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I pay a LOT for health insurance, yet I have not nearly enough energy to actually use it. That's because, while the monthly fee is almost prohibitively high, the actual coverage is weak and the rules you must follow to receive said coverage are draconian. For instance, if (hypothetically!) I wanted to have a fully-functioning, psychic eyeball removed from the palm of my hand I have to see my doctor, wrestle him to the ground for a referral, then get blood drawn, come back to my PCP (that, in the parlance of people getting fucked by healthcare corporations, is "Primary Care Physician"), get another pair of referrals for both an opthalmologist and cosmetic surgeon. Then, if either of those specialists require more than two visits, I have to return once more to my PCP, who is collecting $20 for each visit, even if I only use him for his signature. The PCP treats you like a glitch in a video game that allows your character to make an infinite number of return trips to a room filled with gold coins and invincibility spells to keep racking up your score. The administrative process is so deliberately maddening that, to save time, money, and a bit of mental well-being, I just bought a mitten. Hypothetially, of course.

I think most people with the kind of health insurance I have hate their PCPs, because the foundation of this particular brand of health services is based on a system of referrals to nicer, more competent doctors. PCPs tend to be over-crowded, under-qualified, and super-distracted. Enter my PCP's offices and it looks like a holding cell at the Immigration and Naturalization Service headquarters. The downtrodden wait and wait, applying pressure to open wounds or coughing themselves off their chairs. The last time I was at my PCP's office I had to wait over two hours while she rotated in about 15 different patients, including a prized fighting cock. While I waited for my referral-appointment, I occupied my time by thumbing through one of the many healthcare trade publications available for patient consumption. The magazines have titles like Pulmonary Health Forum and What's Up, Doc?, and a typical article would be something like, "May I Have Some More...Prilosec? Finding Healthcare Management Solutions in the Work of Charles Dickens."

After I got the signature I needed, I went to the receptionist's area to fork over my co-payment fee. As she counted out my change, she tapped her Monoxodil-sponsored pen against a glass fish bowl resting on the counter. The sign taped to the bowl, written on a blank prescription, read, "TIP JAR." Does anyone know what the Canadian job market is like right now?

WE FIRST MET ON 10.21.2002

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