Wednesday, April 11, 2012
Thursday, April 5, 2012
The Tyranny of Statistics
I attended an evening retreat of senior management of my hospital last Tuesday. Another 3 hours of my life that I won't get back. At least they served dinner and we were allowed to have a glass of wine before dinner.
The topic of the retreat was quality. Of course we are all for quality. It was only yesterday and today that I realized that the purpose of retreat was to prepare us for the release today of the hospital statistics from the CIHI which compares hospitals according to a number of indices. Traffic on the website has been heavy so I haven't been able to look at my hospital's performance nor have I been able to look at other hospitals. I am assuming by the 5 memos of talking points I just received that we might have some problems but that is just speculation.
About a month ago, I watched Moneyball which I thoroughly enjoyed. Moneyball is of course how statistics can be used to get the same performance using less expensive players. The most interesting fact with Moneyball was how different statistics from what had always been traditionally used were the important statistics, things like on base percentage rather than batting average, pitch count rather than ERA. Hospitals, health systems and human beings are way more complicated than Major League Baseball and I wonder whether anybody has even tried to look at intangibles.
The retreat started out with the concept of a dashboard. This is a chart where 8 or so variables are displayed, the idea being to track changes and motivate staff. For example in an operating room we might track on-time starts, sick days, cancellations etc. The two administrators from our sister operating room had actually brought a copy of their dashboard for our table to view. They were quite proud of it. I was sitting next to our head nurse and asked her whether we had a dashboard. She told me that in fact we had one the past which was posted but she stopped doing it because it made absolutely no difference to performance, the numbers went up and down randomly.
As things went on, the red wine and the buffet meal facilitated the mental effect of the boring presentation that was going on and I started to day-dream. I always ask applying residents whether medicine is an art or a science. (I am not the only person who does obviously because most of them have a pat non-answer.) I am more and more beginning to think of what I do at work is more art than science. Sure there is some science but how we apply it is an art. As we learn more about physiology it is more and more apparent how different rather than similar we all are. Add in surgical insults, time of day etc and we are talking art. Then I drifted off to how could we measure the performance of my colleagues and me. Do we measure on-time starts, turnover (important to admin and surgeons), recovery room times, average post-op pain scores, average nausea scores. Does all of that make a difference. If my patients are discharge ready early, is that any use if they just end up waiting for a porter longer? If my drug costs are lower is that just because my patients awake in pain?
I then drifted off to the band practice I was missing. Music can be very mathematical, there is a lot of science in it, especially in the area of instrument design but no one would argue that it is anything but an art. If you play something too mechanically you will be told to be more "lyrical". I never play a piece the same way twice, not the same tempo (they tell me I rush, but I think everybody else drags), volume or tone; not intentionally that is just how I do it. Multiply that by 50 people and think of the various permutations that come out in the final product. Throw in variations like the acoustics of the room which of course change from the empty hall you rehearse in to the hall full of relatives who were strong-armed into watching you play. Playing outside is a whole different experience. I have played about 7 outdoor concerts as an adult, every single one of them has been entirely different. In someways it is the minor imperfections in music that make it a joy to listen to.
Try putting a number to all of that. At the end of the piece, the concert or the rehearsal, I can think whether I played really good, okay or badly. I could have a dashboard; average variance from tuning, tempo, mistakes etc. but I don't. If we liken a hospital to a huge really complicated orchestra you can see how limiting appraisal of its performance to a snap-shot of 20 or so statistics is going to completely miss the boat.
The other issue is of course that as soon as you introduce statistics into the game, you introduce gaming. Most statistics are subjective so it is possible for a smart hospital to "upcode" its patients and procedures to improve their "batting average". (At the retreat we were advised to sort of do this, not in an illegal of course). Further it opens the door for hospitals to refuse to accept patients that they know will affect their "batting average". In the 1990s our province financially penalized hospitals whose average length of stay was outside the norm. This resulted one hospital refusing to accept palliative care patients because their length of stay was so long. This was by the way the regional palliative care centre.
Soon we will be told to practise medicine in a way that enhances the hospital's stats rather than what is necessarily the best practice. As we computerize more we can mine more data and we can get individual dashboards of all kinds of stats. So we have a bunch of Type A personalities who now have access to stats comparing their "performance" to their peers. Do we become like the teacher who knows what is going to be on the standardized test at the end of the year and teaches to it. Good marks but did the students really learn anything?
And of course statistics lead to cheating such as the case of hospitals who "discharge" and "readmit" patients the same day in order to change a single long stay into two medium stays. Readmissions are tracked which of course gives hospitals a disincentive to discharge patients for fear of worsening their readmission stats. Infection stats are often more a function of a hospital's honesty or the aggressiveness of their ID department than any deviation from quality of care. Sometimes what looks statistically good may not be better for the patients. Length of stay is frequently used stat in Canada. As someone else pointed out this is a stat with a diminishing return if we look at the global picture not just at the hospital.
The more I am exposed to the spurious "science" of medicine, the more I appreciate music.
Tuesday, March 27, 2012
Methinks the Gentleman Doth Protest Too Much
As usual I am way behind the news cycle but I had to get this one off my chest.
We have in Canada what is called the Conservative Party governing us. They are basically the Republican Party without the funny southern accents.
Recently they tried to pass one of those internet snooping laws. This would allow the police to make your internet provider give them a list of all the sites you had browsed without a warrant. This would also include your private email address and any financial transactions which would of course give them your banking and credit card information. It would require the providers to install expensive equipment to monitor this. Of course you know who would really be paying for this, as if we don't pay enough for the internet in Canada. As my mother told me, if you don't have anything to hide, you don't need privacy (my mother also doesn't own a computer). If I really thought that this was going to help the police get bad guys off the street any quicker or more efficiently, I might even agree except we all know that is not going to happen, in 90% of cases it will be used to harass people.
The point man for the government was their family values Minister of Public Safety Victor Toews. Early on in the debate, Mr. Toews framed his position as," you can support the bill or you can be with the child pornographers.". This naturally pissed off people who were against the bill and really didn't support child pornography either.
Quickly up came the Twitter account Vikileaks. This is a play on Wikileaks and our minister's first name. I would show you the site but unfortunately it came down. It seems Mr. Toews has a few skeletons in his closet.
I am always happy to rejoice whenever a politician I don't support gets caught with his pants down. I even posted a link to Vikileaks on Facebook.
Mr. Toews was able to turn what should have been a humiliation and resignation into a bit of a triumph. Press stories covering Vikileaks called the tweets, "unsubstantiated". press instead of trying to flesh out more of the story about Mr. Toews' marital woes, by consulting public records, went after Vikileaks. Eventually it was found that the Twitter account came from within the House of Commons and after some time a poor Liberal staffer fessed up. The Leader of the Liberals had to make a groveling apology, the staffer was fired and the case is closed.
Quite frankly I think he doth protest too much. The only thing I can fault the poor staffer on was being too stupid to use an account from outside the HofC; one that would have been harder to trace. Mr. Toews entire political career has been about being a family values politician including opposing gay marriage. He always campaigned with his wife and family front and centre. In fact according to Vikileaks when they were separated before divorcing, he forced her to campaign with him for appearances sake.
A lot of politicians have wives and families and most of them don't use them as campaign props. You may see them on the podium on election night but that is about it. They deserve their privacy. In the 1970s our Prime Minister Pierre Trudeau campaigned with his beautiful young wife Margaret. When his marriage went off the rails it was all over the news. Some mainstream commentators stated that his choice of a flaky wife (she was later diagnosed with bi-polar illness) was a reflection of his lack judgement and fitness to lead the country. The press had a field day with the fact that while he was losing the 1979 election, she was dancing at Studio 54. And he had no right to complain, he had sacrificed his right to privacy.
Meanwhile the group Anonymous has posted videos disclosing the name of Mr. Toews' mistress on You-Tube. He is naturally not amused by this.
We have in Canada what is called the Conservative Party governing us. They are basically the Republican Party without the funny southern accents.
Recently they tried to pass one of those internet snooping laws. This would allow the police to make your internet provider give them a list of all the sites you had browsed without a warrant. This would also include your private email address and any financial transactions which would of course give them your banking and credit card information. It would require the providers to install expensive equipment to monitor this. Of course you know who would really be paying for this, as if we don't pay enough for the internet in Canada. As my mother told me, if you don't have anything to hide, you don't need privacy (my mother also doesn't own a computer). If I really thought that this was going to help the police get bad guys off the street any quicker or more efficiently, I might even agree except we all know that is not going to happen, in 90% of cases it will be used to harass people.
The point man for the government was their family values Minister of Public Safety Victor Toews. Early on in the debate, Mr. Toews framed his position as," you can support the bill or you can be with the child pornographers.". This naturally pissed off people who were against the bill and really didn't support child pornography either.
Quickly up came the Twitter account Vikileaks. This is a play on Wikileaks and our minister's first name. I would show you the site but unfortunately it came down. It seems Mr. Toews has a few skeletons in his closet.
- Like he was recently divorced, in a fairly messy divorce.
- Like he got divorced because he was boinking his babysitter.
- Like he has a four year son from his mistress, the same babysitter.
- Like said mistress is now on the government payroll working for a Senator.
I am always happy to rejoice whenever a politician I don't support gets caught with his pants down. I even posted a link to Vikileaks on Facebook.
Mr. Toews was able to turn what should have been a humiliation and resignation into a bit of a triumph. Press stories covering Vikileaks called the tweets, "unsubstantiated". press instead of trying to flesh out more of the story about Mr. Toews' marital woes, by consulting public records, went after Vikileaks. Eventually it was found that the Twitter account came from within the House of Commons and after some time a poor Liberal staffer fessed up. The Leader of the Liberals had to make a groveling apology, the staffer was fired and the case is closed.
Quite frankly I think he doth protest too much. The only thing I can fault the poor staffer on was being too stupid to use an account from outside the HofC; one that would have been harder to trace. Mr. Toews entire political career has been about being a family values politician including opposing gay marriage. He always campaigned with his wife and family front and centre. In fact according to Vikileaks when they were separated before divorcing, he forced her to campaign with him for appearances sake.
A lot of politicians have wives and families and most of them don't use them as campaign props. You may see them on the podium on election night but that is about it. They deserve their privacy. In the 1970s our Prime Minister Pierre Trudeau campaigned with his beautiful young wife Margaret. When his marriage went off the rails it was all over the news. Some mainstream commentators stated that his choice of a flaky wife (she was later diagnosed with bi-polar illness) was a reflection of his lack judgement and fitness to lead the country. The press had a field day with the fact that while he was losing the 1979 election, she was dancing at Studio 54. And he had no right to complain, he had sacrificed his right to privacy.
Meanwhile the group Anonymous has posted videos disclosing the name of Mr. Toews' mistress on You-Tube. He is naturally not amused by this.
Sunday, March 18, 2012
Drug Shortages
We take the drugs we find in our cart and in the evil Pyxis machine for granted.
When I go to Ecuador every year, I have to figure out exactly how much of each drug we use, add a fudge figure and buy them all in advance (except the controlled ones which we buy there). That was a little stressful the first time, I have since learned that we can buy most of the drugs we need there anyway.
Now as we recently learned almost all the generic injectable drugs in Canada are produced at a single factory in Lennoxville Quebec, owned by Sandoz which is itself owned by a European company. Some time ago this factory was visited by representatives of the FDA who found safety flaws in their manufacturing process and told them to fix it, essentially shutting down the plant or at least severely curtailing its production while it fixes itself. This happened a few months ago but the shit has only now hit the fan.
Affected are drugs like morphine, fentanyl, rocuronium, glycopyrrolate, ketamine, ondansatron, norepinephrine and protamine (actually it would be shorter to just list what's not affected). Ondansatron is more or less gone once we run out of what is on hand. The rest are currently being rationed. Alternate drugs have been proposed but many of them are also produced by Sandoz. Surgeries have already been canceled in Canada, mostly due to protamine shortages.
The government is acting sluggishly to license drugs from other countries to be imported to Canada and of course companies that could have made these drugs but that have historically been shut out of our market are in no hurry to accomodate us.
A number of observations:
The other thing that has become apparent is the amount of wastage. Our recovery room nurses for example when they give a small bolus of morphine, will draw this from a 10 mg ampoule, give two or three mg and waste 7-8 mg, repeating the process over and over on the same patient. This of course comes from pharmacy and nursing who don't want syringes of morphine lying around and of course when morphine was cheap this was not necessarily rational but supportable. Likewise many of my department will not use a multi-dose vial opened by someone else. I suggested that maybe they should, a small number have refused, believing apparently that we have a pyschopath in our department who goes around adulterating other people's vials.
We are also switching to oral medications to spare the IV meds we use. It only took a couple of days to get Pharmacy to supply us with acetaminophen, ibuprofen, dexamethasone and ondansatron which we now give to patients with a sip of water in the holding area. These are supplied in the evil Pyxis machine. Unfortunately they cannot store enough to last all day and the head of Pharmacy was astounded when I told him, we do about 60 cases a day in our OR. I suggested that if there wasn't room in the Pyxis, why didn't he just leave a large bottle of the drugs around in the holding area. I haven't heard back.
Bureaucracy is still slow to respond. I suggested that the oral drugs above might better be given on the ward and suggested a reasonable protocol. I was told firmly that standing orders and protocols must be vetted by a appropriate committees. Not holding my breath on that one.
Shortages are of course going to become more and more frequent. It is much more profitable for a company to make Lipitor than the mostly generic drugs we use. We have already lost Pentothal; I have heard of propofol shortages in Canada. A year ago we were short of ephedrine (also made by Sandoz which may have been a harbinger of things to come). Many people say we should just let the market sort this out (they have after all done such a great job already) and there is very little appetite in our current government to interfere with the natural order of things.
When I go to Ecuador every year, I have to figure out exactly how much of each drug we use, add a fudge figure and buy them all in advance (except the controlled ones which we buy there). That was a little stressful the first time, I have since learned that we can buy most of the drugs we need there anyway.
Now as we recently learned almost all the generic injectable drugs in Canada are produced at a single factory in Lennoxville Quebec, owned by Sandoz which is itself owned by a European company. Some time ago this factory was visited by representatives of the FDA who found safety flaws in their manufacturing process and told them to fix it, essentially shutting down the plant or at least severely curtailing its production while it fixes itself. This happened a few months ago but the shit has only now hit the fan.
Affected are drugs like morphine, fentanyl, rocuronium, glycopyrrolate, ketamine, ondansatron, norepinephrine and protamine (actually it would be shorter to just list what's not affected). Ondansatron is more or less gone once we run out of what is on hand. The rest are currently being rationed. Alternate drugs have been proposed but many of them are also produced by Sandoz. Surgeries have already been canceled in Canada, mostly due to protamine shortages.
The government is acting sluggishly to license drugs from other countries to be imported to Canada and of course companies that could have made these drugs but that have historically been shut out of our market are in no hurry to accomodate us.
A number of observations:
- How come free market USA has higher standards for drug production than Soviet Canuckistan?
- Who was the genius who decided that all or most of Canada would buy its drugs from a single source?
The other thing that has become apparent is the amount of wastage. Our recovery room nurses for example when they give a small bolus of morphine, will draw this from a 10 mg ampoule, give two or three mg and waste 7-8 mg, repeating the process over and over on the same patient. This of course comes from pharmacy and nursing who don't want syringes of morphine lying around and of course when morphine was cheap this was not necessarily rational but supportable. Likewise many of my department will not use a multi-dose vial opened by someone else. I suggested that maybe they should, a small number have refused, believing apparently that we have a pyschopath in our department who goes around adulterating other people's vials.
We are also switching to oral medications to spare the IV meds we use. It only took a couple of days to get Pharmacy to supply us with acetaminophen, ibuprofen, dexamethasone and ondansatron which we now give to patients with a sip of water in the holding area. These are supplied in the evil Pyxis machine. Unfortunately they cannot store enough to last all day and the head of Pharmacy was astounded when I told him, we do about 60 cases a day in our OR. I suggested that if there wasn't room in the Pyxis, why didn't he just leave a large bottle of the drugs around in the holding area. I haven't heard back.
Bureaucracy is still slow to respond. I suggested that the oral drugs above might better be given on the ward and suggested a reasonable protocol. I was told firmly that standing orders and protocols must be vetted by a appropriate committees. Not holding my breath on that one.
Shortages are of course going to become more and more frequent. It is much more profitable for a company to make Lipitor than the mostly generic drugs we use. We have already lost Pentothal; I have heard of propofol shortages in Canada. A year ago we were short of ephedrine (also made by Sandoz which may have been a harbinger of things to come). Many people say we should just let the market sort this out (they have after all done such a great job already) and there is very little appetite in our current government to interfere with the natural order of things.
Sunday, February 12, 2012
How men in groups are idiots
This past weekend I skied Kicking Horse in Golden BC. Because skiing with my adult children would kill me, assuming that they would actually let me ski with them, I most skied by myself. Due to weather conditions that meant multiple runs from the top to the bottom and taking the 8 person gondola to the top.
First trip of the day around 0930, I tag along with a group of 7 men my age. Early in the morning, the reek of stale booze is nauseating. As I look straight ahead trying not to throw up, I am forced to listen to tales of unrestrained male bonding.
Later in the day, I pile in with 7 20 somethings. The fellow directly in front of me has a green colouration and I hear someone say, "I finally don't feel like I have to throw up". They are on a ski weekend stag. They ask me if I am from Golden because they are looking for a stripper bar. Having watched both Hangover movies, I realize that I am now part of a bachelor party and begin to get worried.
Close your eyes though and you couldn't tell the groups apart. Or maybe I am just jealous.
First trip of the day around 0930, I tag along with a group of 7 men my age. Early in the morning, the reek of stale booze is nauseating. As I look straight ahead trying not to throw up, I am forced to listen to tales of unrestrained male bonding.
Later in the day, I pile in with 7 20 somethings. The fellow directly in front of me has a green colouration and I hear someone say, "I finally don't feel like I have to throw up". They are on a ski weekend stag. They ask me if I am from Golden because they are looking for a stripper bar. Having watched both Hangover movies, I realize that I am now part of a bachelor party and begin to get worried.
Close your eyes though and you couldn't tell the groups apart. Or maybe I am just jealous.
Sunday, February 5, 2012
My private Dell Hell
Have you ever been involved in a relationship that was initially great but has declined with time and now the other's bad behaviour is leading you to want to leave the relationship.
Actually I haven't either but I do read enough novels and watch enough chick-flics to know something about this.
As the title goes this is between me and Dell Computers. (And please Apple users I do not want to hear how I should have bought a Mac)
I bought my first desk top in 1993. 1 megabyte hard drive, 128 kb of RAM, DOS operating sytems. Computers became obsolete within a year then so I bought about one every year. (A major feature of the post-Christmas season was buying a new computer to be able to run the computer games my kids got for Christmas). I always bought from local companies. The computers crashed frequently, the service was horrible. The final straw was when I bought an "in home" warantee for my new computer. When the computer inevitably crashed, I phoned and was told, "Oh the guy who sold you that doesn't work for us anymore and we are not going to honour it." The was about the time Dell started running full page ads on the back page of the newspaper. Therefore we took the plunge called the 1-800 number and 5 days later my wife called me at work to tell me that our new computer had been delivered. New computer day was always a feared day for me, spending hours in uncomfortable positions,having to deal with multiple cables and connections, in between phone calls to customer service; however when I came home my wife had set up the computer and got it running by herself taking advantage of Dell's colour coded cables and easy set up.
Since then I have bought multiple desktops from Dell. They actually last several years. I have also bought 3 laptops (I am typing this on one of them) and I sent my kids off to school with 2 more Dell laptops. Their service has been exemplary, I have had to order new batteries and cables; easily done on their website.
Now a few years ago, I bought a second lap-top, an Inspiron Mini. I paid extra to have it purple. I have taken this little computer all over the world. I loved it as much as one can love an inanimate object. Last fall, the battery stopped taking a charge. No problem I had had it for 2 years and had used it a lot much of the time on the battery. I went onto Dell's website and bought a new battery. A week or so later I had to drive out to the courier depot to pick up the package. When I got home, the battery wasn't even close to fitting into my little computer.
I should at this point introduce a little aside to this whole story. A few years ago Dell opened a call centre in the town where I live. This was open with the usual fanfare and they of course got the usual tax holiday that big corporations get in return for bringing in low paid unskilled jobs to a town. That was where I would have called except that Dell decamped about two years ago; as I was to find out, to India.
Getting back to my story, I called the toll free number, and after some time on hold and after being shunted around a bit, I spoke to someone who assured me that he would personally see that I got the correct battery.
When I did get the battery a week or so later, it too did not fit my computer. Now this computer is a computer that was heavily promoted a few years ago both with full page ads and daily emails to my account. Back to the 1-800 number. The first number I called informed me that I would need to call another number that could only be called during business hours in the Central Time Zone (funny since someone in India was answering the phone). Therefore the next day I called the different number they gave me.
This lead to a hellish 90 minutes on the phone during which I was directed all over the place by a number of polite but unhelpful people with a variety of Indian accents. In between I was tortured by having to listen to Kenny G. I finally actually got to talk to somebody who informed me that he could get me a re-built battery or if I wanted to wait a little longer, a new battery. I told him that I would happily wait for a new battery. That was almost a month ago and I have never heard back from them. Next time I have 90 minutes free I will call them.
I did still have two batteries to send back to get refunds. This required another phone call to explain my problem to polite but unhelpful people with a variety of Indian accents and more Kenny G. Eventually they were able to email me a mailing label (to a Canadian address). I drove out to the courier place where they now know me quite well and sent the batteries back. They weren't finished with me. Periodically during the next week while I was in Ecuador, I would get a phone call from somebody with an Indian accent explaining that they had received my battery or that the refund would soon be processed. Because there were 2 batteries, I got 4 calls.
I now still have my Inspiron Mini which does not work unless I plug it in and frankly I am scared to phone Dell again.
In contrast just before Xmas I ordered a DVD from Amazon and they sent me two by mistake. I was able to go onto their website, "explain" that they had sent it by mistake and they emailed me a pre paid mailing label right away and I was actually able to drop the package in the mailbox.
In time this laptop will start to be unreliable and I will be looking for a new computer. And it probably will not be a Dell. Maybe it will be a Mac.
Actually I haven't either but I do read enough novels and watch enough chick-flics to know something about this.
As the title goes this is between me and Dell Computers. (And please Apple users I do not want to hear how I should have bought a Mac)
I bought my first desk top in 1993. 1 megabyte hard drive, 128 kb of RAM, DOS operating sytems. Computers became obsolete within a year then so I bought about one every year. (A major feature of the post-Christmas season was buying a new computer to be able to run the computer games my kids got for Christmas). I always bought from local companies. The computers crashed frequently, the service was horrible. The final straw was when I bought an "in home" warantee for my new computer. When the computer inevitably crashed, I phoned and was told, "Oh the guy who sold you that doesn't work for us anymore and we are not going to honour it." The was about the time Dell started running full page ads on the back page of the newspaper. Therefore we took the plunge called the 1-800 number and 5 days later my wife called me at work to tell me that our new computer had been delivered. New computer day was always a feared day for me, spending hours in uncomfortable positions,having to deal with multiple cables and connections, in between phone calls to customer service; however when I came home my wife had set up the computer and got it running by herself taking advantage of Dell's colour coded cables and easy set up.
Since then I have bought multiple desktops from Dell. They actually last several years. I have also bought 3 laptops (I am typing this on one of them) and I sent my kids off to school with 2 more Dell laptops. Their service has been exemplary, I have had to order new batteries and cables; easily done on their website.
Now a few years ago, I bought a second lap-top, an Inspiron Mini. I paid extra to have it purple. I have taken this little computer all over the world. I loved it as much as one can love an inanimate object. Last fall, the battery stopped taking a charge. No problem I had had it for 2 years and had used it a lot much of the time on the battery. I went onto Dell's website and bought a new battery. A week or so later I had to drive out to the courier depot to pick up the package. When I got home, the battery wasn't even close to fitting into my little computer.
I should at this point introduce a little aside to this whole story. A few years ago Dell opened a call centre in the town where I live. This was open with the usual fanfare and they of course got the usual tax holiday that big corporations get in return for bringing in low paid unskilled jobs to a town. That was where I would have called except that Dell decamped about two years ago; as I was to find out, to India.
Getting back to my story, I called the toll free number, and after some time on hold and after being shunted around a bit, I spoke to someone who assured me that he would personally see that I got the correct battery.
When I did get the battery a week or so later, it too did not fit my computer. Now this computer is a computer that was heavily promoted a few years ago both with full page ads and daily emails to my account. Back to the 1-800 number. The first number I called informed me that I would need to call another number that could only be called during business hours in the Central Time Zone (funny since someone in India was answering the phone). Therefore the next day I called the different number they gave me.
This lead to a hellish 90 minutes on the phone during which I was directed all over the place by a number of polite but unhelpful people with a variety of Indian accents. In between I was tortured by having to listen to Kenny G. I finally actually got to talk to somebody who informed me that he could get me a re-built battery or if I wanted to wait a little longer, a new battery. I told him that I would happily wait for a new battery. That was almost a month ago and I have never heard back from them. Next time I have 90 minutes free I will call them.
I did still have two batteries to send back to get refunds. This required another phone call to explain my problem to polite but unhelpful people with a variety of Indian accents and more Kenny G. Eventually they were able to email me a mailing label (to a Canadian address). I drove out to the courier place where they now know me quite well and sent the batteries back. They weren't finished with me. Periodically during the next week while I was in Ecuador, I would get a phone call from somebody with an Indian accent explaining that they had received my battery or that the refund would soon be processed. Because there were 2 batteries, I got 4 calls.
I now still have my Inspiron Mini which does not work unless I plug it in and frankly I am scared to phone Dell again.
In contrast just before Xmas I ordered a DVD from Amazon and they sent me two by mistake. I was able to go onto their website, "explain" that they had sent it by mistake and they emailed me a pre paid mailing label right away and I was actually able to drop the package in the mailbox.
In time this laptop will start to be unreliable and I will be looking for a new computer. And it probably will not be a Dell. Maybe it will be a Mac.
Saturday, February 4, 2012
Why I haven't posted lately
No reason in particular.
I got caught in the Christmas spirit and I really didn't feel like spewing the negative sarcastic stuff I usually write. I did have a nice Christmas thank you.
In January I went to Ecuador for two weeks. This was a medical mission followed by a week of vacation. This is the sixth visit for me. I have some good stories from there that I will eventually tell.
I got caught in the Christmas spirit and I really didn't feel like spewing the negative sarcastic stuff I usually write. I did have a nice Christmas thank you.
In January I went to Ecuador for two weeks. This was a medical mission followed by a week of vacation. This is the sixth visit for me. I have some good stories from there that I will eventually tell.
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