Justin Angelos, “vessel” 2012 - collage
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Sriracha Hot Sauce Catches Fire, Yet 'There's Only One Rooster'

The first thing you smell at the Huy Fong Foods factory in suburban Los Angeles is the overwhelming aroma of garlic, a key ingredient in the company’s signature product: Sriracha Hot Chili Sauce. The first thing you see, however, doesn’t make nearly as much sense. In the lobby is a blown-up picture of two astronauts—one Russian, the other Asian-American—hovering in zero gravity in the cramped confines of the International Space Station. Why it’s hanging there becomes clear on closer examination: An arrow superimposed on the photo points to a little green plastic cap, the top of a Huy Fong sriracha bottle floating in the background.

David Tran had the picture hung a few years ago. Tran is the 68-year-old founder and owner of Huy Fong, and the creator of the sauce that has brought his family-run business some fortune and fame as one of the fastest-growing food companies in America. Last year, the company sold 20 million bottles.

The NASA picture represents a milestone for Huy Fong. There’s a theory that space somehow dulls the taste buds. So to ensure its astronauts enjoyed a flavorful meal, the agency’s food sciences division began sending Huy Fong’s sriracha into orbit a decade ago. In the poster, the little green cap is hard to find, but it was all it took for one of the company’s fans, who e-mailed Huy Fong to say he had spotted it.

Such fan mail is not uncommon at Huy Fong—even though the company has never advertised in the U.S. It also has no Facebook page and no Twitter account, and the home page of its website serves as a kind of memorial to its nonchalant relationship to the wider world: It states plainly that it was last updated on May 10, 2004. Yet despite this aloofness, Huy Fong’s sriracha has earned a passionate following that’s helped make it an icon.

Like ketchup, sriracha is a generic term, its name coming from a port town in Thailand where the sauce supposedly was conceived. When people in America talk about sriracha, what they’re really talking about is Huy Fong’s version. It’s been name-checked on The Simpsons, is featured prominently on the Food Network, and has inspired a cottage industry of knockoffs, small-batch artisanal homages, and merchandise ranging from iPhone cases to air fresheners to lip balm to sriracha-patterned high heels.

Last April, market-research firm IBISWorld identified hot sauce production as the eighth-fastest-growing industry, behind for-profit universities and solar panel manufacturing. IBISWorld noted that in 2012 the industry’s revenue surpassed the $1 billion mark for the first time. It also had grown nearly 10 percent a year over the previous decade, recession be damned. That growth coincides with the burgeoning Asian population in the U.S., which expanded 45 percent in the 2000s, according to the most recent U.S. census. “As that subset grows, it not only demands more sriracha but spreads the word, too,” says IBISWorld analyst Agata Kaczanowska. “It leads restaurant owners to put it out there. And if it’s on the table, people are more likely to try it.”

by Caleb Hannan, Bloomberg Businessweek | Read more:
Image via: Tumblr

Simon and Garfunkel

Andrew Wyeth
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When Brain Damage Unlocks The Genius Within

Derek Amato stood above the shallow end of the swimming pool and called for his buddy in the Jacuzzi to toss him the football. Then he launched himself through the air, head first, arms outstretched. He figured he could roll onto one shoulder as he snagged the ball, then slide across the water. It was a grave miscalculation. The tips of Amato’s fingers brushed the pigskin—then his head slammed into the pool’s concrete floor with such bone-jarring force that it felt like an explosion. He pushed to the surface, clapping his hands to his head, convinced that the water streaming down his cheeks was blood gushing from his ears.

At the edge of the pool, Amato collapsed into the arms of his friends, Bill Peterson and Rick Sturm. It was 2006, and the 39-year-old sales trainer was visiting his hometown of Sioux Falls, South Dakota, from Colorado, where he lived. As his two high-school buddies drove Amato to his mother’s home, he drifted in and out of consciousness, insisting that he was a professional baseball player late for spring training in Phoenix. Amato’s mother rushed him to the emergency room, where doctors diagnosed Amato with a severe concussion. They sent him home with instructions to be woken every few hours.

It would be weeks before the full impact of Amato’s head trauma became apparent: 35 percent hearing loss in one ear, headaches, memory loss. But the most dramatic consequence appeared just four days after his accident. Amato awoke hazy after near-continuous sleep and headed over to Sturm’s house. As the two pals sat chatting in Sturm’s makeshift music studio, Amato spotted a cheap electric keyboard.

Without thinking, he rose from his chair and sat in front of it. He had never played the piano—never had the slightest inclination to. Now his fingers seemed to find the keys by instinct and, to his astonishment, ripple across them. His right hand started low, climbing in lyrical chains of triads, skipping across melodic intervals and arpeggios, landing on the high notes, then starting low again and building back up. His left hand followed close behind, laying down bass, picking out harmony. Amato sped up, slowed down, let pensive tones hang in the air, then resolved them into rich chords as if he had been playing for years. When Amato finally looked up, Sturm’s eyes were filled with tears.

Amato played for six hours, leaving Sturm’s house early the next morning with an unshakable feeling of wonder. He searched the Internet for an explanation, typing in words like gifted and head trauma. The results astonished him.

by Adam Piore, PopSci |  Read more:

Illustration: The Genius Within Paul Lachine and Graham Murdoch

The Queen’s New Gambit: Chess as a Great American Spectator Sport

Julian Schuster first heard the rumor a year and a half ago. Susan Polgar, the legendary grand master known to journalists as “the Queen,” was unhappy in her current position as Texas Tech’s chess coach. She was feeling unappreciated. She had made this known to certain people in the tight-knit world of chess, and the news had traveled from one of these confidants, a foreign grand master living in Texas, to the ears of Schuster, a passionate fan of the game, in St. Louis.

He knew her story, of course; it had achieved the status of legend. Her father raised her and her two sisters to be chess prodigies. In the 1980s, the three Polgar sisters began showing up at tournaments and crushing all comers, men and women alike. At age 21, Susan, the eldest of the three, became the first woman to earn the title of grand master in the way men always had, by proving she could hold her own in competition against other grand masters. Once, over the course of 16 hours and 30 minutes, she played 326 chess games simultaneously, winning 309 of them—a world record at the time. She blazed a trail for women in the game.

Beyond her career at the board, Polgar had made a name for herself as a dominant coach—arguably the dominant coach—in the thriving if mostly invisible world of American collegiate chess. In 2007, at the age of 38, she took her first coaching job, at Texas Tech, whose team was then unranked. By 2010 she had led the Knight Raiders’ all-male squad to the President’s Cup, known as “the Final Four of college chess”; the following two years the Raiders won it all, topping not just Yale and Princeton but the two traditional chess powerhouses, the University of Texas at Dallas and the University of Maryland, Baltimore County (UMBC).

But the conflicts between Polgar and Texas Tech over the kind of issues usually associated with big-time football programs—scholarships, resources, the future of the team—were real, as Schuster, provost of Missouri’s Webster University, would soon learn. A small private school with an unusually dense network of international campuses, Webster lacked a chess team, despite the fact that its main campus was located just outside the city limits of America’s new chess capital. St. Louis is home to the top-ranked player in the US, 25-year-old Hikaru Nakamura, as well as one of the game’s most deep-pocketed benefactors, 68-year-old multimillionaire Rex Sinquefield, who stepped up to build the most opulent chess venue in the country and probably the world, the 6,000-square-foot, $1 million-plus Chess Club and Scholastic Center of St. Louis.

In the summer of 2011, Schuster, a native of the former Yugoslavia who grew up hearing tales of the Polgar sisters’ heroics, invited Susan to St. Louis. He gave her a tour of the Webster campus and, later, talked to her about the resources the school could provide if she decided to coach there. Polgar liked what she heard. In February 2012, she announced that she would be transferring to Webster as its new chess coach. But not only that; eight of her players would be transferring too. Webster would be picking up their scholarships. It was unprecedented: A college chess coach was shifting allegiance from one university to another and bringing a significant chunk of her team with her. No volleyball coach, no tennis or baseball coach, had ever done anything close. News of the deal made The New York Times, USA Today, National Public Radio, and even that custodian of the sporting zeitgeist, ESPN.com.

Polgar’s sudden departure from Texas Tech surprised her fellow collegiate chess coaches, but they couldn’t deny that the move made sense for Webster; they knew how useful chess could be for a school looking to boost its intellectual reputation. Today’s collegiate game is dominated by a slate of elite squads at schools most people have never heard of. Places like UT Dallas, which has no football stadium but does have a Chess Plaza where graduating players get their pictures taken next to enormous chess pieces, and UMBC, which uses money from the school’s beverage contract with Pepsi-Cola to offer hefty Pepsi-Cola Chess Fellow scholarships to students with extraordinarily high chess ratings. The coaches for these and other top-ranked teams regularly travel abroad to recruit talented young players from Eastern Europe; they identify high schools in the US and elsewhere that can serve as feeder programs; they take calls from hedge funds wanting to offer jobs to their best players.

But among the top coaches in collegiate chess, Polgar has established herself in just five years as the most aggressive: a flamboyant personality, a fierce competitor, and a dogged recruiter. All told, her team at Webster now includes eight grand masters, who hail from the US, Mexico, Brazil, Cuba, Germany, Hungary, Israel, and the Philippines. This is an unheard-of concentration of talent for a single team. The next strongest squad, at UT Dallas, has only four grand masters. (To put that in context, there are nine grand masters in the entire country of Canada.) As soon as Polgar’s new team began competing, it was ranked number one in the country; no wonder that in the national championships of collegiate chess, which will be decided next month, Webster goes in as the top seed. But Polgar has set her sights beyond dominance of the collegiate game.

It’s been a long time since Americans really cared about chess. The last big spike of interest came in 1972, when one of our own, Bobby Fischer, faced down the Soviets’ top gun over a board in Iceland. Inspired by Fischer’s victory, a generation of smart, shy kids hurried out to buy chess manuals. Then Fischer went nuts. The Cold War ended. Chess was still, fundamentally, a game where two people sat at a table and thought a lot, and America was still a culture without a deep legacy of chess appreciation. Polgar wants to change that. She wants to win the hearts of soccer-addled adolescents and cable TV executives; she wants Americans to think of chess as a sport every bit as legitimate as golf or poker. All chess needs to break through, she believes, are some compelling public faces—and her all-star team of collegians might fit the bill. Engineered from childhood to be a grand master, Susan Polgar is trying to engineer an unlikely chess resurgence in the US.

by Jason Fagone, Wired |  Read more:

Photo: Paul Truong

Marino Marini (1901-1980) From Color to Form, Plate II, 1969
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Depeche Mode

We Couldn't Stop Looking

Aperture magazine, which just celebrated its sixtieth anniversary, has published Aperture Magazine Anthology: The Minor White Years, 1952-1976, a marvelous anthology devoted to Minor White, its founder and long-time editor, that collects the best of the critical writings on photography that appeared in the magazine in those years. Leafing through its pages and seeing the familiar cover photographs brought back many memories, since I worked for Aperture between 1967 and 1970 and played a small part in the production of eleven issues of the magazine and a few books. (...)

Though I was listed on the masthead of the magazine as “business manager,” I did everything that needed to be done around the office. I answered the rare phone calls, opened and answered mail from subscribers, swept the floor, paid the bills, delivered proofs to the printers, and was on call for various emergencies when an issue was in production, since there were no other full-time employees. These visits to the printers, engravers, and compositors—who in dimly-lit lofts with grimy skylights and windows in lower Manhattan and Brooklyn plied their trade using old-fashioned letterpresses with the skill to achieve the range and depth of tone in the black-and-white photographs we published—were especially memorable. One entered a world that had hardly changed in a century to be met by some gaunt, ghostly-pale old man who looked like a character out of Dickens, who would then be joined, as he squinted over the image I had brought, by two equally venerable fellow workers. They would study it a long time, hardly exchanging a word, until one of them would indicate an area of the photograph with his finger and another one of them would either shake his head or nod in agreement. (...)

In one of the older issues, Minor White had an essay called “What is Meant by ‘Reading’ Photographs” that made a big impression on me. He writes in it about hearing photographers often say that if they could write they would not take pictures. With me, I realized, it was the other way around. If I could take pictures, I would not write poems—or at least, this is what I thought every time I fell in love with some photograph in the office, in many cases with one that I had already seen, but somehow, to my surprise, failed to properly notice before. There is a wonderful moment when we realize that the picture we’ve been looking at for a long time has become a part of us as much as some childhood memory or some dream we once had. The attentive eye makes the world interesting. A good photograph, like a good poem, is a self-contained little universe inexhaustible to scrutiny.

by Charles Simic, NY Review of Books | Read more:

Photo: George Peet

Lily Furedi  Subway, 1934
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Jacques Henri Lartigue (1894 – 1986)

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Max Dalton, Guitar Lessons
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Eat Bray Love

The corruption of Anthony Bourdain, the return of Emeril Lagasse, and the state of food television.

A decade ago Emeril Lagasse was omnipresent, sprinkling catchphrases and cayenne nightly in front of a live studio audience. A lumbering, rump roast of a man who cooked like Paul Prudhomme but talked like the Gorton's Fisherman, Emeril was the unlikely poster boy of the transformation of what had once quaintly been known as "cooking shows" into a more unwieldy behemoth: "food TV." Fueled by the insatiable advertising needs of the Food Network and a viewing public suddenly interested in distinguishing deglazing from deveining, the staid format established by Julia Child and Jacques Pepin was chucked into the garbage like spoiled milk. It was no longer enough to stand behind a stove top and instruct. The new goal was to entertain. Chefs were required to prep themselves right alongside their mise en place, to garnish their dishes not with parsley but with personality.

And so, beginning in 1997, Emeril applied essence and kicked things up to varying notches. He employed a soft jazz band and cooked with Pat Benatar. He made garlic an applause line and convinced untold millions of Americans to try their hand at something called Urky Lurky. The goal remained ostensibly the same, despite the extra volume: to make home cooking appear doable and fun. But the extra noise soon began to drown out the message. Emeril endorsed toothpaste and floor mats and allowed someone to talk him into starring in an NBC sitcom. Eventually, the demands of celebrity scraped Emeril's plate clean, and by the time Emeril Live's goose was finally cooked in 2007, he'd unwittingly set the table for an entire generation of cheesy blasters still to come.

With no way to serve us an actual steak, the Food Network rebranded itself in desperate search of sizzle. The hyperactive appetite of television — for youth, for spark, for drama more genetically modified than a tomato in December — is far more demanding than any mere gastronome. And so the TV part of the equation began to outweigh the food. Legit cooks like Mario Batali and Michael Chiarello also went out the door. The rise of the hubris-devouring succubus that is The Next Food Network Star — and the long-term cheap replacement labor it provided — meant that their expertise was expendable, easily sacrificed on the altar of accessibility. Cooking isn't all that difficult, but cooking well absolutely is. And so the second generation of Food Network shows focused on making everything as easy as humanly possible, an interchangeable cavalcade of shortcuts and time-savers and "healthy alternatives," an endless slate of chipper idiots demonstrating idiotproof ways to successfully make sandwiches. The rest of the schedule was given over to a series of increasingly ludicrous competitions: The honorable Japanese Iron Chef begat a tarnished American version. Cupcake Battles escalated into Halloween Wars. Newer shows promised to reveal — and humiliate — the Worst Cooks in America. There's the even more execrable Rachael vs. Guy Celebrity Cook-Off, which revels in subhuman incompetence.

The schizophrenic network seemed committed to the idea of separating its viewership into either cartoony warriors or overmatched civilians, presenting the kitchen as either a battleground or a ticking time bomb. Food itself was either impossibly out of reach or beside the point, like fat floating on the surface of a broken sauce.

Fermenting just beneath Emeril's rise, the sourdough to his bubbly yeast, was Anthony Bourdain. The acerbic former junkie turned professional raconteur talked more smack than he'd ever injected, particularly on the subject of chefs on TV. (Emeril, for example, was both an "Ewok" and a hack.) Bourdain was a proud and snarly outsider, a thoroughly undistinguished line cook lifer suddenly handed a bullhorn on the back of a surprise bestseller. The chip on his shoulder was the size of a Yukon Gold. But, first on the Food Network and then on the Travel Channel, Bourdain proved himself to be a peerless ambassador for the extremes of cooking, high and low.

He was never half the chef Emeril was — something he'd be the first to admit — but he was twice as good on camera. No Reservations, which recently ended a triumphant nine-year run, was consistently one of the best things on television, a gorgeously shot valentine to global food culture. Bourdain's snark was always as much of an affectation as the earring and cigarettes — both now mercifully discarded — and so I never found him off-putting. Rather, I found him brilliantly and persuasively respectful, making the case that eating a raw seal eyeball or a bowl full of deep-fried crickets aren't isolated acts of gross-out machismo but a way to connect with people and traditions that existed long before Cool Ranch Doritos Locos Tacos — and will hopefully survive long after that abomination is wiped from the earth.

At its foul-mouthed best, Tony Bourdain's shtick is absolutely empowering, but not in the faux-populist manner of a Sandra Lee or Guy Fieri. What's made his voice so important is his steadfast refusal to coddle anything but eggs. Unlike most food shows, the central message of No Reservations was actually, no, you can't do this; you can't cook it, you can't re-create it, you can't dumb it down. Bourdain was a knight-errant of good taste, a champion of expertise and authenticity. Real food experiences, he argued, whether at a sushi counter in Tokyo or a hot dog stand in Chicago, are worth seeking out. Appreciation is just as important as enthusiasm.

by Andy Greenwald, Grantland |  Read more:

Photo: ABC

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The Robot Will See You Now

Harley lukov didn’t need a miracle. He just needed the right diagnosis. Lukov, a 62-year-old from central New Jersey, had stopped smoking 10 years earlier—fulfilling a promise he’d made to his daughter, after she gave birth to his first grandchild. But decades of cigarettes had taken their toll. Lukov had adenocarcinoma, a common cancer of the lung, and it had spread to his liver. The oncologist ordered a biopsy, testing a surgically removed sample of the tumor to search for particular “driver” mutations. A driver mutation is a specific genetic defect that causes cells to reproduce uncontrollably, interfering with bodily functions and devouring organs. Think of an on/off switch stuck in the “on” direction. With lung cancer, doctors typically test for mutations called EGFR and ALK, in part because those two respond well to specially targeted treatments. But the tests are a long shot: although EGFR and ALK are the two driver mutations doctors typically see with lung cancer, even they are relatively uncommon. When Lukov’s cancer tested negative for both, the oncologist prepared to start a standard chemotherapy regimen—even though it meant the side effects would be worse and the prospects of success slimmer than might be expected using a targeted agent.

But Lukov’s true medical condition wasn’t quite so grim. The tumor did have a driver—a third mutation few oncologists test for in this type of case. It’s called KRAS. Researchers have known about KRAS for a long time, but only recently have they realized that it can be the driver mutation in metastatic lung cancer—and that, in those cases, it responds to the same drugs that turn it off in other tumors. A doctor familiar with both Lukov’s specific medical history and the very latest research might know to make the connection—to add one more biomarker test, for KRAS, and then to find a clinical trial testing the efficacy of KRAS treatments on lung cancer. But the national treatment guidelines for lung cancer don’t recommend such action, and few physicians, however conscientious, would think to do these things.

Did Lukov ultimately get the right treatment? Did his oncologist make the connection between KRAS and his condition, and order the test? He might have, if Lukov were a real patient and the oncologist were a real doctor. They’re not. They are fictional composites developed by researchers at the Memorial Sloan-Kettering Cancer Center in New York, in order to help train—and demonstrate the skills of—IBM’s Watson supercomputer. Yes, this is the same Watson that famously went on Jeopardy and beat two previous human champions. But IBM didn’t build Watson to win game shows. The company is developing Watson to help professionals with complex decision making, like the kind that occurs in oncologists’ offices—and to point out clinical nuances that health professionals might miss on their own.

Information technology that helps doctors and patients make decisions has been around for a long time. Crude online tools like WebMD get millions of visitors a day. But Watson is a different beast. According to IBM, it can digest information and make recommendations much more quickly, and more intelligently, than perhaps any machine before it—processing up to 60 million pages of text per second, even when that text is in the form of plain old prose, or what scientists call “natural language.”

That’s no small thing, because something like 80 percent of all information is “unstructured.” In medicine, it consists of physician notes dictated into medical records, long-winded sentences published in academic journals, and raw numbers stored online by public-health departments. At least in theory, Watson can make sense of it all. It can sit in on patient examinations, silently listening. And over time, it can learn. Just as Watson got better at Jeopardy the longer it played, so it gets better at figuring out medical problems and ways of treating them the more it interacts with real cases. Watson even has the ability to convey doubt. When it makes diagnoses and recommends treatments, it usually issues a series of possibilities, each with its own level of confidence attached.

Medicine has never before had a tool quite like this. And at an unofficial coming-out party in Las Vegas last year, during the annual meeting of the Healthcare Information and Management Systems Society, more than 1,000 professionals packed a large hotel conference hall, and an overflow room nearby, to hear a presentation by Marty Kohn, an emergency-room physician and a clinical leader of the IBM team training Watson for health care. Standing before a video screen that dwarfed his large frame, Kohn described in his husky voice how Watson could be a game changer—not just in highly specialized fields like oncology but also in primary care, given that all doctors can make mistakes that lead to costly, sometimes dangerous, treatment errors.

Drawing on his own clinical experience and on academic studies, Kohn explained that about one-third of these errors appear to be products of misdiagnosis, one cause of which is “anchoring bias”: human beings’ tendency to rely too heavily on a single piece of information. This happens all the time in doctors’ offices, clinics, and emergency rooms. A physician hears about two or three symptoms, seizes on a diagnosis consistent with those, and subconsciously discounts evidence that points to something else. Or a physician hits upon the right diagnosis, but fails to realize that it’s incomplete, and ends up treating just one condition when the patient is, in fact, suffering from several. Tools like Watson are less prone to those failings. As such, Kohn believes, they may eventually become as ubiquitous in doctors’ offices as the stethoscope.

“Watson fills in for some human limitations,” Kohn told me in an interview. “Studies show that humans are good at taking a relatively limited list of possibilities and using that list, but are far less adept at using huge volumes of information. That’s where Watson shines: taking a huge list of information and winnowing it down.”

by Jonathan Cohn, The Atlantic |  Read more:

Illustration: Bart Cooke

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Bitter Pill: Why Medical Bills Are Killing Us

When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.

Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.

Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children.

About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.”

Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card. The hospital says there was nothing unusual about how Sean was kept waiting. According to MD Anderson communications manager Julie Penne, “Asking for advance payment for services is a common, if unfortunate, situation that confronts hospitals all over the United States.”

Diagnosed with non-Hodgkin’s lymphoma at age 42. Total cost, in advance, for Sean’s treatment plan and initial doses of chemotherapy: $83,900. Charges for blood and lab tests amounted to more than $15,000; with Medicare, they would have cost a few hundred dollars

The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.

Why? (...)

When I asked MD Anderson to comment on the charges on Recchi’s bill, the cancer center released a written statement that said in part, “The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”

The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.

The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companies.”

DePinho’s salary is nearly triple the $674,350 paid to William Powers Jr., the president of the entire University of Texas system, of which MD Anderson is a part. This pay structure is emblematic of American medical economics and is reflected on campuses across the U.S., where the president of a hospital or hospital system associated with a university — whether it’s Texas, Stanford, Duke or Yale — is invariably paid much more than the person in charge of the university.  (...)

Recchi’s bill and six others examined line by line for this article offer a closeup window into what happens when powerless buyers — whether they are people like Recchi or big health-insurance companies — meet sellers in what is the ultimate seller’s market.

The result is a uniquely American gold rush for those who provide everything from wonder drugs to canes to high-tech implants to CT scans to hospital bill-coding and collection services. In hundreds of small and midsize cities across the country — from Stamford, Conn., to Marlton, N.J., to Oklahoma City — the American health care market has transformed tax-exempt “nonprofit” hospitals into the towns’ most profitable businesses and largest employers, often presided over by the regions’ most richly compensated executives. And in our largest cities, the system offers lavish paychecks even to midlevel hospital managers, like the 14 administrators at New York City’s Memorial Sloan-Kettering Cancer Center who are paid over $500,000 a year, including six who make over $1 million.

Taken as a whole, these powerful institutions and the bills they churn out dominate the nation’s economy and put demands on taxpayers to a degree unequaled anywhere else on earth. In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.

by Steven Brill, Time |  Read more:

Photo: uncredited

That’s Not A Droid, That’s My Girlfriend

Osamu Kozaki’s life in Tokyo is, by his own admission, often a lonely one. The 35-year-old, an engineer who designs industrial robots, has had few relationships with women in his life. Those few have almost always gone badly.

So when Kozaki’s girlfriend, Rinko Kobayakawa, sends him a message, his day brightens up. The relationship started more than three years ago, when Kobayakawa was a prickly 16-year-old working in her school library, a quiet girl who shut out the world with a pair of earphones that blasted punk music.

Kozaki sums up Kobayakawa’s personality with one word: tsundere – a popular term in Japan’s otaku geek culture, which describes a certain feminine ideal. It refers to the kind of girl who starts out hostile but whose heart gradually grows warmer. And that’s what has happened; over time, Kobayakawa has changed. These days, she spends much of her day sending affectionate missives to her boyfriend, inviting him on dates, or seeking his opinion when she wants to buy a new dress or try a new hairstyle.

But while Kozaki has aged, Kobayakawa has not. After three years, she’s still 16. She always will be. That’s because she is a simulation; Kobayakawa only exists inside a computer.

Kozaki’s girlfriend has never been born. She will never die. Technically, she has never lived. She may be deleted, but Kozaki would never let that happen.

Because he’s in love.

Kozaki is one of hundreds of thousands of Japanese who have bought Love Plus, a game released on the Nintendo DS in 2009, which is intended to simulate the experience of high-school romance with one of three pre-programmed teen girl characters. For a sizable number of loyal male gamers, it has become something more: a relationship that, if not entirely like dating a real woman, comes close as a source of affection.

“I really do love her,” Kozaki explains, when he and two of his friends meet with me in a coffee shop in Akihabara, the Tokyo neighbourhood at the centre of Japan’s otakuculture. Kozaki fully expects the game to be a lifelong commitment. “If someone were to ask me to stop, I don’t think I could do it,” he says.

Kozaki recounts what happened when an updated version of the game came out; which meant he had to move his saved data onto a new program. Kozaki couldn’t come at the idea of having two simultaneous versions of his virtual girlfriend in existence, so he asked a friend to delete the old saved data for him. It was — almost — as if he had arranged for someone to be murdered, he says. “I cried when he pushed that delete button,” he says, acknowledging that it sounds strange. “It was as if I crossed a border line from reality.”

by Aubrey Belford, The Global Mail |  Read more:
Photo: Aubrey Belford

Banksy (see also: Banksy Mural Mystery Deepens)

Social Work in the Tenderloin Will Kill Something Inside of You

The Tenderloin is widely acknowledged as the most hellish neighborhood in San Francisco. Out of the city's ten most violent crime plots, the Tenderloin is home to seven. Recent stats estimate the neighborhood has an average of three major crimes per hour, including one-third of the city’s drug offenses, with a yearly mean of two crimes per resident. The population is made up of more than 6,000 homeless people and contains one-fourth of the city’s HIV-positive drug users. Filthy sidewalks and vacant buildings peppered with single-occupancy hotel rooms provide a home to all levels of drugs and prostitution.

My friend Lorian has been employed as a social worker in the Tenderloin for several years now. Her tweets about it (things like: “today: 4 dead clients, 1 murdered provider, 1 client defecated in the lobby, 1 dead dog, & 1 facebook friend posted pictures of nachos.”) got me curious as to what her job is like. She was kind enough to answer some of my questions.

VICE: I imagine it varies greatly, but can you describe your average workday?

Lorian: The first thing is getting through the door at 9 AM. We usually have to step over clients or random strangers passed out on the benches from drinking and/or using since God knows when. The smell is the first thing that hits you—a stench of urine, feces, poor hygiene—it's really at its strongest in the morning, but you get used to it throughout the day. Then we check our voicemail. Twenty messages from the same two or three clients who either scream their financial requests over and over, simply sit there and breathe, or tell you that witches are under their beds waiting for the next blood sacrifice. Paranoid clients like to fixate on witches, Satan, etc. Anyway, we get ready to open and hand out checks to the clients who are either on daily budgets, or who make random check requests. The budgeted clients are the most low-functioning, as they can be restricted to as little as $7 per day in order to curb their harm reduction. They'll go and spend that $7 on whatever piece of crack they can find, and then two hours later they're back, begging for more money. Clients will find some really brilliant ways to beg. When we're not dealing with clients out in the lobby, which can involve anything from handing out checks to cleaning up blood to clearing the floor for folks having seizures, we're usually dealing with the government agency assholes over at Social Security. I personally work with around 200 clients, so the paperwork and filing can be extraordinary. My “average day” starts at 9 AM and lasts until 7 or 8 PM.

by Blake Butler, Vice |  Read more:

Images: uncredited