One Must Imagine Sisyphus Happy

2026-01-24

You’ve been needing it for a while. You can’t go to the psychiatrist without a referral—you tried that already with a telehealth app and they couldn’t do anything to help you. So you finally pull yourself together enough to get your SO to help you make an appointment at the doctor’s office. Little bit of a wait, but hey, it’s the first step! You tell the doctor about some of the mental struggles you’ve been dealing with and how you have Y symptoms, so he gives you a referral. Great! A specialist who will be able to address your issue specifically: a psychiatrist! First, you have to do some blood work. That’s fine, that makes sense so you schedule an appointment to have your blood drawn and also, apparently, to pee in a cup. You wait a few days and arrive promptly on time. You have to pay $50 though—something in the fine print of your insurance plan, it turns out. Bummer. But whatever, you gotta do it to proceed. Your blood work comes back a week later and it’s fine; a few metrics slightly out of range, but nothing that eating less fat and drinking less beer won’t fix.

Time to schedule the psychiatrist visit! You call up the number, the lady answers the phone, and they don’t have your referral yet. That’s weird. Okay, well you’ll call the doctor’s office back and get them to do it again. So you do. Days pass. You call the psychiatrist again. Did they get it? They didn’t get it.

“What was the fax number that the doctor had on file? Oh no, sweety, it hasn’t been that in years. Look, here’s the current fax number. You got a pen? Call them back and tell them to re-fax the referral to this number.”

And so you do and they do.

“We got the fax. Only… it doesn’t include all the patient information that we need. Can you have them send it back with the-“

“Can I just give them your number so you can tell them what you need?”

“Oh,” sigh, “sure. That’ll work.”

And so you do and they do.

Days pass.

You call the psychiatrist again.

“Yes, we can get you scheduled. The next availability we have is… looks like January 21st.”

It’s November.

“Fine, that’ll work. January 21st at 1 o’clock. Sounds good.”

So now there’s a date and all there is to do is just go about your life. Your issues are still there, but they’ve been there for so long, what’s another few months? So you wait ‘cause there’s a date. You wait for the date. It’s a great date. The wait for the date is great. The rain in Spain falls mainly on the—boy, this is taking a while.

It’s here! The great date is here!

“You got your insurance card sweety?” You’re standing at the reception counter.

“I’ve got it on the app. Sorry, just a sec.” You jab your thumb at the app icon and it goes dim and the little pie chart starts to fill. Stupid 64gb phone can’t hold all your apps on it. I mean for fuck’s sake, you can go down the street and pick up a tiny SD card with a whole fucking terrorbyte of storage for 150 doll hairs but Apple is gonna charge you extra for more than 64 gigs of—okay, it’s done downloading. Yep, haven’t logged in in a while, gotta do that. Tap, tap, tap. The lady looks at you expectantly. You’re logged in. The screen reads:

Based on your plan details, you should be using the BlueCrossXX Mobile app to access your personal health plan details wherever, whenever you want them. Please uninstall BlueCare Advisor and install BlueCrossXX.

And so you open the app store and get a new pie chart to start filling. Gotta log in. Tap, tap, tap. What time is it? 1:06. Cool, your appointment time already started. You’ve now logged into BlueCrossXX so that you can access your personal health plan details wherever, whenever you want them. It’s super glitchy and the UI is too big for the screen. You tap “View my card” and are met with a blank screen. You try it five more times. Five more blank screens. Back on the janky home screen it lists the group ID and membership number. That should be enough. You hand off your phone.

“It’s not pulling anything up. Is this the right address? It is? Hmm, I don’t see anything.”

She hands your phone back and starts doing something on the computer, presumably trying other options; hopefully not doing anything like what your doing, which is tapping “View my card,” looking at the blank screen, going back, and then doing it again.

“I’m sorry, I can’t pull up anything,” 1:10. “We can still see you today but I’m going need to give you this form and code the visit as out-of-pocket and then afterwards, once you’ve figured out your insurance, you can call billing back and we’ll resubmit the claim. For out-of-pocket, there is a $100 pre-pay and then the rest will be billed afterwards.”

So you put a $100 charge on your credit card and she hands you a clipboard with a form and a thick stack of papers.

“Since this is your first visit, you’ll need to fill these out too.”

The door to the right of the reception desk opens and the psychiatrist calls your name. He can’t see the receptionist and she can’t see him. Awkwardly, you tell him that you still need to fill out the paperwork; that there was an issue with your insurance. He says “no problem” and goes back whence he came.

The paperwork starts out with two forms that are nearly identical where you have to fill out your name, DOB, SSN, etc. Then a couple of disclosure papers. Hidden in the middle of the paragraphs about HIPAA and consenting to your medical data being available to law enforcement is a little paragraph saying that you give consent for the doctors to use AI in their documentation of you. You cross it out and write “do not consent.” You wonder how many people know that’s in there. You wonder if they’ll even check if you consented.

1:16. The psychiatrist once again emerges from behind the door to call your name only for you to tell him you need like five more minutes. He agrees and disappears again. You kick yourself for your people pleasing. You need more than five minutes.

You try and speedrun the series of questionnaires that all seem to say the same things:

Are you suicidal?
Are you homicidal?
Are you manic?
Do you ever hear “voices”?
Are you depressed?
Have you ever experienced hallucinations?
Are you manic?
Have you ever felt like things will never get better?
Have you ever found yourself unable to control your worrying?
Are you depressed?
Are you sometimes manic and other times depressed?
Does your mania depress you?
Has anyone else ever noticed you being manic?
Do you promise your not sui/homicidal?
Are you depressed?
Are you manic?
What are your top three fears right now?

You make it through them all and it’s on to the last form, the “pay out-of-pocket” form. One of the bullet points on the form says that you will not be allowed to submit a claim for it later. So you bring it up to the receptionist counter unsigned and point that out. She says she’ll need to go call her manager. She disappears with the clipboard to a back room and, as though they were performing some kind of Scooby Doo door gag, the psychiatrist appears at the other door. 1:22. You tell him there was an issue with your insurance and that she has to consult her manager to find out how we should process this.

Actually what you say is: “There’s an issue with uh insurance… uh the form says I can’t have them claim later uh but that’s what she told me to do earlier or actually to call about it uh now she went back to the office to call… uh…”

He says to come on back anyway. You finally see what’s beyond the door: a dingy white hallway; the promised land. Then he asks the billing lady inside something and after she replies, he tells you “Actually, it looks like they need to do something first. Why don’t you wait in the lobby a little longer while they figure it out.”

And so you do and they do.

They tell you that they’ll skip the form for now but to make sure you call billing to get it worked out after your visit. You say okay and the doctor leads you to the promised land once more. He leads you through the promised hallway into the promised office.

The room is about 50 square feet. There’s a painting of a landscape in a “golden” frame on wall above the loveseat and fake ficus. It looks like what you would find if you searched Amazon for “painting of a landscape.” The room is lamp-lit with the same $10 standing lamp you bought for your college dorm, and it does a serviceable job softening the ugly floor and drop ceiling. The love seat is too close to the desk so you sit in the flimsy folding chair in the corner beside it, opposite his desk chair.

The psychiatrist begins rapidly punching things into the computer and asking you questions without looking up.

From you he extracts where your from, what you do for work, where you lived growing up. He probes; you deliver. You tell him about your parents’s divorce, split custody, your distant relationship with them, your even more distant relationship with your sibling. Soon, he induces the vomiting of your relationship history, experience moving here, your history of abuse, etc. You sit with the plastic plant and the cheap lamp and the generic landscape and you spill and spill as fast as you can while you still have appointment time left your deepest secrets and anxieties to this stranger who punches them into a computer, dutifully looking up occasionally and performing empathy. He asks what kind of abuse and you tell him. Click clack. Soon you find out you’ve been diagnosed with X. This is no revelation; you were already diagnosed with X years ago. You tell him that the reason you came in was for your symptoms that you suspect are Y. He tells you that they don’t diagnose Y here. In order to diagnose Y, you have to go to the Psychological Services building for an evaluation. It’ll be 3 sessions: the introduction, the evaluation, and the conclusion. For whatever reason, it’s not covered by insurance so you’ll have to pay for each one.

“I can put in a referral for you, if you’d like.”

“How much do the sessions cost?”

“I’m sorry, I don’t know any information pertaining to billing.”

You tell him to go ahead and refer you. Worst case scenario, you just don’t go.

“If I can’t figure out my insurance, how much will this visit cost?”

“I’m sorry, I don’t know any information pertaining to billing.”

And you believe him; of course he doesn’t. He’s neatly closed off from the department who knows what his services cost, and they themselves are closed off to how much any other department’s services cost. It’s a carefully maintained information flow. They wouldn’t want to be so vulgar as to discuss financial matters with you. You make a sardonic comment about the American healthcare system and he forces an uncomfortable chuckle. His look says I don’t want to think about what I’m costing you. You are causing me discomfort. You must only express other grievances here.

You tell him that you were referred here from your doctor specifically for these Y symptoms. Why couldn’t the doctor just have referred you to Psychological Services?

“Primary care physicians generally don’t know the specifics involved with the specialists they’re referring you to. He probably wouldn’t have known. And either way, you’d still have needed to come to a psychiatrist first.”

Of course he wouldn’t. The information flow.

“Whether you choose to get evaluated for Y or not, I’d like to make another appointment in April so we can talk a little more before trying any prescriptions.”

And so your journey to get help has turned into a doctor’s visit, some labs, some clerical work to set up your referral appointment, a psychiatrist visit, a scheduled second appointment, and a second referral for three visits to yet another location if you want a real diagnosis. Whether your insurance (that you’re paying for with every single check) will cover any of this or not is unknown. That each step of this process has yielded profit is certain. None of this has helped you. None of these people behave like humans. The world has never felt colder and more alien. Suddenly, here in this artificially cozy environment it dawns on you that all the encouraging messaging of the last decade and a half to take care of your mental health, to reach out for help, to go to therapy, to destigmatize psychiatry—all of it now reveals itself to be advertising. You’ve been advertised services. Going to therapy means spending money. Going to psychiatry means spending money. Getting a prescription means spending money. More mental health conscious people is tantamount to more customers. It’s all advertising. And as with all effective advertising, there’s truth mixed in. These things are important. There is a need for them. And more than mere want, capitalism’s bread and butter are monetizable needs. Needs are gold mines. When there is a need, people will pay anything. They’ll follow up with as many goddamn referrals as you can write. They can make sick people do all the work themselves setting things up and they’ll even fall over themselves to give them the money for it, all for a little help. They’ll give you their personal data to share with the police and AI. They’ll tear themselves open and let spill their weakest human moments, their trauma, their shame, their secrets for unfeeling professionals to fill out standardized assessments.

And so you did. And so you will again.

To be in these healthcare spaces is to enter into an uncanny world where you and the humans who work there must proceed through the transaction without acknowledging the absurdity. It’s as though everyone involved has a vulture on their head, pecking their eyes out and must pretend like it isn’t so. The whole time you are there you want to scream and shake these people and show them that they bleed the same as you.

And yet, even if you never get anywhere, you will push the boulder to the top of the hill again and hope that it doesn’t fall all the way to the bottom this time. What else is there to do?

This system is dripping with evil. You know it and I know it and more regulation will not fix it. Nothing less than the complete abolition of privatized healthcare will fix it. Where there is a need, there is someone willing to sell it to you. This is one of the greatest evils of capitalism. It filters for these vultures and rewards them. These insurance companies, these private practices, these for-profit facilities, they’re not villains, they’re entrepreneurs. They’re being shrewd. They found a need and filled it, right?

The profit motive spreads into every corner of our world until all things that were once universal goods are for a price. They become private goods. You don’t get to enjoy them just because you’re human, they’re only for people who can afford them. Capitalism makes it such that even health is not for everyone. It is made a luxury. And a society in which you are not guaranteed healthcare, a society where it costs money to remain alive is not built for everyone and it deserves to be torn down.

That we all should be alive and healthy must be our starting place. A barer minimum cannot be imagined.