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    Could It Be Worse? It Could Be Worse.

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    Richard P. Mills, MD, MPH

    By Richard P. Mills, MD, MPH, Chief Medical Editor, EyeNet

    On a recent trip to Scandinavia, as I was plying the Norwegian fjords in the warm, dry cocoon of a cruise ship, it occurred to me that in this closed system, my fellow passengers and I were headed for a state of maximum entropy. To break this vicious cycle, I determined to go ashore to find out how this small country had achieved the number-one ranking in quality of life, as measured by the United Nations Human Development Index. (Never mind that it is also the world leader in cost of living, almost double that of the United States.) Was it North Sea oil money? Free health care? To start a conversation with the usually taciturn natives, I complained about the weather, which at the time of the conversation was either foggy, misty, or rainy. In reply, I heard the refrain, “It could be worse; it could be windy.” Or “It could be worse; it could be sleeting.” A guide later told me it was a national mantra to parry complaints with the “It could be worse …” phrase. As I pondered this, I realized it could also apply to complaints arising within one’s self, never verbalized to others. Think a negative thought about something that happened, and immediately think of something worse that didn’t happen. It’s a pretty nifty trick, turning two negative thoughts into something that makes one feel better.

    On arrival back home, I decided to try this newly learned quality-of-life technique myself. A good candidate for this experiment was the Congressional stalemate on how to fund a repeal of the Sustainable Growth Rate (SGR)—a formula that virtually all lawmakers agree was a bad idea to start with and has proved unsustainable in its implementation. We were so close to achieving a repeal, yet at the last minute another one-year patch, ironically paid for by reductions in physician Medicare payments, passed both houses and was signed by the president. Yes, it could have been worse. We could have both failed to repeal the SGR and received no patch—and faced a 24 percent immediate reimbursement reduction.

    Another candidate was my attitude toward my very own cable company, Comcast, known around my house as the evil empire. It’s quite a “Comcastic” operation they have going. They scramble the signal so thieves can’t tap in to watch “Jeopardy” for free. Then they rent descrambler boxes to subscribers, and did I mention that you need one for each TV? And you can’t record a show you like for later viewing without renting a digital video recorder (DVR) box. You’ve already paid for the content the first time (basic cable), and now you get to pay for it again (via DVR rental). And, of course, you can’t share it with anyone unless they happen to be sitting next to you on the couch. All these charges add up so much that the new brand name, Xfinity, is a good descriptor of a monthly bill. Before moving back to Seattle after a sojourn in Kentucky, I wanted the cable to work, so my daughter went to sign me up. Told she had to open the account in her own name, she did, and ever since then I have been unable to switch the account to my name without both of us present and notarized. All of this is to protect my security, they say. “But this isn’t a bank, it’s a cable company,” protested I in vain. Now, when I call the nerve center of the evil empire, I identify myself as Emily in a deep bass voice, and as long as I remember the last four digits of her Social Security number, I’m enabled. But I figure it could be worse; they could be practicing gender identification.