20.

I have a blog. You're looking at it. It's been almost 20 months since its last update. I'm not making any apologies, for I have no readers. Instead I'm using this as an opportunity to attempt to remember the past 20 months of my life.

Each day for the next 20, I will remember on this blog the events of a month of my life beginning with March 2008, moving forward to October 2009. Nobody will read them, but I will know myself better for the writing.

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20.

I fell and broke my HIPAA

Driving home from work just now I heard a news report concerning the possibly privacy issues inherent in medical staff blogging about their job and their patients. With that in mind, here's another blow to HIPAA.

At work last night, we had a particularly crowded emergency room with, at one point, over 60 people in the waiting room, and another 60 already in beds, ready to be seen by a physician. Normally, those numbers are closer to half that. Four of those patients were on some degree of psychiatric watch. The craziest, by far, was a certain teenage alcoholic.

Under the kind of strain, interesting things are bound to happen.

Upon arrival it was clear he had to be restrained. He didn't want to be restrained. He fought with spit, urine, tooth and nail - emphasis on the tooth. He bit the hand of a security guard who was holding him down while the nurses wrapped the leathers around his wrists and ankles. This security guard decided not to be the bigger man in the fight and instead punched the kid several times in the head. A nurse pulled the curtain around the bed, surely thinking only of HIPAA.

Don't get me wrong. Patient confidentiality is very important, especially when there is still a social taboo on things like getting an AIDS test and having a mental illness. It was just an awesome story I had to tell.

The radio piece was almost entirely ridiculous. Every single hospital staffer I've met in every single hospital in which I've worked knows not to freely discuss patients' information unless necessary for, or at least related to, the job at hand. The only time that info gets passed around willy-nilly is when a story is just too great to pass up (like the one up there) and people are scrupulous in leaving out names and other specifics.

The main concern of the broadcast was that if enough nonspecific information were posted, a person might be able to identify themselves as the patient being discussed, or, worse yet, an acquaintance might be able to identify the person.

This reminds me of a website I saw recently. It was a forum that allowed restaurant staff to post the names of bad tippers with the goal of humiliating these bad tippers to their friends and families. The main failing of this site is the same as the main defense of healthcare blogs: the internet is vast, and the population large.

The odds of someone who knows you finding your name on a 'bad tipper' list, or even caring to look, are slimmer than my chances having hair when I'm 60. Likewise, the odds of someone finding you, and being able to identify you by a vague description at best, are practically nonexistent. And if you manage to find yourself mentioned? Keep quiet about it and nobody else will know!

At least the article ended on a positive note, explaining that prospective patients often feel more comfortable with a doctor who shares openly his medical know-how in a blog or otherwise, rather than one of those stuffy white-coat types who only communicates with you via stethoscope.

Concerning the guy from Chino who laughed excessively in the San Diego cafe

At 3:36 in the morning hours, a person needn't have any excuse to act stupid, silly, or just plain off. The trouble comes when a person actually is one, or all, of the above. Can I get an amen?

Six coworkers and I were taking in a hot drink at Lestat's Cafe in the Normal Heights neighborhood of San Diego. We sat in lush armchairs, sipped luscious coffees and teas, and discussed things like literature, sex, and death (marriage). Then G. noticed something strange happening outside in the street.

A thickly built man in hibiscus patterned board shorts and a tight, colorful t-shirt was up to something in the middle of the street immediately outside the cafe. When I first turned my head to look, he was bent over, hands on knees, facing away from his audience. That was fine though, since his butt was probably more emotive in its gyrations and pumpings than anything his face could serve up.

Nevermind. Once he turned around we saw that his face was equal to the task with its vacillations between a Mr. Potato Head grin and a Lamaze-esque look of exercising agony. He rhythmically punched the air and stomped the ground in turn, and then took to jogging.

He bounced up and down the small tract of concrete before the cafe, still pumping fists in all directions, until he found a spot to stop, bend over, gyrate, and then he jogged around again until finding a new spot.

We loved this guy. At one point he noticed us and waved enthusiastically, though I suspect he had intended for us to watch him all along, given his decision to jazzercise in front of the only open business for miles. But then, Mr. Chino, a frumpy white guy sitting nearby, reared his fool head.

"BWAHAHAHA, LOOK AT THIS CHARACTER! ONLY IN SAN DIEGO I TELL YA!"

I was glad he appreciated the guy. I really was. Hell, I appreciated him, why not everyone else? I leaned over and asked him with genuine curiosity, "where are you coming from?"

"CHINO."

Everything he said reeked of capital letters - the kind you find in misspelled forum posts begging understanding and sympathy for Britney Spears. Chino explained it though. It explained his amazement at anything remotely fun, anyway. It didn't explain why he wasn't getting his fun-fix in Hollywood, much closer to home.

Speaking of Hollywood, "only in San Diego"!? As though this painfully mono-seasonal, military-entrenched border-town held the franchise on freaks exercising in the streets at 4 am? Maybe I'm a bit arrogant (fine, there's no maybe), but I believe my little hometown to the north is a much stronger contender for the rights to that honor.

San Diego, nice town as it may or may not be, is probably not tops in any category you might invent. No, not even in stupid hyperbolic statements shouted amid vacuous Chino guffaws.

Thought of the Day

How wild would it be if you were backpacking in some developing nation and suddenly you a saw someone wearing a t-shirt that had your picture on it, instead of the usual sports franchise logo from the 70's?


I think it would be pretty wild.

Job <3 Me

Scene from a manager's meeting that may never have happened:

"Okay, everybody - the most pressing piece of business on the agenda today is MattJosh's imminent departure. His contract with our organization is almost up, and I think he deserves a big break as a going away present."

(Here ensues such a brouhaha of agreements that makes parliament seem downright civil)

"Yes, yes, settle down, we all feel the same way about him, that remarkable bastard. So how do we express our admiration? Try to think up ways for him to make more money the closer he gets to his end date. I open the floor for your suggestions."

"We could start paying him for his commute! That would be a big break for him considering he's driving daily between LA and San Diego right now."

"And hey, while we're paying him for the commute, let's convert him to a non-exempt employee so he'll be making overtime for all those hours spent on the road. And of course we'll continue to reimburse him for his mileage at a rate far better than actual gas prices."

"Naturally - way to go on that non-exempt idea, too."

"Why not make him turn in his company laptop a month early, but then give him a huge bonus so he can buy that MacBook Pro he's been hankering for?"

"Oooh, I like that, but remember he's getting a huge bonus at the end of the contract already."

"True enough, all that commute and mileage money will more than pay for that laptop anyway."

"That's right, anything else?"

"Why don't we keep paying him after he leaves, as some sort of on-call consultant basis? You know, so he can still get a paycheck while he's on vacation in Europe?"

"Splendid! Meeting adjourned!"

***

Something like the above exchange must have taken place amongst my bosses recently. How else could I be so fiscally lucky in my last month at this job? The only thing that hasn't happened (yet) is that last one, but I'm keeping my fingers crossed!

Granted, many of the changes taking place will actually be really unfortunate for my coworkers who have contracts extending beyond my own, but I can't deny that I am personally benefitting hugely from such crazy changes. I just wish they'd done it three weeks ago so I could have milked it for my entire stay in San Diego.

Basically, what I'm trying to say is this:

I am one high rolling son of a bitch right now.