Art and Science on the Walls of LA

My impression of MedtronicDAF and the Getty Museum.

I saw some amazing things on the walls in Los Angeles. A 1667 painting that we were convince was an endo visit but may have been an EPT and guys with leather chaps and Harley gear visiting the Flemish gallery at the Getty.

Of it all, I liked the impressionists best.

Manet’s “The Rue Mosnier with Flags” was stunning. Painted in 1878 it strikes me as a relevant critique of public displays of nationalism while the veteran with crutches shows who may bear the costs.

I found Monet’s painting of light somehow, more real than actual light. Yet it was Desborough’s Depictions on the Principles I found most hopeful. His series of single page works are fine art.

Desborough?

Lane Desborough is part of the artificial pancreas research team at Medtronic. On one wall the team has posters detailing the principles that guide their work. They all signed the posters committing to the principles. Hanging on the opposite wall are brief, one page papers, illuminating their progress to waypoints on the journey the principles inform.

Note: We were asked not to photograph the documents as some 

content is proprietary. This image was provided by Lane.

I tried to read a few of the one page abstracts. Like the works of other impressionist masters, when you look closely what seems a clear picture of an event, place or light on water is something else entirely. Something possibly outside your expectations and possibly beyond your ability to comprehend. Step back and an image appears clear again.

Lane's team are serious scientists including PhDs from domains other than diabetes, like aerospace and industrial chemical refining. One had been in defense contracting. Their art is to understand and transfer variability from one place to another where it is tweaked and adjusted. For example aerospace understands autopilots. A plane can be moved deliberately through three dimensions, safely, with input from gyroscopes and navigational instruments. Chemical plants routinely crank out refined products and we think nothing of the catalysts and complexity involved. The team's work is to defend future patients from some of diabetes variations.

It is fine art. Engineering art. This team is bringing their experience to make an autopilot to refine blood sugar. They are guided by principles, post abstracts on the walls and when you step back an look at their art you can see that maybe there is an image of the future in their art. An image of a better future.

Lane sent me a video of a trebuchet he and his son build with Legos. That too is fine art and better father, son and dog interaction that managing a boy’s insulin. Being dad, like science is an art.  That art matters most, or at least that was my impression of what I saw on the walls in LA.



Notes: 
In a future post I will share more about the guiding principles with lanes consent but for me the reality is in the impression.

Also, Lane was clear that part of his process is to consciously work past the not invented her syndrome and proudly borrow from other domains. With that in mind please see my disclosure about MedtronicDAF proudly borrowing from a friend.

Sara's Message on Fairness, Disclosure and #MedtronicDAF

I again had the privilege of joining a number of other Diabetes Online Community writers as a participant in Medtronic's Diabetes Advocates Forum last Friday. Our host, Medtronic paid for travel, room and fed us for the time we were in LA. They did not ask us to make any specific comments or any comments at all.

They presented topics including their sensing program, work towards and artificial pancreas, MySentry, a Build-a-Bear Lenny the Lion (that we responded to a lot more than apparently the internal staff at Medtronic though we would,) presented a book and talk about Better by Chuck Eichten and gave us some time to talk about what was important to us as diabetes advocates.

I hope that we listened attentively and questioned with the passion of people who appreciate progress made, but are still impatient and passionate about better diabetes care. I don't know how or why I was chosen to receive an invitation. The T1D's in our household are not Medtronic customers. The choice of what pump, if any, my kids wear, if any, is theirs alone. I have reviewed some Medtronic initiatives one of which I had given me some real concerns. The issue was about the Lenny the Lion iPhone app and an initial version that collected email from potentially little kids. To their credit they changed the app which I still never reviewed.

One of the conversations that I had with other DOC folks was about sharing our strengths and not repeating or competing with others in the DOC. My good friend Sara writes on Moments of Wonderful that the privilege of attending these events giver her a feeling that it is unfair. I can not equal Sara's eloquent consideration of the matter and strongly encourage you to read her post.* Particularly as this year Medtronic has offered a trial use of the MySentry product. Medtronic wants honest and thoughtful feed back. If one of my kids is willing to wear the sensors, I hope that our household can again provide feedback that is useful to future users.

I hope that the group of DOC writers who participated collectively can have an impact on the development of Medtronic products that benefits all future patients. To the extent that we can represent other effectively hopefully there is a balance in our participation that addresses the question Sara raises about fairness.

I believe that those who sponsor these events appreciate honest feed back. That is one thing I am good at.  Very many over the course of my life have said too good at. I hope that I am a honest, thoughtful and at time both funny and forceful advocate for people and families living with diabetes. I think that type 1 household have a unique ability to appreciate the balance of disparate things, like say carbs, exercise and insulin. Maybe advocates and industry can have a similar relationship. If so then on balance I hope my participation can be fair.


*Kim also has wonderful comments on TextingMyPancreas.

Other YDMV Posts on MedtronicDAF
http://www.ydmv.net/2012/04/art-and-science-on-walls-of-la.html
See last years post disclosure. 

I’m Not Clark Kent

... so that rules out superman too.

Clark is an ace reporter. I am not so good at the who, what, where, when, how but then come to think of it I never noticed Clark doing much actual reporting either. For actual play by play of the Medtronic social media event I think there may be more accurate recounting by the folks who were taking notes on laptops. Keep your eyes open I am sure the reports will start flowing in.

Here roughly the outline of the day. I try to add some color commentary:

• Amanda Sheldon, Director Medtronic PR opened and we got her talking and ran into the time that was allotted for:
• Katie Szyman who has been President of the diabetes business unit for a year and a half.
• Lane Desborough who’s title was Product Specialist. He is an engineer who recently joined MM from other larger industrial chemical engineering endeavors following his son’s T1 DX.
• Brad Monosmith introduced an app for that where that is diabetes and the long arm of the law keeps the device and the app from talking to each other.
• We took a picture:

• We talked more about a closed look and connectivity With Lane and Todd Robin director of CGMs.
• Dr Francine Kaufman spoke from clinical and medical research perspective and shared some research on a pump in Europe that turns off insulin with hypos. Due to certain Minister of Magic regulations we’ll just call it the Pump the Can Not Be Named.  (I’m kidding FDA, it was a Joke, no need to call out the Dementors from the IRS)
• Dr. Richard Rubin of Hopkins talked about diabetes burnout. Great stuff. One key point - Joking around about diabetes is good (that FDA as the dark arts bit was strictly medicinal I swear! Oh wait that means I need to wait years for clearance before using it...)
• There was a cool tool tour of the sensor manufacturing plant.

We interrupted and talked over everyone of these folks and led them down all kinds of digressions. Scott Johnson drank all the diet Dr Pepper.

Probably the most shocking utterance was early in the day when Lane used a dirty word:

"Control."

Yeah I know! The nerve of that guy. It sets off all kinds of emotional responses doesn’t it?  But he didn’t mean it like ‘you diabetic scum need to be compliant and be in range all the time - how hard can it be? what the heck is wrong with you.’ He used it as an engineer.

Engineers speak a different language. To them control isn’t profanity.  It is a process of transferring variability from one place to another. In the diabetes case to transfer some variability in blood glucose to variability in electrical current. Then to use that electric variation as feed back to have an impact on BG. He went on to talk about the success of that transfer in two time frames; first the moment and second over time. It was all very geeky and since I am a little geeky I thought it was all very fascinating.

More fascinating was the idea that some problems have been solved in other disciplines and those solutions can be transferred to diabetes care. Engineers transfer variability in large complex refineries to systems that manage outcomes in the moment and over time. It keeps the plants from blowing up. Possibly the algorithms, logic and processes used there can be brought to bear on the reality of your diabetes varying.

That I found this interesting is proves what I said, I am a geek at heart. So is Lane because he appreciated the need to minimize the space on a kids’ Bat Belts (and bat bellies) for all the stuff this may involve.

Somewhere in all this we got a first pass at the idea of data standardization. Since Bernard (BandYard) Farrell missed his flight to to a snow storm, the rest of us were more than happy to provide a little of the open honest feedback our Medtronic hosts were looking for. I happen to have ranted about data standards a bit, not as long as Bernard. He is the patients’ Superman of Data Standardization. I am more of the Jimmy Olsen on the beat.  When I get into trouble he saves me. Interestingly the engineers seemed to agree that data standards would be valuable and I don’t know that the business / lawyers side of the equation feels the same way. I am fairly confident Medtronic heard the standards message, more than once. It is one of the messages I was there to share.

That is a conversation worth having. We are the market. If we as the market start and keep demanding it it may happen. When there is a movement to standards, it will have to get past the whole secretive FDA dark arts process. I don’t expect them soon.