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.

Sunday, July 15, 2012

eReadings 19

The Sea-Hawk
Rafael Sabatini
When I started reading this I didn't know anything about it. Later I found that the author was English, in spite of his name suggesting otherwise, and that he was a somewhat prolific writer of swashbuckling tales. Another of his works is Captain Blood.

We can assume that he was fascinated by the early days of sailing, and must have spent some time learning about the history of the time. This isn't a history book, but a novel about a privateer turned gentleman, after having been given a title by Queen Elizabeth for his help in defeating the Spanish Armada. It so happened that I had read, though perhaps scanned might be more accurate, a nonfiction book, How Britannia Came to Rule the Waves, by WHG Kingston, and in it he credits the various privateers for their help in building the Royal Navy and in defeating the Spanish.

But The Sea-Hawk is of course a novel, about Sir Oliver Tressilian, who has amassed some wealth through piracy to go along with his title. It is full of dialog, both between people and the various characters with themselves, and rather verbose dialog it seemed to me.

Nonetheless, this is compelling storytelling, perhaps getting off to a slow start as we read what seems like it's going to be a book about the interfamily goings on revolving around Sir Oliver's plan to marry Rosamund Godolphin, then taking some quite amazing turns, so that we abruptly leave England and head off to the Mediterranean, quite active with Arab corsairs raiding Spanish and other ships. both for the riches, but also for the slave market. Suddenly we are introduced to Sakr-el-Bahr, an infamous corsair with the interesting past.

The story here is interesting, riveting at times, but seemed to bog down with the ever-heavy dialog.

Thursday, July 05, 2012

eReadings 18

Common Sense
Thomas Paine

Yes, this is that famous book, a pamphlet really, published in 1776 as the Revolution was taking shape. You know a book is small when you click to the next page and each Kindle page is 1% of the book.

I'll be honest, it's not such an easy read. The language is a little thick, with some unusual words to be sure, but the sentence structure very heavy with clauses and loaded with commas. One might think that this was the English language of the time, which in some respect may be true, but one can read works by Samuel Johnson or Boswell's Life of Johnson and find a very different readability of 18th century English literature. I read Life of Johnson some time ago and found it quite easy reading.

Look at this passage from early on in the book:

Society in every state is a blessing, but government even in its best state is but a necessary evil; in its worst state an intolerable one; for when we suffer, or are exposed to the same miseries BY A GOVERNMENT, which we might expect in a country WITHOUT GOVERNMENT, our calamity is heightened by reflecting that we furnish the means by which we suffer. Government, like dress, is the badge of lost innocence; the palaces of kings are built on the ruins of the bowers of paradise. For were the impulses of conscience clear, uniform, and irresistibly obeyed, man would need no other lawgiver; but that not being the case, he finds it necessary to surrender up a part of his property to furnish means for the protection of the rest; and this he is induced to do by the same prudence which in every other case advises him out of two evils to choose the least. WHEREFORE, security being the true design and end of government, it unanswerably follows, that whatever FORM thereof appears most likely to ensure it to us, with the least expense and greatest benefit, is preferable to all others.
It's not that this isn't understandable, but reading page after page like this is certainly tiring. We have a way of getting to a point much quicker these days.

I would have probably stopped reading early on, but then I realized that July 4th was coming up so I persisted. One of the things which struck me in the early pages was that, if one translated to a more modern English, this was basically a rant such as one might read on the internet these days, or perhaps see on some news report. It becomes quite clear that Paine has no good words for monarchy, and in particular King George.

I did appreciate reading first hand some of the concepts that formed our country and its subsequent government, where he talks about creating a land governed by the rule of law rather than the rule of a man. It becomes a bit repetitious, but he sets out to bring up the many objections to the current state of affairs, the possible remedies, with the only sensible one being secession from England and formation of a new country with its own government, and finally that the time was NOW to do these things.

As a reminder of the history of the time, the thoughts of people at the time, this is a very enlightening book. Be prepared for slow reading of this formal 18th century English.

eReadings 17

The Innocents Abroad
Mark Twain

Having previously read A Tramp Abroad, I was reluctant enough to read this one that I read a bit first with a browser before downloading to my Kindle.

This book predated A Tramp Abroad, being published in 1869, after a chartered excursion to Europe, sailing around the Mediterranean. It differed quite a bit from the cruises popular now, since one might be let off somewhere in Italy and then go travelling for a month to Paris and other inland sites.

One certainly gets quite a bit of commentary of the mercenary nature of travel at the time. Everywhere you go, there is someone to pay some fee to, some guide to hire, and many a beggar along the way.

Not so different from sightseeing now is the pressure one feels and the ease of being shuttled around from sight to sight, and we hear Mr. Twain railing against the fatigue that sets in as you visit yet another church, with its collection of relics, with so many churches professing to have pieces of the Holy Cross or the Crown of Thorns. The artwork, the sculpture, at least for him, became numbing.

It's necessary to remember that this was the world before World War I, so a very different sort of place from today. He lost his passport somewhere in the middle of the journey, but that never appeared to be an impediment to travel. A number of ports were closed due to fears of cholera.

One could no longer travel as he did from Turkey to Syria to Palestine on horseback, camping out in tents as they went. He certainly appreciated the depth of history in Palestine and especially in Egypt, but the terrain and climate were awful. In addition, beggars were everywhere in the Middle East.

In the end, this is a very enjoyable book, full of insights into a time we think we know but have never heard about what it was like from a first-person perspective, hearing not only about the history and famous architecture and art, but the lives of the people in the lands he visited.