Over the past few months, I have been fascinated with Neuroscience. Especially the process of thinking. It is how you track an idea (thinking actively), let the idea ruminate (passive) and then you have the “a-ha” moments; especially in the passive phase where you actively form the links between the different idea-chains.

These themes dictate each post (or my writing elsewhere). I could, of course, crystallise the thought process and the new software workflows (I will, I promise) but that is not the moot point here.

I had stumbled on an interesting discussion on Hacker News (Ycombinator website)- to create more ideas (than reading up) as it would help to fight off redundancy. Interestingly, after working on different themes (in both active and passive phases) followed by incessant hammering on my keyboard, I could easily spot patterns between them. Each idea links to another inextricably like a spider web.

The previous iteration.

While previously, my intention of having a specific blog was to showcase a niche interest (neurooncology), I quickly realised that it was a self-imposed limitation. It did help me to get the ideas off the ground, but not in the direction that I needed it to go forward (for example, in terms of getting a career “development”). As such, it was a learning experience in itself; to be a “generalist” while dealing with the niche themes.

Further, I have also been impressed with a few newsletters that I stumbled about while searching for regular reading. Each one of them showcases specific technology domain (like for example, neurosciences newsletter I alluded to above). (I will discuss them in a future post). Regular writing does require a specific set of mental discipline which one needs to cultivate in earnest. I reiterate- it is not difficult to write but have a clear line of thinking instead.

For example, the thoughts behind this specific blog post were always there- I just had to communicate clearly on why I started up this venture. It was germinating all the while.

The design process

I have kept the template and idea simple. I wish to analyse the papers. Especially create a workflow to share essential annotations. There are several ways to achieve it, specific software and project management tools. I don’t claim perfection using those tools, but I aim to create an inspiration that would help to synthesise newer ideas.

Ideas aren’t formed in a vacuum- I call it as a combinatorial process. We read, discuss, deliberate, think and “mash-up”. These then create a novel perspective which aims to “educate” the users. Let’s call this blog as a starting point for research.

The why for this blog

Several threads can go forward (as the starting point for research) but this a slightly long-form post is about defining the “why” for the blog. I had been experimenting with the efficiency aspect of the process yesterday, and I have pleased with the process.

Using technology and software tools

Technology is a great enabler. I like the way software interacts with the ideas to bring out a fresh insight into what’s in my mind. There are several ways out to achieve your end goal- while I won’t specifically delve into how the different processes stack up together, I will push my own into this domain. As I mentioned earlier, it helps to concretise the thoughts into words.

I am positively impressed with the idea of making mind maps. There are several ways to achieve it, but it helps one to zoom out of the perspective and get an idea. Likewise, as much as I loathe the publishing process, these are inextricably linked to one another. I am often surprised that breast cancer radiation still gets frequent mentions for reducing lymphedema, for example. The simplest way to avoid it is to ask the patients to exercise. As I said, we end up losing the trees for the woods.

Crying need for collaboration!

This blog is also about trying to foster collaboration. Despite many tools to collaborate online, I find very few users on them. They usually prefer the asymmetric tools like Twitter (perhaps as a way to “interact”) but the “microblogging” tool as it is made out to be, fosters no ideation at all. It has become a haven for bad politics and drowning out the thoughts (especially in conformation biases) by using opaque algorithms. I still maintain an active Twitter account, but I realised it is easier to build up tweets by using specific bots and processes to get the word out. Likewise, I haven’t found any specific use cases for Slack/Sharepoint or any number of online collaboration tools that promise to make your team stronger. I am still finding an individual who would want to stay connected to work offline.

Writing is, indeed, therapeutic.

Future Directions

Several threads merit a deep dive. I have no intention to make the blog “SEO” friendly- by looking up specific keywords that Google could digest. I intend to relay out the ideas in the public domain and use tools that encourage data portability. I would be using a public Dropbox folder to share articles (PDF’s and annotations). I use Mac OS because as much as I tried, I couldn’t find specific “open-source” alternatives.

Philosophically, I strongly advocate and push for open source (not open access publishing- that’s a political minefield). However, there is a strong idea that open source should be free, which violates the fundamental idea of paying up for someone’s labour. Software development isn’t free and requires significant time investments. Paying up for it is a reasonable explanation.

Attention is a scarce resource. We need to find out life hacks- to achieve zen, inbox zeros, restricting screen time etc. The blog isn’t about those pursuits though. I consider them as “pop-technology”. Something that makes the news because their marketing department considers it essential to push out. However, our attention though, has fixated or gravitated towards audio-visual media. It was perplexing thought before I signed up for WordPress and plonked my hard-earned money. The central question is- how will I able to add value in the time when the attention spans have reduced.

Luckily, my workflow gives me plenty of time to think/ruminate and write. The initial process will, of course, be about the “discovery” of the critical paper. One of the reasons why I earlier thought Twitter would be a good idea was to dump all the oncology papers in one stream and use the “wisdom of the crowd” to highlight the crucial papers. AltMetrics does something similar, but then it could well be skewed in favour of something controversial or provocative. My further grouse is that clinical data is inherently heterogeneous. In the era where we speak about personalised oncology, it is a misnomer to “standardise” patients undergoing “radiation for brain metastases”.

As much as I tried, the Twitter experiment didn’t work. The rate of engagement on Twitter stream is less than 2% (out of your whole network). Likewise, I am sure that no one would read the blog post in its entirety- unless they are die-hard fans of long-form. (I am assuming that you know what long-form is!).

So the process of discovery has to be individual. Like I mentioned earlier, collaboration doesn’t happen online or offline because our attention spans are highly fragmented. We are more attuned towards visual rich medium than a wall of text. It is, therefore, not surprising that people find more value in Instagram than the old classical medium of blogging.

I often wonder that if Television were called as the idiot box, what are the mobile screens best defined as? It must be the idiot’s paradise!

Technology and Software

Technology (and “digital health”) is fast changing our perspectives on the patient-doctor relationship. I would call it an “uberisation” of medicine. Especially as the end-users become accustomed to convenience and giving up their data for “doctor-on-call”. There used to be a time when users would go to a restaurant to have an experience. However, hospitals have transformed themselves to transactional marketplaces where “users” (not patients) purchase the “expertise” to stay “healthy”. In the not-so-far and distant future, patients would only require visits for surgeries. There might be specific “surgical suites” (an encapsulated chamber) that will offer “remote surgery”) with a recovery period at home. It may sound futuristic (or downright banal) but Telemedicine has made remote consultations possible. What would stop any venture capital fund (like SoftBank, for example) to see if this idea clicks?

I would also channelise other ideas (especially on technology) here and see how they feed off each other. It is difficult to justify the “returns on investment” on something that offers no apparent value upfront. How does investment in the electronic medical records, for example, pay off? How will a manager understand the process of “efficiency-gains” or “patient-benefit”. I have seen a better user stickiness to those hospitals which have invested in the records upfront. One of the downsides is to get the user interface “right” at the first instance because it becomes next to impossible to force specific changes once the end-users become accustomed to it.

Technology has its critics, and it becomes difficult to play ball to end-users who stumble on its use case. The behavioural modification should be an active area of research, especially in the oncology domain. Using the records, for example, becomes difficult for users to adapt if they are accustomed to scribbling notes. There has been a proliferation of different software to replicate those habits, but they only reinforce them; not change them. Change is essential because medical records, for example, require a clear thought process for transcription.

Getting hands dirty

A quick note on the software that I will be using (and a deeper dive in the future posts). My writing software of choice is Scrivener and Ulysses. I prefer Vivaldi browser for browsing. I am using PowerNotes- it is an innovative cloud-based solution for making annotations. There might be other solutions, but I haven’t seen them all. Collaboration becomes difficult in the face of “tech-resistance” for the colleagues because a newer solution has to disrupt patterned reflexes. (No wonder, big companies give huge “academic discounts” to lock users into “habits”). I am still trying to wrap up my head around an interesting desktop solution called MarginNotes. It creates mind maps as you annotate but has a considerable feature overlap with another iPad based solution called LiquidText. I am not surprised that they copied features (MarginNotes comes from China).

PDF annotations are more accessible through various reference managers- Mendeley, Bookends and ReadCubes (a new avatar of PapersApp on Mac). I hope to use either MarginNotes (to get the mind maps as pictures here) or HighlightsApp to have annotations as markdown. I will also be using a mind mapping software- I have been using Scapple for its ease of use) but there has been no significant update in a long time. (It is a sister concern of Scrivener). Ever since I first learned about these software solutions (nearly 5 years back), there has been an explosion of “me-too” solutions.

It can be difficult to pay for them all at one go. I stumbled on SetApp to manage the subscriptions- pay once for all. It is significantly, cheaper alternative than trying to chase down App Store management.

Wrap up

So, there it is- a miss-mash of the ideas- starting from the neurosciences to underscore my motivation for writing and sharing my ideas. The blog is an ideal medium than either the online web services like Twitter or even Facebook. While it can be challenging to get the word out and push for “readership”, but a straightforward solution is to enjoy reading the same script that I am working on. If I can’t understand what I am writing, it would be difficult to justify it to a niche readership.

The posts are likely to get technical, but it is not for the general audience. As I explore the format further, the tag-line “notes from the Isocentre” is justified. As radiation oncologists are fantastic, they are incredibly focused too!

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