Weird observation

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Weird observation

Gillian Densmore
While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.

Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!

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Re: Weird observation

Marcus G. Daniels

It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.

As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.    

 

From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Friday, July 13, 2018 at 8:39 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: [FRIAM] Weird observation

 

While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.

 

Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!


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Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
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Re: Weird observation

gepr
For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)

That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?

On 07/13/2018 07:48 AM, Marcus Daniels wrote:

> It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
> As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>
> From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
> Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
> Date: Friday, July 13, 2018 at 8:39 AM
> To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
> Subject: [FRIAM] Weird observation
>
> While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>
> Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!


--
∄ uǝʃƃ

============================================================
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Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
uǝʃƃ ⊥ glen
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Re: Weird observation

Marcus G. Daniels
Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?

On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:

    For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
   
    That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
   
    On 07/13/2018 07:48 AM, Marcus Daniels wrote:
    > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
    > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
    >
    > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
    > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
    > Date: Friday, July 13, 2018 at 8:39 AM
    > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
    > Subject: [FRIAM] Weird observation
    >
    > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
    >
    > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
   
   
    --
    ∄ uǝʃƃ
   
    ============================================================
    FRIAM Applied Complexity Group listserv
    Meets Fridays 9a-11:30 at cafe at St. John's College
    to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
    FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
   

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Meets Fridays 9a-11:30 at cafe at St. John's College
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FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
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Re: Weird observation

gepr
Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).

To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.

On 07/13/2018 08:06 AM, Marcus Daniels wrote:

> Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
>
> On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>
>     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
>    
>     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
>    
>     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
>     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
>     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>     >
>     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
>     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     > Date: Friday, July 13, 2018 at 8:39 AM
>     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     > Subject: [FRIAM] Weird observation
>     >
>     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>     >
>     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!


--
∄ uǝʃƃ

============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
uǝʃƃ ⊥ glen
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Re: Weird observation

Marcus G. Daniels
Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.

On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:

    Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).
   
    To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.
   
    On 07/13/2018 08:06 AM, Marcus Daniels wrote:
    > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
    >
    > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
    >
    >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
    >    
    >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
    >    
    >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
    >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
    >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
    >     >
    >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
    >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
    >     > Date: Friday, July 13, 2018 at 8:39 AM
    >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
    >     > Subject: [FRIAM] Weird observation
    >     >
    >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
    >     >
    >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
   
   
    --
    ∄ uǝʃƃ
   
    ============================================================
    FRIAM Applied Complexity Group listserv
    Meets Fridays 9a-11:30 at cafe at St. John's College
    to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
    FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
   

============================================================
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Meets Fridays 9a-11:30 at cafe at St. John's College
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FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
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Re: Weird observation

Curt McNamara
Actually the question was about the nurse :-) and (from my understanding) the dynamics of medicine is such that nurses *don't* give doctors feedback on things like this. So the good advice here (which i agree with) would need to be passed onto the doctor directly

           Curt

On Fri, Jul 13, 2018 at 10:20 AM, Marcus Daniels <[hidden email]> wrote:
Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.

On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:

    Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).

    To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.

    On 07/13/2018 08:06 AM, Marcus Daniels wrote:
    > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
    >
    > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
    >
    >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
    >     
    >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
    >     
    >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
    >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
    >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
    >     >
    >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
    >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
    >     > Date: Friday, July 13, 2018 at 8:39 AM
    >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
    >     > Subject: [FRIAM] Weird observation
    >     >
    >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
    >     >
    >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!


    --
    ∄ uǝʃƃ

    ============================================================
    FRIAM Applied Complexity Group listserv
    Meets Fridays 9a-11:30 at cafe at St. John's College
    to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
    FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove


============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove


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Meets Fridays 9a-11:30 at cafe at St. John's College
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Re: Weird observation

gepr
Probably.  In the context of a more acute situation (e.g. emergency room, or the patient is in severe distress), the nurses are trained to inject their judgment.  But in a more casual context (like an office visit to a GP), they're not.

The important point, though, is it's a matter of *competence* not something trivializable like "bedside manner" or "rudeness".  If the Dr is too incompetent to know how to assess a patient, you do not want that Dr.

On 07/13/2018 08:23 AM, Curt McNamara wrote:
> Actually the question was about the nurse :-) and (from my understanding)
> the dynamics of medicine is such that nurses *don't* give doctors feedback
> on things like this. So the good advice here (which i agree with) would
> need to be passed onto the doctor directly

--
∄ uǝʃƃ

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Meets Fridays 9a-11:30 at cafe at St. John's College
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uǝʃƃ ⊥ glen
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Re: Weird observation

Marcus G. Daniels
In reply to this post by gepr
Glen writes:

"That interaction successfully grabbed his attention."

My observation is that it is not necessarily helpful to others' concentration to interrupt them and to try to control the conversation.    I don't see doctors as any different from any other specialist, in spite of the fact they try to raise themselves above others through authoritarian signals like wearing lab coats and having nurses on a humiliatingly-short leash.   As a result, people have too high of expectations of them, and thus malpractice insurance contributes to the high cost of medical care.  

Marcus

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Re: Weird observation

gepr
I disagree completely.  If we consider you and your Dr colleagues who share the same objective, then when a colleague of mine interrupts me, I tend to have enough respect for them to assume they're interrupting me because they think I should be interrupted.  Similarly, if they seize control of the conversation, I assume it's because they've judged they should seize control.  And I'm saying this as a person who *hates* being interrupted.

Now, if a colleague abuses that privilege often enough, they get demoted and will no longer be a colleague.

Such interruptions from colleagues are not only helpful, but *necessary* for efficient and effective teamwork.

But to be honest, this is not a collegial relationship.  Your Dr is the vendor and you are the customer.  I still try to treat my vendors as if they're colleagues.  But under full reduction, they're not.

On 07/13/2018 08:34 AM, Marcus Daniels wrote:
> Glen writes:
>
> "That interaction successfully grabbed his attention."
>
> My observation is that it is not necessarily helpful to others' concentration to interrupt them and to try to control the conversation.    I don't see doctors as any different from any other specialist, in spite of the fact they try to raise themselves above others through authoritarian signals like wearing lab coats and having nurses on a humiliatingly-short leash.   As a result, people have too high of expectations of them, and thus malpractice insurance contributes to the high cost of medical care.  


--
∄ uǝʃƃ

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Meets Fridays 9a-11:30 at cafe at St. John's College
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Re: Weird observation

Marcus G. Daniels
Yeah, I try not do that until I've observed a person for a while.   Some people are more sensitive or inflexible, but not necessarily for reasons they can control.   I don't see that vendor and customer really makes a difference in the extreme cases.  What matters is getting to the truth, using the available resources.   It doesn't matter who is in charge.    I lot of medical situations aren't very serious though, and a lot of doctors could do the job.   I'm thinking of when one has sought out an elite specialist, and that specialist is a bit of an asshole.  

On 7/13/18, 9:48 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:

    I disagree completely.  If we consider you and your Dr colleagues who share the same objective, then when a colleague of mine interrupts me, I tend to have enough respect for them to assume they're interrupting me because they think I should be interrupted.  Similarly, if they seize control of the conversation, I assume it's because they've judged they should seize control.  And I'm saying this as a person who *hates* being interrupted.
   
    Now, if a colleague abuses that privilege often enough, they get demoted and will no longer be a colleague.
   
    Such interruptions from colleagues are not only helpful, but *necessary* for efficient and effective teamwork.
   
    But to be honest, this is not a collegial relationship.  Your Dr is the vendor and you are the customer.  I still try to treat my vendors as if they're colleagues.  But under full reduction, they're not.
   
    On 07/13/2018 08:34 AM, Marcus Daniels wrote:
    > Glen writes:
    >
    > "That interaction successfully grabbed his attention."
    >
    > My observation is that it is not necessarily helpful to others' concentration to interrupt them and to try to control the conversation.    I don't see doctors as any different from any other specialist, in spite of the fact they try to raise themselves above others through authoritarian signals like wearing lab coats and having nurses on a humiliatingly-short leash.   As a result, people have too high of expectations of them, and thus malpractice insurance contributes to the high cost of medical care.  
   
   
    --
    ∄ uǝʃƃ
   
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Re: Weird observation

Steve Smith
In reply to this post by Marcus G. Daniels
Gil -

I am intuiting from your current riff of questions/anecdotes here, that
you are feeling out of sorts on many fronts.  With a significant
engagement with the health-care system, THAT interface is an important
one for you and is broadly, if not categorically not working for you
right now...  various providers and interface staff are not responding
well to you and it is adding to your "out of sortiness".   It sounds
like a positive feedback loop, where you are anticipating being
mishandled and sending signals that lead staff/providers to then go off
their normal "bedside manner game" in some way or another which just
reinforces your feelings of being mishandled, etc.   I don't mean to
"blame the victim"... just pointing out that you are probably
participating in the breakdown in some way which you might be able to
change and get a better result.

I have any number of "service" interactions which I know I don't handle
well by my nature.   I don't engage in the health care system much at
all (sometimes avoiding for decades) for this reason... I find the whole
paradigm flawed and I wear that on my sleeve when I *do* engage and THAT
naturally puts some of the people I'm interacting with off.   Similarly
I have to be thoughtful/careful when I try to buy technology (in person)
or seek repair or parts for my technology.  I used to have lots of
problems with cell phone companies (who doesn't?).  I often have trouble
with ISPs...  and all because I often *do* know more about their
technologies and service than the average customer, and maybe (in some
cases) "just enough to get me in trouble", or at least enough to
irritate the first line service/sales people trying to just get through
their day and sell/install/service 100 more commodity (to them) items.

Our "service" and "care" systems are optimized to deliver their services
on *their model* and they appear very fragile if you try to get them to
interact on YOUR model.  

Even fast food... "have it your way" is a little like Henry Ford's "you
can have your Model-T in any color you want as long as it is black".  
Many can handle simple substitutions/deletions but that is about it.  
When I was a young vegetarian I learned to order a "cheeseburger, hold
the meat, and if the cook can handle it, toast the bun upside down".... 
What I often got was the "grilled cheese sandwich with lettuce, tomato,
pickle" I wanted but was not on their menu. I don't think I *ever* got a
grilled cheese just by asking for it if it wasn't on their menu, but
nobody ever turned me down on deleting the meat from a cheeseburger.  If
the place had served me before it usually went easy and the bun was
usually toasted and "inside out" as I asked.   Sometimes I paid full
price for a burger, other times they followed the formula for what an
extra patty would cost and I'd end up with the grilled cheese at a steep
discount: "$2.50 for the cheeseburger - $1.00 for the patty... that will
be $1.00+ tax!"  If they were busy, I would just come back another
time... it wasn't in my interest to stress their system for my quirky
preferences.   Today it would be gluten-free, keto-friendly,
paleo-compliant, non-gmo, grass-fed-dairy...  and $15.

TLDR: (Auto Mechanic Anecdote) I had the same problem with auto repair
until I recognized what I was doing and made a very acute effort to meet
them on *their turf*.   Until I started a 60 mile RT daily commute I had
done most if not all of my own car repair, up to and including swapping
out engines and replacing stripped gears in transmissions.  I was not an
expert, but for other shadetree mechanics here, you may know that the 
resources are amazing at some level...  half the parts you need are
already stocked at a store nearby and they can get virtually any other
within hours or days just by specifying the details of the vehicle and
it's subsystem...   third party manuals (Haynes/Chiltons) are far from
perfect but once you find a good one for your vehicle.. and if that
isn't good enough... dealer service manuals are available for about the
price of an hour or three of shop time from a real mechanic, etc.   The
bottom line was that I *thought* I knew more about my vehicle than the
mechanic (well, in some  ways I did) and I wanted him to start with MY
diagnosis and MY preferred solution when it just didn't fit his
paradigm.   Generally mechanics don't trust civilians to know their cars
and the subsystems and diagnose them well, and in fact, if I hadn't dug
into the problem up to my armpits myself, I was often guessing (and
guessing wrong) based on superficial symptoms.     In any case, they
almost always disappointed me with their bedside manner... they didn't
want to listen to what I already knew about the problem and they REALLY
didn't want to listen to my repair suggestions.   They were usually
superficially polite but my empathetic self had me radiating my own
hostility or doubt in them I suspect.   Eventually I tried a mechanic
that was known to me, very convenient and with a generally good
reputation and I backed off and put my vehicles in their hands.  I let
them change oil, rotate tires, top off fluids, etc.   and I let THEM
tell me when they noticed a growing problem (e.g. oil leaks, bad tread
wear patterns, etc) and they proved quickly to me that THEY were as
competent as I (or more) to notice growing problems and recognize
reasonable solutions.  I occasionally mention things to them to look at,
but unless the symptoms are acute, I leave it to them to notice and they
(almost) always do! They have better shop manuals and better tools
(especially a lift in a heated space) and extra hands when a job is
easier with two people.   I paid $50/hour (the good ole days) for them
to do things I felt I could do in half (in reality, twice) the time and
it irritated me, but almost exclusively, they *never* lied to me or
mislead me.  Previous mechanics I'd tried this with would do a job or
two OK then they would tell me something I knew was patently false
(e.g." you need a new clutch slave cylinder" on a vehicle I knew to have
a mechanical linkage).   In retrospect, I don't think they were trying
to cheat me, but might have been being lazy or sloppy... they may have
"guessed" at something without looking closely, not realizing that *my*
model had a different subsystem than the one they were most familiar
with, or they cross-remembered another vehicle, or ???    In any case, I
would go away mad and go back to not trusting mechanics, etc.   

Today it has been almost 20 years I've been with my primary mechanic...
his son has taken over (most of) the business and they know all my
vehicles by heart and are happy to do pre-purchase inspections on new
ones I am considering.   Some problems and vehicles I don't bring to
them because they aren't familiar with them.   I don't expect them to
work on the hybrid components of my Gen1 Hybrid Insight and I don't ask
them to do much on my 1949 Ford Dump (though they do like the truck, it
doesn't fit in their bays easily and can only be raised about 3 feet on
their lifts, and parts are *very* hard to get, complicated by the fact
the engine is from an early 60's ford farm equipment and while a
standard Ford design, has oddities specific to the tractor/thresher/???
it was pulled from.  I only asked them to try to tune the mechanical
fuel injection on my mid-80s VW Cabriolet once... then did it myself
after not finding an obvious mechanic with specific familiarity.   I'm
in the midst of trying to get a new (used) 20Kwh hybrid battery
installed in my 2011 Chevy Volt.   It weighs 400 lbs, carries 360V when
energized, has sophisticated battery management subsystems and
integrating systems internal and external to it, and has to interface to
a number of computerized subsystems including the main computer, the
ECU, a charging control system, etc.   The service manager at the dealer
is waaaay over his head on this project and I get the sense that the
factory trained tech (for this specific model) has not had occasion to
ever remove or replace (or diagnose beyond pulling DTC codes from the
main computer).   But I know I am at their mercy.   The vehicle
subsystems are so specific to GM that (almost literally?) nobody except
GM dealers have the specialized tools and computer codes/software to
handle the re-energizing/calibrating of a battery.   The physical
aspects of swapping the battery are daunting enough, especially without
a lift, and I wouldn't expect ANY sane mechanic with a lift, etc. to
want to mess with this HV system.   I have done enough hybrid/EV/HV
electronics work to feel I could do it safely myself, but it would be
only *my life* on the line.  So I had to talk the service manager
through discovering that his Volt trained technician *could* install a
battery not provided by GM directly (a very few others have done this
around the US) and come up with the shop hours (7@$111) for the
procedure so I could order up a salvaged one (from a low-mileage
recently wrecked vehicle) to be delivered to them by freight. (BTW, a
NEW (refurbished?) GM Battery System is $8K retail plus installation).

  I'm sure the service manager was frustrated with me *many* times along
the way and his demeanor often left me wanting to cop my own attitude
and "go away mad".  I think now that we are at the point of having
scheduled the work and the battery is en-route... he has become
intrigued by the project and probably wants to see it succeed rather
than just "wanting me to go away" which is how I felt through more than
a little of the process.  And *I was aware* of the pitfalls of wanting
non-standard things that I have more knowledge about than the service
providers and I *still* stressed them almost to their limit.  I *wanted*
to blame them and be angry and resentful, but I had to acknowledge that
my kind of task is NOT their bread and butter, that the individuals (and
the whole system) has to see an upside to working with me before they
are going to be willing, much less positive about it.

Gil...  YOU may be the Chevy Volt of the human world.  Your needs may be
unusual enough that it is *hard* for the standard systems to meet you on
their terms and as you probably already know/guess, it really is up to
you to understand what the system is capable of and how to meet it on
terms where neither you nor they are too stressed by the interface to
function properly.   I don't know you *well* but believe you to have the
self-awareness to find productive ways to change your
interface/expectations enough to begin to reduce the stress you are
feeling right now.   Your other stated activities (hiking, gym, dancing,
etc.) seem like very positive directions to help you regulate (physical
activity is almost always a positive thing for virtually everyone) and
find new and varied friends and interests.    I don't make it to WedTech
often (annually if lucky?) but next time I'm in town with some time on
my hands, maybe we can get together for a bite or some coffee or tea and
we can bore (entertain?) one another with anecdotes about trying to
interface with a world of commodity objects and services.

- Steve


On 7/13/18 9:20 AM, Marcus Daniels wrote:

> Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.
>
> On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>
>     Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).
>    
>     To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.
>    
>     On 07/13/2018 08:06 AM, Marcus Daniels wrote:
>     > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
>     >
>     > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>     >
>     >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
>     >    
>     >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
>     >    
>     >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
>     >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
>     >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>     >     >
>     >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
>     >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Date: Friday, July 13, 2018 at 8:39 AM
>     >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Subject: [FRIAM] Weird observation
>     >     >
>     >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>     >     >
>     >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
>    
>    
>     --
>     ∄ uǝʃƃ
>    
>     ============================================================
>     FRIAM Applied Complexity Group listserv
>     Meets Fridays 9a-11:30 at cafe at St. John's College
>     to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
>     FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>    
>
> ============================================================
> FRIAM Applied Complexity Group listserv
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>



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Re: Weird observation

gepr
In reply to this post by Marcus G. Daniels
OK.  When you caveat it as a rare specialist with an attitude, then I'd agree with you, at least in practice.  Let them do their tiny/special job and don't expect/require them to think/care about you as a whole person.  But in those cases, who is in charge does matter a great deal.  If they're so hyper-focused on their tiny little slice of the world, then they *need* a general contractor to integrate their work into the whole.  And in our fscked up mostly for-greed healthcare system, the patient is considered the integrator.

On 07/13/2018 08:53 AM, Marcus Daniels wrote:
> Yeah, I try not do that until I've observed a person for a while.   Some people are more sensitive or inflexible, but not necessarily for reasons they can control.   I don't see that vendor and customer really makes a difference in the extreme cases.  What matters is getting to the truth, using the available resources.   It doesn't matter who is in charge.    I lot of medical situations aren't very serious though, and a lot of doctors could do the job.   I'm thinking of when one has sought out an elite specialist, and that specialist is a bit of an asshole.  

--
☣ uǝlƃ

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uǝʃƃ ⊥ glen
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Re: Weird observation

Gillian Densmore
In reply to this post by Marcus G. Daniels
Nailed it

On Fri, Jul 13, 2018, 8:48 AM Marcus Daniels <[hidden email]> wrote:

It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.

As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.    

 

From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Friday, July 13, 2018 at 8:39 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: [FRIAM] Weird observation

 

While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.

 

Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!

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Re: Weird observation

Gillian Densmore
Freedman barly even pays attention!

On Fri, Jul 13, 2018, 11:01 AM Gillian Densmore <[hidden email]> wrote:
Nailed it

On Fri, Jul 13, 2018, 8:48 AM Marcus Daniels <[hidden email]> wrote:

It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.

As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.    

 

From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Friday, July 13, 2018 at 8:39 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: [FRIAM] Weird observation

 

While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.

 

Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!

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Re: Weird observation

Gillian Densmore
That's on top of today bitching about the time my appointment was taking

On Fri, Jul 13, 2018, 11:08 AM Gillian Densmore <[hidden email]> wrote:
Freedman barly even pays attention!

On Fri, Jul 13, 2018, 11:01 AM Gillian Densmore <[hidden email]> wrote:
Nailed it

On Fri, Jul 13, 2018, 8:48 AM Marcus Daniels <[hidden email]> wrote:

It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.

As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.    

 

From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Friday, July 13, 2018 at 8:39 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: [FRIAM] Weird observation

 

While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.

 

Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!

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Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove

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Re: Weird observation

Gillian Densmore
In reply to this post by Steve Smith
Steve if it's a "sudden" riff of questions it's because I honestly genuinly don't know what else to do to find the rescources I need: I've NEVER on this or any other list consously said (I hope) I simply don't know. Yeah i'm in my "late" (humoursl voice VERY late) 30's): because just say certain fam members reasonably don't know what the heck to do given a rif that's not at all apropiate for this list: I can not rely on them. I do not want to lean on them. So I am all due to some on this list pulling a start-rek trek. I do not want this to be read as sarcastic:
I simply genuinly don't know what else to do, or why it might be weird to say: Uh advice please!  What ever I was doing before simply isn't working I need some guidance, and advice.  I am not at all trying to come off as throwing this in anyones face!
I have no idea why it took so long for me to push my comfort zones and want to have friends. No it may not have started as a support group. I do consider many on the list at least aquaintences some strait up friends: Nick and Kim (I have no idea if Kim Sorvice ist still subbed)

What all that said:: I for one hit a wall and fell appart I'll leave what between family and a theriapist. I have never denied I go to those and sorting what the what wrong or very right for the real pros.
The observation was simply huh weird do people really find it so weird for a stranger to open doors for them when they have their hands for with groceries (that's a real example)? oO
And while at the doctors office someone acted like In vented the chevy volt or hydrogen feul cell: oh sorry sir you can go first.
*shruging* no I don't expect to be "budy budy" with a doctor. I DO however think it's reasonable that a pro at least be cordial, not complain about the clock, or that I clearly need and stil need a bit of TLC' That's what those kind of pros are for.

I am trying to find the right places for a Re-do. 
I'm sorry if it came off as a flood or riff for needing and wanting some guidance from people that might have vastly more experience than I do in those areas. Hell that horribly laacking resrouce can well be: oh have tried (forum here) I found them really great for (stuff here)?!

I did ask presbytarian because---bluntly I've had enought of Saint Vincents being jerks about routine questions.So why not ask for others experience? is that not a good idea? oO

On Fri, Jul 13, 2018 at 10:26 AM, Steven A Smith <[hidden email]> wrote:
Gil -

I am intuiting from your current riff of questions/anecdotes here, that
you are feeling out of sorts on many fronts.  With a significant
engagement with the health-care system, THAT interface is an important
one for you and is broadly, if not categorically not working for you
right now...  various providers and interface staff are not responding
well to you and it is adding to your "out of sortiness".   It sounds
like a positive feedback loop, where you are anticipating being
mishandled and sending signals that lead staff/providers to then go off
their normal "bedside manner game" in some way or another which just
reinforces your feelings of being mishandled, etc.   I don't mean to
"blame the victim"... just pointing out that you are probably
participating in the breakdown in some way which you might be able to
change and get a better result.

I have any number of "service" interactions which I know I don't handle
well by my nature.   I don't engage in the health care system much at
all (sometimes avoiding for decades) for this reason... I find the whole
paradigm flawed and I wear that on my sleeve when I *do* engage and THAT
naturally puts some of the people I'm interacting with off.   Similarly
I have to be thoughtful/careful when I try to buy technology (in person)
or seek repair or parts for my technology.  I used to have lots of
problems with cell phone companies (who doesn't?).  I often have trouble
with ISPs...  and all because I often *do* know more about their
technologies and service than the average customer, and maybe (in some
cases) "just enough to get me in trouble", or at least enough to
irritate the first line service/sales people trying to just get through
their day and sell/install/service 100 more commodity (to them) items.

Our "service" and "care" systems are optimized to deliver their services
on *their model* and they appear very fragile if you try to get them to
interact on YOUR model.  

Even fast food... "have it your way" is a little like Henry Ford's "you
can have your Model-T in any color you want as long as it is black".  
Many can handle simple substitutions/deletions but that is about it.  
When I was a young vegetarian I learned to order a "cheeseburger, hold
the meat, and if the cook can handle it, toast the bun upside down".... 
What I often got was the "grilled cheese sandwich with lettuce, tomato,
pickle" I wanted but was not on their menu. I don't think I *ever* got a
grilled cheese just by asking for it if it wasn't on their menu, but
nobody ever turned me down on deleting the meat from a cheeseburger.  If
the place had served me before it usually went easy and the bun was
usually toasted and "inside out" as I asked.   Sometimes I paid full
price for a burger, other times they followed the formula for what an
extra patty would cost and I'd end up with the grilled cheese at a steep
discount: "$2.50 for the cheeseburger - $1.00 for the patty... that will
be $1.00+ tax!"  If they were busy, I would just come back another
time... it wasn't in my interest to stress their system for my quirky
preferences.   Today it would be gluten-free, keto-friendly,
paleo-compliant, non-gmo, grass-fed-dairy...  and $15.

TLDR: (Auto Mechanic Anecdote) I had the same problem with auto repair
until I recognized what I was doing and made a very acute effort to meet
them on *their turf*.   Until I started a 60 mile RT daily commute I had
done most if not all of my own car repair, up to and including swapping
out engines and replacing stripped gears in transmissions.  I was not an
expert, but for other shadetree mechanics here, you may know that the 
resources are amazing at some level...  half the parts you need are
already stocked at a store nearby and they can get virtually any other
within hours or days just by specifying the details of the vehicle and
it's subsystem...   third party manuals (Haynes/Chiltons) are far from
perfect but once you find a good one for your vehicle.. and if that
isn't good enough... dealer service manuals are available for about the
price of an hour or three of shop time from a real mechanic, etc.   The
bottom line was that I *thought* I knew more about my vehicle than the
mechanic (well, in some  ways I did) and I wanted him to start with MY
diagnosis and MY preferred solution when it just didn't fit his
paradigm.   Generally mechanics don't trust civilians to know their cars
and the subsystems and diagnose them well, and in fact, if I hadn't dug
into the problem up to my armpits myself, I was often guessing (and
guessing wrong) based on superficial symptoms.     In any case, they
almost always disappointed me with their bedside manner... they didn't
want to listen to what I already knew about the problem and they REALLY
didn't want to listen to my repair suggestions.   They were usually
superficially polite but my empathetic self had me radiating my own
hostility or doubt in them I suspect.   Eventually I tried a mechanic
that was known to me, very convenient and with a generally good
reputation and I backed off and put my vehicles in their hands.  I let
them change oil, rotate tires, top off fluids, etc.   and I let THEM
tell me when they noticed a growing problem (e.g. oil leaks, bad tread
wear patterns, etc) and they proved quickly to me that THEY were as
competent as I (or more) to notice growing problems and recognize
reasonable solutions.  I occasionally mention things to them to look at,
but unless the symptoms are acute, I leave it to them to notice and they
(almost) always do! They have better shop manuals and better tools
(especially a lift in a heated space) and extra hands when a job is
easier with two people.   I paid $50/hour (the good ole days) for them
to do things I felt I could do in half (in reality, twice) the time and
it irritated me, but almost exclusively, they *never* lied to me or
mislead me.  Previous mechanics I'd tried this with would do a job or
two OK then they would tell me something I knew was patently false
(e.g." you need a new clutch slave cylinder" on a vehicle I knew to have
a mechanical linkage).   In retrospect, I don't think they were trying
to cheat me, but might have been being lazy or sloppy... they may have
"guessed" at something without looking closely, not realizing that *my*
model had a different subsystem than the one they were most familiar
with, or they cross-remembered another vehicle, or ???    In any case, I
would go away mad and go back to not trusting mechanics, etc.   

Today it has been almost 20 years I've been with my primary mechanic...
his son has taken over (most of) the business and they know all my
vehicles by heart and are happy to do pre-purchase inspections on new
ones I am considering.   Some problems and vehicles I don't bring to
them because they aren't familiar with them.   I don't expect them to
work on the hybrid components of my Gen1 Hybrid Insight and I don't ask
them to do much on my 1949 Ford Dump (though they do like the truck, it
doesn't fit in their bays easily and can only be raised about 3 feet on
their lifts, and parts are *very* hard to get, complicated by the fact
the engine is from an early 60's ford farm equipment and while a
standard Ford design, has oddities specific to the tractor/thresher/???
it was pulled from.  I only asked them to try to tune the mechanical
fuel injection on my mid-80s VW Cabriolet once... then did it myself
after not finding an obvious mechanic with specific familiarity.   I'm
in the midst of trying to get a new (used) 20Kwh hybrid battery
installed in my 2011 Chevy Volt.   It weighs 400 lbs, carries 360V when
energized, has sophisticated battery management subsystems and
integrating systems internal and external to it, and has to interface to
a number of computerized subsystems including the main computer, the
ECU, a charging control system, etc.   The service manager at the dealer
is waaaay over his head on this project and I get the sense that the
factory trained tech (for this specific model) has not had occasion to
ever remove or replace (or diagnose beyond pulling DTC codes from the
main computer).   But I know I am at their mercy.   The vehicle
subsystems are so specific to GM that (almost literally?) nobody except
GM dealers have the specialized tools and computer codes/software to
handle the re-energizing/calibrating of a battery.   The physical
aspects of swapping the battery are daunting enough, especially without
a lift, and I wouldn't expect ANY sane mechanic with a lift, etc. to
want to mess with this HV system.   I have done enough hybrid/EV/HV
electronics work to feel I could do it safely myself, but it would be
only *my life* on the line.  So I had to talk the service manager
through discovering that his Volt trained technician *could* install a
battery not provided by GM directly (a very few others have done this
around the US) and come up with the shop hours (7@$111) for the
procedure so I could order up a salvaged one (from a low-mileage
recently wrecked vehicle) to be delivered to them by freight. (BTW, a
NEW (refurbished?) GM Battery System is $8K retail plus installation).

  I'm sure the service manager was frustrated with me *many* times along
the way and his demeanor often left me wanting to cop my own attitude
and "go away mad".  I think now that we are at the point of having
scheduled the work and the battery is en-route... he has become
intrigued by the project and probably wants to see it succeed rather
than just "wanting me to go away" which is how I felt through more than
a little of the process.  And *I was aware* of the pitfalls of wanting
non-standard things that I have more knowledge about than the service
providers and I *still* stressed them almost to their limit.  I *wanted*
to blame them and be angry and resentful, but I had to acknowledge that
my kind of task is NOT their bread and butter, that the individuals (and
the whole system) has to see an upside to working with me before they
are going to be willing, much less positive about it.

Gil...  YOU may be the Chevy Volt of the human world.  Your needs may be
unusual enough that it is *hard* for the standard systems to meet you on
their terms and as you probably already know/guess, it really is up to
you to understand what the system is capable of and how to meet it on
terms where neither you nor they are too stressed by the interface to
function properly.   I don't know you *well* but believe you to have the
self-awareness to find productive ways to change your
interface/expectations enough to begin to reduce the stress you are
feeling right now.   Your other stated activities (hiking, gym, dancing,
etc.) seem like very positive directions to help you regulate (physical
activity is almost always a positive thing for virtually everyone) and
find new and varied friends and interests.    I don't make it to WedTech
often (annually if lucky?) but next time I'm in town with some time on
my hands, maybe we can get together for a bite or some coffee or tea and
we can bore (entertain?) one another with anecdotes about trying to
interface with a world of commodity objects and services.

- Steve


On 7/13/18 9:20 AM, Marcus Daniels wrote:
> Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.
>
> On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>
>     Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).
>     
>     To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.
>     
>     On 07/13/2018 08:06 AM, Marcus Daniels wrote:
>     > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
>     >
>     > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>     >
>     >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
>     >     
>     >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
>     >     
>     >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
>     >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
>     >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>     >     >
>     >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
>     >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Date: Friday, July 13, 2018 at 8:39 AM
>     >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Subject: [FRIAM] Weird observation
>     >     >
>     >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>     >     >
>     >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
>     
>     
>     --
>     ∄ uǝʃƃ
>     
>     ============================================================
>     FRIAM Applied Complexity Group listserv
>     Meets Fridays 9a-11:30 at cafe at St. John's College
>     to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
>     FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>     
>
> ============================================================
> FRIAM Applied Complexity Group listserv
> Meets Fridays 9a-11:30 at cafe at St. John's College
> to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
> FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>



============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove


============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
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Re: Weird observation

Gillian Densmore
In reply to this post by Steve Smith
And you aright steve IMO anyone sane or sober should be beyond pissed at what is litterally making news: what healthcare? what government?  Health is one of the few things you can not ignore the older you get the more you'll (in my experience anyway) have to use it at least some. Even if it's a routine check up. It is (bluntly said) IMO a horribly set up  system. The whys are mere speculation from me.

On Fri, Jul 13, 2018 at 10:26 AM, Steven A Smith <[hidden email]> wrote:
Gil -

I am intuiting from your current riff of questions/anecdotes here, that
you are feeling out of sorts on many fronts.  With a significant
engagement with the health-care system, THAT interface is an important
one for you and is broadly, if not categorically not working for you
right now...  various providers and interface staff are not responding
well to you and it is adding to your "out of sortiness".   It sounds
like a positive feedback loop, where you are anticipating being
mishandled and sending signals that lead staff/providers to then go off
their normal "bedside manner game" in some way or another which just
reinforces your feelings of being mishandled, etc.   I don't mean to
"blame the victim"... just pointing out that you are probably
participating in the breakdown in some way which you might be able to
change and get a better result.

I have any number of "service" interactions which I know I don't handle
well by my nature.   I don't engage in the health care system much at
all (sometimes avoiding for decades) for this reason... I find the whole
paradigm flawed and I wear that on my sleeve when I *do* engage and THAT
naturally puts some of the people I'm interacting with off.   Similarly
I have to be thoughtful/careful when I try to buy technology (in person)
or seek repair or parts for my technology.  I used to have lots of
problems with cell phone companies (who doesn't?).  I often have trouble
with ISPs...  and all because I often *do* know more about their
technologies and service than the average customer, and maybe (in some
cases) "just enough to get me in trouble", or at least enough to
irritate the first line service/sales people trying to just get through
their day and sell/install/service 100 more commodity (to them) items.

Our "service" and "care" systems are optimized to deliver their services
on *their model* and they appear very fragile if you try to get them to
interact on YOUR model.  

Even fast food... "have it your way" is a little like Henry Ford's "you
can have your Model-T in any color you want as long as it is black".  
Many can handle simple substitutions/deletions but that is about it.  
When I was a young vegetarian I learned to order a "cheeseburger, hold
the meat, and if the cook can handle it, toast the bun upside down".... 
What I often got was the "grilled cheese sandwich with lettuce, tomato,
pickle" I wanted but was not on their menu. I don't think I *ever* got a
grilled cheese just by asking for it if it wasn't on their menu, but
nobody ever turned me down on deleting the meat from a cheeseburger.  If
the place had served me before it usually went easy and the bun was
usually toasted and "inside out" as I asked.   Sometimes I paid full
price for a burger, other times they followed the formula for what an
extra patty would cost and I'd end up with the grilled cheese at a steep
discount: "$2.50 for the cheeseburger - $1.00 for the patty... that will
be $1.00+ tax!"  If they were busy, I would just come back another
time... it wasn't in my interest to stress their system for my quirky
preferences.   Today it would be gluten-free, keto-friendly,
paleo-compliant, non-gmo, grass-fed-dairy...  and $15.

TLDR: (Auto Mechanic Anecdote) I had the same problem with auto repair
until I recognized what I was doing and made a very acute effort to meet
them on *their turf*.   Until I started a 60 mile RT daily commute I had
done most if not all of my own car repair, up to and including swapping
out engines and replacing stripped gears in transmissions.  I was not an
expert, but for other shadetree mechanics here, you may know that the 
resources are amazing at some level...  half the parts you need are
already stocked at a store nearby and they can get virtually any other
within hours or days just by specifying the details of the vehicle and
it's subsystem...   third party manuals (Haynes/Chiltons) are far from
perfect but once you find a good one for your vehicle.. and if that
isn't good enough... dealer service manuals are available for about the
price of an hour or three of shop time from a real mechanic, etc.   The
bottom line was that I *thought* I knew more about my vehicle than the
mechanic (well, in some  ways I did) and I wanted him to start with MY
diagnosis and MY preferred solution when it just didn't fit his
paradigm.   Generally mechanics don't trust civilians to know their cars
and the subsystems and diagnose them well, and in fact, if I hadn't dug
into the problem up to my armpits myself, I was often guessing (and
guessing wrong) based on superficial symptoms.     In any case, they
almost always disappointed me with their bedside manner... they didn't
want to listen to what I already knew about the problem and they REALLY
didn't want to listen to my repair suggestions.   They were usually
superficially polite but my empathetic self had me radiating my own
hostility or doubt in them I suspect.   Eventually I tried a mechanic
that was known to me, very convenient and with a generally good
reputation and I backed off and put my vehicles in their hands.  I let
them change oil, rotate tires, top off fluids, etc.   and I let THEM
tell me when they noticed a growing problem (e.g. oil leaks, bad tread
wear patterns, etc) and they proved quickly to me that THEY were as
competent as I (or more) to notice growing problems and recognize
reasonable solutions.  I occasionally mention things to them to look at,
but unless the symptoms are acute, I leave it to them to notice and they
(almost) always do! They have better shop manuals and better tools
(especially a lift in a heated space) and extra hands when a job is
easier with two people.   I paid $50/hour (the good ole days) for them
to do things I felt I could do in half (in reality, twice) the time and
it irritated me, but almost exclusively, they *never* lied to me or
mislead me.  Previous mechanics I'd tried this with would do a job or
two OK then they would tell me something I knew was patently false
(e.g." you need a new clutch slave cylinder" on a vehicle I knew to have
a mechanical linkage).   In retrospect, I don't think they were trying
to cheat me, but might have been being lazy or sloppy... they may have
"guessed" at something without looking closely, not realizing that *my*
model had a different subsystem than the one they were most familiar
with, or they cross-remembered another vehicle, or ???    In any case, I
would go away mad and go back to not trusting mechanics, etc.   

Today it has been almost 20 years I've been with my primary mechanic...
his son has taken over (most of) the business and they know all my
vehicles by heart and are happy to do pre-purchase inspections on new
ones I am considering.   Some problems and vehicles I don't bring to
them because they aren't familiar with them.   I don't expect them to
work on the hybrid components of my Gen1 Hybrid Insight and I don't ask
them to do much on my 1949 Ford Dump (though they do like the truck, it
doesn't fit in their bays easily and can only be raised about 3 feet on
their lifts, and parts are *very* hard to get, complicated by the fact
the engine is from an early 60's ford farm equipment and while a
standard Ford design, has oddities specific to the tractor/thresher/???
it was pulled from.  I only asked them to try to tune the mechanical
fuel injection on my mid-80s VW Cabriolet once... then did it myself
after not finding an obvious mechanic with specific familiarity.   I'm
in the midst of trying to get a new (used) 20Kwh hybrid battery
installed in my 2011 Chevy Volt.   It weighs 400 lbs, carries 360V when
energized, has sophisticated battery management subsystems and
integrating systems internal and external to it, and has to interface to
a number of computerized subsystems including the main computer, the
ECU, a charging control system, etc.   The service manager at the dealer
is waaaay over his head on this project and I get the sense that the
factory trained tech (for this specific model) has not had occasion to
ever remove or replace (or diagnose beyond pulling DTC codes from the
main computer).   But I know I am at their mercy.   The vehicle
subsystems are so specific to GM that (almost literally?) nobody except
GM dealers have the specialized tools and computer codes/software to
handle the re-energizing/calibrating of a battery.   The physical
aspects of swapping the battery are daunting enough, especially without
a lift, and I wouldn't expect ANY sane mechanic with a lift, etc. to
want to mess with this HV system.   I have done enough hybrid/EV/HV
electronics work to feel I could do it safely myself, but it would be
only *my life* on the line.  So I had to talk the service manager
through discovering that his Volt trained technician *could* install a
battery not provided by GM directly (a very few others have done this
around the US) and come up with the shop hours (7@$111) for the
procedure so I could order up a salvaged one (from a low-mileage
recently wrecked vehicle) to be delivered to them by freight. (BTW, a
NEW (refurbished?) GM Battery System is $8K retail plus installation).

  I'm sure the service manager was frustrated with me *many* times along
the way and his demeanor often left me wanting to cop my own attitude
and "go away mad".  I think now that we are at the point of having
scheduled the work and the battery is en-route... he has become
intrigued by the project and probably wants to see it succeed rather
than just "wanting me to go away" which is how I felt through more than
a little of the process.  And *I was aware* of the pitfalls of wanting
non-standard things that I have more knowledge about than the service
providers and I *still* stressed them almost to their limit.  I *wanted*
to blame them and be angry and resentful, but I had to acknowledge that
my kind of task is NOT their bread and butter, that the individuals (and
the whole system) has to see an upside to working with me before they
are going to be willing, much less positive about it.

Gil...  YOU may be the Chevy Volt of the human world.  Your needs may be
unusual enough that it is *hard* for the standard systems to meet you on
their terms and as you probably already know/guess, it really is up to
you to understand what the system is capable of and how to meet it on
terms where neither you nor they are too stressed by the interface to
function properly.   I don't know you *well* but believe you to have the
self-awareness to find productive ways to change your
interface/expectations enough to begin to reduce the stress you are
feeling right now.   Your other stated activities (hiking, gym, dancing,
etc.) seem like very positive directions to help you regulate (physical
activity is almost always a positive thing for virtually everyone) and
find new and varied friends and interests.    I don't make it to WedTech
often (annually if lucky?) but next time I'm in town with some time on
my hands, maybe we can get together for a bite or some coffee or tea and
we can bore (entertain?) one another with anecdotes about trying to
interface with a world of commodity objects and services.

- Steve


On 7/13/18 9:20 AM, Marcus Daniels wrote:
> Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.
>
> On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>
>     Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).
>     
>     To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.
>     
>     On 07/13/2018 08:06 AM, Marcus Daniels wrote:
>     > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
>     >
>     > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>     >
>     >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
>     >     
>     >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
>     >     
>     >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
>     >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
>     >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>     >     >
>     >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
>     >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Date: Friday, July 13, 2018 at 8:39 AM
>     >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Subject: [FRIAM] Weird observation
>     >     >
>     >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>     >     >
>     >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
>     
>     
>     --
>     ∄ uǝʃƃ
>     
>     ============================================================
>     FRIAM Applied Complexity Group listserv
>     Meets Fridays 9a-11:30 at cafe at St. John's College
>     to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
>     FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>     
>
> ============================================================
> FRIAM Applied Complexity Group listserv
> Meets Fridays 9a-11:30 at cafe at St. John's College
> to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
> FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>



============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove


============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
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Re: Weird observation

Steve Smith
In reply to this post by Gillian Densmore

Gil -

I'll reply more off-list.   I was mostly trying to acknowledge to you that we (or at least I) recognize that  you are acutely struggling right now, but that it may also be a "good sign" if it is helping you to seek changes, etc.

My typical anecdotal story about my own challenges when dealing with "systems" and the people stuck in them trying to execute what sometimes are contradictory rules or policies was intended to hopefully help you realize that while you are the one seeming to get the bad end of things in any given moment, one can also imagine how much it must "suck to be them", even if it isn't obvious what *they* are facing which seems to lead them to be rude or just plain dysfunctional.

Anyway, I'll follow up off list with some specific ideas, etc.

- Steve


On 7/14/18 10:23 AM, Gillian Densmore wrote:
Steve if it's a "sudden" riff of questions it's because I honestly genuinly don't know what else to do to find the rescources I need: I've NEVER on this or any other list consously said (I hope) I simply don't know. Yeah i'm in my "late" (humoursl voice VERY late) 30's): because just say certain fam members reasonably don't know what the heck to do given a rif that's not at all apropiate for this list: I can not rely on them. I do not want to lean on them. So I am all due to some on this list pulling a start-rek trek. I do not want this to be read as sarcastic:
I simply genuinly don't know what else to do, or why it might be weird to say: Uh advice please!  What ever I was doing before simply isn't working I need some guidance, and advice.  I am not at all trying to come off as throwing this in anyones face!
I have no idea why it took so long for me to push my comfort zones and want to have friends. No it may not have started as a support group. I do consider many on the list at least aquaintences some strait up friends: Nick and Kim (I have no idea if Kim Sorvice ist still subbed)

What all that said:: I for one hit a wall and fell appart I'll leave what between family and a theriapist. I have never denied I go to those and sorting what the what wrong or very right for the real pros.
The observation was simply huh weird do people really find it so weird for a stranger to open doors for them when they have their hands for with groceries (that's a real example)? oO
And while at the doctors office someone acted like In vented the chevy volt or hydrogen feul cell: oh sorry sir you can go first.
*shruging* no I don't expect to be "budy budy" with a doctor. I DO however think it's reasonable that a pro at least be cordial, not complain about the clock, or that I clearly need and stil need a bit of TLC' That's what those kind of pros are for.

I am trying to find the right places for a Re-do. 
I'm sorry if it came off as a flood or riff for needing and wanting some guidance from people that might have vastly more experience than I do in those areas. Hell that horribly laacking resrouce can well be: oh have tried (forum here) I found them really great for (stuff here)?!

I did ask presbytarian because---bluntly I've had enought of Saint Vincents being jerks about routine questions.So why not ask for others experience? is that not a good idea? oO

On Fri, Jul 13, 2018 at 10:26 AM, Steven A Smith <[hidden email]> wrote:
Gil -

I am intuiting from your current riff of questions/anecdotes here, that
you are feeling out of sorts on many fronts.  With a significant
engagement with the health-care system, THAT interface is an important
one for you and is broadly, if not categorically not working for you
right now...  various providers and interface staff are not responding
well to you and it is adding to your "out of sortiness".   It sounds
like a positive feedback loop, where you are anticipating being
mishandled and sending signals that lead staff/providers to then go off
their normal "bedside manner game" in some way or another which just
reinforces your feelings of being mishandled, etc.   I don't mean to
"blame the victim"... just pointing out that you are probably
participating in the breakdown in some way which you might be able to
change and get a better result.

I have any number of "service" interactions which I know I don't handle
well by my nature.   I don't engage in the health care system much at
all (sometimes avoiding for decades) for this reason... I find the whole
paradigm flawed and I wear that on my sleeve when I *do* engage and THAT
naturally puts some of the people I'm interacting with off.   Similarly
I have to be thoughtful/careful when I try to buy technology (in person)
or seek repair or parts for my technology.  I used to have lots of
problems with cell phone companies (who doesn't?).  I often have trouble
with ISPs...  and all because I often *do* know more about their
technologies and service than the average customer, and maybe (in some
cases) "just enough to get me in trouble", or at least enough to
irritate the first line service/sales people trying to just get through
their day and sell/install/service 100 more commodity (to them) items.

Our "service" and "care" systems are optimized to deliver their services
on *their model* and they appear very fragile if you try to get them to
interact on YOUR model.  

Even fast food... "have it your way" is a little like Henry Ford's "you
can have your Model-T in any color you want as long as it is black".  
Many can handle simple substitutions/deletions but that is about it.  
When I was a young vegetarian I learned to order a "cheeseburger, hold
the meat, and if the cook can handle it, toast the bun upside down".... 
What I often got was the "grilled cheese sandwich with lettuce, tomato,
pickle" I wanted but was not on their menu. I don't think I *ever* got a
grilled cheese just by asking for it if it wasn't on their menu, but
nobody ever turned me down on deleting the meat from a cheeseburger.  If
the place had served me before it usually went easy and the bun was
usually toasted and "inside out" as I asked.   Sometimes I paid full
price for a burger, other times they followed the formula for what an
extra patty would cost and I'd end up with the grilled cheese at a steep
discount: "$2.50 for the cheeseburger - $1.00 for the patty... that will
be $1.00+ tax!"  If they were busy, I would just come back another
time... it wasn't in my interest to stress their system for my quirky
preferences.   Today it would be gluten-free, keto-friendly,
paleo-compliant, non-gmo, grass-fed-dairy...  and $15.

TLDR: (Auto Mechanic Anecdote) I had the same problem with auto repair
until I recognized what I was doing and made a very acute effort to meet
them on *their turf*.   Until I started a 60 mile RT daily commute I had
done most if not all of my own car repair, up to and including swapping
out engines and replacing stripped gears in transmissions.  I was not an
expert, but for other shadetree mechanics here, you may know that the 
resources are amazing at some level...  half the parts you need are
already stocked at a store nearby and they can get virtually any other
within hours or days just by specifying the details of the vehicle and
it's subsystem...   third party manuals (Haynes/Chiltons) are far from
perfect but once you find a good one for your vehicle.. and if that
isn't good enough... dealer service manuals are available for about the
price of an hour or three of shop time from a real mechanic, etc.   The
bottom line was that I *thought* I knew more about my vehicle than the
mechanic (well, in some  ways I did) and I wanted him to start with MY
diagnosis and MY preferred solution when it just didn't fit his
paradigm.   Generally mechanics don't trust civilians to know their cars
and the subsystems and diagnose them well, and in fact, if I hadn't dug
into the problem up to my armpits myself, I was often guessing (and
guessing wrong) based on superficial symptoms.     In any case, they
almost always disappointed me with their bedside manner... they didn't
want to listen to what I already knew about the problem and they REALLY
didn't want to listen to my repair suggestions.   They were usually
superficially polite but my empathetic self had me radiating my own
hostility or doubt in them I suspect.   Eventually I tried a mechanic
that was known to me, very convenient and with a generally good
reputation and I backed off and put my vehicles in their hands.  I let
them change oil, rotate tires, top off fluids, etc.   and I let THEM
tell me when they noticed a growing problem (e.g. oil leaks, bad tread
wear patterns, etc) and they proved quickly to me that THEY were as
competent as I (or more) to notice growing problems and recognize
reasonable solutions.  I occasionally mention things to them to look at,
but unless the symptoms are acute, I leave it to them to notice and they
(almost) always do! They have better shop manuals and better tools
(especially a lift in a heated space) and extra hands when a job is
easier with two people.   I paid $50/hour (the good ole days) for them
to do things I felt I could do in half (in reality, twice) the time and
it irritated me, but almost exclusively, they *never* lied to me or
mislead me.  Previous mechanics I'd tried this with would do a job or
two OK then they would tell me something I knew was patently false
(e.g." you need a new clutch slave cylinder" on a vehicle I knew to have
a mechanical linkage).   In retrospect, I don't think they were trying
to cheat me, but might have been being lazy or sloppy... they may have
"guessed" at something without looking closely, not realizing that *my*
model had a different subsystem than the one they were most familiar
with, or they cross-remembered another vehicle, or ???    In any case, I
would go away mad and go back to not trusting mechanics, etc.   

Today it has been almost 20 years I've been with my primary mechanic...
his son has taken over (most of) the business and they know all my
vehicles by heart and are happy to do pre-purchase inspections on new
ones I am considering.   Some problems and vehicles I don't bring to
them because they aren't familiar with them.   I don't expect them to
work on the hybrid components of my Gen1 Hybrid Insight and I don't ask
them to do much on my 1949 Ford Dump (though they do like the truck, it
doesn't fit in their bays easily and can only be raised about 3 feet on
their lifts, and parts are *very* hard to get, complicated by the fact
the engine is from an early 60's ford farm equipment and while a
standard Ford design, has oddities specific to the tractor/thresher/???
it was pulled from.  I only asked them to try to tune the mechanical
fuel injection on my mid-80s VW Cabriolet once... then did it myself
after not finding an obvious mechanic with specific familiarity.   I'm
in the midst of trying to get a new (used) 20Kwh hybrid battery
installed in my 2011 Chevy Volt.   It weighs 400 lbs, carries 360V when
energized, has sophisticated battery management subsystems and
integrating systems internal and external to it, and has to interface to
a number of computerized subsystems including the main computer, the
ECU, a charging control system, etc.   The service manager at the dealer
is waaaay over his head on this project and I get the sense that the
factory trained tech (for this specific model) has not had occasion to
ever remove or replace (or diagnose beyond pulling DTC codes from the
main computer).   But I know I am at their mercy.   The vehicle
subsystems are so specific to GM that (almost literally?) nobody except
GM dealers have the specialized tools and computer codes/software to
handle the re-energizing/calibrating of a battery.   The physical
aspects of swapping the battery are daunting enough, especially without
a lift, and I wouldn't expect ANY sane mechanic with a lift, etc. to
want to mess with this HV system.   I have done enough hybrid/EV/HV
electronics work to feel I could do it safely myself, but it would be
only *my life* on the line.  So I had to talk the service manager
through discovering that his Volt trained technician *could* install a
battery not provided by GM directly (a very few others have done this
around the US) and come up with the shop hours (7@$111) for the
procedure so I could order up a salvaged one (from a low-mileage
recently wrecked vehicle) to be delivered to them by freight. (BTW, a
NEW (refurbished?) GM Battery System is $8K retail plus installation).

  I'm sure the service manager was frustrated with me *many* times along
the way and his demeanor often left me wanting to cop my own attitude
and "go away mad".  I think now that we are at the point of having
scheduled the work and the battery is en-route... he has become
intrigued by the project and probably wants to see it succeed rather
than just "wanting me to go away" which is how I felt through more than
a little of the process.  And *I was aware* of the pitfalls of wanting
non-standard things that I have more knowledge about than the service
providers and I *still* stressed them almost to their limit.  I *wanted*
to blame them and be angry and resentful, but I had to acknowledge that
my kind of task is NOT their bread and butter, that the individuals (and
the whole system) has to see an upside to working with me before they
are going to be willing, much less positive about it.

Gil...  YOU may be the Chevy Volt of the human world.  Your needs may be
unusual enough that it is *hard* for the standard systems to meet you on
their terms and as you probably already know/guess, it really is up to
you to understand what the system is capable of and how to meet it on
terms where neither you nor they are too stressed by the interface to
function properly.   I don't know you *well* but believe you to have the
self-awareness to find productive ways to change your
interface/expectations enough to begin to reduce the stress you are
feeling right now.   Your other stated activities (hiking, gym, dancing,
etc.) seem like very positive directions to help you regulate (physical
activity is almost always a positive thing for virtually everyone) and
find new and varied friends and interests.    I don't make it to WedTech
often (annually if lucky?) but next time I'm in town with some time on
my hands, maybe we can get together for a bite or some coffee or tea and
we can bore (entertain?) one another with anecdotes about trying to
interface with a world of commodity objects and services.

- Steve


On 7/13/18 9:20 AM, Marcus Daniels wrote:
> Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.
>
> On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>
>     Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).
>     
>     To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.
>     
>     On 07/13/2018 08:06 AM, Marcus Daniels wrote:
>     > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
>     >
>     > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>     >
>     >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
>     >     
>     >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
>     >     
>     >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
>     >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
>     >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>     >     >
>     >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
>     >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Date: Friday, July 13, 2018 at 8:39 AM
>     >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Subject: [FRIAM] Weird observation
>     >     >
>     >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>     >     >
>     >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
>     
>     
>     --
>     ∄ uǝʃƃ
>     
>     ============================================================
>     FRIAM Applied Complexity Group listserv
>     Meets Fridays 9a-11:30 at cafe at St. John's College
>     to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
>     FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>     
>
> ============================================================
> FRIAM Applied Complexity Group listserv
> Meets Fridays 9a-11:30 at cafe at St. John's College
> to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
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>



============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
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FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
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Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
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Re: Weird observation

Gillian Densmore
In reply to this post by Steve Smith
Steve, btw afre re re-reading your email:
Thank you.
And some of the out of sortsness that is coming across: it's been a rotten week. Thought made a bit better (possible) friend and I HER health provided my hang out today. Something about Fibroid Myagliag. I am more engaged in the health system than Perhaps I'd like or others think is normals. I genuinly honetly simply do not know wich. I may have for more than' I realized simply needed slighly more fine tuning here and theire.  You did nail it though and thak you for that. For example Some sort of what may have started as having screwed something up at the gym one day...many years later  now causes me a TON of physical pain in pretty much everything mid back up. I for one do not consider it ok to not get that kind of thing properly managed, and find it lame, and rediculous that of the health systems I know of: Oh it's in your head (wha the?)
And glen: thank you. Nailed that as well. 
My hopefully soon to be former psychiatirst only fidgets with a computer and yesterday snapped at me for needing to fall appart for as steve pointed out (thankfully) my god awfull week+a desire to push my not at all normal comfort zones was more than I realized I could deel with.
Said psychiatirst after digging: has had many complaints against him for that part....So yeah the health system (such as it is all due to at least) NM has been on my mind.

And Steve may also have nailed it in some ways: I got tired of short term soultions, so asked here and some other turns out to de defunct list> Basically I need a re-do here's the issues  want to fix. Anyone have some advice and sugestions?

I guess I just find it wered that's unusual. I try to rely on myself for I cooking cleaning. But stuff what ever I was doing just was a bad way to do it (in my head I thought): ok lets try to ask for options (said optimistically) I've also discovered at least for me  email has a weird way of not at all expressing what it is I want to exrpess somtimes. 

I'm sorry to the list for hitting a ton of walls many really good. It was not at all my intention to spam. I just thought: ya know I need some advice. lets do it and try asking around. As a compliment to Steve (for example): Dude it's great you want to find clubs make friends etc but having been where  you are at IMO: take one big step at a time...
That is exactly the kind of guidance for what ever reason at the moment is super helpful. It is entirely possible sometimes I (just) need a bit more advice or plain TLC than usual...As I said before just a guess. :

Guys:
Thank you. I Know I've taken to asking a lot more questions than I might have in the past. It's whole no teritory. My simple guess is people hit what ever stage of life  Others may  in now 20's  So yeah, got a ton of catch up and a lot more questions than usual, and a sense of urgancy.  
My promise FWIW is to try not to spam! 



On Fri, Jul 13, 2018 at 10:26 AM, Steven A Smith <[hidden email]> wrote:
Gil -

I am intuiting from your current riff of questions/anecdotes here, that
you are feeling out of sorts on many fronts.  With a significant
engagement with the health-care system, THAT interface is an important
one for you and is broadly, if not categorically not working for you
right now...  various providers and interface staff are not responding
well to you and it is adding to your "out of sortiness".   It sounds
like a positive feedback loop, where you are anticipating being
mishandled and sending signals that lead staff/providers to then go off
their normal "bedside manner game" in some way or another which just
reinforces your feelings of being mishandled, etc.   I don't mean to
"blame the victim"... just pointing out that you are probably
participating in the breakdown in some way which you might be able to
change and get a better result.

I have any number of "service" interactions which I know I don't handle
well by my nature.   I don't engage in the health care system much at
all (sometimes avoiding for decades) for this reason... I find the whole
paradigm flawed and I wear that on my sleeve when I *do* engage and THAT
naturally puts some of the people I'm interacting with off.   Similarly
I have to be thoughtful/careful when I try to buy technology (in person)
or seek repair or parts for my technology.  I used to have lots of
problems with cell phone companies (who doesn't?).  I often have trouble
with ISPs...  and all because I often *do* know more about their
technologies and service than the average customer, and maybe (in some
cases) "just enough to get me in trouble", or at least enough to
irritate the first line service/sales people trying to just get through
their day and sell/install/service 100 more commodity (to them) items.

Our "service" and "care" systems are optimized to deliver their services
on *their model* and they appear very fragile if you try to get them to
interact on YOUR model.  

Even fast food... "have it your way" is a little like Henry Ford's "you
can have your Model-T in any color you want as long as it is black".  
Many can handle simple substitutions/deletions but that is about it.  
When I was a young vegetarian I learned to order a "cheeseburger, hold
the meat, and if the cook can handle it, toast the bun upside down".... 
What I often got was the "grilled cheese sandwich with lettuce, tomato,
pickle" I wanted but was not on their menu. I don't think I *ever* got a
grilled cheese just by asking for it if it wasn't on their menu, but
nobody ever turned me down on deleting the meat from a cheeseburger.  If
the place had served me before it usually went easy and the bun was
usually toasted and "inside out" as I asked.   Sometimes I paid full
price for a burger, other times they followed the formula for what an
extra patty would cost and I'd end up with the grilled cheese at a steep
discount: "$2.50 for the cheeseburger - $1.00 for the patty... that will
be $1.00+ tax!"  If they were busy, I would just come back another
time... it wasn't in my interest to stress their system for my quirky
preferences.   Today it would be gluten-free, keto-friendly,
paleo-compliant, non-gmo, grass-fed-dairy...  and $15.

TLDR: (Auto Mechanic Anecdote) I had the same problem with auto repair
until I recognized what I was doing and made a very acute effort to meet
them on *their turf*.   Until I started a 60 mile RT daily commute I had
done most if not all of my own car repair, up to and including swapping
out engines and replacing stripped gears in transmissions.  I was not an
expert, but for other shadetree mechanics here, you may know that the 
resources are amazing at some level...  half the parts you need are
already stocked at a store nearby and they can get virtually any other
within hours or days just by specifying the details of the vehicle and
it's subsystem...   third party manuals (Haynes/Chiltons) are far from
perfect but once you find a good one for your vehicle.. and if that
isn't good enough... dealer service manuals are available for about the
price of an hour or three of shop time from a real mechanic, etc.   The
bottom line was that I *thought* I knew more about my vehicle than the
mechanic (well, in some  ways I did) and I wanted him to start with MY
diagnosis and MY preferred solution when it just didn't fit his
paradigm.   Generally mechanics don't trust civilians to know their cars
and the subsystems and diagnose them well, and in fact, if I hadn't dug
into the problem up to my armpits myself, I was often guessing (and
guessing wrong) based on superficial symptoms.     In any case, they
almost always disappointed me with their bedside manner... they didn't
want to listen to what I already knew about the problem and they REALLY
didn't want to listen to my repair suggestions.   They were usually
superficially polite but my empathetic self had me radiating my own
hostility or doubt in them I suspect.   Eventually I tried a mechanic
that was known to me, very convenient and with a generally good
reputation and I backed off and put my vehicles in their hands.  I let
them change oil, rotate tires, top off fluids, etc.   and I let THEM
tell me when they noticed a growing problem (e.g. oil leaks, bad tread
wear patterns, etc) and they proved quickly to me that THEY were as
competent as I (or more) to notice growing problems and recognize
reasonable solutions.  I occasionally mention things to them to look at,
but unless the symptoms are acute, I leave it to them to notice and they
(almost) always do! They have better shop manuals and better tools
(especially a lift in a heated space) and extra hands when a job is
easier with two people.   I paid $50/hour (the good ole days) for them
to do things I felt I could do in half (in reality, twice) the time and
it irritated me, but almost exclusively, they *never* lied to me or
mislead me.  Previous mechanics I'd tried this with would do a job or
two OK then they would tell me something I knew was patently false
(e.g." you need a new clutch slave cylinder" on a vehicle I knew to have
a mechanical linkage).   In retrospect, I don't think they were trying
to cheat me, but might have been being lazy or sloppy... they may have
"guessed" at something without looking closely, not realizing that *my*
model had a different subsystem than the one they were most familiar
with, or they cross-remembered another vehicle, or ???    In any case, I
would go away mad and go back to not trusting mechanics, etc.   

Today it has been almost 20 years I've been with my primary mechanic...
his son has taken over (most of) the business and they know all my
vehicles by heart and are happy to do pre-purchase inspections on new
ones I am considering.   Some problems and vehicles I don't bring to
them because they aren't familiar with them.   I don't expect them to
work on the hybrid components of my Gen1 Hybrid Insight and I don't ask
them to do much on my 1949 Ford Dump (though they do like the truck, it
doesn't fit in their bays easily and can only be raised about 3 feet on
their lifts, and parts are *very* hard to get, complicated by the fact
the engine is from an early 60's ford farm equipment and while a
standard Ford design, has oddities specific to the tractor/thresher/???
it was pulled from.  I only asked them to try to tune the mechanical
fuel injection on my mid-80s VW Cabriolet once... then did it myself
after not finding an obvious mechanic with specific familiarity.   I'm
in the midst of trying to get a new (used) 20Kwh hybrid battery
installed in my 2011 Chevy Volt.   It weighs 400 lbs, carries 360V when
energized, has sophisticated battery management subsystems and
integrating systems internal and external to it, and has to interface to
a number of computerized subsystems including the main computer, the
ECU, a charging control system, etc.   The service manager at the dealer
is waaaay over his head on this project and I get the sense that the
factory trained tech (for this specific model) has not had occasion to
ever remove or replace (or diagnose beyond pulling DTC codes from the
main computer).   But I know I am at their mercy.   The vehicle
subsystems are so specific to GM that (almost literally?) nobody except
GM dealers have the specialized tools and computer codes/software to
handle the re-energizing/calibrating of a battery.   The physical
aspects of swapping the battery are daunting enough, especially without
a lift, and I wouldn't expect ANY sane mechanic with a lift, etc. to
want to mess with this HV system.   I have done enough hybrid/EV/HV
electronics work to feel I could do it safely myself, but it would be
only *my life* on the line.  So I had to talk the service manager
through discovering that his Volt trained technician *could* install a
battery not provided by GM directly (a very few others have done this
around the US) and come up with the shop hours (7@$111) for the
procedure so I could order up a salvaged one (from a low-mileage
recently wrecked vehicle) to be delivered to them by freight. (BTW, a
NEW (refurbished?) GM Battery System is $8K retail plus installation).

  I'm sure the service manager was frustrated with me *many* times along
the way and his demeanor often left me wanting to cop my own attitude
and "go away mad".  I think now that we are at the point of having
scheduled the work and the battery is en-route... he has become
intrigued by the project and probably wants to see it succeed rather
than just "wanting me to go away" which is how I felt through more than
a little of the process.  And *I was aware* of the pitfalls of wanting
non-standard things that I have more knowledge about than the service
providers and I *still* stressed them almost to their limit.  I *wanted*
to blame them and be angry and resentful, but I had to acknowledge that
my kind of task is NOT their bread and butter, that the individuals (and
the whole system) has to see an upside to working with me before they
are going to be willing, much less positive about it.

Gil...  YOU may be the Chevy Volt of the human world.  Your needs may be
unusual enough that it is *hard* for the standard systems to meet you on
their terms and as you probably already know/guess, it really is up to
you to understand what the system is capable of and how to meet it on
terms where neither you nor they are too stressed by the interface to
function properly.   I don't know you *well* but believe you to have the
self-awareness to find productive ways to change your
interface/expectations enough to begin to reduce the stress you are
feeling right now.   Your other stated activities (hiking, gym, dancing,
etc.) seem like very positive directions to help you regulate (physical
activity is almost always a positive thing for virtually everyone) and
find new and varied friends and interests.    I don't make it to WedTech
often (annually if lucky?) but next time I'm in town with some time on
my hands, maybe we can get together for a bite or some coffee or tea and
we can bore (entertain?) one another with anecdotes about trying to
interface with a world of commodity objects and services.

- Steve


On 7/13/18 9:20 AM, Marcus Daniels wrote:
> Perhaps the first step needs to be "How sensitive is this patient to bedside manner?", and from that estimate then prioritize the relative timing of one sort of analysis over another.   I assume I'm dealing with an intelligent, if imperfect, person.    I think it takes some self-control to be a good patient, too.
>
> On 7/13/18, 9:13 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>
>     Perhaps.  But if that's the case, I would immediately leave and find another Dr.  As I explained before, and is peppered throughout Renee's training, the "assessment of the patient", which involves really *looking* at the patient, is more powerful than any other (set of) metric(s).
>     
>     To be clear, the patient assessment machine can be completely autistic.  But they must "assess the patient" by looking at her.
>     
>     On 07/13/2018 08:06 AM, Marcus Daniels wrote:
>     > Is it not possible the doctor looking at her computer is just like Glen listening to music without moving?    Focusing on the facts of the matter and not on distracting emotional signals?
>     >
>     > On 7/13/18, 9:03 AM, "Friam on behalf of ∄ uǝʃƃ" <[hidden email] on behalf of [hidden email]> wrote:
>     >
>     >     For what it's worth, my Dr. thanked me after our 1st interaction.  He walked in with his laptop, sat down and started poking at it.  I then used my familiarity with electronic medical records (I was a product mgr at such a company at one point) to finagle his attention and demonstrate our mutual affinity for how computation can help him provide good healthcare.  I even explained how I'd looked him up online beforehand and knew all the schools he went to and that he had no active malpractice suits against him.  (Which was no small feat since he's an immigrant from India.)
>     >     
>     >     That interaction successfully grabbed his attention.  Perhaps, since you're also computer literate, you could use the same trick next time a Dr's attention is too focused on the computer?
>     >     
>     >     On 07/13/2018 07:48 AM, Marcus Daniels wrote:
>     >     > It is a bigger problem that people are more concerned about `getting along’ than they are about maintaining a functional government.
>     >     > As for doctors, I don’t want them to my friend.   I want them to take their limited time and focus their extensive training, to rationalize the symptoms I present.
>     >     >
>     >     > From: Friam <[hidden email]> on behalf of Gillian Densmore <[hidden email]>
>     >     > Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Date: Friday, July 13, 2018 at 8:39 AM
>     >     > To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
>     >     > Subject: [FRIAM] Weird observation
>     >     >
>     >     > While at doctor's office trying ask a nurse to politely express to a doctor that it comes off as rude when that doc is obssed with a computer gets a reaction like you've invented warp drive.
>     >     >
>     >     > Is it really that unusual for people to try to actively be cordial these days? If so captian we got a problem!
>     
>     
>     --
>     ∄ uǝʃƃ
>     
>     ============================================================
>     FRIAM Applied Complexity Group listserv
>     Meets Fridays 9a-11:30 at cafe at St. John's College
>     to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
>     FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>     
>
> ============================================================
> FRIAM Applied Complexity Group listserv
> Meets Fridays 9a-11:30 at cafe at St. John's College
> to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
> FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove
>



============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove


============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove