The Medevac Threshold

There’s a trope in stories called the Godzilla Threshold. This usually comes up in large-scale stories, the kind where you can expect a scene of leaders pouring over maps or pacing a high-tech command room, and is more common in action, in particular disaster, movies, but it comes up other places as well. The Godzilla Threshold is the point at which all bets are off, and any measure, even releasing Godzilla, in the hopes that he will fight the new monster attacking the city, is justified.

This concept, and variations of it, come up all the time. In military strategy we have tactical nuclear weapons, which are employed when the cost of an enemy victory would be worse than nuclear escalation. In statistics, we routinely put dollar values on human lives and wellbeing to measure against other lives, or more frequently, to determine the point at which the cost of additional safety measures are more trouble to implement than whatever harm they’d prevent.
Are there other ways to stop the raging monster besides releasing Godzilla? Probably. Almost certainly. But all of those plans suffer from some variation of being more expensive, more trouble to implement, or they would’ve had to include long term planning and investment that started long before the monster arrived.
So here’s the thing about traveling with chronic health issues: there’s a very good chance that things will go catastrophically wrong. I never know if or when things will go wrong, only that they might. I have some idea of how they might go wrong, and knowing this, I have some limited idea of what would need to be done in those emergencies. I can’t know if or when, or which way things will go wrong, but I can make some contingency plans for the likeliest scenarios. This is why I always carry a full backpack within arm’s reach, equipped with sufficient variety of contingency supplies that it has been playfully dubbed by friends as “the Mary Poppins Bag”.
But my preparative efforts have to stop somewhere. At some point, trying to pack and plan on the assumption that anything that could go wrong will crosses the thin line from preparedness to paranoia, and more pertinently, becomes logistically impractical. At some point, I run out of space in my suitcase for backup prescriptions and redundant syringes. And long before that point, the extra burden, both literal and idiomatic, of trying to outwit the fates becomes simply too cumbersome to achieve anything of meaning.
After all, if I have more migraines than I packed medication for, then it’s pretty obvious that my day is already ruined, regardless of whether or not I have the medication. Similarly, if my life support device, my backup device, and the failsafe delivery mechanism, all get broken, it’s unlikely having syringes to fall back on are going to let me just go about my business. Far more likely would be a scenario where all of the above are destroyed by the same disaster, and then all I’ve accomplished is wasting the cost of syringes in addition.
There is no fix for fate deciding that today is not my day, and at a certain point, the amount of effort to salvage my plans by myself start to exceed the amount of grief that I would find from simply giving up and seeking outside help. I call this threshold the medevac threshold, because often I have to consider this in the context of packing for a cruise, where the only option for outside help may well be having a helicopter fly out and pick me up off my vacation, at great effort and exorbitant expense. But really this can apply to walking into the ER, or even to a pharmacy to get a refill.
Obviously, where this threshold is depends on the specifics. The namesake example of having a rescue helicopter fly out to intercept my cruise ship, like a scene out of The Hunt for Red October, presumably weaving through gale force winds and dodging lighting strikes, because of course that’s how it happens, is somewhat on the extreme end of possibilities. Even so, though it would certainly be a contender for most action-thriller-esque moment in my life, it wouldn’t be an automatic winner, which is, I think, a good reminder that even the worst case scenario isn’t that bad.
Keeping this in mind is one of the things that keeps me from second guessing my packing ad infinitum. Bearing the medevac threshold in mind is a good way to keep perspective. I am packing this week, and balancing between the need to be prepared and the need to avoid overstuffing the car is as challenging as ever, and so I remind myself that, in fact, failure, though it may not be pleasant or desirable, is an option.

Too Many Tabs Open

It occurs to me that I don’t really have a quantitative, non-subjective metric for how much stress I’m under these days. I recognize that short of filling out a daily questionnaire, I’m not going to have a truly objective assessment of how I’m doing. Even the most detailed questionnaire is limited. Even so, it would be nice to have a yardstick, so to speak, to judge against.

For most of the people I know who have such a yardstick, it tends to be some kind of addiction or vice which they fall back on in difficult times. With the possible exception of chocolate, which I do occasionally use as a pick me up, but also indulge in semi-regularly because I see no point in denying myself enjoyment in moderation, I don’t believe that I have any such addictions. Nor are any of my vices, or at least the ones that I am consciously aware of, particularly correlated with my mood. I am just as likely to buy an expensive Lego set, over-salt my food, snap at people, and become distracted by side ventures when I am happy as when I am sad.

Previously, my yardstick was how many assignments I am working on. While it was never a perfect correlation, as obviously even before I graduated, there were ample things outside of school which also brought my stress, but it was something that was easy enough to track for a ballpark view. The correlation looked something like this:

Amount of Stress versus Number of assignments.

Now, however, I have no assignments, and hence, no yardstick. This might not be a problem, except that, in my goal of continual self-improvement, it is necessary to have, if not an accurate, than at least a consistent, assessment of how I am doing relative to how I have done in the past. Thus, I have cobbled together an ad-hoc assessment which I am hoping will give me something a little more concrete to work with than my own heuristic guesses. Here’s my formula.

Add 5 points for each app running in the background
Add 5 points for each tab open in safari
Add 1 point for each of note that was edited in the last week
Add 3 additional points if any of those were edited between 1:00am and 11:00am
Add 1 point for each note that’s a blog post, project, checklist, or draft communique
Add 5 additional points for any of those that really should have been done a week ago
Subtract 3 points for each completed checklist
Subtract 3 points for each post that’s in the blog queue
Add 3 points for every post that you’ve promised to write but haven’t gotten around to
Add 1 point for every war song, video game or movie soundtrack you’ve listened to in the last 24 hours. 
Add 10 points if there’s something amiss with the medical devices

Doing this right now nets me around 240 points. I would ballpark an average day at around 120-170 points. Admittedly this isn’t exactly statistically rigorous, but it does give me a vaguely scientific way to measure a vague feeling that has been building, and which I feel has come to a head in the last few days. Not a sense of being overwhelmed per se, but rather a feeling that precedes that. A feeling that I have too many things running in tandem, all occupying mental space and resources. A feeling of having too many unfinished notes, too many works-in-progress, and too many tabs open concurrently.

You see, despite my aversion to busywork, I also enjoy the state of being busy. Having an interesting and engaging project or three to work on gives me a sense of direction and purpose (or more cynically, distracts me from all the parts of my existence that bring me misery). Having things to do, places to go, and people to see is a way for me to feel that I am contributing, that I am playing a role, and that I am important. The fact that I need to rush between places, while physiologically tiring and logistically annoying, is also an indication that my time is sufficiently valued that I need not waste it. This is a feeling that I thrive on, and have since childhood.

I am told from my high school economics class that this kind of mindset and behavior often appears in entrepreneurial figures, which I suppose is a good thing, though if this is true, it also probably increases my risk of bankruptcy and the related risks of entrepreneurship. Nevertheless, my tendency towards always trying to be doing something both productive and interesting does seem to be at least moderately effective at spawning novel ideas, and pushing me to trying them at least far enough to see whether they are workable.

It has also gotten me to a point where I have far too many topics occupying space in my mind to properly focus on any of them. Rather than wait until I am well and truly spread too thin, I have decided to try and nip this problem in the bud.

So here’s the plan:

First, I’m going to put a number of projects in stasis. This isn’t “putting them on the back burner” as in my book that usually means keeping all the files active, which means I still see them and thing about them, and the whole point of this is to make it easier to focus on the projects that I actually want to complete soon. I mean I am going to consign those plans to the archives, indefinitely, with no concrete plan to bring them back out. If they become relevant again, then I might bring them back, or start over from scratch.

Second, I’m going to push in the next few days to knock a bunch of low hanging fruit off my list. These are little things like wrapping up blog posts, finalizing my Halloween costume, and a couple other miscellaneous items. This means that there will be a flurry of posts over the next few days. Possibly even a marathon!

All of this will hopefully serve to get, or rather, to keep, things on track. October is coming to a close, and November, which has always been a historically busy month, promises to be even more exciting.

I will add one final, positive note on this subject. While I may feel somewhat overwhelmed by all of the choices I have found in my new life free of school, I am without a doubt happier, certainly than I was over the last two years, and quite possibly over the last decade. Not everything is sunshine and lollipops, obviously, and my health will fairly well make sure it never is. But I can live with that. I can live with being slightly overwhelmed, so long as the things I’m being overwhelmed with are also making me happy.