Curiosity Over Pride (FYI: To comment, send an e-mail to

Friday, June 25, 2010

A Fondness for Earth

(I'm grabbing this from Econolicious' comment to Hell's most recent post. Upon reading it I had one of those "I'm glad somebody finally said it" moments a la The Emperor's New Clothes.)

We must stop viewing the issues of sustainability and climate change as good or evil and we must stop viewing this planet Earth as a servile entity, a slave that we can dominate and beat into submission. If we don't criminalize the battering of the planet and coerce the ignorance that allows this battering into submission, we risk the loss of our species on this planet. The survival of our species on this planet can not be achieved through democratic means. This planet Earth, is simply not going to allow us the timeframe to build consensus and vote for solutions to this problem.

We can either step up to the plate "right now" and conserve, preserve and reclaim the damage we have done to this planet by whatever means are necessary and recruit the receptive, persuade the skeptic, coerce the ignorant and eliminate the recalcitrant, or we can leave it to the wisdom of our natural environment to eliminate our entire species, both the so called good and the so called evil, in the same fashion that we eliminate viruses that endanger our species.

I think that vegetarianism is a given on our planet with 7B humans. I've given up all meat except fish for the last 7+ years and its honestly not that bad. I still have to kick fish and dairy, admittedly.

Other things humans may have to give up: Alcohol (encourages us to make bad decisions and is wasteful), creating offspring before age thirty, using more that 5 gallons of gasoline a week, the entire fashion industry, and non-recyclable plastics. Please feel free to fight with me in the comment section.

Monday, June 21, 2010

To Keep Our Brains Fresh and Springy

Surely Thai wouldn't have wanted us moping around pathetically. Katherine has added a few of the speeches from his service on Remembering Thai and I'm in awe with how much he managed to do with his 43 years besides entertain and educate us here in the saloon and on Sudden Debt.

So in that spirit I'm taking a look at Science Daily daily to look for things that would have doubtlessly set him off. And there are many. On the political/economic spectrum I'm referring to a site he once mentioned called Some Assembly Required . Its a horrific daily summary of humanity's misdeeds with a zippy little punchline at the end of each factoid to keep you from total despair.

So read up and then come back here to rant and rave ;)

Tuesday, June 15, 2010

An Article About Thai!!!

Thai McGreivy appreciation

By John Donnelly

On May 29, at 8:18 p.m., Dr. Thai McGreivy posted a guest blog on the Street Rat Crazy Saloon site titled, ``OK, my first short health care thoughts.’’ The item wasn’t so short, it wasn’t just about health care, but it was vintage McGreivy – provocative and piecing together seemingly disconnected big issues.

He wrote that municipalities were in budget crises and they might take aim at Emergency Medical Services. It made sense, he said, because spending had risen rapidly for EMS, but those extra costs weren’t resulting in improved survival rates.

Less than two days later, on Memorial Day, McGreivy, 43, suffered a massive heart attack while biking on Goldsboro Road in Bethesda en route for a long ride to Poolesville. EMS paramedics rushed to the scene, where he lay unconscious with no pulse. They did everything possible, including getting him to an emergency room at Suburban Hospital as quickly as possible. There, a team revived his heart.

McGreivy, an emergency room physician himself, remained in a coma as his heart showed signs of recovery. Four days after his collapse, doctors performed a critical test – a CAT scan on his brain, and the results were heartbreaking: severe brain damage due to a long period of oxygen deprivation. Nearly one week after his heart attack, officials pronounced him brain dead and his family authorized doctors to harvest all salvageable organs for those in need.

In death, McGreivy gave life – two kidneys and enough tissue for roughly 20 medical applications -- and his family and friends are grateful for the exemplary work of the EMS crew. They kept him alive against all odds.

But his guest blog post wasn’t wrong – not in terms of the metrics of public health. And therein lies a story about a relatively young man who left a mark on the quality of health care around the region precisely because he was unafraid to challenge anyone or anything, especially when it came to health care. In a very real sense, long before the national health reform debate, McGreivy was a one-man reformer – about a host of national issues around budgets and health and energy.

McGreivy, a husband, father of four boys, California born, was passionate about figuring out what made things work and what were the underlying factors that influenced outcomes, ranging from emergency rooms to global economic crises.

``His mind never stopped – ever,’’ said his wife, Katherine, softly laughing. ``I loved him dearly, but sometimes he was exhausting. He never stopped thinking and analyzing, and he always wanted to talk about ideas, and after hours of this, I would be, like, `Can’t we just gossip about the neighbors?’’’

He was chief financial officer of Medical Emergency Professionals (MEP), a 100-plus-employee company based in Germantown that runs five emergency rooms in Maryland – Shady Grove Adventist Hospital and Germantown Emergency Center in Rockville; Washington County Hospital in Hagerstown; Western Maryland Health System in Cumberland; and St. Mary’s Hospital in Leonardtown.

In all, the group, which started in 1997, oversees the emergency-room treatment of 300,000 patients a year; it contracts with each hospital, assuming all costs of ER service (which often run at a huge deficit to hospitals in part because of the numbers of uninsured) for no fee.

In each hospital, McGreivy and his partners strove to find cost-saving efficiencies while also improving patient care. In both Hagerstown and Cumberland, their system saved hospitals hundreds of thousands of dollar a year and shaved time off how long patients had to wait to see a doctor or nurse. At St. Mary’s Hospital, surveys showed patient satisfaction doubled over the past five years, now reaching levels of more than 90 percent reporting being satisified with their care.

McGreivy, said hospital CEO and President Christine R. Wray, ``was a tremendous catalyst to help St. Mary's Hospital change for the good. He was a terrific advocate in pursuit of excellence through data analysis.’’

Dr. Angelo Falcone, CEO of MEP, said McGreivy frequently pushed his peers. ``He always talked about how we had to make the hard decisions from an efficiency standpoint, and make sure they positively impact patients’ health,’’ he said.

One example rose in the Hagerstown hospital recently – a puzzle as to why doctors were seeing fewer patients than targets set by the group. At first, McGreivy and others hired $20-an-hour scribes to take notes for doctors, but that did not get the desired results. McGreivy studied it some more, discovering an anomaly at the hospital: physician assistants were seeing an unusually high number of patients. This was a problem because some of those patients could have gone straight to the doctor, and the doctors, in the meantime, had too much time on their hands. They could have been more productive – a cost savings to MEP and also, ultimately, to patients.

``There were a lot of moving parts in trying to figure out what was going on – 15 to 20 variables,’’ said Dr. Michael Cetta, MEP’s chief of business development. ``But he was able to think out of the box, and identify why it wasn’t working as well as possible. At our last management meeting, just a few weeks ago, he had figured it out, and now we are trying to fix it.’’

That was just one part of McGreivy’s impact, said his peers.

Justin Shaper, chief technology officer at PSR, a Dallas-based company that worked with MEP to help it manage its business, recalled how he and McGreivy developed software to standardize reviews of doctors’ charts of patients. Today, MEP and roughly a dozen other doctors’ groups around the country now use this more scientific approach to better evaluate doctors’ performance.

``There are a lot of overachievers out there, but what was special about Thai was that he never lost sight of the human connection in things – he kept coming back to the patient quality of care,’’ Shaper said, talking on his cell-phone while driving into downtown Dallas. He started to choke up. ``I’m sorry,’’ he said finally. ``Let me tell you a story about a dinner that we had together.’’

Seven years ago, Shaper, his wife, and their two children were eating a meal with McGreivy during a break in a conference in the Florida Keys, in Islamorada. ``At one point, Thai, who is an emergency room physician, one of a group of people who work under phenomenal pressure, who make life-and-death decisions, who make life better for people every day, he turns to my kids and says, `I hope you know your dad is helping save people’s lives.’’’

Shaper wept over the phone. ``That was the thing about Thai – while he was really into all these intellectual things, he still had an appreciation for what others were doing, and he let them know they were a part of doing something important.’’

And so it was, too, in his blog on EMS for Street Rat Crazy Saloon, when after writing about the questionable costs of EMS services, he wrote, ``I truly think most of the men and women in EMS are heroes.’’

In the hours before doctors removed McGreivy’s organs on June 6, Katherine McGreivy, in a waiting room with Falcone, decided to look up her husband’s most recent blogs on an iPhone. She found the EMS post.

``It gave me goose bumps,’’ she said. ``While we’re waiting for the whole surgery and the donation, we’re reading about his thoughts on EMS, and do they make a difference in outcome. Because he was saved from an almost certain sudden death, two people are getting a kidney, many others are getting tissues. It did make a difference – with him. He was still giving life even in his death.’’

A memorial service for McGreivy is scheduled for Thursday June 17 at 3 p.m. at the Bethesda Theatre at 7719 Wisconsin Avenue, Bethesda. The family has set up a memorial fund in honor of McGreivy that will fund educational scholarships for excellence and intellectual curiosity in science, mathematics and economics. In lieu of flowers, our family will request donations to this fund.

Friday, June 11, 2010

The Thai Experience

Being that he had insatiable intellectual curiosity, he voraciously tore into the internet. In his numerous internet wonderings he came across a certain blog that fascinated him and he began voicing his ideas in the comment section. People with similar curiosity began responding to his comments; the comment section became boisterous. A community was formed.

One of the members gave Thai the nickname “The Fractal Rabbit”. It pleased him greatly. He had a reputation for an obsession with fractals, hence the fractal part of the nickname. He also had a habit of letting his curiosity lead him into “rabbit holes” a la Alice in Wonderland. He would come across a new idea and dive into the internet rabbit hole with frenzied intention to learn all he could about the new subject. Therefore the rabbit part of his nickname. The rabbit part was also apt because he was FAST! He would encounter his new subject, study it ruthlessly, post his findings on the blog, and demand you consider its relationship to the universe. By the time you had started your first query into Google to try to catch up with him, he had already repeated the process with a different new exciting idea. And likely correlated the two and demanded that you consider that as well. You couldn’t help but be infected by his enthusiasm for new ideas.

What was he searching for ultimately? I believe he wanted to make sense of the world and then fix it so people could be safe and happy. At least in the “big picture’ this seems to summarize what he was subconsciously driven by. In the more “normal daily life” perspective I think he just found it to be fun and fascinating ;)

Not being a religious guy, he couldn’t just adopt a preformed view of the world (in fact, when one blogger suggested it would be interesting to discuss the Old Testament he replied that “he’d rather stick his hand in a blender”. Tres amusant, no?). So this left him with the difficult job of crafting his own world view.

Physics. Chemistry. Evolutionary biology. Great, that set the stage of the universe and created the actors in it. The actors then did some really strange things for a couple hundred thousand years. Groups formed different systems of doing things. Politics. Economics.

Yet, there was something odd. In all these different areas he was seeing patterns. Whether driven by the laws of thermodynamics or the nature of humanity, these various systems were similar to each other in some way. He came across the concept of fractals and was entranced. This is what keeps happening!! Define the boundaries of a system, insert or remove energy, and the results are predictable. Every iteration that the system cycles will be similar to the previous and next iteration. Fractal self-similarity.

This fractal key became how he made sense of the world. So on to fixing the world to make people safe and happy. Humanity is a system like any other system. How to make it the best system it could be…..

If the members of a group were not cooperating there was a lot of misspent energy that could have been better used. If they cooperated all that energy could have been used forging ahead to a new layer of complexity (which is good- the library of a major university in 2010 is more complex than the three books some guy in a village 15 km away has in 1510). To cooperate requires rules. For people to follow rules they have to be perceived as fair. How do we determine what’s fair? How do our brains do that? Language seems critical to the process for humans. How do our brains know what language is? Down more rabbit holes!!!!

He didn’t get to finish the puzzle. I type that with terrible sadness. He was 43 years old. I’ll always wonder what he would have come up with if he had another 43 years to search and ponder. With every new scientific discovery I’ll think “Man, he would have gone ballistic on the blog over this!”. Bittersweet.

And it wouldn’t be right to not mention his life outside cyberspace. Both his mother and father had terrific adventures ( his mother was sent to Thailand by the Peace Corps so “Thai”) and were educated at UCLA which was also his alma mater. He met his wife when they were both still in school and he adored her for more than twenty years. She went with him all over while he finished medical school. He had some wild experiences working in Emergency Departments. He had four kids that he doted on tremendously. He read truckloads of fiction and non-fiction. He watched TED conferences online. He listened to NPR. His energy for learning was matched only by his energy for enjoying people.

How lucky I was to become his friend. You’ll be remembered fondly, Buddy.

Wednesday, June 9, 2010

Velveteen Rabbits

This header for this blog post was inspired by Thai's widow, Katherine (by the way, that was also my mother's name), who in an e-mail to me said this:

"I want you to know that you had actually, like the velveteen rabbit in the children's story, become real to me."

This was in response to my e-mail to her where I reminded her that she referred to me as Thai's "imaginary friend." We are all now becoming real to her, just like the beloved rabbit in the story. And just like the rabbit in the story, The Velveteen Rabbit, we are all shedding a tear for Thai now.

Meeting Thai

It was the fall of 2008; I was working out of an office in Somerset, Pennsylvania. It was a great time for me. I was staying in this tiny little town called Mill Run. It was just four miles from a famous Frank Lloyd Wright home called Fallingwater. This project allowed me to explore a large part of the country that I had never been to before.

Anyway, Thai had suggested that we meet for lunch. I didn't want to waste an opportunity so I left in the morning and drove to Hagerstown, Maryland, to meet him at a little hole in the wall (and I do mean hole in the wall) deli. The entrance was down an alleyway and wasn't much to look at inside or out. But Thai had assured me that it came highly recommended by his peers at work.

I showed up about 10:45, and expected to wait the 15 minutes until the agreed upon meeting time of 11:00. Well, 11:00 comes and goes; no Thai. I think Thai calls me around 11:15 and says he just arrived. But he doesn't know where the deli is at. (Wait, you mean you suggest a place and you don't even know where it's at...?) He tells me he is out on the main road, and I walk down the alleyway to the sidewalk. I should interject here that I have some PTSD due to an angry driver trying to run me over with a car. While walking down the alley, someone in a car drove up behind me. In the alley, there was nowhere to run. So I had to face my fear and step to the side as far as possible. I get through it. Heart pounding and panting with fear, but I get through it.

So Thai tells me what he is wearing (and I am looking all over the place as I am in a strange place and not feeling completely safe) and I finally spot him waving at me. I can't remember the explanation exactly as to why he is late. I think it had something to do with his kid being sick, or getting up late, or something.

But anyway, we finally sit down to eat lunch. He isn't scheduled to go to work until 2:00 or something. We talk for 2 full hours about a whole number of subjects. Everything from the debt issues, to my work, to medical issues and everything in between. We part, having talked fully about all of the issues that interested us both. We were going to meet again in Cumberland, where Thai had another hospital he worked at, but by the time Thai got around to working over there, I had already been sent home. You know, I never did get to take that train ride in Cumberland like I had planned.

A Friendship Develops

After that, Thai and I started exchanging e-mails and phone calls regularly. Besides discussing the political and financial issues of the day, we exchange information on a professional level. I would ask him medical questions (often about my own health issues). And he explained medical concepts in a way that would be understood to a ordinary person (like me).

The phone calls became so frequent, that on the day that RKohn announced Thai's death in the comments over at Sudden Debt, I was just about to call Thai and tell him the good news that I had lost 20 pounds in the last 5 weeks. I had also noticed that he had not been posting here at Street Rat (I had just assumed he was busy with work.) I was also going to ask him to explain some other medical issues that another friend's dad had suffered from.

Anyway, I had asked him how to lose weight. "Calories, calories, calories" was his answer. So I have cut my caloric intake to 1000 calories per day and have been walking at least two miles per day in the summer sun (with a sauna suit on). And usually another two miles in the evening (without the sauna suit). But, being next to the lake here, it is hot and muggy in the evening. Just right to cause a lot of sweating. It seems to be working, at least so far. But I still have a long way to go.

The Kübler-Ross Model (the five stages of grief)

I suspect we are all experiencing some -- or all -- stages of the Kübler-Ross stages of grief right now. I know I am.

1. Denial – My initial shock of "No, it can't be true!" This passed quickly as reality set in.

2. Anger – For me, this manifested itself in the form of "How could you deprive me of another (expected) 30 years of intellectual challenges and stimulation?"

3. Bargaining – I didn't really suffer from this stage (yet). As I realize that I am helpless to change anything now.

4. Depression – This is the stage I am most likely in. I already miss Thai and want that expected time back (bargaining?). But I realize there is nothing that I can do but go on. But who will I find that can challenge me like Thai did? An intellectual equal isn't as easy for me as you might think. And in Thai's fractal world, he always had to be the blog hog and make the Pareto half of all of the comments (do the math, if you don't understand, ask about it in the comments and I'll explain).

The Pareto Principle is related to fractals. I think it was one of the subjects that got us talking to begin with.

5. Acceptance – I am sure I will reach this stage eventually. It is just so hard to see it from here.

Thai's death, coming when it did, reminded me of my mother's passing near Memorial Day.

A Song That Keeps Going Through My Head

I think that this song expresses our sentiments pretty well.

But there never seems to be enough time
To do the things you want to do once you find them

Jim Croce: Time in a Bottle

And, a happier song that seems to explain Thai's understanding of fractals:

He was in search of an answer
The nature of what we are
He was trying to do it a new way
He was bright as a star
But nobody understood him
"His numbers are not the way"
He's lost in the deepest enigma
Which no one's unraveled today

But he knew, he knew more than me or you
No one could see his view, Oh where was he going to
And he tried, but before he could tell us he died
When he left us the people cried,
Oh where was he going to?

He had a different idea
A glimpse of the master plan
He could see into the future
A true visionary man
But there's something he never told us
It died when he went away
If only he could have been with us
No telling what he might say

But he knew, he knew more than me or you
No one could see his view
Oh, where was he going to
But he knew, you could tell by the picture he drew
It was totally something new,
Oh where was he going to?

Kansas: Portrait (He Knew)

Goodbye, my friend. I hope that someday all of our questions will get answered. You certainly left us too soon. You will be missed.

In some spiritual way, I hope that we can meet again and finish exploring all those ideas that you have left asked and unanswered.

Tuesday, June 8, 2010

An Unspeakable Loss

I just found out this morning. I am so sad. I will write a proper salute when out of shock.

Buddy, you will be missed.

Friday, June 4, 2010

Wednesday, June 2, 2010

JS Mills Redux

*I tried to embed, but it wouldn't take

The Most Fabulous Objects In The World

  • Hitchhiker's Guide To The Universe trilogy
  • Lord of the Rings trilogy
  • Flight of the Conchords
  • Time Bandits