Your Design Matters: The Gift of Hearing

Those of you who know me personally know that I’m half deaf. It’s not really a source of embarrassment or even significant difficulty. Often, it’s quite hilarious. (Jokes involving  ”can you hear me now?” verizon commercials, or what’s been designated the “Tim move” wherein I move you to my right side so I can hear you.) But it’s often easy to forget how powerful the gift of a sense can be.

Any product you interact with, whether an addictive “I should be working” website or a simple can opener, caters to your senses. Meaning, someone on the other end of your use as the consumer had to intelligently design and be considerate of your specific needs. I used to think product design was easy; as consumers it’s easy to be critical. It’s probably the hardest part of my job so far. Once you’ve doven into your project, you no longer can view it objectively.

Well this post is about one simple feature and consideration Apple made and just how powerful such a feature can be.

I usually only listen with one headphone in, since only one ear works well anyways. When I went to adjust the sound settings on my mac, one of the prominent settings is the left-right pan. Maybe PC’s have this too, or maybe there’s an external app that might let me control how much volume goes into each ear, but it was one of the few settings I could change in the mac sound settings — I couldn’t not notice it.

So I decided to jack up the volume into my left (deaf) ear as loud as it could go. And while my hearing is nearly non-existent in that ear, the volume was high enough that it vibrated the bones in my ear, bypassing my defective ear canal. In short, I could hear. (To preempt suggestion for hearing-aids, they don’t work well for my type of hearing loss. I’ve tried.)

I began panning back and forth between left and right and for one of the first times in my life, I felt I had directional sense (this is what you lose when you only have one good ear), a taste of what hearing what two ears must be like. The emotional response was unexpected, but how odd it must have looked to see someone tearing up with near giddiness at the joy of a pan function.

Now this is definitely an extreme case, but I share it to illustrate a single point. Your design matters.

The biological clock & the higher education bubble.

I had dinner with a friend tonight, and we touched on a topic that now reaches any young professional in their mid-twenties. When the heck am I supposed to start a family?

As the world got smarter, jobs began to specialize. And while the amount of total training required for these new jobs wasn’t strictly additive, it did require some extra time to become a specialist. No longer was anyone a renaissance man. Then, these additional years of education continued to increase until the point where becoming a sub-specialist in a field, say medicine, meant being in school past your thirties. I mention medicine as a example only because it is the field with which I’m most acquainted, but it applies in most others as well. (Just substitute medical school and residency with ‘corporate ladder’). There’s this idea that we must suffer before reaching long-term success that is at least partially true, but the period of suffering seems to get longer and longer without reason.

Enter a room full of medical students listening to a reproduction lecture where we’re told that the age at which the risk for embryo testing a child for genetic conditions is worth it is at age 35. Put another way, the chances of genetic defects before age 35 were too low to warrant an invasive procedure that could potentially destroy the embryo. What the females in the class heard was “your biological clock is ticking.” Ready, set, go. While less daunting for men, the race against the biological clock is equally present.

There’s no longer much time to start a family. Higher education is in the way.

I agree with Peter Thiel when he says that we’re in a higher education bubble, though my opinions differ in solution. His argument is to bypass higher education altogether and push students into start-up world. Don’t get me wrong, I love what he’s doing. But there is much value in a structured educational setting beyond high school that complete avoidance of the academic world would miss. It’s forced horizon-broadening that results in life experience. So rather than cut out higher education altogether, we need to cut out the inefficiencies.

Part of my specialization argument above is flawed. My friend at dinner discussed the first years of law school while I discussed the first years of medical school. Our conclusions were the same. Top tier schools will continue to be top tier schools simply because of the school’s name; they’ll always draw the strongest applicants. Companies will continue to hire from these schools and the process will repeat. Notice something? Once the cycle is self-sustaining, the emphasis on the quality of education is left behind. (disclaimer: I go to Penn Med specifically b/c they do a great job of fighting this trend). Many researchers come in and gladly spout off an hour-long lecture, but the problem is in their title; they’re researchers, not teachers. Our conclusion from dinner was that students spend a large amount of time learning extremely low-yield information and are tested on things that matter much less in the field. It’s an inefficient learning process.

College is no exception to these rules. Certain institutions ( I’m including the undergraduate program at Penn in this one ) pressure their students so intensely that again, an emphasis on quality is lost. Learning for the sake of learning disappeared.

Now I think we can solve both the problem of the biological clock and the devaluation of higher education simply not being afraid of breaking existing educational norms. Does medical school need to be four years? To a new student, does testing them on the current research yield any long-term benefit? It’s what we in the start-up world call disruption.

If an active approach isn’t take, time allocated towards family and life will continually be stripped away to a point where things will forcibly change. Hopefully it’ll happen before we’re that desperate.

Medical School vs Doing a Start-up

People often ask whether I’ll be returning to medical school, whether he/she should pursue medical school or go do XYZ, or how I decided to take a extended leave-of-absence to start Meddik. It’s funny, though. The mind behind those questions is hoping for a definite, concrete answer, for me to say “yes, you should do… ” or “no, this doesn’t seem right for you.”

It’s never that easy. But I can at least share with you my decision process. And unfortunately, it’s a bit of a long-winded rant.

The knowledge I constantly search for I dub “eternal or lasting knowledge”. In short, I want the highest value for what I’m learning — the biggest bang for my buck (which in this case, is time). Things that immediately jump out at me: math, a universal skill that transcends spoken languages; music, a subjective expression of emotion via sound than somehow exists in all cultures; learning languages, a way to constantly prove to yourself that you’re limited by your own tongues and effectively a way of rewiring your own brain (there are things in every language that cannot be translated into any other); and lastly (though there are many more), health. As long as we haven’t reached the singularity, we will still be dependent on our flesh and blood.

It is in this latter subject that I chose to place my career, largely because it’s the field in the poorest shape. Millenia later and we still don’t understand a majority of the human body. There are still conditions we can do little about, and symptoms that boggle us at every turn. And even for the few (but amazing) innovations that do exist, we fail so magnificently at distributing these solutions on a global scale that their effectiveness is a minute fraction of the potential benefit. We’re consistently stymied by government policies and backward cultures (*cough* our own) that hinder our own innovation. Hence, I dive in.

From here, I knew I needed a solid education. I knew that in order to fix the problem I had to study it. Get a taste of what it meant to be a physician and gain some basic knowledge about the human body. Now while I’m still far from that minor goal, I haven’t forgotten it — I do hope to return to medical school one day.

After my second year, I was presented, or observed rather, with an immediate opportunity to add towards the movement of fixing the largest problem that exists in healthcare today — communication. We’ve yet to leverage the internet as well as could and still use old-fashioned solutions to solve obvious problems that have faster and better analog fixes in every other industry. My decision was simple. My goal in entering medicine was to use my skills and abilities to best serve as many people as I can as effectively as I can. In a different time, this meant being a practicing physician. With the skill set and interests I’ve been given, this meant starting a company.

Now my journey is far from finished. Hell, I’ve barely started. But that vision is still on the horizon. The same vision that pumps me up everyday is no different than the one that got me up for class in medical school. So I’m happy to offer my thoughts on your personal decisions, but at the end of the day, do what fulfills your goals and no one else’s. Use your gifts and talents to best accomplish what you set out to by becoming a physician. Again, for me, this means doing a start-up.

(Though the penchant for not sleeping and love of technology also help)

Gamification and Social Media in Health

So on its face, gamification and the integration of social media and healthcare seems like a phenomenal opportunity for preventative care. But from what I’ve seen (anecdotally and in epidemiological studies) is that there’s a demographic mismatch. By and large, though this statistic is gradually changing, the subset of people who use and know how to use smartphones and more complex UI web apps tend to also be healthier. These are people who are already conscientious about their health. But the average hospital patient is of a lower socioeconomic status, often without medical insurance, and it is that group that waits til the last minute until coming to see a physician due to fear of costs. And it is that group that then requires expensive procedures and surgeries.

Not to say that there isn’t gradient of tech-savvy-ness or that the statistics aren’t gradually changing, but I feel as though we have a huge number of start-ups and companies targeting a disproportionate fraction of the patient population. Just look at the socioeconomic spread of the obesity epidemic. Those who need the most medical attention rarely carry around iPads.

The true innovations that stick in this next episode will be low-tech, wider-reach ideas, while we wait for health tech catch up. Recall, one of the biggest (if not the biggest) game changer in nosocomial diseases were those Purell stations — simple, but effective.

It’s hard to accept, but if you want to have a wide patient-side reach in healthcare, it is often necessary to revert a few years back in technology. Not to say that these wellness apps aren’t fantastic — they are — but the world might not be ready quite yet to handle them all.

[note: of course an exception to this entire argument are within niche diseases that are truly environment independent w/o socioeconomic disparities]