OK computer

8 03 2011

This is what I get for not being paranoid.

Okay, so “paranoid” is a strong word; sufficiently cautious, perhaps.

One of my e-mail servers went down and I’ve been unable to access that account. That’s a bummer, one which has been magnified since I didn’t import every last address into my alternate account.

Laziness, blah blah. Yeah, I know.

See, I was smart enough to set up an alternate account, but not smart enough to duplicate the information across the two services. Until the problem (whatever it is) gets fixed, a whole lotta addresses are out of reach.

I could have set up the second account so that mail from the first is automatically forwarded to it, but I prefer keeping the two sets of mails separate. No, there’s no clear dividing line between the types of mail get shunted into each account, but, still, I like them separate.

So I’m not kicking myself for that—I made a decision, after all, one which makes sense to me even amidst this mini-blackout. (Although I may end up creating yet another account and using that as a drop-box. Christ.)

When I was working on my dissertation I was freaked out at the thought of losing chapters. (I mean, I wrote a lot of nonsense, especially at the start, but I wanted to be the one who got rid of something, not my computer.) I made copies of copies on goddess knows how many computer disks (remember those, anyone?) and kept some of these in my office—in case, you know, my apartment burned down or something.

Given the importance of the dissertation, how much work I put into the various chapters, and the circulating story of someone who lost half of her dissertation, well, I considered the investment in 3.5″ diskettes and the time it took to copy that work on to those disks to have been well worth it.

Nothing happened, happily, but the insurance of those back-ups did assure me. I had precious little peace of mind in those days, so one less thing to worry about did matter to me.

Which reminds me: I’m overdue for a copy of my documents on to my external hard drive.

♪ Better safe than sooorrry. . . .♫

Now give me money, that’s what I want

6 03 2011

Dr. Donald Levin feels bad.

The psychiatrist is no longer able to treat patients with talk therapy, is no longer able to meet with them for those regular 50-minute-hour sessions, no longer able to sit and take in the vagaries of human existence. Instead, he must limit himself to 15-minute increments, enough time to write a scrip for meds but not, alas, much time to get to know them, or even remember their names.

As he told a reporter from the New York Times,

“I miss the mystery and intrigue of psychotherapy,” he said. “Now I feel like a good Volkswagen mechanic.”

“I’m good at it,” Dr. Levin went on, “but there’s not a lot to master in medications. It’s like ‘2001: A Space Odyssey,’ where you had Hal the supercomputer juxtaposed with the ape with the bone. I feel like I’m the ape with the bone now.”

I had some sympathy for Dr. Levin. Insurers are stingy in reimbursing all types of medical care, and can be especially stingy in mental health care. Levin has to pay the bills, which means adjusting to a reimbursement system which pays him more and more reliably for those 15-minute increments than it does for the 5/6 hour.

But then I read this:

He could have accepted less money and could have provided time to patients even when insurers did not pay, but, he said, “I want to retire with the lifestyle that my wife and I have been living for the last 40 years.”

“Nobody wants to go backwards, moneywise, in their career,” he said. “Would you?”

My sympathy shriveled.

There is still a nugget of fell0w-feeling: The man has lost a way of life which was both congenial and supported him, and loss is loss.

The shrivel comes in, however, insofar as he made a choice: Psychotherapy or money, and he chose money.

A very practical choice, and not one to be gainsaid. After all, as the article pointed out, a psychiatrist can make $150 for three 15-minute med visits versus $90 for 50 minutes of talk therapy. Levin (with help from his wife, a former psychotherapist), now works 11-hour days and sees around 40 patients per day. They charge for missed appointments, faxed refills, and penalize for missed co-pays.

It’s quite a business they have set up, and the patients who spoke to the reporter seemed satisfied with their relationship to Dr. Levin.

But here’s where the shrivel comes in: Levin chose this business. Not a “free” choice, true, but most vocational choices are not. He could have chosen to continue to practice psychotherapy and forgo the money; he could have chosen to mix psychotherapy with the scrip mill, sacrificing some money but keeping some of the “intrigue” of the therapeutic relationship; or he could turn his office into a full-time scrip mill, in order to maximize financial returns—which is, of course, what he did.

He may lament the consequences of this choice, but, as he noted himself, he wanted the money. More than anything else, he wanted the money.

I don’t begrudge him that. Really. There is nothing dishonorable in what he’s doing, and, as noted, he appears to be helping his clients.

But I also don’t know why I should in any way care about Dr. Levin’s lament that “I had to train myself not to get too interested in their problems”—because doing so would mean he’d spend too much non-reimbursable time with them.

He might genuinely feel bad about his loss, but if so, he’s crying all the way to the bank.

Up against the wall

1 03 2011

He has promised that he will not leave the country, that he will fight to remain in power “to the last drop of blood.”

The last drop of his blood: This man ends  like Ceaușescu, dead against a wall.

This is what he has done to his country; this is what he has done to himself.

Photo: AP