Adventures with medical bureaucracy

 

Last Friday I mentioned that my blog post that day would be abbreviated due to a medical appointment.  I duly attended it, and it accomplished what I wanted.  I asked about alternative neurosurgical practices, since I'm not happy with the one I've been using, and the doctor referred me to another neurosurgeon in Dallas for further investigation.  (It seems the problem is to decide precisely what surgery I need:  to fuse two or three more vertebrae in addition to the existing pair, or to remove the latter and encase my entire lumbar spine in a sort of metal cage to stabilize the whole area.  There appears to be serious disagreement over which approach would work best, so I've asked for a second opinion from a more professional professional, if you know what I mean.)

So far, so good . . . but then I called the new doctor's office to set up the appointment.  The conversation went something like this.

Me:  I've been referred to Dr. X for further investigation of my spine injury.  My medical insurance is XYZ, and you should have been sent my medical history, copies of X-rays and myelograms, and all that stuff.

Doctor's nurse:  Let me check . . . Yes, we have those.  You'll have to get another myelogram, though, because the previous one was done more than six months ago.  Dr. X won't see you until the new results are available.

Me:  Er . . . this is a problem.  A myelogram is a very expensive and complex procedure.  I can't just ask for it as a private patient:  I have to be referred for it by a doctor.  However, if Dr. X won't see me, he can't issue the referral;  and my local general practitioner certainly can't do so, because it's a specialist procedure.  I can't ask for a referral from my previous neurosurgeons, because I'm moving on from them.  What now?

Doctor's nurse:  I'm afraid that's Dr. X's protocol.  He won't see you without an updated myelogram.

Me:  Well, his protocol has just run headlong into medical bureaucrats, and I'm pretty sure they're going to win.  You're asking me to do the impossible.

Doctor's nurse:  I'm sorry, but my hands are tied.  You're going to have to find some other way to get that myelogram.

Me:  Hangs up, bites tongue, bangs head against brick wall, etc.

I checked with my general practitioner, and sure enough, they can't refer me for a myelogram because it's a specialist procedure, outside their area of competence.  The neurosurgery practice that ordered the previous myelogram has no good reason to order another one.  After all, I'm going to see one of their competitors for a second opinion,  so they'll expect the new doctor to prescribe whatever tests he thinks are necessary.  They're not going to do it for him.

"Laugh!", they said.  "Things could be worse!"  So I did.  And they were.

Oh, well.  This, too, shall pass . . . I just need the administrative equivalent of an enema for the bureaucrats, to make sure it does!

Peter

Two different perspectives on technology, and both are thought-provoking

 

First, an article in American Intelligence addresses artificial intelligence in the agricultural sector.  (American Intelligence provides very few details about itself or those behind it.  I did a search using Supergrok, which provided these details, if you're interested.)

America cannot lead the AI farming revolution while federal policy keeps imported labor cheaper than machines

Every agricultural economy has a legacy. The question is which part is being preserved. The fertile soil is a legacy. The family farms are a legacy. The harvest is a legacy. So is the labor model that brings it in. And across American agriculture, that model has for forty years depended heavily on foreign labor, illegal hiring, and a political class determined not to disturb either.

When a city brochure pairs “legacy” with AI robotics in the same breath, it is not just describing the future. It is making a quiet promise: the technology will advance, but the labor model will not.

America is preparing for the AI age everywhere except the place that feeds the country.

. . .

Autonomous tractors already plant, till, and spray without a driver. Computer-vision systems can scout crops plant by plant. Machine-learning models can optimize water, fertilizer, pest control, and yield down to the meter. Robotic harvesters can pick faster, cleaner, and longer than hand crews. Precision irrigation can be guided by satellite analytics. AI-assisted breeding can compress decades of plant selection into months.

The question is no longer whether American agriculture can automate. It is whether Washington will stop subsidizing the cheap labor model that makes automation a losing bet.

America should be leading this revolution. It builds the software, funds the research, trains the engineers, and talks constantly about technological dominance. Yet federal policy still props up an agricultural labor model built on cheap imported labor, illegal hiring, and guestworker expansion. That bargain has kept human labor cheaper than machines, delayed mechanization, and now risks leaving the United States on the sidelines of a revolution it should own.

There's more at the link.

To a technologist, that sounds wonderful.  Machine intelligence and labor will take over the agricultural sector, modernizing everything and guaranteeing much greater yields and more efficient utilization of resources.  So far, so good . . . but what happens to the many millions of people who earn their living working on farms and in the food industry?  When they're replaced in the fields and the food processors, where will they find employment?  Almost every other sector of the economy is also paring back on human resources and switching to ever greater automation.  How is our economy, our nation, going to cope with the burden of all those thrown out of work by this sea-change?

Furthermore, what will it do to nations that cannot afford to grow their own food even today, but also cannot afford to automate their agriculture?  Will there be seeds they can grow, or will even that be absorbed into techno-agriculture?  What about the illegal aliens who used to flood across our borders to work on American farms?  Now they'll be stuck in their own countries, without work, and possibly without local food either.

I'm not a Luddite.  I think automation and technology can serve us well, if properly managed, and hold out great hope for the future.  However, we can't embrace them blindly unless we also account for those who will be displaced by them.  How are we going to cope with them in our increasingly digital society?  How are they going to adapt, particularly if there's no work available for them to earn a living while they and their families adapt?

That dilemma was discussed last year at the Nexus Conference 2025, 'Apocalypse Now: The Revelation of our Time'.  It was held under the auspices of the Nexus Institute, which describes its mission like this:

As an independent non-profit foundation, the Nexus Institute brings together the world’s foremost intellectuals, artists, scientists and politicians, and encourages them to discuss the questions that really matter. How are we to live? How can we shape our future? Can we learn from our past? Which values and ideas are important, and why?

From reading its Web site, the Institute seems fairly typically left-wing and progressive, but it does appear to try to provide those with different philosophies with an opportunity to participate in wide-ranging discussions.  Here's an excerpt from a panel from last year's conference titled "The Wild West of digital technology in a capitalist system".  I don't agree with many of the points raised (unsurprising, from my right-of-center perspective), but I think they present aspects of the problem that are important, and worth examining.

The future of our technological society is far from settled, and is in many cases unsettling to think about.  I try to keep informed about all sides of the debate, and the article and video clip above have helped me to do that.  I hope you enjoyed them, too.

Peter

Shocking news - except to Africans

 

I note the following news report.

A South African hotelier is believed to have been eaten by a 15ft crocodile after human remains were found inside the swollen reptile.

The animal was shot from a helicopter and airlifted from the crocodile-infested Komati River in a daring police operation before a post-mortem examination was carried out.

A ring was found inside the belly of the 500kg apex predator and is thought to have belonged to Gabriel Batista, 59.

The businessman was swept away in floodwaters while trying to drive across the Komati River in the north-east of the country a week ago.

Investigators will carry out DNA tests on the bones and flesh found inside the crocodile.

. . .

 As well as the body parts, six different types of shoes were found, according to Capt Potgieter.

There's more at the link, including images.

The comments from friends and acquaintances in the USA have been amusing.  A surprising number are absolutely horrified that a man who'd just escaped drowning had promptly been eaten by a wild animal.  It's almost as if it was unfair, somehow.  They weren't comforted by my assurance that in large parts of Africa, that sort of thing happens on an almost daily basis.  As for the "six different types of shoes" . . . yeah, I'd say Mr. Batista was far from the only human meal that croc had enjoyed.  Local tribespeople were doubtless greatly relieved by the news that it had been caught.

Rural Africa remains a very dark continent, filled with very deadly animals.  Actual examples:

• A man visits a neighboring village, gets drunk, and decides to walk back to his village along a deserted path at night.  Halfway there, a passing leopard finds him and decides that he'll make a satisfactory supper.
• A man goes looking for a lost cow along a river bank.  A hippo, grazing on long grass a short distance away, decides that she doesn't want him (or anyone else) getting between her and the water, which is her security blanket.  She bites him in half.
• A hunter gets too close to an elephant, which promptly tramples him into pink slush in the mud.  He isn't able to shoot her in time to save himself, and in the stress of the moment, only wounds her.  While she's recovering from the bullet wound, she kills several local villagers who get too close to her, on the general principle that if a man did this to her, she's going to presume that any man she sees is going to try to do likewise.
• An armored personnel carrier is driving through thick brush and trees.  The vehicle commander is standing with his head and shoulders outside the turret, trying to see through the thick growth to plot his course.  A boomslang (tree snake) is jarred off its branch by the APC as it brushes against the tree.  It falls onto the vehicle commander, bites him (injecting a full dose of poison, which proves fatal) and then falls through the turret hatch into the interior of the vehicle, biting two other soldiers before it's killed by a rain of rifle butts.  The two survive, but only because it had already injected much of its venom into the vehicle commander.  They're sick for several weeks.

All those incidents were personally known to me.  I was nearby when they all happened.  That's the norm in wild rural Africa.  The cities can be a lot tamer, but not always.  A few decades ago, I remember two leopards who set up house in the concrete basement and utility spaces of the biggest soccer stadium in Soweto, surrounded by hundreds of thousands of people.  They lived off local cats and dogs.  When their presence was deduced (due to the rapid decline in other local pets and wildlife, and the presence of their tracks after rain) the local police were asked to hunt them down and shoot them.  Freely translated and interpreted, the local cops' reply was along the lines of, "You want us to go into a concrete labyrinth, with no light at all, to hunt two big cats that can see in the dark?  Oh, hell, no!  Here, take our rifles and show us how it's done.  We'll watch.  In fact, we'll sell tickets on pay-per-view!"

I'm very sorry for Mr. Batista, and for his family, of course . . . but that's Africa:  and in Africa, the good guys don't always win.  It goes with the territory.

Peter

Memes that made me laugh 310

 

Gathered from around the Internet over the past week.  Click any image for a larger view.

Sunday morning music

 

I've found that a lot of people know the more "common" songs by Jethro Tull, but most are unaware that there are literally dozens of less-well-known pieces out there.  Some are outtakes, some are from concept albums that were never released as such, and some appeared in other channels.  Many of them are a lot of fun, and I enjoy listening to them.

Today I'd like to bring you four of Jethro Tull's less-well-known pieces.  The first, originally intended for their album "Broadsword and the Beast" but left off the final set, is called "Motoreyes".  This recording is from the compilation album "20 Years of Jethro Tull".

Next, here's the theme music from the 1984 Channel 4 television series "Blood Of The British".  David Palmer wrote most of the music for the series, but Jethro Tull performed the title song, "Coronach".

From their double CD "Nightcap:  The Unreleased Masters 1973-1991", here's "Rosa On The Factory Floor".

And finally, again from their "20 Years of Jethro Tull" compilation, here's one of my favorites:  "Part Of The Machine".

Please let me know in Comments if these songs were new to you, and if you'd like more of Jethro Tull's less-well-known music.  If so, I'll put up a few more posts like this.

Peter