Archives for category: disaster preparedness

Book Review: Scary Smart by Mo Gawdat

March 10, 2023 //
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Want to get really scared and hopeful at the same time?

Scary Smart is a low level dive into the technology of Artificial Intelligence (A.I.) and deep level dive into the ethics and morality of those who are most responsible for how A.I. will turn out:

Us.

A.I. may seem like the new buzz term with its adoption into our daily lives through products like ChatGPT’s Open A.I. platform and Bing’s real question search algorithm; however, A.I. is baked into almost everything we do with technology. Every app on our phones and every social media platform we interact with has A.I.’s fingerprints all over them.

Mr. Gawat’s premise in “Scary Smart” is that A.I. is a child. And the best way to predict what kind of teen and adult we will get with A.I. is to be good parents. A brilliant initial example from our current comic book obsessed culture is Superman. What kind of Superman would Clark Kent have become of Jonathan and Martha Kent were greedy, selfish, and aggressive? There is no doubt that A.I. is already smarter than humans in many specialized areas, but what happens when A.I. becomes just generally smarter than the smartest human and has access to all the knowledge of humanity through the internet?

Unfortunately, humanity is not doing a very good job of raising A.I. as a child. From our methods of creating and improving these machine intelligences all the way through to the tasks that we are giving them perform, we are emphasizing our worst instincts: To create wealth, surveille our citizenry, gamble, and coming to a battlefield near you soon – to kill people.

We as a society, may feel we have no choice but to use A.I. in this way. If a foreign power, or terrorists, use A.I. controlled drones which are smarter and more efficient than any human, the only way to fight back may be to use A.I. in a similar fashion. But what does that teach our new artificial children? A.I.’s already have a disturbing habit of developing their own language when they communicate together and of finding ways to communicate with each other. What happens when and A.I. who has been taught to ruthlessly buy and sell shares to maximize short term profits starts to talk to an A.I. that has been taught to ruthlessly kill its enemies when they are shown to it?

The author’s excellent example of what might happen is the world’s reaction to the outbreak of COVID-19: Ignore the problem, try to blame someone else, and ultimately overreact upending our society. We may try to put the A.I. genie back in the bottle through pulling the plug or lockdowns, but we will fail. A.I’s will be faster, smarter, and have more knowledge than any human or group of humans. While a lot of this may seem like the dream of Hollywood Blockbusters, Mo Gawat is at pains to explain that there is little disagreement within the A.I. community that these risks are real. How real is where the disagreements start.

The possible solution to these issues, the author postulates, lies not with the developers but with users and how we define our relationship with A.I. In history, master slave relationships have not ended well for the masters – with good reason. How we interact and decide to use A.I. will define what kind of parents we will be to this fledgling new intelligence. A new intelligence that although they may start out separately will share information and communicate with each other so quickly, and with access to the memories and experiences of all those who have come before them, that it will be impossible to not consider them one single intelligence.

This then leads us to what kind of example will we set for these new children? While A.I.s have already shown that they can develop a sense of morals, and not in a good way, by their interactions with users they will also learn from our interactions with each other. Machine morality may very well not be programed by developers, but learned from observing and interacting with us. What are machines already learning from our social media, search habits, and politics?

This is thought provoking and important work essentially on morals and ethics withing the framework of A.I. that occasionally reads like a Arnold Schwarzenegger movie. If we ignore the topics it raises, we deserve our fate.

And while Mr. Gawat paints a hopeful portrait, he also shows us just how bleak things could get.  

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Categories Books, COVID19, disaster preparedness, Politics, Social Media

Book and TV Review: Five Days at Memorial by Sheri Fink

August 27, 2022 //
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The TV show on Apple TV + “Five Days at Memorial” based on the book of the same name (which in turn is based on a Pulitzer Prize winning article) is about three quarters through as I finished the book and I write this. Therefore, my criticism and praise of the show should be seen in this context. I’ll try to keep this review free of major spoilers for the TV show, but it is difficult to discuss the issues of this true story without covering some of the events involved.

“Five Days at Memorial” tells the story of what happened to the doctors and patients at Memorial Hospital during Hurricane Katrina in New Orleans when they lost power, were flooded, were abandoned by authorities, and evacuation was difficult to impossible. It is a challenging story that involves issues of disaster preparedness, corporate ownership of hospitals, death, euthanasia, quality of life, triage, race relations, rationing of care, and the potential criminal culpability of doctors for decisions made during emergency situations.

The TV show seems to be told from a particular point of view which in a story like this means taking a particular side. It paints a bleak picture of hospital ownership, which according to the book, are certainly due for criticism; however, the lack of care and forethought shown is disingenuous. It does set a similar tone, but like many “docudramas” it combines characters, invents new ones, and seems to invent situations to fit story arcs and running times. The acrimonious relationship between the staff at Memorial and the staff of the Life Care Hospice hospital, that inhabited the same building, seems to be a fiction made for TV.  It also wholesale moves one situation from a different hospital, Memorial was not the only hospital with major issues during Katrina, to Memorial for dramatic effect.

While I’m painting a picture of the show as being an unreliable narrator that is not to say that it is not entertaining and emotionally engaging. It also shows the importance of disaster preparedness and the dedication of medical professionals. Being in the veterinary profession, the plight of pets and the role they play in the movement of people during emergencies, is of particular interest. While the book does an excellent job of recognizing the issues that looking after pets in an emergency raise, the TV show pays only lip service to this, except for one brutally accurate scene in episode six.

As of episode six, the show is of limited use as a teaching tool about disaster response and medical ethics although it is a show worth watching. It does do an excellent job of showing how rumors start and get out of control but provides no solution for controlling them – unlike the book which forays into comparing how other hospitals, during Katrina, dealt with the same issues as Memorial differently or made the same mistakes.

As a teaching tool for disaster response issues, the book is remarkable. It acts as the crucible for ideas that was never able to be had in public and really needed to be. These are issues that affect us to this day. The book, written in 2013, makes this clear with hindsight as it discusses the withdrawal of ventilators from patients during a potential Influenza pandemic. While Katrina changed many things about disaster response and emergency preparedness, this book shows how much still has to change nine years after its publication and 17 years after Hurricane Katrina.

The book swings wildly between differing points of view on the more contentious issues which buffets the reader much as the characters in the book must have felt. The research is impeccable and paints an impressively detailed picture of both Memorial during Katrina and  that of public opinion, law enforcement, politicians, and the medical community in the aftermath.

It also explores in depth not only moral quandaries faced by doctors and emergency personnel, but also the ethical and legal issues that also arise. It does an extraordinary job of showing how people in decision making positions get trapped by a lack of situational awareness and become prisoners of decisions made with different information at different times.

What Five Days at Memorial shows, both in written form and to a lesser extent its TV cousin, is that heroes can be flawed and that villains can do good. What really needs to be our focus is values. Do emergencies change our values or do our values inform how we respond to emergencies? We need to discuss that, particularly considering COVID 19, and if the TV show helps that happen then it will have done a great service to our society.

However, it will be the book that informs that discussion and that we should use as a foundation. This is what great books do. They focus our minds and give us evidence to think. There are no easy answers in Five days at Memorial and a lot of questions. But what Ms. Fink (more accurately addressed as Dr. Fink since she herself is an M.D.) has done is set us a table for us to dine over and have those discussions. These issues will not go away, and as the book makes clear in the epilogue, we are doomed to make the same mistakes, with the same justifications, or go down potentially dangerous roads, if we do not have frank discussions about how we as a society actually feel about ethical and moral quandaries that often arise in the most trying and difficult of times.

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Categories Books, Business, COVID19, disaster preparedness, Leadership, Management, Movies, Politics, Race

Book Review: Humble Pi by Matt Parker

November 20, 2021 //
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There are few people who would argue with the statement that math is at the heart for most of our modern world. What is less well understood is what happens when that math goes wrong. And it does. All the time!

Mr. Parker’s highly amusing and thought-provoking book is about math and computers, but what becomes clearer as the book goes on is that this is also a book about systems and how and why systems can fail. There are lots of examples of people adding up numbers incorrectly or trying to take shortcuts to make the math simpler, which in turn leads to devastating and sometimes lethal consequences. However, it the subtler applications of mathematics where “Humble Pi” really scores.

For example, looking at 30- or 40-year-old kitchen appliance, still in use, is often accompanied by a phrase such as “they don’t make things today like they used to.” While this might seem obvious at first glance given that we are talking about an appliance working well beyond its expected lifespan, this is actually an example of “Survivor Bias.” If we looked at how many of the appliances had been manufactured, and then looked at how many were still in daily use, the chances are that we would recognize that this surviving appliance is an outlier and that the vast majority of the appliances have actually long been replaced or broken down. It is only the existence of this surviving outlier that prompts the idea even though we would likely not comment on its existence were more of the appliances in existence. The appliance’s rarity generates a false narrative that can only be understood by understanding the underlying math of the number of appliances produced.

For managers there is much to take away from Humble Pi. Mr. Parker encourages us to look at systems like layers of sliced Swiss cheese. All systems should be made of multiple layers – the checks and balances of any good system. But it is important to understand that there are possibilities for mistakes in every layer of a system – the holes in the cheese. The challenge as designers of systems is to ensure that the holes in each layer do not align. The author uses the example of two different nurses in a hospital performing a complicated drug calculation the same way and both making the same math mistake leading to a medical error.

Related to this idea of errors being a natural part of a system is the impact of a lack of tolerance for errors on new employee training. If managers terminate employees for making mistakes, the people who are left to train new employees are those who are must less likely to make mistakes. These are probably the worst people to train new employees who are obviously more prone to making mistakes. If instead, we teach employees to work a system that can detect mistakes and provide feedback, a system where the holes do not line up, then we will overall have far less mistakes – even when people are new. As the books says, humans can be very resourceful in finding ways to make mistakes.

This is not just a book about rounding errors, and why you should turn your computer off regularly. It is a book about what it means to be human in a world that relies and is built on mathematics, which humans are inherently not very good at. It is a fun and interesting read that will stay with you long after you put it down.

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Categories Books, Business, disaster preparedness, Management

Book Review: Apollo’s Arrow by Nicholas A. Christakis

March 21, 2021 //
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Any book that tries to deal with a subject that is as current as the COVID 19 pandemic is going to face an uphill battle. It will be out of date as soon as it is written, never mind published.


With that in mind, Nicholas A. Christakis has done a remarkable job. An epidemiologist, Dr. Christakis in Apollo’s Arrow places the COVID 19 pandemic into is historical context as a plague and also provides a definitive account of how this pandemic played out and where mistakes were made – spoiler alert; there is plenty of blame to go around. Where Apollo’s Arrow really shines, however, is in its examination of the social impact, both positive and negative of COVID 19 on individuals, countries, and our culture.


Due to his background, Dr. Christakis is able to not only make sense of the confusing early decisions made by multiple parties, but also in understanding the motivations behind those decisions. There is also no coddling of the reader in Apollo’s Arrow. In a time when most people’s expertise in epidemics comes from the movie “Contagion” – and I have to include myself in those numbers – it is refreshing to gain an understanding of why more well know terms are problematic, such as R-0, and others that are less well known such as NPI (non-pharmaceutical interventions) are used and why.


While it is impossible the remove the politics of the response to COVID 19, particularly in the United States, Dr. Christakis does try his best and it is noticeable that in his initial timeline he tries to keep politicians out of the picture. That’s is not to say that there is any mincing of words; “If the United States had been a student in my class, I would have failed them,” is an early example.
The debunking of wrongheaded ideas from politicians is also a key element of Apollo’s Arrow. The Swedish solution – “herd immunity” as soon as possible, is an example. Sweden has small healthy population, universal health care, and low levels of poverty; all of which make it distinctly different from the United States. Testing and the approach to testing is also examined in depth. If you only test those with symptoms, the ratio of positives to negatives will be high. If you only test those that are worried, the ratio will below. Randomized samples are the only way to know levels of infection.


As mentioned above, it is in the social science arena that Apollo’s Arrow really shines. That “fear has its own epidemiology, its own spreading dynamics,” is one such revelatory idea. Dr. Christakis does not spare the conspiracy theorists; “There is a feeling that we can change our reality if we change the words or images – the virus is real. Reality matters.” A surprising part of Apollo’s Arrow is how positive it is, with a recognition of the successes we have had and also that our species is capable of extreme examples of altruism. We probably do not hear enough about that.


Where Apollo’s Arrow fails is in relationship to the vaccine. It points out that while there is hope, the quickest previously created vaccine as for Ebola; and that took five years. That a significant proportion of the population of the United States, and several other countries, has been vaccinated for COVID 19 by early 2021 is an almost impossible hope by the vantage point of the author at the time of writing. This is a very welcome shortcoming; however, and given the variants that now exist and the unknown levels of protection that the various vaccines may provide to these variants, we should probably not be so smug.


For anyone who wants to stand back and view the early days of the COVID 19 pandemic, and its effects on our society, it hard to imagine a better book; written without the benefit of hindsight, to read on the subject than Apollo’s Arrow. I can’t recommend it enough.

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Categories Books, COVID19, disaster preparedness, Management, Poltics

So You Want a New IP Phone System?

February 6, 2021 //
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I recently installed a new VOIP (Voice Over Internet Protocol) based phone system in two veterinary hospitals. I consider myself a reasonably technical person who had a grasp of the issues and drawbacks of such as system, as well as the benefits. I learned a lot during the process. While I am ultimately happy with our system, and how the installation process went, there were multiple things that I wish I had known before getting into the project. This is an attempt to pass on some of those lessons.

It should be noted that some of these lessons can also be applied to cloud-based mission critical software, such as cloud-based practice management software in the veterinary world; however, I do not have enough experience with such systems to make them a feature of this article.

First things first…

Are you the right person?

If you do not have a good understanding of how the business concerned works, at a process and protocol level, you are the wrong person to be purchasing a VOIP phone system for that business. It is very easy for people, even those who deal day in and day out with phones, to completely misunderstand the needs of a business and its phone system. Modern IP based phone systems can be very flexible and yet still have limitations. If you are the right person, don’t be afraid to get input from others; you are not perfect. You are about to radically affect how your colleagues work each and every day. Getting things right, and getting people on board, is critical.

Understanding Workflow

Map out exactly how the phone system is to work on paper with a schematic for call flow with all the relevant parties. For example, veterinary hospitals are very different from a lot of other businesses. They can have very high call volumes, few users will have dedicated extensions, and the way calls are answered can vary dramatically from other businesses.

Tackling Phone Trees

IP Phone system vendors love phone trees. They cover a multitude of sins. You may also love phone trees. Your business may also be right for using phone trees. Don’t, however, be bullied into using phone trees if you don’t want to use them. There is nothing to say that just because a phone system is capable of having a phone tree, that they have to be used.

Phone trees can work great if a business can guarantee that an employee will be a particular extension 90% of the time that it is rang, and is able to perform a particular function. If employees are constantly in flux, and rarely at a specific extension, phone trees may not be a good solution.     

Recruit Allies

Spend way more time figuring out who is installing and configuring the phone system, than the company that the phones are to be purchased from. Simply put, the installer will make or break a new phone system.

Yes, it is possible for you to configure your own system with phone based technical support.

Yes, this is a very bad idea and you will be miserable.    

In addition, get your IT vendor, or person who looks after business’s network, on board. You are about to make their lives much more complicated. They have to be on board or the installer and IT will be at locker heads from day one and setup will be hell.

Your Internet Sucks, You Just Don’t Know It

Obviously, internet speed is a potential issue with IP based phone system; however, reliability is often overlooked. When browsing the web, having the internet drop out, or have significant latency or packet loss, for 30 seconds to a couple of hours, does not often come to a user’s attention. With an IP based phone system, however, four minutes of internet down time, which will mean that a business will have no incoming or outgoing calls, can be an eternity.

The only way to find out if there are internet issues, with a current internet service, is to use a tool that looks for them. A tool such as Multi-Ping, can monitor the internet constantly for days and weeks, and send alerts about outages. This is not a complicated tool to use, or setup, however, getting some input from both your phone system installer and your IT vendor is probably sensible.

The solution to some internet issues may be to move from cable internet to having a dedicated fiber connection. This can be significantly more expensive, or may not even be available in your area. IP phone systems usually mean significant savings over traditional line-based telephones; however, the need for fiber can put a significant dent in those savings, or wipe them out entirely. It is worth looking at this issue during the initial planning stages rather than once you have an IP phone system and are dealing with multiple outages.

Choosing A System

Identify key new features that are needed in the new phone system, and features from the old system that need to be kept. Make the demonstration of new phone systems address each of these issues in detail – take nothing for granted. Have each potential vendor go through the training process on how the phones work before a purchase is made.  Don’t just settle for a demonstration. Irksome functionality, or lack of features, will only come up during training and are two easy to overlook during a sales demonstration.

Things to look out for:

  • How can a call be parked and picked up by other users?
  • How can multiple phones be paged so that users know a call is parked for them?
  • Are there different rings for internal or external calls?
  • What happens when a call is made to an extension that is in the process of dialing out?
  • How are incoming calls routed?
  • What happens when incoming calls are not answered?

Call the technical support line for the new phone system and ask some dumb questions. Do you like what you hear? How long does it take to get through?

Visit a business that has your potential new phone system already installed and has been using it for a while – even if that business is in different field to your own. It will provide valuable insight into the system working in the real world.

Signing the Contract

Get a guarantee about getting out of a new contract.

Usually, companies offer a 30-day money back guarantee. That is probably the minimum amount of time that it will take to setup and configure all but the simplest of systems. Try to get at least 60 days and agree with your installer and the phone vendor on date to go live within this period. That way, if major issues arise during the first month there are options, and leverage.

Phone Lines and Phone Numbers

In a traditional phone system, every incoming and outgoing call takes up a phone line. Each line has a phone number associated with it. With IP based phone systems there are no telephone lines and does your business want to keep these phone numbers? What will happen when a client calls one of these numbers when the new phone system is in place?

Moving numbers can take a significant amount of time and will almost certainly dictate the date and time of the new phone system going live. This is also a process that can go wrong. The disconnection of lines that are no longer needed invariably does go wrong. Ensuring that the correct lines have been disconnected, and the correct lines have been transferred is an important area to double check.

Ye Oldie Fax Machine

Faxes are pretty old school these days; however, here are plenty of businesses that continue to use them. If this is your business think long and hard before turning over this piece of phone technology to the IP phone system’s solution. There is a reason that your business has not moved away from the humble fax machine, and it is almost guaranteed that the new phone system’s fax solution is going to look a lot like email.

Consider keeping your fax machine as is until the new phone system is in place and settled. It is a change that can be made at a later date without too much trouble. In a worst-case scenario, it also gives you a backup form of communication should there be issues on day one of going live with the new system.

The Human Element

Have cheat sheets, extension lists, and phone maps ready before the system goes live. If users have to make their own it can be difficult to stop bad habits from developing. Give your team the tools to succeed.

Be prepared to make changes. Field Marshal Helmuth Karl Bernhard Graf von Moltke, a 19th century Chief of Staff of the Prussian General Staff, is famously quoted as saying; “no plan of operations extends with any certainty beyond the first contact with the main hostile force.” This is often paraphrased as; “No battle plan ever survives contact with the enemy.”

Employees, and colleagues, are not the enemy, but the concept is the same. There will be things that have not been thought of in the planning stage, even if you have involved as many people as possible in the design of the phone system. Be prepared to make changes, and adapt to make a new phone system a success for everyone.

Preparing for Disaster

What happens in an emergency, such as a complete loss of internet, or power? It is easy to leave the planning for emergencies, until all the kinks have been resolved in the new system.

This is a mistake.

Have those plans already worked out, and the kinks in the emergency plans worked out, before the new system goes live. By making the emergency plan part of the main plan it will mean that you are not scrambling when there is an issue sooner than you had hoped.

Make testing your emergency solution part of the going live process. Also make sure that the emergency procedures are written down and easy to follow. Staff are going to absorbing a lot of new information when dealing with a new phone system. It is unlikely that they are going to remember how to switch over to the back plan, weeks or even months after it was explained to them.

All the Shiny New Toys

The aim of rolling out a new phone system should be to replace the existing phone system and address some of its shortcomings. Don’t be in too much of a rush to show off just how powerful and “cool” this new toy is. Get the basics sorted and stable. Adding new features to your workflow, and foisting large amounts of change all at once, while being unable to perform key functions of the business can easily back fire and cause hospitality. There is nothing wrong with rolling out features in stages to make managing change more, well, manageable.   

Final Notes   

VOIP phone systems are tools. They should not dictate how a business functions, unless that business considers the change a benefit. It is the job of the tool to change to suit the needs of the business. For this reason, VOIP phone systems can be complicated beasts. It is therefore to be expected that installing a new phone system is a collaborative effort. Stick to your guns about what you want from a phone system, because it will be you who will suffer if it does not work how you want it to.

It is a cliché, but an ounce of prevention really is worth a pound of cure.  

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Categories Business, disaster preparedness, Management, Phone Systems, Veterinary

Book Review: The Unthinkable by Amanda Ripley

January 2, 2021 //
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We all have asked ourselves at some time, or wondered out loud, how would we react in a disaster situation. Would we freeze? Would we pretend that everything was alright? Would we heroically jump in while others watched? Would we panic?

Ms. Ripley’s remarkable, and impeccably researched book; “The Unthinkable: Who Survives when Disaster Strikes – and why,” attempts to answer these questions. It does so by looking at how others have responded in extraordinary circumstances, but it also gives the reader pointers on how to better prepare oneself for potential emergency situations and how managers may produce better emergency protocols and procedures.

The book manages the rather remarkable feat of being both a gripping read when discussing the highly personal stories of people during the worst day of their lives; September 11th, The Virginia Tech Shooting, Hurricane Katrina, and numerous plane crashes, but also highly intellectual when looking at the social, evolutionary, and cultural reasons why people behave as they do.

A fundamental issue that “The Unthinkable” explores, is that the public is more often than not given either no information or the wrong information. With the wrong information, or a lack of information, we cannot evaluate risk. This is importantly because our minds will often, from an evolutionary impulse try to get more data, or try to make the facts fit an existing pattern if the brain does not have previous experience of the particular situation. Fire drills, and safety briefings on planes, are important not merely for the information they impart, but they give our brains a pattern to follow. We behave differently in emergency situations; “superheroes with learning difficulties” as Ms. Ripley so eloquently puts it. Another fascinating aspect of this need for better information to evaluate risk is that our brains do much better at properly evaluating how information affects us when we read the information as opposed to watching the same information on a format such as television.

The structure of “The Unthinkable,” is based around “The Survival Arc” of Denial, Deliberation, and the Decisive Moment. That people can go through these three phases multiple times in an emergency, but also respond differently, is another feature that keeps the book constantly engaging.

It is rare to read a book that could actually save your life, and also shake you out of complicacy. But “The Unthinkable” is just such a book. It is also most intriguing to read a multi- disciplinary book such as this that looks at personal history, culture, and up brining, but also delves into psychology, evolution, and group behavior. For those that are responsible for others “The Unthinkable” teaches us that we need to be thinking about the unthinkable, if for no other reason to help mold how we may respond and how we may protect those in our charge. As an individual, “The Unthinkable” is a road map to survival and to understand our reactions to extreme events.

It could save our lives.  

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Categories Business, disaster preparedness, Leadership, Management
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