Writing for the New York Times, Atul Gawande reports on

a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves.

... The results were stunning. ... the rate of bloodstream infections from these I.V. lines fell by two-thirds.

However, "the Office for Human Research Protections shut the program down" because the researchers had not followed the informed consent protocols required for experimenting on patients: changing a checklist may alter patient care as much as an experimental drug, and so should be subject to the same controls. Gawande concludes, "the authorities ... [are] in danger of putting ethics bureaucracy in the way of actual ethical medical care."

As a project manager and Master of Public Administration student, I'm sensitive to the accusation of bureaucracy. I went and looked it up, and it turns out that's it's always been pejorative. OED defines bureaucracy as "Government by bureaux; usually officialism", and defines bureau as

An office, esp. for the transaction of public business; a department of public administration. ... Hence bureauism, officialism, 'red-tape-ism'.

Gawande condemns the Office for Human Research Protections for following "a certain blinkered logic" to reach a "bizarre and dangerous" decision, which it then imposes broadly to the detriment of many. But it's basically just enforcing some rules about paperwork, albeit poorly. Isn't the checklist he lauds another set of rules about paperwork? It seems to me that either bureaucracy should be acknowledged as a neutral word, leading to good bureaucracy and bad bureaucracy, or, if bureaucracy is to maintain its pejorative status, a new word should be introduced for an office transacting public business in a positive fashion.

How strong is exam culture in Singapore? Our first semester grades were available online (or by SMS!) a few days ago. I found out because another student clued me in to look; a day or two after we got this alert by email:

The online exam results for Semester 1, 2007/2008 have just been released. Pls check the NUS Student Intranet for more updates [...]

As far as I know, these are the actual class grades, not just the final exam. The final exam made up between 30 and 50% of my grade for various classes. But in Negotiation and Conflict Management, the instructor successfully petitioned NUS (not the Lee Kuan Yew school, but the NUS mothership) to skip the exam, and there is a result for that class, so I'm pretty sure these are class grades, not exam results. But, presumably influenced by the historical practice of having exams be 100% of class grades, they are labeled on the web page as "NUS Graduate Examination Results". I'm happy to say I passed, with results good enough to maintain my scholarship. I didn't have any particular reason to worry, but apparently no matter how old you get, the wait for results can still get under your skin.

In order to maintain a PMP credential (Project Management Professional), you need sixty PDUs (Professional Development Units) per three-year period, which you can get by attending classes, writing articles, and various other means. While this gets warm bodies to show up for professional events, those warm bodies aren't necessarily eager.

In November I attended the Singapore Project Management Institute's annual Symposium, a one-day event taking up a few low-ceilinged, windowless rooms in the Suntec Convention Center. This was roughly as exciting as you would expect; as the keynote speaker said, "I know many of you want to attend just for the PDUs." I'll try to give you just the highlights in my notes.

• We started fifteen minutes late. Project Managers aren't any more organized than anybody else.
• There were over 300 people present; most were male and Asian, Chinese in particular. Of fourteen speakers, twelve were male.
• The keynote address was entitled "Project Management 2.0 and a Flat World". Ehhn.
• Idle thoughts during a presentation: there's a maxim that "you fall behind one day at a time". I wonder if that's really useful? Equally valid, it seems to me, would be "you fall behind a year at a time", which happens every time somebody drafts an unrealistic schedule.
• Gaah! IBM has seven levels of Project Manager, from Project Assisstant to Portfolio Manager.
• Do you have "T-shaped SSME" skills? "Every PM should have SSME skills in order that we are valuable employee for the new economy"
• A speaker, talking about consulting work for an Indonesian company, said that she couldn't give the key presentation herself as they needed to hear it from an ang moh.
• The merger of Chase Manhattan and Chemical Banks entailed 4000 projects for 58 units. The GANTT chart covered three walls of a conference room, and was used to prove to analysts that the merged entity would enjoy $1.5 billion in savings, which caused the stock price to go up. Not covered in the presentation: what savings actually materialized. (I'm too chicken! I should have asked)
• I have an entry in my notes for "MS Omega". I'm not sure if that's an actual software program from Microsoft, or a doomsday device.
• Lunch was excellent; any catered lunch that has a whole separate table for "Indian Vegetarian" has my love
• I did make an effort to talk to people. Everyone I talked to was there for PDUs to maintain their PMP, except for one person who works for a training company. I had lunch with a local telecom project manager, and never quite managed to understand what exactly he did. I also chatted with a Korean guy who works for a company that does telecom support for oil companies. He said he's done one trip to Nigeria, and it was very harrowing because the locals are cut out of the oil wealth and so target everyone associated with the oil companies.
• I am interested in doing some PMP training, not only for the $$ but also to help keep the material fresh in my own head, and also because, heck, teaching is something professionals in any field should do. However, that apparently will only be possible if Singapore changes the rules for student visas.

Overall, I didn't learn very much. I probably should have gotten my act together and proposed a presentation of my own, either on using Open Source (not very PM-specific) or how to incorporate Agile techniques without swallowing the full pitcher of Koolaid. Next year.

Here's the photo album. That's my balding head in the second and sixth pictures.

Classmate Tai Yan and his girlfriend were kind enough to take my sister and me out around Singapore Saturday. After he provided a list of fifteen possible destinations, we whittled it down to breakfast at a tasty and newly popular toast shop, a morning visit to Changi Beach, lunch at the Changi Beach food court, and an adventure to find Mount Pleasant Cemetery, which is essentially some nearly abandoned tombstones in the jungle. Then we all took a nap and then went out for dinner. Photos start here.

On the strength of Mr Brown's recommendation and the Youtube video, I saw Ling perform a free concert at the Esplanade, in a nice outdoor venue across a small inlet from a lovely little container port. The music was fun but quite amateur, mixing covers with originals. I have no musical talent, but I had the impression that the guitar player was sometimes straining to make it through tricky passages in the alloted number of beats, and that the drummer, who was fantastic, spent most of the set chasing after the other musicians as they wandered naively through the multiverse of possible speeds and timings and rhythms. More damaging was Ling's inexperience reading an audience: We sat down in a crowd that was at least 80% Tamil, on a day that was a major Muslim holiday (Eid al-Adha, called "Hari Raya Haji" in Singapore and commemorating "Ibrahim's (Abraham's) willingness to sacrifice his son, Isaac, under the order of Allah"), and the stage patter was about Christmas. I personally enjoyed the music selection, which was mostly Canadian woman singer-songwriters, but I'm not sure how much it spoke to the audience. There was certainly some talent and potential on display, and most of the problems should go away with practice and experience. Of special note was the amusing dissonance between the Singlish patter, available here, and the music.

The second act was "Two Guys, a Girl, and Amanda", which seemed like a quite capable bar band, which covered a number of catchy, terrible songs, followed by a selection of much better songs. All in all, a perfectly pleasant evening which, for better and worse, was more or less completely within my cultural reference area.

Today's seminar at the East Asian Institute: China's Success in Using Foreign Aid to Diplomatically Isolate Taiwan, by Prof. John Copper from Rhodes College. Text is my paraphrase of the speaker unless marked in quotes; hyperlinks are mine.

In the 70s and 80s China got out of the game (of foreign aid to diplomatically isolate Taiwan).

Definition of foreign aid for our purposes: Economic help for political and possible economic gain

Published amounts are misleading because many countries promise aid but don't deliver. Europeans frequently criticize the US for not giving much aid as a percentage of GDP, but the US provides market access that the EU doesn't and Japan doesn't, but China does.

Only 24 countries have diplomatic relations with Taiwan, none important. Total population of smallest ten is under one million people.

China's Taiwan policy: territory, regime. China still claims Taiwan, and claims that the Taiwanese regime is not legitimate.

In the spring of 1950, Mao was preparing to invade Taiwan. Troops got sick from a liver fluke in Fujian province, then the Korean war broke out, and then Truman changed his mind and sent the Seventh fleet to protect Taiwan. Later attacks in 1954 and 1958 but China backed down in the face of US protection of Taiwan (including nuclear artillery in 1958). Stalemate.

1969 border war with USSR; Nixon negotiated with Mao regarding Taiwan; contents of these negotiations remains unknown.

Deng Xiaoping hoped to solve the Taiwan problem as a side effect of growing China's economy, as Taiwan would seek to rejoin voluntarily.

In 1956, in an attempt to end its diplomatic isolation, China offered aid to Cambodia, then Nepal, Indonesia, Sri Lanka, middle east. Didn't do anything in Latin American, except very briefly Cuba. Grants, loans, project aid, 10, 20, up to 100+ million dollars. Big recipients: North Korea, North Vietnam, Albania, and a north African railroad.

Issue of China joining UN. Most countries, other than the communist bloc, kept ties with Taiwan. 1969 was a turning point. Albania proposed a resolution that PRC, not ROC, should have China's UN seat. Joel's note: here's Time magazine from 1971: "THAT annual rite of fall—the struggle over who should represent China in the United Nations—used to be fairly predictable. In past sessions, the drama has swirled around the so-called Albanian resolution, which offers the U.N.'s 127 members a simple choice: Taipei or Peking." Almost all countries China gave aid to voted for Beijing. Cambodia was one exception; Indonesia broke of relations with China after 1965 due to suspicion from Indonesian military.

Another few dozen countries recognized the PRC after this, about half of which received aid from China.

Aid from China dropped; Taiwan became the world's #1 country for foreign exchange and had the ability to compete with China in aid-giving.

Since 2000 and Taiwan's election of Chen Shuibian, more efforts to strip away Taiwanese friends. Foreign aid from a secret fund became a politicized issue in Taiwan. Chen's wife was indicted in 2006 for forging withdrawals from the secret fund for personal use. The prosecutor, a Chen supporter, said he refrained from indicting the president only because the crimes did not constitute treason. Chen may leave Taiwan before his term ends to avoid prosecution.

Macedonia went from China to Taiwan and back to China. Macedonian press Taiwan had promised between 1 and 1.6 billion (US dollars) of aid, which is much greater than Taiwan's total (public) aid budget. China offered aid and threatened to veto ongoing UN peacekeeping in Macedonia unless Macedonia switched to China.

China promised US$130 million to Nauru, which has 13,000 people. This angered Chen into saying that there were two entities, one on either side of the strait, which statement angered China. (Joel's note: Wikipedia says $60 million and mentions that Nauru went back to Taiwan in 2005.)

Chen had made a big deal of diplomacy and aid with other democracies, and so was embarrasses when Senegal, one of the most diplomatic countries in Africa, went to China. The premier of Taiwan was on a plane to Chad when Chad announced a switch to China.

Of Taiwan's remaining 24 friends, some are critical. Nicaragua is one. Panama is another. Chen Shuibian has been pushing the notion that Taiwanese are not Chinese, which is undermining Taiwan's position with overseas Chinese, including in Panama.

China's trade is skyrocketing in Latin America whereas Taiwan's is mostly flat.

Conclusion: China's won the diplomatic battle with Taiwan.

What's the effect if Taiwan's number goes down to 20, or 10? Unclear; Spain once had 2; Russia once had 2. What could China do next? It's clear that China absolutely doesn't want anybody else to control Taiwan, but finds the status quo acceptable for now.

Q: Would China reach a point of diminishing returns and stop even trying to reduce the number? Would it affect the Taiwanese regime's legitimacy? A: I don't think so.

Audience comments: It would matter in that Taiwan would find it much harder to file the UN applications that it uses to make noise. You can't find Taiwan in World Bank data. China doesn't want to overpay because then more countries would start switching back and forth.

A: Taiwan has informal, cultural diplomacy with many countries. China is insensitive to this as long as it isn't formal or implying statehood.

Q: If it comes to a crunch, should Singapore abandon Taiwan? Taiwan supported Singapore with FDI in the early days. (very long-winded details about consequences of Taiwanese independence and Korean opinions ultimately interrupted) Can China up the ante in this competition? A: Yes; but what's the hurry? On your Singapore question, it's the Singapore policy to oppose Taiwanese independence. But it doesn't matter. In my opinion, if Chen declared independence, Bush would call Hu Jintao and ask for 48 hours, and then overthrow the Taiwanese government. ("Is that on the record?" "It's my opinion")

Q missed it. A Much of China's aid is now money instead of labor. I think the US hasn't thought much about what to do about China's foreign assistance. US may support it as another way to promote development in poor countries. But US uses some Pacific islands for strategic reasons. Some criticism of China destabilizing the world market in oil and other commodities.

Discussion of race issues, who is really Chinese. Chinese colonizers of Taiwan taking local wives. Q: What about culture? A Taiwanese groups stir up these issues to win the election. If KMT wins, it will die down

Taiwanese foreign aid to a huge leap in 1989. But now many Taiwanese feel poor. Conflict between perception of decline in Taiwan and desire of Taiwanese not to feel isolated. Taiwanese consumer confidence is lowest in Asia; very low confidence in the government. KMT accusations that Chen ruined the Taiwanese economic miracle.

In a sense China is giving economic assistance to Taiwan by buying up agricultural products well above market price. Many Taiwanese companies do quite well in China.

Speculation about China's manipulation of Taiwan. Stock market manipulation.

Q: What about Vatican relations? Recent election of a bishop in China suggesting tacit approval of Chinese government. Will the Vatican dump Taiwan and recognize Beijing? A: yes, the Vatican would switch if these could reach an agreement with Beijing. Pope won't give up the right to select bishops in China. Point from audience: Vatican has apostolic representatives, not ambassador, and so could have both China and Taiwan. —I don't think China would tolerate that.

Q: Doesn't this aid competition benefit the small countries? Would foreign aid to these entities decline sharply if Taiwan and China merged?

Q: What is the Chinese population in Panama that could influence Panamanian opinion?

A: I'm not sure— there's enough to — they are a minority community and they have money to influence politics.

Discussion about identity and race in Taiwan. Many Taiwanese elite hold dual US/Taiwan citizenship. Promotion of Taiwanese language, which they acknowledge is impractical. It's not entirely rational. (Joel's note: At the Taiwanese birthday dinner I went to the other night, forty Taiwanese sang happy birthday in English, Mandarin, and Taiwanese.)

Q: In the US there are many undocumented workers, we often call them "illegals". The same situation exists in China. The labor flow may be very important in foreign aid issues. A: In the US, you are talking about 15% of the population (Joel's note: the most common number is 12 million, which is closer to 3% of US population); the number would be much smaller in China. Africans in China? I've never heard anybody say that. —I've seen Africans in Malaysia, students and people holding good jobs. —I've studied a report that there are over 200,000 illegal African workers in Guangzhou alone.

If I were to derive Singapore's laws regarding pedestrian/car interaction from observation, I would guess:

1. If a pedestrian is in a marked crosswalk, cars may charge at but not actually hit pedestrians.
2. Drivers may disregard all pedestrians on pavement outside of marked crosswalks. Pedestrians step on unmarked pavement at their own risk.
3. If a pedestrian is on a sidewalk and moving towards a road, drivers may honk to warn the pedestrian not to proceed.

I did some research, and found that I pretty much guessed correctly. The law says,

Crossings for pedestrians (referred to in this section as crossings) may be established on roads, or on subways constructed under roads, or on bridges constructed over roads, in accordance with this section." (Provision 121, Paragraph 1 of the Road Traffic Act)

However, there are supplementary rules which are not available online, and I had to get help at the Law Library to get a copy of "Road Traffic Act (Chapter 276, 121 and 140), Road Traffic (Pedestrian Crossings) Rules", which says that

"pedestrian crossing" means any crossing established for the use of pedestrians on a road, subway or bridge indicated by traffic signs, road markings, or otherwise as shown in any of the diagrams ..."

It also says that

Except as provided in paragraph (5) [relating to physical incapacity], any pedestrian who is within 50 metres of either side of a pedestrian crossing ... shall make use of the pedestrian crossing for the purpose of crossing the road.

Section 4:

The driver of a vehicle who is in the process of turning his vehicle at a road intersection or junction where there is a pedestrian crossing shall stop his vehicle in order to give way to any pedestrian who is either crossing or is starting to cross the intersection or junction.

I didn't research the definition of right of way but this blogger claims pedestrians don't have it. This is apparently the norm in former British colonies.

So pedestrians have precedence in marked crosswalks, but nowhere else. I live on Bukit Timah Road, which is a major arterial, and simply to walk along the road on the sidewalk you must constantly cross driveways and side roads; none of these implied crossings are actually marked.

In contrast, here's the standard in the US:

The 2000 Uniform Vehicle Code and Model Traffic Ordinance (Uniform Vehicle Code) (Section 1-112) defines a crosswalk as:

1. "That part of a roadway at an intersection included within the connections of the lateral lines of the sidewalks on opposite sides of the highway measured from the curbs, or in the absence of curbs, from the edges of the traversable roadway; and in the absence of a sidewalk on one side of the roadway, the part of a roadway included within the extension of the lateral lines of the existing sidewalk at right angles to the centerline.
2. Any portion of a roadway at an intersection or elsewhere distinctly indicated for pedestrian crossing by lines or other markings on the surface."

(Federal Highway Administration)

And here's the relevant law for Washington State:

RCW 46.61.235.1 The operator of an approaching vehicle shall stop and remain stopped to allow a pedestrian or bicycle to cross the roadway within an unmarked or marked crosswalk when the pedestrian or bicycle

So, Singapore needs to either change its laws or paint a whole bunch of lines. And lest you think the latter is implausible, in the last few weeks the government has been sending crews to embed yellow textured mats in the curb cutouts. I assume this is to help blind people (of whom I've met or seen exactly one in public in all of Singapore. I think I've seen all of one or two wheelchairs, powered or otherwise; like most of Asia, the norm is for handicapped people to stay out of sight). Don't misunderstand: I applaud accessible infrastructure. I just wonder why they couldn't throw some zebra stripes down while they were at it.

Pictures from our Sunday Morning Walk.

(Some serious catch-up here: I read some of these six months ago or more)

Harry Potter and the Deathly Hallows, J.K. Rowling
A perfect airplane book. It came out a day before my flight. I started it at the SeaTac airport and finished it on approach to Tokyo; left it on the plane for the next person. I was satisfied with the conclusion, but I do feel that the only part of the series with really exceptional writing was the last third of book 3 and the whole of book 4.

Death of an Expert Witness, P.D. James
Grabbed it from the university library on a whim, enjoyed it. No particular hurry to read more.

The Dark Tower series, Steven King
It's Steven King's magnum opus, for better and worse. It reads like he just wrote it on the fly, which he pretty much did. If you like King enough to want to spend a million words with him, you'll like it. The atmosphere is great, the characters are sometimes great. The horror and scary level is mostly cranked way down. Despite the length, it's not really that Epic, partly because not all that much happens and partly because of the claustrophobic feeling of being in just enough of a world for him to tell his story (the opposite of Tolkien Syndrome). The last three books, especially, feel somewhat like playing a computer game, as you go from location to location, and then back, and then find the widget, and then go back to that one place where the widget reveals a secret door, and then see what's back there, and then go back to that other place and now you see that the guard you killed happened to land on top of the other widget, that's why you didn't see it the first time and wasted two hours before you searched google for a cheat guide, and all the time you are alone, and the computer-generated characters walking in their computer-generated routes for you to sneak past just make you even more alone, with only your thoughts for company. That kind of feeling. Except that you're alone with Steven King's thoughts.

Arthur and George, Julian Barnes
This is Literature in the best sense; you get sucked in and just keep reading and it gradually dawns on you that what you are reading is immaculately awesome in conception and execution. This and Sacred Games were easily the two best books I read in 2007.

Mao: The Untold Story, Jung Chang and Jon Halliday
I already had a sense that Mao was a villain for all time and an equal partner with Stalin and Hitler as the most heinous mass murderers of all time. This book fills in a lot of details, and takes it a step further. It's a very thorough attempt to paint pretty much everything Mao ever did as an act of calculated evil. I understand that the quality or provability of some of the research is under attack. Many people seem to have recoiled just at the intensity and completeness of the argument, taking the position that any description which is so one-sided must be somewhat exaggerated. I don't see that as a logical rebuttal, but I do have my own issues with the narrative, especially the account of Mao during the war period (Long March to 1949). The authors attempt to explain almost all of Mao's successes and escapes as consequences of Mao's masterful manipulations of friends, rivals, allies, and enemies. Given the slender evidence for some allegations, they don't seem to hold up well to Occam's razor. Isn't it more likely that some of his opponents just screwed up or were stupid, rather than that he pulled all of the puppet strings all of the time?

I don't see those kinds of issues as wholly discrediting the book. I learned a lot, even though I found it so horribly depressing that I couldn't read too many pages at a sitting, and ended up setting it aside about two thirds of the way through. Anyone who has a positive or mixed opinion about Mao must be seeing the evidence through very rose-colored glasses; the genuine debate seems to be only about if he's purely evil to the last cell, or just really, really evil.

One Jump Ahead, Mark L. Van Name
A pulpy sci-fi story. I bought it on the strength of the first page or two; it passed the time and had some style but didn't seem especially novel or well-plotted.

Ghost Brigades, John Scalzi
More of the same from Scalzi; it's good, but like diet soda has some weird, unpalatable aftertaste. SPOILER: It may be related to the debate (sorry, couldn't find a link quickly) about whether it's fair to criticize the fascist tone of the earlier book when that tone may represent the narrator's views rather than Scalzi or the world Scalzi has created, or it may just be something about his writing almost but not quite rubbing me the right way.

The Omnivore's Dilemma, Michael Pollan
Almost everything we (in the United States) eat contains corn. A typical fast food meal may be predominantly corn, in that corn is the input stock to industrial processes that make sweeteners, thickeners, and a myriad of other "ingredients". This is because corn is the most efficient crop at converting sunlight to energy; soy is the most efficient at converting sunlight to protein and so soy is the other main crop in the US. Corn as the foundation of industrial farming is really bad for society for many reasons, not least of which because the corn ecosystem requires huge inputs of petroleum. The proximate cause of this is really destructive farm subsidies and policies.

The book is, for the most part, ultra-readable. Pollan does a lot of hands-on research into farming and the corn industry, including spending time on a modern factory farm and on a smaller, more natural farm which integrates agriculture and livestock in a labor-intensive and astoundingly productive enterprise. The parts where he collects all of the ingredients for his own home-cooked meal are probably the least engaging, but the book has definitely changed how I look at manufactured food.

Uncommon Carriers, John McFee
Like the Omnivore's Dilemma, this book starts tremendously, with very gripping details about mundane infrastructure, and then peters out as the author gets more personal. The stories about a long-distance trucker, a coal train, a Missisippi barge crew; all fantastic and give you a wonderful sense of being there.

1634: The Baltic War, Eric Flint
I've been enjoying this pleasingly escapist multi-novel story about a modern West Virginian coal town transplanted to 17th century Germany, but experiencing diminishing returns. At first I thought I was just getting tired of the story, but then I read this and realized that the real problem is that the writing is degenerating into a "Mary Sue" story. The moderns always face small setbacks but overcome them with ingenuity and steadfast leadership; the locals get entranced by good old American values; it seems like every book features plucky, scared but brave American teenagers getting over their heads in world affairs and having beautiful, progressive 17th century teenagers fall in love with them and it always works out. I liked the ideas, trying to figure out how 17th century culture would interact with 20th century small-town Americans; the pro-union bent of the authors; seeing how you might try to reconstruct modern industrial technology almost from scratch. But the execution has completely turned me off, and I've stopped reading this series, probably a book or two too late.

Star Trek: Swordhunt, Star Trek: Honor Blade, Star Trek: The Empty Chair, Diane Duane
The Romulan Way remains my favorite Star Trek book ever (not meaning to damn with faint praise); these sequels extend the story in a fairly unsatisfactory way. Spoiler: How come it seems like every Diane Duane book (Star Trek or otherwise) has the same climax, as the diverse good guys, now bonded as BFFs, pluckily march once more unto the breach with some sort of reality-bending mystical energy thing as background, a la Madeleine L'Engle? Counting My Enemy, My Ally, Duane uses this ending twice in the same series, not to mention all her non-Trek books. It seems like the Mary Sue virus is at work here too.