Most simply, 'present shock' is the human response to living in a world that's always on real time and simultaneous. You know, in some ways it's the impact of living in a digital environment, and in other ways it's just really what happens when you stop leaning so forward to the millennium and you finally arrive there.

I use a portable pocket ultrasound device instead of a stethoscope to listen to the heart, and I share it with the patient in real time. 'Look at your valve, look at your heart-muscle strength.' So they're looking at it with me. Normally a patient is tested by an ultrasonographer who is not allowed to tell them anything.

Sometimes I like to watch TV, though I never get to watch any of the shows in real time. I'm a fan of 'Downton Abbey,' 'Boardwalk Empire,' and 'Boss.' There's a British series called 'Luther,' but in England, they think a series means four episodes. And I like 'Mad Men.' Otherwise, it's always good to unwind with a book.

Writing plays supplied for me everything that painting didn't, which is the ability to tell stories in real time, in a real space, in three dimensions, in flesh and blood. I realized I had been trying to cram all this narrative into my paintings, but ultimately painting was a static medium. So it just opened up this whole new door.

One of the biggest challenges we face today is finding managers who can sense and respond to rapid shifts, people who can process new information very quickly and make decisions in real time. It's a problem for the computer industry as a whole - and not just for Dell - that the industry's growth has outpaced its ability to create managers.

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