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December 3, 2004

BehindTheMedspeak: PillCam


One of the greatest new technologies in medicine.

PillCam ESO (for esophagus) was approved this week by the FDA.

It's the first non-invasive alternative to diagnostic endoscopy.

An endoscopy is a procedure in which a thick, flexible tube is inserted into your mouth and down your throat.

It's uncomfortable, requires sedation, and hours of recovery until you can go home.

Less well appreciated is that people from time to time are oversedated by nurses, techs, or others who have no business giving IV narcotics and sedatives.

When that happens in the quiet, dark endoscopy suite, often the first sign that something's wrong is cardiac arrest.

A "heart attack" in the endoscopy suite - like those that occur in dental offices - is no such thing.

Rather, it's a respiratory arrest due to oversedation, leading to hypoxia of the brain stem and the medullary centers controlling cardiac function and respiration.

But I digress.

The PillCam requires no sedation and you leave immediately after the 20 minute procedure.

For now, gastroenterologists are safe: you still need an endoscopy if the PillCam sees something that requires a tissue sample for biopsy.

But that won't be for long: I guarantee you that as we speak, PillCams with biopsy and surgical capability are undergoing clinical trials.

Oh, what a great time to be an invasive radiologist.

Here's how a PillCam procedure works:

1) You lie down and swallow it with some water

2) The head of the bed is gradually raised to let gravity pull the device down your esophagus

3) Meanwhile the PillCam, equipped with miniature cameras and flashing lights on both ends, wirelessly transmits 2,600 color pictures at a rate of 14/second to a recording device

4) The images are downloaded to a computer for a physician to review

5) You poop out the PillCam naturally, usually within 24 hours (wonder if you get to keep it?)

The device is made by Given Imaging of Israel,


which also makes the original PillCam SB (small bowel), approved by the FDA in 2001 to detect abnormalities in the small intestine in precisely the same fashion.

December 3, 2004 at 04:01 PM | Permalink | Comments (0) | TrackBack

The future of journalism is in... Chile?


So it would appear to me after reading an absolutely fascinating story by Danna Harman in yesterday's USA Today.

Yes, it's a future come to us via Chile, a country that a few decades ago was lost in the shadows of the past, repression under the Pinochet regime having rendered it effectively inert.

Long story short: a stodgy old newspaper called LUN, "102 years old, boring, unpopular, and basically 'a middle-of-the-road piece of nothing,' has been transformed - by the internet - into Chile's most widely-read paper."

How did this happen?

Simple on the surface: the newspaper's publisher, Augustine Edwards, decided to "listen to the people."

He put the paper's website's statistics up so everyone in the newsroom could see them.

Then he simply let the public click "yes" or "no" for stories that appeared, basically letting the crowd - in this case, the paper's readers and life-blood - give a "thumbs-up" or "thumbs-down" as to whether they liked a story and thus, by implication, wanted more like it or not.

If a story gets only a few clicks, it's spiked; if it's popular, LUN pursues it for the next day's paper.

Says Edwards, "I'm not of the school that says, 'Eat porridge, it's good for you.'"

The usual suspects have their knickers in a twist over this developement.

"It's an alarming success," says Orville Schell, dean of the University of California-Berkeley's graduate school of journalism.

Gee, I wonder if he feels the heat under his seat as the whole system totters.

Schell calls this new force - what the reader wants - "an online Fifth Column."

I'm loving it.

Do we hear echoes of the UNOS organ transplant fiasco as people decide they're not going to die quietly waiting in line for a transplanted kidney but instead acquire one on the web?

I do.

Anything that removes those with power over others and gives it to the individual is what I'm about.

Hey, back when bookofjoe was in Version 1.0, with the babes and all, I got 25 times more traffic and readers than I do now with my stodgy G-Rated/Disney approved Version 2.0.

But you know what?

I like it this way 25 times more.

Because I've got a whole other class of people here with me now - not better, not nicer, just other and different.

And that's mighty fine by moi.

Here's the USA Today story.

    In Chile, instant Web feedback guides the next day's paper

    It was 102 years old, boring, unpopular, and basically, as economist Marta Lagos puts it, "a middle-of-the-road piece of nothing."

    Now, it's a phenomenon.

    Las Ultimas Noticias (LUN) - The Latest News - is Chile's most widely read newspaper today, setting tongues wagging, talk-show hosts chatting, celebrities and politicians denying, serious folks wailing, and advertisers calling.

    No, it's not a tabloid, insist the employees at the slightly shabby downtown newsroom.

    Rather, they say, it's a revolution in journalism, a reader-driven product that reflects the changing values and interests of a postdictatorship public that grew up on a diet of establishment news and now wants more.

    Or, as some say - because of the often low-brow content - less.

    This revolution has occurred, says the paper's publisher Augustine Edwards, thanks to his decision to listen to "the people."

    Three years ago, under Edwards's guidance, LUN installed a system whereby all clicks onto its Web site (www.lun.com) were recorded for all in the newsroom to see.

    Those clicks - and the changing tastes and desires they represent - drive the entire print content of LUN.

    If a certain story gets a lot of clicks, for example, that is a signal to Edwards and his team that the story should be followed up, and similar ones should be sought for the next day.

    If a story gets only a few clicks, it is killed.

    The system offers a direct barometer of public opinion, much like the TV rating system - but unique to print media.

    What news, then, did readers choose in a week when a dozen world leaders gathered in Santiago for an important trade meeting?

    Among the top stories: Where Secretary of State Colin Powell went to dinner and what he ate (shrimp with couscous).

    Also, a rundown - with a photo of scantily clad waitresses - of which delegations gave the best tips (Japan).

    "This is very experimental, and it seems to be working," says Axel Pricket, a senior editor at LUN.

    "But," he hesitates, "how are you going to get a journalist to cover an important visit, say, of the Chinese trade minister when you know in the evening everyone will click on the story of the scantily clad girls?"

    No editor, he points out, is going to be able to say: "Let's showcase an issue which is totally uninteresting to the public."

    "And why in the world would they want to?" roars Edwards, dismissing arguments that it is a newspaper's role to educate and inform the public, and rolling his eyes at the charge that the media is causing a "dumbing down" of society.

    "I am not of the school that says, 'Eat porridge, its good for you,' " explains Edwards, warning that it's wise to be humble when deeming something "trivial" or "tabloid."

    "I'm focused not on what people should be reading, but on uniting them around what they want to be reading."

    As such, he argues, the paper is fulfilling a civic role - but with a twist.

    "We are serving the people what they want without passing judgment on their tastes or values, and we are reflecting a liberalizing, changing society that is Chile today."

    "Give me a break," moans Lagos, the economist, reflecting the attitude of many intellectuals here.

    With only 30% of the country having access to the Internet, and even assuming all those 30% are clicking on LUN, is the paper truly a reflection of society? she asks.

    "The paper is taking its cues only from a very specific sector."

    But observers see this small sector as representative of a growing movement.

    "The appeal of LUN is indicative of several cultural trends taking place in Chile," says Roberto Mendez, director of Adimark, a research firm.

    Chile, under the dictatorship of Augusto Pinochet from 1973-90, was one of the most conservative and repressed countries in the Western world, he points out.

    Films were censored, pornography banned, and news reports very official, and frankly, dull.

    "The last 15 years have seen a tremendous cultural revolution, in which social attitudes are changing rapidly," he says.

    "And all this is coming at the same time as the Internet explosion and the increasing prosperity in Chile."

    Most media remain wedded to the old news selection system while LUN, says Mendez, is tapping into the new mood - and making a commercial success out of it.

    It's an alarming success, says Orville Schell, dean of the graduate school of journalism at the University of California, Berkeley.

    He says it bodes badly for the future of serious journalism.

    "The quest for eyeballs has soundly trumped good, sound news judgement," he says.

    "Market forces have established yet another beach head in the publishing world, albeit, through an online fifth column."

    Back In the LUN newsroom, Orietta Santa Maria is grinning.

    Her story - on the arrival of the wealthiest man in the world, the Sultan of Brunei (for the trade meeting) - is one of the top click winners.

    Her follow up, she says, might be something about the daily activities of his "exotic" entourage.

    "We are all still getting used to the new system here," she says.

    "It's all down to a science, with the clicks guiding you more than an editor does."

    None of the LUN correspondents have news beats anymore, rather, they compete one against the other.

    Edwards says he will start financial incentives, with salaries reflecting the monthly clicks each reporter accrues.

    Editors, he adds, will work more as coaches than bosses.

    "I want my correspondents to be writing for the people," he stresses.

    "Not for me, or their editors, or the bureaucrats who put out press releases."

    "Some years ago I covered good stories, like the Pinochet case," says Santa Maria.

    "I spent my time cultivating sources, and it was serious." She misses it once in a while.

    "But this is a phenomenon," she says with a shrug, "and I am not going to fight against it."

    In a Santiago hotel, clerk Raul Sepulveda is reading the story about the Sultan of Brunei.

    "Imagine, the wealthiest man in the world in town. I wonder how they choose his hotel?"

    No, he is not interested in the free-trade agreement just signed between China and Chile - or in Iraq.

    "Of course these things are important," he says. "But do I have to read about them?"

December 3, 2004 at 03:01 PM | Permalink | Comments (1) | TrackBack

Blik-mas Tree


"Wall graphics for the commitment phobic" is Blik's slogan and it's right on the money.

They make a whole slew of cool stick-on graphics you can use to instantly personalize a space.

And when he gets tedious, possessive, or simply begins to lose the charm that got you to move in, well, wait till he heads off to work, then simply peel your cool stickers off the walls and you're on to your next.

Slick, what?

For the upcoming Yule festivities, Blik unveils its new Blik-mas Tree.

For $60 they'll sell you the following:

• Eighteen 3" red Blik-mas balls

• Twelve 9" green branches

• Eight 6" white presents

• One 11" yellow halo


December 3, 2004 at 02:01 PM | Permalink | Comments (0) | TrackBack

BehindTheMedspeak: 'How Doctors Think'


That's the title of Dr. Jerome Groopman's upcoming 2008 (!) book, to be published by Houghton Mifflin.

I was just reading about it Wednesday in the New York Times.

They said he'd received "an advance of more than $500,000" for it.


Wait just a minute.


Half a million simoleons?

For vaporware, to be published in four years - maybe?


I mean, even at 4% interest, that's a sweet twenty grand a year in walking around money from the interest alone.

What the heck am I doing here?

I'm gonna crank out a prequel, and call it "Can Doctors Think?"


Then - if it meets with the kind of reception I think it will - I'll follow it up very quickly with a sequel entitled, "Do Doctors Think?"


That should be worth a cool million up front, at the very least.


Who wants to negotiate my contract?


You get 25%.


But remember: unless you're using new math, 25% of zilch is, well, not a whole lot.


But we have so much fun here, who cares about money?

December 3, 2004 at 01:01 PM | Permalink | Comments (0) | TrackBack

'Quotes' - by J.G. Ballard


Now comes the author of such memorable books as "Crash," "Empire of the Sun," "The Atrocity Exhibition," and "Super-Cannes" with a collection of his most memorable bon mots.

From the book:

    The new totalitarianism is docile and subservient, and all the more threatening for that.

    The New Totalitarians come forward smiling obseqiously like head waiters in third-rate Indian restaurants, and assuring us that everything is for our benefit.

    Rockets belong in the age of the 19th century, along with the huge steam engines. It's brute-force ballistic technology that has nothing to do with what people recognize as the characteristic technology of this century: microprocessors, microwave data links - everything that goes in the world at the speed of an electron.


    The suspicion dawned that Outer Space might be - dare one say it - boring. Having expended all these billions of dollars on getting to the Moon, we found on our arrival that there wasn't very much to do there.

    Americans are highly moralistic, and any kind of moral ambiguity irritates them. As a result they completely fail to understand themselves, which is one of their strengths.


    The president of the United States bears about as much relationship to the real business of running America as does Colonel Sanders to the business of frying chicken.

    Modernism: The Gothic of the Information Age.

    Money: The original digital clock.


    If you can smell garlic, everything is all right.

December 3, 2004 at 12:01 PM | Permalink | Comments (0) | TrackBack

Auto Card Manager


Pick a card - any card.

Well, maybe not any card.

This $39.95 device lets you press one of six labeled buttons on the outside to produce that particular credit or ID card.

Comes with 18 interchangeable card identity buttons.

Also has a removable money/receipt clip.

Your choice of eight great colors: burgundy, cobalt blue, camouflage green, camouflage tan, camouflage white, forest green, black, and silver.

They'll even engrave three initials on it for you.

Supposedly prevents demagnetization of your credit cards.

Measures 4" x 2.5" x 1/2" deep at the front end; 3/4" deep at the back end.

Weighs 3 ounces.

What I like is the spiel in the hard-copy catalog (not online) that says, "If you're a user of many credit cards and ID's this is a "must-have" tool."

Hey, guess what?


If you're a user of "many ID's," you need a lot more than this tool if you're gonna keep all your balls in the air.

December 3, 2004 at 11:01 AM | Permalink | Comments (0) | TrackBack

Brian Williams of NBC News is too pretty to last


You heard it here first.

Well, maybe second: tart-tongued Maureen Dowd, in her Op-Ed page column in yesterday's New York Times, wrote: "Even Tom Brokaw is a little surprised that he has been succeeded by someone who looks like the love child he and Peter Jennings never had."

Williams is wonderful to look at, with a great voice and a very calming, reassuring manner.

Then why don't I think that when you turn on the NBC Nightly News on December 3, 2009 - five years from today, which happens to be the second day of his reign as Tom Brokaw's successor - it won't be Brian Williams' face you'll see?

I simply find him so overwhelmingly perfect that it will be impossible for men to watch him for long.

Women love him, no question: it's time the networks offered them something to balance out the CNN eye-candy-for-guys that's been characteristic of that network from the get-go.

All the other anchors have their rough edges, though Peter Jennings comes pretty darn close to being without any.

FunFact: people with hearing loss find Peter Jennings the best newscaster out there, because he's the easiest to lip-read.

It's the imperfections that make someone likeable over the long term.

Ever notice how the things that first charmed you about someone turn out to be their most off-putting features once your point of view changes?

So with the reverse: the twangy South Dakota lilt of Tom Brokaw's voice and Dan Rather's earnestness have made them comfortable presences over the years.

Brian Williams will never make himself at home in the American TV viewer psyche and so, after a few years, he'll be shuffled off to some lesser stage.

You heard it here second.

The very same place you learned that John Kerry would - no doubt about it - win the election.

December 3, 2004 at 10:01 AM | Permalink | Comments (3) | TrackBack

Louis Vuitton Diaper Bag


Forget the Pooh prints and pastels, girlfriend - here's what's happening.

For $1,190 you get this stylish canvas shoulder bag with a monogram-embroidered changing mat and natural cowhide trim.


Comes in Sable or Terre (khaki to you, Englishwoman).

Doubles as a computer case.

"Thermo-compressed technology allows for lightweight, semi-rigid construction, while multiple compartments and a comfortable strap create exceptional organization and ease of use."

So you don't have to worry about getting pooh all over your Crystalmini.

Measures 14.6" x 12.2" x 3.5."

Magnetic snap closures.

Durable textile lining.


What're you waiting for?

December 3, 2004 at 09:01 AM | Permalink | Comments (0) | TrackBack

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