Thursday, August 31, 2017

Age...MY FOOT!

I once played golf with an 80-year-old who was more than twice my age at the time. We played the “white Tee boxes.” While I hit long off my drives into the woods, he hit 160 yards onto the middle of the fairways. He parred while I danced with bogeys and double bogeys. It was a classic show of inexperience and hubris over a tested, hardened and enriched mechanical philosophy. The game ended with him beating me by an embarrassing 20 strokes! 20-strokes in golf is a face in the towel, sniveling, red-eyed, shame.

Enough shame weighted time passed and I began my journey to rectifying the military version of golf into the steady, boring version, I had witnessed those many years ago. Lessons just crushed my soul and after going through two full days of analysis, I could not hit the golf ball at all. With all those mechanics of 9 O’clock and 3 O’clock positions and other ego-deflating maladies that I could not conquer.

So I set on a course to correct myself the uncorrectable. I started to become a “feel” player, learning the mistake in every swing. Analyzing in my head when the ball launched correctly and when it didn’t. Soon, I concluded that the slices and fades were a function of the club face meeting the ball from “outside-in.” I had been told that, but it had no meaning. I experienced it, learnt from it and then gradually as building blocks go, I exaggerated the inside out swing. MY scores hovered in the low 90s for a while. There was still something amiss. After two summers, it dawned upon me that my drives were anemic. From my all-time best of 310 yards, I could barely pull off a 220-yards flight. Age they said, does that. BS, I cried in my head. BS!

One day on a windy day, I stood over the Tee box 430 yards from the pin on a PAR-4 hole with trees on the right and the left and a 50-yard-wide fairway. I decided to swing the club like a baseball bat to loosen up and then realizing that using the same pivot points I addressed and hauled at the little white dimpled innocent thing. The ball flight was so pure moving slowly as it gained distance, first towards the trees on the right and then finding the right inside spin of the draw, curved tantalizingly close to the tree branches and then making its way back to the fairway 130 yards from the pin! Age, my foot!

The dilemma continues still on every address over every shot to this day. But the game of understanding my faults and learning from them, continues. You see, learning is an art form of dedication in analyzing mistakes. To error is human. To error is inevitable. To error is Universal. But to error is not all bad. It is a place of learning. It is a place from where we make things better.

And so it goes with everything in life. In mechanical engineering marvels that crash and burn like the Challenger
and the Columbia and
 Space Vehicles, the European Mars lander crash from a 1-second inertial error
Errors are commonplace in life. They occur in the field of medicine and from them we learn new things. The fungus and Alexander Fleming’s Penicillin discovery, Jenner’s Cowpox vaccine against Small Pox, John Snow’s discovery of the fecal hand route dissemination of Cholera and Robert Koch’s discovery of Vibrio Cholerae. From Aircraft disasters like this one in Baghram Airport of a 747 Airlift where the cargo changed the Weight and Balance of the aircraft, as it did for the Korean Airways on the ground.

Most accidents are unfortunate. They are tragedies filled with loss of human lives. But we must learn from them, using our critical thinking. Without reason and critical-thinking we would still be rubbing sticks to make fire.

Learning is an art form only when critical thinking and reason are employed. It cannot be forced into the skull like meat into a sausage. It can only be there when experienced. We learn from other’s mistakes and our own, so as not to repeat them. In aviation many have spilled blood and bent aluminum to teach us rules of error avoidance. In medicine the same holds true. But arbitrary rule-making without reason is the most-vile of all monsters that plagues the society these days. We are continually with the help of self-proclaimed experts and the ignorant journalists jumping on anything that correlates or associates and claim that to be the gospel.

To those, I say…learn to analyze and assess and reflect and understand so you may learn the wisdom of the 80-year-old golfer…slow and steady, disciplined perfection with each shot and a designated point of reference to hit to.

Age…my foot!

Sunday, August 20, 2017


“My name’s Blurryface and I care what you think”

The tide has turned. Nostalgia comes in waves, crashing on the shores of comfort. Life is different, subtle distinctions arrive at the doorstep every day. Art seems to find itself at the forefront of all that is human endeavor. Society is at a crossroads once again.

What happens from here on is a matter of how we as humans ascribe ourselves the kernel of dignity. Should we crawl or take a step and stand firm? Should we pine about what we want and not plan for what we need? Should we live in the sea of nostalgia crashing and dashing all hope of individuality? Should we go back into the comfort of our caves or should we hunt and gather?Where should we go?

The lyrics above give us a clue of our lives as they are today. Everyone wants to be heard because everyone feels that everyone is being heard. Everyone wants to be successful, because everyone thinks that everyone else is successful. But the lone difference in their thinking of replicating the success is one of being handed over that success. A few hit it and gloat to the excess, others continue on a journey besieged with doubt, insecurity and wanting to be back in the comfort of their mother’s womb. Precious little time is spent articulating the measure that will drive their desire forward. More time is spent complaining about the inequalities than about the effort. More is spent on wayward dreams that have no end than on the reality that sits idly in front, staring. There is less and less to pursue and more and more to march towards laziness, which has given way to a mentally tired brain that seeks the pleasure of the oxytocin, merely by an injection than by hard work and solution creating.

Life now hovers on the next “like” or the next “tweet.” How many likes did one get? And if only a few arrive on the screen, a despondency grows. Depression sets in and people get stressed out. And stress has a way of coming in many forms; displaced anger, a quiet involution into one’s own thoughts, sleeplessness and aloofness.

Yes, once upon a time we dreamed big and worked towards the dream. Today we dream big houses, yachts and jets without picking the dirty clothes off the floor.

In the end success and a better future is not in a nostalgic wave but in the hard work - dedication to a cause and striving towards a goal that matters. It is not about feeling “micro-aggressed” and needing a “space” that matters, it is about satisfaction from dedication and effort. These “wants” and “cries of inequality” are but the childish demands of juveniles that some experts promote to satisfy their own tenured consultancies.

Get out of the rut.
Make a name for yourself through hard work.
Stop “feeling” and start “doing,” for a change.
Wishing won't make it happen.
Stop “caring what others think!” Follow your dream and live it!

Or it will pass you by, filled with regrets and unfulfilled dreams.

Friday, August 11, 2017


Ever hear of quantum tunneling? 

An interesting phenomenon to say the least; proximity invites such a phenomenon, where one packet tunnels into another sphere to change the dynamics of the other, when in the reality Newtonian world of gravity and not gravitational waves, it would never be able to surmount such a barrier. It is like ghosts walking through the walls. Now why is that important? This is the question that must dawn the synaptic flow of every mind. Indeed, as a thought tunnels itself via words to another’s mind, it can change the thinking. And yet when you add the entanglements between different spins of these bits of matter the attachment between concepts, ideas spread and overtake us all even when there is no direct contact between the speaker of the thought and the receiver. A term used in German vocabulary calls it zeitgeist. Such powerful memes spread ethereally or so we are lead to believe.

The mind remains the metaphorical matter of such concepts.  So we floss each other’s ideas with memes that echo from our lips and sometime with subtle actions and with sometimes nary a meaning. The echoes keep coming incessant like the waterfall, crashing and changing the human actions. What is it about us that makes such non-rhyming couplets become music? 

The world changes slowly, imperceptibly hurtling into the abyss of an entropic future where form is glory and substance slowly fades to dissolve. The present seems sometime, to become the dystopian future of the past. Clearly we feel powerless in this game of change and yet we propel inexorably forward towards it with each passing linear moment.

One such delectable moment, where it is hard to pinpoint when this became the de facto principle in the field of medical oncology remains unclear. The use of PFS or Performance Free Survival slowly became the underpinnings of drug benefit in medical oncology. Not only that PFS also became the modus operandi for the FDA to give approvals to drugs that showed a PFS improvement of a miniscule of 4 months but no absolute OS in a small “n” studies.  After many studies failed to show a clear and present improvement in Overall survival or OS in patients, now some are starting to cry foul as drug costs outweigh drug benefits. The cost of cancer medicines seem to climb the ladder of “no worries.” As long as the third party payers pay, well, who really cares? It is the joyous world of memes and meaningless get-rich-quick-and-stick-it-to-others selfies world. It unfortunately realizes the old adage, wherever there is great need and ignorance, predation lives. 

Other important measures that have confabulated the mind, if not decimated thought completely is the statistical bent that harrows the medical literature; the issue of “significance!” Using p-values to show significance continues its daily quest to win over the scientific community at large even though fewer “scientists” actually sit down and figure out the reality behind the headlines.

So what of this tunneling issue. Unfortunately, this generation is poised to become the most prolific quantum tunnel-ers in the history of science. We continue on our quest to obfuscate and create new and complex rules in order to hide the real facts under the burden of statistical fiat. Might it be time, now that the “cost-containment” is the zeitgeist of the day and heads are ready to roll? Might we hurtle accidentally into the real reality away from the Matrix? Yet through it all, one might consider that the "Tunnelling" effect just might happen with good information as it readily does the bad version. One can dream, can't one?

Or maybe not! Given the rise of the machines such as IBM’s Watson whose glorified technical abilities will launch science in general and medicine in particular to new heights is nothing better than a Bayesian Trap of a sophisticated yet superficial search engine. A rare but accelerating form of sophistry. For, it is based on the shards of preexisting information and deciphering a new set of rules of the ever changing biology is not currently within the realm of this Artificial Intelligence that uses past data to give reams of mathematical information couched in Confidence Intervals, and probabilities framed upon known knowns. And Quantum Tunelling is becoming a large a factor here as well, petabytes of data notwithstanding. ( ) But imagine if you will, where this data resides if quantum tunneling were to happen between what is "good" and "actionable" data with the proliferating snake-oilsmen virtuoso bits? Ah life will get even more interesting as the guardians of the computing gate bow down in worship of this slowly bit-by-bit mutating beast. Such stuff as dreams are made on.

So you see, dear reader, if you are still with me through this Alice’s inspired rabbit hole, the art of the spread of the zeitgeist is more than the gain of wisdom, it is simply regurgitated information couched and spread as knowledge. What is then is nothing more than what information tunnelling makes it to be. The world changes by the memes that control the eyes and ears of humans.

And while “an honest tale spreads best, plainly told,” this one is a complex series of moving parts that humans have lost control of for a while. How should we, or better yet can we control the ever stretching and mind-bending future that seems to lay out before us without us even entertaining a thought. It seems we are propelled by the unseen force of this quantum-packet-magic, ethereal and invisible, to slowly play out like Shakespeare’s fool upon the stage and then be heard of no more. And as Benjamin Franklin might have hinted at, obliquely of the growing act of these agents in the future of his world, “Any fool can criticize, condemn and complain - and most fools do.” We have an ever-burgeoning library of them.

The essence then, must be to use our faculties for their best and think critically for ourselves, lest the rabbit hole leads below into the molten core, where heat vaporizes all.

Monday, August 7, 2017



  1. the action of anticipating something; expectation or prediction.

Anticipation is a strange word, come to think of it. Dictionaries describe it as an expectancy of fulfillment of desire. So clearly it is the expectant reward in the future.

Now let me delve into this futuristic feature, briefly, so to speak.

There are several layers that bear witness to this anticipatory reward or outcome. Assume you have just crossed the hold short line and are turning onto the runway for a takeoff. The anticipation here is the act of pushing the throttle to the wall and the slow (sometime fast with afterburners), but progressively increasing acceleration that forces your back into the leather seat (assuming your aircraft seat has Corinthian leather) and watching the scenery accelerate away from you as the needle threads its way to the (blue line in twins) and VSO1.3 in the single four or six banger and you anticipate the loss of the rumbling noise and the bumpy turbulence of the wheels on the runway to give way to smoothness and vagaries of the wind and weather. Ah! Your mind cries, “what an exhilaration!” It happens to me each time sitting in Seat 10F, 20F or 30A of a commercial jet too; that moment when the surely bonds of earth do not chain me or the lumbering megaton piece of Aluminum to gravity and the quiet roar of the jet engine turns into a whine and smoothness takes over. Ah what a feeling!

So where is the lesson in all this?

Glad, you asked. Here it is! At liftoff, there must be a certain anticipation of dread that must be encountered as well.

What ifs?

What if the engine should quit on takeoff? What then? Many an accident has taken the life of the non-curious pilot. What if, is therefore anticipatory. Of not a reward or the thrill of it but the ignominy of the workings of a gremlin (or your last mechanic or you in inadequate preflight). If you anticipate such an eventuality that gremlins do exist, then you are prepared for the outcome. Landing straight or 30 degree bearing left or right of the flight path below 700feet on a takeoff, on a single runway airfield, or reversal of course above 1000 feet. And you must have anticipated where to land on previous takeoffs where to safely set the aircraft down in case of such an “anomaly” (as NASA would call it). In fact, it behooves us, as pilots to look for safe landing zones (at your airport) while entering the traffic pattern. Have you checked for them? In fact, this should be a routine at any airfield. The 45-degree angling into downwind has its rewards, accept them eagerly.

Anticipation is common to most pilots as it must be to all. For instance, if you bank the aircraft left or right, there is a loss of the vertical component of lift, isn’t it? That leads to a dropped altitude, hence the accompanying action to the bank is a slight pull on the stick (or yoke) to maintain altitude. But if there is no thrust (as in engine power failure) the lift component degradation is more significant. Try finding out that altitude loss at higher altitudes with your instructor- and a wind-milling prop. Maneuvers practiced at altitude and in controlled environment bring the calm needed when things go “clink.” That will serve you well in a real calamity.

Oh, and I might as well mention this while I am at it. For those trained as Instrument Pilots (As I believe all pilots should be for safety reasons alone) entering the clouds the first time on any flight should alert one to review the status of all instrument functionalities (In addition to a thorough prior preflight check on the ground). The Attitude indicator, Airspeed indicator, the Altimeter etc. Those gauges are all we have when the electronic or mechanical gremlin tickles its personal fancy to mess with your $200 hamburger flight. If those beautiful TV screens fail, you are left with the basics as well. Learn to use them well! Scan the steam gauges and the data on the glass; constantly. 

Pilots, Repeat after me, ”Attitude, Altitude, VSI, Airspeed, HIS/Gyro Heading Indicator, Turn Coordinator” Got it? For Glass lovers, same stuff, different format.

And sometime other non-discrimatory gremlins can cloud the view as happened in this F-16 crash at Whittman Field at Oshkosh, WI in 2011 when the canopy got clouded due to depressurization-environmental issues and the pilot went 300 feet beyond the threshold for a $5 million oops!

So, anticipation is the desirous word for that deliciousness, or not, yet to come. Some events might not have the same charm to them as others, but they are all events worthy of note. It is always the prepared (anticipatory) pilot who learns to enjoy and weather all outcomes equally with a similar measure of quiet aptitude, attitude and decision-making.

“Live Long (Fly Long) and Prosper” as Spock might have said.