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Canonical link: https://siderea.dreamwidth.org/1355110.html

[We interrupt the previously scheduled rant for another rant.]

At some point, if you are so lucky, you will be old. You may already be old. Somebody you love may already be old. Old people, being people, require medical care, and are often treated – because this is basically what primary care in our society consists of – with medications.

Thing is, old bodies handle medicine differently than young ones.

Take the liver... [3,340 Words] )

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this week. month. season.

Sep. 22nd, 2017 04:20 pm
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[personal profile] jazzfish
The weekend was alright-to-good. I'd moved my dentist appointment to Monday from the middle of next week, and that went fine except for some gumwork that I'll need to have done in a couple of weeks. Then come Tuesday night the stress stacked up again. Emily's successfully located a subleaser, at least for a couple of months: yay! I won't have to pay half the mortgage in addition to Vancouver rent, and I might even not be dipping into savings. At least for that couple of months.

Trouble was, the subleaser wanted in on 1 October, and I was scheduled to leave Thursday evening and not get back 'til next Sunday. The first. Panic ... did not exactly set in, though stress certainly did.

Over the course of Wednesday I:
  • Got a couple of friends to hang out with me Wednesday night and help finish packing, which otherwise would have been a) slow, b) frustrating, and c) generally sad-inducing.
  • Acquired a small storage unit on short notice.
  • Decided to just call in exhausted on Thursday due to not sleeping well (this is not a lie), and just go in for my early-morning meetings.
So that happened and the packing went fine, and the move itself went fine. I left the bookcases and coffee-table there for the subleaser's use; the bookcases might fit into the storage unit if necessary. I'd intended to find myself a new better bed and move the old one to the condo so the subleaser could use it but given my state the last week or so, finding a decent bed was Not Happening. I'll throw money at Emily to find a bed. And then I guess I'll have two low-end beds.



After all that I made it back to my basement apartment about an hour before I'd expected, with plenty of time to pack for ten days up north. Indeed, I managed to leave about an hour early to get to the airport, so I'd have plenty of time to grab a leisurely dinner before my flight.

Except that when I got to the airport I realised I'd forgotten my viola, which would make it difficult to a) practise and b) have a Skype lesson on Tuesday. So, half an hour transit back out to the apartment and half an hour back to the airport, and there went all the extra time I'd built in for dinner. I did manage to grab something to eat anyhow but it was a close thing.

I then discovered, once I got here, that I'd left my glasses at home as well. This is deeply frustrating, as it rather limits my late-evening options. It's also gonna make things interesting if my contacts self-destruct again.

(I briefly thought I had lost my Nexus card, but it turned up again. Still not sure what happened there. I'd blame my lack of glasses except that I generally find things by touch and not by sight, so.)



But the weekend was pretty good: reconnected with Erin, went out to a couple of events to start trying to make connections in the local kink community, generally got a little more sociable and a little less stuck in my own head.

And today's the equinox, so maybe the horrificness has just been the fault of summer and it'll start to settle out now. I can hope, anyway.

*snif* *snif*

Sep. 20th, 2017 04:28 pm
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[personal profile] gale_storm
AH-CHOO!

I sneezed, which brought The Cat in here, where she watched me closely for about 5 minutes before lashing out at me.

I'm currently ignoring her.



[sci hist] A Most Remarkable Week

Sep. 17th, 2017 12:52 am
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[personal profile] siderea
(h/t Metafilter)

This link should take you to the audio player for The Moth, cued to a story, "Who Can You Trust", 12 minutes long.

The Moth, if you didn't know, is an organization that supports storytelling – solo spoken word prose – true stories. This story is told by Dr. Mary-Clare King, the discoverer of BRC1. It concerns a most extraordinary week in her life, when pretty much everything went absurdly wrong and right at all once. It is by turns appalling and amazing and touching and throughout hilarious.

It's worth hearing her tell herself before the live audience. But if you prefer transcript, that's here – but even the link is a spoiler.

Recommended.
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I have a recollection of hearing a filk song, I think from a tape, that had a climactic line or repeated like in the refrain, to the effect of "And that's what cities get from trains". I have an impression it was a Leslie Fish song, but I don't know that for sure.

Not having any joy of google. Does anybody recognize it?

Book of Athyra / 500 Years / Dragon

Sep. 13th, 2017 11:38 am
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[personal profile] jazzfish
The Great Big Dragaera Reread, part 3

The Ace books have decidedly Aged Well, which is always a pleasant surprise. The treatement of Easterners feels remarkably relevant and contemporary (at least, so saith this white dude), and the sense of having wandered into someone's high-powered D&D game doesn't persist past Jhereg, or maybe Yendi. I'd definitely recommend them.

Athyra, Orca, FHYA, Dragon )
siderea: (Default)
[personal profile] siderea
(h/t Metafilter)

I just heard about Senior House. Goddamn.

Also. I hadn't realized that dealing with the administration in his capacity as Senior House's housemaster is what drove Henry Jenkins from MIT. Goddamn.

I am surprisingly angry and sad about this, given that I'm not a SH affiliate.

The shutdown of Senior House would be bad news, by itself. This is appalling:
The questionnaire, the Healthy Minds Survey, was administered by the University of Michigan. Many schools around the country give it to students as a way to pinpoint problems on campus and decide how best to allocate resources. When MIT administered it in 2015, they told students that it was a confidential survey intended to help them. One of the chancellor’s assistants who had lived in Senior House when she was an undergraduate went to Senior House and specifically requested that the residents take it. They did, in large numbers.

What they didn’t know—and what they couldn’t have known from reading the consent form that accompanied it—was that MIT had embedded metadata that allowed the administration to pinpoint the location of those filling out the questionnaire, enabling them to segment the results by dorm. The only question about dorm type in the survey was vague—“What kind of dorm do you live in? Small, large, off campus?”—but by tracking the metadata, Barnhart and the administration were able to see exactly where respondents lived.

It was this data that enabled Barnhart to see what she called a troubling hot spot of drug use. “If it wasn’t a direct violation, it was at least a violation of the spirit of informed consent,” Johnson says.
In light of that...
As Senior House students spread out across campus this year, former advisers worry that they’ll be at even greater risk. They can reach out to MIT’s mental health services if they need it, the chancellor says.
Is there some reason that MIT students should trust MIT Med to keep their information confidential? When MIT just used the confidential results of a "Healthy Minds Survey", which was advertised as a way of seeing where resources were needed, to eliminate resources from vulnerable populations? And the relevant IRB gave it a pass?

(Dear MIT students, and alums concerned about them: it is apparently hypothetically possible for students on the default MIT student health insurance ("extended" plan) to see therapists unaffiliated with MIT, but it has a pretty punative copay:
If you are covered by the MIT Student Extended Plan, and you see a mental health clinician who participates in the Blue Cross Blue Shield (BCBS) PPO, your first 12 visits in a calendar year are covered in full (100%). After that, you will have a $25 copay for each visit.

If you are covered by the MIT Student Extended Plan, and you see a mental health clinician who does NOT participate in the Blue Cross Blue Shield (BCBS) PPO, your first 12 visits in a calendar year are covered at 100 percent of the BCBS allowed amount. After that, your insurance will cover 80 percent of the allowed amount, and you will pay the other 20 percent. For all of your visits, your clinician may bill you for the difference between the BCBS allowed amount and his or her charges. This is something you should discuss with your clinician ahead of time.
I don't know for certain what BCBS's "allowed amount" is, but I know they're paying master's level therapists about $85 per therapy session, so I'm guessing that's it. So if a therapist's regular fee is $100, you'd be paying ($85*0.2)+($100-$85)=$32 per session. A lot of therapists are charging rather more that $100/session these days. At $120/session that's $52/session.

That copay/cost-sharing is absurd. Obviously, many students couldn't possibly afford $25/week copay – specially the most vulnerable ones. So that's a hell of an incentive to seek care from MIT Mental Health and Counseling Service directly: as they proudly state, no copay or other fees to see the therapists that work for MIT.

Less obviously, it's not even vaguely in line with the market right now. I see people who have jobs and pay $10 and $15 copays on other insurances. That students would be charged a $25 copay to see a therapist – in-network! – is incredible. Honestly, students being charged any copay is pretty out of line.

Seriously: MIT students, the people who stock the shelves in the Star Market behind Random have better access to mental health care than you do. That grocery store shelf stocker qualifies for a subsidized Medicaid Expansion plan, which covers at least a therapy session per week, with no copay. Also, their plan has hundreds, if not thousands, of therapists to choose from, none of whom report to your landlord cum diploma-granter-maybe cum civil authority cum boss of your local police.

Also, availing yourself of the option of seeing a non-MIT therapist on your MIT student insurance, even though it's through BCBS, requires a "referral" from MIT Med:
If you are already seeing an outside clinician or have a specific outside clinician in mind, you don’t have to make an appointment at MIT Medical to get a referral. Just call the Mental Health and Counseling Service at 617-253-2916, and ask to speak with someone about getting a referral for your outside treatment.
This may be completely pro forma, but the upshot is that MIT is making it a requirement on you that you notify MIT if you're getting psychotherapy, and that you divulge to them from from whom you are getting it. That someone is in therapy and from whom they get that therapy is highly confidential information, that frankly MIT has no business knowing. You should be able to see a therapist on your student insurance without MIT even knowing about it.

So if you wanted to work for the benefit of students' mental health, there's a great target: demand that MIT's insurance for students provides off-campus, unaffiliated psychotherapy with no copay, cost sharing, or balance billing – or radically less than at present, so MIT students can freely avail themselves of treaters not on MIT payroll; and abolish the need for a referral, because info about your utilization of mental health care is prejudicial, privileged information that can be used against you. But be careful to keep a third-party insurance co in the loop, instead of MIT directly paying therapists; whomever pays the therapist is allowed to snoop in your psychotherapy records.

Or, honestly, given some of the crappy-ass general health care friends of mine have gotten through the Med Center, maybe just agitate for all students to just get a regular BCBS PPO membership instead of having to go to the Med Center, at all. Or given how much BCBS sucks, try to get students into the Medicaid Expansion, so students get a choice of providers. That would be harder.

P.S. Disclosure of conflicts of interest: none – I don't take BCBS, so even if the copay/cost-share/balance-billing were eliminated, and students started flocking to off-campus therapists, I still wouldn't benefit by any of that business, unless somehow you managed to get students into Medicaid Expansion, and then only if students were willing to travel all the way to Medford to see me – I just have it in for MIT Med, and MIT MHCS especially.)
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