Wisdom from Carlos Mencia

From what I remember of  Mencia's standup routing describing an interview he participated in for inclusion in a political discussion roundtable concerning immigration reform.

Interviewer: So, what is your angle?

Mencia: Upright

Interviewer: I mean, where are you coming from?

Mencia: My home. Why don't you just be man enough to ask me the question you want to ask me?

Interviewer: Ok, are a Republican or a Democrat?

Mencia: Neither

Interviewer: What do you mean?

Mencia: Well, I consider myself reasonably intelligent and I don't like being half right all the time.

Interviewer: Okay, Are you conservative or liberal?

Mencia: Yes.

Interviewer: What do you mean by that?

Mencia: I have a teen age daughter. When it comes to her I am very conservative - Bible believing, bible belt buckle, thou shalt not, fire and brimstone, truth, good vs evil all the way.
But with your daughter - I am liberal.

Mencia was not asked to be on the panel to discuss immigration reform.

U2 The Joshua Tree, Led Zeppelin IV, Ted Nugent The Great White Buffalo, Jim Hendrix Electric Lady Land, Beatles, Sgt. Peppers Lonely Hearts Club, Pink Floyd, Dark Side of the Moon.

All crap compared to what I just heard. I mean, the first four tracks of The Joshua Tree would be a tour de force, if, released as an EP. The rest of the album just kind of fizzles out. Led Zeppelin is, well Robert Plant screaming and Jimmy Page fumbling through riffs in some kind of substance altered state. Dark Side of the Moon, good, pretty good in a black-lit tapestried room with those big Princess Leia ear phones on either side of one's head. The Beatles, maybe I am too young. Never liked the Beatles.

Joe Bonamassa's Dust Bowl, is perhaps the best recording I think I have ever heard. Okay, I'll go ahead and say it. It IS the best all-around recorded album ever digitized and sold in those impossible-to-get-open, ostensibly thief-proof land fill fillers.

Think Stevie Ray Vaugn with a little more precision, bless his soul.
Think Joe Satriani with less technician and more emotion.
Think BB King (Bonamossa opened for BB King when just 8 years old)
Think honey riffs floating off rosewood.

That's Joe Bonomossa.

Here's the deal. Bonamossa doesn't skimp on the music. You'll get close to a full hour of music for your $18.00. Anyone remember when cassettes and vinyl cost you $5.99 and every song was good? Now you pay $20 for a couple of hits and the rest has been picked up off the studio floor, dusted off and slapped on the end. And even then, you get maybe 30 minutes of music for your bill. Not with this guy.

Every song on Dust Bowl is a keeper. Bonamossa floats from grungy yet precise delta blues, lyrical with his instrument and earthy with his lyrics like in Black Lung Heartache; to soulful, slow, beautifully precise yet stocked with emotion, in Last Matador of Bayonne; to whimsical, almost country blues in a duet with John Hiatt in Tennessee Plates and his duet with Vince Gill, yes Vince Gill, in My Rowena. It's all good. And that's not bad for walking into Barnes and Noble, picking it up without ever hearing one track (our B&N did away with their headphone song sample system), slapping down my $20 and listening to it all the way home.

I know where my allowance is going for the next few paychecks...I am going to own, on CD, something I can hold, every thing he's ever recorded.

Failure Misunderstood

On my first day back on the job, at my old work place, before going half crazy and attempting to "live off the land", I was greeted by an old friend. It was not, however, the warm greeting I had hoped for.

"That whole farming thing didn't work out did it?"

At this point along my journey to reentering the rat-race, I was unprepared to answer this kind of greeting.


9 months later, after a serendipitous chain of unfortunate events, I find myself back in my old job as the department manager and, as a result, find myself speaking with many of my old manager coworkers in this, my new-old sphere of influence.


Friday was my first big "meeting" with many of these former, and once again, co workers. Again I heard many of the same comments on my return...."Farming thing didn't work out huh?" was the ubiquitous response to meeting me again for the first time. There was another, "I told you, you were crazy!"


And it struck me that many in our American society regard trying something and failing in that endeavor is somehow less honorable or sane than having never tried at all.


So let's break it down. Was my too o'er hasty "retirement" a failure?


If success in our attempt at full time farming is measured in dollars earned or in longevity in the endeavor, or a stubborn refusal to quit, then I would have to say yes to this question. We failed to do what we set out to do.


If success in our attempt at full time farming, meant we learned some very important things...


1) we learned just how little we can live on.
2) we learned that we really enjoyed the experience, over all, and I had a year of spending every day with my wife. Something I may never have again.
3) we learned that dreams can be realized and that it is okay if they are not what we expect.
4) we learned that failure is less tragic than "failing to try" something new for wont of courage
5) we learned that living life in a line is much more difficult than it sounds, especially when life offers you a circle back to try again.


then I would have to say that our attempt at full time farming was an overwhelming success!






Why is the failure almost always held to be more shameful than the failure to try? In the last three years, we've been called crazy; we've been called failures; we've been accused of going back on our word, one person actually chastising me for not letting my Yes be yes and my No be no. We've met people, who for forty or more years have never left the town they were born in; who can't comprehend the insignificance of social status, income, stuff. Its as if, they are still in terror of this mythical permanent record we've all been told about since grade school.


How do I measure or success or failure over the last 4 years? I guess I would have to say, it was neither a failure or a success; or to muddy the waters even more, we were successful in our failures even in our failure of achieving success. The greatest success derived from our failure is the conquering of the fear of trying something, just because you want to try something new.


Success then, is the acceptance of whatever comes one's way, either from the failure or the success one achieves.

Things I Think I've Learned This Week

The words one says - mean something.
The things one does - really affects real people.
I am not defined by my answers to Facebook quizzes.
You can not know me by what I like or dislike.
"We will never have goats again! Even if they are free!" does not mean what I think it means.
One can wear out his welcome.
Running out into the world shouting "This is me take it or leave it" is noble but rarely effective.
"Be all things to all men" has a great deal of Biblical Wisdom about it.
The things I could do, what I could be but for the lack of a single-minded purpose.
To speak well and to comprehend is accomplished, simply, by swallowing one's pride and surrounding himself with people who speak well and think well. Even if those people are in a book, on TV, or on a DVD.
From behind a desk is a dangerous place from which to view the world.
There is nobility, courage, and heroism in the world that is not measured by how much one owns, how much one owes, or how much one is liked.
There are few quiet places in the world - but seek them out, spend some time within them - one will be better able to help someone else after the rest.
Pride sucks.
Negativity is so...negative.
Grabbing hold of and keeping one's IS-ness is harder than it sounds.

Hobbit Breakfast

Hot Black Coffee, Fresh Squeezed Orange Juice. Hot Buttered Grilled Toast, Scrambled mix of free range chicken and duck eggs, Applewood smoked bacon, potatoes and onions fried in bacon grease, mushrooms and a grilled tomato.

Boyd's Megarant Concerning Healthcare Reform Part 3 - LEAN

Toyota: Reputation for building high quality, long lasting, inexpensive automobiles.
Cadillac: Reputation for building high quality, long lasting expensive automobiles.

Two car makers, two very different philosophies on how to build a car.

Toyota is widely considered as the originator of the LEAN manufacturing process. Though upstart car makers like Saturn adopted the same principles before GM (the maker of Cadillac) bought them out and ruined them. The Toyota model looks like this.

One car built at a time. Every line worker has the power to stop the assembly line if they see something wrong or something doesn't meet a certain specification for quality. One car is built. When it rolls off the line it goes through one more quality assurance check and then is ready for shipment. This is called, in the vernacular, Single Piece Flow. Do one thing at a time, one product at a time, excellently every time.

What ruined Saturn? GM ruined Saturn and it basically boils down to their American philosophy of manufacturing. Every Cadillac built that leaves the assembly line goes to one of two staging areas; Minor Problems or Major Problems. In these staging areas, defects in the manufactured automobiles is corrected by a team of troubleshooters prior to being delivered to the dealer showrooms. This is called, in the vernacular, Batch Flow.

The result? Two high quality cars, one more expensive, not just because of the name on the badge, but because of the process taken to create them. One, Toyota, very efficient. The other, Cadillac, quite inefficient.

And now for health care... there are two very different kinds of hospitals out there - not to over simplify the problem, but every hospital can be categorized into one of these two manufacturing processes. Single Piece Flow (LEAN) or Batch Flow (the anti-LEAN). There are many at various odd stages between the two but really, our hospitals are efficient or not. If you've worked in or been the victim (benefactor?) of a hospital you probably have a pretty good idea of what I mean.

The Toyota model of LEAN manufacturing has been introduced into our health care industry in the United States. It started in the laboratories. I will now describe the processes in the Laboratory of two very different hospitals - the LEAN and the anti-LEAN.

Hospital A - Blood is drawn from a patient in their room by a Phlebotomist. The test tube is placed in a rack the technician carries around from room to room, floor to floor, until the rack is full and it is turned into the Lab for processing. The lab takes this rack of test tubes and collects them until the gather enough together to place into their mega standalone chemistry analyzers. This entire collection of test tubes filled with blood are all analyzed simultaneously ( or nearly so) and the results are all logged at once. The results are then delivered back to the units from which the blood was drawn and the logged in the medical record - generally manually and all at once. This is BATCH flow. The draw back? The first patient to have their blood drawn has had to wait an hour for their results. The last patient to give blood has waited, perhaps, 30 minutes or less. The Lab shows a turn around time of 10 minutes because it took 10 minutes to run the racks of collected blood. This "lost time" phenomenon is a hallmark of all BATCHING systems. If the analyzer breaks, ALL samples are delayed or lost.

Hospital B - Blood is drawn from a patient in their room by a Phlebotomist. This sample is delivered to the Laboratory within minutes of it being drawn. The barcoded tube is placed in the analyzer immediately and within minutes the results are returned to the doctor electronically and the medical record is updated automatically. The true turn around time for this blood sample is 15 minutes or less. The phlebotomist, meanwhile, has drawn blood from the next patient, the sample sent, analyzed, and results returned in minutes. The result? Every patient has the same quick turnaround experience.  If the analyzer breaks, only ONE sample is delayed or lost while the Lab reverts to their backup process.


This gives you the background for understanding how the LEAN manufacturing process is being introduced, at a cost of several hundred thousands of dollars per year paid to vendors or consultants who offer the analysis, LEAN training, and then get the heck out of dodge. Then it is up to the hospital to spend many more thousands on new Single Piece Flow analyzers, software and computers to crunch data, space renovations, and in some cases the addition of staff to monitor LEAN Processes going forward.

LEAN Basics- All LEAN programs can be boiled down to these basic tenets.

1) Eliminate Waste
2) Standardize Work
3) Single Piece Flow
4) Process Monitoring
5) On the Fly Corrections


1) Eliminate Waste - This is as simple as it sounds and yet much harder than one may suppose. This really means not having more supplies, tools, parts, etc. on hand than you need for a specified period of time. It also means the death of the souls of your packrats who save everything "in case I need it some day." The key to this tenet of LEAN is that one can not be concerned about "someday"; one is only concerned with now. Someday is taken care of in the next section.

2) Standard Work - this simply means that no matter who is doing the work, the work is always done the same way; tools are always where they are supposed to be; supplies are always stocked; supply reorders are always done at the same regular intervals; documentation is always kept uniformly. This way whomever is completing the task knows where things are, when to reorder supplies, and how to do the job.

3) Single Piece Flow - this is vital to LEAN processes. Take care of one thing at a time. In spite of our culture's insistence - or ability - to multitask, taking care of one customer at a time makes the customer feel special and allows the server to concentrate on just them. Taking one test tube at a time, within reason, makes turnaround time consistent for all customers. Repairing one machine at a time, does the same thing for a customer waiting for their machine and allows the technician to focus on this one thing, increasing thoroughness and efficiency, clear work spaces, all tools readily available; no searching through tool kits to find the ones needed for multiple jobs, etc.

4) Process Monitoring- during LEAN assessment, consultants will stage video cameras around the area being assessed, allow a few days for staff to forget the cameras are rolling, and then record a normal business day. From this comes the concept of "Move the Damn Box". During at least one video session it was noticed that staff were like ants in a disturbed anthill, walking all over the place, sometimes miles of cumulative distance in the period of a day. Sometimes these miles are logged inside one room. It is all done in short bursts of frenzied activity. During one of these sessions an equipment operator kept tripping over a box that had been "stored" in a walkway on the floor. When the video was reviewed, the consultant apologized, in advance, to the operator and then asked, "Why don't you just move the damn box!?!" Monitoring the process to make sure it is as efficient as it was first created eliminates what is called "behavior creep" - lapsing back into lazy, sometimes dangerous behaviors over time.  If something isn't working making adjustments.

5) On the Fly Corrections - comes out of constantly monitoring the processes  and being flexible enough to make common sense adjustments to keep things efficiently running. This is kind of like performing a daily (hourly?) tune up of one's car.

The modern health care institution has become so layered with bureaucracy, inefficient process layers designed to correct inefficiencies in other layers, that LEAN is no longer a concept, though EVERYONE I've ever trained in these concepts ALWAYS says something like "that's just common sense! I naturally think like this. Why are you wasting my time training me on something that's just common sense?". Unfortunately they say these things as they are returning to their desk, piled high with stacks of papers and folders, to work on 3 different devices disassembled on their workstations. It sounds simple. It is. But training healthcare workers in these simple principles costs health care facilities hundreds of thousands of dollars per year.

LEAN is good. LEAN should be implemented in health care - all departments from housekeeping, clinical engineering, facilities maintenance, nursing, administration, dental clinics to ICUS and Open Heart rooms. Any attempt at health care reform that does not mandate efficiencies, like LEAN, to be implemented is putting a bandaid on a sucking chest wound.

Boyd's MegaRant Concerning Healthcare Reform - Part 2 - The Consultants

The consultant for a hospital for which I was working, briefly, introduced himself as an expert in Evidence Based Medicine. The $10,000 in fees, plus travel and lodging expenses the hospital paid, I should guess, made him the happiest of all men. In exchange for this handsome sum he was to provide us department directors a two day seminar, which will provide us with tools we can use to promote a "new paradigm in the management of patient care to meet the challenges of the Affordable Care Act." Sadly, or not unexpectedly, there was not a physician or front line nurse in the room.

This "new paradigm" is summed up like this: Hospitals must learn to use the evidence they see before them to diagnose and treat disease and injury.  Ahem, wait, were we NOT doing this? If not, what are we doing?
 This evidence should include feedback from the patient, the patient's family, the technology we use to measure anatomical processes, the electrical signals from the heart, displayed as an EKG; the microscopy used in automatic urinalysis that shows the chemical make up of what leaves the kidneys;  the sodium and potassium levels in the NaK pump within our cells; the black and white (and more frequently) color images from various xray scans which show the internal workings and health of our structures and organs. All too often, the gentlemen said, physicians rely on things akin to trouble shooting charts to determine diagnoses and treatments. They use it like this:

The patient has a rash, a headache, no fever. Look up rash, headache, no fever follow the column over, okay she must have this. Now look up the disease, she MUST have, and prescribe one of these medicines. Have a nice day! (I have yet to run across a physician I've used that actually says Have a Nice Day after he gets done prodding you and making up illnesses for you, so consider this poetic license to show the the doctor's thought process has concluded and you no longer occupy an iota of memory space in his brain.)

Then there's the docs who make frequent use of WebMD and Google (or Bing) to diagnose and treat you.

Another disturbing trend in healthcare is the number of specialty physicians. There is a prevalent myth amongst many of us, that the best thing for us when we think we have something wrong with us is to see a specialist. Here's the deal. A dermatological specialist, has a basic education in general physiology, which may, or may not, be sufficient to begin with, but has spent the last 3 to 4 years learning, in specialty, about the skin. He then diagnosis what is wrong with your skin. He also prescribes therapy based only on his special knowledge of the skin and what his books tell him to prescribe for your current problem. Unless you find the rare "holisic" thinking specialist - holistic as I use it here means "taking in the whole" body and all of its processes and functions and how it affects the skin - this doctor will not even pursue, based on other evidence, what may be causing the skin to be in the condition it is in. For instance, he may treat just the skin, but ignore, because of ignorance, or because he doesn't really care, how one's digestion, diet, lifestyle, or body chemistry is manifesting itself in the boils, fungus, blotches, or acne displayed by one's skin. If you doubt, think about a time you've had a particularly difficult to get rid of condition, when you've been from specialist to specialist and they all run the same tests, get the same results, and frequently prescribe the same medicines in larger and stronger doses. If you've been through this, you are the victim of what I call Specialist-Troubleshooting Guide Medicine. Now the juxtaposition. Evidenced based medicine will take into account other evidences that may be leading to your condition. We should be worried. First of all, because this happens much too frequently. And secondly because hospitals, are spending your deductibles and the 20% you still owe on your last hospital visit to train their staff on something they describe as the new thing in medicine. Evidenced based medicine.