Here is an actual role-play my boyfriend wanted to try out, and its subsequent failure due to the jacked-up American healthcare system.
Him: "OK, you be the hot pharmacist, and I'll be the guy who comes in wanting something for my broken heart."
Me: "OK."
Him: "Sooo...can you help me with my broken heart?"
Me: "When you say broken heart, what do you mean...?"
Him: "I have an arrhythmia."
Me: "Mmm...Well, we can give you some metoprolol...or vernakalant..."
Him: "Mmmm, how big is the dosage on that?"
Me: "Well, it depends on whether you get something by mouth or intravenously--straight to your heart"
*Bedroom eyes exchange*
Him: "...Oh, no! It looks like I don't have any insurance. How are we going to...?"
Me: "We're in Canada."
Him: "...I just came."
Thankfully, we were able to meet the challenge in Canada. However, let's pretend that our role-play would have taken place in the United States. Dissatisfaction abounds:
Him: "Oh, no! It looks like I don't have any insurance. How are we going to...?"
Me: "Well, this is very expensive. I don't know if you have what it takes."
Him: "Are you sure? [leans over counter and whispers] I think I have what it takes."
Me: "No, really. The cheapest form of treatment for this condition is a Tier 3 on most formularies, which is essentially the most expensive situation, unfortunately."
Him: "Which formulary do you want?"
Me: "I'd have to make a lot of calls is what I'm trying to tell you."
Him: "So what you're saying is that I'll have to give you a laaaarrrrge percentage?"
Me: "Yes, but depending on your age, I don't know if you'll be able to cover the donut hole"
Him: "Oh, I think I can cover it, if you know what I mean. Do you carry the generic?"
Me: "Well, it gets a little kinky here, because there is a generic, but we don't carry it. The maker of the brand name basically gave me a better deal in light of their having lost the patent on it, bringing their marketability to zero among insurance carriers. So, you'd inevitably have to pay more regardless, even if you wanted the generic. Take Lipitor for example--"
Him: "You know, I'll just keep my broken heart..."
Thursday, December 29, 2011
Friday, December 16, 2011
Change.org Needs to Fall Back
Change.org needs to change.org. The last good thing they did was publicize the Bank of America $5 fee to get to your own money and help promote a petition to change.org that bullshit. Admittedly, though, the success of that fee getting removed is probably also attributable to the tangential motivation of Occupy Wall Street; when you threaten people's finances, they get pissed off enough to do shit.
That being said, I probably got on the Change.org mailing list after signing a petition I probably believed in. Since then, however, it's been a fucking free-for-all of whatever cause must come to mind at the moment. They Chicken Little my inbox at least 3 times a week with the most sensationalist bullshit I've seen since Justin Bieber's paternity test. Here is a sample of subject lines of e-mails I've gotten from Change.org within the past month or so:
Does this Web site have any filter for what becomes a cause? These people are all over the place, which truly emotionally exhausts those who initially supported the Web site. These subject lines are all ridiculous ways to both captivate my attention and ensure that I won't care; if you want to garner support, exploitative language isn't the way to go. Let's go headline by headline.
"Acid baths as retaliation" Not only have you gotten my attention, you've given my enemies ideas. GREAT.
"Two dolphins dead at a party" This is the biggest Rilli Tho of all. It sounds like dolphins had a crazy time at the rave they went to. Oh, wait, and then you read the actual e-mail, and these dolphins had a crazy time because the rave went to them. "Veterinarians now say their deaths were likely caused by the ear-splitting music of the rave and drugs that ravers threw into the dolphins' tank...Please sign Carin's petition to shut down Switzerland's last remaining dolphinarium." Rilly tho? I likely signed a petition opposing bank's greed, and I'm getting an e-mail about a dolphinarium--by the way, that shit is too specific to be a word--in Switzerland?! Next...
"Five years in prison for being gay" Ok, this is slightly more reasonable, but only because I iz into human rights and shit (I envision animal rights activists plotting to throw me into a piranha pit right now, but this all goes back to Change.org needing to filter their petitions because everyone cares about what they respectively care about). This e-mail contains a petition to the president of Cameroon calling for the freedom of 2 men jailed for being gay.
Though unjust, imprisonment for gayness is not a new thing. My boy Oscar Wilde was imprisoned for being a "sodomite" and that shit made his writing take a dark, dark turn. Also, I feel like if Change.org wants to bring light to homophobia in Africa, they should focus on the more heinous violent acts against gays in places like Uganda.
"Siri, why are you anti-choice?" Hands down, my favorite one. "Siri can't help when you ask it to find abortion services." How many people has this affected? Why are we both A: talking out loud into our phones about abortion? B: Asking our phones where we can get an abortion? I have yet to witness anyone on the street asking where the nearest abortion clinic is, let alone asking their phones.
MAYBE Siri is just against blowing up people's spots. MAYBE she doesn't want to be in a position where you're on the street rhyming to Lil Wayne and you say "Weezy baby baby kill..." and she says "DID YOU MEAN ABORTION?" Ladies and gentleman, I'm gonna go ahead and say Siri is looking out for you.
"This monk needs you" Well now that Change.org has been on a winning streak of freaking me the fuck out with headers, I feel cheated by this one. There is already nothing interesting about monks--not only that, but you're not gonna tell me off the bat why this one needs me? Nah, son. If it's not a Free Tibet rally, I want no part of it. Rilli tho, Free Tibet.
"Dead horse on an NYC street" There is so much outrageous shit that happens in New York. There was a PERSON who was dead on a packed train for 8 hours before anyone noticed. If we're going the horse route...Why don't we talk about why it's 2011 and the NYPD still rides on horses as part of what has to be an ironic anachronistic joke...and then get to this issue?
"Sexual assault and the peace corps" OK, this one is aite too. It's about the Peace Corps needing to man up when issues of sexual assault are presented to them. I'm into changingthat.org.
"Hate crime at McDonalds" McDonalds is a hate crime all by itself. I used to LOVE a drunk snack wrap, until I saw this. Now I just feel pangs of despair and regret when I think about all of the chicken that I've eaten that I now realize was indistinguishable from strawberry fro-yo. Now I hate Change.org for reminding me of this.
OMG, no shit.
That being said, I probably got on the Change.org mailing list after signing a petition I probably believed in. Since then, however, it's been a fucking free-for-all of whatever cause must come to mind at the moment. They Chicken Little my inbox at least 3 times a week with the most sensationalist bullshit I've seen since Justin Bieber's paternity test. Here is a sample of subject lines of e-mails I've gotten from Change.org within the past month or so:
Does this Web site have any filter for what becomes a cause? These people are all over the place, which truly emotionally exhausts those who initially supported the Web site. These subject lines are all ridiculous ways to both captivate my attention and ensure that I won't care; if you want to garner support, exploitative language isn't the way to go. Let's go headline by headline.
"Acid baths as retaliation" Not only have you gotten my attention, you've given my enemies ideas. GREAT.
"Two dolphins dead at a party" This is the biggest Rilli Tho of all. It sounds like dolphins had a crazy time at the rave they went to. Oh, wait, and then you read the actual e-mail, and these dolphins had a crazy time because the rave went to them. "Veterinarians now say their deaths were likely caused by the ear-splitting music of the rave and drugs that ravers threw into the dolphins' tank...Please sign Carin's petition to shut down Switzerland's last remaining dolphinarium." Rilly tho? I likely signed a petition opposing bank's greed, and I'm getting an e-mail about a dolphinarium--by the way, that shit is too specific to be a word--in Switzerland?! Next...
"Five years in prison for being gay" Ok, this is slightly more reasonable, but only because I iz into human rights and shit (I envision animal rights activists plotting to throw me into a piranha pit right now, but this all goes back to Change.org needing to filter their petitions because everyone cares about what they respectively care about). This e-mail contains a petition to the president of Cameroon calling for the freedom of 2 men jailed for being gay.
Though unjust, imprisonment for gayness is not a new thing. My boy Oscar Wilde was imprisoned for being a "sodomite" and that shit made his writing take a dark, dark turn. Also, I feel like if Change.org wants to bring light to homophobia in Africa, they should focus on the more heinous violent acts against gays in places like Uganda.
"Siri, why are you anti-choice?" Hands down, my favorite one. "Siri can't help when you ask it to find abortion services." How many people has this affected? Why are we both A: talking out loud into our phones about abortion? B: Asking our phones where we can get an abortion? I have yet to witness anyone on the street asking where the nearest abortion clinic is, let alone asking their phones.
MAYBE Siri is just against blowing up people's spots. MAYBE she doesn't want to be in a position where you're on the street rhyming to Lil Wayne and you say "Weezy baby baby kill..." and she says "DID YOU MEAN ABORTION?" Ladies and gentleman, I'm gonna go ahead and say Siri is looking out for you.
"This monk needs you" Well now that Change.org has been on a winning streak of freaking me the fuck out with headers, I feel cheated by this one. There is already nothing interesting about monks--not only that, but you're not gonna tell me off the bat why this one needs me? Nah, son. If it's not a Free Tibet rally, I want no part of it. Rilli tho, Free Tibet.
"Dead horse on an NYC street" There is so much outrageous shit that happens in New York. There was a PERSON who was dead on a packed train for 8 hours before anyone noticed. If we're going the horse route...Why don't we talk about why it's 2011 and the NYPD still rides on horses as part of what has to be an ironic anachronistic joke...and then get to this issue?
"Sexual assault and the peace corps" OK, this one is aite too. It's about the Peace Corps needing to man up when issues of sexual assault are presented to them. I'm into changingthat.org.
"Hate crime at McDonalds" McDonalds is a hate crime all by itself. I used to LOVE a drunk snack wrap, until I saw this. Now I just feel pangs of despair and regret when I think about all of the chicken that I've eaten that I now realize was indistinguishable from strawberry fro-yo. Now I hate Change.org for reminding me of this.
Monday, December 12, 2011
When people who are supposed to fix your crazy make you crazy
A Rilli Tho moment I frequently encounter is that wherein a mental health professional fucks up, whether it be a missed appointment or just being an asshole. This is problematic for me because, as a crazy person, I am consistently aware that my sanity is on trial with any therapist/psychiatrist/other; if I demonstrate any behavior even remnant of mania or psychosis, my chart is DOOMED to an Axis II perpetual hell. Even though neither of those is in my repertoire of crazy, diagnoses loom at every moment. A stare that goes a second too long could go from hypervigilance right into paranoia-land. An idea too big, delusions of grandiosity.
I apologize in advance if I am unjustly stealing this image, but it is HILARIOUS. Or sad, if you have no sense of humor. Seriously, it's like the DSM reaper. ...HILARIOUS.
So, it is possible that I am employing hyperbole to draw the reader, but the point is that I am very aware of how I act around mental health professionals (MHPs). Today, my therapist canceled approximately an hour before my appointment via text. I had already gotten to her office. It's one of our first formal appointments, so I'm still not sure how to assess her; we don't have the familiarity for me to gauge her level of responsibility.
However, she has a weird verbal affectation and manner of dress lying somewhere in the range between Lady GaGa and my best friend in high school, so I decided to let the irritability pass as I put back on my OD ridiculous winter hat (it's like that Russian shit that's built for Siberia so I'm prepared just in case they reinstate sending prisoners there somehow except from the US and I get LITERALLY sent up north somehow on what would obviously be a bullshit charge because I am a model citizen except for those reasons listed above and also because I believe in preferential voting and who knows if that could somehow come back to bite me in the ass because I am a radical thinker even though you won't catch my ass at Occupy Wall Street even if they had all the Cuban sandwiches and pink icees [they are THE BEST ONES. The blue ones are equitable, tho] in the world. But more on preferential voting later) and head back to work. I was mostly upset because I had--like the asshole yuppie I feign being during the week--because I had explained to her the demanding nature of my job (reading about how people can't breathe good and should buy this medicine all day).
How do you deal with MHPs who fuck up? I choose a combination of the waiting game and silence because I don't want to give the impression that I'm unreasonable or have unnatural reactions. Even though MHPs should take human response into consideration when making judgment calls as such, they are also human. To add to that, they are always thinking about things that are crazy because that is what they deal with all day. So, I have to completely restrain myself at all times, which unfortunately sometimes--in some cases, unbeknownst to the MHPs themselves--becomes an enabling system.
I left my last therapist because I felt pressured to tell him the fantastical stories of my childhood and adolescence; as things in my adult life became more stable, I felt like he was trying to change the channel from regular-ass Discovery Channel to Discovery Channel Psych Week. BTW, fuck shark week; live every week like it's psych week. I had also created a system wherein I could tell that he wanted me to engage in personal issues about his life, because I imagine I was probably one of the only patients to rationally and reasonably inquire (albeit out of 80% courtesy, 20% interest) about him as a person. Admittedly, he should have been more attuned to the fact that he has degrees to be an MPH; I am a patient; I am a paying patient; and he has OD degrees; but I do see my part (see the Family Systems model of psychology for an expanded explanation of this. It is likely that addiction support groups also elaborate on this model [ie, enabling], but I think most models of AA are a cult). Ultimately, in going with my hypervigilant attitude, I said nothing and gradually phased out of sessions with him.
Other mental health offenses of the past:
1. Anyone Freudian. This goes without too much explanation. If in 2011, you are a mental health professional who is not only using only one theory of practice in the vast array of psychological theorems, but are using psychoanalytic practices SOLELY, you need to get your ass to some continuing medical education (CME) conference shit immediately.
2. I once had a psychiatrist whose waiting room was hideous. HIDEOUS. It was clear that she didn't know what to do with all the money she had somehow made, and so decided to bombard her wall with what can only be described as an absolute cacophony of art: cubism juxtaposed surrealism juxtaposed 18th-century traditionalist Chinese art juxtaposed modern art. It was the worst. Every time I sat in her waiting room, I wondered how her crazier patients could sit there and look at that bullshit and not become instantly crazier for the experience.
3. Fat guy who just sat there. (See Number 1. He was a caricature of a therapist: he had a leather couch and an affinity for awkward, extended periods of silence.)
4. This one time my parents were in divorce court and I had to go to a court-appointed MHP. Let's just say I had to play a board game on divorce...divorce. Who makes this shit? That is also the question I asked when I was 9. (Not gonna lie though, that would make a FANTASTIC Christmas present to passive-aggressively, anonymously send to a couple you know should break up.)
5. Same psychiatrist with the cacophony of art asked me if I'd be down for taking Lexapro (an SSRI for major depressive disorder). She goes to her closet, takes out 8 boxes of samples (which had expired 3 years before, I should note), and says, "Wait, you're not suicidal, are you?" AS IF THE WAY I WAS GONNA GO OUT WAS TO STUFF MY FACE WITH ESCITALOPRAM OXALATE...NAH, SON.
6. Yes, believe it or not, cacophony-of-art psychiatrist ALSO could not get my name right. I saw her for probably 2 years. She thought there was a "ford" at the end of my name. MY NAME SOUNDS NOTHING LIKE ANYTHING THAT WOULD POSSIBLY RESEMBLE THAT EVER.
I apologize in advance if I am unjustly stealing this image, but it is HILARIOUS. Or sad, if you have no sense of humor. Seriously, it's like the DSM reaper. ...HILARIOUS.
So, it is possible that I am employing hyperbole to draw the reader, but the point is that I am very aware of how I act around mental health professionals (MHPs). Today, my therapist canceled approximately an hour before my appointment via text. I had already gotten to her office. It's one of our first formal appointments, so I'm still not sure how to assess her; we don't have the familiarity for me to gauge her level of responsibility.
However, she has a weird verbal affectation and manner of dress lying somewhere in the range between Lady GaGa and my best friend in high school, so I decided to let the irritability pass as I put back on my OD ridiculous winter hat (it's like that Russian shit that's built for Siberia so I'm prepared just in case they reinstate sending prisoners there somehow except from the US and I get LITERALLY sent up north somehow on what would obviously be a bullshit charge because I am a model citizen except for those reasons listed above and also because I believe in preferential voting and who knows if that could somehow come back to bite me in the ass because I am a radical thinker even though you won't catch my ass at Occupy Wall Street even if they had all the Cuban sandwiches and pink icees [they are THE BEST ONES. The blue ones are equitable, tho] in the world. But more on preferential voting later) and head back to work. I was mostly upset because I had--like the asshole yuppie I feign being during the week--because I had explained to her the demanding nature of my job (reading about how people can't breathe good and should buy this medicine all day).
How do you deal with MHPs who fuck up? I choose a combination of the waiting game and silence because I don't want to give the impression that I'm unreasonable or have unnatural reactions. Even though MHPs should take human response into consideration when making judgment calls as such, they are also human. To add to that, they are always thinking about things that are crazy because that is what they deal with all day. So, I have to completely restrain myself at all times, which unfortunately sometimes--in some cases, unbeknownst to the MHPs themselves--becomes an enabling system.
I left my last therapist because I felt pressured to tell him the fantastical stories of my childhood and adolescence; as things in my adult life became more stable, I felt like he was trying to change the channel from regular-ass Discovery Channel to Discovery Channel Psych Week. BTW, fuck shark week; live every week like it's psych week. I had also created a system wherein I could tell that he wanted me to engage in personal issues about his life, because I imagine I was probably one of the only patients to rationally and reasonably inquire (albeit out of 80% courtesy, 20% interest) about him as a person. Admittedly, he should have been more attuned to the fact that he has degrees to be an MPH; I am a patient; I am a paying patient; and he has OD degrees; but I do see my part (see the Family Systems model of psychology for an expanded explanation of this. It is likely that addiction support groups also elaborate on this model [ie, enabling], but I think most models of AA are a cult). Ultimately, in going with my hypervigilant attitude, I said nothing and gradually phased out of sessions with him.
Other mental health offenses of the past:
1. Anyone Freudian. This goes without too much explanation. If in 2011, you are a mental health professional who is not only using only one theory of practice in the vast array of psychological theorems, but are using psychoanalytic practices SOLELY, you need to get your ass to some continuing medical education (CME) conference shit immediately.
2. I once had a psychiatrist whose waiting room was hideous. HIDEOUS. It was clear that she didn't know what to do with all the money she had somehow made, and so decided to bombard her wall with what can only be described as an absolute cacophony of art: cubism juxtaposed surrealism juxtaposed 18th-century traditionalist Chinese art juxtaposed modern art. It was the worst. Every time I sat in her waiting room, I wondered how her crazier patients could sit there and look at that bullshit and not become instantly crazier for the experience.
3. Fat guy who just sat there. (See Number 1. He was a caricature of a therapist: he had a leather couch and an affinity for awkward, extended periods of silence.)
4. This one time my parents were in divorce court and I had to go to a court-appointed MHP. Let's just say I had to play a board game on divorce...divorce. Who makes this shit? That is also the question I asked when I was 9. (Not gonna lie though, that would make a FANTASTIC Christmas present to passive-aggressively, anonymously send to a couple you know should break up.)
5. Same psychiatrist with the cacophony of art asked me if I'd be down for taking Lexapro (an SSRI for major depressive disorder). She goes to her closet, takes out 8 boxes of samples (which had expired 3 years before, I should note), and says, "Wait, you're not suicidal, are you?" AS IF THE WAY I WAS GONNA GO OUT WAS TO STUFF MY FACE WITH ESCITALOPRAM OXALATE...NAH, SON.
6. Yes, believe it or not, cacophony-of-art psychiatrist ALSO could not get my name right. I saw her for probably 2 years. She thought there was a "ford" at the end of my name. MY NAME SOUNDS NOTHING LIKE ANYTHING THAT WOULD POSSIBLY RESEMBLE THAT EVER.
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