Tag Archives: new york times

Stand to lose weight

A NYT Opinionator reminding us how the gradual drag of modern-day-life makes us fat and die. “Stand Up While You Read This”

For many people, weight gain is a matter of slow creep — two pounds this year, three pounds next year. You can gain this much if, each day, you eat just 30 calories more than you burn. Thirty calories is hardly anything — it’s a couple of mouthfuls of banana, or a few potato chips. Thus, a little more time on your feet today and tomorrow can easily make the difference between remaining lean and getting fat.

You may think you have no choice about how much you sit. But this isn’t true. Suppose you sleep for eight hours each day, and exercise for one. That still leaves 15 hours of activities. Even if you exercise, most of the energy you burn will be burnt during these 15 hours, so weight gain is often the cumulative effect of a series of small decisions: Do you take the stairs or the elevator? Do you e-mail your colleague down the hall, or get up and go and see her? When you get home, do you potter about in the garden or sit in front of the television? Do you walk to the corner store, or drive?

Chatroulette’s creator is a 17-year-old altruist

I had seen screenshots of Chatroulette on Reddit threads, but didn’t know what it referred to until this New York Times Bits Blog post, where they track down the once-anonymous creator. It’s basically a service that allows anyone in the world to find a random person to video chat with. Not surprisingly, it’s been trolled by a number of penis shots…which is a stark contrast to the niceness of the creator, a Russian 17-year-old Andrey Ternovskiy.

Ternovskly, who says he’s been programming since age 11, created the site because he and his friends got tired of just chatting with each other. Despite a massive surge in popularity, Ternovskly has only allowed four simple text ads along the bottom, which pays the bandwidth bill (a max throughput of 7GBs a second).

I think it’s cool that such a simple concept can be useful for so many people. Although some people are using the site in not very nice ways – I am really against it. Others do really unbelievable things I could never think of. They make up songs about strangers and sing to them, draw them, listen to music, broadcast them their own music. Two groups of teenagers can party together. That’s just great in my opinion. I am glad that I made this project and it is a pleasure for me to work on it.

He’s apparently too young to be corrupted by the profit-motive (how long will that last?). That a 17-year-old could so wisely execute what should’ve been an obvious idea is both inspiring and a little humbling to us 20+ year olds. Then again, those Russians do have a knack for invention at an early age; Mikhail Kalashnikov, inventor of the AK-47, was 21 when he started on his first sub-machine gun design. Chatroulette is pretty much an AK-47 of a Internet service…cheap, bare-bones, beautiful in execution, and prone to terrible, terrible misuse.

And speaking of age…I always felt smug being young enough to “get” MySpace and Facebook while the thirty-year-olds and older were all perplexed by it. I think Chatroulette is the Internet trend that makes me feel like the old man out.

Read the rest of his interview here.
Some NSFW screencaps here.

NYT: How Unemployment Taxes are Collected; Also, Watch Your Texting Habit

A pretty interesting piece in Jay Goltz’s “You’re the Boss” blog on how unemployment tax is paid for (in Illinois, an employer can pay up to $1.48 per dollar that a former employee collects in unemployment benefits). Goltz argues that this creates a disincentive for employers to hire, knowing that a prospective employee who turns out to be a failure will cost the company in time lost and extra unemployment tax.

Speaking of which, there’s this amusing nugget of a negligent employee who almost cost Goltz’s company that incremental tax, despite “working” for 21 days:

I have recently learned that you can be charged with a claim even if you’ve employed someone for less than 30 days. We fired someone after three weeks because she was text-messaging her friends all day. After we told her twice that she had to work during the day and stop texting, she put her phone away. We then noticed she was leaving her desk drawer open and looking into it a lot. She was now texting out of the drawer.

Now is a good time to refer to my colleagues Jeff Larson and Olga Pierce’s fantastic work in documenting the crisis in states’ unemployment insurance funds. Jeff devised a pretty smart way to scrape the information, and he and Olga came up with a formula to accurately predict whether states’ funds were in the red (see their nerdy formula page here).

Incidentally, Illinois, Goltz’s state of business (he owns five small Chicago businesses), is in the shitter for its unemployment funds, so to speak, according to ProPublica’s Unemployment Insurance Tracker.

NYT: Anti-obesity tax will make soda more expensive than beer

Another one for the Department-of-Unintended-Consequences, from NYT’s City Room:

While the governor is taking aim at obesity caused by sugary drinks, Mr. Eusebio worries that the proposed tax would slim down the beverage industry, which he said pays $6.7 billion in wages statewide and generates billions more for the economy.

But he also mentioned some far smaller numbers that startled a soft-drink drinker.

“A six-pack of soda is going to cost you approximately $4.99” if the penny-an-ounce tax goes through, Mr. Eusebio said, “where you can pick up beer from $2.99 to $3.99.”

Off to the neighborhood supermarket, where it turned out that Mr. Eusebio’s math was not far off. With the tax, a six-pack of Coca-Cola or Pepsi would cost 2 cents more than a six-pack of the cheapest beer in the store.

To be fair, the “cheapest beer” apparently includes such brands as Old Milwaukee…and even the thriftiest, alcohol-friendly consumers will stay with Cola over that. But at $5.61 for a 6-pack of Coke (2 cents per ounce times 6 cans times 12 ounces, plus the 30 cent container tax) is pretty daunting no matter what the alternatives are.

(Update: Headline was reversed…)

NYT: Radiation (IMRT) horror stories; Woman has massive hole burned in chest because several doctors and physicists didn’t know “in” from “out”

Graphic: New York Times

Yet another case study on how the most educated of our professionals are not fail-safe. Not just not-fail-safe, but not not-able-to-tell-up-from-down-safe. The New York Times has an incredible story today, apparently one of many, into the dangers of new radiation treatment called Intensity Modulated Radiation Therapy.

It covers a lot of ground, but one anecdote that sticks out is of Alexandra Jn-Charles, who underwent IMRT to treat breast cancer. IMRT involves delivering radiation as a precise beam to kill a tumor…a great way to avoid the healthy-cell-killing symptoms of traditional radiation treatment.

However, Ms. Jn-Charles ended up with a hole in her chest so big that “you could just see my ribs in there.”

How did it happen? Numerous therapists, and even physicists, failed to notice a simple binary error:

One therapist mistakenly programmed the computer for “wedge out” rather than “wedge in,” as the plan required. Another therapist failed to catch the error. And the physics staff repeatedly failed to notice it during their weekly checks of treatment records.

Even worse, therapists failed to notice that during treatment, their computer screen clearly showed that the wedge was missing. Only weeks earlier, state health officials had sent a notice, reminding hospitals that therapists “must closely monitor” their computer screens.

The series of moronic, tragic errors calls to mind Atul Gawande’s story of the checklist, in which a 5-step list of tasks for doctors, as simple as washing their hands, reduced infection rate for a certain procedure to zero.

What’s the checklist for this cutting-edge radiation therapy?

Maybe there would be one if hospitals weren’t underreporting their accidents, according to NYC’s health department, by “several orders of magnitude.” (According to the NYT, the department apparently did not realize this until the Times started asking).

And then there’s the bad software angle. Varian Medical Systems gets criticized for code that, while allowing for the delivery of a precise and powerful stream of electrons to a tumor, has the stability and error-recovery ability of Windows ME. In the case of Mr. Jerome-Parks, an IMRT machine delivered radiation “from the base of his skull to his larynx” instead of just at the tumor. The reported problem: crash-prone software with poor/non-existent data recovery:

The investigation into what happened to Mr. Jerome-Parks quickly turned to the Varian software that powered the linear accelerator.

The software required that three essential programming instructions be saved in sequence: first, the quantity or dose of radiation in the beam; then a digital image of the treatment area; and finally, instructions that guide the multileaf collimator.

When the computer kept crashing, Ms. Kalach, the medical physicist, did not realize that her instructions for the collimator had not been saved, state records show. She proceeded as though the problem had been fixed.

“We were just stunned that a company could make technology that could administer that amount of radiation — that extreme amount of radiation — without some fail-safe mechanism,” said Ms. Weir-Bryan, Ms. Jerome-Parks’s friend from Toronto. “It’s always something we keep harkening back to: How could this happen? What accountability do these companies have to create something safe?”

Just incredible. Read the whole story here.

Also, a great animated graphic illustrating how IMRT can go awry.

My blog headline says “doctors” when it was “therapists” who apparently missed the “out” and “in” difference 27 times…though, presumably, doctors are involved somewhere in the operational process, even if they aren’t programming the machine themselves.

A NYT reader who says he’s an engineer has this insight:

What did Wedge in / Wedge out really imply to the software programmer? Did he understand the true consequences of the two setting options? Did he have any understanding of medicine at all? Or was his knowledge just limited to what the lines of software code could do?

This person might previously have written software for operating a sprinkler in a garden, where he provided options for turning the sprinkler on and off. Thus, a line of software code could manage Sprinkler On / Sprinkler Off. A similar line of code could also manage Wedge In / Wedge Out. The software is not really all that different; very often, all it does is activate/deactivate one or another relay. But what were the relative levels of importance of the selected options in these two cases? Sprinkler Off would mean the lawn didn’t get watered on one day. No big deal, and easily fixed. What about Wedge Out? Did he know what that could mean for the patient, and how many checks and verifications he would need to include for that in order to take into account situations like the operators of the equipment being mentally distracted, careless, etc.? Should he make lights to flash; warning sounds to be emitted; additional confirmational prompts and checklists each time? To make the system 100% foolproof, would the operator in this case require additional reminders / actions to be taken, which might not be required in the case of the gardener?

I think, now that technology is here to stay and since we are growing increasingly dependent on it, that every person in the chain, including electricians, mechanics, software programmers and others, need to become more medically aware of the implications of his/her particular role in the chain. They should no longer be distanced from the ultimate outcome as they are now, focussed on local actions and completion of job targets.

For instance, this programmer must be made aware that he is setting the radiation scope that could destroy a person. He must think deeply about practical issues and about how to take things like human error into account. He should not get away with just thinking he has met his daily target for number of lines of code written.

I usually don’t use the word “paradigm”, but I think what we need here is a major paradigm shift regarding what we should expect from technology and its providers in medicine. The old saying, “A chain is only as strong as its weakest link”, applies very strongly here.

Hell on Earth: Haiti Coverage

The Haiti earthquake’s aftermath is so horrible that an anecdote like this, which would be the tragic center point for virtually any other kind of story in the NYT, barely registers until you read it over again (“Looting Flares Where Authority Breaks Down “):

“We are all in a bad way,” said Margaret Cherubin, 41, a merchant who lost her husband, Jimmy, and three children in the earthquake. She said she was afraid to return to work because of her fear of thieves. “I have no family, just the clothing on my back,” she said. “I now live with God only.”

The closing anecdote ends up being even more horrific.

NYT photog Damon Winter, in this Q&A on the Lens blog, talks about one moment that didn’t get captured on camera:

There was one thing that didn’t really make pictures. It was my first night here last night. We were staying at a hotel on the edge of a pretty heavily damaged neighborhood and at night, you could hear people singing.

People are out on the street at night. It’s really hard to photograph because there’s no electricity. It’s pitch black. But all night you could hear them singing prayers. It’s pretty amazing the ways that people are dealing with this tragedy. It says a lot about the Haitian character. They are an amazing people.

Chartjunk? Slate’s Kaus vs. NYT’s David Leonhardt on hospital beds and better health care

An example of chartjunk: several colors and 26,000+ pixels to describe five hard-to-read numbers

David Leonhardt put forth a gee-that’s-unexpected-but-possible thesis in the Dec. 30 New York Times: Limiting hospital beds forces hospitals to provide more efficient care; allowing limitless beds pressures hospitals to fill them with patients undergoing unnecessary, costly treatments (Economic Scene: Health Cuts With Little Effect on Care):

Since 1996, the Richmond area has lost more than 600 of its hospital beds, mostly because of state regulations on capacity. Several hospitals have closed, and others have shrunk. In 1996, the region had 4.8 hospital beds for every 1,000 residents. Today, it has about three. Hospital care has been, in a word, rationed.

The quality of care in Richmond is better than in most American metropolitan areas, according to various measures, and it continues to improve. Medicare data, for example, shows that Richmond hospitals do a better-than-average job of treating heart attacks, heart failure and pneumonia.

…when it comes to health care costs, Richmond’s rationing has made a clear difference. In 1992, it spent somewhat less than average, per capita, on Medicare — 126th lowest out of 305 metropolitan areas nationwide. Since then, though, costs have risen at a significantly slower pace than they have elsewhere. As a result, Richmond had the 39th lowest costs in 2006.

A pretty tantalizing concept, and one that helps advocate for the school of thought that doctors should have some sort of restriction on how much “Cadillac” health care they can provide a patient. But even if Leonhardt’s thesis is correct, Slate’s Mickey Kaus is correct to point out that Leonhardt provides virtually no useful evidence to prove it:

1. In Richmond the number of beds per 1000 residents fell from 4.8 in 1996 to “about three.” You would now expect Leonhardt to unleash a string of stats showing that medical care in Richmond has gotten better despite these limits. You would be wrong. Care in Richmond is “better than in most American metroplitan areas,” says Leonhardt. OK, but what was it like before? Maybe it was better than nearly every metro area before. Richmond hospitals do a “better-than-average job of treating heart attacks,” Leonhardt says. OK, but were they much-better-than-average before? Anyway, that’s just heart attacks. … Oh, and a patient named Janet Binns–actually, a patient’s daughter–feels there is “nothing cheap about the care.” Well, all right then!

This goes on, for six more points, with Kaus accusing Leonhardt of being spoon-fed statistics from the White House’s own partisans.

Kaus himself doesn’t provide enough beef to make the accusation a clear verdict, but he’s right that Leonhardt’s statistical reasoning is shallow. He commits the most basic fallacy of “correlation does not imply causation” (What other reforms, demographic changes would’ve affected hospital Medicare data?). He just plain omits, Kaus points out, any substantial data (what are the “various measures” in which Richmond performs well in? In the on-the-other-hand statement, “Some of its hospitals do poorly on Medicare’s metrics,” what are these metrics, and how statistically significant are they compared to the ones Leonhardt uses to support his thesis?). And there are assumptions that seem like common sense…but on second thought…need more explanation (why is Richmond’s performance on heart attacks, heart failure and pneumonia the quality-care metric only worth mentioning?)

This thin-on-numbers piece is a bit unexpected considering that Leonhardt, according to his bio, studied applied mathematics at Yale. But maybe it’s not a failure of the reporting as it is the storytelling form. Leonhardt may have all the numbers, but lacks the column inches to describe them all.

So I’d consider it a textbook example of how traditional narrative can fall flat. Leonhardt’s claim just begs to be illustrated with a few charts and graphs. A line chart showing Richmond’s heart-attack-treatment metric from 1992 to 2006 would concisely refute Kaus’s point (at least one aspect of it) in far lesser space than 80 words. As it is, Leonhardt’s article is effectively a textual example of what infographic-guru Tufte calls “chartjunk”: an unnecessary amount of ink to, at best, clumsily support an important theory, or, at worst, to hide the skimpiness of the actual data.

The Times still leads the way in alternative forms of storytelling. You’ve probably already seen their amazing infographic plotting Netflix rentals by geography. 3,000 words (some of which would be devoted to pithy, but generally unhelpful, cherry-picked quotes from your average-Joe-Netflix-user, to illustrate why ‘Milk’ was so popular in Chelsea) would barely have covered the trends a single metro area, nevermind a dozen.

NYT’s John Tierney: Pleasure yourself, now.

Still from the movie "Sideways"

John Tierney’s latest column covers the phenomenon of procrastinating pleasure. Just last night I was complaining how I didn’t use any vacation time (except for a trip home on Thanksgiving, which is barely a “vacation”) this year. But it was my own fault for not going through the motions of picking a place, date, and flight, thinking that I’d get around to it next month. And now it’s a few days till New Years.

For once, social scientists have discovered a flaw in the human psyche that will not be tedious to correct. You may not even need a support group. You could try on your own by starting with this simple New Year’s resolution: Have fun … now!

Then you just need the strength to cash in your gift certificates, drink that special bottle of wine, redeem your frequent flier miles and take that vacation you always promised yourself. If your resolve weakens, do not succumb to guilt or shame. Acknowledge what you are: a recovering procrastinator of pleasure.

It sounds odd, but this is actually a widespread form of procrastination — just ask the airlines and other marketers who save billions of dollars annually from gift certificates that expire unredeemed. Or the poets who have kept turning out exhortations to seize the day and gather rosebuds.

I thought this was the most eye-opening revelation about prolonged pleasure-procrastination:

Once you start procrastinating pleasure, it can become a self-perpetuating process if you fixate on some imagined nirvana. The longer you wait to open that prize bottle of wine, the more special the occasion has to be.

Remember the advice offered in the movie “Sideways” to Miles, who has been holding on to a ’61 Cheval Blanc so long that it is in danger of going bad. When Miles says he is waiting for a special occasion, his friend Maya puts matters in perspective:

“The day you open a ’61 Cheval Blanc, that’s the special occasion.”