20 Years of Changing Medicine

Twenty years ago this morning, I walked through the door of 1300 York Avenue ready to start a new role as a system administrator. I was looking forward to wrangling a few Mac OS X servers and seeing what life in the world of technology in academic medicine was like.

I’ve gone from racking and stacking, to conference room AV design, to software development, to web transformation, to IT experience, to institutional communications. I’ve grown from systems administrator through a complicated set of titles (and one very significant career pivot) to executive director.

I’ve worked through plane crashes, transit strikes, fires, hurricanes, crane collapses, office floods, power grid failures, earthquakes, and a once-a-century pandemic.

I’ve been welcomed with open arms, greeted with air kisses, and had my shoulder cried on. I’ve spent hours on the stage of Carnegie Hall. I’ve met Tony Fauci.

I have tried to shield equipment from a leaking ceiling, getting soaked in the process, only to be later told that the gross anatomy lab was likely the source of the fluids. I’ve unloaded a large truck full of computers in the middle of a busy NYC intersection. I’ve squashed a sizable cockroach, and disposed of it quietly, before the executive I was waiting on arrived. “Other duties as assigned”, as they say.

I’ve learned that I don’t mind public speaking, perhaps because everyone else dreads it so much. I have built some slide decks threaded with inside jokes just to pop myself.

I’ve had multiple team members pass away. No management training course prepares you to deal with death. I’ve written / edited enough institutional obituaries to lose count.

Per others, I have “solved the web”. I was once told in an annual performance review that I was “never wrong”, which went straight to my head.

On occasion, I’ve been mistreated, had doors metaphorically slammed in my face, and even had my (professional?) heart broken. But patience and fortitude conquer all things.

Some months before I started, I was entrenched in an interview with someone senior. He posed the question: where do you want to be in five years? As is my way, I was honest and open: I didn’t know. I just wanted to see where the job would take me. The interviewer scoffed: “You know that’s not a very good answer…”

I stand by it. For two full decades, I’ve absolutely let WCM take me where it needed me. I have seen my fingerprints and contributions on things, and I accept that someday they will fade. But for now, I know that I have more to do.


Ring Those Bells

It’s February 2023, and I’m standing in the back of Barcade St. Marks, quietly working my way through a two-credit game of The Addams Family pinball. Like many who grew up in the golden age of solid state pinball, it’s an old favorite.

To my right is a Data East Star Wars machine, circa 1992. It goes unoccupied until I start Ball 2, at which point I hear:

“How does THIS work?!”

It is clear whoever has approached the table is wholly unfamiliar with the concept of pinball.

Their date approaches, and tries – in a way that tries to assert knowledge while clearly not holding any – to explain.

“Oh, these buttons, on the side? They move the flippers!”

They collectively take another 30 seconds to realize they need to put coins in. By divine intervention, they find the start button.

Nothing happens. I try to focus on the game at hand, but alas.

“What do I do?!”
“Pull that back!”

Perhaps worth noting here: Star Wars does not feature a traditional plunger, but instead a somewhat unique shifter handle with a launch button on the side. This, while unusual, is noted by the display flashing a picture of it with a giant arrow and “PRESS TO SHOOT” flashing on the display every few seconds.

The couple does not notice this. They just keep tugging on the handle in frustration.

At a break in my game, I do my most gentle and smooth lean-and-point.

“There’s a button.”

“OHHHHHH. Thank you!”

Their game begins, and it admittedly goes better than someone who has never even perceived the concept of pinball before could hope to do. The ball is staying in play and not just draining immediately.

And then it is not long before a friend of the couple slides up, and the following words are spoken:

“This is just like that song, Pinball Wizard!”
“Yeah, I think it’s based on the song!”

It was at this moment – with the implication either being the Star Wars pinball table, or the very concept of pinball itself, was inspired by The Who – that my soul left my body and I departed this mortal coil, leaving two free credits on the machine I was playing.



I am, apparently, Twitter user #79,903. That’s almost 16 years on the hell site – out of what is nearing 30 years online – so it is easily the longest internet platform I’ve ever engaged with.

Like practically everyone, I don’t have much faith in what’s to come. I don’t expect it to fall apart overnight, but like most of the internet, nothing good can stay good forever. (And really, Twitter has been bad long before recent events. But it’s also had critical mass in a way few sites have.)

I don’t know quite what the future holds for Twitter. I will undoubtedly keep passively reading it and engaging when necessary. But my energy has already been going elsewhere for a while.

I’ll spare you a treatise examining years of my mixed feeling about social media and leave it at this:

A. The majority of my social energy these days in on Discord. You can find me at Remy#4558.

B. I am building a small, private Discord community of my own. I have no desire to cannibalize the other small communities I’m in. But if you want to join a small circle of folks that I’d vouch for, drop me a note wherever you normally contact me.

C. I’m also on Cohost. It’s got a very non-serious vibe that I’ve missed. The longer, navel-gazing stuff will probably still end up here.

D. I’m also, as of March 2023, on Mastodon. I’m as surprised as you probably are.

E. I’m also also, as of June 2023, on Bluesky.

E. I’m still on a bunch of other places. The ones I’m most active on: Instagram, Steam, Foursquare/Swarm, Letterboxd.

That’s all for now. Good luck and do your best.