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idiopathic

282 karma · joined February 24, 2008

CEO of Patients Know Best, http://www.patientsknowbest.com Doctor, programmer and founder of start-up in Cambridge 1.0.
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idiopathic··on Germany Enters Recession: Europe's Largest Economy Is Breaking Down
Just to echo your point… USA >> EU US GDP = $23.3 trillion EU GDP = $15.8 trillion even if you counted UK (to make Europe rather than EU) UK GDP = $3.1 trillion
idiopathic··on Ask PG: Do you ever get overwhelmed?
When I was at college I read that Margaret Thatcher slept just 4 hours per night, and I was so envious, wishing I had that extra time every day. Three years ago my wife and I had twin girls and that meant very little sleep at night for me (night shifts were my responsibility as my wife still kept her paid job). In the last year the kids sleep fine, which means I get to sleep better, but strangely I still wake up after four hours without any need to. A few months ago I learned that Thatcher had twins as well :-)
idiopathic··on Ask HN: very qualified but can't find a decent job. What do I do wrong?
Please drop me a line on me@mo.md. I am CEO of a UK start up that uses Java.
idiopathic··on A Classic Startup Horror Story
"Conceptually, if very smart people did it, and other very smart people say it can't be done"

Don't forget the third part, which is what the author described, i.e. "not very smart people say they can easily do it themselves". They do not have to be able to do it, they just have to be able to convince the CEO to spend $1 million in salary on the internal delivery time to try to do it.

idiopathic··on DUDU.com Sold for $1 Million
If I had to guess, it would related to Du.ae, the UAE's second telecoms company - they have a duopoly.
idiopathic··on Want jobs? Encourage immigration
Gulf Co-operation Council countries – Bahrain (my country), Kuwait, Oman, Qatar, Saudi Arabia, and UAE.

They have separated citizenship from work visas. Anyone can come, they do not need to prove that they can do work that anyone else cannot do, and as long as their employer sponsor is happy with their work, they can stay and work. The governments compete on how quickly they approve the visas and how business-friendly they are in doing so.

The system works well enough that 60-80% of the people living in these countries are not from these countries. They work, study, bring up families and they go back home wealthier than when they left.

(I am missing out a lot of politics here, and there are plenty of things I would want to change, but the GCC does have the most open economy in the world, both for goods and for people.)

Disclaimer - I live in the UK, where my start-up is, because I grew up here as my father came to complete his studies and then became an academic here. I have lived and worked in the USA on H1-B visa and so know first-hand how bad that system is. UK has a similarly bad visa system, I am told, but I love the start-up ecosystem here.

idiopathic··on “But The Client Wants IE 6 Support”
Some historical background, which includes plenty of personal bias:

Governments, for all their posturing, love dealing with oligopolies, or even better, monopolies. They feel safer in making purchases from them. So around 2002, the UK government decided IT was so important, it was going to be done centrally for the whole NHS. They gave the job to Richard Granger, who then proceeded to divide England into five regions, each of which would have one vendor responsible for all software in the NHS for that region.

As part of that deal, they licensed MS Windows and Office. At that point, it became more expensive to use open source software than Microsoft's software. Then they standardised on IE6, and many vendors began using ActiveX.

When I ask departments to upgrade, they say they are going to do so, but first they need every single vendor to have signed off that their software works in the new browser. This will take a really long time.

Some will install a new browser for us, but this will actually result in a worse outcome for the clinicians because they have to use IE6 for most of their existing browsing, and then the other browser for us. They do not understand the point or the difference, and new browsers mean a different user interface, and they want to get on with treating patients rather than choosing between browsers.

The epilogue is that the UK government's national program wasted 12 billion pounds (about 20 billion US, ie the same amount the US government is also identically wasting to subsidise electronic health record purchases). And Richard Granger left the UK in disgrace.

He is now a consultant in... Australia :)

idiopathic··on “But The Client Wants IE 6 Support”
Let me tell you about the UK National Health Service. 1 million employees, they are literally saving people's lives every day, and all they are allowed to use is IE6.

What your statement shows is not a understanding of how to solve the problem for such a client, but a rather a complete lack of understanding. Check the audience metrics, check the real problem being solved, and leave the grandstanding aside.

And for the record, I hate IE (6 or otherwise) and never want to support it. But I am not going let me personal dislike for a technology get in the way of helping a client solve a really important problem.

idiopathic··on Immigrant entrepreneur creates 9 jobs, get kicked out of US
Agreed, this was my same thinking when I was in the USA until 2008. Sure, my employer and my wife's both offered to get us a green card, but why wait? I had applied to YC earlier that year with an idea for a start-up that was based on my living in DC and was turned down. I went back to the UK, applied with a different idea that was more appropriate to the UK / Europe. That got funded by Seedcamp, and off we went.

I have no doubt that the USA / SV is a great place to start a company, but why waste your life trying to satisfy government bureaucrats that you should be allowed in when there are plenty of other places that want you?

If you are European, you can move to any of the hubs like London or Berlin. They might not be as brilliant as SV, but they have their own advantages, and the key for an entrepreneur is to get down and make use of these advantages. Folks in the Persian Gulf (I am from Bahrain) can move to any of the hubs there like Dubai or Bahrain, and there are plenty of gaps in the market that an entrepreneur can fill by starting a company. And of course the BRIC countries have huge growth for their own nationals to ride.

So why go through the headaches of government immigration?

(PS I am really sorry for entrepreneur that this story describes. I just hope fewer people have to go through that fate.)

idiopathic··on I Hate My Smartphone
I bought the Kindle when it first out and loved it but never carried it with me, and found it difficult to read at night - so as soon as reader version came out for my Android, I used that and never looked back.

Reading in bed with a smartphone is great because the light does not bother my partner, and after two minutes of my falling asleep, the phone switches off its screen as well. Any bed lamp I use keeps me awake rather than allowing me to fall asleep.

(I know I am the exception as I have been reading on Palm Pilot screens since the late 90s - it was the only way to make sure I could get enough reading time in medical school.)

idiopathic··on Why Arabic is Terrific
Because of satellite television, I would say classical - everyone will understand you, and although you will sound formal in your speech, you will also be able to read and write.

However, you will have difficulty understanding the dialect of the person you are speaking to. And if you have a dialect that you should understand, I would say it should be Gulf Arabic (Saudi Arabia, Kuwait, Qatar, Oman, UAE and of course my own Bahrain).

Economic (thriving free markets, not just oil-funded governments) and military activity in the Arab world is concentrated in the gulf, so unless you are trying to be a tourist (Egypt), the real value is in Gulf Arabic. Note that most Arabic teachers are Egyptian or from the Levant, and will try and persuade you otherwise ;)

idiopathic··on Why Arabic is Terrific
I wanted to add my opinion as an Arab (from Bahrain), which is nowhere as scholarly as yours (I am so in awe of your linguistic nerdiness, thanks for such a lovely article).

Egyptian Arabic is dominant in a similar way to American English, i.e. Egypt had the largest movie industry and population, and everyone else could understand Egyptians while Egyptians had no need to understand other dialects.

What is interesting is the impact of satellite television. These new stations have global audiences and content that Arabs want to watch as opposed to their national censored channels. But their solution to pan-Arab broadcasting is classical Arabic, not Egyptian Arabic, and so there is a resurgence of the use of classical Arabic outside of courts and classrooms.

idiopathic··on Why Arabic is Terrific
It's not funny, it's inevitable - Arab and Israeli tribes were all Semites (which is why accusing Arabs of being anti-Semitic is annoying, as it implies that we are not Semites) they share a common genetic and cultural heritage, and their languages evolved from common roots. If you ignore the current crazies on both sides, Judeo-Islamic tradition makes far more sense that Judeo-Christian one does.
idiopathic··on Why Arabic is Terrific
A couple of corrections I feel I have to make as an Arab.

> There are the diacritics to think about, but outside of the Quran they are simply ignored.

They are not ignored - when they are present, attention is paid to them. I think what you mean is that Arabic speakers, knowing what the diacritics are, do not bother writing them down. That is not because they ignore them, it is because we have paid such close attention to them when learning Arabic that we no longer need to be reminded of them.

> That's still a big problem for a universal language of the internet though, since written Arabic is highly non-phonetic.

Arabic is highly phonetic, and if being phonetic was a criterion for being universal language of the internet, English should be disqualified immediately.

On arrival in England at the age of 10, I had no idea how English people knew how to pronounce their words. Now I know that non-Arab speakers may think the same way about Arabic because we do not write down the diacritics by default... but it is easy to buy books that have these diacritics written, and thus to crack the code.

But English seemed designed to trap foreigners into mispronunciations, to the great amusement of my classmates. (Traveling to America after college, it was mostly place names that tripped me up.)

idiopathic··on Why Amazon Can't Make A Kindle In the USA
The $20 he mentioned is for cablers and phone techs, not for programmers, if I understood correctly.
idiopathic··on Marc Andreessen on Why Software is Eating the World
Sorry to "talk my book" as well - our start-up provides a personal health records system that is connecting the UK's providers where the government's master system approach has failed - but investing in IT does not suck resources from patient care, it frees them up. I noticed this as a physician having to walk around the hospital to deliver pieces of paper. So I wrote software for Palm Pilots with a peer-to-peer encrypted handover system, gave it away, and convinced each of my colleagues to buy a Palm themselves. Each of instantly saved time they could spend on patient care, and the quality and accuracy of our handovers increased.

The problem of health care integration is not just solvable, it is already being solved (we are playing our part) but many in the mainstream are still expecting a big system approach and thus missing the small pieces, loosely joined approach that allowed the internet to scale.

idiopathic··on Women are rejecting marriage in Asia. The social implications are serious.
East Asian would do just fine. Just because the largest land mass in the world contains lots of people does not mean we have to label them together.
idiopathic··on “Real Names” Policies Are an Abuse of Power
My wife hates Facebook - people keep on tagging her and our kids in photos, thus reversing our efforts at keeping our photos private. She only logs in so she can remove the tags.
idiopathic··on Phone-hacking whistle-blower found dead
I had thought the same thing until I read the comment from anigbrowl - police are not saying there is nothing to investigate, just that, in UK police jargon, there are no obvious signs of a homicide.
idiopathic··on Why My Father Hated India
I do not agree with you, but regardless, the example you gave - South Africa - proves the point of the person you were replying to, i.e. they "won", so it is easier for them to forget. Not to take anything away from the extraordinary sacrifices of the native South Africans, but at the end of the day, they got to rule their land again, while the native Americans - and the Palestinian - never got to.

PS this is separate from the issue of whether the land belongs to native americans, native africans, or palestinians, I just mean that getting what you were demanding to be yours makes it easier to forgive previous wrongs.

idiopathic··on Going Paper-Free for $220
What you are describing is not American vs UK attitudes, it is the joys of being a foreigner encountering government bureaucracy designed to remind you that you are a foreigner.

I had the same treatment you are describing when getting my H1B visa in the USA from the UK. And things got even worst when my employer started to apply for greencard, and so I just left the USA.

From a private sector perspective, I had more things paperless available to me in 2003 - when I moved to the USA - in the UK than I did in the USA. And during my time in the USA, I was able to run all of my UK business and government transactions online.

idiopathic··on Long-Prized H-1B Visas Lose Cachet
It is scary, and they will fire you. That scared me a lot. My first job was with the US Federal Government (I was a scientist at NIH) who had nicer terms, plus a reputation of not being able to fire egregiously bad employees.

But then I switched to the private sector and I have since seen that company fire lots of people quickly. To be fair, none of those fired quickly were H1B holders, and the US citizens who were fired were given very generous severance payments (this is a management consultancy that knows former employees are future customers).

My advice is to accept it, and then feel liberated by it. The same contract allowed me to leave my employer without feeling guilty, which is exactly what I did when I wanted to start my own company.

For me, the turning point was when I wanted to have a family. I just found the idea of being forced to leave the country when your employer does not want to sponsor you anymore too awful, especially as I had experienced it as a child when my father had a UK university do the same thing to him. We had 1 month to pack everything and leave the country.

idiopathic··on Demand Al Jazeera in the US
I live in the UK (parents were exiled as pro-democracy activists) and appreciate the same freedom of religion that you describe and I experienced in the USA. No social pressure, some people don't like me, but none can stop me and nor can I stop anyone else. This is wonderful.

I spent 5 years in the USA and what I loved the most was to read US history. Living in DC, I joined a bunch of think-tanks and saw how vibrant the political life is. And I was an admirer of the USA because of its amazing history, just as you say.

I just think the USA can do better than it currently is, and closer to what it is capable of being. I think it lost its ideals and drifted from the honour of a republic to the tragedy of an empire. The UK of course has the legacy of a more cruel empire, and no country in the world is free of blemishes. (And the Arab world is a basket case making its own recovery.)

But I just felt so sad when comparing what I saw Americans do - amazing people, such a pleasure to be around - and what their government did in their name - locally and internationally.

idiopathic··on Demand Al Jazeera in the US
They already have a presence in Washington, DC, and have invested heavily in their newsdesk there. The problem is that no cable network will carry them, even though plenty of people would want them carried.

From my time, I would say that America is a land of free thinking and tolerant people, but not the land, and sadly not the land I had wanted it to be. (Am an Arab who had long admired the USA.)

idiopathic··on San Francisco Doing Everything It Can To Drive Zynga And Twitter Away
My understanding was the same as yours above, but it seems that if there is a valuation event – an IPO, for example – then the rise in value of all shares is counted, not just the ones which were sold.

Separately, I do not think the tax is unfair. Tax has to come from somewhere, and if SF can show a nicer environment for employees and founders to live in, then they can charge a higher price for the environment. Tax competition takes care of testing whether this is a wise decision, and there is plenty of tax competition in the region surrounding SF.

To me, tax becomes unfair if it is arbitrarily applied to some people, but not to others, e.g. letting Twitter and Zynga off, while taxing other start-ups.

idiopathic··on San Francisco Doing Everything It Can To Drive Zynga And Twitter Away
Ah, OK, now I understand a problem I can agree with - so it's not so much the damage from paying 1.5% on a profitable transaction (employees exercise options as part of winning start-up lottery) but rather the company has to pay cash for a gain it only realised in paper. So now I understand why they were saying a company going for IPO would have to pay most of the money raised as taxes, rather than just 1.5% of it.

Why is no one suggesting applying the 1.5% when cash exchanges hands? Everyone is either suggesting keeping the 1.5% as is, or scrapping it completely for stock options. But surely a middle ground allows cash for taxes as a small percentage of cash from profits?

idiopathic··on Homeowner forecloses on Wells Fargo office, becomes folk hero
That's a good point, but for me at the time, I did not know how to short. All I knew was that I should save a third of my paycheque so that, when the crash comes, I have money with which to buy a house at a much cheaper price. (By the time the crash came, I sunk all my savings into my start-up, but that's another story.) At the time, this everyone else thought this was madness because money had to go on a mortgage now, before prices rise yet again.

So my error was not that I was full of it, just that I lacked the financial knowledge to maximize the benefit of the money that I had used to support my bet.

idiopathic··on Are founders really 1000x more valuable than their employees?
I know I am being too literal, and I am sure you did not mean it, but... it is nothing like burying a child. I started a company 2.5 years ago and had twin girls a year ago. The thought of losing one of my kids makes me well up while the thought of losing my company just makes me sad. I have heard lots of people in the world of start-ups say that starting a company is like having a baby. It's nothing of the sort. (I know you did not say that, and again, I know I am being too literal, but I just read your first line and the thought of burying a child filled me dread.)
idiopathic··on How I Got Kicked Out of Y Combinator and Then Raised $1.5m for My Startup
My apologies for misinterpreting.
idiopathic··on How I Got Kicked Out of Y Combinator and Then Raised $1.5m for My Startup
I am sure I do have the story wrong, if only because I was not there. I just went on what was posted so, could the original author of the story either correct the story, or correct PG?

For "We didn't push to apply to YC", the original posting had said "I hadn't really considered an incubator like YC because we already had a product, customers, and whatnot and I thought I really just needed cash to hire a bunch of people. But one of the guys at breakfast really liked what we were doing and wrote an intro email to Harj, one of the partners at YC. It was mid-May so the application deadline for the Summer 2010 session had already passed. But Harj and I had coffee the next day, and he liked what he saw so he invited me to come interview for late acceptance."

And for "he definitely didn't split up the company for us", I was going on "So the day before YC started, I sent Paul and the gang an email letting them know that my team was changing. I didn't think it would be a huge problem. I (naively) thought that they'd just give me advice on how to navigate the new situation. But alas, Paul was not happy with the changes and told me it might put us in jeopardy of getting funded by them." In other words he did not say that you had told him the company should stay put, you had told him you would not fund him, now that the company had split up in trying to fulfil YC's requirement for SV location.

By the way, I am entirely aware of a third possibility, i.e. that you are both right, and that two different people can have correct but different memories of the same situation. But the story as it was written did not make YC look good, even though the author is promoting it with cheeriness as coming through adversity.

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