Father's Day Thoughts

Left To Right: Nick, my brother Frank, Me, Matt

I’ve easily written 10,000 words in 6-7 different posts the past 7 weeks, none which has ever seen the light of day for a variety of reasons. But here it is, just after 9:30 p.m. on Fathers Day, and I’m writing again after just coming back with wonderful dinner at Olive Garden with my oldest son Nick.

Nick has developed into an incredible young man. I always commented that Nick was my minimalist- doing the absolute minimum to get by in life- and I guess it always upset me because I try and do the opposite. In the past year he has shown a side of him that I never saw before. He has become a driven individual who embraces his work, school, and life with a passion doing the very best he can and being the very best he can be. He is close to converting me to become a Mac-aholic like he is, but when your life is spent in the Apple store it tends to do it to you. He is one of the chosen few who got to enjoy his passion for all things Apple by actually securing a job at the Apple store. He is the second youngest employee (by just a few months) at the store with nearly 100 people in it and is doing great at it, slowly but surely climbing the Apple tree yet making sure he doesn’t piss off dear old dad by making work second and school first.

Truth be known I’ve been going through a bad case of pre-empty nest syndrome with my youngest son Matt graduating high school last month. A week after he walked off the graduating stage wearing more robes and honors than half the faculty (Summa Cum Laude, officer in National Honor Society, International Baccalaureate degree, etc.) I was both proud and confused. Proud that my son did so well in school yet confused as to what’s next. Last year when Nick graduated and I felt the same degree of pride in him as I did with Matt but not as much confusion because I still had one of my babies at home to take care of. Soon I may have none….

Five days after Matt graduated high school he was off to Europe visiting eight countries and 11 cities in 31 days with nothing more than a backpack on his back and his best friend Amelia by his side. Ah but to be young and carefree again. This kid planned this trip out better than the invasion of Normandy. He’s been gone 20 days now, and has 11 more to go until he comes back, yet this it’s enough to give me a taste of what my future holds. While I’m excited about having more “me time” I also miss being the dad who was always there. Always. Just ask anyone. They were- and are- are my life. But now…who knows?

Matt called me this morning from Rome to wish me Happy Fathers Day. That's Rome, Italy, not Rome Georgia. My kid remembers to call me on Father’s Day…..from Rome, Italy no less. Amazing.

And Nick. Not only did he take the day off to be with me today and take me to dinner as well but he also gave me a card I’ll always cherish. It simply said:

I listened more than you think.
I remember more than you realize.
I love you more than you know.
Thank you for being my dad.

With a personal message:
Almost 20 years together my how time flies….Thank you for always doing your best in spite of me.

Has it been 20 years already? It seems like only yesterday.

In spite of me? Not hardly. I did my best because of you, Nick…

As I read the cards I got, listened to Matt’s voice from halfway around the globe, spent time with Nick and reflected over the past few decades, five words kept going through my mind over and over again- ”It was all worth it.”

Despite all my shortcomings- and they are oh so many- I guess my kids feel lucky to have me. If they only knew how lucky I am to have them as well, because so few dads have kids as incredible as mine…

Lucky kids, luckier dad. Life is good indeed….

Fava Beans and A Nice Chianti

Call me the sick puppy I am but I enjoyed the movie The Silence of the Lambs. The psycho-drama kept you on the edge of your seat until the very end and no one but no one comes close to Anthony Hopkins in his portrayal of Dr. Hannibal Lector.

There was an event that happened in our industry a week or so back where a press release went out over the newswires and basically said one of the biggies in our industry- Iron Mountain- was getting out of the cloud storage market. Now my ear is usually pretty close to the ground with events like this so it took me completely by surprise. Apparently the Gartner Group put out a press release with the heading "Iron Mountain to shutter cloud storage service" and I questioned if this had any impact IM’s healthcare segment. Since the event was reported in at least 20 trade journals on Monday and numerous others since then I reprinted one of the stories from one of the journals (ComputerWorld®) on AuntMinnie’s® PACS Discussion Forum and asked the question, quite responsibly I might add, " So...what does all this mean for IM healthcare clients? Virtual File Store® and Archive Service Platform® were directly addressed but the DRC (Digital Record Center®) that addresses healthcare was not even though this too is an IM digital cloud solution that should fall under this "cloud". Very weird that this market sector wasn't directly addressed one way or the other in the release through Gartner so it makes me wonder...IM- is you in or is you out? Inquiring minds want to know... “

I expected a response like this :

PACSMan,
Thank you very much for your concern.

Despite a headline that makes it sound to the contrary, IM’s digital healthcare solution is very much alive and well. While the post erroneously made it sound like all of IM’s cloud storage services were closing, this closing only affected two small divisions of IM that were not profitable. The DRC (Digital Record Center) for Medical Imaging is not affected by this and continues to do enjoy a strong presence in the medical imaging marketplace.

Should you or any of AM’s readership have any questions please don’t hesitate to contact me at …….
The Big Kahuna at IM

That would have cleared it up for me and everyone else and the company could have put this PR nightmare behind it. Instead I, and the industry, got absolutely nothing publicly while behind the scenes I was made out to make Dr Lector look like Tinky Winky.

I loved initial call I got 15 minutes after the initial posting hit the PDF asking me who my sources were for some of the broad comments made - “they are- and will remain- confidential” - but even Stevie Wonder could read the rest of the stuff which was all public. So out of courtesy I revised my initial post to reflect the company’s posture (which they should have done, not me) slapping them on the hands only for allowing this release to get out but otherwise doing no harm- or so I thought. The next thing I know I get a voice mail on my cell phone at 9:30 p.m. that starts out “You have got to be kidding me…” then TELLS me in a demanding manner (not politely asking) what I MUST say to make this right. I also had comments made about how I was embarrassing myself through this post, yaddi yadi yada as if I was the reason for it hitting 30 journals. Um..no. Apparently winning through intimidation may work well in certain organizations but it doesn’t work with me. So I sent this e-mail to the big Kahuna there:

“I made the modification to my original post and it stands. I am not IM's mouthpiece nor do I represent IM's position or any other vendors position in this industry for that matter. I also made this post as an individual and not as someone representing AM or anyone else so please don't try and make that connection either.

This was a valid press release published in several trade journals, one that lead to the question I asked- is IM healthcare involved here because it sure reads that way with the global headline as stated. You answered it, I included your response as a courtesy in the revised post and that should be the end of it. Obviously it's not. If you want more you need to do it yourself. I also am not embarrassing or meaning to embarrass you or anyone else or me here; how you can say I am embarrassing myself just defies logic. Maybe from your perspective but not from anyone elses.

The bottom line is we can agree to disagree here but if a press release is made about IMC in print like this I would take immediate actions to modify this. This release actually went out last Friday (4/8) so the problem is not just with Gartner but IM as well for not catching it and addressing it promptly. You caught my post within 15 minutes of it hitting AM- why couldn't IM catch this one equally as fast and address it? Someone obviously is not minding the fort there. I also told you that I was modifying it on AM and here it is 5+ hours later and you are just getting around to calling me about it? That's not what I would call being proactive in my book either.

If you care to add to the post on AM you are more than welcome to do so and were even invited by Outcast to do so as well. His post reads:

They have a brand name and were supposed to use their current relationships to try to build up this business. Other than the occasional press release, I never heard about any customers signing on with them or about an active sales force.

I would be interested in the hearing from IM to clarify the facts.

Many people in this industry feel the same way- we never hear anything about you even though you consistently claim to be so much larger than all the "little piss ant" companies you compete with. That doesn't speak very well for IM now does it?

So here's your chance….get on your pedestal and clarify the facts. Just don't make it personal because that would be a violation of AM's terms and conditions. State your case and let's see where it go where it goes...

Good luck. I'm in tomorrow if you want to chat but I'm not changing anything. Also, if you call please use the business line and not my cell-….

Thanks. Sleep well.

Mike

So where are we today? Let’s go back to the Silence of the Lambs- a great scene where Dr Lector and Clarice have a bit of “interaction”…

Hannibal Lecter: I will listen now. After your father's murder, you were orphaned. You were ten years old. You went to live with cousins on a sheep and horse ranch in Montana. And...?
Clarice Starling: [tears begin forming in her eyes] And one morning, I just ran away.
Hannibal Lecter: No "just", Clarice. What set you off? You started at what time?
Clarice Starling: Early, still dark.
Hannibal Lecter: Then something woke you, didn't it? Was it a dream? What was it?
Clarice Starling: I heard a strange noise.
Hannibal Lecter: What was it?
Clarice Starling: It was... screaming. Some kind of screaming, like a child's voice.
Hannibal Lecter: What did you do?
Clarice Starling: I went downstairs, outside. I crept up into the barn. I was so scared to look inside, but I had to.
Hannibal Lecter: And what did you see, Clarice? What did you see?
Clarice Starling: Lambs. The lambs were screaming.
Hannibal Lecter: They were slaughtering the spring lambs?
Clarice Starling: And they were screaming.
Hannibal Lecter: And you ran away?
Clarice Starling: No. First I tried to free them. I... I opened the gate to their pen, but they wouldn't run. They just stood there, confused. They wouldn't run.
Hannibal Lecter: But you could and you did, didn't you?
Clarice Starling: Yes. I took one lamb, and I ran away as fast as I could.
Hannibal Lecter: Where were you going, Clarice?
Clarice Starling: I don't know. I didn't have any food, any water and it was very cold, very cold. I thought, I thought if I could save just one, but... he was so heavy. So heavy. I didn't get more than a few miles when the sheriff's car picked me up. The rancher was so angry he sent me to live at the Lutheran orphanage in Bozeman. I never saw the ranch again.
Hannibal Lecter: What became of your lamb, Clarice?
Clarice Starling: They killed him.

I did my best to try and keep the little lambs from being slaughtered, yet the company sat back and did nothing while poor little Clarice gets sent off to the Lutheran orphanage. "I opened the gate to their pen, but they wouldn't run. They just stood there, confused. They wouldn't run." . Sounds a lot like what is happening in Massachusetts. What’s funny in a not so funny way is while I was being presented to many as the Anti-Christ by individuals within the company I was actually trying to HELP Iron Mountain, not hurt it. I gave them a chance to clear the air publicly and they blew it, not I. That said, I’m sure it will be my fault again/yet/still for resurrecting this nightmare on my blog site but it defies logic that it should take any company a week or longer to put out a clarification on this. My God even GE can- and would- do it faster…

I used the analogy in the PDF that waiting for IM to do something is like an ED doctor watching his patient die instead of triaging them first and wondering about the how and why later. After much reflection I think instead it’s closer to your wife asking you if this dress makes her look fat. There is only one correct answer and “No honey, your fat is what makes you look fat” isn’t it. You think it through and answer honestly- “While you look stunning both in and out of your clothes, sweetheart, that dress doesn’t compliment you nearly as well as others I have seen you in.” Fred Astaire may have died in 1987 but any man worth his salt knows how to dance.

So here it is a week later and there is still nothing clarifying or correcting this release in print. If/when something finally does come out in print it will no doubt be so anticlimactic it will be all but worthless. There is only one way to address this nightmare in print but I’d be willing to bet they completely miss it in whatever they do. I know what will work here but I don’t work for free and besides they have so many marketing, PR and legal types up there that I’m sure someone can figure it out. That said, doing something now will be like bringing flowers home after making a huge faux pas, walking through the door finding a home as empty as Guido the killer pimp did to Joel in the movie Risky Business and a note that the wife moved in with the neighbor- and BTW here is my attorneys number. Ouch.

This post should have been titled “You Can’t Fix Stupid- Part II” but the “stupid” company I wrote about before has parts II and III coming up because they really are that stupid and for that reason alone they get their very own post. God there are so many stupid companies out there….

Dr Lector asked the question that made Agent Starling pause before answering: “Well, Clarice - have the lambs stopped screaming?“ I can only hope that they do for everyone’s sake. But in the interim I would ask that this company not test me or my patience any further because as Dr. Lector also said, smiling, “A census taker once tried to test me. I ate his liver with some fava beans and a nice chianti.”

Cheers!

Gypsies, Tramps and Thieves

I was listening to the radio this morning and up pops an oldie but goodie that Cher did way back in 1971.....

I was born in the wagon of a travelin' show
My mama used to dance for the money they'd throw
Papa would do whatever he could
Preach a little gospel
Sell a couple bottles of Doctor Good

As the song went on I got to thinking- gee, that sounds a lot like my industry.

Gypsies, tramps and thieves
We'd hear it from the people of the town
They'd call us gypsies, tramps and thieves
But every night all the men would come around
And lay their money down

Even the vendors were represented well..

I never had schoolin' but he taught me well
With his smooth southern style
Three months later, I'm a gal in trouble
And I haven't seen him for a while
I haven't seen him for a while

So why do I think we are an industry of Gypsies Tramps and Thieves? Look at the definitions:

Gypsy: a laborer who moves from place to place as demanded by employment.

Tramp: a person who engages freely in promiscuous sex; or as the Urban Dictionary defines it “ Any woman who will open her legs for anyone, except for me.”

Thief: a person who steals, especially secretly or without open force.

Every year when I go to RSNA, HIMSS, and other trade shows I am amazed at the number of individuals who have moved from one company to the next…IMHO half of them should be collecting unemployment checks but instead their incompetence is often rewarded by them securing a better job with a different company at twice the pay. Does this make sense? Of course it does….That is one of the reasons I don’t have a “real” job in this industry.

The Peter Principle is stated in chapter 1 of the book with the same title: "In a hierarchy every employee tends to rise to his level of incompetence." In the 30 years I’ve been in this industry I’ve seen the Peter Principle applied time and again. This often affects people who lost their jobs due to attrition in a half hearted attempt to show profitability for the company’s quarterly or year end statement. “Look, we made money!! Of course we have no R&D or sales force left but we made money by reducing our overhead!!” The fact that sales wasn’t selling and leadership wasn’t leading that largely contributed to getting you into this fine mess to begin was somehow overlooked…. but these are minor details. Give them a nice farewell package and let them move on to screw up yet another company. This does not apply to all individuals- there are some very good people in our industry who have done exceptionally well and deserve an upward move- but there are some "moves" that I've seen that just completely defy logic.

At times it seems like no one is minding the castle or even cares. I recall several years back when I was asked to come join the sales force of a major PACS company who were holding their annual sales meeting down here at Disney- at the Grand Floridian no less. This week long foray had to have easily set the company back $1M with airfares, hotel charges, luxury meals, etc.- for a sales force that hit all of 74% of its quota. I laugh when comparing this to my times working for Motorola in the late 70’s where we ended up having our sales meeting at a divey Best Western in Cordele, Georgia. We all wondered what we did wrong to deserve this locale- the land of Stuckey’s pecans and shelled peanuts- and the answer came quickly- “You were at 96.7% of quota- close, but we don’t pay you for getting close. When you hit quota you get rewarded, when you don’t you count your blessings you still have a job. You have 90 days to get the numbers up- let us know what we need to do to help you..“ That was it- short, sweet and direct. And you know what? We never missed our quota again.

The contrast between the two companies was stark and is one of the reasons why “big spender company” still hasn’t turned a profit in many many years…and probably won’t for a while either. While “leadership” is finally taking steps to bring spending into control they are doing it the wrong way- by cutting areas that don’t need to be cut, not hiring as many people as they need while burning those they do have out and….but that’s a big company for ya…That’s why I love the little companies…..they think small…and even a few medium size companies who still think like a small company. They see it paying dividends in big ways.

While I'm at it because you hold the title of Senior VP, President, or CEO of the company doesn’t mean you need a limo to take you to McCormick Place or that your require a suite at the Fairmont with fresh fruit platters delivered daily and plenty of space for your handlers to roam about. Get a regular room, meet in the restaurant and take the bus- you might actually learn something about your company as well.

So how does mediocrity continue to thrive in our industry? I guess no one read Ephesians 4:25 “Therefore each of you must put off falsehood and speak truthfully to his neighbor, for we are all members of one body.” If anyone did speak truthfully about the people who were up for various jobs most wouldn’t be in positions they are in now, but the threat of lawsuits is so prevalent that no one dare say anything negative about anyone. There are also always seemingly valid excuses for not making quota, for the company not growing etc. It’s like dealing with my kids when they were younger- it was NEVER their fault and always related to circumstances beyond their control. Thankfully my sons have matured and they now accept responsibility for their actions- most times .

Only once in my decades in this industry have I found a situation that was outside a person’s control where I said you have to leave. This one company was beyond unreasonable when a friend of mine was given a quota for a relatively small territory in South Florida. His quota was larger than what all companies in the entire state of Florida combined would be able to even come close to hitting if all the planets were properly aligned. He was a top performer too and left soon after. Now is making four times what he would have there with one quarter the pressure and at a much better company. He was the exception though, not the rule. Most just move on and do the same thing for few year until the company gets smart and sends them to more verdant pastures- or other companies.

OK, that’s gypsies. Now on to tramps and thieves. In my business- PACS consulting- tramps and thieves are often one and the same. Our business has taken a financial hit like many have plus we are now being inundated with wannabe consultants who head to Fed Ex/Kinkos, print business cards, and viola- they are an instant PACS consultant until they find the next real job and close up shop leaving their customers hanging. Some- but not all- of my counterparts have also started to compromise their own personal integrity by taking on just about any job that is out there to pay the bills. I understand their rationale but…I’m just not willing to sell out that cheaply- or at all.

I have had many jobs offered to me in recent years but more than half of them I pass on because I couldn’t see the value in them and hate taking money from a company for basically doing nothing- even if they see the value in their own request. With damn few exceptions I’ve been in this industry longer than most and can tell in a New York Minute what a company needs and what it doesn’t.

It’s the same with end users who come to me saying “We want to get rid of our incumbent vendor.” My first question is always “What is wrong with them and what steps have been taken to correct the problem?” In 80% of the cases we can save the marriage and move on. Now this doesn’t benefit me at all- I make a whole lot more money do replacement PACS that includes doing data migration and establishing a VNA- but doing what is right for the customer is what is paramount. As the late Michael Jackson sang:

I'm Starting With
The Man In The Mirror
I'm Asking Him
To Change His Ways
And No Message
Could Have Been Any Clearer
If You Wanna Make The World
A Better Place...
Take A Look At Yourself
And Then Make A Change...
(Na Na Na, Na Na Na, Na Na,Na Nah)

I‘ve only done one project in the past several years I didn’t want to do- a customer survey- but the company was insistent that I do it so I swallowed hard and I did. They hated what I found out (it was less than positive) and they had a hard time believing the results even though I had the e-mails from their clients that documented the findings. I’m sure they will now spend 10x what they paid me to take a more “scientific” approach like they did when they were employed by big boys who had more money than common sense and finally get the results they were looking for. Sounds like the methodology many rankings companies seem to take actually .

Thieves steal but isn’t being paid for something that will not benefit the customer the same as stealing? It is in my book. Is taking money for doing nothing stealing as well? Yes. Now I love retainers and yet hate them for the very same reason. Yes, I can make a company a much better deal work-wise if I know that money is coming in regularly, but please make sure I earn my keep by giving me jobs to do. It’s an integrity issue, pure and simple. You get paid, you do the work. Conversely it annoys me when you do the work and then have to beg to get paid months later too. Thankfully there are only a few companies like that…and most are the bigger companies where you are just a number…and where your invoice that will address next month’s payroll can just sit there because it is so low dollar value-wise relative to the other invoices in the queue.

So- gypsies, tramps and thieves? You bet!! It’s what makes our industry so special.

Bring back 2010

It’s a New Year. Whoopee! Nearly twenty days into the new year and already I long for 2010 again. I vowed years ago to never make resolutions I can’t keep (and even more directly, to never keep those that I make) and so far I’m right on target considering that my one big resolution was to blog more. Considering how 2011 started out though I probably would be better off saying nothing at all.

I spend New Years Eve in bed – alone- under my down comforter with a pair of jeans on, tee shirt, sweatshirt, my heavy winter down jacket with a hood and gloves on and was still shivering like crazy with the flu or whatever you want to call it…I can think of much better ways to ring out the old and ring in the new, but let it suffice to say the week between Christmas and New Years was sheer hell. Thankfully I’m healthy and my body won out in the end. I’d shudder to think what might have happened had I had any form of compromised immune system.

December led me to more contracts than ever before and I finally celebrated being able to relax a bit financially going into 2011. And then, just like that- poof- almost every contract that my clients had verbally committed to disappeared like Al Sharpton at a Klan rally. All of a sudden I went from what was a rancorous feast at a churrascaria to eating in the church hall with the elderly people from the trailer park our church feeds every month, people looking for a free meal and some companionship. Thankfully I had some embers in the fire that will get me through the next month or so (I learned a long time ago to never ever to put your eggs in one basket) and have few longer term contracts pending as well. Still, it taught me that once again the only thing you really can trust in is yourself.

I saw yet another long time PACS veteran pass on and while little was said about him- two short paragraphs was all- I do miss having Tom Goliash around. Tom and I agreed to disagree on just about everything since we met in the early 80’s. He was brash, he was direct, he was opinionated, he was everything you aren’t supposed to be running a company- but above all Tom was true to himself. You never had to guess where you stood with Tom- if he liked you he liked you for life, if he thought you were an a$$hole or an SOB you would hear it from his lips directly, not through third parties. As crazy as it sounds I liked that about him. He was an entrepreneur back in the days when the PACS market could sustain entrepreneurs even though almost no two products he ever delivered to his clients were exactly the same. Thankfully I don’t believe they conducted many GMP reviews back in the days of AVP and Megascan and by the time he founded UltraRad a few years back he finally seemed to have his act it all together. Tom was a dedicated husband married for 44 years to the same woman, a father, grandfather and friend and a guy who had one thing so few have in this marketplace- passion. He could have easily retired with the money he made from the sale of his company but instead decided to jump back in with both feet again after taking just a little time for himself to enjoy his passion for sailing. Tom deserved more than just two short paragraphs and while he is gone his presence will be long missed by those of us who knew him.

The day after Tom’s passing my world turned upside down yet again when my very best male friend in the entire world completely decomposed and ended up having to formally address the demons that have haunted him since his childhood days by entering a rehab facility. While his timing was abysmal-he had a week long all-expense paid vacation in Hawaii waiting for him two days later as a thank you for exceeding his quota yet again- it was bound to happen. In so many respects my friend is a huge success- he makes a boatload of money, is a super dad to his kids, is a wonderful friend- and yet he has two weaknesses. He just can’t say no and takes care of everyone but himself often at the expense of himself. A large part of his problems stem from a toxic ex wife who just won’t let go three years hence and keeps hounding him on everything from financial support (he gives her more than twice what the courts would have mandated plus pays for everything related to the kids and still it’s never ever enough) to his personal life about who he dates and what he does. It finally got to the point a little over a week ago where the only rest he got was in the place where he had taken comfort for the past 30 years. Unfortunately once he started his escape this time he just couldn’t stop escaping and needed help. I and a few of his closest friends have been meeting to put together a plan to keep him on the straight and narrow, but we all believe he needs to stop living his life as others think he should live it and instead live his life for him.

The final coup de grace was a change in my own life circumstances. For only the second time in nine years since my divorce I took the chance to get to know someone quite well this summer. All was going fairly well yet we hit a bump in the road that was more like a Florida sinkhole than anything else. As I thought about what I told my friend in rehab I couldn’t help but hear myself talking as well. I enjoy my new friend a lot yet I am trying to absorb myself into a lifestyle that really isn't me and have my friend absorb a lifestyle with me that really isn’t her either. In the end this lead to a few uncomfortable situations and misread communications which just isn't good. I am about as close to being a cowboy as Martha Stewart is to giving my house an award for cleanliness, but that's OK- I Yam What I Yam and frankly Roy Rogers I ain’t. The same can be said about her not being my divine garage sale goddess although she has gone to a few with me and done quite well. Yes, I will mourn the loss of a very dear friend if it comes to that yet I also celebrate my ability to finally open up and share MY feelings directly instead of hiding them behind a wall as has so often happened in the past. I have grown and that is good, even if this relationship did add a very nice vintage Luis Vitton bag to add to the collection of baggage my friend says I seem to carry with me. I always said though if you have to have baggage, then by all means make it the best…

I have so much to share….and yes, lots of PACS news too. Standby- it looks like it’s going to be a very interesting year…

The Last Christmas

Nearly every parent dreads the time when Christmas is no longer magical for their children. For me it happened maybe 6-7 years ago. Thanks largely to the Internet that Al Gore created by the tween years there was a fairly high degree of skepticism about Santa. By age 13 or 14 it was assumed that they knew that Santa Claus was indeed much different than the man in the red suit they saw at the malls or the Santa I played for the Cub Scouts and for his classmates in elementary school using an incredible Santa suit my ex made for me (neither son knew it was me either- that’s how good the suit was). The suit still fits, but now I don’t need quite as much padding as I did then…

This is the last year I will have my kids as kids. While they will always be my kids I could never get over my mom and dad calling my brother and I "kids" well into our 30’s- but it’s different. Nick will be home one more year attending community college, maybe longer depending on where he finishes his last two years of college, and Matt can pretty much go anywhere he wants. His first choice college is in Tennessee but he is also being pragmatic and looking at a school in Tampa as well. With Bright Futures, the Florida Pre-Paid College Fund I’ve been paying into since they were both 6, and scholarships he will no doubt get, he will be like his brother actually getting paid to go to college instead of owing the equivalent of a small town’s annual income when he gets out. But where he goes is his choice, not mine. Both young men are just that- young men- and have good heads on their shoulders. They are super smart, practical, and handsome to boot. Basically they have the world by the balls.

Nick works at the Holy Grail for Mac-aholics as an Apple store employee and did very well his first quarter in college, unlike his father whose 0.923 his first quarter in college was reflective of a belief that college was about women and alcohol and not academics. Going to an all boys Catholic High school tends to do that to you though so…That said, I’ve forgiven myself after so many years….And Matt- my IB student with a 4.3 GPA and 33 on the ACT- he has the entire world pursuing him and rightfully so….I am incredible proud of both boys…

So it’s Christmas Day. I looked over at the clock 6 a.m., 7 a.m. Not a creature was stirring, not even a mouse (or Elvis the Wonder Beagle either but all he does is sleep anyway so…). I miss the days when the kids would tip toe into our rooms at 5 a.m. and ask if we were up (we were now) and then proclaim that Santa had come while they were sleeping…of cursing the translator of instructions from Chinese to what they thought resembled Ing-rish at 3 a.m...of figuring out how something went together…of finding bigger and better hiding spots…of wrapping and wrapping and wrapping… and of course of last minute gifts that were impossible to find a day or two before Christmas- the ones you go to the ends of the Earth to find…like a streetlight….yes, a streetlight… Don’t ask, but I still have it in my closet…

This year I have to realize that my babies aren’t babies anymore but young men who are well on their well to becoming productive members of society, albeit capitalists for sure. Yes, giving them cash is so much easier and practical than finding exactly what they wanted ....but there was also a special joy in finding that one special gift they wanted…I smile every time I see the movie “A Christmas Story” where Ralphie gets his Red Ryder carbine-action, 200-shot, range model air rifle with the compass in the stock. Yes, Ralphie is finally happy but the pride his father had watching him open it resonates much more with me than anything else.

We had so many Christmases like that. After my ex and I divorced Christmas were still special but held at two houses not just one…and we always had dinner together as a family just like we will again tonight even though she has been remarried now for a few years. Thankfully her husband has welcomed me with open arms realizing it’s not about us- it never was about us- but about the kids…. and that we really do have some really great kids…

So tonight we’ll have dinner, maybe watch Billy Murray in “Scrooged” or the “Jeff Dunham Very Christmas Special” or maybe even “A Christmas Story” again and then I’ll hug them both goodnight. But this year’s hug will be more than just saying goodnight. Instead it’s saying goodbye to the end of an era that was as important for me as it was them.

Next year Matt hits 18 and technically my work is done….or so I’m told. Hopefully I’ll have the same relationship with Matt as an independent adult that I now enjoy with Nick- letting his make his own decisions for sure but still pinging the old man every now and then for his opinion. And once, maybe once, just for old times sake, I’ll be lucky enough to have them ask me for something truly unique and different- that one Christmas gift that is so hard to find- so I can search high and low, find it for them and rekindle the joy I had when my babies were still babies and Christmas was a magical time for all.

Merry Christmas to you and yours…His love never ends….

Aunt Mary

Today was Aunt Mary’s birthday. She would have been…well….old….91 to be exact…but alas she went home to her Savior three and a half years ago. Now most of you are thinking what’s the big deal about an aunt who is dead whose birthday was today but my Aunt Mary was a special aunt. She hated the fact that her birthday was so close to Christmas. God help you if you wrapped her birthday gift in Christmas wrapping paper although truth be known Aunt Mary was much better at giving gifts than receiving them.

Aunt Mary never EVER forgot a birthday. She probably had 100 or more relatives in her little black book and each and every one of them always got a card from Aunt Mary on their birthday. Always. And the card always contained $1 in it. If you were 5 years old or 50 you got a crisp $1 bill. That was tradition. And that was what we all looked forward to. Her cards were never ever late either, using nothing but a tattered old date book to keep it all straight. No computer, just her date book.

The date book is long gone, thrown out along with too many irreplaceable family photos and so much more by a cousin who appreciated nothing other than the money that remained in the family bank account. Oh, what I wouldn’t pay to have the single page with my birthday on it as a reminder of an aunt who never forgot me. Once I got older I never forgot her either, always sending her flowers, candy, or something else always wrapped in birthday paper to let her know how much she meant to me. She would always call me up after then too - I was always Michael, never Mike- and thank me. Sadly, the woman who never forgot anyone was all too often forgotten by those closest to her, even her own daughter, yet how could you forget a woman like this?

I was asked to give the eulogy at Aunt Mary’s funeral. The funeral was held at St. Anthony’s Roman Catholic Church in Red Bank, New Jersey, the church where I served as an altar boy from age 7 to age 13. I had only been in that church twice since I left New Jersey back in 1973- once for my mother’s funeral in 1990 and then again for my father’s funeral in 2004. Both times I sat in the front pew. This time though I had to go up to the altar.

When I was younger the altar was a place of mystery. Sadly the church decided it needed to be “modernized” and in the process had changed so much of it that a lot of the mystery and magic was gone. Looking around the only things I remembered were the Stations of the Cross where I had walked to many times during high mass carrying the incense, but the stained glass windows might have been there. I looked up and my heart sank- the choir loft was gone. This was the very same loft where Aunt Mary’s voice would join the voices of the other woman in the choir singing “Oh Bombino” and other songs in Italian at midnight mass every Christmas Eve right after the feast we all had that never had meat because good Catholics never ate meat on Christmas Eve….

I walked up and looked around the church. Poor Uncle Lou was beyond distraught at losing his wife of nearly 50 years, at Aunt Katie who just lost her husband (Uncle Bill) the year before, and Uncle Joe and Aunt Marnie thinking to myself “This is all that is left.” Sadly Aunt Katie passed away a few short months after Aunt Mary did and Uncle Lou went home in 2009, leaving just Uncle Joe and Aunt Marnie- two out of 16 aunts and uncles my brother Frank and I had- remaining.

I gathered my thoughts and began the eulogy. It was good….very good….and I got three quarters of the way through it and then choked up when I got to the words “This year there will be no birthday card from Aunt Mary….” For 51 years I had faithfully gotten a card from Aunt Mary and this year….the reality hit me. It wasn’t about the card. It was about the woman. You would walk in her house and before you had your jacket off she was making you a cup of tea and breaking out homemade cookies. “Sit down, Michael. I’ll make you a cup of tea” she would say… God, I can close my eyes and hear her now…So I stood there, my heart in my throat, trying to talk yet saying nothing, tears flowing down my cheeks, thinking about Aunt Mary…and then I made history….I tried to talk and got one word out then had to stop….another word…then stopped…and then a single word that probably never has and probably never will be uttered from the altar of Saint Anthony’s again. “Shit”. There I am miked up with probably 60 people in attendance and the only word that comes out of my mouth at the time is “Shit.” I heard a few laughs and realized what had happened and caught myself, laughing a bit, saying “Sorry Aunt Mary, sorry Monsignor” before I continued with the balance of the eulogy. Had Monsignor been there I know he would have smacked me upside the head big time for that and required me to say 12 Hail Marys, 7 Our Fathers and 3 Glory Be’s for my offense, but then Monsignor probably already was rolling over in his grave having the Diocese allow girls on the altar who wore sneakers at Mass AND got paid to boot- $10 each. For all I know the choir got paid as well- all 6 of them. When we were growing up there were at least 30 choir members and no one ever got paid…at least not monetarily...and only boys were allowed on the altar. It was a privilege…it was special…..it was a different time and place.

The funeral ended and we all went back to Chiafulio's afterwards for the obligatory feast (although I knew the place as Red Bank Pizza growing up) and later that night I flew home….All went well until my birthday a month later and no card from Aunt Mary..and then the emotions came welling back….And again today, three and a half years later, on her birthday, as I wrapped Christmas presents I saw the birthday wrap too and remembered the woman who never forgot.

If anyone is in heaven it is my Aunt Mary so happy birthday Aunt Mary- take care of everyone until I get there. Know you never have been and never ever will be forgotten.

The Lighter Side of RSNA

There is a side of RSNA that few see- the lighter side. The PACSMan Awards are a blast to write and post on AuntMinnie.com and nearly all are done tongue-in-cheek with a lighthearted attempt at humor. Inevitably someone will think I am vindictive and have a vendetta against their company but that simply is not the case. This year as in years past they were the top read story from RSNA so someone must be enjoying it. If you missed it you missed out, but something tells me if you are reading this blog that you have no doubt already read them in some case many times trying to figure out who won what award. I'll never tell..

Many know of my relationship with Merge- a love/hate one if there ever was one. We should get married but one walk down that aisle is enough for anyone or at least for me. But I’m still friends with many who still work there, including Paul Merrild, Merge’s Senior Vice President of Marketing & Corporate Strategy. Paul introduced me to Justin Dearborn and Jeff Sturges, their President and CEO respectively (even though Dearborn was their CEO before he became President. Talk about Abbott and Costello’s "Who’s on First") but alas Mr Ferro remained as elusive as ever talking only with my good friend the Dalai. Maybe if I had accepted their offer of a glass of Kool Aid I would have gotten to see him, but I limited myself to just a lil candy from their voluminous candy rack (another Merrild trademark) and a cocktail or two at their party. Everyone was cordial to me as well and there was no animosity as well. Paul even allowed me to play on the video games and personally handed me the gun as seen below. You can feel the love can’t you?

Everywhere I went on the floor I knew I was safe from bitchy attitudes because there was chocolate in nearly every booth. ThinAir Data took this a step further and put a packet of Ken’s Salad Dressing in with their Hershey’s kisses as a joke.

But the joke was on them as several overseas members got all excited over the dressing to take back with them and brought many of their friends of their friends others back home which left the vendor scrambling to find more…Hey, whatever it takes to get customers into the booth. It provided a good belly laugh for sure.

I wish every vendor could be as clear and concise in their messaging as this vendor was.

Most marketing managers would be scratching their heads wondering what Revana Health was thinking by having absolutely nothing in their booth besides their corporate logo, but in the 5 minutes I was there at least 5 people came up and asked the same question- “What do you do?” (answer: provides medical imaging centers with a suite of software and services to increase business performance).
Would a booth with all sorts of signs and diagrams and hardware have had the same impact? No- not even close. Brilliant marketing on their part. The fact the two gals who manned it were very cordial and easy on the eyes also helped as well (laugh).

Being a Floridian for the past 30+ years I smiled when I saw the gator sitting on the DR vet table in Canon’s booth. I smiled even more broader still when I saw the kitty cat sitting there as well looking sound asleep. Now I am not exactly a fan of cats- they are much too aloof like many a woman I have dated in life- so the juxtaposition of the gator and kitty was just too good to pass up. I would make a few other comments but I am trying to be politically correct in my old age so those of you who know me can read between the lines.

Having fun is the name of the game and IDS (Integrated Document Solutions) found a great way to get people into their booth with Shan the Candyman (yes, that is the name he goes by). He is only 1 of 3 people in the country who do candy art and he brings it to a level I have never seen before. For this one gal he did a dinosaur eating a dinosaur but could do just about anything for anyone and did. As I left he was doing a football team logo and did a killer Luigi from Ninetendo’s Mario Brothers and a cute pink pony for the owners daughter. This guy has talent with a capital T…



I have talked about the El Grande diner many times but here is the only shot you will ever see from it. The rest is top secret. As the night drew on and margaritas flowed the PACSMan Awards you’ll never ever hear about came out (affectionately known by our group as FC’s). I know you are thinking why are they called the FC’s. We’ll save that explanation for another time and place (laugh). Just know though that it is incredibly hard to find a divey Mexican joint that makes decent margaritas once Salvadors closed finally but we found one.

The guys you see here (a few gals were invited but were no shows BTW) are mostly from AuntMinnie.com and have known each other for years and in many cases decades. We all share a passion for imaging and a respect for each other. I can think of no better group of individuals to be with than these guys. From left to right are Eric, Dr Dalai, Brian, Wayne, Me, Jim, and Erik.

And last but not least, this Cher lookalike is the daughter-in-law of the guy who was behind the Timeo booth.

We chatted a bit about my Italian heritage and he was so much fun to talk to and proud- God was he ever proud “Atsa my daughter-in-law. You takea her picture and put it in the paper, yes?” So from one proud Italian to another here ya go my friend… Hei!! Pay attention. Do Not Hesitate!! Look at her will you…Now I don’t do Musculoskeletal Ultrasound- hell, I don’t even know what it is- but I’d but the book just because she’s in the photo.

You want to get your heart racing even more? Do a Google image search under Cannavo- yes, atsa my name. I used to be on page one, now I’m on like page 6 but do I care with someone as gorgeous as mio cugino Rosaria? Nope. Momma mia, check it out.

She hails from the same area in Sicily as my grandparents and while I’m not 100% sure if she is my cousin or not Ima gonna say atsa my cousin because all us it makes for good press (laugh). I always tell my sons to make sure you know who you are dating because she could be related to you but if she looks like that…who cares? I’ll just sit back and smile and say “Atsa my boy!!”

If Merge Covered Lincoln’s Assassination

I have often said that Merge Healthcare has the very best marketing and PR department in the entire medical imaging marketplace. No one even comes close especially when it deals with handling what is affectionately known in the journalism industry as “spin”.

The most recent third quarter results from Merge speak volumes to this. I’m one of the few who reads the entire story so I was intrigued when I read the headline ”Merge Healthcare Reports Record Sales in the Third Quarter”. Hmmmm, interesting I thought. Then I read the subhead “Revenues grew to $45.2 million in the third quarter, compared with $16.9 million in the third quarter of 2009.” Very interesting…Then I read the rest….until I got to the statement “The company posted a net loss of $5 million in the quarter, compared with a net loss of $936,000 in the same quarter of 2009.” and then look at the rest of the financials. I laughed but wanted to cry. The spin doctors worked their magic. While nothing was hidden and all was very legit, most of the “bad news” was buried deep beneath the marching bands and ticker tape. Fortunately for them most of the investment community never looks far beyond the headlines which allowed the stock to climb almost 29% to over $4.00 per share last week alone.

I got to thinking- how Merge might cover President Lincoln’s Assassination and came up with this, with thanks to Wikipedia:

Sold Out Crowd Enjoys “Our American Cousin”
at Ford’s Theatre
Minor disturbance interrupts an otherwise enjoyable evening
Mrs. Lincoln unhurt in assassination attempt

Washington D.C. April 15, 1865- The Washington elite enjoyed a sold out performance of Tom Taylor’s three-act play “Our American Cousin” which played at Ford’s Theatre last night. The play is a farce whose plot is based on the introduction of an awkward, boorish American to his aristocratic English relatives. It premiered at Laura Keene’s Theatre in New York City on October 15, 1858 and recently moved to the D.C. area. The play concerns the adventures of an American, Asa Trenchard, played by Harry Hawk, who comes to England to claim the family estate.

Numerous socialites from the Washington D.C, area including Major Henry R. Rathbone, his fiancé Clara Harris (daughter of New York Senator Ira Harris), Mary Todd Lincoln and President Lincoln were in attendance. General and Mrs. Grant as well as several other D.C. area power brokers were all slated to appear as well however last minute conflicts pulled each of them away.

The only thing marring an otherwise stellar night was when a Confederate sympathizer, later identified as John Wilkes Booth, interrupted the play halfway through Act III, Scene 2, when Hawk uttered a line that was considered one of the play's funniest:

"Don't know the manners of good society, eh? Well, I guess I know enough to turn you inside out, old gal — you sockdologizing old man-trap..."

Booth used the laughter to mask the sound of his gunshot and fatally shot President Lincoln in the back of the head. Major Rathbone jumped from his seat and tried to prevent Booth from escaping, but Booth stabbed the Major violently in the arm with a knife. Rathbone quickly recovered and tried to grab Booth as he was preparing to jump from the sill of the box. Booth again stabbed at Rathbone, creating a wound that bled profusely from a deep gash that ran the length of his upper left arm, and then attempted to vault over the rail and down to the stage. His riding spur caught on the Treasury flag decorating the box. Booth jumped on the stage and landed awkwardly on his left foot, fracturing his left fibula just above the ankle. This was later confirmed with a CR image that was processed using a Merge OrthoCR® software. Booth then raised himself up and, holding a knife over his head, yelled, “Sic semper tyrannis” the Virginia state motto, meaning "Thus always to tyrants" and made his escape through the back of the theater to a horse he had left waiting in the alley.

Dr. Charles Leale, a young Army surgeon on liberty for the night and attending the play, made his way through the crowd to the door at the rear of the Presidential box. Leale was joined by second doctor in the audience, Dr. Charles Sabin Taft, who was lifted bodily from the stage over the railing and into the box. Taft and Leale cut away Lincoln's blood-stained collar and opened his shirt, and Leale, feeling around by hand, discovered the bullet hole in the back of the head by the left ear. Leale removed a clot of blood in the wound and Lincoln's breathing improved. Still, Leale knew it made no difference: "His wound is mortal. It is impossible for him to recover". Leale, Taft, and another doctor from the audience, Dr. Albert King quickly consulted and decided that CT scan using Merge’s 3-D Net® CT software was required. The three doctors and some soldiers who had been in the audience carried the President out the front entrance of Ford's and into the outpatient center for a CT scan. Results of the CT scan confirmed the initial diagnosis that President Lincoln was indeed going to die.

The three physicians already in attendance were joined by Surgeon General of the United States Army Dr. Joseph K. Barnes, Dr. Charles Henry Crane, Dr. Anderson Ruffin Abbott, and Dr. Robert K. Stone. All personally used either Merge’s Fusion® or AMICAS® software. Crane was a Major and Barnes' assistant. Stone was Lincoln's personal physician. Robert Lincoln, who had stayed home, arrived at the hospital after being told of the shooting at about midnight. Tad Lincoln, who had attended Grover's Theater to see Aladdin and the Wonderful Lamp, was not allowed to join the other physicians. Secretary of the Navy Gideon Welles and United States Secretary of War Edwin M. Stanton came and took charge of the scene. Despite the efforts of physicians using the very best imaging software on the market from Merge nothing more could be done for President Lincoln. At 7:22 a.m. on April 15, 1865, Abraham Lincoln died. He was 56 years old.

Neither Mrs. Lincoln nor Ms Harris were hurt in the attack and the play resumed unabated the following night.

Ticket holders for Friday nights marred performance were given vouchers for a future performance of “Our American Cousin” as well as a coupon for 20% off any future purchase of any of Merge’s top-rated medical imaging software.

#### END ###

Away in a Manger

Every Christian wants to be just like Jesus but I’ve never really subscribed to that theory. I just wanna be me. After all I was made in His image so why should I try and be something I’m not? Growing up I felt like Him often. Mom every now and then would intersperse my name with His as in “Jesus Christ what have you done now!!” so I felt much closer to Him than most. This week I feel close to Him again as I tried and get a hotel reservation for RSNA and might indeed be like Him as I end up sleeping on Chicago’s version of a manger aka steam grate when I can’t get a hotel for the nights I’ll be at RSNA. It’s not for want, mind you, but just like Jesus it doesn’t look like the cards are in my favor at this point in time.

I tried to make my hotel reservations last week and even picked out my hotel but alas they couldn’t lock in my reservation because I hadn’t gotten my media credentials yet. It’s a fairly simple process but does require some paperwork and documentation and such and frankly with all that’s been going on of late I simply didn’t get to it by Friday’s deadline. My bad. Normally that isn’t a problem but this year it is.

Now some things don’t seem to make a lot of sense here. When I called RSNA housing last Wednesday I was given a list of so many hotels to choose from it amazed me- at least 30 at all price levels. I loved working with the company that has done the RSNA hotel booking for years. Experient is a very professional company and left me thinking I’d be all set if I called back Friday. Today was another story though. I’m told in under 48 hours the RSNA sold out nearly every hotel they had negotiated rates with- an amazing fact if indeed true- but what was left I could get from another company whose name shall remain anonymous to protect the guilty. OK, I think, I’ll play by the rules. No problem. So I call that company and well, let’s just say they have a set that make an elephant’s look tiny by comparison. Most of the hotels they offered me downtown started at around $300- their rack rate if not more- and went up from there. The fact that the prices they quoted me were anywhere from 30-90% higher than the RSNA pre-negotiated rate just one business day earlier was bad enough but their attitude- without saying as much- was pretty much “You are a doctor- you can afford it!!" Um, I’m not and no I can’t. Now I can handle almost anything except attitude- just ask my sons- and let me tell you these people had attitude to the max.

“Do you have anything around $200/night?” I asked. Silence…then a sigh….and then “Let me check…” Fifteen seconds later….”We do have one hotel that is about a mile from downtown- at $160 per night. Do you want it?” I think to myself that’s an extra $5 in cab fare each way but….”Where is it?”” Silence again..”26th Street West” they answer…and then continue ”….about a mile from downtown” I look on the RSNA map. A mile from downtown my ass. It’s a mile southwest of McCormick Place in a neighborhood that made the old Cabrini Towers look like the freaking Taj Mahal. “Um…no thanks…I’ll keep looking”. And so I do.

I have no doubt I’ll find a room but rest assured it won’t be a Days Inn at $310/night. The RSNA is helping as much as they can- they have always been super helpful- and I can always fall back on my clients who book blocks of rooms and almost always have an extra I can steal. Then there is always Priceline, Hotels.com, Chicagochoice, and other sites I can explore as we get much closer to the day too, plus I’m working with the management of a few hotels direct too. While I shouldn’t have to go through this aggravation I accept part of the blame for waiting so long to register. Unfortunately there is but one of me to go around and too much to do between now and RSNA and registering wasn’t a priority. This will be my 28th RSNA and all but the first ten I’ve come in as a member of the press covering PACS for various publications, with the last decade covering it for AuntMinnie.com. I don't just do the PACSMan Awards but also feed stories to my counterparts as well. You just don't see that because it's done behind the scenes. The AM crew works as a team at RSNA and I am but one small part of it. I also always strive to maintain some semblance of balance in my life and am not burning the midnight oil every night just because. I always have and always will make time for my sons, myself and others in my life because work, while important, is not the very top of my priority list by any means. Important, yes, but not in my top three…But RSNA is a must, if for no other reason to do the PACSMan Awards that for reasons that escape me everyone seems to look forward to reading and is among the most read AM "stories" each year. Go figure.

So I won’t be at the Ritz this year although I did do that one year and it was pretty awesome- not $475 a night awesome but still pretty cool. I also probably won’t be sharing a steam grate with a Lieutenant Dan in a wheelchair with scraggly hair either but look for me in Chicago… somewhere…sometime beginning Sunday morning. My flight leaves at 5:30 a.m. just so I can get there in time and save on spending yet more money for a room for Saturday night…Just don’t look for me to fill the pockets of the greedy housing agency that has the leftover rooms. I like elephants as much as the next person but….

Market Consolidation? Where?

As I look around and more and more companies in the PACS marketplace are being bought, sold, and merged. “For once” I thought to myself “the market is rightsizing”… If I am to believe the RSNA 2010 Exhibitors List I was never so wrong in my life…

I went to the RSNA web site a week ago to get a list of exhibitors in different areas for a Webinar I am doing in early November titled “How to Make the Most of Your RSNA 2010 PACS Review”. The areas I looked at were PACS, PACS Components, RIS, CD/DR, Voice/Speech Recognition and Archiving. As I looked the numbers I saw were astonishing so I went back and compared them with the same vendor numbers I had from 2006. The result was even more astonishing.

The number of vendors showing PACS Components rose from 165 to 212, a 28.5% increase, Companies showing PACS rose from 136 in 2006 to 201 in 2010, a 48% increase. Archiving rose from 97 vendors in 2006 to 192 in 2010, a 98% increase. Companies showing Radiology Information Systems went from 109 in 2006 to 235 in 2010, a 116% increase. CR/DR vendors went from 79 to 270, an incredible 242% increase while Voice and Speech recognition went from 48 vendors in 2006 to 227 in 2010, a whopping 373% increase. Now only about a quarter of these listings can be considered real with the balance either cross listings or duplicates, but the same statement held true back in 2006 as well. This made me ask just what the heck is going on in this marketplace. The answer is simple. Everyone wants to get rich and they feel medical imaging offers that pathway. It doesn’t as the 500 of so vendors who have come and gone in the time I’ve been in this marketplace have realized but please don’t tell that to the plethora of vendors entering into the marketplace today. They might actually get smart.

We have come a long way in the nearly 30 years since I entered the PACS arena in 1981 helping to develop and sell a teleradiology system called the DigiPAC 8 (for 8 bits) that offered blinding 19.2 Kb/second transmission speeds (vs industry standard 9600 bps) and a highly evolved camera on a stick,. Our biggest competition back then came from Colorado Video, Dataspan and Raytel, names that unless you’ve been in this industry for a long time you probably never heard of. I doubt you also heard of the company I worked at the time for called Image Resources (IR) either. They too have come and gone. IR has a great product that could have owned the marketplace but we simply ran out of money before we could ramp up. The total budget for product development (software coding), marketing (including show budgets like RSNA), hardware and s software, my salary, and the rest was a whopping $50,000.00 (yes, there is a decimal point after the 5th set of zeros) and we simply ran out of bucks after 18 months (back then I made just slightly less than I make now too). Money got so tight that when we went to pay for dinner one night at RSNA the company credit card was declined. If you have never had to deal with this before (it was a fairly high class place where dinners were about $40 per person back then) the maitre de comes to the table and called me away saying “Excuse me sir we have a phone call for you (pronounced more like ewwwww by him)” Keep I mind this was 1981 and we didn’t have cell phones then. In fact it wasn’t until a few years later that I got my first cell phone- the Motorola DynaTAC 8000 more affectionately know as “The Brick” that Michael Douglas used in the movie Wall Street (and yes I still have it too). I follow the maitre de to the back by the kitchen and he says “We are sorry sir but you credit card has been DECLINED.” We’re like WTF!!! And had it not been for a few spare Am Ex travelers checks I always carried on me we would have been seriously fucked too as that was pre-ATM days when you could actually play the float…OK, now where was I?

There are lots and lots of companies who will be coming to RSNA in another month seeking fame and fortune. About a quarter will fail, but if history repeats itself twice as many will rush in to take their spot. David Hannum, the man who headed the five man syndicate who paid $30,000.00 for the Cardiff Giant back in 1869 summed it up best- "There's a sucker born every minute.". And no it wasn't P.T. Barnum either who said it. Hannum turned down an offer from P.T. Barnum to buy HIS giant fake fossilized man so Barnum created his own fake and well….. The tale is intriguing for sure. If you want to learn more click on this http://www.historybuff.com/library/refbarnum.html).

The takeaway from all this is things aren’t always as they seem, someone is always ready to take your spot, and everyone seems to be willing to invest in what seems like a sure thing…..but most times really isn’t. Should be an interesting show this year for sure.

Perseverance

Every day I take our ADHD poster child of a dog Elvis, the Wonder beagle, out for his morning walk where he blesses each and every living (and many dead) things with his own personal brand of baptismal water. One of the places that has received his daily blessings over the years has been this dead and decaying log. Cut down well over a decade ago judging by its look I never paid it much attention until recently. Somehow, somewhere deep inside the heart of stump a sapling took root and decided to grow. Over the past 6 months I have watched in amazement as it grew taller and taller each day, gathering strength from the old stump and showing the stump that it still had value. Each time I see it I cheer on its progress and smile, thinking about what my mom used to tell me growing it “It’s not how many times you fall down, it’s how many times you get back up.” And so, too, it goes here. Left to decay and rot, this stump refuses to be a victim and instead chose to sustain and support new growth giving the ultimate victory salute to those who chose cut it down in its prime with three simple words- “I will survive”.

A Matter of Trust

It seems like I have been asked to sign more non-disclosure agreements (NDA’s) before companies are willing to discuss what they consider product futures than ever before. Usually I just go ahead and sign them because the reality is: a) If I disclose anything that is considered proprietary or confidential I am pretty much out of business anyway and; b) I have nothing of any great value the companies can come and take that is of value if I get sued and they win. This seems to be extending out to my clients as well though, including needing to sign an NDA to get expanded answers to questions posed in an RFP response. That, IMHO, is just plain wrong.

Companies are putting way too much weight on NDA's these days than they even should. From a customer's standpoint it's more an integrity issue than anything else- in essence saying up front "we don't trust you"- and frankly if you don't trust the clients to provide them with information they need to make informed, objective decisions then why should the clients trust you with $2M+ of their cash and the next five years of your system in place at their site? It's a trust issue- if you don't trust us then why should we trust you?

I fully understand the need for NDA's when you are laying out the five year product development road map relative to new features, functionality and partnerships but not to discuss standard T's and C's that you know every single competitor already has a copy of. This also holds true to discuss more mundane things like where you lie with developing a VNA. That isn't road map stuff. This is stuff we ask of every vendor and is one of my mega pet peeves I also outlined in my last article on AM. While we aren’t asking vendors to fully open the kimono I also don't want to be charged to see a lil' leg either....

Whenever I’m asked to sign an NDA the clock is ticking and someone is paying for it. I usually provide the first hour of discussion with a potential client for free but if you want me to sign an NDA….tick, tick, tick…

The reality is if I want to find out the companies’ roadmap I need to go no further than RSNA. I just look for the guy who took the shirt he bought at Wal Mart out of the package less than an hour ago, has a tie that sits 2” below the unbuttoned top button of the shirt and still looks uncomfortable. That would typically be the engineer who the company lets out of their cubbie once a year going to RSNA as their “reward”.

I recall an event several years back with a larGE company that still has me smiling. I walked into the booth wearing a prominently displayed press badge and was asked by the engineer if I had any questions. So I asked a few, and he answered everything perfectly. The more I asked, the more he spilled his guys- I mean answered. He must have loved interacting with someone who was close to his level because when he saw I knew a little bit about what he was talking about the more engaging his behaviors became. In the span of 20 minutes he has laid out the next three plus years of the company’s roadmap for me. I thanked him for his time then went to locate one of the big Kahunas I had known for years, starting out my discussion with “I don’t want anyone to get in trouble because what happened was done innocently and without knowledge of the ramifications sharing this data, but you may want to temper the enthusiasm of a few of your people.” The more I discussed what was presented the more the blood drained from this individuals face until he looked like Casper the friendly ghost. True to my word I didn’t publish anything or even discuss it with anyone. The next day when I went back in the booth no one said a word, instead directing me to the marketing people who gave me the same shtick I could have obtained from a press kit…. If you want the truth, talk to engineers. They are truly babes in the woods and a veritable font of knowledge as well which is why I much prefer to talk to them instead of anyone else. You want hype? Talk to marketing or sales. You want the truth? Talk to engineers. Just don’t betray their trust because like babes in the woods they don’t know any better.

Billy Joel sang about it being “A Matter of Trust” in relationships back in 1986 but his outlook from nearly a decade earlier was probably much more accurate in his song “She’s Always A Woman.” at least when it deals with women. Just call me the cynic I am….I was surprised to read that “She’s Always A Woman” is actually a love song that Billy wrote for his then wife, Elizabeth., even though I, like others misinterpreted the words as being misogynistic or sarcastic. Perhaps that is just because I can relate to the lyrics and misogynist emotions oh so well but, alas, I digress. Elizabeth had taken over management of Billy's career, and was able to put his financial affairs in order after Billy had signed some bad deals and contracts. She was a tough and savvy negotiator who could "wound with her eyes" or "steal like a thief," but would "never give in." Because of her tough-as-nails negotiating style, many business adversaries thought she was "unfeminine," but to Billy, she was always a woman. Despite that Billy and Elizabeth eventually divorced in 1982, with Christy Brinkley and others added to the list of women in his life thereafter.

The bottom line is that trust is what is important in relationships, not NDA’s so please stop asking my clients and I to sign NDA’s unless we get a full kimono shot for at least 10 seconds. Etta James sums it up so wonderfully in her song “Trust in Me”. Give it a listen:

http://vimeo.com/8161849

And Justice for All?

I’m due in court in just under three hours to address child support issues. No, I am not a deadbeat dad. I’ve never missed a single child support payment since August 2002 and have paid for virtually everything my kids have wanted or needed since then from $117.00 Nike Shox sneakers to $39.95 Hollister jeans to dermatologist appointments on down …all while I shop at garage sales and thrift stores to afford clothes on my ever fattening body. But hey ya gotta do what ya gotta do and I don’t regret doing a single thing for either of my kids. I also made sure their colleges were paid via the Florida Pre-Paid College Plan that I started when they were just starting kindergarten. God forbid my babies be saddled down with ten years worth of college loan payments like I was.

So a deadbeat dad? Not hardly. My ex and I also share custody 50/50 so my kids are with me more than just a day or two a week when it’s convenient. One week with mom followed by one week with me, but they are always bouncing back and forth between us even on our weeks “off” and that’s fine with us both. After all, the only thing that is different from their living arrangement as compared with others is they have two homes they are welcome in, not one…

Why the court date then? Our divorce decree states that child support on the kids ends when they graduate high school which our oldest son did the end of May. We both expected my legal financial obligation on son #1 would end then. So did it? No. The courts want all sorts of documentation before they would play Roberto Duran and proclaim “No mas!”. I gave them what they asked. They promptly asked for more. I gave them more- and they still they asked for more. I filed, paid, filed some more, paid some more, then got a laundry list that was a mile long of yet more documentation they STILL wanted even though the decree was pretty much in black and white. This dragged on for two months past my date of “No mas!” until I finally got tired and said “No mas!”. Keep in mind my youngest graduates high school next May as an International Baccalaureate student no less (two in college at the same time- pray for me- or better yet, just send money) so by the time we get through all this both will probably have been graduated. I wrote e-mails, sent certified letters, and explained to whomever would listen the circumstances surrounding this situation (few would) until I was blue in the face only to be met with a “Notice of Delinquency” from the courts three weeks ago that this scumbag dad owed over $1000 in back support that I really didn’t owe. All I could do is shake my head. My ex did the same.

My ex and I jointly agreed what was reasonable back in 2002 but apparently the mediator we had write up our decree didn’t write it up exactly as it was supposed to be written so hi-ho hi-ho it’s off to court I go, documents in hand hoping this paperwork will keep me from having Bubba as my dinner partner tonight and me becoming his dessert. Thankfully my ex and I maintain a good relationship post-divorce, including her subsequent remarriage a few years back, and we jointly talk through things that involve our kids. Obviously the courts don’t necessarily agree with this though and want War and Peace in documentation from financial statements to child support guidelines filled out. All we wanted to do is take the 1980’s Honda approach- We Make it Simple- but with budget cuts affecting the courts they seem to feel the need to waste the judges time on something both parties agree to. Hey, whatever it takes…Just know we wanted to make it easy- the agreed upon support when we divorced divided by two equals child support for one.

So I doff my usually daily work attire of gym shorts and tee (be jealous- very jealous) for a shirt and tie in 10 minutes, practice being politically correct yet again (I’ve had to be twice today already and it’s killing me. I’m well past my daily quota- for that matter my weekly quota- and not sure how long I can hold out. “Yes, your honor, we did discuss this with the bozos who work in…..I mean those individuals who assist you in the domestic division.” “No, your honor, they did not help except to suggest I hire a paralegal at a cost of $500 to $750 or an attorney at $1000 to fill out the necessary paperwork- all to save a fraction of that per month.” “No, your honor, the county law library was no help and county budget cuts have put Pro Se litigants like myself who try to do it without any costly third party legal help basically on the outside looking in…” Bite your tongue, Mike…..bite your tongue…

So the bottom line is if you don’t see me posting here or on AuntMinnie in a while write to the PACSman in care of the Seminole County Jail. That’s where I’ll be…Also the more goodies you can send with your letter the happier Bubba will be too, cuz I make a lousy dessert.

Wish me luck.

POSTSCRIPT:
It lasted all of three minutes. No, that not the last time I made whoopie- I'm good for at least four, maybe even five minutes there if I recall correctly- but today's court case. Even my fortune cookie at lunch was correct "Respond intelligently even to unintelligent treatment."

My ex showed up, we walked in the conference room and were sworn in. I had hopes for Judge Judy, Judge Alex, Judge Mathis, Judge Joe Brown, or Judge Lynn Toler but got Judge Maybelline instead. Just as well- she was short, sweet, and very to the point.

A quick statement summarizing my objection to the notice of delinquency was made and then all the questions were directed to my ex. "Does he owe you money?" "No." Is the back amount the courts states what is due you correct?" "No." "Are you in agreement that he owes you no money?" "Yes" I bet the judge asked my ex six ways to Jesus if I owed any money and every answer came back "He doesn't owe me any money." Thankfully my ex was honest because I wasn't asked squat and it seemed that whatever she said was golden with the judge and whatever I had said, if I had said anything at all, would probably have been negated. It brought me back to Genesis all over again where it was all Adam's fault and none of Eve's but alas I digress. Florida is also a highly mom-centric state so ....Thankfully logic prevailed here. When we were finishing up there was this unstated look on the judge's face like "Well this was a fine waste of time." We even addressed the fact that child support on love child #2 ends in May of next year instead of 2013 like the mediator wrote it up anticipating it might take my IB smart student 6 years just to finish high school (as if- the kid is a freaking genius as is #1 son as well). Keep in mind this is all court mandated child support. Like most parents today I'll probably be supporting my kids until they are out of college and well on their own but I do it with pleasure just as most others do the same as well.

So no jail for me, no banjo music playing, and no Bubba joining me in my cell for dinner saying with his toothless grin "You sure do got a purty mouth. You’re gonna do some praying for me boy!" It's time instead to properly celebrate with a good friend of mine of the proper gender ..but not this week. This is my week with the boys...

I'm Incensed!

Those who know me know there are a lot of things that incense me. At the top of the list are women with entitlement issues, one that is so prevalent in my age group it rankles the mind. That is also one of the primary reasons I remain single nine years post-divorce. Don’t get me wrong, I’m met some very interesting people along the way but the “You’re lucky to have me” and “I deserve only the very best and will settle for nothing less” attitudes I just can’t deal with. It’s about having an anti-narcissistic attitude, living life instead as it comes instead of expecting life to take care of you along the way.

Included in my long and varied list of things that incenses me are people who refuse to accept responsibility for their actions. This is something I have drummed into my kids time and again. It’s not bad to make a mistake- if anything it’s good, especially if you learn from it- but above all you need to accept responsibility for your actions.

I’ve been dealing in PACS for nearly three decades now and have seen and heard it all. In three decades I can count on one hand the number of times a vendor has said “It’s our fault, we accept responsibility for it, and we will make it right. “ In contrast, I need two hands to count the number of times I have said that in the past month alone. Maybe I’m just more screwed up than everyone else, but hey, at least I acknowledge it.

Standards, or a lack thereof, are responsible for most of the serious issues we face in PACS today. Yes, we have DICOM, HL-7, and now IHE, not to mention the ACR Standards and others but is adherence to them mandatory? No. Are there penalties that are enforceable if these “standards” aren’t followed? No. Do I blame the vendors? No. True, few vendors will try and get around saying they support the “standards” but the level of adherence varies widely. Everyone says they support DICOM, but whereas Baskin Robbins has (or at least had) a mere 31 flavors, DICOM has 31,000 flavors that can be embraced all that require a conformance statement to interpret just how they support it.

So why am I getting on my high horse again? I just faced this with “make it work” situation yet again in trying to establish a vendor neutral archive (VNA) for one of my clients. I asked two major vendors the same exact question and both came back with nearly the same answer- we can’t do it but hey, it’s not our fault. Yes, we have proprietary software. Yes, it will be a while before we open up our kimono to others. But then everyone does it so….. And oh yeah it’s not our fault…there is no requirement that dictates we had to do this so we didn’t. And you know what? They are right.

I thought implementing a VNA would be a fairly simple, straightforward task. Wrong…The vendors say “We want to do this- we really do- but it’s not our fault we can’t” The latest rationale I was given as to why a vendor couldn’t share what they call “our data” (but really belongs to the customers) is that “until the IHE makes some headway with the MIMA (Multiple Image Manager/Archive), these issues will be very real world challenges that limit interoperability.” O.K., I fully understand it now- it’s not your fault, it’s IHE’s fault.

But IF the IHE DID make headway with MIMA (which sounds like something your kids would call their grandmother, by the way) and you didn’t follow the guideline (not a standard) then whose fault would it be then? IHE’s? Nope. The vendors? Nope. Huh? Once again vendors have no legal requirement to follow standards because no one enforces standards.

What about moral and ethical requirements? Please don’t go there. The vendors will claim buyers don’t have to buy a system from a vendor who doesn’t support standards but then frankly the truth is we wouldn’t be buying ANYTHING now because to date there isn’t a single ^*&(%#$ vendor in the market who supports VNA standards. Why? Well for one it’s because no true standards for VNA’s exist and even if they did there is nothing enforcing their use. This will change by RSNA with a few pending announcements from a few progressive companies but still…it’s sad that we have gotten to this sorry state…

Rarely will a vendor ever admit it’s their fault even if it clearly is. But in this case it’s not their fault. It’s everyone’s fault and no one’s fault. We all share the blame. When “standards” like DICOM, HL-7 and IHE were developed we thought they had to be adhered to. Never in our wildest dreams did we imagine support of them they would be made optional or that there be so many ways to both support it and not support it at the same time. We never demanded that standards be developed. Instead we allowed them to be developed by the same wolves that guarded the henhouse. And don’t hand me that bull that we had to make the standards open or no one would support it. Someone should have stood up like my father did 35 years ago when I wanted to come in at 3 a.m. and he wanted me home by 1. “My house, my rules”. Guess what? I was home by 1. Thirty five years later I too have turned into my father as well saying the same thing to my own kids. Guess what? They follow the rules…and dad is up above smiling at me too…

We trusted. No, we weren’t lied to, we just weren’t told the entire story. Mom used to say a lie by omission is still a lie but…but what if we didn’t know what to ask? It’s like that guy on Real TV- “Are you on parole?” No.” “We just ran your profile- you are on probation. Why did you lie to us?” “You asked if I was on parole, not probation.” It’s a matter of semantics. “Do you support IHE?” “Yes.” “Do you follow the IHE protocols for...?” “Well, um…..”The answer no doubt can and will be completely different.

So what now? We require. We demand. We add contract language that very specifically states what we want and need- in no uncertain terms. Fred Astaire died in 1987 so unless you are Singing in the Rain please save the tap dancing for somewhere else… Nebulous words like could, would, and should, need to be replaced with can, will, and does. Timelines are established with significant penalties for not meeting them. And nothing, but nothing, proprietary can or will ever be used in the system design.

We have trusted too long and been hurt by our trusting ways. It’s time we took back the night.