Silk Road forums
Discussion => Off topic => Topic started by: KnightOfVenus on December 23, 2012, 04:23 am
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Let's see, where do I start... While I'm not a typical silkroader (very little interest in recreational drugs), I do very much uphold the philosophy of My Body, My Choice - the philosophy on which the drug market community is presumably based. (I'm going to abbreviate it as MBMC.) So that's one thing we have in common. The other major thing in common between me and the SR community is the belief that just because something might be illegal, that does not make it wrong or bad - hence we can discuss such things.
Thanks to the SR and other resources that exist nowadays, practicing MBMC has become fairly easy if the substances you need are in the form of pills or some other form fit for self-administration. But what if one's practice of MBMC requires (or at least strongly calls for) the services of a nurse, operating out of an establishment that closely resembles a conventional clinic?
If anybody reading this is from Russia or some other post-Soviet or Eastern Bloc country, you might remember how each of the state-run general walk-in medical clinics (called "polyclinics") had what was called a "procedure room" - a nurse would sit in that room for the entirety of her shift, while walk-in patients forming a live waiting queue outside (no appointment needed) would come into the room, one at a time, to have various simple procedures done to them - mostly injections. (I'm guessing those rooms did other things besides injections, but I don't know what they were/are.) Of course, the nurses staffing those procedure rooms were officially supposed to only give injections of those medications that were ordered by a doctor, but in practice there was very little enforcement: if you walked into the procedure room, greeted the nurse with "Hi, I'm here for an injection" and handed her a vial of some standard/common injectable medication, it is very, very unlikely that she would spend a half-hour verifying that indeed a doctor ordered that specific shot for you - instead she would simply tell you to lie down on the couchette and give you your shot. (Usually in the butt - SO much more comfortable than the modern jab-it-in-the-arm way!)
But now living in USA, I and my friends really miss having such a service available. And so we've got this crazy idea: we are going to attempt setting up a little underground clinic in the corner of USA where we happen to be living, offering services very similar to the procedure room of a Soviet-era polyclinic.
Just to be clear, we are *not* proposing a setup where someone buys a vial of heroin from SR, walks into our clinic with that vial, and has our nurse administer an injection of that H: while I hope very much that some day we'll live in a society in which one could do that, doing that in our current society would be difficult, to say the least. Instead, the use cases we envision are just a little bit less radical.
As just one example, suppose that a citizen of country A is living in country B, which is not his/her home. Our hypothetical user does not trust the medical establishment of the country s/he has to live in, and instead prefers the advice of a non-conventional doctor in his/her home country - whom s/he can't see in person because of the enormous distance involved. Based on the advice of that distant doctor (or alternative medicine practitioner), or based on his/her own knowledge of his/her body, our hypothetical user decides that s/he needs an injection of some drug which is not totally taboo like heroin (i.e., is legal, albeit perhaps Rx only, in at least some countries), but for which s/he still can't get an official prescription from a licensed MD in the country our user is stuck living in.
Now suppose our hypothetical user found a source of the needed injectable medication: bought on SR, or perhaps found a way to produce a script which a local pharmacy accepts and fills. But what about administration? The usual black market answer is to self-administer, or maybe have your spouse or partner give you the shot. But that is a very substandard solution, at least subjectively for me and my friends. Can't speak for everyone, of course, but at least for us having to self-administer would seriously ruin the experience. And even if you have a partner do it, i.e., you are giving shots to each other, having to do it in a home or similar environment that's very substandard relative to a proper clinic still ruins it.
Under the MBMC philosophy, the role of doctors should be to provide medical advice, diagnosis and treatment to those patients/customers who seek their services on their own free will - not to own your body and tell you what you can and cannot put into it. Once again, with the pills it is a known problem, and a solved one now thanks to SR etc. But when one needs an injection rather than just pills, and wants it given in the comfortable (even pleasurable to some) manner (you lie down and have a trusted nurse stick it in you, rather than self-admin), there is now a 3rd party involved: the nurse. And the problem in the "first-world" countries like USA with "modern first-world" medical systems is that nurses are merely accessories to doctors, and can't do much on their own.
Our underground clinic will be staffed by one or more nurses, and no doctors. And I am using the word "nurse" in a definition that probably differs from the legal one: for our purposes it makes no difference whatsoever whether or not you have an official license or certificate or whatever the heck one needs to work as a nurse in an official doctor's office. Instead when it is time to hire our nurse(s), the only thing we are going to care about is whether or not you have the skills to do the job of a nurse, be it legal or illegal. And of course, we'll need someone who believes in the principles of MBMC and would be willing to work as a nurse-sans-doctor.
We seek to set up a physical facility that will have the *exact* equipment, look, smell and ambiance of a standard exam/procedure room in a conventional doctor's office or clinic, 100% authentic. It turns out that all needed equipment and supplies (with the exception of Rx medications, see below) are readily available to the general public from clearnet sources, and not even particularly expensive. We are going to have a sit/lie-down table/bed just like any "normal" clinic or doc office would have (Ritter model 203 tables are available on ebay quite inexpensively; this table feels very similar to the couchettes in Soviet-era polyclinics), and sites like www.atlanticmedsupply.com carry virtually all necessary supplies: table paper, towels, gloves, disinfectants of every sort, nurse wear, needles and syringes, sharps containers, and even some sterile injectable solutions (sterile water, saline, dextrose etc, no active substances). We'll furnish the room and stock it with supplies *exactly* like a "normal" doc office or clinic would do; we'll also find out what disinfectants are normally used, and use the exact same ones in our facility: for both practical benefit (the same level of sterility as an official clinic would have) and psychological/ambiance factors (the same smell).
What kind of services are we seeking to provide using the above setup? The primary service would be injections, and this service can be subdivided as follows:
1. You come in with your own vial of medication (from your local pharmacy or from SR or from wherever - none of our business), and our nurse gives you the shot in the most comfortable manner, just as if you were getting it at your doctor's office - that's exactly the way the "procedure room" normally worked in the old Soviet-era polyclinic healthcare system.
2. We stock some medications ourselves, and you come in to get a shot of one of our standard stock meds.
For mode 2, what medications are we going to stock? Ideally we would like to offer a fairly wide selection, basically all the same stuff that an average community clinic would be able to give you from its own stock without sending you to a pharmacy with a script, but that would be quite expensive and difficult to obtain, so we are going to have to start small.
The one major use case that is driving our interest in this venture is injectable birth control - currently DMPA (Depo-Provera) for women, and hopefully some day something will exist for men too. I know several women using the Depo shot, including my own significant other, and they generally like it - they like having no periods, and it eliminates the vulnerability of forgetting to take the pill. And the experience of getting the Depo shot in the dorsogluteal IM injection site is also quite pleasurable - but unfortunately the other aspects of the doctor/clinic visit aren't pleasurable at all.
In the part of the world we live in, there are only 3 places where a woman can currently get a Depo shot, aside from buying the medication on the black market and self-administering:
1. Private physicians: expensive, and you are totally at the whim of whatever attitude your doc happens to uphold. My significant other has found a doctor who is absolutely awesome in other major ways (among other things, he gives her an incredible supply of oxycodone pills), but for some reason, he is either unable or unwilling (we couldn't even tell which of the two) to stock the DMPA medication in his office and have his nurses administer it. And even if this particular doc changed his stance on the matter, it still wouldn't be a general solution for our local community. (For one, his office is very small and cannot have a large number of patients.) Also going to a full-scale doctor's office for a birth control shot is philosophically wrong in my opinion: the doctors' time and patient-serving capacity needs to be directed to serving patients who actually need the services of a doctor, not a nurse. If you need a simple nurse-only job like a Depo shot, you should be able to get it from a nurse without *ever* having to see a doctor anywhere in that process.
2. Local community clinic: not as a high-end as a private physician's office, so less of a moral concern about wasting capacity resources. The clinic *is* set up to serve the needs of the local low-income community, and does a lot of nurse-only visits like children's immunizations for school, etc. They are perfectly set up to give birth control shots, and they used to do them as simple nurse-only visits. That's what my lady friends currently use.
But recently the clinic has become an incredible pita to deal with. In a sensible world, the lady would come into the clinic, be seen by a nurse as soon as one is available (while sitting in their waiting room, we often see nurses wandering around, looking like they aren't particularly busy), get the shot, and be out of there in a few minutes. But this isn't what they do: they first make the lady wait an insanely long time before being seen, and when she is finally taken into the back, instead of being given the shot, she gets subjected to a bunch of interrogation: "how long have you been on the shot? have you considered other forms of birth control? when was your last Pap smear? oh, you haven't been getting Pap smears?! why not?" - that kind of thing. My lady friends tell me that it is a horrible experience sitting there, being grilled with all those questions and stressing if they are going to shut up and give you your shot, or if they are going to deny it to you for some ungodly reason and leave you screwed.
A particularly noteworthy point is that officially you are not supposed to be able to get birth control if you don't allow yourself to be raped with a speculum every year. (I regard the Pap smear as a form of rape, and the doctors who force their patients to submit to it under the threat of being denied birth control should be prosecuted as rapists.) My S.O. has been able to continue getting her Depo shots from the clinic after she stopped getting Pap smears, but every time they bring it up, we always have this fear that they are going to deny the shot.
3. Planned Parenthood. The place is very sleazy, caters to clientele of the lowest social stratum, hence very unpleasant to go into. But we've tried them once, because they are known for being lax on the Pap smear requirement. My S.O. had gone off the shot for a while to give her body a break, then we went into PP to get her back on it. And they did give her the shot without grilling her about the Pap smear - but there was another totally unexpected snafu. All of us strongly prefer the dorsogluteal IM injection site, and all of my lady friends who have been on the Depo have been getting it there. But guess what, PP absolutely refused to give the Depo shot anywhere except the deltoid muscle (upper arm)! They didn't have the longer IM needles which one should use to reach the muscle reliably with gluteal injections, and from what my lady told me, the room they took her to had no table, nothing one could lie down on or lean over. We haven't been back there since.
Long before we discovered SR, I had successfully bought a dose of the DMPA injectable med from a clearnet source: I think it was www.valuepharmaceuticals.com. Their wording was to the effect of "prescription required, but you can instead include a statement that it's for your own personal use", so I did the latter as a test run. I still have that dose I bought those years ago; it is now expired by 2 y or so. But we never went that route: self-administering a shot in the butt isn't very practical (and certainly wouldn't be pleasant even if one could do it), changing to a different injection site wouldn't be pleasant either, nor would having me administer it to the lady. We really want to have a nurse doing it in a clinical-looking and smelling room with a table or couchette, etc. Besides, we have concerns about the storage requirements (temperature control and whatnot) for this medication - I'm going to ask that in another thread.
So what we are looking to do now is to solve this problem for all women in our local community: set up a nurse-only (no doctors) clinic where a woman could simply walk in, ask for a Depo shot, and get it. In addition to providing our own nurse and all authentic clinical equipment in the room, we'll need to stock the DMPA injectable medication as well, and rigorously maintain whatever storage conditions it requires in order to remain effective - if a woman gets that shot from us, and it fails to protect her from unwanted pregnancy, the cost of that failure would be very, very disastrous.
I don't know if such an operation could be given a thin cover that would make it look legal on the surface, or if it would have to be just as explicitly-illegal as the backalley abortions used to be. After all, we would be not much different from Planned Parenthood: most PP clinics don't have doctors working there regularly, just nurses, and they seem to be able to get away with giving out birth control without demanding Pap smears in return. In fact, the only real reason we haven't been back to PP ourselves is because of their refusal to accommodate our injection site preferences - and I highly doubt that such a minor detail can make the difference between an operation being legal or illegal.
Oh, and we are planning this operation as more of a charity than a business. The idea is that everyone receiving services would be given a little piece of paper indicating how much it actually costs us to provide the service (the cost of the medication if they aren't bringing their own and we are giving them ours, the cost of paying the nurse to sit there, and the cost of maintaining the room: rent and upkeep), and asked to make a donation (either cash in person while they are there, or send BTC after they get home) - but for services like the Depo shot, no one will be turned away for lack of funds.
According to the Georgia Guidestones and other reasonable estimates, the carrying capacity of the Earth for humans is somewhere around 500 million. We are currently in a state of enormous overshoot (think of caribou population overshooting its carrying capacity and then crashing to near extinction - example right out of a university biology class), so it ain't gonna be pretty, and we need to take the overpopulation issue seriously. As we are all believers in personal freedom and autonomy, the forced population control approaches taken by some countries look very, very unpleasant - and it absolutely infuriates me that while countries like China are *forcing* their people to curb procreation, in countries like USA a woman who *voluntarily* wishes to block her reproductive system for 3 months with a simple injection is faced with enormous obstacles.
When we get our nurse clinic set up (and it is a question of when, not if), any woman coming in for a birth control shot will be treated like a princess: our nurse will greet her in the nicest manner possible, pull up her record under an anonymous patient ID number, and ask if she wants consultation, or if she already knows what she wants and would like to just get the shot. If the girl wants the shot, just give it to her: no questions, no harassment, no power play, no demanding that she do anything else. And make the shot experience itself wonderful too: take the girl to a private room, and once in the room, offer her the choice of arm or butt. Have the room equipped with a couchette (table/bed) on which one can either sit or lie down comfortably, let the patient choose her preferred position. Have many different needle sizes in stock, and choose the appropriate one for each patient (tiny girl, big woman, everything in between) and for her preferred injection site. Ask for a donation to cover the cost, but no one gets turned away for lack of funds - we would much rather give a poor woman a free Depo shot at our charity expense than inflict another baby on our poor planet.
So why am I posting about this project here? As I've said at the beginning, this community is the rare breath of fresh air in today's world: the principle of MBMC (My Body, My Choice) and the open-minded attitude that just because something might be illegal, that doesn't automatically make it bad or wrong, and one can still talk about it, e.g., discuss techniques to minimize the risk.
I would be interested to hear if anyone else here has ever thought along similar lines, if something like what I have in mind has ever been attempted (where, with what results), and if anyone else has any other insight or suggestions.
Of course, I would also be very interested if some vendor might be able to supply the Depo-Provera medication (name brand or generic, doesn't matter) in the quantities we are going to need - but I'm going to ask about that in another thread.
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Of course, I would also be very interested if some vendor might be able to supply the Depo-Provera medication (name brand or generic, doesn't matter) in the quantities we are going to need - but I'm going to ask about that in another thread.
It looks like PriscillaMarie90 was also looking for the same injectable medication about 1 year ago. I have just reopened that thread:
http://dkn255hz262ypmii.onion/index.php?topic=5899.0