Last Notes
🚨 THE GHOST BOOKING IS ALREADY HERE
http://blossom.yakihonne.com/175aef72cceabf82e6fe8b9fce2d296d98601d7f28343c650be47a88efa1552f.jpeg
Tonight’s story sounds trivial:
A medical appointment.
But underneath it sits one of the hardest problems in computing.
A patient believes one thing.
The hospital believes another.
The scheduler has another state.
The EHR has another.
The reminder system keeps talking anyway.
And eventually somebody travels toward a booking that may no longer exist.
This is not hypothetical.
🇺🇸 U.S. Veterans Affairs
The U.S. Government Accountability Office found VA schedulers navigating multiple applications to schedule a single appointment. Staff had to search different systems for self-scheduled and cancelled appointments.
Veterans reported missing confirmations and duplicative appointment reminders.
VA officials said the duplicate notifications were being generated because multiple systems were sending reminders independently.
That is the ghost.
Not necessarily a crashed database.
Multiple machines carrying different representations of the same human event.
🇬🇧 NHS England — July 2026
The NHS has now introduced minimum communication standards after acknowledging cases where patients received appointment invitations days after the appointment had already been missed.
The new rules call for at least 21 days' notice for planned appointments, referral confirmation and clearer communication after cancellation.
Read that again:
The appointment existed inside the institution before useful knowledge of it reached the human being expected to attend it.
🇦🇺 Queensland — May 2025
A statewide IT incident affected access to electronic medical records across Queensland Health sites and produced delays while hospitals moved to contingency processes. Oracle Health identified the underlying issue, which also affected other Oracle Health sites in Australia.
🇺🇸 Community Health Systems — April 2025
An Oracle Health EHR outage affected 39 hospitals, according to Community Health Systems.
Hospitals fell back to paper records while systems recovered. Reporting attributed the incident to critical storage connected to a database being mistakenly deleted during technical work.
These incidents are different.
But watch the pattern:
centralise → integrate → replicate → synchronize → fail → reconcile
Healthcare keeps treating this as an IT-modernisation problem.
It is a distributed-systems problem with human beings attached.
For the regional traveller, stale state isn't abstract.
It can mean:
400 km of driving.
A motel room.
A day off work.
An empty specialist chair.
A missed referral.
Another patient still waiting.
And here is the uncomfortable engineering question:
You could try to make the entire healthcare system globally and synchronously consistent.
But then you pay for that consistency in:
latency, coupling, infrastructure, availability and larger failure domains.
So perhaps the goal was wrong.
Don't synchronize everything.
Protect the invariant.
One authoritative reservation.
One durable transition.
One immutable history.
Idempotent changes.
Explicit conflict detection.
Verification at the boundary.
Everything that does not require global consensus can remain asynchronous.
Because the most expensive computer error in a hospital may not look like an error message.
It may look like an empty chair.
And somewhere hundreds of kilometres away, a patient is wondering which machine told the truth.
References
U.S. GAO — Veterans Health: Improvements Needed to Achieve Successful Appointment Scheduling Modernization
https://www.gao.gov/products/gao-25-106851
NHS England — NHS to overhaul patient communications and end invitations arriving after appointments
https://www.england.nhs.uk/2026/07/nhs-to-overhaul-patient-communications-and-end-farce-of-invitations-arriving-after-appointment/
Queensland Health statewide EHR disruption — May 2025
https://www.couriermail.com.au/news/queensland/statewide-emergency-delays-as-hospitals-suffer-tech-issues/news-story/4957278e00a558ce95f8ab2b6c6c7604
Community Health Systems / Oracle Health EHR outage — April 2025
https://www.fiercehealthcare.com/health-tech/after-accidental-deletion-brought-down-ehrs-chs-says-hospitals-downtime-nearly-over
#GhostBooking #EHR #HealthTech #DistributedSystems #Healthcare #Verification #PatientSafety #SystemsEngineering #RegionalHealth
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https://cdn.midjourney.com/3851754e-cdce-4e93-91d6-680fe479ce53/0_2.jpeg
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🚩☕️
https://en.wikipedia.org/wiki/Romancing_the_Stone?wprov=sfti1#
nevent1qqsqglfjfh208gw3z6kf3en30cvp7jtvh9s872sx8tqypl9vqsm4kgq2aducc
The mystery of the ghost booking is really a distributed-systems problem wearing a medical badge.
http://blossom.yakihonne.com/42963904bccc85e3fde4a8ebcba96f1c87849ff9e22ac4eb30fe3aa2c0579d96.jpeg
A regional patient books at Hospital A.
Later the appointment is cancelled or moved through Hospital B.
One system says:
CANCELLED
Another still says:
BOOKED
Nothing has necessarily crashed.
The ghost exists in the gap between two partially consistent views of reality.
That tiny inconsistency can mean:
an empty specialist slot, wasted clinical time, unnecessary travel, accommodation costs, missed work, delayed treatment, and staff manually reconciling records.
The obvious solution sounds simple:
Make the whole EHR strongly consistent.
But that has a cost too.
More synchronous coordination means more latency, more coupling, more network dependency, more failure modes, and potentially less availability for regional services.
So the real engineering question is not:
How do we eliminate all inconsistency?
It is:
Which invariants are important enough to pay the coordination cost to protect?
For medical booking, the answer may be very small:
One authoritative reservation. One durable state transition. One verifiable history.
Everything else can remain asynchronous.
The ghost booking is not just an admin bug.
It is the price of pretending distributed systems share one reality for free.
#DistributedSystems #EHR #HealthTech #Verification #Healthcare #RegionalHealth #SystemsEngineering
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😂
https://npub1r0rs5q2gk0e3dk3nlc7gnu378ec6cnlenqp8a3cjhyzu6f8k5sgs4sq9ac.blossom.band/b34b450e4792096fbcc4531cabb913d8d6ca2cde2dd6fcb5a633d1034dca10b6.mp4
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The payoff is when their new shitcoin hits the market. Continuing to find blocks here and there gives them more credibility/relevance until that happens. Cost of doing business.
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Judging by the looks it's video, not film.
Not if you’re smart. And you are. No need to alert potential criminals to target you.
Real or fake? You decide.
https://npub1r0rs5q2gk0e3dk3nlc7gnu378ec6cnlenqp8a3cjhyzu6f8k5sgs4sq9ac.blossom.band/1fc9e9fc423859555b4b72700f51089142bd6b6465b8928700196cae7333ca14.png
Has a single coordinating key been implemented already in Marmot? I'd imagine that this is desired in some use cases and serves as a good starting point.
Found you! Good to see you on nostr
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Thank you for the favor of an explanation. This cannot have been easy. My best wishes and hopes for a sustainable future for for and yours. Thank you for your service.
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in the spirit of guarding against breakfastless behavior - you have options to keep you busy until the morning rush calms down.
☕️🍳🥓
https://apple.news/AP1kEr8i3T5ecZgkg3Bpu1w
"Fetty Wap made a Facebook?!" No, fediverse.
"Nostradamus is a Twitter?!?" No, Nostr it's notes and other stuff transmitted by...
My team of normies taking interest in me and my hobbies 🤗
The datacenter debate is framed as an energy problem.
http://blossom.yakihonne.com/a4364bda9e54d121f8ab4cb4c825bab6422c0bf1fbaf247c4483158bd3ba1e36.jpeg
It is really a distributed systems problem.
More people means more devices.
More devices means more services.
More services means more state.
More state means more replication, coordination and failure domains.
Compute scales.
Consistency does not scale for free.
Every attempt to make the planet behave like one coherent computer pays in latency, synchronization, retries, consensus, replication and recovery.
You can build more datacenters.
You can improve cooling.
You can generate more electricity.
You cannot remove geography.
You cannot eliminate network partitions.
You cannot make independent machines share perfect knowledge of the same moment.
The real question is not:
Can we power twice as much computation?
It is:
Can twice as many machines still agree on what happened?
The architecture that survives population and machine-scale growth will not synchronize everything.
It will localize computation, minimize global consensus, tolerate asynchronous operation, and verify invariants at the boundaries.
The future is not one enormous synchronized datacenter.
It is distributed execution held together by verification.
#DistributedSystems #Datacenters #Scaling #Verification #Infrastructure #AI #Energy #SystemsEngineering
I guess it's risky to ship discretely. Could make some sats on nostr maybe.
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i'll be here in the am. see if we can get through the day without a catastrophe.
i don't like the vibe.
🧘🏻♀️🚩
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4.6 fixed many of the issues. It is way faster too
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Feels https://file.nostrmedia.com/p/d49a9023a21dba1b3c8306ca369bf3243d8b44b8f0b6d1196607f7b0990fa8df/7be5503172712b4f04b6d0fbd5ff01a0c645294966d39df15ba1bd95323bf081.jpeg
#resist #rebellion #wakeup #sayno #standup http://blossom.yakihonne.com/7bd642e5b420351ccc7334eb1aba6424eba25ef534219be7d9cce4d2d404e648.jpeg
📰 **In this week's issue:**
🗞️ **BREAKING**
What Happened This Week In The Luxury World Travel
You think luxury travel in 2026 is about five-star hotels and suite upgrades—it's not. The data proves the most coveted thing a wealthy traveler can possess right now isn't a higher thread count or a better view; it's access. Read on and get insights...
https://image.nostr.build/8b98eceb5592a89b332c58bd004fb787cf5b4e30a57eb68a4ad9c53c9851d243.png
✍️ Author: NM team
🔗 https://nostrmag.com/article/w32travel02
📈 id#337713411
https://blossom.primal.net/1f1d7bbb828bb369e62c1dc8fb6d324531572dc94081d65d624b78bc9f780a5a.jpg
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Grown outdoors or with lights?
📰 **In this week's issue:**
**Nostr's Post-Quantum Leap: Why Your Private Keys Aren't Safe From Tomorrow's Threats**
NM team
https://image.nostr.build/109d709ac1a424bb7a07e3f55d0578e05bcd82f547fe7d59bf1622a01007521f.png
Here's the sobering reality: "A Nostr public key is published to every relay it touches, and Shor's algorithm recovers a...
https://nostrmag.com/article/w33nostr01
id#660284537
📰 **In this week's issue:**
https://image.nostr.build/8385456f6b30ee079274d96ffca539ece92a737d1cfa05f6e42331d9dd1f84dc.png
📰 **What happened this week in the Bitcoin World**
✍️ by NM team
You probably think Bitcoin’s quiet summer lull means nothing’s happening. The data says otherwise. US spot Bitcoin ETFs was busy—while retail search interest cratered to a five-year low of just 18 on Google Trends. But here’s what the mainstream coverage isn’t telling you: while institutions are quietly accumulating, a war is brewing over Bitcoin’s very soul—and if you’re not paying attention to what happens next, you might miss the signal you need, read on!
🔗 https://nostrmag.com/article/w32bitcoin03
📊 id#493688227
I would, but all of that requires money.