It’s Wednesday, October 26, 2022 in Portland, Oregon and yesterday I wrote a proposal that extends into 2023 and we are officially living in a dystopian future.
I will go back in time and tell younger me that we walk around with super-duper-computers in our pockets blithely and complain that they don’t keep working when we drop them too much, that women’s right to bodily autonomy is as we suspected being systematically erased, that people wear masks now, but also they don’t, and that’s made a lot of people very angry on both sides, and not to say the phrase both sides too much in my future. And I could go on.
Just one thing today.
This might not be what you’re thinking based on the title.
So. After years of bad posture and lots of typing, I started getting pain in my right shoulder. It’s gotten better since I switched to an upright mouse (mouse progression: regular tiny Apple Magic mouse, then a Logitech MX Master 31, and now a Logitech MX Vertical mouse2 which which is fantastic other than it lacks the second scroll wheel, which it turns out I used a lot! The vertical mouse makes a difference - instead of having my wrist (and so the rest of my arm) rotated, it’s upright, like in the “hey dad, is it true that you used to hold out your hand and then another person would grab it and you’d shake them in the beforetimes?” sense.
After putting it off for, I don’t know, maybe a year, I go to see a physiotherapist at the insistence of my dad (i.e. he just went a booked an appointment for me and told me I was going). Tip: listen to your dad, they might have good advice.
I saw a good physiotherapist! She was, to apply a stereotype, matronly in manner, with a sort of no-nonsense, brusque and straightforward approach. Short sentences, very precise. And yet also pretty compassionate, which is not what you’d usually expect: lots of “yes, this happens a lot” and “we are where we are” and “this makes a lot of sense” and then even better “good news, we just need to do a few exercises”.
Turns out there are some muscles in my right shoulder that aren’t as strong as they need to be, so there’s a stretchy resistance band exercise I need to do that will build all three muscles back up.
So far so boring and you’re all reading me talking out loud about my physio appointment, wondering where this will get to the technology bit.
So, physio-not-matron does one thing first: she gets me to take off my shirt and go through some motions to diagnose and confirm her prediction. It is correct.
And then asks me to do them again, because she can video them on her iPad, we can look at them together and she can show me what she sees so I understand what’s happening, and then AirDrop them to me, so we can look at them together.
And then we do the same thing when we’re doing the exercise so I can see how I’m supposed to do the exercise, as opposed to watching someone else do it on a pre-recorded video. This way I get to think about what I’d want to see to check I’m doing the exercise properly and we get a bunch of angles.
So I ask her: wow, it must’ve been a big difference when you started using an iPad to show and share video, how did you do it before?
Physio-not-matron: Oh, it was very difficult. We had a camera set up and a big TV, and we’d have to look at the TV, I wouldn’t be able to make copies…
And, you know, this feels like a super big deal. You’d think that one affordable digital video recording, the storage and compression required for it to be high quality, the infrastructure required to share it easily in person, and then the market penetration of such devices so that the recipient actually can watch it… that’s a lot to come together, and it didn’t even come together deliberately.
One approach you might take to “the problem of physio” and “using computers these days” might be “oh wow, you could use computer vision and inverse kinematics to estimate skeletal position and maybe even ML a predictive model as to how muscles are moving around and then auto-diagnose”.
Or, you could just have a practitioner take a video, turn around and show it to you, pause it, pinch-to-zoom-in, scrub it back and forth until the patient sees what it is they’re supposed to see and then share it.
You could even do that badly. You could decide you want to wrap it all in an app and worse, you could build your own playback engine, you could decide not to use the system engines and interfaces for video recording and playback, you could decide to compress it in your own weird proprietary format, you could keep the video in your app container/storage so it can only be shared through the app to, I don’t know, a portal.
Or, you could use exactly the same tools and process that anyone else would do to record a goddamn TikTok and just AirDrop, email, or send it to someone.
Now, there are reasons why you might feel like you have to develop an app. Some of them might, in the U.S., have to do with something like HIPAA and privacy, which if you’re receiving healthcare services in America you might experience in terms of an email that says “hello, we have sent you an email, please log in to the secure portal to view it” and if you’re lucky it’s a portal by one of the two major Electronic Healthcare Record providers, and if you’re unlucky, it might look a bit like what if Matt’s Script Archive had HIPAAMessaging.pl as a hacked-up version of guestbook.pl.
As an aside, there’s something I’ve noticed recently where you can just email a healthcare provider in the U.S. because they say that their access to the email is “secure”, which also means they can… just email you back? No portals required? Huge if true! I mean, it looks like hushmail will send you a turnkey [sic] HIPAA privacy-compliant email system3 that also includes webforms, and I only remembered Hushmail might have a thing for this because of brand recognition.
But I digress, which is easy to do so when you’re talking about healthcare and you live in the U.S.
My point was: this was a healthcare provider who figured out on their own, in another example of users aren’t stupid, they figure out what they need to figure out to do their job and some of them are more adventurous than others. This is, in my mind, in the same space as your office worker who accidentally becomes a critical piece of infrastructure because of an Excel spreadsheet they made once.
Sure, it could’ve been better, and there are tradeoffs. It could’ve been better if the video were annotatable, and there are hacky ways to do that using iPadOS’s built-in photo/video application: take a screenshot, whip out your Pencil, draw over it, then send that screenshot. Messy. There’s probably apps to annotate video. But then they’re apps to annotate video or other video-specific apps, which is a whole rigmarole in terms of finding them. Then there’s the “Okay, after I’ve received the video from my physio over AirDrop, it’s helpfully in the giant pile of videos and photos in Photos on my iPad. That’s an iPad search/organizing problem that would otherwise be solved by user effort, like me labeling/titling/tagging/putting the videos in an album like “Videos My Physio AirDropped Me That Are Relevant Not Only Because Of My Shoulder Hurting, But Also Interesting From A Technology Point Of View”.
I loved talking with her about it. She was so excited about it, and not in the “new” excited about it fashion, but more in the “this works really well for my job” and “my patients appreciate it”.
So. Consumer technology being repurposed not just in terms of the street finding its own uses for things but, uh, physiotherapists in their practice.
Oh, P.S. Matt Levine, who is a writer I aspire to whom I aspire to be at least a millionth as good, has taken over the entire issue of Bloomberg Businessweek to explain crypto in The Crypto Story4, something that’s only happened one other time in the magazine’s 93 year history, and now I am awaiting the inevitable 40,000 word Axios bulllet-point story in retaliation.
Okay, that’s it for today. Just the one thing.
The long saga of “will Twitter let me share newsletter.danhon.com or even danhon.com today” continues. As of, uh, press time [sic], it is not letting me! This is despite some more false positive reports and asking Twitter do fix it.
(You can help: tell Twitter that newsletter.danhon.com is safe, in the “well, in the larger sense, no, it is not harmful content” sense, much as when my psychiatrist asks me if I ever feel like people are listening to me, and I say, well, no more than usual given today’s environment of near-ubiquitous surveillance-based advertising, and then we both laugh and there’s a beat and we sigh, wearily).
So. I am taking one more step to giving up and just registered thingsthatcaughtmyattention.com which is not live, and is a longer domain name than I would like, but who types domain names now anyway?
How are you doing?
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The Crypto Story, Matt Levine, Bloomberg Businessweek, October 31, 2022, and archive.ph version. ↩