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"A couple Thursdays ago, I got an early-morning call from my radgroup: Don’t bother trying to log in for work, that day or indeed the next few. A nasty bit of hacking had occurred, and taken their entire computer-system down.\n\nWorking via teleradiology since 2011, and in facilities large and small before that, I’m no stranger to outages. Sometimes they’re a welcome break…especially if you’re salaried and getting paid the same whether you’re working all day or twiddling your thumbs. Not as much if you know that imaging-cases are still accumulating, and you’ll be frantically trying to catch up when your access to them is restored. Definitely not if you’re “per click,” earning zippity-doo-dah while your employer pulls itself together.\n\nUnlike other outages I’d seen, this one wasn’t over in a matter of hours, or even a couple of days. I still don’t know all the details; one of the other telerads theorized that it was on the level of ransomware/cyberterrorism, such that Federal entities were involved. Everything was down, even the group’s websites and email systems, and there was nary a guesstimate as to when we’d be back on our feet.\n\nSo far beyond the realm of anything that might have been planned for, this was tantamount to a “black swan” event for the group. I’ve referenced the term in this column before, and there’s a worthwhile book on the subject (“The Black Swan: The Impact of the Highly Improbable,” by Nassim Nicholas Taleb). I won’t rehash it here.\n\nJust because you can’t predict such things, doesn’t mean you won’t have to deal with them if they happen. And even though you can’t thoroughly plan for the unknown (or it would be prohibitively costly to protect yourself against everything that’s less than 0.001% likely to ever occur), there are some things that can make you more resilient for when it comes busting down your door.\n\nDeveloping and maintaining plans for more probable/predictable incidents is a good start. Some components of those plans might be useful when a “black swan” turns up. For instance, a contingency strategy dealing with more typical, briefer outages might provide a framework for when hackers hold your system hostage or terrorists detonate an EMP in the area. It’s a lot easier to modify a partially-relevant plan for your current situation than to create one from scratch.\n\nEven if none of the plans you’ve formulated can be adapted, devising them in the first place has you in a better place than if you hadn’t. You (and, hopefully, your team) have already gone through the exercise of thinking about the various components that make your operation work, and what happens if one or more of them are taken out. What it might take to function in their absence, if any substitutes can be used, who to call for repairs/replacements, etc. The basic process of methodically sizing up a bad situation will come a lot more readily to you if you’re done it before.\n\nStill, by its very nature a “black swan” event isn’t tidily handled by preparation. The best means of dealing with it is being ready to take, and roll with, its punches. Rather than panicking and going to pieces, you take stock of your troubles and what’s still intact. Then, you have an idea of what stands between your current situation and normalcy, and can start figuring how to get from hither to yon.\n\nFacets of this need not be complex puzzles or massive undertakings. For instance, my radgroup’s usual means of communication (email and instant-message app) were down. Reestablishing contact began with simple phone-calls, followed by external email accounts. Those wanting to keep personal e-ddresses out of the mix simply created new Gmails for the purpose. Group-messages could then be used to relay marching orders and share updates as new information became available (also for offsite rads like myself to post questions).\n\nAnother important aspect of being able to roll with the punches is having flexibility and redundancy in your setup. If, under even the best of circumstances, your operation is stretched to its limit or liable to unravel if one tiny component falls out of place, it won’t take a black swan to create havoc…but such an event will be all the more devastating when it happens.\n\nMore robust by far is an organization whose members’ roles overlap. If one or more are taken out of commission for any reason (illness, equipment failure, whatever), others might have to stretch in compensation but the net is more capable of holding the burden than tearing under it. And if members of the team are used to having Operations “call an audible” to redirect their efforts when circumstances warrant, they’ll be that much more capable of shifting focus in times of crisis.\n\nIndividual members of the team can also make themselves more resilient for when black swans come a-calling. In a lot of ways, similar to the organizational-level stuff: Don’t panic, be ready to adapt as situations arise, etc. That’s especially important for per-click rads who might be facing a sudden cutoff of income for the duration of an outage. Having emergency funds in reserve, for instance, instead of living paycheck-to-paycheck. Some might even maintain separate sources of income, such as contacts with locums agencies.\n\nSimply keeping an adaptive frame of mind can go a long way: Sure, it might be worrisome when your employer is down for the count and you don’t know when they’ll be back up. Maybe you nervously eyeball job-listings, just in case…but, in the meantime, you’ve suddenly got an unexpected bit of vacation. Even if it’s unpaid, try to make use and/or enjoyment of it. Sleep in, jumpstart your fitness regimen, get that stuff done around the house you’ve been putting off, meet up with some friends you haven’t seen.\n\nThat visit from the black swan, played the right way, might ultimately turn out to be something you look back on and realize you desperately needed."
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