Rendered Fat Content


Illustration from Agostino Ramelli’s Theatre of Machines (1588)
"A moment of reverent silence in homage, please."

Thanks to recent advancements in technology, I yesterday renewed a prescription in a mere three and a half hours. The process fully respected my need for privacy and also afforded me the opportunity to catch up on some reading, as I spent much of the time waiting, on hold. A so-called portal stands as the centerpiece of this marvelous system, for it serves as the sole access point for contacting my primary care physician. Should I need to send my nurse practitioner a message, for instance, I need not simply send her a message but rather I'm directed to log into the portal and send it from within there, where editing software apparently lifted from an early prototype of an actual online text editing system circa 1993, awaits my request. From there, my message, theoretically, will be easily routed to the practitioner's queue for review and response. The whole deal depends upon my logging into the portal. The sole design flaw seems to be that the portal makes it impossible for me to log into it due to technical limitations like it just does not work. I usually just call and explain that the danged portal denied me access again and attempt to leave an actual message with the practitioner, and this tactic sometimes even works, though not always. It does work considerably more reliably than does the portal, which I appreciatively refer to as The Thwartal.

The Thwartal exists for the apparent purpose of denying users access to it.
It's perhaps the finest facility for reducing requests for assistance ever imagined. It's the worst of bureaucracy fully automated, capable of delivering precisely nothing, but only after considerable customer effort. It wears down the requester under the theory that they will eventually simply go away. I admit that my usual response to my encounters with it amount to eventually feeling a whole lot better than I'd originally felt when first imagining that I might somehow make contact. Serial disqualification has a way of doing that, very much like finally choosing to stop whaling away on one's thumb with a hammer. Not whaling feels infinitely better. But I digress.

The Thwartal employs the simplest possible method for disqualifying a requestor, the venerable Username ploy. A blank field appears with a caption imploring entry of a Username. Of course the typical user has no idea of his identity in that moment, but might be in need of a reminder that he never knew it. I'm moved to wonder in awe, "I have a Username?" Gratitude erupts until I remember that I have no idea what that Username might have ever been. I rely upon my computer to remember such trivia for me, but it can't remember, either. I enter one of my usual aliases but it's apparently unrecognizable. On a lark, I call tech support. A sweet-voiced young woman answers, asking with earnest sincerity how she might help me. I can't access the Thwartal, I report. She responds, deadpan, "What's your Username?" "HeckifIknow," I reply.

This encounter plays out as they always do, with her asking after my birthday, given name, and the last four digits of my Social Security number. She quickly identifies me in her system and feeds me my Username. Do I remember by Pastword? Not a chance, so she provides me with a silly replacement, which I enter. The Thwartal then insists upon sending me a confirmation number to assure that I'm not a nefarious actor. A few minutes later, a code arrives, which I enter. The Thwartal finds that number invalid, so we try sending a confirmation number to my email. That never arrives. A couple more tries and an acceptable confirmation number finally appears and I'm inside. (I won't mention the several additional technical complications too difficult to describe here.) I thank my Tech Support helper then retire to take a scheduled call. Once I complete the call, I return to The Thwartal to find my session's timed out. Attempts to reenter just lock me out again. I finally just call the clinic and am surprised to receive a Please Call Back During Normal Business Hours message. It's eleven o'clock in the morning. No hint is given about what normal business hours might mean.

I then remember that the clinic's an hour ahead so I take a break. An hour later, I call and connect to someone who quickly renews my prescription without insisting that I enter via The Thwartal. How reassuring. Then comes the part of the process where I get to interact with the pharmacy because, of course, I've moved away since I last refilled this prescription and so I need it filled in my new location. Twenty minutes later, the pharmacy answers their phone with a curt question asking if I mind being placed on hold without waiting for an answer. Hey, I ain't going anywhere. Later, after a few more apologetic requests to hold a little longer, the pharmacist reports that I'll have to connect with the local pharmacy to affect the change. When I recall that the local pharmacy insisted that only the originating pharmacy could affect that change, I'm told that some branches do that, but
they don't. I call the local place, which uses the same telephone system. I'm on hold for a half hour there, after several times picked up and asked for my birthdate and the last four digits of my social security number. I think it was the third person to ask who finally managed to affect my request. Later, I received a phone message reporting that they were having difficulties with my insurance. Finally, they called to report that my prescription was ready for pickup.

They'd actually filled four prescriptions though I'd only asked for one. I had lost the heart to report their error. Exiting any gauntlet does not inspire reporting problems, it's like that hammer again, finally not whaling on my thumb. I had successfully threaded The Thwartal! I consider it my friend, for it always provides a few hours of entertainment and adventure whenever I feel the urge to communicate with my health care providers. At some point, one of the pharmacy employees offered the classic excuse. "I'm new here," she said. As a veteran of many similar encounters with The Thwartal, I might have responded that experience would never resolve the underlying problem. The systems thinkers insist that any system can be characterized not by its designers' intent but by what it actually does in practice. The portal, then, probably originally envisioned as a be-all and end-all solution exists as its functional opposite, a be-nothing and a perpetual beginning thwarting every attempt to use it for anything. The Thwartal stands as man's ultimate invention, not merely purposeless in practice but capable of undermining any imagined purpose in practice. A moment of reverent silence in homage, please. It's quite the accomplishment!

©2021 by David A. Schmaltz - all rights reserved

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