Going to Google


It is Wednesday, November 14. My practice director, Brittany Conklin, and I, are on a flight to San Francisco to claim our prize: a trip to Googleplex, the home of Google. I should be feeling excited and grateful, but I’m on a plane flying towards a big forest fire. There is an official health warning in the bay area and visibility is limited due to the smoke. I’m wondering how far a plane needs to see in order to land safely. I try to ignore my inner fears and focus on a book about the company we are going to visit.

My four employees, including Brittany, have been instrumental in getting my new practice up and running. Close to two years into existence, and really only a year into a steady practice, our growth has been due to a team attitude where success and failure are shared completely. The part that I cannot take credit for, and it is a big part, is our rise in prominence on the internet, in general, and social media in specific. Brittany, Becky, Taylor, and Krystal have been posting on facebook, adding to our website, and making short little informative and humorous videos for worldwide distribution. I have had only veto power, no creative control. Didn’t want it, or need it.

Two months ago, the company who invented “cryolipolysis”, Coolsculpting, did a clever thing, offering to all the medical practices and spas who had purchased their “fat-freezing” machines a competition: boost Coolsculpting on social media the best and win a trip to Google. Called ”Cool-Not Cool” the contest was right up my staff’s alley. With some video technical help, we started turning out ten to thirty second videos about Coolsculpting. “Frozen”, “Who you gonna call, Coolsculptors!”, and my one silly idea, “Tupac a day smoker” were little online hits. I was still surprised, however, when Brittany told me that she thought we could win the Midwest region. I thought of all of the hundreds of practices and spas with Coolsculpting machines in the fifteen state region. Our little one year, one machine practice against established, multi-machine lucrative enterprises? Brittany showed me her computer screen on which was the Coolsculpting Corporation” top nine videos. Numbers 1,4, 5, and nine were ours! In a few short weeks, we got the news: we had, indeed, won the Midwest region!


I’ve been a practicing plastic surgeon for 29 years. My ambitions have been of the century in which I was born. The twentieth century was about the shift from the global wave of industrialism to the newer wave of information. As a professional, a principal part of my career has been as information gatherer and decision-making advisor to my patients. Notwithstanding any manual technical skills, my career mostly represented the first part of the new wave of information manipulation. At that time, the coin of the realm, knowledge, was hard won by reading books, studying, and memorizing facts and lists, anatomy. As an expert, I could then advise my patients on the best plan. Now, in the twenty first century’s version, the second half of the information wave is more egalitarian. Professionals, lawyers, engineers, and scientists no longer control the flow of important information. The internet, and social media have leveled the playing field and given information access to everyone with a smartphone.

My twentieth century patients were referred from other physicians, previous patients, or word-of-mouth. My twenty first century patients are coming from the interconnectedness of us all on sites and media. It was with this combination of feelings of obsolescence and wonder that I found myself worrying about smoke while flying to Google.


In 1938, two brothers, Milton and Edwin Sirotta were doing one of their favorite things: walking in the woods while talking with their mathematician uncle. Edward Kasner, a Columbia university professor, asked the boys to help him come up with a name for a very large number: one followed by one hundred zeros. Milton suggested the name, “googol”. Two years later, professor Kasner’s book, “Mathematics and the Imagination” contained the term coined by his nephew, as well as the name, “googolplex” for the number ten raised to the power of googol.

Fifty seven years later, and long after Kasner’s death, two friends were contemplating the new world wide web. Larry Page asked Sean Anderson, “What if we could download the whole web and just keep the links?”. Looking to name this idea and its potential company, Sean put, “google” into a domain search. The misspelled name for a very large number was available so Larry registered it.

My eyes are burning from the forest fire smoke as we get off the bus in front of Googleplex, the world headquarters of Google. Visibility is said to be a half mile. Everything is hazy and dull. The modern buildings do not look as coherently planned as I had expected. The tour guide would later explain that the original buildings were the former headquarters of the tech company, Silicon Graphics. As Google grew, it absorbed other buildings, connecting them into a campus where thousands of people are busy developing ideas.

Most of the prize winners in our group are aestheticians and managers of spas and practices. All but four of us in our group are women. I’m the only physician. I felt more like Jed Clampett as I looked in awe at the big fluorescent screen that refreshed every few seconds with a multitude of the world’s top searches. Brad Pitt, University of Virginia, and peanut allergy replaced each other on one red rectangle. Some rectangles were in other languages. I was witnessing Google’s connection to the world in real, and rapid, time. A piano was playing music that was being spontaneously composed by an artificial intelligence neural net. It had been steadily composing for years, playing a long one-off performance of a piece never to be heard again. Animatronic flowers programmed for facial recognition changed color as they read and fed our emotions back to us.

We were shown a rolling computer with a head of lots of camera lenses. This “Museum Robot”, along with many other like it, is responsible for archiving over 30 million 3-D images of art from museums all over the world. Doodling on a screen, Google searched along, coming up with archived images to match our drawing. Doodle search? A hand-crayoned time line with graphs, autographs, and comments, chronicled Google’s life from 1996 to the present.


Our educational program started right in on the relevant issues of digital marketing and social media for cosmetic practices. 17.5 million cosmetic procedures in the U.S. last year generated 26.5 billion dollars. This is expected to double by 2024, just six years from now. Millennials are at least as interested in their appearance as are the rest of us. 80% of us have “excess fat” as our primary issue. Hence, the success of Coolsculpting. Google’s analysis of searches of a person before and after a successful treatment with Coolsculpting show a pre-treatment concern with quick fixes for weight problems, fad diets, etc. After the patient has noted their results from the Coolsculpting, their search profile shows an interest in more long-term healthy lifestyle issues. This observation is in line with my own experience with patients over the years: financial investment and effort to improve oneself yields a sense of ownership in and responsibility for the result. There is now an investment to protect.

After a lecture on the power of “local search”, we were taken to Google’s contradiction of the “no free lunch” adage. At Google, lunch is free, coffee and snacks are free. Healthy items are conveniently located while salty and sugary things are available just a few steps away. The company’s own internal research shows that people will avoid less healthy alternatives if only a few extra steps are involved. The main cafeteria was crowded with people who looked to be in their 20s and 30s probably 40% women and no single ethnic group predominating. There were food lines for Asian, vegan, gluten free, cheeseburger, and salad bar. Those were just the ones that I saw. Our large group approached a table which could accommodate us. The three or four people already sitting there smiled and got up to go sit elsewhere. Art and color and light accompanied our meal.

Our afternoon sessions got more specific on analytics, ad words, campaigns, and obtaining value in our efforts to reach out. A You Tube lecturer showed us how to look back through the T.V. set to see our viewer’s interests and loyalties. Finally, a Google healthcare specialist gave us what I thought was the most important talk of the day. “Marketing in the Age of Assistance” dealt with finding ways to help consumers find, schedule, do, and buy all at the speed of Google search. Assistance is the new opportunity for growth.

I finally got a one-on-one with a Google employee, Cliff, who gave us our walking tour. Cliff had done many things at Google. “They like us to do different things, to try new areas. Currently, I’m a Google Evangelist.” We discussed intelligence and creativity, and how a level playing field in access to information will pose identity and privacy challenges. We especially discussed failure as a part of learning and creativity. If solutions are a response to a temporary failure, then Google’s binary code is composed of a letter for “solution” and one for, “failure”. Persistence in problem solving writes the code: SFFS FSFSS FF…….S.


So what did Brittany and I learn from our day at Google? I had expected that Brittany would pick up a few things and that I would struggle to understand any of it. She is much younger and more computer savvy. A pleasant surprise: I found myself making plans to add a parking app to our mobile website. Being in a downtown office poses some parking challenges to our patients. Maybe an Uber account could help those patients who would like someone else to drive? Brittany was eager to get our CRM software upgraded so that we could offer seamless scheduling, payments, and questionnaires, automatic text reminders of appointments… convenience for our patients.

I believe, though, that the main thing I learned is that, being winners in Coolsculpting’s competition, just being at a place that I thought I would never see, Google, validated everything that we had done in the first year of my new practice.

As we all got back on the bus at the end of our day, I was hopeful for the solutions. I noticed that the air was clearer. A breeze had blown some of the haze away.

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