Michael Sebastian

Please stop sending me “satisfaction” surveys.

I have already rated you, via the marketplace, by choosing to patronize your business with my custom. I do not care to fill out an online survey of any minutes’ duration, given that heartbeats are finite, and time is dear. The only online survey you’ll see from me is my next “buy now” click.

We have just bought a house, which has entailed multiple interactions with various purveyors of goods and services. More fool, I, for giving anyone my email address, because I now have a half dozen surveys in my inbox. I have only two ratings to offer you: 0, if you never hear from me again; 10 if you do. If there’s a problem, I’ll send you an email, in good english, describing the problem and asking for a solution. No visual-analog scale is required for that.

Since we closed on the house late last month, I have received at least four solicitations from the mortgage lender to complete a “satisfaction” survey. The lending officer has practically begged me to complete it, and intimates that “anything less than a 9 or 10 is a zero”. What am I to do with that? I don’t want to hurt the guy, but it was not a “9 or 10” experience. In fact, I’d probably never use this lender again, nor recommend them to anyone else.

Some of that was the lending agent’s fault; not the best communicator to begin with, and AWOL for two weeks during the height of the process. But now this guy gets sent to the gulag or demoted or has his paycheck docked, or doesn’t get a T-shirt, or God knows what else, if I don’t give him and his employer an undeserved 9 or 10 for this particular transaction? The person backing him up was even worse; I don’t think she could put together a coherent sentence if she were testifying at her own parole hearing. Some of it was because of the awful web “portal” I was forced to use for document uploads and “secure” messaging – so secure I usually couldn’t access it. But a good bit of the problem was the post–2008-meltdown regulatory environment; the federal government seems to think it can prevent another housing collapse by keeping qualified borrowers from obtaining funds, while lavishing money on people in politically-favored demographics who have no hope of repaying it.

So, Corporate America, while you await my repeat-business “buy now” click denoting 10-level satisfaction with our previous transaction, maybe you could come up with another way to evaluate and compensate your employees. First question: is your enterprise profitable? If so, then most of your employees are probably doing most things right. If it ain’t broke, don’t fix it. Second, do you get much repeat business? Shouldn’t be too hard to track that. If not, either your product or your service, or both, are shite. Finally, do your employees show up on time and sober, and participate in mandatory company calisthenics and cheers? Do they generally keep their hands off each other while on company time? Sounds like “10’s” across the board.

As examples, look at Southwest Airlines and Enterprise Car Rental. I choose them preferentially over their competitors, even when they aren’t the cheapest option. They treat me like an adult and communicate well, and I don’t think I’ve ever received a survey from either one. You could do a lot worse than to emulate those guys.

I Saw They Shall Not Grow Old last night, Peter Jackson’s First World War documentary. It was a breathtaking artistic and technical achievement. I hope you got to see it; yesterday was a limited release, and I haven’t heard when, or if, it will be shown again in theatres. One hopes it will eventually make its way to the usual streaming services.

Drawing upon a hundred hours of archival footage from the Imperial War Museum in London, and 600 hours of 1960’s and 70’s audio interviews with veterans, Jackson told the story of the war experience of the average British infantryman. He digitally restored the film to an amazing degree of clarity, and enhanced it to smooth out and slow down the jerky, speedy footage we’ve all seen from that era of nonstandard frame rates in hand-cranked movie cameras.

Jackson also colorized the mid-section of the movie, to an astounding level of detail – largely by referring to his personal collection of WWI memorabilia. I guess the guy who directed and produced the Lord of the Rings trilogy can afford to indulge a penchant for WWI uniforms, helmets, rifles, and artillery pieces (yes.) He managed to get the British uniforms the right shade of khaki, and the German the right shade of field gray, along with unit patches and other adornments. He even went to France and Belgium and took thousands of photos so that his colorizers could get the grass right.

All of that was incredible enough, but the soundtrack was perhaps the greatest marvel of all. He hired lip readers to discern what the soldiers were saying in the silent footage. Identifying, where possible, the regiments of the soldiers from their uniforms and insignia, Jackson hired actors from the corresponding parts of the UK to record their words in the correct regional accent. It was so well done that it seemed completely natural.

This movie was clearly a labor of love for the director. Jackson spent half an hour explaining the project after the closing credits; don’t miss that part. He comes across as a quirky but regular guy. He points out that many of our parents or grandparents had a relative who fought in that first global conflict — like my father’s father, who as a teenager served aboard a battleship in the US Navy, and witnessed the scuttling of the German Fleet in Scapa Flow. Jackson’s New Zealander grandfather was wounded early during the Battle on the Somme, and met and married his grandmother while recuperating in England. Likewise, Jackson’s partner had two relatives killed in action.

I’ve long had an interest in military history, so this film was right in my wheelhouse. My wife doesn’t share my affliction, but has ancestors from the north of England, and very much enjoyed hearing the soldiers tell their stories and watching them mugging awkwardly before the camera. The movie was a cultural record of the times, when being filmed was a novelty.

There were many moving scenes, but the most poignant one depicted a company of men huddled in a sunken roadbed before attacking the German lines a hundred yards away. Their fear was palpable, their expressions clearly rendered in the loving restoration of the footage. Within a half hour, they were killed almost to a man.

I can’t recommend this film strongly enough.

In my day job as a board-certified anesthesiologist with 25 years’ experience, I’m frequently struck by the freedom with which patients, and families, feel they can tell me how to do my job. Thanks to the internet, everyone’s an expert — except when they aren’t, which applies to almost everyone, about almost everything. As one of my favorite writers, Kevin Williamson, puts it, “Everything is simple when you don’t know a f$%#king thing about it.”

I had a chance to marvel at this phenomenon again yesterday. A patient showed up to have a surgical procedure done. This is a straightforward procedure, the sort of case that would be assigned to a properly-supervised first-year anesthesiology trainee. But a “simple” anesthetic, nonetheless, still requires knowledge and training to do properly and safely.

The patient had had a previous, similar procedure done, and s/he and the family had extrapolated, wrongly, from that experience to the current one. They brought a laundry list of suggestions/demands for how we were to proceed. They had “researched” such things as the “right” antibiotic for the procedure; and which anesthetic medications and techniques would be “appropriate”. The patient insisted on not going “all the way to sleep” for the procedure, as s/he hadn’t last time. They wanted me to do things exactly the same way, using the same drugs and doses. That they were all lay-people, with no medical training other than the isolated factoids they had gleaned somewhere, didn’t seem to affect anyone’s perception of the situation.

Turned out that every single thing they mentioned was either dead wrong, or inapplicable to the specifics of this patient’s situation — as I knew might happen, and had tried to explain. I wound up having to deviate from the previous anesthetic plan, because though the surgery was similar, other circumstances had changed. This is the sort of nuance that training and experience confers, and which can’t be acquired by an untrained person with a Google search.

Like most physicians in this age of the almighty Patient Satisfaction Score, I feel compelled to at least appear to listen to the maunderings of patients and families. Making people mad on a regular basis by not acting like the help, and acceding automatically to their whims, can be bad for one’s career standing and income. And I always keep an ear cocked on the odd chance that a patient or family might offer something of actual use, perhaps portending problems ahead. Even a blind hog finds the occasional truffle. Separating wheat from chaff in the torrent of information offered by patients and families is itself an important skill that takes years to develop.

Where technically feasible and safe, I accommodate harmless requests. At other times I gently deflect, and try to explain why the request is wrong; most people, when offered actual expertise in an understandable form, see reason. Only on a few occasions have I had to flat-out refuse to comply with a patient’s wishes. In one instance, the patient declined my services, and ultimately one of my partners did the anesthetic — in exactly the manner I’d recommended — after inconveniencing everyone and him-/herself by a last-minute spurious cancellation at the threshold of the OR door.

I realize it’s unfashionable to say it, people, but you will never be able to know enough or to Google enough to dictate a safe anesthetic plan — or any other medical procedure, for that matter. I make no apology for this statement; every doctor I know believes it, even if he or she won’t say it forthrightly. When it comes to healthcare, you don’t know jack-sh%t, and won’t ever know it. “Expertise” comprises at least two factors: factual knowledge, and the judgment to apply it. First comes knowledge, later paralleled by hands-on training and more study to learn how to apply that knowledge. This process, starting with undergraduate sciences, followed by medical school and residency training, takes twelve to fifteen years. And you think you can second-guess such a person after an afternoon with Google? That’s laughable. Hate to break it to you — but there are actual experts in the world, and the gap between you and them is insurmountable.

It would be similarly absurd for me, an expert in my field, to tell a civil engineer, an expert in hers, how to design and build the viaduct I drive ever day to get to work. Yes, I might be able to study materials science and computer-aided design, and the physics of static and dynamic load-bearing, and maybe converse knowledgeably with her. But I’d never think of telling her how to design that bridge. She’d rightly disregard my “advice”, and would be within rights to throw me out of her office.

Yet patients and families do essentially the same thing just about daily when they encounter the healthcare system, and it’s beyond passing strange. I suppose it’s an expression of fear, and a manifestation of the urge to control the uncontrollable. Circumstances have forced you to put your life in a stranger’s hands in an immediate and up-close manner — just as you put your life in that civil engineer’s hands every time you drive over her viaduct.

That said, what are you to do? First thing, you need to plan ahead. Here’s something useful Google can do for you. Research the hospitals in your area. The “best” hospitals usually attract the “best” medical staff. Published ratings aren’t foolproof, but they are a place to start.

Everyone needs to develop a relationship with a primary-care doctor well ahead of any actual health crisis. Once you’ve found someone you trust, ask him or her which specialists s/he’d recommend. There’s a decent chance that, in your lifetime, you’ll need a general surgeon, an orthopedic surgeon, a cardiologist, or an oncologist. Ask your PC doctor who she’d recommend among those specialists.

All of us doctors know who the “good” people are. If you know any doctors, ask them to whom they’d send their own family members. You have to do this ahead of time. You’ll have no choice at all if you turn up at the ER with an acute surgical problem; you’re gonna get whoever’s on call for that surgical specialty. It’ll probably turn out fine, but wouldn’t you rather have some control over the situation? In a true emergency — surgery is required within six hours to prevent death or serious disability — there may not be time to arrange a transfer somewhere else, or you might be too sick to be moved.

Things are a bit different with anesthesiologists. Yours will be a solo individual or a member of a group that covers your hospital, and is often someone the surgeon works with regularly. For elective outpatient cases, an anesthesiologist likely won’t be assigned to you until the night before your procedure. For emergency cases, you’ll get whoever’s on call. Again, the better hospitals and better surgeons — who you’ll already have researched, right? — tend to work with the “better” anesthesiology groups. Ultimately, you’ll probably have no say in who does your anesthetic. If there’s time, it’s always possible to request a phone call from him or her; we get those requests and are glad to honor them.

I don’t mean to imply that I expect my patients to blindly accept whatever I tell them; and intelligent questions are always welcome. But, like it or not, you’re going to have to surrender some control, and make a leap of faith. That leap will be less frightening if you’ve done your homework in advance. The threshold of the OR is not the place for you to work out your problems with authority, or to pose as the smartest kid in the classroom. In a healthcare setting, you almost certainly are not. Try to make your peace with that.

Those of you hardy enough to stick with me here have read of our travel adventures in the Southwest, Midwest, and Plains since our family moved to Denver in 2017. Among other long-weekend destinations, we’ve visited Santa Fe; the Black Hills of South Dakota; various destinations in southern Utah and the Four Corners; and most recently, Aspen, Colorado for peak fall color. (No write-up on that one, yet!) Our daughter was recently in town for fall break, and we decided to return to Moab, Utah, to re-visit Arches National Park, and to hike the Fiery Furnace again.

Moab has become one of our favorite places to visit. Five and a half hours from our doorstep, in southeastern Utah, Moab sits at the southern tip of Arches National Park, along the Colorado River. This was my second trip, and my wife’s third. Daughter has never visited, so off we went for a 36-hour weekend jaunt. It is a wonderfully stark desert landscape of red-hued sandstone, a segue from the mountains of Colorado into the “true” southwest of New Mexico, Arizona, and Nevada. Moab is a prime recreational destination for hikers, mountain bikers, and off-road riders.

The drive to Moab is itself something to experience. Starting in Denver, sitting on the western Great Plains with the Rockies in view, one travels west along I-70, soon crossing the Continental Divide through Eisenhower Tunnel. At 11,000+ feet elevation, it’s the highest tunnel in the Interstate Highway system. Emerging from the far side of it, you soon pass Breckinridge and Vail, which anchor the busiest cluster of ski resorts in the Colorado Rockies.

Continuing west, the terrain is still mountainous, but the peaks are lower, softer, and browner. The evergreens of the national forests east of Vail give way to a low scrub as you enter the arid Western Slope of Colorado, whose gateway is Glenwood Springs. Here, I-70 squeezes itself through a rocky gorge along the Colorado River. This was one of the last segments of the Interstate Highway system to be completed, and herculean feats of engineering were required to build a road through the close confines of the gorge.

For much of its course in Colorado, I-70 parallels the Colorado River. But beyond Glenwood Springs, the road and river separate, with the Colorado meandering on a more southwesterly course, to cut across Utah’s southeastern corner on its way to Arizona, and beyond; while I-70 continues almost due west to its termination in western Utah at I-15, that state’s main north-south artery. To get to Moab, you continue westward, exiting I-70 onto US 191 about forty miles inside Utah. 191 heads due south, skirting Arches to its west, and meets up with the Colorado at Moab. So Moab sits at the southern apex of a rough equilateral triangle formed by I-70 on the north, US 191 on the west, and the Colorado River on the east.

We stayed again where we have before, at Red Cliffs Lodge, a rustic resort on the river, a half hour from Arches. It’s serene and beautiful; highly recommended. We got to town in late afternoon, in time to check in and drive to Arches to look around.

There was no one at the entry pavilion to take our admissions fee, and the visitor center was closed, so we drove the road that rings the park, taking in the late-afternoon light and then the sunset as it played across the red sandstone arches that give the park its name. This is the Golden Hour of which photographers speak rapturously; the sun has dipped below the horizon, and the landscape is illuminated only by the sky itself. From there it was back to the lodge for an early dinner and lights out.

We left before dawn and got to the park just as it was getting light. This is another Golden Hour, when the sky is bright but the sun hasn’t yet shown its face to the east. We again drove the ring road, and walked among the arches to make a few pictures. By this point the tour buses had begun to disgorge their hordes of passengers, none of whom had gotten the memo that the park’s majestic splendor might best be enjoyed in reverent silence. We departed to the staccato hammering of DSLR shutters, cameras borne by the wrinkled necks of codgers not much older than myself.

We made it to the Visitor Center just after it opened, to find out that all but a dozen of the daily allotment of fifty Fiery Furnace passes had been sold. Snooze You Lose, indeed. Passes can only be picked up in person; there’s no online ordering, and you can’t get them more than seven days in advance. We paid our money and watched the orientation video, topped up our water containers, and left for the Furnace with our Camelbacks sloshing in our packs.

The Fiery Furnace is a labyrinth of flame-colored sandstone spires and blade-like walls, carved by water erosion over eons from the sedimentary rock of an ancient sea that once covered the region. There are many narrow passageways to squeeze through, and a lot of clambering over rocks. It’s not that hard a hike, but a reasonable level of fitness and strength are required to manage it.

We’d last hiked the Furnace in September 2017 with friends, en route to their place in Park City, Utah. That day it was 100ºF-plus in the Furnace, with scarcely a breath of wind, and the mid-day sun blow-torching the rocks. We felt like onions being caramelized in a giant skillet. We hadn’t brought enough water, a mistake we vowed not to repeat this trip. We’d struggled to find our way along the counterclockwise “trail” that’s marked out for us middle-aged tenderfeet by dun-colored arrows siliconed to the rock, pointing you to the next turn. They are kept unobtrusive in order to preserve the Furnace’s feel of solitude and wild-ness, but last September we could have used a bit more “obtrusion”. We got seriously turned around, and dehydrated, before figuring things out and making our exit. At only fifty passes issued per day, there’s no conga line of hikers to follow to the exit. You might not see another person for a couple of hours.

This time, only a month later in the year than our last trip, it was never hotter than the 70’s in the Furnace, and we had plenty of water. The trail was better marked this time, though you still had to look to find the arrows. We made it in just under four hours, under a cloudless blue sky, gazing in awe over amazing vistas. My knees and hips let me know of their displeasure; my daughter, on the other hand, scampered through the place like a mountain goat on meth.

We headed, weary, into Moab for a late lunch, and pointed the car east to Denver and home.

Now for some observations on what worked photographically this trip.

This was the travel debut of my new-to-me Leica M10. After holding out for years, I’m transitioning to a nearly-all-digital photographic future. I traded a Hasselblad 203 medium-format film kit, and an “obsolete” Pentax 645D digital medium-format kit, and a few other bits and bobs from my vast hoard of photographic gear, toward a like-new M10, just as its successor M10-P was released. I care nothing about the M10-P’s touch screen or supposedly-quieter shutter; the M10 is plenty quiet for me. This one was a demo, came with a full warranty, and was priced to move. It’s the first full-frame digital camera I’ve owned; I’ve otherwise stuck with APS-C, or flirted with 44 × 33 mm “medium format” sensors.

I already have a Leica 3-lens setup — Summicrons 35-50-75 — for shooting with my M6. This trip I used the 50mm f/2 exclusively; the 35 would have been mostly too wide for the huge landscapes we surveyed. That’s one of my gripes about wide-angle lenses; many photographers don’t realize they are best used for shooting close to the subject, not for filling the frame with a massive amount of stuff from far away. Thus do I reveal my bias — photography is about selection and exclusion, unless one is simply taking mapping shots, like a cerebrate Google Street View camera.

A rangefinder like the M10 does not strike most photographers as the “ideal” kit for shooting landscapes. For me it’s ideal for shooting just about everything else, and it’s what I had, so I used it and was well-satisfied with the results. The older I get, the more I appreciate compact-and-light; I’m tired of schlepping shipping-containers of gear around. More importantly, I can actually manage to focus a rangefinder camera, whereas I find it increasingly difficult to manually focus a DSLR or medium-format camera with the usual ground-glass focusing screen. I hated to get rid of the Hasselblad and those lovely lenses; but when one shoots film it’s annoying and expensive to have only 6-8 of 12 images on the roll come out in focus. (Yes, the camera was properly calibrated, and I had an Acute Matte screen. Several, in fact.)

Why not just go with an auto-focus camera? I have one of the Fuji X-series cameras, which I also shot on this trip. It’s an excellent camera and the lenses are fantastic. (I did keep a 23mm lens on the Fuji, equivalent on its APS-C chip to a 35mm for the Leica’s full-frame sensor, for when a slightly wider viewpoint was appropriate.) I have nothing against auto-focus, but I like manual focus, and only rarely miss having auto-focus for the mostly-static stuff I shoot. And I can get by with hyperfocal “zone” focusing for all other situations: pick an aperture, say f/8 (the sweet spot for my lenses), and set the infinity mark just inside the f/8 depth-of-focus line inscribed on the lens barrel. With the 50, that means everything from 3 or 4 m to the horizon will be in focus. Just like photographers did it for the 150 years before auto-focus.

I didn’t take the Leica into the Furnace, because I didn’t want it banging off every rock I had to climb over, nor scraping against every tight spot I had to squeeze through. It would have had to go into a padded case, which I didn’t feel like carrying, or be swaddled in a Domke Wrap in my pack, to be dragged out for every shot. Those of you photographers who travel with non-photographers know how well this laborious process would have been received by your hiking companions.

The iPhone, however, is made for such missions. We just upgraded to the XsMax, and its camera is superior to probably the first four digital cameras I owned in the late 90’s and early 00’s. Mine lives in a rugged case, since I drop it onto concrete floors at least twice a day. It fits in my pocket, is easily deployed, and the images are stellar. That worked nicely.

As for my digital transition, why a “nearly -all-digital” future? Because, dang it, I just love old film cameras, enough to put up with their quirks and the aggravations of the film workflow to use them. My Rolleiflex 2.8F stays, because its lens is stunning and it’s an old-school joy to use. I hope to have it back from overhaul by the end of the year. The Fuji GF670 folder stays, because it’s a rangefinder, it folds to compact size, the lens is great, and it’s quirky and unusual. The RZ67 and the 110 f/2 stay, because they are almost too valueless to bother with selling, and that combo is great for formal portraits, and its screen is one I can focus on because it’s that good. Plus, I have a crap-ton of Fuji instant film to use up, and a couple of RZ Polaroid back to shoot it in.

The 4x5 field camera and Mamiya TLR? Jury’s still out on those. Ditto the M6, which I only just bought in the spring. Just not sure what place I have for 35mm film, when almost any decent digital sensor bests its image quality in all the ways that can be measured. At some point I’m either going to have to cull the photographic-gear herd, or rent a storage cubicle, or get a bigger house.