Sunday, July 13, 2008

I Ain’t Whinin’; I’m Observin’ & Thinkin'

Four of the numerous careers I have had in my 62 years overlap in certain skills:

  • Observe
  • Question
  • Investigate
  • Deduce
  • Do it all again.

As a student of history, I was taught not to accept the conclusions of other historians; rather, one needs to investigation a wide variety of secondary and primary sources before coming to one’s own conclusion.

Likewise, as a military intelligence officer, one must develop a strategic view of the situation and evaluate each individual piece of information based upon its likelihood and the reliability of its source.

Doing social work, both at the micro and macro levels requires that one first and foremost that one be willing and able to listen and observe; only after the information is gathered and evaluated can one assist the client(s) in developing a workable plan for change or maintenance.

Perhaps my seminary education was unique, but it was stressed that each of us must be our own theologian in that we were to question everything, including Biblical Scriptures and Church dogma; as own of my professors, the renowned Rev. Dr. Walter Brueggemann, said over and over: “The whole Bible is true; however, some texts contain much more truth than others.”


My trip to the VA outreach center on Friday left me exhausted through this morning. Saturday I was awake and up at two hour intervals before again being too tired to function and again napping. Perhaps that was from my needing to limit my oxygen intake to be able to get there and back?

As those who read my comments to my Friday post may understand, inside my home my oxygen intake is not limited. I use exclusively oxygen created by the electronic oxygen compressor through the nose hose and only need tanked oxygen in case of an electric power failure. I utilize the oxygen tanks provided by a private company through the Veterans Administration only when I leave home. Therefore, my trips and activities outside the house are limited to how I must budget the 7 tanks of oxygen I am allocated.

Oxygen Compressor

Tanked Oxygen

Portable Oxygen Tank Carrier

When I was first tested for my need for supplemental oxygen, the results were so great that before I returned home from the VA hospital the supplying company had already telephoned and left a message on my answering machine that they were coming by that day to deliver the oxygen compressor and the 12 tanks of oxygen my test indicated that I required.

About two months later I was retested at the VA hospital and my ration of tanked oxygen reduced from 12 to 7 tanks per month. That’s when I began to limit my time outside the house.

Now to my observations: the data from my breathing tests is fed by the VA technician into the VA computer and the computer dictates the quantity of oxygen tanks prescribed. No other input beyond the text results, such as one’s need to be away from home, are considered. I was not even informed of the change until the supplier came and took away 5 of the 12 tanks.

Likewise, it is the same process with every visit I have made to the VA. A computer dictates treatment. The practioner sits before a computer while asking me questions and entering the data. Then, with a push of the enter key, the computer gives the VA person my treatment plan.


I have been told that this same process is used by other medical practitioners, not just the Veterans Administration. I have not investigated this information; however, my sources are reliable.

If this is the case of how contemporary medicine in practiced, I deduce that something very important is missing: the human element!

I have written more than enough on this subject for the moment. However, I shall return to it soon.


  1. i don't get it. is the amount of oxygen you get per month determined by the results of a MEDICAL breathing test which shows how much oxygen you need or by an answer and question session? because if it's the latter, i'd be changing my answers to get the oxygen i need. and yes, by changing i mean lying if necessary.

    if it's determined by medical tests, i'd be complaining, bitching and whining until they give me the oxygen just to shut me up.

    i don't like the idea of you having to ration your oxygen to get to your appointment or being housebound because of a limited supply. i don't like it at all.

    let me know if i can help in some way.

  2. ROBIN: The amount of oxygen—number of canisters no matter what size canister—is determined by how fast I recover from a critical drop in my blood oxygen level. That’s determined by that damned painful pricking of my wrist! The first test indicated I need 12 tanks; the second the computer said that I require 7 tanks. I am not scheduled to be tested again for another 10 months.

    There is something else about that 2nd test: I collapsed in the hallway as the technician was walking me around without oxygen. Therefore, when she got me back to the testing station it took her 4 or 5 minutes to measure my blood oxygen level. In the first test, she waited only about 2 or 3 minutes.

    Of course, the data was inputted into the computer and the computer spit out the treatment plan—i.e., the number of tanks I am allowed each month.

  3. Computers are fine - to a point. Computers should never take the place of human thinking and logic. I think bureaucracies are worse than the computers themselves.

  4. There's your problem. The information fed to the computer by an idiot of a technician.

    That's another problem with the VA. They don't care if their people are even competent (let alone proficient), as long as they have warm bodies filling the positions...

    I'd look for an avenue to appeal the VA's decision to reduce your O2 supplies. They have no right to risk your life like this!

  5. sum up the reduction to human error. the nut behind the computer doing the inputting. you know the drill GIGO.
    I agree with Catnapping (Army Veteran) there has to be a way to apear the reduction of O2 they give you.
    Oh I foegot we vets are just supposed to die and let these beurcrats(sorry about the spelling) alone. That's my story and I'm sticking to it!

  6. What a powerless feeling! Like Catnapping suggested, isn't there an avenue that you have available where you can contest the "ruling" of a computer which can be programmed to say anything that will save the government money?

    government grumble grumble damn government grumble grumble grumble...

  7. I don't know why some extra tanks can't be added to cover time for you to be outside or away from home. I would contact somebody at VA on this. You should never risk running out of these tanks.

  8. SQUIRL: I’m in total agreement. My next post on this will center on bureaucracies, who I don’t believe are intrinsically bad, but are at the very least a barrier to one receiving what one needs.

    CATNAPPING: You’ve identified another part of my concern: none of the practitioners with whom I’ve had contact know anything about ME. I’m just a number—“last four, please”—on a computer screen. Even the mental health guy who prescribes the antidepressants knows nothing about me except what’s on his computer screen, which he stairs at constantly throughout our time together.

    MIKE GOLCH: When the company that supplies the oxygen thanks informed me that the number of tanks had been reduced, I attempted to discern why. I was on the telephone for most of one day, being bounced from one person to another. It was at the end of that experienced that I learned about the computer produced treatment plan: “the computer says that 7 tanks are all that you require.” Baseline: no one I spoke with seemed to have any authority or, if they did, was willing to use it on my behalf.

    CAROL: I hope there is a way of contesting VA decisions. I have been attempting to locate that avenue since I began being “served” by VA. I have encountered some folks who have done the best they could to help me. For example, the woman who set up the homemaker service that supplies Tasha. During out second interview she noted that I was having problems reading the small print on a form and suggested that I have my eyes checked. To do that, she said, I needed a referral to my primary care physician (case manager) and even sent an email to my primary care physician requesting the referral. A few weeks later I received a phone call from a physician who is head of the eye department at the hospital to whom the email mail had been cc’d. He expressed his concern that the referral had not yet been received and asked my permission to contact my primary care physician on my behalf. Unfortunately, at that time my primary care physician was on maternity leave and the VA had no one covering her caseload. It was ten months later—6 months after my primary care physician returned from maternity leave—that the referral was finally made by my primary care physician.

    ANONYMOUS: I agree. Please see what I have written above about my contacts with VA regarding this. I am at the point, since I now am enrolled in Medicare, of seeking some non-VA health care. I feel I shouldn’t need to do so, but the frustration had gotten to be more than I am willing to endure.

  9. Another problem with the VA is that they pick and choose who gets treatment. Another blogger who writes me came down with a terrible infection and the VA refused to treat him. He was an NCO in the Persian Gulf war; he was in combat and was also in an Airborne unit. Soldiers who have served 3 tours in Iraq are getting conned out of their benefits.

    I am not surprised that the treatment you are getting is substandard. We are at war, yet Bush and Congress consistently cut VA benefits, which means fewer jobs, fewer humans and an increase in dumb machines. And it isn't unique to Iraq; most of the people who were hit hardest by the depression in the 30s were WWI vets. Everyone waves the flag and complains that Mr. Obama doesn't wear his flag in a jacket lapel, but they stay uninformed about the treatment of military personel.

    By the way, you have done a heck of a lot--kudos to you--you epitomize what Christians would call service.

  10. ENEMY OF THE REPUBLIC: You are so right! What enrages me even more than the hassles I’ve faced with VA is the treatment being given young men and women who have combat related wounds.

    Once, while awaiting my turn at the orthopedic clinic back when they were trying to figure out what was wrong with my left leg (they never have), I was seated next to two young men who had been wounded in Iraq. One was in a wheelchair, having lost one of his legs from the knee down. He had a temporary prosthesis and was awaiting his permanent one so that he could really get on with learning to walk again. He told me that he had been waiting for 9 months and it still wasn’t available!

    That, to me, in inexcusable!

  11. That just doesn't seem fair.

  12. I'm happy to hear that you will seek treatment elsewhere, if need be. I always worry about the folks that don't have anyone to help with their treatment. It's been our experience that some of the staff don't seem to have very good memory of certain things. Also, the thing with the computers irritates me!

  13. I read Alex's blog and he was really worried about his hooman. How very frustrating. A computer will probably diagnois all of us soon. Did you see the 60 mins program Sunday where a gentleman is running a free clinic. It was held in Knoxville on a cold winter morning. peace be with you. Love the Monday jokes.How did you get a picture of me in the morning with my coffee?

  14. ABBEY: Nope. It is neither fair nor just. But it is very American, I am afraid.

    ANONYMOUS: Thank you.

    LADY DI TN: Alex often seems to worry about me, such as whether I will give him his favorite cat food or brush his coat or open the door so he can go outside and play. In other words, the furball acts like a normal cat. At the moment he is napping on my desk under the high intensity lamp. The strange thing is, I don’t remember him leaping up there!

    The whole computer thing really is concerning to me. I remember when pocket calculators came into existence. It wasn’t too long before folks began to forget how to do math without them. What happens if computers do the same to the medical profession and for whatever reason a crisis makes them inaccessible to physicals?

    I had not heard about the free clinic in Knoxville. I believe that free clinics are wonderful, meeting needs that otherwise would go unmet. One of our UCC churches in northwestern Kentucky had 3 or 4 physicians and several nurses in the congregation. They set up a free clinic in which the church members volunteered their time and resources. It was a real benefit to the community.

    As for that graphic, I had it in my archive and found it was I was actually looking for something else. I think it’s rather appropriate for Monday jokes, don’t you.

  15. I hope there is a way of contesting VA decisions. I have been attempting to locate that avenue since I began being “served” by VA. I have encountered some folks who have done the best they could to help me. For example, the woman who set up the homemaker service that supplies Tasha. During out second interview she noted that I was having problems reading the small print on a form and suggested that I have my eyes checked. To do that, she said, I needed a referral to my primary care physician (case manager) and even sent an email to my primary care physician requesting the referral.