Biology Reference
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economy,” how such gifts pay off. For example, if one does a favor for one person, then they
will likely do a favor back later—one gift deserves another. A friend of mine ran six hedge
funds (and left before the new Great Recession) and was an expert at foreign exchange dealing
having trained with George Soros' former partner. That gift economy mentality exists in the
equity and banking industries, however, he personally disliked “tips” because they were often
inaccurate, too late usually if passed on, and then for him, it took the fun out of winning the
game of collecting the trophy. He enjoyed much more the “hunt” for new investments by
attending for example trade shows and asking the leaders in the field what the trends were and
then investing broadly in an industry. This also holds true for the earlier “gift economy” of
hunter-gatherers like San Bushmen that seems to be part of our inheritance —you can use my
water well if I can hunt on your territory—or contemporary foreign relations—you give me
one billion dollars a year and help me politically, and you can hunt Al Qaeda and Bin Laden
on my territory (the US military would notify Pakistan before a strike, partly to clear the air
space, before strikes, but after the Bin Laden attack, the open channel is no longer as before
and communication is supposedly by fax). Thus, helping out the department professor with his
project may help one get promoted or get a favor in return. The issue is much more complex in
academics than just financial. This is one reason that scientific papers are blindly reviewed
otherwise an open reviewer may give a favorable review to a paper in the hope when his
paper comes up for review in turn, the original author will return the favor.
Bruce and I run and supervise the Cleveland Clinic Main Campus and Affiliate
Cardiothoracic Surgery Program Quality of Care program and had a similar analysis of care as
the Michigan Society that we called Cause of Death Analysis (CODA) and a method of
process improvement assessment: Processes, Organization, Governance, and And Systems
(POGAS). We use these programs to track the about 12,000 patients annually for
cardiothoracic quality care in the Cleveland Clinic Health System. Bruce, as Heart and
Vascular Institute chairman, has overall responsibility for the running of our Institute, affiliates,
and the consulting we do for interested programs. Based on these quality measures and process
improvement, our team has had a particularly good first six months in 2011 with 99.3%
survival for so-called Society of Thoracic Surgery defined operations (coronary artery bypass
alone or with aortic or mitral valve surgery or aortic and mitral valve operations alone), and
98.6% overall for all heart operations at main campus (2045 patients for the first six months).
I related the story about the bear to some colleagues at lunchtime at the Michigan meeting.
My wife and I had visited a small park outside Seattle where grizzlies (see earlier photos)
were only kept behind an electrical wire and bison roamed free as you could drive passed
them and throw hamburger buns to them. One bison got annoyed with us for not giving him
more buns and promptly rammed our small Geo, ripping the rear view mirror off. A friend of
mine, Mike, told us that when he was in Yellowstone many years ago with his family,
including young kids, they stopped to photograph some bison when a woman got out of another
car and decided to try and pet one of the bison. Of course the bison became enraged and gored
her, slammed her against a car and tossed her; her intestines and stomach ripped out in front of
all the people. For a long time his children were completely traumatized by this memory even
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