In the Acumen blog last week Diana Strubler tackled the Quality portion of the MIPS composite score, otherwise known as the "Monster of MIPS". The Abominable Snowman of Quality with big, scary teeth is threatening to eat everyone up, so this week it's Rudolph the Red-Nosed Reindeer to the rescue in the guise of feisty Rear Admiral Grace Hopper. Welcome to techno-holiday story time.

Prologue
Recently my husband and I received an Amazon Echo Dot as an early Christmas present and we have had more fun than expected talking to "Alexa". Last Monday, I walked by the Echo Dot and said, "Alexa, good morning."
She replied, "Good morning. This week is the Hour of Code project, which occurs every year during Computer Science Education Week in recognition of the birthday of Rear Admiral Grace Hopper. To learn more say, 'Alexa, tell me more'." Alexa is a worldwide web of information!

Chapter 1: Computer science education is coming to town
The annual Hour of Code project supports computer science tutorials for tens of millions of children of all ages around the world. The project supports teachers and facilitators in leading 1-hour sessions, demonstrating the fun, creative side of computer programming. The tutorials are listed by grade level like pre-reader or beginner. One pre-reader tutorial is "Box Island" where participants "learn the basics of algorithms, sequences, loops and conditionals." (I'll definitely need to start at an early grade level since I have no idea how to manage loops and conditionals.)

In addition to housing the content for delivering tutorials, the Hour of Code website provides interesting computer science statistics. Data shows a mismatch in education in the U.S. with 90% of parents wanting children to have computer science exposure in school and only 40% of schools offering such programs. As the graph below shows, computer science ranks high as a class that was "liked a lot" in a U.S survey of high school students.

In another national survey, respondents said that computer programming was important for jobs and preparation for the future and that schools should provide computer science education in equal measure to traditional sciences, like biology, anatomy, and physiology.
Chapter 2: Do you recall, the most famous coder of all?

The Hour of Code project week always occurs in early December in celebration of the birthday of Grace Hopper who was born December 9, 1906. In 1934 Ms. Hopper earned a PhD in math and physics at Yale before returning as a professor to her alma mater, Vassar College. In 1943 at the age of 37, she joined the Navy to serve in WWII and following boot camp was assigned to the Bureau of Ships computer project at Harvard. She was one of the programmers for the IBM Automatic Sequence Contolled Calculator or Mark I "computer" that was 51 feet long, 8 feet high, 2 feet deep and had a large electric motor. During her career she wrote some of the first compiler-based computer programming languages including Math-matic and Flow-matic and was known as the "Queen of Software".

Grace Hopper was on active Navy duty or in the Navy reserve until her non-voluntary retirement as a rear admiral at 79 years, 8 months, and 5 days. At that time she was the oldest active duty commission officer in the U.S. Navy and her retirement was celebrated aboard the oldest commissioned ship, the USS Constitution in Boston. During retirement she traveled around the country speaking at school events about the amazing speed and power of computers and the fun and importance of computer science. When she was almost 80 years old she was a guest on the David Letterman show. Check out this video clip to see her 1985 Letterman appearance.

Chapter 3: Ideas so bright
In 1947 while working on the Mark II computer at the U.S. Navy base in Dahlgren, VA, Ms. Hopper and her staff noticed that the computer relay was not working properly. When they took apart the faulty relay section of the computer they found a dead moth stuck in the machine. The team taped the moth into the computer log book and noted the event as the "first actual case of a bug being found." This log book is in the permanent archive of the Smithsonian Museum of American History.

In addition to Grace's moth in the Smithsonian, you will also find Renalnet.org artifacts. Renalnet was the first Kidney Information Clearinghouse started by Gamewood Data Systems, Inc. in 1994 and the early days of the World Wide Web. Renalnet included online renal discussion forums, a dialysis unit search tool, a renal job market listing, and links to renal research sites and journals. One of the website's featured "Nephrology Resources" was a link to renal biopsy case studies and a renal pathology tutorial provided by Dr. J. Charles Jennette, chair of nephropathology at the University of North Carolina in Chapel Hill. Dr. Jennette regularly refreshed cases and biopsy images to be used as educational resources around the world. Renalnet.org won a Computer World Smithsonian Award in 1995. Some Renalnet artifacts are online here; the Smithsonian medal hangs on the office wall of Renalnet founder Dr. Frank Maddux.

Today, our technology minds of the future are learning algorithms and sequences in preschool, building on technology steps that have come before. Where the story will take us is hard to know. Grace Hopper first worked on the monster Mark I in 1946, and when she died in 1992, IBM had released the ThinkPad tablet. She and her team literally pulled a moth out of the electromechanical Mark II computer, and today preschoolers are writing code after watching 1-hour tutorials on the internet. I'm sure Grace would find the Hour of Code project amazing and hopeful as a means for technology to improve human life.
Epilogue: Going down in history
Do you remember Rudolph the Red-Nosed Reindeer? The stop-motion animated movie debuted in 1964 and the digitally re-mastered version airs on television every December. In the story Rudolph runs away from the North Pole because of his bright red nose, meeting Hermey the elf who wants to be a dentist, Yukon Cornelius, and all of the misfit toys along the way. When he returns home he finds that his family, who left to search for him, has been captured by the Abominable Snowman. Rudolph rescues his family while Hermey pulls all of the Abominable Snowman's teeth and Yukon wrestles him over a cliff. Yukon and a reformed, friendly snowman reunite with everyone just in time for Rudolph to salvage Christmas Eve by using his beacon nose to guide Santa's sleigh. Maybe technology pioneers of today fixing bugs and finding new conditionals will tame all of the MIPS monsters we have to face.

Wishing you much grace this holiday season!

Dugan Maddux, MD, FACP, is the Vice President for CKD Initiatives for FMC-NA. Before her foray into the business side of medicine, Dr. Maddux spent 18 years practicing nephrology in Danville, Virginia. During this time, she and her husband, Dr. Frank Maddux, developed a nephrology-focused Electronic Health Record. She and Frank also developed Voice Expeditions, which features the Nephrology Oral History project, a collection of interviews of the early dialysis pioneers. www.acumenmd.com