Ménière’s Disease: Requiem for My Left Ear

This past Friday, my doctor told me I have Ménière’s disease. These two words explained a week of incessant, high-pitched ringing and pulse-throbbing pressure in my left ear, an unsteady gait when walking, and a counter-clockwise swirling of the room following any rapid movement of my head. The only action that seemed to curb it was sleeping, which is what I did. While there was much to be done, I felt like doing NOTHING!

Of course, I indulged in self-diagnosis in between waves of vertigo. Was it the result of too much coffee? Too little down-time? A simple case of the flu? I settled on three possibilities: an inoperable brain tumor (in deference to my mother – may God rest her soul – who believed in establishing an extremely severe alternative no matter how unlikely so that almost any diagnosis made by the doctor would be good news in comparison); an ear infection (where my bets were placed); and wax build-up in the ear canal (I knew this one was a long-shot, but it at least served as a balance to the first choice). Ménière’s disease?! Never heard of it!

“What is it?” I asked. The doctor offered an explanation: no one knows what causes it…could be genetic…could be a virus…there is no cure…it comes and goes unpredictably…you have atypical vestibular Ménière’s disease because you are not experiencing hearing loss in the left ear…long term prognosis is that you probably will have total, permanent hearing loss…severe vertigo can be incapacitating due to nausea and vomiting…can only treat the symptoms…surgery works in some cases to lessen vertigo. In the meantime, here is a prescription for 25mg of Meclizine to reduce dizziness…the side-effects include feeling lightheaded, sleepy, having blurred vision, change in thinking clearly…avoid driving, doing other tasks or activities that require alertness or clear vision. Anything else I can do for you?

I entered into the privacy of the doctor’s office aware of my very real, but unspecified condition. It was real because I physically and mentally experienced its consequences. And in that moment it was mine alone. No one else knew what I had or how I was affected by it, not even my wife who accompanied me. However, the doctor gave it a name. He now knew, my wife knew, and I knew and I was no longer alone with the unknowable.

The mere fact that it was symbolized with letters gave it a virtual existence extending far beyond me and touching the millions of others who have the same condition. This virtualization gives me access to the experiences, knowledge, empathy, and understanding of others; and they to mine. Because of a name, Ménière’s disease, such widespread connectedness becomes a powerful way for me to learn about myself and the result may carry far beyond the bounds of the condition. So, to start…

A Google search on the term, “Ménière’s disease” yields 667,000 results. A search of Amazon generates two pages of books, journals, magazines, even herbal medicines. There are 28 Yahoo! Groups and 3 Google Groups and almost 2700 groups across the Internet dedicated to the Ménière’s-related topics such as tinnitus, vertigo / dizziness, vestibular virus, etc. There are countless variations on how Ménière’s manifests itself and what people who have it do in response. The choices are many, ranging from pharmacological prescriptions to alternative medicines, and from low-salt diets to surgery.

It is almost impossible NOT to get connected. Clearly, I don’t know what’s next for me with Ménière’s — I could have another episode tomorrow or I could never have another one. At the moment I have no vertigo, no hearing loss, no spinning computer screen, no pressure in the ear, only a slight ringing. The prescription for Meclizine is filled, but unused. So in the moment, I go on reading more, asking more, learning more. And even if I don’t have call to use this knowledge for myself, I have it at hand in case others I meet or know are afflicted with similar symptoms and diagnoses. This potential for learning together in the future marks a distinct value of virtualization. If and when Ménière’s strikes again and the realization of the condition hits me hard, I thank all of you in the vast global network in advance for imparting your knowledge and wisdom and making me a better person for it!

Originally posted to New Media Explorer by Steve Bosserman on Saturday, October 22, 2005 and updated on Monday, October 24, 2005

A Wedding Framework

Last week, I had the distinct pleasure of participating in my daughter’s wedding. As typical for fathers of brides, I just showed up and did as I was told so as to contribute as best I could to her having the complete experience she wanted. Obviously, my participation fulfilled an essential role within a “wedding framework” my daughter spent years envisioning. However, it became obvious as the day unfolded that my role was only one of many within a complex blend of activities and sub-routines among people, businesses, and processes over the previous six months that led to the wedding framework “realization” we shared at that time.

This speaks volumes for the necessity of an envisioned framework upon which to define and queue critical activities. It is also a classic example of what happens along a virtualization — realization continuum as a total solution is put into play. As they began their wedding plans, my daughter and her then fiancé chose to get married in a small town along the coast of Maine even though they lived in the Kansas City area. I found out later this is called a “destination wedding,” or as a friend of mine termed it an “announced elopement.” In their case, neither of them lived in Maine, had been to Maine, nor knew anyone in Maine; but that was no deterrent. Enter virtualization!

Successful virtualization relies on three key elements: presence – visibility on websites, blogsites, profiles, and listings wherein a person, business, or organization can be found through routine searches; networking – chatter, buzz, references made by others that corroborate what a person, business, organization claims about themselves; and interactivity – responses in timing and content to emails, voice mails, site comments, etc.

My daughter and son-in-law brought these three elements into play right from the start of their planning. First, they tapped into their personal networks and searched the Internet for information about Maine. Their particular interest was the coast of Maine then small towns on the coast that have white churches in stereotypical settings of rural New England, followed by requisite splashes of fall colors dotting the countryside in early October. A combination of affirmative statements from family, friends, co-workers, and others within their trusted networks who had realized experiences in Maine, what they gleaned from online sources, and what was learned in exchanges of email and phone conversations with people in Maine, the destination was targeted – Camden.

Finding the location was only half the challenge. The second step entailed populating the envisioned overall “wedding framework” with virtualized pieces that nested together to create a whole virtual experience of the total solution. The same networking — web-surfing — loop-closing communication patterns used to find the location were repeated several times over the course of the six-month planning horizon with one critical difference – secondary trusted networks were available.

One of the outcomes of the initial round of site selection was the discovery, “testing,” and subsequent addition of those who passed the test into their trusted networks. These new members were local to Camden. Of course, those Camden locals knew others in their trusted networks who had the necessary qualifications and availability to fill-in the missing blanks on the wedding framework. As a result, church, pastor, bed and breakfast rooms for guests, photographer, baker, florist, marriage license office, etc. were found, their roles clarified, and their commitments sealed – the virtualized total solution was completed slightly ahead of the realized form. As a backup, the local trusted networks had sufficient redundancy that in the event of failure with one of the contracted parties another was quickly available to step in at the moment of realization to assure success.

My daughter and son-in-law had a wedding framework in mind from the start. They went through the steps necessary to find and integrate the people, businesses, and organizations required to first virtualize, then realize their “total wedding solution.” Such an integration role is central in putting together and carrying out any complex project or initiative. Successful “integrators” build new, penetrate existing, and connect interrelated networks. This skill enables them to take a framework of their or another’s making, organize it into a latticework of interconnected cells, and then pull from dense webs of resource networks to “fill” each cell with multiple layers of possible responses. It is a skill that is becoming THE key differentiator among those who are seemingly equals. It is one that my daughter and son-in-law executed flawlessly.

Just as “beauty is in the eyes of the beholder,” my description of a virtualization — realization process that was wonderfully done means nothing unless the one it is about agrees with the result! When describing the experience as her wedding day was winding down, my daughter said, “It was PERFECT!” There is nothing sweeter to the ear for a dad than to hear his daughter say this. So, indeed, it WAS perfect!

Originally posted to New Media Explorer by Steve Bosserman on Friday, October 14, 2005

A Solutions Triptych, Panel III: Value Proposition Redefined

The virtualization-to-realization continuum introduced in Solutions Triptych, Panel II portrays two different sets of activities on either side of a portal through which identified opportunities for solutions are met by packaged and delivered solutions. The graphic below expands on this concept by highlighting adjoined, three-dimensional “conversational spaces” representing virtualization and realization separated by a porous “communications grid.” The portal acts as a conduit between them directing the flow of conversations taking place on either side and through the grid.

The forums and agendas within these two conversation spaces are highly interdependent. While the virtualization characteristics (intuitive – intelligent – integrated) and realization characteristics (cost – quality – schedule) are certainly different, they are of mutual interest to the customer and the solution provider. Both strive for improvements in cost, quality, and schedule and both see the direct benefit in terms of better realization performance from wider adoption of virtualization characteristics.

The forums and agendas for solutions-focused conversations and the subsequent flow of solutions through portals are also shaped by the type of solution considered. The diagram below illustrates the three solution types introduced in Panel II – product, system, and total – positioned in the conversational spaces. Also captured in each type are the order and distance between the “point of virtualization” (PV) and “point of realization” (PR). These relationships have a direct bearing on the way in which conversations are conducted and their results.

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A customer’s negotiation with competitive businesses in the selection of a product solution is not the same negotiation when choosing a system solution or total solution. In other words, the value propositions are not the same requiring different formulas to reach a decision. The defining factor for a value proposition is who is doing the integration and why.

In product solutions, the customer is the integrator. The customer is the only one who knows the context in which the product solution being proposed fits. As a result, the customer is in control of the integration of multiple product solutions into more complete and comprehensive system and total solutions.

In the opposite case, a business playing the role of integrator delivers a total solution to the customer. The business is in control of the integration. This assumes three conditions are met: the business understands the context in which the customer operates; second, the business is capable of delivering a better, more cost effective total solution to the customer than the customer could have done alone; and third, the customer has viable options for spending time and energy other than doing integration. Missing any of these three conditions and the value proposition crumbles resulting in unmet expectations for all concerned.

As is often the case, the truth rests in the middle as with the center graphic where the customer and business share integration responsibilities and co-manage expectations. This middle ground produces opportunities for businesses to check contextual understanding and for customers to play with integrative alternatives. The resulting value proposition grants businesses the latitude to “virtualize” an array of system solutions before building inventories of realized product solutions that may or may not be sold and turned. Meanwhile, customers are able to experience system solution alternatives in virtual space before making a buying commitment to a set of product solutions that may or may not integrate effectively or truly be responsive to actual needs and wants given the context.

This suggests that customers and businesses give strong consideration to three sets of questions within the conversational spaces separating them as their negotiations begin:

Business: What is the customer’s context and how do I describe it so the customer knows I know?

Customer: What is the scorecard I follow that lets me know a business truly understands my realities?

Business: What can I do to make the customer’s virtual experience with solution alternatives more intuitive, intelligent, and integrated?

Customer: What can I do to make the real experience fit within the cost – quality – schedule parameters I have?

Business: What alternatives can I offer that capture the interest, curiosity, and commitment of the customer in lieu of doing integration?

Customer: What are the unrealized opportunities I can pursue if I had the time, energy, and capacity to do so?

These question sets constitute new agendas for businesses and customers to use in their conversations with one another as they BOTH learn to adapt to rapid changes in information and communication technologies. In fact, this learning about, with, and from one another – business and customer – is an essential feature of the shift gradual, but inexorable, shift to total solutions. Then again, isn’t learning the point behind whatever we are doing, or if it’s not, shouldn’t it be?

Originally posted to New Media Explorer by Steve Bosserman on Friday, October 7, 2005 and updated on Saturday, October 8, 2005

A Solutions Triptych, Panel II: Virtualization and Realization

Solutions, as they are defined and delivered in response to identified needs and wants, are manifested along a continuum of virtualization-to-realization. In the graphic below, the uncolored image of the portal diagram from Solutions Triptych, Panel I becomes the background over which the dynamics of virtualization and realization are shown. The portal acts as a lens to focus that which is conceived virtually in preparation for its eventual realization in physical form at a later time.

As information and communication technologies extend their capabilities, three key characteristics of virtualization will accelerate the pervasiveness and rate of adoption for these technologies:

Intuitive – human interaction with them will become easier and more transparent
Intelligent – they will become more human-like in their functioning so that people are able to engage in other activities rather than tending to the technologies or what the technologies are designed to do
Integrated – interfaces between one technology and another and one component in a system with other components will be designed so that the components in a system can be upgraded and the system’s overall functionality and effectiveness improved without having to replace the entire system

In fact, as people become more experienced with and confident in virtual solutions meeting or exceeding their needs, their expectations for more intuitive human factors, more intelligent functioning, and more integrated features will grow. The result will be a decided pull from customers for business investment to continue in developing even more powerful virtual solutions.

However, that which is virtualized must be realized at some point either with the means to experience the solution satisfactorily in virtual space or with tangible goods. The flipside to the three virtualization characteristics is another set for realization. These are extensions of what is commonly experienced within most manufacturing operations, namely:

Cost – related to the business providing the realized solution and to the customer who is “investing” in it
Quality – how well the realized solution performs according to specifications and for how long under diverse / changing conditions
Schedule – when the realized solution is available from the business and when it is needed by the customer

The perennial challenge within industry is how to balance these three realization characteristics. The rule of thumb in management is to emphasize any two of the three depending on the tolerance of customers then develop strategies based on those and letting the third “float.” This is not an ideal circumstance in which to manage, but a conundrum of significant familiarity with those in industry!

Through rapid and marked increases in virtualization techniques and capability, the formulae for managing the realization characteristics have changed. The diagram below illustrates some of these dimensions.

At the heart of the virtualization-to-realization transition is the spatial and distance relationship between the point where the solution is virtualized and the point where it is realized. For instance, in the bottom relationship one product solution goes to many customers. The “point of realization” (PR) precedes the “point of virtualization” (PV) as inventory is produced then presented to the customer through virtual presentation in hope that sales are forthcoming, inventory is quickly turned, and the cycle repeats. The customer has little influence on the specification and utility of what is represented by a particular business. Instead, the customer exercises choice by cost – quality – schedule comparisons among competitors offering similar solutions.

In the middle relationship, a system solution is packaged using components from “some” providers then delivered to a well-defined market segment comprising a distinct “some” set of customers. PR and PV are in very close proximity to one another. The customer has more direct influence over the specification of the system solution rather than component parts. Businesses are able to facilitate the customer’s choice by offering a wide range of configurations and feature combinations along a relatively lengthy decision-making timeline. As a result, the customer has longer to consider the alternatives in virtual space before making a final selection. Also, businesses can defer adding inventory until the last moment when the customer’s decision triggers realization of a solution already sold virtually.

The top relationship shows how a much larger population of “many” businesses bring products / services into a total solution in response to well-identified needs and wants of “one” customer. In this instance, the PV precedes the PR and each customer has the latitude to experience a total solution tailored specifically for their situation and distinct requirements. Oftentimes, the virtual experience of the total solution is so effective that the customer can sharply reduce the investment in physical / tangible assets required to realize the application value of the solution. This is a win for both the businesses providing the solutions and the customers acquiring them as the costs of operating in virtual space are much less than with tangible assets. While the conversion of virtual experiences into physical applications will be the mainstay in many transactions, it is trending such that this will be less the case as time goes by. This is significant for businesses and customers everywhere!

These three relationships – one to many; some to some; and many to one – play across a larger continuum of commoditization-to-customization depicted with the arrow in the background. Depending on the capability of a business to influence the juxtaposition of its “point of virtualization” to its “point of realization” determines the guidelines for an appropriate strategy for that business. Those that can adopt more intuitive, intelligent, and integrated information and communication technologies are better prepared to differentiate themselves from competitors by presenting highly customized total solutions in virtual space. Those less willing or able to do so focus directly on going head-to-head with competition in the delivery of singular products and services with a more favorable cost – quality – schedule result in the eyes of customers. An “appropriate strategy” keeps the PV and PR aligned with placement on the commoditization-to-customization continuum. This assures care is taken for the transactions passing through its portal from virtualization to realization, which is the real significance of any thoughtfully considered and well-executed business strategy.

Originally posted to New Media Explorer by Steve Bosserman on Saturday, October 1, 2005 and updated on Monday, October 3, 2005

A Philosophy of Solutions

There are myriad ways in which we humans understand ourselves and our needs and wants within our experiences of the world around us. Self-awareness coupled with the dissatisfaction resulting from unmet needs and wants motivate us to influence circumstances in an effort to have a more favorable experience—to find a solution. Contentment, if ever achieved, is fleeting. The viability of a solution just found crumbles in the face of curiosity, “antsiness,” or ennui as further needs and wants rush in to renew the cycle. While this predicament may appear to be a routine fueled by frustration, the continual search for solutions is the creative impetus that advances every aspect of human civilization.

Solutions exist at multiple levels. The one most familiar to us, personally, is at the mind level. Despite our immediate circumstances we can always dream about a reality quite different from our current condition. In the realm of the imagination all realities are possible. Even though I may not have the details, the mental world in which my solution is envisioned is different than what I experience in the physical world; and it is preferable. This reality envisioned is a powerful construct, that when acted upon externally has the potential to bring a solution into existence at other levels.

Solutions stated are externalized. Whether verbalized, graphically represented, or physically demonstrated, the act of moving a solution from the mind to the surrounding world externalizes the solution. It becomes an agenda item in a forum outside myself and initiates conversation with others. Those in my family or community or workplace react to it by doing nothing or something, but react they must.

Solutions experienced externally are virtual or material. For instance, I can play soccer on a real field in a real stadium with real teammates and a real opposing team or I can play soccer on a virtual field in a virtual stadium with virtual teammates and a virtual opposing team. In the first case I am required to be somewhere at a specific time with the proper equipment and be prepared to expend a great deal of physical and mental energy for the duration of the game and run considerable risk of getting exhausted or injured. In the second case, I have an avatar who responds as I dictate within a virtual space wherein my teammates and the opposing team are similar representations. The game can start whenever and be played by whoever shows up online or I can make up my own players and have my own game independent of others. Fatigue and injury are still possible. However, eye fatigue from staring at the screen too long and injury to fingers and wrists due to excessive rapid maneuvering of the joystick are of a different nature!

The cost of designing and developing the material solution dictates the use of a virtual solution. When the cost of the material solution is quite high and testing is essential to manage risks, modeling that solution virtually at the outset carries significant value. Buildings, equipment, vehicles, appliances, even construction and manufacturing systems are likely candidates for designing and developing the virtual solution first to prove the concept before converting it into the much more expensive material solution.

Virtual and material solutions are transactional. Once solutions are expressed in the external world by whatever means other people experience those solutions and have conversations about them. Our desire to see our solutions be successful defines needs and wants for information, resources, and authority beyond what we can muster by ourselves to fulfill our solutions in the virtual or material realm. These needs and wants lead us to conduct conversations with others in transactional patterns to gain their understanding of, agreement with, and commitment to or permission for our solution to advance. Many times the world easily accommodates our efforts to advance our solutions and the transactions required to carry them out are minimal. Other times, though, the social and natural systems are perturbed by our solutions such that we are compelled to engage in numerous transactions to move forward with our solutions.

Transactions are economic. I need or want information, resources, or authority that others have and I must negotiate with others to get it. Either they give it to me through some altruistic motivation or we come to an agreement where I get it in exchange for something I give them. The nature and type of transactions I conduct to get what I need and want are directly related to the importance and urgency I have for my solution to be successful. As a result, transactions are governed by social convention, ethical and moral frameworks, conversational skill and savvy, and immediate personal circumstances. Transactions constitute the medium of exchange within an economic system by which solutions are externalized within the political and business arenas.

Originally posted to New Media Explorer by Steve Bosserman on Sunday, September 18, 2005 and updated on Saturday, September 24, 2005