Coping: How I Learned to Understand Healthcare

Thanks to HIPPA (which stands for lawyers are watching if personal healthcare information is released) I can’t be specific with names in this report, but I’ll relate the pertinent medical facts and assure you that every aspect of what I am going to tell you is true.

The story begins last week when a woman, age 70, goes to take out the garbage at her suburban home.  She’s done this hundreds if not thousands of times since she’s lived in the house for about 40-years.

Well, this trip didn’t go as planned.  As she turned to wheel the garbage container out to the street, she slipped and fell on the driveway.

Unable to get up, she flagged down a passing car…which summoned the local EMS team and they suspected a broken hip.  So off to suburban Hospital A.

There, while her kids figured out what went on and came from work to see her, the Big Wheels of Healthcare began to roll.  Turns out Hospital A didn’t do the kind of surgery needed, so she was moved to big urban Hospital B.  Apparently, there is some kind of bidding/buying process for surgery time…but she goes to Hospital B.

Once there, she is MRI’ed and prepped for surgery.  The Doc is first rate and the surgery is done in 2-hours and all is well.

This was on Thursday or Friday and by Sunday the woman is back at home, one of her children with her for the first week since (with a new hip to get used to_) because she’s considered a secondary falling risk…and all this makes sense.  The woman is fit and I gotta say, down just 2-days for a hip replacement, is pretty damn good – at any age.

The one thing apparently “normal” from hip replacements is that there are quite a few meds involved.  Serious antibiotics, tissues this’s and pain killer that’s.

All of which leads (indelicately) to having to use the bathroom every couple of hours where thins are decidedly are “loose” to put it as delicately as I can.

So the daughter on shift decides to call the on-duty consulting nurse.  She wonders if this loose condition is normal?

Oh, sure…not unusual at all…” she is reassured by the nurse.

“OK, thank you,  bye… “  says the on-duty daughter.

“Wait!  Before you go, I need to ask you some questions.”

“Oh…OK…what?”

“Has you mom been to Sierra Leone in the last 21 –days?”

No.”

Has she traveled to Liberia or Nigeria in the last 21-days?

“No…she hasn’t left (city name) in several years.”

OK.  Has she traveled to Mali in the last 21-days?”

No.”

Have any contact with anyone just back from West Africa

“Not that we know of….”

This went on a bit longer, the consulting nurse explaining along the way that these were  new Health Department required questions as part of Ebola operations.

It takes over a month to get the administrative wheels going and even then, people are still coming in from West Africa, crews are rotating in from the oil patch back and forth, yet this woman aged 70 who hasn’t left a 25-mile circle in several years, who has understandable G.I. tract follow-up from a hip replacement…

I shake my head in wonder, sometimes, as how the world really works.

I talk to my consigliore about it.  Although he’s double-degreed in Accounting and Law, he has been fascinated with how bureaucracies work and almost went the Public Administration route.

Because of all his degrees, we’ve been following his projections on Ebola cases and seems pretty close to the mark so far.  Especially the part where he forecast lying would be the biggest problem because people do what?  (Go look at any political site, go on!):  They LIE!

But when we were chatting about Ebola this week, he also mentioned that big bureaucracies have a problem with flexibility.  Yes, yes, I’m beginning to see that. 

As the showdown over the Maine nurse’s quarantine showed, sometimes we get treated to the real-life version of the old physics problem:  “What happens when two irresistible forces collide?”

One State figures IT is the irresistible force.  You can damn-sure bet the Obama Administration believes IT is irresistible, too.

The facts of the case  ultimately yield the definitive  answer the physics problem thusly:

If irresistible Force A is the stationary driveway and irresistible Force B is gravity, the result in Today’s World is a Recent Travel Quiz.  The broken hip is ancillary to the discussion, though we wish the recipient a speedy recovery.

The broken hip has added tremendously to our understanding of modern healthcare. Rack ‘em & stack ‘em, bid ‘em, and fix ‘em, and push ‘em out the door.  And then quiz them on stuff that was in the patient H&I (history and information) from the get-go.

Take this new-found knowledge, along with two aspirin,  a law degree, plus three box-tops from political connections and you too might qualify to be the next Ebola Czar.

Just don’t spend too much time in the bathroom, even if you’ve had your hip replaced.

A Word from the Wiz

A reader of ours (The Wizard) is not surprised that my wife scored higher on an IQ test than I did.  Come to think of it – and this is disconcerting – seems no one was surprised by the outcome except, uh, ME…hmmm…

Well, anyway, the Wiz has a sure-fire method to turn things around:

Saw your paragraphs on the IQ test today (Elaine’s is the same as my MBA daughter’s by the way).

I remember that last week (?) at some point you said that, while Elaine was trim & eats more healthfully and gets regular exercise, you could stand to lose 30 pounds and get off your butt now & then.  That sounds a lot like The Lovely Mrs Wizard and me.

Coming back to the IQ thing, I have found a way to prove to my wife that I am smarter than her – and she can’t argue with it!! And you can use it too.

It’s quite simple – First you tell her that you can prove it – she will say something like ‘How do you figure?’, and you say “Well, I married you <big grin> and look what I got!!  You married me <disgusted face> and look what you got.”

First time I did it, The Lovely Mrs Wizard’s jaw flapped open & closed silently a couple times, then it was just “DAMN!!!!

Enjoy!

Wizard

Dear Wiz: 

You may wish to get some pictures and maybe a video of the silently moving mouth.  This will change over time.  Trust me on this.

WoWW:  Odd Light Flash Follow-up

Have to mention for reader Tom up in Illinoisy that he’s not the only one who saw the odd light flash Sunday…

Thanks for mentioning Tom in Illinois. I also saw a flash recently as he described, and also got up to investigate. I chalked it up to blood vessels in the eye doing their thing- but if his wife also saw something, it probably wasnt that.  Sounds like this guy lives in my general area as well.

Now if it was just one reader…but check this from  a READER DOWN UNDER:

Dear Mr Ure,

I’ve been following your site for a few years now but never wrote to you until now. I read the post you had in your daily newsletter on Monday about one of your reader and his wife seeing a flash. Well on Sunday nigh my two girls aged 8 and 10 were walking into the kitchen, all of a sudden they stopped and looked at each other. The older one said to her younger sister “did you see that” the younger one answer “yes I did, what was that?”. When I asked them what they saw, they said that they both saw a flash of light in the corner of their eye. Now I didn’t see anything but it’s interesting that they both saw the same thing at exactly the same time. That was on Sunday at around 7:30pm in Sydney Australia. Interesting coincident Hmmmmm.

Kind regards

Joanna=

(Never feel any reluctance to write.  I read 100% of everything it get in email  including those stupid campaign emails.  I may not respond to each and every email or if I do, Dragon Screeching may muddle my reply.  But it helps us both.  You keep me on track and I get wondeeful reader adventures to share.)

I remember seeing a flash of light like that once, myself.  It was kind of like a sparkler flash…and it was in a dark room.    I did some research at the time d it might have something to do with energy from space hitting an optic never just right.  Never did get around to asking OptoDoc Rob about it…

But there’s a more sinister aspect of this.

What would happen if the government developed a machine that could “project” a laser quality image into people’s heads?  In other words, what if a Second Coming could be projected globally from space?  Or an entire “alien invasion” faked?

This all gets us back to mention of Project Blue Beam – widely discredited not because government is so transparent and trustworthy, but more because it hasn’t happened – yet.

A RationalWiki discussion over here will fill in the blanks if you haven’t heard of it, but surely you have, right?.

Hey!  All we need is an informer coming in now to tell us that increasing fluoride levels in public drinking water will fight Ebola and we’ll b e all primed, right?  Bring on Blue Beam..it’d be cheaper than streaming video…

Old Man Winter and Dopamine

Let’s begin with the dopamine part:  When you anticipate a reward and it is larger than expected, more dopamine neurons in your brainstem fire.  Yee-haw!

Conversely, when a reward is less than expected, less dopamine neuron firing takes place.  Insert frowny face and mutter “aw shit…” 

And, if there is no change to expectations even with a novel event, because you KNEW it was going to happen, then the dopamine-fired neuron rate is stable.

Now, we have here a whole bunch of useful information:  We know (beginning geniuses and all, such as we are) that this is key to Prospect Theory and this is a cool branch of behavioral economics.

More to the point, it also is the Holy Grail of television – especially series and news shows.  The way to build market share is to deliver dopamine “buzz” via the unexpected.  Think about Amazing Stories and FringeTwilight Zone and all the rest of it. Yeah, sure, the shooting of J.R. on Dallas, too, if you insist.

As a former bit city news director, I can assure you that there are lots of people who are “news junkies” and similarly, much of our taste in music is determined by ibidly tweaks to our chemical selves.  But you knew all that.

(New word:  ibidly means similarly but that was used previously, or likewise which is totally 18th century.  Derived from ibid  meaning “ in the same source (used to save space in textual references to a quoted work that has been mentioned in a previous reference). Sometimes used in conjunction with previousity.  Example:  “As I mentioned in an ibidly previousity.”)

But what you hadn’t maybe stitched up (we’re back on point now, thank God) was the way, method, and manner that all this plays into repeatable news stories.  And one phenomenal source of such repeatable stimulation is the Dow Jones Industrial Average.  Depending on whether you’re long or short the market, it’s almost Pavlovian how people react.  Right up to the equally Pavlovian “closing bell.”  As it turns out, there’s an opening bell, too, and lots of slobbering in between.

Und zo?

The  Farmers’ Almanac is another gem of stimulation science.  Hold on to your dopamine levels:

And at the moment, the Persimmon Lady seems to be forecasting a cold winter.

Then just as the neuron level reaction to that rolls by, the news jockey tosses up a report about the Gulf Stream slowing and a bitter winter may be coming for England/Europe this coming winter.

Dopamine neuron firing may not keep you warm this winter, but as Prospect Theory goes, it will keep the news channels going and ad sales alive.

At last, what our thinking reveals is a strange concept:  If we could all lead chemically stabilized lives (level dopamine, or more bounded than what we have at present), would the world be any happier? 

Or, is the unexpected (hence dopamine hit to the brainstem) why my son jumps out of airplanes?

It explains, too why news is no longer news; it’s infotainment.  Because with infotainment you can press a lot further outside the normal news/dopamine levels.

From dopamine comes ratings and rankings, news junkies, buzz, and tweets galore. Brainstem dopamine firing is indirectly monetized.

Oh, and as a bonus, we get a nation full of dopes….er….so to speak.  Always ready for another Hard Winter story and a Groundhog Day.  Predictable and good hits to the brainstem, depending on forecast.

When comes to media, very few of us use it for a purpose.  Mostly, it’s mindless dopamine buzz…not unlike the monkeys who – given enough coke – will eventually overdose.  But it has been a hell of a party, hasn’t it?

Say…have you checked the CO2 levels, lately?

Write when you break-even

George   george@ure.net

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