Kaiser Should Be Terminated

After many years of attempting to use Kaiser, specifically Kaiser behavioral health, I can tell you flat out that they are incompetent and useless.  Their emergency room and laboratory delivers false results which will damage your health and your medical record. They cannot deal with very common medical and behavioral issues. Therefore do not waste your time, disenroll from them, and try to find a real health plan.  I will from time to time post specifics about their incompetence and how they have damaged my life but this little introduction will have to do for now. 

Advice for Dealing with Doctors

The following guidelines are compiled from 30+ years of wrestling with the medical profession.  Some of what is suggested here may result in a better medical outcome but in general the following, if it has any value, it is because it may lower your frustration level and maybe help you avoid some pitfalls.

1. No matter how good and reliable the system that you have set up may be, it will eventually self destruct.  You may wish to plan for this in advance.

2. As part of above, doctors do not last forever.  They wear out, retire, get weird, or other.

3. You may potentially extend the service life of your doctor(s) by minimizing what you tell your doctor.  The worst thing you can do is to honestly explain what is going on, it is likely to freak them out and cause them to "get clever" and make your life worse.

4.  If you tell them too much, they will just use that information against you.  Do not give them that opportunity.

5. Although the doctor(s) think they are in charge, in fact you are the one making decisions here.  Just like a lawyer ultimately it is your responsibility, not theirs.  

6. The best advice anyone can give you is to have a lot of money.  The health system can be made to function somewhat without money, or with less money, but it is much harder.

7. At any time, the doctor upon whom you rely may choose to make your life miserable and, for example, make it impossible for you to work.  Do not think that they give a hoot, they do not.

Good luck!

(insert notes about different doctor cultures)

ADD/ADHD Article in The Atlantic and Medical Malfeasance

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The Atlantic has an interesting article about Adderall and ADD/ADHD in which it reveals that the medical community failed to even recognize adult ADD or take it seriously as a disease until 20 years ago, if that. And of course Adderall may be over prescribed today as a result, or is it?  After all, amphetamine is a recognized human performance drug with some well known side effects, why shouldn't people be using it whether or not they have ADD?  

As the article makes clear, the medical community is guilty of gross malfeasance in this area, and I think it is very reasonable to resent being required to go to these wankers as one gateway of many to get the most important known medication available for this disease/syndrome/whatever.

https://www.theatlantic.com/health/archive/2023/04/adult-adhd-diagnosis-treatment-adderall-shortage/673719/

 

 

Setting Doctor / Patient Expectations

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If we have healthcare by the free market system in this country, which I am told is the case, then it should be possible for one to have a contract with one's doctor in order to set expectations and obligations clearly.  In my experience, this is not done, and all the obligations are on the part of the patient, with the doctor being able to do whatever they damn please.

Although you will hear about such things as a "Patient's Bill of Rights" to the best of my knowledge no such thing exists in any serious form, at least not that it would have protected me in any of the dozens of cases where I might very well wish to be protected.

Having made this mistake many times in the past, here is a short list of things I would like known and agreed to up front.

1. The doctor will not release information about the patient without the patient's written consent.  This happens all the time when a doctor sells his practice to someone else.

2. The doctor understands that he is responsible for delivering proper prescriptions on a schedule and that failure to do so will cause the patient damage.

3. The doctor understands that he/she is responsible for advocating for patient in any dispute or misunderstanding with the pharmacy and any failure to do so will cause the patient damage.

4. The doctor understands that when he/she goes out of town or is unavailable for any reason, that another doctor is made available to cover and will know enough and be comfortable with prescribing the appropriate medication in his or her absence.

5. In the event that the doctor and patient must discontinue their relationship for any reason, that the doctor will still provide prescriptions and interaction with the pharmacy for at least six months (and this term may have to be more).

6. The doctor will understand that this responsibility is serious and he/she can not just say "oh thats not important".

I am tired of having to deal with these irresponsible scum in order to get the medication I need to live my life.

That Secret Californian Medical Database

It was fun to go to Urgent Care in Santa Barbara and get a prescription for my ADD/ADHD medication.  This was very unusual and very convenient relative to going to the Emergency Room.  It would not have worked in Escondido, by the way.  

Apparently the new rules are that any prescribing doctor now has to check the database before giving a prescription.  What is entertaining about this is that the patient is not permitted to see his medical records that are in this database.

And you thought you lived in a fair and just society?

Value of a Psychiatrist in our Late Capitalist Society

A friend, who is aware of the stress I am going through, suggested I go see a psychiatrist he knows down here. The good news is that my friend wants to help. The bad news are the details, so lets go through it.

I think my friend knows all this, by the way.

The short version is to skip to item 10.

1. The doctor he recommends is an adult psychopharmacologist, I already have a psychopharmacologist. About six months ago, I was thinking of changing, but now I plan to stick with the one I have until I leave the area at the end of the year. (This particular recommended psychopharmacologist is also semi-retired and expensive).

2. Psychopharmacologists are good for one thing, prescribing drugs, period. My psychopharmacologist already prescribes the maximum of the drugs I intend to take. (Note: I would take more if I could, but I cant, so I have to deal with that).

3. There is a more general kind of shrink called “a therapist”. Some of them can prescribe drugs, some dont. In my experience, they are useful for one thing: the rent-a-pal phenomenon. When you talk to a shrink once a week, you tend to lean less on your friends for moral support. This is valuable! But time consuming and expensive.

4. Doctors cost money. I dont have the money to spare.

5. The money could be spent on many other things, like travelling to Sf to see an ex girl friend. That might cheer me up more than any doctor.

6. The problems I deal with at this time of life comes from trauma experienced in my 30s and afterwards. That trauma results in anxiety attacks today when I am not in control of where I live or how I am going to afford to live.

7. Therefore, if you want to help, and my friends do want to help, you should listen and say something cheerful, or (this is much more difficult....) you should help me find a job, or arrange for a place for me to live, or give me money or introduce me to someone who can. Unfortunately, that is easier said than done, especially in today's world.

8. We live in a corrupt, late-capitalist society. Money is necessary to solve problems. Shrinks are a tool which used judiciously, can be helpful. But, like lawyers, they are not a panacea and they run on money. At the end of the day, money may not buy happiness, but money, or a steady job, or both, will buy stability and some satisfaction. This is not the only path but it is a good one and very straightforward.

9. I recognize that most people can not provide this help for their friends, or when they do, only in very limited amounts. I have sampling error here. There was a time when I could give people jobs, two different times in fact, but those times are past for me and may have never existed for my friends. Your good wishes and thoughts are appreciated.

10. But the biggest mistake here is to think that doctors are good for anything and the patient knows nothing, even after a life time of dealing with this.

11. Send money!  Just kidding, sortof.  Thank you!

CVS Pharmacy and Single Payer Bribery

draft

A surprise tonight on my medication costs. To make a long story short, I normally spend $20 / month at Vons Pharmacy for a medication I do for "restless leg or whatever". But I let it run out, I am bad, and so I went to my 24 hour CVS pharmacy to discover that *after discount* they were going to charge me $220.00 for the exact same thing.

I wonder, do our politicians get a cut of this every time a sick person is raped for their medication? Or do they just take some agreed upon fee at the end of the year? Hey I dont have to sleep tonight, and I can pick up my medication when Vons opens tomorrow.

I just wonder if it might not be possible to examine how our politicians are paid for their crimes against the people.  Perhaps if we made their bribes more efficient, perhaps a single-payer bribe mechanism, our medical costs could be lower?

Its worth a try, I think.

Scientists Propose Force Feeding Brains to Right Wing Sufferers of Dementia

Scientists have discovered that a New Guinea tribe that routinely ate the brains of their human enemies not only did not suffer from horrible Prion-caused dementia, but actually developed genetic immunity to this tragic brain-destroying disease.

“Quick action is needed to bring this immunity to other members of the human community”, says Dr. Filbottom of the East Saxon Community Medical Center, who was not an author of the study. “Since clearly our political right wings the world over are suffering from a form of dementia, denying evolution or global warming, by forcing them to eat human brains we can potentially cause them to develop an immunity to their debilitating and life-threatening disease that causes so much hardship and destruction in the world. We must act at once to force feed them brains if necessary in the hope that they will also develop this immunity".

The proposed treatment is to begin with neoconservatives and inject into them mad-cow infected brain particles.  "Just imagine we had this treatment a few years ago, the whole second Iraq war might not have happened at that huge cost of lives and money which did no good.  We must begin this process at once and hope we are in time to save us from other delusions of the right wing demented.  They need our help."

Read more about this exciting discovery here:

http://www.theguardian.com/science/2015/jun/10/brains-helped-papua-new-guinea-tribe

What is this Cancer Thing All of a Sudden

As you read this, I have four friends who have been diagnosed with cancer that has metastasized and are under various courses of treatment, usually radiation and chemo.  They range in age from 30 to 60.  None of them have particularly evil habits so far as I know, e.g. no heavy drinkers or smokers or obesity, etc.   Furthermore, 3 of the 4 are close friends of mine, people who I collaborate and interact with.  People I will miss should anything happen to them.  (The other one is a more distant friend, but still a friend).

Of the four, three of the individuals are walking around, and one of them is in a hospice and unable to speak. 

When you were growing up, did your parents, or school, or other institution (church, synagogue, community center, whatever), did anyone happen to mention that your life could be cut short at any time and that you could have your body ripped apart by a legion of vicious and deadly diseases?

Did they mention that you could be of any age when this happens, and that while there are a variety of things you can do to avoid this fate at least in terms of the odds, that ultimately it is up to chance and how your genes feel like mutating.

Also, if you catch it early, in other words, if you worry about things like this all your life and get tested regularly, then you can probably, but not necessarily, extend your life, i.e. increase survivability. But if you fail to worry about these things then it is possible even likely that you will not notice the problems until it is far too late.

It seems to me that this sucks.

I also have two friends who are HIV positive and have been under treatment for years, perhaps a decade. But they seem to be out and about and doing well.

I have also noticed that my friends who leave this world early all seem to be the nicer ones.  The evil people seem to go on forever.   What is going on here?

Previously Discredited Treatment for Depression Shows Amazing Success in Trials

Millions of right thinking Americans have depression but in spite of years of therapy and the prolonged use of various anti-depressants, a large proportion of those who suffer do not respond to treatment or respond only in a limited way. But now an obscure therapy first pioneered by a radical fringe group of doctors in Queens, NY has been found to have an unprecedented success rate of over 80% in the group of patients that previously did not respond to therapy.

“We are completely astonished,” said Dr. Irving Bloomworth of the Institute for the Prevention of Mental Disorders, whose headquarters is located in Falmouth,  NY. “As part of reviewing old and discredited approaches to treating depression, we came across this approach from the 1930s. We felt that there may have been some procedural mistakes in the trials back then and that it was worth trying again. But we never expected this kind of success.”

In a multiyear experiment funded by the NIH, several different groups of subjects were assigned either the therapy in question or a placebo. Those who received the actual therapy were given paper sacks filled with large amounts of money. The control group received paper sacks filled with old copies of the NY Post "Page Six" column.  

“We noticed a striking improvement in the mood and functionality of the people who received the sacks of money,” said Dr. Bloomworth in a press conference yesterday. "Those who received the placebo were mildly amused but the effect did not last long. But those who received large sacks of cash not only reported feeling better, that feeling seemed to persist for long periods of time."

"As a doctor, someone who wants to heal the sick, I was very gratified when some of the selected group, people who had been depressed and stuck in life for years, suddenly began to have new hope and solve problems that they previously thought were unsolvable.  The depression seemed to disappear as if by magic when they could just throw money at a problem". 

"The mistake we noticed in the original experiments in the 1930s was that they limited the amount of money involved to less than $100.   Of course, $100 was worth a lot more back then, but even so this caught our eye.  What if they had simply not been using enough cash, we wondered.  We created an experiment that gave out money in the 10s of thousands of dollars and we immediately saw an amazing improvement in the quality of life of the subjects as well as an improvement in their attitude towards problem solving."

One limitation of the technique is that the subjects must be allowed to keep the money, doctors discovered.  When they took the money away again, the subjects reported that the depression immediately returned and brain scans confirmed this.  Those who had received the NY Post, on the other hand, were not much affected one way or another when the popular newspaper was taken away.

The therapy was seen to be enhanced by post-care care in which the recipients received help with accounting, investment and taxation.  Tellingly, only those who actually received sacks of money responded to this care.  Those who received the placebo, the NY Post related material, were not affected one way or another by the contributions of an outside accountancy firm.

“This is a very exciting, possibly breakthrough approach,” said Dr. Fremkin at the NYU Medical School who was not involved in the study. “But we must not rush to judgment, many more studies must be done before we just start handing out sacks of money to depressed people”.

Followon large scale trials are being planned.


__________________________________________________

Notes:

National Institutes of Health

www.nih.gov

National Institute of Mental Health on Depression

http://www.nimh.nih.gov/health/topics/depression/index.shtml

Page Six at the NY Post

http://pagesix.com/

The Plausibility of Getting Medication in Mexico

In order to clear up a misunderstanding... the interest in getting medication in Mexico is not predicated on a desire to save money nor it is to avoid getting proper prescriptions.  It is because DEA and Ca. restrictions on certain medications make it impossible to get these medications under various circumstances (e.g. the pharmacy will not sell them to you) even with legitimate prescriptions.   

One function of the Internet which can be said to be socially neutral is to share information among people who have a common interest, whether that interest is sailing, jihadist terrorism or getting legitimate medical help in a region of the world. This feature is certainly of positive value some of the time, but it is also of (culturally dependent) negative value other times. Clearly we do not see advice on blowing people up as positive, but those who seek to right what they see as wrongs do.

In that spirit I am going to discuss what I think I know about getting the medications I need to treat ADHD in Mexico. One of the few advantages of living in Hell is that I am near the border of Mexico. Its an hour away.

This note is not intended to aid people figure out how to get recreational drugs or anything of the sort. It is intended to be a personal journal of my attempts to get legitimately prescribed medications for a disorder that for reasons known to the DEA are difficult to get in this country.

I also happen to believe that American adult citizens of good standing should be permitted to be able to choose what they take in their bodies without the consent of doctors or government as long as they are of proper age, and do not do stupid things like drive motor vehicles under the influence. Which of course they do every day of the week under the influence of the most dangerous drug of them all: alcohol. But that opinion of mine is not relevant to this and related posts. This post is solely about getting properly prescribed medications that are not disbursed in this country for a variety of regulatory stupidities.

There is a lot of misinformation about getting meds in Mexico on the Internet and I am probably adding to it. As time goes by I will add links to the useful sources I have found. So far, I have not tried any of this and I have not been to Mexico for years. This information comes entirely from reading dozens or hundreds of posts on the Internet and forming my own judgement. No doubt I will try some of what I discuss here if for no other reason to satisfy my curiosity. Repeat, none of the following is personal experience.  And I despise giving what appears as advice without direct personal experience, but here we are.  Any numbers quoted are numbers found on the Internet and are likely to be “internet numbers” which is to say not true, or only somewhat true.

First notes, and then tentative conclusions.

Americans going to Mexico to get medication is a vast business. There are numbers like 40 million visitors per year just for this purpose. There are numbers such as $200M a year in pharmaceuticals bought by Americans and carried back across the border. Remember, these are internet numbers, taken with a grain of salt.

There are at least a thousand pharmacies in Tijuana that exist to service this business. These pharmacies fall into two classes. Only the much more rare first class handles what we would call controlled substances. The more common second class of pharmacies handles the more common and uncontrolled substances.

The vast majority of purchases fall into a few classes: older people seeking to save money on the medications they need to survive or not be in pain and who are looking to ease the appalling costs added to medications in American in order to extract more money from innocent victims. As you might imagine our government is outraged that sick and poor people would try to get the same deal that large corporations get by going offshore, and do anything to stop it. But for some reason the border guards will permit these prescription, but non-controlled or scheduled substances back across the border if they are carried by the person they are for and are for personal use. I know very little else about what is involved in getting these medications and they are of no interest to me, at least not yet. The other major group of purchasers are young men looking for Viagra at a discount or other appalling date rape drugs which are apparently easily available. There is also a big business in self medicated antibiotics and people stock up on these. This is the sort of behavior that makes doctors in this country and their paid servants, the politicians, mad with rage and they do whatever they can to stop it. There is another category of people who are seeking medications not yet available in this country but are available in Europe. Mexico seems to follow the European approvals.

Many of these medications are made directly in Mexico in factories run by the major pharmaceutical companies. There is a lot of discussion about what is and what is not of adequate quality. My feeling is that this should not be a major concern unless you are doing things like cancer drugs or heart disease drugs. In my case it is not a concern. The medication will work in the manner that I expect or I will not repeat the experience. If it doesnt work I am no worse off than I was before.

Generally speaking your American prescriptions are not good over there. Mexico has their own system of prescribing medications and if you are interested in so-called controlled substances you will need a Mexican doctor to write you one. This is apocryphally not too difficult it is said. See notes below. A photocopy of an American prescription or empty prescription bottles *may* be of use in demonstrating that you are of good will and it *may* be useful in talking to a licensed Mexican doctor in getting a prescription for what you need. On a personal note I plan to take with me photocopies of a relevant prescription and an empty bottle or two just in case they turn out to be useful.

It is apparently common for a person to go to a pharmacy, be directed to a doctor, and get a prescription for what they need for what we would consider a nominal sum, e.g. $20 or $30 US. Again take this all with a grain of salt.

The doctor may wish to break the prescription down to small amounts and suggest you go to separate pharmacies.

Coming back across the border seems to be the following. You are supposed to declare anything you buy of this type. If you do not, and they find them, you are guilty of a misdemeanor and what you bought are likely to be confiscated. If you do declare and they are for personal use, generally they let you through. If you are carrying so much that they think that you are going to resell them, then they will confiscate. It is not so clear to me that any of this applies to controlled substances, but if they are small amounts for personal use, and you have copies of legitimate prescriptions or American bottles, then it is believed they let you through. I consider this a major flaw in the whole scheme because it is very likely that the behavior may depend on who is manning the station and what the enforcement flavor of the month is.

You will need a passport.

Tentative conclusions:

For non-controlled substances that are not health critical, such as heart disease, this is likely to be a way to save substantial money and has no apparent risks.

Those who use medications that are health critical need to be more careful and you can find discussions on the internet of how to do so.

Carrying an American prescription and or empty bottles may be helpful in getting the medication or coming back across the border, or it may be totally a waste of time.

You will need a Mexican prescription for anything that is controlled in Mexico. This includes most but not all of the controlled substances in this country. For ADHD, anything useful is controlled in both countries.

Coming back across the border is a dubious activity that may be helped by the medication being for your personal use, and having proof of legitimate American and Mexican prescriptions. It is critical that this medication be for your own use and not for resale. Failing to declare these things is a crime, do not do it, it will get you into trouble.

You will need an American passport.

Plan to spend all day on this activity, at least the first time you try it.

In conclusion, I am leery of the whole process. It is an ambiguous venture, not quite tantamount to drug smuggling but perhaps one of those odd holes in the control of trade materials across the border. But we are told we live in a world of globalization and that it is ethical to destroy American livelihoods by using slave labor in China, a vicious dictatorship, so why shouldn't Americans try to get a little savings by going to Mexico.

The hypocrisy of our system is rampant, overt, and starting to get annoying.

The DEA Will Protect Us from Evil

Thank God for the Drug Enforcement Administration!  Without them, how would we navigate the moral obstacles and danger in our secular lives?   It is the DEA and only the DEA that is qualified to judge who will die in pain and who will not.

On the list of areas where this country has utterly failed to live up to its promise, add the item of how one may pass from this world to the next in the horrible health care system that we have.  If this is the best we can do, well, we are not very good then.   If you have had the pleasure of having someone die on you in the health care system, you know it is a pretty fucked puddle of shit.

One area that seems to have some consensus behind it is that when someone is wasting away from incurable cancer or other fatal disease and is in excruciating agony, that doctors are willing to prescribe serious pain killers to at least keep the patient from screaming pitifully at the top of their lungs and thus disturb the workers as they try to extract money from the other patients / victims.

But the DEA knows that this is wrong.  What, just consider for a moment, what if in the process of prescribing these serious pain killers that someone were to unethically sell them to school children, perhaps even with dirty needles.  Come here children, my father is dying of cancer, but I am going to give you these opiates!! HA !

So the DEA has come down harshly on this pandering to the merely soon-to-be-dead in screaming agony in order to avoid this threat of Percodan addicted elementary school children.

Here is a letter from the Attorney Generals of this country asking why the all knowing and perfect DEA decided to go back on an agreement they made with the states on pain relief for those in chronic pain.

But whatever you think, don't worry, you have no input into this situation.  You can not decide how to live your life and how to end your life, the DEA is going to do that for you and your opinion is not the least bit interesting to them.  The DEA will stand fast to protect us from ourselves and keep our children free from this nefarious threat.

Here is the link to the DEA letter referenced in this post.

http://www.managingpain.org/naagletter.htm

__________________________________________

The Cost of Medical Care in N. San Diego County Compared with Manhattan

When I compare NYC with N. San Diego, well, there is just no comparing. NYC just has architecture, culture, museums, music, theatre, mass transit, universities and stuff like that. But N. San Diego county has actual golf courses and cheap mexican restaurants!

Do not confuse N. San Diego County with San Diego.  They are an hour away from each other. One is a nice city, very pleasant, with a lot of Navy.  The other is a central California agricultural region with no center, very little art or culture worth speaking of, and a bunch of chain shopping centers that are connected by highways. There is not much here and mostly the young people gnaw at their leg to get away.

But it has golf courses, so of course it must be very expensive to live here, and it is.  San Diego and N. San Diego County has the highest power costs of any metropolitan area in the country outside of Hawaii (remember Enron came from here).  The citizens think that they are living in some fabulous dream community, but they are not.  Its just a silly suburb with nice weather if you like that sort of thing.  The air, I admit, is clean.  

NYC has very high real estate costs and unions and infrastructure to support and a lot more.  N. San Diego has medium real estate costs and no unions, its a perfect Republican heaven or nightmare.  

As you know, I manage a chronic but not life-threatening medical situation and the way the federal government and our medical professionals arrange things, if there is any schedule screwup, you have to pay the expense of an emergency room to get your medication.  I could explain this to you but frankly it would just bore you and you would not really believe it until it happens to you.

Suffice it to say, I visited an emergency room in NYC and one in N. San Diego County within a year of each other to comply with their bureaucracy.  In each case, I had my blood pressure taken, talked to a doctor for 3 minutes, and got a prescription and a stern warning for which they should go fuck themselves.

The Hospital in NY was NYU Langone Center a world class medical center.  The hospital down here was the Palomar medical center, which seems nice but is not known for anything.  

Want to guess which one was more expensive.

One cost $175 and one cost $400 for this service.

Guess.

Thats right, San Diego is so fucking pretentious and full of itself that it charges $400.  Whereas the world class hospital in one of the most expensive cities in the world charges $175.

Isnt that just fucking great ?

___________________________________________

NYU Langone

http://www.med.nyu.edu/

More About Malfeasance in Medical Care in S. California

[On swift wings revenge approaches.   They should tremble in fear to know that I am biding my time until the moment is right, then I will strike!]

As many of you know, I have a chronic medical condition that requires that I take certain medication every day.   When I can not get access to that medication a variety of things happen that are unpleasant both for me and for people around me.

Is this situation life threatening?   Well, it is certainly very inconvenient.   The way that this medication is controlled and made available to the citizens of this country means that, unless one is rich, one spends something like 1/4 to 1/2 or more of one's time securing the medication and not always succeeding.  In other words, the system is set up such that it is perfectly likely, in my experience, and even probable that one will regularly go without the medication due to the system set up by the state on several occasions during the year.

That's just tough shit.  We all have our cross to bear, nevertheless it is no fun. Not for me, not for anyone who may be working with me. It generates tremendous psychodrama, angst and general unpleasantness. I would go so far as to say that it may disqualify me from working at a real job since most real jobs have such things as deadlines, travel, and extraordinary stress that is incompatible both with how the medication works and the process of getting it.  The good news is that what I always forget is that when one has a real job, and live in a real city instead of out here in hell, one can build systems that mitigates most of this.  

At a later date I will explain all of the reasons why getting this medication is so complicated.  But one word of advice, unless you have had to do it for a couple of years at least, you do not have a clue how bad it is. You only think you know.   Trust me, it just goes on and on and on.   But in this post I will tell you a story about one little wrinkle in this many volume puddle-of-shit that is procuring this medication.   This particular fuck comes from moving from the NY area to Los Angeles as part of accepting a "job".

One deliberate back door that is supposed to allow for special events in getting this medication is that when something unexpected happens, one is supposed to be able to go to any emergency room, show the doctor your prescription bottle, explain what the current crisis is about (a snowstorm, a hurricane, a last minute affair with someone you have had a crush on all your life, whatever) and walk out with a one-time prescription to tide you over until you get back home and see your real doctor, or find and a new doctor, or whatever.  

This back door worked in NYC. Even more amazing is that it was rarely necessary.  When a doctor there goes out of town, apparently, or takes a vacation, they designate a replacement for the period of time. Not so out here in sunny S. California. Although going to an emergency room is not something you want to do very often for a variety of reasons, it is something that is considered routine back east.  So it would seem.

But when I moved to LA, to my surprise, it did not work. The doctor at Cedars Sinai in West Hollywood told me that they were prohibited by law from giving out such prescriptions. Then later, when I was dealing with a life-threatening illness in my family in San Diego, I went to the ER in the hospital where my relative was in intensive care and they also refused to help me, saying that their hands were tied by the law.   Thus I had to deal with one of the most traumatic periods of my life made much worse by their actions.   Of course, in both cases, I also received a bill for their services.

So I asked my various doctors in California about what I was told. Was there any such law? Not that they knew about. How would I find out for sure?  No one knew.  No one gave a fuck.  Not their problem.

Fast forward to this week. I am in the middle of medication hell the week before SIGGRAPH and so I decided to try one more time and go to an ER to see if they could help me out. They could, and they did. I got a stern lecture, told that they would not do it a second time, and got a prescription for a few days, which will not be enough for me to find another doctor, exactly, but it was helpful and I have been able to solve this problem in time for SIGGRAPH.  So the system did what it was supposed to do.  But that is just the beginning of the good news.

The doctor at this ER confirmed for me that those other doctors were lying to my face. What I was told was a common lie told in ERs he says when they don't want to deal with this kind of medication. You the patient are expected to believe them and go away and die or whatever.  You are garbage in their eyes.   They do not care to help. 

So lets be clear.

Twice now in S. California I went to the ER for help, a help they could have easily provided, and they chose to lie to my face and let me suffer because it was more convenient for them, for some unknown reason.  The lies were to deflect my anger from their harmful actions.  This is not just incompetence, this is malfeasance.   What are my legal remedies?

None.

What is the solution?

Become rich and the problems go away.

I do not know if this is unique to S. California or if other communities have the same problem.

I can not wait to get out of S. California.

The two 'bad' hospitals by the way were Cedars Sinai in West Hollywood and the older Palomar Hospital in Escondido, CA.  The ER that actually helped me was the *new* Palomar Hospital in Escondido and the experience was quite pleasant and efficient, as these things go.

[How then will I get my revenge on these evil scumbags who serve Satan?   I can not reveal this as yet.  But their time is coming and then they will know my wrath and they will be punished!  And all those who protect and enable them, they will be punished as well!]

Doctors and Pharmacies, Please Hold Hands and Share

Everyone who reads this blog knows I see a variety of doctors and do a variety of interesting medications. I continue to maintain that I am lucky because the problems I have are mostly addressed by the medications and this is more than a lot of people can say.

The new policy is that I keep a good sense of humor no matter what happens.  I do the same thing when I am flying on airplanes, which is to cultivate a state of Zen-like calmness.  I just look puzzled and smile and try to get what I want.  No stamping of feet.  No snarling permitted. Absolutely no heads are to be ripped off no matter how much they may deserve it and no matter how much they might benefit from having their heads ripped off because it would build character.

But what amazes me, simply amazes me, is that the doctors and the pharmacies are on completely different pages as to what the DEA says the rules are.   Everyone has a different idea of what the rules are and anyone who has not dealt with the pharmacies seems to not realize what is going on.  Its not crazy exactly but it is at best annoying and can have results that waste a lot of time and often results in patients who do not get their medication for 72 hours or so if ever.

Do you think they could bother to learn what the rules are so that the patient does not have to always appear to be correcting their doctor and be in the middle between the doctor and the pharmacy?

But it will never get better.

It is my karma to deal with this for the rest of my so-called life.

Curse you, Drug Enforcement Administration, you have truly succeeded in your goal to make my life more miserable!

http://www.justice.gov/dea/index.shtml

Repent! The End is Near!

Prophets of doom rarely made a good living in the old days. Prophets of happiness and so forth could count on buying that new goat, wagon, or slave from profits from grateful customers. But prophets of doom, never. They lived in caves and wore sackcloth and needed a bath.

I remember reading all the way through Hemingway's "For Whom the Bell Tolls" before I figured out what the title meant. (1)

As many of you know, I keep a variety of doctors employed and off the streets. Because of various regulations involving the illegal resale of certain attractive medications, I need to see them every month or so, as the prescriptions are kept on a tight leash. Since I am an outlyer in various ways, it can be problematic to find a suitable doctor and therefore, once found, I stay with them for a while. So I drove to LA to see one of these doctors whom I had been seeing for a decade and they channeled me to one of his assistants whom I knew and liked because, I assumed, my doctor was not available. Well, yes, but not the way I thought.

She opened the conversation with "So let me tell you why you are seeing me today instead of Dr. Friedman. Dr. Friedman died last week suddenly and unexpectedly of a heart attack. His funeral was a few days ago."

Excuse me? Bob Friedman was in perfect health when I saw him about 30 days ago. He looked about 65 years old (he was a few years older it turns out but so what), and was in great shape. Yes, he could have lost a few pounds and I doubt if he spent too much time doing aerobic exercise, but he had years and years to live, as far as anyone could tell.

But when the penalty flag goes down, death appears like a thief in the night and there is no appeal.

And he left some very confused people, including his many employees who would like to continue their practice and keep working together and probably will, but its all a little confused because, sensibly, Bob did not expect to be leaving anytime soon, so nothing had been arranged.

Therefore do not expect to be warned, or rather, take this as your warning. The bell could go off at any time, make good use of the day and see that your paperwork is in order.

This may be the only notice that you will receive.

______________________________________________

1. It comes from something John Donne wrote a few centuries ago. He wrote, 

"No man is an Iland, intire of it selfe; every man is a peece of the Continent, a part of the maine; if a Clod bee washed away by the Sea, Europe is the lesse, as well as if a Promontorie were, as well as if a Mannor of thy friends or of thine owne were; any mans death diminishes me, because I am involved in Mankinde; And therefore never send to know for whom the bell tolls; It tolls for thee."

The custom in Europe (or parts of Europe) was to ring a single bell very slowly to announce the death or funeral of someone in that parish. People would know to come to the church to find out who it was tolling for, if they did not already know.

Introducing "Lithic Fragmentation"

Lithic Fragmentation is a bold new therapy designed to reclaim the lives of otherwise worthless human refuse who have fallen into shame and degradation. These poor dregs of former human life, forced to endure their hundreds of millions of dollars of unearned wealth, or to exercise their power as leading yet corrupt members of our society, now have a way to correct the course of their formerly pointless lives and learn new and better skills.

The process of Lithic Fragmentation is simple yet subtle. It begins with the therapy candidate being volunteered by their fellow citizens in local "therapy committees" where suitable candidates are proposed, discussed and elected, all without the concern or knowledge of the potential therapy receiver. We do this for their own good and we have no doubt that they appreciate all the effort that is expended on their behalf.

The therapy process continues with the transfer of all their wealth to the therapy centers. This totally voluntary wealth transfer, which is provided for them at no cost and without them having to do anything, is the second part of their therapy. By receiving their ill-gotten wealth, we selflessly take on the burden, and the therapy receivers immediately experience a great sense of relief at not having the guilt associated with their ill-gotten and undeserved riches.  Already the therapy receivers can sense a great improvement in their lives.

Before we get to the core of the therapy, the patient is relocated to special centers which are dedicated to this work.   These centers are located in beautiful parts of our great country such as Death Valley or the Jornada del Muerto.  Each patient is given their own private suite with bed and private bath and a view of the stark yet beautiful countryside.  In order to foster a serious feeling of dedication, they are given new clothes for their stay which are simple, comfortable and distinctive with fashionable black stripes on a white background.

Every day at dawn, our therapy receivers are led to a new location, filled with big rocks. There, armed with only a simple hammer, the therapy recipient proceeds to turn big rocks into small ones, hence the term "Lithic Fragmentation".  Oh, how happy they will be as they realize that for the first time in their lives they are doing something productive with their own two hands!  How eagerly they will return each day for the pleasant 12 or 16 hours of daily exercise outside and in nature continuing this process!  With each rock that they fragment, they will experience a great sense of pride and feeling of accomplishment!  No more a life of shame for these lucky men and women!

And there is other symbolism as well. That big chain that connects them to their fellow therapy receiver? That is the "great chain of being" that reminds them that we are all connected on this planet, and have a responsibility to each other, unlike their former, disgusting lives before therapy.

At the end of the day, the happy fragmenters return to their individual cells and receive a healthy bowl of soup and a solid 4-6 hours of sleep before the next day of self-improvement begins.

There are other aspects to this therapy that are used to enrich the lives of the therapy receivers. For example, therapy providers "Jerome" and "Big Julie" give private and personalized therapy to worthy candidates, all of whom report a unique and transforming experience.   In addition, the therapy receivers can look forward to regular sessions of group discussion in which they criticize their prior lives and actions in a spirit of honesty and sincere desire to reform. Usually one therapy receiver in particular is the subject of this therapeutic group criticism.

After an all too brief period of self-improvement, rarely more than 10 or 12 years except in special cases, the happy fragmenter returns to the world, a changed and much better person, and with a prestigious certificate to indicate successful completion of the course.  

Here is a picture of happy therapy receivers awaiting a personal session with Jerome and Big Julie.