Tuesday, June 21, 2016

The time has come, the walrus said...

As I was saying a couple of years ago, I was contemplating retirement, and now I've decided. It will be this year, a few months from now.

It wasn't exactly a difficult decision when I finally came to it. The main thing was that I was enjoying medical practice less and less, finding the relief of the weekends too short, and the dread of the coming week on a Sunday more and more.

For the short term, I'll have plenty to do, with various things around the house to catch up on. In the longer term, there is some uncertainty, but I look forward to being away from set schedules, all the various messages demanding answers, and so on.

People ask me if we'll be traveling a lot, but we've traveled quite a bit over the years, so nothing out of the ordinary is planned. Occasionally I have seen something about some trip that might last a couple of weeks that formerly I would never have considered, so maybe that will change.

Perhaps I'll find more time for this blog.

Saturday, February 14, 2015

eReadings 20 -- World War I

No, I didn't stop reading since the last eReadings post. I've actually read a LOT of things since then. Of course, I'm talking about on my Kindle, not other reading, of which I do a lot also.

What I fell or drifted into in the last year or so was a series of books about World War I, written at the time. What follows is a somewhat ordered list of what I have read so far.

My Four Years in Germany
James W Gerard

Mr. Gerard was appointed the US ambassador to Germany in 2013, before there was any inkling of war breaking out. To be sure, there was a lot of militarism in the world, especially in Germany.

This is a personal account of his time there, which of course ended when the US declared war on Germany. He describes in great detail the structure and operation of the Kaiser's court, and of Germany in general. Once war was finally underway, he became the representative for Britain and several other countries.

This was very interesting to get this insider's view of the prelude and beginning of the war.

From October to Brest-Letovsk
Leon Trotsky

This is Trotsky's account of the Russian revolution, going on of course as Russia was involved in World War I. As the communists come to power, they have more pressing things to do, and sue the Germans for peace.

What I found interesting was how rapidly Lenin and his followers adopted totalitarianism, control of the press, and created a ruling group. There was never any plan to give any real power to the proletariat, who were supposedly those for whom the revolution was carried out. An interesting item in the negotiations with Germany was that both sides formally agreed there would be no independent Ukraine.

What is Coming? A Forecast of Things After the War
H. G. Wells
Wells describes himself as a futurist, and aside from the various novels we are more commonly aware of, he also published works describing things as they were and trying to predict where they were going. This book was written as WWI was being waged, and as such contains some interesting insights.

He anticipated that Germany would lose the war, though how confident he was at the time is hard to gauge. He nonetheless expected that Germany would not be seriously damaged by this war, and would be able to wage war again, and thus felt an important outcome should be removing the Kaiser from power. He was a strong advocate of a world government and saw that England needed to reach out to learn more about other important countries. At a time before the Russian revolution, he was suggesting that England should become closer to Russia, even teaching Russian in English schools.

There is therefore a lot of his predictions which were quite off base, but considering they were written in 1914, very interesting in that context.

Mille et un jours en prison à Berlin
Henri Severin Beland
Ok, showing off a bit. This book is in French (1001 Days in Prison in Berlin). I've spent some time with my Kindle working on my French (e.g., simultaneously going through Candide by Voltaire in French along with its English translation), and a couple of years ago translated a French book on Scribus to English at the flossmanuals.net site. Somehow I was able to read this book pretty comfortably (with the occasional help from Google Translate), perhaps because this is a chronicle rather than a novel.

This is the story of a French Canadian physician, who was travelling through Belgium as WWI broke out. Initially he offered his services to a local hospital as it began to treat war casualties. As conditions worsened with the German occupation he tried to be allowed to travel to Holland so that he could go back home. The Germans initially sounded like they might acquiesce, but eventually higher ups had him sent to detention in Berlin, in a former prison, which by then had a number of people from various countries.

Repeated petitions for release to return home were ignored, though he did manage to get some privileges due to the fact that he assisted the prison's physician in taking care not only of the other prisoners, but also the German soldiers who worked there.

Mr. Britling Sees It Through
H.G. Wells
When I started this one, I had no idea that it would have anything to do with the war. After some preliminary chapters describing Mr. Britling as an essayist, perhaps something like Wells was himself, suddenly the war is upon Britain.

Mr. Britling was too old to fight in this war himself, but there are close friends and his son who do get involved.

Much of the book purports to be his ruminations about the possibility of war, the onset of war, and its conduct plus the effect on British society. As such, his ruminations seem entirely too wordy to be believable even for someone of high intellect.

Aside from this, it offers an interesting glimpse of wartime in England from the perspective of those not directly involved with it, yet having to deal with a variety of the war's effects and side effects.

Thursday, May 08, 2014

Exit Strategy

It wasn't that long ago that I honestly told people that I had no idea when I might retire.

Somehow things have changed. In some future posts I would like to explain this a bit, but let's just for the time being say that I'm in the process of finding a way to stop doing what I'm doing as a physician.

My "Uncle Doc", my grandmother's brother, some years ago told me that he "retired too soon." This coming from a man who retired from family practice at 84yo. But what he meant was that he had no exit strategy. He didn't take the time, take the bother to develop some outside interests, some idea of what he was going to do when he retired. So when he retired, he spent his days, first of all stopping by the office where he used to practice to chat to his former staff, then he'd swing over to the hospital he used to attend at and sit in the doctors lounge and chat with colleagues.

I can't see myself doing that. Sure, I may stop and visit at times, but that's not going to define my days, and from his experience it's just as well.  He died not long after that visit I had with him.

I don't find medicine as envigorating as it once was. Yes, I enjoy my time in the hospital, facing some unknown issue, getting a history, doing an exam, putting together some hypothesis about what's going on, what to do about it. But I am more bothered by episodic interruptions, by getting the names of new consultations in the mornings. Not that I see things I don't know what to do. I've seen so much it all just happens now, the differential diagnosis, testing, empiric and other treatments. And it's not boring.

But still this dread of having to go in every day, not knowing when the next new thing is coming. I think it's time to look for the exit from this.

Getting back to my uncle, what's next? I have a lot of interests. Many of them involve computers. I have this blog, but the time since my last post says a lot about how invested I am in this. I help with the development of Scribus, an open source software program. My job is mostly documentation.

I'm thinking I need to carve something else out. Maybe something I haven't done before, or maybe only dabbled in. I have some interest in, but not necessarily a lot of faith in the various things you find out there for "preventing dementia." Do these things work or just identify people who were low risk in the first place?

But I like learning new things anyway, so this will probably be part of my strategy. I like to travel, and no doubt will continue that to some degree, but I also know that travel is irritating in various ways, so I don't see spending a lot of time on that. Maybe I can now take some trip that might last a couple of weeks or more, something I haven't ever considered in the past. You take two weeks off work and the mountain that piled up while you were gone is amazing.

There are any one of a number of charitable things I could do in some way related to medicine, but right now I just don't see these as options. Maybe I just need some time away to see their appeal.

So here I am, still at the beginning or the middle of this. The reason I'm blogging about it is that I think it's true that one of the ways of working through a dilemma is to write down your thoughts about it. The process of turning a lot of competing, well- and ill-formed ideas into something you can understand yourself begins with making some coherent piece that lays it all out so you can create and reread it later.

Thursday, September 27, 2012

Further notes on the Nexus 7

Battery Life
I've read some articles suggesting a battery life of about 11.5 hrs for the Nexus 7. This is of course with continuous usage, but this isn't how I need to or actually do use mine.

Typically I shut it down at night, since I don't use it then, and even during the day I am mostly leaving it in suspend, then periodically using it -- I turn it on about 7:30 in the morning, and then shut it down at about 8-9 pm. I'm not streaming video or music, not doing a lot of emailing. I find I can easily use it for 2 days without recharging, and even at the end of the second day there is still 30% or so of the charge left. So this means a typical day runs about 30-40% of the battery down.

The external keyboard I bought is mostly unused, but this doesn't mean I wish I hadn't bought it. When I got my new "black bag", I was carrying the keyboard in it, but space was a bit cramped, and after I noted that I rarely needed it, thanks to the TouchPal soft keyboard, I took it out, so my black bag is that much lighter -- not a lot, but clearly noticeable.

I was on the verge of buying the Pro upgrade of Jota+ (simple text editor), but then I saw that the ONLY benefit is being able to load more than 2 files. I'd rather fish around for more feature-full editors, but in the meantime, 2 files at a time is adequate.

Tuesday, September 18, 2012

Android vs Linux

On the surface, this might seem like a nonsequitur, since in a sense Android is Linux, but the ecosystems are different.

On Linux there are a host of utilities and applications, all full-featured, and FREE in all the senses of the term.

Yes, there are free apps for Android, but most are shadows of their incarnations on Linux, and beyond that, the free versions are typically crippled in one or more ways to encourage you to buy the PRO (or whatever) version. Example: the Jota app I mentioned only allows 2 files open at a time.

So Android wants to compete on the mercenary Apple playing field, and metrics are generated which measure Android's success by how much money is spent on apps.

But I can manage. The only app I've purchased was one that more time passed than the allowable 15 minutes for me to decide it wasn't going to work for me to decide I wanted a refund, since it was of no use to me. So in addition to my basic attitude,  I now also have a bad taste in my mouth from a purchase I did make. At this rate I may never use up my initial $25 credit at Google Play.

15 minutes?

(incidentally, this post is the first done with my Nexus 7)

Saturday, September 15, 2012

Nexus 7 and Files

The Nexus 7 doesn't come with any built-in way to look at files, as in looking at the files in the various directories. I'm using File Manager HD, and this does what I need, such as getting a look at the directory structure, seeing what files are where, and so on. But what about transferring files to or from the tablet?

The presumption seems to be that you will use the internet, either by transferring them as email attachments or maybe using something up there in the cloud. But you may want to be a bit more private that either of these.

There is a capability of transferring via the USB socket, but the filesystem is an MTP format, not native to anything, so you have to go througn some steps to do this. I decided I didn't want to bother.

I've used ssh (secure shell) at home for years for transferring files, signing onto another computer remotely, and also the related sftp means of uploading files to my site. It took me a while to get the syntax right. Generally speaking I am using my desktop to interact with the tablet, so given that the wifi address of my tablet is, I can type

ssh -o Port=2222 root@

to remotely connect to the tablet, and

scp -P 2222 somefile.jpg root@

to send the picture somefile.jpg to the tablet.

sftp -o Port=2222 root@

sets up an sftp connection to the tablet, where you might serially send and receive a number files to/from the device. For example, after connecting with the sftp command above, I could type

put somefile.jpg

to accomplish the same thing I did with the scp command, but afterward, I'm still connected to the tablet, until I type 'bye'.

get anotherfile.jpg

would download anotherfile.jpg from the device.
Once I have the file there, then typically I may use File Manager HD to move it where I want to. It's helpful to know which directories your files are in, since some apps have minimal ability to search directories.

SSHDroid is only setting up your tablet to be a receiver from other computers, it's not loading an ssh binary on the tablet.

Friday, September 14, 2012

Google Nexus 7

After a considerable delay in getting any tablet at all, reading a lot of reviews, picking up various tablets at stores, I finally decided to get a Nexus 7. The specs and various reviews sounded good. Without saying anything more about it, I do not expect to ever own an iPad or an iPhone, just as a personal choice.

The idea with the Nexus 7 was to find a replacement for the laptop I carry on my medical rounds. I still have the laptop, still use it daily for generating EMG reports, but I wanted something smaller and lighter for rounds. The key thing was that I needed to have access to the hospital charts via the free wifi the hospital has.

Getting to the Chart
Some time ago, the hospital switched from a Windows-only means of hooking up (and required IE 6 and XP), but they began using Citrix for connection, and Citrix has receivers not only for Windows, but also MacOS, Linux, and Android. I knew the Android works because I have it on my phone. The screen size of the Samsung Galaxy S is not conducive to navigating and reading hospital charts, however, let alone trying to see a CT or MRI scan.

I thought I was going to have to use a browser to connect, since I didn't know all the settings for the standalone receiver, so at first I connected through Firefox, since Chrome didn't work. Later, I found out what to enter in the domain setting, so now just use the receiver. It takes a little while to get all the usability issues resolved. While the Nexus 7's screen is much bigger than my phone, there is still limited real estate. Except for some of the larger targets, many of the clickable things on the hospital chart UI are quite small, and yes, you can zoom in, zoom out, but it's annoying to be doing that constantly.

I'm guessing it comes from the Citrix receiver, but it turns out there is a small tab to click on at the top of the screen, and tapping this slides down a number of choices, including a soft keyboard and a mouse pointer. You use the pointer by sliding it around the screen over a target, then tapping anywhere on the screen is like clicking where the cursor is, so this is what most navigating is done with. You can also simultaneously activate the keyboard with this pointer active.

The biggest problem with the keyboard is that it shoves the screen contents aside, so you tap out something, then slide the keyboard away. Fortunately, there isn't so much data entry involved with the UI, and sometimes holding the tablet in portrait orientation works Ok.

A Real Keyboard
After a couple of days I bought a bluetooth keyboard (Targus), and this is handy for doing something more than tap-tap-tap. Even with the predictive nature of keyboard entry guessing words, typing is slow. The Targus keyboard works fine right out of the container. At first I seemed to have some trouble with something like keybounce, where tapping a key enters the character twice, but I believe it was because I was hitting the keys too hard, so it seems less a problem now.

A Better Soft Keyboard
I thought maybe I would try out a Swype keyboard like I use on my phone, where you just wipe your finger over the keys to enter words. I works surprisingly well even with pretty sloppy swiping, since it also is looking for words, and gives choices if it isn't sure. What I found at the App store was actually something better, called TouchPal.

TouchPal has the swiping down pretty well, and also briefly shows a blue trail where you have swiped. It has more available keyboards, even one which has arrow keys, an ability to select, copy, cut, and paste text, plus Home and End keys. You can also download and use keyboards for other languages. I'm still working on my technique, but another cool feature, aside from a dedicated keyboard with numbers and symbols is that on the QWERTY keyboard the top row shows small numbers in the upper right corners -- for example, the Q has a 1, the W a 2, and so on. If you press firmly on the Q key, then slide up to the corner where the number is, you type a 1. I'm getting better at it, but still making some mistakes.

My Census and Charges
This took a while to sort out conceptually. What I have been doing for years, many many years in fact, is to use a database to keep track of my hospital patient census and the daily charges and patient diagnoses. On my Linux computers I learned how to use Postgresql, and so used that, even though this is a pretty trivial database. I thought maybe there might be an Android port, but not yet, at least anything that works.

One thing about the Nexus 7 is that you cannot directly print from it. Someone might figure out how to use the USB port, but you have to find software to handle the task. So right away I needed some other path. I found Jota+ for a simple text editor, and so far am still using that. The next step after creating some file is then to email it so that I can either get the attachment at my laptop or a desktop. But do I just do plain text files, then edit later after emailing?

Then I remembered that my favorite program Scribus can import CSV files. CSV stands for comma separated values, and is a way of saving spreadsheet data, as well as importing it to a spreadsheet or maybe even a database. The first thing I had to do was to review CSV files and Scribus, then I played around by exporting some Postgresql data as CSV files. Since I have Scribus not only on my laptop running Linux but also on my office computer running Windows, it was easy to come up with some styles which would display the information in the appropriately distanced columns. After that, it's just a matter of playing around with fonts and labels for that right "look". Now that I have the TouchPal keyboard, generating these files is quite easy, and actually simpler than the process I had for Postgresql.

In Postgresql you use commands like "update census set mon='31' where lname='Johnson';", whereas with CSV (using semicolons as separators), I just add "31;" to the line with Mr. Johnson's name on it, and I can copy and paste to other lines.

If I had some initial anxieties about keeping the Nexus 7 safe, they were underscored by dropping my previous unpadded canvas medical bag in which I was carrying the tablet 2 or 3 times in just a few days. I had no intention of running a test on the toughness of Gorilla glass. So, carrying my tablet with me, I went shopping for a bag at a luggage store (Taylor Trunk, here in Louisville), and found a nice heavily padded one, with a pocket sized exactly right for the Nexus 7. And there are several other pockets, so the only thing in the tablet pocket is the tablet. 

So at this stage, I'm right where I wanted to be, making my rounds with the tablet, and only needing to carry my medical bag, no additional laptop. I'll have some comments on some other apps I've found useful in the future.