I Sure Hopes It Fits
Gifford Brickley
At HOPE we understand that there are an overwhelming variety of orthotic and prosthetic options. Your first visit is an opportunity to discover the best solution to help you regain the functionality you need in your everyday life.
Once we discover your goals, we will take the measurements we need. In many cases, we will also need to obtain a cast or 3D scan of your limb. This will allow us to build a device that matches your needs perfectly.
The casting process allows our custom devices to fit to your body perfectly. If we are building an artificial limb it can take several intermediate fittings to make sure that the interface is properly contoured to your body.
At your delivery appointment we will make sure everything fits and functions properly. We will also explain the use and care of your new device. We will work with you and discuss how to get used to having your prostheses or brace as part of your life. We want you to be comfortable using your device and make sure that you attain your goals.
Once you have an artificial limb or brace, we don't go away. We are always available to follow up with you and make sure that your device is still meeting your needs. We are excited to work with you and other healthcare providers to help improve the function of your daily life.
I know a fellow fashion editor friend who routinely buys incredible designer clothes (we're talking Lanvin, Derek Lam, and Narciso Rodriguez here) two sizes too small to motivate herself to get to the gym. Seriously. While I can't risk dropping that kind of cash on something I may never get my left butt cheek into, I will admit that I still have...
a pair of size 24 jeans from college. How on earth I managed to wear something that size while a.) Drinking beer as if it were my paid profession, b.) Eating late night pizza with a similar sense of gusto, and c.) Never, I repeat never, entering the gym once during my four years on campus is utterly beyond me. I'm pretty sure no amount of hot yoga would help me slip them on these days--in fact, the only thing that *would *help me slip them on is a can of Crisco.
And yet...I refuse to part with them. They just sit there on an upper shelf in my closet, waiting for...who knows what. I'm all but certain I'll never be able to wear them again, and when I think about my body back in those days, I'm relieved at how much more fit and toned and healthy I am now, with a few more pounds of muscle on me (I used to be what you'd call "skinny obese." I weighed about 100 and looked like I was thin, but I was noting but fat and bones!). But I still keep them up there, as both a barometer of my body (scales lie, jeans that won't button don't!) and some kind of weird memento of my super-skinny days.
I'm curious...do you guys have a pair of "skinny jeans" that you're holding on to in hopes that you'll be able to wear them again one day? Do you have "fat jeans" that you turn to when you've packed on a few pounds? Have you ever succeeded in getting back into your skinny jeans? What other items are you holding on to just in case you can get back into them? And just how long do you think it's healthy to hold onto these things before calling a spade a spade and buying the next size up? Share!
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The danger of being on the open sea, and in a variety of other circumstances, can bread fear. Many see fear experiences as unhealthy, to be avoided. Having fear experiences is often seen as pathological, yielding bad decisions, mental illness and unhappiness.
Indeed some people are unhealthily obsessed by fear as in post traumatic stress syndrome (PTSD) and phobias of spiders and other animals and events. These people need to reduce their attention to fear and to experiences of fear in order to enhance their decisionmaking, their health and their happiness. Short and long run success in treating these fear pathologies is with exposure therapies, happening in the environment naturally or by therapy, Amsel et al. (2014). Exposure therapy does not try to coddle the person from experiencing the phenomena that terrifies them.
Ending the prescription drugs bubble has been attempted for decades by documenting the corruption and by those courageous politicians, unbribed by prescription lobby campaign funds, who manage to implement legislation to curb specific malpractices. But the success from the transparency tactic of valiant skilled writers of articles in scientific journals, books, newspapers, magazines and television documentaries, coupled with piecemeal legislation has been modest. It has not even been enough to curb the dramatic rise in usage of drugs in the treatment of mental illness.
For solid lasting elimination of the bubble, there needs to be a comprehensive reform package addressing simultaneously all major factors contributing to the bubble, and enabling a winning coalition of those benefitting from ending the bubble to instate the needed legislation. The outlines of this package are in Pope (2012a, b, c). One strand of the package is the re-allocation of resources from bubble prescription drugs to interventions that enhance mental health. Such reallocation is facilitated when the medical community, the public and politicians have an overarching framework of what determines mental health to replace their current one of chemical balancing.
The task of the soft-wired brain is to risk process stimuli through to beneficial decisions. If we lived in a simple world where only a few things repetitively happen, the automatic responses of hard-wired animals might have evolved to yield optimal responses to stimuli. But in our complex world, the capacity to analyse stimuli so as to perceive risks and uncertainties and decide how to respond to them is an advantage.
Risks are often conceived as the possibility of nasty events. In this paper we shall expand the concept of risk in three ways. One is to use the term risk more broadly, to include the possibility of pleasant and neutral events, not merely nasty ones. In this sense we use the term risk in this paper as most people use the term uncertainty. We are not limiting the term risk to the possibility of exclusively nasty outcomes. Economists use the term risk more broadly in this way and it is convenient to do so also in this paper.
The second way in which the term risk is expanded in this paper is to include the normal situation in which a person lacks numerical probabilities of possible risks. Economists often distinguish risk from uncertainty by using risk for cases where possible events have precise numerical probabilities. As these cases are extremely rare, in this paper that risk/uncertainty distinction is ignored.
In panel 1 the tortoise has resolved its sensual risks and decided it sees a new thing. In panel 2 it has decided that the new thing is either food or not food, but faces the risk of not knowing which. In panel 3, it has decided that it can go to it or stay, but faces the risk of not knowing whether it will decide to go to it. In panel 4 it has decided to start walking, but still faces the risk of whether the new thing will turn out to be food or not. In panel 5 the entire succession of risks and associated hopes and fears is passed: it has the disappointment and physical damage of having discovered it was thorns and not food. This bad experience may induce more caution in deciding to explore and discover in the future. The tortoise thus faced a succession of risks, hopes, fears and surprises.
Hope is focussing on having pleasant possible surprises at a later stage. Hope makes risk enjoyable. Fear is focussing on having possibly nasty surprises at a later stage. A tiny bit of fear is enjoyable also. As Scitovsky (1976, 1981) observes, when people lack tiny doses of fear, they seek to remedy their lack by watching horror movies or taking roller coaster rides and such like activities. Too much fear makes risk unenjoyable. Far too much fear makes risk horrid.
If people know that a pleasant outcome will eventuate, they can feel safe, confident. But they cannot feel hopeful since they do not anticipate any change in knowledge ahead. They already know that the outcome will be pleasant.
Likewise if people know that a nasty outcome will eventuate, they can feel dread, be sad. But they cannot fear since they do not anticipate any change in knowledge ahead. They already know that the nasty outcome is not a mere possibility, but something guaranteed to eventuate.
In turn this means that hope is not merely focussing on the pleasant possible outcome. It is focussing on the pleasant possible outcome while aware that instead a merely neutral or maybe even a nasty outcome might eventuate. Likewise fear is not merely focussing on the possible nasty outcome. It is focussing on the possible nasty outcome but being aware that instead a neutral or maybe even a pleasant outcome might eventuate.
There are two alternative ways for the tortoise to face a sure option at noon. One is that it knows that deciding to walk to the rose will guarantee an outcome that the rose is food. Then by noon the tortoise would have placed a probability of 1 on the food outcome in panel 2, and on the other outcome, not food, the tortoise would have placed a probability of 0. The tortoise would know at noon on deciding to start walking to the new thing that the outcome will be that the rose is food. It is a pseudo discovery trip as the tortoise knows the outcome at the point of choice. The probability distribution over the two outcomes is by definition degenerate with only one outcome possible from making the discovery walk, that with a probability of 1, the outcome will be food.
The second way for the tortoise to face a sure option at noon is that it knows that deciding to walk to the rose will guarantee an outcome that the rose is not food. Then by noon the tortoise would have placed a probability of 0 on food outcome in panel 2, and on the other outcome, not food, the tortoise would have placed a probability of 1. This second way thus reverses in the degenerate probability distribution which outcome has the probability of 1.
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