Itinerancy Rule #1: The Unimportance of Planning

The Jews have a saying: Mann traoch, Gott Lauch. Man plans, God laughs. Best made plans of mice and men often go to shit. But it's especially hard on the mice. The cable guy will be over there precisely between 8AM and 5PM. Fedex will deliver at the time you're at work or stepped out. Your wife's baby will be delivered early. Or late. Or your wife will go missing. The barman will lose his bonhomie. The hitchhiker will turn out to be a serial killer. And you can forget about making a grocery list because you are lucky if you find one thing you were looking for without compromising brand, size, price or sanity.

I flew back to NYC on a business trip a month ago. It has now come to an end. My departure last Wednesday was scheduled during the horribly malapropped "snowpocalypse" by all the fake news companies, essentially all the news companies, that are still calling the collosal recent clusterf@ck of an economic collapse a "recession." All the flights were cancelled, schools closed, mayor advised everyone to stay home. As mayor Bloomberg's compensation is famously only $1 a year and he, ostentatiously, has to take a $2.5 subway ride to work, any workday is a substantial 150% loss on his balance sheet EVERY DAY, NOT COUNTING HIS RIDE BACK HOME when he reportedly gets home by diamond helicopter. Thank God for regressive tax laws. Bloomberg saves a chunk in deductions by the end of the year. It's for the birds, but any amount of deductions for his massive 10 billion dollar empire is a gain. As a result of this "snowmageddon," I have been unable to fly out along with everyone else on the Eastern seaboard. My departure was moved two days ahead as the intervening flights have been quickly nabbed by the streetwise straphangers.

This marks the third time in my life as an itinerant that I have been unable to catch my scheduled flight out of NYC. The first time was when I tried to make my maiden voyage to Seattle, to which I moved without so much as a look-see. I really had no idea where I was going at the time beyond some complimentary words by tourists and a Wikipedia entry. From this I knew that Seattle was an incredible resort town that for three years in a row was ranked as the most educated place in the US, and one of whose two seasons was basically spent underwater. Moving to Seattle was a leap of faith, as I described it since, and it worked out very well for me. Thanks to the surfeit of vacant apartments in the city and to my employer because of whom I was able to take an unpaid week of administrative leave, I landed in Seattle on Sunday, landed an apartment contract by Wednesday, and moved basic Swedish furnicrap (aka Crapea) in by next Sunday. I did have to order the mattress via expedited delivery from US Mattress. Unsurprisingly, it was late, so I spent nearly ten days on the floor. I hadn't slept on the floor since I moved, as a newly-minted fellow at the National Institutes of Health, in my brand new ground-floor 300 sq foot Buckingham in a residential complex situated on the next-to-terminal station of the DC metro's Red Line. The first several days I was making do with a deeply discounted air mattress I bought at Bed Bath and Beyond. The reason for the discount became obvious when in 72 hours floorboards started tickling me through the mattress. I used the pump the second time. The pump blew the fuse. I said good-bye to the mattress. Kudos to Bed, Bath and Beyond for the refund. Since then I had slept on the floor until I got the real deal. Afraid of suffering a heart attack after opening my bank statement, I subsisted on Subway sandwiches and sodie pop the first two weeks. Subjectively I lost ten pounds, not so much because of the Jared diet, as of the fact that all streets in Seattle for some reason go uphill at a right angle, and, being a native New Yorker, I did an awful lot of apartment hunting a la carte.

The first time my flight was aborted was when I tried to fly out to Seattle. I used Delta as my carrier. Delta has a poor reputation and deservedly so. The Delta terminal was overloaded beyond capacity. It was not so much a fire hazard as a biohazard as, so confined it was, I routinely found myself inside random strangers. Baggage check-in had a Soviet-style bread line with only one Delta representative behind it. Obviously by the time I reached her, I was told that the baggage compartment has been sealed and unless I had 20 grand to pay the airport fine for opening it up, I should lose the luggage and try and make it through the Soviet-style security check-in bread line. I tried to speak with the manager until his shift ended and he was replaced by another manager. I tried to speak with the other manager (by that time an hour passed) and was told she had no power so I should call Delta and rebook. I called Delta's operator and threatened to sue. I was told the mailing address and number of the Delta HQ office and congratulated on the reasonable decision. That took me by surprise a little. Who am I kidding? That took me by surprise like a jolt of electricty. I gave up and went home. That night I placed at least four other phone calls to Delta. I cursed, I spat, I bargained, I wished the plague take them, I tried to deal with the consequent denial and acceptance. Kubler-Ross be damned. In the course of all this I found out that Delta often overbooks its flights and, as a result, denies passage to a fraction of its passengers. In fact those passengers were present, complaining, to the same manager, as they had been on a layover and their kids and extensive vacation luggage had to spend the night at the airport. I swore then and there that I would advertise how Delta bankrupted me to everyone I knew and make every effort to ruin them. The next day I was able to ruin them a little by buying a $600 Delta ticket to Seattle. The latest news is that Delta is merging with Northwest airlines. No doubt thanks to my efforts. We will cross paths again, Northwest. We shall see who is the last to laugh.

The second time I tried to fly out of JFK like a loser, I did this on somewhat of a gamble. This was November 2009 and I was planning to come to NYC for Thanksgiving to visit with my parents. At the last moment I was asked to go on a business trip to DC. The business in DC would happen one week eariler than my planned vacation and I agreed. By that time I had already booked my flight in and out of NYC by Continental. Since I was flying to DC on the government account a week earlier, I did just that. I caught Amtrak from DC to NYC, boarding at third call, nearly missing the train because of an ill-timed attempt to work out at the hotel gym. I spent the four hours uncomfortably scrunching my knees since I got a bad seat and the Asian lady across from me ordered me to move my legs one way so our legs wouldn't touch. The rest of the time she spent making faces and pretending she was made of different shit than the rest of us, peons. Ooooh, the touching taboo! What happened to the good ol' days when you could slap your secretary's butt and tell her to get you a coffee and a pack double fast? By the end of my homecoming I tried to print a Continental boarding pass and was told that my flights were cancelled. After a heart attack or two, few sputtering calls to Continental during which I cursed, I spat, I bargained, I wished the cholera take them, I was told that by not boarding the flight to NYC, I forfeited my right to fly out of NYC. Please, someone, please, explain to this idiot if it makes a damn mote of sense to you. I was and still am at a loss for words. I swore I would never fly Continental and advertise it to all my friends. So, friends, I am insistent in my instructions to you to avoid Continental at all costs. Thanks to the wonder of recession combined with holidays, I was able to get a great deal from Virgin America, absolutely the @#$!ing best airline company I have ever used, to fly NYC - San Francisco for $100 with a day's layover in SF and a $40 flight to Seattle. I had a blast in SF. Took the Aquarium tickets for a cheesy boat ride underneath the Golden Gate bridge and saw Alcatraz island from the side looking away from Fisherman's Wharf. Still, I overpaid for my tickets and was mightily pissed.

The third time I am not able to fly out of NYC is presently. So if this is fate and I am not supposed to finish this blog, cry a tear for me. I take personal checks. Make them out to Disaffected Itinerant. Disaffected Itinerant, he who never learned to taste that ever-rare fruit of things-going-smoothly.

(Update)

I wish this was a joke. I just went to see my dentist and...the electricity was out. This is not Hickville, mind you. This is New York City in the 21st century. I spent an hour waiting for the dental technician guiding an electrician in a daring replay of blind leading the blind determine whether there was current in the walls with a magic wand. I left the office.

('’)

Second order of Itinerancy: A game of Imagine.

First thing you've got to think about at the outset of your itinerancy is where you will be eating. Second, sleeping. And third, once you get into a scrap with the hick who will hold you up in a dark alley, who will sew your arm back on? 

A friend of mine just moved across the continent to the West Coast to seek a new life for herself. Her prior employer’s insurance coverage has just elapsed. Which brings me to today’s subject.

What is health insurance? Auto insurance is insurance. You get paid upon an accident. But do you with health insurance? Clearly, I will argue "no", so if you are a car or a human with no time to spare, leave now and be a four-wheeled jerk.

The rest of us, kids, let’s play a game of Imagine (no copyright, free distribution license, GNU, boilerplate, boilerplate).  Imagine you get sick (had an accident if you’re a car). If you’re a car, you get paid. If you’re the egalite-fraternite-type-human with rights for liberty, property, happiness, yet not the happiness of affordable health care, employment , or comfortable retirement, what can happen to prevent your treatment? Imagine, your company drops its health plan.  According to the U.S. Census Bureau , the percentage of the population covered by employer-based health insurance has fallen every year since 2000, from 64.2% to 59.3%.

Imagine your company goes belly up.

Imagine you lose your job because,  imagine, the unemployment rate as of this writing is in the double digits. No Census Bureau data needed.

Imagine you leave your job voluntarily because your grandma, who lives in a house on the other side of the wolf-infested Dark Forest, needs her medicine.

Imagine you depend on your spouse for medical coverage and imagine she runs away with her health insurance agent because he’s so much better off than you are.

Or imagine you live in the worst depression since the great Depression. Your employer drops its health plan because health care is getting more expensive or the company is in bad shape. Or imagine, you get sick and  losing many work days costs you your job. Your wife leaves you because the insurer has a job and you don’t. And here you are a lone afloat in the individual insurance market without a job, a wife, or a rescue boat in sight.

Imagine you do get sick but your insurer, the one who ran away with your wife in the first place, rescinds your policy because he’s such a douche or because you didn’t read the fine print in which your contract clearly specifies that your insurance doesn’t cover the treatment you need. Or he hires a detective to plunder your medical records to find a reason to deny you insurance.

Now you don’t need to imagine that whatever this is, it is not insurance. It’s employer-subsidized health care for the duration of your employment. Much like your retirement is. Once you’re in the individual market, you don’t have to imagine that you have no right to affordable health insurance. An insurer can refuse to insure you, charge you a premium only Bill Gates can afford in a free market only Bill Gates can afford. The problem is Bill Gates doesn't need insurance. At least not of the health kind. Bottom-line medical care will always rise with time. Itmakes a fool out of your insurer, who need I remind you is happily banging your wife right now probably right in front of your kids in Bermuda, if he would NOT charge you for your potential medical care more than it would cost you out of pocket. 

With a bottom-line pharmaceutical industry, the motivation for fast cures is very small indeed. I am reminded of that horror-pic, Extraordinary Measures, that I wandered into by mistake at the movie theater in NYC. Rather the highest revenue can come through disease or wellness maintenance. In the recent issue of Popular Science, an article announces the beginning of expiration of a pharmaceutical patent block this year to wind down by 2016. Many brand-name drugs bringing in $140 billion in sales will be replaced by cheap generic versions using their patent. The upside is that prescription drug costs will decline in the next 10 years. Pfizer’s patent exclusivity on Lipitor which has garnered Pfizer $12.4 billion in sales in 2008 and is one of the most profitable drugs in history will expire. FDA approval of drugs has fallen from 35 a year in 1996 - 2001 to 22 in 2002 - 2007. Vioxx problems, a prescription pain reliever, were to blame after studies showed that over a hundred thousand patients suffered heart attacks. Without the $12 billion Lipitor revenue and other brand-names, R&D funds would decline despite of the growth of superpharma concerns: Pfizer’s merger with Wyeth and Roche with Genentech.  To generate more revenue, the companies will bank their R&D funds on their biggest cash cows: obesity, cancer and immunological and neurological diseases that require maintenance but cannot be cured completely just yet.

Medical insurance doesn’t cover patients with pre-existing conditions, often has no prescription drugs benefits, doesn’t cover specialists, doesn’t cover hospitalization or does at trivial expense and has gargantuan deductibles. There’s more that regular health insurance plans don’t cover than do. When I was employed as a freelancer, clinging to the life raft of individual insuance, my deductible under HIP from the Freelancers’ Union, was $5K on top of the monthly $300 premium. I couldn’t afford to go to the doctor to check my wonky knee. When the opportunity came up to downgrade my freewheeling life of an international gigolo to an anchored-down zippered-up desk jockey position, I did me harm by making the expedient choice because of the inexpensive PPS attached to the job.

Imagine you are about to be hospitalized. If you have health insurance. If you have no “priors”, i.e., pre-existing conditions. What happens? The hospital actually outsources you to your family care. So not only do you have to make your own coffee at the coffeeshop, but you have to sew yourself up after your appendix is removed as well.  An eighty year old grandma gets trained on how to wash a tube for her daughter’s catheter or change her bandages after invasive surgery. I suppose the short-term solution to medical cost-saving is not to use trained medical personnel. Here’s the vaunted American ingenuity at work! In the same vein,  If a sewage pipe bursts in your house, you shouldn’t call the plumber. Put a bandage on it. Or take a plumbing course, which is less expensive than calling a plumber. Or move out. What if it’s the husband who must take care of his wife? Will he have to take time off work? Most likely. For how long can he do it and retain his employment? The average seems to be  120 days under most state laws. This not bad, considering. However take a coworker of mine who after a decade of hunkered-down data entry was diagnosed with acute carpel tunnel of both her wrists. Having opted for surgery and suffered complications because of the doctor’s delegation of his responsibilities to a resident, my coworker spent 9 months in home care unable to resume work. A carpel tunnel is not cancer. And yet to her, it proved more debilitating because of lost earning ability. Here’s another lesson in this. Many city hospitals unable to hire physicians to fill all slots because of financial constraints are opting to hire residents for the positions served by doctors in the past. This is another cost-saving that the modern system encourages, heaping revenue not on providers but on insurer intermediaries. In 1971, a mother giving birth to a non-caesarian child stayed in the hospital for 5 days. A caesarian – 10 days. Now, the mother  gets discharged within 24 hours, sometimes with the help of legislation. Profitable? Yes. Efficient? Certainly. Quality care? Quality of life? Risks of negative outcomes? These get swept under the rug. In the end, these are not quantifiable indices and economists have no means to take note of them even if they wanted to. Then are we as a people, as proud Mericacans, saying life is not important? Take an example from WW2 Russia sending its troops to the battle armed to the teeth only with their exceptional patriotism, where every rookie would pick up the rifle of his fallen comrade. Imagine a circle of rifles borrowing a new pair of human legs and a trigger finger to advance a few meters into the heart of the enemy. This is the inanimate revolution. This happens when human life is made subservient to things. Read: critique of American consumerism. Take another revolution. Prior to the French Revolution, much of the same privatization of profits was going on. Then the Enlightenment placed emphasis on equality, humanitarianism, and quality of life.  If history has a tendency to repeat itself, it is only a matter of time before Enlightenment reasserts itself and reinstates human values over the values of Mammon. Insured health care is just one cog in the modern ascendancy of corporate tyranny. The ongoing shift from democracy to corporatocracy some day will become our new American Magna Carta. Here’s hoping, kid.

And to resume our weekly tradition of solving one global crisis at a time. Here's my solution to the crisis of medical care in five sentences or more.

It is a well known fact that as monetized industries go, health care is one in which any person, dead or living, would give up her first-born for the chance to sew-up a torn off limb back onto her torso. More if it's a new and better limb or, even cooler, a claw. Read in this the biological imperative, spiritual degradation, WISIWIG, Res Ipsa Loquitur, qua es cogito ergo laude summa cum, etc., etc.  The problem is that there is no market check on the runaway charges fixed to the invaluable service of sewing heads back on, especially in a social order without any matter of social safety nets such as guaranteed full disability or above-poverty-level unemployment entitlement. Getting injured or chronically sick equals death more often than not. Currently the check is being provided by the so-called insurers with doctors' dues being limited to a fraction of their billing appetites. However, the costs are a speeding locomotive and if you like to know where your money is going, here's a linkie. The solution appears to be in government's subsidizing medical students way through school in exchange for a commitment to gain experience as a government retainer for a number of years treating patients free from the motivations of profit or insurance companies' constraints, providing treatment at government-determined prices. This is nothing new. Even as we speak, a similar program requires new physicians' service commitment in the armed forces whose length is determined by the number of years the medical student's education was subsidized. Problem solved. Voila. 

('’)

First Order of Itinerancy: Recognizing Your Itinerancy

 The first stage of the coping process is to realize that unchecked grieving is priming you for a heart attack. Nothing works better than selfishness in stopping to care for others or, as the case may be, worrying about the commitments and obligations involved in selling your meager belongings, recently acquired in an impulsive move to the West Coast 3000 miles away from your hometown in order to move even further away to a tropical island nation of Dominica, which somehow reminds me of Vonneguts' dystopic Republic of San Lorenzo, to begin a four year journey to earning the diploma of a doctor of medicine that every practicing physician you ever asked when you were a premed told you was an odious, vain, pugnacious, dimwitted, hebetudinous, doltish, thickish, bad, bad, BAD career move.

The second stage of the coping process is to sandwich your head between your hands and run around screaming bloody murder. Nothing works better than bloody murder. Violence is the solution. You may prefer a handbag weighted with paperweights or orange peels wrapped in a sock against the back of the head, but blunt trauma only removes your anxiety. It is a short term solution. The problem will resurface when it eventually comes to in a pool of own vomit and hangs around your backyard late at night waiting for you to come back from work. The best murder is bloody and screaming bloody murder is the closest you can come to bloody murder without steeping your hands in bloody murder. Can you tell I lived in Brooklyn for two decades?

In the end, your itinerancy must be recognized as inevitable. In all fairness, you have examined your options and in that limited exercise of free will made the most rational decision based on the facts: 1) you hate your life; 2) you are not getting younger and 3) that white-collar pit of vipers that you buried your twenties in trying alternately to wrest, ignore, or appease, is going to be your tomb. Indeed, itinerancy must be extolled and exalted, for in motion is the very seed of animal life: En motius es nutus animalus indeedus. For to be in motion is to be an animal, to reconnect with that somnambulent part of yourself that wants to clip your boss on the nose for promoting a ne'er-do-well alcoholic lickspittle over someone worthy, but which you choke down and go sit at your desk like the miserable vegetable you are. Itinerancy sets you free. And that is its biggest uncompromisable virtue. It may empty your wallet while doing so. It may give you bruises. It may sour you on human goodness. But it sets you free. Even in taking giant steps backwards you could be conceived as going forward as, to paraphrase Newton, all motion relative inertial frames of reference is grinding to oblivion and in that we are all like Wall Street.

On the Bandwagon, up, up, and away!

 Dear friend,

It has been a long time since I have spoken to you. Please remind me who you are and what you have ever done for me. In any event, I moved on. I said goodbye to all childish things and left my hometown for good. I did not beat around the bush. I announced to the world that I was moving on. Not lingering and changing pleasantries. Not keeping any last-minute rendezvous. Not being ambiguous about it. Sorry, I am a different person now.

I would really appreciate if you were to give me a hint as to your identity. There has been so many new faces and experiences, that I am at a loss.

Until later, whoever you are.

Up Yours, 

Itinerant

P.S. Here’s my number 206 555 xxxx. Do make it short. It’s not that I have a lot of work, but I get easily tired pretending to be interested in commoner things. 

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You, my fellow itinerants, have license to use this letter for finishing all your landlubber business. I drafted it for all those I am leaving behind. After all, we had a long journey together, and if my friends could not become the friends I couldn't leave behind, there is nothing more they can say to stop me.
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This post is the first. Let's raise a glass and pop a squib. W00t. What's special about today? Absolutely nothing. Life is meaningless. We'll all burn in hell. But enough about my philosophy. We have done a fair bit of getting to know each other now. On to current events...

Today the universe's gift to me is insomnia. God damn. Every day it's something new. Six years ago, a cheerful Indian attending at the Coney Island Hospital Surgery Department told me my acute appendicitis burst into the lumen of my intestine while I was waiting in the emergency room, and I should be fine. That was after the emergency physician examined my CT CAT scan and asked me, "Do you see anything wrong here? I don't," to which I gently responded, "Let's assume, for the sake of the argument, that today I am the patient." Five years ago an orthopedic surgeon at Cornell Medical, holding an X-ray of my knee, told me I was fine, as I hobbled out of his office trying to make his faith work for me too!  Two years ago it was hemorrhoids. Last week the chest X-ray reconfirmed I have spondylosis of the spine and one of my vertebrae is deformed. Two days ago, the dental hygenist said I have an onset of gingivitis and mild cariez in my #28 and #29 that she recommends dipping in concrete, or whatever the hell they do. I sure hope my health insurance agent reads this. Health care is at a point where you probably can blackmail someone with this information for a good chunk of change. Don't get any ideas. You don't know me very well at this point, and you might get the impression I'm a pissy Jewish pessimist. You are half-correct. I am a recovering self-aware pissy Jewish pessimist. And I like dashes -- apparently. Many times I have been instructed to look on the bright side as per fascinating American custom and have been working towards it. Speaking of working toward it, what is it with people saying going forward as a verb phrase to replace "in the future" recently? It's been catching on on all the news channels. The entire Wall Street is going forward. Okay, Wall Street has a good reason to go forward. It's running away from something clawed and toothed, but the rest of us peasants should probably stick with, you know, the human language. As I am attempting to look on the bright side of staying up through the night well into 9 AM, I am reminded of the book I picked up by Barbara Erenreich, Jebus bless her name as it is unspellable, titled Bright-Sided. I was not looking forward to it, as I was disappointed with her last book, Bait and Switch, but, having picked this one up at the bookstore will, going forward, be looking forward to thumbing forward through it eventually. Forward! The first chapter was so appalingly depressing, I was ready to move out of the US and to that happiest nation  of all: Denmark, where lemon drops hang off chimney tops and beatings are only administered with candy canes. Pick the book up at the bookstore and go through the first chapter. It is seriously upsetting. I felt right at home reading it.

The CNN is playing in the background. Today it's record snow and the tea party wingnuts have been making noise again. It's appropriate this particular group has chosen teapots to serve as its emblem. What better symbol to show you are a crackpot than a teapot? Ok, maybe a crackpot, but where do you get earthenware in this day and age? Specialty store? I bet you've got to drive around a bit. In any event, if I was hitting the streets, risking forstbite, to protest something like a lunatic, I'd do it for the trillion dollar stimulus.

And to set a trend to solve one global problem in every other of my logs, let's turn our attention to the mortgage crisis. Why did it happen? Who's to blame (cough: Gramm, Leach, and Bliley: cough)? Where to get the dough? Let's have the banks stop securitizing mortgages and selling them off to unwitting investors. If the bank has to hold onto the mortgage to see the repayment through, the bank will do a bangup job evaluating who can and who cannot afford it. There. Problem solved. Till next time, kiddies.