Entries Tagged as 'AlignMap Web'
January 15th, 2008 · Comments Off
An Introduction To AlignMap In Cites
AlignMap In Cites is a new tumblelog I’m auditioning as an augmentation to the AlignMap web site and weblog.
For readers who are in the adult, non-geek population, the Wikipedia definition of tumblelog is provided below:
A tumblelog (or tlog) is a variation of a blog that favors short-form, mixed-media posts over the longer editorial posts frequently associated with blogging. Common post formats found on tumblelogs include links, photos, quotes, dialogues, and video. Unlike blogs, tumblelogs are frequently used to share the author’s creations, discoveries, or experiences while providing little or no commentary.
It may also be helpful to think of AlignMap In Cites as the quicker, less obsessive, happy go lucky younger sibling of the curmudgeonly, prolix, and sometimes abstruse AlignMap Weblog.
Both the design of tumblelogs described above and Tumblr, the software that powers AlignMap In Cites, make posting a link to a site, such as an online abstract or text, the home page of a compliance-enhancing product, or another blog covering an aspect of adherence, a quick, easy process. Posting a link to web site X can be accomplished without leaving web site X.
The ease and speed of posting makes this process ideal for pointing to items that require little or no explanation beyond, “Hey, look at this.” It’s not unlike mentioning to a colleague over lunch that he might be interested in a study on noncompliance of 50-60 year old males with hip fracture rehabilitation programs in the new issue of the New England Journal.
Although I just began posting to AlignMap In Cites this morning, I’ve been playing with Good Clean Wholesome Fun, the tumblelog sidekick for my personal Heck of a Guy blog, for four or five days and feel as though I’m getting the hang of the thing.
While I’m convinced this format is worth trying, I am not yet convinced of its utility. As I said, it’s a tryout, and you get free tickets to the dress rehearsal.
The first two AlignMap In Cites entries are online at
Tags: AlignMap In Cites · AlignMap Web
November 26th, 2007 · Comments Off
Two Wall Street Journal articles that are especially pertinent to patient compliance were published on 20 November 2006 during the AlignMap blog’s holiday hiatus.
Cell Phones Provide Medication Information and Reminders
don’t 4get ur pills: Text Messaging for Health by Rachel Zimmerman explores the use of text messaging on nearly ubiquitous mobile phones as a real time means of conveying information about medical treatment, responding to healthcare queries, and, most significantly for patient compliance, sending reminders about medication doses to patients.
While I have been critical of marketing that promotes reminders of various sorts to be the complete solution to medication noncompliance or suggests that reminders always result in downright miraculous improvements in adherence rates, I am taken with the notion of cell phone text messaging as a useful tool for patients who have difficulty taking the right medications at the right time (a category in which I frequently find myself when a new medication, such as an antibiotic, is added to my ongoing medication schedule for a one or two week period) and for exchanging information precisely because it requires, for most of us, no new or specialized equipment and fits into our daily routines.
Because I already use an analogous service to text messages to myself about everything from taking out the trash early Monday mornings for the weekly pickup and buying specific items currently on sale at my local grocery to adapting a business presentation in time for a meeting next week, I can see how medication reminders could also integrate into rather than impinge upon ones behavioral patterns. I can also imagine younger individuals, such as my 18 and 21 year old sons who would promptly toss a reminder device that attracted attention to themselves under a passing truck, being comfortable with this type of reminder.
Readers may recognize one service provider mentioned in the article, Intelecare Compliance Solutions, as the group represented by Knight, the author of the Medication Noncompliance Blog:
Intelecare Compliance Solutions Inc., based in New Haven, Conn., sells a service — which companies can then provide to their employees or customers — that sends text, email or voice-mail messages reminding users to take their pills, refill prescriptions, get to appointments or check vital signs. Drug companies, insurers and large employers hoping to improve efficiency and decrease absenteeism are Intelecare’s main customers,
Patients, Doctors, Dollars, and Communication
Your Doctor’s Business Is Your Business by David Armstrong discusses how patients might best deal with the possibility that their doctor has a potential conflict of interest (e.g., a physician with a financial interest in an orthopedic device he developed might be tempted to prescribe it unnecessarily or a doctor might advise patients to undergo a CT scan at a given facility which he owned). While I certainly see the value of open disclosure on the part of clinicians re special financial considerations they might receive from prescribing a specific treatment, I’m less convinced of the practicality of the course of action promoted by this article. In a framed box entitled “WHAT EXPERTS RECOMMEND,” the recommendations are
1. Ask if your doctor has any financial connection to the recommended treatment.
2. If the answer is yes, seek a second opinion.
3. If unwilling to ask the doctor, do research on the Web. …
Even though I’m a physician myself, I would find it awkward to ask each of my doctors every time they prescribe a medication, operation, physical therapy, etc, if they will personally benefit from that transaction. Using as an example, the treatment I received for my recent hip fracture as an example, I should, according to a straightforward reading of the article, have asked about conflicts of interest when
- My personal physician ordered a diagnostic x-ray from a facility located in a different office of the same medical building as his office
- My personal physician had his nurse obtain blood samples for the hospital admission work-up
- My personal physician referred me to a specific hospital for reparative surgery
- My personal physician referred me to a specific orthopedic group for further diagnosis and treatment
- The orthopedic surgeon recommended a hip pinning rather than other options
- The orthopedic surgeon referred me to a inpatient physical therapist for purchase of an assistive walking device and training in its use as a condition of discharge
- The orthopedic surgeon ordered pain medication for my post-operative use as needed
- The orthopedic surgeon ordered follow-up x-rays of the hip to be done in his office before every follow-up appointment
- The orthopedic surgeon recommended outpatient physical therapy at a specific facility
It seems to me that the real question readers are being prompted to consider is “Is my doctor ripping me off?” And, I think that is a legitimate enough concern; the problem is that if such fiscal treachery is afoot, one would hardly expect the perpetrator to automatically fess up when confronted with a simple question. How useful would it be to ask a car salesman, “By the way, my good man, are you charging me an excessive amount for this automobile and pushing the special undercoating only to build up your own commission?”
The author of the article, perhaps recognizing this issue, advocates a second opinion if any potential conflict of interest is found. I’ve always pushed my own patients to obtain second opinions to pacify any qualms about my diagnoses or treatment recommendations, but second opinions are themselves often expensive (especially if not covered by insurance) and take time to arrange. Moreover, an expert in the appropriate field whose reputation is blemish-free and who is absolutely independent of potential conflicts may be hard to find on short notice. And, if the course of action recommended in the second opinion differs from the first treatment suggested, does the patient get a third opinion to break the tie? What if it turns out that the doctor providing the second opinion has his or her own financial arrangements that compete with those of the first doctor?
Finally, how significant and how specific to a given treatment does that financial involvement have to be to warrant notifying patients? Should the doctor who sells and dispenses mediations within the office list his profit margins for those medications? Does the prescriber who owns stock in a pharmaceutical company have a different obligation to inform clients than the prescriber who helped developed a medication and receives a royalty for every pill sold? Do doctors working for an HMO who receive an incentive for prescribing generic rather than brand drugs disclose that to every patient? Does a doctor who sends patients to a facility that uses a certain type of CT machine on which holds a patent have a different responsibility to disclose his financial arrangement than a doctor who orders CT scans on his patients done in the office with the CT machine his group practice owns and operates?
If the following statements were true, should I have told patients, “I’m prescribing Prozac for your depression, but you should be aware that Eli Lily, the company that manufactures Prozac, …
… pays me a royalty for every Prozac capsule sold because I helped get FDA approval”
… sells these capsules to our pharmacy wholesale and our pharmacy, which our practice owns, charges you a 200% markup when we sell you your medicine I’m prescribing”
… sends a salesman here every month who takes me to lunch where he tells me why I should prescribe Prozac instead of another medication”
… may be in the portfolio of some of the stock funds in which I’ve invested so their profit would benefit me”
… offered second year medical students at many medical schools in 1973 a free, medium quality stethoscope that I accepted”
I suspect few would think that admitting that I accepted a stethoscope from Lily is either necessary or useful, but defining how much financial involvement by a physician merits or requires disclosure is not a trivial task.
My discomfort with this piece, in fact, is not that the problem of a physician’s conflict of interest doesn’t exist but that the simple fixes the article described belies that complexity of the problem.
Additionally, such questions put to doctors are not always benign and may yield negative results, a concern noted in this excerpt:
Patient advocate Trisha Torrey isn’t so sure it is a topic worth bringing up. The doctor-patient relationship is already stressed, and questioning a doctor about financial connections “can create more harm,” she says. That doesn’t mean patients should be unconcerned about financial relationships. She says patients should do their own research and seek second opinions if they suspect their doctor could profit from a certain treatment recommendation.
Readers may also recognize Trisha Torrey as the author of Every Patient’s Advocate, a blog which occasionally appears here at AlignMap.
_________________________________
Disclosure Statement
Ahem, I have not accepted any financial remuneration from The Wall Street Journal, Every Patient’s Advocate, Medication Noncompliance, their authors, or their associated companies for mentioning them in this post.
One possible reason, in addition to my stalwart Midwestern upbringing, my seven years of perfect attendance at Sunday School, the two semesters I spent at Oklahoma Christian College, and my preternaturally staunch moral fiber, for my incredibly righteous stance in this regard is that none of those entities has (yet) offered me any such remuneration. I mean, if someone were to go to the trouble of, say, placing a manila envelope filled with a significant chunk of cash in small, unmarked bills in a locker at the bus station and sending me the locker key, it would be rude not to at least consider taking the money. Or if Mr Murdoch, who could certainly afford it, saw fit to comp me a daily copy of the WSJ, to which I subscribe at the exorbitant, full-price online subscription rate, I would feel obligated to live up to the standards of politeness instilled in me by my mother and to accept that offer as a no-strings goodwill gesture from a fellow publisher.
I freely admit that both of the individual blog authors mentioned do occasionally email me, typically to tell me or ask me about something going on in the wide world of patient compliance or exchange a tidbit or two about our personal lives. Trisha, for example, moved recently, and we briefly discussed the stresses such endeavors may inflict on households. I am only a teen-tiny bit jealous that their businesses were mentioned in WSJ articles and mine wasn’t. Both bloggers have written positive comments about AlignMap or me in previous posts, which is always nice.
Footnotes
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Tags: AlignMap Web · Communication · Enhancements · Lay Media
November 20th, 2007 · Comments Off
Happy Thanksgiving
Because of my travel plans this holiday week, no new AlignMap blog entries are anticipated until regular postings resume Monday, 26 November 2007.
I hope your Thanksgiving is filled with joy.
Tags: AlignMap Web
October 18th, 2007 · Comments Off
The Technical Difficulties Blues
Internet access has become an overwhelming if transient problem and, for the nonce, has effectively rendered posting to the AlignMap blog or web site difficult to the point of impossible unless I have two or three hours to spare.
I’ve decided instead to devote whatever extra time is available to fixing the problem.
Your patience is, of course, appreciated.
Tags: AlignMap Web
September 25th, 2007 · Comments Off
New Articles Echo Previous Posts
Two articles have appeared in the lay press in the past 24 hours that focus on topics recently addressed in this blog.
Health Literacy
In today’s Chicago Tribune, Literacy can be a matter of life and death By Leslie Goldman examines the crisis caused by the inability of large numbers of patients to understand basic medical instructions, resonating with several AlignMap entries, including Health Literacy , Medication Leaflets, and The Gap Betwixt, Health Literacy: A Clear Problem Without A Clear Solution, and Healthcare Illiteracy Linked To Higher Mortality Among Elderly .
This short piece features intimidating statistics from pertinent studies, such as the following:
Dr. David Baker, chief of general internal medicine at the school, and his colleagues followed 3,260 patients older than 65 and found that one-quarter were deemed medically illiterate based on tests of their ability to comprehend common medical information such as prescription labels, appointment slips and instructions on preparing for an X-ray. This resulted in problems far greater than missed doctor visits or one too few pills swallowed: Those people with poor health literacy had a 50 percent higher mortality rate over five years compared with peers who had adequate reading skills.
Compensatory measures healthcare professionals can make are also discussed.
This article can be found at Literacy can be a matter of life and death
Incentives For Results Rather Than Enrollment
An article By Elizabeth Dunbar in the 24 Sept 2007 Washington Post, Study: Money Can Prod One To Lose Weight adds to themes raised in Monetary Incentives To Decrease Obesity and Another Case Of Cash For Compliance, reporting that
research published in the September issue of the Journal of Occupational and Environmental Medicine found that cash incentives can be a success even when the payout is as little as $7 for dropping just a few pounds in three months.
The article focuses on the economic benefits such an incentive plan, which provides no help to participants on how lose weight, would hold for employers:
Unlike providing onsite fitness centers or improving offerings in the company cafeteria, cash rewards provide a company with a guaranteed return, the researchers said. “They really can’t be a bad investment because you don’t pay people unless they lose weight,”
Details of the study itself and further consideration of its implications can be found at Money Can Prod One to Lose Weight
Tags: AlignMap Web · Enhancements
August 20th, 2007 · Comments Off
Expect Delays In AlignMap Blog Postings
Because of the hassles created by the aftermath of my fractured hip conjoined with the obligations of a new project, it’s likely that AlignMap Blog entries will be sparse in the immediate future.
Email addressed here will be continue to be answered although those replies may be less prompt than usual.
Tags: AlignMap Web
July 29th, 2007 · Comments Off
Because my compliance with the treatment of an acute health problem is time-consuming and a hassle to boot, posts to this blog over the next six weeks will probably be sparse and sporadic. Posts that are published are likely to be brief and general in nature.
After that treatment is completed, new AlignMap blog entries should be again added on its typical, more or less daily (i.e., each business day) schedule.
Allan Showalter, MD
Tags: AlignMap Web
June 30th, 2007 · Comments Off
I began Ted Nugent, Patient Compliance, and Jerry Lewis, my post earlier this week about Ted Nugent’s comments on healthcare compliance made during his appearance on the Glenn Beck Show as a novelty Celebrity & Compliance piece serendipitously made available by virtue of having my TV tuned to CNN Headline News in the wee hours of the morning.
It grew into a full-fledged post as I considered the implications of his catchphrase, “If you don’t care about your health, how dare you ask for healthcare.”
Since then the post has taken on a life of its own with readers emailing and phoning their agreement with the underlying premise.
I’ve also described the episode on my personal blog in the posting, Sex, Scrubs, and Rock and Roll, garnering a similar response.
Finally, I’m flattered to have received an email from Sasha, Ted Nugent’s daughter, about the AlignMap post appearing on the rocker’s official web site at Ted Nugent on Healthcare.
Tags: AlignMap Web
June 8th, 2007 · Comments Off
Lazy Hazy Crazy Days Of Summer Vacation
Both my family and the AlignMap Blog will be on vacation for most of the next two weeks.
Summer Reading List
During this break, I immodestly suggest something, as the lads from Monty Python’s Flying Circus might say, completely different – these popular posts from my personal, ostensibly clever, theoretically humorous, and exponentially more heavily read Heck Of A Guy Blog:
If you are a Leonard Cohen fan – and if you’re not, you should be – you’re in luck. There there are a plethora of posts on the man and his music, including some material not to be found elsewhere, all conveniently available through this link to the imaginatively named category: ~Leonard Cohen~
Leonard Cohen and Anjani at her concert in Warsaw
Similarly, if you like Anjani Thomas (AKA, Leonard Cohen’s lover) or if you just like the concept of an incredibly seductive female vocalist, check out her category, which includes a number of posts constituting an online flirtation between the dulcet-toned enchantress and yours truly (I know; I can’t believe it either):
~Anjani Thomas~
If you’re in the mood for a non-fiction love story, start at this post and follow the links: ~This Is How A Love Story Began~
Also in the warm and fuzzy genre are these offerings:
For the cynical side of romance, click on ~Wedding Protection~
For offbeat, vacation destinations, try
As a season-appropriate sports offering (that has almost nothing to do with the sport itself), go to ~The Best Of Baseball~
And these sports are always in season:
Pedantic yet entertaining sums up
And for uncategorized fun,
Vaya Con Huevos
An obsessive reader, I consider books an absolute requirement for a successful vacation. Consequently, I offer as a friendly farewell (for now) the exquisite opening paragraphs of Italo Calvino’s If On A Winter’s Night A Traveler:
Excerpt From Italo Calvino’s If On A Winter’s Night A Traveler
You are about to begin reading Italo Calvino’s new novel, If on a winter’s night a traveler. Relax. Concentrate. Dispel every other thought. Let the world around you fade. Best to close the door; the TV is always on in the next room. Tell the others right away, “No, I don’t want to watch TV!” Raise your voice–they won’t hear you otherwise–”I’m reading! I don’t want to be disturbed!” Maybe they haven’t heard you, with all that racket; speak louder, yell: “I’m beginning to read Italo Calvino’s new novel!” Or if you prefer, don’t say anything; just hope they’ll leave you alone.
Find the most comfortable position: seated, stretched out, curled up, or lying flat. Flat on your back, on your side, on your stomach. In an easy chair, on the sofa, in the rocker, the deck chair, on the hassock. In the hammock, if you have a hammock. On top of your bed, of course, or in the bed. You can even stand on your hands, head down, in the yoga position. With the book upside down, naturally.
Of course, the ideal position for reading is something you can never find. In the old days they used to read standing up, at a lectern. People were accustomed to standing on their feet, without moving. They rested like that when they were tired of horseback riding. Nobody ever thought of reading on horseback; and yet now, the idea of sitting in the saddle, the book propped against the horse’s mane, or maybe tied to the horse’s ear with a special harness, seems attractive to you. With your feet in the stirrups, you should feel quite comfortable for reading; having your feet up is the first condition for enjoying a read.
Well, what are you waiting for? Stretch your legs, go ahead and put your feet on a cushion. on two cushions, on the arms of the sofa, on the wings of the chair, on the coffee table, on the desk, on the piano, on the globe. Take your shoes off first. If you want to , put your feet up; if not, put them back. Now don’t stand there with your shoes in one hand and the book in the other.
Adjust the light so you won’t strain your eyes. Do it now, because once you’re absorbed in reading there will b no budging you. Make sure the page isn’t in shadow, a clotting of black letters on a gray background, uniform as a pack of mice; but be careful that the light cast on it isn’t too strong, doesn’t glare on the cruel white of the paper, gnawing at the shadows of the letters as in a southern noonday. Try to foresee now everything that might make you interrupt your reading. Cigarettes within reach, if you smoke, and the ashtray. Anything else? Do you have to pee? All right, you know best.
It’s not that you expect anything in particular from this particular book. You’re the sort of person who, on principle, no longer expects anything of anything. There are plenty, younger than you or less young, who live in the expectation of extraordinary experiences: from books, from people, from journeys, from events, from what tomorrow has in store. but not you. you know that the best you can expect is to avoid the worst. This is the conclusion you have reached, in your personal life and also in general matters, even international affairs. What about books? Well, precisely because you have denied it in every other field, you believe you may still grant yourself legitimately this youthful pleasure of expectation in a carefully circumscribed area like the field of books, where you can be lucky or unlucky, but the risk of disappointment isn’t serious.
So, then, you noticed in a newspaper that If on a winter’s night a traveler had appeared, the new book by Italo Calvino, who hadn’t published for several years. You went to the bookshop and bought the volume. Good for you.
In the shop window you have promptly identified the cover with the title you were looking for. Following this visual trail, you have forced your way through the shop pas the thick barricade of Books You Haven’t Read, which were frowning at you from the tables and shelves, trying to cow you. But you know you must never allow yourself to be awed, that among them there extend for acres and acres the Books You Needn’t Read, the Books Made For Purposes Other Than Reading, Books Read Even Before You Open Them Since They Belong To The Category Of Books Read Before Being Written. And thus you pass the outer girdle of ramparts, but then you are attacked by the infantry of the Books That If You Had More Than One Life You Would Certainly Also Read But Unfortunately Your Days Are Numbered. With a rapid maneuver you bypass them and move into the phalanxes of the Books You Mean To Read But There Are Others You Must Read First, the Books Too Expensive Now And You’ll Wait Till They’re Remaindered, the Books ditto When They Come Out In Paperback, Books You Can Borrow From Somebody, Books That Everybody’s Read So It’s As If You Had Read Them, Too. Eluding these assaults, you come up beneath the towers of the fortress, where other troops are holding out:
- The Books You’ve Been Planning To Read For Ages,
- The Books You’ve Been Hunting For Years Without Success,
- The Books Dealing With Something You’re Working On At The Moment,
- The Books You Want To Own So They’ll Be Handy Just In Case,
- The Books You Could Put Aside Maybe To Read This Summer,
- The Books You Need To Go With Other Books On Your Shelves,
- The Books That Fill You With Sudden, Inexplicable Curiosity, Not Easily Justified.
Now you have been able to reduce the countless embattled troops to an array that is, to be sure, very large but still calculable in a finite number; but this relative relief is then undermined by the ambush of the Books Read Long Ago Which It’s Now Time To Reread and the Books You’ve Always Pretended To Have Read And Now It’s Time To Sit Down And Really Read Them.
With a zigzag dash you shake them off and leap straight into the citadel of the New Books Whose Author Or Subject Appeals To You. Even inside this stronghold you can make some breaches in the ranks of the defenders, dividing them into New Books By Authors Or On Subjects Not New (for you or in general) and New Books By Authors Or On Subjects Completely Unknown (at least to you), and defining the attraction they have for you on the basis of your desires and needs for the new and the not new (for the new you seek in the not new and for the not new you seek in the new).
All this simply means that, having rapidly glanced over the titles of the volumes displayed in the bookshop, you have turned toward a stack of If on a winter’s night a traveler fresh off the press, you have grasped a copy, and you have carried it to the cashier so that your right to own it can be established.
You cast another bewildered look at the books around you (or, rather: it was the books that looked at you, with the bewildered gaze of dogs who, from their cages in the city pound, see a former companion go off on the leash of his master, come to rescue him), and out you went.
You derive a special pleasure from a just-published book, and it isn’t only a book you are taking with you but its novelty as well, which could also be merely that of an object fresh from the factory, the youthful bloom of new books, which lasts until the dust jacked begins to yellow, until a veil of smog settles on the top edge, until the binding becomes dog-eared, in the rapid autumn of libraries.
No, you hope always to encounter true newness, which , having been new once, will continue to be so. Having read the freshly published book, you will take possession of this newness at the first moment, without having to pursue it, to chase it. Will it happen this time? You never can tell. Let’s see how it begins.
Perhaps you started leafing through the book already in the shop. Or were you unable to, because it was wrapped in its cocoon of cellophane? Now you are on the bus, standing in the crowd, hanging from a strap by your arm, and you begin undoing the package with your free hand, making movements something like a monkey, a monkey who wants to peel a banana and at the same time cling to the bough. Watch out, you’re elbowing your neighbors; apologize, at least.
Or perhaps the bookseller didn’t wrap the volume; he gave it to you in a bag. This simplifies matters. You are at the wheel of your car, waiting at a traffic light, you take the book out of the bag, rip off the transparent wrapping, start reading the first lines. A storm of honking breaks over you; the light is green, you’re blocking traffic.
You are at your desk, you have set the book among your business papers as if by chance; at a certain moment you shift a file and you find the book before your eyes, you open it absently, you rest your elbows on the desk, you rest your temples against your hands, curled into fists, you seem to be concentrating on an examination of the papers and instead you are exploring the first pages of the novel. Gradually you settle back in the chair, you raise the book to the level of your nose, you title the chair, poised on its rear legs, you pull out a side drawer of the desk to prop your feet on it; the position of the during reading is of maximum importance, you stretch your legs out on the top of the desk, on the files to be expedited.
But doesn’t this seem to show a lack of respect? Of respect, that is, not for your job (nobody claims to pass judgment on your professional capacities: we assume that your duties are a normal element in the system of unproductive activities that occupies suck a large part of the national and international economy), but for the book. Worse still if you belong–willingly or unwillingly–to the number of those for whom working means really working, performing, whether deliberately or without premeditation, something necessary or at least not useless for others as well as for oneself; then the book you have brought with you to your place of employment like a kind of amulet or talisman exposes you to intermittent temptations, a few seconds at a time subtracted from the principal object of your attention, whether it is the perforations of electronic cards, the burners of a kitchen stove, the controls of a bulldozer, a patient stretched out on the operating table with his guts exposed.
In other words, it’s better for you to restrain you impatience and wait to open the book at home. Now. Yes, you are in your room, calm; you open the book to page one, no, to the last page, first you want to see how long it is. It’s not too long, fortunately. Long novels written today are perhaps a contradiction: the dimension of time has been shattered, we cannot love or think except in fragments of time each of which goes off along its own trajectory and immediately disappears. We can rediscover the continuity of time only in the novels of that period when time no longer seemed stopped and did not yet seem to have exploded, a period that lasted no more than a hundred years.
You turn the book over in your hands, you scan the sentences on the back of the jacket, generic phrases that don’t say a great deal. So much the better, there is no message that indiscreetly outshouts the message that the book itself must communicate directly, that you must extract from the book, however much or little it may be. Of course, this circling of the book, too, this reading around it before reading inside it, is a part of the pleasure in a new book, but like all preliminary pleasures, it has its optimal duration if you want it to serve as a thrust toward the more substantial pleasure of the consummation of the act, namely the reading of the book.
So here you are now, ready to attack the first lines of the first page. you prepare to recognize the unmistakable tone of the author. No. you don’t recognize it at all. But now that you think about it, who ever said this author had an unmistakable tone? On the contrary, he is known as an author who changes greatly from one book to the next. And in these very changes you recognize him as himself. Here, however, he seems to have absolutely no connection with all the rest he has written, at least as far as you can recall. Are you disappointed? Let’s see. Perhaps at first you feel a bit lost, as when a person appears who, from the name, you identified with a certain face, and you try to make the features you are seeing tally with those you had in mind, and it won’t work. but then you go on and you realize that the book is readable nevertheless, independently of what you expected of the author, it’s the book in itself that arouses your curiosity; in fact, on sober reflection, you prefer it this way, confronting something and not quite knowing yet what it is.
Footnotes
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Tags: AlignMap Web
April 10th, 2007 · Comments Off
AlignMap.com Web Site Tune-Up and Spring Cleaning
Today, the time usually devoted to developing a post about patient compliance was instead spent in tweaking the mechanics of the WordPress blogging platform and the interface with AlignMap.com’s hosting site that are the means by which AlignMap is displayed on the internet.
Because most of this effort consisted of updating, replacing workarounds with solutions, eliminating redundant code, and the like, the results should be invisible to the viewer. There was also, in the course of the work, some incidental rewriting of content to correct typos and a couple of egregiously horrid sentence constructions.
Google-Powered AlignMap Web Site and Blog Search Engine
AlignMap.com did gain one new feature of significance the brand new, shiny SiteSearch, which can be accessed by clicking on the “SiteSearch” tab at the viewer’s upper right on each AlignMap page.
SiteSearch is a Google-powered search engine that covers only the AlignMap.com web site and blog. While it is only now being introduced here, I’ve used it long enough at my personal Heck Of A Guy blog to be convinced that it is often more thorough and almost always more convenient to use than the WordPress Search. The familiar Googlesque interface and functions also render this search easy to use for regular Google users.
While Google charges no fee for the use of the technology, there is, of course, a cost. The price of using Google custom search is the display of context-sensitive ads on the search results page. These ads are not controlled by AlignMap, do not feed revenue to AlignMap and do not imply AlignMap’s endorsement of any advertised product or service. My experience with this process thus far is that it seems a fair exchange, not unlike having ones barn painted in exchange for displaying “See Amazing Merrimac Caverns” on the barn’s roof.
So, give SiteSearch a spin, and if there are problems with it or any other web site operations, please let me know.
Footnotes
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Tags: AlignMap Web
January 31st, 2007 · Comments Off
Techno-Monster Vanquished
My extraordinarily talented web site consultant has performed his usual heroics and wrestled this site’s recent technological problems (see In The Midst Of Draining The Swamp …) into submission.
Unless new catastrophes declare themselves, business should resume in the next day or two.
Again, my apologies for the hassles.
Tags: AlignMap Web
January 30th, 2007 · Comments Off
Update: As of 31 January 2007, this problem has been corrected and the temporary measures described here obviated. See
One Problem — One Hero. The correct AlignMap home page can again be found at
AlignMap.com.
Changes (gleefully described as an “upgrade” by the code-mongers) in the software used to publish this web site have resulted in all manner of havoc, disarray, and no small amount of frustration.
One especially confusing consequence has been that the AlignMap blog now turns up on its own page, AlignMap Blog and as the AlignMap Home Page.
I’m wanted to assure readers that I am aware of the glitch and am working to repair it.
I apologize for the hassles.
Tags: AlignMap Web
