standing with our gay brothers
that we would never marry
until gays in our state
Now that gay marriage has
destroyed the sacred
what’s the point?
standing with our gay brothers
that we would never marry
until gays in our state
Now that gay marriage has
destroyed the sacred
what’s the point?
I was lucky enough, after more than two months in the wilderness, to get an appointment with a nephrologist who seemed to be very well-liked by his patients. Sekhnet located this doctor for me, by persistence and almost pure chance. He was not listed as a participating provider in my health plan, but Sekhnet’s call to his office confirmed that he accepted my insurance. The only bad news was that his next available appointment was September 19th, almost four months after the biopsy confirming my progressing kidney disease. I had a call back from his office Tuesday, could I come in Thursday? On Wednesday, the next time my primary care doctor was available, I neglected to get a new nephrology referral, something that is the patient’s sole responsibility.
Thursday I found myself at the nephrologist’s office without a referral. My fault, though somewhat understandable, due to the last minute nature of the changed appointment. I called my doctor’s office and spoke to his service, who informed me he was off on Thursdays. She promised me a call back, but as I ‘d never had a call back from him, I had my doubts. Ten minutes later I had a call back from someone in his office, offering to try to get the referral faxed over. Problem solved, or possibly not.
The problem was, my insurance company requires an Emdeon electronic referral, according to the new doctor’s receptionist. A faxed paper referral won’t be accepted, she told me, though it had been accepted by the prior nephrologist’s office. There was a discussion of back-dating the referral, something I’ve been told is insurance fraud.
“Just to be safe,” the receptionist told me, “let’s have you sign this, to avoid a surprise bill.” The form she gave me stated that the nephrologist did not participate in my plan, was out-of-network, and that therefore I was responsible for paying the full cost of the visit.
I asked what the cost of the visit was and the receptionist told me she had no idea. They cannot tell you the price of any medical service, under Obamacare, until after the service is rendered. It’s a menu with no prices next to anything, the waiter just keeps smiling and tells you not to worry, that you will be billed in thirty days. It’s fucking insane. “Just to be safe,” I thought, and then told her I couldn’t sign a paper saying the doctor wasn’t in-network when he was. I pointed out to Sekhnet, who assured me that she would pay for the visit, if it came down to it, that by signing this, agreeing to pay “whatever”, I was waiving any defense under the recent Surprise Bill amendment to Obamacare. Even though the bill would, indeed, be a surprise.
The receptionist had another idea. Call my insurance company and make the doctor my primary care doctor, he was an internist as well as a nephrologist. This way I wouldn’t need a referral. The call to my insurance company lasted for 29 minutes. There were a series of hurdles and I was placed on hold several times, listening to muzak, the last patient of the day, waiting in the doctor’s empty waiting room, earphones in my ears. Toward the end of this endless call the doctor passed by and I asked if he had any IV valium. He smiled and told me not to worry, he was in no rush.
There followed a discussion of his office location. I told Karen, at the insurance company, that I was at 161 Madison Avenue. She told me I could only see the doctor at his East 88th Street office. I repeated this out loud and the receptionist, who by this point had already hugged Sekhnet twice, nodded emphatically that it was no problem. “Tell her you’re at 88th Street,” she said. I have a hard time with an outright lie, so I said “88th Street, fine.”
I was now at the last hurdle: a three question questionnaire about my reason for switching primary care doctors. The last question was about convenience.
“Is the location of this doctor’s office more convenient for you?” Karen asked me kindly. Not really, I told her. I explained that the doctor I’d been seeing was half a block from my house and that this doctor was located about an hour from my home, but that I wanted to switch anyway.
“Is the location of this doctor’s office more convenient for you?” Karen asked me again, prompting me. I repeated Karen’s question out loud for the receptionist and Sekhnet, both now actively coaching me, nodding like two mad women.
“Yes,” I told Karen, “much, much, much more convenient. Thank you.” She thanked me, the transfer was done, I was able to see the nephrologist.
When the nurse began taking my vitals I heard Sekhnet’s agitated entreaty from the waiting room. “Don’t take his blood pressure yet, he just got off the phone with the insurance company!” I told them both it was OK. My pulse was 57, blood pressure 122/82. I told them I’d become so used to being screwed around by the insurance company that it rolled off me like water off a duck’s back.
The young doctor smiled again when I apologized for being late (it was now an hour after my original appointment time). We discussed my idiopathic membranous nephropathy and he told me candidly that the reason there is not more recent research on the disease, which is not as rare as the lack of research might suggest, is that there is no pharmaceutical in development. The drugs used to treat the disease have been around for a long time. When a new pharmaceutical is in development that drives research. “Death by American Healthcare,” I thought, but nodded thoughtfully instead.
He was indeed a very likable doctor. The upshot was roughly the same as at the previous nephrologist, my best bet was medicine’s only bet: immunosuppressive therapy. He would refer me to the doctor he trained under, who specializes in glomerular (a word I still can’t pronounce– definition below*) diseases like mine. There was no immediate rush to begin treatment, he said, as the disease progresses slowly, but his senior colleague was the expert and would fully inform me of everything I needed to know. We shook hands and bid each other goodbye. Sekhnet was beaming from ear to ear.
“You should keep this doctor,” she told me, “even though it’s inconvenient to get to his office.” I told her I’d think about it. This morning at 9 a.m. he called to discuss the results of yesterday’s blood test. We’ve been playing phone tag since, but it was impressive to hear back from him so soon.
* glomerulus: a cluster of capillaries around the end of a kidney tubule, where waste products are filtered from the blood.
Leaving aside my increasing need to make a few copeks from writing, somehow, I have been writing recently to survive. I’ve been writing out, as clearly as I can, what I need to try to digest in order to keep my frustrations from crushing me. There is something to be said for closely studying a hideous monster, setting the monstrousness out on a page as plainly as possible. It is preferable, in my view, to squeezing the eyes shut and groaning “no… fucking no…. arrghhh….”
So on that theory, and to keep my writing pencil sharp, I tap out these words every day. It feels like a psychic necessity. I have two things I need to write, two things I’ve been too preoccupied to tend to as I worry about the long difficulty of finding a nephrologist, as I struggle against Death by American Healthcare. I have an appointment with a nephrologist tomorrow, so I am once again thinking of the future.
One thing I need to write is my long-planned letter to NYS Attorney General Eric Schneiderman. He is one of the few AGs who proposes legislation and advocates for it. I wrote an untenably long letter to him in January that I never sent. I need to write a short, persuasive letter, with many attachments. It needs to proffer a kiss or two for his activism against creeps and corporate malefactors. It needs to alert him to the need for a NYS regulatory agency to intervene in the epidemic of frauds committed by health insurance companies in NYS, corporations not presently regulated in any way in New York State, except in the most cursory regard.
Sounds like a simple enough letter. Its last paragraph would set out what the attachments are, as in a legal brief. #1 sets out the useless cul de sac of helpline numbers NYS consumers currently have access to. #2 is a series of examples of seemingly fraudulent practices I can testify to. #3 is a description of the dysfunctional practices of the NYS of Health Marketplace. Just writing it out this way makes me feel that the project, though important and proposing sorely needed oversight that could help thousands presently screwed, is also mad.
The other thing I need to write is a note to Jeremy Scahill, both as a letter of introduction and to have him confirm something that has been gnawing at me since the extra-judicial execution of the American Muslim Anwar al-Awlaki. Everywhere but in Scahill’s detailed discussion in Dirty Wars, Awlaki is referred to as a top al Qu’aeda leader and the organization’s number one English-speaking recruiter. When I say everywhere I mean: NY Times, PBS, NPR, Fox News, CNN, Washington Post, Wikipedia, any other source you can turn to for information on the first American citizen killed by the US president as an enemy that must be “killed or captured”.
Scahill describes an initially non-political American imam targeted for blackmail by the FBI, fleeing with his family to Yemen, locked up in Yemen, at the request of America, and held in solitary for a year or more, a man increasingly outraged by the worldwide war against Islam unleashed by his own country after 9/11. Scahill reports that there was no proof of Awlaki’s involvement with al Qua’eda and no charges against him at the time of his murder by drone launched missile.
No charges against this dangerous al Qua’eda leader? US Government agencies involved in the killing refuse to comment on whether there were charges against him at the time of his killing. You can read that everywhere too, right next to the claim that he was a supremely dangerous terrorist leader. We had to kill him because he hated our freedom and inspired other terrorists to hate us, goes the official story. No need for a showing of any kind in any court, there is no appeal once placed on the new Presidential Kill List. Appeal denied. End of story. Freedom on the march, nothing to see here.
The history of the world, of American Empire, is written in the blood of people whose deaths were used to tell one story or another. I think of the widely disseminated lie about the death of American hero Pat Tillman. The heroic legend Bush and Cheney’s people concocted about Tillman makes anyone who learns the real story want to vomit. Tillman was killed by Rumsfeld’s inept handling of the war in Afghanistan, a victim of an idiotic policy, shot in the face by a guy in his own platoon.
His uniform and journals were burned before his mostly headless body was flown back to the US for a hero’s funeral. The journals were burned, presumably, to get rid of the evidence of how critical he’d become of America’s misguided and mismanaged “War on Terror”. Tillman’s family doggedly pursued the truth, eventually got it, put it out there. Jon Krakauer wrote a powerful book about Tillman, that’s how I know. Most people don’t give a rat’s ass. Something is wrong, something smells bad, better spray some Febreze. Ah, that’s better.
I cannot turn my eyes away, some how. If you can kill an American citizen without trial, without charges, even — what the fuck? Why isn’t everybody fucking angry? An idealistic American hero, killed by the ineptitude of the Secretary of Defense, his death lied about before his burial as a martyr to American Exceptionalism? What? Oh, wait, America’s Got Talent just started, got to get ready to vote. Thank God I recorded Dancing With the Stars, though, regrettably, I won’t be able to vote. Sucks to watch the show with absolutely no say on who advances to the next round…
The two psychologists pictured below were paid over $80,000,000 by the Bush administration to design a torture program for use against captured terrorism suspects. The torture program was called “enhanced interrogation” to give the torture and inhumane treatment a fig leaf of legal deniability, just in case anyone later decided to follow up on the systematic violation of American and international law. Nobody successfully did, until this ACLU lawsuit on behalf of two living and one murdered torture victim.
from a Spokane paper, Quackenbush is the District Court judge in the case:
In the last hearing, defense attorney Brian Paszamant argued that his clients only provided the CIA with a list of potential interrogation techniques.
“The problem is my clients were involved in drafting the guidelines (for the CIA) and didn’t know they were going to be applied at” CIA black-site prisons, Paszamant said. “There is a huge disconnect.”
Quackenbush asked Paszamant about the treatment of Rahman, who was placed in a diaper before he died on a cold floor. Evidence suggested that Jessen helped interrogate Rahman but it only included one slap to his face.
“I’m not sure a single slap to the face would constitute torture under international law,” Paszamant said last month.
Quackenbush replied: “He was tortured.”
Paszamant pointed out that Rahman died of exposure … “none of which my clients had anything to do with. I’m not at a position to acknowledge (Rahman) was subjected to torture.”
The judge then added: “That’s why we have juries.”
In his written findings, Quackenbush noted that the defense attorneys made “several unconvincing arguments” that there was no connection between developing the interrogation techniques and those applied to Sulieman and Ben Soud.
Lawyers for these two psychologists also argued that the defendants could not be held accountable for their work because the scientists who invented Zyklon-B, the poison used in Nazi gas chambers, were not prosecuted at Nuremberg. The judge rejected that argument as well. He ruled yesterday that the case against these two will proceed to trial.
I, like many Americans, spend much of my psychic energy every day trying to keep the top of my head from blowing off. This happens when a person is placed in a psychological pressure cooker of one kind of another. In my case the present pressure cooker, primarily, is the near impossibility of seeing a recommended doctor to treat my serious kidney disease– an eventually life-threatening difficulty I’ve been stuck in for two months now as unknown damage may or may not be occurring in a vital organ/organs.
Solving this vexing health problem would only relieve so much stress, of course. I would still face the many frustrations of living in a competitive pressure-cooker of a society where people are pitted against each other in a zero sum war, while ugly partisan battles rage daily and the earth itself is becoming uninhabitable due to the incomprehensible greed of a few already immensely wealthy people. We watch problems that should be intelligently discussed and solved go unaddressed, except for the televised bickering of well-dressed two year-olds spouting talking points, talking past each other to score meaningless points with those who support them, year after year.
The result of enforced powerlessness is resignation and rage. These things sound at first like opposite reactions, but they are not mutually exclusive, they are two sides of a coin. You feel hopeless and resigned, you brood about why you are in the situation you are in and you feel rage. Your rage leaves you hopeless again, but it is building in the background for the next wave. The rage and hatred at least provide a surge of energy, a phantom feeling of some kind of power.
In my case, I find myself hating frequently deadly American Corporate Health Care and the culture of personal greed that justifies countless preventable deaths as an acceptable cost of doing supremely profitable business. When corporate medical providers and corporate insurance companies blame each other for the medical predicament I find myself in, I turn my hatred to the corporate “person”. I understand that this legally created person is a psychopath, it exhibits every one of the DSM’s characteristics of the psychopath. Callous unconcern for the feelings of others, reckless disregard for the safety of others, deceitfulness, repeated lying and conniving against others for profit, incapacity to experience guilt, etc.
I can defend my hatred with countless examples. It doesn’t help me solve the immediate problem, avoiding death by American health care, but critically analyzing the faceless entity that is nonchalantly and impersonally trying to kill me offers momentary relief from the feeling of being sodomized. The confirmation bias comes into play. Every time I see another example of corporate psychopathy, and there are many, I am confirmed in my view that the practices of these poisonous institutions should be tightly regulated instead of corporations being the omnipotent rulers of the “Free Market” that is the democratic world order. I dismiss ads by Koch Industries that tout the wonderful, creative, life-sustaining, people-friendly company they are as the work of an amoral public relations agency making a shit load of money putting a good face on the hell-bent moral equivalents of Nazis.
Here’s the larger point, though:
We live in the stubbornly gridlocked political dysfunction of a divided nation of self-interested partisans, bigots and haters of bigots, barking past each other, each side howling catch phrases to its base. This hideous farce is currently presided over by the personification of unearned privilege and the idiocy that is marketed to Americans as success. This “winner” was born rich, sought endless attention, finally attained it as an abrasive, wildly popular ‘reality-TV star’, and, through an aggressive, divisive campaign narrowly won the Electoral College (designed to protect slavery from the whims of the democratic voters) and took on his dream role of the most powerful man in the world. His presidency is a symptom of the miasma of rage most Americans live in.
Everything I have said above about my hatred of the corporation can be said, in one form or another, by anyone who hates. We do not believe anything without being able to justify it 100%. As I can make my case against corporate psychopaths, someone who hates immigrants can make their case, someone who hates Muslims, or Jews, Blacks or homosexuals can make a case as tight as a noose. The analysis may not be as convincing in each case, but a case is made and an undying belief confirmed.
Trump appealed to the rage that millions and millions of white Americans feel, having been told over and over they are “privileged,” as they watch brown and yellow people, many who don’t even speak English, pushy women, transsexuals, foreign-born secret Muslim presidents, etc, moving ahead and “winning” while they are not, and worse, as they lose they are being held guilty for wrongs done long ago, wrongs they had nothing, personally, to do with. It’s not hard to understand why many white people would be angry, watching the American Dream slipping away from them.
It’s hard to dispute that most Americans are worse off than we were a generation or two ago. Certainly in terms of hope for a better life for the next generation. Adjusting to that reality is maddening. As the super-wealthy increase their wealth, the vast majority of Americans grow more economically insecure in our casino capitalist system while a government of millionaires performs disgusting theatre in a pay-to-play system that does not act in the interests of the screwed majority who voted them into office.
The candidates in the recent presidential elections spoke to that injustice to varying degrees. Millions, particularly the young and most directly screwed, supported Bernie Sanders, who analyzes the situation astutely, speaks plainly and proposes humane solutions based on crucial systemic changes. Millions who hated Trump did not bother voting for Hillary Clinton, the second most hated political brand in America, because she spoke the language of a corrupt insider, promising incremental change, the rising tide that lifts all boats, and empowering little girls to grow up to be rich, powerful women. Trump, meanwhile, spoke nakedly to hatred and rage, making an emotional appeal to a mythical past when everyone knew their place, demonizing immigrants and angry minorities, and promising things he had no intention of delivering to suckers he correctly said would have supported him if he shot someone on Fifth Avenue.
Not all analysis is equal, of course, but the confirmation bias means we will select data that supports our thesis, ignore data that contradicts it. Particularly, and this is worth noting again, when we are angry. When we are angry, we feel perfectly right to be angry, there is no question abut that. Virtually everyone who voted for Trump still believes they were right to vote for him, that he is doing his level best to carry out his promise to Make America Great Again, in spite of being surrounded by traitors, liars, leakers and other cowards. Trump is regularly throwing red meat to them, directly to their phones, confirming over and over that he is their man, working for them, no matter what.
Consider this example. Black kid sneers at cop, or menaces him, cop shoots black kid to death. There is a big difference, legally and morally, if the cop felt disrespected or was in actual danger, or protecting others from imminent danger, but that is a question for a jury of one’s peers. That is, if you can get a Grand Jury to indict a police officer who kills in the course of his duty to protect and serve. Depending on who the jury is, we will have two very different outcomes.
A jury of poor blacks will know other families who have lost a son to an angry cop, may have their own experience being treated badly by the police. A jury of policeman will know other cops who have been killed because they hesitated to defend themselves with deadly force. Conviction or acquittal, in a system based on ‘reasonable doubt’, will come down to where the trial is held and the composition of the jury. Lawyers are paid big bucks to get the right venue for trial and pick the best jury.
That is not to say, of course, that everything is relative and depends on your point of view. Something happened right before Michael Brown was shot to death in Ferguson, Mo. Cop told him to “get the fuck out of the street.” Brown may have said “back atcha, you fucking racist cunt.” Brown may have moved menacingly toward the cop, punched him and made a violent move to reach into the car to grab the officer’s gun, as the cop said, justifying the six shots that killed the young man. Just because we will never know exactly what happened does not change the fact that something objectively happened. Here is one account trying to piece together what actually happened.
If the officer had been wearing a body camera, and it had not been switched off, the entire incident could be viewed. That video could have exonerated the policeman in short order, if the kid actually did reach into the car to grab his gun.
There will be Americans who sincerely believe that an angry black kid who curses back at a cop deserves whatever he gets. Death sentence is fine with them. They will be outraged that a black person would respond to “get the fuck out of the street” by cursing the cop, or making a menacing move toward him. Unthinkable that anyone could curse at a police officer, no matter what the cop may have done to the citizen, let alone shove or punch a cop. I suspect Trump got the vote of virtually every American who feels that way.
We live in a culture of systematic manipulation, driven by the profit-motive, which never sleeps. It is no surprise that the most toxic notions in the world are routinely sold here in America. Millions here believe “Climate Change” is a hoax dreamed up by prosperity-hating commies like propagandist Al Gore. No amount of evidence can change a view that is baked in and confirmed by everyone they trust.
A psychopath has no limitations on what he will say or do to get his way. That’s the liberating beauty of being a psychopath, or a corporation, for that matter. If you truly have no regard for others, outside of taking their money, and no shame, you have a great advantage in a society that teaches there is only one measure of success: unlimited fame and vast fortune.
As for me, I continue to try not to let my powerlessness and hatred destroy me, and to keep the top of my head from blowing off.
Apparently, the way to find out if a doctor is in network (and this well-reviewed nephrologist seemingly is), is to do a provider search and find this result:
I won’t even mention Obama, except to say “fuck that charismatic sell-out punk and the whores he rode in on.” I buy my health insurance through the New York State exchange under the immensely complicated compromise scheme crafted under his watch. I suffer from a serious kidney disease. I am unable to get an appointment with a recommended nephrologist who accepts my insurance plan, one of fifty or more sub-plans offered by the corporation that provides my health insurance.
The insurance company has now listed three doctors, each one highly recommended, as participating in my specific plan. You call and eventually find out, oops, devil is in the details, they don’t actually participate. The insurance company blames the providers for not keeping them updated. I blame corporate medicine for fucking people to death with a tireless mechanical dick. In fairness to them, there is no regulation of their practices, so why blame them for taking advantage?
Nothing I can write here will ease my frustration or rage one bit. I might as well bang my face against the wall until I black out. That is probably a better bet than anything else I can do at the moment.
I just note for the, hahaha, record, that the theory of Obamacare is that doctors are fungible, interchangeable, any doctor is as good as any other doctor. Relationships between doctors and patients, and trust, are irrelevant. Better to pick a name out of a hat and see a doctor than to have no doctor at all, goes the theory. Sometimes that goes badly, as when a doctor does not believe in sharing diagnostic information with a patient with too many questions. “I am expert,” says the doctor, “you deal with side effects from chemo,” and that should be answer enough. You want another doctor? Dip your hand back into the hat, motherfucker, maybe you’ll do better this time.
Or maybe you will run full force into a wall, over and over again, until you lose consciousness. That is probably a better bet for you today. Have a nice day, your business is very important to us, please continue to hold.