For everyone who has ever thought “this would be best done by a centralized bureaucracy” let me remind you that when you let things be done by “the government” what you’re doing is giving power to people who have sat behind desks so long they’ve turned into Terry Pratchet’s auditors and think reality is classifiable into codes and numbers.
Perhaps it is because I’m one of those people who whenever she runs into a carefully coded system that I feel leery of such systems. Though with National Health Care to give them credit (it’s credit, right?) they’re trying to cover every possible instance… Except I bet I still fall between the cracks.
They’re also classifying as pathologies things that… you’ll see.
So, this started because son shouted from his room “WT ACTUAL F People?”
In such circumstances I run to see what he’s looking at.
We’ll start with the codes that most affect our people, shall we?
The Funny Take: We call this a Science fiction convention!
The Serious Take: Bizarre according to WHOM? Perhaps I don’t like your mustache, doc!
From the other side: We call this a Science fiction convention!
Funny Take: Don’t do it, Lady! Make him buy you dinner first!
Serious Take: Well done, you. Now all the employees of Sea World are covered when a dolphin gets amorous.
The other take: What happens at the convention pool stays in the convention pool.
Funny take: Bitten? Bitten? The bastards had lances!
Serious take: seriously wouldn’t “animal bite” do? What is it with the weird specificity? Is this how you justify your sucking at the tax-payer teat? And really, really, THREE more specific codes? And guys, no one get bitten by a squirrel for another year, okay?
The other take: Were you at one of those Science Fiction cons?
Funny Take: Yes, I know you discovered the formula for Greek Fire. Don’t use it to make water skis
Serious Take: Someone turn off the Merry Melodies cartoons in this bureaucrat’s office.
Take from the other side: Was this Sunday morning, at worldcon?
Note for those not speaking the lingo — subsequent encounter means the patient came to the doctor who wasn’t on the scene of the accident.
Funny take: Does the code cover that much superglue?
Serious take: Dude! Dude. A jet engine is a blender. A really large blender. With fire in it. If you get sucked into it, you’re not going to need a code. You’re going to need a coffin.
Other side take: Well, we call it a jet engine, but it was really Mike down in the Klingon party after, you know– Ahem, anyway, you get him a couple of drinks, and he can get a little rough.
Funny Take: Was this a Star Trek “sequela”?
Serious Take: Another code that affects millions, no, mayhap billions of people a year, and so totally warrants its own code, right?
Take from the other side: 
Funny take: I don’t think it’s billable. Do you know a chick named Buffy?
Serious take: How serious was this bite? How often does this happen? Or do people go to the doctor for a hickey
Other side take: What do you mean those fangs weren’t fake. Kate Paulk SAYS she writes FICTION.
Funny take: Wait, what? You go to the doctor for that?
Serious Take: No, seriously?
From the other side: They found out you go to science fiction cons????
The funny take: At last. A code to end all codes.
The serious take: W the actual F people? REALLY?
From the other side: It’s okay. You can admit to us you go to science fiction conventions. It was Mike, wasn’t it?
And that is a small sample. If you search ICD-10 codes and are willing to part with a good portion of your time, you’ll find many, many more instances where you’ll laugh out loud. Mostly because, paraphrasing what Heinlein said in Stranger in a Strange Land, laughing is what you do when the situation is too sad to cry about.And perhaps the most laughter/crying worthy of all is this comment on this site after an article about the codes:
#Cassie Kiehl commented on September 25, 2011:While the Wall Street Journal may think it’s a laugh, with over 300 million citizens, macaw mishaps are going to happen. The specificity of the codes helps to track public health hazards that could occur in pockets due to particular services, vendors, products, or even the pet de la mode. Interestingly, the US pioneered injury coding , changing our ICD-9 version to include causes of injury. Clearly the WHO ran with it in ICD-10. Fortunately, there are software solutions to speed iCD-10 coding like SpeedECoder, http://www.speedecoder.com. There’s no difference in time typing macaw than dog when someone comes in for an animal bite.
Yes, indeed. But the specificity in codes betrays the type of mind where EVERYTHING must be classified. What this person doesn’t seem to understand is that once the code exists, you become the code, and if you fall outside the code, you stop existing.
And that, ladies and gentlemen is the evil of letting bureaucrats run with codes. They poke their moral sight out, and start seeing people as things: Classifiable, measurable widgets easily pluggable into the system, each intrinsically valueless.
I hope laughter is the best medicine, because a lot of us are going to die laughing.
According To Hoyt 
I work in a hospital lab… I’m definitely forwarding these articles to some of my coworkers.
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GAH! Someone! Please stop the planet. I want off …!
Where’s Ford Prefect when you really need him?
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My towel is wrapped around my head and I am ready to go. ;-)
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And yet, at the same time codes are being dropped in large numbers from the DSM-5 so as not to “stigmatize” persons with alternative lifestyles such as bestiality or necrophilia.
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Alternative what? On behalf of my gay friends, I’m OFFENDED.
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As an aside, the word “gay” has become the name of a political orientation, not a sexual one, to such an extent that straight liberals have absolutely no problems accusing me–who has been openly bisexual for twenty years now–of homophobia.
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I’ve been accused of homophobia too. MUST ask best gay buddies (two of them are best buddies period, but not all) if they’ve had it flung at them yet.
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Don’t you know–only straight white rich heterosexual men can possibly be conservatives. Everyone else is too weak to protect themselves without Big Brother watching over them.
Gay conservatives can’t exist according to liberal doctrine, and so they have to be silenced by whatever means necessary.
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This is weird. I shall have to inform my friends of this. Expect mushroom clouds over several parts of the country as they blow up.
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Don’t forget “Politically Conservative” equals “Conservative Christian”.
There was a guy who visited Ringo’s Tavern just after Ringo’s _Princess of Wands_ came out. He was so sure that John Ringo was conservative Christian. Note, IIRC John has said that he’s lapsed Catholic.
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Having read Ghost before I read Princess of Wands… somehow I just never assumed that about John.
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Never said that the person was very smart. [Wink]
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I’ve been accused, more than once, of being an uneducated redneck, so…
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I would expect anyone so enlightened as your accuser to be aware that “uneducated redneck” is a redundancy.
Of course, what the anointed deem an “education” is rather astray from what the term has traditionally communicated, and more accurately fits the definition of indoctrination.
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… “uneducated redneck” is a redundancy
I beg your pardon, good sir, but y’all don’ know whatcher talkin’ ’bout. Rednecks can indeed be educated. :-)
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a smarty folk type on YouTube just was busy calling the Me, the Kochs, and Cristian conservatives et al Fascist, and only he/she/it was upholding the views of the Founding Fathers. Asked to name one single ideal the Kochs (or Christians for that matter) held that was the same as Benito the Dead’s political party, they just ranted on about the founders (apparently they were all of a single mind, never disagreed and were apparently Atheists and not Christians for the most part)
They kept using that word …
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I’m sure they already know.
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Gay conservatives can’t exist …
I’ll have to tell younger son this. I’m sure he will be fascinated to learn he can’t exist.
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Yeah, there’s more of us than the liberals want to admit. There are a lot of working class gay, lesbian, and bisexuals who are starting to realize that the Left is far scarier than they are trying to paint the Right.
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I’ll go you one better – I’ve got a friend who is openly gay. But because he prefers sex with what he refers to as “men” – ie men who enjoy similar things to him (motor cycles, hunting, etc) rather than twinks, he’s been accused of being homophobic.
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Oh, yes. In order to be “really” gay you have to be a helpless faux female, complete with fainting couch and a fetish for designer clothes. Evidently a desire for men must include a horror of anything masculine.
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Tell that to the bears.
(I have a friend in a longstanding male relationship who took a gender studies class and shocked his professor at the end of the term by causing said professor to figure out that he was NOT an angry, straight male. Well, angry I’ll grant. He’s had to learn strong anger management since a head injury many years back.)
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The number of people with stereotypical assumptions about homosexual presentation is not terribly surprising given the popular portrayals.
What’s surprising is the number of people who make some claim to homophilia, yet hold the same stereotypical assumptions.
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And sometimes, I wonder if the stereotypical presentations are not so much Inherent in the orientation, but a cultural behavior desperately signalling a desire to be known as that orientation?
I’m not homophobic, I just find hyperactive twinks who are constantly signalling really, really obnoxious.
(Of course, not BEING gay, when I use the term Twink, clearly it means I’m homophobic, while if I were gay, the entire sentence would be valid, right?)
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Oh, I’m fairly confident that such stereotypical presentations are not inherent and are signalling.
While signalling is important is social interaction, there’s a distinct positive feedback loop in this situation leading to outrageous behavior in response to non-related input. The signalling becomes less about in-group dynamics and more about out-group division/isolation.
Wherein it’s conscious, no problems. Wherein it’s unconscious, or worse a failed understanding of in-group signalling, really obnoxious.
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See my response to Sarah below.
But yeah, sometimes “Flaming” is just a way to let people know you’re gay, but when the audience doesn’t give a shit about your sexuality, continuing to push the issue is just annoying. And when they get the impression that the ONLY feature of your personality is one’s gayness, they begin to turn off to you as a person. (At which point the defense mechanism of calling everyone homophobes kicks in, and solves exactly zero problems).
But it’s kind of sad when they think “Well, I’m gay, this is how I’m SUPPOSED to act!” when really, they’d probably be a lot happier if they dropped the act. Only they’ve integrated it so much into their identities that they can’t.
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And when they get the impression that the ONLY feature of your personality is one’s gayness, they begin to turn off to you as a person.
Yep. I suspect a lot of this is out-group division behavior. They’re trying so very hard to separate themselves and indicate how little they care about being part of any standard definitions that they’re reduced their social dynamic to the narrowest possible band. And it’s counterproductive.
But it’s kind of sad when they think “Well, I’m gay, this is how I’m SUPPOSED to act!” when really, they’d probably be a lot happier if they dropped the act. Only they’ve integrated it so much into their identities that they can’t.
And this is part of that unconscious thing, compounded by the lack of role models. I’ve read some real condemnations of Hollywood from the gay community. Not necessarily because it’s damaging an “image” but because it’s damaging people.
And you’re right, it’s sad.
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You see the same thing in Science fiction. What I call “pour epater les mundanes.
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Heh, I’m reminded of the New Orleans vampire in _Preacher_ who adopted the whole Anne Rice schtick when he was turned, and freaked out at crosses and wouldn’t go in to churches, all because he thought that was what he was supposed to do.
The “good” vampire (Cassidy) set him straight on that, though it still didn’t end well for him.
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Mauser, I think the stereotype builds the behavior as much as the behavior builds the stereotype. NOTHING drives me as nuts as a gay character back in, oh, Rome, who acts like an American gay guy.
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I know a pair of guys who have been a couple for what must be getting close to 20 years. They don’t “Present” gay like so many I would characterize as “trying too hard”, probably because they’re perfectly comfortable with themselves and their relationship.
Those who are trying too hard make everything they do into something “about” their gayness, and try to turn any topic or joke into some kind of gay double-entendre (The latest annoying trend is invoking George Takei’s “Oh my!” expression. And Jesus, George himself has really cranked it up to 11 lately.)
(The archetypical annoying twink in college I keep thinking of would repeatedly, and with no reason, sing and dance the “French Mistake” bit from Blazing Saddles as if it was the funniest joke in the world. This stood in stark contrast to another gay guy in the group was was totally mellow.)
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It’s my understanding that there was a strong element in the gay community that *wanted* to shock the “mundanes”.
Oh, it’s my understanding that this was a minority of the total gays in the US.
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And heaven help us when after 30 years, it’s not working so much any more.
I’ve heard some lamenting the growth of mainstream acceptance of gays. Kinda like what happens when your youthful rebellion is now mass marketed at Hot Topic stores.
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“Freaking the ‘danes” is one of those suicidal impulses that seem to strike a sizable portion of every group that feels outnumbered and ostracized. (Note, no requirement that anybody else give a fig. They just have to feel bullied. Yes, this does show up in many activists…..)
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It’s a fairly benign, and not infrequently rejuvenating part of social dynamics in healthy societies.
When practiced by teenagers. With a tiny bit of wiggle room in some populations in their very early 20’s. After that…
Well, after that it’s only reasonable when non-members enter into reasonably private societies of non-standard behavior. If you’re the minority outlier in a sub-cultural grouping, expect to be exposed to some shock-effect behavior. Outside of such situations? Public life/private life separations ought reasonably apply.
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You’re far more generous than I am about when that childish behavior has reached its sell-by date.
It’s a glorified version of the toddler who runs around yelling “poopie butt!” because it makes his parents freak out.
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Weeeellll…There’s a degree of rational boundary pushing and exploration that extends beyond childhood. And from these societal growth may spring, in time.
It’s worth pointing out, however, that not all “freak the mundane” activities qualify as the more mature version. Quite a few of them are toddlers running around yelling their version of “poopie butt.” No reason to cut them any slack.
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Ah, you’re including nose-tweaking, or at least some steps in that direction! That’s much more understandable.
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Yeah, there’s acting out: Childish, ridiculous, ought be mocked. And there’s finding the boundaries and conformities of your sub-group, an activity which often bothers the larger population.
Geek culture, as a for instance, frequently involves some social missteps and proud moments as intelligent and often hyperfocused individuals find where they fit and how. Occasionally where they fit involves squeezing in to new places and discomfiting the natives. Growth involves tamping down the geeky bits in general company and finding the accommodation.
Acting out, on the other hand, involves declaring your sub-group to be immune from normalizing social pressures and celebrating the proud non-conformist moment as a way of life. Those who have no desire to find the accommodation with the larger society yet want to force the larger society to accommodate them? Childish.
There’s another category, one that may be mistaken as intending to freak: Those whose lives don’t require an accommodation, and who don’t wish to force an acceptance. They’re happy on the margins and happy to be ignored. I know a lot of people in this last group.
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I’ve run into some folks who claim they’re in the last group… yet somehow their “happy to be ignored” always ends up being in grandma’s livingroom or similar. (More than can be accounted for by confusing “happy to have behavior be ignored” and “expecting it to be ignored.”)
Humans are very good at lying to themselves. :/
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Yep. Failure to understand the role model, and reverting back to acting out.
Percentage wise, I believe the last group is relatively tiny. As you say, people are adept at lying to themselves.
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How on earth would you know? Most of the “happy to be ignored” folks are going to be polite!
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True. Absent visible cultural markers likely to be obscure, if not invisible. Culturally speaking.
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Speaking of gay minorities: http://www.cdc.gov/nchs/data/nhsr/nhsr077.pdf
Seems the overall population is even smaller than I’d thought.
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What about ancient Greece? Say, Alcibiades, who carried such a torch for his buddy Socrates? Mincing across the deck of his galley outside Syracuse, with his tight, pink chiton riding inches above his knees, his sandals with the three-inch wedge heels, his cuirass cut into a genuine boob-plate and his hair well-oiled and elaborately coiffed, the great Athenian general lithpth as he callth out commandth to his phallanx of thtrapping young men in leapard-print chlamys-es (I decline to decline, tyvm). Would this not be a sight to behold?
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Don’t make me hurt you.
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How dare homosexuals not adhere to the stereotypes the Anointed have prescribed for them! If that kind if nonconformity is allowed then pretty soon women will commence to thinking for themselves instead of voting how they’re told, and next thing we know the
DarkiesAfrican-Americans will leave the Liberal Plantation and chaos will reign! All for lack of the lower orders conforming to the categories dictated for them.After all, if we start allowing people to self-define they will pretty soon become individuals and might not acknowledge the superiority of the Anointed.
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Or has a Hapsburg Lisp …
The first admitted gay guy I knew acted like one of the Gophers from Looney Tunes (his partner had already drunk himself to death by then so I know not if they were the pair) and a guy I went to school with (who did did shock me when he admitted he had gotten married and had a daughter) was slightly flaming even in school but back then wasn’t annoying (only chat with him from time to time online, so I don’t know how he acts now)
I knew a pair who were not what anyone would think of as gay. One rebuilt starters and alternators, the other I think worked in a shipyard, and they lived in a mobile home.
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I’ve long held to the theory that while homosexuality itself isn’t a mental illness, homosexual behavior is often attractive to those with mental illnesses. It allows them to shift blame for their problems from their own behaviors to “society” at large which somehow doesn’t understand them. Thus there are some who are born with a homosexual orientation, a lot of others are simply willing to engage in homosexual activity because the culture allows them to avoid treatment for other issues. Hence the reason that so much of “gay culture” portrayed in popular culture seems to resemble nothing more than personality disorders on a large scale.
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I Like Sadism, Necrophilia and Bestiality; Does That Mean I’m Flogging A Dead Horse?
(And what would the ICD-10 code for the unfortunate infection one might get from such an interaction?)
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Brain Bleach!
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F. Paul Wilson had a funny line one of his novels (IIRC The Touch). This doctor was in a government hearing on Health Care. (The politician in charge had a beef concerning doctors giving “proper” health care). After the doctor commented on the fact that he believed touching the patient helped them, the doctor chuckled and said that he expected the politician to mandate the “proper” methods of touching the patient. [Evil Grin]
Minor note, the doctor later got a true Healing Touch and the politician was the “bad guy”.
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I saw that first picture and my immediate thought was “NHS doctor or nurse?”
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How long before those ‘codes’ migrate to everyday life??? OBTW, Misha is right, my daughter is a Paramedic and they have been told to be very ‘careful’ how they classify certain injuries from alternate lifestyles… sigh
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Never classify why they got the dog bite?
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“There’s no difference in time typing macaw than dog when someone comes in for an animal bite.” Except that you have to search through the 14, 569-item list to find it. (I’m taking bets as to whether it will be organized in a compact, logical fashion. Yes, I am…)
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Exactly. there’s no difference to typing in macaw bite or dog bite and tossing the code, either.
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Sure there is. How long does it take to establish that the biter was a macaw vs a parrot, toucan, eagle, owl, “really big funny looking bird”? At least the bitee can probably identify “dog”.
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Does dog include dingo? coyote? or wolf? or do these animals have separate codes? and if they do what code do they use when you are bitten by a half-breed such as my boss’ former pet (half german shepherd, half coyote)
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bitten by half-werewolf. ;)
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What was the other half?
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Dragon. [Dragon Grin]
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In that case we’ll just classify him with the jet engine guy.
BTW, it is possible to encounter a jet engine and survive. There’s a video out there of a skittle who got sucked into a jet engine head first. His cranial (helmet) wedged in the jet’s intake, saving his life, but you can see his legs kicking out the front of the plane while everyone else runs up.
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Everything is in the intertubes, including old Navy safety vids:
http://www.youtube.com/watch?v=unXNdrtf2_g
PO Bridges on teh TR in 1991
…though I remeber the one you mention with the feet still sticking out as well, from a daylight evolution, which would have to be form before then.
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The front half we hope.
(I briefly considered the answer for the inevitable question that raises, but I figured I’d reserve it, it’s pretty outre’.)
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I am trying to muzzle one of my characters who wants to know how you would code a demon bite/attack.
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It’s a fair question.
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OMG. That would be a great opening for a story. intern trying to find right code, other intern saying it can’t be a demon bite, and then demons break in. (Um)
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Worse – gettting the wrong code for a PUFF application and having to go back through everything to sort out that instead of minor abyssal creature (DVL13.666:2xd), your secretary had applied for PUFF on a two-meter tall office-based were-hamster (DVL12.666:2xd).
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Hey, I am Exempt!
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You’re a were-hamster?
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he’s a vampire.
I’ve been worrying about my puff status lately.
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:) I knew about the vampire part, but I haven’t been sure if it is possible to be several things at the same time. Would a vampire who can transform into a hamster still be just a vampire, considering they usually transform only to bats and maybe wolves?
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I think they can become rats too. If he turns into a hamster instead then I’d guess his bat and wolf forms more closely resemble a sugar glider and a Bichon Frise:-D.
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Ouch…
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/gigglesnort
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It depends where the demon bites you
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The response I just got from that character: In the woods, I was out camping. (she’s being deliberately obtuse.)
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Blackflies are notably associated with demons, and they like to bite. Running into Beelzebub in Canada in the woods in summer might be an unhappy experience. Unless St. Anthony the Abbot is running some kind of demon-ignoring business up there.
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We have a photo of the back of my younger sister’s neck somewhere, just to prove you really can have that many blackfly bites in that small an area.
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A giant blackfly – or maybe a giant mosquito. A swarm of giant… Let’s say mosquitoes, and they are not giant giant as mansized, but just Permian dragonfly sized, and there is a swarm, and you get sucked and stabbed to death. Or if other insects, bitten and eaten, and maybe end with eggs inserted too, ready to hatch while you are still alive.
Okay, that would be demonic enough.
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Sulfur Crested Cockatoos can do some nasty damage with bites
hmm.. I’ve been bit by a seagull once (stole my yellow perch while it was being reeled in on the fishing line and got hooked in the tongue) that was a pretty good scar for many years
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And if medical personnel are clear and concise in their descriptions, the codes are not needed by anyone trying to do quantitative analysis, as the data can be scanned for the words, and analyzed without benefit of the codes.
Believe me on this – I analyze online ad data which is identified in a multiplicity of ways, and has to be sliced, diced, and julienned in order to categorize everything for our purposes.
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You gotta remember, once upon a time an epidemiologist said “Wouldn’t it be great if…”
20 years later the bureaucracy caught up with the idea. With 30 year old implementation.
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These codes go WAY back to where semantic analysis was way too expensive and you couldn’t offshore the translation of the case notes because there was no offshoring.
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Imagine the chaos if it weren’t possible to determine the injury rate from macaws vs. dogs vs. rabbits. Without that data, how would a bureaucrat know how to run your life?
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I’m guessing the hickey code is for teenagers who don’t want to admit that they snuck out to be with a significant other, and so they have to pretend something is horribly wrong when their parents notice the hickey.
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Or a bureaucrat who’s significant other caught him/her/whatever cheating . . .
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True story: a few years back, when I was working at the bookstore, one of my female coworkers came in one morning with what seemed to be a bruise on her neck. Not thinking, I asked, “What happened to your neck?”
She turned so RED.
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“Pit bulls are dangerous!” “No, check by the specific codes. It’s Macaws! Those hideous birds are giving the entire animal kingdom a bad name!”
So . . . when we go to the doctor, we can say “That’s between me and my fictional character. And I don’t want my husband to hear about it! My sex life is private!” “But, but fictional . . . ” “You realityist! You should be ashamed to be so judgemental!”
So the doc calls for the men with the wrap around white coats . . .
I’ll have to study these codes, and find ones to suggest to the doctor. She will not appreciate it.
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I wish we could laugh. We are in the middle of diagnostic testing right now. Maybe in a year or two.
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See, the real secret is this is the Schenectady Story Idea factory made searchable. We all need to come up with stories based on one or more of these codes (and put the diagnosis code in the Author Comments for extra fun.) I am thinking Suicide by Jellyfish needs to be a story.
This reminds me of one of my favorite old books, The ABC Telegraph Code (1916 edition). It had codes for all sorts of amazing eventualities, so you could send a cheap 6 character telegram from Shanghai to corp headquarters that translated to “ship damaged in storm, 6 sheep washed overboard, captain arrested for littering, send money.” Really.
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Oh, we TOTALLY should.
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New anthology coming from NRP!
Only question: who has the time for the editing?
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I think you just volunteered, son
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That’s a hard lesson to learn.
No, not learning to edit an antho, put together covers, metadata, submission work, and actually choosing the bleeding stories. Nope. That’s easy. I’m talking about learning not to open my fool yap. Add it to the pile, I suppose. At this rate, I’ll be through it when Wee Dave is old enough to start college.
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You can call it “I’ve Got a Code in My Nose.”
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Someone forgot the real meaning of NAVY: Never Again Volunteer Yourself.
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So, can we pick our favorites or do we do get the codes roulette style?
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And suddenly I’m reminded of the Comedian’s Retirement Home joke, where they all rattled off joke numbers instead of the actual jokes since they all knew them all so well.
So one old guy would shout out “47!” and the other comedians would all laugh, “Oh, that’s a classic! How about 72?” and so on.
The young son of a comedian was visiting and observed this, and he thought he’d give it a try. “28,” he said.
Crickets.
“What’s wrong? Is that a bad joke?”
His old man turned to him and said “The joke is fine, but your timing is terrible.”
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The version I heard ended in “Some people just can’t tell a joke.”
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True story… my dad brings my mom to his little home town for the first time. Back then the community was still functionally bilingual, at least if you were an old coot since my Dad’s generation never learned. So he took my mom to the main street cafe for a milkshake or something and the old farmers sitting behind them were joking and my Dad started to laugh at a punchline. Mom is all… “But Si, I thought you said you didn’t speak Norwegian?” “I don’t,” he said, “but I’ve heard that one before.”
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I heard the punchline as the entire place going nuts laughing, and the kid asking, “Why the reaction?” and was told, “”They’ve never heard that one before”
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Actually, there are ways to get sucked into a jet and survive. (A few navy folk have survived the experience) but it depends on the design. Other designs, you are right … Will it blend? yes, yes it will.
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Yes, Dorothy told me of someone who survived, but how often does that happen? A whole code? This is what I mean by this form of insanity.
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and most of your survivors are going to be military and not dealing with 0care … unless they plan to extend it to the Nimitz, and the G.H.W. Bush
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Honestly, half of these made me go “TURN OFF THE CARTOONS.”
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sadly. I doubt they watch ‘toons, as they have no sense of humour and would be more likely to spend the time attempting to regulate what we see … oh, wait … the effin’ killjoys have already done that
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Alas, the military uses the ICD-9, as well.
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ICD is “International…”
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I am sure there is a code for “foreign objects up rectum” but I can’t determine whether a bureaucrat’s head is a foreign object in that context. There are bound to be many a “subsequent encounter” so they best make a determination.
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That would be the non-billable code. The more detailed codes indicate what the foreign object(s) are, how many, and how they got their in the first place. “hamster, deceased, in rectum, patient sat on it” (I fully expect someone to search the codes and tell me this is true).
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Wouldn’t said bureaucrat’s head only be a foreign object if his or her citizenship was with another country.
Domestic object up rectum is probably a different code. Qualified as to whether it is a recurring or continuing event.
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icd9 937 Foreign body in anus and rectum
icd10:
Foreign body
|-alimentary tract T18.9
|-anus T18.5
|-rectosigmoid (junction) T18.5
|-rectum T18.5
Subsequent encounter is T18.5XXD and sequela is XXS. XXX is not given a name.
Oh, and OB Pop Culture Reference:
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Injury due to other encounter with cow. Obviously the person wondering why this code is needed, since there are already codes for being bitten and kicked by cows, has never dealt with cows. I would venture to guess the most common injury dealt out by cows is, squeezed between cow and immovable object. Cows tend to see how much they can compress others with their shoulders, hips, etc., then of course you have, stepped on by cow (also a habit cows seem very fond of), shoved off of drop-off by cow, shoved into barb wire by cow, head butted by cow, gored by cow, kneeled on by cow subsequently to any of the above or simply while attempting to work on injured cow, also laid on by cow, see same as kneeled on.
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This is why I decided to sell the lovely little Jersey heifer I bottle-raised. At eight months old I was already seeing the potential for serious injury from her. I’m sticking with my goats. They can cause injuries, too, but they don’t weigh almost half a ton!
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Paraphrasing my parents:
there will not be a known tries-to-hurt-people cow in a herd that they manage any longer than absolutely required, because cows can hurt people just fine by total accident.
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Of course, if a person got rid of every “step on your foot on purpose” cow or every “step sideways and squash you against something” cow, you wouldn’t have any cows left.
We had two that would coordinate… they’d each take one step sideways and squish you between them.
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Yeah, I noticed that. Real lack of imagination and familiarity. Maybe they’ll change in in the ICD-11 when most of the codes come back “Other contact with cow.”
And they probably don’t want the cattle and dairy industry getting a hold of the billing. Few folks around there are going to be interested in having “other contact with cow” in their medical records…
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Ever read “All Creatures Great and Small” (and its sequels) by James Herriot? You learn a lot about the ways one can be injured by cows… :)
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Loved that series. I re-read them occasionally.
My mom (who was a farm girl) started me on them when I was young. Then she’d pick stories in the book and talk about when that happened to her or her siblings.
Oddly, I was never inclined to test my mom’s strength…
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Yep, read them as a young kid, and then reread some around high school. Should really read them again some time.
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I once read a biography of the author, Alfred Wight. They had some oddball laws in England about vets not profiting from publicity or something, so he had to anonymize his stories and publish under a pseudonym (of a cricketer, actually.) So a lot of the details are wrong but the overall sense is right (such as his wife’s parents BOTH being alive and well when they married.) The author included some early snippets of his writing, and he really had to learn to tune his humor.
I guess those books fall under the category of “semi-history”, kind of like the Little House books. Love them, almost literally to pieces (I’ll have to get new copies for my kids when they’re old enough.)
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I wouldn’t use them as veterinary medicine guides, but as stories about animals and their owners? Priceless. (Tricky-woo used to live on my parents’ block and his owner used the same vet we did.)
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Having spent a quarter century in federal civil service I can say with some confidence that the people responsible for this code table are quite proud of their efforts and I suspect several got substantial bonuses for their hard work and the completion of their task.
Their world is so divorced from our reality that they will never see how totally ridiculous and disfunctional their product really is.
Lord, I am so glad to be well and truly out of that mess.
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And it seems that http://www.icd10data.com/ is where you get to search for the code of your choice.
Sadly no hits for lion (other than sea lion) so apparently if you are bitten by a lion and survive the treatment is not billable…
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What? No http://www.id10tdata.com?
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That sounds like a great place to host a parody site of the real one :) And yes indeed it would seem it is available for purchase
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That was my question. ID10(t) has the greatest permeation potentiality, surpassing that of Helium. It gets everywhere.
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No emu or ostrich but there is a llama code.
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You’re probably required to cross-code ostriches as cattle.
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While this is a hilarious list – did you find the alien encounter code yet? – the reality is that the costs of mandating that the entire US healthcare and healthcare insurance industries convert to this list have been massive to no benefit. Obamacare in a microcosm.
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I know.
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Gawd – we were told a lab test my hubby needed was denied. We where gobsmacked (I wanted to do some gobsmacking of my own with a heavy object).
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I was told I couldn’t have ultra violet for eczema, because we hadn’t tried everything else. Yes, we had but my doctor did it and didn’t have the codes.
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This — this is the sort of thing that really frustrates me in the current medical trends (it was happening before Obama stuck a fleshy cylinder into healthcare, it’s just going to be worse now).
Algorithmic medicine. Useful for diagnosing cars.
There is a very real value in the combined experience of a medical team, and the ability to bypass portions of the decision tree through an aggregate analysis of the patient and condition that will not fit on the color-coded f@^&ing chart!!
Algorithms have their place. That place is not sitting between the medical team and the patient.
For those not familiar, just imagine your medical team working through the typical robotic decision tree, say — an automated phone system. And being required to hit each level on the tree.
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Is your patient plugged in? Are you sure your patient is on? Have you tried rebooting your patient? Have you taken all the latest patches for your patient?…
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I believe that particular decision tree is called “cardiology.”
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Back in 2010 I took a “Trauma Care Under Fire” class (gotta love a first aid class that as part of the supplies includes 500 rounds of ammunition).
Pretty much the opening of hte class the instructor dispense with the “normal” analysis of the patient thusly:
“You don’t have to look for live wires, you don’t have to shake him and see if he’s ok. You heard a sharp crack, or an explosion. He fell down. It’s probably not a heart attack.”
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Reasonable and rational advice.
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There was an episode of the TV show “Emergency” (about para-medics) where they were dealing with a former Army medic. He wasn’t listening to the doctors (on the other end of the radio) because he *knew* the patients problems. Unfortunately, there was a case where he *knew* it was a heroin over-dose when in fact the patient was diabetic. Fortunately, he was stopped and to be fair when he learn the patient’s real problem, he was shocked about what he almost did.
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Yea – my sense of humor is not surviving this newest foray into medical. I haven’t slept well in days. So I wish I could laugh GAWD I wish. At the very least please wish us luck.
Oh yes– and if you don’t use the code, it never happened–right?
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We will pray.
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Seconded.
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Thank you very much.
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A test documented is a test completed.
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Best of luck. Did the doctor’s office speak directly to the insurance company to be sure there wasn’t a miscommunication? If not, it can’t hurt to call them and at least ask why.
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Yes – see– Medicare.
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Medicaid denied my MIL a transfusion the doctor ordered, because it wasn’t part of the approved treatment for menstrual bleeding (even though she had something REALLY wrong and needed the blood). I got on the phone and read somebody the riot act and they decided that it would be ok.
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We get insurance through my husband’s job, and since that’s federal we thus get all the “interesting” new e-record stuff….
When I went in four months pregnant, they coded it as “irregular cycle– no menstruation.”
Thankfully, I can put in notes.
“DISPUTED– menstruation while in second trimester is generally bad, see: (birth of daughter, five months later).”
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yea – ugh
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And god forbit someone typo in the wrong code so that you are reported to be suffering from, say, herpes instead. Then the entire treatment plan gets disallowed because it’s the not approved for that disease
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Ouch
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As discussed above, 18.5 is foreign object in Rectum. 17.5 is Foreign body in bronchus.
There’s a joke about one slip of the tongue…
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This is not as harmless or funny as it looks. Everything MUST have a code, so that everything can be regulated…and restricted.
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TRUST ME, I KNOW.
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Interesting what isn’t there. No listing for leshmaniasis (sandfly lesions) except as “sandfly fever” which seems to include Dengue as well.
When you have a disease you can’t code, it is going to be hard to treat it.
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This takes us into the realm of Obamacare “Death Panels” where bureaucrats effectively practice medicine — is the attending physician adhering to prescribed standards of care? — by removing treatment plans from physician hands. This enables administrative denial of care by pettifogging, foot-dragging and procedural roadblocks without awkward confrontation with patients and/or their family members.
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But… this doesn’t even make sense for classifying stuff.
The way to make it make sense would be to have some basic classifications, like….
type of injury — Abrasion, Crushing, Cutting, basic ways things happen to cause injury
then
causes (human, animal, machine, unknown)
then
places, like home, work, recreation, shopping, Other
then
(whatever other major details are important)
Put all the classifications that go into an “incident,” and then have a basic write-up.
You want an alphabet, not pictograms.
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Unless the purpose was creating a database to feed regulatory agencies with justifications for further regulations. Its not for doctors’ convenience obviously….
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yep. exactly.
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This is the consequence of giving the epidemiologists run of the joint. They got tired of having to manually examine and classify medical records for analysis, so we started coding. Like every other field of population analysis, they need new and more specific categories to examine in order to justify their daily wage. And they see no reason the point of service can’t go ahead and divide up this info for ’em, then the epidemiologists can just import to their fancy computer models and go play!
Looked at another way, the collective data studied by epidemiologists is being given priority of consideration over the individual patient encounter. Anybody who doesn’t think this is so has not watched how much of a doctor’s time in each “patient encounter” is spent sorting through screens on a computer.
The real coup, of course, was when the epidemiologists teamed up with the accountants in the billing department…
Caveat, general, 1 each: Epidemiology is an important field, and fantastically important information has arisen from this field. I’ve got nothing against epidemiologists. When they’re doing epidemiology and not gettin’ in the middle of medical care.
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But with the doctor doing the coding, that leaves less for the epidemiologist to find. They can’t detect a NEW trend if there is no code for it.
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See my comment above about searching text (using a computer) to do codifying, instead of up front. Someone who had the time to do the work could probably make a killing doing medical data analysis.
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Closing the circle, see my comment above to your comment above. (delivered prior to this round of comments.)
This is fun!
:D
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No! Not a recursive comment thread! AGHGHGH!!!
:-)
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‘Round here? Couldn’t happen.
:twisted:
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*to the harmony to “Ezekiel saw da Wheel”* Thread in a thread in a thread in a thread, oh thread in a thread in a thread in a thread.
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It probably started off like that.
And then the OCD and the Bureaucrats got involved.
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Alternatively it’s the “International”, so it could have started off as a reasonable way to code stuff across cultures. Strep throat might be something (poision wind?) in Chinese, but underneath it’s a streptococcus infection in the back of the throat. One code to rule them all etc. etc.
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Sooner rather than later you will be required to carry ID that has these codes programmed right into, like the codes on your drivers license, so that cops and bureaucrats know how to most effectively harass and abuse you.
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I’m being discriminated against. There’s no code for my favorite fetish. I mean, please, bitch, do I look like a common ICD-10-CM F65.0 to you?!
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^This^ made me laugh.
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.1?
An Uncomon F65.0?
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“The specificity of the codes helps to track public health hazards that could occur in pockets due to particular services, vendors, products, or even the pet de la mode. Interestingly, the US pioneered injury coding , changing our ICD-9 version to include causes of injury. Clearly the WHO ran with it in ICD-10.”
I am reminded of an incident that happened bout 30 years ago.
My mom was holding one of our cats and got clawed in the face. Dad took her to that base hospital. When they arrived, she was holding a towel to her mouth, trying to staunch the bleeding. The Airman doing admittance was so focused on his animal bite forms, making sure that he got the kind of animal right, that he let my mother sit there, bleeding, for several minutes. My dad finally got fed up and told the airman he could tear up the form (I’m sure he wanted to add cram it) that he was taking his wife some place where she could be properly treated, then he would be filing a complaint with the base hospital. At which point he got Mom out her chair and started for the exit. Before they got to the parking lot a sergeant came out, calling them back. Of course, then they wanted to treat it as a scratch and just but a bandage on it. Turns out, the scratch was so deep it nearly slit her lip in half. It took surgical glue and several steri strips to close the wound. [my memory is kind of fuzzy now, but I don’t think she had stitches.] In the end, Mom had a scar on her lip for the rest of her life, but because they finally got someone (a surgeon I think) to look at her, it wasn’t as bad as it could have been.
The point is that the airman was so focused on his forms that he let someone sit there, bleeding, in pain. It took threat of legal action to motivate someone to do their real job – helping people.
This (and other similar incidents with Air Force aka Military medicine) is what I think of when people start talking about state run medical care, and this ACA.
[oh, by the way, no nothing happened to the cat. It was an accident. Mom came home and loved on him to let him know that she was not angry and that she was okay.)
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Military medicine for all it’s faults (there’s a list) is simply overbureacratized and is still subject to end result analysis. Degrading the effectiveness of the force through bad medicine gets noticed.
The ACA is worlds worse.
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Dad got excellent care. But you’d expect that considering that his was an officer and his job put in the cockpit of a B-52 – during the height of the cold war. He had access to the cream of the crop, called a Flight Surgeon. It was his dependents that got the short end of the stick. We weren’t high enough on the food chain to warrant that kind of care.
Nah, no hard feeling at all. I just wish I knew what happened to my ped records that vanished between bases – everyone else’s records arrived fine.
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Don’t forget that the guys who take custody of your records when there’s suspicion of malpractice are likely to have conflicts of interest (friend, classmate, former co-worker) of the guy who screwed up, if it’s not the actual person who did the malpractice.
A friend’s prescription for steroids to treat some kind of an infection had a decimal moved over, and it induced a heart attack. The doctor who treated him for it was a friend of the one who screwed up… and removed that page of the medical record, then diagnosed it as a “panic attack.” (The on-site reports from him having it in the steak joint on base were also disappeared. Panic attacks don’t generally cause the heart to actually stop…..)
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And that sergeant almost certainly caught no end of flak for not filling out the proper forms in the proper order. (Well, perhaps not 30 years ago. Now, certainly.) Not excusing the neglect, by any stretch of the imagination, simply noting that with bureacracy, people are that unfortunate portion of reality that seem to think the bureaucracy – and the bureaucrat – exist for their benefit. Foolish peons that they are, they don’t realize the true nature of their existence is for the bureacracy – and by extension, the bureacrat – to have something to hold power over.
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Our late lamented Petronius tore my wrist vein open once — my fault. I forgot he had a terror of the carpet cleaner, and he was scared and in pain (minor injury) and I carried him past it.
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For a while I looked like a cutter (before they became a trend) because Rowen the Strange had gotten me with both hind feet when something surprised him. Eight parallel scars right across the vein.
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Is that an American Curl in your avatar? I notice the ears seem to curl out.
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Not exactly. It’s a Mokave jag, or jaguar-cat, one of the newer wild-looking specialty breeds. Our Esteemed Hostess thought my maroon bluebonnet looked like a space monster, so I hunted around for something “mostly harmless.” Mostly.
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I’ve never heard of that one. I’ll have to look it up. The pic is cute. :-)
I’ve lost track of all the scars I acquired from our cats over the years. ;-) Aroused studs, playful kittens, to just panicked cats, I’ve run into all of them. Mom’s cut was by far the worst of the cat related injuries though.
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I thought they were lupins. Sorry.
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You were right. Bluebonnets are a type of lupine. (Lupinus texensis). The one I had was L. texensis Aggius.
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I admit to occasionally singing the Dennis Moore song on seeing your avatar. Now I only have to feel mildly ashamed for doing it, and not for misidentifying the flower.
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We spent Thursday morning in the ER. The lady asked us to wait (only about 10 minutes… it wasn’t busy) and brought us in and my husband sat down on the chair and she said “let’s get you signed in, what is your… ” she looked up, “Excuse me, are you having chest pain?” Husband moans and nods his head as he’s got his arms crossed in front of his chest and his hands in a death-grip on the blanket around his shoulders. She stands up, “You need to tell us if it’s chest pain, lets go this way your wife… wife, right?… she’ll sign you in.” And zip, he was gone.
It wasn’t his heart. It probably was acid reflux or something (which we sort of figured it was which was why we weren’t freaking out as soon as we got there) but he was in so much pain we had to go in and be sure. Everyone was very nice, but wow does the ER suck.
We did the military thing, too, and he had both really bad care… put him on quarters over and over and over again but never got him a CT scan of his back or sent him to any sort of real doctor… in fact, he was told… “I can’t put you on quarters again in a row because if I do I have to put you in the hospital, so here’s some pain meds.” When we were on leave prior to a PCS to Clark we were far enough away from any military hospital that the military would pay for going to a local doctor… he got the images of his back, walked into his new duty station and handed them to the doctor. Clark Air Base had a neurosurgeon on staff and they admitted him the next day.
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I will be fair… he probably could have gotten his back seen by the dummies who were refusing to send him to specialists had he insisted on it… but he was a young man and the doctors really did try to discourage complaining and you’re conditioned not to make a stink. Even as a not-so-young-man he rates his pain a couple of numbers lower than it is.
I told the ER nurse that he was doing that and she nodded because they know. She said they’ll get people in the ER chatting away and texting on their phone and ask them to rate their pain between 0 and 9 and they’ll interrupt their chattering to say, “Oh, it’s about an 8.”
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“to rate their pain between 0 and 9”
With my first child, they had the chart listed with the top number being “the worst pain you can imagine.” I told them I could imagine quite a LOT, and I don’t think I went above a seven based on that.
You read fantasy and history, and sooner or later you get an idea of how much pain someone can put someone else through…
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in ’05 I had some abdominal pain for over a week, and finally walked into an ER.
Asked to rate my pain “Bad enough to walk in here with a low paying job, no insurance and willing to pay what ever to get it to stop.”
Gastroenteritis was the diagnosis and I ended up paying for the ER, the Doc, an MRI and a ton of antibiotics.
Oh, and how does an ER treat a possible Troglodyte (what they called folks with no insurance and not going pay in New Orleans)? “Do you have $150 dollars or do we get a social worker in and take 10 minutes longer for the doc to see you?” I joked “what, no threats to toss me out in the street?” I paid and the Doc was in before the nurse returned with my receipt. I still ended up waiting for some time… they fed me the chalky garp for the MRI and waited for it to go to all the right places.
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Twice I’ve been told I couldn’t really be (whatever) because I wasn’t acting like I was (whatever.)
Once when I walked in to emergency under my own power with a blood ox of sixty five. They were sure I should be passed out if not dead.
Next when Marshall was crowned an hour and a half after I entered the hospital. I couldn’t be that far gone, said the nurse from the door, because I was discussing a book with my husband. Then she took a look and ran to call the doctor.
Bragging? Oh, heck no. what I know is that there’s something wrong with how I perceive things. Two people in my family just escaped death because the early heart attack knocked them out enough to go to emergency.
I suspect I’ll die in my tracks like my great grandmother, who cooked for an entire family, saw them out the door, cleaned the kitchen, then dropped without a sound, and was dead.
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I broke my shoulder and got driven to the ER by a co-worker. After the CAT and inspection by the on-duty MD they sent me home with a sling, they’d have the x-rays read and they’d schedule me for what they needed. A week later I went back to work to clean out my desk (I’d got my lay-off notice before the injury) and showed off the x-rays of the 6 pins they put in to stabilize the pieces to heal. The guy who drove me to the ER was aghast, he said he had no idea I was so badly injured. I just told him that I had things to get done before I could stop and hurt.
I’m not tough. I work in an office after all. I am stubborn.
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Yeah, I’m stubborn as heck too.
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When my brother wrecked his motorcycle, he landed in a field and broke his collarbone. He got up, walked something like a mile to a friend’s house, and got them to drive him to the hospital. He told the doctor there that he had broken his collarbone, and the doctor contemptuously asked how he could possibly know that, and he pointed to the place where his collarbone should be and said, “Feel it right there. It’s gone.”
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I knew a guy (business partner of a friend) who fell timber for a living. He had a widowmaker (dead tree top) come out one day and hit him in the shoulder. He went on working, but three days later he finally told his partner, “I’m going to have to go to the doctor and get my shoulder checked out. Every time I pull on the saw to start it, it hurts so bad I almost pee my pants.”
Yeah, he had a broken collarbone, and broken bad enough they had to put half a dozen pins in it.
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Friend of the family’s an ER doc and has gotten used to old ranchers coming in with broken limbs after they finish their work. he asked one gent, who had broken his leg, splinted it with a fencepost, finished fixing the fence, and then drove himself to town, why he waited to come in. “Because I needed to fix the fence.”
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Well yeah, it is a lot less hassle to fix the fence with a broken leg, than it is to drive to town and get the leg fixed. Then come back on crutches and round up the cows that got out, Then fix the fence while on crutches.
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When the fence needs fixin’, it needs fixin’ right bloody now often enough. Cattle, horses, and in-laws have no concept of patience, ya know!
*grin*
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My aunt (by marriage into the family) once told me that she had been unable to lift her left hand above her shoulder for most of her life because she had injured it when she was about ten or so – she had been working for their neighbor, had fallen and hit her shoulder while carrying something heavy, had finished her job and gone home. And then gone back to work the next day. Of course she had told her parents but it would have been several hours to the nearest doctor, and they were pretty poor. So nothing was done, then or never afterwards. She just got used to working with a gimpy shoulder.
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Um, yeeeaaaah, we’d like to avoid that. At least any time in the near future, “near” being defined as +/- 60 years, tyvm.
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My Aunt in N.O. had surgery on the roof of her mouth and they prescribed a rather heavy dose of Demerol … several hours later, she was still complaining it hurt a bit too much, and then the dental surgeon called to check on her … “What? She’s coherent? … She can TALK?” he chatted with her for a minute and called his Professor (dental school ) who also called and talked to her…they doubled the dose and she said that dulled it enough to likely get to sleep, but she was still hurting, they were amazed she could even talk with all that demerol in her. But she once was a heroin addict, and then methadone (gov’t sponsored addiction she quit cold turkey) and that affects how you handle other drugs.
I’ve had plenty of co-workers who took a day off because they “hurt” for some reason. If I took a day off every time I hurt I’d never work. Now, I have missed work due to random pain … but I stand all day on concrete, and I have had hips or knees that had decided they just were not going to support me that day. Recently it was my upper back (luckily I do not have lower back issues) but I really missed because it caused me to be unable to dress, as my work load that day was not high enough for the pain to stop me … and I probably didn’t need to be riding a bike to work like that, so I would have had to **gasp** drive my truck in. The hips and back are the big work killers, the knees I can toss on some braces and get by most of the time. Elations drinks work great too btw (I’m too far gone for Joint Juice to work well anymore)
Arthritis really sucks
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I have a sister-in-law who has something that’s called, in part, persistent anemia (with no direct cause; they’ve tried to figure it out for years.) Apparently, the first time they figured out that her iron levels were low, they looked at her numbers, looked at her sitting calmly in her chair, and said, somewhat awed, “with those numbers, you should be dead.” She has to do a type of chemotherapy where they put iron sludge directly in her bloodstream on a regular basis.
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http://xkcd.com/883/
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Yes, exactly. :)
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This young lady didn’t think the pain scale was good enough:
http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html
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This will need to be printed out.
Yes.
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I’ve been having killing pains from heart burn that paralyze my left arm. It happens.
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I can’t describe how much pain he was in.
There are all sorts of things that hurt worse than child-birth and it seems like he gets all of them. :(
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TRUST me, I know how much pain he’s in. if I eat anything fried at night I get it.
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Antiacids. Seriously. That acid can do serious damage, up to and including increasing chance of cancer
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Me, too, and with Sean still in the hospital, I’m sitting at about a 6 on the scale most of the time right now.
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I was told in the ER that I couldn’t have strep because I’d had my tonsils out so I probably had a blood clot in my lung but since I didn’t have insurance, they weren’t going to check because it was expensive. I was there because I was vomiting from dehydration and I was pretty sure I had strep. My mom had driven me in and lost her shit when she heard what they said.
A bag of IV fluid and a new doctor later, it was confirmed I had strep. One of the nurses managed to talk my mom off the ceiling.
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I had one doc give me meds that made my throat more sore than the Strep. After getting an extension of the prescript after going back because the pain was not going away, I finally had enough and walked into a Ear Nose Throat specialist. After he looked at me and looked at my ‘script, he cursed, had me take a free bottle of something for the throat pain, a few pills of an antibiotic … He figured the strep was either gone, or not ever there but best be sure and this stuff would otherwise be harmless (but I should eat some “real yogurt”), and told me to not go back to that guy. He explained the meds were a decent antibiotic, but were not good on strep and a side effect was a raw throat and aggravation of GERD …
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At a civilian “urgent care” facility in Palo Alto, CA I watched a woman dressed in horse clothes come in with a pretty bloody towel wrapped around her hand. The receptionist checked her in, and had her sit down.
WIth the towel.
Dripping.
I was offended.
(and yes, I gave her some Kerlix from my kit I carry with me. It wasn’t bad enough for the IBD or the tourniquet)
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On the other hand, I have no complaints on how our “urgent care” facility handled Mom. After she had fell while I was trying to get her into the car (to go to her adult daycare), I took her to the urgent care facility. I thought it was a mini-stroke but it turned out to be a heart attack. Those people got her taken care of fast (including getting her to the hospital). Now it could have partially because one of the doctors had to help me get her into a wheel chair but still….
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There had better be something in there for pissed off Snow Geese attacks. Those things dive bomb, like flying harpy tire irons. Also, squirrels that steal peanut butter, there should be a law.
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Put the peanut butter on a rat trap, problem solved, no law necessary.
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Call it “Third Shift in the Waiting Room of Good and Evil”
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Yes please. :)
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Reminds me of military life, especially of imagery reporting. We used to have fun with newbies fresh out of tech training, having them search an image for a B (one) RD, telling them that it may be camouflaged. Most caught on fairly quickly, but one guy NEVER DID get it, even when it was explained to him. I can see doctor jokes growing out of this new code book. Some of them will be funny to everyone, but a few will always be insider jokes.
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When I was in, a friend of mine was hazing a new medic on his floor one night, and sent her to the lab because they were out of Fallopian tubes. I was on duty, and when she asked for some I told her that she had more than I did.
She was cute, though, so I helped her get back at my friend. I made up a fake specimen and had her tell him that she didn’t see anyone in the lab, but she found this…
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Had a Staff Sergeant come into supply looking for a can of beep for the horn. No, really.
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I’m too dense for that one to work on me. I’d stand there looking at the guy who told me to get it, with my head tilted to the side, confused, going, “What, you mean like a can of air?”
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We used to send all the new chain men down to the saw shop as soon as they got their first plumb bob… to get it calibrated.
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One of them the guy down at the shop took the plumb bob in the back, came back in a few minutes and returned it. Printed out a receipt and told the kid that the first time on a new plumb bob is free, if he had to bring it back to be recalibrated it would be $X.
This invariably worked on the summer help, college kids, that were hired. But I can never recall anybody becoming permanent that fell for it. Not sure if that was because those looking for a permanent manual labor job like that had used a plumb bob long before they graduated high school, (or at least before they turned 18) or if to be good enough to be hired permanent you needed enough common sense to realize that gravity does a pretty dang good job of calibrating.
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I guess I never worked with any creative pranksters. Most of the stories I heard involved sending the new guy for a left-handed wrench or a metal stretcher.
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I tended to really piss off the “pranksters,” because when they’d send the new guy up to waste the calibration shop’s time I’d have them sit down, in the nice air conditioned room, they’d have a cup of coffee, and when enough time was wasted they’d go back.
I have very little use for these “pranks” because I notice that if you do not “fall” for them, things get nasty– there’s also the problem of where they waste my time and their supposedly so desperately needed labor. F that for a lark.
If some shop was actually over manned and such? Sure, fine, screw with someone who isn’t busy, but don’t send the guy your chief went to the captain screaming for off on dumb work to the shop that actually is at about one third of required manning.
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Thing is, with an E1 or an E2, yeah, it’s just harassment.
This was an E6. Someone who had been in that field for at least 10, and probably closer to 12 or 15 years.
He SHOULD have known better, and it wasn’t INTENDED to be a f*k with the new guy. The remark was tossed off as a joke. He took it seriously.
He was a blooming idiot. One of the people for whom “Muscles Are Required, Intelligence Not Experienced” was created for.
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Now THAT one I would have realized was a put-on, but depending on the day, might have gone along with the joke.
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One of John Ringo’s characters knew what was being attempted and played along to the embarrassment of the person who attempted the joke. [Evil Grin]
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Codes help with building statistics. If you want to try to determine when exactly squirrels began to rise up against their oppressors, you don’t want to do a database search of multiple comment fields, hoping that the caregiver correctly spelled squirrel, when a simple code sorts things nicely.
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Exactly — without the specificity and immediate access to data compilation enabled by the codes, how will we be able to distinguish between the actual Rodent Liberation Front uprising and a mere feint?
Sure, somebody might notice a drop in Gauloises availability, but do we want to rely on so indirect a measure?
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Zarene, who was just at the register, said to tell Elise how much she loved “A Fatal Stain.”
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Oh? Thank you.
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This fails to address the most serious problem of the new health care regime: rampant discrimination!
“Gender” being a social construct we cannot have true equality until ALL Americans are entitled to the full range of health treatment & therapy, without regard to irrelevant, oppressive and arbitrary exclusions arising from stereotyping. Until ALL Americans can receive hysterectomies and prostrate exams, can be prescribed birth control pills and ED therapies without regard to artificially imposed stereotypes then the promise of the American Dream will remain unfulfilled.
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I told her to check occasionally for “A Deadly Paws.”
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“A jet engine is a blender. A really large blender. With fire in it. If you get sucked into it, you’re not going to need a code. You’re going to need a coffin.”
Surely an urn would suffice once you are thoroughly pureed.
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only sometimes. much of the time you stall out the turbine and the thing stops before a full mince
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Got to see the engine of one of the RF-4s that sucked in an albatross while I was in Vietnam. Pieces made it through the first three sets of blades before the pilot could shut down the engine. One whole wing was still visible. They sent the engine back to San Francisco in a ConEx box, bird and all. I’d hate to have been on the receiving end. Both the pilot and the RSO were ok, but the plane was a total write-off. Pieces of turbine blades were everywhere.
We used to do a chore called a “FOD Walk” along the active runway from time to time, looking for anything that might be sucked into a jet engine. Something as small as a screw, sucked into a jet engine, can do thousands of dollars’ worth of damage. The flight safety people would show us photos of things embedded in turbine blades – everything from wrenches to nuts and bolts to one photo of a quarter, embedded halfway through a turbine blade.
The military is constantly making up codes to define different things. They never got around to breaking out the “FOD” (foreign object damage) code into specifics, but there was a place to write a comment describing what caused the damage. I think the doctors are trying to get too specific, and should back down a little. Computer programs these days could accommodate writing in the type of animal that bit someone, under a base code of “animal bite”. Getting specific only clutters up your database.
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I worked at an FBO and had to do the FOD walk from time to time.
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I think people today are getting wasteful of space because they can. There’s so much storage and so much computing power available today that you can store and do correlations of billions of records in minutes on a good system, so people don’t try to be efficient of space and computing power.
I know there are older computer people here, meaning that they won’t be particularly impressed, but when I was going to college, we had whole semester courses dedicated to how to design data structures to save space and processing time. Now, I doubt if much is dedicated to that at all.
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You’re right. Medical records are tiny, which is one less reason to code them. There are still large data sets, but the medical records of everyone in the country is not one of them.
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I’ve seen medical records for 5 year olds that aren’t quite “big data”, but let’s just say that the text alone wouldn’t fit on a CD. And that’s one kid in one mid sized hospital.
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Are you sure about that? How many feet thick was the file?
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Three or four folders. Probably 18 or 20 inches?
Yeah, those were some sick kids. It was a teaching and research hospital, so we got some bad ones. Kids with flippers, kids in bubbles, that kind of thing.
Yeah, probably doing the math it wouldn’t quite be a CD full, but in a country of 300 million people, it doesn’t take too many years before you’re talking pretty serious storage, and we haven’t started talking MRIs, CTs and regular old X-Rays.
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I’m not sure how much actual memory it took up, but the Navy was putting folks’ entire medical file on the solid state memory on their ID cards when I was in between 01-07; that means it had to not only have room for the guys who have 25 years of high amounts of medical information, including images, there was room for it to be accessed which I believe means it destroys and copies to a different area.
That said:
I poked around long enough to find the biggest file format I could (RAW, used by pro photographers, supposedly) and then for the biggest image file size mentioned there, if doubled, would fit ten on a CD. (I figure all of that is a good stand in for “people being dumb with file formats.” I may be a little optimistic, though.)
Then again, my phone has the cheapest tiny little SD card we could find– the ones that are smaller than a finger nail– and it has five times the storage of a CD, so the ability to store more cheaply than on paper is in fairly easy reach.
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…can we let the bureaucrats run with scissors?
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Probably better not. If they fall and hurt themselves, their injuries will have to be coded. Although, if they have to sit and wait for the doctor to find the right code, maybe they will learn something.
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Could you all please keep this in mind when you hear about “insurance fraud” by the doctors? The point of these (one of the points) is to make it easy to tell doctors that they used the wrong code and they aren’t getting paid. Or jail them if they get to loud demanding fair treatment. Medicare says that each incidence of “fraud” meaning using the wrong code for an encounter is worth a $10000 fine 10 years in jail. Now, these are encounter codes rather than diagnosis codes, but it’s the same principle.
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