The whole point of advertising is to dissuade us of the notion that we are OK and the worst offender is advertising for beauty products. I love this put on.
Fotoshop by Adobé from Jesse Rosten on Vimeo.
Category Archives: Americana
9AM….everyday
Everyday at 9 AM, I go into Sequoia Hospital for an intravenous shot of an high-octane antibiotic – daptomycin, Daptomycin with a capital “D”? – to protect my cow aorta valve. Every day for six weeks; Saturdays, Sundays, New Years Day, at 9 AM. I do not think that I have done the same thing at the same time for six weeks in my entire life, it is very strange – not bad necessarily, but strange – and I am having a hard time getting used to it.
What is also strange is the PICC line in my arm, just below the armpit, that runs through a vain – or artery, I am not sure which – up, through my shoulder, and down to a large gaggle of pipes near my heart. According to Wikipedia, the PICC lines are used when intravenous access is required over a prolonged period of time or when the material to be infused would cause quick damage and early failure of a peripheral IV, and I think that is the case with me. I had a peripheral IV port in my hand that they used for a couple of days and my hand is still sore.
I think of the PICC as a very small, very long, hole that runs from outside my body to, almost, my heart. It is very handy: anything anybody wants in me can just be shoved in through the hole; the Flue Vaccine I forgot to get earlier in the year, a Pneumonia Vaccine I didn’t even know I should have, lunch – I guess. But, and it is a big BUT, protecting that hole from bad stuff getting in is a big deal. A much bigger deal than protecting a IV because any bacteria traveling up the PICC would end up right next to my heart which is what they are trying to protect, in the first place, by pouring in the dosages of antibiotic.
Tuesday is the changing of the covering-dressing day and it is sort of emblematic of my whole Sequoia experience and – by only slightly fantastical extension – our health care system.
The changing of the covering-dressing is almost ritualistic in its detailed, loving, complexity; it is driven, in large part, by outside vendors coming up with new, improved, and increasingly expensive ways to do it; it is staggeringly wasteful; and once you see it, it is hard to think of a cheaper, simpler, way to do as good a job. First the nurse takes a sterile envelope containing sterile gloves and opens it to to form a sterile area, then she empties all the cleaning supplies and sterile dressings on to the sterile area. After she puts on the gloves and facemask, my existing dressing is removed and the area cleaned.
Each part of the new dressing comes in a sterile package that is now waste and has to be carefully disposed of. As an aside, much of the waste has my name and birthdate on it and each time that happens, it has to be disposed of differently so that my name doesn’t end up in the garbage where somebody could see it. End aside. Then the new dressing, including a jell-packet of disinfectant, is put on to cover the entry point of the PICC.
Lastly, the new dressing is dated. Then, probably for the second or third time, the nurse asks me my name and birhdate and gives me my daily charge of daptomycin. I have no idea what all this costs, somebody once said that the daptomycin, alone, is $110.00 and it comes with its own – wrapped in a sterile covering, of course – connecting line and two syringes to flush the PICC line before and after the dose.
Then I am happily on my way, back into the world.
Atrial Fibrillation and Obamacare
Last week, I had a dizzy, nauseous spell – eposode as I don’t like to call it – and went to my doctor. Then, on the next day, to my cardiologist. It turns out that I have Atrial Fibrillation – and I don’t think that is the right way to put it, although I am or I caught Atrial Fibrillation is certainly wrong – and I am now wearing a new Holter monitor. A Holter monitor records heart activity over a period of time. In this case seven days, my first one was for twenty four hours and was so big I had to wear it on my belt – this one is just stuck to my man boob and it lasts for seven days. Ain’t progress grand.
Speaking of progress, for some reason – maybe because a large percentage of doctors are conservative – the medical profession has resisted computerizing records. I am 71 and my files would require a wheelbarrow to carry around if most of them hadn’t – fortunately – been lost. The file at my cardiologist is probably about an inch and an half thick and I have only been going to her for about four years and she is only one doctor. As an aside; What we really need is a chip similar to the chip our cat has but that is going to be a real fight. I see over at Last Days News – where they tell us that These End Times Prophecies are 100% Accurate! In case you had any doubts- that a The Bible says those who take the 666 Microchip will receive the Wrath of God. I am not a Christian and I am not much of a believer in the Bible as an authority but if it really does mention Microchips, I will be instantly converted. End aside.
Anyway, on to Obamacare and computerized records. This week, both my doctors – well, I have more than two, but both doctors I went to – are deep into switching over to computers and it already seems to be paying off. My primary doctor entered her notes into the computer and my cardiologist has them the next day when I go to her office. I leave the cardiologist with a printed list of instructions rather than oral instructions and an hand scribbled prescription. I have a question about my meds and call the cardiologist, her assistant looks up my files at his desk, and in about fifteen second gives me my answer. Last month, he would have had to call me back.
By the time Obama leaves office five years from now, I suspect that few people will still want to revoke Obamacare.
Western State Lines and Handicap Parking
My theory is that the further the people making the law – or rule – are from the people having to obay the law, the more arbitrary the law and the more likely it will not relate to what is actually happening on the ground. The borders of almost all states west of the Mississippi are an example.
Most of these state borders are straight lines following a compass heading totally ignoring any relationship to the topography. Because the people drawing the lines way back in Washington had no idea of any topographic detail. They didn’t know where the streams or mountains were so they couldn’t care. California where our northeastern border runs from some arbitrary point in the Great Basin near Goose Lake, due south to Lake Tahoe, is typical. That corner of California, about the size of New Jersey, is on the Nevada side of the mountains from the rest of California and would have been in Nevada if the people dawing the lines had lived anywhere near the lines being drawn.
A couple of days ago, Michele and I went on a short walk in the Thornwood Open Space Preserve. When we got to the parking lot, I noticed that the Handicap Space was little used and it re-booted my gripe about bureaucratic rules. Having Handicap Parking at the trailhead for a walk that handicapped people can not make is stupid. That is not to say that the people who made sure the handicap space was there are stupid but that the law – made from afar – is stupid.
I do not think that this applies only to government it applies equally, maybe even more so because there is less chance for recourse, to big business. Just think of trying to get something changed through a big bank or insurance company. The rules override reasonableness. I suspect it is even more frustrating to the person charged with enforcing the law that they know does not fit the situation.
Ironically, these arbitrary rules hurt more than they help.
First, they make the enforcer stupider and more likely to make a mistake. When I first started my own building company, our lender was Wells Fargo Bank and our lending officer was a local guy. (His brother was a real estate broker, so the real estate biz was in their blood.) When we wanted a loan for a project, we had to convince him. Wells trusted him to make the right decision and he was responsible to know the project and know that it would work.
Now there are twenty five times as many rules, the decision gets kicked up to a committee and – if the project meets all the requirements – it gets passed with none of the decision makers having to actually visit the site. Nobody really has a vested interest in the project working. That is part of the problem that lead to the bank failures.
If the lending officer – who now is really only a data collector at a large bank – follows the rules and the project doesn’t work, nobody is to blame, they all followed the rules, after all. The rules are made to make the lending environment safer but they really make it more dangerous. Everybody knew there were stupid loans being made, but nobody cared.
Second, this arbitrariness pisses people off and builds disrespect for the government or company. People are more willing to cheat; to design a project to fit the rules rather than be successful. In schools, it becomes teaching to the test rather than educating students.
We are all heroes
in our own minds, except that we are not. When I was about 31 or 32, I read The Winds of War by Herman Wouk. It is one of those book with lots of characters and shows the wind- up to WWII from different view points and if you haven’t read it, I would recommend it – although I may be wrong, as I did read it almost forty years ago and our collective sensibilities may have changed – if you like historical fiction. Anyway, a couple of the characters are Aaron Jastrow and his niece, Natalie. They are Jewish – duh! – and in Europe. From almost the beginning of their part of the story, it became obvious – from my view point of looking back on the war – that they were going to end up at one of the German Death Camps.
When I would get to the Aaron and Natalie sections, I would just skip ahead. I couldn’t read all the bad choices they were making; choices I knew that I would not have made. In my mind – at 31 or 32 – I would have, heroically, made much better choices. Now – forty years later – I know that I would not have made those heroic choices of my fantasies. Now I know that I couldn’t read many of those sections because I saw myself in Jastrow’s mistakes.
These remembrances came up when I read a blog post by Ta-Nehisi Coates today. In it, he writes about how easy it is to think we would do something different than what the slave owners and slaves actually did do, if we had lived in the slave society of the pre-Civil War south. It is a constant theme of Coates and was brought up by an article by some fool white guy saying what he would do if he were a black kid being raised in poverty. Read it, really! It goes directly to the question that people who are raised in poverty tend to stay in poverty and should society try to change that or just say, It’s their fault, with all the ramifications that brings.
By the way, the prison camp photo above is one of the camps we – we being the United Sates of America – built, in one of our racist fits, to intern our Japanese citizens during WWII. I want to say that I would have been against these camps if I had been my parent’s age when they were built, but I doubt it.