Thursday, January 17, 2013

Empty Life Syndrome

     There are two kinds of people.
     The ones who are always up to something, and therefore run into conflicts and problems.  And the ones who contemplate being up to something, but mostly do the same thing day after day, so that their lives are not really about anything, or at least not about anything new, or expressive of them.
     The first group is composed of people who give America its renegade reputation:  creative individuals who ask, "What's next?" and "What if?"  They're not all admirable or good, like Ben Franklin, Bill Gates or Stephen Hawking, nor are they all wild and zanily successful, like Donald Trump, Alan Greenspan, or Madonna.  Some are thieves and bamboozlers, or small-time artists and craftsmen, and some are colorful people who zigzag through the world without definite goals or a desire to achieve.
     Educated American parents like to think they're raising kids whose creative instincts are being fulfilled.  They're short on discipline and long on praise with their progeny, and select schools that will foster our outlier ideology, which is epitomized by the cowboy, inventor, protester, orator, poet, painter, mountain climber, firefighter, mystic, insurrectionist, heretic, iconoclast and unrestrained defender of the self.
     These kids end up being homogenized, for the most part, by the corporate-induced culture of sameness in which they live with their peers, despite being raised American and having parents who indulge them.  Conformism, built into our genes, is used by marketing geniuses to manipulate us into acting according to some fabricated ideal so that we purchase all the accoutrements of that ideal.
     Some kid-products of creative parenting become self-referential, and think they should have their way no matter what; some retain a smidgen of self-love but learn to consider their effect on others and therefore become reliable citizens, and a few could care less about anything, they're so driven by inner imperatives that nothing matters except answering their compulsion, sometimes for the good of mankind, as in the case of Mozart.
     One good thing about parenting the American way is that it produces, often, people who are brave, and decide to take on new projects or change their lives in dramatic ways even if it means they might lose everything.  Entrepreneurs are an example:  they win and lose assets as though it were all one big game, from which they can always rebound.  People who have lost everything are sometimes risk-takers, too:  they're not afraid of running aground, because they've been there, and so can act with daring or generosity.  They're not compelled by fear into that grabby possessiveness that typifies those who've played it safe, in case they might get into trouble and lose what they have.
     Most of the world's population is comprised of people who play it safe.  They're the ballast for the high-flying others, and they stabilize the human race.  They provide a safe dropping-place for people who are falling from their dreams.  There's nothing wrong with them, unless their lives start feeling empty.  There's nothing wrong with people in the first group, either, unless they haven't managed to find meaning in what they do.  Meaning comes from referring to an inner directive.  It has to be related to the irrefutable fact of one's death.
     I was talking to my oldest son on the phone, today, listening to his usual diatribe about why I'm in the trouble I'm in, as he puts it.  He has very strong opinions, for a twenty-something.
     He says I never should have owned or sold a business.  Nor should I have built a house or developed a farm or dug a pond or had a chicken coop because, after all, so many problems have arisen along the way.  Contractors take money and don't show up, projects aren't completed according to specifications, people lie and cheat and report you for nothing.  Ponds get alligators, hawks nab chickens, hurricanes fell oaks, roofs leak, businesses run aground, friends betray you, septic systems have to be reconfigured.  Even worse, government agents don't do their homework--preferring, instead, the adrenalin rush and feeling of importance that come from staging a raid.  And then there are lawyers, who are...well, lawyers.
     "You can't tell me I shouldn't have done any of those things."
     "Yes, I can.  If you hadn't had so many ideas, you wouldn't have the government after you now."
     "People can't sit around being passive all their lives.  And neither can you."
     "Why not?"
     "If you don't do something," I said, "you'll end up with Empty Life Syndrome."
     "What's that?"  he asked.  Perhaps he thought I was describing an actual medical condition.
     "It's what happens when you don't put your heart into anything."
     "Yeah.  Like when people think they can keep out of trouble by doing the same old thing every day, and avoiding anything new."
     "Do you think that's what I'm doing?"
     "I don't know.  Are you?"
     "But look at all the trouble you're in," he countered.
     "If I hadn't tried to do anything, I might not be in trouble.  But what kind of life would I have?"
     "You'd have a safe, quiet life."
     "I'd have Empty Life Syndrome."
     "Wouldn't that be better than what's happening to you now?"
     "No, I don't think so.  Empty Life Syndrome is pretty bad.  I'd rather be in trouble--even if it means thrashing around in the slime and muck of humanity--than have that."
     "What can it do to you?" he asked.
     "Turn you into a slug, for one thing."
     "What else?"
     "It can make you afraid to do anything.  The less you do, the less you do."
     "I don't know," he said.
     Despite the liberal, Waldorf upbringing he received, my oldest son is a cautious guy.  He'd probably make a good security guard, or bricklayer, or lawyer.  He's a solid counterweight for those who might otherwise drift into outer space, as has happened with some of his friends.  But he can't bear to see me in trouble.
     "What if you go to jail?" he asked.
     "I'll get to read a whole lot of books."
     "I'm serious," he said.
     "Will you bring me books in jail?"
     "It would still be better than Empty Life Syndrome."
     "Yeah, okay, enough, Mom." he said.


  1. FRAUD ? How about a pregnancy test for someone who doesn't have sex, or a 50 dollar charge for a phone consultation that didn't happen ? Or what about a 400 buck surgery charge not for cutting on the patient, but from reading a page of a report to the patient ? Nah. No fraud going on there. Perhaps an address as to where patients or other interested parties can get their records after you close would be helpful.

  2. What an interesting comment, "from the other side." Thank you for taking the time to write, although it might have been more courageous for you to state your name. It seems you may need a primer on coding and "charges," as well as the word "surgery." Unfortunately, when you receive your EOB's from your insurance carrier nothing is explained.
    First, doctors don't "charge" insurance companies. Insurance companies "set fees," i.e., determine what they will and won't pay for. Very often they state that they will pay for services, such as preventive visits or telephone calls, but they don't. Blue Cross, for instance, has codes for physicians to use for telephone visits, and sets a fee for paying for them (in lieu of telling every patient to come in for a visit), but often refuses, without explanation, to pay according to their own fee schedule.
    No telephone calls made by me or my nursing staff are billed when they "didn't happen." Instead, physicians like me have ten times more phone call messages to address than patient visits, as patients want to avoid a visit (and the attendant copays, waits, and inconvenience to them) when they think they can get advice or answers to their problems over the phone.
    I don't do "back surgery," so I can only guess what you mean, based on what I imagine you are thinking when you read an EOB sent to you by your insurance carrier. Did you know that "fracture management" is a service that Medicare and other carriers introduced some years ago as a way of reimbursing physicians for taking care of patients with fractures, for example, vertebral compression fractures, without "surgery"? It serves as an incentive to physicians to care for patients without referring them to orthopedists, or the hospital, or neurosurgery, if in fact they don't need surgery, but require other kinds of care, such as casts, crutches, back braces, pain medication, and conservative healing modalities. EOB's sent to patients may record this, erroneously, as "surgery," but if you research the CPT code billed, you'll see that it isn't surgery at all. I don't program the computers at the insurance companies before they spew out reports of what doctors billed, or I would write them in plain English, with actual descriptions of what the codes represent. Another example of misleading EOB terminology sent to patients is the explanation of 97535--a code for teaching patients how to manage certain medical conditions at home--as "occupational therapy." We teach lots of patients what the code represents, but it's not "occupational therapy," as the EOB states--therefore, many patients are confused. Whether the "charge" for fracture management is $50 or $5,000 is irrelevant: as I said, charges are meaningless, because insurance companies set the fees and pay only those fees.
    As for the "pregnancy test of someone who doesn't have sex"--it would be naive to assume that everything patients tell doctors is "the truth," especially about sensitive topics like sex, and especially when an x-ray could subject an unborn fetus to harmful radiation if the $3 test wasn't done. You will not find a physician in an ER who orders radiographic procedures on women of child-bearing age without first obtaining a urine pregnancy test. Sorry.
    If you'd like your records, simply visit my office in the next three weeks and ask for them. We'll ask you sign a form saying you're picking them up, and you can take the entire chart with you.

  3. Is it fraud to do a urine drug test on someone who says he or she doesn't use drugs? Why don't we just believe them?