Readers know mariner enjoys pop psychology’s simplistic but somehow relevant descriptions of various personalities. He has developed another shortcut description for the mind’s many hardwired behaviors.

There are two types of problem solving patterns: one is called analog and the other is called algorithm. An analog is a formula that finds final value based on other values that may be introduced during the process. A simple example is a need to know what the weather is like before one can decide what to do. Another example is when computers learn from repeated processes; each time the analog is run, new information identifies relevant facts and discards irrelevant values. Eventually, a finite value is determined.

A person who problem-solves with an analog is a person who doesn’t know the final solution so they begin filling in values in an effort to know what the solution might be – an unknown at the beginning. The human pattern is a person searching for some fact like what shirt to buy, what carpet to select, what destination for a vacation, browsing in a library looking for something to read or any situation where the final value is unknown. This is a repetitive process and is prone to indecision.

A person who knows what the solution is upfront will execute an algorithm to accomplish the desired, already known conclusion. This person has one solution in mind and does not consider variations. Simply, the person constructs a formula of activity that leads to the predefined answer. The algorithm process is prone to failure if the final solution in fact does not exist. For example, how many times has one gone to the pizza shop for a cheese pizza only to discover the pizza shop is closed?

To humanize this a bit, generally, male shoppers will know exactly what they want, walk into a store, find the item, pay for it and leave. Generally, women will walk into a store looking for variables that may reveal what the item should be. Mariner dislikes depending on sex as a constant but his experience has shown the tendencies to be sexually oriented.

Mariner’s wife uses a term, ‘male pattern blindness’. Basically, it means if the product is not where mariner thought it should be, or its size is unexpected, or its display has been changed, mariner will not find it. Sadly, this is true. Mariner leaves home with a distinct image of the solution and if it isn’t there, the algorithm fails.

On the other hand, mariner’s wife has been searching for new carpeting. She is still searching . . .

When mariner’s wife read the draft of this post, she suggested the analog/algorithm was not new; it is a behavior difference that goes back to the days of hunter/gatherer.

Ancient Mariner

Every four or five years, mariner takes his hajj to the Mecca of modern medical diagnostics: the MAYO Clinic in Rochester, Minnesota. He has now returned from his visit. It occurs to mariner that this is quite an unusual experience totally unrelated to normal doctor/hospital experiences. So here is an accounting of his recent trip to MAYO:

Imagine that the reader has a large room in their house where a nationally recognized physician from every medical discipline that exists is waiting. They are waiting for the reader to come into the room. Brain problems? Covered. Bone problems? Covered. Any internal organ problems? Covered. Runny nose? Covered. Back pain? Covered. Sore toe? Covered. Dementia? Covered. Depression? Covered . . . The reader gets the idea – name an irregularity, it’s covered.

But the reader’s room may not be large enough to hold the activity of MAYO. Does the reader have a room that can hold ten buildings, five of which have 18 floors and altogether cover eight square blocks? Does the reader’s room have a walking subway system that connects not only all the MAYO buildings with four separate elevator systems but nine hotels and parking, two shopping malls, US Post Office, and four national banks? Perhaps in the backyard does the reader have room for fourteen more adjacent buildings containing innumerable independent health corporations?

Within this small city, the reader first will meet a reception doctor who has a role similar to a primary care physician. The doctor will interview the reader at length based on at least six in-depth questionnaires completed before the reader actually visits MAYO. This doctor will establish and manage the reader’s itinerary. Unlike typical hospitals and clinics where the doctors are at the top of the pecking order and each sets their own schedule, at MAYO the reception doctor calls the shots so that as many tests and consultations as possible can fit into a typical three-day visit. This is how MAYO does its magic for more than 3,000 visitors per day.

Another unusual factor is the huge staffing ratio per physician. The reception doctor provides a chart of photographs showing each person that will have a role in managing the reader’s itinerary; mariner’s doctor had two additional physicians, three registered nurses, seven practical nurses, three administrative specialists, a personal representative for the patient, and a specialist in medical administration.

The on-line physicians had large professional staffs as well. As an example, mariner’s several ultrasound examinations utilized a total of ten young nurses who covered most of his body with ultrasound grease; it took four uniquely trained nurses to perform just one examination, each gathering a different set of data. Each examination goes the extra mile with duplication for accuracy and the use of every kind of examination machine that can be imagined.

In each medical department at the end of examination was a consultation with the lead doctor for that department. Finally, there is a meeting with the original reception doctor who discusses an overall evaluation of the visits, results and prescribed solutions. All in all, mariner had twelve examinations and associated consultations not counting the reception doctor, special trips for preparation, bloodletting and urinalysis.

Three days – done and done.

But all the financial investment, all the expertise, all the attentive, efficient specialists – are not what is remembered about MAYO.

Who is it that must scurry between ten buildings, five of which have 18 similarly numbered floors and four separate elevator systems and altogether cover eight square blocks? Who must navigate a walking subway system that connects not only all the MAYO buildings but nine hotels and parking? Who is it that starts each day in a waiting room by 6:30AM? Who is it that may sit in a waiting room for extended periods of time? Who is it that must find a restaurant for dinner? Who is it that must time bathroom breaks according to available times?

The reader, that’s who!

What the reader will remember is the fatigue, the confusion of which building? Which floor? Which elevator? What time? East or West? Desk number? North or South? Mariner’s itinerary was modified three times. The reader will remember being lost at the intersection of several tunnel options. The reader will remember the long one-third mile walk to the specimen department. The reader will feel the exasperation of driving into the MAYO neighborhood which is not only busy with MAYO traffic but downtown traffic as well and the overall urgency of finding and parking the car in the right garage associated with hotel reservations. Mariner strongly recommends reserving the first day back home as a day of rest and recovery – especially if it’s at the end of a six-hour drive.

There are good memories, though. Setting aside the overhead of being at MAYO, one remembers the hard-working, intelligent, caring staff. The depth of interest in one’s health is remembered and the quality prescriptions for the future are genuine. One can surmise whether trying to get it all done with back home medical support could ever be accomplished – let alone the obviously superior quality. Mariner makes sure that local doctors receive a copy of his full examination as a way of ensuring quality judgment at home.

The pace is steady and tasks require continuous focus by the staff. When mariner was receiving one of his greasings, the nurse at one point asked him to push in his abdomen “real hard like you were pushing a bowel movement”. A few seconds later she turned to look at her computer screen and mariner innocently asked, “What do I do with my bowel movement?” She broke out in great laughter; it was a break from her intense focus. It made mariner realize how hard these staffers work.

Ancient Mariner