Monday, May 26, 2008

Time Line

4:30 p.m. -- go to friends' house for sociable meal.

5:00-8:30 -- socialize

8:30 -- depart for home

9:00 -- arrive home, check email, begin to write newspaper column

11:00 -- finish column, get ready for bed

11:45 -- actually get to sleep. Alarm set for 5:45 to calibrate water testing instruments.

2:00 a.m. -- P

3:00 a.m. -- Hear cat vomit on bed. grope for flashlight so as not to wake other human in bed. Locate vomit. Mop up. P.

4:00 a.m. -- P

5:00 a.m. -- begin to wake because of light. Not really awake because of lack of sleep.

5:20 -- get up, turn on coffee pot and YSI 556 multi-meter. Return to bed while both warm up.

6:00 -- Crawl out to begin chemically stimulating brain and calibrating YSI 556. Discover that calibration instructions are not present. Look up lengthy pdf of manual on line. Dredge brain to recall streamlined procedures.

Cats and spouse sleep peacefully.

After testing and whatever breakfast I might dig up, ride to work for the rest of the day. What's for lunch? Besides caffeine, I mean.

7:00 p.m. -- pass out. See you Tuesday.

Tuesday, May 20, 2008

Oh yeah, Iraq

Backalong, we refinanced our mortgage to get rid of the bullshit adjustable rate the bank stuck us with because we actually needed the money we were borrowing. The reasoning is that if you haven't proven the ability to pay back, they should have the right to jack your rate to make your payments higher. This is in case you couldn't hack the lower one. Are you following this?

And what does it have to do with Iraq? I'll tell you.

While making the sound financial decision to lock in a low, fixed interest rate once we had established ourselves as good, dutiful debtors with our local lending institution, we also decided to tack on a few thousand so we could add a little doohickey to the living room to make it more livable. As built it had turned out rather long and narrow. We got an estimate, but could not start the work right away.

While we waited to start our project, President George Bush started his. When we talked to our contractor sometime after the occupation of Iraq began, he said material prices had spiked and supplies were down because mass quantities of plywood were being sent over for the rebuilding.

Okay, we take one for the team. We ended up pissing that money down the health insurance rathole, because we couldn't keep up with the annual jump in premiums from our insufficient cash flow. C'est la vie.

Watching C-Span one day, I tuned in during a hearing at which whistle blowers testified about contractor abuses in Iraq. One man reported that massive quantities of plywood and other building materials arrived over there and sat around in piles until the order came to burn them because the construction was going to be done with steel instead.

Okay, these are Democrats, no doubt relishing the opportunity to grind their ax against the Republican administration, but where there's smoke, there could be burning plywood. It was mildly amusing to have this bit of cross reference, a sort of closure, viewed from an odd angle to the television in my living room because we never got to bump out that wall.

Monday, May 19, 2008

The Best Health Care System in the World

A few minutes before 11 a.m., I arrived at the reception window at my doctor's office.

"Hi, just checking in for 11 o'clock with Doctor Bladiblah."

"Your name?" asked the smiling attendant. I gave it to her. "Hmm, something's not right here. When did you make the appointment?"

"Nearly a month ago. I was told he couldn't see me until now."

"Did you get a call last week confirming this?"

"I don't think so."

"Well I'm sorry, but you're not in the system at all and there's no way we can fit you in. Dr. Bladiblah is already two patients behind. The best I can do is get you 11:30 with our visiting doctor, Dr. Soandso."

"I'll take what I can get. But I'd wanted Dr. Bladiblah to take a second look at this skin blemish he deemed benign a couple of years ago when it was less than half the size it is now."

"I see, well, we can get you in with Dr. Soandso at 11:30. Will that be all right?"

When I agreed, she gave me a form to fill out. That was quick and easy, because under insurance I could simply write "none." When they didn't immediately grab me by the shirt collar and seat of my pants and heave me out, I figured I'd passed the first hurdle. I leaned back in the waiting-room chair to nap.

Well before 11:30, someone fetched me in to have vital signs taken, and showed me to an examining room. Dr. Soandso appeared shortly. I exhibited my deformities. He examined the skin blemish with a strong light and magnification and said it looked like it was probably harmless, but had some color variation, so it would be best to have a dermatologist look at it. Who the hell gets a beige melanoma? But I don't even have normal abnormalities.

Next we got to the scarier stuff. I've had this little squishy lump on the side of my neck for years, but when my wife noticed it from a distance and asked me what it was I suddenly realized I'd been taking it for granted. You mean everyone doesn't have one? Oh, shit!! This is right out of every cheesy melodrama or horrible bit of gossip you ever heard. "He had no idea. He felt fine."

Once I decided something wasn't right and found out I had to wait a month to see my physician, all I could feel was that part of my neck. It felt like a goiter, or a second head pushing out obscenely. Everyone must see it and wonder how I could put up with such an obvious deadly tumefaction bulging from my flesh. After a few trepidatious prods around its vicinity, I grew afraid of my own neck and avoided touching that side of it as much as possible.

Dr. Soandso came to grips with it unhesitatingly. He squished it from top and sides.

"Any pain?" he asked. "Does it hurt you?" His fingers nearly met in the flesh of my neck, but I didn't think that was the pain he meant. I didn't bother to explain the pain that went with my fixation. When a classmate of mine lost her leg to bone cancer when I was in high school, my own leg ached unrelentingly for a year. I am just supremely freaked out by the random hideousness of cancerous growth. Except for a very few lifestyle-related factors to certain specific cancers, you really don't seem to be able to do much of anything to deflect that particular bony finger of death. Death is something we all have to face, but what's the hurry? Pain? Factoring out neurosis and your pincerlike grasp, no.

He seemed fairly confident it is a lipoma, a little blob of fat, rather than a malignancy. But he did say I should show it to the dermatologist when I'm there.

"They might feel it's worthy of a small-needle biopsy," he said.

Well. As long as it's only a small needle, heck, let's all have one.

Duly discharged into the hands of the front office staff again, I sat with a very friendly and helpful woman while she tried to get me in with a dermatologist. Remember that we're supposed to hate socialized medicine in part because, "it takes forever to get to see a specialist, unlike in our free-market system for profit."

Okay. It's May 19. The first dermatologist we tried didn't have an opening until August 4. We scored at the second one, though. June 30. No sweat. I just have to drive about 40 miles each way, but that's what you get for living in the country.

The bill was modest. The estimate for the dermatologist is less so, but still within budget. The crappy policy I used to have would have covered none of this, and the premiums would have gobbled up the money I would have wanted to pay my own bills, so I continue to cling to my ledge and defy the elements.

In Other News

Grey squirrels have taken a liking to the hummingbird feeder on a decorative pole in the small garden around the well head. We took down the seed feeder because wild turkeys were decimating the plantings, scuffling for fallen seeds. It didn't matter with four feet of snow on the ground, but now they can rip up the earth.

The plastic parts of the hummingbird feeders have deteriorated badly from exposure to ultraviolet over the years. The base got banged up badly enough when a bear took the first seed feeder a week ago. The pole was bent, so it must have swayed wildly as the hungry bruin yanked down the handy snack we'd carelessly left hanging there. The squirrels continued the vandalism. The joke's on them when they all get cavities. We should throw out some sweetened fluoride mouthwash for them.

I removed the temptation for now. It needs repair or replacement before I put anything back out. Maybe the squirrels will have moved on, since both seeds and sweets have gone away.

Sunday, May 18, 2008

Didn't Need no Welfare State

As more people get spat out of the "health insurance" system, we will get to appreciate more and more what life is like in developing and undeveloped countries, where a few very wealthy people have decent lives and a large number of struggling workers, educated or not, live as long as their luck holds out. It's not that the facilities and skilled providers aren't there. It's that the rank and file should not be encouraged to live beyond their means.

In our case, we earn enough to live a little bit comfortably until we try to pay for that hideously flawed instrument, health insurance. Insurance that provides basically nothing still busts our budget, let alone leaving us enough to put into a bullshit "medical savings account" to cover the massive deductible. Given the choice of draining our savings to pay a premium we probably wouldn't be able to maintain if one of us got sick, or depleting them later to pay down a debt for actual services received, I know what I choose. But either way we end up on the rocks. The financial aspect dumps another completely separate challenge on top of any medical considerations.

You can find all kinds of debate about what drives medical costs up. It seems to be malpractice premiums, drug costs and inflation generated by the insurance system itself.

Inflation from insurance takes two forms. One part stems from providers inflating their prices to cover the amount the insurance companies are going to chisel them down. The other part stems from the extra staff needed to keep track of the volley of paperwork back and forth between the service provider and the insurance company, and both those entities and the patient. The doctors and insurance companies have paid staff to play this game. The patients have to do it as amateurs in their spare time.

I guess we all need to come to terms with a more natural model of life and death, in which sickness and injury are once again as serious as they used to be in the primordial past. Forget what's technically possible. If no one can afford to pay for those medical miracles, they might as well not exist. As costs spiral upward, procedures that we've come to view as routine become unreachable, unimaginable miracles to the people cut off from them by the high financial fences of the invisible gated communities in our society.

You have no value as an individual. You only have value if you get yourself employed by someone willing to pay for your upkeep, or you generate enough revenue through your own enterprises, or you sign on to do your country's dirty and dangerous work in theaters of war around the world. What might you have to trade for that? Think carefully, because either way it will cost you your life.

Forced to think about that health care thing

After a slightly worse than minor bike crash on the local wretchedly designed bike trail, my wife has had to go to the hospital twice in two days for chest X-rays. Her doctor advised the first one yesterday, the day after the crash, because of the pain and other symptoms my wife described. On her home monitor, the doctor determined both lungs were properly inflated, but her screen did not have the resolution to show the small pneumothorax in the upper left. The radiologist caught that and actually phoned us at home to advise a follow-up shot to see if it was reducing on its own.

It sobers you up when a doctor calls you at home without being asked, to let you know you could have a life-threatening condition. It wasn't a full-on emergency, but he said we should check it out before she suddenly couldn't draw a full breath. I downed a bunch of coffee, since sobering up to ambulance-driving standards really was on the docket. The radiologist should have called before we enjoyed our relaxing, before-dinner libations.

We drove to the hospital in the rainy darkness. I did not point out the smell of sticking brake caliper that indicates another upcoming drain on the family finances. Goddamn cars cost you money to drive and cost you money not to drive often enough.

At the hospital, we breezed straight into radiology, because we were there on a specific mission, and the paperwork had been taken care of on the first visit. The tech took her right in and shot the new film. Of course they're not films anymore, but anyway...

While we waited, the ER attending came in. He's a cyclist and has patched me up a couple of times over the years. Two of his children are in Laurie's string program. Then the on-call surgeon came along to assess the condition. He said it looked stable and small. It should take care of itself, but she needs to take it easy. That's good, she was doing that anyway.

All this is happening during the couple of days before an appointment I made with my own doctor to have some things checked out on me that could be nothing or the end of everything. You just never know. It seems like the surest sign that you're desperately ill is that you feel fine. That's certainly how it is on TV shows like Death by Emergency Room or Horny Doctors with Messed Up Lives. You go in for a hangnail and go out in a body bag. Hell, they even do it on Scrubs. And what about House? They should run a ticker across the bottom of the screen, showing how his diagnostic process is jacking the patient's bill through the roof.

Y'know, it's not so much the illness as it is the money. You really have to decide whether the bit of life you snatch back from death will be worth living under the burden of crushing, impossible debt. But in some countries, and the entire animal kingdom, you just get sick and die. And life probably sucked pretty good prior to that anyway. So fut the wuck.

Tuesday, May 13, 2008

Day to day

Got the clothesline up. Now the dryer sits as idle as my car, only getting used under similar circumstances of inclement weather.

Hummingbirds arrived on the 12th as always. Also as usual, it was one sighting of one male. Over the next couple of weeks we will see more and more.

Fuel prices and the bad economy have had the usual stimulating effect on the bike business. Unfortunately, that also means the business will become more competitive, as those who survived the collapse of the mountain bike boom seek to resuscitate their fortunes. A lot of familiar voices have returned to the radio in ads, as bike vendors push their wares. Can price wars and unwanted "innovation" be far behind?

The early-1990s mountain bike was the perfect platform for consumer bikes. A knowledgeable shop could turn it into whatever form a particular customer needed. It may not have been the perfect tool for thrashing down a rough trail at racing speeds, but the vast majority of riders had no interest in that at all. Nor did they want some comatose "comfort bike." And if they did, we could build it on the same platform we could tweak for the intrepid explorer to play in rougher stuff.

No matter. That's all gone now. Consumers at all levels have been brainwashed to think they need suspension. Shifting systems have turned into an endless acid trip.

The day job has a way of expanding to obliterate everything else. Cycling's a good cause to support, but it's just one line of effort among many.

At least the weather's nice.