The DOGE

 Historically the DOGE was the highest authority in Venice. I recall walking about in the DOGE's residence, well done in the finest of things. So strange that this new Government office is DOGE. I would guess that anyone with a modicum of knowledge would have made the connection.

But, let's take one entity. The FCC. The primary function of the FCC has been running spectrum auctions and pouring Billions into the Government Coffers. Now that takes little effort.

The manage spectrum, making sure people who are unauthorized do not abuse it. I am a licensed Radio operator. But the exams were outsources and all the FCC does is keep the record. Then the FCC has Administrative Law Courts. Unlike real courts they are made up of political appointees and decide whatever.

The FCC managed monopolies such as ATT. Now we have oligopolies, not monopolies and they seem unregulated.

So what does the FCC really do with all those people. Perhaps the DOGE may have its first target!

FDA and Drugs

 The FDA has a mandate to approve new drugs. Now this is a difficult process, especially as newer therapeutics are developed. Fundamentally there are three steps:

1. Does the new therapeutic cause no harms?

2. Is the new therapeutic effective. Namely does it do what it is supposed to.

3. Is the new therapeutic better than what is already available. Namely efficacy.

This may sound simple but to perform these tasks one needs a large enough statistical sample to show it is true or not. Now step 1 can be easy, relatively. But safe to whom? The normal healthy person or the ones with the disorder? Step 2 requires a large enough group of those with the disorder willing to be tested over some period of time. That can be difficult if the disease is rare. Step three is an A to B comparison. That means we have to test this perhaps for two or three years.

Now adding all these up leads to a five to ten year lag in approval. The FDA has found ways to expedite but no matter what there are always people who are harmed, often a small percent, bu always there. Then again with many of the new cancer immunotherapeutics we see 60% to 80% who are non responsive. Why? Not fully understood. Yet we utilize the therapeutics any way.

The challenge to an incoming FDA/HHS is to understand that we are in a major tectonic change in therapeutic introductions and approval. In a sense the mRNA vaccines are a now classic example. Unlike the classic smallpox vaccine, the Salk polio vaccine etc the mRNA vaccines are good at best for 6 months. The older ones are for a lifetime. Why? One would have thought that the NIH folks would have spent some time on that issue but no! Blame the head of the sub-agency I guess.

The incoming team, whoever is approved, must be open to face the challenges. As we learn more we recognize that the "unknown unknowns" start to dominate. There must be a willingness to move forward while still accepting we are dealing with a complex environment, the human body.

Multimedia Communications

 A few years back a edited a 1989 set of note from the first course on multimedia communications I taught at MIT. I think some of the students grasped some of the ideas. I also thought it may be worth posting my Preface from the update:

This is an edited version of the 1989 class notes on Multimedia Communications which I taught at MIT. I have tried to keep all the original material and eliminated some material which is so out of date that it has little use. However, in view of the slow growth of multimedia communications over this some thirty plus years, I felt an edited and useful version may be of interest. This is NOT a view from the current time but an edit of what was known in 1989. It is worth looking at this and comparing what has been accomplished and what is left undone. The basic and fundamental issues and ideas have not changed. The technology has advanced but the integration of that technology into a true and working multimedia communication environment has not. The current virus pandemic has placed an emphasis on the need for true multimedia communications as presented in this old notes. Two areas are of most import are education and medicine. Students are left with useless laptops trying to participate in classes using the limited abilities of a Zoom or some other primitive form of communications. In medicine we have telemedicine that uses the same limited technology and, in my opinion, does less than what I was doing at Harvard in 1986-1990. Instead, the current technology implementation has, in my opinion, wasted decades on such things as Apps while leaving the two areas just mentioned a wasteland. 

 There is a philosophy of multimedia communications, a philosophy as to what we are trying to do as humans in interacting with one another human or group of humans and even our environment. Multimedia communications is displaced human interactions. It tries to erase the sense of displacement; it tries to bridge the gap of technology qua technology. None of the systems currently available have even tried to understand this human interaction challenge. One cannot accomplish this with a screen on a smart phone. A laptop shining in one's eye glasses creates an ethereal image of unreality. Poor speakers and microphones present an almost comedic interaction, and of course the background is more like a reality home show than a true normal interaction. Finally, the technology itself gets in the way of interacting .In 1989 I tried to understand and remedy such issues with a philosophy of multimedia communications. Unfortunately, most technologists who design and deploy today's systems are devoid of any understanding of human interactions. Multimedia Communications must be "displaced human interactions". It is a simple concept but complex to execute. It must be a seamless and as Heidegger noted "ready at hand" and a simple "thing" that disappears when used, making the users act and communicate as if the distance was not there. This is a highly complex challenge. It requires understanding human interaction, human linguistics and the very nature of humanity at the highest level.

This current viral pandemic has demonstrated how poorly we have achieved this goal. Just the thought of using a smart phone to take university classes, or even primary school classes is an insane idea. This is the App world of Silicon Valley, a short term monetizable artifact that has set humanity back, and not allowed us to move forward. How can a Second-Grade teacher interact with her students? Clearly not with what we have now. How can a father read to his daughter, not as we have now? How can a Physician interact with a cancer patient unable to come to the clinic, not as we have now? Thus, the issuance of this slightly modified revision I believe has value and merit .I want to also provide a belated thanks to Professor Muriel Medard (MIT) who was my Teaching Assistant during this first course. She did a magnificent effort in assembling key references and sources and in managing the class structure. It is to her and my many other students to whom I dedicate this revision.  

Terrence P. McGarty Thornton, NH January 2021

Welcome to the Fourth World!

Well today's not on our crumbling country is the total power outage in Madison, NJ. This is a town owned and operated system. They had announced a local outage mid-day, but at 4 PM there was total outage! On the main street just prior to max traffic. This local entity is classic town managed and operated. Costly, inefficient, and in my opinion nearly incompetent. I have had experience with many such local power companies. They are remnants of early 20th century Socialism, namely literally power to the people. This closed all stores, medical practices etc. Clearly a potential cause for irreparable harm. Madison in my opinion and my experience has an aloof Government which seems to care less for citizens outside heir town.

Corporate Collapse of the Day

 I have used Fidelity for years. Under the new management they have become almost unbearable. Today their total system is down. I recall when I was first at Bell Labs and they introduced the first Electronic Switching System, ESS No 1. A system was in Beverly Hills. It had an EA 5, and Emergency Action 5, namely a crash and reboot at just before 1PM PST or 4 PM EST. Namely just before the Stock Market closed. Well you could image heads rolling. So what is the new head of Fidelity doing now that apparently her system has crashed? We are told it is a "snag". Just what in God's green earth is a "snag". You system has crashed! Customer's are losing money! 

Are you out of business, do I still have my money? Perhaps the Board should consider a realignment. 

UPDATE: This is what Fidelity states:

We are Sorry. There was a Technical Issue.

We are currently aware of an issue with some 3rd party browser plugins that are causing issues with access to the Fidelity website. Please try running your browser in incognito mode - or using an alternative browser as we work with the 3rd parties to resolve the issue.

If you continue to receive this page please contact customer support and provide them the reference number below.

Reference Error: 18.cb292117.1731636227.54aedbf9

Customer Service FAQs: Technical Support

Customer-Service Numbers

Now read this. It says the customer must fix the problem. I tried several browsers. I cannot find an "incognito" mode, nor should I. This is in my opinion a clear indication that the customer comes last, especially when you blame them and tell them to fix it themselves!

The Perils of Nationalized Medicine

 The New England Journal published an interesting piece on England's NHS. The following charts tell a story.

Note especially graph B. The treatment of Cancers withing 62 days after referral. It is now almost just 50% Now some malignancies can take this 62 day delay such as most prostate cancers. However a melanoma delay would be terminal. As would a sebaceous cell carcinoma and many others. 

The other charts also tell a story of pathetic treatment. In my experience, from the time of suspicion to the time of diagnosis and treatment by a specialist has often been less than 48 hours! Of course this is NY/NJ and I clearly have contacts and knowledge, but also I can work the system. Others can do so also. But in the NHS it just fails!

So Washington beware. nationalized health care is a scam, and a deadly one at that!