looking the part (i don't want no scrubs)

If you want to be perceived as competent & capable, the single easiest thing you can do is put on a jacket.

Yes, really.

We had a session of our Women’s Leadership Program today on professional image. Unfortunately, I can’t find the study that Sarah referenced in her talk, a University of Manitoba piece that took a group of like-performing salespeople and had them make calls on identical client sets. In 98% of cases, the calls made by those wearing jackets (matched with someone of similar style and experience) were successful over the calls with [source: Sarah Hathorn, Illustra Image Consulting].

It makes sense – and not just professionally.

Dress is just another form of design (my favorite form of design, maybe). It makes sense that you want to design something for a professional (or romantic) context that looks professional (or attractive). Designing something professionally attractive is pleasing, and people like that. And people like to do business with people they like (read item 4).

So boys, take note: girls don't like guys who look like scrubs. In business or in life.

Time to go jacket shopping.

don't put your life on hold while you travel

The worst way to grow from a blog is to neglect it for weeks at a time. The past three weeks have been full of ignoring my blog. Mostly, I’ve spent a lot of time traveling, and the weeks that I’m not traveling have been taken up by races, weddings, work, and the epiphanies of everyday life.

I’ve always enjoyed travel. When I was a child, we were lucky enough to spend time traveling with my dad when he had conferences or guest professorships in Europe. In fact, we spent a few summers living in Linz, Austria – where I developed my appreciation for town squares and discovered my lack of affection for spoken German. I’ve been from the Straits of Malacca to the Taj Mahal, and until recently, I’ve never had a problem maintaining my life while on the road.

But these past few months have been crazier than most, and because of it, I realize that my travel schedule has taken over my life. When I’m on the road, I’m constantly moving from city to city, as most of my trips aren’t long enough to spend more than a few nights in one place. When I’m home, I’m preparing for the next trip while taking care of things that can only be done at home.

I once read that your life can’t be put on hold while you travel, and I’m now understanding what that means. I don’t do a great job of hitting the gym or creating new designs or coming up with intelligent blog posts when I’m away from home. Although those are things that I really value, I let those things be interrupted by my weekends (and weeks) away. I never feel like I have enough time to do them perfectly, so I end up  not doing them at all.

So I’m trying to do better. What travel is good for, at least for me, is exposure to new ideas and some downtime to think about them (essential for ENFJ types to grow). So here’s a thought to grow on from my recent travels – this weekend, I went on a hike to the Seven Sisters waterfalls in Palm Springs Indian Canyons. At the top of the canyon, we jumped into a snow-melt waterfall that was just a few degrees above freezing. I tried to toe my way in the water and just couldn’t bring myself to fully submerge in the pool (submersion in cold water makes your peripheral vessels constrict and your blood pressure skyrocket). Finally, our guide, Jason, pulled me into the water and dragged me, kicking and screaming, under the waterfall.

And you know what? It all ended up just fine.

(

(photo courtesy of Jason Bruecks... that water was colder than it looks!)

Sometimes, you just have to dive in headfirst and not worry about how you’ll feel afterwards. Sometimes, you have to squeeze in your two-mile run on the treadmill instead of the full 10k, because doing something imperfectly is better than doing nothing at all. Not all posts have to be perfect, not all thoughts fully baked. That's what my travel schedule has taught me this week.

mindfulness comes from exploring your white space

I am terrible at yoga. Not so much the poses - I’m bad at coordinated breathing. I’m bad at sitting still. And most of all, I’m bad at not thinking about how bad I am at coordinated breathing and sitting still (maybe I'm not white enough?).

(personal image, please do not reproduce without permission)

I’ve always been a restless person (unless there was food involved… see childhood photo, in which my parents bribed me with food to stand still and look at the camera). My DISC profile shows that I’m a strong I and a moderate C, making me an anal-retentive people person who has trouble sitting still. Every week in class, I struggle with my inability to be mindful in downward dog.

Ironically, I find that peace and clarity in busy places. I love busy coffee shops and nice days at the park. I’m at my most creative and aware when I’m around other people, when I’m engaged in conversation, when I’m replying to blog comments and having four gchat conversations. To me, yoga class is full of mental chatter, but real conversations bring clarity. Real conversations inspire me to create, to fill the white space within myself. And the most interesting places are the empty spaces – they are what changes. But real conversations are hard work - you have to be willing to open up and explore your own thoughts, and listen to those of someone else. You have to think about contributing meaningful content, about asking good questions, and sometimes, about admitting you're wrong.

I’d rather drag myself to yoga week in and week out, hoping that one day I’ll find the self-awareness and mindfulness that my instructors talk about. And every week, I find myself thinking too hard about timing the rhythm of my breath with my ustrasana, or find myself trying to mentally correct the instructor’s Sanskrit pronunciation. What I really need to be doing to recharge is to spend my Sunday morning at Octane, reading a book and writing an article and having a conversation on the nuances of apologizing for drunken behavior in ancient Chinese culture (tip: Allen). And I know it. I’m just not at peace with that yet. Because it's easier to go to yoga and listen to someone else tell me how to find my inner being.

We all do that - we know, on some level, who we are. People have always been fascinated with finding out more about themselves, be it through art, meditation, or personality profiles. But the more important thing for us to explore is not quite who we are - it's finding and shaping who we can become. It's our white space. And by pursuing endeavors that bring out that white space, we become more mindful. And finding that white space is hard work.

why i still can't work our tv remote (hint: it's not because i'm stupid)

I’m in the middle of reading a pretty interesting book called The Design of Everyday Things. Donald Norman opens the book by talking about devices that seem impossibly complex to use, and reassuring the reader that their difficulties with such objects are the fault of bad design (and not their own ineptitude). Reading that, I couldn’t help but laugh and think about my constant battles with our tv remote.

(image courtesy of my iPhone)

I’ve never been a tv watcher, so I don’t hold tv remotes in any high regard, but this one really takes things to a new level.

The actions we perform in any given day are motivated by a goal and (hopefully) result in a desired outcome. Things that are designed simply, with the user’s perspective in mind, have a clear map from goal to outcome. If I want to type a particular letter on the keyboard (goal), I would look for a key that matches the symbol I wanted to recreate, and then I would push it (action). Pushing is intuitive – buttons are meant to be pushed. Then, I would get clear feedback (outcome) that the letter had been typed because I can see it on the screen. This is a simple action map.

Sometimes, a designer can anticipate a single goal that might be so critical that multiple actions will lead to the same goal. Usually, when an inexperienced person is learning to use such technology, they’re confused about the redundancy of action, but can figure out the conceptual model in a relatively short time frame.

Where we really get into trouble, though, is when multiple outcomes can result from one goal. This can happen as the result of one action (which is incredibly frustrating… just think of being a guy using a voice-dialing system in which your phone can’t decipher “Call Mom” from “Car Horn”).

The case of our remote is a little something like this:

I’m not sure what kind of design choice leads to a tv “PWR” button next to an “ON” button. I can't, despite my training in design and my own career in user-centered product design, figure out which action actually turns off the tv (and I have a feeling I'm not the only one... although I could just be stupid).

I realize that many of you aren't designers, at least not in the literal sense. But mental models of goals and outcomes are applicable to people as well as things. In fact, the place between a goal and an outcome is the gap between stimulus and response. Unfortunately for us, our mental models and possible actions to reach our desired goals look less like the first concept map I showed and more like the last, with multiple courses of action and relatively uncertain outcomes. Effective communication comes from a clear goal and a good understanding of the outcome, with somewhat variable action. Let's hope that we learn what buttons to push on people faster than we learn on our televisions.

winning arguments vs. solving problems

(image courtesy of...)

In Barack Obama’s second book The Audacity of Hope, he makes an astute observation:

"... most people who serve in Washington have been trained either as lawyers or as political operatives - professions that tend to place a premium on winning arguments rather than solving problems." (page 48)

This extends, I think, beyond our national politics (minus the formal training in law and policy). We’re becoming an entire nation of people who focus on winning arguments, and not to knock the lawyers among you, but winning the argument doesn’t do much for us. Winning the healthcare argument doesn’t make costs lower or care more affordable. Winning the argument with a friend or family member doesn’t mean you’ve built a closer relationship. And winning the argument at work doesn’t mean you’ve been more productive.

In our own lives, at work, at home, with friends, we should focus on solving the problem, not winning the argument.  It’s not to say we don’t have things that we shouldn’t fight to win. There are arguments worth having and values worth debating and defending; the challenge lies in reframing those to address the basic issue and fight for what’s most important to solve the real problem. From Thank You for Smoking: “That’s the beauty of argument. If you argue correctly, you’re never wrong.”

Not being wrong isn't the same thing as not doing wrong. And isn't that a higher value to strive for - being good?

inventing for the future consumer

“Think one hundred years in the future, and ask ‘what will people wish we had done?’ ”

I first read that quote when I was waiting for a meeting at the Centers for Disease Control in Atlanta. It’s posted on the wall behind the Smallpox Eradication exhibit, and attributed to William Foege (who is something of a legend in the global health world). Reading that statement, it’s hard not to be excited about the work that lies ahead for me. In fact, that exhibit and the ensuing conversation inspired my research during my last year at Tech (for those that are interested, since I allude to this a good bit, the title of my working paper is “Defining The Process of Innovation: Common Themes in the Development of Biomedical Technologies for the Developing World”, advised by Thomas Barker in the Coulter department of BME at Georgia Tech).

As many of you know, I design. Specifically, I design medical devices, and although my work doesn’t yet cater to the developing world, it is nonetheless challenging and often frustrating to design for future consumers. For one, current consumers don’t know what they want or need. Henry Ford once said, “If I had listened to my customers, I would have built a faster horse.” Market research has a place, don’t get me wrong, but as I’m finding out now, the feedback you get from the market is more a blur of mumbled whispers than it is a conclusive cry of need.

Given the confusion of customer opinion, it’s frustrating to balance the need of the current user with the pressures of the future marketplace. The more removed you are from your user, the more difficult this gets. When you’re dealing with consumer goods, you’re designing for an everyday person not dissimilar from yourself, and your release cycles are typically short (less than a year) – and your feedback is still mixed. When you get into more complex markets, such as healthcare or aerospace, you’re designing for more than one user, and often a purchaser that’s entirely separate. For example, when I design a device, I consider the user (a clinician or nurse), the object of use (the patient), and the purchaser (a hospital GPO or contract manager). Add that to a release cycle of 18 to 24 months minimum (without clinical trials), and you can see how challenging this gets – trying to predict the preferences and needs of three distinct use profiles at least two years in the future in the face of rapidly changing technology.

I wish I had more insightful commentary on how to do this. It’s been a focus of mine for a while, as a young engineer trying to learn all that I can about customer preferences and how to meet needs through design. Designing for people in the future is something I’m struggling with – heck, designing for people in the present is challenging enough right now. Tim Brown of IDEO suggests “structured brainstorming”, but I think that it also requires a leap of faith, and in some ways, younger designers who better relate to future consumers are at an advantage, especially those that are scripted in systems thinking.

Maybe I should have been an imaginary engineer after all.

(and sorry Shan, for a post without a picture)

two thoughts on the state of healthcare in the united states

(image courtesy of...)

Over the weekend, I got a chance to talk to Elli. He was attending the 2010 Missouri State Medical Association Convention, and mentioned listening to a doctor-turned-state-representative who essentially argued that healthcare is not a right. Upon further investigation of the topic, I came across this editorial (not from the same person, I assume); the author suggests healthcare is not a right because the rights that we’re guaranteed under the Constitution (life, liberty, and the pursuit) are rights to action, not rights to reward. Interesting points, but I really take issue with this paragraph:

The battle against the Clinton plan, in my opinion, depends on the doctors speaking out against the plan -- but not only on practical grounds -- rather, first of all, on moral grounds. The doctors must defend themselves and their own interests as a matter of solemn justice, upholding a moral principle, the first moral principle: self- preservation. If they can do it, all of us will still have a chance. I hope it is not already too late. Thank you.

Moral grounds? Self-preservation as the highest moral value? His argument unravels there. Self-preservation is certainly not my highest moral priority, and nor do I think we are being morally sound to deny healthcare to citizens who can’t afford it. Although we should pay for the goods and services we use, society collectively helps to educate its citizens for the betterment of the society as a whole, and doctors are no exception. Additionally, the externalities that all of us gain from having a healthy population far outweigh the costs to the individual.

Unrelated, but equally thought-provoking: regarding fee-for-service models, from the New England Journal of Medicine, in a roundtable with the well-known Atul Gawande and Dr. Elliot Fisher of Dartmouth Medical School, among others:

Fee for service does not pay for us to have long conversations with our patients. When we're feeling constrained, it's much harder for us to have that long conversation with a patient with heart failure to see if we can safely manage them at home. The default position in many communities becomes, "Gosh, I'm too busy. I better send them to the emergency room." The emergency room physician recognizes that they don't have time to manage the patient with heart failure in the emergency room, so admits them to the hospital. To the extent that those resources are available for us and we're not paid to do the things that we really would like to do or know we should do, we see huge differences in the likelihood of really unnecessary hospitalizations in different communities.

Dr. Fisher sums up the problem well – we incentivize doctors to spend less time talking to their patients and more time trying to comply with 80+ agencies’ regulatory and compliance requirements, and trying to keep their practice afloat. The practice of medicine in our society, in other words, is about so much more than patient care.

learning to say no

Something I've struggled with for a long time. I think lots of people do - they know they should, they want to say no, but they end up saying yes anyway.

From Covey:

"I don't mean to imply that you shouldn't be involved in significant service projects. Those things are important. But you have to decide what your highest priorities are and have the courage - pleasantly, smilingly, nonapologetically - to say 'no' to other things. And the way you do that is by having a bigger 'yes' burning inside. The enemy of the 'best' is often the 'good'.

Keep in mind you are always saying 'no' to something. If it isn't to the apparent, urgent things in your life, it is probably to the more fundamental, highly important things. Even when the urgent is good, the good can keep you from your best, keep you from your unique contribution, if you let it."

... it's that nonapologetically bit that gets me.

asking good questions (and getting good comments)

Just before I graduated from my undergraduate program at Georgia Tech, I sent two emails to help me through the process of figuring out where to go next.

(image courtesy of...)

The first, due to my interest in global health, was to the President of the Global Health program for the Bill and Melinda Gates Foundation, Tadataki Yamada. At the time, I was right in the thick of things with my research into technology development for global health, and had lots of ideas (and lots of questions) about how to impact healthcare in the developing world. When Dr. Yamada’s staff scheduled a 15-minute call for him to advise me on my next steps, I was thrilled. I spent weeks preparing for the call, and when I finally got my 15 minutes to talk to one of the leaders in the field, I had condensed my questions and planned my time to get some real meaningful content out of the call.

Several weeks later, I sent an email to Steve Jurvetson, a well-known venture capitalist. I had been keeping up with Steve’s flickr stream, The J Curve, and knew through several articles that Steve knew lots of things about early-stage biomedical companies. I spent 15 minutes composing a well-thought out email (or so I thought), and summarized the crux of my request as:

I am particularly interested in biomedical design for the developing world, among other things, and would love to hear your perspective and thoughts on the future of biotechnology in this area.

Looking back on that email makes me cringe. Peter Drucker once said, “The most important and difficult job is never to find the right answers; it is to find the right question.” My question didn’t give Steve any insight into what I was already thinking and what kinds of technology I was inquiring about. I was relying too much on a good answer to help me figure out where I needed to go, but I wasn’t mature enough in my question-asking to help myself get there.

It's the perfect example of understanding the space between stimulus and response. Asking a good question gives the responder the psychological space to give to a good answer, and helps both of you grow. Science is all about asking good questions, and I wasn't being a very good scientist.

Predictably, Steve sent back a very quick response along the lines of, it’s a great field, but I’m too busy right now to help. I realize now that I didn't give him enough constraints to effectively answer my question.  Strangers can’t decide for us what it is we should focus on – that has to come from us. But once we get our feet pointed in the right direction, people like Dr. Yamada can help bridge the chasms along the way.

Blogging is a little like that. I certainly don't know that I provide a lot of insight or "answers" on my fledgling blog... or that I want to. Being able to write an effective post is like asking a good question - how do you present the topic in such a way that allows people to formulate their own answers, and hopefully, their own questions?

art & science

  (image: Nikki Graziano)

I’m fascinated with things at the intersection of art and science. Jonah Lehrer has a great book called Proust Was A Neuroscientist. The High in Atlanta just sponsored a Da Vinci exhibit about the intersection between Da Vinci’s sculpture and his understanding of the physical world. The new Le Laboratoire in Paris is dedicated to exploring that space.

The image above is by Nikki Graziano, and currently serves as the background on my laptop. Lots of my coworkers come closer to take a second look, and most dismiss it as one of my nerdy hobbies (of which I apparently have plenty). And maybe it is nerdy. But it’s art. And it’s science. And it’s beautiful.

Design lies at the intersection of art and science. Maybe that's why I like it so much. Designing things – whether that’s objects, systems, shoes, or medical devices (shameless plug) – is most successful when the functional (the science) is married with the beautiful (the art). One can’t exist without the other. It makes perfect sense for engineers and scientists to pursue art as well, because engineering and science are inherently creative pursuits.

Medical devices, then, make for an interesting creative exercise. As Lehrer says about the human body, “We are such stuff as dreams are made on, but we are also just stuff.” We have to be creative in how we address the body’s science (by, say, generating electrical signals to keep the heart beating through a pacemaker), but we also have to protect and nurture its art (regulating that rhythm to fluctuate with the body during exercise).

The beautiful part of Nikki's photograph is that the function isn't a simple harmonic oscillator with whole number boundary conditions. Her equations are complex because life is complex, and her photography is beautiful because the world is so.

"Like a work of art, we exceed our materials." (Lehrer 8)