note: this page is updated in March 2015 zero trust in health services

and now it is too late to bother.

As “new reforms” in health services are introduced by our politicians, as they are every other year or so here in Norway, all talk about it goes in one ear and out the other at my end. It is “the emperor's new clothes” all over again every time, and he is still not dressed up well, and is probably not going to be in the fore­see­able future.

About the only good thing one can say about health services here in Norway, is that they – at least for the time being – are reasonably cheap for those who need, and get, access to them. Economically, for the individual citizen, our health care system is actually working.

In other ways it is not so reliable. If someone on the inside has a bad hair day (or something of that nature), you may wish you didn't have to suffer any contact with same “health services”.

Of course, there are many good, knowl­edge­able and hard-working people in our health services – same as in all pro­fes­sions. But, in my very personal opinion, the good ones count for much less than half of those who are in the relevant pro­fes­sions, and they can be very hard to find. The really good people usually don't stand out you know, you have to look them up.

If something really serious hits you, you may all too often be better off playing russian roulette with the issue, and hope you get lucky.

excuse me ‽

Back in the mid ‑70s I was once told by an apparently quite upset head nurse at a hospital1 at the West Coast of Norway, not to speak up against the head doctor. According to her he took something I said very hard, and took it out on his personnel and other patients. Not an overly pro­fes­sional way to handle things on his part, I have to say.

Well, if the head doctor could not stand the heat with me in there, he damn sure should not have let me “into his kitchen” and fixed me up in the first place.

All I had done was to try to move a rather big piece of Norwegian granite with the front end of my car. I lost a car and busted up my face, in the clearly quite un­suc­cess­ful fight with a West Coast mountain. But, I had not lost my head, or my good sense of fairness, on the trip to the nearest hospital afterwards.

The head doctor did in fact do a great job stitching my face together. I have no com­plains about his handiwork, and, to the degree that it can be seen at all, it still looks fine today nearly forty years later.

However, the next day he started talking down at me the way doctors sometimes do, and seemed to know nothing and care even less about common courtesy in doctor / patient relations.

My response was pretty much in line with his way of talking, and he clearly was not used to, and did not like, that patients talked back at him with as much authority as he thought he had.

In general I am a nice and flexible person, and can let lots of nonsense pass with a smile. But, if and when the situation calls for a reaction, I do know perfectly well how to call a spade a spade, in any company.

why I am on “state pension”

For completeness: medical personnel checked for concussion after my incident back in the mid ‑70s, but they did not check for whiplash nor did they do anything to prevent further damage to my neck – whiplash was not a “popular medical condition” back in those days. About ten years later I had to pay a pretty heavy price for that omission.

My neck problems grew slowly over the years, without anyone in the medical services taking me serious. In the mid ‑80s I almost went into a vegetabile state, because nerves and blood-vessels in my neck got pinched as my body over-tensioned muscles and tendons as a natural reaction to damage and pain in the area.
As a result, my profes­sional and private life pretty much got shut down in 1986.

Took (another) five to six years to fix the problem2 to such a degree that I could function more or less normal. By then I was bankrupt, and could no longer work at normal capacity and/or normal hours. As a consequence I ended up as “semi-retired on state pension” before the age of forty, which still is my “position” today over twenty years later.

As for work: that my profes­sional expertise as developer in mecha­tronic automation and related stuff for the most part is well on level with what the profes­sional market needs, doesn't matter at my age. Over the years since I retired I have tried nearly all options available on the market, and with the latest development regarding my health (#1, #2) there really are no options left.
These days, when I can find time and have a need for something out of the ordi­nary, I “roll my own” (elec­tron­ics that is) in my own workshop. Saves me for buying sub­standard and/or over­priced stuff on the market.

Now and then – every few years – I still need treatment for the uncon­trol­lable neck pain and related problems. It is amazing what a good chiropractor can achieve, in a case that regular doctors gave up on more than twenty years ago.

Did I mention anywhere that I have zero trust in our health services? Well, if so, it was a gross under­state­ment on my part.

excuse me again, but kissing asses is definitely not my style…

Most seem to see people in medical professions as having unique positions in our societies, probably because we all tend to become dependent on their services at one time or another. It is as if we must accept more of the “my way or the highway” attitude from people in medical service positions, than from people in other professions.

Most people like being looked up to, so no wonder many in the higher positions in medical profes­sions get used to this and that some of them also “take off” a little.
Would be strange if this didn't happen amongst people in medical profes­sions as it does in other profes­sions, with the result that – deserving or not – quite a few “mini-gods” are created.

(26.oct.2014) This is definitely not a Norwegian phenomenon, as the arrogance of modern medicine is (of course) the same everywhere.

I see no reason to pay more respect to people in some profes­sions and positions, relative to people in others. Thus, whether people who work at hospitals are head doctors, accomplished surgeons, or their job is to carry and/or empty bedpans, they all initially deserve the same respect in my opinion. Or, they may end up deserving no respect at all, as is all too often the case if/when they show off sub­standard work and/or attitudes.

People who because of ignorance or lack of responsi­bility regularly do substandard work, are, quite literally, nothing but dead weight in any work force in my opinion. Such “workers” deserve no respect for what they do, no matter what positions they fill. (How they act in private is totally irrelevant here.)

For the most part such “workers” are not worth a single word, neither spoken nor written. I do however have no problems expressing my wish to see them gone, if and when the situation calls for expressing anything about, or to, them.

no quality implicit in numbers

I reckon that maybe as many as 10 percent in any profession perform really well, that maybe as many as 25 percent more perform well in line with reasonable standards, and that the rest for the most part do substandard work.

If I am right in these numbers – and I believe I am reasonably close on average, then maybe as many as 65 percent of workers in any profession should either improve their performance considerably, or leave their positions open to some that do at least try to perform to higher standards.

With regard to people who work in and around our health services, my numbers above indicate that more than half of them should better find something else to do, as …
1) their performance is substandard by any standard,
2) their work does not satisfy their clients / patients.

Do I think I, and others, will be worse off with more than half the staff in medical professions gone? My answer has to be a strong “NO”.

I do in fact believe that we all will be much better off, without those in medical professions who regularly show weak performances and/or bad attitudes. High numbers definitely does not equal high quality…

As in most professions, loads of work in hospitals and care centers can be done through automation (robotics in various forms). This way carers can be carers, decision makers can be decision makers, and people in redundant and/or obsolete jobs can be re-trained for jobs that cannot easily be taken over by “intelligent machines” as of today … there are a few…

Easy to replace half the people in all larger work forces this way, and the approach is already producing results in hospitals and care centers in some countries – not so much to reduce work forces but rather to increase efficiency with existing work forces.
Quite positive effects for patients / clients in most cases, as pure technology don't need many breaks, and (usually) don't show attitudes.

The only negative effect of such moves that I can see, is that many of those who will have to leave one profession because they do not perform well, won't perform much better in another profession. Thus, weak performers will to a large degree only be moved around, and their numbers only be slightly reduced in the process.

The problem as a whole clearly can not be solved by moving people back and forth between professions, unless all noto­rious under-performers are moved to positions where their “work per­for­mances” don't matter to anyone. Of course, this will not happen, but I can think of a few positions in our societies where that is the case…

for heavens sake, get real!

No matter how I look at it: moving systemic under-performers out of health services and into other, less critical, professions, can only be a good thing. In my very personal opinion: we will all live better, healthier and happier lives with them gone, as quality trumps numbers every time, everywhere.

Being doctor, nurse or whatnot in our health service work forces, is after all not a human right, and we will all want, and need, high-quality performers in these professions sooner or later. It is only a question of living long enough to be in need of medical support and repair, and … many of us do.

Like at car-repair workshops, the knowledge and attitude of the personnel make all the difference when it comes to what the client / customer can expect.

And, don't waste time on trying to convince me that medical personnel are held to higher or different standards than others, and that their work therefore should not be compared to that of other “service personnel”. They most certainly are not.
Also, don't bother to pull in the old “we/they are only humans” phrase here, as that “universal excuse” is equally relevant and/or irrelevant everywhere, and carry no real meaning anywhere.

The only difference is that medical personnel literally can bury their mistakes, and think nothing more of them while they are going on to making entirely new mistakes. Those at the car-repair workshops on the other hand, may actually have to pay for their mistakes before going further.

Numbers of days topside on this earth may matter to some – maybe even the majority of people on this earth. Without quality of life, life in itself isn't worth much to me though, and true quality of life can not be bought in any store – not even in a country as rich as Norway.

This is maybe the main reason why I write this article, as I am the only person on earth who can define what the term “quality of life” means to me. I have not delegated that basic human right to some “doctor” anywhere, or whatever those who work at various levels in Norwegian health services, or in public administrations, call themselves these days.

what is it all about then?

Some doctors and various medical personnel may have sworn an oath to protect and preserve life, but I am far from sure what, if anything, such an oath means to indi­vid­uals in Norwegian health services. I am not even sure if I want to know the answer to such a question … afraid I will be even more disap­pointed in the humans involved than I already am.

That medical personnel in certain positions get bribed by suppliers of medication and equipment to make them support use of certain brands over others, is well known. Sometimes the bribers and/or bribed get caught, but only a few cases will ever become publicly known. No doubt there is plenty of it going on in the shadows, all the way to the top.

I am convinced that many – many too many – who work in medical services, are there mainly, or only, for the pay-check and/or social position. I am equally convinced that most of those don't worry all that much about their patients' wellbeing, as all that matters to them is that they get well paid and/or are looked up to – I call it “fools gold”.

What is a real pity in all this, apart from the serious harm they may cause patients, is that all medical personnel – also the really good, hard-working and caring ones – get mis­trust­ed and class­ified at a lower level than they deserve, because of these “pay-check and status hunters”.

Did I mention that it seems to be equally bad in all professions? Well, as can be expected, it is, but knowing that does of course not help anyone.

nobody owes anybody anything…

Almost as a rule, I initially have as little trust in medical personnel in our health services, as I have in our national politicians. They will at least have to prove they're worth anything at all, if they want me to upgrade them from that initial state of zero trust in my very personal ranking. Don't think it matters much to many of them though.

I will continue my search for exceptions to the rule – the few good people in our health services, as I know from personal experiences that those rare creatures who can be trusted, are out there. Lucky you if you have found one of those.

As I write this, I am under radi­ation treat­ment at the regional hospital, nearing the end of that phase in my cancer treatment.

Only time will tell if they do a reasonable good job, or not, in my case. It is too late now for me either way, so I see no point in wasting time on worrying about it.

I can at least guarantee that the placebo effect does not play much of a role in my case(s), as that effect rely on that people believe in and trust “something” – “anything“ … and I don't.

My experiences over the years may of course in themselves have negative effects on my healing. But so what, who in our health sevices cares – there's always another case…

(15.jul.2014) The bladder inflammation caused by radiation gets worse by the day. There is blood in the urine now … See: relevant blog post update.

(26.oct.2014) The hospital did call me in for check-up, but I declined … See: relevant blog post update.

almost done…

I have written my piece because it simply had to be written one day, and I may expand on it with more examples, and some documentation, later on – in my own good time.
Beyond that I am not going to waste time on such issues, as doing so won't do me any good. I have more important issues for me person­ally, on my agenda.

Let them all have their fun (or what­ever they call it), and let me have mine until it is time for me to say the final goodbye.
Sure hope there are none from our health services around when I do, as that is a day I do not want ruined.

Nope, I am not about to say goodbye – not to life nor anything else. It is just that I really don't care anymore which direction life in and around our societies goes – up or down or straight to h***. None of this is my business anymore, as I got to be able to live with myself as a human being.

Others, for instance those who are busy destroying every­thing and every­one in their path in search of “fools gold”, will have to worry about such minor details on the way to their respective graves. I am too busy living by totally different sets of logic and rules, and when my time comes, one day, I'd like to die by them too … as a human being.

May all medical personnel have better experiences with their own services than I have, as otherwise God help them …
I certainly will not.

sincerely  georg; sign

Hageland 16.jun.2014
last rev: 09.mar.2015

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