Wondering, wandering, and making sense of the world.


Archive for July, 2012

Death and Facebook

I’ve written about death and the internet before, three years ago and six years ago, both inspired by hearing about the passing of people I knew in college. Over the weekend, I found out through Facebook that Ben Horne died in the Peruvian Andes while descending from Palcaraju Oeste.

I didn’t know Ben so well in college. He ran the college radio station down the hall from where I worked as an editor for the school newspaper. We had lots of mutual friends but we didn’t talk so much. After graduation, he and I along with few of our mutual friends started blogging, and I kept up with his life for few years before I was overwhelmed with information and other social media. I didn’t realize that he became such an amazing mountaineer, athlete, and affected so many people’s lives, even though I’m not surprised. Like with what happened with my friend Daniel Huffaker six years ago, Ben’s wall (or is it called timeline now?) is becoming a memorial with his friends and families leaving living memories, and I’m only finding out now what an incredible life he lived.

Since I wrote my first post on death and the internet six years ago, Facebook has now adopted a policy for memorializing the accounts of the deceased. You can read the details here, but in short, someone can report an user deceased whose account then become s”memorialized,” which limits its visibility and access.

I am 29 years old and have over 1600 friends on Facebook, most of whom are in my generation. Not surprisingly, my newsfeed these days are bombarded with engagements, weddings, and baby announcements. I can’t go two days without seeing pictures of an engagement ring, wedding dress, or baby as those posts are the most liked and commented, helping it float to the top of my newsfeed. Sometimes I have to remind myself that there are people who are living amazing lives out there who aren’t getting married or having kids, like Ben.

This is my life on the Social Network in my late twenties. What will happen in forty to fifty years, when I’m in my seventies and deaths become more common? While not everyone will die before me, all 1600+ friends I have on Facebook will die someday. Will it still be bearable to log onto Facebook when every week I find out that someone I knew passed away?

Of course death announcements are nothing new. People die, and people find out, but until now, the death of the average man travelled by word of mouth and maybe the local newspaper obituary section. The Facebook wall/timeline/memorial is much richer. There are wonderful messages on Ben’s wall that could be read out at his funeral. We are the first generation to live in the age of digitally extended social networks. We now have the power to casually keep up with the lives of hundreds of people. When the news is positive, this can be great, but when the news is negative, will we be able to deal with it?

For now, I am saddened by the passing of Ben. I wish I kept up with him more since college, and not just find out how incredible he was at the last chapter of his life. Rest in peace Ben.


What can hospitals learn from Toyota and modern retailing?

Pins inserted to hold the broken bones together

I’ve recently spent a lot of time at the hospital and in doctor’s office because of a broken hand on which had to be operated on, and I couldn’t help but realize that most of the time in the hospital was not meeting a doctor, taking an x-ray, or anything meaningful but waiting. I would say approximately 80% of the time spent in the hospital or doctor’s office (besides being under care) were spent waiting. Extrapolate this out to the whole medical care seeking population and this is an incredible productivity loss on society.
Why is it so bad?

Because healthcare doesn’t really operate under market principles. Often times, people don’t have a choice of what hospital to visit because of insurance limitations or there is only one in the area, and for most people, not going to a hospital is a not a realistic alternative. You could imagine that if the waiting times for a bowling alley is four hours, most people will go somewhere else, like a movie theater. That’s not an option. You can’t simply leave a hospital and go to a masseuse. Hospitals simply don’t have the motivation to minimize the waiting times. Instead, they are motivated by minimizing the cost of care, and doing so often means getting just enough equipment and doctors to serve the patients of the day. Hospitals are often understaffed and under-equipped at the expense of patient experience because it’s cheaper that way.

So what’s the solution?

A true red-blooded capitalist would say that the easy solution would be to turn healthcare into a true market product. Provide different options, give people the choices, let people pay what they’re willing to pay for different levels of service.

I am not a fan of this solution. For one, healthcare isn’t really just another product, it’s life. People are willing to spend more than a fortune for healthcare and providers know this. This is why in the US, where healthcare operates closest to market principles compared to other industrialized countries, healthcare costs have skyrocketed.

Healthcare cost vs life expectancy (Source: National Geographic)

Having lived in Japan, Europe, and the US, I really do believe that healthcare in the US is broken.

Instead of imposing market principles into healthcare, I suggest creating new forms of incentives for hospitals to motivate them to do better. As many hospitals are government subsidized, hospitals with lower waiting times could be rewarded with higher subsidies. I don’t know if waiting times at hospitals are currently being measured, but I bet the increased cost in measurement would be quickly offset by the societal benefit and increased productivity.

This of course only solves the motivation side of the equation and not how these hospitals will actually minimize the waiting times. The obvious solution would be to purchase more equipment and hire more technicians and doctors but that would be costly. If we think about the waiting time problem, it’s really about logistics. The challenge is to process as many people as possible in a healthcare factory with a number of random variables (for example, how many people need an X-ray in any given day). Even with the seeming randomness, with past data I’m sure one could create a fairly reliable input-output model of a hospital. While the problem doesn’t map entirely, hospitals could probably learn from the masters of logistics such as Toyota, Walmart, and other modern day retailing operations. How does Toyota minimize stock in their factories yet maximize throughput? How does Walmart make sure that the right number of products are on the shelves at any given moment? Healthcare is not the same as a car factory or a retail store, but I’m sure there is plenty of inspiration to go around.

If we think beyond waiting times and consider the waiting experience, much more could be done. How does your local hairdresser try to keep your mind off the waiting time? For one, having open WiFi could be a great start. (Note: I have seen hospital waiting rooms with WiFi and magazines, but that’s not the case in Germany, or at least the places I visited)

I’m just a wondering designer. I don’t have all the answers, I just see where things can be better and inspirations for a good start.


Dear future kid(s)

I have no idea if you exist or not, and if so, how many of you there are. I just wanted to write this post in the off chance that you do exist and find this blog, which you most likely will as nothing on the internet disappears anymore.

See, once upon a time, almost no one used the internet. People actually kept journals on paper, not using computers but writing long prose with their hands. These journals of course never went online and was often left in a dusty box in the closet. The adolescent dramas of my parents were secure from their kids, but as my generation became empowered by the internet and more open, I fear that your generation is going to know a lot more about your parents than we were ever able to.

Now I’m sure many of my friends scrambled to get their digital traces wiped as their kids became cognizant, but as I write this, that is not my intent. My guess is that this kind of past disclosure will become the norm and that there are at least few politicians who endured mini-scandals from their teenage Facebook musings and blogs posts (is Facebook still cool?).

By the time you are reading this, I’ve probably written over a thousand blog posts and tens of thousands of tweets, so it’s going to take sometime to consume all of them. There are definitely posts that I think are silly and immature now, especially from the early days of my blogging, which probably seem even sillier and more immature from the future.

Don’t judge me too harshly for what you’ve found on what I’ve done and written in my past. If current trends continue, many things from the past will inevitably look ridiculous. That’s what we think of tight fitting jeans and mullets today; maybe they are fashionable again in the future?

From 2012, I can’t help it but wonder what kind of world you are living in now. Are there automated cars? Are you reading this on a screen or something more futuristic? Do you have robotic help in your home? Did we reach, or are we close to reaching the singularity? Did we finally solve the global warming problem? The challenges of your days are probably vastly different from the ones of today. Fret not. In every age, there are always people who think the world is going to end, and they are always wrong. The same, however, could be said about utopias as well.

The person who is your dad is probably a very different person from the one who is writing this blogpost. Hopefully I am a better dad than I am a writer today, come say hi when you get this letter.


Dad, age 29


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