March 09, 2005
Ingo Maurer LED Table
The greatest lighting designer in the world continues to exceed himself.
In 2003 he created this spectacular LED table.
Each of the three shatterproof laminated glass leaves contains 288 white LEDs connected via an invisible conductive film to the electric power source.
The lights, visible from both sides, appear like the starry night sky.
The top measures 89" x 84.5".
MorphWorld: Nicole Richie into Paris Hilton
You know how married couples, husband and wife, sometimes seem to grow to resemble each other over time?
And how people often take on the appearance of their pets?
Nicole Richie has hung out with Paris Hilton so long, she's starting to look like her.
It's startling, actually, when you consider how unlike they appeared when "The Simple Life" began.
I'm reminded of that very scary 1992 movie, "Single White Female,"
in which Jennifer Jason Leigh starts to imitate and then try to become her friend, played by Bridget Fonda.
BehindTheMedspeak: Medical Helicopters Crash Too Often
Kevin Helliker and Vanessa Fuhrmans wrote a great investigative piece for the March 3 Wall Street Journal on the recent spate of emergency medical helicopter crashes.
Long story short: more often than not an old-fashioned ambulance, with its sirens and flashers and all, makes the trip faster than a helicopter would.
In fact, a Stanford University study published in 2002 noted, "In multicasualty situations, it has not been uncommon that ground ambulances arrive before an airship with patients from the same event."
Not only do helicopters crash far too often (so far this year, there have been four fatal crashes, killing six crew members and one patient), they cost a fortune.
A helicopter ambulance evacuation generally costs from $5,000 to $10,000 a trip, and sometimes up to $25,000, according to industry experts quoted in the Wall Street Journal story.
That is typically five to ten times as much as a ground ambulance.
A 1995 study of air transport of potential organ donors in Houston, conducted by trauma surgeon Christine Cocanour, found that 27 out of 28 would have arrived faster by ground ambulance.
I remember back when I was working at the University of Virginia Medical Center and the powers-that-be decided that they needed a helicopter to be "big-time."
Everyone got all excited about how great it would be, having the ability to fly to Tennessee and West Virginia and bring patients to UVA Hospital.
All I saw was major money out the window and even less sleep than I was already getting when I was on night call, taking care of people who could be just as well and probably better treated in Tennessee and West Virginia.
I mean, they have big-time tertiary care hospitals too.
Nice to know I had the right idea, even back then.
As Bob Dylan wrote, "You don't need a weatherman to know which way the wind blows."
Here's the story.
- Air Ambulances Are Under Fire
Critics Say Emergency Medical Helicopters Are Overused and Offer Few Benefits to Patients
For weeks now, federal regulators have been investigating the safety record of the air-ambulance industry, which has experienced four deadly crashes this year.
But an increasing body of evidence suggests there is a larger question to be asked about emergency-medical air transports: Do they benefit most patients?
The conventional wisdom is that air ambulances save the lives of patients who are too critically ill to withstand a slower ride in a ground ambulance.
Yet some observers of the industry say medical air transports actually save very few lives -- while costing as much as 10 times more than ground ambulances.
A number of published studies including research at Stanford University and the University of Texas, show that the flights often transport minimally injured patients when ground transport frequently could get them to a hospital faster, and with less risk to others.
"In 20 years of experience in urban critical-care helicopter transport, I can count on the fingers of one hand the number of times I thought flying a patient to the hospital made a significant difference in outcome compared to lights and siren," says David Crippen, an associate professor of critical care and emergency medicine at University of Pittsburgh Medical Center.
Inspired by images of helicopters evacuating wounded soldiers in Vietnam, the air-ambulance industry took root in the 1970s and has grown steadily ever since.
The industry fleet has nearly doubled since 1997, and patient transports are rising an estimated 5% a year, according to Tom Judge, president of the Association of Air Medical Services, a trade group.
The current probe of this year's fatal crashes, begun in January, comes as the industry has drawn increasing scrutiny over not just safety, but also efficacy and possible overuse.
Also in January, the journal Prehospital Emergency Care published an abstract reporting that a study of 37,500 helicopter-transported patients determined that two of three had only minor injuries.
One of four had injuries too minor to require hospital admission.
"The evidence says too many patients are being flown, and yet they keep flying more," says Bryan Bledsoe, a physician who co-authored the Prehospital Emergency Care abstract.
Among other recent research critical of air-transport use, Stanford University trauma surgeon Clayton Shatney conducted a study of 947 patients flown to Santa Clara Valley Medical Center and concluded that helicopter service potentially saved the lives of only nine of them -- while potentially serving as detriment to five who could have arrived faster by ground.
Travel by helicopter often is slower in urban situations, in part because of a lack of places to land.
"In multicasualty situations, it has not been uncommon that ground ambulances arrive before an airship with patients from the same event," says the Stanford study, published in 2002 in the Journal of Trauma, Injury, Infection and Critical Care.
Critics say air ambulances are overused and offer few benefits to patients
To be sure, there are situations where there is little debate that medical air transport has clear benefits, such as in rural areas where patients must travel long distances quickly.
Some smaller hospitals that fly patients to bigger facilities say they must err on the side of caution with a patient they aren't equipped to handle themselves.
And there is research that shows a value for patients.
A 2002 study, conducted by an air medical service in Boston compared patients flown with patients driven and showed a 24% survival benefit among the most seriously injured who were flown.
"That's an enormous benefit," says Mr. Judge of the Association of Air Medical Services.
The cost of air ambulances varies -- generally from $5,000 to $10,000 a trip, and sometimes as much as $25,000, according to industry experts.
That is typically five to 10 times as much as ground ambulance.
But ground transportation also can be not just less expensive, but faster: A 1995 study of air transport of potential organ donors in Houston, conducted by trauma surgeon Christine Cocanour, found that 27 of 28 would have arrived faster by ground ambulance.
Air-transport industry leaders, including Stephen Thomas, a physician and associate medical director of Boston MedFlight, an emergency medical air-transport service, attribute the high rate of minimally injured patients to the difficulty of conducting accurate injury assessments at the scene of accidents -- especially considering that such calls often are made not by physicians but by paramedics and even police.
But the majority of air transports occur not from accident scenes but from hospitals, according to the Association of Air Medical Services and others.
Frequently, doctors at a smaller hospital assess and stabilize patients before dispatching them to larger medical centers.
Insurance companies -- which often must pay for the costly transport -- say they are reluctant to second-guess the decisions of these doctors, who may view air transport as the least-risky choice for both the patient's health and the hospital's liability.
Consider the decision on Jan. 11 to fly Ryan Memering out of Memorial Hospital of Carbon County in Rawlins, Wyo.
Mr. Memering had two fractured vertebrae and a deep gash inside his mouth from a car accident.
Doctors at Carbon County made the decision to fly him to a larger trauma center in Casper, 120 miles away.
Hospital officials in Rawlins say that ordering the air transport was a clear-cut decision: Though the 45-bed rural hospital has a small intensive-care unit, it lacks full-time specialists for higher-level acute or trauma care.
"Any time you have something out of their scope of practice, that's a liability for anyone. Do you want to take that risk?" asks Candace Hofmann, the hospital's ambulance director.
The plane dispatched to retrieve Mr. Memering attempted to land in the dark at Rawlins Municipal Airport.
It crashed three miles away, killing three of four crew members on board.
Not until the next day did Mr. Memering get flown to the Casper hospital, where doctors performed no surgery and released him in four days.
"The staff there said Rawlins had panicked basically," says Serena Memering, the patient's wife.
Her husband, she says, "feels guilty that three people died because of this. In my opinion, it was a waste of lives."
The Rawlins crash represented the third fatal accident of an air ambulance during the first two weeks of 2005, prompting federal regulators to open a probe.
Safety experts say the industry's crash record is less a threat to patients than to crew members, who if they worked 20 hours a week for 20 years would face a 40% chance of being involved in a fatal crash, according to Johns Hopkins University epidemiologist Susan Baker, a professor in the Johns Hopkins Bloomberg School of Public Health who has studied the industry.
Possible outcomes of the federal probe include a requirement that pilots wear night-vision goggles.
The four fatal crashes so far this year of air ambulances have killed six crew members and one patient.
Patients can end up paying for helicopter transport that wasn't medically necessary.
After 9-year-old Tyler Herman fell and broke his jaw in the wilds of Arizona, doctors at a community hospital decided the boy should fly to Phoenix to undergo plastic surgery for a gash on his face.
During the flight he was well enough to sit up and remark on the scenery. Upon arriving in Phoenix, he waited nearly 20 hours to undergo surgery.
"We could have driven him there in four hours," says Sharon Herman, the boy's mother. Her insurance didn't cover air transport, leaving the Hermans with a bill for $25,000.
On its own, the air ambulance doesn't appear to be a huge money maker.
Earnings at the industry's largest player, Air Methods Corp., climbed to $5.1 million from $3.4 million during the five years ended in 2003.
But a 2003 Journal of Trauma study conducted by the University of Michigan Health System, which runs a flight service, found that flown-in patients had better insurance and generated significant "downstream revenue" because the patients developed a relationship with the hospital and often returned years later.
You probably thought this post was gonna be about the latest iteration of Honda's Asimo robot.
No such thing.
Rather, it's about a clever device you screw into the back of one of your kitchen cabinet doors.
It's a storage container for plastic bags, and much more: "raise the swivel arms and create an 'instant wastebasket' by hanging a bag on it!"
$11.99 here. (bags not included)
Vladimir Putin's excellent plastic surgery adventure
The President of Russia had a superb result from a rhinoplasty performed decades ago.
So much so that the fact he had one has never before, to my knowledge, been mentioned in print or, for that matter, in any media.
It's understandable: his surgeon wisely chose to create a nose that harmonized with the shape of Putin's face, rather than the ridiculous morphology chosen by so many Beverly Hills doctors and their equally over-the-top star-patients.
That's why you've never seen Vladimir Putin on awfulplasticsurgery.com - and you never will.
'This I Believe' — by Carlos Fuentes
Perhaps we will die knowing all the things that there are to know in the world, but from then on, we will be only a thing. We came and were seen by the world. Now, the world will continue to be seen, but we will have become invisible.
The terrible thing about the loss of a friendship is abandoning all those days to which the friend gave meaning.
To have desires and to know how to sustain them, correct them, abandon them... what is the path of this experiential ideal? It is precisely that very delicate balance between the moment that is active and the moment that is patient.
Europeans of the seventeenth century hoped that death would arrive from Spain, so it would arrive late.
Experience itself – good or bad – makes sure to remind us that, time and again, we will fail to rise to the opportunity of the day. We will turn our backs on those who need our attention, we will not even listen to ourselves. Time and again, what we thought to be permanent will prove to be fleeting. Time and again, what we imagined to be repeatable will never occur again.
Diamond Dust Necklace
"Five carats," is what you'll answer with your Cheshire cat smile, when someone asks you what you're wearing.
And that's the truth — the whole truth and nothing but.
True, the five carats have been subdivided, as it were, into zillions of chartreuse octahedrons.
Also true is that the diamonds are of industrial rather than gem quality.
But you know what I say?
They're still a girl's best friend.
Rhode Island artist LeeAnn Herreid can't hand craft these fast enough: she's running about two weeks behind demand right now.
But hey, you've waited this long to get what you deserve: two more weeks won't matter.
The sterling silver pendant has a glass face that overlies a mineral quartz crystal enclosing your jewels.
Rob Weaver, master of surface — II
He graced this site with his work back in January; I've missed his sense of depth and grace in color.
So he - or rather, his work - has returned today, with a few more of his creations for your female and/or male gaze.
Much more by this gifted man here.
There are those, now that I think about it for a moment, who would argue that he and his work are interchangeable; for all I know, Rob Weaver might say as much.
I certainly would say that's true of bookofjoe: it's me.
When you read it, you're reading me.
I'm beyond transparent.
So much so, I gotta wear shades.