doctors get paid too darn much, whitman versus poe

Massimo Campigli - Seamstresses

 Seamstresses. Oil on canvas, 1925. By Massimo Campigli (1885-1971).

 

Seriously—The Evidence is Overwhelming That Americans Pay Too Much To Go See The Doctor

Amidst many hundreds of words of discussion of the subject he totally buries the lede:

Standard economic theory suggests that over all, American doctors are overpaid, although perhaps not the primary-care specialties. This position leans on the fact that at existing incomes there is still considerable excess demand for places in medical schools among bright American youngsters – not to mention a huge pool of highly qualified foreign applicants. This suggests that the lamented doctor shortage in the United States is the result of an artificially constrained supply of medical school places and residency slots, which serves to inflate physician incomes above what they would be in a better functioning market without supply constraints.

That’s really what you need to know about the subject. At current wages, the supply of qualified doctors could easily be increased. Alternatively, if doctors’ wages were reduced there would be no decline in the supply of qualified doctors. That’s because the supply of qualified doctors is being doubly restricted, first by regulations that make it exceedingly difficult to import qualified doctors from abroad and second by cartelization that prevents medical schools from training more doctors.

Towards he end of last year a survey of doctor income showed that general practitioners with a few years experience were averaging $200k. Specialists – heart and brain mostly – with a few years experiencing were averaging $300k. That does seem a little high. I think I more or less accepted it at the time because CEO salaries ( Mr 47% Romney) was on my mind. Campbell CEO had a total compensation package of $9.6 million in 2007. I bet we could find someone with a near genius IQ who could manage the company as well or better for a $125k a year. Throw in a $25k bonus if she meets certain standards – a living wage for employees, good environmental record, fair profit and so forth. CEOs just don’t have that kind of value. Most of them are not where they are because they have remarkable skill sets, they’re there just because. They navigated the in and outs of the business world, talked a good game. The real numbers people, the analysis, who are usually well paid, work at a lower level. The first thing any CEO does before they make a decision is consult the number crunchers. They do not provide enough value to society to justify making more than overpaid doctors.

Edgar Poe's Significance

Edgar Poe’s Significance by Walt Whitman.

Edgar Poe’s Significance , last page. These are the hand written manuscript pages from Walt Whitman’s (1819–1892) essay on Edgar Allan Poe (1809 – 1849). Pages three and five respectively, which contain the bulk of his argument against Poe. I’m just going to post what I consider the major portion of his analysis of Poe, you can read the rest here.

By common consent there is nothing better for man or woman than a perfect and noble life, morally without flaw, happily balanced in activity, physically sound and pure, giving its due proportion, and no more, to the sympathetic, the human emotional element—a life, in all these, unhasting, unresting, untiring to the end. And yet there is another shape of personality dearer far to the artist-sense, (which likes the play of strongest lights and shades,) where the perfect character, the good, the heroic, although never attain’d, is never lost sight of, but through failures, sorrows, temporary downfalls, is return’d to again and again, and while often violated, is passionately adhered to as long as mind, muscles, voice, obey the power we call volition. This sort of personality we see more or less in Burns, Byron, Schiller, and George Sand. But we do not see it in Edgar Poe. (All this is the result of reading at intervals the last three days a new volume of his poems—I took it on my rambles down by the pond, and by degrees read it all through there.) While to the character first outlined the service Poe renders is certainly that entire contrast and contradiction which is next best to fully exemplifying it.

[  ]… Almost without the first sign of moral principle, or of the concrete or its heroisms, or the simpler affections of the heart, Poe’s verses illustrate an intense faculty for technical and abstract beauty, with the rhyming art to excess, an incorrigible propensity toward nocturnal themes, a demoniac undertone behind every page—and, by final judgment, probably belong among the electric lights of imaginative literature, brilliant and dazzling, but with no heat.

spring tree leaves wallpaper, the conservative triangle of propaganda

spring tree leaves wallpaper

spring tree leaves wallpaper

 

Does anyone have the impression that the IRS singled out or “targeted” conservative groups seeking special tax status (501(c)4. If so, how did you get that impression. Did you read the New York Times or the Washington Post, watch ABC or the other networks. If you read this The Latest Lie: IRS Targeted Conservatives - it may change your mind. That article does have links to primary sources, including the report from the IG that everyone is using as absolute proof conservatives groups were targeted or denied the status they were seeking unfairly. Not one, not even one tea party group was denied the (501(c)4 status that deserved to have it. In fact some of the groups granted (501(c)4 status should have been denied because they were funneling more than 51% of their donations directly to advertising that advocated the election of certain candidates or the disposition of certain clearly partisan legislation. Why do we find ourselves in this bubble of misinformation. These major media outlets do not seem to have a liberal bias, according the well-known myth. On the contrary. The IG’s report (pdf), which many people have not bothered to read, trusting that the media would not get such a big story wrong. In the report it says that “For the 296 total political campaign intervention applications TIGTA reviewed as of
December 17, 2012, 108 had been approved, Final Report issued on May 14, 2013 28 were withdrawn by the applicant, none had been denied, and 160 were open from 206 to calendar days (some for more than to the Internal Revenue Service Acting three years and crossing two election cycles).” I’m not claiming the IRS is completely innocent ( the time delays seem unfair). Only that conservative groups were not signaled out. That perhaps some of the groups that gave up seeking 501 were conservative, but that is not that same as targeting. Some of them were liberal groups. Why are we not hearing from the media about liberal groups being subjected to the same basic litmus tests as conservative groups. Why are we not hearing that more liberal groups were denied 501 status than tea stain groups. This tsunami wave of sound bites has happened before. It is not a coincidence and no tin foil is required, it is not an especially secret conspiracy. Like the IG report on the IRS. People could read that. It does take some reading comprehension and analysis skills, but nothing a high school grad couldn’t handle. Yet we’re not reading the report, we’re hearing or participating in the echo of the media’s interpretation of the report,  Background: Democrats & The Netroots

The Triangle

Looking at the political landscape, one proposition seems unambiguous: blog power on both the right and left is a function of the relationship of the netroots to the media and the political establishment. Forming a triangle of blogs, media, and the political establishment is an essential step in creating the kind of sea change we’ve seen in the aftermath of Hurricane Katrina.

[  ]…With a well-developed echo chamber and superior top-down discipline, the right has a much easier time forming the triangle. Fox News, talk radio, Drudge, a well-trained and highly visible punditocracy, and a lily-livered press corps takes care of the media side of the triangle. Iron-clad party loyalty – with rare exceptions – and a willingness of Republican officials to jump on the Limbaugh-Hannity bandwagon du jour takes care of the party establishment side of the triangle. The rightwing netroots, therefore, is already working within the triangle on most issues. Their primary strategic aim is to prevent the left from forming its own triangle, as occurred with Katrina. It’s a defensive posture, with the goal being the preservation of the status quo. Which explains why the right is profoundly hostile to dissent and why the pretense to libertarianism is common: “independent thinkers” don’t like to be seen as defending the powers that be.

The triangle construct also explains rightwing bloggers’ relentless attacks on the “MSM” and on anyone who contends that the media is conservative. In a nation dominated by shrill rightwing voices, with all branches of government in the hands of Republicans, and an ineffectual press corps, the “liberal media” myth is so absurd that it requires no rebuttal. But the right desperately needs to keep the media from doing what they did in the aftermath of Katrina: tell the unvarnished truth. They need to block the left from building the kind of triangle that Katrina generated, where outspoken left-leaning bloggers are joined by leading Democrats and reporters who have no choice but to describe the catastrophic results of Bush’s dismal leadership. The result in Katrina’s case is a major political crisis and a dramatic shift in public perceptions, a body blow to the long-standing conventional wisdom of Bush as a “resolute leader” and a protector.

Whereas rightwing bloggers can rely on their leadership and the rightwing noise machine to build the triangle, left-leaning bloggers face the challenge of a mass media consumed by the shop-worn narrative of Bush the popular, plain-spoken leader, and a Democratic Party incapacitated (for the most part) by the focus-grouped fear of turning off “swing voters” by attacking Bush. For the progressive netroots, the past half-decade has been a Sisyphean loop of scandal after scandal melting away as the media and party establishment remain disengaged.

Some people will dismiss conservative bloggers because of how unhinged they sound. Not just on any particular day or topic, but everyday they post. With Drudge at the top of that pyramid. At the level of Drudge and the next level down, his echo, new realities are created. So it goes with the IRS controversy, where tea stain group were not targeted and were not asked questions anymore silly than they asked liberal groups. Besides the conservative love of victim-hood this controversy serves their agenda. They get to funnel more money from more anonymous donors to groups getting special tax treatment, and in return they get more control over elections.

duel after a masked ball, helper robots have emotional flaws

Duel after a Masked Ball

Duel after a Masked Ball by Jean-Leon Gerome (11 May 1824 – 10 January 1904). Oil on canvas, 1857).

 

Helper Robots Are Steered, Tentatively, to Care for the Aging

Researchers at the Georgia Institute of Technology have developed Cody, a robotic nurse the university says is “gentle enough to bathe elderly patients.” There is also HERB, which is short for Home Exploring Robot Butler. Made by researchers at Carnegie Mellon, it is designed to fetch household objects like cups and can even clean a kitchen. Hector, a robot that is being developed by the University of Reading in England, can remind patients to take their medicine, keep track of their eyeglasses and assist in the event of a fall.

That sounds like what I am hoping for. Progress towards an agile, artificially intelligent robot to help me in my old age. Though there are already ethical issues. People with neuro-degenerative diseases are using robots and are talking to them in the frequent absence of human care takers. That might look like tragic-comedy in a movie or novel, but real life is another matter. These people think the robots can understand and sympathize with what they are saying.

“I felt like this isn’t amazing; this is sad. We have been reduced to spectators of a conversation that has no meaning,” she said. “Giving old people robots to talk to is a dystopian view that is being classified as utopian.” Professor Turkle said robots did not have a capacity to listen or understand something personal, and tricking patients to think they can is unethical.

That’s the catch. Leaving the questions of ethics aside for a moment, building robots is not simply about creating smart machines; it is about making something that is not human still appear, somehow, trustworthy.

Even if the robot is trustworthy i terms of not hurting the person or damaging property, it will be a while before there are C-3PO, emotionally aware robots who understand the story about your grand children and shows something like genuine empathy. Otherwise we are just tricking the naive or sick that they have a real companion that can listen.

Monet in front of his paintings (The Waterlilies) in his studios

Monet in front of his paintings (The Waterlilies) in his studios. 1920. Gelatin silver print by Henri Manuel (1874-1947).

A Right-Wing Mole at ABC News Jonathan Karl and the success of the conservative media movement

After a stint at the New York Post, Karl soon found his way to CNN, but he was still connected to ideological pursuits; he was a board member at the right-leaning youth-oriented Third Millennium group and at the Madison Center for Educational Affairs—which, like the Collegiate Network, seeks to strengthen young conservative journalism. After moving to ABC in 2003, Karl contributed several pieces to the neo-con Weekly Standard, such as his April 4, 2005 article praising Bush Secretary of State Condoleezza Rice as out to “make her mark with the vigorous pursuit of the president’s freedom and democracy agenda.

Recently Karl and ABC News pushed that fake e-mail that suggested some kind of White House cover-up of Benghazi. Maybe not a coincidence that Karl did not do much in the way of verification before passing along a fake e-mail to the public as “news.”

car ferry in winter, how fox news betrayed america

Car ferry, winter. Detroit River, c1900.

Car ferry, winter. Detroit River, c1900. This picture brings up an unusual aspect of some photography. Some of the smoke is just steam from the mix of hot air and cold air creating condensation. The other part is pollution from the coal fired steam engine. Part of the beauty of the picture is created by something ugly and harmful.

What is the difference between being a true whistle-blower and a reporter leaking classified national security information. Books have been written on this complex subject so I will not attempt to define all the differences and every situation. Though in general a whistle-blower is someone that does reveal classified information, but that information is in regards to illegal activity by the government/government officials. A leaker is someone who reveals national security information for whatever reason – the ego of the reporter, maliciousness, or ignorance – the list is as long as the reasons that can motivate someone to do something. Some may remember the biggest whistle-blower story of the modern era, the revelation by two NYT reporters that the Bush administration had skipped the courts and the warrant process ( demanded under the 4th amendment) to allow the NSA to spy at will on U.S. citizens, December 16, 2005 – Bush Lets U.S. Spy on Callers Without Courts

Months after the Sept. 11 attacks, President Bush secretly authorized the National Security Agency to eavesdrop on Americans and others inside the United States to search for evidence of terrorist activity without the court-approved warrants ordinarily required for domestic spying, according to government officials.

Under a presidential order signed in 2002, the intelligence agency has monitored the international telephone calls and international e-mail messages of hundreds, perhaps thousands, of people inside the United States without warrants over the past three years in an effort to track possible “dirty numbers” linked to Al Qaeda, the officials said. The agency, they said, still seeks warrants to monitor entirely domestic communications.

The previously undisclosed decision to permit some eavesdropping inside the country without court approval was a major shift in American intelligence-gathering practices, particularly for the National Security Agency, whose mission is to spy on communications abroad. As a result, some officials familiar with the continuing operation have questioned whether the surveillance has stretched, if not crossed, constitutional limits on legal searches.

“This is really a sea change,” said a former senior official who specializes in national security law. “It’s almost a mainstay of this country that the N.S.A. only does foreign searches.”

Nearly a dozen current and former officials, who were granted anonymity because of the classified nature of the program, discussed it with reporters for The New York Times because of their concerns about the operation’s legality and oversight.

The NSA or National Security Agency is a department of the Pentagon. They are barred from domestic spying based on the law and legal precedent. The NYT did what a free press is supposed to do, act as the people’s watchdogs against abuse by the government, industry or individuals. In the case of leakers that another matter. The NYT among other news services has at times acquired classified information, the government has become aware of it and explained to those news services that leaking said information may damage national security. Conservatives claimed that what the NYT did in the case of exposing clearly illegal activity (Federal Judge Finds N.S.A. Wiretaps Were Illegal) by a Republican administration, was treason. Which like their claims about Benghazi lack anything like legal justification, or rational thought. Then Bush appointee to the CIA , Porter Goss, also seemed to lack any guidance from clear headed thought, Why Are Republicans So Riled Up About Obama’s Justice Department Reading a Reporter’s E-mails When They Cheered the Bush Administration For Doing the Same Thing?  

In mid-March, after Attorney General Gonzales raised publicly the possibility of prosecuting journalists, the Director of the CIA, Porter Goss, suggested that it was his “hope” and “aim” that the leak investigations would lead to subpoenas requiring me to testify about the identity of my confidential source(s). Only two months into the investigation, Goss explained: “It is my aim and it is my hope that we will witness a grand jury investigation with reporters present being asked to reveal who is leaking this information.”

Very irresponsible and politically motivated assertion by an administration crony to claim that reporters who exposed illegal activity by the government, just be held accountable to a grand jury investigation. Grand juries can be nasty instruments of the law. The rules that apply in normal courts, the ones we see in court room dramas all the time do not apply to grand juries. From that same article  Kurt Eichenwald also notes that in the current controversy over the DOJ investigation of Fox News reporter (To call anyone who works at Fox a reporter is a stretch of reality) he notes that James Rosen and his source did not expose some illegal activity by the Obama administration, but exposed a national security secret about North Korea.

The Fox case involved a report by Rosen in June 2009 that American intelligence officials had issued warnings that, should the United Nations adopt sanctions that were under consideration, North Korea would begin conducting new nuclear tests. According to the F.B.I. affidavit in the case, the information was top secret and was contained in an intelligence document disseminated to a small number of government officials that same morning. The report was marked top secret.

Fox news and James Rosen are not whistle-blowers. They exposed national security secrets to a foreign power, for whatever reason. They broke the law and compromised national security. The Obama administration, or rather the DOJ and FBI may have been too zealous, but they did follow the law and obtain warrants. America seems to be having difficulty hearing the story of how Fox News, who is for all practical purposes the communications office of the Republican Party,  probably committed treason.

when drugs do not work – the new brain stimulation, the immoral inquisitors are back

Glacier streams at Mt. Cook New Zealand

Glacier streams at Mt. Cook New Zealand.

 

Deep brain stimulation: a fix when the drugs don’t work

Artificial cardiac pacemakers are typically associated with controlling and resynchronising heartbeats by electrical stimulation of the heart muscle.

In a similar manner, DBS sends electrical impulses to specific parts of the brain that control discrete functions. This stimulation evokes control over the neural activity within these regions.

Prior to switching on the electrical stimulation, electrodes are surgically implanted within precise brain regions to control a specific function.

The neurosurgery is conducted under local anaesthetic to maintain consciousness in the patient. This ensures that the electrode does not damage critical brain regions.

The brain itself has no pain receptors so does not require anaesthetic.

…Drug therapy for Parkinson’s disease involves the use of levodopa (L-DOPA), a form of dopamine that can cross the blood brain barrier and then be synthesised into dopamine.

The administration of L-DOPA temporarily reduces the motor symptoms by increasing dopamine concentrations in the brain. However, side effects of this treatment include nausea and disordered movement.

DBS has been shown to provide relief from the motoric symptoms of Parkinson’s disease and essential tremors.

For the treatment of Parkinson’s disease electrodes are implanted into regions of the basal ganglia – the subthalamic nucleus or globus pallidus, to restore control of movement.

I practically grew up on One Flew Over the Cuckoo’s Nest and Suddenly, Last Summer. So I have a built in anxiety about anyone messing around with the brain. While some level of wariness is reasonable when considering brain altering treatment, modern medicine seems to be leaving the nightmarish Nurse Ratcheds behind.

I’m posting this in it’s entirety so you’ll have the background, What’s Next For Kaitlyn Hunt, The Teen Charged With A Felony For Same-Sex Relationship With Classmate.

On Friday night, 18-year-old Kaitlyn Hunt and her family went public with their story: Kaitlyn was charged with a felony stemming from a relationship she had with a 15-year-old girl at her high school. The response in the 48-hours that followed, Kaitlyn’s father Steven Hunt told ThinkProgress in an interview, was “extraordinary.”

Already, nearly 40,000 people have signed a petition calling on the Assistant State Attorney, Brian Workman, to drop the case. On Facebook, more than 13,000 people have joined a group — Free Kate — in support of the family.

Last week, her father said, Workman offered Kaitlyn a plea bargain. She could plead guilty to child abuse, a felony, and spend two years under house arrest. The judge would determine if she would have to register as a sex offender. They were given a deadline of May 24th to accept the offer or face trial.

Kaitlyn’s father suggests his daughters arrest — and the substantial sentence sought by the prosecutor — are motivated by anti-gay bias. He told ThinkProgress that the younger girl’s parents have told teachers at the high school that “their daughter will NOT be gay.”

So what’s next for Kaitlyn?

The family is hoping that public pressure will improve the offer from the State Attorney. Her father said Kaitlyn would be willing to plead to a misdemeanor, but not a felony. If the position of the State Attorney does not change, Kaitlyn and her family are prepared to go to trial.

The family’s attorney, Julia Graves, has assembled a table of experienced defense lawyers that will convene next week to discuss Kaitlyn’s legal options. Meanwhile, Kaitlyn is scheduled to appear in court again on June 20. At that time, if a plea agreement is not reached, the judge could set a date for trial.

We dangerously close to returning to the worse of American historical traditions, with attitudes that resemble those of those Salem witch-hunters. Two teens having a relationships. Oh the horror. That has never happened before, someone must be punished. Criminal laws are supposed to be about protecting victims from abusive and violent behavior, negligence by individuals and corporations, not enforcing the twisted 17th century moral sensibilities of local inquisitors.

fury of the french at antwerp, poltical scandals and shameless hypocrisy

Fury of the French in Antwerp

Fury of the French in Antwerp by Ferdinand de Braekeleer. Oil on canvas. Belgium, Between 1827 and 1846. I’m not an expert on Antwerp history, but I am fairly certain this is a depiction of one night in the Belgian Revolution. Many in North America should be able to relate to this frustration by an early liberal movement for freedom to worship as one wished, and freedom of the press, among other issues. The Netherlands are still a stellar world examples of liberalism to this day.

Double standards. That might be part of what is fueling the foaming at the mouth hysteria of the radical Right over two non-scandals, the current IRS screw-ups (IRS Audited Democratic Groups Under Bush, No Outrage from Conservatives) and the tragedy of Benghazi. Though since conservatives have an infamously low regard for ethics and genuineness, their shrill cries are mostly theater. A public display feigned outrage more in need of smelling salts and cold compresses than yet more expensive congressional kabuki. Why Obama Is Not Nixon

In order to stoke the conspiracy theories, Republican congressional aides leaked false versions of the interagency emails and ABC ran with them without checking. Republicans focused the controversy on Hillary Clinton rather than David Petraeus, the CIA director at the time, though Petraeus also agreed to the talking points and was responsible for hiring the local defenders who melted away at the first shot, and the misinformed intelligence on what happened that night was a failure by the CIA. (But Petraeus was most unlikely to run for president in 2016.) That the US presence in Benghazi was essentially a CIA operation was kept quiet. The inability to adequately protect our foreign missions has been a bipartisan failure and Congress’s stinginess with funds for the protection of our assets in foreign countries also bears some responsibility. In any case, the Republicans might be well advised to tread carefully on the matter of ignored warnings. So far, the George W. Bush administration has got by amazingly with their obvious failure to act on indications months before September 11, 2001, that a major terrorist plot was in the works.

Not just Bush, but the arrogance and incompetence of the conservative mindset was responsible for one of the biggest national security failures in our history. Then told a pack of lies connecting Iraq to 9-11, are now engaged in a deranged campaign to turn a tragedy, that they are also partly responsible for, into a scandal. The shamelessness of conservative hypocrisy alone is blinding. Maybe instead of Obama’s preschool initiative we have a national educational initiative to educate the conservative movement on ethics.

Science humor, Cells must use their brakes moderately for effective speed control

All living cells have a regulatory system similar to what can be found in today’s smartphones. Just like our phones process a large amount of information that we feed them, cells continuously process information about their outer and inner environment. Inside the cells, information is sent and processed via a large network of interactions between signalling molecules.

In electronic circuits it is common with negative feedback, inhibiting functions, to make signals clearer and to reduce noise that can obscure important information. Cells also use this technique for reducing unwanted noise. Almost half of all signalling molecules that regulate which genes should be on or off, regulate their own genetic expression through biochemical reactions acting as inhibitors.

“If the number of signalling molecules is more than necessary, they shut down their own production for a short while, to later resume it. The difference between feedback in electronic systems and biological systems is that biological systems are much more imprecise and slow”, explains Andreas Grönlund, lead author, currently active at Umeå University.

Together with professors Per Lötstedt and Johan Elf, both at Uppsala University, he has used new data and mathematical models to calculate how long the molecules must remain in their binding sites to make the feedback exactly strong enough to reduce noise as much as possible.

I have always been amazed at the billions of reactions the body carries out without conscience input from the thinking part of the brain. If life seems complicated now – work, family, bills, plans, relationships – imagine having to think through every biochemical reaction required to stay alive.

china rivers sunset wallpaper, depression linked to out of sync biological clock

china rivers sunset wallpaper

china rivers sunset wallpaper. China’s river system, at least those that have not dried up or been drained are a nightmare. Up towards their mountain origins things are not as bad.

 

Depressed people’s body clocks ‘out of sync’

Every cell in our bodies runs on a 24-hour clock, tuned to the night-day, light-dark cycles that have ruled us since the dawn of humanity. The brain acts as timekeeper, keeping the cellular clock in sync with the outside world so that it can govern our appetites, sleep, moods, and much more.

But new research shows that the clock may be broken in the brains of people with depression—even at the level of the gene activity inside their brain cells.

This discovery may mean there are distinct biomarkers for chronic depression. That knowledge may lead to better medications and the ability to fine tune them for the individual. While most people probably already realize this, depression and mood disorders are not a sign of personal failing. These findings are another proof that most depression, is the result of biological processes. That is not to say that therapy does not help. Therapy is a way to sort emotions. Emotions have biological consequences in a kind of feedback loop. That is why the combination of psychological therapy and medication has been the most effective treatment.

What is the difference between conservatives in America and the Taliban in Afghanistan? As far as I know conservatives have not started cutting off hands for stealing a loaf of bread. I’m still figuring out the others, Virginia GOP Nominee For Attorney General Would Force Women To Report Their Miscarriages To Police.

If a woman in Virginia has a miscarriage without a doctor present, they must report it within 24 hours to the police or risk going to jail for a full year. At least, that’s what would have happened if a bill introduced by Virginia state Sen. Mark Obenshain (R) had become law.

And yet, the Virginia Republican Party wants to make Obenshain into the state’s top prosecutor. This weekend, Virginia Republicans selected Obenshain as their nominee to replace tea party stalwart Ken Cuccinelli (R) as the state’s attorney general.

This obsessive need to control others bodies, humiliate people during a tragedy and get government deeply involved into one’s personal life is some kind of value. A value out of a dystopian hallucination.