Find Info On & Articles by Dr. Sema Kahn

Client

Time allotted for task: 60 minutes

Dr. Sema Kahn is a surgeon at Northwestern Memorial Hospital. I have heard that she has written an article on doing mastectomies (removal of breast) in patients with metastatic (Stage IV) breast cancer.

Please do some web research (and academic library databases if you have access) to see if you can find this or other related (e.g., breast cancer, metastic breast cancer) articles and information about Dr. Sema Kahn.

Send me PDFs or links to articles and web pages as a summary.

Assistant

You can find all my research notes and references in this Google Notebook.

The first article, which I think is the one you are looking for is called “Does aggressive local therapy improve survival in metastatic breast cancer?” I was not able to find a copy of it through my university library. It is found in MEDLINE and the PMID is 12407345.

The second article, by the same author, “Does resection of an intact breast primary improve survival in metastatic breast cancer?” was available through my university. I want to be careful about circulating documents that have restricted access however. What is purpose of using the document, if this is one you are interested in?

Let me know what steps you would like taken from here, if any.

Best!

60/60 minutes used

Client

Thank you! I would love to see the article that you referenced at the end, and I appreciate your respect for the intellectual property represented by this article. It’s been a long time since I’ve been in school, so I don’t recall the appropriate uses of these databases…so please use your judgment and only send if the following fits the criteria.

My mother is a metastatic breast cancer patient and we are considering having her see Dr. Kahn for a consultation. The types of treatment that Dr. Kahn is researching are rather controversial in the medical field (some dr’s believe they can help, others feel it’s not worth it because the patients are terminal anyway). Since Dr. Kahn is doing this cutting edge research, I’d like to learn more about what she’s finding before making a decision to have my mother see her or not.

Thanks!

Client

Follow-up Question: I clicked on the link for the first article you referenced (”Does aggressive…”) but couldn’t find how to access the full article. Can you instruct me how to get to the full text of the article?
Thanks!

Assistant

Thanks for the info. I found an option that permitted emailing the document. You will find the the second article “Does resection of an intact breast primary improve survival in metastatic breast cancer?” attached as a pdf document.

RE: Follow-up Question
I’ll need to work on keeping the Google Notebooks a little cleaner and easier to follow. There was no available link to the full text version of the document as referenced in the Google Notebook; however, after digging a little more I found that you can access the first document. It’s a little patient research thing that allows the patient or friends/family to receive the document and print it off–includes a handling fee of $4.95. Click Here to begin accessing the article and follow the steps to have it sent to you. This should be a good route to go.

20 additional minutes were used.

I recently took an airplane-ride-skim of a little book called 30 Days to a Simpler Life. It’s about ten years old, but the advice was largely still relevant. One of my favorite takeaways was to

Simplify before you organize

It makes perfect sense when you read it, but it’s easy to work quite differently. Whether you’re looking at too many shoes in your closet, projects scattered around the office table, or even todos that are rolling around in your head, the tendency might be to think “okay, I need to put all this in a nicely structured system, and then I can decide what to do with it all.”

wrong.

Instead, whip through whatever mess you have and mercilessly delete things. Delete might mean throwing it in the garbage, recycling it, giving it away, or crossing it off your mental list before it ever sees the light of your GTD app. In the end you’ll spend less time organizing, and you’ll buy less stuff to organize with.

Here was my original request:

I’d like to take my wife to either an evening or a matinee (daytime) show of Wicked in Chicago within the next two weeks. Please give me the basic prices and availability for buying direct from the theater. Also do a quick check on Craigslist for any decent offers.

And here was the response:

The prices vary based on the seat, and the day. If you go during the
week (tuesday through thursday) the prices range from $32 (per ticket)
for the upper balcony to $85 for the front row. If you go on a weekend
(friday through sunday) the prices range from $37 for the upper
balcony to $90 for the front row. I am not sure that these are the
right prices, however, because on craigslist wicked tickets are selling
for over $100, but those prices are taken directly from the Wicked,
Chicago website.

There are a pair of tickets for sale on craigslist for $89 each, but
they aren’t front row.

I also happen to know about a little local secret. There is a drawing
held before each evening show, where if you win you can get one or two
$90, front row tickets for only $25 each. They only draw 10 people,
but it’s worth a try. Check this website for details.

You can probably guess what comes next…

I asked Hank to show up for that drawing each day he was able to for the next week. But he only had to go once. He won tickets that first evening.

My wife and I tucked our daughter in bed and had a neighbor come over to the house. We drove downtown, pulled up in front of the theater, exchanged our car keys for tickets on row B, and Hank took the car back home to relieve our neighbor from holding down the fort.

Hank moves back home to California in a month, after which he’s headed off to Hawaii for college. I know he’ll continue to do great “virtual” work for us, but I’ll certainly miss having a local!

I’m not even going to look at all the other great advice out there, let alone try and steal from it. The list below– whether helpful, useless, fresh, or seemingly-unoriginal, is just from my own little experience.

#1- Business or personal. Take your pick. Can’t decide? Create two blogs. It’s not hard. I’m cringing at the thought of approaching another election season here in the U.S., because it means I’ll have to wade through all the politically charged garbage from blogs that I usually look to for helpful Actionscript snippets. That doesn’t mean you can’t incorporate your personality and personal experiences into your site- that’s part of what makes for interesting reading! Just save the completely off-topic stuff for Twitter or Facebook.

#2- Draft and wait. This post was like a lot of others- it sat in my WordPress database as a bullet-point draft for a couple weeks. Then I came back and filled in the blanks, and let it sit for a few more days. It’s not that I’m trying to be a perfectionist. It’s just that the internet has made people forget the value of rough drafts and iterations. Thanks to search engines and archives like the internet way-back machine, retracting your words is almost impossible online. As I look back through the posts in this site, it’s obvious to me (and perhaps to you!) which posts were flung out to the world 10 minutes after they first sparked in my brain.

#3- Pace yourself. We don’t need any more short-lived blogs. Most of them go like this:

• First post: “hey, my friends convinced me to start a blog.”
• Second post: “here’s what I did today. soon I’ll upload some photos.
• Third post: “sorry it’s been so long since I’ve posted. But I just made a resolution to start posting more regularly!”

In keeping with my #2 advice, I actually jotted down ideas for this site for almost a month. I had about 20 rough drafts before I even bought the domain name. I didn’t end up posting all those drafts, but it helped me determine that this would be more than just a two week novelty.

#4- Don’t apologize. It’s okay if you haven’t posted for a while (especially if your blog is more of a personal one). You have more important things to feel guilty about. Other than your mother, your readers are not sitting there bored at their computers, just waiting for you to post something. If they are, I hope you’re making a killing off your Google Ads!

#5- Learn to link. It’s not just about saving your users from 5 seconds of Google searching. Linking to sites and books (instead of just mentioning them) is proper web etiquette. You’ll help that site get better Google rankings. They’ll be able to see where their traffic is coming from. And it’s not uncommon that you’ll end up hearing back from that site owner and making some interesting connections.

If you know of a “top # tips for blogging” post that’s especially useful, feel free to drop it in the comments.

Looks like GetALife360 is yet another “we have an office in the U.S. but we’re really in the Phillipines” personal outsourcing service. On their homepage, they state:

honesty is our only existing policy

That’s why I was particularly surprised to see one of my most popular posts pasted on their site verbatim, with no attribution. Our lawyer made a call and in less than an hour it was removed.

You might be tempted to call it an honest mistake, but as of right now, they still have the post they stole from AllBusiness.com sitting on their home page. Apparently they’re considering these matters on a “case by case basis”

UPDATE: They’ve now taken down the AllBusiness article as well.

Have a great weekend everyone!

I’ve been having George do more of the initial exploration. This week he introduced me to Google Notebook. Last week he experimented with creating forms that insert data into Google Spreadsheets. In the past few months we’ve been playing with:

• RescueTime
• GrandCentral
• Wufoo
• the new multi-user Backpack
• TripIt
• Google Apps for your domain

…and a handful of others. It’s usually the case that trying to “half-outsource” a task results in really inefficient use of time; I generally prefer to hand the whole thing over. But in these cases it’s worked out really well to toss ideas and findings back and forth. I spend less time than I would if I were on my own, but I glean as much (and often more) information about the tools.

Our setup is pretty simple. Using PayCycle we can have assistants set up as contractors, and then send off checks really easily. We have also used PayPal in some cases.

If you pay them less than $600 in any given year, then nothing further is required. If you go beyond the $600, you’ll need to have them fill out a 1099 form, and submit a copy to the IRS. I have no idea what the ramifications are if your assistant is not based in the U.S. We’re all onshore here.

And of course if you don’t wanna mess with all that, you can just use an outsourcing service (sorry, couldn’t resist).

I’m talking about BBQ! With spring (finally) in the air, it’s time for some outdoor cooking. Unfortunately, I neglected to give my grill a proper cleaning before the winter hit. Armed with a couple scrubbies and a healthy dose of elbow grease, Hank brought back the proper shine.

Afterwards he dropped off some batteries for recycling and picked up the dry cleaning- similar to tasks I’ve already written about. Hank will be busy for at least the next month continuing to do these same kinds of tasks, so next week we’ll switch back to highlighting some work from our remote assistant (George).

* photo by gretchen

I wanted to work full-time on my own projects, teach some classes at my graduate school, travel, and return to my entrepreneurial roots as a speaker at my undergraduate university. Forgive me the self-indulgence of retrospection, but it’s been rare for me to set goals like that and actually achieve them in a timely fashion. Suffice it to say that we couldn’t have asked for more. We feel very fortunate that we can keep our lives headed in this direction.

The coming year is going to be a wild ride for us. I can’t wait to see how it all plays out!

So, I sent Hank to Home Depot to pick up a few basic supplies; a putty knife, some sand paper, and a paint roller. After I gave him some quick instructions, he took over. It’s easy to tell there’s been some repair work if you look, but it’s a great example of how sometimes good enough is good enough.

This weekend I’m in Miami at the IASummit. I present in an about an hour as part of a panel on Practical Prototyping.

Next weekend I’ll be in Toronto at FITC. It’ll be my 5th year in a row going to this one- it’s always a great time.

If by some chance you’re attending either of these conferences, give me a shout!

I decided to have my assistant George track down contact information. I tried to provide quick details for some of the contacts, like where I knew them from, where they worked, or if they might have a new last name through marriage.

Two weeks later, George gave me an update on his progress.

Jed,

I have contact info. for 10 of the 13 listed. For the other three, I have made some progress. I have provided two listings for xxx which are in the same area. I have emailed someone who might be able to provide an email for xxxx, but his info. is otherwise unlisted. Finally, I have had little luck tracking down xxxxx because I don’t have her new last name. I can dig a little more on this one if you would like, but I’m not certain I could find her contact information if I did.

-George

I asked him to spend another 30-40 minutes on the last contact, and he provided me with two possible listings. Neither of them were the person I was looking for though.

1. You can make money. This is important if the costs of outsourcing are making you hesitant.
2. It’s non-urgent. That means both low-pressure for your assistant, and something that you’ll probably never get around to doing yourself.
3. As a side benefit, it helps you unclutter your life. We all need that.

While you can get half the benefit by having a virtual assistant list and manage your sales, much of the hassle of selling things online comes from getting your booty out of the chair and over to the post office after the item is sold.

On Hank’s first day, I dropped a stack of technical books on the table.

“Punch in the ISBN for each of these books on Half and Amazon. Find any that are selling for more than $10 and list them on the appropriate site. Take the others out to the recycle bin.”

The next time I handed him a few tech gadgets I had sitting around: an extra bluetooth mouse, a wireless router, etc.

“Search eBay history to get an average price for these items, and list them with a minimum bid of $5 and a ‘Buy it Now’ price just a couple bucks above the average selling price.”

That in itself saved a chunk of time. But for me, the bonus came when the books and items sold. I give him enough cash to cover the shipping and he takes care of the rest.

We’ve made over $300 in the past couple weeks. I’ve spent almost no time myself, and Hank’s time has cost less than $50. And now there are a few less books and boxes taking up space on our shelves.

I won’t miss the TV much, but I don’t think you understand the demons you have unleashed by hauling off my 24-inch iMac (that thing you probably thought was a huge iPod) and the external hard drive (to which you forgot the power cord).

I’ll make you a deal: bring me back that hard drive and we’ll call it even, okay? There are thousands of photos and hours of video footage from the first two years of my daughter’s life on there. They won’t mean anything to you, but they mean everything to my wife.

Regards,
-Jed
p.s. thanks for at least leaving my guitar.

Thank you Bandwagon. Thank you Flickr (I wish we used you more). And a future thank you to Undercover.

You see, I can roll out of bed in the morning, throw on a shirt, and look ready to go. When it’s late and I’m tired, my head can hit the pillow without leaving a trail of American Crew. I can give myself a haircut at 4 am, in less than 10 minutes. I can wear a tuke (that’s a snow-hat for you Yankees) without needing to primp in front of a mirror upon arriving at my destination. It takes me months to get through a bottle of shampoo.

In short, it’s practical.

But it doesn’t come without its tradeoffs. Luckily my head has a normal shape so it looks okay, but it doesn’t look nearly as fabulous as when it’s longer– when a little pomade gives me that oh-so-hottie messed-up look. My wife will be the first to tell you she doesn’t care much for it when it’s short. Maybe next year I’ll grow it out again, but not right now. There are too many things I’d rather spend my time and effort on.

Eliminating the obvious time- and space-wasters is a great first step. After you get those out of the way, it’s time to start making the tougher decisions. Your homework is to find a new “haircut.” Pay attention to your daily and weekly routines and carefully consider how much you’re getting in return from the time you put in to your rituals, routines, and habits. Maybe you can drop one of your least-favorite TV shows. Better yet, kill the cable entirely and just grab your favorite shows online or on DVD. Buy more wrinkle-free shirts. Eat Tasty Bites a couple times a week instead of cooking or eating out. Prune your RSS feeds.

Bonus points if you share your success with the rest of us!

Meet “Hank”: a 17-year old high school senior. He’s a sharp kid, and he’s finishing his last semester of school via home school. This means he gets his school work done in less time, and has a very flexible schedule. Perfect :). And of course his rate is a little lower than what we pay George (who is currently working on a Masters degree).

I wanted to test two things:

1. Outsourcing tasks that require some in-person local help.
2. Requesting and coordinating tasks in person as an alternative to digital means, even if those task could be done by a remote assistant.

It’s been working quite well. Sometimes he works beside me, sometimes he works from home. When we’re working in the same spalce, it’s really tempting for both of us to interrupt each other- him to ask little questions and get confirmation, and me to jump in and suggest and correct. While this can sometimes save a little hassle and effort, it also takes away from the “set it and forget it” aspect that makes personal outsourcing so appealing. We both try to keep the chatter to a minimum, but when it’s necessary I try to work on things that don’t require as much sustained mental focus. For example I might cook a quick breakfast while he’s walking through a vaguely-defined task and encounters unexpected snags.

I’ll share more specific examples in the coming weeks. To start, let’s take it full circle here. In my first Outsourced Wednesdays entry, I described how George helped me find a good mechanic. That was last summer, and the car is once again in need of a little tune-up, an oil change, and a thorough cleaning. Tomorrow morning, Hank will be taking care of that for us, and I’ll get a couple hours of my life back.

Ed. note: It’s times like this that I’m glad I don’t own an expensive sports car…

Last week I did it. It was under much different circumstances than I pictured 10 years ago; I originally thought I’d wait until I was a mid-40’s billionaire astronaut cowboy who flies helicopters and races sports cars. But I wanted to give the students a little different perspective. I hope I succeeded. Whatever the case, I had a lot of fun doing it.

Outsourcing starts at around the 20-minute mark. Credit is given to some of my important influences during the intro.

It was especially nice having my wife there. We’ve been married 7 years, and she’s never been able to attend any of my presentations!

Get my payroll automated

George-

I use a service called PayCycle* where I submit hours logged on a weekly basis. The problem is that every week the hours are exactly the same, but I still have to manually approve them via the website. Contact PayCycle to find out what steps need to be taken to have the payroll system automated so I don’t have to approve the hours every week.

Also, I can’t remember if there’s a way for us to easily pay Independent Contractors via PayCycle. Can you check into that?

Thanks,

-Jed

==================

Automated Payroll
You do not have the option to have it automated. However, you can go in for one month at time (or perhaps longer) to approve payment for several periods at one time. The lady reminded me that you need to do two things so you don’t create multiple checks for the same period. (1) change the pay period, and (2) change the date. I assume that would make sense if you have used the service before.

Independent Contractor / 1099 Form
They support non-employee compensation, rent compensation, and gross procedes paid to an attorney.

In order to do this sign up for one of the options: Login to your account, click on the tab ‘taxes and forms’—> then ‘overviews pay tax forms’—> and ‘1099′—>walk through the service, and sign up for what you need.

Time: 20 min.

### end task

Ed. Note: We’ve been using PayCycle for about 6 months now and I couldn’t be happier. It’s a nice web-based system for not only handling payroll, but filing all the required state and federal business and payroll taxes.

#1- I’ve used it less than I thought

Ah yes, sitting on a beach somewhere while an army of personal assistants handles every less-desirable aspect of your life. And doing it for two dollars a day, no less.

In reality, even with a great assistant and a smooth workflow, it’s easy to leave your assistant with an empty queue. And it’s not for lack of things to outsource- I got over that challenge a long time ago. The simple fact is that the more you outsource, the more outsourcing you have to manage. One key technique is to set up ongoing, repeatable tasks. Right now my assistant logs less than an hour a week doing ongoing tasks. A lot of my life is already automated, but there are plenty of routine things I still need to get off my plate.

#2- It’s more rewarding than I thought

The novelty factor in Personal Outsourcing is huge, particularly when floating your tasks overseas. It just makes you feel cool. I thought that would wear off, and it did. Despite the public nature of this site, many of my friends and colleagues have no idea that we have an assistant. Those that do know, generally only find out because I try to give some background to HTD when people ask me what I’m working on these days.

And yet, there’s still something fantastic about coming back from lunch, sitting down to my computer, and seeing an update: “made that phone call and fixed that thing.” I think to myself “instead of waiting on hold during the noon hour, I just had lunch with a friend.” Or I’ll check in on ongoing task after 3 weeks of forgetting about it, and see that it’s been successfully repeated each Friday morning as requested. It’s just nice. Using outsourcing less than I thought I would doesn’t really matter. Even a couple hours a week has a noticeable impact.

#3- I’m a demanding boss

Actually, we all are. We all have these nasty little micro-managers inside us just waiting to come out. We’re quick to justify spending a few minutes (or hours…) at work surfing the web or doing otherwise “less-productive” activities. But once the tables are turned and we’re covering the payroll, it’s easy to really scrutinize the little details of how and when work gets done, how much time it’s taking, etc. It might take a little while, but eventually you learn to let go- at least if you have a solid assistant.

Those are my big 3. Feel free to share your own surprises in the comments.

Having an online business, I wanted to know how it stacked up against our leading competitor by measuring Google search rankings. Not only that, but I wanted to gauge how my company rankings changed week-to-week compared to my competitor. This was a task for George. So I explained to him that I wanted a weekly update on the rankings posted on a Google spreadsheet.

I left this task fairly open-ended for George because I hadn’t thought through best way to format the rankings. I just provided him with a list of words or phrases to search for, asked him to come up with a format to make the rankings easy to compare, and let him have at it.

George,

I want to be able to make comparisons between —— and ——. To do this, do a Google search on each of the words or phrases below and record the rankings on a Google Spreadsheet. Come up with a format that makes it easy for me to compare rankings and then share the spreadsheet with me. Let me know if you have any questions.

Thanks,

-Jed

================

This is one of those tasks where I really didn’t want to be pestered with questions, I just wanted it done. After a couple weeks, I noticed that I wanted something changed on the formatting, so I made a comment for George once I saw the results:

Great work thus far with the spreadsheet! I’ve got a few things I want to tweak with the formatting. The goals are to be able to see at-a-glance:

1. how we stack up against — for each given term
2. what rankings have changed (for better or worse)

The spreadsheet you currently have can accomplish that, but I think we can tighten things up a bit.

With that, he made the changes, and I had a regularly updated spreadsheet with rankings for the next three months.