Why I Hate The Outdoors

Growing up on farmland without internet or television, I spent most of my time outside imagining fantastical adventures.  Like most relationships, the beginning was beautiful.  Nature and I were inseparable.  Those were the days when it would put on it’s slinky dress and I would show it off to my friends.  Thirteen years into the relationship, and the magic had died.  Suddenly Nature was complaining about how I didn’t appreciate it enough.  I just thought that maybe if it ever took off the sweatpants and made me some goddamn spaghetti, maybe I could appreciate it more.

Let me just say, that going anywhere with the roomie ends in tears.  When I agreed to go hiking in South Mountain Park, I did so against my better judgement.  However, when I heard that the mayor of North Carolina has advised against going there, I had to find out what was up.

First mistake of the day was asking the roomie to write down the directions.  We start out about about 12:00.

Kristi: First go to I-85 north.

Me: What? I don’t know how to get to I-85 north!

Kristi: Really?! I can get you there.

Four hours later, we are lost and no where near I-85.  I am two seconds away from stabbing Kristi with a shank made from spare car parts. Luckily, we did find somewhere we knew…which was about an hour north of where we started.   I say that it was luck, but there was a bit of asking.  Let me just point out that gas stations and pawn shops in Georgia apparently have no idea what I-85 is.  The first gas station had two girls who pointed us to a road not too far away that would take us I-85.  We passed some road called 365 and continued driving into Mudcreek country.  The Mudcreek community has no imagination.  While driving on Mudcreek road, we passed the Mudcreek church, the Mudcreek auto repair, and the Mudcreek Anarchy Wrestling house.  Next we asked some pawn shop owners where I-85 might be.  The young boy answers that 365 is was they “consider to be I-85.”

What does that mean?  “Consider to be?”  It either is or isn’t the road I want…you misleading sonofabitch.  Also, the guy in the gas station next to you considers I-85 to be itself, and he even gave me directions to it, jerkface.  I suspect this was all because I didn’t buy that GPS you offered me.

At this point, I am not going home without seeing this mothafuckin park. Two hours later, we are in North Carolina…somewhere very near to where we want to be.

Me: How many miles until the next road.

Kristi: I don’t know! Just turn when you see it.

Me: If you don’t write down the mileage, how do I know if I miss it?!

After about 20 minutes we reach the end of this road…clearly having missed our turn.  The Dollar General people are not exactly helpful, but you get what you pay for.  I guess at going down one random turn and get us back on track.

We finally make it to the park, but not because the park made it easy for us.  After going down a detour road for a couple of miles, I had to go down a road that claimed to be closed for construction just to get to the entrance.  It is now 7:30.  We have been driving for 7 hours, and the park closes at 9 pm.

After having a bit of fun messing around, I’ve realized that the only reason that the mayor would warn against this place is that it is in the middle of no where.  We decided to finally go see the Upper Waterfalls.  The sign said that it was 1.5 miles away.  While we knew we were going to be pushing our luck, we were gonna see the goddamn waterfall.

We walked up mountain number one thinking that…clearly the Upper waterfalls could not be anywhere but the top. NOPE.

We have to go down a bit more and walk up an even taller mountain.  Kristi abandons her bags saying we will come back for it…forgetting that it has our only phone and $200 dollars there.

We climb mountain number two to find that the Upper Waterfalls require us to descend to the foot of this mountain in order to find them.  The sign at the top doesn’t even mention the waterfalls, just that there is a pathway toward them at the bottom.

What we find at the bottom is a campsite, a creepy outhouse, and a sign saying that the waterfall is 0.5 miles away.  Now, I may not be the most avid hiker in the world, but I do run. I run quite a lot.  Let me tell you that there is no way we hiked up a winding path to ascend and descend two fucking mountains in only 1 mile.

At this point, twilight has caught up with us, and we abandon all hopes of seeing this waterfall.  On the way back, Kristi is desperate enough for a restroom that she almost uses the outhouse.  Since we weren’t planning on a nighttime adventure, only the camera flash can illuminate…

The rest of our night was spent following a winding mountain path with only the light of my camera to show the way.  It is only after the moon is fully out that I realize that mountain lions are not as mythical as I’d like them to be.  I had openly questioned the wisdom of the mayor of North Carolina when we first got to the park, but it quickly dawned on me that the man is a sage.

We reached the bottom and I had bested Mother Fucking Nature.  Kristi….well…Kristi just made it out alive.

That’s when it happened.  I walked into a spider web.  No! Not a spider web, not even a spider condominium…a spider metropolis.  I will face down a mountain lion before I will showdown with a spider.

Me:***shriek***

Kristi: What’s wrong?!

Me: **pulling at hair and considering getting naked** Spiders….web…everywhere…

Me: My glasses!! *pause* Just leave them!!

That’s right. The beautiful red sunglasses were abandoned because nature is a passive aggressive bitch.  Using my one weakness against me like that…taking the thing I love most. Hell, that’s actually damn overtly aggressive.

Anyway, the rest of the night was filled with rangers admitting it wasn’t 1.5 miles and telling us how they almost called in more help to look for us.  I didn’t care…I just needed the hell outta there.

So then we went to Taco Bell.

PS. Lost face

Grilled at the Gas-Station

I really wish that my experience at the gas station was as porn…y as it sounds.  Instead the title describes a showdown I had with the trickster cashier in order to get gas.  May I just say that when gas is so precious a commodity that obtaining it is treated much the same way as was entry into Thebes, times is hard.

Gas station pumps never like taking my card, and obnoxiously lock up…telling me that I have to go see the cashier in order to get my gas.  Most of the time, I either plead with the pump, saying things like, “Please! Just gimme one more chance.  I promise I’ll get my zip code right the next time,” or I’ll refuse and move to a new pump.  That’s right…I’m a rebel without a cause!

This time I decided to just go inside and get the nice man at the counter to unlock my pump.  Enter the sphinx…

Me: Can I get $20 on 8 please?

Cashier: *long thoughtful pause*  If I put this container into the microwave, would the coffee inside get hot?

Me: I’m sorry, what?

Cashier: This cup has coffee in it.  If I put it in the microwave, would the coffee get hot?

Me: ….yes.  I guess it would.

Cashier: Trick question! It’s an insulated container.  As it is now, the coffee would not warm up.

Me: Oh.  I guess you’re right….  Oppes. Can I get $20 on 8?

Cashier: Hmmmm….   Can you tell me how I could change this container to allow the coffee to heat in the microwave?

Me:  ….uh…..you could take off the top….?

Cashier: Very good! 20 on 8 you said?

Downside: I looked like an idiot, and I was too embarrassed to ask for 8 dollars of gas in person, so I ended up with 20.

Upside: If I imagine a soundtrack which starts low with a mystical/mysterious feel to it…that slowly becomes loud and epic, my whole gas station experience almost fills a bucket list item I have: winning a riddle battle with a fairy tale creature.

In other news, lately I’ve been the shirtless intern for Boybutante.  We are only one week from the kick off of the festivities.  I’m hoping tons of people attend, mostly so I can show off this scantly clad body of mine!

Also, Netflix now has TED Talks, My Little Pony, and new Doctor Who episodes.  Basically my life has been made.  That combined with the fact that Felicia Day now has her own youtube channel, GeekAndSundry, has made for the best viewing pleasure I’ve had in a long time.

What’s that?  A Guild music video? Yes it is!

As a new challenge to myself, I hope to make the posts in the near future all have porn themed titles.  It should be fun!

Will You Be My Nerdy Valentine?

Many of you may not know of my rivalry with Hallmark, possibly because I invented it only a few days ago. However, since that time, I have put a lot of thought into this perceived rivalry, and feel pretty confident that we are now arch -nemeses.

So I’ve been dating a science nerd for a while.  Do you know how many Valentine’s Day cards Hallmark makes for science nerds? Well neither do I, but I’m guessing very few.  As such…I made my own.

Suck it Hallmark!

P.S. I was almost as proud of my scroll over for the second page as I was of the actual poem.

Doc Holliday Does What He Damn Well Pleases

So recently I had one of those moments when you realize that something your parents or grandparents told you when you were younger altered the way you viewed the world around you.  It’s like when my mom told me that wearing one shoe was very bad luck, so now I’m on high alert whenever I’m in between putting on the left and right shoes.  Due to years of brainwashing, I’m convinced that I will die at that exact moment.  Not only would I die, but I would die with only one shoe on…  Granted, it’s not exactly as embarrassing as dieing on the toilet, but it just isn’t classy.

Wow, that was a tangent from my original thought, but it ties in nicely with what I meant to say.  I do not trust people who are wearing suits!  Don’t trust em!  To hell with your business suit, whatcha need to be so fancy for anyway, fancypants?

Seriously though, people who are wearing suits when in non-suit venues put me on edge.  This probably has something to do with my pa.  Every time we watched Tombstone, which was every other day, he would tell me that people wore their best suits to shootouts because they might be buried in them.

Which brings me to Wendy’s.  A man in a black suit, black dress shirt, with a black tie walks in.  Then it hits me, I’m going to die.  It is 9:00 am and someone walks into a fast food place dressed exquisitely in all black, and this means that he is going to kill us all, or he is an omen…the deaths of everyone in that Wendys is assured in some sort of Final Destination-esque manner.  **inserts a rice-cooker reference**

Of course, after I fled the Wendys, I saw the same man at the hospital where I work, at a thrift store I went to, and at the Wendy’s for lunch.  That’s it…he’s my own personal moth-man.

This was a random post that I hurried along because I noticed I hadn’t done anything for about a month.  The take-home message is not to wear suits without a reason unless you are Doc Holliday…”whatcha need to be so fancy for anyway, fancypants?”  It is in no way the fact that I ate Wendys twice in one day.

Aging

Some of the older patients on my unit like to say cliche things about how they enjoyed aging.

“Oh no Philip,” they say, “I’ve enjoyed every age I’ve been.  They all have their own unique advantages.”

“Look Mrs. M.,” I say, “right now my hands are full of wet wipes and your excrement, so don’t tell me how awesome aging is.  Also, don’t tell my how great my job is, because frankly, it’s full of shit!”

Okay, so that exact conversation hasn’t quite happened, but I there is a lot of subtext going on between my patients and me…

Recently I turned 24.  This is terrible news all around!  In one year, I will have lived for a quarter of a century, and I’ve already lived in 4 different decades.  (80′s, 90′s, 00′s, and now the 10′s…just in case you didn’t get that statement.)

I was okay with this change, because I didn’t feel any significant change; therefore, I could completely ignore my birthday and go on telling the world that I’m actually 22.  Then a friend of mine asked me to come audition for a play of Hedwig and the Angry Inch.  Audition? I’ll have to read a script and sing a song?  Ridiculous!!  When I was actually 22, I could get by on looks alone, and now…all of the sudden…the world expects me to have talents and to contribute…

My audition didn’t go great, which probably had a lot to do with the fact that I was so nervous.  Between the failed awkward jokes and my minor “cardiac event” that I had when it came time to sing, I was just glad that they didn’t burn me out of the building.

Anyway, I just found out that I got the part of Tommy Gnosis…which is freaking awesome.  Suck on that senescence!  I still get to rely on these failing looks for now…talent requirement has been staved-off for another year!  I’m super pumped about this play….love love love Hedwig!  It’ll be tons of fun, other than the part where I have to sing a song…I foresee another myocardial event…

Completely unrelated to everything else I just said, I have a new youtube addiction.

Gym Bunny Aspirations

As a skinny, barely muscular white boy, gyms are not exactly what I would consider my home-front.  In fact, I do as little of this “interacting with people” thing as I can when on this enemy territory.  Apparently, breaking from this mold is not an option at the moment.

Today’s first interaction was a water bottle showdown.  First of all, I would like to point out how much I have always hated these big ass muscle fiends with 2 gallon water containers.  Have none of them considered the fact that all gyms have water fountains available for refills?  This is not some apocalyptic wasteland wherein your wealth is measured by the water you have obtained…not yet at least!  That being said, I noticed out of my periphs that one of my fellow gym-goers just happened to be taking swigs of water every time I did.  Of course, I did some test swigs just to see if he responded…and he did!  I took this to be the equivalent of revving your engine at a red light, and there are not words enough to describe how competitive I am .  I took up that gauntlet with a fury!  My next swig, I looked right in the challengers eyes and took a swig wearing my most obscenely satisfied face.  His retort was not so much face quality as it was quantity of water.  Well, not to be bested, I prepared myself for a drink of water that would quiet even the fires of hell…only to realize that I didn’t have enough water in my puny water bottle.  My roommate points out that I was bringing a knife to a gunfight, which has prompted me to carry a gallon jug next time!

My next adventures happened in the locker room.  Oh ho!!  No but really, they were pretty mundane.  A little known fact: as regular gym-goers gain muscle, they lose the ability to see scrawny people.  Now that I’ve started to become the very definition of all that is masculine and intimidatingly strong, these gym bunnies have started striking up conversations with me….but not very well.  One tiny white boy left just as I entered.  Apparently Muscle McManly Arms could not tell the two of us apart.  He looked up, gave me a confused look, and tested the waters with a, “I guess I shouldn’t have got it in the first place….?”

Me with an equally confused look, “Yes? I agree!  Definitely should not have gotten that thing! Aha! …..?”

Muscle McManly Arms who is not amused, “……you’re not that same guy right?”

Downtrodden Me, “….no.  But I was right, right?”

My nervous laughter throughout this exchange did nothing to improve his unamused disposition!

 

Oh well! To hell with interacting with people!  I decided to drown my awkward woes in my first visit to a steam room.   Two seconds into my venture into the steam room, I realized that I’d be drowning my troubles in the profuse amount of sweat I was producing.  And that’s when it happened; that’s when the heat got inside of me.  No wonder such disgusting things happen in locker rooms.  I had to hop into the shower to prevent the certain jail sentence I would have gotten had I stayed in that sauna.

The subsequent shower also proved to me that I don’t pay enough attention to people or the going-ons of society.  Three dispensers were in that shower: shampoo, conditioner, and shower gel.  How have I gone all these years without hearing about this “shower gel.”  I spent about 5 minutes of my shower wondering if the shower gel should go on me or on the shower.  I mean…it was an odd color, and it’s smell wasn’t really something I wanted on me.  In the end, I just have to pray that it should have gone on and around my skin, and not or and around the shower walls.

There was one more notable occurrence, but talking about it will effective declare war on an entire section of the gym going community, so I’ll save that one for later.

….and inside of me.  It’d be nice if that didn’t kill me…not that it happened…

Healthcare and HCAHPS on the Horizon

The Centers for Medicare and Medicaid (CMS) fills a very useful role in the healthcare profession.  Unfortunately, the hoops that one has to jump through in order to shake money out of them are ridiculous.  It is not unusual to find a clinic that charges a flat rate of cash, instead of dealing with all the paperwork involved in actually getting money out of them.

At work I know that I have to get all the ICD-9 Codes/Diagnosis Related Group numbers exactly right if I want insurance to cover the tests that are being performed.  Not to mention the arbitrary rules that dictate whether a test is covered.  For example, under certain insurances, such as CMS, ordering a test twice in the same day for the same reason is unacceptable…despite the many reasons one might have for doing so.

An additional hoop is coming up soon, and hospitals everywhere are trying to prepare.  Beginning in 2013, CMS will start holding a percentage (I believe it starts at 1%) of the Diagnosis Related Group reimbursement.  DRG’s basically dictate how much insurance is willing to reimburse the hospital for a patient’s treatment.  For example, for a DRG for stroke, insurance will be expecting a certain amount of money for the treatment.  So if you start treating this stroke patient for the heart failure and COPD they also have, you’d better code for that as well.

In any case, 1% of that money will be held by CMS and then given back to the hospital depending on how well the hospital ranks (this amount would increase to 2% by 2017).  Of this amount,70% that is withheld will be reimbursed based on the hospital’s patient outcome.  This means things like, did the patient die, or how often to patients have to return to the hospital for the same diagnosis because of lack of education/treatment, and all sorts of jazz like that.  The other 30% will be returned based on the the national survey that all hospital patients receive after discharge, the HCAHPS.

Here is some random hospital’s HCAHPS score.  As you can see, there are many categories covered in the survey, and it asks how often your expectation were met in these areas.  It’ll mostly give choices along the lines of “never” through “always.”  For the purposes of the HCAHPS, the only scores that matter are the ones for “always.”  If you’ve ever been in a hospital in which they insert that word in forced manners, that is the reason why.  As I understand it, scores would be awards based on the HCAHPS percentile the hospital attained, the improvement of care from baseline figures, and consistency.  These scores would then be used to decide the amount of money reimbursed.

As you might guess, hospitals and nursing staff everywhere are uneasy.  It would be great if these surveys were definite in their answers, but patients rarely know how hospitals function.  They probably don’t realize that hospitals are not really ever quiet places, that nursing units are understaffed and busy, that often pain will realistically never be eliminated with many admissions, etc.  Even if patients were well versed in hospital procedure, who honestly would “always” to most of the topics listed above.

Anyway, that’s a long post about a boring topic.  I was going to talk about medical ghostwriting, but this post is already entirely too informative.

Some last minute thoughts…

Ever since the healthcare reform, people have been blaming every new policy on Obama… despite the fact that most healthcare policies take years to form and enact.  So for everyone who uses the word “Obama-care,” two things: stop trying to be clever, and this was in the works back when Bush was in office.

Also, doctors need to start sweating too.  You may not be hit with this immediately, but that is already being planned by our darling CMS.