Author: James Vornov

I'm an MD, PhD Neurologist who left a successful academic career on the Faculty of The Johns Hopkins Medical School to develop new treatments in Biotech and Pharma. I became fascinated with how people actually make decisions based on the science of decision theory and emerging understanding of how the brain works to make decisions. My passion now is this deep explanation of what has been the realm of philosophy, psychology and self help but is now understood as brain function. By understanding our brains, I believe we can become happier, more successful people.

Book Review: “Rough Beauty” Dave Anderson

This is a book of photographs made in the small Texas town of Vidor. While I’m not particularly drawn to the subject matter or emotionally affected by the content, I do like Anderson’s photographic style. He shot these on film with a Hasselblad on Plus-X 220 and traditional silver process enlargements.

Technically, I noted two things about the images that I’m using in my own work. First, Anderson takes a cinematic approach to the images, creating a dramatic hyper-real portrayal of the scene that is far from reality. In an interview in the book, he actually contrasts his “cinematic” approach with the straighter vision of someone like Dorothea Lange.

Second, using traditional black and white, Anderson is limited to burning and dodging. The page from the book that I’ve linked to above shows obvious traces of the dogding of the main subject. Interestingly, the messy border of the lightening of the subject creates a dramatic glow that works well as long as you don’t look so closely that you see it as manipulation. The glow from the baby’s head clearly bleeds over into the background. I too have seen in my Photoshop light painting that sharp borders often work at cross purposes to the effect. It’s better to soften the layer by decreasing opacity so that it fades to being unobvious and hence more believable.

Glimpsed in the Fog



Glimpsed in the Fog, originally uploaded by jjvornov.

On Friday, I drove to Rockville, Maryland for a business meeting. While crawling in some early morning traffic, I pointed the D300 out the car window and grabbed this scene.

I’m now considering selling the D80 since I no longer notice the added weight of the D300 and I’m so enamored with the images that I hesitate to pick up the D80 at this point.

Training All of the Muscle?

Today I ran 20 minutes of random length intervals, Speedplay, at the suggestion of The 20 Minute Fitness Solution. I ran on the local high school track doing two 400 meter intevals as the longest and a bunch of 8 second run / 12 second jog cycles with a few sprints of varying length thrown in.

While I may just be enjoying the efficiency of these short, high intensity workouts and benefitting from the novelty and lack of adaptation due to my inexperience, I’m beginning to suspect there is something else going on here as they feel very natural to me. They are short, hard and fun.

It may be, as Clarence Bass speculates here that these high intensity intervals bring a higher percentage of muscle fibers into play- including fast and slow twitch fibers. If, as I suspect, I’m not a gifted endurance athelete, but I am strong, I may benefit more from training that recruits the stronger side of my muscular abilities.

Lighting Exercise



Lord of San Francisco, originally uploaded by jjvornov.

This image was small, generally unsuccessful experiment in manipulating light in a street photo as if I had used lights in the street on the subject. The original had very flat lighting. I’d like to rework this from scratch to get a more cinematic and dramatic quality.

The Pink WIndow: Monochrome



The Pink WIndow: Monochrome, originally uploaded by jjvornov.

I spent some time trying out the monochrome conversion method that VIncent Versace describes in “Welcome to Oz”. It’s complex and I don’t fully understand it. Some of the steps don’t result in the state he describes in the book. Some of this may be changes in Photoshop CS2 to CS3 however.

He describes a method in which rather than blending the RGB channels together, three separate layers are created- one for R, one for B and one for G. He then goes through the effects of changing the order of the three layers and then, of course, using masks to select how different areas of the image are converted.

For example, in this image I wanted the grate to be dark, which it isn’t in the color version. I wanted the sill to be close in value to the rest of the paint. This took a bit of painting back bright or dark layers in these areas.

Overall, it’s a destination that I couldn’t have gotten to without the methods. Using the transformation preset that engineered into a monochrome film is a much more constrained process.

8 second intervals on the road

This week in Baltimore we had record high temperatures- reaching 70°F yesterday. So I needed to get out on the roads and do some bicycle riding. The 20 min interval session of 8 seconds of work, 12 seconds of recovery works well indoors on a trainer. I was faced with how to push the intensity in a similar way on the bike.

On a quiet stretch of road, I was able to keep an eye on the elapsed time readout of the Garmin 305, but it’s not a reasonable way to ride. Eventually, I figured out that it was about 12 full pedal strokes in 8 seconds, so I pushed for 12 and then let up. On a short ride, I got into a rhythm of pushing 12, resting for about the same, driving my heart rate up to the same zone that I did on the trainer for a 20 minute session. On a longer ride, I just threw in 8 second intervals keep my heart rate up during a longer 90 minute extensive ride.

Neurology Notes

Not Practicing

It looks like I’m not alone in Maryland as a non-practicing physician:

State lacks practicing physicians — baltimoresun.com: “While the state has about 25,000 licensed physicians, the second-highest rate per capita of any state, nearly 40 percent are engaged in teaching, research and administrative duties, according to the study, and some of the rest spend part of their time in such nonclinical work.”

One the insights that I had many years ago was that in practice, one had no way to leverage one’s activities. Economically a physician is valued for their direct time in providing care. And procedural activity, like surgery or angioplasty, is valued per unit time way above examining and diagnosing. In research and business, there are value multipliers as others participate in the enterprise. The return on time is potentially much higher for a phyisician outside of practice.

Low FDA Approval Rates

The rate of new drug approvals for the pharmaceutical industry is dropping. One reason may be FDA delay:

Eye on FDA: Impact of Approvable Letters 2007 – Part 1: “However, it is important to think about the implications of so many approvable letters.  They represent more than an inconvenience to companies and to patients who are awaiting therapies with serious implications for both, as well as for investors in companies, particularly smaller companies that do not yet have a product on the market.  ”

The drug is safe and effective, but is not yet allowed to market. This in between status for a drug can drag on for years, destroying companies.

First Composite Image

Trees Watch Trees

Late this afternoon I went out into my backyard with the express intent of harvesting images for use in Photoshop compositing. While I sometimes have problems in images capturing a full range of intensities, I am more often frustrated by focus problems. Even with the small sensor and relatively small apertures, I often which that I had more real front to back focus.

In this image I combined an image with the foreground trunks in sharp focus with one that had the rear trees sharp. As it turned out, I used the image with the foreground in focus and painted in the trees in the back along with the fence behind. Like a high dynamic range photo, it creates a bit of a “hyper-real” impression because photos usually lack this kind of selective focus. I hope it helps guide the eye back from left to right and front to back through the image space, landing on the nicely lit fence.

I’m building a small portfolio of these tree images, but I’m still exploring the possibilities in their arrangements and patterns.

Neurology Notes

Worth the Subscription

I subscribe to the online edition of The Lancet Neurology. The 2007 Round-Up was worth the subscription price itself. I need to keep up very broadly and these are the kind of overviews that help me the most.

Also in The Lancet Neurology:

The Lancet Neurology: “We used a unique response-conditional crossover design to provide rescue treatment if needed, and patients who showed an improvement in inflammatory neuropathy cause and treatment (INCAT) disability score during treatment were re-randomised into a 24-week extension phase.

I’m reading this both to gain some insight into immunologic treatment successes, but I’m trying to figure out how useful the trial’s design might be. I’ve been skeptical of enrichment designs in the past, but this may be a more clinically relevant way to study the reality of clinical responses.

Memories

I did my MD, PhD training as well as my medical internship at Emory School of Medicine in Atlanta. I’m sorry, but not surprised that it may close.

A Safety-Net Hospital Falls Into Financial Crisis – New York Times: “Once admired for its skill in treating a population afflicted by both social and physical ills, Grady, a teaching hospital, now faces the prospect of losing its accreditation. Only short-term financial transfusions have kept it from closing its doors.”

When I trained, Grady was a resident’s hospital. Care was provided by residents under the direction of Chief Residents who had completed training and were often specialty fellows continuing training and a group of incredibly knowledgeable teachers who ran the services and provided checks on care through morning rounds. There were teaching attending physicians, but their function was to teach and supervise, not provide care.

After I left, medical reimbursement rules changed so that the attendings had to provide care and sign off everything if the school was going to be able to bill at all. Having to switch from resident care to medical faculty care kicked a big prop out from under academic medicine and was one of the forces that eventually led me to my career in industry.

On Deciding . . . Better 2.0 Is Off the Air

After 6 months of regular writing here, I took down my previous weblog. Because of it’s long life, decidingbetter.com had better page ranking than this weblog on Google. I’m redirecting the domain here for now and plan to hold on to it.

I looked over the referer log for the last 6 months and found that there was only one theme that was getting regular searches, which was some posts on chromogenic C41 process black and white film. That should be replaced, since I don’t think there’s a great deal of information on this alternative on the net.

But the site was ugly, was probably leading to occasional attacks on my home network and wasn’t where I wanted searchers looking for my net writing. For now then, I’ve consolidated here.