Breakthrough: Hughes and Banting

In my ongoing effort to remember what the heck I have read, some notes on a good (albeit not great, but a solid good) book: Breakthrough.

It is the story of the purification of insulin which has saved millions of lives.  The book itself focuses on the Canadian scientist Frederick Banting and a young American girl Elizabeth Hughes – who was one of the first to receive insulin.  The Chapters description of the book is excellent so take a read of that if you want a sense of the book and its story.

Young girl injecting herself with insulin.  Courtesy of the book's authors website: www.breakthroughthebook.com

Young girl injecting herself with insulin. Courtesy of the book’s authors website: http://www.breakthroughthebook.com

My thoughts on the book are two fold: a glimpse on a world gone by and a glimpse to a revered albeit fairly unsympathetic individual in the form of Dr. Banting.

The book starts with a look into a world of privilege for Elizabeth Hughes.  Born into wealth, power and status – her life changed in 1919 with the death sentence of a diagnosis of diabetes.  At that time, there was not a cure – only an existence that involved living in an isolated world away from the temptations of food and subsisting on a starvation diet. The images of emaciated bodies of young people who would haunt the world 25 years hence of Nazi concentration camps where self-inflicted by young people hoping to live long enough until there was a cure or a treatment for their affliction.

This is the glimpse into a world we know longer know, the world before the medical breakthroughs.  Although I was aware of effects of diabetes at an intellectual level, the book did a great job of bring it to a personal level.  That is the impact on a vibrant lovely young girl/woman who choose near starvation on the faint hope of a future cure.

In Canada (and certainly the developed world), diabetes is the most common chronic disease and its incidence is on the rise.  A scourge in first nation communities, its long term effects are heart breaking (blindness, amputation of limbs, other diseases).  As bad as these long-term effects are; dealing with them in the long-term short beats dying a horrible short-term death which was the scenario before insulin.

The other glimpse the book provides is into the competitive and ‘Keystone-cop-esque’ world of University research departments and Dr. Banting.  As a Canadian I wish I could say that Banting’s behaviour was an example to follow but alas he is a fairly unsympathetic character who was petty, jealous and quite frankly immature.  He was also driven to find a treatment for diabetes which allowed him to persevere in the face of setbacks and failure.  In the end, these failures are not remembered as well as his success in mitigating the horror of diabetes.

If you enjoy medical-history story and a fairly well written book about a time period distant but not that long ago – a well recommended read.  The authors have done a good job in weaving the personal stories of the two main protagonists (Banting and Hughes) around the larger historical drama.

Tchibo – Impulse Buying (and summer cheating)

This blog is cheating.  But then it is summer so a bit of laziness is understood.  Actually some folks asked me about some cycling blogs I made on a site called Toytown when I was living Munich Germany circa 2005-2006.  Before getting to the cycling blogs, I came across this gem on a European/German institution: Tchibo.

For those who have never been to Europe or never noticed the Tchibo stores, give this blog a pass.  For those who know Tchibo, read on for some information on them.  Be sure to take a read of comments from the original thread, posted about 8 years ago.

Original thread: http://www.toytowngermany.com/forum/index.php?showtopic=28469&st=0&p=404809&fromsearch=1&#entry404809

Typical Tchibo Store Front

Tchibo: A new experience every week

Get rich selling coffee, and toasters, and…

Tchibo is quintessentially German. When I first arrived, the now familiar Tchibo logo was simply part of the background noise. My wife nudged me toward awareness as she started to buy their coffee. It was then that I noticed a whole spectrum of seemingly bizarre and unrelated products. So, for those of you who are still in the background noise phase of their Toytown sojourn; or if you don’t have a kindly wife to point out the obvious, here is the basic synopsis of this business.

Tchibo started out in 1949 selling mail-order coffee. Given the post-war state of the West Germany at this time and the shortages of many basic food stuffs, this was pretty innovative. 1963 sees Tchibo expanding its distribution channels of coffee into local bakeries; 18 years after the war’s end and before the advent of the big box store, this was another bright idea. Expanding on this pre-existing channel, in 1972 Tchibo enters the consumers goods market, but with a twist.

Each week a different set of 15 products are offered linked by a common theme. However, once these items sell out, they are gone – no rain checks, back orders or second chances. They called this model is ‘A new experience every week’ and it relies unabashedly on impulse shopping. Given that 60% of Tchibo revenue is estimated to come from non-coffee sources, a weekly collection of related consumer goods obviously works.

Nor are these themes random act, carefully planned upwards of 18 months in advance, Tchibo buyers will review numerous competing products and select the best quality for the lowest possible price. As a result, Tchibo patrons may only be offered one iron but it will be the best valued iron for its price point and features. And if it breaks, a generous guarantee with good customer service backs up the product. After all, nothing kills an impulse buy then a bad past experience.

Tchibo is described as a ‘secretive’ company owned privately by the Herz family of Hamburg. Coffee and weekly products must be lucrative because Michael Herz, his brother Wolfgang (each estimated to own 34% of the business) are multi-billionaires. There other brother Günter and sister, Daniela are out of the business but are reported to have exchanged their inheritance for $5B. A fourth brother, Joachim, makes due with a 15% share of the pie.

Even if you have not met the Herz’s or bought a gadget from them, you have probably have supported their wealth. Tchibo Holdings owns about 50% of Beiersdorf AG, the maker of Nivea products. And, until recently, they owned a large stake in the world’s fourth largest tobacco company, Reemtsma (since purchased by Imperial Tobacco). Tchibo’s brand awareness is reported to be 99% in Germany and rising in the other markets they have entered such as Holland, Austria, Switzerland, Eastern Europe and recently the UK.

I do wonder if a Tchibo concept would work in North America? Americans and Canadians have had a historical tradition of using mail order services, but we are also accustomed to a big box store having every possible variation of a product immediately available 24/7. I don’t know if North Americans would have the patience for a New Experience Every Week, we rather have one every day… oh, and here is my rain check on last months experience that I missed!

So, what is your best Tchibo experience (good or bad)? UK’ers, impressions from the Tchibo invasion on your shores, is the model working amongst the English? Any takers on buying the franchise rights to North America, it could be the next IKEA!

Select Sources: http://www.tchibo.com and links http://www.nationmas…ionaires-(2005) http://www.hoovers.c…factsheet.xhtml

Travelling Up North, Back in Time and With Pierre Berton

If you are either a North or a Berton-phile, do I have the book for you: The Mysterious North by Pierre Berton.

I am not a huge Berton fan.  I have found some of his books great and some of them are a tedious bore.  Nevertheless he is a Canadian icon and he did do much to explain my country.  Born in the north (the Yukon), he was part of that great generation which grew up poor, went to war and then built a country.

This particular book is a series of essays and articles he wrote, mostly for Maclean’s Magazine, from 1947 to 1954.  This is a gold age before he become to much icon and not enough Berton.  He discusses a series of trips and provides some excellent vignettes about not only the territories but also about cities such as Edmonton before Leduc #1 changed its character.  After each chapter is an updated post script (circa 1989) which its self is a time capsule.

Some tidbits to look out for:

  • Writing in the classic Berton style the pre-dates the stuffy political correctness.  The first nation people are Indians and they are presented as the good, the bad and the ugly.  In other words closer to real people.
  • How far things have changed.  Writing just at the end of WWII, he calmly explains that a highway was needed and one was built (the Alaskan).  Oil was needed to build the highway and a pipeline was built to provided (the Canol Pipeline).  Employment was needed to so mines were sought out and built.
  • The lost opportunities to make the north self-sufficient.  Muskox meat taste likes beef, reindeer can be herded and a 1950’s guess of arable land in the north suggested that there are a million acres of it.  To the latter, unfortunately it is not contiguous but it has upwards of 86 frost free days a year (more with a warming climate).

Great maps, great classic Berton writing style and a good read.  Well recommended (particularly on a sweltering July evening with a cold beer).

 

Phrankism: Documentation is a Waste of Time

In World War Two, the British counted the bullet holes in airplanes that returned from missions.  Based on where the holes were, they now knew where not to bother putting armour on their airplanes (see this Mother Jones Article).

Continue reading

Chance Favors the Prepared Mind – and the Oblique Approach

(With apologies to Louis Pasteur)

Louis Pasteur, courtesy of Wikipedia.

Obliquity: Why Our Goals Are Best Achieved Indirectly by John Kay

I have spent most of my professional career thinking and planning for the future.  Certainly not as a futurist but as a ‘Budget-Guy’ or strategic planner.  Unlike most accountants, I preferred the numbers of tomorrow to those of yesterday.

Given that I have written my fair share of plans, I was interested in John Kay’s book which has a premise that the path to tomorrow is often not straight and definitely may not be quantifiable.  Kay proposes that a focus on passion and excellence leads to better profits than maximizing shareholder value.  For example, Boeing was more successful when aeronautic-philes ran the board room versus when it was filled with suits, MBAs and accountants.

Given that I a) own a suit; b) am an accountant and c) have a MBA; should Kay’s premise worry me?  Are budget guys of the future doomed to be replaced by those with passion?  I think not for two good reasons, both contradictory, like the premise of this book.

The first is that passion is a well-known and recognized attribute of successful companies.  Passion causes people to work long hours for NASA so as to put a man on the moon.  Or passion drives working for a charity or a non-profit organization.  Business gurus have cleared whole forests coming up with other names for passion such as an organization’s Vision or the need to stick to one’s knitting.

The second good reason is in the form of the question: ‘how do we know that Boeing was more profitable when it was run by passionate versus suited-accounting-MBA types?’.  Presumably because in both cases, suited-accounting-MBA types were still there paying the bills, developing budgets and keeping government regulators at bay.

In other words, we should be willing to take the long road home and follow our passions.  Great discoveries have been found through chance when the right person was looking in the right direction (hey, it got Louis Pasteur a nice Nobel Prize).  So, Obliquity is something to cultivate and encourage… but… in the end only execution matters.  The aeronautic-phile executives at Boeing developed the 747 through both vision and a lot of hard work (including the suited-accounting-MBA variety).

And this brings us back to Kay’s book and whether or not you should bother to read it?  My thoughts are:

  • a) Yes, because he is right.  Chance favors the prepared mind and the organization needs to expect a bit of serendipity to accomplish its goals.
  • b) No, Kay has cherry picked his examples.  For every Boeing that has re-located its passion there are dozens of Packard Motor Works who had passionate people but lacked the capital or size to compete.
  • c) Yes, because Kay is an engaging writer.  Even if the book suffers from a lack of research, it is still a great read.

I was going to suggest that you rush out and buy the book but decide to instead recommend obliquity finding it in a book shop near you while not looking for it.

Healthcare Ethos: Its Positives and Negatives

The healthcare ethos extends well beyond the front line worker. Front line managers, administrators and support staff also participate in the healthcare ethos although the strength of the values and belief systems decreases with the distance from the patient or client.

Like many things, the healthcare ethos has a positive and negative side. The positive side is a powerful motivator; people have been known to go to heroic extremes for the safety their patients. Managed properly, the ethos can help healthcare organizations to deliver the very best patient focused services. Without proper management, the ethos can lead to stagnation, animosity and anything but organizational harmony. The larger organization goals can be clouded by the immediate priorities of the care giver.

So how do successful healthcare organizations strike a balance between the good and the bad of the ethos, through 4 strategies.

1. Communication, Trust and Respect
2. Managing the Group through the Individual
3. Intangible Asset: Nurture but don’t Exploit
4. Manage change transparently, but practice tough medicine

Healthcare Ethos – As a Motivator

(This is the second in an intended series on the Healthcare Ethos, be sure to Read the Ethos Definition.)

I have worked directly or indirectly for healthcare organizations for nearly 15 years. During this time I often ran internship or cooperative education programs and thus would have a steady stream of young people joining and leaving my teams. One of the ways I introduced a fresh-faced twenty-something to the world of healthcare was to give them this observation on their first day of work:

“Somewhere in this hospital (or organization), there is a small premature-baby weighing about as much as a pack of ground beef; and all he wants to do is take his next breath. Somewhere else is a little old lady surrounded by children and grandchildren who wants to take her last breath with dignity and respect. This is what we do for a living.”

I would go onto explain that while we may be doing budgeting, accounts payable or some other seemingly far removed work from that baby and beloved grandmother, we were still contributors to their well-being and journey in life.

As a result, I found that by explaining the Healthcare Ethos, my staff better understood our role, were better motivated and interested in the work at hand. This does not come without a warning about not abusing this emotional message however, but more on that in future blogs.

The Healthcare Ethos – A Definition

Overview –Motivating People is Hard Work

Motivating people is hard work.  If you are responsible for more than yourself, you know the difficulties in keeping your staff engaged.  As tough as your circumstances are, consider this question.  How do you keep staff motivated working in a hospice in which every single client will die?  How do you motivate staff on a paediatric oncology department in which too many of the children will lose their battle with cancer?  How about within a mental hospital; how do you motivate the staff whose clients sometimes face limited cure possibilities, a life of poverty, loneliness and an ostracizing stigma?

A black sofa is seen amongst a backdrop of vibrant green.

Couch amongst the bushes.

These are the motivational challenges facing managers who work in healthcare.  Yet despite the seeming difficulty, the vast majority of people who work in healthcare enjoy their job and generally look forward to helping the patients and clients that they serve.

Motivators and Organizational Ethos

Good pay and benefits help, but as Herzberg pointed out, lack of pay and benefits may lead to job dissatisfaction but they are not themselves motivators.  Thus the enigma of what keeps a nurse, a doctor, or an aide going back to work, day after day and dealing with circumstances that are by definition life shattering?

The enigma of course is also the solution.  A number of separate studies of nurses have consistently shown that the prime motivation to enter that profession is to make a difference, engage in the human connection, a need to be needed and altruism.  Individuals working directly with patients are exposed to many of the strongest and most powerful human emotions.  Pain, suffering, despair are balanced against hope, joy and relief.  Thus frontline healthcare workers are active participants in the human condition.  For most healthcare workers, this exposure is life affirming and positive.

Of course healthcare workers are not unique in this regards.  Police officers, firemen, teachers or soldiers can also experience intense emotional environments.  In each case, a fraternity develops amongst the workers and there is a desire to do ‘good’.  In the case of healthcare I call this motivation and fraternity the healthcare ethos which is defined as follows:

“The vicarious emotional impact felt by healthcare workers as they experience the human condition indirectly through their patients.  This impact acts at the individual and group level as a motivator, driver to protect patients and as an affirmation of purpose and importance of the work done by the group or individual.”

PP+E, Its Life, Its Verification, Its Article

Happy Victoria Day (the first long weekend of the traditional Canadian Summer, e.g. no snow – maybe).  In addition to celebrating a long dead monarch of the British Empire, I am also celebrating the publication of my 6th published article (an even half-dozen!).  Entitled, the IAEA Property, Plant and Equipment Lifecycle Framework (whew!), I am pleased at how it turned out.  If you want to read it right now, visit the Spring 2014 FMI-Website.

If you want some more details on the framework, be sure to check out my Director’s Cut of the Framework.  Included in the Director’s cut is a bit more detail on the Verification Framework and Attractive Assets.

Once again, thank you to my ‘friendly peer-reviewers‘ who assisted me in developing this article and to the IAEA for giving me a chance to solidify this set of ideas (and an incredible one year!).

So, enjoy the long weekend (fellow Canadians) and if you have trouble sleeping, take a read at article number 6… and now to start writing article number 7… after the long weekend!