This is obviously a hot topic these days. The reality of our system is hard to grasp unless you are in need of health care and then that reality takes on a surrealistic edge. I was ill with what turned out to be sinusitis last week. It was as bad as I have ever had making it impossible to sleep or focus. The easiest thing to do was to lie in bed, not move my head too much and keep my eyes closed with the hope that I would sleep. On the third day of doing this, I called my doctor–this was a Saturday so I reached the doctor on call who told me that it might be meningitis and that I should go to an emergency rooom.

I have been in emergency rooms around the world, from Australia to Indonesia, India and London, Kansas City to Mt. Kisco, NY. Almost all of them have been staffed well and run smoothly. Last Saturday, I was at Mt. Sinai and the experience for a ten minute diagnosis lasted from 10:45 to 6:30. The emergency room was certainly busy and I felt terrible that for sinusitis I was taking up room in place of people that were far more ill. Why did my experience last so long?

The only thing I can think of is that doctors are taught not to rush. This is probably an excellent thing, but I have to say that the procedures surrounding the diagnosis could be a great deal faster. An efficiency expert could have had a field day at Mt. Sinai last Saturday identifying redundancy and other wasteful procedures. I was not impressed but extremely thankful for the care. It is clear to me that the health care debate needs debating on a great many levels as well. Would that the Republicans would join into it.


I love Malcolm Galdwell’s writing. It is as smooth as silk and makes me feel as if he is giving me instruction on a one to one basis. His style is relaxed and non-threatening and he accumulates and uses his facts expertly. His first two books, “The Tipping Point” and “Blink”, were attempts at explaining the unexplainable. He didn’t quite convince me in either case, but the books were an enjoyable read. His latest book, “Outliers” is about exceptional people and I have an easier time accepting at least one of his reasons for their success, the punch line to the question of how do you get to Carnegie Hall, practice, practice, practice–ten thousand hours at the minimum.

Great furniture represents the work of a practiced craftsman. The seven year apprentice required of cabinetmakers in the 18th century were those 10,000 hours and it is a time period where even average pieces seem exceptional. The craftsmen of that era were truly practiced. I recently flew to an auction in a far flung city to see a stool that looked in the photographs to be something exceptional. It wasn’t as it was clearly made by someone who did not know which way to run a chisel so that it was going with the grain as there were gouges on the surface from where the chisel ripped the timber. It was clearly not made by an 18th century craftsman who might have made that mistake once, but never on a finished piece. I certainly wish I could have seen this in the photos from the auction house, but you just couldn’t. That is the why that you go and look at everything you buy.

Gladwell cites one “genius” who never “made it” for reasons he makes clear throughout the book and he uses this genius as a counterpoint to people who have made it such as Bill Gates and The Beatles. The problem I have is that genius and “making it” are two separate things. I have known a number of very intelligent people who have never “made it” save for the fact that they have had happy lives and I have known “one note” people who have pounded on an idea and made great wads of money. Which situation is preferable? Would I rather talk to someone engaged in the world who may not have made great money or to someone whose interests are confined to making money? Having said this, “Outliers” is Gladwell’s most successful book in my opinion and may he continue to probe ideas that seem unfathomable. I always enjoy swimming along with him.