Monday, September 14, 2015

One Symptom in New Medical Codes: Doctor Anxiety

[ed. How about patient anxiety? If there's an upside for anyone here other than insurance companies (who would deny your claim), I'm not seeing it.]

The nation’s health care providers are under orders to start using a new system of medical codes to describe illnesses and injuries in more detail than ever before. The codes will cover common ailments: Did a diabetic also have kidney disease? But also included are some that are far less common: whether the patient was crushed by a crocodile or sucked into a jet engine.

The more than 100,000 new codes, which will take effect on Oct. 1, have potential benefits, as they will require doctors to make a deeper assessment of many patients.

But the change is causing waves of anxiety among health care providers, who fear that claims will be denied and payments delayed if they do not use the new codes, or do not use them properly. Some doctors and hospitals are already obtaining lines of credit because they fear that the transition to the new system will cause cash-flow problems.

“It’s a sea change for physicians,” said Dr. Pardeep Kumar, a 46-year-old internist here who is counting down to Oct. 1. “We will have to be very much more specific.” (...)

The codes, from the 10th revision of the International Classification of Diseases, or ICD-10, have significant implications for patients. For example, Dr. Kumar said, doctors may need to perform additional tests to help determine if a patient with high blood pressure has heart failure.

ICD-10 includes 68,000 diagnostic codes, compared with 14,000 in the current compendium. The number of codes for inpatient hospital procedures will expand to 87,000, from 4,000.

Consumers often need prior approval from insurers for expensive tests and medical procedures. To get approval, they need a valid diagnostic code.

Dr. Michael R. Marks, an orthopedic surgeon and coding expert in Connecticut, said that if doctors did not use the proper codes, insurers could delay approval. “The patient,” he said, “will get frustrated and ask: ‘Why has my M.R.I. not been authorized yet? Why has my surgery not been scheduled?’ ” (...)

As people make the change, doctors and hospital executives say, it is inevitable that some claims will be denied for services that were provided but not properly coded. Patients may see the denials in statements they receive from insurers.

Many doctors and hospitals say they will step up efforts to collect the patient’s share of the bill, including deductibles and co-payments, at the time of service.

by Robert Pear, NY Times |  Read more:
Image: James Brosher

Thursday, September 10, 2015


roll of materials edo period
via:
 

Calvin and Hobbes
via:

Hipster Barbie Is So Much Better at Instagram Than You

Coffee & Kinfolk. Cuz my lyfe is beautiful.
[ed. See also: Socality Barbie Hits Uncomfortably Close to Home]

The Future of New York City Transportation: Goodbye Cars, Hello Rails

By any measure, young city dwellers are less and less likely to own a car. And New York City officials have spent millions of dollars and thousands of man-hours ensuring that trend works for the recent grads and young professionals that flock to it constantly. NYC bus, rail, and ferry systems are keeping up with a growing population; the roads, well, that’s a different story altogether.

Transportation engineer Samuel Schwartz — better known as “Gridlock Sam” to his readers in the Daily News — has studied transportation in New York City for almost all his life, beginning as a taxi driver in the 1960s, and eventually serving as the Department of Transportation’s Chief Engineer. Today, his eponymous consulting firm helps the city consider what efficiency could look like and his new book, Street Smart: The Rise of Cities and the Fall of Cars, is on the display rack. The semi-autobiographical book follows New York City’s evolution into a public transit powerhouse and kicks dirt onto the grave of urban drivers.

In the book, Schwartz makes an excellent case for why the future of most big metropolitan areas is in optimized public transit systems. He gave Inverse a preview of what’s coming down the tracks for New Yorkers.

What is the current status of transportation infrastructure in New York City?

It’s a mixed bag. The good news is that loads of people are using our ubiquitous subway systems. We have such an extensive network, but it’s a network that’s being stressed with some more frequent delays and breakdowns in the systems. I doubt if anybody would rate it an “A,” but one treasure is that it’s attracted 100 million more visitors in just one year. We’re beginning to see traffic volumes of people we haven’t seen on our subways since the late 1940s. That’s before the big surge in car traffic.

I saw that they were ranked fourth-worst in terms of car congestion, and that’s not a surprise to me, but then again all the cities that made the hit list — San Francisco and Washington D.C., Los Angeles — have also been doing very well as of late, so it’s not such a bad list to be on. And, as I pointed out in my book, congestion isn’t always a bad thing. In fact, at times it makes sense to introduce some congestion measures to slow the traffic down; it actually helps business.

What are the changing conditions that will affect New York City transportation in the next 25 to 50 years?

We’re already seeing more rapid changes than we’ve seen in a very, very long time. One is just land issues — the amount of development within three miles of the central business district. Within the central business district itself, growth has been extraordinary. It’s largely been driven by millennials, who are living in all the communities that have covered the East River — from Williamsburg, to Red Hook, to Long Island City, to Hunters Point, to Astoria. That’s created a whole change in demand. These are people that are looking for active transportation.

Bike and pedestrian paths will reach their limits. Before the East River bridges opened the only way that you could get directly from Queens or Brooklyn into Manhattan were bike or pedestrian paths. Even more rapidly changing have been transportation network companies, like Uber, Lyft, Via, and about 30 others that are all going around the United States and the world, and are looking to get into the New York market. So we’re seeing many many more vehicles on city streets, a lot of people that just use Uber, driving part-time, and that’s adding to congestion. Travel speeds have been going down.

The third big factor is that autonomous vehicles are coming. We probably will have them by 2030; they’ll be fairly common. Before 2030, I believe there will be lanes on highways that will be autonomous vehicle lanes where you take your hand off the steering wheel. You already have devices in cars that can allow you to accelerate and decelerate and cruise in lanes, so we’re not that many years away. Maybe in 2020 or so we might start seeing the first of those lanes!

But what autonomous vehicles will do is both good and bad. For those people who are going to be driving anyhow, it does make it safer. But it also will only contribute to a lifestyle that’s more sedentary and ever-increasing, which I discuss in my book parallels the growth of obesity and cardiovascular diseases, diabetes, stroke and others problems. I worry about a future in which people don’t walk. Their Uber car takes them right to the portal of wherever they’re going, and their office chair comes right out and greets them. Or it’s their home and their recliner comes and greets them. We won’t need legs anymore, like in Wall-E.

Your new book discusses how cars are falling out of favor in cities all around the U.S., including NYC. When did you first start noticing that cars in urban communities were on the decline? Was this all of a sudden, or gradual?
(...)

What we thought was lousy transportation in the 1950s is no longer seen that way. The younger people want to be able to get places. It’s not about the status symbol of your big car with the huge rims, which was my generation. I had a big Chevy Impala with huge rims on it and I loved that car and that was a sign of freedom for me. Now a sign of freedom is having a smart phone and having the apps or Uber, Lyft, Zipcar, or Via. Suddenly you’re more free. You don’t have to lug around several thousand pounds of steel and figure out a place to park it and worry if you’re going to have a couple drinks and fight the traffic on the way home.

by Neel V. Patel, Inverse |  Read more:
Image: Jon Harald Søby

F*ck Your Feelings

Put down the talking stick. Stop fruitlessly seeking "closure" with your peevish co-worker. And please, don't bother telling your spouse how annoying you find their tongue-clicking habit—sometimes honesty is less like a breath of fresh air and more like a fart. That’s the argument of Michael Bennett and Sarah Bennett, the father-daughter duo behind the new self-help book F*ck Feelings.

The elder Bennett is a psychiatrist and American Psychiatric Association distinguished fellow. His daughter is a comedy writer. Together, they provide a tough-love, irreverent take on “life's impossible problems.” The crux of their approach is that life is hard and negative emotions are part of it. The key is to see your “bullshit wishes” for just what they are (bullshit), and instead to pursue real, achievable goals.

Stop trying to forgive your bad parents, they advise. Jerks are capable of having as many kids as anyone else—at least until men’s rights conventions come equipped with free vasectomy booths. If you happen to be the child of a jerk, that's just another obstacle to overcome.

In fact, stop trying to free yourself of all anger and hate. In all likelihood you're doing a really awesome job, the Bennetts argue, despite all the shitty things that happen to you.

Oh, and a word on shit: “Profanity is a source of comfort, clarity, and strength,” they write. “It helps to express anger without blame, to be tough in the face of pain.”

I recently spoke with the Bennetts by phone about what the f*cking deal is with their book. A lightly edited transcript of our conversation follows. (...)

Khazan: How would you sum up your approach to life’s problems, whether it’s love or childhood issues, or work?

Sarah Bennett: The first step is accepting what you can't control. So many people who come to my father—they want something they can't have. They want a happy relationship that’s never going to be happy, or they want opportunities that are not easy to come by.

So it's going into accepting what you can't control, the factors that are out of your hands, and seeing what you can do with what you can control. And learning to be proud of yourself not just for accomplishing what you can, and not beating yourself up for what you can't. Not seeing yourself as a failure, when you haven’t really failed because it’s not something that you could have controlled in the first place. And admiring your ability to withstand a feeling of rejection, and the frustration and the pain, and keep going on towards a more reasonable goal while being a good person. That’s also what’s emphasized so heavily. Figuring out your own values and sticking to them.

Michael: A big part of this—and it’s so hard to capture—is being able to laugh at how much life sucks. If you can laugh at it, you don’t take it as personally. That moment when you can laugh at how much life sucks and open your mind to the idea that, there you are. What are you gonna do?

Khazan: How would you say that this differs from other advice that you see out there? What’s the main difference between you and a lot of the other “how to be more content” books?

Sarah: Well, from what we know—and we are two people that have never read a self-help book—they seem to put the onus for happiness on the reader. I've had too many friends who made Secret collages. And that makes it seem like, if you made your collage as prescribed by [the pseudoscientific self-help book] The Secret, and you’re not happy, you screwed up. When that’s not really fair to you. You could wake up that morning determined to be happy, and the first step you take out of your building is into dog shit, and now you’re unhappy, but you didn’t put the dog shit there. It's not your fault. You really can't control your happiness, no matter what a book says.

Michael: I think there ought to be a law that you spend a certain amount of time right up front looking for the limit and preparing yourself for it. ... You go in the hospital and right away you start to think about what the limits are—what does it mean if things don't go right? Where is the point where you’ve had enough? People are ready to think like that, and they’re starting to think like that about medical problems. We should think like that about psychiatric problems. (...)

Khazan: I know that the title is a little bit glib, but do you think there’s any downside in walling off your emotions or not necessarily exploring the roots of your emotions too deeply?

Sarah: We always try and make sure that people know that we don’t hate feelings in general. That we aren’t total Vulcans. But this is more of a book about solving problems. It’s to not make feelings the most important factor in how you would approach a problem. In terms of getting to the source of problems, the issue with that is a lot of people think about it like, “If I can remember where I last saw my keys, then I can get them and everything will be okay.” If you can get to where you last or where you first saw this issue, that doesn’t make the issue go away.

Sometimes the search for the source of a problem can be a distraction, and it can also be a disappointment. A lot of the time, knowing why, for example, you pathologically cheat on partners, and you can say, “Aha, it’s because my dad was a jerk and he cheated on my mom.” That isn’t immediately going to flip a switch in your brain and make you monogamous.

What’s the real result? Will it just be rumination on all these bad things that have happened to me? Or, what is a more active action I can pursue that can have a more possible positive and constructive outcome?

by Olga Khazan, The Atlantic |  Read more:
Image: YulyYulia

You Aren't Good Enough to Win Money Playing Daily Fantasy Football

Every first-time player of daily fantasy football begins the new season undefeated, just like even the most hopeless NFL teams. But after 16 weeks of real football, most rookie fantasy players will have been separated from their money, just as certainly as the Cleveland Browns will be disabused of their playoff ambitions.

Daily fantasy is getting ready to generate more losers in 2015 than ever before. Each year in the history of daily fantasy sports has been bigger than the last, and September has become the biggest month for new fans trying the game, which combines the stats-jockeying of traditional fantasy contests with the thrills of old-fashioned sports betting. (Fantasy sports are exempted from the federal ban on sports gambling.) FanDuel and DraftKings, the two main services, will bring in a combined $60 million in entry fees in the first week of the NFL season, according to Adam Krejcik, a partner at Eilers Research. Sports books in Las Vegas, by contrast, are expected to handle about $30 million.

The rival startups prospered in football's offseason. Both companies raised huge new rounds of investment, bringing DraftKings’s total haul to $426 million and FanDuel’s to $363 million, and both are now valued at more than $1 billion. To get to the size their investors are expecting requires a continuous stream of new players lured by ever-increasing prize pools with the help of muscular advertising campaigns. These ads never spell out a simple truth about daily fantasy competitions: While any player might get lucky on the back of a handful of entries, over time nearly all of the prize money flows to a tiny elite equipped with elaborate statistical modeling and automated tools that can manage hundreds of entries at once and identify the weakest opponents.

As in poker, the top fantasy players who make off with most of the prize money are known as "sharks," and they've become embodiments of the riches on offer as well as threats to conitnued growth. “We don’t make any apologies that it’s a game of skill, and you might go up against the best in the industry,” says Nigel Eccles, the chief executive of FanDuel. “Some of the people are really good.” But new players won't stick around to keep paying entry fees unless there's at least a sense that victory is possible. Nobody wants to be a fantasy football fish.

Saahil Sud is a fake-sports apex predator. He enters hundreds of daily contents each day in baseball and football under the name "maxdalury," and he almost always trounces the field. He claims to risk an average of $140,000 per day with a return of about 8 percent. Sud studied math and economics at Amherst College and took a job in data science at a digital marketing firm before shifting to full-time fantasy. He's now the top-ranked daily fantasy sports player, according to Rotogrinders, a stats site for daily fantasy players. He says he's made more than $2 million so far this year. (...)

What Sud does each day doesn’t seem much like sports fandom—or even like much fun. He spends between eight and 15 hours working from his two-bedroom apartment in downtown Boston; the range reflects his uncertainly over whether to count the time watching games as work. During baseball season he puts about 200 entries into tournaments each night, and he can play more than 1,000 times in the weekly contests during NFL season.

by Joshua Brustein, Bloomberg | Read more:
Image: 731; Photos: Alamy (1), Getty Images (1)

Wednesday, September 9, 2015

Bud Powell


[ed. Reminiscent of my childhood growing up in the canefields of Hawaii, sugar mill and all. So much fun.]
via:

Goodbye, Privacy: ‘Selfie-drones’ Will Hover Over Vacationers

Think remote-controlled drones and selfie-sticks are intrusive? Prepare for the selfie-drone.

This next generation of drones, which are just beginning to roll out, doesn’t require users to hold remote controllers: They are hands-free. Simply toss them in the air, and they will follow you like Tinker Bell. With names such as Lily (around $700 on pre-order) and Nixie (not yet available for pre-order), they are capable of recording breathtaking video footage and trailing adventure travelers across bridges and streams, down ski slopes and into secluded gardens.

Nixie, which you can wear on your wrist until you want to fling it off for a photo or video, has a “boomerang mode” that allows it to fly back to you as if it were a trained raptor. A promotional video for Lily shows a man with a backpack lobbing the drone like a stone over a bridge and casually walking away, only to have the thing float up and follow him. Think you can outmaneuver the contraption in white-water rapids? Lily is waterproof. I watched with awe a video of Lily being dumped into a river beside a woman in a kayak (where one assumes Lily will perish), yet within seconds emerging and rising, like Glenn Close from the bathtub in “Fatal Attraction.”

There is no denying that the latest drone technology is impressive. And the footage is striking. Adventure travelers who wish to watch themselves scale Kilimanjaro or surf in Hawaii along the North Shore of Oahu will no doubt want one. But if selfie-drones become staples of every traveler who can afford them, we stand to lose more than we stand to gain when it comes to privacy, safety and quality-of-life factors like peace and beauty.

by Stephanie Rosenbloom NY Times/Seattle Times |  Read more:
Image: Wesley Bedrosian/The New York Times

Tuesday, September 8, 2015

Water Bears

When scientists at the American Museum of Natural History mounted an exhibit about creatures that survive under conditions few others can tolerate, they did not have to go far to find the show’s mascot.

“We just got them from Central Park,” said Mark Siddall, a curator of the show, Life at the Limits. “Scoop up some moss, and you’ll find them.”

He was talking about tardigrades, tiny creatures that live just about everywhere: in moss and lichens, but also in bubbling hot springs, Antarctic ice, deep-sea trenches and Himalayan mountaintops. They have even survived the extreme cold and radiation of outer space.

Typically taupe-ish and somewhat translucent, and a sixteenth of an inch or so long, they are variously described as resembling minuscule hippopotamuses (if hippos had giant snouts and eight legs, each with several claws), mites or, most commonly, bears. Many people call them “water bears” or “bears of the moss.” (The word “tardigrade” is from the Latin for “slow walker” and pronounced TAR-dee-grade.)

Once an object of interest only among zoological specialists, tardigrades now are generating widespread enthusiasm. Admirers have produced artwork and children’s books about them, and have even organized the International Society of Tardigrade Hunters “to advance the study of tardigrade (water bear) biology while engaging and collaborating with the public.”

According to the society, formed this year at the University of North Carolina at Chapel Hill, people can find tardigrades if they gather some lichen or moss, especially on a damp day, put it in a shallow dish of water, and “agitate” it a bit. Debris will settle to the bottom of the dish, and tardigrades will probably be prowling in it.

The museum exhibit, which runs until January, also includes beetles, flowers, corals and other animals with unusual ways of coping with hostile environments. But its entrance is guarded by a 10-foot replica of a tardigrade, seemingly floating overhead. That’s fitting, because the tardigrade, which has a natural life span of about a year, is particularly impressive among the exhibit’s “extremeophiles.”

Confronted with drying, rapid temperature changes, changes in water salinity or other problems, tardigrades can curtail their metabolism to 0.01 percent of normal, entering a kind of suspended animation in which they lose “the vast, vast, vast majority of their body water,” Dr. Siddall said. They curl up into something called a “tun.”

Tuns can be subjected to atmospheric pressure 600 times that of the surface of Earth, and they will bounce right back. They can be chilled to more than 300 degrees Fahrenheit below zero for more than a year, no problem. The European Space Agency once sent tuns into space: Two-thirds survived simultaneous exposure to solar radiation and the vacuum of space.

Without water, “the damaging effects of freezing cannot happen,” Dr. Siddall explained. “It protects against heat because the water inside cannot turn into a gas that expands.” Even radiation needs water to do damage, he said. When cosmic radiation hits water in a cell, it produces a highly reactive form of oxygen that damages cell DNA. The tun doesn’t have this problem.

Tuns have been reconstituted after more than a century and brought back to life as tardigrades, looking not a day older.

by Cornelia Dean, NY Times |  Read more:
Image: Eye of Science/Science Source

The Cheap Phones Quietly Winning the U.S.

In most AT&T, Sprint, or T-Mobile stores, it takes a while to find the ZTE phones, buried in the back, past the latest from Apple and Samsung. But they’re there. In AT&T stores it’s the ZTE Maven, which has a screen, speakers, and a processor with capabilities somewhere between the iPhone 5 and 6. As Tony Greco, ZTE’s head of U.S. retail marketing, puts it, “These were state-of-the-art features two years ago.” The Maven’s draw, really, is price. Without any subsidies from a wireless carrier, the phone costs just $60. And it’s not even one of the company’s cheaper models.

ZTE is quietly becoming a force in the U.S. by selling good enough phones at low prices—smaller prepaid smartphones for $30, basic phones with QWERTY keyboards for about the same, and so on. The Chinese company’s products are among the cheap phones of choice at three of the big four U.S. carriers. (Verizon doesn’t carry them.) ZTE claimed about 8 percent of America’s smartphone market in the second quarter of this year, says researcher IDC, up from 4.2 percent in the first quarter of 2014. That ranks the company fourth among smartphone makers overall, behind Apple, Samsung, and LG. “We came from nowhere, and now we are a solid force,” says Lixin Cheng, head of ZTE’s U.S. operations.

by Bruce Einhorn, Bloomberg |  Read more:
Image: via:

Monday, September 7, 2015

Football With a New Age Twist

Jimmy Graham, an all-star tight end, quickly learned things were different with the Seattle Seahawks after he arrived this spring from the New Orleans Saints in an off-season trade.

After he dropped a pass during practice, Seahawks Coach Pete Carroll came bounding over to him — not with a torrent of invective, as might happen on other football fields, but with fatherly counsel not to worry and just to focus more.

He soon found that the soft touch did not stop there. He had arrived on a team in which cursing is frowned upon, a former competitive surfer turned “human optimization specialist” enlightens players in the “arc of the journey” rather than the arc of the pass, and — after one of the most spectacular losses in Super Bowl history — despair is defeated by New Age-style platitudes urging players to be mindful and seek “high-quality moments.”

Graham, like many new arrivals, was taken aback, too. This is a league, after all, that in recent years has determined that one team was operating a bounty system that rewarded players for hurting opponents and in which several members of another team harassed a teammate so much that he left the sport.

“Football has an old-school mentality: We’re going to grind you into the ground, we’re going to make men out of boys, and when you do something bad, we’re going to demean you,” Graham said. “But here, they feel like you guys are already men and we’re going to treat you like men. It’s literally all positive reinforcement.”

That philosophy will be put to the test this season as never before as Seattle tries not only to get back to the Super Bowl but to rise from one of the most deflating losses in the game’s history. With the Seahawks poised to win in the closing seconds, an intercepted pass at the goal line sailed into football’s Hall of Fame of flubs and handed a 28-24 victory to the New England Patriots.

“I couldn’t be more excited for the challenge of winning and coming back again and going again,” Carroll told reporters during training camp, still answering for the loss. “How hard could it be? We’re going to find out.”

The road back, he added, rests on “our beliefs, and we’re going to bring them to the front and see if they can stand the test, and if we do, we’ll be stronger and tougher than ever.”

Tough may not come immediately to mind with his unorthodox approach.

Although psychologists and consultants are not new in professional sports, Seattle has so integrated their work that more than a half-dozen teams have called to ask about the team’s approach. (...)

“It’s not, ‘I have the answers and you don’t,’ ” he said. “It’s a learning-based organization that is hungry to figure out the challenges of expressing human potential.”

The world outside the locker room is focused on championships won and lost. But Gervais said he reminded players that they were not defined by a single event, even a Super Bowl loss.

“I feel badly for those people who measure success by one point in time,” he said. “But if it’s a process and journey and life engagement, you have a choice to be successful in the arc of growing.”

by Ken Belson, NY Times |  Read more:
Image: Elaine Thompson/Associated Press

The Opposite of Hoarding

As long as she can remember, Annabelle Charbit has loathed “stuff.” She hated birthdays because birthdays meant gifts. And gifts meant finding a way to toss them.

At 5 years old, Charbit would sneak toys into her younger brother’s room. By age 10, she was stashing her belongings in alleys around her London neighborhood. At 13, she discovered charity stores, smuggling bags past her parents and out the door.

Living on her own in her twenties, Charbit, now 41, continued her spartan ways, eschewing even lamps. “I would be in semi-darkness,” she says.

Currently a neuroscience researcher at the University of California, San Francisco, Charbit was obsessively decluttering before the word really existed in popular culture. Google Ngram, which charts the use of certain words in book titles, shows that “declutter” first came into use in the 1970s, its popularity shooting up through the ’80s, ’90s, and the first decade of the 21st century. According to Oxford University Press, the term was only added to the 20-volume Oxford English Dictionary in June 2015. Today, women’s magazines routinely urge readers to purge; personal organizers offer to coach clients in their pursuit of minimalist perfection; earlier this year, Marie Kondo’s book The Life-Changing Magic of Tidying Up, which promises to help people achieve “the unique magic of a tidy home,” became a bestseller. But for some people, the cultural embrace of decluttering can provide cover for more problematic behavior.

“Do we just assume that decluttering is a good thing because it’s the opposite of hoarding?” says Vivien Diller, a psychologist in New York who has worked with patients like Charbit who compulsively rid themselves of their possessions. “Being organized and throwing things out and being efficient is applauded in our society because it is productive. But you take somebody who cannot tolerate mess or cannot sit still without cleaning or throwing things out, and we’re talking about a symptom.”

Unlike hoarding, which was officially reclassified as a disorder in 2013, compulsive decluttering doesn’t appear as its own entry in the Diagnostic and Statistical Manual (DSM); instead, it’s typically considered a manifestation of obsessive-compulsive disorder. “I see it all the time. People rarely come into my office because they have a problem with being too efficient or wanting to declutter,” Diller says, but the problem usually makes itself known in other ways: “They’re not sleeping at night and they’re feeling jittery and irritable … they’ll sit in my office and straighten my pillows. They’re not comfortable until everything is in order.”

Scientists still aren’t sure exactly what causes OCD, which is typically treated with therapy and medication. What they do know is that the condition causes sufferers to lock onto distressing thoughts (obsession), generating anxiety that can only be soothed by performing a particular act (compulsion). “By doing the ritual, you get temporary relief, and then that cements you into doing the ritual,” says Michael Jenike, a professor of psychiatry at Harvard Medical School and the founder of the OCD treatment program at Massachusetts General Hospital. “So you do it again and again.”

Diller’s compulsive-decluttering patients, she says, sometimes describe “this tightness in their chest if they see things that should be thrown out,” one that can be eased only by getting rid of the offending objects.

“Any behavior can technically become a problem when it starts having an obsessive and compulsive nature. Even [otherwise] healthy behavior,” says Jennifer Baumgartner, a clinical psychologist in the Washington, D.C. area who has worked with patients who suffer from obsessive-compulsive cleaning. Both cleaning and decluttering can be positive behaviors, she says, but become a problem when they’re driven by obsessive thoughts.

One day in 2010, Charbit, then a neuroscience graduate student at University College London, Googled “the opposite of hoarding” and “clutter phobia.” She was in the process of writing a novel about a woman who suffers from the same compulsions as Charbit herself (the novel, A Life Lived Ridiculously, was published in 2012) and wasn’t sure how to describe her character’s symptoms—there’s no official term for compulsive decluttering. “I was a grown adult, fully medicated, with plenty of insight … but with no name for [the behavior],” says Charbit, who began taking medication for OCD at age 18. Her search led her to an article on “obsessive-compulsive spartanism,” she recalls. Clicking it open, she immediately recognized her own experience.

For Charbit, the thoughts began within seconds of waking up each day. “You have a few seconds of peace,” she says. “Then it all comes flooding: The anxiety, the dread … It's that constant nagging. You never reach a point where you're satisfied.” Even now, after years of treatment, “I would rather throw something out and buy it again than keep it.” The medication helps, she says, but it hasn’t stopped her from discarding and re-buying a food processor three times. “And don’t even tell me to recount how many books I tossed, only to go to Amazon and repurchase them.”

by Leslie Garrett, The Atlantic |  Read more:
Image: Lasse Kristensen, Shutterstock

Jerry Garcia, David Grisman, Tony Rice