ARTS & FARCES internet

Most informed dialysis patients know the mortality rate among said patients is 20-25% annually in the US. Those aren’t very good odds but they’re certainly better than the alternative.

Last week, a metro Chicago woman died while on dialysis after bleeding out and going into cardiopulmonary arrest. Apparently she was a home hemodialysis patient and pulled a needle out while changing clothes.

Bleeding out has to be one of the most common fears among dialysis patients. That and getting an air embolism during treatment. It’s why I can rarely sleep during treatments—after more than nine years on dialysis, I’m only now able to nod off occasionally. Each time I awaken startled. This is why it only took me about five minutes to consider nocturnal dialysis and reject the idea out of hand. What if I fall asleep, roll over and pull the venous needle out. Just how long would it take me to bleed out?

Last Friday, the patient next to me at my dialysis center nearly bled out. I say nearly because she was conscious when the paramedics wheeled her out and hopefully she got transfused and recovered. It was a horrible event. She coded—her heart stopped and she stopped breathing—but miraculously regained consciousness a short while later. It was unnerving being a few feet away and absolutely unable to help in any way. Three days later I can’t get the look on her face as the paramedics wheeled her out to the ambulance out of my mind.

This isn’t the first time something like this has happened during my dialysis run. But when this has happened in the past, blood has spurted everywhere: on the ceiling, all over the walls, everywhere. This time the blood merely pooled under the patient’s chair.

One has to wonder, if the top criteria for determining and administering healthcare were the best possible patient outcomes rather than corporate profits, if things would be different.

Update: Wednesday, 09 September 2009 07:23AM CDT: The dialysis patient in question survived and had an uneventful dialysis treatment on Monday. The event, my proximity to it, and the processes surrounding it are still extremely disturbing.

In 2003, I had a catastrophic equipment failure in my office. My working hard disk—including all of my manuscripts—and its backups were destroyed. Back then I never archived my projects, only backed them up, redundantly. I thought that was enough. I was mistaken. In referring to my earlier writings, I discovered that much of that writing holds up pretty well, so I’m reproducing it here for reference and the record. This article is from Macintosh Hypermedia Volume I, Reference Guide (Scott, Foresman and Company, 1990).

The third figure in the hypermedia historical triumvirate is a madman extraordinaire and one of the most brilliant minds of our time. How do you describe someone who carries around an encyclopedic knowledge base between his ears and simultaneously manages to maintain the spark of creativity? What are we to think of an individual who, when after almost 30 years of intense work finally receives adequate funding for his publicly accessible hypermedia repository, scribbles notes on his arm in purple marker during a press conference? How much stock should we put in the ideas of a computer visionary who generally refuses to use a computer? Sounds like my kind of guy. The caricatures are of Ted Nelson: the individual generally credited with coining the term hypertext and popularizing the concept by making it real to anyone who cared to immerse himself or herself in Nelson’s vast stores of rambling knowledge.

Nelson, influenced by Vannevar Bush, first used the term hypertext in the mid-1960s to describe a form of nonsequential writing. Most of his written works, most notably Computer Lib/Dream Machines and Literary Machines, have served to influence the current generation of hypermedia pioneers more than any other texts. If Bush was seen as a forward-thinker, Nelson has to be perceived as not of this planet.

His project of almost 30 years is Xanadu, a global information repository and network he refers to as the “magic place of literary memory.” Based on his concept of “universal hypertext,” Xanadu will consist of many thousands of nodes throughout the world, some of which will exist as fast-food franchiselike establishments Nelson refers to as “Silverstands.” When Xanadu becomes a reality—as it most assuredly will now that implementation funding has been acquired—many thousands of users will have simultaneous access to mountains of information, through which they will be able to create their own knowledge trails and endless document revisions. Of course, Nelson himself acknowledges that the name “Xanadu” is based on Coleridge’s unfinished poem, so there are no guarantees.

In the late 1960s, Nelson worked with Andries van Dam and a group of undergraduate students at Brown University to create the Hypertext Editing System, one of the first hypertext systems. The initial project was funded by IBM and was used for the Apollo space missions by National Aeronautics and Space Administration (NASA). The system, almost predictably, was not a commercial success and by 1970 Nelson was on to other projects. Andries van Dam and his students went on to create FRESS (an acronym for File Retrieval Editing SyStem) at Brown.

Last July at the Aspen Ideas Festival, one of the sessions was Frank Gehry in conversation with Tom Pritzker. Gehry is one of the US’s top architects, if not the country’s leading architect, known for his iconic buildings.

At the end of Gehry’s converstation, Fred Kent, founder and president of Project for Public Spaces (PPS), rose to ask a question.

Kent asked Gehry if iconic architecture also succeed as public space (it’s about 54 minutes into the video clip). Gehry was dismissive of both the questioner and the question then, and has since refused to consider the question.

James Fallows was in the audience and noted the dismissal in his weblog for The Atlantic, referring to Gehry calling Kent “pompous” and waving him away as, “a dismissive gesture, much as Louis XIV might have used to wave away some offending underling.” Fallows followed-up with additional articles, and links to others. Fallows expressed interest in the question but doesn’t “know enough about the argument as it involves Gehry’s buildings to have a view right now.” Presumably he’s researching the issue.

Jay Walljasper, PPS senior fellow, wrote a piece on the PPS weblog about the exchange.

It’s surprising to me that this issue hasn’t come to the forefront in discussions about the role of architecture in society and in urban planning circles. Maybe it has and I haven’t noticed. To my way of thinking, this is one of the most pressing issues architects face and they should all—including Gehry—be answering the question posed by Kent. As Walljasper writes, “... discussions about how we create congenial public places where people can come together is a major issue of our times. Public space is not just an aesthetic detail, or minor sideshow for the design community. It’s central to the fabric of lives and future of our society….”

Do you tweet from or about the Twin Cities? If so, consider joining TwinCitiesTwitter, a hyperlocal tweetstream for the Twin Cities—Minneapolis and Saint Paul—Minnesota USA.

Here’s how:

1. Send a Twitter @reply message to @mfraase requesting to be added.

Here’s an example from any Twitter client or your account on the Twitter website:

@mfraase Please add me to TwinCitiesTwitter. Thanks.

That’s it.

Once you’re added, everything you tweet will appear on TwinCitiesTwitter.

How this happened

Dave Winer and I have known each other for years, although I’m pretty sure we’ve never met in person. I’ve used his software from time to time for just about as long as I’ve been using a computer—starting with ThinkTank and just about everything else up to and including Radio; for about a year, this site ran on Winer’s Frontier software, which he graciously provided gratis. Today marks another milestone in that regard.

Last week Winer put together an aggregator for Berkeley-based tweets. Late last night he tweeted asking if he should apply for a Knight grant for his hyperlocal tweetstream. I was scrolling through last night’s tweets and responded that, yes, absolutely—I’d like one for the Twin Cities. Winer asked if I wanted to work together on it: If I got the people together he’d set up the system. I did and he did, and TwinCitiesTwitter launched about three hours later. As I tweeted shortly after the launch, Winer is a mad good hacker and coder and both the Berkeley and Twin Cities tweet aggregators are fine examples.

But both are community endeavors—this won’t work unless there’s a lot of individual participation. Get yourself added and get yourself heard. Tell others about it. I seeded the list to start with Twin Cities people and publications I follow and figured would want to participate. But it was just a start—there was nothing nefarious or even nontransparent behind the launch selections and no one’s been turned away who’s requested to be added. I’m uncomfortable adding anyone else who doesn’t request addition, but I’m open to alternative views about that. If you were added without a request and want to be removed, just let me know.

The power of Winer’s Twitter hack is irresistible. I’d like to see every Twin Cities neighborhood have its own hyperlocal tweetstream. On the other hand, I’d like to see each major issue of the day have its own aggregated tweetstream. The applications for what Winer has created are close to endless.

I wish this was up and running when the tornado recently hit downtown Minneapolis. I wish it was up when the State Fair opened in Saint Paul.

Got ideas? Let’s hear them; if you’re on TwinCitiesTwitter and you tweet them, we’ll all see them. New to Twitter? Rafe Needleman’s “Newbies guide to Twitter” is a good start.

Some suggestions

Please be patient. It may take a while to get you added—I don’t live in Twitter, I have a day job, my own 30-year-old business that acts like a 12-year-old, and a complicated life.

If you tweet about a lot of different things, consider creating a separate Twitter account for your geographically local tweets. Or better yet, tweet local more often.

Take this for what it is: an experiment; a quick hack. There’s nothing going on here other than what you see. Really.

Remember that everything you tweet—everything—gets automatically republished on TwinCitiesTwitter.

Update: Sunday 06 September 2009 09:33PM CDT: Edited how to get added section for clarity; added call for additional ideas and Twitter introduction. I’ll be updating, adding, and filling in blanks as necessary. A lot of the edits aren’t transparent because I believe usability/readability trumps transparency in this one instance. This isn’t the norm for articles on this site where edits and additions are transparent.

Update: Monday 02 November 2009 07:09AM CST: With the introduction of the Lists feature in Twitter, Twin Cities Twitter becomes, at best, redundant; at worst, obsolete. Accordingly, support and maintenance of Twin Cities Twitter is no longer provided. The account will probably be deleted in the near future. Thanks for your past support of the idea.

Anyone who’s been paying attention has to realize that higher education is caught in the same death spiral as real estate and the banks. But instead of debt fueling the spiral, higher education’s spiral is fueled by rising tuition and endowments. It’s unsustainable. Colleges and universities are in the information transportation business. Yes, yes, there’s the self-exploration and professorial interaction that’s an enormous part of the college experience—and the value delivered—but in the main, institutions of higher education transport information. Technology in general, and the internet in particular are collapsing the economics of transporting information in all areas of the culture and economy.

Call it simultaneous disruption from the top and the bottom, but, as Kevin Carey writes in “College for $99 a Month,” in the Washington Monthly‘s outstanding College Guide, “... these two trends threaten to shake the foundation of the modern university, in much the same ways that other seemingly impregnable institutions have been torn apart.”

At the same time individuals need almost continual education to stay afloat in an economy and society that are one big disruption after another.

Carey presents StraighterLine as one option: All the higher education courses you can eat for US$99 per month. Sort of like O’Reilly’s Safari for college. Carey sites a woman taking courses through StraighterLine and her daughter taking the one of the same courses at the local community college:

“... she realized that her daughter was using exactly the same learning modules that she was using at StraighterLine, both developed by textbook giant McGraw-Hill. The only difference was that her daughter was paying a lot more for them, and could only take them on the college’s schedule. And while she had a professor, he wasn’t doing much teaching. ‘He just stands there,’ Solvig’s daughter said, while students worked through modules on their own.”