1408 Cardio.

I really wish I had more time to give to this page. I was still pretty off when I made it and it looks different to my eyes now. It’s a page that really showcases some of my favorite aspects of Nina as a character. She chooses to strive for joy against the uncertainty of the world. It took me almost three decades to even come close to understanding why this is one of the best choices to make. It’s not easy either. It takes an almost delusional strength to see the world the way she does. She makes it seem effortless. A benevolent creature gliding from place to place while trying to bring joy to others. What a gift people like her are.

Went to the doctor today. Talked about all the issues I need to deal with. He seemed pretty pleased with my status. I was out and about for several hours, but eventually the heat finally got to me and I had to go sit in the car and wait for everyone else. Being up on my bad leg made it swell up quite a bit, but it went back down a lot once I got it elevated again. I still can’t take heat for very long, but that seems to be a combination of things contributing to that problem and not one serious one. Basically I’m still healing and this is just part of it. I don’t need any special gear for the foot, but I’m looking into alternate masks and things for my cpap. It’s having a significant enough ill effect on my sleep that I got reffered to a specialist about it, rather than a regular tech. So I’m doing okay.

I got the statement for the ambulance ride today. It’s just ridiculous. 1070 dollars. Can you believe that? Why in the world is it so expensive? I could repair my truck significantly for that kind of money. With my insurance I have to pay about $400. That just blows my mind. The rest of the bill is absolutely terrifying to me. I’m having visions of all the donation money not even denting it…

Nothing for it but to just keep working and hope things work out.


God I always wanted to do that.
Actually I don’t know why I never commented anything, been following this comic since 3 years ago. Tis an awesome job sir!

Actually…your comic means more to me than I would let people know. It was the first work online that I ever read, and it made me want to read more. Much more. Like right now I’m following eight or nine webcomics and they’re all so incredible and I would not even know that people can do such wonderfull things if I did not come in contact with your work first. So thanks man. And good luck.

hah! ya same here started with this one…. now I’m at like 45. I’m not addicted I swear! ~jitters out of comment section directly into another~

“Yeah, I can quit anytime I want. Why don’t these other comics update as reliably as BF……..slackers…”

I’m right in the middle of a page but I stopped to make sure tonight’s upload was ready and wanted to say thanks you guys for the kind words. It’s stuff like this that makes me stick to my updates and try hard. Don’t think that if I don’t have time to comment it means I don’t care, or haven’t read your posts. It just means something is keeping me from it. Usually making more comics. XD

And Ed is thinking “There’s no MIGHT about how amazing you are.”

Ed is probably still flabbergasted at the tantalizing offer to bite Nina somewhere. My first bet would be her inner thighs…any other bets, anyone?

Shoulder, but not the bony part; just a bit into the tender part above the breast. And, gently, guys.

Parking lot, near the entrance to his apartment. That way he can decide if he might want more than a taste.

“Why in the world is it so expensive?”

A lot of reasons, only two of which are logical.

1) You’re getting the use of a highly specialized vehicle, chock full of stuff specifically designed to keep you alive long enough to get you to the magic hands of ER personnel.
2) You’re getting the use of two trained EMTs, also designed to keep you alive long enough etc etc etc.

When I had The Cardiac Event nearly a decade ago, the bill was ridiculous (nearly $100 for toothbrush, toothpaste, shaving cream, a razor, and a small bar of soap?), but the one thing I never even thought twice about was the ambulance bill. Those guys were total pros, without whom I probably would have… I dunno, stroked out, eventually. I’d rather not think about it.

The hospital bill? That’s something I’m glad I had really, really good insurance for.

I just looked it up – EMT median salary is around $31,000 per year. That’s about $15 per hour. Double it for benefits, double again for two of them, quadruple that for the time they sit around waiting for an emergency to happen… it comes out to $120 per hour. I doubt the ambulance took more than an hour in this case.

Googling finds that a fully equipped ambulance can cost $300,000. OK, that’s a cost of (rough estimate) 30,000 per month or $1,000 per day. If the ambulance is busy 1/4 of the time at 1 hour per call, that’s 6 calls per day, or $166 per call.

Add in some administrative overhead, which is extra-high due to the extra-regulated medical-industrial complex.

Then there’s the fact that (likely due to extreme pricing) only 1/2 to 1/3 of bills are actually successfully collected. So whatever the actual cost to the company is, multiply it by 2 or 3.

There’s an answer on Quora which claims (without citation) that ambulance companies actually make very little profit.

So, doing the math… the cost per-ride is not completely divorced from reality. Of course, the reality includes our whole health care system with all its regulations – which drives up the cost of both the ambulance and its equipment.

I’ll come clean on something, and I do expect some flak for it: I work for an insurance company.

I started out in one of their claims call centres and survived there for nearly 5 years. You have no idea how desensitized you get when you’ve got to explain to people why something isn’t covered or why it isn’t covered as much as they think it should have been. Most people can’t handle the emotional stress of the job, if you last past 6 months you’re one of the few. When I was hired, I started with 10 people, 3 were left after 6 months including myself. I’ve heard the most heart wrenching, saddest stories imaginable. I’ve also been called everything you could think of and even more things you probably couldn’t. I did do my best to help people in any way I could, but there are more rules and red tape then i would care to admit. It isn’t to prevent the insurance from paying out either, it’s usually because of past litigation, legislation or the employers request. The job did pay well and it did have good benefits though.

I now work drafting insurance contracts for businesses. Way better in every respect but I now see the flip side of things. These policies are insanely expensive to keep and they can pay out equally insane amounts of money. Most businesses try and put limits on what gets paid out and what requirements something needs to keep costs down, if it’s too easy for people to claim something, it almost always gets abused by either a few people or even providers themselves.

For what it’s worth, I believe you.

The problem is mostly government created, and has very little do with the insurance companies themselves, for the most part. Another problem is the pervasive “litigious society” that has been foisted on us by unscrupulous legal, media and political forces.

I believe that people were generally a lot happier and more reasonable before they were told that every little irritation in their lives required legal representation.

That’s part of it. Although at times they are a nesessary evil when a doctor won’t admit fault for carelessness. The heart of the issue is medical care is something we all need at one point in our lives and they know it. Add rediculus amounts of money made in the field and you have the current system. Sadly it’s going to get worse. The thing i am learning due to my own health issues is practical cost effective solutions are not always considered… if at all. It is usually up to the patient to discover them. Case in point i use a salve called Prid from time to time. It doesn’t solve the problem every time but it does work. Most doctors i know doesn’t even know it exists despite salves like it being around for a very long time. A 3 dollar salve vs 300 treatment for a boil… i have a feeling focus shifted to solutions like that without cutting corners medical costs would drop like a rock. Sadly at this point i think it’s up to the patient to do the research and find a doctor who is willing to listen….

From the flipside view of the UK, where healthcare is largely funded through taxation, there is a body (NICE) whose job it is to review the effectiveness of treatments and balance these against their cost.

It’s far from an ideal system, as it can take a long time for the long-term benefits (and problems) of a treatment to be firmly established. For example, there is a drug for mitigating the problems of Alzheimer’s which to begin with was only recommended (i.e. permitted) by NICE for advanced Alzheimer’s, and it was several years before it was recommended for mild or moderate Alzheimer’s. And there are a number of cancer treatments that just aren’t available – because NICE considers that the modest improvements in life expectancy they offer aren’t worth the high financial cost. That’s a cruel blow for someone who just wants a few extra months to say proper goodbyes to their family, maybe see a grandchild born, to be told their lives just aren’t worth it.

However, it does keep costs down, as doctor’s can’t secure public funding for the very latest treatments which may cost 10 times as much as the basic treatment while offering very modest benefits – with the result that the UK national medical bill is a bit more than half the US (as a measure of GDP). At the cost, of course, of much higher taxation.

Swings and roundabouts ;)

Oh, and another problem in the UK – with the national healthcare system providing the bulk of healthcare, there are fewer options available privately to those who can afford them, simply because the market isn’t big enough.


No, I’m not squealing like a little girl waiting for them to kiss. That’s just the… um… kettle. Yeah, the kettle.

This is the first webcomic I read every day it’s available, and it’s worth it every time.

About six weeks ago, my wife had a massive heart attack. The ambulance came and I followed in the car. When I arrived at the hospital, I was told her heart had stopped in the ambulance, but they had gotten it started and needed my consent to take her by helicopter to a cardiac hospital in Tampa, about 25 miles away. She has since made a complete recovery.

Four days ago, I got a call from the Air Ambulance people. My payment to them was $5400. Total cost for that helicopter trip? $40,000. Astonishing, but those people kept my wife alive even after she had died once until she got to the cardiac surgeons table. That also was worth it.

How are you gonna pay for that?

The insurance covered all but the $5400, and I set up payments on that. How will I cover the 2 weeks she spent in cardiac intensive care? I honestly don’t know. Like you, I haven’t seen any bills come through. When they do, I’ll figure it out.

My hospital allowed me to make interest-free payments, so I decided to make minimum payments until the bill is taken care of (the ambulance and ER doctor sent me separate bills and wouldn’t take payments, but that’s a another issue). If you can work out something like that, you may be making payments for three generations, but at least it’s something you can live with.

Same with the Air Ambulance company. With the size of the bills, interest-free payments can help a lot.

P.S. Due to medical issues on both our sides, I never got a chance to drop you a note to thank you for the awesome picture of Carol you sent. So far above and beyond anything I expected. I was truly blown away. To anyone who isn’t supporting Jackie on Patreon, do so immediately. The return is much more than you expect.

Everyone should have a Nina happen to them once in their lives. People like her are even more beautiful on the inside than they are on the outside (and @Jackie made her pretty special).

When I called 911 during my appendix rupture a year ago, the local Fire Department dispatched an ambulance. They did pretty much nothing but drive; I had to get into the ambulance and walk into the Emergency Room by myself. Still, it took them 20 minutes to get there and cost me almost $900 for 8 miles, and my Insurance Company only paid what they called “Reasonable and Customary,” or about $400 (less than half). Next time I’ll have my brother drive me. If I pay him $250 we can split the difference and both do well.

I like how you think. :)

(I hit post before completing my thought…)

I like how you think regarding Nina.

Still looking for her, unfortunately.

I had her and I let her go. She married some sucker who didn’t appreciate her to begin with (he told her she was stupid and ugly — she’s neither) and then he moved off to Florida to live with a much-younger bimbo. She won’t divorce him because of her religion, and now she lives like a nun.


Perhaps my mind is in the gutter, but that design on Ed’s shirt is suggestive of what he’d like to do with Nina. Talk about wearing your heart on your sleeve!

I’ve been thinking that for days now….

Because I am a much better Cyrano than I am a flirt/flatterer: Ed: “So you’ll have to forgive me if I’m staring.”

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