Medical Mystery
January 3, 2024 1:07 PM Subscribe
I had my health. I had a job. And then, abruptly, I didn’t. A first person account from NY Magazine. Harrowing, with bonus understated outrage at the US' failing and disastrous healthcare system.
The medical-mystery column doesn’t usually dwell on how slowly the inquiry goes in our fractured health-care system. How the highly recommended pulmonologist doesn’t return the first phone call and only has an opening five months away, and how the major-medical center does have an appointment but isn’t in network with the major-medical insurer. How the chest X-ray is over by the East River and the breathing booth is in the West 160s and the phlebotomist is by Columbia, and how each one has its own online portal for billing and results.
The medical-mystery column doesn’t usually dwell on how slowly the inquiry goes in our fractured health-care system. How the highly recommended pulmonologist doesn’t return the first phone call and only has an opening five months away, and how the major-medical center does have an appointment but isn’t in network with the major-medical insurer. How the chest X-ray is over by the East River and the breathing booth is in the West 160s and the phlebotomist is by Columbia, and how each one has its own online portal for billing and results.
Thank you for the archive link! I should have thought of that; it didn’t come up as paywalled for me. I will ask the mods if they can add that to the FPP.
posted by mygothlaundry at 1:20 PM on January 3 [1 favorite]
posted by mygothlaundry at 1:20 PM on January 3 [1 favorite]
Gah. I'm just about to leave for multi-week trip to the U.S. Thank god for my evac clause.
posted by Tell Me No Lies at 1:23 PM on January 3 [1 favorite]
posted by Tell Me No Lies at 1:23 PM on January 3 [1 favorite]
I think this is a story that is familiar to many people in countries with modern healthcare at scale, whether they privately organized or publicly. Certainly, I've heard angrier (and less worldly-weary -- I like the author's tone a lot) descriptions from friends in the UK and French systems as they try and navigate finding a diagnosis for a chronic problem among scattered, and busy, professional doctors.
I can't speak to whether it's worse in the US. My experience has been mixed: it's certainly more expensive for the patient!
posted by ntk at 1:44 PM on January 3 [1 favorite]
I can't speak to whether it's worse in the US. My experience has been mixed: it's certainly more expensive for the patient!
posted by ntk at 1:44 PM on January 3 [1 favorite]
The US system has a greater potential to put you in permanent debt every step of the way. Basically the majority of Americans are a few bad breaks away from falling off the economic ladder and spiraling towards homelessness or worse at any time.
Key economic indicators are good though.
posted by Artw at 1:47 PM on January 3 [15 favorites]
Key economic indicators are good though.
posted by Artw at 1:47 PM on January 3 [15 favorites]
"We don't have 'healthcare' in the USA.
We have healthcare theater performed for investors."
(Source)
posted by CheesesOfBrazil at 1:50 PM on January 3 [38 favorites]
We have healthcare theater performed for investors."
(Source)
posted by CheesesOfBrazil at 1:50 PM on January 3 [38 favorites]
Repeat after me: The American health care system is not designed to deliver health care. It's designed to give capital more leverage over labor. It's working exactly as designed.
posted by vibrotronica at 1:51 PM on January 3 [71 favorites]
posted by vibrotronica at 1:51 PM on January 3 [71 favorites]
I never ended up in the hospital, but it still took more than a year from when my symptoms became distressing and debilitating to when a rheumatologist finally had a diagnosis. And I now understand that many of the diagnostic symptoms had been there for decades. And then, like Tom Scocca, I became immunocompromised, because it's better than barely being able to move while my body slowly destroys itself.
And this can happen to anybody. Including you.
And it sucks out here, as Ed Yong clearly explained almost 2 years ago now: The Millions of People Stuck in Pandemic Limbo: What does society owe immunocompromised people?
posted by hydropsyche at 2:26 PM on January 3 [16 favorites]
And this can happen to anybody. Including you.
And it sucks out here, as Ed Yong clearly explained almost 2 years ago now: The Millions of People Stuck in Pandemic Limbo: What does society owe immunocompromised people?
posted by hydropsyche at 2:26 PM on January 3 [16 favorites]
Okay, well, this was really good for me to read, as well as a bit horrifying.
I've been struggling with figuring out what the hell is wrong with me for literally years at this point. And as best I can tell it IS just conversion disorder. I've tried twice before to get some course of testing and diagnosis and possible treatment going for myself, but it is SO hard to coordinate as an individual even if you're really on the ball with all sectors of your life, which I am decidedly not.
I'm now on Medicaid, and the plan I have has care coordinators! I've already reached out to them to see if we can get this started early. I really need someone I can call and say "okay, so I just went and did those things, what are the next steps?" and get actual information.
This is a question I've asked repeatedly at the end of various medical encounters, "okay, so what is the step after this one" and the number of times I've been given zero information or help has been enough of a wall that it's been impossible for me to overcome.
I don't know these systems. I don't know how to play the game. I hope I can get some help in this because I'm not a reluctant patient -- I'm a disorganized one who doesn't know what he's doing.
Anyway, I'm glad I read this. And I really hope he gets a diagnosis at some point. Just getting a name put on something really helps a lot.
posted by hippybear at 2:26 PM on January 3 [13 favorites]
I've been struggling with figuring out what the hell is wrong with me for literally years at this point. And as best I can tell it IS just conversion disorder. I've tried twice before to get some course of testing and diagnosis and possible treatment going for myself, but it is SO hard to coordinate as an individual even if you're really on the ball with all sectors of your life, which I am decidedly not.
I'm now on Medicaid, and the plan I have has care coordinators! I've already reached out to them to see if we can get this started early. I really need someone I can call and say "okay, so I just went and did those things, what are the next steps?" and get actual information.
This is a question I've asked repeatedly at the end of various medical encounters, "okay, so what is the step after this one" and the number of times I've been given zero information or help has been enough of a wall that it's been impossible for me to overcome.
I don't know these systems. I don't know how to play the game. I hope I can get some help in this because I'm not a reluctant patient -- I'm a disorganized one who doesn't know what he's doing.
Anyway, I'm glad I read this. And I really hope he gets a diagnosis at some point. Just getting a name put on something really helps a lot.
posted by hippybear at 2:26 PM on January 3 [13 favorites]
I think about moving to the UK sometimes (was born there, never lived there beyond the infant years). This is a major driver, the NHS doesn't have a great rep at the moment but it's also not this and in conjunction with the design of the rest of the country delivers consistently higher life expectancy than the US.
I have friends who decide jobs based solely on health benefits here. It's just so evil, forever, and without any real hope of fixing it after Lieberman and at least 9 other faceless dems refused to allow the public option when the (seemingly only in our lifetimes) chance arose.
posted by Slackermagee at 2:28 PM on January 3 [11 favorites]
I have friends who decide jobs based solely on health benefits here. It's just so evil, forever, and without any real hope of fixing it after Lieberman and at least 9 other faceless dems refused to allow the public option when the (seemingly only in our lifetimes) chance arose.
posted by Slackermagee at 2:28 PM on January 3 [11 favorites]
Frankly, my advice to anyone is to rid yourself of your will to live as early as possible, just to make things easier.
posted by Faint of Butt at 2:30 PM on January 3 [12 favorites]
posted by Faint of Butt at 2:30 PM on January 3 [12 favorites]
Oh, that left years ago. I'm just running on autopilot now.
posted by hippybear at 2:31 PM on January 3 [6 favorites]
posted by hippybear at 2:31 PM on January 3 [6 favorites]
I can't speak to whether it's worse in the US. My experience has been mixed: it's certainly more expensive for the patient!
It's absolutely worse when you spend 3 hours on the phone bouncing between your employer's benefits manager, a doctor's office, and the medical insurance company the benefits manager, only for it to slowly dawn on you that there is not actually anyone on God's green Earth that can tell you for sure whether a visit with a specific doctor will be covered by insurance or not in advance because it's in no party's interest to bother untangling the web of payment agreements between the two companies unless they're saving money by denying someone's insurance claim.
posted by Zalzidrax at 2:36 PM on January 3 [22 favorites]
It's absolutely worse when you spend 3 hours on the phone bouncing between your employer's benefits manager, a doctor's office, and the medical insurance company the benefits manager, only for it to slowly dawn on you that there is not actually anyone on God's green Earth that can tell you for sure whether a visit with a specific doctor will be covered by insurance or not in advance because it's in no party's interest to bother untangling the web of payment agreements between the two companies unless they're saving money by denying someone's insurance claim.
posted by Zalzidrax at 2:36 PM on January 3 [22 favorites]
Even more fun is when you don't have insurance and need a medical procedure. I needed a barium enema exam at one point for possible diverticulitis, and didn't have insurance, and spent maybe six hours total phone call time [not including research time about how to call] trying to get the answer: I'm paying cash for this, how much will it cost?
They finally gave me a price over the phone and then billed me for more than that afterward and it was a fight at that point.
posted by hippybear at 2:39 PM on January 3 [2 favorites]
They finally gave me a price over the phone and then billed me for more than that afterward and it was a fight at that point.
posted by hippybear at 2:39 PM on January 3 [2 favorites]
My mum passed away recently and I was back in the UK for it. The NHS and assorted government bodies did so much stuff for her towards the end, a hospital stay, then setting her up at home with a bed and an oxygen machine, nurse visits… obviously a lot was going on and it was a lot to process but some part of me couldn’t help thinking “this would utterly financially destroy a US family”.
posted by Artw at 2:41 PM on January 3 [23 favorites]
posted by Artw at 2:41 PM on January 3 [23 favorites]
I read things like this and realize how I was super lucky when I got cancer back in 2002.
Obviously unlucky to get cancer but very lucky in my treatment.
I had no insurance and was working a kind of shitty job. I had been having digestive issues and self diagnosed myself as maybe having some sort of gluten intolerance but then an online friend said "What medical school did you graduate from?" and insisted I see a doctor.
As it happened my mother was seeing a doctor about an issue and she mentioned to him that I was having some problems and he told her to tell me to come in and he'd do an exam.
He found a tumor like one knuckle into my rectum. Turns out it was colo-rectal cancer.
Also, this doctor was a great surgeon and had just stepped down as the chief of staff or something like that at the local hospital so he had a lot of 'pull' with the medical people in this town. He also seemed to take a liking to me.
He told me to immediately go fill out the paperwork to get on the local version of medi-cal because I was going to rack up a lot of bills.
Then he called around and used his pull to get me appointments right away. I was showing up at doctor's offices and they were checking me out on their lunch breaks. What might have taken months I got taken care of in like the first week after my diagnosis.
When I eventually went in for surgery my no insurance having ass ended up in a private room.
Eventually it was all done except for the healing. I had a drawer full of bills (from that first month before Medi-Cal kicked in) but I just chucked them all in the trash because I had staples holding my torso together at that point and had no idea when I would be able to get back to work or even if I would survive (20 years later still here so I guess I got lucky there too).
Apparently my bills got sent to a local collection agency and when they got too annoying I went down to their office and explained I had no money to give them and might very well never have any and I would appreciate it if they quit calling me and bothering me and somehow that worked. They never called me again.
posted by Dirk at 2:52 PM on January 3 [32 favorites]
Obviously unlucky to get cancer but very lucky in my treatment.
I had no insurance and was working a kind of shitty job. I had been having digestive issues and self diagnosed myself as maybe having some sort of gluten intolerance but then an online friend said "What medical school did you graduate from?" and insisted I see a doctor.
As it happened my mother was seeing a doctor about an issue and she mentioned to him that I was having some problems and he told her to tell me to come in and he'd do an exam.
He found a tumor like one knuckle into my rectum. Turns out it was colo-rectal cancer.
Also, this doctor was a great surgeon and had just stepped down as the chief of staff or something like that at the local hospital so he had a lot of 'pull' with the medical people in this town. He also seemed to take a liking to me.
He told me to immediately go fill out the paperwork to get on the local version of medi-cal because I was going to rack up a lot of bills.
Then he called around and used his pull to get me appointments right away. I was showing up at doctor's offices and they were checking me out on their lunch breaks. What might have taken months I got taken care of in like the first week after my diagnosis.
When I eventually went in for surgery my no insurance having ass ended up in a private room.
Eventually it was all done except for the healing. I had a drawer full of bills (from that first month before Medi-Cal kicked in) but I just chucked them all in the trash because I had staples holding my torso together at that point and had no idea when I would be able to get back to work or even if I would survive (20 years later still here so I guess I got lucky there too).
Apparently my bills got sent to a local collection agency and when they got too annoying I went down to their office and explained I had no money to give them and might very well never have any and I would appreciate it if they quit calling me and bothering me and somehow that worked. They never called me again.
posted by Dirk at 2:52 PM on January 3 [32 favorites]
I think about moving to the UK sometimes (was born there, never lived there beyond the infant years). This is a major driver, the NHS doesn't have a great rep at the moment but it's also not this and in conjunction with the design of the rest of the country delivers consistently higher life expectancy than the US.
The NHS is being strangled. There are more than 8 million (1 in 7 people!) waiting for routine treatment - routine encompassing things "basically that won't kill you in the next month".
Chemo? Cancer test results? Call back in 3 months. Replacement hip? Current wait : 2-3 years.
The US 'market' system is FUCKED. But the UK system in some ways is currently worse: given a choice of no treatment at ALL for YEARs or rolling the dice with bankruptcy? I don't envy either choice.
Cites for above numbers:
https://www.theguardian.com/society/2023/sep/14/record-number-people-waiting-start-routine-nhs-hospital-treatment-england
https://www.theguardian.com/society/2023/jul/29/revealed-how-hidden-delays-blight-cancer-care-in-england-and-wales
https://www.theguardian.com/news/video/2023/sep/26/unthinkable-nhs-waiting-lists-force-patients-to-get-surgery-abroad-video
posted by lalochezia at 2:58 PM on January 3 [6 favorites]
To start off the avalanche of "well actually, in the US I waited for..." posts, I had alarming (but not life threatening) symptoms and waited about a month for a specialist consult, and two months for a be-under procedure as someone in their mid-30s, with good insurance, in the DC area (so just absolutely loaded with hospitals and specialist practices).
The UK system has the benefit of actually being fixable, if Labor ever gets over fucking Thatcherism. Building it from scratch is the hard part.
posted by Slackermagee at 3:11 PM on January 3 [7 favorites]
The UK system has the benefit of actually being fixable, if Labor ever gets over fucking Thatcherism. Building it from scratch is the hard part.
posted by Slackermagee at 3:11 PM on January 3 [7 favorites]
Frankly, my advice to anyone is to rid yourself of your will to live as early as possible, just to make things easier.
To paraphrase an old Marc Maron joke, I'm not suicidal but it's nice to know the option is there.
posted by rhymedirective at 3:15 PM on January 3 [7 favorites]
To paraphrase an old Marc Maron joke, I'm not suicidal but it's nice to know the option is there.
posted by rhymedirective at 3:15 PM on January 3 [7 favorites]
My employer, like many in the UK, gives us private health insurance as a benefit. To access it, I have to go through my NHS GP but all I need to say is "I have BUPA" and the GP breathes a sigh of relief and says "who do you want to see?" and makes the referral. I will already have chosen the BUPA consultant (specialist doctor) that I want to see from BUPA's list of approved practitioners. All of these consultants will also have NHS jobs too, and fit their private work in around that. Then I'll get an appointment in a matter of days, rather than months, to see the consultant at a private hospital or clinic.
Although providing private health insurance isn't really necessary for UK employers - because we all, in theory, have access to the NHS - it's more cost-effective to have an employee who needs carpal tunnel surgery or a hip replacement to have it done quickly and paid for by insurance rather than have to wait several years for an op on the NHS, by which point they're crippled and unemployable.
For critical, urgent care I think the NHS is second to none, but it is at breaking point. It's being privatised bit-by-bit with services being contracted out, e.g. cleaning, catering, laundry, etc. The £350million a week Boris fucking Johnson lied about to get people to vote for Brexit was never going to happen, and the effect of Brexit on recruiting staff has only made things worse.
People in the UK might not go bankrupt because they need healthcare, but a hell of a lot of people needing routine surgery or treatment will die waiting for it.
posted by essexjan at 3:26 PM on January 3 [15 favorites]
Although providing private health insurance isn't really necessary for UK employers - because we all, in theory, have access to the NHS - it's more cost-effective to have an employee who needs carpal tunnel surgery or a hip replacement to have it done quickly and paid for by insurance rather than have to wait several years for an op on the NHS, by which point they're crippled and unemployable.
For critical, urgent care I think the NHS is second to none, but it is at breaking point. It's being privatised bit-by-bit with services being contracted out, e.g. cleaning, catering, laundry, etc. The £350million a week Boris fucking Johnson lied about to get people to vote for Brexit was never going to happen, and the effect of Brexit on recruiting staff has only made things worse.
People in the UK might not go bankrupt because they need healthcare, but a hell of a lot of people needing routine surgery or treatment will die waiting for it.
posted by essexjan at 3:26 PM on January 3 [15 favorites]
The one time I was in the ER, still conscious, I had a moment of zen. A nurse putting an IV in my right arm and another nurse putting a credit card receipt in my left hand. At the same time.
The symmetry of that has stuck with me for years.
posted by howbigisthistextfield at 3:38 PM on January 3 [29 favorites]
The symmetry of that has stuck with me for years.
posted by howbigisthistextfield at 3:38 PM on January 3 [29 favorites]
I'm really a layperson commenting on these matters, but surely if you were to remove private health insurance, have the dollars the employers are paying to BUPA into the NHS, wouldn't that both put more money into the NHS to shore it up as a public service and free up appointment slots for everyone who needs them so NHS people aren't shoved to the back of the line?
posted by hippybear at 3:42 PM on January 3 [4 favorites]
posted by hippybear at 3:42 PM on January 3 [4 favorites]
Having spent all of early Dec. in 2022 in the hospital, boy do I feel this story. And the doctors knew what was killing me. Can't imagine how hard such a non-diagnosis would be to deal with. And I was only billed $488,000 for my stay. And hospitals are understaffed and run pretty terribly in our system. Pay your fucking nurses.
posted by Windopaene at 3:48 PM on January 3 [2 favorites]
posted by Windopaene at 3:48 PM on January 3 [2 favorites]
IMO, this doesn't have that much do to with being in the USA, as it pertains to the expense side of the coin - that's where the US medical establishment sucks, other than mentions of so-many payment portals. In the middle, he even booked a whale watching family trip as a bucket list item. That's like $400. The only real administrative failure mentioned is state of NY unemployment, which due to reasons only a state bureaucracy would understand ruled him ineligible for unemployment.
There are of course mentions of US healthcare administrative failures - overcrowded hospitals, his hospital room neighbor with an untreated condition due to the expense, but those are background flavors.
It's more that this guy had an issue that normal tests couldn't diagnose, and that's a failing of evidence-based medicine, and the limitations of modern medicine - which is still basically in its infancy.
posted by The_Vegetables at 3:51 PM on January 3 [8 favorites]
There are of course mentions of US healthcare administrative failures - overcrowded hospitals, his hospital room neighbor with an untreated condition due to the expense, but those are background flavors.
It's more that this guy had an issue that normal tests couldn't diagnose, and that's a failing of evidence-based medicine, and the limitations of modern medicine - which is still basically in its infancy.
posted by The_Vegetables at 3:51 PM on January 3 [8 favorites]
I'm just 13.5 months out from my covid infection. It was a slog crawling out from Long Covid. I felt pretty good in July and then fell back again at the end of August. Now I'm taking blood pressure meds and have been hosting a kidney stone since at least halloween with one trip to emergency. I also have shoulder impingement and a very sore hip joint (a possible side effect of taking FloMax to try an relax my ureter so my stone could pass). I've had to add steroid nasal sprays to my allergy control regimen.
It is hard to say if this is Long Covid knock-ons or if it is just that I am over 50 and now in what a Guardian editorial I read last week called "Sniper's Alley" but I went from an empty medicine cabinet and a Garmin Fitness age 15-20 years younger than my age all the way up to 5 years older than my age (it was down to 10 years youngers before the hip problem sidelined me).
So I read this article and felt it in both my organs and my bones.
Also today I successfully moved up my latest Urologist appt by 15 days! It really is amazing how much a kinder receptionist in a medical office can make my day. It's also pretty wild how I am getting bills from random companies I have never heard of and phone calls from places I have never been. I even got a sperate bill for the heart monitor leads from my ER visit! I feel like I have to be an office manager for my own body now to counter the amorphous health care system where responsibility for my well-being resides with nobody but me and I get paid nothing for it while everybody else is making bank of my decline.
People in the UK might not go bankrupt because they need healthcare, but a hell of a lot of people needing routine surgery or treatment will die waiting for it.
I've had my kidney stone since Halloween in the american health care system. My very elderly father had a urological issue in Canada at the same time and got an appointment and resolution in under two weeks. My appointment was a month wait for just a consultation in the American system in Chicago which is saturated with doctors and hospitals.
posted by srboisvert at 4:22 PM on January 3 [11 favorites]
It is hard to say if this is Long Covid knock-ons or if it is just that I am over 50 and now in what a Guardian editorial I read last week called "Sniper's Alley" but I went from an empty medicine cabinet and a Garmin Fitness age 15-20 years younger than my age all the way up to 5 years older than my age (it was down to 10 years youngers before the hip problem sidelined me).
So I read this article and felt it in both my organs and my bones.
Also today I successfully moved up my latest Urologist appt by 15 days! It really is amazing how much a kinder receptionist in a medical office can make my day. It's also pretty wild how I am getting bills from random companies I have never heard of and phone calls from places I have never been. I even got a sperate bill for the heart monitor leads from my ER visit! I feel like I have to be an office manager for my own body now to counter the amorphous health care system where responsibility for my well-being resides with nobody but me and I get paid nothing for it while everybody else is making bank of my decline.
People in the UK might not go bankrupt because they need healthcare, but a hell of a lot of people needing routine surgery or treatment will die waiting for it.
I've had my kidney stone since Halloween in the american health care system. My very elderly father had a urological issue in Canada at the same time and got an appointment and resolution in under two weeks. My appointment was a month wait for just a consultation in the American system in Chicago which is saturated with doctors and hospitals.
posted by srboisvert at 4:22 PM on January 3 [11 favorites]
My second to last kidney stone flare up, I went to the ER, got properly diagnosed, got some drugs ( including Flomax, which did seem to help ) and a referral to a urologist.
I went to that office I think 3 times and never saw the actual doctor, just the PA, and she never seemed interested in collecting the stone to see what was it was made of or any of that. Second time I took in what I had captured, which seemed to ick her out and she just tossed it saying it was just a blood clot.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 5:12 PM on January 3 [6 favorites]
I went to that office I think 3 times and never saw the actual doctor, just the PA, and she never seemed interested in collecting the stone to see what was it was made of or any of that. Second time I took in what I had captured, which seemed to ick her out and she just tossed it saying it was just a blood clot.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 5:12 PM on January 3 [6 favorites]
For critical, urgent care I think the NHS is second to none, but it is at breaking point. It's being privatised bit-by-bit with services being contracted out, e.g. cleaning, catering, laundry, etc. The £350million a week Boris fucking Johnson lied about to get people to vote for Brexit was never going to happen, and the effect of Brexit on recruiting staff has only made things worse.
What has been done to the NHS fills me with white-hot incandescent rage and I honestly am astonished that the British public have let it happen.
Still, from an American perspective, the NHS is a bizarre wonderland. I have had to interface with it twice, once in 2003 and once in 2022, and both times it was an amazing experience where they… determined I needed medical care and then… gave me medical care, without filling out a single form. Even in 2022, you can apparently just roll up and go “this bad thing happened to me and I would like help, please” and they go “yeah sure no problem here is all your medicine now go away.”
I don’t know when or how we’re going to escape this neoliberal capitalist hellscape that has been foisted on us so white men can commit soul fraud to die rich, but I fear things are going to have to get a lot worse before they get better.
posted by rhymedirective at 5:40 PM on January 3 [11 favorites]
What has been done to the NHS fills me with white-hot incandescent rage and I honestly am astonished that the British public have let it happen.
Still, from an American perspective, the NHS is a bizarre wonderland. I have had to interface with it twice, once in 2003 and once in 2022, and both times it was an amazing experience where they… determined I needed medical care and then… gave me medical care, without filling out a single form. Even in 2022, you can apparently just roll up and go “this bad thing happened to me and I would like help, please” and they go “yeah sure no problem here is all your medicine now go away.”
I don’t know when or how we’re going to escape this neoliberal capitalist hellscape that has been foisted on us so white men can commit soul fraud to die rich, but I fear things are going to have to get a lot worse before they get better.
posted by rhymedirective at 5:40 PM on January 3 [11 favorites]
The only real administrative failure mentioned is state of NY unemployment m
There was the part where he couldn’t see the specialist that was best fit and had an earlier appointment because they were out-of-network for his health insurance.
posted by eviemath at 5:55 PM on January 3 [1 favorite]
There was the part where he couldn’t see the specialist that was best fit and had an earlier appointment because they were out-of-network for his health insurance.
posted by eviemath at 5:55 PM on January 3 [1 favorite]
Every time I read one of these stories, I'm really glad that my chronic illness manifested when I was still in high school (in the 1980s) and had an available, not-employed-outside-the-home parent to be my strong advocate in dealing with the medical system.
As an adult, I'm lucky enough that I'm on a regular semiannual or faster cycle of specialist appointments and they catch things that are wrong with me pretty easily. Also, now, lucky enough to be in a teaching hospital system so my doctors think my problems are interesting instead of trivially dismissing them.
posted by gentlyepigrams at 6:12 PM on January 3 [3 favorites]
As an adult, I'm lucky enough that I'm on a regular semiannual or faster cycle of specialist appointments and they catch things that are wrong with me pretty easily. Also, now, lucky enough to be in a teaching hospital system so my doctors think my problems are interesting instead of trivially dismissing them.
posted by gentlyepigrams at 6:12 PM on January 3 [3 favorites]
We've achieved a sufficient level of automation where it's just not profitable to keep us in good shape for very long. Like horses after the Great War. Surplus to requirements.
And this is why my retirement plan is to become glue or pet food. Possibly both if I'm feeling productive.
posted by She Vaped An Entire Sock! at 6:31 PM on January 3 [5 favorites]
And this is why my retirement plan is to become glue or pet food. Possibly both if I'm feeling productive.
posted by She Vaped An Entire Sock! at 6:31 PM on January 3 [5 favorites]
Serious things with no obvious cause are so troubling though. If you have a label, then you have some guidance about the range of things that can happen from here. Without a diagnosis, it's wide open. To me that's the worst part of this story. Will he get worse? How fast? Fatally? Is there anything we can do? None of these questions has an answer without that label.
posted by i_am_joe's_spleen at 6:47 PM on January 3 [5 favorites]
posted by i_am_joe's_spleen at 6:47 PM on January 3 [5 favorites]
The writer, Tom Scocca, is so much more than an example of how fucked up the medical system is in America. He's a fantastic editor, and had a direct hand in some of the reporting that made the loss of Gawker and the gutting of Deadspin as bad as it was. He's edited at Slate, contributed to the Awl, was Features Editor for Gawker, and deputy editor for their Special Projects Desk. That he is struggling to find work is a goddamn shame. His writing, on Substack, is worth reading.
posted by Ghidorah at 7:21 PM on January 3 [13 favorites]
posted by Ghidorah at 7:21 PM on January 3 [13 favorites]
I think we have passed the Golden Age Of Modern Medicine, and as Collapse unfolds, it's devolving. It will get harder and harder to get good care as time goes on, and require more and more effort and waiting from patients to get any care at all.
Right now the System writ large has a lot of forward momentum, but the wheels are disintegrating and entropy is increasing, and access to care is dwindling.
You have to take in the big picture to be able to see it - a lot of people haven't experienced the failures of the medical system personally yet, so to them, everything is fine. But the system is grinding away and the forces propping it up are weakening.
Some factors: physician shortages worsen as more leave the profession, and nurses as well. Nurse admins get bonuses for keeping headcount and pay low, so they understaff on purpose for personal financial gain. Patient care quality, safety, and nurse burnout rates be damned.
This is how the system undergoes catabolic collapse. The remaining personnel get worked harder and harder until they, too, decide to leave. There are no countervailing forces in play capable of reversing this decline - there is a severe shortage of nursing instructors in nurse training programs because the pay is terrible.
And we live in the kind of world where, rather than doing the obvious correction to this clearly-identified problem and increasing the pay, the people in charge instead decide to just *let the system fail*. That's the choice that is made, up and down the line, even though it leads to increased suffering and unnecessary preventable deaths.
This is Madness, but no one with the power to fix it will fix it, they evade any kind of personal accountability for this abdication of responsibility, and there is no feedback from these failures that is sufficient to get them to correct their decisionmaking and save people's lives. It's a sick, broken system that is poisoned by the worship of Profit and cost-cutting.
And the severe and dire lack of GP's in the Canadian system caused by low pay is also somehow not getting fixed by the obvious solution of INCREASING THEIR PAY.
I feel like this level of incompetence has to be some kind of calculated malice, because it makes absolutely no damn sense otherwise.
Humans deserve better and are capable of better but refuse to do better. Conclusion: humankind is a failure as a superorganism.
I get in cynicism spirals a lot, because so much of the problem is fixable if people would just be *decent*.
posted by cats are weird at 12:04 AM on January 4 [10 favorites]
Right now the System writ large has a lot of forward momentum, but the wheels are disintegrating and entropy is increasing, and access to care is dwindling.
You have to take in the big picture to be able to see it - a lot of people haven't experienced the failures of the medical system personally yet, so to them, everything is fine. But the system is grinding away and the forces propping it up are weakening.
Some factors: physician shortages worsen as more leave the profession, and nurses as well. Nurse admins get bonuses for keeping headcount and pay low, so they understaff on purpose for personal financial gain. Patient care quality, safety, and nurse burnout rates be damned.
This is how the system undergoes catabolic collapse. The remaining personnel get worked harder and harder until they, too, decide to leave. There are no countervailing forces in play capable of reversing this decline - there is a severe shortage of nursing instructors in nurse training programs because the pay is terrible.
And we live in the kind of world where, rather than doing the obvious correction to this clearly-identified problem and increasing the pay, the people in charge instead decide to just *let the system fail*. That's the choice that is made, up and down the line, even though it leads to increased suffering and unnecessary preventable deaths.
This is Madness, but no one with the power to fix it will fix it, they evade any kind of personal accountability for this abdication of responsibility, and there is no feedback from these failures that is sufficient to get them to correct their decisionmaking and save people's lives. It's a sick, broken system that is poisoned by the worship of Profit and cost-cutting.
And the severe and dire lack of GP's in the Canadian system caused by low pay is also somehow not getting fixed by the obvious solution of INCREASING THEIR PAY.
I feel like this level of incompetence has to be some kind of calculated malice, because it makes absolutely no damn sense otherwise.
Humans deserve better and are capable of better but refuse to do better. Conclusion: humankind is a failure as a superorganism.
I get in cynicism spirals a lot, because so much of the problem is fixable if people would just be *decent*.
posted by cats are weird at 12:04 AM on January 4 [10 favorites]
And the severe and dire lack of GP's in the Canadian system caused by low pay is also somehow not getting fixed by the obvious solution of INCREASING THEIR PAY.
We have the same discussions in Australia, where full time GPs earn about $340k on average which is IIRC is very much a top 1% in terms of pay - so it's hard to get the 99% to understand they need to contribute more to a one percenter's salary.
Worse, I'll provide one data point, I know a GP clearing $300k on bulk billing (zero cost to patient). If the government doubled his pay rate, he would most likely halve his hours worked and still clear $300k per year. So he could spend more time with his wife and kids and on leisure activities like video games. It's far less likely that seeing the pay rates go up he instead decides to suddenly work 6 days a week...
I don't think there are huge numbers of people who decided against a career in medicine because they judged the pay too low, and now suddenly they want to do medicine because the pay went up...
I am generally more optimistic about medical care, I have many friends and family working in GP and hospital acute care, all public service. There have been truly incredible advances in medicine and survival rates for many fatal diseases like certain cancers are so much better than even 10 or 20 years ago.
but surely if you were to remove private health insurance, have the dollars the employers are paying to BUPA into the NHS, wouldn't that both put more money into the NHS to shore it up as a public service and free up appointment slots for everyone who needs them so NHS people aren't shoved to the back of the line?
Ironically I'm with BUPA as well (Australia) and did have private surgery which was covered about 40% by BUPA, I'm on their lowest cost plan and I'm fine with it.
The way it works is that there's only $X in health funding available each year, taxpayers hate tax increases, and as costs go up the easy thing to do is focus public health on acute care and gradually let the private sector take care of elective surgeries by just letting wait lists for public elective surgeries get longer. This way you have both systems operating in parallel. The surgery I wanted to have took care of something that was painful and would confirm that it was not cancerous, but it wasn't life threatening and the public option would take about a year, while with the private option I could just walk into any hospital and get it done immediately for maybe $1,500 of my own money which included an overnight post-operative stay. That's actually one the things, with a "free" public option - even with waiting periods - this constrains what the private sector can charge because they're competing with a free service. So I'm comfortable having a low tier of insurance because I know private sector care won't be ruinously expensive.
Yes, perfectly logical if we would snap our fingers and put more money into public health instead of private healthy. If you are talented enough to convince millions of voters to part with their money, you could definitely be the Prime Minister, because none of ours have been able to =P
posted by xdvesper at 4:49 AM on January 4 [2 favorites]
We have the same discussions in Australia, where full time GPs earn about $340k on average which is IIRC is very much a top 1% in terms of pay - so it's hard to get the 99% to understand they need to contribute more to a one percenter's salary.
Worse, I'll provide one data point, I know a GP clearing $300k on bulk billing (zero cost to patient). If the government doubled his pay rate, he would most likely halve his hours worked and still clear $300k per year. So he could spend more time with his wife and kids and on leisure activities like video games. It's far less likely that seeing the pay rates go up he instead decides to suddenly work 6 days a week...
I don't think there are huge numbers of people who decided against a career in medicine because they judged the pay too low, and now suddenly they want to do medicine because the pay went up...
I am generally more optimistic about medical care, I have many friends and family working in GP and hospital acute care, all public service. There have been truly incredible advances in medicine and survival rates for many fatal diseases like certain cancers are so much better than even 10 or 20 years ago.
but surely if you were to remove private health insurance, have the dollars the employers are paying to BUPA into the NHS, wouldn't that both put more money into the NHS to shore it up as a public service and free up appointment slots for everyone who needs them so NHS people aren't shoved to the back of the line?
Ironically I'm with BUPA as well (Australia) and did have private surgery which was covered about 40% by BUPA, I'm on their lowest cost plan and I'm fine with it.
The way it works is that there's only $X in health funding available each year, taxpayers hate tax increases, and as costs go up the easy thing to do is focus public health on acute care and gradually let the private sector take care of elective surgeries by just letting wait lists for public elective surgeries get longer. This way you have both systems operating in parallel. The surgery I wanted to have took care of something that was painful and would confirm that it was not cancerous, but it wasn't life threatening and the public option would take about a year, while with the private option I could just walk into any hospital and get it done immediately for maybe $1,500 of my own money which included an overnight post-operative stay. That's actually one the things, with a "free" public option - even with waiting periods - this constrains what the private sector can charge because they're competing with a free service. So I'm comfortable having a low tier of insurance because I know private sector care won't be ruinously expensive.
Yes, perfectly logical if we would snap our fingers and put more money into public health instead of private healthy. If you are talented enough to convince millions of voters to part with their money, you could definitely be the Prime Minister, because none of ours have been able to =P
posted by xdvesper at 4:49 AM on January 4 [2 favorites]
I imagined living in a world and a class where a person could retreat to a sanatorium and shut everything down until the problem was figured out.
My understanding is that either within living memory or within a generation of living memory, this kind of thing might well have been possible for someone with a job like magazine editor in chief. We've all lost so much, just to make a handful of rich bozos fractionally richer.
(And, as a trans person from the UK, it's best not to get me started on the NHS. I'm pursuing HRT privately this year, and I mentioned to my partner that I could be looking at up to seven months of wait time for an initial appointment. He asked why I didn't go private, and I had to explain that this was indeed the wait time for private services, because the lack of NHS resources means that everyone who can even vaguely afford to pursue private care tends to do so - though I've been 'lucky' and will hopefully get an appointment around March/April time. If I went via the NHS route I would likely be waiting seven years for an initial appointment.)
posted by terretu at 4:58 AM on January 4 [6 favorites]
My understanding is that either within living memory or within a generation of living memory, this kind of thing might well have been possible for someone with a job like magazine editor in chief. We've all lost so much, just to make a handful of rich bozos fractionally richer.
(And, as a trans person from the UK, it's best not to get me started on the NHS. I'm pursuing HRT privately this year, and I mentioned to my partner that I could be looking at up to seven months of wait time for an initial appointment. He asked why I didn't go private, and I had to explain that this was indeed the wait time for private services, because the lack of NHS resources means that everyone who can even vaguely afford to pursue private care tends to do so - though I've been 'lucky' and will hopefully get an appointment around March/April time. If I went via the NHS route I would likely be waiting seven years for an initial appointment.)
posted by terretu at 4:58 AM on January 4 [6 favorites]
terretu, I had a very similar experience. Something like a seven or eight month wait for private HRT (actually longer, that initial wait was for a first appointment. Then began another few months waiting to actually get anything).
As for getting HRT on the NHS, that wait took over two years for me, and that's one of the shorter waiting lists in the country. Other clinics have wait lists measured in decades.
posted by june_dodecahedron at 5:40 AM on January 4 [2 favorites]
As for getting HRT on the NHS, that wait took over two years for me, and that's one of the shorter waiting lists in the country. Other clinics have wait lists measured in decades.
posted by june_dodecahedron at 5:40 AM on January 4 [2 favorites]
I imagined living in a world and a class where a person could retreat to a sanatorium and shut everything down until the problem was figured out.
But there is no such class. I have a brother in law's whose family is wealthy - like medical clinics with their name on it in Africa and names of buildings at Ivy Leagues wealthy. His father got ALS and he got a few extra years with all the money and the 'best doctors' - (so the anecodote about the recommended doctor in the article I missed because I don't really believe such doctors exist) and suffered the same fate as everyone else.
A diagnosis might be kind of comforting in the "now I sort of know" kind of way, but it's in no way equivalent to a cure.
That's why I say modern medicine is still in it's infancy.
Some factors: physician shortages worsen as more leave the profession, and nurses as well.
Eh. Physician shortages are the same as housing shortages. There are serious problems with training physicians that could be fixed immediately, but the existing ones don't want a hit to their income. Same with hospital beds -the US (at least) is actively choosing not to build more hospitals. It's not some passive problem that is intractable.
posted by The_Vegetables at 7:17 AM on January 4 [3 favorites]
But there is no such class. I have a brother in law's whose family is wealthy - like medical clinics with their name on it in Africa and names of buildings at Ivy Leagues wealthy. His father got ALS and he got a few extra years with all the money and the 'best doctors' - (so the anecodote about the recommended doctor in the article I missed because I don't really believe such doctors exist) and suffered the same fate as everyone else.
A diagnosis might be kind of comforting in the "now I sort of know" kind of way, but it's in no way equivalent to a cure.
That's why I say modern medicine is still in it's infancy.
Some factors: physician shortages worsen as more leave the profession, and nurses as well.
Eh. Physician shortages are the same as housing shortages. There are serious problems with training physicians that could be fixed immediately, but the existing ones don't want a hit to their income. Same with hospital beds -the US (at least) is actively choosing not to build more hospitals. It's not some passive problem that is intractable.
posted by The_Vegetables at 7:17 AM on January 4 [3 favorites]
For critical, urgent care I think the NHS is second to none,
As two-time immigrant I researched the serious disease health outcomes for Canada, United States and the UK. They were all pretty equivalent in 2005 (if you had access in the US) with just some minor differences for some specific rarer types of cancer. There are pretty big differences between the three health care systems in delivery so I thought that was kind of interesting. A lot has happened in the last two decades particularly in the UK where the Tories have been waging war on the NHS so while the talent may still exist the capacity probably does not.
posted by srboisvert at 9:24 AM on January 4 [2 favorites]
As two-time immigrant I researched the serious disease health outcomes for Canada, United States and the UK. They were all pretty equivalent in 2005 (if you had access in the US) with just some minor differences for some specific rarer types of cancer. There are pretty big differences between the three health care systems in delivery so I thought that was kind of interesting. A lot has happened in the last two decades particularly in the UK where the Tories have been waging war on the NHS so while the talent may still exist the capacity probably does not.
posted by srboisvert at 9:24 AM on January 4 [2 favorites]
In the middle, he even booked a whale watching family trip as a bucket list item. That's like $400.
Obviously the fact that he could afford a $400 whale watching trip invalidates everything else he had to say about his condition and the economic hardships of getting it properly diagnosed.
I have a brother in law's whose family is wealthy - like medical clinics with their name on it in Africa and names of buildings at Ivy Leagues wealthy. His father got ALS and he got a few extra years with all the money and the 'best doctors' [...] and suffered the same fate as everyone else.
You're very keen to argue against the idea that socio-economics have anything to do with the level of care people get or the hardships they face. You might want to check your own privilege before you start complaining about a $400 whale watch.
posted by RonButNotStupid at 11:32 AM on January 4 [2 favorites]
Obviously the fact that he could afford a $400 whale watching trip invalidates everything else he had to say about his condition and the economic hardships of getting it properly diagnosed.
I have a brother in law's whose family is wealthy - like medical clinics with their name on it in Africa and names of buildings at Ivy Leagues wealthy. His father got ALS and he got a few extra years with all the money and the 'best doctors' [...] and suffered the same fate as everyone else.
You're very keen to argue against the idea that socio-economics have anything to do with the level of care people get or the hardships they face. You might want to check your own privilege before you start complaining about a $400 whale watch.
posted by RonButNotStupid at 11:32 AM on January 4 [2 favorites]
Some factors: physician shortages worsen as more leave the profession, and nurses as well.
Eh. Physician shortages are the same as housing shortages. There are serious problems with training physicians that could be fixed immediately, but the existing ones don't want a hit to their income. Same with hospital beds -the US (at least) is actively choosing not to build more hospitals. It's not some passive problem that is intractable.
That was...literally the point of their comment? That these problems are neither passive nor intractable but they will nonetheless never be fixed because nobody who can fix them wants to.
posted by We put our faith in Blast Hardcheese at 11:37 AM on January 4
Eh. Physician shortages are the same as housing shortages. There are serious problems with training physicians that could be fixed immediately, but the existing ones don't want a hit to their income. Same with hospital beds -the US (at least) is actively choosing not to build more hospitals. It's not some passive problem that is intractable.
That was...literally the point of their comment? That these problems are neither passive nor intractable but they will nonetheless never be fixed because nobody who can fix them wants to.
posted by We put our faith in Blast Hardcheese at 11:37 AM on January 4
(Honestly situations like your BIL's are the ones that give me hope--if enough rich idiots finally figure out that all the money in the world won't save your dad if nobody ever bothered funding research for a cure or training for the doctors, maybe they'll finally ever do something useful with themselves and develop decent politics.)
posted by We put our faith in Blast Hardcheese at 11:41 AM on January 4 [1 favorite]
posted by We put our faith in Blast Hardcheese at 11:41 AM on January 4 [1 favorite]
Primary care doc here. Multiple uninsured/uninsurable patients waiting months for life-saving treatment, many more patients (even the insured!) forgoing care due to ancillary expenses. One of the hardest parts of my job is being customer service for this macabre joke we call a health system.
And the comparison health system is *not* the NHS or Health Canada. Both organizations are being slowly pecked to death by the vultures of capital. The comparison is Cuba which boasts longer life expectancy by a year, 3x as many doctors per capita and twice as many hospital beds, wait times measured in hours, not months, and <1/10th healthcare spending per capita to boot.
Market-based solutions to healthcare are like bourbon-based solutions to thirst: sensible only from a position of willful ignorance, intoxicating, and ultimately fatal.
posted by Richard Saunders at 3:31 PM on January 4 [23 favorites]
And the comparison health system is *not* the NHS or Health Canada. Both organizations are being slowly pecked to death by the vultures of capital. The comparison is Cuba which boasts longer life expectancy by a year, 3x as many doctors per capita and twice as many hospital beds, wait times measured in hours, not months, and <1/10th healthcare spending per capita to boot.
Market-based solutions to healthcare are like bourbon-based solutions to thirst: sensible only from a position of willful ignorance, intoxicating, and ultimately fatal.
posted by Richard Saunders at 3:31 PM on January 4 [23 favorites]
You're very keen to argue against the idea that socio-economics have anything to do with the level of care people get or the hardships they face.
No I'm not. You think that hospitals in wealthy areas are lacking in hospital beds or doctors? No they are not. The US (the only system I can speak of) is extremely variable based on your income and the area you live in, outside of abnormal circumstances. IE: during flu season, even the wealthy children's hospitals have long waits for the ER.
I'm only arguing that in this particular article, that the hardships of care in the US that this individual person faced had nothing to do with his ability to pay, and that in this particular case, getting access to 'better' doctors wouldn't have helped, because the average quality of 'great doctor vs average to poor doctor' is not very wide.
posted by The_Vegetables at 8:16 AM on January 5 [1 favorite]
No I'm not. You think that hospitals in wealthy areas are lacking in hospital beds or doctors? No they are not. The US (the only system I can speak of) is extremely variable based on your income and the area you live in, outside of abnormal circumstances. IE: during flu season, even the wealthy children's hospitals have long waits for the ER.
I'm only arguing that in this particular article, that the hardships of care in the US that this individual person faced had nothing to do with his ability to pay, and that in this particular case, getting access to 'better' doctors wouldn't have helped, because the average quality of 'great doctor vs average to poor doctor' is not very wide.
posted by The_Vegetables at 8:16 AM on January 5 [1 favorite]
While that’s an important clarification, I think part of the issue is that a for-profit healthcare system can lead to worse outcomes for everyone, including those who can afford the best care available in the system. That you can have all the money in the world, but if something unusual and thus not profitable to research or treat happens to you, the medical knowledge or treatments needed for your care will still be unavailable.
This is an important point, both for folks in the US who want to broaden support for a single payer, non-profit health care system and for those of us in countries like Canada or the UK where there has been some political pressure to privatize components of the system. Individuals may feel, pointwise, that their individual medical care improves by accessing the private care options. And when you just focus on a one-time care choice in the system configuration as it currently is, sure, that is indeed the case for many people. But it’s a prisoner’s dilemma, where the more people make use of the private options, the more resources are drawn away from the public option, so the worse the public option gets; and then privatization increases in scope, until you end up with something as broken as the US system.
(Which is not to say that rare diseases or conditions, or things that interact negatively with societal prejudices (chronic pain, women’s reproductive health issues, etc.) necessarily get well-studied under single payer or public health care systems either; just that the possibility exists for that to happen, and can be influenced by means available to everyone, such as public pressure.)
posted by eviemath at 9:40 AM on January 5 [1 favorite]
This is an important point, both for folks in the US who want to broaden support for a single payer, non-profit health care system and for those of us in countries like Canada or the UK where there has been some political pressure to privatize components of the system. Individuals may feel, pointwise, that their individual medical care improves by accessing the private care options. And when you just focus on a one-time care choice in the system configuration as it currently is, sure, that is indeed the case for many people. But it’s a prisoner’s dilemma, where the more people make use of the private options, the more resources are drawn away from the public option, so the worse the public option gets; and then privatization increases in scope, until you end up with something as broken as the US system.
(Which is not to say that rare diseases or conditions, or things that interact negatively with societal prejudices (chronic pain, women’s reproductive health issues, etc.) necessarily get well-studied under single payer or public health care systems either; just that the possibility exists for that to happen, and can be influenced by means available to everyone, such as public pressure.)
posted by eviemath at 9:40 AM on January 5 [1 favorite]
In the middle, he even booked a whale watching family trip as a bucket list item. That's like $400.
Obviously the fact that he could afford a $400 whale watching trip invalidates everything else he had to say about his condition and the economic hardships of getting it properly diagnosed.
Yeah I'd see it the other way based on my own experience. After my kidney stone attack trip to the ER where I had bp with 190+ on the first measure I bought myself a $2000 camera and a $1600 lens because confronted with my health decline I decided to do it now rather than later because who knows what's coming down the pipeline. I also got on blood pressure meds and started losing weight and things are under control but I now know I am vulnerable. Memento morbis and mori. Live a bit for today even when you're ill and suffering.
posted by srboisvert at 10:33 AM on January 5 [3 favorites]
Obviously the fact that he could afford a $400 whale watching trip invalidates everything else he had to say about his condition and the economic hardships of getting it properly diagnosed.
Yeah I'd see it the other way based on my own experience. After my kidney stone attack trip to the ER where I had bp with 190+ on the first measure I bought myself a $2000 camera and a $1600 lens because confronted with my health decline I decided to do it now rather than later because who knows what's coming down the pipeline. I also got on blood pressure meds and started losing weight and things are under control but I now know I am vulnerable. Memento morbis and mori. Live a bit for today even when you're ill and suffering.
posted by srboisvert at 10:33 AM on January 5 [3 favorites]
Honestly I can't tell you the number of times I've been basically completely broke but I bought myself concert tickets because what the fuck I only live once. And that's not even me being ill, that's just me realizing that the moments in time that pass me by will never come back around.
posted by hippybear at 8:15 PM on January 8 [4 favorites]
posted by hippybear at 8:15 PM on January 8 [4 favorites]
A sort of follow-up, Defector just launched a new Scocca-written column for this year's election, Margin of Error. The first piece went up today. I'm relieved to see him getting at least something regular, and have this weird sort of sensation that took me a moment to recognize: I feel good about a way in which I've spent money, seeing the thing that I'm supporting reaching out to take care of one of their colleagues and good friends when that person needs it most. It's unfortunate how rare that feeling is.
(although I get that sort of feeling whenever they publish a Hamilton Nolan piece on boxing, or, to a lesser extent, Jaguars Junction)
posted by Ghidorah at 9:43 PM on January 25
(although I get that sort of feeling whenever they publish a Hamilton Nolan piece on boxing, or, to a lesser extent, Jaguars Junction)
posted by Ghidorah at 9:43 PM on January 25
« Older "End this chaos" vs "nation-wrecking nightmare" vs... | Slashdot's Top Stories of 2023 Newer »
This thread has been archived and is closed to new comments
posted by Pickman's Next Top Model at 1:12 PM on January 3 [6 favorites]