benefit, they should have considered his stand as incomprehensible folly; there should have been rustles of astonishment and derision; there were none; they sat still; they understood.
"Do you mean that you are refusing to obey the law?" asked the judge.
"No. I am complying with the law - to the letter. Your law holds that my life, my work and my property may be disposed of without my consent. Very well, you may now dispose of me without my participation in the matter. I will not play the part of defending myself, where no defence is possible, and I will not simulate the illusion of dealing with a tribunal of justice."
"But, Mr. Rearden, the law provides specifically that you are to be given an opportunity to present your side of the case and to defend yourself."
"A prisoner brought to trial can defend himself only if there is an objective principle of justice recognised by his judges, a principle upholding his rights, which they may not violate and which he can invoke. The law, by which you are trying me, holds that there are no principles, that I have no rights and that you may do with me whatever you please. Very well. Do it." "Mr. Rearden, the law which you are denouncing is based on the highest principle - the principle of the public good."
"Who is the public? What does it hold as its good? There was a time when men believed that 'the good' was a concept to be defined by a code of moral values and that no man had the right to seek his good through the violation of the rights of another. If it is now believed that my fellow men may sacrifice me in any manner they please for the sake of whatever they deem to e their own good, if they believe that they may seize my property simply because they need it - well, so does any burglar. There is only this difference: the burglar does not ask me to sanction his act."

A group of seats at the side of the courtroom was reserved for the prominent visitors who had come from New York to witness the trial. Dagny sat motionless and her face showed nothing but a solemn attention, the attention of listening with the knowledge that the flow of his words would determine the course of her life. Eddie Willers sat beside her. James Taggart had not come. Paul Larkin sat hunched forward, his face thrust out, pointed like an animal's muzzle, sharpened by a look of fear now turning into malicious hatred. Mr. Mowen, who sat beside him, was a man of greater innocence and smaller understanding; his fear was of a simpler nature; he listened in bewildered indignation and he whispered to Larkin, "Good God, now he's done it! Now he'll convince the whole country that all businessmen are enemies of the public good!"

"Are we to understand," asked the judge, "that you hold your own interests above the interests of the public?"
"I hold that such a question can never arise except in a society of cannibals."
"What ... do you mean?"
"I hold that there is no clash of interests among men who do not demand the unearned and do not practice human sacrifices."
"Are we to understand that if the public deems it necessary to curtail your profits, you do not recognise its right to do so?"
"Why, yes, I do. The public may curtail my profits any time it wishes - by refusing to buy my product."
"We are speaking of ... other methods."
"Any other method of curtailing profits is the method of looters - and I recognise it as such."
"Mr. Rearden, this is hardly the way to defend yourself."
"I said that I would not defend myself."
"But this is unheard of! Do you realise the gravity of the charge against you?"
"I do not care to consider it."
"Do you realise the possible consequences of your stand?"
"Fully."
"It is the opinion of this court that the facts presented by the prosecution seem to warrant no leniency. The penalty which this court has the power to impose on you is extremely severe."
"Go ahead."
"I beg your pardon?"
"Impose it."
The three judges looked at one another. Then their spokesman turned back to Rearden. "This is unprecedented," he said.
"It is completely irregular," said the second judge. "The law requires you submit to a plea in your own defence. Your only alternative is to state for the record that you throw yourself upon the mercy of the court."
"I do not."
"But you have to."
"Do you mean that what you expect from me is some sort of voluntary action?"
"Yes."
"I volunteer nothing."
"But the law demands that the defendant's side be represented on the record."
"Do you mean that you need my help to make this procedure legal?"
"Well, no ... yes ... that is, to complete the form."
"I will not help you."
The third and youngest judge, who had acted as prosecutor snapped impatiently, "This is ridiculous and unfair! Do you want to let it look as if a man of your prominence had been railroaded without a --" He cut himself off short. Somebody at the back of the courtroom emitted a long whistle.
"I want," said Rearden gravely, "to let the nature of this procedure appear exactly for what it is. If you need my help to disguise it - I will not help you."
"But we are giving you a chance to defend yourself - and it is you who are rejecting it."
"I will not help you to pretend that I have a chance. I will not help you to preserve an appearance of righteousness where rights are not recognised. I will not help you to preserve an appearance of rationality by entering a debate in which a gun is the final argument. I will not help you to pretend that you are administering justice."
"But the law compels you to volunteer a defence!"
There was laughter at the back of the courtroom.
"That is the flaw in your theory, gentlemen," said Rearden gravely, "and I will not help you out of it. If you choose to deal with men by means of compulsion, do so. But you will discover that you need the voluntary co-operation of your victims, in many more ways than you can see at present. And your victims should discover that it is their own volition - which you cannot force - that makes you possible. I choose to be consistent and I will obey you in the manner you demand. Whatever you wish me to do, I will do it at the point of a gun. If you sentence me to jail, you will have to send armed men to carry me there - I will not volunteer to move. If you fine me, you will have to seize my property to collect the fine - I will not volunteer to pay it. If you believe that you have the right to force me - use your guns openly. I will not help you to disguise the nature of your action."
The eldest judge leaned forward across the table and his voice became suavely derisive: "You speak as if you were fighting for some sort of principle, Mr. Rearden, but what you're actually fighting for is only your property, isn't it?"
"Yes, of course. I am fighting for my property. Do you know the kind of principle that represents?"
"You pose as a champion of freedom, but it's only the freedom to make money that you're after."
"Yes, of course. All I want is the freedom to make money. Do you know what that freedom implies?"
"Surely, Mr. Rearden, you wouldn't want your attitude to be misunderstood. You wouldn't want to give support to the widespread impression that you are a man devoid of social conscience, who feels no concern for the welfare of his fellows and works for nothing but his own profit."
"I work for nothing but my own profit. I earn it."


There was a gasp, not of indignation, but of astonishment, in the crowd behind him and silence from the judges he faced. He went on calmly:
"No, I do not want my attitude to be misunderstood. I shall be glad to state it for the record. I am in full agreement with the facts of everything said about me in the newspapers - with the facts, but not with the evaluation. I work for nothing but my own profit - which I make by selling a product they need to men who are willing and able to buy it. I do not produce it for their benefit at the expense of mine, and they do not buy it for my benefit at the expense of theirs; I do not sacrifice my interests to them nor do they sacrifice theirs to me; we deal as equals by mutual consent to mutual advantage - and I am proud of every penny that I have earned in this manner. I am rich and I am proud of every penny I own. I made my money by my own effort, in free exchange and through the voluntary consent of every man I dealt with - voluntary consent of those who employed me when I started, the voluntary consent of those who work for me now, the voluntary consent of those who buy my product. I shall answer all the questions you are afraid to ask me openly. Do I wish to pay my workers more than their services are worth to me? I do not. Do I wish to sell my product for less than my customers are willing to pay me? I do not. Do I wish to sell it at a loss or give it away? I do not. If this is evil, do whatever you please about me, according to whatever standards you hold. These are mine. I am earning my own living, as every honest man must. I refuse to accept as guilt the fact of my own existence and the fact that I must work in order to support it. I refuse to accept as guilt the fact that I am able to do it better than most people - the fact that my work is of greater value than the work of my neighbours and that more men are willing to pay me. I refuse to apologise for my ability - I refuse to apologise for my success - I refuse to apologise for my money. If this is evil, make the most of it. If this is what the public finds harmful to its interests, let the public destroy me. This is my code - and I will accept no other. I could say to you that I have done more good for my fellow men than you can ever hope to accomplish - but I will not say it, because I do not seek the good of others as a sanction for my right to exist, nor do I seek the good of others as a sanction for my right to exist, nor do I recognise the good of others as a justification for their seizure of my property or their destruction of my life. I will not say that the good of others was the purpose of my work - my own good was my purpose, and I despise the man who surrenders his. I could say to you that you do not serve the public good - that nobody's good can be achieved at the price of human sacrifices - that when you violate the rights of one man, you have violated the right of all, and a public of rightless creatures is doomed to destruction. I could say to you that you will and can achieve nothing but universal devastation - as any looter must, when he runs out of victims. I could say it, but I won't. It is not your particular policy that I challenge, but your moral premise. If it were true that men could achieve their good by means of turning some men into sacrificial animals, and I were asked to immolate myself for the sake of creatures who wanted to survive at the price of my blood, if I were asked to serve the interests of society apart from, above and against my own - I would refuse. I would reject it as the most contemptible evil, I would fight it with every power I possess, I would fight the whole of mankind, if one minute were all I could last before I were murdered, I would fight in the full confidence of the justice of my battle and of a living being's right to exist. Let there be no misunderstanding about me. If it is now the belief of my fellow men, who call themselves the public, that their good requires victims, then I say: The public good be damned, I will have no part of it!"

The crowd burst into applause.

Rearden whirled around, more startled than his judges. He saw face that laughed in violent excitement, and faces that pleaded for help; he saw their silent despair breaking out into the open; he saw the same anger and indignation as his own, finding release in the wild defiance of their cheering; he saw the looks of admiration and the looks of hope. There were also the face of loose-mouthed young men and maliciously unkempt females, the kind who led the booing in newsreel theatres at any appearance of a businessman of the screen; they did not attempt a counter-demonstration; they were silent.

As he looked at the crowd, people saw in his face what the threats of the judges had not been able to evoke: the first sign of emotion. It was a few moments before they heard the furious beating of a gavel upon the table and one of the judges yelling:
" -- or I shall have the courtroom cleared!"
As he turned back to the table, Rearden's eyes moved over the visitor's section. His glance paused on Dagny, a pause perceptible only to her, as if he were saying: It works. She would have appeared calm except that her eyes seemed to have become too large for her face. Eddie Willers was smiling the kind of smile that is a man's substitute for breaking into tears. Mr. Mowen looked stupefied. Paul Larkin was staring at the floor. There was no expression on Bertram Scudder's face - or on his wife, Lillian's. She sat at the end of a row, her legs crossed, a mink stole slanting from her right shoulder to her left hip; she looked at Rearden, not moving.

In the complex violence of all the things he felt, he had time to recognise a touch of regret and longing: there was a face he had hoped to see, had looked for from the start of the session, had wanted to be present more than any other face around him. But Francisco d'Anconia had not come.
"Mr Rearden," said the eldest judge, smiling affably, reproachfully and spreading his arms, "it is regrettable that you should have misunderstood us so completely. That's the trouble - that businessmen refuse to approach us in a spirit of trust and friendship. They seem to imagine that we are their enemies. Why do you speak of human sacrifices? What made you go to such an extreme? We have no intention of seizing your property or destroying your life. We do not seek to harm your interests. We are fully aware of your distinguished achievements. Our purpose is only to balance social pressures and do justice to all. This hearing is really intended, not as a trial, but as a friendly discussion aimed at mutual understanding and co-operation."
"I do not co-operate at the point of a gun."
"Why speak of guns? This matter is not serious enough to warrant such references. We are fully aware that the guilt in this case lies chiefly with Mr. Kenneth Danagger, who instigated this infringement of the law, who exerted pressure upon you and who confessed his guilt by disappearing his guilt by disappearing in order to escape trial."
"No. We did it by equal, mutual, voluntary agreement."
"Mr. Rearden," said the second judge, "you may not share some of our ideas, but when all is said and done, we're all working for the same cause. For the good of the people. We realise that you were prompted to disregard legal technicalities by the critical situation of the coal mines and the crucial importance of fuel to the public welfare."
"No. I was prompted by my own profit and my own interests. What effect it had on the coal mines and the public welfare is for you to estimate. That was not my motive."
Mr. Mowen stared dazedly about him and whispered to Paul Larkin, "Something's gone screwy here."
"Oh, shut up!" snapped Larkin.
"I am sure, Mr. Rearden," said the eldest judge, "that you do not really believe - nor does the public - that we wish to treat you as a sacrificial victim. If anyone has been laboring under such a misapprehension, we are anxious to prove that it is not true."

The judges retired to consider their verdict. They did not stay out long. They returned to an ominously silent courtroom - and announced that a fine of $5,000 was imposed on Henry Rearden, but that the sentence was suspended. Streaks of jeering laughter ran through the applause that swept the courtroom. The applause was aimed at Rearden, the laughter - at the judges.

Rearden stood motionless, not turning to the crowd, barely hearing the applause. He stood looking at the judges. There was no triumph in his face, no elation, only the still intensity of contemplating the enormity of the smallness of the enemy who was destroying the world. He felt as if, after a journey of years through a landscape of devastation, past the ruins of great factories, the wrecks of powerful engines, the bodies of invincible men, he had come upon the despoiler, expecting to find a giant - and had found a rat eager to scurry for cover at the first sound of a human step. If this is what has beaten us, he thought, the guilt is ours.

He was jolted back into the courtroom by the people pressing to surround him. He smiled in answer to their smiles, to the frantic tragic eagerness of their faces; there was a touch of sadness in his smile.
"God bless you, Mr. Rearden!" said an old woman with a ragged shawl over her head. "Can't you save us, Mr. Rearden? They're eating us alive, and it's no use fooling anybody about how it's the rich that they're after - do you know what's happening to us?"
"Listen, Mr. Rearden," said a man who looked like a factory worker, "it's the rich who're selling us down the river. Tell those wealthy bastards, who're so anxious to give everything away, that when they give away their palaces, they're giving away the skin off our backs." "I know it," said Rearden.
The guilt is ours, he thought. If we who were the movers, the providers, the benefactors of mankind, were willing to let the brand of evil be stamped upon us and silently to bear punishment for our virtues - what sort of "good" did we expect to triumph in the world? He looked at the people around him. They had cheered him today; they had cheered him by the side of the track of the John Galt Line. But tomorrow they would clamour for a new directive from Wesley Mouch and a free housing project from Orren Boyle, while Boyle's girders collapsed upon their heads. They would do it, because they would be told to forget, as a sin, that which had made them cheer Hank Rearden.

Why were they ready to renounce their highest moments as a sin? Why were they willing to betray the best within them? What made them believe that this earth was a realm of evil where despair was their natural fate? He could not name the reason, but he know that it had to be named. He felt it as a huge question mark within the courtroom, which it was now his duty to answer.

This was the real sentence imposed upon him, he thought - to discover what idea, what simple idea available to the simplest man, had made mankind accept the doctrines that led it to self-destruction.

Atlas Shrugged: Francisco d'Anconia's Money Speech

FYI, this is NOT a PACS entry, and it could be considered slightly to the right of center. Therefore, Left Wing NutJobs might want to skip today's post and return to the nurturing bosom of one of their favorite sites.

Anyway...After last year's "Christmas Carol" send-up, I was asked to consider next a parody of Ayn Rand's "Atlas Shrugged" with a radiological bent. Since I had not yet read the book, I figured that doing so might be wise before starting such a project. I'm about half-way through, and I'm not sure my meager talents are adequate for the job, but in the meantime, I've been absolutely overwhelmed by Rand's prescient writing.

"Atlas Shrugged" was published  in 1957, 55 years ago. Aside from some clearly dated references, this work could have been written today. The description of the criminalization and demonization of wealth and productivity could have come straight from the Left's playbook, tactics promoted by the Administration from Mr. Obama on down.

The character Francisco d'Anconia, an enigmatic playboy heir of a copper mining fortune, overhears someone at a party state that money is "the root of all evil."  His response follows.  Read it all; it's worth your time:

Rearden heard Bertram Scudder, outside the group, say to a girl who made some sound of indignation, "Don't let him disturb you. You know, money is the root of all evil – and he's the typical product of money."Rearden did not think that Francisco could have heard it, but he saw Francisco turning to them with a gravely courteous smile.

"So you think that money is the root of all evil?" said Francisco d'Anconia. "Have you ever asked what is the root of money? Money is a tool of exchange, which can't exist unless there are goods produced and men able to produce them. Money is the material shape of the principle that men who wish to deal with one another must deal by trade and give value for value. Money is not the tool of the moochers, who claim your product by tears, or of the looters, who take it from you by force. Money is made possible only by the men who produce. Is this what you consider evil?

"When you accept money in payment for your effort, you do so only on the conviction that you will exchange it for the product of the effort of others. It is not the moochers or the looters who give value to money. Not an ocean of tears nor all the guns in the world can transform those pieces of paper in your wallet into the bread you will need to survive tomorrow. Those pieces of paper, which should have been gold, are a token of honor – your claim upon the energy of the men who produce. Your wallet is your statement of hope that somewhere in the world around you there are men who will not default on that moral principle which is the root of money. Is this what you consider evil?

"Have you ever looked for the root of production? Take a look at an electric generator and dare tell yourself that it was created by the muscular effort of unthinking brutes. Try to grow a seed of wheat without the knowledge left to you by men who had to discover it for the first time. Try to obtain your food by means of nothing but physical motions – and you'll learn that man's mind is the root of all the goods produced and of all the wealth that has ever existed on earth.

"But you say that money is made by the strong at the expense of the weak? What strength do you mean? It is not the strength of guns or muscles. Wealth is the product of man's capacity to think. Then is money made by the man who invents a motor at the expense of those who did not invent it? Is money made by the intelligent at the expense of the fools? By the able at the expense of the incompetent? By the ambitious at the expense of the lazy? Money is made – before it can be looted or mooched – made by the effort of every honest man, each to the extent of his ability. An honest man is one who knows that he can't consume more than he has produced.

"To trade by means of money is the code of the men of good will. Money rests on the axiom that every man is the owner of his mind and his effort. Money allows no power to prescribe the value of your effort except by the voluntary choice of the man who is willing to trade you his effort in return. Money permits you to obtain for your goods and your labor that which they are worth to the men who buy them, but no more. Money permits no deals except those to mutual benefit by the unforced judgment of the traders. Money demands of you the recognition that men must work for their own benefit, not for their own injury, for their gain, not their loss – the recognition that they are not beasts of burden, born to carry the weight of your misery – that you must offer them values, not wounds – that the common bond among men is not the exchange of suffering, but the exchange of goods. Money demands that you sell, not your weakness to men's stupidity, but your talent to their reason; it demands that you buy, not the shoddiest they offer, but the best your money can find. And when men live by trade – with reason, not force, as their final arbiter – it is the best product that wins, the best performance, then man of best judgment and highest ability – and the degree of a man's productiveness is the degree of his reward. This is the code of existence whose tool and symbol is money. Is this what you consider evil?

"But money is only a tool. It will take you wherever you wish, but it will not replace you as the driver. It will give you the means for the satisfaction of your desires, but it will not provide you with desires. Money is the scourge of the men who attempt to reverse the law of causality – the men who seek to replace the mind by seizing the products of the mind.

"Money will not purchase happiness for the man who has no concept of what he wants; money will not give him a code of values, if he's evaded the knowledge of what to value, and it will not provide him with a purpose, if he's evaded the choice of what to seek. Money will not buy intelligence for the fool, or admiration for the coward, or respect for the incompetent. The man who attempts to purchase the brains of his superiors to serve him, with his money replacing his judgment, ends up by becoming the victim of his inferiors. The men of intelligence desert him, but the cheats and the frauds come flocking to him, drawn by a law which he has not discovered: that no man may be smaller than his money. Is this the reason why you call it evil?

"Only the man who does not need it, is fit to inherit wealth – the man who would make his own fortune no matter where he started. If an heir is equal to his money, it serves him; if not, it destroys him. But you look on and you cry that money corrupted him. Did it? Or did he corrupt his money? Do not envy a worthless heir; his wealth is not yours and you would have done no better with it. Do not think that it should have been distributed among you; loading the world with fifty parasites instead of one would not bring back the dead virtue which was the fortune. Money is a living power that dies without its root. Money will not serve that mind that cannot match it. Is this the reason why you call it evil?

"Money is your means of survival. The verdict which you pronounce upon the source of your livelihood is the verdict you pronounce upon your life. If the source is corrupt, you have damned your own existence. Did you get your money by fraud? By pandering to men's vices or men's stupidity? By catering to fools, in the hope of getting more than your ability deserves? By lowering your standards? By doing work you despise for purchasers you scorn? If so, then your money will not give you a moment's or a penny's worth of joy. Then all the things you buy will become, not a tribute to you, but a reproach; not an achievement, but a reminder of shame. Then you'll scream that money is evil. Evil, because it would not pinch-hit for your self-respect? Evil, because it would not let you enjoy your depravity? Is this the root of your hatred of money?

"Money will always remain an effect and refuse to replace you as the cause. Money is the product of virtue, but it will not give you virtue and it will not redeem your vices. Money will not give you the unearned, neither in matter nor in spirit. Is this the root of your hatred of money?

"Or did you say it's the love of money that's the root of all evil? To love a thing is to know and love its nature. To love money is to know and love the fact that money is the creation of the best power within you, and your passkey to trade your effort for the effort of the best among men. It's the person who would sell his soul for a nickel, who is the loudest in proclaiming his hatred of money – and he has good reason to hate it. The lovers of money are willing to work for it. They know they are able to deserve it.

"Let me give you a tip on a clue to men's characters: the man who damns money has obtained it dishonorably; the man who respects it has earned it.

"Run for your life from any man who tells you that money is evil. That sentence is the leper's bell of an approaching looter. So long as men live together on earth and need means to deal with one another – their only substitute, if they abandon money, is the muzzle of a gun.

"But money demands of you the highest virtues, if you wish to make it or to keep it. Men who have no courage, pride, or self-esteem, men who have no moral sense of their right to their money and are not willing to defend it as they defend their life, men who apologize for being rich – will not remain rich for long. They are the natural bait for the swarms of looters that stay under rocks for centuries, but come crawling out at the first smell of a man who begs to be forgiven for the guilt of owning wealth. They will hasten to relieve him of the guilt – and of his life, as he deserves.

"Then you will see the rise of the double standard – the men who live by force, yet count on those who live by trade to create the value of their looted money – the men who are the hitchhikers of virtue. In a moral society, these are the criminals, and the statutes are written to protect you against them. But when a society establishes criminals-by-right and looters-by-law – men who use force to seize the wealth of disarmed victims – then money becomes its creators' avenger. Such looters believe it safe to rob defenseless men, once they've passed a law to disarm them. But their loot becomes the magnet for other looters, who get it from them as they got it. Then the race goes, not to the ablest at production, but to those most ruthless at brutality. When force is the standard, the murderer wins over the pickpocket. And then that society vanishes, in a spread of ruins and slaughter.

"Do you wish to know whether that day is coming? Watch money. Money is the barometer of a society's virtue. When you see that trading is done, not by consent, but by compulsion – when you see that in order to produce, you need to obtain permission from men who produce nothing – when you see that money is flowing to those who deal, not in goods, but in favors – when you see that men get richer by graft and by pull than by work, and your laws don't protect you against them, but protect them against you – when you see corruption being rewarded and honesty becoming a self-sacrifice – you may know that your society is doomed. Money is so noble a medium that it does not compete with guns and it does not make terms with brutality. It will not permit a country to survive as half-property, half-loot.

"Whenever destroyers appear among men, they start by destroying money, for money is men's protection and the base of a moral existence. Destroyers seize gold and leave to its owners a counterfeit pile of paper. This kills all objective standards and delivers men into the arbitrary power of an arbitrary setter of values. Gold was an objective value, an equivalent of wealth produced. Paper is a mortgage on wealth that does not exist, backed by a gun aimed at those who are expected to produce it. Paper is a check drawn by legal looters upon an account which is not theirs: upon the virtue of the victims. Watch for the day when it becomes, marked: 'Account overdrawn.'

"When you have made evil the means of survival, do not expect men to remain good. Do not expect them to stay moral and lose their lives for the purpose of becoming the fodder of the immoral. Do not expect them to produce, when production is punished and looting rewarded. Do not ask, 'Who is destroying the world?' You are.

"You stand in the midst of the greatest achievements of the greatest productive civilization and you wonder why it's crumbling around you, while you're damning its life-blood – money. You look upon money as the savages did before you, and you wonder why the jungle is creeping back to the edge of your cities. Throughout men's history, money was always seized by looters of one brand or another, but whose method remained the same: to seize wealth by force and to keep the producers bound, demeaned, defamed, deprived of honor. That phrase about the evil of money, which you mouth with such righteous recklessness, comes from a time when wealth was produced by the labor of slaves – slaves who repeated the motions once discovered by somebody's mind and left unimproved for centuries. So long as production was ruled by force, and wealth was obtained by conquest, there was little to conquer. Yet through all the centuries of stagnation and starvation, men exalted the looters, as aristocrats of the sword, as aristocrats of birth, as aristocrats of the bureau, and despised the producers, as slaves, as traders, as shopkeepers – as industrialists.

"To the glory of mankind, there was, for the first and only time in history, a country of money – and I have no higher, more reverent tribute to pay to America, for this means: a country of reason, justice, freedom, production, achievement. For the first time, man's mind and money were set free, and there were no fortunes-by-conquest, but only fortunes-by-work, and instead of swordsmen and slaves, there appeared the real maker of wealth, the greatest worker, the highest type of human being – the self-made man – the American industrialist.

"If you ask me to name the proudest distinction of Americans, I would choose – because it contains all the others – the fact that they were the people who created the phrase 'to make money'. No other language or nation had ever used these words before; men had always thought of wealth as a static quantity – to be seized, begged, inherited, shared, looted, or obtained as a favor. Americans were the first to understand that wealth has to be created. The words 'to make money' hold the essence of human morality.

"Yet these were the words for which Americans were denounced by the rotted cultures of the looters' continents. Now the looters' credo has brought you to regard your proudest achievements as a hallmark of shame, your prosperity as guilt, your greatest men, the industrialists, as blackguards, and your magnificent factories as the product and property of muscular labor, the labor of whip-driven slaves, like the pyramids of Egypt. The rotter who simpers that he sees no difference between the power of the dollar and the power of the whip, ought to learn the difference on his own hide – as, I think, he will.

"Until and unless you discover that money is the root of all good, you ask for your own destruction. When money ceases to be the tool by which men deal with one another, then men become the tools of men. Blood, whips and guns – or dollars. Take your choice – there is no other – and your time is running out."

More to come.

"If I Wanted America To Fail..."

What's Up With EMC?

I don't like SPAM, and I don't like cold-calls from vendors. Today, I received both from representatives of EMC. For about the 10th time. My storage needs for the present time have been met, thank you, and I'll be sure to call EMC if I should decide that I need their services.

In the meantime, as I told the young lady who called my cell wanting to speak to someone who made IT decisions in my organization, if I receive one more unsolicited contact from EMC, my next communication will be with their CEO. We'll see how HE likes cold calls...

Phear Of Photons

I never pass up an opportunity to throw in a Star Trek reference...

I had the usual joy of taking call last night, and the discussion about a particular case prompts me to put pen to paper, or fingers to keyboard as it were.

The call came through from the ER at 10 PM or so. The rather agitated ER doc related this scenario to me, desperate for advice: "I've got an elderly man with history of lung cancer, now presenting with dyspnea and wheezing after probably aspirating a beet. You know, the little red vegetables? Yeah, those. Anyway, he also had some EKG and lab abnormalities, and some chest pain. I just don't know what to order. I suppose he needs a CT pulmonary arteriogram, but I'm so afraid to give him any more radiation...."

Ummm, excuse me? The ER doc is afraid to give more radiation? The same ER department that just ordered about 30 CT's in the last four hours? The same ER that has no hesitation in ordering a CTPA-gram on teenagers? You're afraid to order a scan on someone whose already had a malignancy and is already on up there in years? You're AFRAID??

Clearly, we radiologists have shot ourselves in the foot on the issue of radiation. Because of a small number of scary articles (the latest now definitively states that we'll get meningiomata from dental radiographs), our ordering docs are now terrified of using radiation on those whom it will affect the least.

I've had the honor and privilege to participate in the most amazing technical miracle ever to happen to mankind. The diagnostic tools which we use daily, sometimes with some degree of nonchalance, are nothing short of magical wonders of the sort that could only be dreamt of not very long ago. Between CT, PET, MRI, SPECT, and the other members of our alphabet soup of toys, we can literally look inside the body without benefit of knives or getting our hands bloody. We can filet you open without filleting you open, and isolate abnormalities down to the molecular level (at least that's coming to a hospital near you soon). I could go on, but I might get emotional, and we can't have that. But when you think about it, what we do in Radiology is nothing short of amazing.

I've often said radiation is a lot like electricity. Use it carefully, and it's your friend. Stick your finger in the socket, and you'll get shocked. Proper use of our diagnostic tools saves lives. Improper use can cause trouble. Sadly, we've again got a disconnect between the truth and perception. Somehow, we've allowed the belief to flourish (or fester) that the next scan might cause a malignancy, even in the face of a more immediate threat. We need to do a better job of educating our clinicians. Somehow.

Set phasers to dumb....

By the way, the patient had a large piece of beet in the right lower lobe bronchus.

Attention Blog Spammers...

I've probably received about 100 comments posted to this blog over the years which are clearly Blog-Spam. They have little to no connection to the post they are supposedly commenting on, and usually advertise something else entirely. Many of them relate to medical software or websites that originate in India or elsewhere in the third world. There is a significant dump (as in defecation) from those wishing me to link to their less-than-illustrious blogs as well.

These blog-spammers are attempting to co-opt my readers and obtain free advertising. My personal opinion is that anyone who needs to resort to this sort of bottom-feeding activity knows full well that his/her product is an absolute piece of garbage, and won't sell to any but the least sophisticated out there. I'm assuming my audience would not appreciate being exposed to such filth.

My first instinct is to actually give these dirtballs what they want and publicize their sites, with the understanding that you, my intelligent readers, won't patronize them beyond perhaps sending a little note to their ISP's informing them of the behavior of their low-life clients. However, if only one of you actually does patronize the spammer's site, rather than electronically spit on them, they win, and we can't have that.

For the moment, these scum shall remain nameless, but if I should hear a great outcry, and promises from you that you will indeed ummm, inform the miscreants and their ISP's of the misdeeds, well, then, I might just be persuaded to publish a little list of the jerks in question.

As an aside, the VAST majority of SPAM e-mails I receive, something like 98%, comes from overseas, generally from Russia, Nigeria (I still get dozens of 419 scam emails per week), Ukraine, China, Korea, Romania (I started forwarding these to the Romanian Ministry of Communication, or the equivalent, and they stopped, or at least slowed), Poland, Portugal, Iran, Saudi Arabia, Israel, and many more. Clearly, the laws or at least the enforcement thereof outside the US is sadly deficient. I'm wondering if there is a way to completely block the receipt of any mail from foreign lands until the ISP's over there can get their act together. Frankly, I wonder if those ISP's are actually in cahoots with the spammers. As a matter of fact, the 419 scams are said to be the third-largest industry in Nigeria. I would think the world internet community would consider cutting that nation off of the 'net completely until they clean house. And newly-"capitalist" Russia seems to be the major source of this garbage these days. Remember, this isn't capitalism, it's unwanted refuse. I guess Mr. Putin has other things to do than monitor his nation's internet spew.

Anyway, I would advise human blog-spammers not to waste time on my blog. Those who use 'bots to troll other's blogs should consider reprogramming them to avoid this one. Or better yet, find a REAL job and stop trying to peddle crap. Or see if you can find Jack Kervorkian's instruction manual and follow it to the letter.

April 5 2063: Happy First Contact Day!

First Contact...Image courtesy of Startrek.com

Rather than restate everything, here is the official description from StarTrek.com:

It was – or will be – in the evening of this day in 2063 that the Vulcan survey spacecraft T’Plana-Hath landed in Bozeman, Montana, after following the warp signature of the Phoenix, a ship that represented the human race’s first successful attempt at achieving warp drive. Soon after, a robed Vulcan, offering the Vulcan salute, met Dr. Zefram Cochrane, pilot of the Phoenix and the inventor of warp drive. First Contact was now etched in history, and it paved the way for the formation of the United Federation of Planets.

While it’s true, of course, that First Contact and First Contact Day are fictional creations, they have been well developed across the Star Trek franchise. Anyone interested in the finer details should be sure to check out some of the following:The TOS episode “Metamorphosis” features Glenn Corbett as Cochrane. 

The TNG film First Contact, with James Cromwell playing Cochrane as a man with a penchant for booze and rock and roll, and the nickname “Z.” Cromwell later reprised the role, in a blink-and-you-miss-it cameo, in “Broken Bow,” the pilot episode of Star Trek: Enterprise.

The books First Contact (a novelization of the film), First Frontier, Starfleet Academy,Imzadi and Federation, as well as the TOScomic book, A Warp in Space.The Voyager episode “Homestead.” In it,Neelix and Naomi Wildman throw a party celebrating the 315th anniversary of First Contact Day. There’s a retro jukebox, lots of Cochrane’s favorite munchie (cheese pierogies), and the particularly amusing moment in which Tuvok very reluctantly raises his fingers in the Vulcan salute and intones the legendary phrase, “Live long and prosper.”

So, everybody, are you going to let your kids skip school? Will you stay home from work? After all, it is First Contact Day.

Displaying The Future: Project Glass

Google and Apple, two companies that didn't exist for much of my lifetime, are out to change the world and the way we interact with it. Today's post examines a new way of looking at our world, courtesy of Google, although I'm sure we'll hear about project iGlass from Apple one of these days...

Google's Project Glass follows the same philosophy I advocate for PACS:

We think technology should work for you—to be there when you need it and get out of your way when you don’t.

A group of us from Google[x] started Project Glass to build this kind of technology, one that helps you explore and share your world, putting you back in the moment. We’re sharing this information now because we want to start a conversation and learn from your valuable input. So we took a few design photos to show what this technology could look like and created a video to demonstrate what it might enable you to do.

The lead photo above shows what this mobile heads-up display might look like to those outside the Matrix.

The YouTube concept video is quite compelling...not only does Google envision the mating of the real to the virtual in this manner, they seem to think they can outdo Siri, and without the annoying metallic female voice to boot.  More power to them.

Naturally, the second thing I thought of was how this technology might be applied to PACS. The possibilities here are endless. How about displaying the pertinent anatomy to a surgeon who is knee-deep in someone's abdomen? Or maybe utilizing computer aided diagnosis (CAD) while reading studies. Or maybe reading studies without a monitor altogether. I wonder how many pixels this thing may ultimately manifest?

What's that? What was the first thing I thought of? Well...we all know what has driven most other technology over the years. Think Gutenberg and I Modi. Now you know why the young lady in the photo is so happy.


Hat tip to 23 Skidoo.

From the Gyn Oncologist:

Comment from the GynOnc whilst watching me make the PACS do something no one else understands: "You touch things I would never have even thought of..." Probably a complement from anyone in OB-Gyn.

Thank God For Big Brother...

The tears welled up in my eyes. A passing waiter noticed that my glass was empty and came back with the gin bottle.

I took up my glass and sniffed at it. The stuff grew not less but more horrible with every mouthful I drank. But it had become the element I swam in. It was my life, my death, and my resurrection. It was gin that sank me into stupor every night, and gin that revived me every morning. When I woke, seldom before eleven, with gummed-up eyelids and fiery mouth and a back that seemed to be broken, it would have been impossible even to rise from the horizontal if it had not been for the bottle and teacup placed beside the bed overnight. Through the midday hours I sat with glazed face, the bottle handy, listening to the television. From 3 to closing-time I was a fixture in the bar. No one cared what I did any longer, no alarm woke me, no television admonished me. Occasionally, perhaps twice a week, I went to a dusty, forgotten-looking office in the hospital and did a little work, or what was called work. I had been appointed to a sub-committee of a sub-committee which had sprouted from one of the innumerable IT committees dealing with minor difficulties that arose in determining Meaningful Use within the Affordable Care Act. We were engaged in producing something called an Interim Report, but what it was that they were reporting on I had never definitely found out. It was something to do with the question of whether commas should be placed inside brackets, or outside. There were four others on the committee, all of them persons similar to myself. There were days when we assembled and then promptly dispersed again, frankly admitting to one another that there was not really anything to be done. But there were other days when we settled down to our work almost eagerly, making a tremendous show of entering up our minutes and drafting long memoranda which were never finished - when the argument as to what we were supposedly arguing about grew extraordinarily involved and abstruse, with subtle haggling over definitions, enormous digressions, quarrels - threats, even, to appeal to higher authority. And then suddenly the life would go out of us and we would sit round the table looking at one another with extinct eyes, like ghosts fading at cock-crow.

The television was silent for a moment. I raised my head again. The bulletin! But no, they were merely changing the music. I pictured vote tallies behind my eyelids. The trends were a diagram: a red arrow tearing vertically southward, and a blue arrow rising rapidly. As though for reassurance I looked up at the imperturbable face in the portrait. Was it conceivable that the red arrow did not even exist ?

My interest flagged again. I drank another mouthful of gin. A shrill trumpet-call had pierced the air. It was the bulletin! Victory! It always meant victory when a trumpet-call preceded the news. A sort of electric drill ran through the bar. Even the waiters had started and pricked up their ears.

The trumpet-call had let loose an enormous volume of noise. Already an excited voice was gabbling from the television, but even as it started it was almost drowned by a roar of cheering from outside. The news had run round the streets like magic. I could hear just enough of what was issuing from the television to realize that it had all happened, as I had foreseen; a vast electoral surge, the blue arrow tearing across the tail of the red. Fragments of triumphant phrases pushed themselves through the din: "Vast strategic manoeuvre - perfect co-ordination - utter rout - half a million counties reporting - complete demoralization - control of the whole of the Electoral College - greatest victory in human history - victory, victory, victory!"

Under the table my feet made convulsive movements, and I felt a thrill going up my leg. I had not stirred from my seat, but in my mind I was running, swiftly running, I was with the crowds outside, cheering myself deaf. I looked up again at the portrait of Big Brother. The colossus that bestrode the world! The rock against which the hordes of Republicans dashed themselves in vain! I thought how ten minutes ago - yes, only ten minutes - there had still been equivocation in my heart as I wondered whether the news would be of victory or defeat. Ah, it was more than a right-wing party that had perished! Much had changed in me since those first days of the Administration, but the final, indispensable, healing change had never happened, until this moment.

The voice from the television was still pouring forth its tale of electoral booty and slaughter, but the shouting outside had died down a little. The waiters were turning back to their work. One of them approached with the gin bottle. I, sitting in my blissful dream, paid no attention as my glass was filled up. I was not running or cheering any longer. I was back in the hospital, with everything forgiven, my soul white as snow. I was walking down the white-tiled corridor, with the feeling of walking in sunlight, and an armed guard at my back. The long hoped-for bullet was entering my brain.

I gazed up at the enormous face. Four years it had taken me to learn the smirk of a smile. O cruel, needless misunderstanding ! O stubborn, self-willed exile from the loving breast ! Two gin-scented tears trickled down the sides of my nose. But it was all right, everything was all right, the struggle was finished. I had won the victory over myself. I loved Big Brother. Thank God for Big Brother.

But only for today...