Technology and Being a Patient

I am sitting in the chemotherapy treatment lab, with about 5 other patients. I have been surprised at how busy this place is - I had no idea that this many people were dealing with cancer in this area. Every time I have come in here there have been 10 - 20 people in the waiting room.

This is not new news, but I have been reflecting recently on how technology has changed the experience of being a patient. As soon as I found out I had cancer, I immediately went to the web and began reading as much as I could about it. My neighbor is a doctor, and he also pulled some information off of the web for me. By the time I first met with the oncologist, I already knew the terms and could speak fairly intelligently about my test results. As he talked with me about those results, I understood more than I would have, as I had been exposed to the new terms already, and had looked up those that I wasn't familiar with.

Then there is the chemotherapy treatment lab. Here I sit, in a recliner, with my laptop on my lap, connected to the Internet. I have already done some work, answered some e-mails, and of course am blogging from this "comfy chair" (a reference for those Monty Python fans out there...). Except for the I/V in my arm, and the few strangers walking around in this room, this is much the same as when I work from home. Not exactly what I would have expected chemotherapy to be.

The availability of information and the widespread connectivity available today certainly makes the experience of being a patient much different than it once was. I wonder if the doctors find that a help or a nuisance.

When will technology serve us?

So, I have to get something off my chest. When I started my new job I was told that we use Groupwise for our corporate e-mail. No problem - I was peripherally involved in the creation of Groupwise many years ago (at WordPerfect, before Novell bought them), and I really liked it.

The problem is that I have been maintaining a personal folder in Outlook for several years. This is very important to me, as it contains all of my personal notes, e-mails, etc, and I refer to them on a regular basis.

OK - so this is not a problem, or so I thought. I would just use Outlook for my personal e-mail, and have Groupwise handle my corporate stuff. A rather simple solution, since technology should serve our needs - this will work just fine.

Little did I know that Outlook would automatically detect that I had Groupwise on my machine, and connect to it for me. Not only that, but as soon as I installed it, I could no longer send e-mails from either Groupwise or Outlook. So, I decided to uninstall both, and install and configure Outlook first. Having successfully accomplished this, I then re-installed Groupwise. Of course, Groupwise automatically detected that I had Outlook on the machine, and re-configured it to read my Groupwise e-mail - in the process, of course, removing all of the other settings I had set up. After all, these programs know better than I how they should work.

I spent several hours over the course of the next few weeks trying to find a configuration that would work for me. I am sure that there are some e-mail aficionados who would have been able to figure it out faster, just as I am sure that some would have given up long ago. At any rate, I finally have a configuration that doesn't cause havoc - albeit with some strange side-effects. Of course, I lost over 200 e-mail messages in the process, as Outlook kindly retrieved them, and then sent them into oblivion because it couldn't figure out how to route them to my personal folders with Groupwise on the box. I finally figured out how to get Outlook to ignore Groupwise, with the exception of the startup - Outlook continues to ask me for my Groupwise password, even though it doesn't handle any of my Groupwise messages now.

Why do we still have consumer applications that require a CS degree to configure the way we want? When will technology be truly intuitive, and truly serve us, rather than making us jump through hoops just to end up with a semi-acceptable solution, rather than a great solution?

I guess the answer is "when we stop accepting the mediocre solution, and demand intuitive software that does exactly what we want". In other words, probably not in my lifetime...

A personal note

I really debated whether to blog about this here, since this is a very personal issue. But, many who are already aware of what is going on have asked me if I am going to blog about the experience, and I finally decided that it might be a good idea. So, this post (and some others in the near future) will deviate from my high-tech focus, and will delve into more a much more personal issue that I am now working through.

Just after starting my new job I was diagnosed with testicular cancer. I had known for a few months that something was not right, but I really didn't think it was the "C" word - after all, that happens to other people, not me. When I finally decided to see my doctor, he immediately recognized that this was quite serious. Within two days I had received an ultrasound and seen a specialist. A week later the tumor was removed, and I was informed that the cancer had already started to spread into the abdomen. It was really a whirlwind - add this to the normal stress of starting a new job, and you can see that I have been quite distracted.

It has been three weeks since the orchiectomy, and we are now "staging" the cancer. This means that we are trying to find out how far it has spread - if it is in the lungs, then I would be a stage III. If it is remained in the abdomen, I would be a stage II. Either way, I will be starting chemotherapy next week. I am told that I should expect to be in the cancer treatment center for between 4 - 6 hours each day for the first week (which really cuts into my work day...), and then I will return for a quick visit each Tuesday for the next two weeks. We will then start the process all over again, and I will go through that either 3 or 4 times.

As I begin the chemotherapy, I will continue to blog here about the experience. I hope to continue to work while going through this, although some friends say I am being overly optimistic, and they think I will be too tired to work. Everyone reacts differently, so until I know that I can't focus I will plan on trying to work as I go through this experience.

The real question in my mind is: do I wait for my hair to fall out, or shave it off before hand? Actually, anyone who knows me understands what a minor issue this is, as I am already bald by most standards. At any rate, I finally decided (with the help of my wife) that this really comes down to an issue of control - shaving my head is the only thing I can really control right now. If I do it before, then I am doing it on my terms, and not allowing the cancer to take control. Interesting perspective (she is smart that way). I am planning to shave my head before I start chemo on Monday...

blogging from my blackberry

I have never been a bleeding-edge kind of guy. I guess that is why it has taken me so long to get a blackberry. Now that I have had it for a week, I wonder how I got along without it.

So, I am posting from it now. As you can tell from my prior posts, I am usually quite verbose. Maybe the plus side of having this blackberry is that I will learn to be more consise.

At any rate, blogging from a blackberry is pretty cool.

Loosing "Craplets"

It looks like Dell is listening - they have come out with the "Vostro" line of desktops for small business. The really cool thing is that they are not shipping any trialware on this line of machines (which Walt Mossberg refers to as "craplets").

This is significant because it indicates that we have come full-circle. Everyone wanted to get their trialware on Dell machines - it was like a comic getting called over to Johnny Carson's desk after their bit - it meant you had arrived. Unfortunately, Dell (and others) took advantage of this, and saturated the market so customers became so frusterated with all of the stupid apps that they didn't request, but yet had to remove from their machine, that we have now come full-circle, and it is "big news" that Dell is shippinng a computer without them.

As a customer, I am very glad about this switch, and I hope others follow suit. As a software guy who has tried to get small businesses up and running, I believe that we will have to get more creative regarding our marketing and delivery mechanisms now.

All in all, this is a very good thing.

"That Agile Crap"

I have recently started a new job. In my experience, I usually drive home from my first day thinking one of two things: either I am wondering how I landed such a great job, and just can't wait to get to work tomorrow to gert started on some of the challenges ahead, or I am asking myself if I made a huge mistake and what can I do now to fix it. For me, there is usually not much middle ground here.

Having been such an advocate of Agile Methodologies, I was very interested to see how (if at all) agile processes had been implemented here, and what my role would be in either implementing or improving them. My first day was full of one-on-one meetings, where I was able to meet some of the key decision makers in my new organization. As I like to do when starting a new job, I asked each of them what I could do to be successful in this role in their eyes. One answer evoked a surprising comment about agile development - which was a real surprise, since I didn't mention agile or development practices at all (I try not to reveal my feelings on the subject yet, as I don't want to taint the well, so to speak).

I was told that a particular project was in disarray. As we talked about the reasons, he said something like "the development team keeps re-working things, and they keep doing the same thing over and over. You know, its because of all that agile crap".

Once again, it seems that Agile is being blamed for bad development practices. Either that, or the development team is using Agile as an excuse for not delivering - I guess I will have to figure out which it is. Either way, it seems that Agile development is always an easy scapegoat for projects gone bad.

While it is true that an agile approach leads to some re-work, it is also a key agile principle that the output of the agile team must meet the customers needs, and re-work should only occur if it is in direct response to a real customer need, not a perceived future benefit that has not yet been requested by the customer.

It seems that the real problem here is that the customers requirements are not understood by the developers working to solve their problems. Where the source of that breakdown is I don't yet know, but the failure certainly is not because of the "agile crap" - it is more likely that either the development team doesn't understand the customers real needs, or they are not practicing true agile principles.

So, on my long drive home, I found myself thinking about my day, and I did indeed fall squarely into one of the two camps I mentioned above. Which one it was should be quite obvious to anyone who knows me...

Ajax and Nielsen Ratings

I was very interested to read that Nielsen/NetRatings will change the way that they rank websites - mainly in reaction to the adoption of Ajax technology. Rather than ranking pages based on clicks or views, they will now rank pages based on amount of time spent on the page.

Of course, this is because of Ajax - referred to in the article as a "software trick". As this technology is becoming more popular, the page views are naturally reducing, as this is one of the key concepts of Ajax. Pages can refresh and update data without requiring a new page view request.

This is really quite interesting to me, because we have long fought with this concept as we try to report on time spent on the Internet in our product. How do you know if someone has their eyeballs on a page, or if they browsed to a page and then became distracted, or even left the room completely, but left their browser sitting open? Ad revenue will now be based on this concept of time spent, rather than page views, and (in my opinion) may be much less accurate. When you factor in the tabbed browsing capability, this has the potential for being very inaccurate, and a poor measure of true website popularity.

The article reports that this benefits AOL, since now all time spent on their Instant Messing is counted as part of this new metric. Thus, AOL ranks first with 25 billion minutes for May. Of course, this also means that Yahoo! ranks above Google, since they have different strategy with regard to web search - Yahoo! wants to provide you with data to read on their sites, where Google wants to link you over to your data as fast as possible.

When trying to determine popularity of web sites, and how much to charge for ads on those sites, I suppose it is necessary to find a better metric than page views. I am just not sure that time spent is the right one either.