For Reasons, I got rather drunk Saturday night at Fourth Street. While I was trying to fall asleep, I felt just plain weird, and I thought to feel my pulse. I was missing every eighth beat. That's...a lot of PVCs. Since then, I've been noticing occasional tightness in my chest, a very slight something that one might call shortness of breath, and a lot of missed beats. Now, at least some of the weird feeling in my chest is almost certainly muscular. I don't wear a bra, I am old, and the muscles attaching to my rib cage are a bit stressed. And some of the shortness of breath may or may not be related to asthma.
One night at work, with entirely too much time on my hands, as my patient was coming in late, I hooked myself up to the amplifier, just running the EKG. (This cost my work exactly two disposable snap electrodes, one alcohol wipe, and one sani-wipe.) Yep, my heart was throwing PVCs. One morning, I was throwing between six and twelve a minute.
Possible triggers: alcohol, caffeine, and Allegra. So, I've stopped taking Allegra, stopped having a nightcap after work, and reduced the caffeine. I tried eliminating the caffeine, but that caused me to become depressed, and there's literally no future in that. I switched to Claritin, which doesn't work as well, but man I need to not claw my eyes out.
I repeat: PVCs are almost always a benign arrhythmia. There are tests. I should probably have them done. Possibly a Holter monitor, probably a (shudder) stress test. Ick. Probably expensive. Sigh. After a month of monitoring my pulse for missed beats, messing about with my chemical profile, and whinging and moaning about not liking doctors, I sent an email to my doctor through the automated system, describing my symptoms, providing the above information, and asking for an appointment.
And now we get to how health care is really not a consumer good.
I get back an email stating that they cannot schedule me an appointment based on my reported symptoms, and I need to talk to a nurse, first. I roll my eyes. I call the clinic's Nurseline, and go through all the above information. I assume she can also see my email to my doc, but who knows. She asks me a series of questions, the answer to most of them is "no." Am I in pain? Does the pain radiate? Am I dizzy? Do I feel nauseous? No, no, no, no. She then says, "You should go to the Emergency Room." I explain that I will not do so. I point out that PVCs are almost always benign. (When they aren't benign, they still aren't a terminal rhythm. They're a symptom of cardiomyopathy or some other serious damn thing, but not instantly fatal.) I am still paying off my last visit to the ER, eight months ago. The nurse tries to insist. I tell her that I will, under no circumstances, do any such thing. We get rather cross with each other. She states that their guidelines do not permit them to schedule an appointment for these symptoms, the guidelines require that I be seen on an emergent basis. I point out that this is health care, and I can refuse any damn thing I want.
Eventually, she says that she will have to talk to my provider, and will call me back. I point out that I evidently have a condition so dire that I must be seen on an emergent basis, but if I refuse, they will not permit me to see my own damn doctor, and how does that even make sense. We became even crosser with one another.
I wake up to a voice mail stating that I can call my clinic and schedule an appointment. By this time, of course, the clinic is closed, and after hours people cannot schedule.
So, this morning, I call the clinic. And am offered an appointment at 9:40 a.m. I explain that this simply doesn't work, as I have to go to work tonight, which means I need to be in bed by 11:00 a.m. The nurse asks why that doesn't work. I point out that even if I get in and out in an hour, I'm still not home before 11:00 a.m., and that means probably not in bed until 11:30 or noon, and that assumes that they don't decide to do a bunch of stuff, and what's the chance of that? She allows as to the justice of my remarks, and offers me...Urgent Care. Yeah, no. While not as expensive as the ER, it a) doesn't solve my problem with needing to be in bed, and b) IT'S NOT AN EMERGENCY, FFS. She says that the guidelines are that I be seen same day.
Quick note: You know how I know that this isn't an emergency? Because every time the nurse attempts to make me go to the emergency room, they say, "guidelines." If it really were an emergency, they'd be talking about, you know, death. (I did have a nurse say that to me once, in reference to a possible case of tetanus.) The fact that the nurses sound vaguely unhappy about the guidelines is also a tell.
We go a couple more rounds. My normal provider doesn't work on Thursdays, is full on Wednesday, and is also completely booked on Friday. It is suggested that perhaps I call back on Wednesday morning and see if anything has opened up. I point out that the system is completely broken. The nurse agrees. Eventually, she asks, "Do you have to see your usual provider?" No, I don't. I mean, I like my doctor, but I'm willing to go to someone else. So she schedules me for 7:40 (oh god) a.m. on Thursday with some guy I've never seen.
I am a price sensitive and informed consumer of health care. And at every turn, the system is trying, desperately, to shunt me into a high cost alternative, for no good reason. Additionally, I already know that there is no point in asking what any of this will cost. The provider has no idea what my insurance will cover. The insurance company typically will not answer these questions. Moreover, once I surrender myself to the professionals, they will run whatever tests they think wise, and I will have almost no say over them. I will certainly not be given enough information about the test, the cost, the possible results, and the potential treatment to make an informed decision about whether or not the test is a cost-effective choice. I have less control over my own health care, and less information, than I have about my cat's health, where they will cheerfully lay out exactly what the tests cost, what they might reveal, what the treatment path would be based on various scenarios, etc. The other thing I have very little control over is my insurance. I get insurance through work, and it is both expensive and not very good. I have a $3500 deductible, and the things it covers at only 80% (after deductible) is long and irritating. Nor can I, as an individual, shop around for a better deal.
Health Care is not a consumer good. A consumer good responds to market forces if the consumer is informed, if there is information available, if there are alternatives, and if the primary driving force behind the consumption is rational rather than emotional. Most importantly, the consumer needs to have some control. None of this is true about health care.
I noticed - flitting past me on Twitter the other day - somebody eyerolling at, if not codfishing, some bloke's plaint that watching Dunkirk had made him realise that The Modern Man does not have these Manly Challenges To Rise To -
And being a historian, I thought that, actually, there have been long generations, at least in my country, where most men were not being called upon to take arms and fight, and the general attitude to the soldiery was summed up by Kipling in Tommy.
And that thing about Challenges to Rise To always tends to be seen in a context which leads to e.g. the Battle of the Somme, rather than to being a despised Conscientious Objector, a decision which history may read entirely differently -
Which possibly links on to that thing I also saw flit past me on Twitter apropos of alt-history narratives which allow the viewer to believe that they would be The Resistance, which reminded me of that nasty piece of work Jimmy Porter in Look Back in Anger going 'where are the good brave causes?', and really, one can think of a few relevant to the 1950s, not to mention, we do not, ourselves, envisage J Porter going off to Spain in the 30s.
And the whole notion of Heroic Actions and somehow, not here, not now.
And I thought, did not my beloved Dame Rebecca say somewhat to this point in Black Lamb and Grey Falcon, and while this has the rhetorical universalisation and generalisation to which she was (alas) prone, it does seem relevant to this notion of some kind of masculine Rite de Passage:
All men believe that some day they will do something supremely disagreeable, and that afterwards life will move on so exalted a plane that all considerations of the agreeable and disagreeable will prove petty and superfluous.
As opposed to, persistently beavering away at the moderately disagreeable in the hopes that it might become a little more agreeable.
This involved a certain amount of faff and hassle about making sure we were buying the right kind of ticket for the train which would also give us free rides on public transport, ascertaining which platform the train in the right direction left from, etc etc. And then when we arrived a) finding the right stop for the tram b) missing the stop we wanted and being carried on to a point we didn't want.
Except it turned out to be right around the corner from Hundertwasser's Waldspirale apartment block, which was on the list of things to see.
After which we wandered down in the direction of the Schloss (which can only be seen by way of guided tours, we passed) and had what was a rather more leisurely lunch than we had intended at the Altes Rathaus before going to the Hessische Landesmuseum, based on the collections of the Grand Dukes, which has some nice stuff.
We then went out to Mathildenhöhe, which was where the artists of the Jugendstil Art Nouveau movement hung out. This includes a Russian Orthodox Church (not particularly Art Nouveau) and the Hochzeitsturm, Marriage Tower, which looks as if it might be the HQ of one of those somewhat spooky early C20th New Agey cults that crop up in mysteries of the period, and a rather small museum (but I think part of it was closed) of furniture and objects created by the artists of the colony.
And then back to Frankfurt, whence we flew home today.
And in other news, spotted this in today's Guardian: the strange world of book thefts:
“We caught a gent last Christmas with £400-worth of stolen books in his trousers and elsewhere.... As we showed him the door he told us: ‘I hope you’ll consider this in the Žižekian spirit, as a radical reappropriation of knowledge.’”As an anarchist friend of a friend remarked when his car was nicked, 'Property is theft: but so is theft theft'.
All the Birds in the Sky, by Charlie Jane Anders (Tor Books / Titan Books)
I love this book. It is not long, but there so much in it. It is a modern fable, pulling in tropes from all kinds of pop culture: fairy tales, comic books, movies and cartoons. At the same time it is seriously realistic. The world is going to hell in exactly the same ways that ours is, just a little bit faster. People are (mostly) sympathetic and mean well but they are imperfect and success is often beyond them, especially as the world's problems become even more daunting. The tone is wry but not cynical. Things seem to be heading towards a conflict between magic and super-science, but the different schools of magic don't see things the same way, and the different groups of scientists and technologists are often competing instead of cooperating. But it's still worth trying. And it's worth trusting other people even when there is no way you can imagine how or why you can.
A Closed and Common Orbit, by Becky Chambers (Hodder & Stoughton / Harper Voyager US)
I found out that it is a sequel to The Long Way to a Small, Angry Planet so I read both. The worldbuilding is good, especially the aliens are truly diverse. It presents a vision of the future that is mostly positive. It reminds me of James White's classic SF. But the characters are just kind of what they are, and there are some structural issues. It's uneven. A Closed and Common Orbit is better written, and it has two really great characters with compelling stories. Along the way it raises some very interesting and subtle questions about morality (vs. legality), friendship, and personhood. In other words, don't underestimate this book, just because it's a fun read and it's nice.
Death’s End, by Cixin Liu, translated by Ken Liu (Tor Books / Head of Zeus)
I really liked The Three Body Problem. I started reading The Dark Forest and bounced off the prose in the first chapter. It was so clunky. I picked it up again recently and was able to make headway. I plan to finish the trilogy presently. I didn't feel any urgency to finish it before voting because the first book in the trilogy already won (deservedly), and the third book would have to be amazingly good in order to justify awarding two Hugos to what is really a single work in three volumes.
Ninefox Gambit, by Yoon Ha Lee (Solaris Books)
The common question about this book is if it is really science fiction or merely fantasy. I am squarely in the it's science fiction camp. Space opera as a genre requires faster than light travel in order to maintain its traditional plot pacing (which happens to be exactly the same as 19th century steamship stories, go figure). Faster than light travel is bogus science. So are force fields, blasters, phasers, anti-gravity, teleportation, and so on. Yoon Ha Lee invented a fresh and new form of bogus science to power his space opera. He gets to do that. Go him. I think it's a lot of fun. The space opera is set in a grim dystopian interstellar empire. Not fun. I've read some other reviews where readers were bummed out because it was so grim and the characters were so constrained by the system. I didn't read it that way. The system has a lot of cracks in it, including a really huge one that maybe we'll learn more about in the third book. Many of the main characters are wild cards. Unexpected things happen. Overall, I think it's one of the most innovative and interesting space operas in recent years.
The Obelisk Gate, by N. K. Jemisin (Orbit Books)
I think the The Obelisk Gate is good, but not at the same level as The Fifth Season. It reveals some things about the Earth that are very big, but we have to wait for the third book to see anything climactic (as opposed to climatic). The middle book is more about developing characters and moving the plot along. Unfortunately, the key character developments are sad, or creepy and unpleasant. At least the sad developments are very weird and leave at least a smidgen of hope. I am waiting for the third book and we'll see what happens.
Too Like the Lightning, by Ada Palmer (Tor Books)
Too Like the Lightning is a dazzling and enthralling debut novel that is also unreliable and contrarian, sometimes even infuriating. Or maybe it is just Mycroft Canner, most reliable of servants and most unreliable of narrators. On the plus side, it's a science fiction novel set on a near future Earth where nobody is hungry, there are no wars, and politics are based on the fundamental principles of the Enlightenment: rationality, order, justice, humanism, enterprise, and compassion. On the minus side, decisions seem to be made by a very small number of elite leaders who are very much in bed with each other (except the utopians are snubbed for some reason), and it seems about to fall apart. What seems like an ultimate love letter to the Enlightenment could turn out to also be a devastating critique of it. Enough has been revealed in the first book to make it clear that it does not stand alone.
Novels I nominated:
Everfair, by Nisi Shawl (Tor Books)
This is a book that needed to be written and I am glad that Nisi wrote it the way she did. The steampunk movement imagines an alternate past where the second industrial revolution was accelerated to extraordinary heights and at the same time somehow was shared in an egalitarian way without colonialism, racism or sexism. Which of the two imaginations is more unrealistic is hard to say. Nisi tackles both head-on by establishing a 19th century high-technology utopian settlement in the Belgian Congo. It works because the settlers are not just technically skilled, but also radical socialists, the kind of people who would really try to create a steampunk utopia, and to fight King Leopold II. (It helps on the super-technology side that the Congo has major sources of uranium.) What I really liked about this novel was how the native African characters were just as empowered and important as the settlers. Also, as one would hope with radicals, just about every possible unconventional relationship that could occur does, and the love and care in these relationships is a great strength.
Arabella of Mars, by David D. Levine (Tor Books)
A delightful, strongly feminist, alternate-cosmology planetary romance that riffs on Jane Austen, Patrick O'Brian, Jules Verne and Edgar Rice Burroughs. Featuring a plucky heroine, a dashing captain and his brilliant mechanical sidekick, and a motley crew of tuckerized SF writers and fans. What more could you ever ask for? Okay, maybe it starts a bit slow. But it really gets moving soon enough, and the ending is fantastic. Now that it's won the Andre Norton Award, it is officially certified as suitable for corrupting the minds of our youth. But there's no reason not to corrupt your own mind too, it's good for all ages.
I just don't like talking to strangers. And when I feel like I'm barging into a group it's worse. These forums or groups have been around for years. They "all" know each other, and I get the feeling that they look on outsiders with distrust. I may be imagining that whole distrust thing, but it wouldn't be unreasonable. There is a reason all that fun content is put behind a proverbial locked door, after all.
I just feel like I'm putting on this false face, a smiling, happy, "I'm so excited to find you all here" mask when really I want to sneak in, take a look around, assess the situation and decide if I really want to be there. But no, I can't. I have to act outgoing.
I used to think such a thing was only tiring in real life. I was wrong. Trying to act friendly on line is just as exhausting.
Having a weekend with partner in Frankfurt.
Hotel perhaps overdoing the stylish minimalism: why does this always mean, nowhere to put stuff in the bathroom? However, good marks for the breakfast buffet.
On matters of modern design, am I the only person who finds themself waving their hands at a tap that turns on some other way, and vice versa?
Today to the Stadel- art gallery, very good stuff and lots of it. Among works observed, one C16th courtesan as Flora, with obligatory symbolickal bubbie displayed.
Also to the Arts and Crafts Museum, which has gone full-on poncey and eschews labeling in favour of composing curatorial 'constellations'. Though I could have spent more time with the shiny pillow-like balloons that one was permitted even exhorted to touch. (Sometimes I am shallow and frivolous.)
Some general flaneurserie, looking into churches, etc.
Well, let's try this... I went to "View your images" Grid View, copied the "Embed" link under the thumbnail, went back to edit my post, shifted into HTML mode, and pasted in the Embed link.
OMG, that is awkward. Please tell me this isn't the only way.
On the plus side, it DID put in a smaller picture that links to the fullsize one in the back room.
The Italian directors Tizza Covi and Rainer Frimmel’s hybrid of a film follows a young man on a sort of odyssey across Italy.
By GLENN KENNY
NYT Critic’s Pick
Directors Tizza Covi, Rainer Frimmel
Writer Tizza Covi
Stars Tairo Caroli, Wendy Weber, Arthur Robin, Lilly Robin
Running Time 1h 30m
The Girl Without Hands
In Sébastien Laudenbach’s animated adaptation of a Grimm fairy tale, after her father’s deal with the Devil, a young girl loses her hands and must navigate the world without them.
By MONICA CASTILLO
NYT Critic’s Pick
Director Sébastien Laudenbach
Stars Anaïs Demoustier, Jérémie Elkaïm, Philippe Laudenbach, Olivier Broche, Françoise Lebrun
Running Time 1h 16m
In his brilliant new film, Christopher Nolan revisits a harrowing, true World War II mission in a story of struggle, survival and resistance.
By MANOHLA DARGIS
NYT Critic’s Pick
Director Christopher Nolan
Stars Fionn Whitehead, Damien Bonnard, Aneurin Barnard, Lee Armstrong, James Bloor
Running Time 1h 46m
Genres Action, Drama, History, War
-- Of Possible Interest --
A slimy, many-tentacled alien has sex with several unhappy residents of the Mexican city of Guanajuato in Amat Escalante’s movie.
By A. O. SCOTT
Director Amat Escalante
Writers Amat Escalante, Gibrán Portela
Stars Kenny Johnston, Simone Bucio, Fernando Corona, Jesús Meza, Ruth Ramos
Running Time 1h 40m
Genres Drama, Horror, Sci-Fi, Thriller
If you can summarize the plot of Luc Besson’s film adaptation of the graphic-novel science fiction series, you weren’t paying attention.
By A. O. SCOTT
Director Luc Besson
Stars Dane DeHaan, Cara Delevingne, Clive Owen, Rihanna, Ethan Hawke
Running Time 2h 17m
Genres Action, Adventure, Sci-Fi
Not Rated Drama Directed by Martin Provost
Two great French actresses, Catherine Deneuve and Catherine Frot, share the screen in this film about forgiveness and redemption.
By GLENN KENNY
Director Martin Provost
Stars Catherine Deneuve, Catherine Frot, Olivier Gourmet, Quentin Dolmaire, Mylène Demongeot
Rating Not Rated
Running Time 1h 57m
Re the current hoohah about Boots the chemist charging well over the odds for the morning after pill, I was going to comment - when posting the link on various bits of social media, to go 'and Edwin Brooks must be spinning in his grave!'
Brooks was the MP who put through the sometimes overlooked but significant 1966 Family Planning Act: as discussed in that post I did some while back on 'why birth control is free under the NHS'.
However, I discovered from googling that - as far as one can tell from The Usual Sources - Brooks is still alive, but moved to Australia. I am profoundly shocked that the Wikipedia entry, under his political achievements, doesn't include that act. We wonder if, in the long history of reproductive rights, it got overshadowed by the more controversial 1967 Abortion Act, or, by the final incorporation of contraception into the NHS in 1974. If I had time on my hands (which at this moment I don't) I would go and try and edit that entry.
*I think this is a quotation from someone? but I can't find a source.
Except some of it doesn't seem to be, o hai, I am now making an effort, it is more that various academic things (seminars, conferences, etc) that I had flagged up in my diary ages ago finally came up and were all within the space of a few weeks, I don't know, it's the 'like buses' phenomenon. And some of them I did do some social interaction at and others I just slipped in and out, more or less.
Have booked up, what I was havering about, the annual conference in one of my spheres of interest that I was usually wont to go to but have missed the (I think) last two because I was not inspired by the overall theme that year. And it's not so much that I'm not inspired by this year's theme, it's more 'didn't they do something very similar a few years ago and I did a paper then, and don't really have anything new to say on the subject', so I didn't do that, but I think that it would be a useful one to go to to try and get me back into the groove for that thing that the editor at esteemed academic press was suggesting I might write and talk to people (if I can remember how to do that thing) and hear what's going on, and so on.
Also had a get-together with former line manager, which between the two of us and our commitments involves a lot of forward planning, but it was very nice to do it.
Have also done some (long) and (a bit less) outstanding life admin stuff, which I both feel pleased about and also as if I haven't actually done anything, which is weird.
Did I mention, getting revised article off last week, just before deadline? and then got out of office email from the editor saying away until end of month. WHUT. The peeves were in uproar.
And generally, I am still working out what I do with the day when it does not begin with posting an episode of Clorinda's memoirs and go on with compiling the next one. Okay, there are still snippets to come, but they come slowly.
What I read
Melisande Byrd His Lordship Takes a Bride: Regency Menage Romance (2015), very short, did what it says on the tin, pretty low stakes, even the nasty suitor who molests the female protag in a carriage (the Regency version of Not Safe In Taxis) just disappears. The style was not egregiously anachronistic (apart from one or two American spellings) but a bit bland.
Janet Malcolm, Forty-One False Starts: Essays on Artists and Writers (2013) - charity shop find. Some of the essays were of more interest to me than others, but all very well-written.
On the go
Matt Houlbrook, Prince of Tricksters: The Incredible True Story of Netley Lucas, Gentleman Crook (2016). I depose that somebody whose scams got rumbled and who was banged up in various institutions for his crimes is not exactly trickster royalty. He then went allegedly straight and got into journalism, partly writing up the inside stories of the crime world, but these are very much complicated by the author as to their authenticity and did he actually write them. While he was more of a career criminal than the opportunistic upperclass louts in the McLaren book mentioned last week, he did have claims to gentility, but again, so not Raffles The Amateur Cracksman.
I'm currently a bit bogged down in it, which may be a reflection of the author's own experiences in trying to write about somebody who lived by lying, had numerous false identities, etc etc (which are very much foregrounded).
Simon R Green, Moonbreaker (2017) - came out this week, I succumbed.
Also started one of the books for review.
There's a new Catherine Fox out tomorrow (allegedly)...
By JULIA MOSKIN
Why would an ambitious chef open a restaurant in western Norway, where only 3 percent of the land is arable and the growing season is a blip?
A Match Made in Baking and Blue Ribbons
By KIM SEVERSON
Two Atlanta doctors are cleaning up at the competitions, joined in marriage and a fervent commitment to cakes, pies and bakeware.
A GOOD APPETITE
This light herb and pasta dish uses the heat from freshly boiled pasta to melt the mozzarella without requiring an oven.
Pasta, Herbs and Plenty of Melting Mozzarella
By MELISSA CLARK
This warm-weather dish is light, bright and garlicky — and easy to make.
Recipe: Pasta With Mint, Basil and Fresh Mozzarella
Old-fashioned scalloped corn, a bubbling, creamy casserole topped with toasted, buttery cracker crumbs, is an alternative to corn on the cob.
Finding Comfort in Scalloped Corn
By DAVID TANIS
This homey, bubbling, creamy casserole topped with toasted, buttery cracker crumbs is an alternative to corn on the cob.
Recipe: Old-Fashioned Scalloped Corn
A cast-iron spice grinder from Skeppshult.
Swedish Gadget Crushes Spices With a Few Twists
By FLORENCE FABRICANT
The rough-hewed cast-iron grinder from Skeppshult can store ground spices, too.
The Surprising Elegance of Braised Beef Tongue
By GABRIELLE HAMILTON
Braised tongue dressed with a sauce gribiche lively with tarragon and parsley, cornichons and capers.
The unconventional cut dressed with sauce gribiche can make you appreciate a meat you might otherwise avoid.
Recipes: Braised Tongue | Sauce Gribiche
WINES OF THE TIMES
Montepulciano d’Abruzzo doesn’t have the star power of many other Italian wines and regions, but it has enough going for it to warrant a second look.
Lively and Refreshing Wines at the Right Price
By ERIC ASIMOV
Montepulciano d’Abruzzo doesn’t have the star power of many other Italian wines and regions, but it has enough going for it to warrant a second look.
How about, not?
Do we not get the impression that he has a very halcyon vision of what working on the land might involve? I suspect that there are not enough lovely organic farms practising biodynamic agricultural methods to take up anything like the numbers of intending students there are each year and a lot of them would end up working in agribusiness enterprises (which I suppose might be a salutory awakening, or not).
Also, would not much of the work be seasonal? What would they do the rest of the time?
Might there not be objections from the local communities?
I also think of the lack of amenities in many rural parts, e.g. no or inadequate public transport: in the evenings, not in the least worn-out from hours of back-breaking toil for poverty wages, maybe they'll gather round and sing folk songs and dance traditional folk dances and practice folk crafts?
And actually, I don't think this is true:
We also know that without contact with nature we will not form an attachment, we will not learn to love it.
See the rise of the notion of the healing powers of nature and the pastoral way of life in Britain as the society became increasingly urbanised, and therefore romanticised the supposedly more simple and harmonious existence of country life.
I have a feeling that people who live close to nature know exactly how dreadful nature can be. Tetanus! Anthrax! entirely natural.