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	<title>Ed's Book List</title>
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	<description>Things I am Reading</description>
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		<title>Ed's Book List</title>
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		<title>improv, inside and out</title>
		<link>http://melendezreads.wordpress.com/2009/02/17/improv-inside-and-out/</link>
		<comments>http://melendezreads.wordpress.com/2009/02/17/improv-inside-and-out/#comments</comments>
		<pubDate>Tue, 17 Feb 2009 03:15:33 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[improv]]></category>

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		<description><![CDATA[      Mick Napier seems like an interesting guy.  He&#8217;s a bad-ass improviser and no-nonsense kind of artist.  I can&#8217;t imagine him as a teacher, though.  When you read the prose in Improvise: Scene from the Inside Out, he seems like he would be pretty impatient unless you were a talented and imaginative performer [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=25&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
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<p style="text-align:center;"><img class="size-medium wp-image-29 aligncenter" title="021520096211" src="http://melendezreads.files.wordpress.com/2009/02/021520096211.jpg?w=300&#038;h=225" alt="pic of coffee and a notebook, unrelated to text" width="300" height="225" /></p>
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<p class="MsoNormal">Mick Napier seems like an interesting guy.<span>  </span>He&#8217;s a bad-ass improviser and no-nonsense kind of artist.<span>  </span>I can&#8217;t imagine him as a teacher, though.<span>  </span>When you read the prose in <em><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=032500630X" target="_self">Improvise: Scene from the Inside Out</a></em>, he seems like he would be pretty impatient unless you were a talented and imaginative performer before you darkened his door.<span>  </span>His book almost seems like a preemptive strike, as in read this before you show up to his class.<span>  </span>Fix a few things and then maybe I can teach you something.<span>  </span></p>
<p class="MsoNormal">Napier&#8217;s book reads like an intermediate improviser&#8217;s &#8220;how to&#8221; manual. <span> </span>You have already learned how to accept other&#8217;s offers, to &#8220;yes and.&#8221;<span>  </span>You have learned the basic tools: scene starts, characters and who-what-where.<span>  </span>Now, you have to learn how to work with those tools to make something that people will actually want to watch.<span>  </span></p>
<p class="MsoNormal">While his advice is sometimes tough, it&#8217;s also practical and pragmatic.<span>  </span>I especially like the exercises you can do alone, because I simply don&#8217;t have the time to do as much improv practice as I&#8217;d like.<span>  </span>I wish I could attend more jams, workshops and practice, but I&#8217;m always balancing that with work, side projects and a family.<span>  </span>I keep reading this book in different ways.<span>  </span>Only now am I reading it in a traditional sense, from front to back.<span>  </span>The first time I read it, I read those chapters which seemed most relevant to me and my needs, and then I read the exercises in the back as a way to practice whenever I had a few moments alone.</p>
<p class="MsoNormal">This book is turning out to be one of my favorite improv guides.<span>  </span>It’s well worn and contemplated because it’s one of the few books I’ve read on the subject that really delves deeply into the challenges of creating fresh, interesting and (gasp) funny material.<span>    </span>But it also helps you remember to take chances and get away from self-judging, which my guess is one of the biggest challenges to performers.<span>  </span>It is certainly my biggest challenge.<span>  </span></p>
<p class="MsoNormal">Buy <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=032500630X" target="_self">Improvise: Scene from the Inside Out</a> from your locally owned bookseller. </p>
<p class="MsoNormal"> </p>
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			<media:title type="html">emelendez</media:title>
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		<title>&#8220;easily accessible, yet profoundly complex&#8221;</title>
		<link>http://melendezreads.wordpress.com/2008/07/27/easily-accessible-yet-profoundly-complex/</link>
		<comments>http://melendezreads.wordpress.com/2008/07/27/easily-accessible-yet-profoundly-complex/#comments</comments>
		<pubDate>Sun, 27 Jul 2008 17:12:32 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=20</guid>
		<description><![CDATA[Haruki Murakami is one of the few writers whose fiction I follow without fail in the New Yorker. Sputnik Sweetheart has all his signature themes: being Japanese in a globalized world, ennui and unfulfilled love. Buy Sputnik Sweetheart locally.<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=20&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p style="text-align:center;"><a href="http://picasaweb.google.com/emelendez/AlbuquerqueAustinAndNewBraunfels/photo#5020698684057464194"><img class="aligncenter" src="http://lh4.ggpht.com/emelendez/Ra0a2jOELYI/AAAAAAAAAFc/DvutXPUGp-I/s400/IMG0030.JPG" alt="" /></a></p>
<p><a href="http://en.wikipedia.org/wiki/Haruki_Murakami">Haruki Murakami</a> is one of the few writers whose fiction I follow without fail in the <em>New Yorker. </em><em><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0375726055" target="_blank">Sputnik Sweetheart</a></em> has all his signature themes: being Japanese in a globalized world, ennui and unfulfilled love.</p>
<p>Buy <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0375726055"><em>Sputnik Sweetheart</em></a> locally.</p>
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			<media:title type="html">emelendez</media:title>
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		<item>
		<title>improvise this!</title>
		<link>http://melendezreads.wordpress.com/2008/07/27/improvise-this/</link>
		<comments>http://melendezreads.wordpress.com/2008/07/27/improvise-this/#comments</comments>
		<pubDate>Sun, 27 Jul 2008 16:53:29 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[communication]]></category>
		<category><![CDATA[mindfulness]]></category>
		<category><![CDATA[impro johnstone]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=14</guid>
		<description><![CDATA[I never realized how strong my anxiety about public speaking was until I attended an improv workshop while in business school.  While I think I&#8217;m a perfectly adequate speaker and presenter, I&#8217;ve always struggled with making real connections with audiences, not simply convincing them of an argument.  By removing some of my emotion and presenting [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=14&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<div class="wp-caption aligncenter" style="width: 510px"><a href="http://farm4.static.flickr.com/3288/2703223537_caef569a1b.jpg"><img src="http://farm4.static.flickr.com/3288/2703223537_caef569a1b.jpg" alt="Santiago, assessing a chalk outline of a tree." width="500" height="375" /></a><p class="wp-caption-text">Santiago, assessing a chalk outline of a tree.</p></div>
<p>I never realized how strong my anxiety about public speaking was until I attended an improv workshop while in business school.  While I think I&#8217;m a perfectly adequate speaker and presenter, I&#8217;ve always struggled with making real connections with audiences, not simply convincing them of an argument.  By removing some of my emotion and presenting rational, well-prepared statements, I was able to do what I had to in a presentation, but I never really felt able to connect to an audience, much less inspire them to act.  In the improv workshop, our facilitators, a couple of improv luminaries, led the group in a series of exercises intended to short-circuit our best efforts to prepare for what we were going to say.  I hated it.  It made me anxious and made me feel actually less confident of my ability to present.  I wrote it off as one of the many challenging tasks I faced in business school, the ones in which I was weakest and hopefully would never have to face again after I demonstrated basic competence.  But after graduation, I ended up having to do more public speaking than ever and having to do it with less and less preparation time than ever.  I didn&#8217;t help matters by procrastinating my prep time until the absolute last moment.  Worst of all, a whole host of competing egos that I encountered continually knocked me off balance, intentionally or not.  So, I decided some type of acting training could at least help me fake being comfortable with all the chaos that I sensed prevented me from reaching my full potential.   The method acting class was at an inconvenient time, so I signed up for improv instead.</p>
<p>It took a month for me to stop faking disinterest, another tried and true method of self-protection.  Then, the challenge was simply staying focused during the three hour sessions following a typically stressful work day.  But when I stayed focused, the strangest thing started happening afterward.  My concentration lingered and I felt more connected to the world around me.  At the risk of sounding too mystical, there was a sharpness of focus to my mind that don&#8217;t remember experiencing so strongly.  I started to be more interested in the exercises and enjoying the weird high following class.  But I still sucked at improv.  So I repeated the basic class again.   I&#8217;m still struggling with it, I&#8217;m still stuck on a plateau after many many classes.  But I like the feeling and the high stays longer.</p>
<p>Keith <span class="misspell">Johnstone</span> is apparently the guru of improv.  I actually know very little about the whole subculture of improv, which I hear is robust in Austin.  I watch very little of it, mostly due to the incompatibility of hours and subject matter to the life of my 3.5 year old son.  But I am told <em><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0878301178" target="_blank"><span class="misspell">Impro</span>: Improvisation and the Theatre</a> </em>is the bible of improvisation.  Most interestingly, <span class="misspell">Johnstone</span> talks quite a bit about the altering of consciousness that improvisational exercises can effect.  He also explains the origins of some of the &#8220;standard&#8221; games.  I strongly recommend reading the book after you&#8217;ve studied improv for some time.  It helps connect the dots retrospectively.  It may actually confuse you if you read it before you practice.  The whole section on masks alternates between intriguing me and creeping me out.  But between a series of patient teachers and tons of practice, I&#8217;ve gotten myself to enjoy the progressively more challenging games, but I&#8217;m still a pretty miserable improviser.  I&#8217;ll be on this plateau for long, long time.</p>
<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0878301178">Buy <em>Impro: Improvisation and The Theatre</em> at your favorite local bookstore.</a></p>
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			<media:title type="html">emelendez</media:title>
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			<media:title type="html">Santiago, assessing a chalk outline of a tree.</media:title>
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		<title>what are you doing right now?</title>
		<link>http://melendezreads.wordpress.com/2008/07/06/what-are-you-doing-right-now/</link>
		<comments>http://melendezreads.wordpress.com/2008/07/06/what-are-you-doing-right-now/#comments</comments>
		<pubDate>Sun, 06 Jul 2008 19:16:30 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[business]]></category>
		<category><![CDATA[careers]]></category>
		<category><![CDATA[communication]]></category>
		<category><![CDATA[mindfulness]]></category>
		<category><![CDATA[Csikszentmihaly]]></category>
		<category><![CDATA[flow]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=13</guid>
		<description><![CDATA[In the Life of Meaning course at Acton, one of the questions you are to ask yourself is &#8220;what activities so absorb your consciousness so as to cause you to lose all track of time?&#8221;  If you can identify those items, you&#8217;re halfway to figuring out what you should be doing with your life.  That&#8217;s [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=13&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
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<p>In the <a href="http://actonmba.org/program_curriculum.php#life_meaning" target="_self">Life of Meaning</a> course at <a href="http://actonmba.org/" target="_self">Acton</a>, one of the questions you are to ask yourself is &#8220;what activities so absorb your consciousness so as to cause you to lose all track of time?&#8221;  If you can identify those items, you&#8217;re halfway to figuring out what you should be doing with your life.  That&#8217;s the idea touched on in popular career guides as well.  Part social science, part generalist observation on the modern world and part layman&#8217;s philosophical text, Mihaly Csikszentmihaly&#8217;s <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0060920432" target="_self">Flow</a> is a spot on primer for understanding all the ways humans attain higher levels of consciousness, with techniques like yoga and meditation only a small sample of the possibilities.  Great stuff to think about as you try to figure out what you should be doing with your life &#8211; and it&#8217;s probably not simply laying on your back on  a beach with a beer in your hand, either.</p>
<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0060920432" target="_self">you could buy this book at a locally owned bookstore by clicking here</a></p>
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			<media:title type="html">emelendez</media:title>
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		<title>i dream of bunko</title>
		<link>http://melendezreads.wordpress.com/2008/06/21/i-dream-of-bunko/</link>
		<comments>http://melendezreads.wordpress.com/2008/06/21/i-dream-of-bunko/#comments</comments>
		<pubDate>Sat, 21 Jun 2008 20:13:21 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[business]]></category>
		<category><![CDATA[careers]]></category>
		<category><![CDATA[I Dream of Jeannie]]></category>
		<category><![CDATA[Johnny Bunko]]></category>
		<category><![CDATA[manga]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=11</guid>
		<description><![CDATA[Back in business school all of a year or so ago, I remember reading a class note discussing the approaches of various time management systems. The basic message was this: there are various methods of managing your time, each with their own relative strengths and weaknesses, but these differences are ultimately minor. What is important, [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=11&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p style="text-align:center;"><a title="jeannie by Edward Melendez, on Flickr" href="http://www.flickr.com/photos/edward-melendez/2598721574/"><img class="aligncenter" src="http://farm4.static.flickr.com/3268/2598721574_42f433bedd_o.jpg" alt="jeannie" width="398" height="316" /></a></p>
<p style="text-align:left;">Back in business school all of a year or so ago, I remember reading a class note discussing the approaches of various time management systems.  The basic message was this: there are various methods of managing your time, each with their own relative strengths and weaknesses, but these differences are ultimately minor.  What is important, though was having the discipline and constancy to actually enact and diligently apply the system you chose.  That note pretty much broke me of my habit of looking for the perfect personal organization/time management book or gadget.  No one trick or gizmo was going to change my behavior, only I was going to.</p>
<p>So I didn&#8217;t find it too terribly presumptuous when I read the subtitle of Daniel Pink&#8217;s <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1594482918" target="_blank">The Adventures of Johnny Bunko, The Last Career Guide You&#8217;ll Ever Need</a>, and after reading it, I agree.  It looks like I have now broken the addiction of seeking the perfect approach to my career as well.  Dan Pink first got on my radar with <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0446678791" target="_blank">Free Agent Nation</a> and <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1594481717" target="_blank">A Whole New Mind</a>.  <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0446678791" target="_blank">Free Agent Nation</a> was one of the first mainstream analyses of the way work changed with a knowledge based economy and the end of linear career paths, especially those dominated by lifetime careers with a large, paternal employer.  While both were definitely sustainers for my own fractal career path, <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1594481717" target="_blank">A Whole New Mind</a> really cemented the concept that the synthesis of both right brain (creative) and left brain (rational) thinking was the real differentiator in success and innovation. Besides, he used to be Al Gore&#8217;s speech writer when he was Vice President.  That gives him super wonk credentials in my book.</p>
<p>Johnny Bunko is its own synthesis of right and left brain thinking.  Drawn in Japanese manga format by young hotshot <a href="http://theanimeblog.com/manga-reviews/rising-stars-of-manga-volume-6-review/" target="_blank">Rob Ten Pas</a>, Pink succeeds in blending what could be another tired how to book into something accessible, memorable and super fast to read.  It took me maybe an hour, and a week later, it still pops into my head when I see a situation at work that reminds me of its advice.  I wouldn&#8217;t be spoiling anything by listing the very simple six rules, but that would give you an excuse not to read it and you&#8217;d forget the rules anyway, right?  There&#8217;s a good hook in who delivers the “career secrets” in the book.  The mentor is a cute manga vixen with an MBA.  Her name is Diana and the book jacket describes her as “part Cameron Diaz, part Barbara Eden,” a description scientifically designed to appeal to mid-career males.  Does anyone under the age of 35 still know who Barbara Eden is anyway?  I am curious how the book would appeal to women – of course my wife won&#8217;t go near anything that smacks of a business book, so I can&#8217;t test it at home – but the whole manga thing really seems to play better to males than females, at least that&#8217;s what I intuit.</p>
<p>Regardless of your gender, you won&#8217;t be disappointed.  And think, you&#8217;ll never have to plow through another one of those what-color-is-your-parachute career guide/pop psychology books again.  Think of the time you&#8217;ll have to google “I Dream of Jeannie” while you&#8217;re taking a break from your cool job.</p>
<p><a title="Buy it locally." href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1594482918" target="_blank">Buy it at your local bookstore.<br />
</a></p>
<p style="text-align:left;">
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		<title>good schtick: made to stick</title>
		<link>http://melendezreads.wordpress.com/2008/04/08/good-schtick-made-to-stick/</link>
		<comments>http://melendezreads.wordpress.com/2008/04/08/good-schtick-made-to-stick/#comments</comments>
		<pubDate>Tue, 08 Apr 2008 03:10:38 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[business]]></category>
		<category><![CDATA[communication]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=10</guid>
		<description><![CDATA[Possibly one of the most useful business books in many years, the Heath brothers&#8217; Made to Stick is a must have have for marketers and anyone else who needs to get an idea diffused. The book is eminently useful and built around a template for creating compelling and memorable vessels for ideas. The formula is: [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=10&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>Possibly one of the most useful business books in many years, the Heath brothers&#8217; <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1400064287" target="_blank">Made to Stick</a> is a must have have for marketers and anyone else who needs to get an idea diffused.  The book is eminently useful and built around a template for creating compelling and memorable vessels for ideas.  The formula is:</p>
<p><strong> S </strong>implicity<br />
<strong> U</strong> nexpectedness<br />
<strong> C</strong> oncrete<br />
<strong> C</strong> redible<br />
<strong> E</strong> motional<br />
<strong> S</strong> tories</p>
<p>Catchy acronym, eh?</p>
<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1400064287" target="_blank">buy it at your local bookseller</a></p>
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		<title>guessing the future</title>
		<link>http://melendezreads.wordpress.com/2008/03/15/guessing-the-future/</link>
		<comments>http://melendezreads.wordpress.com/2008/03/15/guessing-the-future/#comments</comments>
		<pubDate>Sat, 15 Mar 2008 20:10:20 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[business]]></category>
		<category><![CDATA[economics]]></category>
		<category><![CDATA[black swans]]></category>
		<category><![CDATA[scenarios]]></category>
		<category><![CDATA[the art of the long view]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=9</guid>
		<description><![CDATA[I believe most of us, to one extent or another, are trying to predict the future. If you knew what was coming up, so many decisions would be simplified. It would be easier to know when to buy a house, start a business or save extra money. Obviously, experience shows us that it’s pretty damn [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=9&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>I believe most of us, to one extent or another, are trying to predict the future.  If you knew what was coming up, so many decisions would be simplified.  It would be easier to know when to buy a house, start a business or save extra money.  Obviously, experience shows us that it’s pretty damn hard to know what’s coming up.  There have been plenty of “<a href="http://en.wikipedia.org/wiki/Black_swan_theory" target="_blank">black swans</a>” in the last decade: September 11, Hurricane Katrina and the current <a href="http://www.nytimes.com/2008/03/16/business/16bernanke.html?_r=1&amp;ex=1363320000&amp;en=bde5e6fde4e0635b&amp;ei=5088&amp;partner=rssnyt&amp;emc=rss&amp;oref=slogin" target="_blank">banking crisis</a> are just a few that come to mind as unplanned, consequential events, at least for Americans.  But unique occurrences aside, can we ever hope to get a reasonably coherent idea of the future without quickly getting overwhelmed by all the variables at play?Using techniques developed for Royal Dutch/Shell’s scenario planning, Peter Schwartz’ <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0385267320" target="_blank">The Art of the Long View</a> explains a clear, accessible and manageable method for making some educated guesses about the future.  You might not get the “right” answer, but the process of imagining the future helps form the strategies you will need to manage it.</p>
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		<title>Escape Fire: Designs for the Future of Health Care</title>
		<link>http://melendezreads.wordpress.com/2008/01/28/escape-fire-designs-for-the-future-of-health-care/</link>
		<comments>http://melendezreads.wordpress.com/2008/01/28/escape-fire-designs-for-the-future-of-health-care/#comments</comments>
		<pubDate>Mon, 28 Jan 2008 03:45:01 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/?p=8</guid>
		<description><![CDATA[Escape Fire: Designs for the Future of Health Care Cassie, Santiago and I recently visited the office of a pediatrician that we had been referred to. After we all shook hands and said hello, the doctor made the statement, completely unbidden, “healthcare is a mess these days.” Besides being a complete non-sequitur within the context [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=8&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0787972177" target="_blank">Escape Fire: Designs for the Future of Health Care </a></p>
<p>Cassie, Santiago and I recently visited the office of a pediatrician that we had been referred to.  After we all shook hands and said hello, the doctor made the statement, completely unbidden, “healthcare is a mess these days.”  Besides being a complete non-sequitur within the context of the visit, his comment sounded cavalier and resigned, as in “I&#8217;m the best you can hope for.”  Initially, we tried to overlook the comment, along with much of the rest of his obviously well worn monologue for the next 20 minutes.  There was almost no conversation, merely a recitation of his opinions in response to our questions, some relevant, some not.  I came out of the meeting feeling that sense of dread I feel so often as I muse on our system of healthcare, particularly when I see it from the perspective of a patient.</p>
<p>I have the pleasure of working with a  host of sophisticated healthcare practitioners, people whose smarts and values intersect in the care of the uninsured.  These people are doing the good work and applying some of the best thinking available to the underserved.  But I actually feel more vulnerable and less optimistic when I, with my commercial insurance and above average knowledge of healthcare find myself in the shoes of the consumer.  In the past two years, I&#8217;ve had family members who received substandard care in name brand hospitals and were afraid of making a formal complaint for fear of retribution from the staff.  Another family member was unable to get a flu shot at his doctor&#8217;s office.  It seems that they forgot to order vaccine for children, even though the office is a Family Practice.  The staff at the front desk suggested visiting a sliding fee clinic for the uninsured, essentially pitting an insured individual against uninsured ones for a dose of vaccine.</p>
<p>At a recent “drop in” appointment for a routine cholesterol check, what was promised as a 10 minute visit turned into an hour long affair for my wife.  When the nurse finally came to the lobby and called for her, the staffer apologized for the delay; it seemed that she had misplaced my wife&#8217;s chart under some papers and forgot about it.  Oh, and the insurance company declined to pay a portion of the bill for this simple preventative test that could potentially save thousands of dollars of expensive healthcare by catching the markers of a serious illness while a person is still young and healthy.  On top of the $20 co-pay, we were stuck with another $20 that the insurer refused to pay.</p>
<p>Any thoughtful review of the healthcare system in the US suggests these types of anecdotes are more than one person&#8217;s grousing.  The litany of failures grows: the only country in the developed world that does not guarantee healthcare to everyone, with nearly 40 million <u>citizens</u> uninsured and for those with insurance, at least half of all claims paid are for medical treatment necessitated by lifestyle choices like obesity, smoking and other high risk behavior.  Medicine and healthcare is disproportionately applied at the wrong stage of life.  Our country spends <strike>$1.9</strike> <a href="http://www.healthaffairs.org/press/janfeb0801.htm" target="_blank">$2.1 trillion</a> a year on care while the health of the population gets worse by most standard measures and 100,000 people die in hospitals each year from preventable medical errors.</p>
<p>If you&#8217;re not worried yet, there is plenty more bad news.  The bottom line is that this is a slow motion train wreck and there&#8217;s a lifetime&#8217;s worth of work to do.  The good news: <a href="http://www.ihi.org/ihi" target="_blank">The Institute for Healthcare Improvement</a> (IHI) has been pointing out the elephant in the room for over 15 years.  Its co-founder and spiritual leader is Donald Berwick, MD.  He&#8217;s a leading authority on healthcare policy and improvement, a professor of pediatrics at Harvard and all around gut check on the industry.  <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0787972177" target="_blank">Escape Fire</a> is a collection of 11 of his keynote speeches at the annual Forums on Quality Improvement offered by IHI.  He is a physician who understands the art and science of medicine, but never lets it lose its focus on who really matters in the system: the patient.  His speeches are like his approach to medicine: equal parts scientist, efficiency expert, storyteller and unwavering humanist.  His examples are drawn from some of the more heroic and tragic stories of modern medicine, including stories from his own struggles as loved ones entered the healthcare system and their safety was continually in peril.  But he also brings parallels from NASA, corn farmers in Iowa and Harry Potter.  Berwick tells us where we&#8217;re going and what&#8217;s possible and not only to not give up home, but to work effectively and with compassion.</p>
<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0787972177" target="_blank">Buy this book at your local bookseller.</a></p>
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		<title>pay attention</title>
		<link>http://melendezreads.wordpress.com/2007/12/29/pay-attention/</link>
		<comments>http://melendezreads.wordpress.com/2007/12/29/pay-attention/#comments</comments>
		<pubDate>Sat, 29 Dec 2007 04:49:37 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[mindfulness]]></category>
		<category><![CDATA[zen]]></category>

		<guid isPermaLink="false">http://melendezreads.wordpress.com/2007/12/29/pay-attention/</guid>
		<description><![CDATA[Wherever You Go, There You Are by Jon Kabat-Zinn. Meditation and mindfulness stripped of any mystical trappings and made practical and relevant. &#8220;Everything is connected; everything changes; pay attention.&#8221; -Jane Hirshfield Buy this book at your local bookstore.<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=7&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1401307787" target="_blank">Wherever You Go, There You Are</a> by Jon Kabat-Zinn.</p>
<p>Meditation and mindfulness stripped of any mystical trappings and made practical and relevant.</p>
<p>&#8220;Everything is connected; everything changes; pay attention.&#8221;<br />
-Jane Hirshfield</p>
<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=1401307787" target="_blank">Buy this book at your local bookstore.</a></p>
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		<title>Porter Analysis of the &#8216;Hood</title>
		<link>http://melendezreads.wordpress.com/2007/12/02/porter-analysis-of-the-hood/</link>
		<comments>http://melendezreads.wordpress.com/2007/12/02/porter-analysis-of-the-hood/#comments</comments>
		<pubDate>Sun, 02 Dec 2007 14:50:19 +0000</pubDate>
		<dc:creator>emelendez</dc:creator>
				<category><![CDATA[business]]></category>
		<category><![CDATA[economics]]></category>
		<category><![CDATA[informal economy]]></category>
		<category><![CDATA[inner city]]></category>
		<category><![CDATA[michael porter]]></category>
		<category><![CDATA[organizational theory]]></category>
		<category><![CDATA[venkatesh]]></category>

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		<description><![CDATA[Sudhir Alladi Venkatesh&#8217;s Off the Books is what you would get if you sent Michael Porter into the ghetto with a notebook. Venkatesh makes a fascinating analysis of the competitive forces at play in the &#8220;underground economy,&#8221; in which the players make difficult tradeoffs as they struggle to survive in a decaying inner city. This [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=melendezreads.wordpress.com&amp;blog=1522041&amp;post=5&amp;subd=melendezreads&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>Sudhir Alladi Venkatesh&#8217;s <a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0674023552" target="_blank">Off the Books</a> is what you would get if you sent <a href="http://en.wikipedia.org/wiki/Porter_5_forces_analysis" target="_blank">Michael Porter</a> into the ghetto with a notebook.    Venkatesh makes a fascinating analysis of the competitive forces at play in the &#8220;underground economy,&#8221; in which the players make difficult tradeoffs as they struggle to survive in a decaying inner city.  This book is compelling as an ethnography but also as a primer for anyone trying to understand the economics of the &#8216;hood, which are not as simplistic as the stereotype of ghetto grocers and criminal activity.  Instead, it is a vast web of relationships that span the boundaries of what is legal and what is not and the decisions that players have to make in their neighborhoods when their community is physically and economically isolated from the larger society, lacks support from government policy and is deprived of even a basic police presence.Great reading for understanding the economy, political and otherwise of cities with predominately black inner cores like Chicago or New Orleans.  I highly recommend it to my colleagues doing community work in the Crescent City: after this, you will never think about <a href="http://www.nathanielturner.com/stclaudeavenuesweet.htm" target="_blank">St. Claude</a> the same way.<a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0674023552" target="_blank"><i></i></a></p>
<p><a href="http://www.booksense.com/product/info.jsp?affiliateId=EMelendez&amp;isbn=0674023552" target="_blank"><i>Buy this book at your local bookstore.</i></a></p>
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