a gap between stimulus and response

moved to tumblr!

noreply@blogger.com (anu) — Wed, 06 Jul 2011 04:01:00 +0000

This my 100th blog post.

(I feel like that statement should have some fanfare associated with it. Some streamers, a marching band, something. 100 posts is a lot of words, even for me.)

Today is also my birthday (true story, and no, I didn't plan it out this way). So, as a birthday present to me (can I even ask for a birthday present?), do me a favor and redirect your feeds, bookmarks, and the like over to:

http://thegapbetween.tumblr.com

I won't bore you with an analysis of why I decided to switch from Blogger to Tumblr (user interface, mobile capabilities, easy static page creation, a superawesome community, along with a personal desire to shake up my content a little bit and include shorter snippets as well as long posts), but I hope you'll take a look around the new site and tell me what you think.

I won't be using this domain any more for new posts, so mosey on over to Tumblr.

See y'all on the flip side!

health is measured by the ability to recover

noreply@blogger.com (anu) — Mon, 04 Jul 2011 09:45:00 +0000

To Heal A Fractured World | Jonathan Sacks

It's Peachtree time.

Race number, sneakers, iPod armband. Ready.

I am not a morning person. And I've never thought of myself as a runner. Yet I still drag myself out of bed most mornings to lace up the sneakers and hit the pavement.

When I was young, I did mostly anaerobic sports. Other than swim team, I was a competitive gymnast and cheerleader, and never got in the habit of sustained aerobic exercise. I started running a little less than two years ago. I'm not even sure why. It didn't require much to get started, it gave me something to do, and it was a way to spend time outside after being in a lab all afternoon mixing glue (my adhesive project, not drugs, geez).

That first 5K in March of 2010.

Last March, I ran my first race - a 5k. Last Fourth of July, I ran my first Peachtree.

In between the Georgia heat on the Fourth of July, weaving through 60,000 runners, listening to bands play and supporters cheer and festive chants to celebrate America's birthday, it's the most fun race I've ever run. This year, I have shin splints from running in four cities over the past three weeks, but the atmosphere and energy of running through the heart of the city far outshines the negatives of running with sore shins.

On the best mornings, when I stumble out of bed in the dark and lace up my sneakers, I catch a glimpse of stars in the pink glow of the dawn. There are deep breaths of honeysuckle and Georgia grass as I stretch, and there are the familiar faces of other morning runners on the trails through my hometown. On those mornings, it's easy to be thankful for the ability to put one foot in front of the other. It's easy to remember a time when I couldn't run three miles, much less six. It's easy then, to marvel at what our bodies can accomplish, one day at a time, and over the course of an entire lifetime. The abuse that we take - the easy stresses of daily life - and our bodies' abilities' to take them in stride.

Enjoy your body; use it every way you can. Don't be afraid of it, or what other people think of it - it is the greatest instrument you will ever own.

Ah, the Peachtree. Past the Buckhead Strip and Cardiac Hill and the Midtown Mile. See you on the other side of these glorious six miles.

less designing products and more designing outcomes

noreply@blogger.com (anu) — Sun, 03 Jul 2011 16:15:00 +0000

Thanks to Shalini, I started playing with Google+ this weekend. It's definitely interesting. I set up my Circles, checked out some Streams, tried to put in some Sparks (still haven't tried Hangouts - if you're on Plus and want to check it out with me, let me know!). My first thought mirrored the xkcd cartoon, "It's not facebook... but it's just like facebook!"

Rocky Agrawal wrote a great post about Circles yesterday. In particular:

The biggest unsolved problem in social networking remains unsolved with Google+: separating signal from noise. Twitter, it seems, doesn’t even want to try. The timeline is as dumb as it has been since the beginning, a reverse chron firehose of information. Facebook’s feed has improved over the years, but a friend in New Jersey trying to get rid of a bookshelf is just not relevant.

The lack of quality tools for generating signal out of these feeds is inhibiting the creation of content. People are multidimensional and manual segmentation at the person level isn’t enough. I create content about a lot of things, including social networking, mobile, daily deals, my travel, my reading and more. But as I was reading Onward, I shared less than I would have because I didn’t want to flood people’s streams. If I annoy people, they have a blunt tool to fix it: unsubscribe entirely. So I mitigate my posting.

I'm a very selective content consumer, and an even more selective content creator. I blog, but I won't tweet. I'll post location on Instagram, but not on Facebook. When it comes to organizing my Reader feed or picking people to follow on Buzz or Tumblr, I'm merciless. And as a creator, my biggest concern is not about privacy (although I make it seem like it is). It's about irrelevance.

At the end of the day we don't need more creation and consumption tools. Everyone has their favorites - Facebook, Twitter, LinkedIn, Blogger, Wordpress, Digg, Disqus, Tumblr, Buzz, Flickr, and a thousand others that pop up every day. Right now, all it's doing is giving us more sites to check to get the content that's relevant to us. What's important is how we create value out of these things to generate a stream of content that's meaningful to us. And I'm hoping that as Google+ grows, it addresses the "signal-to-noise" problem that's overwhelming our lives.

The future for content sharing is bright, but the path to get there is still nebulous. Kind of like DTW.

A few months ago I had a great conversation with one of our national sales directors about creating products in healthcare. Healthcare is a great example of a market in which companies have focused on creating and selling products to solve problems. But what's valuable in healthcare is not products - it's outcomes. A subtle nuance, but important. Technology on its own is useless, unless it can drive the outcome - better health, less disease, higher quality of life - that we desire. The tool has to reflect the task.

Google has created a tool to drive its market share in social. It's created a product. But what social needs right now is not products. It's outcomes.

Consumption and creation are huge topics of interest for me. In fact, it was a conversation over seafood in Midtown about how we create and consume that led to this blog. At that time, it was Google Buzz that was new and exciting in social. Now, as I near my 100th post (we're up to 98, for those keeping score) more than a year later, I'm excited to see what Google+ does to the creation and consumption landscape.

the soft bigotry of low expectations

noreply@blogger.com (anu) — Fri, 01 Jul 2011 03:13:00 +0000

I can't remember where I first read that line. Maybe it was The Audacity of Hope, or Freakonomics. Maybe one of the painfully dry books I force myself to read, like The Paradox of American Power or maybe Guns, Germs, and Steel. I think President Bush said it in a speech once (or maybe it was President Obama...). The soft bigotry of low expectations.

Two days ago I had coffee with a very good friend of mine not far from where this picture was taken.

Covington Square. This is in front of more than one store. Gotta love working in the rural South.

We talked a little bit about stereotypes. Not for long. I'm not good at talking about stereotypes. Mostly because I haven't felt discriminated against too many times in my life. A few cases, for sure, but not enough to know right away when I'm being discriminated against. I'm a racial and religious minority in a conservative, Christian part of the country. I'm a woman in a male-dominated industry and profession. But John is a successful and talented software engineer for a high-profile startup in San Francisco. And he's black.

Last week I wrote about defying people's expectations. Working a lathe as a 5' 2" Indian girl wearing pink heels. Engaging in a Milton and Faulkner discussion group as an engineering major. Leaving cheerleading practice to tutor someone in calculus. But I've found in my life that those aren't the biases that bother me. It's the small things - having someone assume that I will quit working in three years to get married and have children. Assuming that I can work on a Sunday because I'm not going to church.

We don't live in the days of segregated stores, but that doesn't mean we don't discriminate. Real diversity isn't about race anymore (although our attitudes about race are still deeply ingrained). It's about socioeconomic status and life experiences. Malcolm Gladwell makes obscene amounts of money talking about this in Blink - about how we expect people with certain backgrounds (and yes, certain looks) to behave and perform a certain way. And how those expectations can shape how we treat someone - from people we hire, to people we fall in love with, to people we elect as President.

I love this line so much, the soft bigotry of low expectations, because it illustrates a perfect point. You don't need a plaque that calls out the color of skin to exclude or offend. We do it through the things we say, and sometimes the things that we don't. We do it when we ask a woman we've just met how many kids she has, and asking her husband what he does for a living. Sure, it might be a fair point, but by doing it, we've made an assumption about what's important to someone because it fits our model of what's important to us.

design lessons i learned from the sunscreen song

noreply@blogger.com (anu) — Mon, 27 Jun 2011 02:48:00 +0000

Lately I've been doing a lot of research about designing clinical interactions. Specifically, in how clinicians can interact with patients to boost healthcare outcomes. It strikes me how similar it all is to happiness research (The Happiness Project was this week's travel book). Designing smart interactions is like designing a happy life:

1. We're happier when we have meaningful relationships in our lives. A doctor-patient relationship in which both parties contribute to the conversation leads to better health outcomes and more patient satisfaction.

Also, did you know that the best predictor of loneliness is the number of female friends you have? Male friends don't make any difference in the loneliness statistics; it's because women are easier to open up to. This might make a great case for why people prefer female doctors.

I also find this sort of worrisome, because I have few female friends.

2. Patients are more likely to be compliant when there is a clear link between action and result. Feedback is a core tenet of interaction design. It's frustrating to receive instructions from a doctor, follow them meticulously, and not see the intended result. Since health is individual and outcomes are not guarantees, we should design devices to facilitate this kind of feedback as best we can. And related...

3. We shouldn't compare our outcomes to those of others. You can replicate treatments, but you can't guarantee outcomes from patient to patient. We're all different, and it takes different things to make each of us healthy. We've all heard the crazy stories of the man who lived to be 90 smoking a pack a day, and the perfectly healthy marathoner getting metastasizing cancer. Our science is unique; that's what makes us works of art. Similarly, keeping up with the Joneses doesn't make you happier, because the things that make you happy are different.

4. Experiences make us happier than things. Visiting someone in the hospital is much more meaningful than sending flowers.

A great line in the book is "there is no love; there are only proofs of love." This isn't unlike Khalil Gibran's line in The Prophet, "Work is love made visible." Or Covey's idea that love is a verb, not a feeling. Proactive people treat love as an action. But I digress.

5. People who are grateful for what they have and appreciate their lives the way they are have shorter recovery periods and a higher quality of life. So much so that the American Heart Association has counseling programs for stroke sufferers on positive thinking.

Basically, these are all things I learned from the Sunscreen Song (it's here if you haven't heard it). It's easy to overcomplicate clinical design and positive interactions with bells, and whistles, and features. But there are no secrets to happy, and no secrets to healthy, either.

Get to know your parents; you never know when they'll be gone for good. Be nice to your siblings - they're your best link to your past, and the people most likely to stick with you in the future.

Being nice to my brother on Rakhi, many moons ago.

Understand that friends come and go, but with a precious few, you should hold on. Work hard to bridge the gaps in geography and lifestyle, because the older you get, the more you need the people you knew when you were young.

I'm thankful for the kind of friends that bridge gaps in geography and fly into town just to have dinner (thanks, friend!).

Read the directions, even if you don't follow them.

Don't waste your time on jealousy. Sometimes you're ahead; sometimes you're behind. The race is long, and in the end, it's only with yourself.

Maybe you'll marry; maybe you won't. Maybe you'll have children; maybe you won't. Maybe you'll divorce at 40; maybe you'll dance the funky chicken at your 75th wedding anniversary. Whatever you do, don't congratulate yourself too much, and don't berate yourself. Your choices are half chance. So are everybody else's.

Dance, even if you have nowhere to do it but in your own living room.

Enjoy your body; use it every way you can. Don't be afraid of it, or what other people think of it - it is the greatest instrument you will ever own.

Learning something new at Circus Fitness class.

Writing closing sentences has never been a strong suite of mine. It just feels awkward. But I love the ending to the song, which circles back to the research ("but trust me on the sunscreen"). So I'll circle back to the research:

The findings here are tentative and in need of replication. Until then, including empathy in the clinical encounter has little potential for harm and has positive influences that extend beyond the medical consultation. A “connection” also enhances continuity and builds a foundation for relationship-centered primary care within the patient’s medical home.

defying expectation (why do engineers wear ugly clothes?)

noreply@blogger.com (anu) — Tue, 21 Jun 2011 21:29:00 +0000

This morning I checked into Hartsfield an hour before my flight. After finding a parking spot (which proved to be more difficult than you'd think), getting my baggage squared away (I'm carrying a Chatillon gage and some other assorted medical-devicey-things), and getting through security with time to spare, I found out my flight had been moved from the T-gates to concourse E. So, still with time to spare, I made my way to the other end of the airport, and to the gate with 15 minutes left, only to be told by a Delta gate agent that they had given my seat away and I couldn't board.

Let me recap for a minute: I had time to check my bags, go through security, get through a gate change from one corner of the airport to the absolute farthest point, and still made it in time to see people on the jetway boarding the flight. And couldn't get on.

So basically I spent the morning waiting in line, on the phone with Bard Travel, emailing Hertz, and dealing with the general annoyances of rebooking flights and cars to obscure cities and small airports.

OK, vent session over.

I also spent the morning people-watching at the world's greatest airport. Over lunch, I met a man who runs a logistics company and he asked me, as most people do, what I do for a living. I told him I was an engineer, and he laughed. As most people do. He told me I didn't look like an engineer.

This is not the first time I've heard this. Once, when Iris and I were at an ICU visit in Fort Lauderdale, the nurse told us that when he heard he would be hosting two engineers, he was expecting "two old white guys."

We are about as far from two old white guys as you can get.

It doesn't really faze me. Or at least, not any more. I've grown up doing things that people don't expect. I grew up listening to emo and country.

With my dad (Happy Father's Day!) on senior night at Parkview.

I was probably the first Indian cheerleader at Parkview High School. We'll say that I was, because who even knows how we would every verify that. One time I skipped an AP Comparative Government exam to go shopping. I was Student Body President of a student body that is only 30% female. I get french manicures and operate heavy machinery.

OK, a Dremel isn't heavy machinery, but I don't have pictures of myself operating the band saw.

When Frank told me I didn't look like an engineer I laughed. I told him sorry that I wasn't wearing ugly clothes. I don't know why engineers have a tendency to wear ugly clothes. If I were married, or wealthy enough to have my own photographer, I would post photos of outfits, like Anh does on 9to5chic. I love her, because she works in the old-boys-club of the medical device industry and makes it a point to not look frumpy or old fashioned.

I don't know that we always realize how important our expectations are. Expectations color our perceptions, and no matter how unbiased we try to be, our perceptions shape our realities. This is especially true if you're a woman working in a male-dominated industry. When men dress well for work, it's seen as dressing well. When women dress well at work, it's seen as trying to leverage their looks to get ahead in their careers. When I was at Georgia Tech, I would read blogs about the perception gap about women and men in high positions. I showed up to meetings in pants suits because I didn't want my legs to communicate that I wasn't capable of doing my job.

I did all my headshots in pants. No exceptions.

At some point in the past two years, I stopped caring. Not because I didn't have to, but because, like Penelope says, I'm over it. Other people have fought that fight for me, and I can move on to bigger issues. Whether or not a man thinks I'm as intelligent and as capable of doing my job isn't dictated by my hemline. I've proven my point.

And now I wear a skirt and heels to work almost every day.

Because there's nothing wrong with wearing pretty clothes to the clinic or the lab.

I was going to make this a post about how unexpectedly nice the Delta agent who rebooked me was, but now I'm tired. And I'm on a flight to Manchester, NH and my bags are en route to Burlington, VT by way of JFK. And I haven't figured out why engineers wear ugly clothes. And now this post is about me, pretty clothes, and how not to be afraid to tell someone that I'm good at something because I'm a girl.

I wish I remembered her name. I would write to Delta about how she was the third agent I talked to, and all of them acted like they were too busy to do the job of finding me a new flight. I defied her expectations and walked across two concourses to get to an open Delta desk. She defied my expectations too, and rebooked me without a fuss.

i just bought a cheese plate on an airplane

noreply@blogger.com (anu) — Sun, 19 Jun 2011 23:33:00 +0000

... and the lady sitting next to me is looking at me like I'm crazy for pulling out my American Express to pay for food on an airplane (I had to write that sentence last because she's taken to observing my screen with great care as I type).

Maybe it is crazy. I don't know. Everyone I work with thinks that I live a ridiculous life. Rafting trips on weekends. Conference calls from ski slopes. It'll change when you have a family, when you have kids, they tell me. But whatever. I spend money on things that matter to me. On my ideal life (of the moment) On gorgeous and satisfying experiences (which, by the way, make you so much happier than things).

A pretty incredible place to have a swim.

A pretty incredible place to have a conference call.

We tend to be attracted to people who are like us. We like friends who are like us. We also are influenced by the people who are around us, to a greater degree than we realize. I have friends who appreciate my love of experiences because they're willing to participate in them with me.

So when we get together, we partake in amazing experiences. Money can't buy happiness, but money can buy experiences that change your perspective and enrich your life.

At the National Mosque in Malaysia.

Holding a baby gator in the Bayou.

From the Tiffany What Makes Love True website (see tip #8... well, actually, read all of them):

Light the Candles.
Use the good china. And crystal.
When you are together put style in your life.
This is part of living well, together.

There's so much design inspiration in a life well lived.

The floor of Auntie Nat's Cafe in Kuala Lumpur, Malaysia.

I'm living as close to my ideal life as I can. Putting style into my life. Living well. And happily eating my cheese plate.

commitment, to the problem you want to solve & the life you want to lead

noreply@blogger.com (anu) — Sun, 19 Jun 2011 22:57:00 +0000

Lunch on Friday in the Financial District. We were sitting in a gorgeous courtyard, full of marble and light and San Francisco sun. I asked Charlie if he ever gets sidelined by the perception from inside a company that consultants come in uninformed about and uninvested in a company's goals and culture, suggest swooping changes and then leave the actual implementation - the hard part - to someone else.

Sure, he said. But that's what happens only when the tasks haven't been well-developed. When a company hires a consultant without knowing what problem they're trying to solve.

This isn't so different from product development. I get frustrated with how often requirements change. Of course, time changes things. Patients change. Procedures change. Technology changes. But what can't change is our commitment to the problem that we were originally trying to solve. That's the easiest way to kill a good product idea before it hits the market.

You can't design to a moving target.

Don't get me wrong. You can design to accommodate change. You can design with a vision of how that design can change. What can replace it. Apple's the classic example of companies that develop products with multigenerational product strategies. But the point is, commit to something. A set of requirements that may not last forever, but that last for right now and give you something to work towards.

Commitment is a whole separate topic. It takes courage. We're so afraid of it. We're afraid of what might happen if we commit to one thing and miss out on ten others. This is true in product development. This is true in life.

Thomas living his ideal life in Napa Valley.

I was reading Unclutterer yesterday when I came across this post. Erin's post is like Covey's second habit: begin with the end in mind. I think the hardest part of being young is realizing that it's ok to change your mind as you get more information. That the ideal life right now doesn't have to be the ideal life forever, that your life has its own multigenerational design strategy. What shouldn't change is your commitment to live according to the things that you value.

options from awful to worse

noreply@blogger.com (anu) — Fri, 17 Jun 2011 04:09:00 +0000

Saw this at Hartsfield-Jackson earlier this evening:

I'm not sure which is worse....

Would you rather have your body imaged as if you were naked... or felt up?

I've had trouble writing lately. Lots of ideas, not enough clarity. I haven't slept enough (not getting enough sleep is basically like being drunk, all the time). Off to sleep on another cross-country Delta flight...

five years ago i worked in the emergency room

noreply@blogger.com (anu) — Wed, 08 Jun 2011 03:14:00 +0000

One of my new goals is to learn everything about core body temperature in the ICU. Why it’s taken, how it’s measured, when it’s used. What information it gives a clinician and how they can use that information to drive clinical interventions. It goes without saying that I’ll be spending some pretty significant time in the hospital over the next several months.

Five years ago this June, I worked in a hospital. Grady Hospital, specifically, in the trauma center. Grady is one of those classic inner-city hospitals you hear about. It’s the largest trauma center in the Southeast, and the only Level I trauma facility within 100 miles of Atlanta. My first day, we intubated a woman shot in the mouth during a work scuffle (she lived). My last day, we watched a chief resident attempt a full thoracotomy on the way to the elevator for a man who had been shot in the chest with an AK-47 (he died).

I was technically a Research Associate. We were supposed to be running four studies for PIs at Emory – interviewing patients, coordinating with pharmacy, observing procedures, the like. Honestly, I don’t remember doing much other than talking to the homeless people about their smoking habits (one of the studies) and waiting for two hours by the bedside of a man who had a seizure while driving so we could measure the extent of his head injury (another study).

What I do remember learning that summer was how little of being a doctor is treating a patient’s condition. Instead, and especially in a place like Grady, it’s about demographics, socioeconomics, and psychology. And paperwork, too.

You do more for a patient by helping them find a job with a decent wage than you do by prescribing anti-depressants. Or by reducing sodium intake instead of prescribing lasix in patients with CHF. Or just by sitting at the bedside with an elderly homeless woman who has thrown herself off a bus to get a place to stay and a person to talk to.

I always meant to be a serious blogger about device design. I think I write about design like James Altucher writes about hedge fund trading (he doesn’t). That summer at Grady was for my medical school dreams what this blog is about my life as a designer.

Five years ago, the day before my birthday, I was at the hospital late. I was scheduled to leave at 8, but at 7:15, we got our first LifeFlight call. A peds case, but no details. In the hospital, “peds” case can be anything from a few months to 18 years old. Half an hour later I rode up to the roof with another research student and a PA, a stretcher and an excited silence between us.

The next day, my 20th birthday.

I don’t remember what actually happened. A helicopter landed. A boy, bigger than I was, was pulled off the board and onto the stretcher. We ran back to hold the elevators for the trauma team on call. I remember pointing out that he might be a candidate subject for a design research study, but quickly dismissing the thought as we took a separate elevator back to the trauma bay.

The details came slowly, from quiet conversations at the nurses’ station and the residents’ orders to the pharmacy. He was 15, spending the holiday weekend at the lake with family. He played football at the local high school. He was a good student.

He had attempted suicide.

His parents came in, having driven from the lake, about 45 minutes later. I vaguely remember the attending dismissing the first and second year residents minutes before they walked in. It’s hard to understand what to say to a parent whose son has just attempted suicide when it’s your first week on the job at Grady’s ER. I remember standing in the corner of Trauma 2, peeking into the next room, thinking that he was just three years younger than I was, and yet we were so far apart.

It's a patient privacy violation to take pictures of patients in hospitals, but this seemed fitting.

I think about that night a lot. About the look on his parents’ faces when they walked in to that trauma bay. About the promise of a young man’s life – a young man who hadn’t yet learned to drive, or been to the prom, or filled out a college application. About the life that lay ahead of me at 15. About all the things that I had yet to do and see and experience.

Sometimes, when I am in the hospital doing design research, I think about how all the technology in the world can’t save you if you don’t nurture the soul inside you. That all the diagnostics in the world can’t tell you everything that’s going on inside the human body. Design becomes practical to me in that moment. Hope becomes visible. We become human.

i'm not sure what city i'll wake up in on friday

noreply@blogger.com (anu) — Wed, 01 Jun 2011 12:12:00 +0000

Of all the posts I've written, the one that I've gotten the most emails, most comments, and most feedback on is the post about business travel. It's interesting - I'm not a professional business traveler. I'm not a consultant (I'm not sure if those two are synonyms, but I do remember when I was little and someone asked me what my dad did, I told people he was a professional traveler).

Actually, my travel schedule - both business and personal - is the opposite of a consultant's. It's really erratic and pretty unpredictable. In the years since college, I've started traveling (usually alone, sometimes with friends or coworkers) at least once a month. It's Wednesday, and I'm still not sure what city I'll be in at the end of the week.

I think - think - that this is El Paso, Texas.

I think you can tell a lot about a person's professional personality by the way they handle two things: email and travel. In terms of email, I'm a nazi. Almost nothing stays in my inbox for more than 48 hours - it gets read, sorted, forwarded, or otherwise dealt with. It's a habit I developed in college, and I've found that it's one of the most effective ways (for me) to get things dealt with.

Travel is a bit more complicated. I think if you travel often, the goal is less to maximize your time and more to make your life feel normal. I have a friend who dealt with a year of constantly being on the road at the age of 18 by playing putt-putt in every city he visited. My boss finds a bar in every airport he goes through. And I take pictures of my feet and read entertaining posts from Penelope's blog about life-disguised-as-work-advice (which is true even for travel - people are more lost, both literally and figuratively, when their travel plans are their own doing).

I'm pretty sure this is why hotel loyalty programs were invented. Staying at the same hotel, or the same type of hotel, gives us a sense of normalcy. A sense of our stay not being so transient. When Kimpton calls me to greet me by name and give me information on a city two days before I arrive, I feel like someone knows my story and remembers that I was there.

If you look at my DISC profile, most of you could probably guess that I'm a classic "I". I'm also a high "C". Meaning, I prefer knowing to not knowing, and (some sort of) structure to waking up in a different city every week. I have to continually find ways to keep myself grounded when I don't know where I'm going to be.

It's hard to handle frequent, unpredictable travel with grace (one of the best ways to learn about someone is to travel with them to a place that neither of you have been before). Everyone has their own way of dealing - whether or not they check bags (I always do, even though I make sure it's small enough to be a carry-on), what airlines and hotels they choose, which airports to connect through. But the more telling aspect of our personalities is how we deal with our bags being misplaced, or an incorrect hotel reservation, or what we do with our spare time in an unfamiliar place. It's not an easy balance when you're jet-lagged, drowning in email, and in a city far off the map that you've never seen before.

watch Good Morning America this week! (updated: with link)

noreply@blogger.com (anu) — Tue, 31 May 2011 04:01:00 +0000

I'm usually not a TV watcher, but that's about to change this week. The lovely and amazing Colleen Coyle is filling in for Sam Champion as the morning meteorologist on Good Morning America all week!

Watch the full Tuesday show here.

(all photos are personal - please do not reproduce without permission)

Colleen showing me how it's done at KPSP Local 2 in Palm Springs, California.

Hiking Indian Canyons in Palm Springs.

Good friends, great times, and Sawra the dog.

(This is not a shameless plug - she really is lovely and amazing, and the fact that we were roommates in college has nothing to do with that. Well, maybe a little. And fun fact for her fan club: she's a terrific photographer.)

Tune in Tuesday through Friday, 7 to 9 AM local time on ABC!

multidimensional design and a fresh start

noreply@blogger.com (anu) — Mon, 30 May 2011 15:34:00 +0000

I found out this week I'm switching teams.

For those with a background on the medical side of things, I'm leaving the Vascular Interventions team to head over to Critical Care / Renal Function. From a purely clinical perspective, this is a huge opportunity. Bard's big business is in Foley catheters (this link may or may not be SFW... depending on where you work), and more than 10% of its annual revenues as a corporation comes from the critical care Foley business. I'm going to be leading a huge project involving core body temperature and diagnostics, and I'm tremendously excited to get started.

Of course, I'm sad to leave my team behind. If you are one of the people that enjoys my gchat status updates during the week, I regret to inform you that the days of ambiguously hilarious updates about "PWOMs" and "LBigs" are numbered (or at least, will be reduced). Over the past two years, we've become not only subject-matter experts in venous infusion, but also good friends in the process.

Last week, I sat down with my new boss to discuss human-centered design. It was interesting, in that the conversation was happening between two engineers who see their craft as a balance of logical facts and human misgivings. We are consummate systems thinkers, trying to find where people fit into process.

Not to knock engineers (after all, I am one), but part of our problem in product design is that we try to systemize everything. We want an orderly and repeatable process to come up with orderly and repeatable innovations. Life is messy. It doesn't flow gracefully in neat, logical form. Instead, it flits its way from idea to idea, lumping together things that have no business being put together.

I'm trying to find my place in between designers and engineers. I think, then, it's important to build our lives richly, to cultivate experiences that can show us different dimensions of the problems we're trying to solve. It's the officially-unofficial first weekend of summer, and as I get ready for a fresh start on Tuesday morning learning about sepsis and kidney function and multiple-organ failure in the ICU, I'm trying to commit myself to an exploration of multi-dimensional design as well.

1. Two-dimensional design. I'm a lousy artist, so I take photographs instead. Here's a photo that sums up the weekend in Atlanta:

It's only May...

2. Three-dimensional design. I've decided to build a desk. Well, sort of. I wanted to build a desk. Then I realized that there are desks out there that are almost what I want. So I decided to find a desk to repurpose and refinish. But that's proving to be more difficult than I thought.

Four furniture stores and two hardware stores later, this is the best imitation of butcherblock I could find :-/.

3. Four-dimensional design. A new dance class that reminds me of why I started dancing in the first place. This weekend we're finishing up Ciara's Gimmie Dat, one of my favorite songs-of-the-moment (the video's choreography isn't as good as Vera's). I'm always impressed with the ability of good choreography to translate energy, emotion, and passion from individual movement and isolations to an entire crowd of people.

Since I didn't get to wear Ciara's awesome A-town hat in our video, I'll post this picture instead.

Our brains aren't wired to work in logical systems. Design is just as disorderly as life. Composing photos, creating a desk, and a choreographing a hip-hop class can teach us something about uniting human needs with systems capabilities.

the sound and the fury

noreply@blogger.com (anu) — Fri, 27 May 2011 11:00:00 +0000

When I came home last night, there were fire trucks and cops blocking my street.

In front of the Ramos's house - there were a line of cop cars and ambulances down the street.

The awe and the fury of nature is astounding. The neighbors had their house struck by lightning, and in an instant the rear of the house was up in flames. Thankfully, no one was hurt (including their two dogs).

Sawra looking very morose in her rubber ducky raincoat as she watches the firemen.

It's been a crazy tornado season. In the United States, more than 500 people have died - making it the deadliest season in more than half a century. What's made it so real this year, though, is that some of my closest friends are from Ringgold, Cullman, and Tuscaloosa.

I love this picture, posted by a storm-chasing-meteorologist-great-friend of mine taken in Joplin last weekend, that sums it up perfectly: nothing happens, until it happens to you.

(photo courtesy Colleen Coyle - thanks roommate!)

An overt reminder that there are some things in this life that are out of our control. No matter how we try to design our lives, we have to be flexible for the things that life hands us, too.

the little things on my mind

noreply@blogger.com (anu) — Mon, 23 May 2011 03:55:00 +0000

It's Sunday night and I'm spent.

It's the kind of weekend that's spent working on the little things. So often we wait for the big things that will define us - a degree, a particular job title, a promotion or a product launch. But life isn't lived in the big things.

I got an email earlier this evening from a friend of mine (and I hope you don't mind that I quoted this):

"[...] i'm glad that you post. particularly with the material that you do because if you tried to share this information on an individual basis, i might never have heard you "talk" about all the things and topics that you blog about. in fact, your blog actually helped me refine my "public health" eye to include a design element. plus your references to various books and articles inspired me to read them too and find ways for them to relate to my work and passions. [...]

so basically, thank you for blogging. i know it's hard but i'm glad that you do.

It's a small thing, and I get a fair amount of emails about the blog, but it made a difference. In a world of big things, a small thing like a thank you can change everything.

Lehrer writes,

"This is life as it's lived - our epiphanies inseparable from our chores, our poetry intermingled with the prose of ordinary existence."

If we live intentionally, we design our lives to take care of the poetry. But in doing so, we sometimes forget to appreciate the beauty of the prose.

So tonight, some snapshots of life's ordinary moments as they're lived - small celebrations among the chores.

I laugh at this at least once a day. The line about dry cereal? So true.

A small tradition that's still going strong. Better Than Ezra at Center Stage.

Sawra making friends on our weekly pilgrimage to the Piedmont Dog Park.

A little part that's a big part of my life right now.

A little space in a cab with seven others.

The simple joy of using fat Sharpies vs. skinny Sharpies. You know you know what I'm talking about.

Sometimes the little things are actually really big things - wearing the insanely huge ACC championship ring, looking far less cool than the owner.

I was babysitting the little cousins on Friday night, and we happened to be watching Cartoon Network. I wondered aloud why in the world they show human tetris on Cartoon Network, of all channels, when my 8-year-old cousin piped in, "People like to watch other people get smushed by foam walls and pushed into pools of water!"

Yes, sometimes, it's the little things in life.

caption contest: improper microwave use

noreply@blogger.com (anu) — Sat, 21 May 2011 03:18:00 +0000

In this week's episode of poorly-worded design, we have the cup I tried to make oatmeal in this morning:

I'm honestly not sure what that's supposed to mean. So - tell me friends. What constitutes "proper" and "improper" microwave usage?

Best caption wins a prize.

on trust

noreply@blogger.com (anu) — Mon, 16 May 2011 05:02:00 +0000

Thursday night, we had a team dinner with our Mexican counterparts at Antica Posta (a restaurant that's coming to rival Ecco for best Italian in Atlanta). Three hours over wine and veal is probably not a necessary expense in a struggling economy. But somewhere between the lobster bruschetta and the panna cotta, with multiple conversations flowing in a mixture of English and Spanish, we got more done than we did in three days of meetings.

Antica Posta might have the best foie gras in town.

Breaking bread is a way to share a human experience. It's a interaction designed to build trust. It creates a space for the emails, phone calls, and Webexes to become relevant. It brings the words to life, and bridges the gaps in communication and understanding that a conference call or two-day deep dive meeting can't.

I'm not a fan of The Purpose-Driven Life. It's probably because I'm not Christian, and I grew up as a very obvious minority in the heart of the Bible belt. But - there is a piece of the book that I remember often. On Day 18, Warren tells us that life is meant to be shared.

I've said before that I find blogging hard. It's hard to trust people you don't know (and in some cases, even harder to trust the ones you do know) with your words and thoughts. It's very public, and in the world today it's very permanent.

I get grief all the time for not having a Facebook wall or public photos. I am inherently a private person. I prefer to send a hundred personal emails (as some of you can attest) or spend hours on the phone rather than post a public comment or photo album. Words, in my mind, are a gift, given intentionally, to a particular person or group, to create or inspire or motivate or understand. I'm afraid that when I put ideas out for everyone to read, I dilute the ability to speak to this person, in this moment, with this particular cause. And most of all, I'm afraid that you won't respond not because you don't agree with me, but because the words don't speak to you.

So my blog, like dinner, is a lesson for me in trust. It's about designing a space that allows me to trust the people who care enough about my ideas to read them, and about you trusting me to be honest and open with my thoughts. It's about slowly giving up privacy in favor of sharing a human experience and a human perspective.

Team dinner. I'm going to trust that you won't reproduce without permission.

Blogging, however, does not come with the perks of foie gras or Italian buffalo mozzarella that team dinner does.

work that matters

noreply@blogger.com (anu) — Fri, 13 May 2011 23:00:00 +0000

This is a long post is going to piss some people off.

I had an early morning meeting a few weeks ago that I’ve been mulling over in my head. An old acquaintance told me over breakfast about the work that his firm is doing in healthcare financing and insurance estimation. It’s very high level policy oriented work that is front-and-center with healthcare reform, and it’s a lucrative prospect. He asked me if I would consider joining him and his team – because not only are “we changing the game in how we fund healthcare, we’re going to make a lot of money doing it.”

Work right now is all-consuming. I’m barely above water trying to figure out how to launch a major medical device. There are questions of technical assessment, market strategy, brand positioning, and a thousand things that I’m ultimately responsible for that I’ve never done before. And since January, it’s been a thousand miles an hour with no breaks. I’m stressed.

But what I do is create technologies and systems for people in their most vulnerable moments. I spent thirty minutes telling him why I didn’t go into consulting or hedge fund trading (and I had the opportunity). Sure, I could have made more money. But money isn’t what I was chasing.

It IS possible (but not always easy) to do what you care about and make money.

So to be asked, point blank, to leave and do something else for the money? I was almost insulted.

I’ve heard all the arguments that you can make money first and then use it to make real change in the world – a la Bill Gates or Warren Buffett. Or that you need to work at a place like a consulting firm to “get exposure” and “learn the industry” before you can do meaningful work of your own.

Please. I went to a top five engineering school with a footprint at all the major consulting firms. I served on an Advisory Board alongside lawmakers and CEOs of major corporations. It wasn’t for lack of opportunity or exposure that I chose the route I chose. It was because I didn’t want to wait for four years of exposure and experience (and a fat paycheck) to do work that I found meaningful.

I’m not saying that I love every piece of my job. The past five months have left me ready to pull my hair out at times. But what’s important to me is that moment of quiet joy when I stand at a patient’s bedside and a doctor introduces me as the engineer that made sure the medicines made it into your body.

Some people genuinely enjoy working at consulting firms or finance houses (and I have lots of friends that do). That’s fine. But I also have friends that have deluded themselves into thinking that working where they are is what they actually want. The point here is to not turn down something you love in favor of something you aren’t passionate about. Real passion – passion for the work – not just passion for the money (Penelope Trunk has a related post – about falling in love with a person, not falling in love with money). Don’t justify to yourself that you’re passionate about something if you’re doing it for the name, the prestige, or the paycheck.

Here is a story from Ramit Sethi (I believe the link to the story requires a free subscription).

A few years ago, I was a senior in college, deep in interview season, and one of the guys in my dorm had been talking about working at a company (let’s call it Company A) for months. It was an awesome company where he would be doing cutting-edge work — IF he could get an offer.

He was OBSESSED with the firm. He spent weeks prepping, doing informational interviews, researching them, talking to alumni who worked there… and put together a phenomenal interview strategy. And FINALLY, after all his hard work, he received a great job offer from them.

…but then he received a job offer from Company B for about $5,000 more.
Company B was basically a financial chop shop where they took elite grads and forced them to work for 16 hours/day doing Excel and Powerpoint. It has a prestigious name, but the work is a joke (and everybody knew it). Yet they pay top dollar and pick off people like my friend year after year.

It was amazing to watch him change overnight. “Yeah, Company A is pretty cool…but B is doing some REALLY interesting things. I could totally see myself working there for a few years, then doing what I really want. Maybe an MBA? Or starting my own firm?”

I’ll never forget thinking that it only cost $5,000 to buy his dream and squash it.

Back then, I hadn’t developed my philosophies about Conscious Spending and honestly, I was more judgmental than I am now. So keep that in mind when I tell you what happened.

“Why would you turn down your DREAM JOB for a little extra money?” I asked.

“It’s not just about the money,” he said. “The work is really interesting and I think there are some good opportunities once I finish my two years there. And it is an amazing brand on my resume. Yeah, the money is good, too…”

This was a guy who’d spent months CONSUMED with getting into the other company. He knew exactly what he would do there. We used to joke about these big-name companies that just swoop in and buy the best talent, but then stick them in jobs that a monkey could do. Plus, he essentially had his pick of jobs and was graduating debt-free from Stanford (thanks to his parents). He could work anywhere and not worry about money.

Now this is going to sound a little arrogant, but I said it back then, and I still mean it today.
“Dude, $5,000?” I told him. “In the grand scheme of things, that’s NOTHING. If you make the right moves, you’ll be able to make that in a month…or even a day.”

But even though he loved this company, and had psychologically committed to working there for MONTHS, when he got slapped in the face with a fat job offer he changed overnight. It’s hard to turn down that amount, even if it only adds up to about $100 per week. It’s difficult to imagine your friends making thousands more than you do… even though you “could” have made that much.

And so he went to work there. He hated the job. But he made money, and now he’s become yet another finance guy.

This is the part that will upset people. I know I’ll get some emails from people in finance and consulting telling me how much they love what they do and that I don’t understand because I’m one of the “lucky” engineers that does what they want. But this isn’t about finance and consulting. This isn't about people who actually, legitimately feel like the work they do is fulfilling. This is about being honest with yourself about what fulfills you - and making the conscious decision to pursue just that.

We are responsible for designing the lives we live.

channel strategy in the developing world

noreply@blogger.com (anu) — Sun, 08 May 2011 20:05:00 +0000

Effective channel strategy makes sure devices get used on patients.

Our Vascular Care group constantly talks about channel strategy (that is, how our devices make it to the bedside and ultimately to patient use). We know that designing the right product is not enough - we have really strong clinical efficacy evidence and a proven value proposition. Our products work, and clinicians that you talk to know the benefits. And yet we still have trouble driving compliance across a hospital. If a nurse knows that this device provides better clinical outcomes for patients and saves complication costs for the hospital, why do they neglect to use it with every IV insertion?

A usable device discarded by a hospital (at MedShare International).

Channel strategy is not just a medical device challenge. I'm currently rereading Prahalad's The Fortune at the Bottom of the Pyramid. In it, he argues that the poor - the consumers at the base of the pyramid - pay a "poverty penalty"that causes goods and services to be more expensive than they would be in corresponding areas of town that are more developed. The interest rates on credit in Dharavi are between 600 - 1000%, whereas on Warden Road it's a more reasonable 12 - 18% -- 53 times more expensive. Municipal grade water is 37 times more expensive, medications are 10 times more expensive, and rice is 1.2 times more expensive (see chapter 1).

Access and distribution channels in the developing world are just as complex as they are in a field like developed world healthcare. No one strategy will work. In poor areas, inadequate infrastructure makes it even more difficult (and even more expensive) to grant access to technologies and services by people who cannot afford to pay more for them.

Prahalad is not the only one who talks about access and distribution. There's a book by Frost & Reich available for free online called Access: How do good health technologies get to poor people in poor countries? It's sort of an interesting framework for why some technologies gain a foothold and some don't, from a distribution perspective (sort of similar to my own research).

So how do we lower the poverty premium? It's not necessarily by designing products for poor people (although that helps). It's by doing the basic, unglamorous things. System design. Capacity building. Effective training. These things are so needed and neglected in the developing world, but doing them can increase bandwidth and innovation in the developed world as well. As Prahalad liked to say, "If you build it for the poor, the rich will come. If you build it for the rich, the poor can't come."

back stateside, and safe in el paso

noreply@blogger.com (anu) — Wed, 04 May 2011 23:57:00 +0000

Our latest adventure in Mexico is over.

I have lots of thoughts from the visit on Mexican business culture, on the balance between American prosperity and Mexican labor, and on my experience hand-building parts on the manufacturing floor (and I'm sure I'll get to those... all in good time), but crossing the border and seeing flags flying always reminds me of how thankful I am for the opportunities I have being an American.

The vehicle border crossing at the Zaragoza bridge.

Crossing the border in Juarez is always a strange and sort of surreal experience - and doubly so after the events of this week. A friend of mine wrote an op-ed for the Atlanta Journal this week on what it means to be Muslim-American (an excellent piece, and I highly recommend it!), and today, as we walked across the Zaragoza land bridge, over the Rio Grande and back into the states, I took a minute to read the words on page 14 of my passport:

“Let every nation know, whether it wishes us well or ill, that we shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe, in order to assure the survival and the success of liberty.”

a crazy end to a very eventful week (month)

noreply@blogger.com (anu) — Mon, 02 May 2011 04:11:00 +0000

http://english.aljazeera.net/news/americas/2011/05/2011522132275789.html

I've spent the evening preparing for a short trip abroad tomorrow, and tonight, I'm thinking about what it means to be an American. It's been ten years - ten years - since the September 11th attacks. We don't know what this means yet, and only time will tell how the implications will play out, but tonight, I'm thankful to those who give their lives to make ours safer.

World Trade Center site, New York City.

From The World Is Flat:

The Arab-Muslim world is a vast, diverse civilization, encompassing over one billion people and stretching from Morocco to Indonesia and from Nigeria all the way to the suburbs of London. It is very dangerous to generalize about such a complex religious community, made up of so many different ethnicities and nationalities. [...] The question I want to explore is: What produced this violent Islamist fringe, and why has it found so much passive support in the Arab-Muslim world today- even though, I am convinced, the vast majority there do not share the violent agenda of these groups or their apocalyptic visions?

When Muslim radicals and fundamentalists look at the West, they see only the openness that makes us, in their eyes, decadent and promiscuous. They see only the openness that has produced Britney Spears and Paris Hilton. They do not see, and do not want to see, the openness - the freedom of thought and inquiry - that has made us powerful, the openness that has produced Bill Gates and Sally Ride. They deliberately define it all as decadence. Because if openness, women's empowerment, and freedom of thought and inquiry are the real sources of the West's economic strength, then the Arab-Muslim world would have to chance. And the fundamentalists and extremists do not want to change.

raise your hand if you remember this

noreply@blogger.com (anu) — Thu, 28 Apr 2011 01:49:00 +0000

I spoke at Omicron Delta Kappa's Freshmen Leadership Reception on Monday night, and got the chance to speak to some Freshman Council members afterwards. For those of you who know what this is from, breathe easy - they assured me that (for now), FC is safe at Georgia Tech.

Probably more pictures of myself than I'll ever post again...

Tonight, as we're anxiously waiting in the calm before the storm in Atlanta, I found this old gem. Fittingly enough, we've been joking about this as we approach President's Dinner. An old picture, a great memory.

a generation of question-askers

noreply@blogger.com (anu) — Wed, 27 Apr 2011 02:19:00 +0000

I bought my mom an iPad recently. Last week, we went to dinner to celebrate her 50th birthday. We were sitting at Ecco in Midtown on a gorgeous night, and I was asking her how she was liking the new iPad. She remarked to me that she hasn't sat down at her computer in at least 4 or 5 days, but she's still afraid to take it with her anywhere because she "might break it."

Great conversation, gorgeous night at Ecco in Midtown Atlanta.

My mom is sort of afraid of technology. I find it frustrating to teach her how to use new pieces of technology. She grew up in a time and a place that didn't encourage learning by doing. I grew up in a culture that supported playing, exploring, and trying things out without asking permission. Our paradigms of how we approach something are totally different.

When you think about it, Generation Y is a bunch of question-askers. We aren't afraid of asking questions, because we've always had the tools to find the answers. When it came to computers and the internet, we very rarely asked our parents how to do something, because they knew as much about the technology as we did. As a result, we were allowed to explore, to learn, to break things if that's what it took. We had a much higher tolerance for questioning, answering, and failing in our early lives, because it didn't take time to try again.

I wish I could get Shan to write a guest post about success, failure, and startups. Michael Fairbanks said last weekend that to understand what you really should be chasing, "fail frequently, fail fast, fail originally" - Gen Y is in the perfect place to do that. To take risks. It's sort of exciting, given our backgrounds and upbringings, to think about the next 30 years of innovation in technology. To think about the next 30 years of thinking in human-centered design.

The iPad is a great device for Mom. Once she overcomes that initial barrier, that fear, it encourages her to play, to touch, to try. What's the worst that could happen, I asked her - that you break it and we have to get a new one? It's a low investment to learn to ask good questions and seek good answers.

designing cradle-to-cradle

noreply@blogger.com (anu) — Fri, 22 Apr 2011 17:40:00 +0000

In honor of Earth Day, a question: for any of you in [product] design, who generate physical things as a result of your work, have you ever designed anything to be cradle-to-cradle?

Chicks dig recyclers (true story). World of Coca-Cola, Atlanta, Georgia.

As in, something that can be completely repurposed and completely diverted from the waste stream?

It's a difficult proposition in medical devices, because of biohazards and body fluids, but I'd be curious to see some good examples of how, in this age of smarter consumption, designers are coming up with smarter creations as well.

On another note, I've posted three times in two days! That's got to be some sort of record or something. I'll take a cookie for that.

gumption is one of my favorite words

noreply@blogger.com (anu) — Fri, 22 Apr 2011 13:11:00 +0000

There have been a few times in my professional career where I've walked into a room and surprised someone with the gumption I've displayed. At Georgia Tech, I walked into the Athletic Director's office and told him that I was going to get my way through hell or high water. As a brand new engineer, I told my boss's boss that I would not release product because I couldn't tie my name to bad science. And this past week, I told our senior management team that I can't support a project that I don't agree with.

Jonathan Sacks wrote, "We bear responsibility for what we could have prevented, but didn't." Martin Luther King said, "A time comes when silence is betrayal." Sometimes, you have to say no because saying nothing is the same thing as saying yes to something you don't believe in.

Standing up for what I believe in at the Unite for Sight conference in New Haven, Connecticut.

As time goes on, it gets easier to say "no" to things you don't stand behind. Sure, sometimes it's still scary. You don't necessarily know what the consequences are, or how it changes the perception of you in someone else's eyes. But we are responsible for the design of our own lives. And I have infinite respect for people who display the gumption to say "no" - pleasantly, smilingly, nonapologetically - to the things that they can't justify doing.

Likewise, I am continually amazed by people who have the courage to unabashedly go after what they want. People who aren't afraid to have difficult conversations. People who harbor no pretenses and make no compromises. I'd like to think that one day I'll have that kind of gumption. I'm not there yet, but I'm working on it.