Cataract Followup

I blogged the other day complimenting Kaiser on its cataract surgery setup.  Very good, but...

My mother-in-law had cataract surgeries about 10 years ago, in the office of her ophthalmologist, with the staff just a nurse, the receptionist, and the doctor.  Her results were good.  I'd assume Kaiser does a better job by devoting more people and better routines (i.e., checklists, etc., everything Atul Gawande would approve of). But "better" is at the margins, an incremental improvement.  Now when it's my eyes, I want every little increment I can get, but as a society we might be better off if one of the Kaiser staff was employed as a home-visiting nurse.  Might be, but there's no way in our society to get there from here.

Calm Down

That's my general attitude to the transition to the Trump administration.

See Brad Plumer's tweets this afternoon, just as an indicator:

I dunno. Stories about EPA frozen grants, deleted websites, media blackout… seems like they've all been smaller than first thought, no?

Is that because the initial coverage was overblown — or because the initial coverage was right and Trump's team backed down? Hard to tell.

[Updated:  This indicates agencies are being cautious in their Federal Register publications.]
 I remember similar stuff happening in previous administrations.  Two things to remember: we're disrupting old political habits, the new administration doesn't know what they're doing and neither does their opposition, so opportunities for mistakes and misreading are great; because we're in new situations emotions run high leading to further exaggeration.

Once we (the administration and the public) get accustomed to our new roles we can start identifying what is going wrong and which policies are bad.

[All of the above doesn't mean I've taken back my endorsement of the demand to release Trump's tax returns.]

The Last Mile Versus the Last 1 Percent

The old saw (Pareto) says 80 percent of the cases can be handled with 20 percent of the effort.  An extrapolation would be: self-driving cars can handle 80 percent of the driving very easily but it's the last 5 percent, especially the last 1 percent of the time which is difficult.  Which I find to be rather like the old "last mile" problem in cable: easy enough to move data across country in a flash, but getting it the last mile was difficult. 

Nissan has an answer, whether it's workable remains to be seen.  They're using a telecenter to handle the unexpected problems (like a emergency road crew patching potholes or something).

Cataract Surgery

Had my second surgery yesterday. Apparently I haven't mentioned it.  It's time to recognize the capabilities of modern medicine and medical technology, and the good people at Kaiser Permanente Tysons Center who performed the surgery.  The mix of backgrounds of the people there warms a liberal's heart (as does the diversity of the people at the Reston Kaiser center where my internist and optometrist work).  

[Updated: Dr. Slack performed the operation and some of the people involved  were Dominique at reception,  Melita in Pre-op, Rizza Bernard and Reagan Jerome in the operating room, and Erin C. in recovery--I hope I've got the names right and there were others whose names I don't have.) Thank you all.]

FSA Makes the NY Times

Usually it's bad to be mentioned in the national media.  So it is this time, when an article on bald eagles killing chickens on a Georgia farm includes how FSA administers the Livestock Indemnity Program. Under the program farmers suffering loss of livestock can be compensated.  The loss is roughly calculated by determining the dead divided by the total herd/flock.  But the compensation is not for the total loss, it's for the loss over the normal, the usual.  The usual mortality rate for chickens is 4 percent, but that's for conventional flocks, living indoors.  The Georgia farm is part of the food movement, so his chickens are free range.  So what's the usual mortality rate?  40 percent was FSA's first try; 18 percent was the second, the third is still pending.

(I'm assuming the Livestock Indemnity Program, included in the 2014 farm bill, was intended as an alternative to a crop insurance policy, which livestock producers have been asking for.  The indemnity approach dates back at least to the 60's, when occasionally there was DDT contamination of milk, and we had indemnity payments for that.  Of course DDT was the reason that bald eagles were an endangered species and why there's still stiff laws protecting them.)

What Next for Women's Marchers?

That's a question being widely asked.  A modest suggestion:  if one out of every hundred marchers is inspired to seek elective office in the next election cycle, whether local, state, or federal office,  and half of the marchers work to support such candidates, they'd make a major increase in the number of women in office.  (Looks like about 2,000 women in state and federal office; if a million marched today that's 10,000 candidates, assume a quarter win that's 2,500.)

Women's Health in Nineteenth Century

The Jstor blog has a piece on de facto first ladies.  What's telling is that the list ends in 1915, with Woodrow Wilson's daughter (his wife died and there was a (short) time before he remarried).  There are 13 daughters, daughters-in-law, and nieces listed for the 19th century, but only one for a bachelor (Buchanan).  (The list does omit Anna Roosevelt, who often acted for FDR because her mother was out doing good works.)  That factoid shows two things:

• life was hard for 19th century women
• life, particularly because of public health improvements, was better for 20th century women.

Petition Trump

As of 3:24 today the Whitehouse petition site was still up, with petitions for Trump to divest assets and release tax returns.

Seattle WTO Protests and Today's of Trump

I wonder at the background of the protestors in DC today, the ones who destroyed some windows.  Were they perhaps the children, actual or ideological, of the WTO protestors of 17 years ago in Seattle?  And how do they relate to Trump's inaugural speech, which certainly was anti-global institutions and anti-elite? Or is it just the violent impulse present in all of us, using whatever materials are available to rage against the world, a world weighing too heavy on them?

Days of Hope

Reading this NYTimes piece from 8 years ago sparks memory of another era.  Briefly, Obama held, or spoke at, dinners honoring John McCain and Colin Powell on January 19, 2009.  (I was prompted to do a search by a tweet comparing photos of Trump's crowd at the Lincoln Memorial and Obama's.)