Crazy Days at Metropolitan State Hospital – The Exam

Years and years ago, I worked at Metropolitan State Hospital in Waltham, Massachusetts, a state mental hospital, as a “mental health assistant.” It was a crazy place, even before its decline and decay after shutting down, as evidenced in these pictures.

After being hired while pursuing a degree in Psychology, I was grouped with about 25 people hired at the same time for a week long orientation. Some, like me, were hired as MHA’s, but the bulk of our class were destined for janitorial, kitchen and other support duties. For reasons still not clear to me, the bulk of the new hires were French-speaking Haitian immigrants. We were taught hospital procedures, patient advocacy, humane restraint techniques — and it was constantly impressed upon us to speak English around the patients. The point was made that speaking foreign languages around the clinically paranoid inevitably agitated them due to a belief that the conversation is about them, and several people had been severely injured or killed by chattering away in French in front of them. Most regarded the entire orientation program with a kind of detached boredom, which I found mildly disturbing, even as I absorbed everything intently and practiced restraint with fervor.

After the first day, we were taken to another building for compulsory medical examinations, lined up on a bench in order. I showed up on time, and therefore was first in line, filling out medical history and employment eligibility paperwork. As a native English speaker, I also finished that first, so I was called first. A nurse turned my arm into hamburger taking a huge number of blood samples (explaining briefly that more than 20% of new hires were testing positive for AIDS) before directing me to the exam room. Down the hall, second door on the left, I was told — the walk seemed like miles down a dark corridor lit with bare bulbs, and I counted two doors on the left far apart from each other, and walked into an operating theater the size of a gymnasium.

In the middle of this vast room, there was a man dressed in white, holding a clipboard, next to a gurney and a cart of medical equipment, wearing a head mirror. He was lit from above, but due to the size of the room, it was still mostly dark except for the center. Old, disused medical equipment lined the peeling walls in the gloom. Overhead, dark windows indicated an observation deck once used to observe surgeries, a broken pane or two indicating that there was probably nobody up there.

The doctor handed me a hospital gown and told me to take off all my clothes, including my watch. There was an enormous clock up on the wall of the room, but it had stopped long ago — I put my watch back on over three hours later, after the most intense physical examination I’ve ever had. The reflex hammer went everywhere, I was tested for strength and balance (he handed me an enormous dictionary to lift in various ways), old school eye charts, hearing tests, organ palpitations, ice-cold stethescope, and the rubber glove treatment. At the end of it all, I was given dozens of pages of exam documentation to take back. I got a clean bill of health, and he even managed to identify my mild tinnitus.

I put my clothes back on and took the long walk back to the waiting room. Everybody was still there, looking terminally bored. “Next!” I said, cheerfully.

One of the MHA’s spoke up. “You’re the last one. Where have you been? We’ve been waiting for you so we can go to lunch.”

The thought then occurred to me that I hadn’t been seen by a doctor at all, but I had gone to the wrong room and encountered a lunatic masquerading as a doctor. “You’ve already been examined?”

“Yeah, took maybe ten minutes,” he said. “Seriously, dude, where did you go?”

As it turns out, there were two exam rooms, and the doctor I saw was well known for his “old fashioned” examinations, so they always sent the first person to him. My paperwork was official, if superfluous. Three days later, I was officially medically approved to work in the hospital — and I noticed that fully 75% of the others who started orientation with us were now gone. “Lotsa AIDS in this group,” said our instructor tersely.

Due to my size (I’m a big guy) and my apparent competence at restraining patients, I was assigned to a chronic, long-term ward. “These guys are the worst of the worst,” explained the instructor on my last day of orientation. “Do your best to stay alive.”

I spent the rest of my tenure at the hospital doing exactly that.

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Misdirected email and email disclaimers

Like many people who have been active on the Internet since AOL was a standalone service, I’ve accumulated a number of email addresses over the years, many of which I still use. Some are short and easy to remember, and at least a few of them are routinely given out by people who think they are their own.

The worst offender was a ski resort, who kept giving out my email address as their own — perhaps they even used it as their “reply to” address, since people were particularly stubborn in their insistence that they had the right address. I had a lot of conversations like these:

“I’m sorry, I’m not affiliated with any ski resort, you’ll have to phone or mail the resort to get the correct address.”

“But this is the address they gave me. Do you have parking for an RV?”

“Well, on the street, but I’m not sure what good this will do you, since I’m probably a few hundred miles away from where you want to be. As I mentioned, I have nothing to do with the resort, and I do not know how to get in touch with them.”

“Oh good. How far is the street from the slopes?”

Perhaps they just appealed to a particularly obtuse clientele, but they kept doing it. So I asked somebody who emailed me for the number of the resort, and I called them to let them know their mistake. “No, that’s our email address,” I was told. I couldn’t convince them otherwise. Eventually I resorted to just giving out reservation confirmations, and they finally stopped.

“Is it too late to reserve rooms for eight people for this weekend?”

“No, you’re all set. Your confirmation number is 6893-261#-3472@.9653!7160321796. Please have this ready when you arrive.”

I guess having irate people show up is a lot more effective than politely asking them to knock it off. A lot of people give one of my email addresses out as their own when asked for an email address. I’m not sure if they just don’t know their own, or they just don’t think it matters, but I’ve been signed up by proxy for an appalling amount of things:

  • Bank accounts (complete with “here’s your password to bank online”)
  • Home loans (complete with “update your payment address”)
  • Retail sites of all kinds, a handful with active “buy it now” credit cards
  • Medical records
  • Insurance records
  • Porn memberships (with recurring payments and a changeable password)
  • Job sites (complete with “update your resume/profile”)
  • Social networking sites (as above)
  • Dating sites (even more fun, as above)

As the mood takes me, I might locate the phone number of the person whose account it is, and notify them of their mistake (reactions have ranged from confusion to threatening to sue me.) Sometimes I’ll just change the password and forget about it (there are probably a few poor schmucks still paying for porn that they don’t have access to and can’t cancel.) Sometimes I’ll update their profile in amusing ways. Although the thought has occurred to me to drain a few bank accounts, these are people who strike me as most genuinely confused and in need of an explanation — and I’m not really that much of a bastard.

I also get signed up for a lot of mailing lists, which can be fairly obnoxious. If mailing lists have a simple way to unsubscribe, I will. Better yet, mailing lists that ask for confirmation. I don’t confirm, and that’s the end of it. Some mailing lists are particularly obnoxious — no way to unsubscribe, or even worse, the only way to unsubscribe is to enter a lot of personal information on a separate web site (which, if it doesn’t match whatever information the idiot gave them when they provided your email address, won’t let you unsubscribe) or points to a site that doesn’t exist or resolve, etc. Since I don’t want to be on the mailing list, I’ll complain directly to their ISP. I’ve had a few car dealerships disconnected from the Internet by their ISP’s — who are usually pretty cooperative.

Note to email list administrators: always confirm email address, and have a simple way to unsubscribe, or you’re a spammer.

I also get emails directly from misguided individuals. It’s remarkable the amount of personal detail that people will include to an email address they’ve never sent anything to before. I usually reply to let them know I’m not who they think they’re contacting. Occasionally, they argue (which is bizarre to me, but some people get ideas stuck in their heads. “Dot! Stop fooling around!”) and occasionally, they’re just weird — some ask for unrelated computer help (which I provide, to the extent that I can help via email) and one lady told me that she was a “married Christian woman” and that it was improper for her to talk to a strange man. (This, of course, implies to me that she desperately wants to, and either is unhappy with her husband or her repressive brand of Christianity — and she actually does keep writing — go figure.)

High on the obnoxiousness scale are the business emails I get, usually with tons of insider information, and a standard disclaimer telling me what I can and can’t do, my duties if I’m not the intended recipient, etc. I’m not a lawyer, and this isn’t legal advice by any means, but I don’t think I’m bound by any of this crap. If you send me an email, it’s mine. I’ll do what I want with it. If you’re incompetent enough to send me insider or confidential information from your company, I’m going to feel free to post it on the Internet if I damned well feel like it, and you can stick your disclaimer wherever you like.

We don’t have a contractual relationship, and your email was unsolicited. You can’t create one using your disclaimer; I don’t agree to your terms. Any of your terms. If I feel like sending you back an email informing you of your mistake, I might do that. Doing so does not mean I agree to your disclaimers, nor does it obligate me to send you another email informing you of your future mistakes when you do it again and again.

If we were to have a contractual relationship, I could see the value of a disclaimer, to, say, remind me of a confidentiality contract we mutually signed. But unsolicited email is precisely that; just as you can’t send me junk in the mail and obligate me to do anything with it, you can’t via email, either.

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Outlook, Mail Archives, and Duplicates

Exchange and Outlook are dismal examples of code, but the fact remains that they are ubiquitous. Nobody has managed to create a mail/calendar/contacts/task application with wider adoption, and it has enough inertia that well designed applications have little chance to make inroads, which means a lot of people are stuck with it. For those of us who prefer elegant, well designed applications, putting up with their quirks is maddening.

Outlook, for example, has a hard-to-explain 2 gigabyte limit on mail archives — and mail archives are arguably one of the niftier features that Outlook offers. Early versions of Outlook don’t know any better, and simply corrupt your mail archives. Later versions of Outlook know better, and warn you not to exceed the limit. While some noise has been made about Outlook finally removing the 2 gigabye limit, it’s actually not quite true, it’s only been removed for Exchange style mailboxes, and is still there, for example, for imap mail boxes.

For those of us with lots of mail and the need to archive it (I receive a lot of technical documents, some very large, via email) using Outlook’s built-in “archives” isn’t really an option, so I used the simple expedient of setting up an archive IMAP server, where the size wouldn’t be an issue. While this works reasonably well going forward, Outlook puked enough while trying to move messages from its proprietary formats to imap, that I was left with a vast number of duplicates.

On a significantly large mailbox, this is a bigger problem than it sounds like — especially since the duplicates were created with different mail id’s, and in many cases the white space or envelopes are different, while the messages are clearly identical. Maddening, but it largely means that any automated duplicate removal will have to happen through IMAP, not through the filesystem.

While it seems that a tool to locate and eliminate duplicate IMAP emails would be simple to find, it appears that such a beast simply does not exist, except for the trivial case in which the message id’s are identical. At the imap level, there are a decent number of tools here:

http://www.athensfbc.com/imap_tools/

Which work admirably, for the most part. For the remainder, I used this Thunderbird Add-on, which took care of the remaining fringe cases. The only problem, of course, is that on a really large email folder, Thunderbird starts to complain endlessly about script timeouts. However, you shouldn’t really need to do this regularly.

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Mail, DNS entries, and domains

I recently overhauled bits of the mail system here to take care of a few lingering quirks that I’d never had the time nor inclination to track down. All of my various email addresses and aliases go to the exact same mailbox, through the multiple expedients of fetchmail, which picks up my mail from gmail and AOL, and DNS MX records that point everything to the same place.

Until recently, if you sent mail to “user@goodjobsucking.com” it would be transformed by the server into “user@baddomain.com” unceremoniously. It would show up that way in the mailbox, and only by delving into the mail headers was it obvious that the mail was originally destined for a different domain. For addresses I didn’t make use of much, this was fine, though it leads to the curious circumstance where somebody sending mail to goodjobsucking.com would get replies from baddomain.com, which deviates from the principles of separating domains in the first place.

It turns out the root cause was that goodjobsucking.com, rather than having its own A record in the DNS tables, used a CNAME to baddomain.com. Apparently this implies that mail sent to goodjobsucking.com is actually for baddomain.com. I imagine this would be particularly useful for adjunct or typo domains, where you want to correct the original destination or transition from one domain to another. It’s also useful in that the mailer only needs to internally relay for, and listen to, mail destined for baddomain.com; any mail sent to a CNAME from another domain pointing to it works perfectly well.

Moving the domain from a CNAME to an A record effectively separates things out again, though now the mailer must also be aware that it’s listening for mail for yet another domain.

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