Saturday, October 31, 2009

Leveraging positive ethnic stereotypes

The first story of Ten Little Indians –a collection of Sherman Alexie’s stories – is about Corliss, a spunky, independent college-going Spokane Indian teenager. Unlike other sophomores Corliss lives alone. She does not want to share her place with another Indian because “she’d soon be taking in the roommate’s cousin, little brother, half uncle, and long-lost dog, and none of them would contribute anything toward the rent other than wispy apologies. Indians were used to sharing and called it tribalism, but Corliss suspected it was yet another failed form of communism.”

Corliss also does not want a white roommate. Why? Because Corliss is well aware of her native identity and the effect it has on mainstream society. She wants to retain the allure of her identity so she can benefit from it. Here’s a long -- and funny -- excerpt where Alexie takes us through Corliss' rationale:
White people, no matter how smart, were too romantic about Indians. White people looked at Grand Canyon, Niagara Falls, the full moon, newborn babies, and Indians with the same goofy sentimentalism. Being a smart Indian, Corliss had always taken advantage of this romanticism, but that didn’t mean she wanted to share the refrigerator with it. If white folks assumed she was serene and spiritual and wise simply because she was an Indian, and thought she was special based on those mistaken assumptions, then Corliss saw no reason to contradict them. The world is a competitive place, and a poor Indian girl needs all the advantages she can get. So if George Bush, a man possessed of no remarkable distinctions other than being the son of a former U.S. president, could also become president, then Corliss figured she could certainly benefit from positive ethnic stereotypes and not feel any guilt about it. For five centuries, Indians were slaughtered because they were Indians, so if Corliss received a free coffee now and again from the local free-range lesbian Indiophile, who could possibly find the wrong in that? In the twenty-first century, any Indian with a decent vocabulary wielded enormous social power, but only if she was a stoic who rarely spoke. If she lived with a white person, Corliss knew she’d quickly be seen as ordinary, because she was ordinary. It’s tough to share a bathroom with an Indian and continue to romanticize her. If word got around that Corliss was ordinary, even boring, she feared she’d lose her power and magic. She knew there would come a day when white folks finally understood that Indians are every bit as relentlessly boring, selfish, and smelly as they are, and that would be a wonderful day for human rights but a terrible day for Corliss.
Alexie is brilliant here: through Corliss’s character, he’s brought to fore a host of issues: identity, what it means at the individual level, the sense of entitlement it may bring; the stereotyping of minorities but also the reverse stereotyping of the majority (which is essentially what Corliss is doing); and -- though this is more subtle -- the touchy question of reparations.

Monday, October 26, 2009

Fall in Massachusetts

New England, as many of you may know, is famous for fall colors. When I moved to Amherst, Massachusetts in August last year, I hadn't given much thought to what was in store. But two Octobers later (October is when the leaves change) I consider myself very fortunate. All four pictures are of places in my immediate neighborhood -- they are all a minute's walk away.

The first picture is of Puffers Pond. The pond is where the Mill River drains before making its way to the more voluminous Connecticut River. The second picture is the road adjacent to the pond. The cars are parked close to hiking trails.

The third picture is of a stand of trees on my drive to the university -- this is where you typically see the best juxtaposition of colors. A half-decent photographer would have done a much better job. And the last picture is of the street I live in (the silver-gray car is mine). With leaves strewn all over, fall is indeed the perfect word to describe the season. The rustling of dry leaves is the dominant sound; the leaves conspire even to enter your home, traveling unobtrusively with your footwear.

Friday, October 23, 2009

Outline of the republic

Basharat Peer, author Curfewed Night, reports from Pakistan (via Amitava). Excerpt:
One mid-June afternoon, while walking in the heart of mainstream Pakistan, on the Mall Road in Lahore, I stopped briefly at a row of tables collecting relief for the Swat refugees. One of the largest was run by an organisation called Falah-i-Insaniyat – Benefit of Humanity. A young man was at the table; stacks of clothes, pulses, rice bags and utensils were piled in the tent behind him. He gave me a pamphlet with details of his organisation’s relief work. It proclaimed in Urdu: “Hundreds of thousands displaced by the Operation are waiting for your assistance! Falah-i-Insaniyat Foundation is feeding 20,000 displaced people everyday. We have treated 15,000 in our medical camps across the frontier. We have distributed one month’s food to 1,100 families.” It ended with a call for monetary support and gave the number of a bank account in Lahore.

I told the young man I had never heard of Falah-i-Insaniyat.

“The name is a new one,” he replied. “We are the Lashkar-i-Taiba. Have to come up with new names because of the ban by America and our own government.”

Lashkar-i-Taiba has mostly attacked Indian targets, particularly in Kashmir, and India blames it for last year’s assault on Mumbai. A week earlier, the Lahore High Court had released their chief, Hafiz Mohammad Sayeed, from house arrest for lack of sufficient evidence. “Hafiz Sahib is free now despite the pressure from India and America,” the man behind the table said with a smile. “Thousands of people are coming to see him at the city office. You should go there.”

Tuesday, October 20, 2009

Streets of Kumbakonam

For those unaware, Kumbakonam is a south-Indian town renowned for its temples. All pictures below are from my July 2009 trip.

A bike stand facing a shop

I've always wondered the effort that must go into painting these checked patterns on trees.

The chariot of one of the temples in town

The tradition of making idols from metals goes well back in history. This picture is of a shop that continues that tradition -- it's likely they use the lost wax method for some of their work.

Thursday, October 15, 2009

Embracing science but reliquishing the soul

Jerome Groopman writes in the New York Review of Books that our fascination with technology and the commodifying of the practice of medicine may be stripping it of its human element:

At the conference, an animated discussion followed, and I heard how changes in the culture of medicine were altering the ways that the young doctors interacted with their patients. One woman said that she spent less and less time conversing with her patients. Instead, she felt glued to a computer screen, checking off boxes on an electronic medical record to document a voluminous set of required "quality of care" measures, many of them not clearly relevant to her patient's problems. Another resident talked about how so-called "work rounds" were frequently conducted in a closed conference room with a computer rather than at the patient's bedside.

During my training three decades ago, the team of interns and residents would move from bedside to bedside, engaging the sick person in discussion, looking for new symptoms; the medical chart was available to review the progress to date and new tests were often ordered in search of the diagnosis. By contrast, each patient now had his or her relevant data on the screen, and the team sat around clicking the computer keyboard. It took concerted effort for the group to leave the conference room and visit the actual people in need.

Still another trainee talked about the work schedule. Because chronic sleep deprivation can lead to medical mistakes, strict regulations have been implemented across the country to limit the amount of time any one resident can attend to patient care. While well intentioned and clearly addressing an important problem with patient safety, the unintended consequence was that care became more fragmented; patients now were "handed off" in shifts, and with such handoffs the trainee often failed to learn how an illness evolved over time, and important information was sometimes lost in the transition.


But only recently has medical care been recast in our society as if it took place in a factory, with doctors and nurses as shift workers, laboring on an assembly line of the ill. The new people in charge, many with degrees in management economics, believe that care should be configured as a commodity, its contents reduced to equations, all of its dimensions measured and priced, all patient choices formulated as retail purchases. The experience of illness is being stripped of its symbolism and meaning, emptied of feeling and conflict. The new era rightly embraces science but wrongly relinquishes the soul.

More here. Indeed, the "management economics" people that Groopman mentions are the operations researchers I wrote about in my last post -- these practitioners continuously focus on "costs", "throughput", "bottom line". They are trained that way, and sometimes the constant use of a particular type of language -- despite the best of intentions -- can in fact change one's worldview.

Other healthcare pieces: Reforming Healthcare in the United States; Healthcare Costs: The Atul Gawande New Yorker essay. And Pauline Chen writes about mindfulness in medicine.

Saturday, October 10, 2009

Introducing: Operations Research

At heart, I am a humanities person; that is why this blog has existed for as long it has. But I do lead another, very different life that consumes most of my waking time. I am an academic in a field called “operations research” – a baffling term for those unaware of its existence. Briefly, operations research can be described as “the science of efficiency”, or “the science of planning well”; the most popular version, though, is the glib-sounding “the science of better”.

Still puzzled? Well, let me try again, this time with an analogy.

We are surrounded by technological marvels. It seems magical – to me at least – that a plane carrying hundreds of passengers and tons of luggage, actually manages to take flight; that there are such things as wireless phones; that there is a large, scattered yet miraculously unified network called the “Internet”. Amazing right? Each of these applications is possible because of engineering, which makes clever use of the underlying science, be it fluid dynamics, signal processing, or fiber optics. Such engineering is not always obvious, but the lay person is aware that there are specialists -- aerospace engineers, computer scientists, electrical engineers to name just a few -- who make these things work.

In the same way, do you wonder how your FedEx package from the Philippines arrived without delay to the small Midwestern town you live in; how the Netflix movie you ordered gets to your address exactly on the day their email claimed; how large airports, such as Heathrow and JFK, manage their flights, schedules, and air traffic? We take these systems for granted, but they work because they are engineered. This type of systems level engineering – the science of allocation and scheduling in the face of uncertainties and the fluctuating dynamics of supply and demand – is called operations research. In business schools it is called management science. Since it is a less tangible kind of engineering, the lay person is generally unaware of it.

You might argue that many systems are rarely well managed. What’s in a science that produces long lines and sapping delays? True, systems may be dysfunctional because of bad planning but this is not unique to operations research. A mechanical problem – arguably caused by the traditional “nuts and bolts” engineer – can stop a flight from taking off as well. In fact, an operationally conscious airline will have a contingency schedule that minimizes the traveler’s disruption in case of a cancellation. Think of all the flight groundings and cancellations that happened on and post 9/11. Have we given close thought to what it took to bring everything back to normal?

Operations research is a mongrel field. Like other engineers, the operations researcher uses mathematical methods, but she also may dabble in statistics, economics, and computer science. She will also need knowledge of the domain she is working in; and importantly, if her domain involves people, she will need to know that people do not behave as rigidly or rationally as her math models assume. This mongrel quality of the field makes it breathtakingly versatile – applications have advanced well beyond the “operations” realm and have entered even areas such as designing beam angles for radiation therapy. The flip side of the coin, however, is that some think of it as an “anything-goes” field with no real identity.

My work is in healthcare operations research. I look at how medical practices can provide timely care while trying to rein in costs. This coincides with the ongoing upheaval in the US healthcare system. Cost and coverage are major issues and they have the power throw askew the balance of supply and demand and influence the quality and timeliness of care. For example, emergency departments in the United States – one setting which I study in my research – experienced a 32% increase in demand over the last decade. The number annual ED visits in the US went up from 90 million in 1996 to 119 million in 2006. This has led to crowded conditions, especially during late afternoons and evenings. Can better staffing, improved coordination of processes alleviate the long wait times of patients? Perhaps -- at least that is what my hypothesis is.

I have also recently discovered – to my great delight – the many ways in which operations research can intersect with the humanities. Let me list a few examples. The resettlement of refugee farmers in India after the partition of the Indian subcontinent in 1947 was a difficult problem in every sense. Nearly a million people had to be allotted new land, and the partition had been extremely violent. Yet it was successfully done, without computers: a classic example of hands-on operations research in which people management and administrative organization are the main skills. The person who led it was Sardar Tarlok Singh of the Indian Civil Service, a graduate of the London School of Economics.

More recently a Markov model (in more plain terms, a probability model) was used to identify syntactic patterns in the as yet undeciphered Indus script of nearly 3000-3500 years ago -- another unconventional application that has nothing to do with “operations”. I am also fascinated by how humanitarian organizations – the UN World Food Program (WFP), Medicines Sans Frontiers – deliver their services in resource constrained settings; understanding why FEMA messed up post-Katrina; and how the dreaded LTTE efficiently coordinated rescue operations post-Tsunami in Sri Lanka.

In short, there’s plenty to learn and explore.

This post comes as I travel to San Diego for the annual meeting of the Institute of Operations Research and Management Science (INFORMS09). Nearly 4000 people will attend the conference; it’s a great way to catch up with friends from graduate school and make new friends. I was also invited to be one of their twelve official bloggers (that gives me an excuse to point to this post there).

This isn’t the first time I’ve mentioned operations research. Here are a few earlier posts: My Adventures During a Queuing Study; Queues and Illegal Immigration; A Visit to an Emergency Room; The Mathematics of Matching Kidneys.

Thursday, October 08, 2009

The temple at Tirvuannamalai and a Kaval Deivam shrine

A little busy with work these days, so I have only pictures to offer. The first is of the gopuram (tower) of the temple in the town of Tiruvannamalai, in Tamil Nadu. Notice how the style and color of the gopuram differs from that of the Brihadishwara temple of Thanjavur. Behind the temple is the sacred Arunachala hill which has drawn many saints over the years, the most recent of them, Ramana Maharishi. During the Tamil month of Kartigai (Oct-Nov), a light is lit atop the hill and it is visible for miles around.

The second picture is an informal shrine for kaval deivam -- guardian spirits. I came across it in the countryside between Krishnagiri and Tiruvanamalai. If my understanding is right, these gods are specific to villages in Tamil Nadu -- that is, they are not pan-Indian like say Shiva or Vishnu. More information here and here.

Sunday, October 04, 2009

Climate change cuts both ways

Jared Diamond surveys the impact of climate change research on three roughly contemporaneous civilizations in the most recent issue of Nature (subscription needed): Maya, Khmer, and Inca. The first two might have declined because of environmental changes, but the Incas, who built their empire in high altitudes, benefited from it. We are talking of the period between the 9th and 12th centuries CE. Excerpts:
From time to time, separate archaeological projects on different societies end up by suggesting common themes to events in the ancient world. Thus, two new studies point to parallels between the collapse of cities on opposite sides of the globe — the southern lowland Maya cities in Central America, and Angkor, the centre of the Khmer empire in what is now Cambodia. These parallels include the effects of climate change, which hurt both the Maya and the Khmer. By contrast, as a third report indicates, climate change seems to have benefited another ancient civilization, the Incas of South America.


This reminds us that climate can change in either direction, and that in the past such change has variously helped or hurt human societies. But human overexploitation of environmental resources never helps. As Lentz and Hockaday note, "Tikal's inhabitants became trapped in a positive feedback loop wherein increasing demands on a shrinking resource base ultimately exceeded the carrying capacity of their immediate environs. The ecological lessons learned from the Late Classic Maya, with their meteoric population increase accompanied by environmental overstretch, serve as a distant mirror for our own cultural trajectory." Amen.
The same Nature issue also has articles on the genetic history of Indians -- a loaded issue, no doubt. For an abstract of the study, see here.

I'll try to avoid subscription only links in the future -- my apologies to readers.