A site of satirical musings, commentary and/or rhetorical criticism of the world at large.

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Location: Southeastern, Pennsylvania, United States

Wednesday, September 30, 2015

A New Era

Today is the last day that the antiquated ICD-9 diagnosis coding system will be used in medical practices and hospitals across the country. As of tomorrow, medical billers will be required to use the newer (to this country) ICD-10 system, which is already used in the rest of the civilized world. Coders, billers, and most other medical professionals have invested a lot of time preparing for this day.

There was training to be done and subsequent testing and finally certification of the coders. Then the computer systems in every medical practice had to be upgraded with the new information, and oh yes, be tested for HIPPA compliance. And, as one of our blogging friends reminded us on several occasions, medical notes themselves needed to be updated with the new codes. Surely this was a long, arduous task and one that I seriously doubt could be billed to any insurance carrier. This meant that many medical professionals would have to revise their notes on THEIR time.

Oh, the horror of it all!

I’m not belittling their efforts by any means. You just need to compare one diagnosis to see the difference in the two systems to realize the amount of work that needed to be done.

Let’s take diabetes mellitus. The ICD-9 system uses a maximum of five digits. The very basic code for diabetes is 250.0, but this doesn’t account for the over 200 diabetes related conditions and their corresponding codes. In most of these cases, this requires the addition of a fourth digit to further describe the complication and the fifth digit to describe if the condition is either type one or type two.

ICD-10 lists diabetes mellitus as E10. Yes, this is an actual code and not a peg hole on your Battleship game.

Unfortunately, all of the codes in the new system are not this simple. ICD-10 is more precise in its descriptions of the condition, its location (body part or organ) and even the stage of treatment for the condition (new or subsequent visit). Location of the condition is trickier in ICD-10. The old system merely differentiated between right and left side of the body or organ. The new system, for example, divides one organ, the heart, into quadrants: upper left, upper right, lower left, lower right. All this precision means more codes and the possibility of more digits (up to seven) in each code.

Anyway, my point today is not to bore everyone with endless coding examples, because it is time to party! It’s the end of an era and time to usher in the new era a la New Year’s Day! Out with the old, in with the new! A time for toasts at midnight, frivolous conviviality, and especially an excuse to imbibe in nasty chips and nasty chip dip!


Oh, who the hell am I kidding. I’ll be in bed by 8:30p. Besides, as far as I know, the AMA is not planning any special events. No party, no orchestra, not even dropping a ball made entirely of used rubber gloves at midnight. 

Hrumph! Some celebration! Another hrumph!

Who planned this transition in the middle of the year, in the middle of a work week, anyway? Oh, that’s right, the killjoys in Congress. No surprise here!

(Thank you for reading. Happy New Coding, Spo!)

Wednesday, September 02, 2015

For Jay in VA

Our blogger circle of friends lost a good friend today (the third this year). He was large (literally) and gregarious. Definitely the life of every party whenever he entered a room. He could be loud, but it was a wonderful loud as in “Isn’t life great?” loud!

Oh well…can’t find many more words to say. Can’t condemn the way he chose to live and die. He did like the rest of us wish we could live…on our own terms. Many of us won’t get that opportunity to choose. 
For those of us who knew him, we’ll have to live with the idea that no matter what we could have done to help him, we would have failed in the end anyway. And that thought is going to hurt for a long time.

And we’ll all find our own ways to overcome that hurt because, as Jay showed us, life can be great!

Only those of us who knew him or were privileged to have him leave a message on our blogs will understand the significance of my final word for Jay in VA:


Tuesday, August 11, 2015

Pack It In, Psychotherapists

The demise of the concept and discipline of psychotherapy is at hand. Why do I make such an outrageous statement? 
Actually, I question that my statement is no more outrageous than saying that Mexico is sending their worst citizens to our country. More outrageous than questioning a Vietnam veteran’s credibility as a war hero, given that he was captured and tortured by the enemy? More outrageous than the boorish behavior exhibited at a political debate and afterwards casting sour grapes at one of the questioners because the questions were too tough?

See how my outrageous statement can get lost in this shuffle!

We all know who the source of these events is. I won’t name him here; lord knows he gets enough publicity on his own. However, to avoid confusion, we will name him He Who Wears A Badger Toupee. We’ll call him Badger Toupee for short.

Ever since the race for the White House 2016 began (I believe it was January 20th, 2013), there has been a lot of opportunity for responsible political discourse to resolve society’s problems. Instead, we have been treated to a lot of hot air that is, to put it frankly, stupid.

All of the 17,000 Republican candidates vying for the presidency can share in the blame for this phenomenon of political meteorology, but Badger Toupee has been consistently ahead of the pack. Unlike the other political candidates, he has zero political cred, but his supporters are saying that this is his strength. He is the outsider who is shaking up the established status quo of stagnant governance.

I’m all for sending a message to DC that the obstructionist style of governing needs to change, but Badger Toupee is and cannot be the American voters’ final salvation. He topped the polls when he derided Mexicans as thieves and rapists. He didn’t suffer any sag in his popularity when he said Senator John McCain is not a hero. Then, since the first debate last week when he blew back at Fox News anchor Megyn Kelly when he suggested that she possibly succumbed to a female hormonal weakness when she questioned his sexist past, a new crop of polls came out. 

Any sane person would have thought that this, finally, would affect Badger Toupee’s poll numbers. The controversy from the past weekend would surely produce a backlash that would end his political ambitions once and for all, and exile him back to the canyons of Manhattan. Surely this would happen, right?

Nope, Badger Toupee is still topping the polls for favorite Republican candidate. PEOPLE, WHAT ARE YOU THINKING???!!!!

The conclusion is obvious: there is no longer a sane person living on this planet, ergo my pronouncement about the future of psychotherapy at the top of the page. 
Dear Psychotherapists, you have provided a wonderful service in the name of humanity for many years. You have helped many people overcome their fears, their phobias, their anxieties, and many of us owe you a debt which can never be repaid. But, let’s face it, it’s over. Badger Toupee's continued popularity despite chronic stupidity is undoubtedly a sign of the coming cultural psychological apocalypse.

So where do you go from here? Many of you have earned a comfortable retirement, lounging by a pool somewhere, traveling at your leisure, and doing anything you want to enjoy life in this insane world. Or, if you still feel a need to do something, then perhaps you can take the easier alternative. Instead of trying to cure psychoses, perhaps you should go the other way. You should consider convincing the sane (there can’t be that many left in the world) and those of us who are otherwise undiagnosed to become psychotic.  

Obviously the American electorate, or at least those answering these polls, has gone stark raving mad. Come Election Day 2016, who will notice the difference.


And, oh yes, free guns for everyone! Wheeeeeeeeeeeeeeeee!!!!!

(Thank you for reading. Or, if you insist on continuing to treat the insane American voter, then God bless you.)

Saturday, August 08, 2015

As One Circus Folds, A Sideshow Begins…

The Daily Show with Jon Stewart came to an end this week, with many pundits rightly decrying that this was the end of an era. Meanwhile, on the same night and a few hours after Stewart taped his final episode, Fox News debut their masterpiece of accidental satire, The Fox News Republican Presidential Debate.

But more about those losers later….

I remember very well when Stewart took over the reins of the show from Craig Kilborn in 1999. The takeover seemed hostile at first. At the time, Stewart’s most striking comment was that the current crop of correspondents was “history”. We were fearful at the time that our beloved Daily Show would also be history soon.

Fortunately, our fears were unfounded. Yes, God Stuff (a piece highlighting the most absurd televangelist moments of the week) limped along for awhile under Stewart, and creator Liz Winstead’s parents no longer called in their Final Jeopardy question of the day. Kilborn's jealousy took the Five Questions segment with him. (Sample question to John Cleese, “Why does British food suck?” Answer, somewhat huffily as I recall, “Because we had an empire to run.”)

The debacle of the 2000 presidential election gave the show a chance to prove its satirical chops with a segment called Indecison 2000. The events of 9/11 and our subsequent invasion into various venues in the mideast forced the show to shift its focus further away from satire of pop culture into a lampoon of the daily issues. The Stewart era settled into a nice comfortable groove from that point forward.

There was always laughter at the expense of ourselves and our views, and occasionally there were flashes of brilliant journalism. One moment that truly rose to the level of Edward R. Murrow was Stewart’s interview of a group of 9/11 first responders on the eve (12/16/2010) of a Congressional vote to extend healthcare benefits to those who had been exposed to life-threatening substances when they performed their duties that day. Up to that point, legislation was stalled in the Senate courtesy of a Republican led filibuster. Stewart’s actions shamed Congress for the stall and shamed the other media outlets for not covering the story.

The bill passed both houses five days later. The accomplishment was not too shabby for a “news program" on a comedy network that once got by on the strength of a puppet show (No, not Crank Yankers, but MST3K.)

This week, Stewart did not say goodbye, but would only say the show was pausing in its national conversation and that he himself was "going to get a drink”. Good for him, but leaving so that the satire void is filled by the amateurs at Fox News? I’m not totally comfortable with this alternative. 

And so it came to pass on Thursday night that the candidates ranking highest in the polls gathered in Cleveland under the auspices of Fox News for the first of what will most likely be an interminable number of televised debates. It was nearly a brawl on the lake when Fox News anchor Megyn Kelly (and the other candidates, for that matter) took on top seed blowhard Donald Trump. The ratings were great for Fox, which almost guarantees that America will be subjected to a long series of these events without actually making a reality series out of the political process.

Did I say accidental satire? I probably should have termed this a freak show.  After all, this is democracy in action!

The almost a catfight in Cleveland took some nasty turns. Rand Paul and New Jersey Governor in Absentia Chris Christie got into a heated exchange about warrants for possible terrorists. Trump and Kelly also nearly came to fisticuffs over his characterization of women as “fat pigs,” “dogs,” et al. Reportedly, the other eight candidates also attended, but apparently did not do anything overtly controversial to warrant them a mention on the media outlets the next morning.

And these people want us to choose the next leader of the free world from among them? And this is the world Jon Stewart left us to survive on our own???


Jon, come back! Come back, Jon!

(Thank you for reading. Seriously, Mr. Stewart, have a drink, enjoy life, but don’t make yourself a stranger.)

Tuesday, August 04, 2015


The next James Bond film is due out this year, and it appears that the producers are reaching way back into the Ian Fleming novels to resurrect Bond’s old nemesis, the terrorist organization known as SPECTRE. I can’t help wondering if any thought has been given to reaching out to the remainder of the Fleming oeuvre. A scene from the next Bond film might play out something like this.

Q: Okay Bond, here is your Walther PPK for your next mission. Try not to lose it. Our budget this year is tighter than a euro in Greece.

Bond: Are you kidding? Replacing one of these should not be a problem, especially if I find myself in America. Hell, I could walk into any pawn shop in that country and buy one over the counter. They wouldn’t even question my numerous psychoses on their silly forms.

Q: Well, you might be right about that. Now pay attention, you’ll have a new car for your next assignment. Here it is….

Bond: What??? That! That is my new car?? 

Q: Don’t scoff, 007! It may be an older model than what you’re used to, but it is reliable.

Bond: Not as reliable as my Aston Martin!

Q: Aston Martin! Now you’re the one that’s kidding! What have I requested that you do with the Aston Martin before every one of your assignments over the past 50 plus years?

Bond: (tired sigh) “Try to bring it back in one piece.”

Q: What part of that don’t you understand? There are no more Aston Martins. Every one of them we’ve allowed you to drive is either blown up, riddled with bullets, or comes back with disgusting stains on the backseat upholstery. You’ve voided the warranty on every Aston Martin Her Majesty ever purchased for government service!   

Bond: All of them?

Q: All of them! You’ve been through the lot!

Bond: All right, but this thing looks ridiculous! What are those things coming out of the sides?

Q: Those are wings! Just press the button underneath the steering wheel and voila! It becomes a flying machine.

Bond: Flying Machine…as in "Smile a Little Smile for Me"? 

Q: Enough of your juvenile references to 1960’s music pop culture, 007! This is all that’s available for your next mission.

Bond: But I can’t drive this! I have a certain reputation to uphold! With an Aston Martin, I exude the personification of testosterone overload, oozing with confidence, sophistication, and danger. If any self-respecting terrorist group sees me drive up in this, they’ll laugh themselves to death.

Q: We don’t care how you use your license to kill, 007. If they laugh to death, then so be it.

Bond: But, Q…

Q: But nothing, Bond. It’s Chitty Chitty Bang Bang or nothing!

(Thank you for reading. I can hardly wait for SPECTRE.)