What can hospitals learn from a national restaurant chain like Cheesecake Factory?
‘It is unbelievable to me that they would not manage this better,’ Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. ‘I don’t know anything about medicine,’ he said. But when I pressed he thought for a moment, and said, ‘This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.’
This is not at all the normal way of doing things in medicine. (‘You’re scaring me,’ he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the ‘best practices’ are?
“Big Med.” — Atul Gawande, The New Yorker
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An examination of authors Gore Vidal and Terry Southern’s literary erotica:
“Gore Vidal was a friend and admirer of Terry Southern, calling him ‘the most profoundly witty writer of our generation’ and he could not have failed to have had the example of Candy in mind as he embarked on his own adventure in black-humored sexual satire, Myra Breckinridge. Like Candy, the book had its inception in a high-porn enterprise: Kenneth Tynan had asked Vidal to contribute a sketch to his planned erotic review Oh Calcutta! But as soon as he set to work, the mysterious sentence ‘I am Myra Breckinridge whom no man will ever possess’ sprang to mind and Vidal knew he was heading somewhere else entirely. The book became an outrageous theater of polymorphous perversity, a heady cocktail of Aristophanes, Marcuse, and Nietzsche married to an encyclopedic knowledge of the American cinema of the thirties and forties.”
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Published: Apr 1, 2003
Length: 8 minutes (2,188 words)
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What can hospitals learn from a national restaurant chain like Cheesecake Factory?
“‘It is unbelievable to me that they would not manage this better,’ Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. ‘I don’t know anything about medicine,’ he said. But when I pressed he thought for a moment, and said, ‘This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.’
“This is not at all the normal way of doing things in medicine. (‘You’re scaring me,’ he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the ‘best practices’ are?”
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Published: Aug 6, 2012
Length: 39 minutes (9,881 words)
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Cosmopolitan magazine is often spurned as “mindless,” but it has also grown into 64 editions worldwide, and a readership of 100 million teens and young women in more than 100 nations—including those “where any discussion of sex is taboo”:
Akisheva, the editor in Kazakhstan, told me that until recently, she received a handwritten note from Brown after the publication of each issue. ‘Our readers might not be very familiar with Helen Gurley Brown’s books and biography,’ she said, ‘but they surely are influenced by her original ideas. Because this is what Cosmo keeps telling them: You are strong, you can control your life, you can earn as much as men do and you can have sex before marriage and not be condemned by society.’
But what about the other stuff that Cosmo is telling them? One morning at Cosmic, a panel discussion included talk of some favorite Cosmo topics: sex toys (said to produce ‘the most incredible combinations of orgasms’), how to help men get erections more quickly and anal sex (‘backdoor booty’ as the magazine has called it). One panelist, a young Spanish woman, said that she teases her boyfriend with anal sex and then, jokingly, that she has to save something for marriage. The crowd roared. ‘Only at Cosmo,’ said the editor of Cosmo Australia, Bronwyn McCahon, between bites of miniature muffins and sliced melon, ‘will you be talking about anal sex at 10 a.m.’
“99 Ways to Be Naughty in Kazakhstan.” — Edith Zimmerman, New York Times Magazine
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Cosmopolitan magazine is often spurned as “mindless,” but it has also grown into 64 editions worldwide, and a readership of 100 million teens and young women in more than 100 nations—including those “where any discussion of sex is taboo”:
“Akisheva, the editor in Kazakhstan, told me that until recently, she received a handwritten note from Brown after the publication of each issue. ‘Our readers might not be very familiar with Helen Gurley Brown’s books and biography,’ she said, ‘but they surely are influenced by her original ideas. Because this is what Cosmo keeps telling them: You are strong, you can control your life, you can earn as much as men do and you can have sex before marriage and not be condemned by society.’
“But what about the other stuff that Cosmo is telling them? One morning at Cosmic, a panel discussion included talk of some favorite Cosmo topics: sex toys (said to produce ‘the most incredible combinations of orgasms’), how to help men get erections more quickly and anal sex (‘backdoor booty’ as the magazine has called it). One panelist, a young Spanish woman, said that she teases her boyfriend with anal sex and then, jokingly, that she has to save something for marriage. The crowd roared. ‘Only at Cosmo,’ said the editor of Cosmo Australia, Bronwyn McCahon, between bites of miniature muffins and sliced melon, ‘will you be talking about anal sex at 10 a.m.'”
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Published: Aug 3, 2012
Length: 15 minutes (3,977 words)
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The hype and marketing behind the “fastest man in the world”:
It’s no surprise that every sports meeting in which he participates is organized around him. When he ran in Ostrava in the spring, there were posters featuring Bolt all over the Czech city, the stadium was sold out weeks ahead and there were young blonde girls in the stands who had painted the Jamaican national colors on their cheeks.
‘Usain?’ the stadium announcer shouted.
‘Bolt!’ the crowd shouted back. And there were still three hours to go before the 100-meter race.
The other athletes were mere accessories, Olympic and world champions playing the opening act for the fastest man in the world. The journalists were interested in only two other athletes. One was Oscar Pistorius, who is running the 400-meter race on prosthetic lower legs, and the other was 800-meter runner Caster Semenya who, for a time, was rumored to be a man.
“Myths, Legends and the Making of Usain Bolt.” — Alexander Osang, Spiegel Online
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The hype and marketing behind the “fastest man in the world”:
“It’s no surprise that every sports meeting in which he participates is organized around him. When he ran in Ostrava in the spring, there were posters featuring Bolt all over the Czech city, the stadium was sold out weeks ahead and there were young blonde girls in the stands who had painted the Jamaican national colors on their cheeks.
“‘Usain?’ the stadium announcer shouted.
“‘Bolt!’ the crowd shouted back. And there were still three hours to go before the 100-meter race.
“The other athletes were mere accessories, Olympic and world champions playing the opening act for the fastest man in the world. The journalists were interested in only two other athletes. One was Oscar Pistorius, who is running the 400-meter race on prosthetic lower legs, and the other was 800-meter runner Caster Semenya who, for a time, was rumored to be a man.”
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Published: Jul 27, 2012
Length: 12 minutes (3,031 words)
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A look at the rights of same-sex parents after a mother abducts her daughter and heads to Nicaragua after a civil union dissolves:
Isabella’s tumultuous life has embodied some of America’s bitterest culture wars — a choice, as Ms. Miller said in a courtroom plea, shortly before their desperate flight, ‘between two diametrically opposed worldviews on parentage and family.’
Isabella was 7 when she and Ms. Miller jumped into a car in Virginia, leaving behind their belongings and a family of pet hamsters to die without food or water. Supporters drove them to Buffalo, where they took a taxi to Canada and boarded a flight to Mexico and then Central America.
Ms. Miller, 44, is wanted by the F.B.I. and Interpol for international parental kidnapping. In their underground existence in this impoverished tropical country, she and Isabella have been helped by evangelical groups who endorse her decision to flee rather than to expose Isabella to the ‘homosexual lifestyle’ of her other legal mother, Janet Jenkins.
“Which Mother for Isabella? Civil Union Ends in an Abduction and Questions.” — Erik Eckholm, New York Times
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For centuries, humans who were infected with the rabies virus had a fatality rate of 100 percent. A new treatment is providing hope, but its effectiveness is being called into question:
Not long ago, the medical response to this grim situation would have been little more than ‘comfort care’: administration of sedatives and painkillers to ease the suffering. Untreated, this suffering can be unbearable to watch, let alone experience. That telltale difficulty in swallowing, known as hydrophobia, results in desperately thirsty patients whose bodies rebel involuntarily whenever drink is brought to their lips. Soon fevers spike, and the victims are subject to violent convulsions as well as sudden bouts of aggression; their cries of agony, as expressed through a spasming throat, can produce the impression of an almost animal bark. Eventually the part of the brain that controls autonomic functions, like respiration and circulation, stops working, and the patients either suffocate or die in cardiac arrest. A decade ago, the only choice was to sedate them so their deaths would arrive with as little misery as possible.
But today, after millennia of futility, hospitals have an actual treatment to try. It was developed in 2004 by a pediatrician in Milwaukee named Rodney Willoughby, who, like the vast majority of American doctors, had never seen a case of rabies before. (In the US, there are usually fewer than five per year.) Yet Willoughby managed to save a young rabies patient, a girl of 15, by using drugs to induce a deep, week-long coma and then carefully bringing her out of it. It was the first documented case of a human surviving rabies without at least some vaccination before the onset of symptoms.
“Undead: The Rabies Virus Remains a Medical Mystery.” — Monica Murphy and Bill Wasik, Wired
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A look at the rights of same-sex parents after a mother abducts her daughter and heads to Nicaragua after a civil union dissolves:
“Isabella’s tumultuous life has embodied some of America’s bitterest culture wars — a choice, as Ms. Miller said in a courtroom plea, shortly before their desperate flight, ‘between two diametrically opposed worldviews on parentage and family.’
“Isabella was 7 when she and Ms. Miller jumped into a car in Virginia, leaving behind their belongings and a family of pet hamsters to die without food or water. Supporters drove them to Buffalo, where they took a taxi to Canada and boarded a flight to Mexico and then Central America.
“Ms. Miller, 44, is wanted by the F.B.I. and Interpol for international parental kidnapping. In their underground existence in this impoverished tropical country, she and Isabella have been helped by evangelical groups who endorse her decision to flee rather than to expose Isabella to the ‘homosexual lifestyle’ of her other legal mother, Janet Jenkins.”
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Published: Jul 28, 2012
Length: 13 minutes (3,276 words)
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