mahiwaga

On some Saturdays, I head out to the Mission Cafe in North Park before it gets overly crowded and buy myself an L.A. Times (because, frankly, the San Diego Union-Tribune is not fit to wipe my ass with.) On the front page, I found two rather depressing stories: (1) the beleaguered Charles Drew/Martin Luther King, Jr. Medical Center in South Central L.A. has failed a “make it or break it” federal inspection, thereby losing funding from CMS and (2) this character piece about a guy named Ronnie Wise who has been fighting illiteracy in the Mississippi delta for the past 30 years in the face of institutionalized racism, uncaring politicians, arsonists, and weather, and who has decided to retire early.

For all you nitwits who continue to insist that racism is a thing of the past and that we now live on a “level playing field,” here’s what I think of you:

The King/Drew debacle has been going on for years upon years, and for some reason (and the L.A. Times itself was the publication that exposed, once and for all, that it wasn’t because of a lack of money) they have been unable to come into minimal regulatory compliance. It is notorious for being a place where it is not safe to go if you ever get sick or injured. It had already failed to obtain JCAHO certification and CMS had already threatened to pull funding multiple times.

A good part of this disaster is the fault of corrupt physicians who were taking advantage of the situation, and these bastards earn my utmost contempt. And naturally, there was all sorts of political corruption, hiring corruption, nepotism, and gross incompetence.

I feel angriest because of all the patients (all of whom are poor and/or minorities)they’ve let down. I hope these bastards who contributed to this mess never get another job in health care.

The other thing is that the ripple effect will be all little hair-raising. Guess where all the county patients have to go now? L.A. County/USC and Harbor/UCLA, naturally, despite the fact that these aren’t exactly underutilized hospitals. We’ll see if the EMS system in Southern California can actually continue to function.

But the article about illiteracy in Mississippi was just as depressing. I can’t believe what it must be like not to be able to read. I guess I’ve taken it for granted. According to my parents, I could already read a little when I was two years old, and I’ve always been able to read above grade level since, and I always have to have a book I’m reading. The idea that all these words and sentences floating around everywhere should be indecipherable scares the crap out of me.

Now I know that reading is not a natural human function. I know people who are actually quite high-functioning but who are dyslexic or otherwise challenged. And then there is blindness, which happens to be something that I am at higher risk for than the average population. The inability to read is the main reason that I fear going blind. So I’ve had people tell me that they really envy my ability to read quickly. Reading fast is something more natural for me than, for example, making friends and fostering human relationships, something that other people seem to do quite easily, but this is neither here nor there.

So I guess I found myself identifying with this Ronnie Wise character. He appears to be someone who is quite reticent about himself, a little gruff, a little off-putting, who has few acquaintances and apparently no friends. And yet, somehow, he manages to find a woman who loves him (which is mentioned almost as an aside in the story, although it may be a big contributor to his reasons for deciding to retire early.)

If I had any hope left… but I don’t.

In any case, he is an object lesson in trying to do the right thing in the world, getting beaten down and persecuted for doing it, and ending up burning out and unappreciated for it. At the very least, he didn’t get crucified or shot, I suppose.

Sometimes my Catholic (though slightly heretical) upbringing rears up its ugly head, and I can’t help but wonder if this isn’t actually Hell already, and have all already been condemned.

I stumbled upon this blog post about how most of the time spent developing code is actually spent rewriting rather than actually writing, which actually fits the aphorism about how most of writing in general is rewriting. But the thing that he discusses is that this is a function of the fact that most developers can’t immediately grok what code is supposed to do just by reading it, and a lot of them end up trying to rewrite what has already been written, which, in my estimation, is a glorious waste of time.

In my mind, this is simply another example that most developers can’t properly comment on and document code to save their life, although perhaps it is also a sign that the particular high-level language they’re working in is not human readable. (C and C++ comes to mind, although I come from a background of learning to code in BASIC, Logo, Lisp, and Pascal and, God help us all, assembly, and the only thing that I know how to do these days is write Perl scripts, although I sometimes delve into the atrocity known as JavaScript, so take that as you will.) Whether or not this is applicable to real-life development these days, I grew up believing that if you can’t read your code, you’re simply not doing it right. Supposedly, well-written code is self documenting, and all you should have to do is read the procedure/method/variable name, and figure out quite easily what it’s supposed to mean and/or do. If you actually have to rewrite the code, that means that the guy who came before you really fucked things up, or that you are completely illiterate when it comes to this particular high-level language.

Of course, this may all be bullshit, because I don’t code for a living.

What I do do, however, is practice medicine, and I find that there is a lot of similarities here. Because most people who have medical illness tend to have more than one doctor, you’re forced to dig through old notes and lab tests that you didn’t order and you have to try to figure out just what the hell some other guy was thinking without necessarily being able to talk to him or her. And, let me tell you, the human body and human pathology is far less documented than computer architectures and high-level languages, and, frankly, we don’t run into this problem of having to reinvent the wheel each time. Sure, there are some that rewriting is done, in the sense that sometimes the plan has to be modified, but most of the time this is because new, unexpected data comes in, or because the patient just doesn’t want to do what you told them to do. (Imagine coders trying to deal with non-compliant adherent computers.) But even the most inexperienced physicians (such as myself) can rifle through some chicken scratches, glean what medications someone is on, and maybe even talk to the patient themself to figure out just what the heck is going on without having to start entirely from scratch.

Sure, the notion that reading about something is not the same as doing something is valid, but sometimes you have to make do with the reading (because in the beginning, all I ever really knew about heart failure was what I had read,) and you don’t have time with the doing (because recreating all the experiments since Galen figured out the cardiovascular system would be just a tad time-consuming), so ultimately, whatever is practical tends to win over whatever may be theoretically correct/proper, and practically speaking, you don’t have time to grok code by rewriting it all.

But I grant that the connection between writing code and treating patients is tenuous at best.

But again, a brief note: it always seems that whenever I get a new blog engine working, I find myself typing about all sorts of crazy minutiae. Eventually I will settle down some and not blog. I promise.