This is what I have come to believe about complex systems.
I used to be really interested in system complexity and all the mystery in it. I think this is from the early days of continuous data and diabetes systems - trying to make predictions and imagining all the relevant variables. There was a fascinating magic about the physiology back in the day.
Now I am old and cranky and have come to have a certain disdain for complex systems. The medical system, for instance. Computer systems that fail are another frustrating example. What I have been taught, through the passage of time and the advice of those more experienced than I, is that complex systems fail. Even systems that might start out reasonable become complicated and disorganized with the passage of time. The law is like this. People add on more and more laws until the law starts to contradict itself and everyone who encounters it are in some sort of violation.
Medicine is a hotbed of failing systems because of its complexity.
I, as a diabetic, am sandwiched in some unholy trinity of medical bureaucracy, government, and technology that makes every little thing I try to do, like fill a prescription, impossible. It has always been this way. It has always made me mad. I just didn’t have the words or the life experience to express it.
My disability has so little to do with actual medical illnesses and so much to do with being handcuffed inside of systems that do not function. It feels like I live in a little subsection of America that is operated by the old Soviet Union and everything there is broken.
I feel like the right thing to do when confronted with these catch-22 situations that arise in diabetes is to poke at the complex systems. Even though its a lot of work to do that, its relatively easy to break those systems because they are buckling under the weight of their own complexity. Its easy to break them and you should. You should show people how the systems are broken. People don’t like that, but its good for them to know how brittle their complex systems are. Often, the systems break just by trying to understand them and comply with them.
Debugging the State DMV system and its medical drivers licensing procedures forced the State to clean up its computer system and its laws. Why? Because it was in violation of its own law…that it made, but couldn’t follow because it was all too complicated.
Forcing the system to fill a prescription that its under contract to supply, scored me 3 months of Dash Pods for $300, instead of $850 for a 6-week supply. Why? They could see the system breaking under its own weight and they couldn’t fix it. That’s how overly complex systems behave - in a way that is unmanageable and in a way that no one can understand or fix (because no one can understand how it broke…because its too complicated).
There is societal good in forcing the system complexity to come under control. That is my current position on diabetes. Otherwise, the obstacles for people who have less experience with this stuff is hopeless. I can barley manage and I’ve been doing diabetes paperwork for 31 years. I do it differently now than I used to. When the system makes me suffer, I self advocate and I make the system suffer. It deserves to get some of what it dishes out. You should poke holes in things that don’t make any sense. Systems should function. I, as an individual will not bear the burden of unmanaged system complexity and broken systems. I’m tired of it. I’ve been tired of it my whole life.
You don’t have to TRY to break systems like these. They just break. It’s in their nature. When they break, you should raise hell. They can’t fix systems once they reach a certain level of insane complexity. Its remarkable how weak their systems are. Remember the MT pumps w/ no encryption? Weak!
