What a field day for the heat
A thousand people in the street
Singing songs and carrying signs
Mostly saying, "hooray for our side"

Wednesday, February 1, 2017

Linkee-poo a storm is threatening my very life today

Short editorial note. The next 3 weeks are going to be a slog for me, so publishing may become erratic. As with all such pronouncements, now watch me post hyper-regularly and on weekends. I've thought about using this quirk in my nature/universe to spur my other writing, but then I remember that Murphy's Law is not recursive.

There's been a lot of good twitter the last 24 hours, but this one I wanted to put up top: "@ChuckWendig Be wary of those "rogue" WH accounts. Treat them like satire or parody, unless of course you like fake news without a whiff of evidence." Oh my this very fucking much. You don't want to know the holes I've gone down but haven't posted here because I couldn't really verify the information (or in the worst cases, it all ran back to the same origin point). And I've even questioned some of what I would consider legit sources, especially when it hits my confirmation biases. I'm especially careful when it does that.

Terri Windling on beginning again. In the past I have waited for the Muse/genius to start dictating and as a pantster I can tell you that the act of putting words down in a coherent order when you don't feel inspired is a small miracle of the mundane Muse. All the words are from them, because the Muse is you in the final analysis (even if you're writing for someone else). The hard part these days is finding the time and energy. I like to have a few hours to dedicate, but I'm working on trying to train myself for smaller periods of time. Now if I could do something about the energy part. As with all of Terri's posts don't forget the image rollover text.

"Last Word: addictive browser game for word-slingers."

"Prolonging life might sound like a good thing, but Warraich notes that medical technologies often force patients, their loved ones and their doctors to make difficult, painful decisions… he writes about a patient with end-stage dementia who screamed 'kill me' as a feeding tube was inserted into his nose." Been there. Please make a living will, let the people around you know your wishes. If you want every measure taken to preserve life, go ahead and tell them that. Understand that without orders that's what we will do. If you don't want those measures take, you have to tell us. "Knowing when to stop is much harder." Yes. Do it while you have you facilities.

"Screening for lung cancer using low-dose CT scans can save lives, but at a cost: Tests frequently produce anxiety-producing false alarms and prompt unnecessary procedures." This is why most medical professionals both say that those "full-body scans" offered by traveling medical groups were worthless, but also probably won't read the full radiologist's report to patients. We see lots of things that are just variations in anatomy and/or benign. "There was a benefit to the 20 or so patients out of this large initial population who had their cancer detected while it was likely to be treatable." And so the balance game begins. How many cancers/disease do you allow to pass undetected versus how much you want to panic people with false positives. For medicine tests are weighted toward the false-positive rather than the false-negative, that is we would rather have a positive result that is later proven negative than a negative result when there should have been a positive. One can be ruled out by further testing, the other leads to greater patient suffering. The flip-side to this story (and this is the only way these stories are presented, btw) are those times that we don't discover cancer (or another disease) until very late (stage 4). And yes it's terrible on the patient, but the care providers also take a hit. There is a particular silence that falls in the control room as we get the pre-compiled images and notice a problem. I've had 3 patients who we've discovered late stage cancer for which they had no previous diagnosis. I had to stand stoic in an ER room as a doctor explained to a patient they needed surgery now, probably before midnight if possible, and that no, waiting to consult their regular doctor isn't in the cards (the patient was in severe denial, their spouse was losing it in the hallway while 2 nurses helped them). So while, yes, it's a pain to have a false positive. Trust me, you do not want it the other way.

How's that swamp draining going? "…one of the things Donald Trump did to win the election was shift to the left on a number of key issues — promising to avoid cuts in Social Security and Medicare benefits and adopting a longstanding Democratic pledge to let Medicare negotiate bulk discounts in the price it pays for prescription drugs… Today, after a meeting with pharmaceutical industry lobbyists and executives, he abandoned that pledge, referring to an idea he supported as recently as three weeks ago as a form of 'price fixing' that would hurt 'smaller, younger companies.'… Trump’s new plan is that he’s 'going to be lowering taxes' and 'getting rid of regulations.'" Literally the one thing I agreed with Trump on is now gone. So now it's just more of the same. (Grokked from Chuck Wendig)

Oh, and this, "A lawsuit filed Monday accused three makers of insulin of conspiring to drive up the prices of their lifesaving drugs, harming patients who were being asked to pay for a growing share of their drug bills." Want to know why your insurance keeps going up? "Several companies have recently tried to head off criticism by taking actions to address rising prices. In December, Lilly said it would offer a 40 percent discount off the list price of its insulin product, Humalog, for patients who are forced to pay full price." Yep, so if you have to pay cash they'll knock off 40% (which still makes it 150% more expensive than 2001 if I've done my math correctly). "And Novo Nordisk, which makes Novolog, has pledged to limit price increases in the American market to less than 10 percent in a year." Or they promise to raise it less than 5x the rate of inflation. Good to know.

Having secured the US election, and with his thumb firmly on the scales for the French and German elections, Putin is on the move again. "Freezing and nerve-shattered residents of an eastern Ukraine town battered by an upsurge in fighting between troops and Russia-backed rebels flocked to a humanitarian aid center Wednesday to receive food and warm up."

"Embattled Alabama Gov. Robert Bentley emptied his leftover campaign funds to pay legal bills as his faced an impeachment push and fallout from a scandal."

"Explaining that he wanted to be prepared for any unforeseen outcome, local Donald Trump supporter Fred McGuire, 52, said Tuesday that he has a few backup scapegoats ready to go in case the president’s planned aggressive policing and monitoring policies aimed at immigrants don’t fix everything." Oh Onion, don't ever change. (Grokked from Robert J Bennett)

"At least 17 Jewish community centers across the United States were targeted with bomb threats in the third wave of such mass disruption this month." Nazis. (Grokked from Chuck Wendig)

"But the movement toward limiting protesters’ free speech rights is not confined to the terminals of DIA. In anticipation of an active protest movement during Trump’s administration, multiple Republican-controlled states are currently pushing for legislation that would discourage and even criminalize nonviolent, public demonstrations." Just like they did in the 70s and 80s. They're also trying to make "picketing" illegal (which would muzzle unions). (Grokked from Charles de Lint)

"With every mass shooting, the initial news is almost always riddled with inaccuracies—misidentification is common, and rarely is there more than one attacker. By now this is very well-known in newsrooms. Earlier on Monday, an additional suspect was reportedly in custody: a man of Moroccan origin… Quebec officials soon clarified that this second person was considered a witness, not a suspect in the attack. But the toothpaste was already out of the tube with Fox News, which had pushed the story in a particular direction…" Also with the Press Secretary. (Grokked from Kathryn Cramer)

"DeVos questionnaire appears to include passages from uncited sources." Oh sweet Cthulhu. (Grokked from Fran Wilde)

How totalitarianism takes root: "The totalitarian mass leaders based their propaganda on the correct psychological assumption that, under such conditions, one could make people believe the most fantastic statements one day, and trust that if the next day they were given irrefutable proof of their falsehood, they would take refuge in cynicism; instead of deserting the leaders who had lied to them, they would protest that they had known all along that the statement was a lie and would admire the leaders for their superior tactical cleverness." Also, most people skew toward authoritarianism. And the majority of those who don't will skew that direction under a perceived threat.

Character is what you do when you think no one is watching. "A person secretly recorded closed sessions on national security and health care (at the private GOP retreat in Philadelphia) that were attended by many dozens of GOP lawmakers. They had gathered for a private discussion of some of the thorniest legislative issues of the moment, as well as a question-and-answer session with Pence." And there's now a hunt on to find the person, whom they believe was someone posing as a spouse of a lawmaker who was ejected from the confab. (Grokked from Xeni Jardin)

Tweet of my heart: @jonrosenberg Donald told us he would run the country like he runs his businesses and now we know why he declared bankruptcy six times. (Grokked from Eric VanNewkirk)

Double dip: ‏@claytoncubitt Centrist Aggressive Explainer Tweetstormers are the high-fructose corn syrup of the information diet. Tempting but mostly empty calories. (Grokked from Xeni Jardin)

Third time charm: ‏@keewa Weird how many Lone Wolves there are and how they all seem to occupy the same white nationalist spaces online (Grokked from Matt Staggs)


Doug said...

Steve, I would like to write more into my living will, but I don't know how to write it. The built-in language only applies to my future permanently unconscious state. There are so many other mental conditions where I might be too impaired to say Stop, but I don't know how to define them.

I also don't want to accidentally give the medicos permission to let me go when I'm still worth recovering, by too broad of a statement.

Is there an AI for the purpose of composing better living will language, or maybe a page full of samples that one could browse?

Doug C

Steve Buchheit said...

Hey Doug, what you want to look into are what are called "Advanced Directives" (of which a Living Will is just the start). This is a way of planing out actions and to give advice to your health care providers when you can't speak for yourself. Also you may want to designate a durable healthcare power of attorney. That's someone who can make decisions for you when you can't. As for samples, I don't have any at my finger tips. Most family or probate lawyers could probably set you up. I think if you google it you could find some examples.

Doug said...

Great advice. We have a family attorney, so that's where I will turn. The durable HC POAs are already done, but advanced directives beyond that have never been discussed.

Doug said...

Or, it occurs to me, I can just clearly make the directives available to our health care POA. She's an eminently trustworthy and sensible woman. Thanks again for helping me think through this Steve.