Collective Imagination

The other day I fell and bumped my knee, and I did it in the Northeastern Suburbs of the Twin Cities. Well, I did more than bump it. I busted the patella into a zillion pieces and severed the main tendon connecting my upper leg to my lower leg. That totally put the kibosh on my plans for that 2010 Winter Olympics figure skating gold medal.

Anyway, the ambulance had to take me away from the crash site, and brought me to a hospital in the region (St. Johns). It is a fine hospital and I was glad to be brought there, but it was one I had never heard of, as I live almost an hour to the west, in the Northwestern Suburbs of the Twin cities.

The emergency room doc was kind enough to make an appointment for emergency surgery for me, and he asked me who I usually have do my emergency orthopedic surgery. I said, "I don't have a clue, can you suggest someone who is really good?" So he hooked me up with a surgeon, a Dr. Myer, who in fact is quite good, and had I had the opportunity to have done the research I would have picked him, mainly because of the Carmen Fasulo Effect. Which I shall explain later if someone reminds me to do so.

Dr. Myer runs a practice typical of the twin cities, where he migrates between a handful of hospitals and a handful of clinics, all in the same region. His region is the Eastern Suburbs of the Twin Cities, but he also goes to St. Johns in the Northeastern Suburbs.

Now, when it came time to go home after the surgery, Amanda and I realized that it would be really hard to go home for a number of pragmatic reasons, so were are staying temporarily with my in laws. They are in the Western Suburbs of the Twin Cities.

So, today, my mother in law drove me from the Western Suburbs to the Eastern Suburbs where I got checked out by Dr. Myers. Dr. Myers wanted me to get a new brace for my leg, and the place he uses for this is in the Far Eastern Suburbs (right on the Wisconsin Border). So I asked about places maybe closer to the Western Suburbs, and the staff at Myer's clinic went ahead and found a location closer to where I am staying... and that orthopedic bracery (or whatever one calls such a thing) is in the Southern Suburbs of the Twin Cities, down near the airport.

OK, so, in your mind you have a circle, starting in the upper left where I live, moving to the upper right where my injury occurred, moving to the far right where my Doctor's office is located, moving to the south where the Bracery is, and then to the far left where I am currently staying, in a big clockwise clocky thing. Putting it another way, my injury and its treatment over the last two weeks has encircled the entire twin cities. We've got 'em surrounded!

And although not a lot of people live here in the Twin Cities, it is pretty darn big. This circle, if superimposed on the Dallas region, would be like a big lasso encompassing much of Dallas and all of Ft. Worth. For New Yorkers, it's like I'm staying in the Palisades, but I really live upstate in Yonkers, my Doctor is in Hicksville on The Island, and I need to take the ferry down to Staten Island to get the brace. For Los Angelinos, think of me as beached out in Santa Monica, ekeing it out Burbank, but my Doc is in The Valley, and I have to buzz down to Lynwood to get the brace. Or, for those of you in Britain, I'm on holiday in Windsor Castle (hey, why not?), but I reside in Watford, my Physician is in Stratford, and I need to go to a chemist in Tooting go get the bloody brace.

Now, let me add a fine point to this: In each of these twin cities areas, the local people ... in the hosptical, medical offices, home-visit nurses and therapists, the brace guy, etc. ... as helpful and wonderful as they all have been, were clueless as to the facilities available outside of their quadrant of the Twin Cities. Just today, the staff at the surgeon's place in the Eastern Suburbs all looked at each other funny and kind of grinned while slowly shaking their head back and forth when I asked "Anybody know of a place to get a brace over by Plymouth or Golden Valley?" One of the staff, a woman in her 40s, said she'd never been out that way before. Meanwhile, heading out in the car with my mother in law to the eastern region, she quipped, looking around, "Hey, it looks like they are starting to settle this part of the prairie," or words to that effect.

Everything is working out OK for me because of the particular nature of the coverage under which all this is being paid. But for people with certain health care plans, this could be quite difficult. As it turns out, I have had to provide the vitals (not BP, pulse, temp, but insurance provider name and number, date of injury, etc.) to a dozen different entities, and had this all been handled in the same "service area" that number would be reduced to three or four, most likely.

Which is what the chip would be for. Stop asking me questions. Just scan the nape of my neck (where I assume the chip is actually planted) and integrate the data with a good GPS system and provide a route map for the ambulance, me, the physical therapists that now must trudge across town to find me every few days, and above all, to the pharmacy system so I can always, always have my pain meds.

An obvious question that arises is this: Am I the first person ever to have suffered an injury requiring emergency attention in a place other than their own HMO's service area? I assume not, though of course, statistically, most people do get injured near where they live. However, I object to the idea that my situation is THAT rare, and I can even cite a parallel situation that underscores this sort of difficulty but on a day to day basis.

This is the situation of public access TV. I live in one town. My wife teaches at a school in a different town. My daughter goes to a school in a third town. I've done a number of public access TV shows in a fourth town. So, when we sit at home and watch Public Access TV, we don't get to see what is happening at my wife's school, or my daughter's school, or the stuff I've done. We only get to see the stuff for the immediate community in which we sleep at night, but not the broader community in which we live.

A chip in the head would not solve this problem, obviously. But I point out the Public Access problem to underscore what may be a disconnect between the actual geography with which we live, and the presumed geography for which many of our systems are tuned. The chip, which is obviously not something I want planted in my head but for the present purposes serves as a mere literary device, represents the broader approach of using technologies to solve this geo-experiential dissonance.

I'll leave you with one more example of geo-experiential dissonance.

When we went out to the doctor's office today, my mother in law programmed the GPS machine to guide us there. There were a total of about 35 instructions. The first 22 or so amounted to "Take this road you know really well east" but came out as "turn right, go 200 yards, turn left, go on quarter mile, take this ramp, this road, stay left, stay right, this exit, that exit" etc. etc. In other words, the GPS machine was unaware of the fact that we already know exactly how to get from where we are to several points around us, major intersections of key highways, etc. Beyond that, the next dozen or so instructions were about how to not accidentally take an exit that we obviously didn't want while driving on one single highway across the region. The only instructions we needed were what exit to take at the end of the trip, and then, which two turns to take to get to the medical arts building.

That is also a geo-experiential dissonance, but rather than one of locality, it is one of distribution and detail of knowledge. This problem as well can easily be solved with the right technologies, and maybe in this case the chip would actually help! (But not as much as a volume control on the GPS machine so we can selectively hear it or ignore it...)