Today, Kathy had her first radiation therapy session.
I drove her to the appointment out of concern for the unknown - would she feel pain? Would she be fatigued? Would there be any post treatment side effects?
The radiation oncology staff carefully aligned her body in the linear accelerator using the tattoos she received last week. She'll be receiving 25 doses of radiation to the left breast and 8 to the left axilla. Today's was to the left breast.
The actual treatment only lasted 3 minutes.
Post treatment she felt no burning and no pain. She was given a moisturizing cream to apply to the skin in the case of dryness or irritation.
After the treatment, I took her to lunch and we discussed the next 7 weeks.
She'll be driving into Boston every weekday. Treatments will typically be 3 minutes within a 30 minute appointment slot. Daily dosing means an intense 42 days of medical care.
Side effects from radiation are a bit hard to assess since Kathy is still feeling a bit fatigued from the chemotherapy and surgery she's experienced over the past 6 months.
Her mood is good, her numbness is improving, and her free time is spent caring for the chickens/guinea fowl and planning the herd of Alpaca we'll be bringing to our farm this Summer.
So far so good.
Setting Compliance Priorities
Today we begin the first of two compliance planning retreats at BIDMC as part of the Summer of Compliance
Recognizing the importance of compliance projects and the need to jointly set priorities between compliance experts and IT leadership, we're putting all the stakeholders together for discussion, debate, and project ranking.
Our agenda is here.
There are very large number of possible projects to address the constant stream of regulatory change.
To set priorities, we need to understand risks, change management complexity, and resource requirements.
As a first step, stakeholders were asked to bring an inventory of their risk concerns which vary from the challenge of personal devices used to check email to website defacement.
All technology projects require the joint participation of business owners and IT service providers. Projects are a function of scope, time and resources, all of which are limited.
The challenge of addressing regulatory requirements is that demand (which can be infinite) must be balanced with supply (which is fixed). Without prioritization it's like a farmer trying to put 100 pounds of manure into a 50 pound bag (sorry for the agricultural analogies).
I'm sure that other organizations have the same challenges, so I'll openly describe the process and our conclusions. Governance is a great way to set priorities when the projects as discretionary. With regulatory requirements, nothing is discretionary and everything is about the spectrum of risk.
I look forward to our work over the next two weeks.
Recognizing the importance of compliance projects and the need to jointly set priorities between compliance experts and IT leadership, we're putting all the stakeholders together for discussion, debate, and project ranking.
Our agenda is here.
There are very large number of possible projects to address the constant stream of regulatory change.
To set priorities, we need to understand risks, change management complexity, and resource requirements.
As a first step, stakeholders were asked to bring an inventory of their risk concerns which vary from the challenge of personal devices used to check email to website defacement.
All technology projects require the joint participation of business owners and IT service providers. Projects are a function of scope, time and resources, all of which are limited.
The challenge of addressing regulatory requirements is that demand (which can be infinite) must be balanced with supply (which is fixed). Without prioritization it's like a farmer trying to put 100 pounds of manure into a 50 pound bag (sorry for the agricultural analogies).
I'm sure that other organizations have the same challenges, so I'll openly describe the process and our conclusions. Governance is a great way to set priorities when the projects as discretionary. With regulatory requirements, nothing is discretionary and everything is about the spectrum of risk.
I look forward to our work over the next two weeks.
A Protagonist at the Harvard Business School
The faculty at the Harvard Business School wrote a case study about the November 13, 2002 CareGroup Network outage and use the case to teach healthcare leadership in the MBA and Executive Education programs.
I'm often invited to sit in the back of the room as the "protagonist" in the case while the students discuss my performance during the crisis.
It's always enlightening to listen to teams evaluate what I could have done better - seeking help faster, enhancing infrastructure sooner, developing more detailed disaster recovery policies etc.
Yesterday, I spent the afternoon with 60 healthcare leaders at an HBS Summer Course recounting my feelings, anxieties, blind spots, and hopes during the early hours of the crisis.
They initially evaluated my performance with letter grades that varied between A- to C-.
Then, they turned to ask more difficult questions - What would they do in a similar crisis? How could IT be better prepared for disaster?
They debated the balance between control and freedom, predictability and innovation, bureaucracy and agility.
After the class we had a great discussion about the era in which we live - organizations are increasingly matrixed and complex. Accountability is clear but authority is not. As CIOs we are responsible for ever increasing regulatory and compliance demands but we often lack the top down control of the global organization needed to enforce policies.
In 2002, the issue was infrastructure - lack of redundancy and hardware updates.
In 2012, the issues for CIOs are much more complex - mandates to control behavior throughout the organization (such as mobile device encryption) but challenging organizational dynamics to implement constraints on personal choice. Infrastructure is no longer a pain point - the Cloud makes it all so simple…
The class speculated that survival as a CIO is very difficult in 2012. Either the demands/expectation of the job have to change or the resources/authority needs to be increased.
Given the evolution of challenges from 2002 to 2012, it will be very interesting to watch the next 10 years. Who knows uncharted waters exist for 2022!
A great discussion with the class.
I'm often invited to sit in the back of the room as the "protagonist" in the case while the students discuss my performance during the crisis.
It's always enlightening to listen to teams evaluate what I could have done better - seeking help faster, enhancing infrastructure sooner, developing more detailed disaster recovery policies etc.
Yesterday, I spent the afternoon with 60 healthcare leaders at an HBS Summer Course recounting my feelings, anxieties, blind spots, and hopes during the early hours of the crisis.
They initially evaluated my performance with letter grades that varied between A- to C-.
Then, they turned to ask more difficult questions - What would they do in a similar crisis? How could IT be better prepared for disaster?
They debated the balance between control and freedom, predictability and innovation, bureaucracy and agility.
After the class we had a great discussion about the era in which we live - organizations are increasingly matrixed and complex. Accountability is clear but authority is not. As CIOs we are responsible for ever increasing regulatory and compliance demands but we often lack the top down control of the global organization needed to enforce policies.
In 2002, the issue was infrastructure - lack of redundancy and hardware updates.
In 2012, the issues for CIOs are much more complex - mandates to control behavior throughout the organization (such as mobile device encryption) but challenging organizational dynamics to implement constraints on personal choice. Infrastructure is no longer a pain point - the Cloud makes it all so simple…
The class speculated that survival as a CIO is very difficult in 2012. Either the demands/expectation of the job have to change or the resources/authority needs to be increased.
Given the evolution of challenges from 2002 to 2012, it will be very interesting to watch the next 10 years. Who knows uncharted waters exist for 2022!
A great discussion with the class.
An Honest Graduation Speech
My daughter graduated from Wellesley High School in 2011. Her favorite teacher was David McCullough Jr. (son of author/historian and Pulitzer Prize winner David McCullough)
David Jr. gave the commencement speech at Wellesley High School this year, delivering a sobering message.
"You are not special. You are not exceptional."
He noted that there are 37,000 valedictorians and that statistically the graduates of Wellesley High School are no different than those from countless other schools throughout the country.
His point was to live life to its fullest, reveling in the diversity of experiences the world provides rather than bolstering your own ego with thoughts that you are special.
"The fulfilling life, the distinctive life, the relevant life, is an achievement, not something that will fall into your lap because you’re a nice person or mommy ordered it from the caterer. You’ll note the founding fathers took pains to secure your inalienable right to life, liberty and the pursuit of happiness--quite an active verb, “pursuit”--which leaves, I should think, little time for lying around watching parrots rollerskate on Youtube."
We can all be exceptional by being relevant. Relevance comes in many forms. Fame, fortune, and degrees from the most competitive schools do not necessarily imply that you've made a difference.
What a great message that statistically we all regress to the mean and that it,s up to us to live life in ways that make an impact on everyone around us, leading to our own distinctiveness and satisfaction.
Now go make the best of your day, whatever that means to you!
David Jr. gave the commencement speech at Wellesley High School this year, delivering a sobering message.
"You are not special. You are not exceptional."
He noted that there are 37,000 valedictorians and that statistically the graduates of Wellesley High School are no different than those from countless other schools throughout the country.
His point was to live life to its fullest, reveling in the diversity of experiences the world provides rather than bolstering your own ego with thoughts that you are special.
"The fulfilling life, the distinctive life, the relevant life, is an achievement, not something that will fall into your lap because you’re a nice person or mommy ordered it from the caterer. You’ll note the founding fathers took pains to secure your inalienable right to life, liberty and the pursuit of happiness--quite an active verb, “pursuit”--which leaves, I should think, little time for lying around watching parrots rollerskate on Youtube."
We can all be exceptional by being relevant. Relevance comes in many forms. Fame, fortune, and degrees from the most competitive schools do not necessarily imply that you've made a difference.
What a great message that statistically we all regress to the mean and that it,s up to us to live life in ways that make an impact on everyone around us, leading to our own distinctiveness and satisfaction.
Now go make the best of your day, whatever that means to you!
Cool Technology of the Week
Running a farm on nights and weekends, I've had to learn an entirely different set of technologies i.e. what tractor technologies are needed to manage pasture, woodland, manure piles, hay etc? What chainsaw is the right balance between power and ease of use?
Two technologies I had not imagined I would need to master are clearing weeds on a massive scale and managing poison ivy by the ton.
For weed control (not poison ivy), the environmentally friendly and effective management tool is a modified flamethrower. I know that sounds very "Mad Max" but it works! I use the Red Dragon backpack model to keep my roads and paths clear of weeds. Heating weeds to the point that their cell membranes burst is quick, easy and safe - no need to actually burn the plant. In a few days the weeds disappear.
Poison Ivy is trickier. You do not want to burn Poison Ivy since the compounds that cause skin irritation cause respiratory distress if aerosolized in a fire. Although I really do not like to use herbicides of any kind, there is not much choice for clearing significant stands of poison ivy. Our tree specialist recommended that I use a Chapin backpack sprayer with a specialized nozzle that enables precise application. The poison ivy formula he recommended is 3 gallons of water, 7.8 ounces of RoundUp, and 4 tablespoons of Miracle Grow, applied in June when the leaves are fully grown but still tender. The Miracle Grow allows the use of 25% less RoundUp, which is better for the environment. Also, RoundUp is foliar, not soil- based, so there is less contamination. I carefully sprayed all our poison ivy last night and we'll see what happens.
Now that I've mastered weeds and poison ivy, I can turn my attention to electric fencing technologies this weekend - a blog post for next week.
Two technologies I had not imagined I would need to master are clearing weeds on a massive scale and managing poison ivy by the ton.
For weed control (not poison ivy), the environmentally friendly and effective management tool is a modified flamethrower. I know that sounds very "Mad Max" but it works! I use the Red Dragon backpack model to keep my roads and paths clear of weeds. Heating weeds to the point that their cell membranes burst is quick, easy and safe - no need to actually burn the plant. In a few days the weeds disappear.
Poison Ivy is trickier. You do not want to burn Poison Ivy since the compounds that cause skin irritation cause respiratory distress if aerosolized in a fire. Although I really do not like to use herbicides of any kind, there is not much choice for clearing significant stands of poison ivy. Our tree specialist recommended that I use a Chapin backpack sprayer with a specialized nozzle that enables precise application. The poison ivy formula he recommended is 3 gallons of water, 7.8 ounces of RoundUp, and 4 tablespoons of Miracle Grow, applied in June when the leaves are fully grown but still tender. The Miracle Grow allows the use of 25% less RoundUp, which is better for the environment. Also, RoundUp is foliar, not soil- based, so there is less contamination. I carefully sprayed all our poison ivy last night and we'll see what happens.
Now that I've mastered weeds and poison ivy, I can turn my attention to electric fencing technologies this weekend - a blog post for next week.
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