Sunday, May 31, 2015

The Wright Brothers by David McCullough

The Wright Brothers by David McCullough was a solid book by the noted historian who among many other books, wrote three I previously enjoyed immensely in John Adams, Truman and 1776. The Wright Brothers was interesting to me in that I found it a bit dry at times while reading, but then upon skimming back through after finishing, my estimation went up as I saw the depth of information that McCullough passed along in the book, with some of the details noted below:

Orville and Wilbur grew up in Dayton, Ohio and their mother died in 1889 when Wilbur 22, Orville 18 and their sister Katherine 15. The siblings then continued to live with their father, Bishop Wright, for decades to follow. The family read heavily and widely and in 1896, Wilbur became interested in human flight after reading about German glider enthusiast Otto Lilienthal. In 1899, Wilbur wrote to the Smithsonian in Washington inquiring about available reading on aircrafts and human flight and the assistant secretary of the Smithsonian provided pamphlets on aviation as well as a list of books.

In 1900, the brothers for several months left Dayton and the bicycle shop they had opened and went to Kitty Hawk, on the North Carolina Outer Banks, to start the path towards flight by working with a glider they built. The Wrights saw flight as being controllable through the concept of "wing warping" (or "wing twisting") with movements of the wings enabling airflow to cause movements of the plane. They then returned to Kitty Hawk in 1901 and while back in Dayton the following winter, had huge advances forward with a wind tunnel they built, a wooden box 6 feet long and 16 inches square that they used it to test how glider wings should be set to get them to operate as desired. In the spring of 1902 they built a new glider using what they learned from the wind tunnel and from successful glider trips, then started on the step of building a motor.

In December 1903, they flew for the first time with the motor providing power, each brother going up separately so that in case one killed, the other could continue the work and in 1904, they began flying outside of Dayton. The flights were successful, but didn't attract a lot of media attention, with in September 1904, Amos Ives Root for his company's beekeeper trade journal writing of Wilbur's first attempt to fly in a complete circle. The plane was catapulted in the air, then flew 20-25 feet above the ground and landed successfully, with the article appearing in January 1905 to little notice. Around this time the Wright brothers tried to get the U.S. Government interested in their efforts, but to no avail, even though nothing was asked for, and by the fall of 1905, the brothers knew how to fly and were doing flights of 25 miles or more. With the lack of interest from the U.S. Government, the brothers were negotiating the sale of a plane to the French and Wilbur in May 1907 sailed for Paris to negotiate and then Orville sailed for Paris and brought a plane with him. The brothers returned home, leaving the Flyer in storage in France and in Feb 1908 signed a deal selling it to the French contingent upon a public demonstration that summer.

By May 1908, Wilbur and Orville were in Kitty Hawk flying and starting to get press attention, then both returned to France and in August, Wilbur did a successful flight for the public which led to huge media acclaim. He continued doing demonstrations and they were big news in the U.S. as well and Europe and that same year Orville began doing more public demonstrations in the U.S. In 1909, the brothers as well as Katherine were in Europe and sensations with demonstrations in front of huge crowds and they returned to the U.S. heroes in May of that year, with continued public demonstrations of flying, including for luminaries and around New York City. Wilbur died of typhoid fever in May 1912 at 45 and Orville continued flying until 1918 when he stopped at 46 due to lingering pain from injuries suffered in a plane crash, and then he died of a heart attack at 77 in 1948.

The details from McCullough were interesting and what struck me about Orville and Wilbur's story from the book was how the brothers knew that while the calculations and technology had to be right to enable human flight, what was just as important was practice, through many hours spent flying, they were become proficient at it.

Friday, May 29, 2015

Outdoor writing - by Holland & Zimmermann

There's been some great recent outdoor-oriented writing I've seen with a feature for SB Nation Longform and several stellar pieces from the latest issue of Outside Magazine.

The SB Nation piece was by Eva Holland with "Unclimbable," a first-person account of a trip to the Cirque of the Unclimables, a remote area of stunning-looking granite peaks in Canada's North Territories, and it's a really cool story of friendship, loss, adventure and acceptance.

Two features from the latest Outside Magazine that stood out were "Rory Bosio Doesn't Really Train" by Nick Heil on the 29-year-old long distance (100+ miles) runner from Truckee, CA and the "The Piscivore's Dilemma" about the sustainability of fish as a food supply. It's an extensively researched and detailed report from Tim Zimmermann which covers different types of fish that can be consumed as food along with the source (i.e. farmed vs. wild) of those fish.

From the same issue of Outside was "The New Adventure Library," a feature not currently available online, which briefly overviewed 33 different tales of adventure. With the forms ranging from books to movies to daredevil adventures, there were featured things I've seen and loved as well as not previously aware of, but now wanting to check out.

Solid business writing - on Elon Musk & Tesla, wine thieves, ILM & Dr. Charles Arntzen

Some of the pieces are from a week or two ago, but there's been some really interesting business writing that I haven't posted on up until now.

From Businessweek were two excellent features, starting off with "Elon Musk's Space Dream Almost Killed Tesla," excerpted from the recently released Ashlee Vance book Elon Musk: Tesla, SpaceX, and the Quest for a Fantastic Future. It's a fascinating look at the Tesla and Space X CEO and related to Tesla were two additional interesting pieces, first a transcript of Musk's speech introducing Tesla Energy and then San Jose Mercury News article "Is Tesla's Powerwall home battery worth the price?" by Jonathan Fahey.

The other Businessweek story to note here was "A Pinot Noir: Hunting the Thieves Behind a Rash of Six-Figure Wine Heists" by Claire Suddath, a highly interesting read which brought to mind the Max Potter book Shadows in the Vineyard: The True Story of the Plot to Poison the World's Greatest Wine.

The other two pieces of really interesting recent business writing to mention were from other sources with Alex French and Howie Kahn for Wired writing "Inside the Magic Factory: The Untold Story of ILM, a Titan That Forever Changed Film," an oral history of the George Lucas created Industrial Light & Magic, and Adam Bluestein for Fast Company writing "Meet Ebola's Soft-Spoken, Plant-Loving Arch Nemisis" on Dr. Charles Arntzen, who came in at number one on the Fast Company "100 Most Creative People 2015" list.

Saturday, May 16, 2015

Atul Gawande feature on unnecessary medical care

There's a really fascinating piece of writing by Atul Gawande (who I've posted about a few times previously) from a recent New Yorker with "Overkill" on unnecessary, expensive and often harmful medical care provided. In terms of the scope of the problem, Gawande writes below...

"In 2010, the Institute of Medicine issued a report stating that waste accounted for thirty per cent of health-care spending, or some seven hundred and fifty billion dollars a year, which was more than our nation’s entire budget for K-12 education. The report found that higher prices, administrative expenses, and fraud accounted for almost half of this waste. Bigger than any of those, however, was the amount spent on unnecessary health-care services."

The reasons for the waste, or no-value care as Gawande describes it, include tests and treatments both unethical recommended (with providers trying to collect all available insurance and Medicare dollars) and simply not needed, often as a result of there being so many tests and treatment paths available. What occurs is doctors, with patients buy-in, often test for problems that really aren't likely to have a terrible result if the problem found in someone, and then treat the problem because it's been discovered. The issue from this is the care costs money for someone, whether an individual paying out of pocket, an insurer (who as a result may raise rates) or government. Additionally, testing can bring complications for patients, not to mention problems that can result during procedures; and treatment for a given ailment can preclude different, and perhaps more needed, treatment for the same or another ailment.

Just as interesting to me as the problems that Gawande presents is the better path that he provides in the piece, with two examples including one driven from a corporate perspective and one out of a government act. Gawande tells the story of a Walmart employee with back problems who had surgery recommended to him and could have had the procedure done locally, with large out-of-pocket expense incurred, or follow a path Gawande wrote about...

"Taylor had heard about a program that Walmart had launched for employees undergoing spine, heart, or transplant procedures. Employees would have no out-of-pocket costs at all if they got the procedure at one of six chosen “centers of excellence”: the Cleveland Clinic; the Mayo Clinic; Virginia Mason Medical Center, in Washington; Scott and White Memorial Hospital, in Texas; Geisinger Medical Center, in Pennsylvania; and Mercy Hospital Springfield, in Missouri. 

Walmart wasn’t providing this benefit out of the goodness of its corporate heart, of course. It was hoping that employees would get better surgical results, sure, but also that the company would save money. Spine, heart, and transplant procedures are among the most expensive in medicine, running from tens of thousands to hundreds of thousands of dollars. Nationwide, we spend more money on spinal fusions, for instance, than on any other operation—thirteen billion dollars in 2011. And if there are complications the costs of the procedure go up further. The medical and disability costs can be enormous, especially if an employee is left permanently unable to return to work. These six centers had notably low complication rates and provided Walmart a fixed, package price."

Gawande writes of how Taylor went to Virginia Mason in Seattle, and after examination there, was recommended to not have back surgery, and instead focus on recovery through rehabilitation, an approach that Taylor agreed to and as Gawande quotes him saying, "within a couple of weeks, I was literally pain free." It's a fascinating story and not entirely unexpected one as Gawande writes of the Walmart program around spine, heart or transplant procedures...

"Two years into the program, an unexpected pattern is emerging: the biggest savings and improvements in care are coming from avoiding procedures that shouldn't be done in the first place. Before the participating hospitals operate, their doctors conduct their own evaluation. And, according to Sally Welborn, the senior vice-president for benefits at Walmart, those doctors are finding that around thirty per cent of the spinal procedures that employees were told they needed are inappropriate. Dr. Charles Nussbaum, until recently the head of neurosurgery at Virginia Mason Medical Center, confirmed that large numbers of the patients sent to his hospital for spine surgery do not meet its criteria."

As a wrap-up to Taylor's story, Gawande provides the following...

"If an insurer had simply decreed Taylor’s back surgery to be unnecessary, and denied coverage, the Taylors would have been outraged. But the worst part is that he would not have got better. It isn’t enough to eliminate unnecessary care. It has to be replaced with necessary care. And that is the hidden harm: unnecessary care often crowds out necessary care, particularly when the necessary care is less remunerative. Walmart, of all places, is showing one way to take action against no-value care—rewarding the doctors and systems that do a better job and the patients who seek them out."

Another thing Gawande writes of as leading to optimism for care in the future is out of a provision in the Affordable Care that "allows any group of physicians with five thousand or more Medicare patients to contract directly with the government as an 'accountable-care organization,' and to receive up to sixty per cent of any savings they produce." Gawande writes fairly extensively of McAllen, TX and how "two McAllen accountable-care organizations together managed to save Medicare a total of twenty-six million dollars. About sixty per cent of that went back to the groups. It wasn’t all profit—achieving the results had meant installing expensive data-tracking systems and hiring extra staff."

It's a fascinating piece from Gawande and as he towards the end writes "waste is not just consuming a third of health-care spending; it’s costing people’s lives." 

Thursday, May 14, 2015

Remarkable pieces of writing on tragedy - by Carr, Junod & Teague

There were three pieces of recent first-person writing on the subject of death that really struck a cord with me, two from Esquire and one from Glamour.

The Glamour piece was the fairy short essay "My Dad, My Mentor: How Do You Say Goodbye to Your Father?" by filmmaker Erin Carr about her father, David Carr, who died in February. It was a really nice remembrance on the writer who I a few times posted on writing by and about.

The first of two Esquire pieces to note here was by Tom Junod with "The Death of Patient Zero," a followup story to his 2013 "Patient Zero" on Stephanie Lee. I wrote about the original feature in this blog post and as sad as it was to read of Lee's passing, it was almost heartening to read of the friendship that Junod and Esquire Mark Warren formed with Lee and devotion they showed to her. Also, even with the awfulness of Lee dying of cancer so young is the hopeful idea that the efforts to save her put forth by Eric Schadt and his team could continue to move forward and help save others.

The last piece to mention also centered around someone dying of cancer with Matthew Teague writing "The Friend" on his wife Nicole Teague, her diagnosis with terminal cancer, and his best friend Dane Faucheux moving in with them and staying past her death. The essay from Teague is quite possibly the most personal and open account I've ever seen someone write and Faucheux someone that comes across as an absolutely remarkable person.