Bring back 2010

It’s a New Year. Whoopee! Nearly twenty days into the new year and already I long for 2010 again. I vowed years ago to never make resolutions I can’t keep (and even more directly, to never keep those that I make) and so far I’m right on target considering that my one big resolution was to blog more. Considering how 2011 started out though I probably would be better off saying nothing at all.

I spend New Years Eve in bed – alone- under my down comforter with a pair of jeans on, tee shirt, sweatshirt, my heavy winter down jacket with a hood and gloves on and was still shivering like crazy with the flu or whatever you want to call it…I can think of much better ways to ring out the old and ring in the new, but let it suffice to say the week between Christmas and New Years was sheer hell. Thankfully I’m healthy and my body won out in the end. I’d shudder to think what might have happened had I had any form of compromised immune system.

December led me to more contracts than ever before and I finally celebrated being able to relax a bit financially going into 2011. And then, just like that- poof- almost every contract that my clients had verbally committed to disappeared like Al Sharpton at a Klan rally. All of a sudden I went from what was a rancorous feast at a churrascaria to eating in the church hall with the elderly people from the trailer park our church feeds every month, people looking for a free meal and some companionship. Thankfully I had some embers in the fire that will get me through the next month or so (I learned a long time ago to never ever to put your eggs in one basket) and have few longer term contracts pending as well. Still, it taught me that once again the only thing you really can trust in is yourself.

I saw yet another long time PACS veteran pass on and while little was said about him- two short paragraphs was all- I do miss having Tom Goliash around. Tom and I agreed to disagree on just about everything since we met in the early 80’s. He was brash, he was direct, he was opinionated, he was everything you aren’t supposed to be running a company- but above all Tom was true to himself. You never had to guess where you stood with Tom- if he liked you he liked you for life, if he thought you were an a$$hole or an SOB you would hear it from his lips directly, not through third parties. As crazy as it sounds I liked that about him. He was an entrepreneur back in the days when the PACS market could sustain entrepreneurs even though almost no two products he ever delivered to his clients were exactly the same. Thankfully I don’t believe they conducted many GMP reviews back in the days of AVP and Megascan and by the time he founded UltraRad a few years back he finally seemed to have his act it all together. Tom was a dedicated husband married for 44 years to the same woman, a father, grandfather and friend and a guy who had one thing so few have in this marketplace- passion. He could have easily retired with the money he made from the sale of his company but instead decided to jump back in with both feet again after taking just a little time for himself to enjoy his passion for sailing. Tom deserved more than just two short paragraphs and while he is gone his presence will be long missed by those of us who knew him.

The day after Tom’s passing my world turned upside down yet again when my very best male friend in the entire world completely decomposed and ended up having to formally address the demons that have haunted him since his childhood days by entering a rehab facility. While his timing was abysmal-he had a week long all-expense paid vacation in Hawaii waiting for him two days later as a thank you for exceeding his quota yet again- it was bound to happen. In so many respects my friend is a huge success- he makes a boatload of money, is a super dad to his kids, is a wonderful friend- and yet he has two weaknesses. He just can’t say no and takes care of everyone but himself often at the expense of himself. A large part of his problems stem from a toxic ex wife who just won’t let go three years hence and keeps hounding him on everything from financial support (he gives her more than twice what the courts would have mandated plus pays for everything related to the kids and still it’s never ever enough) to his personal life about who he dates and what he does. It finally got to the point a little over a week ago where the only rest he got was in the place where he had taken comfort for the past 30 years. Unfortunately once he started his escape this time he just couldn’t stop escaping and needed help. I and a few of his closest friends have been meeting to put together a plan to keep him on the straight and narrow, but we all believe he needs to stop living his life as others think he should live it and instead live his life for him.

The final coup de grace was a change in my own life circumstances. For only the second time in nine years since my divorce I took the chance to get to know someone quite well this summer. All was going fairly well yet we hit a bump in the road that was more like a Florida sinkhole than anything else. As I thought about what I told my friend in rehab I couldn’t help but hear myself talking as well. I enjoy my new friend a lot yet I am trying to absorb myself into a lifestyle that really isn't me and have my friend absorb a lifestyle with me that really isn’t her either. In the end this lead to a few uncomfortable situations and misread communications which just isn't good. I am about as close to being a cowboy as Martha Stewart is to giving my house an award for cleanliness, but that's OK- I Yam What I Yam and frankly Roy Rogers I ain’t. The same can be said about her not being my divine garage sale goddess although she has gone to a few with me and done quite well. Yes, I will mourn the loss of a very dear friend if it comes to that yet I also celebrate my ability to finally open up and share MY feelings directly instead of hiding them behind a wall as has so often happened in the past. I have grown and that is good, even if this relationship did add a very nice vintage Luis Vitton bag to add to the collection of baggage my friend says I seem to carry with me. I always said though if you have to have baggage, then by all means make it the best…

I have so much to share….and yes, lots of PACS news too. Standby- it looks like it’s going to be a very interesting year…

The Last Christmas

Nearly every parent dreads the time when Christmas is no longer magical for their children. For me it happened maybe 6-7 years ago. Thanks largely to the Internet that Al Gore created by the tween years there was a fairly high degree of skepticism about Santa. By age 13 or 14 it was assumed that they knew that Santa Claus was indeed much different than the man in the red suit they saw at the malls or the Santa I played for the Cub Scouts and for his classmates in elementary school using an incredible Santa suit my ex made for me (neither son knew it was me either- that’s how good the suit was). The suit still fits, but now I don’t need quite as much padding as I did then…

This is the last year I will have my kids as kids. While they will always be my kids I could never get over my mom and dad calling my brother and I "kids" well into our 30’s- but it’s different. Nick will be home one more year attending community college, maybe longer depending on where he finishes his last two years of college, and Matt can pretty much go anywhere he wants. His first choice college is in Tennessee but he is also being pragmatic and looking at a school in Tampa as well. With Bright Futures, the Florida Pre-Paid College Fund I’ve been paying into since they were both 6, and scholarships he will no doubt get, he will be like his brother actually getting paid to go to college instead of owing the equivalent of a small town’s annual income when he gets out. But where he goes is his choice, not mine. Both young men are just that- young men- and have good heads on their shoulders. They are super smart, practical, and handsome to boot. Basically they have the world by the balls.

Nick works at the Holy Grail for Mac-aholics as an Apple store employee and did very well his first quarter in college, unlike his father whose 0.923 his first quarter in college was reflective of a belief that college was about women and alcohol and not academics. Going to an all boys Catholic High school tends to do that to you though so…That said, I’ve forgiven myself after so many years….And Matt- my IB student with a 4.3 GPA and 33 on the ACT- he has the entire world pursuing him and rightfully so….I am incredible proud of both boys…

So it’s Christmas Day. I looked over at the clock 6 a.m., 7 a.m. Not a creature was stirring, not even a mouse (or Elvis the Wonder Beagle either but all he does is sleep anyway so…). I miss the days when the kids would tip toe into our rooms at 5 a.m. and ask if we were up (we were now) and then proclaim that Santa had come while they were sleeping…of cursing the translator of instructions from Chinese to what they thought resembled Ing-rish at 3 a.m...of figuring out how something went together…of finding bigger and better hiding spots…of wrapping and wrapping and wrapping… and of course of last minute gifts that were impossible to find a day or two before Christmas- the ones you go to the ends of the Earth to find…like a streetlight….yes, a streetlight… Don’t ask, but I still have it in my closet…

This year I have to realize that my babies aren’t babies anymore but young men who are well on their well to becoming productive members of society, albeit capitalists for sure. Yes, giving them cash is so much easier and practical than finding exactly what they wanted ....but there was also a special joy in finding that one special gift they wanted…I smile every time I see the movie “A Christmas Story” where Ralphie gets his Red Ryder carbine-action, 200-shot, range model air rifle with the compass in the stock. Yes, Ralphie is finally happy but the pride his father had watching him open it resonates much more with me than anything else.

We had so many Christmases like that. After my ex and I divorced Christmas were still special but held at two houses not just one…and we always had dinner together as a family just like we will again tonight even though she has been remarried now for a few years. Thankfully her husband has welcomed me with open arms realizing it’s not about us- it never was about us- but about the kids…. and that we really do have some really great kids…

So tonight we’ll have dinner, maybe watch Billy Murray in “Scrooged” or the “Jeff Dunham Very Christmas Special” or maybe even “A Christmas Story” again and then I’ll hug them both goodnight. But this year’s hug will be more than just saying goodnight. Instead it’s saying goodbye to the end of an era that was as important for me as it was them.

Next year Matt hits 18 and technically my work is done….or so I’m told. Hopefully I’ll have the same relationship with Matt as an independent adult that I now enjoy with Nick- letting his make his own decisions for sure but still pinging the old man every now and then for his opinion. And once, maybe once, just for old times sake, I’ll be lucky enough to have them ask me for something truly unique and different- that one Christmas gift that is so hard to find- so I can search high and low, find it for them and rekindle the joy I had when my babies were still babies and Christmas was a magical time for all.

Merry Christmas to you and yours…His love never ends….

Aunt Mary

Today was Aunt Mary’s birthday. She would have been…well….old….91 to be exact…but alas she went home to her Savior three and a half years ago. Now most of you are thinking what’s the big deal about an aunt who is dead whose birthday was today but my Aunt Mary was a special aunt. She hated the fact that her birthday was so close to Christmas. God help you if you wrapped her birthday gift in Christmas wrapping paper although truth be known Aunt Mary was much better at giving gifts than receiving them.

Aunt Mary never EVER forgot a birthday. She probably had 100 or more relatives in her little black book and each and every one of them always got a card from Aunt Mary on their birthday. Always. And the card always contained $1 in it. If you were 5 years old or 50 you got a crisp $1 bill. That was tradition. And that was what we all looked forward to. Her cards were never ever late either, using nothing but a tattered old date book to keep it all straight. No computer, just her date book.

The date book is long gone, thrown out along with too many irreplaceable family photos and so much more by a cousin who appreciated nothing other than the money that remained in the family bank account. Oh, what I wouldn’t pay to have the single page with my birthday on it as a reminder of an aunt who never forgot me. Once I got older I never forgot her either, always sending her flowers, candy, or something else always wrapped in birthday paper to let her know how much she meant to me. She would always call me up after then too - I was always Michael, never Mike- and thank me. Sadly, the woman who never forgot anyone was all too often forgotten by those closest to her, even her own daughter, yet how could you forget a woman like this?

I was asked to give the eulogy at Aunt Mary’s funeral. The funeral was held at St. Anthony’s Roman Catholic Church in Red Bank, New Jersey, the church where I served as an altar boy from age 7 to age 13. I had only been in that church twice since I left New Jersey back in 1973- once for my mother’s funeral in 1990 and then again for my father’s funeral in 2004. Both times I sat in the front pew. This time though I had to go up to the altar.

When I was younger the altar was a place of mystery. Sadly the church decided it needed to be “modernized” and in the process had changed so much of it that a lot of the mystery and magic was gone. Looking around the only things I remembered were the Stations of the Cross where I had walked to many times during high mass carrying the incense, but the stained glass windows might have been there. I looked up and my heart sank- the choir loft was gone. This was the very same loft where Aunt Mary’s voice would join the voices of the other woman in the choir singing “Oh Bombino” and other songs in Italian at midnight mass every Christmas Eve right after the feast we all had that never had meat because good Catholics never ate meat on Christmas Eve….

I walked up and looked around the church. Poor Uncle Lou was beyond distraught at losing his wife of nearly 50 years, at Aunt Katie who just lost her husband (Uncle Bill) the year before, and Uncle Joe and Aunt Marnie thinking to myself “This is all that is left.” Sadly Aunt Katie passed away a few short months after Aunt Mary did and Uncle Lou went home in 2009, leaving just Uncle Joe and Aunt Marnie- two out of 16 aunts and uncles my brother Frank and I had- remaining.

I gathered my thoughts and began the eulogy. It was good….very good….and I got three quarters of the way through it and then choked up when I got to the words “This year there will be no birthday card from Aunt Mary….” For 51 years I had faithfully gotten a card from Aunt Mary and this year….the reality hit me. It wasn’t about the card. It was about the woman. You would walk in her house and before you had your jacket off she was making you a cup of tea and breaking out homemade cookies. “Sit down, Michael. I’ll make you a cup of tea” she would say… God, I can close my eyes and hear her now…So I stood there, my heart in my throat, trying to talk yet saying nothing, tears flowing down my cheeks, thinking about Aunt Mary…and then I made history….I tried to talk and got one word out then had to stop….another word…then stopped…and then a single word that probably never has and probably never will be uttered from the altar of Saint Anthony’s again. “Shit”. There I am miked up with probably 60 people in attendance and the only word that comes out of my mouth at the time is “Shit.” I heard a few laughs and realized what had happened and caught myself, laughing a bit, saying “Sorry Aunt Mary, sorry Monsignor” before I continued with the balance of the eulogy. Had Monsignor been there I know he would have smacked me upside the head big time for that and required me to say 12 Hail Marys, 7 Our Fathers and 3 Glory Be’s for my offense, but then Monsignor probably already was rolling over in his grave having the Diocese allow girls on the altar who wore sneakers at Mass AND got paid to boot- $10 each. For all I know the choir got paid as well- all 6 of them. When we were growing up there were at least 30 choir members and no one ever got paid…at least not monetarily...and only boys were allowed on the altar. It was a privilege…it was special…..it was a different time and place.

The funeral ended and we all went back to Chiafulio's afterwards for the obligatory feast (although I knew the place as Red Bank Pizza growing up) and later that night I flew home….All went well until my birthday a month later and no card from Aunt Mary..and then the emotions came welling back….And again today, three and a half years later, on her birthday, as I wrapped Christmas presents I saw the birthday wrap too and remembered the woman who never forgot.

If anyone is in heaven it is my Aunt Mary so happy birthday Aunt Mary- take care of everyone until I get there. Know you never have been and never ever will be forgotten.

The Lighter Side of RSNA

There is a side of RSNA that few see- the lighter side. The PACSMan Awards are a blast to write and post on AuntMinnie.com and nearly all are done tongue-in-cheek with a lighthearted attempt at humor. Inevitably someone will think I am vindictive and have a vendetta against their company but that simply is not the case. This year as in years past they were the top read story from RSNA so someone must be enjoying it. If you missed it you missed out, but something tells me if you are reading this blog that you have no doubt already read them in some case many times trying to figure out who won what award. I'll never tell..

Many know of my relationship with Merge- a love/hate one if there ever was one. We should get married but one walk down that aisle is enough for anyone or at least for me. But I’m still friends with many who still work there, including Paul Merrild, Merge’s Senior Vice President of Marketing & Corporate Strategy. Paul introduced me to Justin Dearborn and Jeff Sturges, their President and CEO respectively (even though Dearborn was their CEO before he became President. Talk about Abbott and Costello’s "Who’s on First") but alas Mr Ferro remained as elusive as ever talking only with my good friend the Dalai. Maybe if I had accepted their offer of a glass of Kool Aid I would have gotten to see him, but I limited myself to just a lil candy from their voluminous candy rack (another Merrild trademark) and a cocktail or two at their party. Everyone was cordial to me as well and there was no animosity as well. Paul even allowed me to play on the video games and personally handed me the gun as seen below. You can feel the love can’t you?

Everywhere I went on the floor I knew I was safe from bitchy attitudes because there was chocolate in nearly every booth. ThinAir Data took this a step further and put a packet of Ken’s Salad Dressing in with their Hershey’s kisses as a joke.

But the joke was on them as several overseas members got all excited over the dressing to take back with them and brought many of their friends of their friends others back home which left the vendor scrambling to find more…Hey, whatever it takes to get customers into the booth. It provided a good belly laugh for sure.

I wish every vendor could be as clear and concise in their messaging as this vendor was.

Most marketing managers would be scratching their heads wondering what Revana Health was thinking by having absolutely nothing in their booth besides their corporate logo, but in the 5 minutes I was there at least 5 people came up and asked the same question- “What do you do?” (answer: provides medical imaging centers with a suite of software and services to increase business performance).
Would a booth with all sorts of signs and diagrams and hardware have had the same impact? No- not even close. Brilliant marketing on their part. The fact the two gals who manned it were very cordial and easy on the eyes also helped as well (laugh).

Being a Floridian for the past 30+ years I smiled when I saw the gator sitting on the DR vet table in Canon’s booth. I smiled even more broader still when I saw the kitty cat sitting there as well looking sound asleep. Now I am not exactly a fan of cats- they are much too aloof like many a woman I have dated in life- so the juxtaposition of the gator and kitty was just too good to pass up. I would make a few other comments but I am trying to be politically correct in my old age so those of you who know me can read between the lines.

Having fun is the name of the game and IDS (Integrated Document Solutions) found a great way to get people into their booth with Shan the Candyman (yes, that is the name he goes by). He is only 1 of 3 people in the country who do candy art and he brings it to a level I have never seen before. For this one gal he did a dinosaur eating a dinosaur but could do just about anything for anyone and did. As I left he was doing a football team logo and did a killer Luigi from Ninetendo’s Mario Brothers and a cute pink pony for the owners daughter. This guy has talent with a capital T…



I have talked about the El Grande diner many times but here is the only shot you will ever see from it. The rest is top secret. As the night drew on and margaritas flowed the PACSMan Awards you’ll never ever hear about came out (affectionately known by our group as FC’s). I know you are thinking why are they called the FC’s. We’ll save that explanation for another time and place (laugh). Just know though that it is incredibly hard to find a divey Mexican joint that makes decent margaritas once Salvadors closed finally but we found one.

The guys you see here (a few gals were invited but were no shows BTW) are mostly from AuntMinnie.com and have known each other for years and in many cases decades. We all share a passion for imaging and a respect for each other. I can think of no better group of individuals to be with than these guys. From left to right are Eric, Dr Dalai, Brian, Wayne, Me, Jim, and Erik.

And last but not least, this Cher lookalike is the daughter-in-law of the guy who was behind the Timeo booth.

We chatted a bit about my Italian heritage and he was so much fun to talk to and proud- God was he ever proud “Atsa my daughter-in-law. You takea her picture and put it in the paper, yes?” So from one proud Italian to another here ya go my friend… Hei!! Pay attention. Do Not Hesitate!! Look at her will you…Now I don’t do Musculoskeletal Ultrasound- hell, I don’t even know what it is- but I’d but the book just because she’s in the photo.

You want to get your heart racing even more? Do a Google image search under Cannavo- yes, atsa my name. I used to be on page one, now I’m on like page 6 but do I care with someone as gorgeous as mio cugino Rosaria? Nope. Momma mia, check it out.

She hails from the same area in Sicily as my grandparents and while I’m not 100% sure if she is my cousin or not Ima gonna say atsa my cousin because all us it makes for good press (laugh). I always tell my sons to make sure you know who you are dating because she could be related to you but if she looks like that…who cares? I’ll just sit back and smile and say “Atsa my boy!!”

If Merge Covered Lincoln’s Assassination

I have often said that Merge Healthcare has the very best marketing and PR department in the entire medical imaging marketplace. No one even comes close especially when it deals with handling what is affectionately known in the journalism industry as “spin”.

The most recent third quarter results from Merge speak volumes to this. I’m one of the few who reads the entire story so I was intrigued when I read the headline ”Merge Healthcare Reports Record Sales in the Third Quarter”. Hmmmm, interesting I thought. Then I read the subhead “Revenues grew to $45.2 million in the third quarter, compared with $16.9 million in the third quarter of 2009.” Very interesting…Then I read the rest….until I got to the statement “The company posted a net loss of $5 million in the quarter, compared with a net loss of $936,000 in the same quarter of 2009.” and then look at the rest of the financials. I laughed but wanted to cry. The spin doctors worked their magic. While nothing was hidden and all was very legit, most of the “bad news” was buried deep beneath the marching bands and ticker tape. Fortunately for them most of the investment community never looks far beyond the headlines which allowed the stock to climb almost 29% to over $4.00 per share last week alone.

I got to thinking- how Merge might cover President Lincoln’s Assassination and came up with this, with thanks to Wikipedia:

Sold Out Crowd Enjoys “Our American Cousin”
at Ford’s Theatre
Minor disturbance interrupts an otherwise enjoyable evening
Mrs. Lincoln unhurt in assassination attempt

Washington D.C. April 15, 1865- The Washington elite enjoyed a sold out performance of Tom Taylor’s three-act play “Our American Cousin” which played at Ford’s Theatre last night. The play is a farce whose plot is based on the introduction of an awkward, boorish American to his aristocratic English relatives. It premiered at Laura Keene’s Theatre in New York City on October 15, 1858 and recently moved to the D.C. area. The play concerns the adventures of an American, Asa Trenchard, played by Harry Hawk, who comes to England to claim the family estate.

Numerous socialites from the Washington D.C, area including Major Henry R. Rathbone, his fiancé Clara Harris (daughter of New York Senator Ira Harris), Mary Todd Lincoln and President Lincoln were in attendance. General and Mrs. Grant as well as several other D.C. area power brokers were all slated to appear as well however last minute conflicts pulled each of them away.

The only thing marring an otherwise stellar night was when a Confederate sympathizer, later identified as John Wilkes Booth, interrupted the play halfway through Act III, Scene 2, when Hawk uttered a line that was considered one of the play's funniest:

"Don't know the manners of good society, eh? Well, I guess I know enough to turn you inside out, old gal — you sockdologizing old man-trap..."

Booth used the laughter to mask the sound of his gunshot and fatally shot President Lincoln in the back of the head. Major Rathbone jumped from his seat and tried to prevent Booth from escaping, but Booth stabbed the Major violently in the arm with a knife. Rathbone quickly recovered and tried to grab Booth as he was preparing to jump from the sill of the box. Booth again stabbed at Rathbone, creating a wound that bled profusely from a deep gash that ran the length of his upper left arm, and then attempted to vault over the rail and down to the stage. His riding spur caught on the Treasury flag decorating the box. Booth jumped on the stage and landed awkwardly on his left foot, fracturing his left fibula just above the ankle. This was later confirmed with a CR image that was processed using a Merge OrthoCR® software. Booth then raised himself up and, holding a knife over his head, yelled, “Sic semper tyrannis” the Virginia state motto, meaning "Thus always to tyrants" and made his escape through the back of the theater to a horse he had left waiting in the alley.

Dr. Charles Leale, a young Army surgeon on liberty for the night and attending the play, made his way through the crowd to the door at the rear of the Presidential box. Leale was joined by second doctor in the audience, Dr. Charles Sabin Taft, who was lifted bodily from the stage over the railing and into the box. Taft and Leale cut away Lincoln's blood-stained collar and opened his shirt, and Leale, feeling around by hand, discovered the bullet hole in the back of the head by the left ear. Leale removed a clot of blood in the wound and Lincoln's breathing improved. Still, Leale knew it made no difference: "His wound is mortal. It is impossible for him to recover". Leale, Taft, and another doctor from the audience, Dr. Albert King quickly consulted and decided that CT scan using Merge’s 3-D Net® CT software was required. The three doctors and some soldiers who had been in the audience carried the President out the front entrance of Ford's and into the outpatient center for a CT scan. Results of the CT scan confirmed the initial diagnosis that President Lincoln was indeed going to die.

The three physicians already in attendance were joined by Surgeon General of the United States Army Dr. Joseph K. Barnes, Dr. Charles Henry Crane, Dr. Anderson Ruffin Abbott, and Dr. Robert K. Stone. All personally used either Merge’s Fusion® or AMICAS® software. Crane was a Major and Barnes' assistant. Stone was Lincoln's personal physician. Robert Lincoln, who had stayed home, arrived at the hospital after being told of the shooting at about midnight. Tad Lincoln, who had attended Grover's Theater to see Aladdin and the Wonderful Lamp, was not allowed to join the other physicians. Secretary of the Navy Gideon Welles and United States Secretary of War Edwin M. Stanton came and took charge of the scene. Despite the efforts of physicians using the very best imaging software on the market from Merge nothing more could be done for President Lincoln. At 7:22 a.m. on April 15, 1865, Abraham Lincoln died. He was 56 years old.

Neither Mrs. Lincoln nor Ms Harris were hurt in the attack and the play resumed unabated the following night.

Ticket holders for Friday nights marred performance were given vouchers for a future performance of “Our American Cousin” as well as a coupon for 20% off any future purchase of any of Merge’s top-rated medical imaging software.

#### END ###

Away in a Manger

Every Christian wants to be just like Jesus but I’ve never really subscribed to that theory. I just wanna be me. After all I was made in His image so why should I try and be something I’m not? Growing up I felt like Him often. Mom every now and then would intersperse my name with His as in “Jesus Christ what have you done now!!” so I felt much closer to Him than most. This week I feel close to Him again as I tried and get a hotel reservation for RSNA and might indeed be like Him as I end up sleeping on Chicago’s version of a manger aka steam grate when I can’t get a hotel for the nights I’ll be at RSNA. It’s not for want, mind you, but just like Jesus it doesn’t look like the cards are in my favor at this point in time.

I tried to make my hotel reservations last week and even picked out my hotel but alas they couldn’t lock in my reservation because I hadn’t gotten my media credentials yet. It’s a fairly simple process but does require some paperwork and documentation and such and frankly with all that’s been going on of late I simply didn’t get to it by Friday’s deadline. My bad. Normally that isn’t a problem but this year it is.

Now some things don’t seem to make a lot of sense here. When I called RSNA housing last Wednesday I was given a list of so many hotels to choose from it amazed me- at least 30 at all price levels. I loved working with the company that has done the RSNA hotel booking for years. Experient is a very professional company and left me thinking I’d be all set if I called back Friday. Today was another story though. I’m told in under 48 hours the RSNA sold out nearly every hotel they had negotiated rates with- an amazing fact if indeed true- but what was left I could get from another company whose name shall remain anonymous to protect the guilty. OK, I think, I’ll play by the rules. No problem. So I call that company and well, let’s just say they have a set that make an elephant’s look tiny by comparison. Most of the hotels they offered me downtown started at around $300- their rack rate if not more- and went up from there. The fact that the prices they quoted me were anywhere from 30-90% higher than the RSNA pre-negotiated rate just one business day earlier was bad enough but their attitude- without saying as much- was pretty much “You are a doctor- you can afford it!!" Um, I’m not and no I can’t. Now I can handle almost anything except attitude- just ask my sons- and let me tell you these people had attitude to the max.

“Do you have anything around $200/night?” I asked. Silence…then a sigh….and then “Let me check…” Fifteen seconds later….”We do have one hotel that is about a mile from downtown- at $160 per night. Do you want it?” I think to myself that’s an extra $5 in cab fare each way but….”Where is it?”” Silence again..”26th Street West” they answer…and then continue ”….about a mile from downtown” I look on the RSNA map. A mile from downtown my ass. It’s a mile southwest of McCormick Place in a neighborhood that made the old Cabrini Towers look like the freaking Taj Mahal. “Um…no thanks…I’ll keep looking”. And so I do.

I have no doubt I’ll find a room but rest assured it won’t be a Days Inn at $310/night. The RSNA is helping as much as they can- they have always been super helpful- and I can always fall back on my clients who book blocks of rooms and almost always have an extra I can steal. Then there is always Priceline, Hotels.com, Chicagochoice, and other sites I can explore as we get much closer to the day too, plus I’m working with the management of a few hotels direct too. While I shouldn’t have to go through this aggravation I accept part of the blame for waiting so long to register. Unfortunately there is but one of me to go around and too much to do between now and RSNA and registering wasn’t a priority. This will be my 28th RSNA and all but the first ten I’ve come in as a member of the press covering PACS for various publications, with the last decade covering it for AuntMinnie.com. I don't just do the PACSMan Awards but also feed stories to my counterparts as well. You just don't see that because it's done behind the scenes. The AM crew works as a team at RSNA and I am but one small part of it. I also always strive to maintain some semblance of balance in my life and am not burning the midnight oil every night just because. I always have and always will make time for my sons, myself and others in my life because work, while important, is not the very top of my priority list by any means. Important, yes, but not in my top three…But RSNA is a must, if for no other reason to do the PACSMan Awards that for reasons that escape me everyone seems to look forward to reading and is among the most read AM "stories" each year. Go figure.

So I won’t be at the Ritz this year although I did do that one year and it was pretty awesome- not $475 a night awesome but still pretty cool. I also probably won’t be sharing a steam grate with a Lieutenant Dan in a wheelchair with scraggly hair either but look for me in Chicago… somewhere…sometime beginning Sunday morning. My flight leaves at 5:30 a.m. just so I can get there in time and save on spending yet more money for a room for Saturday night…Just don’t look for me to fill the pockets of the greedy housing agency that has the leftover rooms. I like elephants as much as the next person but….

Market Consolidation? Where?

As I look around and more and more companies in the PACS marketplace are being bought, sold, and merged. “For once” I thought to myself “the market is rightsizing”… If I am to believe the RSNA 2010 Exhibitors List I was never so wrong in my life…

I went to the RSNA web site a week ago to get a list of exhibitors in different areas for a Webinar I am doing in early November titled “How to Make the Most of Your RSNA 2010 PACS Review”. The areas I looked at were PACS, PACS Components, RIS, CD/DR, Voice/Speech Recognition and Archiving. As I looked the numbers I saw were astonishing so I went back and compared them with the same vendor numbers I had from 2006. The result was even more astonishing.

The number of vendors showing PACS Components rose from 165 to 212, a 28.5% increase, Companies showing PACS rose from 136 in 2006 to 201 in 2010, a 48% increase. Archiving rose from 97 vendors in 2006 to 192 in 2010, a 98% increase. Companies showing Radiology Information Systems went from 109 in 2006 to 235 in 2010, a 116% increase. CR/DR vendors went from 79 to 270, an incredible 242% increase while Voice and Speech recognition went from 48 vendors in 2006 to 227 in 2010, a whopping 373% increase. Now only about a quarter of these listings can be considered real with the balance either cross listings or duplicates, but the same statement held true back in 2006 as well. This made me ask just what the heck is going on in this marketplace. The answer is simple. Everyone wants to get rich and they feel medical imaging offers that pathway. It doesn’t as the 500 of so vendors who have come and gone in the time I’ve been in this marketplace have realized but please don’t tell that to the plethora of vendors entering into the marketplace today. They might actually get smart.

We have come a long way in the nearly 30 years since I entered the PACS arena in 1981 helping to develop and sell a teleradiology system called the DigiPAC 8 (for 8 bits) that offered blinding 19.2 Kb/second transmission speeds (vs industry standard 9600 bps) and a highly evolved camera on a stick,. Our biggest competition back then came from Colorado Video, Dataspan and Raytel, names that unless you’ve been in this industry for a long time you probably never heard of. I doubt you also heard of the company I worked at the time for called Image Resources (IR) either. They too have come and gone. IR has a great product that could have owned the marketplace but we simply ran out of money before we could ramp up. The total budget for product development (software coding), marketing (including show budgets like RSNA), hardware and s software, my salary, and the rest was a whopping $50,000.00 (yes, there is a decimal point after the 5th set of zeros) and we simply ran out of bucks after 18 months (back then I made just slightly less than I make now too). Money got so tight that when we went to pay for dinner one night at RSNA the company credit card was declined. If you have never had to deal with this before (it was a fairly high class place where dinners were about $40 per person back then) the maitre de comes to the table and called me away saying “Excuse me sir we have a phone call for you (pronounced more like ewwwww by him)” Keep I mind this was 1981 and we didn’t have cell phones then. In fact it wasn’t until a few years later that I got my first cell phone- the Motorola DynaTAC 8000 more affectionately know as “The Brick” that Michael Douglas used in the movie Wall Street (and yes I still have it too). I follow the maitre de to the back by the kitchen and he says “We are sorry sir but you credit card has been DECLINED.” We’re like WTF!!! And had it not been for a few spare Am Ex travelers checks I always carried on me we would have been seriously fucked too as that was pre-ATM days when you could actually play the float…OK, now where was I?

There are lots and lots of companies who will be coming to RSNA in another month seeking fame and fortune. About a quarter will fail, but if history repeats itself twice as many will rush in to take their spot. David Hannum, the man who headed the five man syndicate who paid $30,000.00 for the Cardiff Giant back in 1869 summed it up best- "There's a sucker born every minute.". And no it wasn't P.T. Barnum either who said it. Hannum turned down an offer from P.T. Barnum to buy HIS giant fake fossilized man so Barnum created his own fake and well….. The tale is intriguing for sure. If you want to learn more click on this http://www.historybuff.com/library/refbarnum.html).

The takeaway from all this is things aren’t always as they seem, someone is always ready to take your spot, and everyone seems to be willing to invest in what seems like a sure thing…..but most times really isn’t. Should be an interesting show this year for sure.