This Joy’s Life

Story Time for Jack from Joy Fisher on Vimeo.

If you call me an a**hole, I WILL put less than two feet between me and your bouncer.

I’m currently reading Outliers: The Story of Success by Malcom Gladwell, author of The Tipping Point: How Little Things Can Make a Big Difference and Blink: The Power of Thinking Without Thinking.  The entire book so far has been SUPER interesting, but there is one section in particular that I’ve loved for the insight it provides me as a Southerner.  Chad actually read it first and brought it to my attention because we constantly argue about the virtue of “the high road”.  I think there are times when taking the high road sends the message, “Sure, great, it’s fine to walk all over me.”  In those instances I prefer the middle to low road options and I’m not ashamed.  I’ve now gained some insight into this aspect of myself thanks to Chapter Six of Gladwell’s book and I have a name for it.  It’s due to my culture of honor and I’ll proudly “die like a man, like [my] brother did” when the time comes.  (Hey, don’t worry, Brett’s doing just fine.)

Here’s a link to the excerpt so you know what the heck I’m talking about.

“In Richard Thaler’s and Cass Sunstein’s book, Nudge, which uses urinals, ABBA, and Homer Simpson (and cutting-edge research) to argue that by simply giving more thought to the way they present choices to people — or “nudging” — choice architects can preserve freedom of choice while dramatically influencing the choices people make.”

That’s how one of my favorite blogs (and books) – Freakonomics introduces the book I’m currently reading, Nudge: Improving Decisions About Health, Wealth, and Happiness. Actually, I’ve been reading this book for a while and on the plane ride home I just happened to hit the chapter on Credit Markets. Now, this is government regulation that I can get behind! I’m going to provide an excerpt of the parts I thought were the most relevant to what’s happening in our economy right now, but first I want to give you a little more detail on one of the fundamental concepts of the book, that of Libertarian Paternalism.

The idea behind Libertarian Paternalism is that “we” want to change people’s behavior for their own good, not for our personal gain alone. That’s the paternalism piece. The other key aspect is that in doing so, we must not enact any rules, bans or laws. People must choose to make these changes of their own free will. That’s the Libertarian piece. Take smoking as an example. It is generally accepted that smoking is bad for you. Even smokers will agree with this. No one says, “Tomorrow, I’m going to start smoking.” But, you often hear people say, “Tomorrow, I’m going to quit smoking.” So, an appropriate nudge would be to help the person choose, of their own free will, to quit smoking as it is for their own benefit. The book delves deeper into this and other issues, but I want to focus on the Credit Markets chapter because it is so relevant right now in teaching us, in part, how we’ve found ourselves in this mess and what we might do to keep it from happening in the future:

When markets get more complicated, unsophisticated and uneducated shoppers will be especially disadvantaged by the complexity. . . These factors are exacerbated in the segment of the market that caters to the poorest and highest-risk borrowers, the so-called subprime market. . .

Some, particularly those left of center or in the news media, label all such loans with the derogatory term “predatory.” This broad brush fails to recognize the obvious fact that higher-risk loans will have to have higher risk interest rates to compensate the people who lend the money. The fact that poor and risky borrowers pay higher interest rates does NOT make these loans “predatory.” . . . On the other side, some observers think that the hue and cry about predatory lending is based entirely on the failure of left-leaning journalists and others to understand that risky loans require higher interest rates. As usual, the truth lies somewhere between the two extremes. Subprime lending is neither all good or all bad.

The good feature of subprime lending is that it offers credit to those who could not otherwise borrow, and makes it possible for some poor or high-risk families to become homeowners (or business owners). Subprime loans give people a valuable second chance. . . (134,135).

I’m going to stop here for a minute to backup and explain that one of the things Thaler & Sunstien have previously brought up in the book is how nudging can be used by the government. It is the simple idea of making complex consumer decisions more transparent. Take the cell phone market, for example. An appropriate nudge would be for the government to step in and regulate not how much carriers could charge for their services, but their disclosure practices. It would require carriers to make their fee schedules public in a standard spreadsheet type format and must include any and all fees the customer could be charged. Once a year, carriers would be required to send their customers a complete listing of all the ways they had used the phone and all the fees that had been incurred, thereby allowing the customer to easily see and compare their current plans with those of other carriers (93, 94). A real life example is the Truth In Lending Act which required credit companies to reveal a standard calculation of an annual percentage rate (APR) of interest to consumers. It then became quite easy to compare credit cards and make better decision about which one might be best for us (generally, the one with the lowest APR for the longest amount of time). Now that you understand that concept, I’ll continue with the excerpt:

In 2007 there was an eruption of subprime foreclosures, which caused ripples throughout financials markets, prompting many government bodies to think harder about how to help. Of course markets, left alone, will solve some of the problem, because investors who had been buying up subprime loans learned the hard way that the loans were riskier than they seemed. (In many ways, the mortgage brokers were deceiving the investors who bought up the loans as well as the people who borrowed the money.) But market forces did not prevent the problem from occurring, so there have been calls for more intervention. Some demand an end to predatory lending, but because loans do not come stamped “predatory,” it is hard to implement any such ban without depriving many deserving but high-risk borrowers from any source of financing. And of course, we libertarian paternalists do not favor bans. Instead, we prefer [to help] people make better choices and avoid loans that really are predatory – loans that exploit people’s ignorance, confusion, and vulnerability.

[We suggest changes to the Truth In Lending Act to make it relevant once again.] . . . Mortgage lenders would be required to report lending costs in two categories: fees and interest. . . research finds that people who get the best deals – by a lot! – are those who pay no fees (. . . the broker pays all the fees out of his commission. . .) The likely explanation for this result is that when the fee is zero, it is simpler for borrowers to compare terms, because the interest rate is the only thing they have to look at. The interest-rate disclosure would include the rate, of course, but also a schedule of payments over a period of years, assuming that the underlying interest rates do not change. This would ensure that borrowers at least know what their payments will be when the teaser rate ends. It would be a good idea to add some kind of worst-case scenario information so that borrowers can see how much their payments could go up in the future.

Lenders would also have to provide a detailed . . . report, that incorporates all the fees and interest rate provisions, including teaser rates, what the variable-rate changes are linked to, caps on the changes per year, and so forth. This information would allow independent third parties to offer much better advice. Our strong hunch is that if [this data] were made available, third-party services would emerge to compare lenders.

[This data] would thus make it much easier to shop for mortgages online, which would make the mortgage market more competitive. Online shopping is especially likely to help woman and minority groups. A study of automobile shopping found that women and African-Americans pay about the same amount as white males when they buy a car online, but at the dealership they pay more, even after you account for other factors, such as income (136-138).

I’ve been hearing and reading so many different opinions on our current economic situation in terms of what caused it, who was at fault, and what steps should be taken to keep it from happening again, that I thought this chapter was very interesting and written “in layman’s terms” to help me understand all the talk about predatory lending and subprime markets. If you had questions, as I do, here’s hoping you found this post helpful. Nudge: Improving Decisions About Health, Wealth, and Happiness is a super interesting read and I highly recommend it.

Both Sunstein and Thaler have made posts on the nudges blog specifically discussing the current economic situation if you are interested in reading them. If you are interested in reading a Q&A with the authors of Nudge, you can find one on the above mentioned Freakonomics blog here and on the Amazon.com website here (scroll down to the editorial reviews). You can also click here for a link to the Nudges website.

A book report on Peter Rabbit is the last time I’ve done one of these.

The name of the book about which
this book report is about is
How Doctors Think which is about this – doctor.

Described by the book jacket as a “window into the mind of the physician” and “myth-shattering”, our protagonist, Jerome Groopman, “explores the forces and thought processes behind the decision doctors make.” Which is exactly why I wanted to read this book. Because my father sees a lot of doctors to whom I like to ask a lot of questions and for which I get into a lot of trouble with both my father and mother because they think I shouldn’t be bothering the doctors.
Groopman’s got my back on that one though, as he not only encourages patients and their loved ones to question their doctors but gives you insight and suggested wording on the best way to get the doctor’s thinking along the right path about the case at hand.

He starts the book with a detailed case study of a woman who has been diagnosed with anorexia and irritable bowel syndrome by doctor after doctor. She was put on a 3,000 calorie diet consisting mostly of carbohydrates like cereal and pasta. But because she continued to lose weight, it was assumed by each doctor that she was lying when she told them she was following that diet to a T. After 15 years, she happened to see a specialist who ignored the mound of paperwork that came along with her and stopped to ask himself, “What would it mean if she wasn’t lying and really was still losing weight while consuming 3,000 calories a day?”
That was the key to his ultimate determination that she was actually allergic to gluten, a primary component of most grains. In short, for 15 years she had been ingesting a huge amount of the exact thing that was making her sick!

It is the use of this type of interesting, real-life case study that make How Doctors Think well worth the read, together with Groopman’s council on how both patient and doctor are likely processing the information before them. Following is some of Groopman’s sage advice:

• On average, physicians interrupt patients within eighteen seconds of when they begin telling their story. pg.17
• The way a doctor asks a question structures the patient’s answers. Good doctors begin their conversations with general, open-ended questioning. Specific close-ended questioning – is the pain sharp or dull – suggests a doctor is attempting to pin down a diagnosis. If you are seeing a specialist, for example, or getting a second opinion, close-ended questioning at the beginning of your conversation suggests the doctor has been “tainted” by the write-ups from your other physicians and isn’t coming into the case open to catching a mis-diagnosis. pgs. 17-18
• The sickest patients are least liked by doctors. Many doctors have deep feelings of failure when dealing with diseases that resist even the best therapy. This can lead to feelings of frustration and they may stop trying because all their hard work seems in vain. pg.19
• Patients can learn to question and to think the way a doctor should. Questions like, “Doctor, what would be the worst thing that could be missed in my case?” pg. 23
• Realize that you may fit a stereotype and let the doctor know you know so he knows not to become blinded by it. It will enhance your credibility. Take the case of an eccentric woman in her fifties complaining to the doctor of “feeling hot all over, which makes my skin crawl.” Most doctors would tell her it’s related to menopause and send her home (In fact, 5 out of 6 did just that. 2 told her she was crazy.) By finally addressing it, “Okay, I know menopausal women have hot flashes. But I think this is something else, something more than just menopause,” she helped doctor number six make a mental note of how easy it would be to make an attribution error in this woman’s case. The doctor was then able to stop herself and “assumed for a minute that her patient was telling her something important, something meaningful” that was “indeed different from run-of-the-mill menopause.” (Read the book to find out what was really wrong with her pgs.56-57
• Force your doctor to generate a short list of alternatives, even if both you and he feel his diagnosis is spot on. Doing this is one of the strongest safeguards against cognitive errors. pg. 66
• It is a fair question, especially in a fast paced ER, to ask, “Doctor, what’s the worst thing this can be?” By asking that question, a patient, friend, or family member can slow down the doctor’s pace and help him think more broadly. This is especially important during flu season, for example, where flu-like symptoms can too quickly be attributed to that which everyone else the doctors are seeing has. pg. 75
• Another way that laypeople can focus a doctor’s attention is to ask: “What body parts are near where I am having my symptom?” This is especially important if you have a longstanding history with something in the same area, but you feel this is not the same kind of pain/feeling as it has been in the past. The woman in our case study from above might have said: “Yes, I know my irritable bowel syndrome is my chronic condition. But if the pain is something new, on top of that long-standing problem, what body part might be causing the symptom?” pg. 76

I’m only halfway through the book at this point, but I think there is enough here to give you a feel for how truly helpful and interesting a read this book is. I highly recommend this book for anyone who might ever find themselves sitting in a doctor’s office, so much so that you are welcome to borrow my copy. Read it. I think it’s a book you’ll enjoy, but make sure you return it because, like Robbie the Creep, I’ve got notes in the margin.

A book report on Peter Rabbit is the last time I’ve done one of these.

The name of the book about which
this book report is about is
How Doctors Think
which is about this – doctor.

If you want to find out more (and you should), click over to my Joy of WAHM-ing blog to read my BOOK REPORT. I’m going to make it a regular feature over there.

When your eyes are watching God it means you’ve accepted that there is absolutely nothing you can do. Che sera, sera. Whatever will be, will be.

They say that only God knows what the future holds. So your eyes are watching Him for some clue of what the outcome will be. Praying that a sign will come and be good, fearing that it won’t and knowing there is nothing you can do to influence it either way. It does not matter what you do, therefore you can’t do anything at all except look up with your eyes watching God.

Zora Neale Hurston surely understood this. So much so that she deemed it a worthy tittle for her book.

Dad’s surgery is tomorrow morning early. It will last at least 5 hours. Won’t see him until the afternoon when he gets to ICU.

So, I saw Lance Armstrong the day before last in his very last Tour de France. He was on his bike about 5 feet from me. We saw him the day before he got to Paris in a little town called St. Etienne on the way to Avignon. It was pretty cool. You don’t realize how fast they are riding until you see it in real life.

Tomorrow is the last day of my own Tour de France. I fly out of Nice and into Dublin on Wednesday with a few days to pack before heading home to the good ol’ U.S. of A.

Here’s what’s been happening since I last posted. We spent Saturday driving from Paris to Avignon with the exception of our 4 hour stop in Saint Etienne to see Lance (he asked about everybody back home).

I was surprised to notice as we were driving that the mega amounts of graffiti very common to Paris also abound in the French countryside. It’s funny because Paris and the French countryside are soooo picturesque that the graffiti doesn’t show up in your first impression. I don’t understand why it is allowed to remain in a city and country that prides itself on being so beautiful. I think the French officials need to read Tipping Point and learn about the broken window theory which says that not taking care of a broken window (or graffiti in this case) sends a message that no one cares and then gangs and petty crimes tend to increase in the area and soon more severe crimes are being committed. That’s my two cent (no s on the €uro’s change).

So, when we finally got to the quaint little castle town of Avignon, we progressed very slowly because there were TONS of people all spilling out into the streets for some kind of annual, month long festival that the travel agent neglected to mention and our hotel was in the middle of it all. This was especially stressful for Carrie who had had to do all the driving because getting a rental car that was automatic from the rental company was “not possilbe.” (I don’t know how to drive a stick, not for my father’s lack of trying to teach me.)

Not only that but the car’s GPS (global positioning system) kept insisting that we needed to go straight but the gate in front of us insisted that this was “not possible.” So we made a turn hoping the GPS would recalculate an alternative route for us, be she would have non of that and told us to basically “make a legal U-Turn and start the whole hair-raising drive through the super skinny pedestrian packed streets over again.

Since GPS wouldn’t listen, I decided to have a talk with the gate keeper (there is no Dana, there is only Zool). We agreed that he should open the makeshift gate to make room for our car since our hotel was smack dab in the middle of all the mess.

I wish I had time to finish this story, we have only just begun. Check Carrie’s Musings because I bet she is telling you all about it as well.

Au revior!

P.S. There is at least on crousel in every French city; Paris has one per part of town. I wish now that I had been taking pictures of each one I saw so I could make a coffee table book The Carousel’s of France or something like that.

So sorry not to have updated in so long. We’ve had a wave of guests lately, Sean and Heidi having safely made it this week and so it’s been hard finding time to tell y’all what’s been going on.

James and Amy, friends from Seattle also arrived together late last week. Amy works with PwC and therefore with Chad while James and I run errands and read in the parks all day.

I’ve finished a number of great books, including The Red Tent (thanks Teresa!) and The Tipping Point: How Little Things Can Make a Big Difference. In preperation to our trip to Paris next month, I’m finishing what I started in Paris to the Moon by Adam Gopnik. I need also to get back into Eats, Shoots and Leaves and to – finally – start Dress Your Family in Corduroy and Denim by David Sedaris (I know, Rawee, I know).

Tomorrow Shay arrives and as Sean and Heidi don’t leave until Monday morn, we are all planning to converge on Croake Park tomorrow night in an attempt to score tickets to the U2 concert. Will post our achievement, you betcha!

C U L8tr!
(That’s text speak for your mo-BILE, in case you didn’t know)

It’s true what Adam Gopnik states in his “Distant Errors” essay* that “this business of things almost but not quite being the same” can really shake an American up. He points out, “A pharmacy is not quite a drugstore” in Paris and I would say the same holds true for the UK and Ireland. You’ll find no selection of key rings (asking for key chains will bring only puzzled looks from store employees), no basic cleaning supplies, no snack food or office supply aisle or anything other than drugs and hygiene products.

I would like to add bed sheets as an excellent example of Gopnik’s “almost but not quite” theory. There is no top sheet.

That is to say that the flat sheet that one typically finds between body and duvet is missing entirely. Oh, you might find a flat sheet whose purpose is intended to replace the fitted sheet by providing the diversity of hospital corners and thinly veiled protection between your body and the mattress itself (as there seems to be no manufacturing of a mattress pad/cover either). But, even buying a set of sheets will provide you only a fitted sheet, a duvet cover, and two rectangular (not standard) pillow cases.

The sizing chart is also somewhat difficult to convert. We, in the States, have twin, double/full, queen, king, and California king. They have single, double, large double/king (presumably equivalent to queen), and super king (equivalent to 2 twin beds pushed together).

I miss the top sheet.

*From his book entitled “Paris to the Moon”

Breaking the Code – Update

We have been told by Jane that most likely 1-800 isn’t a type of number that you can dial in Ireland. There must be some other international number that Chad should be using for his calling card.

There are times when you are given a 4 digit number and this may be a free call, as is the case with the telephone company Eircom – 1901.

Sometimes you get a 10 digit number, as with the Eircom Internet group – 1800203204. It’s a 1-800 looking number and a free call and yet there are 10 digits not 11 as in the US.

Deciphering the phone system eludes me still.