Monthly Archives: January 2014


The choices we made

“When you are eighty years old, and in a quiet moment of reflection narrating for only yourself the most personal version of your life story, the telling that will be most compact and meaningful will be the series of choices you have made. In the end, we are our choices”

– Jeff Bezos, as quoted in The Everything Store by Brad Stone

Different people are all different

Many teenagers find it enormously difficult to fit in with the crowd, particularly when they also feed the need to stand out.  The things that differentiate us from the next person – love of comic books, thick glasses, or the giant 1mm mole on the left pinky – are frightening to the developing adolescent.

Growing up is realizing that many parts of life require us to embrace our “abnormalities” – impressing a first date (“I never thought I’d find another person who also likes ____.”), acquiring a coveted career position (“My ______ makes me the ideal candidate for your company”), telling a dinner party story (“The most ridiculous thing happened the other day…”).

It seems that being different is extraordinarily difficult.  After all, only a small number of people can be at the tails of the bell curve, and it is easy to feel just so… average.

In medical blood labs, “normal” is a vague definition.  The normal value range actually encompasses only 95% of numbers you would find in healthy people because there is some overlap with lab values in sick patients.  This means that if we measure enough numbers (say, about 20), we would find some abnormal values in everyone, healthy or otherwise.

These laboratory values catch doctors’ eyes.  They warrant extra seconds of discussion on rounds, extra discussion at the bedside for symptoms, and/or repeat laboratory evaluations.  Most of the time further investigations affirms the simple fact that even the most normal person has some measurable outstanding lab values.

In medicine, we learn that the completely average person simply does not exist.

The difference between lab values and real life qualities is that running a panel of 45 blood labs is simple, but identifying our own eccentricities and innate talents takes introspection and feedback from honest friends.  Then, embrace it – life may not have dealt everyone an even hand, but it is fair in that everyone is playing from some kind of a crooked deck.

Less is more

I was lucky enough to have some time to kill this past weekend.  I was in the mood for a comedy, so I turned to NetFlix and Amazon Prime.

Online on-demand video services are the Pantheon of small screen entertainment, housing tens of thousands of options.  Television show or movie?  What kind of comedy?  Romantic comedy, regular comedy, serious movies with comedic moments, comedies with a political message, sitcoms, sitcoms all about hooking up, sitcoms about absolutely nothing, comedies about being a doctor.  The list goes on.

The decision was difficult to make as I simply kept scrolling down to see the next page of choices – why settle for the second best choice you could find when the first might be on the next page?

Finally, I got frustrated and ended up turning on the TV and surfed between The Godfather, Harry Potter, and Chopped – none of which were comedies but did the trick of providing thinking-optional entertainment.

I knew the choice is almost trivial. In fact, I was fully aware that making the choice was creating unnecessary frustration relative to the marginal “better experience” it would create.  I knew what mattered was not the precise category, or the cast, or even the type of show/movie.  But there is something about having all these choices that made the decision difficult to make.

Yes, choosing a TV show is a trivial, first-world problem, but that is precisely the point.  We now live in a country where almost every decision is complicated not by the lack but by the abundance of choices.  We are taught to decide by placing these choices side by side and pick the better one.  Although logical, this approach sometimes leads to unnecessary agony as the mental angst in differentiating outweighs the marginal improvement that the better choice provides.

Sometimes we might be better off not having thousands of choices to choose from and just going with whatever happens to work.  Just turn on the TV, watch whatever happens to be on, and chill out.

No more boxes

Albert Einstein once said that “insantiy is doing the same thing over and over again and expecting different results.”  Innovation is, then, about thinking outside the box and finding that brand new idea, right?

Thinking outside the box has become a cliched way to describe innovation – an ironically inside-the-box way to motivate someone.  It is also incredibly difficult, probably because no one really know where the box is, how big it is, or what’s in the box.

Our world is populated with myriad of boxes.  In the new world where information flows at the speed of electrons in every industry, every iteration of an idea has at some point been conceived, if not already attempted.  Google was not the first search engine, Microsoft did not make the first GUI-based operating system, Facebook was not the first social website.  The world had thought the search engine, the GUI, and the social network were niche products for the technology business, the geeks, and the science fiction novels.

Only when looking back 10 years later can we gleam a hint of new boxes in the making during those times.

So maybe “thinking outside the box” had it backwards all along, that we should be thinking without worrying about the box – that when a set-back pushes us down, it is worth to just stand up, brush off the dust on our buttocks, and charge right back into the fray with renewed vigor.  Boxes are for those looking back, not for the people that must keep moving forward.

3 reasons I went back to OneNote

I let Evernote Premium expire in December after being disappointed by some of its qualities. But the problem is this: I had clearly subscribed to EN Premium for a reason – with the new void I must now find a new solution.

Here are three reasons why I decided to take up OneNote after leaving EverNote Premium – and why other alternatives leave more to be desired.

1. Formatting is Preserved When Clipping

Evernote is a good tool for clipping web articles.  It had one shortcoming – after clipping a lot of the fancy HTML/RSS (i.e. formatting) is lost, leaving only the images and text intact.  When clipping articles later reading or for recipes this tendency does not create problems.  But if you wish to mark up an article or otherwise preserve it for future reference, this becomes a problem.

Evernote butchers formatting when extracting article text.

One workaround is simply to first print into PDF format, then mark up the file using a supporting reader as one would a science article in PDF format.

In OneNote this workaround is unnecessary – the task can be accomplished simply by “Send to OneNote” from printing screen, then the article is available for mark-up immediately.

2. Annotate Anywhere on Images or Text

Because of my work, I often mark up radiographs and CT images downloaded from teaching files (copy an image, type out the expected findings, and draw an arrow to the appropriate place on the image). There are plenty of workarounds – for example, one could simply use Photoshop to edit the images – but because the volume of information is rather vast, efficiency becomes critical.

This is where OneNote provides a unique value proposition.

Send to OneNote plays well with images, text, or a combination – either for annotating actual image filese as above, or for old scientific articles whose PDF format is simply image scans of the paper format.  It is often difficult/impossible to notate such files.

OneNote’s iconic “type anywhere” function allows typing text in an arbitrary location much as one might draw arrows or text boxes on PowerPoint, so that there is no reliance on the importing document’s formatting.  Once the images are properly highlighted, additional notes can be added right beneath them and the page can be re-organized like any other OneNote page.  Creating a proof-of-concept page as shown below takes merely seconds.


This feature is available on the free OneNote apps on mobile as well as the SkyDrive web client.

OneDrive Synchronization

OneNote synchronizes automatically with OneDrive, the Microsoft variant of Dropbox / Google Drive.  The method of synchronization is peculiar because OneNote synchronizes only the modified portion of each notebook, and it attempts to synchronize in real-time.

This means that shared notebooks can be edited simultaneously and the updates sent to all collaborators in real-time (much like Google Docs).  It also makes conflicting copies nearly impossible to create.

Microsoft made an excellent choice of including OneNote 2013 in all Office 2013 installations. With increasing popularity of Google Docs and Evernote, Microsoft had to up its game.  Even without the rest of the office suite, at $49 stand-alone price, OneNote is on par with Evernote Premium in price.

What does your gut tell you?


There is polarized debate on whether instincts are worth following.  Companies are increasingly relying on quantitative metrics for new hires over subjective interviews.   Nate Silver’s The Signal and The Noise pitches old-school scouts against number-crunching quants to find the next baseball star.  And doctors are taught to follow the science even if it sounds counter-intuitive (such as prescribing beta-blockers, a heart slowing medicine, for patients with heart failure actually prolongs life).

But all is not lost for those relying on instincts – as your gut instinct may tell you.  Last year a New York Times article argues that big data is imperfect.  In his research, Nobel-prize winning Daniel Kahneman finds that our minds are naturally wired to think in both instincts (System 1) and data (System 2).

At the end of the day, the new age of big data and massive informatics does not preclude the need to slow down and use our own System 2 to process whether the science behind our decisions truly make sense.  Instinct is neither good nor bad; it is merely instinct.

Cutting through the bell curve

When coming up with new innovation, designs, or just another idea, sooner or later there will come an idea that few people like.

The normal distribution curve is shaped with most of its value surrounding the mean. This is the curve many things in nature follow – most of us are somewhere around the average intelligence, for example. Most people are somewhere around the average height with few tall and short individuals. And most of us have somewhere around the average ability to imagine what the future looks like.

If we were to plot ideas along a bell curve, we would have the few rare brilliant concepts in the far right, where most people in the middle of the bell curve would fail to appreciate.

So sometimes truly great ideas are so out of the box it is a statistical certainty that they are lost to the appreciation of the masses.

The question is, what will you do when you find next idea surrounded by nay-sayers – will you listen to them, or will you push forward with head held high?