Insanity scale

Now it all makes sense to me. I used to wonder why I met all the crazy people. How come every where I turned there was another lunatic in my way? Now I get it. EVERYONE is crazy, except me. They are all whacko's. I get it now.

First, there is the matter of degree. Some people are EXTREMELY crazy in everyway, and they are the ones who can be seen arguing with a brick wall or hanging out in the emergency room at three in the morning with blood dripping down their faces.

Some people are mildly crazy, and you only realize it when you talk to them a little bit. These are the ones who think there is a big conspiracy behind everything in the news, who believe George Bush, and who believe in religion and a supreme being. In other words, they believe things for no reason except that they want to.

And some people are extremely crazy, but hide it well. These are the people who seem normal enough until they tell you "I don't know why I'm so heavy, I don't eat much. It must be fluid." Or they have surgery and everything goes nicely, but the nagging pain they get when they think about going back to work just won't go away. Maybe more percocet will help. And an extra month off of work.

So I propose a new paradigm for insanity. It will be like an IQ test, except it will be for the Sanity Quotient. It will measure whether people want to blame someone besides themselves for every problem. It will measure how little responsibility people will take for their own lives and their own happiness. It will measure how unreasonable and irrational their expectations are.

Of course, I will be the gold standard and everyone else will be defined by how far they fall short of me. To the extent they believe what they read in the newspaper, their Sanity Quotient will go down. If they believe everything the read on the internet, it goes even lower. If the answer spam, lower still. Drive an SUV and complain about gas prices? Down. Have cable TV and spend $100 on your hair and nails but can't afford health insurance? Down. Ride your motorcycle drunk with no helmet? Down, down, down.

But insanity today takes the responsibility from people. Don't feel like getting out of bed? You must be depressed. Not motivated to go to work? You have a diagnosis. Drinking? Gambling? Can't sit still in class? Cheated on your spouse? Fell asleep behind the wheel? Poor baby. You are a victim. With the SQ scale, there will be no diagnosis except a number.

There is such eagerness to dump the problem on to someone else, or even better, something else. Kids can't read? Blame the schools. Can't get out of Iraq? Blame the Iraqi government. Banks collapsing? Blame market forces.

There are two other possibilites that don't get considered: that there are individuals involved who may not be doing what is needed, or that there is no solution to the stated question. Perhaps it isn't the "schools", perhaps it is teachers with a low SQ score. Or more likely, PARENTS with a low SQ score. And perhaps the Iraqi government can't make things stable because nothing could make things stable. Perhaps the answer to the question "how do we stabilize Iraq?" and the answer maybe that you can't, except when it gets so unstable that it breaks apart.

I see this on a small scale every day. A case was brought up for its teaching value last week. It happened at another hospital, but it went like this:

A woman came into the emergency room bleeding from her rectum. She was supposed to drink a jug of stuff that would clean out her intestines so that she could have a colonoscopy. Instead, the nurse gave her a jug of another persons urine to drink. The discussion was about how do you tell the patient about this mistake, etc. But one midlevel hospital administrator talked about what sort of policy could be instituted so that it wouldn't happen again.

Do we really need hospital wide policies against giving patients urine to drink?

I would like to think their is already a policy about that, even if it isn't written down. But we can't blame the nurse, it has to be a "system failure".

And there is a 90+ year old in the hospital now who has a perforation in her colon. Stool is spilling into her belly. We have a half inch plastic tube poked into the area of the problem which can hopefully drain some of it, and she has a colostomy so the stool will come out in a bag instead of out the perforation. But she has pain and we give her pain medication. Then she gets confused. Then she looks dehydrated so we give her fluid. But the fluid sits her lungs so she can't breath. So we can give her lasix so she pees the fluid out and she can breathe better. But then she is dehydrated. How are you going to fix it? The family wants to know.


What they should be asking is how are you going to make her comfortable, because sometimes there is no answer to the stated question.