rehabilitation

When I was young, I used to work out a lot, and rehabilitate injuries occasionally. Now I'm old, I rehabilitate a lot, and work out occasionally. Bah.

I have my first overuse injury from swimming, some kind of rotator cuff problem. Suspect infraspinatus tendonitis but it hardly matters, since the rehab is going to be much the same whichever of the rotator cuff components is busted. Usually with overuse injuries, the cause can be tracked back to some change - more volume or intensity in workouts, new running shoes, old running shoes, etcetera. This time nothing changed, swimming the same distances and intensities as in the past seven years. Then I realized, oh something did change - I got older :-( again :-(

Frankly I'm devastated. Swimming used to be a reliable fallback position, whenever some run or bike or paddling injury sidelined me from the usual pursuits, I could work out as hard as I liked in a swim, with no let or hindrance. Now it's gone, and probably forever: tendinitis in my experience is never cured, only managed. So, I can add regular shoulder icing, stretching and strengthening, to the routine of achilles icing, stretching and strengthening. No time left for actual workouts..

me and Moominpappa

"I cannot stress enough the perils of your friends marrying.. One day you are all a society of outlaws, adventurous comrades and companions who will be pushing off somewhere or other when things become tiresome; you have all the world to choose from, just by looking at the map...
... and then, suddenly, they're not interested any more. They want to keep warm. They're afraid of rain. They start collecting big things that can't fit in a rucksack. They talk only of small things. They don't like to make sudden decisions and do something contrariwise. Formerly they hoisted sail: now they carpenter little shelves for porcelain mugs. Oh, who can speak of such matters without shedding tears !"
Moominpappa's Memoirs, Tove Jansson.

And how much worse it is when you marry in fact your own self, carpentering quietly in a warm little house and wondering where it all went, what was all that ?

pretty colours

playing with the new digital camera, Canon A630 Powershot. It seems to be proof against at least my foolishness, though I am overwhelmed by its software. All I want is a manual focus with automatic exposure bracketing, but setting that up is beyond my capability. I have a postgraduate degree in computer science and decades of tinkering - what do the simple folk do when confronted with one of these 'simple' cameras ?
Oh well. At least I was able to turn the flash off. I like its viewfinder too, saves a bit of power and it's a lot easier to see than most LCDs.


Virginia creeper in rain. It's invasive in warmer climes.


V. creeper in sun


sugar maple alone

cosmos on its own


Gloria cosmos, sugar maple leaves

healthcare nonsense

I see via the reliably interesting Jon Udell that yet another 'health-care database' is being trumpeted abroad in the land. Apparently neither Google nor Microsoft has noticed (or perhaps they prefer not to acknowledge) that the technical problem has been comprehensively solved already, by the Veterans Affairs medical system. The remaining problems are not technical but political. As Jim Gray benevolently wished for us, "may all your problems be technical". The world is full of smart people who can solve technical problems: all the smart in the world can't solve politics.

We can talk about 'shoulds' and 'translucency' all we like, in the end the insurance business will find a way to use such a database punitively.

The real question is how to arrive at a health-care system that doesn't punish the sick. The answer is technically simple but politically difficult. It starts with acknowledging that health care isn't a market. More accurately, it is a market, but the good being traded is healthy individuals, not health care itself. Senator Edward's health-care proposal (or Sen. Clinton's, as it's much the same thing) is a good first step. Once we have a system where we need not fear the database, we can proceed to establish evidence-based medicine.

Until that time, I fervently oppose all attempts to establish a database of medical records. The incentives in our current system are so perverse, that the database will be very dangerous to our health.

A secondary issue is one of simple data gathering. According to the optimistic hurrahs of Microsoft,
"People want to be able to collect, and securely store, and share their private health care information which is today scattered all over the place, with doctor A and doctor B and hospital C, and wherever they were born."
Lovely. How do they propose to extract that information from doctors and hospitals ? For them, that data is part of their competitive advantage. Whenever I get tests or procedures done (and I've had a lot recently) the results are kept secret from me: sent only to my doctor and doubtless a variety of financially interested parties, insurance companies, and so on. On a few occasions kindly nurses or technicians have actually shared the information with me, but that's the exception. For the most part an inquiry as to obtaining the technical details is treated with a kind of amazed wondering contempt by the administrative staff.

Update 2011:
Via the New York Review of Books I see:
"this past April, the Supreme Court heard arguments in Sorrell v. IMS Health, in which IMS Health, in challenging Vermont’s statutory restriction on the sale of patients’ prescription information to data-mining companies, argued that harvesting and selling medical records data is a First Amendment right. "
I don't have much confidence this Court will decide for the patient: then our data will belong to everyone but us ourselves.
Update 2017: the Supreme Court decided that the companies' right to sell your data is more important than the individuals' right to privacy. As expected.

Another notable database effort is the Personal Genome Project. In the different world where this information wouldn't be used by insurance companies to deny care, I'd enthusiastically volunteer. Well, maybe not, given the involvement of the egregious Ms. Dyson.

Update October 2007: turns out these databases aren't subject to the HIPAA privacy regulations. Microsoft's response ? "Trust us". Well, no, I believe I won't.


Update March 2008: ars technica has a decent overview of the situation. The takeaway: "many of the reasons for poor US health outcomes have much deeper structural roots related to a lack of preventative care versus emergency care, issues that are tied in to the lack of a universal healthcare system and the nature of insurance companies, that are outside the scope of medical records databases".

Update March 2010: The announcement of $20 billion in the stimulus bill for electronic health records (EHR) has started a gold rush. There's excellent coverage of the IT issues by Andy Oram on the O'Reilly Radar weblog. It elides the political question unfortunately - with single-payer many of the complexities of the IT implementations simply disappear. The problem of interoperability of competing systems vanishes, for one.

An IEEE Spectrum article covers some of the security implications. In particular my paranoia above is confirmed by Dr. Deborah Peel, who writes
"Today our [the patient's] lab test results are disclosed to insurance companies before we even know the results. Prescriptions are data-mined by pharmacies, pharmaceutical technology vendors, hospitals and are sold to insurers, drug companies, employers and others willing to pay for the information."
EHR will only expedite this process. I'd like to see a blunt rule in the HIT regulations that gives ownership of the medical record to the patient and his heirs and assigns. Currently the ownership is vested somewhere in the aether.

Update July 2010:
the HIT has released its "meaningful use" criteria for the adoption of EHR by doctors, etc. This offers a few thousand dollars (from the stimulus package) for implementation of an EHR. As Andy Oram observes,
"The catch is that they can't just install the electronic system, but have to demonstrate that they're using it in ways that will improve patient care, reduce costs, allow different providers to securely share data, and provide data to government researchers in order to find better ways to care for patients. That's what "meaningful use" means."

A few thousand isn't going to do it. The costs of EHR fall upon the doctor, the benefits accrue to society and the patient. The costs are much higher than a couple of thousand, especially considering the current wholly dysfunctional state of EHR. Many EHRs have no API at all, others have incompatible ones, and so depressingly on. Single-payer with a single EHR solves all these problems at once, but because it's politically impossible, we're left with hideous technical problems.

I am however happy to see that HIT has included the requirement that the EHR be available to the patient.

EHR update 2021, in conversation with an implementer: 

Connecting Epic instances across hospital systems is relatively involved

I said,
This is the same software, running in different places, and it can't manage the most basic of EHR requirements, interoperability. The whole point of EHRs was to be able to interchange health records between different software systems and healthcare systems.
The state of healthcare in the USA is always worse than can be believed..
He responded,

I had a conversation this morning about the best way to exchange a certain class of data, which there was a "standard" established over a decade around said exchange. Our conclusion was that flat files (basically giant CSV files) were likely to continue to be the best option here as every example we found/knew of was either flat files or places that had attempted to implement the standard and then went back to flat files. Maybe next decade the standard will be sufficiently ironed out...

Back to the original 2007 post..

Side rant on a related note, the faery realm of consumer-directed health care: how is it that society spends six to ten years training doctors to provide health care, then rewards them handsomely for their expertise: yet, once the market fairy appears, consumers (who may not have completed high school) are supposed to be able to 'direct' their own health care ?
For what value of 'direct' can this policy actually work ?
Airily assuming that the policy works, the next question arises - What is the market failure that makes doctors so expensive, when untrained consumers are able to effectively make the same decisions and determinations as said doctors, about their health care ?

Shadowfax makes this point much better than I, patients are not and cannot be consumers. From there, "HALF of all health care costs in the US is concentrated in only 5% of the population". It really doesn't matter how scrupulously the other 95% shop for cheaper bypasses, chemo medications, etc.

Update 2015: Apple now plunges enthusiastically into the swamps, with the HealthKit app(endage) to the Apple Watch, which itself requires an Apple Phone. I do not expect it to end any differently from the Microsoft, Google or Samsung projects. The IEEE provides a thoughtful analysis again.

Update 2016: John Quiggin in the Guardian, on market failures:
"Many of the same issues arise in healthcare. Obviously, if we knew what was wrong with our health and how to fix it, we wouldn’t need doctors to tell us. As it is, we need to rely on the judgment of our doctors to give us the right treatment and, equally importantly, to tell us when we will get better without treatment. The greater the role of profit in the system, the greater the incentive to provide unnecessary or overpriced services. The example of the United States, which spends more on healthcare than any other country, with worse results, is an illustration."

Update 2017: the market in healthcare turns out to be your data.  
“Data scientists can now circumvent Hipaa’s privacy protections by making very sophisticated guesses, marrying anonymized patient dossiers with named consumer profiles available elsewhere – with a surprising degree of accuracy”. 

Also in 2017, the state of EHR - still wholly dysfunctional, as predicted.
"43 percent reported that outside patient information was available electronically when necessary, but more than one-third reported that they rarely or never used it. The most common barrier these hospitals reported to using outside information was that their clinicians could not see it embedded into their own system's electronic health record."

Update 2019: Facebook isn't making enough money, so they are also making a health-care play. As @emilymullin notes, of course none of this data is protected by HIPAA either. Facebook says, "trust us" but I think I do not.

Update January 2020: Google now has all your health care data, to do with as it will. So it goes.
" In just a few years, the company has achieved the ability to view or analyze tens of millions of patient health records in at least three-quarters of U.S. states, according to a Wall Street Journal analysis of contractual agreements.
In certain instances, the deals allow Google to access personally identifiable health information without the knowledge of patients or doctors. The company can review complete health records, including names, dates of birth, medications and other ailments, according to people familiar with the deals."

From that same WSJ article, this part is hilarious: 
"Cerner ultimately accepted a less generous offer from Amazon, in part because the company decided Amazon was more trustworthy on security." 
Jeff Bezos, who started Amazon as relentless.com, which he still owns and redirects to Amazon; the company that does this, and this, as we live in serfdom. Trustworthy ?  

Also this month, via @WolfieChristl,  
Experian announced that 'every person in the U.S. population, of an estimated 328 million Americans, have been assigned a unique Universal Patient Identifier'.
The ID is 'not intended' to be 'patient-facing' and is 'not known to the patient'.
'Each individual in the U.S. that has received medical care or utilized a pharmacy has been processed through the solution and assigned a UPI.'
A universal ID that is opaque to the individual, what could go wrong.
This solution comes to you from Experian, with its unparalleled expertise in losing sensitive data and walking away scatheless.
The patient behind the UPI of course might take some harm, but it's unlikely to harm Experian's profit margin, so that's all right then. 

Update 2021: A huge well-funded initiative to 'disrupt health care' run by the smartest guys in the room, just collapsed as we all expected. Helaine Olen has the rundown in the Washington Post. 

The reason our health-care system fails to work for so many is the same reason people were convinced three CEOs could solve the problem: our nation’s worship of the free market and business success. Instead of taking such common-sense steps as permitting the government to regulate the cost of pharmaceuticals or hospital charges for services, we leave it to a pastiche of insurance companies, hospitals, pharmacy benefit managers, corporations, private equity — you name it. The result is that no one is responsible, costs run rampant and the patient all too often gets stuck holding the bag.
...
Bezos, Buffett and Dimon could not successfully take on the U.S. medical system, because when it comes to health care, there is no substitute for systemic government action and overall reform. 

Those magical disruption market beans just aren't giving ROI anymore.

Update 2024: now with AI ! 

Today Sam Altman and I published a piece in TIME sharing our vision for how AI-driven personalized behavior change can transform healthcare and announcing the launch of Thrive AI Health, a new company funded by the OpenAI Startup Fund and Thrive Global, which will be devoted to building an AI health coach. The company’s mission is to use AI to democratize access to expert-level health coaching to improve health outcomes and address growing health inequities. 

This is the Sam Altman that said,

“I probably trust the answers that come out of ChatGPT the least of anybody on Earth,” Altman told the crowd at Bagler’s university, to laughter.

He doesn't trust his product, but I guess it's good enough for the rest of us in the Altman calculus. 

"Compel the poor to live upon a crust of bread, by soft mild arts

when a man looks pale

With labour and abstinence, say he looks healthy and happy"

The fine print shows this coach will give you helpful advice like, sleep more, eat better, exercise more. These are choices that are available only to the wealthy like Sam Altman and Arianna Huffington, and to the upper middle class which has stable employment, predictable work hours, and health care. For the other 80% of the world this coach does nothing. Not to mention that it does absolutely nothing to address inequities. Who is buying this nonsense ? 

"Wisdom is sold in the desolate market where none come to buy"

Discussing Avatar

I'm like Sokka - don't have superpowers, but a good analytical mind, also I'm kinda goofy-looking; I'm like Uncle Iroh, in that I am not wholly convinced that a good cup of tea may not be the most important thing in any given day. It's a controllable happiness. If you base your happiness upon conquering Ba Sing Se, or winning back the love of a father whose love is not worth the winning, misery is likely your lot. I am further like Iroh, in thinking kindness is the primary virtue: though he does a better job of living up to his ideals.
There you have it, apothegms to live by. Some of them may even be not entirely false. Your homework, should you choose to accept it: which parts are true ?

Those are the thoughts that remained after a five-mile run following a discussion with the kids. The other thoughts on the way were mostly sun, wind, and intimations of age. The wind and sun don't write down very well, the intimations are old news that does not improve with the re-telling.

down a muddy river

The map gives a flavour of the expedition - high dramatic redrock canyon walls, vast perspectives whenever the walls opened up. We put in near the ghost town of Cisco, UT, some thirty miles upstream of the map. Actually not wholly a ghost town, there is a general store, five miles off the interstate. The story goes some football player came from Cisco, made his pot, and retired back home with a gregarious wife, who opened the store in an attempt to get some company. Buying an icecream there after the trip is apparently hazardous, the chat will take an hour or more.

Blazing heat at the put-in, I labored for an hour or more packing the barge while H ran shuttle. The boys swam until their lips turned blue, sat in the sun until they were hot again, then swam some more. Mud pies filled in the vacant minutes between these activities. After the loading, tossed out a fishing line with some Powerbait (blood flavour, mmm) which attracted a 1lb catfish in about 30 seconds. More casts brought more fish, but all small. Off down river after a bit more than two hours' wait, with a flotilla of 9 boats. There were many years of paddling experience floating down the river, including Jerry Nolan who wrote the book - well, maybe not the book, but the web page at least - on this stretch of river. What this translates to is a loose assemblage of at least 9 eccentrics, the spouses or spousal equivalents who put up with them, and our two kids. Luckily since we all canoe, we're all eccentric in much the same ways, so within the group we appear perfectly normal to each other. This is occasionally quite comforting.

Fish Ford BLM campsite is very attractive, but is road-accessible. This means at any moment drunken rednecks in 4x4s may descend and render the site uninhabitable, so we skipped it, and went on down to another site. It too had a rough road in, so there was an old sofa above the river next to a 10 foot diameter fire ring mounded high with beer cans. Ah well. The hinterlands were clean, flat, and cottonwood-shaded, so we took it. As we were coming downriver, there was a incessant hum filling the air. At first I thought powerlines, but no. Next theory was the tamarisk beetles, specially imported to kill the alien tamarisks sucking the rivers dry, but this was mere speculation. Upon landing the true source was revealed: vast formations of mosquitoes wheeled and dove down upon our shrinking flesh. We can report that the Repel Lemon Eucalyptus (non-DEET) formulation does work well, but we didn't get 6 hours of protection, only about 3 or so.

More labor, unpacking boat to set up tent, kitchen, snacks, etcetera. Oy. I need an easier tent or a smaller family. Money can solve only one of these problems, so I guess it's retail therapy for me this fall, when I'd rather be camping I'll be tent shopping.

Shattered in mind and body, I went to bed early. The boys stayed up at the campfire, half an artificial log in the world's smallest firepan, while Jeff and Jean played guitar and everyone sang. We all lay on top of our sleeping bags sweating for an hour or two before it cooled enough to sleep. Poor C woke up a few hours later, retching. Poor H took care of him, the five times he woke to throw up. I think he had some bad river water from all that swimming. Of course all these excursions into the mosquito zone allowed the tent to fill up with ravenous bloodsuckers. In the morning the roof of the tent was covered in swollen bugs, too full of blood to fly. Ech. We left C to sleep in the tent while we staggered around packing up camp. This turned out to be a mistake. There were enough hungry mosq's left in the tent that he got devoured alive. On Tuesday at school, they refused to let him in without a doctor's certificate to prove that he did not have some infectious disease rash, obtaining which of course consumed all of H's Tuesday morning.

After cleaning up the puddles of sick on the sleeping bags, sleeping pads, tent floor, groundsheet and shoes, I was ready to start the packing of the dry bags preparatory to starting the packing of the boat. I couldn't see us finishing all this before the launch time, but we had so many helping hands, we were packed before some of the other boats, a first for me in family canoe camping. Thanks Jeff.

On down the river, C perfectly frisky and chirpy, H and I drooping rather. This is a good kid trip, when they get bored we just throw them overboard and let them swim for a bit. After this flat water stretch, there's a day of significant named rapids, which keeps everyone's attention for the most part: though the boys were chatting about Lego in the middle of Ida's Gulch while we had to stare doom in the face, a half-mile of rock spotting and dodging in the equivalent of a loaded 18-wheeler. The Old Town Penobscot 18'6" is a fine boat, but no-one would accuse it of nimbleness, particularly when loaded with 800-odd pounds of people and gear. Momentum, ah we have all the momentum we need to blast through anything, but a turn has to be put on the calendar well in advance, and co-ordinated between bow and stern. "I'm not yelling at you dear, I'm just communicating the turn" sometimes works to patch things up.

Flat water to Dewey Bridge, then a few miles to the first named rapid, Onion Creek: a two-stage rapid with an easy entrance of substantial waves lulling you into complacency, then a sudden boulder garden riddled with holes and pourovers. We took a poor line, I didn't see a rock in time, H was able to get her end of the canoe around it but my end of the barge bounced off. Luckily Ian knows enough to highside, plus that momentum took us past the rock before it could react and grab us (yes, rocks in whitewater have both animas and animus).

Campsites below Onion were almost filled with rafters, but we got the last good site with cottonwoods. Magnificent views across Professor Valley to the Fisher Towers, could not be better. Much too hot to do anything except drink beer in the shade and swim, so that's what we did. Children got bored and fought, a hazard of single-family trips, with not enough playmates to keep the interest up. I think they were also tired and ratty, late night Fri getting to the hotel (we are weenies, yes, but I'm not prepared to try and camp with kids and a 10:30pm arrival), followed by late night and broken sleep on Sat. They needed lots of attention, but we needed to cook dinner and make camp, so it all got a bit fractious. Eventually simmered down with kids fed and tent up. Someone's washing up at the river added a few spaghetti fragments to the mud load of the mighty Colorado, and brought several fat carp in to forage. I plopped a lump of blood-flavour Powerbait upstream of one of them, which charged in with its back showing to gobble it down. Ian pulled it in, about a 3-pounder leaping and flapping in the mud. A handsome fish, though carp get no respect in the USA.

Breathlessly hot again in the night. One tent was pitched in a fine-looking site, below a red cliff, under a cottonwood. That red cliff acted as a radiator, releasing the heat of the day gently throughout the night, and blocking the cooling breezes. We were camped in a much less attractive site, but the winds came through beautifully. Hah. H's ambition for the night was not to be thrown up upon, and have no-one peeing in her shoe. This was a low bar, but it was in fact achieved, hooray.

Next day a variety of rapids. Mostly the obvious route was the correct one, slightly L or R of center, ride out the big waves with a bit of back paddling. Ida's Gulch is on the USGS map as Rocky Rapids, and is the rapid I remember as White's. We ran this twice in the Old Town Discovery 158: the first time on our 1991 wanderjahr, quite alone on the river doing a day trip, filled up and tipped over in the recovery pool at the bottom; the second time in 1996 with Rich Ruehlen, boat loaded for camping, filled up again but did not tip.

The pictures above show C doing his 'see/hear no evil' imitation near the bottom of IG rapid (I never knew he was doing that, was looking somewhere else at the time ;-) When I asked him, he said he finds the bigger rapids scary, but he still enjoys canoeing, just not some rapids. Ian on the other hand laughs all the way down, the bigger the rapid the more laughs. The pictures are by Moab Action Shots. They have photographers camped out on the river, taking pictures of everything that passes. I didn’t know who the photogs under the umbrellas were at the time, but on the way into Moab to Kaleido-Scoops (ice cream shop) we passed their store, and I figured it had to be online. This suggests a new way of rating rapids - those with a photographer camped next to them, must be something significant. Class II rapid, or a Class Photo rapid, hm.

The real White's rapid wasn't anything much, some very big waves and one pour-over that really should be missed, but a straightforward line through it. We had lunch below the rapid, on the first actually sandy beach of the trip. All the other beaches looked like sand, but turned rapidly into a viscous grey mud below the waterline. I'd slipped in said mud and torn the toenail from RMNP (see earlier this month) half off. This was quite painful, plus the fine murky waters infected the wound. When I took the bandaid off on Tuesday night, I could see and smell rotting flesh below the nail, yech. How does a doctor remove a toenail ? with anesthetic, large forceps, and a burly nurse. How.. interesting.

Took off the river at Sandy Beach, yes it was. Unpacked boat, humped gear up the sandy hill to pack it into the car, to take it home and unpack it again (a pattern is emerging). Back to Moab for aforementioned ice cream, very nice, and trundle on home for six hours. The boys went to school on Tuesday without having had a bath since Thursday night. Luckily they'd swum a lot, and boys are supposed to be muddy, so it wasn't too noticeable.

Many thanks to Dave Allured, who put the whole trip together with his usual calm efficiency.

extirpating Think-Adz

The self-styled winantiviruspro2007 has a cute little install pop-up that says 'Click OK to cancel this install'. This fooled number-one-son into clicking 'Cancel', which of course double-negatives into actually installing the winantiviruspro2007. Removing this lying thieving bastard was straightforward, between Scotty and Clamwin, no troubles.

However it brings Think-Adz along with it. That has a cunning trick whereby it re-installs itself every thirty seconds or so. None of the usual helpmeets could touch this - Scotty disabled its startup tasks and marked the dll files for deletion at startup, but after startup, the pox just re-installs; Clamwin didn't find anything, Ad-Aware and Spyware Blaster failed too. I went through the registry and pulled each key out, but before I could restart, it had re-installed. Hm.

Google failed me too: lots of references to Think-Adz, but all the 'solutions' involved buying someone's dodgy-looking software, or helpful 'tips' like "use Add/Remove programs to uninstall". Of course Think-Adz does not list itself in Add/Remove, and if it did, I'm certain the Remove would install something else noxious, plus keep T-A itself.

When in disgrace with fortune and men's eyes, not to say Windows, I trouble not deaf heaven with my bootless cries, but instead go to Sysinternals. Process Explorer (PE) and Autoruns are the essential tools. The Sysinternals tools overlap with Scotty's functionality - Scotty is usually more readable, the tools have useful extras. Since I didn't find this anywhere else, here's a step-by-step for rooting out Think-Adz, and mutatis mutandis, similar infections.

Scotty will show the rogue processes, using tab 'active processes'. This step involves knowing what's usually running on the system, so the skellums can be identified. If the usually running processes are not known, unsigned processes (no Company Name or Version information) are a good place to start. Google the process names for more information, and read with a jaundiced eye. Often infections will give their processes the same names as real Windows executables, and install them in C:\WINNT\system32\, so they look legit. In this case, the rascals were owinpmdt.exe and dwdsrngt.exe, running indeed from \system32.

For this case, look in \system32 using Windows Explorer (WE) or similar, sort by 'Modified Date', and check the files that were installed at a similar time to the known rogues. In this case the files all had recent timestamps from the install, so they all sorted to the top of the heap. Apart from the .exes, there were also two dll files installed in system32, xxyaaxu.dll and awvtt.dll.

These dll's and .exe's can't be deleted from WE, since they are marked 'in use'. Scotty can delete the .exe files - rightclick on the process in Scotty, and select 'delete file on reboot'. The dll's can be removed similarly using another Sysinternals tool, PendMoves, but I prefer to first find out what's using the dll's, to make sure I didn't miss some process.

To do this, start the Process Explorer, then use Find to enter a dll name and see which processes are using it. This revealed the xxyaaxu and awvtt were used by the known rogues, but also by Winlogon.exe, which is a legitimate Windows process. The Winlogon turned out to be where the reinstalls were coming from. Killing Winlogon also terminates Windows very rudely, so there's no simple way to stop the reinstallations. Luckily PE has another option: rightclick on the process in PE and select 'Suspend'. Obviously some bits on Windows won't work right while this is suspended, so complete the T-A removal as a priority.

Now use Scotty and Autoruns to see what new horrors have been scheduled to run at startup. As for the processes, it's good to know what is legitimately started, so the rogues can be identified. If not known, proceed as before to check the signatures and Google the unknowns. As for processes, use Scotty to rightclick on the task and select 'delete file on reboot' for the known bad guys, and 'disable' for the suspected bad guys. Check with Autoruns that Scotty found everything.

I found
C:\WINNT\system32\advpack.dll,DelNodeRunDLL32 C:\DOCUME~1\ADMINI~1\LOCALS~1\Temp\IXP000.TMP\
and
streamci,StreamingDeviceSetup {97ebaacc-95bd-11d0-a3ea-00a0c9223196},{53172480-4791-11D0-A5D6-28DB04C10000},{53172480-4791-11D0-A5D6-28DB04C10000}
in my setup. Neither of these looked legitimate, so deleted them both as well.

Reboot. After reboot, verify that the dlls and exes were deleted from their locations. In my case the dll's still existed, but weren't in use anymore, so that WE could delete them.

For completeness' sake, run a registry edit and search to look for other traces of the beast. If the process above doesn't get rid of it, this will be required. First re-do the steps of the above process up to but not including the reboot. Then, Start/Run or open a command prompt, and run regedit. Read the awful warnings from Microsoft about editing the registry, take a deep breath, and proceed. Backup the registry first if you are feeling timid, but I usually don't bother. Note that in XP and Vista, there will be automatic System Restore points created by Windows, which can be used to restore the registry if need be. If doing this, select a date before the system was infected ;-)

Select 'My Computer' in the left-hand pane of regedit, then use the Edit menu to find all mentions of the known bads, owinpmdt, dwdsrngt, xxyaaxu and awvtt. Delete all keys containing references to these, unless they belong to BillP Studios, which is Scotty. BillP Studios will have references to the bad 'uns, which allow Scotty to delete the files upon reboot. To delete the keys, note that the find will show the reference in the right-hand pane. It's not immediately obvious which key is involved, but look at the bottom of the window, which will list the full key name. Select this key in the left-hand tab, then rightclick and select 'Delete'.

Also search the registry for Think-Adz, and any related data. For example Google turned up ExploreUpdSched, BrowserUpdateSched, kwinkrex.exe, ljdsrngk.exe and twinkmdt.exe as being related to Think-Adz. I didn't see these on my infection, but check and make sure.

After a mere three to four hours' work, you'll be back to an undiseased state. Hooray. Maybe it's time to upgrade to Ubuntu Linux.

strolling

The traffic is busy under an uncomprehending sky of wide and varied clouds. In the open space between office blocks, the harvest is ready: green leaves below the straw-yellow stalks and grain. There's no-one who knows what the grains are, nor will the harvest happen. Our food comes more easily, from China or the other side of the world. Blackbirds in the sky do not care.

When I can't workout at lunch time, due to increasing frailty, I walk with a book. At the end of the walk some fragments collect at the bottom of my consciousness. Often the fragments are the same as last years', both the walk and the thoughts are out and back again.

user-hostile design

The designers of the Kenmore Ultrawash Model 665 appear to think that cold water in the machine is sufficient reason to disable the entire appliance. The 'Clean' light starts blinking in a pathetic call for help, and nothing else responds. The manual directs us to 'call Sears maintenance'. Sears maintenance has a two-week lead time, and a $65 minimum. Washing dishes by hand for the next two weeks sends my evening 45-minute kitchen cleanup into an hour-and-a-half, which pushes bedtime back to well after 11, which means I’m short two hours of sleep every night instead of just one.

Luckily Google is our friend, and reveals the secret keypad dance that may unlock the frozen software bowels of this bugger.

Clean light flashes 7 times, only function available is drain. Start flashes quickly when pressed.
I was told the water temp. going into the machine was too cold and that you should run the water at the sink before starting the machine.
To clear the flashing light code, hit 'heated dry' then 'normal wash', then 'heated dry' and 'normal wash' and then all lights will light up. Hit 'cancel' and it's hi-ho Silver, awaay we go.

This is spectacularly user-hostile. The feature appears to be shared with several Whirlpool machines as well - a good argument for buying AEG.

Update 9/20: $200 for a new heater element. Coincidentally, the warranty period expired just two months ago. Also, there's a recall on some earlier models for fire hazards. Kenmore had a good record in Consumer Reports for repair history but I think it just lost it.

A day in Rocky Mtn NP

By the numbers: 12 hour day, 5 hours hiking; for 13-14 miles and about 2500ft of climbing; three turkey/cheese sandwiches, two liters water, one Coke, one candy bar, two peaches, four oat crunchies; one broken big-toe-nail; one brown trout, one Colorado River cutt, a dozen rainbows, uncounted brookies; lots of gorgeous high-country sunshine and views (ok, that's not a number, sue me).

Started out from the Bear Lake trailhead, milled about a bit (see map) at the forks for Glacier Gorge and other trails before getting on the right road down to the creek. This trail was very little used, looked to be going back to an elk path. After 10 minutes, cut back off the trail into the woods, with that momentary frisson of fear that going trailless always inspires. Glacier creek was small but pleasant, holding water needed to be at least 2 feet deep. Often in these smaller creeks the fish can be found in the shallow riffles as well, but today they wanted good deep water nearby. Opened the batting with a nice 12" brown, then a 10" rainbow followed by a passel of smaller bows 8-9", then a Co. river cutt, then a brookie. Hum, a grand slam. I nearly hopped out to go to the Roaring River to add a green-back cutt and get a 5-species slam, but it was too much like a riskless counting coup. Prospect Canyon is only about 20 feet deep, with a pretty 3-step waterfall into a good pool at its exit, missed a sizeable rainbow there. The rest of the canyon had some holding water, then a major tributary comes in, above which the creek is just a series of rocky cascades with not much visible potential. Good if you like fishing wet rocks.

There were at least 2 guided parties on the lower section. I took a wide loop through the woods around both, tried to give them a quarter mile or so of undisturbed water, but wasn’t too worried. It is a puzzle to me that there are sports willing to pay $300+/day to be walked 100yds off the road and shown easy trout.

Clambered back up through the woods to the elk trail, found a spray-cooled spot by a small falls for the first lunch of the day at 12. Battered up the crowded trail towards Mills lake, pausing to investigate the stream at a flattish spot. Shallow braided gravelly channels, with scatterings of small brookies was all. Those flat-water wild fish are as spooky as they come. I barely even try them anymore, too discouraging - stick a rodtip out of the bushes and the whole pool flushes. Any time you do manage to sneak up on the good-looking ones, some unseen sprats from the tailout panic and tear frantically upstream to startle everything else. These days I just go looking for better water. Second lunch at 1:30pm, quietly by the stream. Bypassed Mills to get up to Black, quite a pull over those 2.8 miles. I had lots of company on the trail, mostly older than me, indomitable old ladies with walking sticks and the occasional greybearded companion. At least they were friendlier than the serious young guys on a mission, hiking fast and silent and unshaven on some imperceptible quest of their own. Lovely stream along this section, plenty of waterfalls and good-looking holes.

Black Lake is very fishy-looking, a huge deep green hole under cliffs with streams tinkling in on two sides. A few mayflies (at 10800 ft ??) coming off, no rises though. Coke and a candy bar in the shade of the krummholz, since I was dragging a bit at this stage. Fat greenbacked brookie in the first puddle of the inlet stream, more brookies on up to the cascades again, to about 11". The stream was only just wide enough for the 11" to turn around. At the bottom of the cascades, a pocket of water about the size of a shoebox, six inches deep with every pebble visible: tossed an ant onto the water, and a ten-inch brookie materialized out of the pebbles. Hanging there eying the ant with its pectorals flared, it looked like a minor shark, a dizzying change of perspective. Tried various things including bobber fishing (hey, I was tired) in the lake, but couldn't find anything more than lanky black brookies to 10" or so. On the way back down, another luminous green-backed brookie of 12" in a plunge pool below a small waterfall, very pretty. Of course there should be green-back cutthroat trout up here: it's a ponderable whether the brookies are developing a similar colouration as the years of evolution produced in the cutts. Small thoughts for a long walk.

Back to Mills lake by 6, sunset on the high barren peaks. The lake had risers, hooked 5 of them but got none to hand. All looked about 10-11", nothing big, and I’m guessing brookies.

7:30pm and time to go. Finished the hike with a flashlight, last man off the mountain. A complete success, all in all. I said I’d go fishing and I did.. although I’m still listing slightly to the right when I walk, which I’ve been trying to avoid because it hurts.

My shoulders were sore for two days after lumping around the daypack with 3 extra layers, raingear, food and water. I was thinking it's really tedious to always pack all the emergency stuff while hiking around with fifty other folks on the trail, but it got quite lonely towards evening. A cautionary tale - it turns out my fishing buddy Ken had been benighted a couple of days ago elsewhere in the park with his (girl) cousin, and a dysfunctional high-tech lighter that wasn't able to make fire. Their guide had gotten ahead of them and lost track of his party. It always ticks me off when hiking/canoeing in tricky areas, some people just don't get the 'stick together' idea and it often ends in tears. That's the African training, get in trouble in the African backcountry and there are damn-all helicopters to get you out again, your own bloody stumps are the only way. Ken's bad joke - I slept with my cousin, and it was the worst night I've ever had !

USAT Sprint championships

short race report: felt like I was going to die, then I didn't. That'll have to count as the victory for the day.

eh. Lightheaded and weak during the swim, and never got better. Front brake rubbing for the first four miles of bike, but fixing it didn't help. Hard painful run, slogged it out.
Long race report may follow if I can regain the use of my faculties..

a successful presidency

The inimitable, yet manly, Lance Mannion has a fine line in invective about Chairman George in an essay on how startlingly successful the Bush presidency has been. 'Success' here being defined not as ordinary mortals might, as being for the general good: rather in terms of the cowboy way, achieving everything his paltry independent individual heart longed for. Torture ? got it. A war, so he could feel good ? got that too. Tax cuts for his friends ? whee !
Read the whole thing, as they say.

I diverge into my own woods at this point. Raised in a police state, complicit in torture long before the age of reason, each day of my adult life was lived in a thin but constant fog of shame, guilt and fear. Although my membership in the oppressing class was wholly involuntary, it was worn on my skin, ineluctable. Among the complex of reasons for leaving S Africa, one of the more powerful motivations was knowing that my taxes went to support a government that tortured in my name. There was no way to vote the bums out, the courage of my convictions led straight to jail and I didn't have those. I thought it couldn't happen here. Again I'm waking up in the morning and wondering if what I can do is enough: again I have to find out how much courage I really can muster. How much do I owe myself and my family, and how much to common humanity ?

I worked in Chief of Staff Intelligence for several years during the late 80s, as a conscript and afterwards. It was known but never whispered what really went on at that farm up north of Pretoria (Tshwane, now). That didn't turn out well. In philosophy 101, we were told that knowledge is 'justified true belief'. The tortured may be telling truth, but until there is some justification there is no knowledge. It's well known that torture does not work - fine for revenge and sadism, but as an intelligence-gathering tool it is practically useless. Don't believe me, listen instead to one of the tortured from Stalin's Russia, Vladimir Bukovsky: "torture is the professional disease of any investigative machinery. Investigation is a subtle process, requiring patience and fine analytical ability, as well as a skill in cultivating one's sources. When torture is condoned, these rare talented people leave the service, having been outstripped by less gifted colleagues with their quick-fix methods, and the service itself degenerates into a playground for sadists.. if Vice President Cheney is right and that some 'cruel, inhumane or degrading' (CID) treatment of captives is a necessary tool for winning the war on terrorism, then the war is lost already."

I emigrated to the USA instead of any of the other countries I could have gone to, in part because it's still (thought he in his innocence) the only country in the world founded on a dream of decency and justice for all. Now I find the majority of my fellow citizens dream happily of torturing other human beings, and I can't account for it.

Edit December 07: Often I feel like an oversensitive old lady with the vapours, agonizing over things that a Real Man would scarcely notice. From a review of J.M. Coetzee's latest novel, in the New Yorker,
**
In Coetzee’s work, emotions like shame, guilt, and disgrace surge beyond rational discussion just as cruelty surges beyond bearable depiction. And here, in his latest novel, another novelist protagonist gives voice to a feeling of unbearable shame, this time at the Bush Administration’s connivance at torture:
"Their shamelessness is quite extraordinary. Their denials are less than half-hearted. . . . The issue for individual Americans becomes a moral one: how, in the face of this shame to which I am subjected, do I behave? How do I save my honour? "
Later, this protagonist asserts that if he heard that some American had committed suicide “rather than live in disgrace, I would fully understand.” He can understand because “the generation of white South Africans to which I belong, and the next generation, and perhaps the generation after that too, will go bowed under the shame of the crimes that were committed in their name.”
**
that's about right.

south africa 2007

Johannesburg is now a reasonable simulation of hell. LA-style traffic, an hour to drive 6 miles at any time of day after 5am, plus carjackings (5000 in the first 6 months of 2007, 52000 violent robberies, and that’s just the official police statistics). Life is lived behind razor wire plus electrified fences, and with regular security patrols (300 000 private security personnel in the country, only 120 000 police). We didn't get carjacked or robbed even once, pretty good going I thought.

It's no longer possible to run in Joburg. I got two different points of view: the one said don't do it unless in a group of three or more, the other pooh-poohed that as mere lily-livered timidity and said just take off your wedding ring and watch, don't wear expensive sunglasses or new shoes, and you'll be fine, just fine. I didn’t try it, too much of a coward. Instead I ran in the Waterberg (met bushbuck and sunbirds), near the Kruger Park (met baboons, zebra, kudu and impala, heard hippos and lions on the other side of the game fence), in Cape Town on the slopes of Table Mountain (met baboons, too many of them, a bit nerve-wracking), and in the Drakensberg (nothing but a beautiful silence).

One of our friends has a game lodge in the Waterberg, in the north near Botswana. We spent a weekend with them up there in palatial luxury. Our bedroom had a view of the waterhole so we could sit in bed sipping tea (delivered to the door, naturally) at 6am, watching giraffes etc also having their morning drinks. The kids slept in a central lodge, so we had the bedroom to ourselves for once, also nice. The downside is that the occasional rinkhals or Mozambique spitting cobra makes its way into the shower looking for cool and damp. One unfortunate girl met a rinkhals there, and leapt out the window, hanging from the window ledge one story up until rescued by one of the rangers. She doesn't go to the bush any more, funny that.

My brother-in-law Peter has fractional ownership of two holiday houses, one near Crocodile Bridge entrance to Kruger, the other in the Berg, so we got weekends in both of them, how kind. The drive to Kruger is nasty, single-lane toll road (?) full of heavy traffic to/from Maputo, but once out in the bush it's still beautiful. I made small square cooking fires in a corner of the huge firepit at the house, using that marvellous hard heavy bush wood. Sitting out under the Southern Cross with a beer while hippos grunted in the pools of the Crocodile, Saffrica seemed quite appealing again. We stole some sugarcane from the plantations on the drive to the gate the next day, C eyed it with suspicion but after biting into it, said with surprise 'this is really good'. Saw four of the five, including a big pride of lions lolling about, but no leopard of course.

We even got to the beach in Cape Town, had a 70 degree day in midwinter. C declared 'it's a perfect day for the beach', so we went to Boulders beach where are more penguins than I’ve ever seen before. It’s now part of Table Mountain National Park: they claim to have stopped trawling for pilchards in False Bay, so there’s been a population explosion of the jackass (now called African) penguins. C was getting very frustrated building a sandcastle, we were trying to help when he yelled 'but it works with snow !' and the rest of the beach laughed. CT is still very pleasant and mellow, house prices are insane, and for the first time in my recollection the private security firms are in evidence. Pete’s house in Kalk Bay bought for R180k is now worth R3-4m.

Out in the Drakensberg (now a Unesco World Heritage site) it’s still pleasant too. The house we stayed in is on a ridge above the D'berg Sun hotel, hike out the front door and into the little Berg, very nice indeed. There were even trout in the hotel dam. We did some kid hikes, to Cleo's Pool where there was a bat in a cave, and up on to the first bump of the little Berg. I'd forgotten how perfect the silence is up there. There's always a jet overhead in the US, no matter where you are. If you want to hike anywhere in the Heritage Site, you have to pay a ‘community guide’ to accompany you – not sure if you could pay them but not take them along. Fair enough I guess, it’s one way to get the tourism dollars into the local community, all of which helps protect the resource.

The trout dam had deep clear water and lots of anhingas. Tough fishing, had only a floating line and some beadheads courtesy of Peter. Used the beadheads as weight to trail a Mrs Simpson or small olive Hamill's Killer, nothing all weekend on the beadheads, only on the nondescripts. I have no confidence in beadheads actually – might get the stockers, or perfectly wild fish, but for the hard-hammered populations that I usually encounter, I don’t believe in them. (Same thing with crankbaits here in the US, everything has a confounded rattle, so the original Rapala is the only thing worth spending money on). Lost a strong 14" the first morning after two blank hours. A fat 16" that evening while trolling from the rowboat. #1 son started to practice fly casting, good show. Next morning went to a fishy corner over by the wall, missed a take first cast, then a chunky 17" off a long cast, first pull tightened into him. Frosty ground and crisp early morning, fish running strong and leaping high. Then a bouncy 12" hit hard right by my feet. Nothing else despite trying for another couple of hours.

Interestingly they’ve just passed a law that makes it an offence to catch and release a trout, R200k fine for doing it. Catch and kill is OK. This is a side-effect of a law concerning alien and invasive species, both carp and trout are considered alien invaders. Not sure how that will pan out.

the working life

The useful O'Reilly Radar has a post on Payscale, which seems to me a perfect web 2.0 (augh!) application - they provide actual information in exchange for your personal anonymized data. At least it appears to be anonymized, I'd have to dig deeper to see if it really is.

From there, on to career paths and the peculiarly upper-class-American notion that you can do what you love and get paid for it. This irritates me. The rest of the world knows that if you're lucky enough to have a paying job that doesn't kill you, you're well ahead of the game. Certainly if you love what you do to earn a living, you'll never have to work, but it takes a fortunate alignment of the planets at birth to get into that happy groove. What becomes of the multitudes of unloveable jobs that have to be done, passion or no ? I like the idea that necessary work honestly done can be just as rewarding, though this may itself be a comfortable delusion. I am however certain that if you have to chase after happiness, you'll never catch it. It's more like a unicorn, but that's a different post..

This notion often gets tangled up with the idea that most people in our brave new world will change jobs many times. This is typically presented with a Panglossian chirpiness, by someone who's never had to change jobs: together with a distressing lack of curiosity about the reasons for, and consequences of, those changes. Actual data shows: "the adverse consequences of losing one’s job appear to have increased. In particular, a higher fraction of unemployed workers remain unemployed for very long periods, and the average reduction in earnings once they are reemployed appears to have grown." A typical earnings loss for the college-educated is about 21%. This is not quite so rosy a prospect as following your passion to a lucrative new job. "A dream took me away from here, but a dream can't bring me home again" (Tom Waits I think).

It's also worth noting the conflation of 'jobs' and 'careers' in these airy tales. Per Webster , a career is "a profession for which one trains and which is undertaken as a permanent calling". By definition it's not possible to have multiple careers, since it takes time to train and time to practice any one career. Becoming an engineer for example takes four or five years of study followed by professional certification, after which you have only the first clue about engineering. Another five or ten years of work in the field gets you to competency. Now imagine retraining for a new career, starting another five years of training on no salary. This time around, with a middle-aged mind and energy levels, plus dependents both familial and inanimate (try maintaining a house without regular infusions of money and see what happens). The interest rates for student loans are now higher, and there are fewer scholarships or grants available. Those fabulous stories of multiple-careerists are either about jobs, not careers: or the protagonist is independently wealthy: or their first career gave them wealth enough to pursue their dreams.

By way of concrete example, a friend who was laid off two years ago, is attempting to retrain as a physician's assistant. The coursework alone is $30k, and there are several pre-med courses to be completed before then, since a degree in computer science doesn't cover the life sciences. There are 60 slots per year in the local university program, for which a thousand or more applicants compete. She's working part-time at one of those unloveable jobs to pay for the studies; studying part-time to get the prerequisites; working full-time as a mom. These add up to rather more than a full life. This career change is voluntary, but the decision was made much easier by being unable to find a job in the first career, post-layoff.

S. African music

on a recent visit to South Africa I stocked up on some new music by old musicians. As life gallops on by at an ever-increasing pace, I find it hard to keep up with the scene: so just buy the names I know. It is a little depressing to find most of them simply repeating their effects. Although they are good effects, I ache, I burn, for newness.. ok enough whining, on to the details.

1. Vusi Mahlasela, Guiding Star
His first release, When You Come Back, was spellbinding. Torrents of magnificent musicality, raw emotion bound by polished execution. This is definitely one of my desert island discs (do I date myself ? very well, I date myself).
Silang Mabele (1997) was the next one I heard. Far more subdued, not the staggering brilliance of the first release, mellower but still inspired. It has a fine cover of the Bright Blue song Weeping.

Guiding Star continues the trend to easy listening, at least if you don't pay attention to the lyrics. I'm having a hard time getting to grips with this one - it's so smooth as to disappear. I'll have to move it to mp3 so I can use headphones and listen fully. All kinds of guest artists here, Dave Matthews most famously.

Johnny Clegg, One Life
Juluka and Savuka are on the soundtrack of my life. I can't dislike anything by le Zoulou blanc, still I find nothing here that compels. Good but only for aficionados.

David Kramer, Karoo Kitaar Blues and Huistoe
Karoo Kitaar is from a show recorded at the Baxter theatre in Cape Town, which raises all kinds of ghosts from my past. Leaving those wraiths to gibber and rattle their chains in the background, the strongest songs on here are all DK's. The Karoo Kitaarists are probably best when both seen and heard. Listening alone did not move me.

Huistoe was inspired by the Karoo music. For some reason the track Onnerwater sounds to me exactly like one of the Springsteen 'Seeger session' tunes, yet none of them are actually like Onnerwater. Guess I'm getting old and batty, or perhaps there's some Jungian imperative at work in the undercurrents of folk music. Huistoe grew on me, at first listen it seemed to be boeremusiek mit concertinas and only flashes of DK's verve, not very interesting. Upon reflection and repeated listening it gets considerably better.
Klipspringer is the 5-yr-old's favorite tune, much requested while driving - 'track number 9, please' says he, getting in to the car. Like many of DK's songs, it makes me want to howl like a lonely wolf, but that's what you get for leaving home.

Soweto String Quartet, Our World
Earlier work by SSQ was absolutely marvellous, remixes of classical music with African inspirations, and vice versa. On this one, they wander off into boeremusiek (Sarie Marais) and popular music, with unhappy results. 'Sarie Marais' may once have had a honest feeling behind it, but I can no longer hear past the Afrikaner Nationalist years; 'I want to know what love is' was meretricious from first conception. The CD is still worth a listen, but not as enjoyable as the earlier ones.