Just say no

Are you using Lightning Source to print your books? If so, Amazon would like to make you a pleasant little offer: switch to BookSurge (with a resulting decrease in quality and increase in costs) or Amazon will stop selling your books. Restaurant owners would find this sort of offer quite familiar.

We don’t print our books on demand, but this story feels like history repeating itself. After several years as a special order customer on an equal footing with any bookstore, Amazon stopped selling our books over 5 years ago when we wouldn’t agree to their demand for better terms and monthly fees. Now a new group of publishers is being squeezed by Amazon, and they’ll have to decide whether to pay up.

The common business logic for publishers has been to offer better terms to the biggest customers, whether that’s chain stores, distributors, or Amazon. As the chains prospered and the independent bookstores closed, publishers failed to see that their discriminatory pricing was inevitably leading to a consolidation in their customer base. Worse, they failed to see that consolidation in their customer base put them at far greater risk when their remaining large customers demanded steeper discounts, or went bankrupt, or decided to become the publishers’ supplier as well. The publishers helped create the current power relationship that now allows a bookseller to demand control over who publishers contract with to print their books. Insisting that small customers be treated on the same terms as large customers requires placing long-term interests over short-term fears, but it could prevent further confusion in the power relationship that should rightfully place publishers on top.

Homeland

“Welcome to the American night.” A hypnotic voice issuing a wake-up call, with soothing melodic strings and synthesizer to raise the alarm. Laurie Anderson’s performance of Homeland at the Boston Opera House tonight lightly chided the audience for failing to respond to their times while offering too few opportunities to even respond to her. A piece late in the show laments the loss of the art of conversation, but she never engages the audience and uses instrumental bridges between independent pieces to suppress applause. While she said much that needs to be said—condemning the suspension of freedom in the name of freedom—she seems unlikely to rouse anyone to action. She cites Thomas Paine’s Common Sense, and one of her most resonant lines is when she echoes Paine’s question of whether it makes sense for an island to rule a continent and asks whether it makes sense now for a country to rule the world. However, her repeating lyrics do not inspire deeper reflection; there are no startling images to follow her beautiful opening story about the endlessly soaring birds from before the world was created.

I was thrilled to see her in concert, and this show was the one I have wanted to see for many years: a return to many of the forms from her United States work that I’ve loved since I first heard the recordings 20 years ago, a live performance by an artist whose magical voice truly captivates me both in story and in song, and a thought-out political statement that extended beyond a quick protest song or short rant. She succeeded in all of those, and I would be delighted to see her perform Homeland again tomorrow or next month or next year. I’m sure that I’m asking too much for her to also encourage change, when her style is more ironic comment. But when those endlessly soaring birds first encountered land, surely that opened up possibilities beyond flight?

Short attention span music

The geek rock concert last night at the Somerville Theater by They Might Be Giants was insanely loud. And the noise level (from the speakers on 11, from the audience) was unfortunately at odds with being able to hear any lyrics. My confusion about why any band would ask a thrash band like Apollo Sunshine (note to self: avoid like plague) to open and blow out the audience’s eardrums ended when TMBG took the stage and tried to be even noisier. I would have liked to hear music rather than noise that evokes music, and I haven’t usually run into that problem except at arenas. Still, fun to be surrounded by hundreds of screaming fans—the energy level was definitely high.

We also saw two shows at Scullers Jazz Club recently: Jane Monheit in February and Grace Kelly in March. Both ended their shows with striking renditions of Over the Rainbow, making me wonder if Scullers specifically asks performers to include the song. Seeing Tuck and Patti at Scullers back in October 1999 was our first unofficial date, but we hadn’t been back there until 2008. The space is still crowded and dark and jazz-clubby (though smoke-free), and the seating is haphazard, but the acoustics are fine.

Take-out lottery

Our last 3 take-out experiences: Ordered 11 items, received 7. Ordered 6 items, 2 were wrong. Ordered 3 items last night, received 2. Should I be unpacking the bag of food at the restaurant and opening each container to see what we might be missing?

Score digit for the bag team

While looking for a law review article about e-book licensing, I found an article on Gizmodo that had been lifted by techfeeds.info. The copying site used a primitive thesaurus algorithm to change many of the words, paying no attention to mere details like part-of-speech or context. An undergrad CS major could construct a better algorithm, but the results would not be anywhere near as funny.

My best guess is that techfeeds.info is a splog that’s trying a (new?) approach to avoid accusations of plagiarism or copyright infringement, like a deluded middle school student who thinks that research means copying an encyclopedia article sentence by sentence while changing a few words. Here’s the kicker: blog posts like this one from Gizmodo sometimes include attributed quotes. In fact, Gizmodo in this post quotes a multi-paragraph summary written by a group of named law students, and techfeeds.info mangles that entire quote as well. In doing so, techfeeds.info may give baffled readers the impression that these law students are incoherent writers, and the impression that Columbia Science and Technology Law Review publishes nonsense. (All while praising the “original, astonishingly readable jural summary.”) Law firms surely Google job applicants’ names, and this could create a rather bad impression. Is techfeeds.info engaged in defamation, slander, or both?

Lisa is home

We’ve been pretty out of touch with the world this week. We spent all of Tuesday in the ER, and got home from the hospital on Thursday afternoon. But Lisa is home now, which is a great step.

Calls and callers are welcome between 10 a.m. and 8 p.m., assuming no active colds, fevers, or infections. This has been a rough few days, but Beth Israel Deaconess has many great people working there, and support from friends and family has been invaluable. Thank you from both of us.

We’ll start towards resuming a normal schedule on Monday with a partial workday, if all continues to go well. We have every reason to hope that it will.

Being thanked

Last week, the Massachusetts Cultural Council invited members of local cultural councils and arts councils to come to the State House in the morning and tour the new ICA in the afternoon. About 350 of us took them up on the invitation, and were treated to an interesting and inspiring day. It was fun to meet people from other councils and compare notes, learn some of the history of the MCC and of the State House, and get a sense of the scale of the LCC project. The highlight for me was having a number of legislators, MCC staff, and other speakers all thank us for our work on our local councils.

I’m actually used to being thanked by name by authors and editors in their prefaces, and I’m occasionally called out at a conference whose proceedings I’m publishing. I’ve also received some wonderful personal notes from authors I’ve worked with. It’s gratifying to be recognized for my work, which I like to think I’m good at and which I believe helps my academic field. But the LCC project is larger (even if my role in it is infinitely smaller), and this day at the State House made me really proud to be a part of it. Gallup reportedly did a research poll recently that asked for the first time what made people satisfied with their communities. The first and second most important factors they found were aesthetics and how welcoming the community is. As Anita Walker, the executive director of the MCC, pointed out, our work in supporting and promoting performances and fairs and concerts and lectures and classes and field trips has a real impact on both of those factors, and helps make Massachusetts a place where people want to live. That’s a good feeling, and being thanked for helping out makes it even better.

Nationalize health care, or daydream #2

We desperately need to change how we provide access to health care in this country, and how we pay for it. The incentives are perverse, leading to rational choices that hurt us all: patients avoid preventive care and crisis care, doctors order unnecessary tests to satisfy health insurers and malpractice insurers, drug companies don’t release scientific studies, patients avoid genetic testing, medical students avoid going into general practice or geriatrics, and an increasing number of the healthy among us avoid the insurance system. Emergency rooms are overloaded with non-emergent cases because of their triple status as the release valve for onerous hospital admission policies, the salve for poor scheduling practices by primary care and specialist offices, and the accepted delivery system for offering health care to the poor and uninsured. The system is navigable by the educated and persistent, who find themselves at great risk of avoidable errors that harm and kill. Objective measures such as infant mortality rates and the increase in medical tourism indicate that our health care system is not just worse than it might be; it is worse than plenty of other systems.

If we did not have to worry about our medical records being used against us, we could wholeheartedly embrace computerizing health care, which would offer numerous advantages for patients, doctors, and researchers. Imagine a universal data exchange system for all medical records. Any practitioner could pull up a patient’s history and test results, even from other hospital networks. Prescription errors and negative drug interactions could be greatly reduced, and off-label drug use could be studied. We could create a patient-centered me.med domain where patients could track their own symptoms, share stories, offer encouragement and advice, review their own records, annotate their own records and ask questions, set privacy and access levels, and start to become the empowered health care consumers that the advertising wants us to be. If the records are all centrally stored, NIH could track symptom and diagnosis patterns. Researchers could have a gold mine of data, and we could learn much faster that drug A is killing people, drug B is useless, and drug C is actually working against the latest variant of strep.

Our incomplete and inaccurate medical records are already for sale in uncontrolled ways, while patients are denied access to their own records in the name of HIPAA. Imagine going to me.med, logging in to your account, and having full access to your own records. You add a follow-up to your recent prescription record, noting when you stopped taking the drug because of a nasty side effect or confirming that you finished the course without missing a dose. You know that no employer will ever see these records, and you know that researchers only have default access to fully anonymized data. Oh, and here’s a note from a researcher, asking if you would answer a few specific questions or be willing to have some blood drawn to test for lead and bromine levels. There’s the randomly assigned anonymized ID code that this researcher has for you, along with a bar code for the clinic to use. You print out the bar code and go to the clinic, where they confirm in the system (without needing to know your name) that this is not a duplicate request, and that the researcher is immediately reimbursing the clinic $40, half of which goes to you in cash. And the results from the lead and bromine testing will be forwarded to your me.med account, so your doctor can advise you to seriously reconsider chewing on your windowsills. The researcher discovers that patients with elevated bromine levels have a negative reaction to Xatiremulch, and me.med lets the doctor know that they might want to reconsider renewing that Xatiremulch prescription until they check if your bromine levels are still elevated.

Nationalizing health care doesn’t mean that me.med will be designed well, any more than saying “We’re using XML” means that you’ve correctly solved your complex data tagging problems. But if we leave the continued computerization of the health care industry up to CIGNA and Blue Cross, I can guarantee that we won’t ever have a patient-centered me.med or a doctor-centered doc.med. Insurers are far from being the entire problem, but they are a critical piece of the problem.

Audit has many meanings

The annual premium that I pay for worker’s comp insurance is based in part on the total wages paid for the year. So at the end of the year, I have to complete an audit for the insurance company, which just requires filling out a few pages of forms and sending in copies of the wage statements that I filed with the government. It’s a minor hassle, like all paperwork, but it’s a rather less intimidating form of audit than most.

I understand the insurance company’s interest in verifying that the total I give them matches the total on a tax filing, and I try to similarly audit various bills that I receive. My monthly FedEx statements typically have a number of overcharges when I compare them to my own records (charges for pickups that never happened, charges for guaranteed-on-time packages that FedEx’s own records show were delivered several days late, residential delivery charges for packages delivered to university libraries, etc.). FedEx appears to see these overcharges as a useful revenue stream, whereas I, well, don’t. So each month I audit my FedEx statement and point out some of the errors to FedEx. And each month FedEx shrugs, issues a credit to me, and keeps their profits up by continuing to overcharge other customers. (Note: this is simply my perception and opinion of FedEx, and I am sure that FedEx would disagree.)

Some bills are essentially impossible to audit, such as my gas bill. I can verify that they took $500 out of my checking account last month, and I can verify that last month’s bill was for $500, but there’s very little about the bill itself that I can verify. What should the various fees and taxes and rates be? I have to trust them. Am I even using the amount of gas that they are charging me for? I know that energy audits on my house have shown that the electric bill is clearly wrong, but there’s been nothing I can do about it. Living without electricity would be challenging.

My merchant credit card account, which lets me accept credit cards for my business, used to be through a wonderful small bank in upstate New York. They had a simple and clear set of charges, and sent me a simple and clear monthly statement that was always correct. That worked for about 12 years, until they sold their merchant accounts to Nova. Now I have to remember to retrieve a much longer and incomprehensible monthly statement. The parts of the statement that are comprehensible frequently have errors, which doesn’t offer much hope that the incomprehensible parts are entirely accurate. Yesterday I called them because the monthly statement warned that MasterCard was going to start downgrading certain transactions that don’t show a “valid” non-zero sales tax amount. (Downgrading means charging a higher percentage of the total as a processing fee. As Vantage Card Services helpfully explains on a web page, “Traditionally, most merchants only paid attention to the qualified rate, so providers have buil[t] huge margins into their mid and non-qualified pricing.” A sentence that speaks volumes about one foundation of our economy.) I called looking for some further explanation, since almost none of my sales are taxable. The phone rep at Nova, after speaking with a supervisor twice, assured me that I should keep entering zero for the sales tax amount and that those transactions will not be downgraded. She told me that I should audit this on my monthly statement, which only presents one obstacle: there’s absolutely no information on the statement showing which transactions have been downgraded or why. Hmm. So I audited the only thing I could: her claim that those transactions will not be downgraded. And, of course, she was wrong. (I’ve learned that I need to ask Nova simple yes/no questions, because then I’ll discover the true answer: it’s almost always the opposite of what they tell me.)

The other audit I read about yesterday was an audit of our local public access television station. One of the questions for the audit was whether the public access television as being provided by the station reflected the diversity of our community. This seems like an important question. But the audit surprised me by changing the question: instead of asking who was putting programs on, who was watching the programs, and who was appearing in those programs, the auditor only looked at who was on the board of directors of the station. Not the metric I would have used, though the answer to all four questions is pretty much the same: old white guys. I’m not sure why that audit took a year to complete, but I’ll be curious to see if I can take the same approach to my worker’s comp audit next year: just change the questions.

Tour de force, or, Macbeth as Theater

On February 17, we saw the stunning Rupert Goold production of Macbeth at the Brooklyn Academy of Music, starring Patrick Stewart. This was far better than the Macbeth we saw last fall, and had far more vision than the dreamy and reductive The Tempest with the same director and star in Stratford 18 months ago.

Many Shakespeare productions set in more recent times seem to be making a fairly simple point: the themes of the play are timeless, or the beauty of the language can overcome the lack of a costume designer. Goold sets this Macbeth in Stalinist Russia and then uses that setting to change the interpretation of many scenes while remaining true to the text. Banquo is murdered in the middle of a crowded train while the other passengers remain uninvolved. Lennox brutally interrogates Ross at the end of Act III in a stark display of violent license, and that scene utterly changes Ross’s later warnings to Lady Macduff. We see the destructive effects that living in a police state has even within a family, as Lady Macduff and her son bitterly jab at each other with lines that could have been tender and funny. The humor is torn from the corners of the play as it has evidently been torn from that world, with the night porter a foul-tempered deviant rather than a comic relief.

Reviewers make much of Macbeth’s preparing a sandwich while hiring the murderers to kill his best friend. That scene does show Macbeth’s growing sociopathy, but it also highlights the weakness of the murderers in their totalitarian world. They cower and simplistically attempt to follow their orders, plotting nothing themselves and betraying neither confidence nor king. If the murderers are weak, then how much more evil are the strong.

That kitchen scene also neatly captures the entirely interior viewpoint of the show. From kitchen to interrogation room to operating room, we see the story develop in hidden places. The banquet scene where Banquo’s ghost appears is one of the only scenes set in a public space, and Goold allows us to experience that scene from the inside by putting Macbeth’s seat at the head of the table downstage facing away from the audience, as if we are each then Macbeth watching our world crumble.

The production uses a lot of video effects, from mood-setting clips of Russian military parades to a truly creepy spreading course of blood on the walls before Banquo’s ghost appears. I finally understand what the American Repertory Theatre was trying to accomplish with integrating video into past productions from The Cabinet of Dr. Caligari to the far side of the moon. Video often seems extremely flat when presented in the context of live theater, but almost nothing is flat in Goold’s Macbeth. The actors find daggers before them in one scene after another, and wield them wholeheartedly. The results are bloody and fascinating.