Thursday, February 7, 2013

Holes in the Safety Net

I feel the need to bitch about the state of Massachusetts Mental Health system.

It works as though the Powers That Be sat down and said, "How much money can we spend and not actually solve any problems?" and went from there.

A few years back, they closed all the state hospitals. This basically meant finding all the mental patients to be cured and shoving them back out on the street. It was a cost cutting measure.

OK, fine. If we feel that "this ain't no hippy commune, you're on your own," that can work. Not exactly compassionate, but a valid philosophy.

Here's the rub. We still pay for it, we just don't get results anymore.

As an example, we got a call to respond to the phonebooth outside McDonalds for the man who was having suicidal thoughts. Fair enough. We headed out, finishing our coffee en route, because I'm not dumping out my $1.97 worth of caffeinated happiness for some guy who can't handle life's slings and arrows, and we find this gentleman at said payphone.

He has evidence of bilateral Samsonite Sign (suitcase in each hand), and wants to go to a Holy Family hospital, which is farther than the town hospital we normally use.

Me: Why the Hole?

Him: I was just there *hands me envelope of discharge instructions*

Me: *scanning papers* OK, you were released from the mental health floor yesterday. Have you been taking these meds?

Him: No.

Me: Ok. Have you called this doctor for follow up?

Him: No.

Me: O....K... So, what's going on today.

Him: *recites list of symptoms exactly identical to those outlined on his discharge instructions*

Me: So, pretty much the same thing that was going on before you were hospitalized.

Him: Yes.

Me: And this is their recommended solution, and you aren't doing it.

Him: *Long, "life is complicated" soliloquy. No ride to the pharmacy, can't make his doctor appointments, etc.*

Me: Uh-huh. So what do you want to go back for, if you're not going to follow the instructions?

Him: Oh, I was fine when I was there. I was at McLean's (another mental hospital) twice this month, then I was at Holy Family, and I'm fine when I'm there.

Me: *Reads more of his paperwork, finds that he was at McLean's from the 12th to the 16th, back from the18th to the 23rd, out for four whole days in the wicked world, then at the Hole from the 27 to the 29*

So, did McLean's talk to you about some follow up or a discharge plan?

Him: Yes, but *life is complicated soliloquy resumes*

Me: *aware that partner wants to get lunch soon* OK, hop in.

Clearly this guy cannot take care of himself out in the real world. Medicaid will pay for a 4 day stay at a short term psych ward, then he'll be given THE SAME FUCKING instructions, and sent out, so he can call me long about the 5th of the month to take him back.

Now, the guy has issues. Just looking at him and talking to him, he's not one of the guys who games the system and has a breakdown two days before the rent is due so he can live for free for a few days. He has real, honest to God issues. He does ok in an institution where they monitor him and make sure he gets his meds. So well, that they boot him out in four days with a list of follow up stuff.

But, he can't hack, and needs to go back.

Now, when we had this guy in a state hospital, it cost the taxpayers money. But now, in three weeks, it's cost them four ambulance rides, four ER visits, and sixteen days of stay at mental hospitals, plus the benefits he gets while on the outside for food and housing. And, guess what, It doesn't work. He's still just as nuts as he was last month.

Now, to put him in a facility long term, and make sure he can handle outpatient treatment before his release would be an expensive solution. Bopping him on the head and dropping him in the river would be a cheap solution. What we are doing is an expensive lack of solution.

God, I hate the way the government saves me money.

Wednesday, February 6, 2013

When the Fic Hits the Fan

Time to make me some enemies.

I don't see the point of fan fiction.

Like, at all.

It's one thing to be influenced by another author. We all are. I can often tell a writer's favorite author just by reading his work. Brust was a Zelazny fan. S M Stirling has read a lot of George MacDonald Fraser. The influence is there. People say my fiction reads like a cross between a consumer safety warning, Miranda rights and the back of a cereal box, and I say "Well, that's what I'm exposed to."



Taking somebody else's setting and characters and writing stuff with them seems kinda....creepy. It's like when I was a kid playing with Star Wars action figures. Except if I did it as an adult. And posted it to a website. For writers to critique. And got pissy when people called me on it.

And I was really proud of the scenario where Luke and Han, with the help of the GI Joe team, beat Darth, two storm troopers and a Care Bear to free Leia and Catwoman.

Ok, I used to freely mix my action figures. We'll just call that "non canonical fan fic"

First up, form a legal standpoint, you'll never have a leg to stand on. You'll never be able to sell it, or even post it legitimately, because it's somebody else's copyrighted material. Even if it's brilliant, it will never be wholly yours. The clear, legal exception is parody. My feature Brokeback Mount Doom, where Sam and Frodo examine the master and servant relationship in lurid detail, was pure art.

Second, it looks juvenile. Like my Star Wars example. When we're kids, we imitate. I played Raiders of the Lost Arc and Star Wars and Robin Hood as a kid. I probably did what would be called Fan Fiction today in creative writing in fourth grade. That was largely because I was eight. I had no adult frame of reference from which to write except those I stole from books and movies. If I'd gone with the "write what you know" theory, my stories would have been about building tree forts, drinking chocolate milk and playing Star Wars, Raiders and Robin Hood.

One of the best ways to be able to write well, is to have experiences on which to draw. You can't write a love story unless you've been in love, or even a love scene generally unless you told some girl you were in love. Or you just had a nice car, but that's not the point. When you are young and inexperienced, sure, you steal the love story from Beauty and the Beast or Princess Bride, because that's what you think a love story is.

It's not until later that you learn about the nerves, how hard it is to look nonchalant buying condoms, how cramped a backseat really is, and the whole awkward learning curve from the first kiss to whether to call the next day. Or the actual glow inside when you look at a woman you've been married to for years and still feel that rush.

Third, it's cheating. A lot of effort goes into creating a good solid world and the characters who inhabit it, and it's just lazy to let some other writer do the heavy lifting and then come in and use the stuff.

Now, there's an appeal to using an interesting, unique established setting and great, well developed characters, but there's an appeal to using marked cards, corking your bat, using steroids or getting some guy in a bar to fall for the shoelace trick.

But it's still cheating.

Do yourself a favor. Do the grunt work. Make up your own stuff.

You'll thank me later.

Stole that one from my dad.