Δαφνη Ευτυχια Αρθουρος

"We have a declining democracy, quite frankly, and in a declining democracy, ground zero is the health of patients -- the nurses see it first. Our health takes place in a political and economic environment. And that's why we had to have a systemic change in the political process in order to be able to have changes in our lives. It's critical. It's urgent. And we can't wait." -- Roseanne DeMoro, executive director of the California Nurses Association, interviewed on the PBS television program Now, "Who Pays For America's Elections?", aired 2006-10-20

Not doing as well as yesterday, but still feeling better than last week. (It didn't take doing very much yesterday to make me realize -- about an hour too late -- that I'd pushed myself too hard.)

Made it to the clinic to see the doctor today. (Urf. I lost track of who there is a NP and who is an MD -- I'd forgotten that they'd brought an MD on board several months ago. Hope she wasn't too offended. Today I saw the MD.) A productive-seeming, if unsettling visit. (She wants me to try some drugs I'm afraid of. But she did back off rather quickly on the one I said I was most scared of.) The focus today was the fibromyalgia, but we also reviewed all my meds and are reducing the dosage of my anti-cholesterol drug. I'm now very, very tired. Hoping that if I sit quietly for now, I might manage to regain some of the get-up-and-go I need to get to HCB rehearsal tonight.

They were looping a videotape in the waiting room, a ... well, at first glance it looked like a news report, but it was too long for that and had infomercial/training-vid types of section breaks; it was designed to look like a general "addressing the problems of men's health" thing using one clinic as an example, but it wasn't hard to figure out that it was really a long advert for one clinic -- the one I was at.

(Wait; why did they need to advertise the clinic to a captive audience of existing patients of the clinic?)

It wasn't turned up as loud as Springer and the soap operas they usualy have on, thank goodness, but the bass was boosted in a way that made every human voice on the tape painful to me. (Yeah, I've still got that apparently-fibro-related hyperacusis thing going on, though it's not as bad as when I wrote about it last week. But as usual for that symptom, the more tired I get, the more pronounced it is.) The voices of people actually present would have been okay by themselves, but in the presence of the oddly-eq'd television they added to the pain. I was able to remove the earplugs when I left the waiting room to see the nurse and again to see the doctor. Hmm. Come to think of it, I should've said more about that symptom to the doctor, just in case it's not "just the fibromyalgia" (but it is a symptom I've seen other fibro patients write about, so that's still my guess). Anyhow, the noise wore me down that much faster, contributing to how tired I am now.

Disconcertingly, the other patients in the waiting room seemed hypnotized by the television, much more so than when they watch the soap operas or celebrity gossip shows or Springer. Maybe because there weren't really any comments to make to each other about what they were watching? Vacant, staring straight ahead at the screen, unmoving, for three or four viewings. Spooky. I was copying stuff to paper from my PDA most of the time -- maybe there was something hypnotic in the visuals that I didn't catch. Or maybe the situation was just plain weird.

Just before I was called back to the consultation room, they started playing a different videotape, drawing detailed parallels between Bush and Hitler. I didn't see enough of it to be able to tell whether it was well-reasoned and focussed on reality and what does seem like legitimate comparisons, or tinfoil-hat predictions about things we can only guess at and tenuous connections. Neither would surprise me; there's plenty to worry about, plenty to heed and be careful of, and plenty to make you go "Hmm", without venturing into foil-hat land, but the way this video came on full-blast "he's Hitler reincarnated" right out of the gate rang some warning bells. (Though I'm aware that there are a number of Bush supporters and -- more troubling -- wishful-thinkers (folks who dislike Bush but can't imagine that the "history storybook" scenario could possibly apply to the real wo the present day, and 'couldn't happen here') who will insist that even the most reasonable cautionary analysis in the first category is to be lumped into the second category. So hey, if you're in either of those groups, don't bother telling me such comparisons are "obviously" full of crap. Every place and time something like that has happened, it happened where people were saying, "but of course it can't happen here because...", and the only reason it can get enough momentum behind it to overcome the reasons why it "couldn't happen there" is that the people who might have been able to stop it earlier were tring so hard to convince themselves it couldn't really be happening instead of doing anything about it. Maybe Bush isn't that bad, maybe the NeoConmen aren't going to take us there, but when things start to swing in that direction, let us not wait until we're already there to decide that it's a bad direction. The usual "rebuttal" to any comparison between Bush and Hitler-during-his-rise-to-power is that Bush hasn't done the worst of the things Hitler did. But only the most extreme Bush-haters are comparing him to Hitler-already-in-control; everyone else who says "let's be careful about this" is comparing him to Hitler before Hitler was able to do the worst, to how Hitler got there. The point is to make sure that Bush (or, considering that it's getting late and I don't think he's got the momentum to be able to suspend elections in 2008, his successors in the neoconmen movement) never becomes late-Hitler -- by not just blindly going along with every "little" change to the laws and the ways of doing things that have served us so well for so long (the "reasons it 'can't happen here'"). Whether you think Bush himself is evil or not, the concentration of too much power in one place with too little oversight it bad for us. Checks and balances, folks, checks and balances and the freaking Bill of Rights. Let's hope the Democrats elected last week are able and willing to rein him in somewhat.)

... But I digress.

As I said, I didn't see enough of this vid to find out whether it was the due caution of historians or mere "IhatehimIhatehimIhatehim look! Hitler!" screeching. But with that opening I doubt it'll convince many people not already in agreement even if its reasoning is sound.

And actually, that's still a digression (though the long digression is important enough that maybe I should use the politics icon for this entry). I was wondering about the first video, the promotional one. Now this clinic used to be operated completely by the city of Baltimore (If I understood correctly). It was for men (yes, we've been through the gender-irony there for me) who had no other insurance or other health coverage. But the state of Maryland instituted its own program of health care for po' folk, which basically meant that as soon as the state program took effect the population the clinic was chartered to serve would no longer exist (anyone who previously had not had health coverage would now qualify for the state program). For a while nobody was certain exactly what would happen. Now comes the part I'm a little vague on and might have misunderstood ... As I understand it, the state program contracts out to other providers, including an HMO or two, that patients have to choose between. The clinic allied itself with one of those, or was sold to it, or came to some sort of arrangement, so its existing patients could choose that outfit as their provider and keep coming to this clinic. So my speculation is that this means the clinic is now at least partly funded by state money allocated per-patient, has some unspecified-to-me type of connection to some (I think) for-profit company that has the actual contract with the state ... and (still speculating here) that has something to do with the perceived need for a promotional informercial.

I wonder whether I'm in the right ballpark. And what else will change if so. (I do get the impression that the staff and the decision-makers who run the clinic (and I'm pretty sure those sets overlap) are resistant to any changes that interfere with their original mission.)

At any rate, so far, I still seem to be getting better care from the free clinic than I've gotten from a more-expensive-every-year HMO in the past. I'll be happy to see that continue to be true.

I think I need to get earplugs that block more bass than treble, for environments like that waiting room.