The Technology Was Never the Problem
Forty years inside medical technology, and the machine that finally learned to ask.
Forty years inside medical technology, and the machine that finally learned to ask.
Out now
320 pages. Twenty three chapters. Foreword by Peggy McDaniel, BSN, RN.
Paperback · $19.99 Kindle · $9.99
The Kindle edition sets its own type size, which is the point. My wife cannot read the paperback.
A pump was set to deliver 28.8 milliliters an hour. The number should have been 1.2. Three weeks later Denise Melanson was dead of fluorouracil toxicity.
I spent forty years building the machines that were supposed to prevent that. Brain monitors in operating rooms. Anesthesia records in Vienna. A box on a kitchen counter that read twenty one different glucose meters. Infusion pumps wired into the hospital records I helped write the standards for.
The technology worked. The outcomes did not move.
This is the honest accounting of why, told from the inside by someone who signed off on the compromises. A vocabulary of care that turned out to be private property. A public library of medical knowledge almost nobody used. An industry that spent tens of billions getting very good at writing things down and never learned to ask a question.
And the one thing that finally changed did not come from medicine at all. It is running now, you can open it in a browser, and Chapter 22 is my own list of everything still wrong with it.
People who build this technology, buy it, regulate it, or use it at three in the morning when it does not behave the way the brochure said. It is not a technical manual and it is not a memoir about a great man. It is an ordinary engineer's account of how he got there and what he built when he arrived.
Inside the Loop is where the argument in this book keeps going, free. The six gates that stop good technology from reaching a patient. What Epic actually announced at its user meeting. Why the toll booth on medical vocabulary is still standing.
Twenty three chapters sat on this site behind a password while a small number of people read them and sent notes back. Several of those notes changed the book. One reader cut a sentence I had been telling wrong for forty years. Another told me exactly where he stopped caring, which is the most useful thing anybody can tell a writer and the one thing nobody ever volunteers.
I asked for critique rather than proofreading and that is what I got, which is rarer than it sounds. The book is better for it, and better in ways I would not have found on my own. Thank you.
One small ask, and it is the only one. If the book is worth anything to you, a short review on Amazon does more for it than anything I can do myself. A first book with no reviews is invisible, and three sentences from somebody who actually read it is worth more than any amount of me talking about it.