Lifetime Unachievement

On the top of my list is how much longer I will continue writing. It is getting very difficult. My fingers are only loose enough to type in the early morning hours. For some reason, control of my nervous system is better after a long sleep and otherwise decreases during the day. Even then, I am down to a few fingers on each hand, not the 10 fingers I could use a year or so ago. I make lots of mistakes and have to correct about one third of the words I type. For unknown reasons, my fingers choose to invert the typing order; e.g., actually typing  "21"  instead of the commanded "12" about 20% of the time. Then there are the mis-types: typing an adjacent letter on the keyboard instead of the one desired. All of this makes writing a lengthy, frustrating experience. That experience increases the intensity of editing as I type each paragraph, but decreases the desire to review and edit an article once completed.

I have tried voice entry software, but it makes too many mistakes. Mistakes have to be corrected by typing, which leaves me with the typing problem all over again.

Handwriting is no longer an option, as I barely recognize my own signature. I frequently spend 5 or 10 minutes in grocery stores trying to figure out an item on the grocery list I wrote just before going there. My ability to write is seriously degraded, but I can print checks.

Personality

Because of my efforts, I learned some peculiar things about my writing abilities. I was surprised to discover that dictation does not produce the same result as typing. That is, how I present things verbally is not at all the same as how I present them in writing. When writing, I am far more conscious of sentence and paragraph organization. I "see" what I am writing in the larger context of a completed article, so I am looking for chapters, headers, subject blocks, etc. Further, when typing I try to express just one thought in each paragraph. Being totally schizophrenic, which is the only way I can describe it, when speaking very little of the foregoing is true. In speech, I tend to ramble and present offshoots of the subject as they arise. I actually cover the same subject matter in speech that I would in writing, but the speech is far less organized, probably because I rarely speak from notes. I view speech as discussion of a formal presentation which was made in writing, or as interchange with my conspecifics ("chatter") about current conditions ("Yes, I closed the door"). So, there is a printed self and a verbal self. On balance, I enjoy talking with people on matters of interest, but I am far more impressed by my writing and written exchanges with others. I generally take the written version as the final, definitive version.

I think my experience with writing shows something about how human brains (thus, Minds) are organized. I suspect all of us really have several personalities, loosely organized as "I." The I is located by reference to a physical body, which is the root of a clever deduction by that part of the brain which presents oneself to itself. While I think we feel our conscious selves as the stream of our consciousness (experience), there has to be some sort of mirroring operation going on, otherwise how would we be aware of our experience? That is, reflexivity requires reflectivity. Whatever it is that does the mirroring must organize all the activities into one frame of reference, the experience of one self. But, underlying that organization, the unitary self, are thousands, possibly millions, of processes going on quite separately. There are the peripheral sensors of temperature, pressure, smell, taste, damage,. etc. There is vision and hearing, both of which are highly processed in large, dedicated areas of the brain. Language and communications are another specialty. All of these underlying functions work separately, and are only organized into a whole at much higher levels of the neural system. My stomach is full, but what do I do about it?

On this view, schizophrenia is the failure of the organizing neurons. All of us are potential schizophrenics. On the other hand, the organizing neurons must be deeply imbedded and/or highly dispersed, since very few people are schizophrenic. Even brain injury rarely results in overt schizophrenia. The resilience of unitary selfhood suggests an early origin for self-consciousness in animal evolution. Recent reports that elephants recognize themselves in mirrors and that some whales have the neurons involved in self-consciousness are evidence in favor of that hypothesis. One reconciliation is that selfhood and self-consciousness are two different things; after all, true schizophrenics are aware of the self currently in charge or being expressed.

I have never had any direct knowledge or awareness of having multiple personalities at any time in m life. I have had periods of severe depression, but not mania (feeling giddy or high). I attribute my gloomy attitudes to my life as a disliked, even despised, minority in an unjust society. I consider my negativity about life in America well justified by my experiences; i.e., a reasonable response to the perceived situation. Moreover, I am quite sure I have not imagined "the situation." Because the official society and its leading members have always denied the sort of allegations I make, I felt a need to justify and prove my positions most of my life. One of the advantages of old age and declining ability is that I no longer have the time or energy for that sort of activity. Also, many of the  things I consider unjust - racism, sexism, ageism, etc - have been exposed by others as actually occurring in our society, so on most charges I feel myself both acquited and vindicated.

Doctors

I am disenchanted with doctors. I tried hard to get into medical school about 35 years ago, but didn't get in. The medical schools turned me down with excuses such as "you're too old," many of which were found illegal a few years later. While I resented not being admitted to medical school for a long time, because I felt more qualified than many who were admitted, now I am glad I didn't become an MD. Medical practice has evolved into something I never imagined.

Despite my personal experiences, I admired and respected those who made it through the process. I was a long time supporter of Western medicine. But, during the last 10-15 years I have had increasing doubts about doctors and medicine as practiced in the United States. With this growing skepticism came a loss of admiration for doctors and, in some cases, a loss of respect as well. I now feel MDs have to prove their worth to me. Certificates hanging on walls aren't good enough any more: what I want to know is who they've actually cured lately and how. I want to know about their attitudes toward their work and their patients. I want to know what expertise they really have.

It's become quite clear to me that there are standard operating procedures in the medical profession, just as there are in most other professions. It is also clear that, most of the time, the standard Treatment Plan is what doctors administer without thinking about it. Why? The greedy medical insurers and malpractice industries have made any other approach unfeasible in the eyes of the medical administrators who now oversee the vast majority of doctor-employees. Corporate doctoring (aka HMO, network, etc) is based on the medical code book: every conceivable procedure has been reduced to a billable code. If it isn't in the book, it's forbidden. Medical billing has reduced medical practitioners to human robots. The next step, of course, is replacing the human robots with machine robots, which is already happening. The beginning of that transition was the enforced use of the "gateway" doctor for referrals, followed by the strongly encouraged use of Nurse-Practitioners as telephone consultants. This last idea is straightforward enough: use lower paid nurses to screen patients at a distance instead of an in-person, higher paid MD. Since the telephone nurses already use an automated procedure to determine what to do with each caller, the next logical step will be to eliminate the nurse altogether.

Replacing people with smart machines will reduce medical care costs dramatically. There's nothing wrong with that idea in principle. I have some acquaintances who prefer talking to the advice nurse, rather than attending the doctor's office. I have some sympathy with that point of view, as doctor's offices can be a deadly trap for the aged and inform. (Old and sick folks both spread and catch diseases there.) The catch is all the non-standard conditions. If your ailment isn't in the book, you must be a nut (technically, an hypochondriac) or malingering. If your ailment looks like something else, you will get treated for something else, not what you've got. Even though medical science has advanced tremendously in the last 40 years since the advent of massive Federal funding, medical diagnosis is still not an exact science. The automated diagnostic software may have an error rate as high as 30-50% false positives and false negatives. If nearly half the computer screened population has to be referred to a qualified human doctor for further examination and diagnosis, it doesn't save any money or time. So, at this state of development, automated systems only save money by dissuading would-be patients from seeking further service. Of course, Medical Administrators have used Denial of Service and Minimal Service as major cost-cutting strategies for decades, so automation is just more of the same.

This leaves many patients, including myself, in a quandary when seeking treatment for their condition. Chances are that "alternative medicine" isn't going to work. There are huge numbers of smooth talking quacks out there. The medical books have become formularies of billing codes. The only salvation is the medical and scientific journals, which are not only expensive and beyond most people, but which require a large portion of one's available time to read.

A further restriction on patient choice is the prescription system, which limits unapproved access to drugs that might help. While the FDA drug approval and oversight process is designed to keep drugs safe and effective, it also prevents or limits their use to those who've seen a doctor. Catch-22: How to see a doctor? More importantly, where to find one that will go along with patient-initiated drug trials? Big Pharma is suggesting patients ask their doctors about the advertised drugs, but doctors and their administrators know they could answer to the malpractice lawyers for prescribing something that does not work.

The trouble with the present system is that patients are considered helpless and ignorant. This leaves doctors and their overseers in charge of things, which perpetuates patient helplessness. Must I go on?

Cycles

After the Opera, we went out to dinner. Our waitress, table-server or whatever they call the people attending tables these days, was thankfully a bit more talkative than the usual quick-gimme-some-money variety. In this more relaxed environment, the California cuisine food was fairly decent, too.

The waitress was a cheery, young person who is in waiting for a career in advertising or marketing. Having struggled through college, she wants to be self-employed. I asked her whether there isn't an alternative career, considering what advertising is all about in comparison to my slogan "Truth is Everything." After some discussion, in which her frustration at not getting a real job after snagging a college degree came out, it became clear she was determined to enter her chosen lists, anyway.

I recalled that, roughly thirty five years ago, I was introduced to some young people struggling to enter the advertising industry. They set up shop near Mission St. in an low cost (city subsidized) studio. Most of them ultimately failed in their quest. The ones that made it turned into the elders they sought to overthrow. Us became them.

So it is with Imperialist America, which, step by step, turns into the very thing Americans supposedly reject. So it seems to be with most things. For the most part, we are the creatures of the system, not our choice. Could it be different? Yes, but only if the system is different.