Messaging Wars

In the history of human communication, the Facebook post is a highly unnatural way to interact with friends and acquaintances. It’s akin to standing before a room filled with every single person you know and delivering a presentation about your personal life. You really don’t want all of those people listening, since a lot of them won’t care and a few of them you’d rather not tell. Sure, Facebook’s privacy controls let you target posts in principle, but in practice it’s a lot of work, especially when you’re trying to share something quickly.

This overly public nature is a big reason why Facebook, long stereotyped as a teenage obsession, today has a self-admitted problem with young people. Namely: They are leaving. By one estimate, some 11 million fewer high school and college kids in the US use Facebook today than did three years ago. Increasingly, kids don’t want to be on a network where their parents can so easily monitor their communi­cations. The generation that has grown up with social media is also wary of its permanence—that picture you post today may come back to haunt you when you’re ready to find a job. Even the site’s central design, a timeline that literally begins with your birth, emphasizes the notion that Facebook is forever.

This approach, as popular and powerful as it turned out to be, has created an opportunity for the mobile-messaging apps. They all foster a more natural feeling of conversation taking place between ad hoc groups of friends. Even better, to participate you don’t have to set up yet another social network. Instead, you just capitalize on the one that’s already in your pocket: your phone’s address book. With all of them, you download the app and, based on matches in your phone book, get automatically connected with any of your contacts who are also on the new service. After that, it’s astonishingly fast and easy to send texts, photos, and more, just as you would with SMS. (...)

But with 450 million people, WhatsApp’s plate is already looking pretty full. Yet Livingston is probably correct in his belief that Facebook can’t win the messaging wars, even with the infusion of WhatsApp’s user base. That’s because the messaging wars might never be won by anyone.

Why? For the same reasons that companies like WhatsApp and Kik have been able to grow so fast in the first place. Mobile apps are easy to download and launch with a single finger tap; the phone’s contact list is always available to get you up and running with at least a few good friends. On mobile devices, the self-reinforcing network effect might not be as important as it has been on the web. A recent study of 15- to 25-year-olds in the UK showed that 25 percent of them were using multiple messaging apps.

“The winner-take-all dynamic is obliterated on mobile,” argues Benedict Evans, an analyst and investor with Andreessen Horowitz. It’s not just that these apps can access our address books, reducing the frictional barriers to joining. The mobile experience makes it trivial to pick different apps for different uses with the mere tap of a thumb. And this shift, in turn, accelerates the process of building com­panies around such apps. “You don’t have to raise $50 million,” Evans says. “You don’t have to have 500 employees. You can have 20 to 40 guys who have never raised any money from venture capitalists reach 500 million users.”

by Mat Honan, Wired |  Read more:

Image: Ben Wiseman

Siobhan Mcbride
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A Better Way to Pick Your Doctor

Last week, the federal government made plans to release a massive database capable of providing patients with much more information about their doctors.

The Centers for Medicare and Medicaid Services, the government agency that runs Medicare, plans to post on its website detailed information about how many visits and procedures individual health professionals billed the program for in 2012, and how much they were paid.

This new trove of data, which covers 880,000 health professionals, adds to a growing body of information available to patients who don’t want to leave picking a doctor to chance. But to put that information to good use, consumers need to be aware of what is available, what’s missing and how to interpret it.

So, what’s out there?

As it stands, patients can go to websites such as Yelp or Healthgrades to read reviews of their doctors submitted by other patients. They can go to the websites of state medical boards to find out whether a doctor has faced disciplinary action. If they’re really adventurous, they can seek out lawsuit filings.

At its website, ProPublica maintains a database on which patients can check whether their doctors have received payments or gifts from any of more than a dozen pharmaceutical companies. Another ProPublica database allows patients to look at which medications a doctor has prescribed to patients in Medicare’s prescription drug program. The data enables patients to compare doctors with their peers, seeing if they have unusual practices or conflicts of interest.

This fall, under a little-debated part of the Affordable Care Act, the federal government will release data on personal, promotional, and research payments to doctors from all pharmaceutical and medical device companies. Armed with this information, patients will be able to at least ask whether their doctors have prescribed a drug because it is the best one for their patients—or because of a financial relationship. (...)

These new tools all have limits. They won’t tell you whether one doctor’s patients are sicker than another’s and need different therapies. They won’t tell you about a doctor’s bedside manner or willingness to return a phone call at 3 a.m. They won’t tell you about a doctor’s surgical skill.

It’s also far from certain whether patients will embrace the tools. Currently, an array of information is available about hospitals and nursing homes, but it’s unclear that it has made much of a difference in where patients seek care. Some people would simply prefer to make decisions the old-fashioned way, relying on community networks rather than data.

Still, our experience in making data available suggests lots of people are eager to use this information to drive health care choices. Millions have visited our Prescriber Checkup and Dollars for Docs news applications.

by Charles Ornstein, Pacific Standard | Read more:Image: Yevhen Vitte/Shutterstock

How a Watch is Made

German watchmaking company NOMOS Glashütte offers a look at what goes into the assembly of one of their watches in this fascinating short film that follows one of their watchmakers.
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Brett Amory
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Here's What Happens If You Don't Do Your Taxes

You, yes you, can do your taxes this year. Many of you are done, most of you haven't started, and a few of you are freaking out. Some of you are thinking: what if I just don't file? What will happen if I don't pay? What if I didn't file last year or the year before that? What will they do to me and will I be in prison with Wesley Snipes?

I have some answers to those questions! You should note that I am not a tax professional, that this is definitely not professional advice and that every situation is unique. Also you should be doing your taxes right now probably, not reading the Internet. But here's some experience, offered person-to-person, that is not professional counsel.

It is better to do a cruddy job and file than to not file.
When I say "cruddy job," I don't mean "making wild guesstimations" or being dishonest. I mean: If you can't nail some stuff down, forget about it and move on. For instance: Do you not have receipts for some expenses? Big deal: cut them out and forget about it. (These small expense-deductions don't generally have too much effect on your tax burden anyway.) Err on the side of "hurting" yourself and just plow through it. It's just not worth making yourself crazy over fifteen bucks!

You can fix your return!
It is easy to amend a return. It's also easy for the IRS to amend your return: "You do not need to file an amended return due to math errors. The IRS will automatically make that correction." Intense, right?

It is better to file and not pay than to not file and not pay.
What happened, you spend all your money? That's okay, pal! Do your taxes, send 'em in, if you have absolutely no money. You will incur not-totally-crazy penalties over time due to not paying, and they will want to talk to you about when you can pay. (Yup, it's always the broke people that have to pay more in this world.) That's not ideal, sure! But it's a lot more ideal than not having filed.

Okay, but should I be scared of the IRS?
The IRS only wants to hear from you. The answer, surprisingly, is a very firm "no"! Not at all! The IRS has some of the nicest, most understanding people I have ever spoken with in my life. True fact.

There's a lot of TV- and movie-propagated terror about the IRS. (As well, the whole idea of the government and money is anxiety-producing on its own, sure.) And the truth is… well, they kind of used to be a little mean? But that's actually ancient history. The people at the IRS are some of the funnest people ever! I have had long hilarious conversations with them on the phone. (For real, there are some hilarious ladies down in Atlanta.) IRS employees are like most civil servants; they deal with confused, freaked out and sometimes very dingbatty people (not you, friend!) every day—the kind of people who do not follow directions, particularly. So if you are not a jerk, they will be delighted to speak to you, at length. They will sometimes be like, "Girl, how did you get into this trouble?" and you'll be like "Oh, haha, I'm a mess! Mistakes happen!" and they'll be like, "I hear you! I get it!" Do not be afraid. What they want is to hear from you.

Should I be scared of my state tax department?
Actually… well, maybe just a little. The same rules apply as above—they do want to hear from you!—but, for instance, the New York State Department of Taxation and Finance seems to be a little cranky. They want their money, they want it now, and if you don't give it to them, they will take it. I'm sure there are some wonderful, caring people working in all of America's fine state tax departments!

What happens if you don't file?
Have I mentioned that the IRS only wants to hear from you?

by Choire Sicha, The Awl | Read more:
Image: Mat Honan

Goat

[ed. Full World Music album here.]

The Truth About Google X

Astro Teller is sharing a story about something bad. Or maybe it's something good. At Google X, it's sometimes hard to know the difference.

Teller is the scientist who directs day-to-day work at the search ­giant's intensely private innovation lab, which is devoted to finding unusual solutions to huge global problems. He isn't the president or chairman of X, however; his actual title, as his etched-glass business card proclaims, is Captain of Moonshots--"moonshots" being his catchall description for audacious innovations that have a slim chance of succeeding but might revolutionize the world if they do. It is evening in Mountain View, California, dinnertime in a noisy restaurant, and Teller is recounting over the din how earlier in the day he had to give some unwelcome news to his bosses, Google cofounder Sergey Brin and CFO Patrick Pichette. "It was a complicated meeting," says Teller, 43, sighing a bit. "I was telling them that one of our groups was having a hard time, that we needed to course-correct, and that it was going to cost some money. Not a trivial amount." Teller's financial team was worried; so was he. But Pichette listened to the problem and essentially said, "Thanks for telling me as soon as you knew. We'll make it work."

At first, it seems Teller's point is that the tolerance for setbacks at Google X is uncharacteristically high--a situation helped along by his bosses' zeal for the work being done there and by his parent company's extraordinary, almost ungodly, profitability. But this is actually just part of the story. There happens to be a slack line--a low tightrope--slung between trees outside the Google X offices. After the meeting, the three men walked outside, took off their shoes, and gave the line a go for 20 minutes. Pichette is quite good at walking back and forth; Brin slightly less so; Teller not at all. But they all took turns balancing on the rope, falling frequently, and getting back on. The slack line is groin-high. "It looked like a fail video from YouTube," Teller says. And that's really his message here. "When these guys are willing to fall, groan, and get up--and they're in their socks?" He leans back and pauses, as if to say: This is the essence of Google X. When the leadership can fail in full view, "then it gives everyone permission to be more like that."

Failure is not precisely the goal at Google X. But in many respects it is the means. By the time Teller and I speak, I have spent most of the day inside his lab, which no journalist has previously been allowed to explore. Throughout the morning and afternoon I visited a variety of work spaces and talked at length with members of the Google X Rapid Evaluation Team, or "Rapid Eval," as they're known, about how they vet ideas and test out the most promising ones, primarily by doing everything humanly and technologically possible to make them fall apart. Rapid Eval is the start of the innovative process at X; it is a method that emphasizes rejecting ideas much more than affirming them. That is why it seemed to me that X--which is what those who work there usually call it--sometimes resembled a cult of failure. As Rich DeVaul, the head of Rapid Eval, says: "Why put off failing until tomorrow or next week if you can fail now?" Over dinner, Teller tells me he sometimes gives a hug to people who admit mistakes or defeat in group meetings.

X does not employ your typical Silicon Valley types. Google already has a large lab division, Google Research, that is devoted mainly to computer science and Internet technologies. The distinction is sometimes framed this way: Google Research is mostly bits; Google X is mostly atoms. In other words, X is tasked with making actual objects that interact with the physical world, which to a certain extent gives logical coherence to the four main projects that have so far emerged from X: driverless cars, Google Glass, high-­altitude Wi-Fi balloons, and glucose-monitoring contact lenses. Mostly, X seeks out people who want to build stuff, and who won't get easily daunted. Inside the lab, now more than 250 ­employees strong, I met an idiosyncratic troupe of former park rangers, sculptors, philosophers, and machinists; one X scientist has won two Academy Awards for special effects. Teller himself has written a novel, worked in finance, and earned a PhD in artificial intelligence. One recent hire spent five years of his evenings and weekends building a helicopter in his garage. It actually works, and he flew it regularly, which seems insane to me. But his technology skills alone did not get him the job. The helicopter did. "The classic definition of an expert is someone who knows more and more about less and less until they know everything about nothing," says DeVaul. "And people like that can be extremely useful in a very focused way. But these are really not X people. What we want, in a sense, are people who know less and less about more and more."

If there's a master plan behind X, it's that a frictional arrangement of ragtag intellects is the best hope for creating products that can solve the world's most intractable issues. Yet Google X, as Teller describes it, is an experiment in itself--an effort to reconfigure the process by which a corporate lab functions, in this case by taking incredible risks across a wide variety of technological domains, and by not hesitating to stray far from its parent company's business. We don't yet know if this will prove to be genius or folly. There's actually no historical model, no ­precedent, for what these people are doing.

But in some ways that makes sense.

by Jon Gertner, Fast Company |  Read more:

Image: llustration by Owen Gildersleeve, Photo by Sam Hofman

Font War: Inside the Design World's $20 Million Divorce

Gotham is one hell of a typeface. Its Os are round, its capital letters sturdy and square, and it has the simplicity of a geometric sans without feeling clinical. The inspiration for Gotham is the lettering on signs at the Port Authority, manly works using “the type of letter that an engineer would make,” according to Tobias Frere-Jones, who is widely credited with designing the font for GQ magazine in 2000. Critics have praised Gotham as blue collar, nostalgic yet “exquisitely contemporary,” and “simply self evident.”

It’s also ubiquitous. Gotham has appeared on Netflix envelopes, Coca-Cola cans, and in the Saturday Night Live logo. It was on display at the Museum of Modern Art from 2011 to 2012 and continues to be part of the museum’s permanent collection. It also helped elect a president: In 2008, Barack Obama’s team chose Gotham as the official typeface of the campaign and used it to spell out the word HOPE on its iconic posters.

Among those who draw letters for a living, Gotham is most notable for being the crowning achievement of two of the leaders of their tribe, Frere-Jones and Jonathan Hoefler. The two men seemed to be on parallel paths since the summer of 1970, when they were both born in New York. Hoefler and Frere-Jones were already prominent designers when they began operating as Hoefler&Frere-Jones in 1999, having decided to join forces instead of continuing their race to be type design’s top boy wonder. Each would serve as an editor for the other, and they would combine their efforts to promote the work they did together.

Colleagues still struggle to explain what a big deal this was at the time. Debbie Millman, president emeritus of AIGA, the major trade organization for graphic designers, begins by comparing them to John Lennon and Paul McCartney, then stops. “They were famous before they got together, so that’s how they’re not like the Beatles. It’s more like Crosby, Stills, Nash & Young,” she says, before pausing again. “You know what—I’ll tell you what they were like. They were like Angelina Jolie and Brad Pitt.”

For 15 years, Frere-Jones and Hoefler seemed charmed. They made typefaces that rendered the stock charts in the Wall Street Journal readable and helped Martha Stewart sell cookbooks. They created an alphabet for the New York Jets, based on the team’s logo. And they saw their lettering chiseled into stone as part of the rebuilding of the World Trade Center. Last year, the duo won the AIGA Medal, the profession’s highest award. It seemed to be one of those rare situations whereby two successful soloists had combined to make an even better supergroup. Hoefler was asked if there were any troubles in their working relationship for a video produced for the AIGA in 2013. “We do have a longstanding disagreement over the height of the lower case t,” he said. “That is the only point of contention.”

Not quite. In January, Frere-Jones filed a lawsuit against Hoefler, saying that their company was not actually a partnership, but a long con in which Hoefler had tricked him into signing over the rights to all of his work, cheating Frere-Jones out of his half of the business. “In the most profound treachery and sustained exploitation of friendship, trust and confidence, Hoefler accepted all the benefits provided by Frere-Jones while repeatedly promising Frere-Jones that he would give him the agreed equity, only to refuse to do so when finally demanded,” the complaint charges. Frere-Jones is asking a court to grant him $20 million. Hoefler won’t comment on the suit directly, but the day after it was filed a lawyer for the company issued a brief statement disputing the claims, which, it said, “are false and without legal merit.” (About Gotham’s creation, Hoefler writes in an email: “No one is disputing Tobias’s role in those projects, or my own, for that matter. [Our] typefaces have had a lot of other contributors, as well — everything we do here is a team effort.”) According to the company statement, Frere-Jones was not Hoefler’s partner but a “longtime employee.”

by Joshua Brustein, Bloomberg Businessweek |  Read more:

Image: Kathy Willens/AP

Victor Pasmore (British, 1908-1998), Punto di Contatto 2, 1982.
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Keeping Up With The Lemmings

Facebook is beginning to deal with death, but only with issues of access, not with the fate of the pages themselves. Nearly 3 million Facebook users worldwide were predicted to die in 2012 alone, their pages achieving an immortality denied to their progenitors. Will famous last words be replaced by famous last entries? Will Stephen King write a ghoulish story about a Facebook user who updates his page from heaven? Will some start-up create a ‘dropped box' in cyberspace for the dearly departed? And what about all those other clouds? Your stuff is safe and backed up. You are not.

When I was growing up, having a pen pal on the other side of the globe was a big thing. It was an early, primitive form of global interconnectivity and many children delighted in communicating with someone so far away. Pen pals satisfied an urge to reach way out there. In those days it wasn't about how many pen pals you had, it was about where they were. Where doesn't matter anymore when here is everywhere or everywhere is here.

So many congenital sociological and biological impulses have been tweaked and distorted by the surge of technology, not least the desire to make contact with others. We no longer reach out to a handful of people, we reach out to a network, and the people we reach can be counted in the hundreds or even thousands if we so wish. We're all encouraged to fashion a version of ourselves, and offer it to the world. (...)

Where is it all going? Even with climate change we still have many decades, possibly centuries left to go. What will we become? Will there be a backlash, a mass closing of Facebook, Twitter and Instagram accounts? Will we all retreat within ourselves, becoming postmodern Thoreaus, seeking safety in solitude, not in numbers? Will we reach in, instead of out? Will we lean out, instead of in? Will history once again prove itself to be a pendulum that swings back and forth between two extremes?

by Brooks Riley, 3 Quarks Daily |  Read more:

Image: Lemmings, uncredited 

[ed. Easy. Start your own blog.]

Health Care Alternative

Barbara Smaller, New Yorker
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Doc Watson

[ed. A guitar-picker's guitar picker. Listen to House Carpenter (11:09) one of the saddest songs I think I've ever learned to play. Lyrics here.]

"Doc Watson's very first solo performances--1962 and 1963, in the heart of New York City's folk revival"--per Amazon.com anon reviewer.

Track list: My Time stamps are subjective and irrespective of Doc's preambles, crowd-work, fond reminisces, or recieved crowd applause. The time stamps represent only the moment the song properly begins till it's proper ending.

1. Little Sadie 00:00 - 2:15
2. Blue Smoke 2:25 - 4:16
3. St. Louis Blues 4:29 - 6:59
4. John Herald Introduction 7:12 - 7:45
5. Sing Song Kitty 7:45 - 10:15
6. House Carpenter 11:09 - 14:52
7. Liberty 15:08 - 16:40
8. The Old Wooden Rocker 17:01 - 19:57
9. Milk Cow Blues 20:08 - 22:03
10. Tragic Romance 22:35 - 26:00
11. The Dream of the Miner's Child 26:27 - 29:04
12. The Wagoner's Lad 29:22 - 32:29
13. Cannonball Rag 32:55 - 34:06
14. Lone Pilgrim 34:38 - 38:52
15. The Roving Gambler 39:05 - 41:10

Backstage Confidential

In 1976, the New York rock and punk scene was made up of the CBGB’s bands and the few music writers who loved them. In total, this may have consisted of about 60 people. This small scene did have great influence, but, like any scene, it just sort of happened. A bunch of people formed bands and had nowhere to play. They found a stage. Another bunch of people heard about those bands and went to see them play. Every night. It was similar to when Max’s Kansas City had its moment: if you skipped one night, you might have missed something. At CBGB’s, there was no velvet rope at the entrance. There was no big deal about “getting in.” There was no “list.” The same people who went all the time went all the time. Since we edited Rock Scene—which became a kind of house fanzine for CBGB’s—Richard, Lenny Kaye, and I were among those who just went all the time. I didn’t have to call a publicist or get a laminated all-access pass or a wristband to go “backstage.” We didn’t have to wait for the lead singer to towel off after the performance and receive people. At CBGB’s, there was no toweling off—there were no towels. To get backstage, all you had to do was walk a few feet past the stage to the back hallway, to one of the crummy rooms on the right where Patti Smith or Joey Ramone would be sitting on the lumpy sofa. We’d all sit around with a few bottles of beer and just hang out. It was easy then to just hang out. It still was possible to discover something—either hearing about it from your friends or stumbling across it yourself. It wasn’t already written about in New York magazine before it had a chance to breathe.

‘Here comes success . . . Here comes my Chinese rug,” Iggy Pop sang in “Success,” one of my all-time favorite songs. I’d seen so many bands go through the stages from struggle to success, and the pattern was usually the same. In Stage One, they were young. They were sexy. They had nothing to lose. They wore some version of their everyday clothes onstage. It took two weeks to make an album. Then came attention (if it came) and some success. In Stage Two, a band moved from a van to a tour bus, or to coach seats on flights from city to city. If they got really big, edging toward Stage Three, it was more “cost-effective” for them to charter their own plane. The rationale was they could fit 12 people on a private jet for the same price as 12 first-class tickets. Sort of. Plus, they weren’t hassled in airports. Each band member had a bodyguard. The band had large dressing rooms backstage. In arenas, there were private dressing rooms with even more private inner dressing rooms, with security guards standing outside the doors. There were extra rooms off the backstage hallways to house the trunks with the band’s traveling stage wardrobe. Their production team had an office backstage. There was a greenroom with food and wine for their guests. It took around six months to make an album. And then full-fledged Stage Three or maybe Stage Four of all this was the move to stadiums. More of their fans could be accommodated. It supposedly thwarted the ticket scalpers (except it didn’t). The band had a stylist who oversaw its onstage costumes. And, finally, the band made crazy money. Along with those multi-million-dollar-grossing stadium tours came the houses in Malibu. By now, it might take well over a year to record an album. And a band in Stage Four had all the accoutrements that accompany big-time rock success—including, but not limited to, the plane, the police escorts, the private chefs, the grass-fed beef, and the complicated, political hierarchy of the backstage pass.

Backstage passes reflect status. The first time I was made aware of this was when I traveled with the Rolling Stones in 1975. The entire touring party had laminated photo passes that allowed us to go anywhere backstage. This became the norm for a major group. Clubs and smaller halls didn’t always have this pass setup, but as soon as a band made it to arenas or stadiums, the elaborate pass situation was standard for what goes on behind the scenes. The first and lowest backstage pass is the stick-on “After Show” pass for the greenroom mob scene. This literally is a square or circular or triangular piece of fabric with paper on the back that you peel off and stick onto (and ruin) your clothes. Next is the stick-on “V.I.P.” pass for the “pre-show” greenroom mob scene. (I always thought it would be funny if some band had a pass that led to a door that opened right into the parking lot outside the venue.) The next level is the laminated “V.I.P. Guest” pass for a “band room.” It isn’t really a band room; it’s a “meet and greet” room where the band—or, in the case of U2, Bono—might make an appearance before the show. After the V.I.P. Guest pass comes the “Staff” laminate, with no photo, which allows the bearer to move freely around the backstage area—except in the band’s dressing rooms. Then there is the “All Access” photo laminate, but you still might need an “escort” with a better pass to take you into the band’s dressing rooms. And then there is the top pass: the “All Access” laminate for friends and family, which allows you to go anywhere, including the band’s dressing rooms and the stage. But still, there might be a sticker or a star on this pass that alerts security just how far you can go: into the band’s private, inner dressing rooms or just the band’s private, outer dressing rooms. The whole structure is byzantine, and familiar only to people who’ve been through all these maneuvers. I recall many a time seeing someone proudly waltz backstage with a stick-on pass on their jacket or jeans, only to watch their face fall when they saw someone else with a laminate. Or those with non-photo V.I.P. laminates glance enviously at those with the photo laminates. The entire pass arrangement is a visual indication of just exactly where you stand with a group. John McEnroe and I became friendly because of just such a situation. In 1978 the Rolling Stones were performing at Madison Square Garden. John was backstage. I was writing for the New York Post, and I was a huge McEnroe fan. I went up to introduce myself to him. He sneered when I mentioned the Post. I pointed to his stick-on pass and pointed to my all-access laminate. No words were needed. It broke the ice; we’ve been good friends ever since.

by Lisa Robinson, Vanity Fair |  Read more:

Image: Bob Gruen

The Long Goodbye: How Modern Medicine Decreases Our Chance of a Good Death

In 2001 journalist Katy Butler’s father suffered a stroke at the age of seventy-nine. A year later a hurried decision was made to equip him with a pacemaker, which kept his heart going while doing nothing to stop his descent into dementia. In 2007 Butler’s mother, exhausted from being her husband’s full-time caregiver and distressed by his suffering, asked her daughter for help getting the pacemaker turned off. Butler agreed, and so began a long investigation into how modern medicine has changed the way we approach the end of life. (...)

In 2010 she wrote about her father’s death in The New York Times Magazine. The piece, titled “What Broke My Father’s Heart,” won awards from the Association of Health Care Journalists, the Family Caregivers’ Association, and the National Association of Science Writers. It went on to become the basis of Butler’s first book, Knocking on Heaven’s Door: The Path to a Better Way of Death. In addition to recounting her family’s experiences with her father’s slow decline, the book looks at Butler’s mother, who died fairly quickly a year and a half later, after refusing open-heart surgery. “Her death was totally different,” Butler says. “She was continent and lucid to her end, and she died the death she chose, not the death anyone else had in mind.”

Since the publication of Knocking on Heaven’s Door, Butler has spent the majority of her time on the road, giving talks about overtreatment, end-of-life care, and “perverse” economic incentives in the medical industry. She’s become an advocate for the growing Slow Medicine movement, which focuses on “non-rushed medical decision-making, palliative care, and comfort-giving treatment, especially as the end of life approaches,” according to its Facebook group.

Mowe: How has the development of modern medicine transformed our experience of death?

Butler: Death used to be a spiritual ordeal; now it’s a technological flailing. We’ve taken a domestic and religious event, in which the most important factor was the dying person’s state of mind, and moved it into the hospital and mechanized it, putting patients, families, doctors, and nurses at the mercy of technology. Nonetheless we still want death to be a sacred occasion.

Mowe: What about those who are more secular in their beliefs?

Butler: I think many of us aren’t as secular as we claim. We’re a society of seekers. Maybe we don’t like organized religion, but we yearn to place the events of our life into a larger, more meaningful context. We want death to be about more than the end of a person’s life. Death is part of an eternal pattern. Obviously if I’m dying, for me that is a major tragedy. But billions of people have died before me and have faced death with varying degrees of courage. A sacred understanding of that can help both the dying and the survivors.

Mowe: And this notion of sacredness has been undermined by modern medicine?

Butler: In the mid-twentieth century there was an explosion of postwar inventiveness: dialysis, the respirator, the ventilator, the defibrillator, the pacemaker. We invented a panoply of devices that both prevented sudden death and in some instances literally brought people back to life. But when we eliminated sudden death, we also eliminated natural death, and we lost the distinction between saving a life and prolonging a dying.

by Sam Mowe, The Sun |  Read more:

Image: Eugene Richards for The New York Times

[ed. Repost: source misplaced}