A reflection on my recent dermatology appointment.

My recent dermatology appointment was my second, and they scheduled a third one for next year again for a full-body scan, since I'm now plugged into yearlies.

They have had a shortage of dermatologists in the area and that's led to mild delays in appointments and then on top of that with this last appointment I encountered another few month delay when a provider I had scheduled with left the practice, but overall, those problems are really no problems at all.

Just thinking back to what my health insurance became in the city that I used to live in, it's like night and day... There, Obamacare not only had narrow networks, but fly-by-night low-end insurers who would price low and come in and then leave in a year or two, and their networks would be full of false listings with no-one you could report them to about that, and when they pulled out or even if they stayed in, you'd rarely establish any care relationship with anyone, and files would get lost in the revolving door, too, on top of ungodly amounts of time and energy wasted getting acclimated to the new system and locating providers and setting up profiles and passwords and billpay and whatnot.

Here, it's like one-and-a-half major providers in the area, and that's it, and once you start, you're good to go indefinitely.

Obamacare was much better everywhere at first, but it really has degraded in major metros for people who can't price up into the higher brandname insurers like Blue Cross Blue Shield, who can charge like $60-80 more in premiums a month, which is like $600-800 a year that you don't necessarily have.

I wonder, too, if those sketchy low-end insurers are also mucking up the market since subsidies are pegged to (I think) the 2nd lowest-price plan, and so they not only provide sh*tty care, but by underpricing they depress the average subsidy in an area and make it noticeably more expensive for someone to go out and pay more out-of-pocket for their premium so they can get into a decent and stable and reputable insurance plan.

A customer the other week at the one (Thai) restaurant where I work now:

A (slightly short) (thinnish but pot-bellied) (neatly dressed in a polo shirt) (washed-out skin-and-hair) (white) guy with (thick-rimmed glasses) who's like in his (mid-50s), who sits down and has like a vintage nudie magazine like you’d get at a garage sale out on the table, and who orders a big bowl of tom kha soup, and when I check to make sure if it’s okay, he says there’s no tomatoes in it, and so I go get the menu and “check to see if there’s a mistake” and show him there’s no tomatoes listed to be in it, and I ask him in so many words how we can correct it, and he's like, no it’s okay, it’s good, my eyesight is just bad.

Two conversations about stir-fry with a (Thai) coworker.

A bit ago, it was just me and my one (taller) (new) (Thai) coworker who wanted our staff meal that shift, and when we were negotiating what to get and I suggested a stir fry, she was like, “I don’t care, I’m not picky,” so I was like, “How about cashew nut…”, and she was like, “Um-hmmm,” and then when I was like, “…with soft tofu,” she started laughing , and was like, “No.”

Also, she works out a lot, so she’s on board with my strategy and defaults a lot to healthier stir fries to eat, and we often get the same vegetable-heavy light chicken one, and when one time I was putting our order in, I asked if it was okay if I put in my usual specification “Less oil, less sauce,” and she agreed, and then I was like, “Less oil, less sauce, less gym,” and she got a kick out of that, and chuckled.

New fascination of a (Thai) coworker:

My one (older) (Thai) coworker who's a whiz at the phones has been endlessly fascinated by the new spoons that we got as new silverware to prepare for graduation, and how they’re almost as big as the serving spoons that we have; “See,” she’ll be like, and she’ll set them side by side to show you how they look pretty much the same, or she’ll nestle a fork in one, to show you how it swallows the fork up, it’s so big.

Thin soles.

The soles on my new-ish tennis shoes are getting so thin, that on my forestep I can feel the individual sharp gravel stone jags through the remaining rubber, when I walk across the gravel alley and cut through a gravel driveway by an apartment building across the way, as I go on my way to work each shift.

Two recent encounters with nature:

1) A squirrel is sitting on a disintegrating wood-block parking marker that lays outside my back window looking onto the alley, and as I watch it, from somewhere it gets a big partially-gnawed avocado seed, and begins to gnaw it some more.

2) As I jog through a park with big trees that’s north of my house one early evening, there’s a group of (late teens) (white) kids all staring up into the branches of this large tree, and so I slow down on the woodchip path before I pass them, and I ask them what’s up, and they say there’s baby owls around and a mother, too, and that they found out through the F*ceb**k page of the local Audobon Society, and if you look up in the tree, you can see the mother owl.

So, I do, and then I say that now I’ll have to tell my friends about it, and they all start laughing at that, as I go to jog off.

Professional perspective of a dermatology nurse and a dermatology doctor...

...at my yearly "full body scan" that I started getting, to be pro-active on any dermatological problems after I had an abnormal mole on my back removed like last year and it turned out to have mid-grade dysplasia:

After they ask me what I do and I tell them and I also add that I had been in eldercare but wage compression really did a number on the frontline care jobs and destabilized the sector over the past 6-7 years, to where you can make noticeably more dollars an hour at a restaurant than as a CNA or whatever, the one says that she's from a nearby (red state) and that those wage levels were news to her and that the problem doesn't exist back in her (red state) as much, since minimum wage there has been kept down and so it doesn't erode the basic healthcare jobs so much, and then when I added that of course you could find better paying jobs in different roles in eldercare but why would you want to when those backbone jobs have understaffing and a revolving door of staffing and you're in a workplace where lots of preventable falls are happening around you because of that and everything smells like lawsuits, they both nodded their heads and they got it, and they were like, "Yeah, no."