Tag Archives: anger

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Fraud in medicine: oxygen

My father died of emphysema in June of 2013. I found him dead on the floor of his house. I expected this because he was nearly a hermit, but it was still hard.

He was on oxygen. It was prescribed to be continuous.

I started cleaning up the house and trying to find his will. I lined up oxygen tanks and called the oxygen company. There were ten tanks.

The oxygen company picked up the tanks.

I found eight more. I was very busy with a large house, a complicated estate, two years of unpaid taxes, he paid bills on line but had not updated the payments when costs increased……

I hired a local estate sale group. They did an excellent job. The house was sold. I picked up the last few things, including the oxygen tanks.

I called the oxygen company. “Why did my father have 18 oxygen tanks?”

They said, “We delivered them as needed.”

I said, “He didn’t need 18 tanks.”

They said, “They are paid for.”

Oh! Medicare paid for the oxygen. No, not medicare. You and he and I paid for it, because we pay taxes to medicare and medicare pays the oxygen company. Well, 80% and then my father paid the other 20% unless he had a medicare secondary insurance, which he also pays for…. Oh, are you under 65 and thought medicare paid for everything once you got it? Sorry to disillusion you…..My father  was supposed to be on oxygen continuously. So the company kept delivering it at the intervals covered by medicare, even though he was not using it all. He sometimes didn’t wear his oxygen and he also had bought his own oxygen concentrator, smaller and easier to move than the one from the oxygen company.

I was furious. “So you kept delivering oxygen even though it was not all being used. And kept charging.”

They said, “We delivered it when it was needed.”

Liars. They delivered more than was needed and I gave some back to them, after medicare had already paid for it.

I still have 8 tanks of oxygen. After all, it’s paid for by medicare, by my taxes and by your taxes. The oxygen is paid for. The tanks belong to the company. I’ll return them when they are empty….. I don’t think the corporation should be able to charge medicare for it twice…..

I should check to see if the company reimbursed medicare and my father for the oxygen when it was returned. If not, I can check into filing a fraud complaint with medicare against the company. But even if they reimbursed medicare and my father’s estate, I am still angry that they kept delivering it when they knew darn well that he had tanks already. Or maybe they don’t even keep track of how many tanks they’ve given out. It’s all about money.

Fight back against corporate greed and fraud. Ask questions. Do not give the oxygen back if it’s been paid for….. give it to someone who needs it instead.

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Dream: Get real, Girl

I dream that I am a prisoner and being tortured. The torturers are indistinct and shadows. They cut slices into my flesh and put me back in my cell.

I am out of my cell again and I am seen from the back, naked from the hips up. The torturer cuts slices in my back with a cutlas. The previous slices have healed and scarred. I am done. I turn, grab the cutlas and slice off the torturers hands at mid-forearm. His hands are visible as they fall away, but the rest of him is still a shadow. I will win, I know.

I have a new vase. I take the white china vase out of the base, which has brass wheels and a support like a coach. Like Cindarella’s coach. I use the vase as a template to carve the base of a pumpkin to fit. I carve it into a coach sitting on the base. I find a plastic horse and the “Get real, Girl” in her hiking boots. I photograph it and caption it: “After she smashes the glass slippers, the coachmen and horses revert to mice and rats and run away. She steals a horse from her father, puts on her hiking gear, skips the ball and heads for the hills for good.”

Then I wake up.

As you can see, I haven’t carved the pumpkin yet, nor found the horse. But I will.

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Humans should behave more like sisters

Humans should behave more like sisters.

My sister and I played together. We’d get angry. We’d fight! We’d sulk! We’d complain to the grown ups! We’d slam doors! We’d ignore each other!

But in the end, there was often no one else to play with. So we would make up. And we loved each other.

I miss my sister so much.

Can’t we learn to love other humans and quit being stupid? Please?

The photo was taken at my wedding by the groom’s uncle in 1989.

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Thoughts on the update from ICD 9 to ICD 10 

I would be very interested in a tune for this poem. 

This poem was rejected by JAMA, the Journal of the 
American Medical Association. Of course, the American 
Medical Association writes the codes. I do not look 
forward to going from the present 14,000 diagnosis 
codes to 42,000. I think it's just another way for 
insurance to delay and refuse to pay physicians. I 
think our country now has a business ethic of "screw 
anyone you can" and I don't like it. 

Thoughts on the update from ICD 9 to ICD 10


They say ICD 9
Just isn't so fine
Not enough codes to choose
To keep us fungking confused

They say ICD 9
Just isn't so fine
The rest of the world
Uses ICD 10, word

But they are liar liar liars
Pants on fire fire
Noses as long as telephone wires

They are liar liar liars
Fungk ICD 10
And let me tell you fungk them
Fungk starting over again

ICD 9 is now 34
Oh what a bore
They say it's too old
I'm older and gold

They say engage a team
Establish a plan
Get focused training
Learn that sh-t from the man

They say what does your practice
See and learn just those codes
Fungk ya'll but wise
I see everything that goes

I do family practice
I'm a rural doctor
The point of the codes
Is insurance don't pay, suckers

They say ICD 9
Just isn't so fine
The rest of the world
Uses ICD 10, word

But they are liars liars liars
Pants on fire fire
Noses as long as telephone wires

I know my ICD 9
Forwards and backwards, up and down
I can code pregnant
by four circus clowns

I can code pulmonary
embolus past
I can code gerbil inserted in the a--

ICD 10
is starting again
Code left or right or other
Those sh-ts would fungk your mother

ICD 10 is starting again
Code where it happened
Or insurance won't pay
Fungkers make my day

They say champion the change
I say channel the rage
Take a book from my page
Incinerate the fungking change

Fungk ICD 10
Fungk ICD 10
Fungk ICD 10
Fungk it again.
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Powergirl takes off

The photo yesterday is of my daughter on the beach, but she is in the air. She is not touching the ground at all. And today the picture is my son airborne at the beach. I wrote this poem in 2005. When I found each of those photographs, I thought of this poem.

Why, you say, does this poem leave the articles out? I went to high school in Alexandria, Virginia. Yes, I was a Titan and graduated from there. In Alexandria when we were really angry or really passionate, the articles got dropped. I try not to talk like this in the northwest, because people get scared. I am also influenced by Walt Kelly’s Pogo and all of the messing around with language and spelling. Stephen Fry on language (https://www.youtube.com/watch?v=J7E-aoXLZGY) is a lovely comfort!

Previously published on everything2 August 25, 2009.

Powergirl takes off
Powergirl have wings
to fly
She related to
Superfly
She scared when
baby almost die
She scared and yes’n’she
do cry

Husband say she much
too strong
He say she most allays
wrong
He sing and dance de
same old song
He rather she put on
a thong
He played too much with
that old bong

Now man he working
ooh he big
He have no time for
little kid
Not that he ever
really did

She research kidses
summer camps
She study schedules late
with lamps
Pay de money, lick de
stamps

Husband say she got too
much power
He say it nearly every
hour
He grumpy sullen and really
sour

Powergirl got wings
to fly
She look with longing
at the sky
She look at husband
wonder why

She finally realize he
a pain
She take a saw to
ball and chain
Husband he whine and
complain
She wonder why he
goddamn insane
She learn divorce lawyer
nice name

Husband lie on ground and
moan
He whine and bitch all on
de phone
Powergirl leave him there
alone
He drink and fuck and get
real stoned

Powergirl have wings
to fly
She rising rising
in the sky
Kids light as she is
hollow bones
They scared to leave
familiar home
Ride on her shoulders
in the sky
She hopes that they will
learn to fly

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mermaid

This poem is related to yesterday’s post about learning to keep my temper. I wrote it in April 2012.

mermaid

when I was born, they took my skin

i had no skin
i was frightened
i wept

a witch came
she studied me
i turned my head from the spoon

“Good,” she said, “You may refuse it if you want.”

She gave me the gift of anger

it was the only defense I had

but over the years
I studied and thought
and I found my tears
and I found my fears

i made my skin of tears
this took me many years
one tear for each hair

at last it is done
my skin
is complete

i smile at the sky
as i don it

i slip into the water
and i am gone

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If you have to cry, do it on the boyfriend who wants you to be angry instead of sad

I used to have a temper that could be set off really really easily.

I had a boyfriend right out of college that said that I didn’t get angry “right”. He had a PhD and I was a mere done with undergraduate person, so what did I know? I went into counseling for a year.

Finally I said to him, “The counselor and I have tried presenting anger to you in every possible form and none of it is acceptable. So now she says you need to come to counseling too.”

His response: “What I want is for you to never get angry at me again.”

Mine: “You are dreaming.”

And so he broke up with me. Immediately. And said I was an ogre when I was angry.

I went back to counseling and was depressed for a year. Then I cheered up, met a boyfriend and went to medical school. I worked on my temper, remembering the ogre comment. I did not want to be an ogre. My boyfriend became my husband and he really liked my dark side and my silly side.

My sister was the person who could set me off angry the most easily. She and I fought like pitbulls, like honey badgers. Once we were in Colorado with my husband, her first husband and my parents. The two husbands had an imitation pretend fight acting as me and my sister. They were vicious. It was horribly embarassing and also funny, because they nailed us both.

In residency in Portland, I had a breakthrough. My sister was divorced from the first husband by then, and with the no meat, no dairy, really pain in the butt boyfriend. We were having a big party, lots of people, grilling salmon and cooking in a group. My sister walked in.

“Oh.” I said, “You didn’t RSVP.”

She fired up instantly. “What? Why does that matter? Do you want me to leave?”

I did not fire up. I held my breath and then said, “No. But if you are here with No Meat No Milk, I didn’t make any food for him, because I did not know you were coming. There is lots of food. You are both welcome to stay, but he will have to figure out his own food.” Then I held my breath again.

There was a long pause. My sister had her breath drawn in and held. She looked like she was going to explode. But I had answered quietly. She really had nothing to explode at.

“We will stay then,” she said, grudgingly. And there was No Meat No Milk. I was pretty happy when she ditched him. But I was also happy that I had not exploded back at her.

That was when I really got control of my temper. Not that I never lost it again, but I was no longer an ogre. I could hold it with my sister. My husband could set me off, but when I stepped back and started recording what he said and my responses, I could hold it there too.

After we divorced, I had one boyfriend who moved in. I had joked to a friend that my family had a lot of enablers and enablees, but that the latter lived longer. I said if I had to be one or the other, the latter seemed better for longevity.

And that boyfriend showed up immediately. I had just been “strongly encouraged” by my employer local hospital to open my own private practice. That is, I was not seeing patients. I was writing a business plan. I met him in a bar, salsa dancing. He said I was cute and I said, “No, I’m prickly.” I swear, it was that sentence and my dancing that attracted him. I always grin like a fool when I’m dancing. I love it. It lights me up.

Anyhow, I got mad at him exactly twice before he moved in. Boy did he come down on me for getting mad and punished me very thoroughly. By now you are wondering why I let him move in and frankly I was too. But my intuition was running the show and I just let it.

Well, he had kissed me like crazy at the start of the relationship. He stopped kissing me, almost as he moved in. He had insomnia. He’d fixed up one of the two upstairs bedrooms. He started sleeping with me less and less and sleeping in the other room, on cushions.

I would wake, worry. I started moving too. I moved to the guest room. I moved to the couch. Once I was out of the theoretically shared bed, I could go back to sleep. He protested that I shouldn’t move. Why not? I was getting insomnia from worrying about him leaving more and more.

He said we’d need couples counseling eventually. I said, ok, and scheduled it. He said, “I didn’t mean now!” I said, “Well, seemed like we might as well get it out of the way.”

He told the counselor I needed to either cut my sister off or do what she said, but instead, I was present and disobeidient. My sister had metastatic breast cancer and we came from an alcohol addiction family. Can you say complicated relationship?

I explained to the counselor that I thought many patients with cancer end up in a “cancer bubble”. Everyone tries to do what they say because they have cancer. This isolates them and does damage to the relationship. I was trying to stay present and real. That is, I did not obey. I was getting pressure from other people to obey, because my sister would complain about me. Whatever.

The counselor thought I was reasonable. I brought up the sleep issues. The boyfriend cancelled the counseling, saying that he needed a break.

At six months living together, he was saying that he might need to go back to the city to work. Two hours away. And I still was not doing what he wanted re my sister.

Counseling again. Again my behavior to my sister was examined. Same story. I turned to him. “I hear you saying you may need to return to the city for work. I hear you saying you may need to move there. What I don’t hear you saying is darling, we will get through a long distance relationship. Are you breaking up with me and not telling me?”

Long silence.

The counselor said, “You need to answer her.”

He finally said, “I wasn’t going to tell you until after I moved.”

I cried. We left. I kept crying.

He said, “You are angry and you are going to throw me out on the street.”

“No!” I said, “I am sad! You move out when you are ready! We will remain friends!”

So then I cried buckets. I cried on him, buckets. I cried every time I saw him, I cried daily, I cried about him, about my sister, about alcoholism, about the hospital getting rid of me. I cried about everything. I cried on him daily.

For six months. He kept saying “You are angry. You are throwing me out.” But I didn’t. I just cried more.

He moved out on the weekend I returned from seeing my sister in hospice for the last time. Her birthday was March 23. I saw her last on March 22. My birthday was March 28. She died March 29. He moved out on the 26th and 27th. I was not mad, I just cried and cried and cried.

I think that he was looking for an angry girlfriend. He thought he’d found her when I said I was prickly. He would have been the enabler and I would have been the angry dysfunctional enablee. It turns out that I was not really interested in being an enablee. Now I want a healthy relationship.

So that is my recommendation. If you have to cry, do it on the boyfriend who wants you to be angry instead of sad.