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I’ve been sick for the last four days. I missed work on Thursday and Friday with a bad cold. Many of the cold symptoms have faded, but I think I’ve gotten a secondary ear infection on my congested ears. I used to get them all the time, and this feels like that. In a just universe adulthood would banish these pesky things.

New medical privacy laws have gone into effect recently.  It used to be that at my pharmacy, when one picked up a prescription, a sticker printed with your name, the date, and the medicine name was affixed to a clipboard.  A little box was provided for you to sign for receipt.  A little glance upwards was all that was required to see the names — and prescriptions — of the people in line ahead of you.  No longer is this permitted.  Likewise, at the the medical testing facility where I have gone to have blood drawn, your name and the prescribed tests were written on a sheet that anyone visiting the office could see.  This, too, is now forbidden.

The overall point — the protection of personal information — has not necessarily sunk into everyone’s heads yet.  My physician still hollers things across the office: “Could you check to see if Josh has received his second Hep B vaccine yet?”  And the techs at my pharmacy seem not to have grokked the gestalt yet.  To wit, a telephone conversation I just had:

Me:  Hi, I’m checking to see if I’ve forgotten to pick up any prescriptions.

Tech:  What’s the name?

Me:  McGee.  Joshua.

Tech:  The last thing I show is from the 19th.  Have you picked anything up since the 19th?

I suddenly wondered how much information she was ready to give out over the telephone.

Me:  Err, I don’t know, what was it I picked up on the 19th?

Tech:  No, it was a call from the 19th.  That was the Lorazepam.  Want me to check if you’ve picked it up yet?

Bingo.  That’s a psychotropic med, but they were comfortable revealing it to someone on the line who merely mentioned my name.  I was calling from work, so it’s not as if caller ID betrayed me.  And I’m sure there’s no chance she recognized my voice: that sort of service has pretty much disappeared, and I’ve only been using this pharmacy since March anyway.  I suspect I could have gotten more information from her: other meds, other dates, prescribing doctors.  Which makes one wonder, who really cares about those little stickers if I can get all of this over the telephone?  And what self-respecting private investigator would bother raiding your trash if this is all free for the asking?

I have been having bad back and neck pain recently.  It has interfered with work and sleep, restricted my range of motion, and left me very uncomfortable.  It feels like certain joints need to have pressure relieved (i.e., it feels like my back and neck need to ‘pop’.)  Unfortunately I could not trigger this on my own.

One day last week it got very bad, and out of desperation I decided to call a chiropractor, something I had never done before.  I first called my insurance company (I have the Aetna EPO plan) and asked if chiropractic care was covered.  “Yes,” they responded, “with a $40 copay.”  That struck me as rather steep, but hey, I was hurting.  I asked how to go about seeing a chiropractor, and was told to choose a name from an online list of in-network providers, and was told that eligibility was based on “medical necessity.”  I asked how necessity was determined, and was told that it was based on the report of the chiropractor.

I chose Jean M. Duffy from their list (I’ll also write “Jean Duffy” here in case someone is using a search engine looking for her) and made an appointment for later that day.  I had, in short, probably the worst clinical visit in my entire life.  The receptionist was unprofessional, the office was severely over-heated, Duffy insisted on teasing me about word choices even though I was in obvious pain.  She struck me as unintelligent and unresponsive.  She was fairly dismissive when I voiced concern about the use of high-velocity popping, which is widely regarded as unnecessary and quite dangerous.  I got a challenge to “define that precisely” for her, then was told in a doctor-knows-best tone that she did “what she decided was necessary”.  At the end of a long questioning process she performed some perfunctory stretching of my neck and back, proceeded to perform exactly two manual manipulations (one in my neck and one in my mid-back), and told me I was done.  When I expressed surprise at this (not the least of which because I was still in pain) I was given a lecture about chiropractic not being a “pill” that “fixes something immediately”.  Sorry, Jean, but the prospect of immediate relief is the only thing that took me to a chiropractor in the first place.  If I wanted slow-but-sure recovery I’d do physical therapy, something with which I had great success a year ago after an injury.  She then iced my back and neck for under five minutes, a quarter of the time that I was iced at physical therapy.

I was asked to make a follow-up appointment two days hence.  I was hesitant to do so because I was unsure I would be coming back, so I asked if I could call tomorrow and make a follow-up appointment.  “No,” Jean said, “It would be better for you to make an appointment and cancel it if you need to.”  (”Sure,” I thought, “that way you could charge me for the missed visit if the notification period is less than 24 hours.”)  I went up to the receptionist without Jean.  She asked me to make an appointment and I repeated my desire to call tomorrow to re-schedule.  The receptionist agreed and I left.

My neck was still in pain and still had limited range of motion.  When I got out to my car I simply turned my neck to the right and it ‘popped’ again, and instantly felt better.  A simple turn of the neck, not a forced turn, and yet Jean did not perform this.  I suppose it’s possible that her work on my neck allowed the later pop, and that that pop could not have occurred otherwise, but I’m skeptical.  I was annoyed leaving the office, and thought to myself that the only thing left would be to find out she was a crook as well, that she’d find a way to charge me more money than she had said.

The next day she called me and told me that she had contacted my insurance company and they refused to pay, saying I needed a referral for chiropractic care, the exact opposite of what I had been told on the phone.

“All I can say is I hope you got someone’s name,” she said.  “We’ll just have to send you a bill.”  I asked how much.  “$50,” she said.  “Just $10 more than your copay.”

I’ll just pay it.  It’s not worth fighting for $10.  And it may be true.  But I won’t be surprised if I find that Aetna has also paid that $10 after all.

I had never gone to a chiropractor before for a couple of reasons.  One, the theoretical basis of their medicine is absurd and discounted by the traditional medical community.  Two, after my father injured his neck some ten years ago he considered going to a chiropractor but went to a specialist and got an x-ray instead.  He was told by the specialist that with his condition, had he gone to a chiropractor he would have ended up a quadriplegic.  So why did I go?  Good question.  All I can claim in my defense was extreme pain, and the anecdotal evidence of friends who have received immediate relief from chiropractic care.  But one is again reminded, in this story, that even pain is no excuse to abandon reason and logic.

Devotees of chiropractic will rightly point out that this is one sample point, one practitioner, and should not be used to make a judgment on the whole discipline.  But next time, if I ever go to a chiropractor again, I will do so strictly based on a referral from a friend.  But will I go again at all?  Probably not.

Two hours ago I drank two liters of 100% juice, ate several pieces of bread and some cheese.  Walking around the building a few minutes ago I felt so dizzy that I thought I would fall down.  I went to the nurse’s station (one of the perks of Rockwell Scientific.)  My blood pressure is fine (diastolic a bit high), no sign of ear infection.  So the nurse took my blood sugar level.

67.  Two hours after a meal my blood sugar level should be between 110 and 170.  65 to 110 is the normal range for a fasting reading.  I called my doctor.  I’m waiting to hear back.

More to come as it unfolds.

OK, I just heard back.  The verdict?  Eat more protein, and more regularly.  Seems a bit facile, but it’s worth a shot.

I just read an article in the Washington Post about a new drug called Modafinil.  This pill allows the user to stay awake and alert for 40 hours at a time.

Its neurological focus is precise, unlike stimulants such as caffeine and amphetamine.  It targets regions of the brain believed to regulate wakefulness, avoiding the jittery and addictive side effects of other drugs.  One “can’t get high on modafinil.  There’s no euphoria to it. When they first take it, a lot of test subjects figure they must have gotten the placebo. When this stuff takes over, it takes over.  Gently, not violently.  No apparent loss of acuity.  But you have definitely kicked into a gear you didn’t know you had.”  And it does not hinder your ability to sleep if you desire.

University of Pennsylvania sleep researcher David Dinges, among others, questions the long-term safety of this drug, and wonders if the drug will at all affect the phenomonon of long-term fatigue accumulation.  But he is looking forward.  “The more far-out question is: What if we eventually had something that was absolutely safe that could substitute for sleep?” he wonders.  “Is that the direction we want to go?  Many would say yes.  I don’t know what the implications are for our species.  Probably not bad. … Should humans try to live without sleep? I don’t know. We’re already trying to do that.”

The author wrote the article in 30+ straight hours after having taken Modafinil.  Near the end he notes that he is tired but not sleepy.  “Interesting to imagine a future in which those are two distinctly separate things,” he notes.

I am terrifically excited about a drug such as this.  I have a medical condition that causes sleepiness.  I take a prescription drug for it that also causes sleepiness, and I have to time consumption of the drug carefully.  I, like many people, never feel that I have enough time in the day to pursue all my interests.  And as a believer in mortality, I do not want to look back at a life in which I spent a third of the time unconscious.  The ability to sleep only every other night, or less, is fantastic.

I am scared of a fen-phen style story unwinding.  If the drug decreases lifespans significantly the good effect is nullified.  But if safe, consider the ability to sleep for recreation, but never to be chained to a pillow.  How exciting.

Sleep research is, in general, exciting.  It is a mystery to me.  We live in a world with electric lighting, plenty of food, medicines; if our daily unconsciousness was evolutionarily advantageous simply for resource management, then the physiological necessity is obsolete.  I wonder if something is going on other than forcing a physical recuperation process.  But what? 

Sick this week, I have had time to watch quite a few films.  Some were excellent, some mediocre, a couple pretty bad.  In case it is of interest (and to keep my brother happy by making a long post) I offer a review here.  Ranking movies quantitatively can be near-impossible (not to mention foolish), but I do my best to rank the following films in descending order of my preference.

1. Cabaret Balkan: This film is entitled Bure Baruta in the Serbo-Croatian.  It is difficult to keep this review anything but an exercise in superlatives.  The plot is deeply symbolic, with each of the characters seemingly an archetype, or, as one reviewer put it, “an aspect of the Balkan psyche.”  My knowledge of the specific history of the region is limited so many of the references are probably lost on me, but many themes are comprehensible without context: perceived emasculation under an oppressive regime, the resort of a traumatized people to absurdism, a status quo of mutually accepted violence smoothly escalating to murder, the blinding effects of nationalism.  In one vignette, the author seems to contend that “Western cleverness” cannot be transposed into the Balkans, which is something to ruminate on.  Despite a few heavy-handed allegories (for instance, the young activist who takes a bus full of people hostage, intent on making the passengers aware of their surroundings and angry at injustices, and is killed by the official driver just as his message begins to sink in) the symbolism is effective.  The use of an absurdist, effeminate, decadent cabaret performer as the vehicle for direct authorial voice intrigues me.  The film is marked by magnificent acting (excepting a few minor characters), especially from Nebojsa Milovanovic, Mirjani Jokovic, Aleksandar Bercek, and Nebojsa Glogovac; the former two offered portrayals that I expect to be seared into my memory for life.  I rated this movie 9 at IMDB.
2. Memento: I don’t remember the last time a suspense film has been this effective for me.  It takes the feeling of the last minutes of The Usual Suspects, Fight Club, or Se7en and extends it over a two-hour film.  I recommend you do not de-Rot13 the following unless you have seen the movie already.  N srj cbvagf bs cflpubybtl ner n ovg jrnx (pna bar ernyyl ratenva pbzcyrk ireony zrzbevrf guebhtu pbaqvgvbavat?) naq guvf gnxrf njnl sebz gur chapu bs gur raqvat fyvtugyl.  Ohg V jnf pnhtug hc va gur pyrirearff, gur gehr fhfcrafr nf gb jung jnf tbvat ba, naq gur terng npgvat.  Gur fpevcg frrzf irel rnfl gb jevgr cbbeyl naq irel qvssvphyg gb jevgr jryy.  Puevfgbcure Abyna (jub nyfb qverpgrq vg) unf jevggra vg jvgu terng fxvyy.  I strongly recommend seeing it without even reading the back of the box.  I rated this movie 9 at IMDB.
3. Genghis Blues: Like many people, I expect, I was first introduced to the culture and music of Tuva through Richard Feynman’s books.  A few years back I purchased Deep in the Heart of Tuva from the always-cool Ellipsis Arts….  The mini-book that accompanies the CD discussed the fascinating Tuvan rituals and culture.  When Genghis Blues, a film chronicling blues musician Paul Pena’s trip to Tuva debuted at Sundance, I knew I had to see it.  Unfortunately I missed it in the theatres, and I have waited until this week to see it.  It is a charming, sometimes heartbreaking, at all times amazing story.  Pena, who is blind, taught himself Tuvan throatsinging by ear; he also taught himself the Tuvan language at home using an electronic text reader, translating Tuvan texts letter-by-letter into Russian, then translating from the Russian to English (no Tuvan-to-English dictionaries existed.)  The film, though marred at times by amateurish photography, shows the beauty and generosity of Tuva and its people, the courage and devotion of Pena, and the enchanting and haunting Tuvan throatsinging in a more in-depth fashion than I have yet seen.  I highly recommend this film, which I rated 8 at IMDB.
4. The Gift: This film, about a psychic woman’s investigation of a murder, is one of those films in which the quality of the final product is far better than it has any right to be.  Based on a cheesy, formulaic plot and featuring uninterestingly-written characters, this film is redeemed by the top-notch acting talent who imbue the characters with magnificent depth.  The always-amazing chameleon Cate Blanchett provides a convincing portrayal, as do Giovanni Ribisi and Greg Kinnear (who is showing himself to be quite a talented actor.)  Katie Holmes is miscast (about five years to young for the role) and Keanu Reeves (an actor whose performances I sometimes respect) is barely competent, but they are made up for by the trio I mentioned first.  The plot could have been ten times better, but the acting talents commandeer the reins and turn a cheesy pseudo-suspense film into an interesting, if predictable, character-driven story.  The acting leads me to rate this as high as 6.5; this turns into 6 on IMDB’s scale.
5. Willow: I have not seen this charming family-film fantasy since the late ’80s, when I enjoyed it much more.  There are charming touches to be sure (the dwarf Nelwyn referring to the normal Homo sapiens as “giants” and using miniature horses as mounts, for instance) but the film in general comes up lacking.  Sets look cheap and unimpressive, there are plenty of obvious façades, and the plot lacks a true climax.    Val Kilmer as Madmartigan, the self-proclaimed “greatest swordsman who ever lived” is fun to watch, as is (for entirely different reasons) the gorgeous Joanne Whalley, but the good points are not enough for me to rate this above 5 at IMDB.
6. Vatel: This film is a period-piece-for-the-sake-of-making-a-period piece, an overindulgent costume drama, a story in search of a plot.  The sad and depressing elements of it are simply not balanced by sufficient quality, and I was left thinking “that’s it?” at the end of it.  Uma Thurman and Gerard Depardieu are both talented actors, but they are given nothing to work with in this film and (unlike in The Gift, reviewed above) predictably make nothing of it.  There is a certain foolishness that embraces swooning, unrequited love stories regardless of how trite and vacuous they are; this film falls into that category.  “Oh, isn’t this film lovely and romantic?”  Well, frankly, no.  This gets a 4 from me.
7. The 6th Day: OK, what can I say?  This is the enantiomorph of Vatel, which I review above.  Perhaps to satisfy some cosmic symmetry, this film provides the vacuous, trite “guy film” counterpart to the vacuous, trite “chick flick”.  Cheesy psuedoscience runs through it, the kind that makes one wish they hadn’t bothered trying to explain the premise in the first place.  Arnold is Arnold, true to form.  The jokes are lame, the effects high-budget but unoriginal, the script the thinnest vellum placed over a camp-wannabee star vehicle. Arnold intones, in his strong bass, “You cloned the wrong man!”  You now have the entirety of the story as well as a large serving of the cheese, and you have saved yourself the $4.50 you might have spent renting the DVD.  This gets a generous 4 from me.

Out of curiosity I checked IMDB’s user ratings of these films; aside from moving Cabaret Balkan from slot #1 to slot #3, my ordering is the same as the ordering of the amassed IMDB scores: