[FRIAM] bad covid story

Merle Lefkoff merlelefkoff at gmail.com
Mon Dec 27 16:54:25 EST 2021 

Have any of you been at an airlines counter lately?

On Mon, Dec 27, 2021 at 11:55 AM Marcus Daniels <marcus at snoutfarm.com>
wrote:

> Here's a story that didn't involve an emergency that triggers my rage.
>
> I'm sitting at a urology clinic waiting for someone.  Everyone is sitting
> quietly.   Some are elderly and look unwell.  The people with them, some
> also older spouses, are doing their best to get them through what may
> involve a whole sequence of treatments.  They whisper.  One could imagine
> some of the situations could be humiliating.
>
> Now a guy a little older than me comes in.  By comparison to the others,
> he is relatively healthy and young.   I count my blessings I am not him.  I
> guess he is a basket case for reasons I can't explain.  He starts talking
> and proves it.   Turns out this guy -- thoughtful enough to talk loud
> enough to be heard 100 feet away -- was frustrated by his inability to
> empty his bladder.   He went to an urgent care where they installed a
> catheter.   (I wonder who goes to an urgent care for such a procedure?)
> Now a day has passed.  He decides he hates the thing.  He arrives at this
> specialized urology clinic -- one that schedules appointments months in
> advance -- without an appointment.
>
> He proceeds to be abusive to the desk staff and nurses and wants to talk
> to a doctor.   He carries on for 15 minutes at least and works through
> different people to try to get the answer he wants.   He will only use the
> name of a person (by now four of them) when it is someone that doesn't push
> back on his demands.  They get names like "Miss Whatever."  Eventually they
> consent to check the catheter, etc. to ensure it is properly installed but
> otherwise he must follow the guidance of his original urgent care doctor
> and wait for the scheduled removal.  The rest of the patients, including
> the person I am with, just had their appointments delayed.
>
> It was very hard not to volunteer to help him with that catheter.
>
> Marcus
>
> ------------------------------
> *From:* Friam <friam-bounces at redfish.com> on behalf of glen <
> gepropella at gmail.com>
> *Sent:* Monday, December 27, 2021 11:23 AM
> *To:* friam at redfish.com <friam at redfish.com>
> *Subject:* Re: [FRIAM] bad covid story
>
> What process do we use to vet the "ministers"?
> Do we need policies and procedures for things like "aura massage"?
> Do you remove the ventilator to give them the pill?
> How much does "whatever that method may be" cost? And who will pay for it?
> How much should doctors' and nurses' and finance staff *practice* their
> proper scripts for what they can and can't say to patients? 10 hours per
> week? Just in med school?
> How many edge cases should doctors have to *calculate* through to handle
> wackos like anti-maskers? What about, say, Christian Scientists? How
> complex do the logic diagrams need to be?
> How do we set the standard for *when* to tell family members the patient
> died? Who sets that standard? What committee?
> Should the doctor wear body armor or have a body guard present when
> informing the family of a death? How much do we pay for such things? Does
> the body armor have to be sterilized? Are the body guards unionized? Who
> pays for their liability insurance? Should they carry guns?
>
> Pffft. As I said, you're being ridiculously idealistic. It's fine to
> engage in wishful thinking and dream of unicorns. But don't use that as an
> excuse for idiots who cause more problems than they solve. Moreover, don't
> use your magical thinking to apply a guilt trip to an already stressed
> workforce.
>
>
>
> On 12/27/21 10:11, Eric Charles wrote:
> > Letting people try long shot, even mystical attempts, to save a person
> we are virtually certain is going to die is less cruel. (If we can let
> ministers pray with patients, we can give them a Vitamin D pill.)
> >
> > Finding a way to let people see their dying family member, whatever that
> method may need to be, is less cruel. (The idea that the doctors have to
> calculate the risk of being accused of murder if they arrange it is a
> negative aspect of the situation, not a positive one.)
> >
> > When you are virtually certain a patient is going to die, not saying "I
> won't won't let you die" is less cruel. (It is cruel to the patient, it is
> cruel to the family, and, frankly, the idea that anyone should have to say
> such lies is cruel to the person saying the lie.)
> >
> > Not going out of your way to convince a family to come to the
> hospital if you know you won't let them in, is less cruel.
> >
> > Not seeking them out while they are still in fight-mode, to tell them in
> person that the patient died, is less cruel.
> >
> > Being prepared for extremely negative reactions in situations where
> extremely negative reactions are likely to occur, is less cruel.
> >
> > Not blaming them for your leaving the profession, after a series of
> unforced errors on your part, is less cruel.
> >
> > Do you remember the UK case with Alphie Evans? When the doctors decided
> the kid should have to stay and die in a UK hospital, rather than be
> transferred to a hospital where doctors wanted to try a long-shot
> treatment? Alfie Evans not allowed to leave country, UK court says | CNN <
> https://www.cnn.com/2018/04/25/health/alfie-evans-appeal-bn/index.html> That
> was about as dystopian and cruel as health care rules can possibly get, and
> it followed all the laws and statutes and policies that existed for
> rational reasons. As a fan of dystopian stories, I can assure you that it
> is common for them to feature bureaucracies following rationally
> constructed laws and statutes.
> >
> > I do agree with Marcus that it would have been much better if the family
> had proactively identified someone who would more closely follow the
> treatment path they wanted. I don't know what the initial path to
> hospitalization was.
> >
> > <mailto:echarles at american.edu <echarles at american.edu>>
> >
> >
> > On Mon, Dec 27, 2021 at 12:28 PM glen <gepropella at gmail.com <
> mailto:gepropella at gmail.com <gepropella at gmail.com>>> wrote:
> >
> >     This is unadulterated bullshit. Sure, perhaps in some ideal world,
> where all people are rational and all systems are frictionless, "the
> process could have been much less cruel". It's bullshit in Frankfurt's
> sense because it's not quite a lie and it's not quite the truth. And given
> your (EricC) ability to think clearly and pay attention to detail, we can
> only assume you *know* it's bullshit.
> >
> >     If it could have been much less cruel, then please suggest the
> concrete modifications to the current byzantine set of laws, P&Ps, cultural
> norms, agency recommendations, political forces, etc. that would get us
> from here to there. (Not the impractical nonsense in your bullets like
> patients' family members prescribing meds that nurses will administer.
> Really? Sheesh.) If you cannot get us, practically, from where we are now
> to that less cruel place, then you're just blowing idealist smoke.
> >
> >
> >     On 12/27/21 09:18, Eric Charles wrote:
> >      > Even if, by the time the story starts, he was going to die no
> matter what happened, the process by which that happened could have been
> much less cruel.
> >     --
> >     glen
> >     Theorem 3. There exists a double master function.
> >
> >
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> --
> glen
> Theorem 3. There exists a double master function.
>
>
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-- 
Merle Lefkoff, Ph.D.
Center for Emergent Diplomacy
emergentdiplomacy.org
Santa Fe, New Mexico, USA

mobile:  (303) 859-5609
skype:  merle.lelfkoff2
twitter: @merle110
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