Sunday, September 29, 2013
Stoplights and Headaches
Paul, who retired from construction a few years back, hurries out for a pint of ice cream one night. His wife absolutely has to have "Mint Mocha Madness," so he heads for the faraway grocery store. It's a quiet 11PM when he pulls up to a lonely T-junction--that annoying one, where the light takes forever to change. After waiting about half a minute, seeing absolutely no one in sight, he creeps forward. No one to the left, no one to the right, no one dead ahead. No headlights, no engine noise, nothing. Feeling a little guilty, but also a little annoyed, he makes the left turn.
Aaaaand, flashing lights come on. The cop, unfortunately, is not inclined to give Paul a warning. He apologizes, they chuckle a little bit, and both go away knowing that Paul's going to make another attempt the next time--only he'll check the spot behind the old tree on the west a little more closely. Paul gets the Mint Mocha Madness, mails $240 to the City authorities, and goes on with life.
Jared is 37, and she has migraines. For all her life, as far back as she can remember, she's had these pulsing headaches that come upon her mostly-randomly, occasionally-predictably. Since she's been nine or ten, when her parents finally took it seriously, she's had a bottle of pills. She can take one when she feels it coming on, and it brings the pain down to manageable levels, where she's able to concentrate, work, sleep, play, and have a life.
The same pills. At the beginning, the neurologists played around with this and that, but eventually, by the time she was ten, they'd settled on the one that she, and thus they, had confidence in. For 27 years, they've worked great. Jared went to college, got her degree in science education, and teaches Chemistry to Juniors, and The Natural World to Freshmen, at the local high school. She's raising a kid right now, in-between husbands, volunteering for the drama club's plays, and sometimes helps out at track meets.
Every six months, come rain or shine, Jared has to go to a new doctor (it always seems like it's a "new" doctor, even though it usually changes every five years or so, when a former associate takes over "Baum-Perkins Family & Internal"), wait in a waiting room, drop a specialist co-pay, and chat a little with a brand-new receptionist, then a nurse trainee, then some 26-year-old resident, about what her migraines are like. The appointments themselves only take about two hours fifteen minutes out of her day, but at the end, they update her six-month allotment of the simple serotonin 1D receptor agonist that she's been taking since she was ten. Finally, she is granted permission to buy her pills--for another half year, at least. On her way out, the receptionist advises her to schedule her next appointment now, because they're already booked through until February.
What happens if Jared doesn't keep her appointments? She loses her prescription--she has no protection against migraines. The power of the drug cartels is such that Jared is not, and never will, be considered intelligent enough to buy her own medication. Even though Jared's had the adverse drug interactions and possible side effects memorized since age fifteen, and she needs the pills to, literally, live at this point, she would lose her home and do hard time if she tried to jump the counter at a Walgreens and get the bottle that allows her to not have such an intense headache that she crashes her car a few minutes after she feels it coming on.
The few times Jared's been irresponsible enough to fail to coordinate her calendar with the people at Baum-Perkins, she's had to telephone-shop every medical office in the greater Pittsburgh area, only to discover that "new patients" need to undergo longer consultations, with more co-payments. Out of options, she's gone into the emergency room, waited for four hours while desperately clutching the last one or two pills in her bottle, then gotten scolded by an emergency resident to be sure to update her prescription ahead of time, next time. The ER writes her a prescription that expires in one month, so she has to rush to get a regular appointment after that, or else it'll be right back to the ER. So, she sticks with Baum-Perkins' rotating cycle of twentysomething residents, calendaring the rest of her life around their office schedule, so that she can keep alive.
Of course, it's going to be hard. With all these new people moving into the area, it's harder and harder to get an appointment, and work is already pretty annoyed with her. The copays seem to keep going up. Why can't she just buy her damn Maxalt, already?
...obviously. Now, there's an argument to be made about "people who might miss seeing oncoming traffic," and "making sure the doctor keeps abreast of your developing condition," but this kind of protection is extended to no other profession. Try it out:
(1) You may not cut your own hair; the operation has to be performed by a State-licensed barber, to ensure that you are kept informed about the latest developments in piloseutical science.
Not apt and/or mortal enough? Fine, (2) You may not attempt to repair your car engine, filled with dangerous, powerful grinding parts, and corrosive, explosive, deadly fluids, which could explode and lead to a fire that could kill you and your neighbors, without the assistance of a State-licensed mechanic, to ensure that you do not accidentally get your hand caught in something, inhale gasoline vapors, or get otherwise hurt.
Still not medical enough? Okay, how about (3) You may not purchase and/or use an advanced handheld oral hygienic device (TOtal Oral Tactus-Hertz BRUSH© system) without a prescription from a dentist, due to the millions of people who suffer each year from advanced tooth decay and gum disease, and the public health interest in ensuring that they get regular checkups. Also, most people brush incorrectly, using a side-to-side motion; if they had to see a dentist every six months to renew their toothbrush prescription, toothbrushes would now cost $45 each and be stored behind steel-link walls, but it would get more people to start using the proper "gentle, small circles" motion.
The regimented stupidities of everyday life complement one another. The more abjectly, boringly, literally stupid that commanded behavior is--waiting for no one at empty intersections, like so many modern Miss Havishams playing the part of courteous drivers on busy streets--the more we accustom ourselves to following directions, and the less to figuring things out.
Wholly integrated networks are attempting to achieve system failure through the magnification of single flaws. Wholly isolated networks are attempting to achieve system failure through the reduction of resources into inadequate size for efficient utilization.