The Weaponization of Psychohistory

January 20, 2017

I had a dream this morning that there was a snake attacking a young cat. I was watching through a window, thinking how I felt bad for the cat. The battle went on for an excruciatingly long time, sometimes the cat would get the upper hand and I would hope it could, by some miracle, kill the snake.

For some reason I couldn’t do anything about it so I just rationalized that it was the circle of life and hoped the best for the cat, hoped that at least the bite would be quick and effective and the cat would be dead if the snake tried to consume it.

After a while the cat became listless, I knew it had been bitten. I turned away for a moment, in sadness or disgust maybe but I really just felt helpless. When I turned back the cat was a baby. I knew the venom was enough to kill a cat but the baby would be suffering for a while. For some reason there was still nothing I could do. The snake was going to eat the baby, alive.

I woke up at 1300 Eastern Time.

According to a source, Asimov wrote about the use big data to manipulate the masses more than seventy  years ago.  I don’t really know, because the limit of my experience with Asimov is his analysis of the Bible. In any case, the rumors of the current administration’s affinity for Strauss and Howe combined with their use of metadata to effect election outcomes has resulted in a great deal of hand wringing in some circles. We watch the news and our news feeds with appropriate consternation  at each new story, new scandal, new outrage that verifies our worst fears. We don’t know what’s coming, but we are sure it will be extraordinarily bad.

Rumor has it the current administration  believes  Strauss and Howe‘s generational theory supports their political strategy. They are  wrong about the coming revolution. Millennials are not going to support their agenda. A 74-year-old man was defeated in the primaries by a 69-year-old woman who was defeated in the general by a 70-year-old man who is installing a slew of establishment elderly to run the country.

The New Right will drive millennials further left, just as the New Left drove Boomers further right. It drove the Boomers so far right that they elected a fascist demagogue to lead this country (way to stick it to your values, hippies). It drove them so far right that an avowed anti-Semite and misogynist with no political experience is considered an acceptable choice for Chief Strategist.

What do you think the Far Left will look like in two years? I have an idea, because my 19-year-old daughter does not share my values. My 19-year-old daughter is an avowed SJW, and while she listens to her father and me in considering her vote (this was her first election) she listens to her friends on social media more. She will be listening to them a lot as she grows, as she refines her individual value system, and as her beliefs mature. As she develops her identity, she will do so in tandem with identity politics. I raised a Democrat (even though I am Libertarian and her father is independent, she is far more liberal that either of us). Trump will raise a Bolshevik.

When the kids currently protesting in the streets are drafted to fight a war, they did not start, in a country far away, while saddled with enormous debt they did not incur, and see more than half of their checks stolen from them to fund a Social Security system they will never benefit from, and a Medicare/Medicaid system they were kicked off of when the ACA was repealed, they will revolt.

There are more millennials than there were Boomers at the height of their generational power. Does anyone remember what Boomers did in the late sixties and early seventies? You think you’re seeing riots now? You ain’t seen nothing yet. These people are more disenfranchised, more ignored, more abused, and they are not all high. Their motto is not “turn on, tune in drop out,” it’s “we will fight them on the beaches, we will fight them on the landing grounds, we will never surrender.” However, they are not fighting Nazis, they are fighting New American Fascism.

We just mandated The Little War. Anyone who read Logan’s Run knows, we all lose.

March 8, 2017

I had this dream that a small fire started in a house. Nobody was doing anything about it. I was in a fugue, unable to act. The fire grew.

I became worried as the fire became quite large, engulfing the room it started in. I know this was bad, and the house could probably not survive. I insisted quite loudly that someone do something. Someone suggested breaking a window, I responded that would just give it more oxygen, and was a bad idea.

I realized nobody was going to do anything, and started to act on my own. I told my daughter to retrieve the animals so they would not burn to death, I told someone else to call 911. I looked around for tools and escape routes, noting where I was in relation to the fire, and the paths that would need to be taken to escape.

Nobody called 911, so I did. They would not answer. When they did they put me on hold. The fire grew.

Somehow, I got the feeling that there was something in the room, in the fire, that I needed to go back for.  The room was fully engulfed.  There was no way that anything of value could have survived, and yet I felt compelled to go back.  I knew, looking at the fire, that I could not succeed, and that I could not survive.  And yet, I decided that I would have to go back into the fire, regardless of the surety of failure and death, there was something there, in that burning room, that was worth my life, to try and salvage, despite having no chance.

And then I woke up.




So this is why They called a “code triage external” at change of shift. This is why there was no cuddle or lean board meeting or any of the daily partial communication that occurs before we start our shift.

My facility is trying to go “lean.”

A fundamental aspect of “lean” is that front-line workers have a say in operations. So now we have to have a pre-shift “meeting” around the “lean board” which captures nothing related to actual patient care or outcomes, only what has been charted (because that is what is audited). After I rather loudly complained that outcomes were not part of this “huddle” (which we euphemistically call a “cuddle”) they started reporting the number of days we have been without a fall, pressure ulcer, CAUTI, CLABSI, etc.

Like the good old days at the plant. “this is the number of days we have not had a Silkwood event thanks to y’all keeping your mouths shut and not reporting anything!!!

Does anyone with a LSS cert think it’s a good idea to *withhold* information from front-line workers who have to respond to a mass casualty event?

Really? No I am not trying to get fired. I am trying to understand how the one time we need info it is not given, but every other day we have to be 15 minutes late to shift report so we can hear the managers whine about our missed punches.

However, this could get me fired. Even though though it is not political, it is not a HIPAA violation (this is a news report, no patients are identified, my facility is not identified, etc etc), and I am not saying any untoward events happened as a result and thus I am not opening my unidentified facility up to legal scrutiny, I could get fired for this post.

Like when I suggested to the rep for our monitors that maybe the vitals could be integrated into the EHR so that I would not have to spend my entire day doing data entry –fired.

Like when I suggested that simulation does not adequately capture the intricacies of a real life emergency and that strict adherence to unnecessary rules could compromise efficacy in an emergency –fired

Like when I suggested that allowing a patient to die due to inadequate treatment for their MI was not preferable to transferring them to a higher level of care — fired (well I quit on the phone but was reported to the BRN for a fabricated incident anyway).

I still have my license, because I either quit or get fired from every place that is a risk for my license (usually I get fired) .