It is my expert opinion that…

There are two things that can happen when a consultant is tasked to work with an unfamiliar and esoteric technology.

Either the consultant will do his own research, by looking at literature searches, calling experts and analysts, and by asking for guidance from knowledgeable individuals at the client and extract just the relevant information for a good outsider’s perspective on the business…

OR, if the consultant is less inclined to building credibility and doing his or her job, what will happen will be more like this.

Alas, because of my junior position in the firm, I am technically the rat…

A case fit for House MD

As I’ve stated before, I’m a huge fan of the show House MD. What is amazing to me is the show’s use of incredibly bizarre, but true medical cases. For example, in one of the earlier shows, House and his team make a diagnosis based on the fact that sleeping sickness can be transmitted by sexual contact. That may sound like nothing extraordinary, until it becomes emphasized that this medical “fact” is actually one reported case in a foreign medical journal. Probable? No. But, fake? Not really.

Unfortunately, consulting does not leave much time in my day for keeping up with scientific papers. I end up accumulating a pile of papers to read which just never seems to shrink. However, I was recently shook from my paper-reading stupor when A. Phan pointed me to one particularly interesting study published in the most recent issue of the New England Journal of Medicine. The AFP article which summarizes the study is simply jaw-dropping:

Girl switches blood type after liver transplant

The medical study details the struggles of a 9 year old Australian girl who needed a liver transplant due to a case of “non-A-to-G hepatitis” (translation: doctors know that something serious is hitting the liver, but they have no clear idea what it is). She is given a liver transplant from a 12 year old boy who died of hypoxia (lack of oxygen to the brain) and is positive for a normally innocuous virus called CMV (cytomegalovirus). The match is nowhere near perfect, so the girl is treated with immunosuppressants to prevent rejection.

Unfortunately, while CMV is normally harmless, it can cause problems in patients with weakened immune systems. Sure enough, the girl had to be re-admitted to the hospital 2 weeks after being discharged. Her doctors noted that the severe lymphopenia (a shortage of the blood cells needed to fight infection) that was ailing the girl prior to the transplant had persisted even 5 weeks after the transplant. The doctors had simply thought this was a combination of infection and the immunosuppressants they were giving her, so they adjusted the medication they gave her.

7-8 months after that (9 months post-liver transplant), the girl was re-admitted to the hospital for surgery due to a bowel obstruction, and it was then that they noticed that the patient’s blood, which had previously been type O-negative, had tested O-positive! This was especially incredible given that both parents were homozygous O-negative, meaning that there was no way, genetically, that the girl could produce O-positive blood. Typically, the only way a blood type switch happen is through a bone marrow transplant, which replaces the blood-making cells of our bodies with the blood-making cells from a donor — and even then, it’s accompanied by something which the girl did not suffer from called GVHD (Graft-Versus-Host Disease), where the new donor immune system thinks that the recipient’s entire body is foreign, and should thus be attacked.

A month after that (10 months post-liver transplant), after a mild respiratory tract infection (a cold or cough), the girl started showing signs of hemolytic anemia. Literally, her blood cells were bursting — something you would expect in blood type mismatch problems. Heavy immunosuppressive therapy and constant transfusions seemed only to alleviate the problem slightly. A careful examination of her blood showed that her immune cells were more than 90% from the donor, something which was verified not only by blood type, but also by the fact that these cells had Y chromosomes (results from fluorescence in-situ hybridization to the right; red dot is a Y chromosome; green dot is a X chromosome; the cell at the top is thus XX — female — and the cell at the bottom right is XY — female).

In words that President George W. Bush might understand, the donor’s new blood cells are US forces in Iraq. The remaining blood cells from the girl are scared Iraqi’s who see strangers everywhere and are prone to using guns. The hemolytic anemia is the result of the ensuing fighting. And the immunosuppresants are some magical way (maybe supplying both sides with alcohol?) to reduce the ability of both sides to fight.

The doctors had a choice. Do they:

1. Give her a drug to wipe out a big chunk of the immune cells from both donor and recipient (nuke Iraq to kill enough people, on both sides, to stop the war)
2. Stop all immunosuppressants and just let the immune cells duke it out (take off all the handcuffs on US forces and let them wipe out the remaining Iraqi insurgents and hope that Iraq is still in one piece when it’s all over)

They went with the second strategy.

It is now about 5 years after the transplant. The girl is healthy, and no longer on immunosuppressants. Her blood is now completely from the donor, despite the lack of bone marrow transplant. There has been no sign of the GVHD which typically accompanies the sorts of bone marrow transplants which could lead to blood type switching, and it would appear that the girl’s new immune system has been “re-trained” to not recognize the liver or the girl’s body as foreign.

So, the big question in my mind is how? How could a non-bone marrow transplant lead to blood type switching? The only two things I can think of are:

1. A virus caused liver cells from the transplant to fuse with the girl’s blood-making bone marrow cells. Why it may be possible:
   1. In biology labs, forcing cells to fuse is oftentimes done with viruses
   2. It is known that stem cells like the blood-making bone marrow cells are prone to fusing (a result which confused many early researchers who were positive they found examples of blood stem cells turning into non-blood cells)
2. Because the boy was so young, it is possible that the transplanted liver still contained blood-making stem cells which were re-activated. Why it may be possible:
   1. The fetal blood supply is produced, at least in part, by cells in the liver
   2. Stem cells which are dormant (e.g. the cells in your skin that can produce new skin) can be activated with the appropriate stimuli (e.g. burn)

This is all just speculation on my part, and I doubt we will ever find the answer in the case of this patient (who is no doubt sick of doctors and hospitals), but things like this are reasons why I love House and why I love science.

Honesty

You know a firm’s finances aren’t doing so well when the firm’s own analysts downgrade themselves. (Hat tip: J. Lonsdale)

From Long or Short Capital:

CIBC May Take $4.1 Billion Writedown, CIBC Analyst Says (headline has changed but the original was as we laid out). This just speaks to credibility of CIBC’s (NYSE: CM) equity research department!! ….or the fact that their equity research department just got laid off.

Now if only all the analysts I talked to were this honest…

Bringing Evil to an All-New Low

The big comic-book nerd in me can’t resist posting this bit from webcomic Evil Inc. (hat tip: A. Phan):

Seeing how I intend to attend the Comic-con this year (and given all the recent controversy over the abominable Marvel Spiderman story One More Day [how abominable will be left to individuals on blogs far more geeky than this one]), this hits a little close to home…

Basic Logic

In theory, logic should be simple.

In practice, it doesn’t turn out that way. Humans really don’t seem to be hard-wired to be that logical. The ways in which our minds defy logic are potentially evolutionary in origin — the caveman who realized that he should avoid snakes probably was better off than the caveman who refused to succumb to the hasty generalization logical fallacy and needed to rigorously connect snakes with poison and death.

While this may have served Fred Flinstone and his compatriots well, this is a more serious issue when facing professions which ought to be more logical. The tendency of people to subscribe to bizarre conspiracy theories (e.g. the 9/11 was a hoax theory), the tendency of scientists to see and count only data which supports their hypothesis while discounting or ignoring data which doesn’t (e.g. the guy who claimed he’d done cold fusion, a lot of stem cell research reporting highly unlikely findings such as cross-lineage differentiation, etc.), and the tendency of businesspeople to subscribe to gimmicky growth strategies (e.g. most corporate Internet strategies during the bubble) are just some examples of how individuals who need to be logical jump to conclusions which aren’t well-founded.

The last example I mentioned, about businesspeople, is particularly challenging as there is no clear “science of business” in the same way that there is a rigorous study of physics. Businesspeople (and the consultants who support them) have to be able to make the tricky distinction between the correct “leaps of logic” and the incorrect and potentially disastrous logical pitfalls.

There is no clear guideline for when something is a “good” leap of logic and when something is a “bad” one, but at the very minimum, consultants and businesspeople should be able to understand the following two basic types of logical fallacies:

1. The inverse of a true statement is not necessarily true. While it is true that all hotels are buildings, it’s clearly incorrect to say that this means that everything which isn’t a hotel is clearly not a building (e.g. the White House isn’t a hotel, but it’s clearly a building). A more contemporary example comes from a recent Republican debate where Mike Huckabee claimed that, “The Air Force has a saying that says if you’re not catching flak, you’re not over the target,” he said. “I’m catching the flak; I must be over the target.” No, Mr. Huckabee, a bomber deployed in Iraq taking fire because it crossed the Iranian border is certainly not over the target.
2. The converse of a true statement is not necessarily true. While it is true that all hotels are buildings, it doesn’t necessarily follow that all buildings must be hotels. This type of logical error is probably the most prevalent example, because it involves people confusing cause with effect. For example, just because a good marketing campaign boosts profits, it would be wrong to conclude that a company can attribute higher profits to its marketing campaign. Just because a good economic policy can mean an economic boom, it doesn’t mean that an economic boom is validation that the economic policy was done correctly. Just because, HIV causes a weakened immune system, it doesn’t mean that all patients with a weakened immune system have HIV.

While the examples I’ve listed seem self-evident when rattled off in list form, these are nevertheless very prevalent in the reasoning of all politicians, business executives, doctors, lawyers, and scientists. It’s why doctors are trained in medical school to avoid looking for symptoms which confirm their natural impulses. It’s why scientists are admonished when they don’t have sufficiently good controls. It’s why lawyers have to, at the bare minimum, pass a basic logic test (in the form of the LSAT) to get into law school. This is not to say that the goal is a completely logical world — the example of the caveman aside, one does not want to live in a world where doctors are paralyzed by indecision (it could be overexertion, but it could also be early stage Guillan Barre Syndrome) or where our political and military leaders wait for all the evidence to come in before acting (yes, we heard that terrorists attacked, but we wanted to see satellite pictures and get a complete situational report from a local investigation before we sent in national aid). But, given the sheer amount of illogical decision-making and its impact, I think its safe to say the world could use some basic logical training.

Life’s Little Victories

My current case is working on high-level strategy work with a tech company, the goal being to help guide their strategic thinking as they attempt to map a strategy for future growth. The case, while very challenging because of its breadth, has been very interesting, not only because of the interesting strategic questions that we are trying to answer, but also because the tech geek in me is literally being paid to learn more about future gadgets and software products.

Oddly enough, though, despite the vast amount of work I’ve done on the case on studying technology markets and technology companies, the work that earns me the highest praise from the partners and stands the greatest chance of being presented by the client’s senior management deals with, of all things, women’s deodorant.

About two weeks ago, I receive a completely unexpected email in the morning from my CTL. Instead of giving me some guidance on my workstream from the previous day concerning profit margins in different technology markets, I was being asked to do research on Procter & Gamble, the large consumer products company. It turns out that the partners on the case are trying to present the client with examples of companies who are able to be more profitable than their peers and explain how they are able to sustain that advantage — and Procter & Gamble was one example of such a company. Our working hypothesis was that P&G was able to be more profitable by effectively becoming the “premium product” in many of the product niches they attempt to play in.

The tricky part was how do we prove this? After a little discussion, my CTL and I decided that the simplest way to do this was for me to drive to the nearest Safeway and go up and down the aisles comparing the prices of P&G goods (e.g. Tide, Pampers, Crest) to their competitors.

Sure enough, I got a lot of weird looks from the store people and from the other shoppers as I canvassed the aisles looking for P&G products and their relevant comparisons. In the hour that I was there searching for products, I learned more about the product diversity of toothpaste, deodorant, detergent, dishwashing soap, than I had ever known (or wanted to know).

Worse was coming back to the office and presenting my preliminary price data to my CTL and manager, both of whom grilled me (although I could see the smirk on my manager’s face and the chuckle in my CTL’s voice as they did so) on whether or not I made the right product comparisons (is Infusium 23 comparable to Finesse? Or Pantene? Are Huggies comparable to Pampers? What’s similar to Tide? Or Secret?)

After begging for help from wiser friends (read: female friends — big shout out to J. Sasaki and K. Teng and V. Liu for all their help!), I prepared a slide showing P&G’s price premium across a number of product categories, and sent the slide out to my CTL and manager, never expecting it to go anywhere or amount to anything.

A few days later, one of the more senior partners in the firm walks by my desk and tells me that the client was very excited about the slide I had prepared and that it stands a decent chance of making it into the CEO’s presentation. Not the other volumes of analysis I’ve done on tech markets, on tech products, on tech companies, on financial forecasts — but the slide I make on women’s de-odorant, women’s shampoo, diapers, and laundry detergent, researched from a couple conversations with friends and a hasty trip to Safeway.

Welcome to management consulting, people.

The Blackberry’s Big O

No, I’m not talking about Oprah or Obama or Osama; I’m talking about Opera, the web browser.

Why speak of Opera when I’ve made it quite clear that I’m a big fan of Mozilla’s foxy open-source browser? The reason is that, with the exception of the iPhone and some of the more cutting edge mobile internet devices out there, web browsers on mobile phones suck.

1. They suck because they are capable of very little. The little pages that you see on most mobile phone screens is stripped of animations, Flash, most DHTML effects, etc — neutering some websites and rendering all but the websites with custom mobile versions as hideous blobs of letters.
2. They suck because they have horrible User Interfaces. An application does not have to have an intuitive interface like the one on iPhone/iPod Touch to have a work-able user interface. The way that the user interface on the Blackberry browsers is designed, however, is the exact opposite of work-able. The clunky interface makes it very difficult to navigate larger web pages. The browser also makes no attempt to auto-rescale websites and sizes, or to auto-detect what user interface mode makes the most sense.
3. They suck because they look and feel nothing like the browser on a computer. This may seem like a nit-picky point, but it lies at the heart of the problem with the mobile browser — it’s supposed to be modeled off software which we are all very familiar with, but it ends up falling short by not making a good effort to emulate, but by focusing more on the device’s limitations (limited screen-size and bandwidth) rather than the device’s potential (emulation to simulate most of the features from a desktop browser).

Opera Mini is Opera’s attempt to solve all three of these problems (hat tip: A. Ow). Opera Mini is a mini-browser Java app which speeds up the browsing experience by fetching all web-pages through a proxy server which performs on-the-fly calculations to rescale webpages and determine the best way for the user to start browsing the page. This is fed back to your phone, making the download faster and allowing the browsing experience to be smoother. Unlike the default mobile browser, Opera Mini attempts to strip down web pages as little as possible, oftentimes preserving the look and feel of the website (the Opera Mini demo shows what sites will look like in Opera Mini) including some Javascript and CSS.

I would strongly encourage people who either use the Internet on their Blackberries a lot or who want to but can’t stand the default Blackberry browser to download this.

On the part of Opera, this is quite a good business ploy — not only because this may mean they can one day capture the mobile browser market, but because I was so impressed with Opera Mini, I actually downloaded and tried the Opera browser for my laptop.

Link Roll

Two of my good friends have recently made very neat posts on their respective blogs.

My friend S. Chen recently described what she saw as the traits which best characterize the strange quirks of the creature we know only as Homo consultantus. I have to say she nails it quite well.:

The typical consultant…

1. Replies to emails ASAP. Especially if it involves free Celtics tickets (heehee)
2. 2 minutes early is on-time, 1 minute-late is late
3. Calls all the time. If no pick up, leave voicemail and send email and follow up within the week
4. Is nitpicky in output. Grammar, spelling, accuracy, and consistency is combed over and over and over until you’ve probably worked on the same slide at least 100 times
5. Listens and takes notes. Instructions and valuable information are only given once. If you didn’t take notes or you didn’t repeat it back and ask a question then and there, then you will look inexperienced if you’re confused later on
6. Has many, many deadlines and manages to meet most of them
7. Is eager to take initiative and plans meticulously. Favorite RSVP/opinion data captures include Excel, surveymonkey, evite, and our internal databases.

How does that contrast to normal life? Most normal people…

1. Take days to reply to an email that supposedly was urgent. Add handicap points if they don’t own a blackberry
2. 7 minutes late is on-time
3. Don’t leave voicemail. Maybe a facebook poke
4. Don’t send follow-up emails or “FYI” tidbits
5. Don’t pay attention to details in an invitation. Even if all the details are in the email – place, time, directions – people will still call or email back and ask what it is
6. Find that time is all relative and deadlines are flexible
7. Hate planning

This is a pretty good description of what the “culture” at a consulting firm is like. What does it mean when I find myself more like the people in the second list…?

My college roommate Eric seems to have absolutely nothing to do, but blog. But, on the way, he’s made his fair share of awesome posts:

• Five Tips for College and Beyond
• An awesome (and unbelievably nerdy) music video about… PCR:
• An interesting discussion on how multiple labs have named the same protein different things — particularly interesting to me, as my thesis research focused on what occurred in that particular biological system

One Helluva Sendoff

Makes me miss my video-making days… now if only I had the star-drawing power…

How Not to Handle Professional Services

In consulting, the client is king. The same is true for many professional services industries. It makes the job particularly challenging, as success involves more than just getting at the correct answer to a client’s problems, but presenting it well and couching it in engaging terms.

While it can be pretty difficult to do this well, it should be very clear that the following pitfalls should be avoided at all costs:

• Not being responsive to phone & email – There is nothing that spells disrespect and introduces doubt quite like being unresponsive to requests for contact. It makes the client feel like a creditor trying to call in some loans.
• Talking down to the client – Unless you enjoy working on answers that never go anywhere, making sure the client impedes rather than helps you in your quest for the right answer, and guaranteeing that the client never hires your firm again, stop talking down to your client, and treat them like the partners they should be. 
• Directly going against the client’s wishes – If the client says, “No, we are not going to do this,” the solution is either (a) don’t do it or (b) work with the client to arrive at a reasonable compromise. Your response should not be, “Well, we think you’re being foolish; let me now waste the next 30 minutes on our phone call pointing out why.”
• Give unclear and round-about answers to your client’s questions – “Car salesman” does not usually bring up positive thoughts — so don’t act like one. Give clear answers to your client’s questions, not answers which suggest you are either hiding something or have absolutely no idea what you’re talking about. Even if you don’t know, it’s oftentimes better to speak the truth, than it is to lie and then lose all credibility when the truth does finally come out.
• Make bizarre jokes about the nature of the relationship with the client. Being casual with the client to build camaraderie – good. Making jokes about possible means to increase the fees that the client has to pay – not so good.
• Not delivering on promises. This should go without saying, but, if you promise to email something by the end of the day, and then don’t. You apparently just don’t like having clients like you.

Why bring these up? Well, aside from the fact that these are key things that consultants (and any professional services worker) should keep in mind, I was actually on the receiving end of all of these — all over the course of one phone conversation. In an interview with a carbon offset provider (as research for my firm’s Green initiative) who had been a potential partner for us (read: we would have paid them lots of money to help us offset our carbon emissions), I experienced an example of each of the pitfalls I mentioned above. Suffice to say, they won’t be a partner if I have anything to say about it.