my guide: obsession

my guide obsession 04.02.13

The upstairs lunchroom succumbed to my invasion without a struggle. I told my employees I needed to escape the phone perched on the corner of my desk and its winking green and red lights. But when I swallowed up the only table in the room, burying it under 323 index cards, that’s when they probably started questioning if one of their company’s founders had snapped.

*   *   *

I’m obsessive. When Green Day first released American Idiot, nothing else played on my iPod for four months. I’ve watched Moulin Rouge at least 50 times.  I spent so many hours playing Tetris in college that colored, rotating shapes floated across my field of vision while Professor Knopp droned on about Shakespeare.

Indulging this trait drives those around me to exasperation. My wife can’t fend off the sonic bludgeoning of “Jesus of Suburbia” or screening number 92 of Ewan McGregor’s forays into Paris’s seamy 18th century underbelly unless she fires off a magazine of negative critical artillery that forces me back into my foxhole. It’s the only way she can survive.

But I can also use my obsessiveness for good on occasion.

After I lost my leg, my pathological focus on understanding the biomechanics of human gait allowed me to walk again more quickly than I thought possible. A 10-minute presentation tends to go smoothly after I’ve practiced it for 3-5 hours. And when it comes to insurance appeals, my belief that I could (and had to) find a better way to present my patient’s case yielded excellent results when I still owned my prosthetic facility.

Those obsessive traits continue to serve me. Yesterday, I slogged through a workers compensation insurer’s labyrinthine denial. Its analysis boils down to this: why should an amputee need a prosthetic foot that has a moving ankle?

Now, if I go to that insurer’s office tomorrow and ask the doctor who penned the “not medically necessary” letter whether he believes ankles are medically necessary, I bet he answers yes. If I inquire whether he prefers life with a fused ankle or an articulating one, I think he chooses the latter. And if I pump him full of truth serum, I think he admits that his “coverage position” is nothing more than a pretext for cost containment.

Using my legal training and decade-plus of reimbursement experience, I have coined a technical term that describes this kind of payor analysis: stupid. And I obsess about stupidity.

This specific kind of stupidity led me to take over the second-floor lunchroom in early 2006 and release a waterfall of 3” x 5” index cards across the pale faux-wood table. Each card contained a single element of an argument supporting my patient’s need for a microprocessor-controlled knee.

At the time, I had an appeal win rate well in excess of 90%. But I believed with a zealot’s ardor that I could somehow reshape the 9/10’ths appeal and pick up another 7%, 5%, or even 2%. I knew that yesterday’s good enough would decay into tomorrow’s failure. Those forces drove me to inundate a table with index cards in 2006. And they forced me to buy Storycraft, a fascinating primer on how to write narrative nonfiction, a little over a month ago.

*   *   *

I sit at a bar in Glen Ellyn, Illinois, writing this. I’ll wake up in the morning and take the elevator to the basement meeting room. I’ll stand in front of prosthetists and their billing staff, separated by tables containing metal water pitchers and brightly-colored cylinders of plastic-wrapped candy no one will eat. They will wait for me to say something that will help free them from the claims tar pit sucking their businesses into oblivion.

I bought Storycraft because I thought it might contain a brilliant insight I could use in that presentation, which focuses in significant part on effective storytelling. But my talk doesn’t need a brilliant insight about narrative. It already works, just like my 9/10’ths appeal.

In fact, I only ventured into the book’s core after I had already assembled the various talking points and drills that now comprise my four-hour talk. But as I slipped deeper into the text this weekend, I realized I didn’t need the book for my presentation. I needed it for this.

I’ve always joked – the best jokes being built on truth – that the weekly format I’ve chosen for less is more works for me because it plays to my lack of discipline (read: laziness). While I’ve always thought I had the potential to write exceptionally well, my screeds in these e-pages always feel only partially cooked to me, examples of not-quite-realized potential. Storycraft reveals why.

Its author, Jack Hart, thinks about writing the same way I think about appeals and presentations. Years of experience combined with a systematic approach to the art result in a riveting “how to” do what I try (and usually fail) to do every week. But like the member of my audience who agrees with my presentation and then goes back to his practice and implements none of it, I now know that if I want to write better, more interesting stories, I’ll have to treat less is more a bit more like “Jesus of Suburbia” and a bit less like a secondary hobby.

While this means I’ll need to work hard in the upcoming days, weeks, and months, I find the prospect exhilarating. Instead of noodling around with wordplay and sometimes humorous (sometimes not) one-liners, I now have the chance to refocus on themes, structure, and arc. For the first time, I see a map that can lead me someplace new and better.

I can’t promise that my writing will improve significantly in future posts. But you have my word that I’ll obsess about it. And that’s a healthy obsession.

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