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

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

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

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

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

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

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

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

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

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)

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.