In quite a few, often intelligence / spying films, out of the USA people use the admonition “it is above your pay grade” to silence junior colleagues and prohibit their access to information. Others say “it is above my pay grade” to plead ignorance. Those on high salaries and with positional power have access to more information and things best kept away from lowly plebs which would not, could not possibly, understand. There are secrets only for the worthy, the elite etc.

I think I have inadvertently upset the applecart here, by examining the CT and MRI images, even having the temerity of printing captured images out. With one exception, our female GP, there has been a weird knee-jerk reaction to being presented with these images. Clearly it is a job demarcation problem for a non qualified pleb to impinge on the wisdom and expertise of a specialist radiographer. Oops, my bad. It is above my pay grade to download image viewing software and examine in detail images.

In France medicine is conducted in silos. A doctor asks a specific question of the radiologist in their silo. He/she replies in short coded statements to the adjacent silo. There is no need for the non specialist to examine images. It is efficient if not comprehensive.

I have had X-rays of my knees and feet done today. They look to me, at first pass OK, so we wait for the written write up which I will get before any GP appointment.

This morning, I have been looking at this Nature Comms Article

Genetics implicates overactive osteogenesis in the development of diffuse idiopathic skeletal hyperostosis

Anurag Sethi, J. Graham Ruby, Matthew A. Veras, Natalie Telis & Eugene Melamud

Nature Communications volume 14, Article number: 2644 (2023)

There are some nice graphics.

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Since I have been looking into diffuse idiopathic skeletal hyperostosis (DISH) I keep reading that the causes are not well understood. Given that it is widespread I ask the question, “why has there not been vast research in the area? It would be of enormous benefit to find a cure / assistance.”

It is a disease of old gits and nowhere near as sexy as cancer or brain surgery. There must be petabytes of images by now.

Clearly it is above my pay grade to ask such a presumptuous question of deity.

According to Nature Comms. I clearly have enhanced overactive rates of osteogenesis.

Does that mean that I get more boners than average? No.

Curiously osteoarthritis seems genetically counter-correlated with DISH. Technically I have a fair fit with the left column above.

Because I have no pay grade any more, no positional power, and no power by association it is probably best that I keep my gob shut and my nose out of the affairs of people way more important than I. I am a relatively poor, increasingly disabled socially non viable being. No way am I a big cheese in the grande fromagerie of life.

Obvs it is for the high and mighty to discuss things amongst themselves. The lofty air up there is way above my pay grade.

It does beg the question, “If you were to come visit me after your death, what would you say, what might you ask?”

“What might you expect me to say or do?”

In my opinion if I were writing a grant proposal, I might start….

DISH detrimentally impacts on the quality of life of more than 15% of the adult population therefore it is both timely and cost effective to understand better the aetiology of the disease so that early stage prophylactic interventions can be developed. Thereby enhancing both recurrent healthcare cost reduction and quality of life outcomes.

But that is above my pay grade.