Archive for the 'categories' Category

When grass looks dead

September 19, 2014

This year I learned that while some patches in my back lawn looked similarly dead, the symptoms were being caused by different problems.

One was dryness and scorching.  It seems that the top of the lawn, near the back retaining wall, is more exposed to sun, perhaps on account of tree removal elsewhere, than it used to be.   We apparently didn’t get a lot of rain either, and there is “ledge” not far beneath the dirt, I am told, so I guess the whole thing dries out easily.

That area has come back from its dormancy with watering.

Closer to the house the patches were being caused by grubs.  I have had this problem in that area before, had it treated and replanted, but the little critters are back, and we’ve had to, again, pull up the dead stuff, take off a layer of dirt, treat with some sort of chemical product, put in new soil, and then seed.

What we were shown was that in the dry patch, the roots are still there.  In the grubby patch, the grass just pulls right away without application of real force  —  the roots are gone.

Why is this interesting to me?

It reminds me of the problem of trying to differentiate between spiritual emergency and mental illness or between dyslexia and cognitive impairment or between viral sore throats and strep — all kinds of situations in which a differential diagnosis makes a big difference in terms of choosing an effective treatment.

It also reminds me of the problem of calibration, another factor that is relevant to finding a helpful response.  Some people become calibrated for people with low pain thresholds or high drama affect, and they become callous to anything short of hysteria.  I’ve encountered doctors and nurses like that, some of whom were apologetic after they discovered their misjudgment.

On the other hand, I am leery of putting too much emphasis on diagnostic category, either.  That can turn into a proxy for getting stuck in the problem and not doing what can be done to improve things:  “Oh, it hurts to walk because I’ve had surgery, I’d better stay in bed, I’m just a post-surgical invalid.”  Or, “I’m not sure what the correct diagnosis is, so I won’t bother looking for strategies that help.”

Of course, if the patient says, even calmly, “This really hurts too much,” it might be well to see if there isn’t actually a complication that warrants a different response.

The other reason the lawn issues catch my attention is that, just as there is a New Testament metaphor about the soil on which the seed is cast, there is, I believe, an issue about on-going upkeep  of the crop  —  if the grass begins to die, we may need to be careful about finding out the cause, because that may make a difference in terms of what response will be helpful.  Watering a patch destroyed by grubs won’t help, reseeding a dry patch is an unnecessarily intrusive intervention.


Institutional cultures

January 27, 2012

Here’s another follow-up.  It’s to my meditation on incongruent taxonomies of employees I came upon in my adventures theretofore in sorting out a family member’s health insurance.

I was on the phone today with a Massachusetts government agency involved in regulating insurance, trying to sort out “guaranteed issue rights” for people under age 65 and disabled and not actively working but with private health insurance through an employer, who enroll in Medicare but don’t purchase a Medigap policy initially.  When I eventually mentioned who the employer was, the fellow said something like, “Oh, they self-insure, so they’re not regulated.  And I’ve gotten questions from them from time to time, and they seem to operate in their own little world, because, not being regulated, they never check in with whether their understandings of the rules are the way the rules are interpreted by the government agencies involved.”

Bingo, it’s not just my experience of this thing, or my imagination.

Bureaucratic worlds collide

January 14, 2012

In the course of trying to sort out a new and exciting bureaucratic issue of significant complexity, I realized that the crux of the matter seems to be that the private bureaucracy involved has one conceptualization for categorizing employees, and the government agencies involved use a different set of distinctions to delineate their categories on the same issue.  Setting aside the issue of how this situation will be resolved, I find it kind of interesting to see how rules take on a life of their own beyond the policies they are trying to promote (even ending up undercutting those very policies), and also how different institutions develop different institutional cultures.  I’m not sure they even are aware that they have an institutional culture, let alone one at odds with other institutions’ cultures.  I am hoping that circulating a form (once I receive it) from one institution to another will focus attention on the fact that the private institution’s categories are not congruent with the government’s.  Once we establish that, then of course there’s no telling what the institution’s reaction will be, but at least we will have established some kind of communication that we’re not communicating.