Metamurmerations – One: Distributed Medical Care & Wearable technology & Digital Tribes

It was paradise, or so they said.

Kehwan sat by the window, a book folded over on his lap. Behind him, John shivered in sweat-soaked sheets. Another difficult night; neither of them had slept well. John wasn’t getting better.

“You up hun?” His voice was weak, distant as though through a wall on the opposite side of the house.

“Mm.” Kehwan grunted non-commitaly. John coughed his response.

“Can you get me some water, please?”

“Sure ‘ting, Bubs.”

Kehwan rose from his chair and shuffled out past the patio and the dinner table, bills and papers still spread across it, lounging like so many unwelcome houseguests. As the cup was filling up, he thought over his options.

I could do a Breaking Bad – maybe get me a drug boat or someting.

The cup was filled and he shuffled back, choosing to ignore his problems for a moment and instead gaze out at the small green lumps dotting the emerald horizon. Seagulls were fighting over a crab on the beach. Heavily, he slumped into the chair next to his husband.

John took the water in feeble hands. His beautiful face was pale, paler than any white face should be. His breathing was raspy and his eyes were sunken; he missed the bright flicker that he could sometimes still see on the good days…but he had to admit, the man was still gorgeous.

John sipped and handed it back, then laid back down, turning over to face the warmth of the sun.

“Shit’s a bitch man…”

Kehwan smirked and put the glass down, then kissed his forehead. He sat back and exhaled. John snuggled up to rest some more as Kehwan stroked his curly hair, looking back out at the far off horizon.

They had the misfortune of being US citizens and not working a nice enough job to afford the premiums for John’s treatment. Then they had the audacity of getting sick, sick enough to be out of work long enough for their bosses to let them go.

They didn’t blame them, really. They were fighting for what they could get, same as them. Oh sure, they were pissed, but they were competing against the Multinats. They couldn’t afford to be short-handed. They had even given them both a little extra time to get well. But when John had lingered after Kehwan had gotten better, Kehwan couldn’t fit the hours they needed and their employers had to let them both go.

That was four months ago.

Four months of near-constant anxiety, stress and not knowing what to do next. He really was to the point of considering a drug boat. Or literally anything, really, short of prostitution. That was less because of any real ethical aversion and more because he didn’t want to get murdered by the multitude of homophobes who called the Caribbean home.

They had joined a d-clan to help make ends meet. The group had a minimum basic income paid in an internal currency, which through a series of exchanges made sure that they were able to get most of their necessities. Everything except a doctor.

He got up and wandered back into the living room, casting a disapproving glance over at the financial papers on the table, who were taking up so much presence the next thing one knew they were going to ask for seconds at a dinner they weren’t invited to.

Snatching the tablet off the coffee table he went to go sit on the patio, cranking the brightness up to drown out the sunlight just outside the awning. Idly he flicked his thumb upwards, scrolling through the job listings. There were the usual handyman jobs, which he had been doing here and there to put food on the table. Then there were the tech jobs, asking for skills so specific the A.I. must have been fed a single name as a learning template.

While scrolling he saw that there was a remote doctor offering their services in the classified section. They were on the mainland and didn’t mention which d-clan they were a part of. But they did take alternative currency. Kehwan sent him a message and crossed his fingers. Maybe they could be convinced to join them?

The heat from the stovetop clashed pleasantly with the cool tile under his feet when he took the past off the boil to server dinner. Conch and creamy alfredo – the latter was from the pantry, the former was from a friend of his he he paid with an old cell phone he had laying around the house. John was at the table, wrapped in a blanket despite the 23°C heat of the tropics. He smiled warmly though as he took the food. Kehwan gestured for him to start eating as he prepared his own meal. Then his phone buzzed. It came with him as he went to the table, unlocking with a touch of his finger.

“What is it hun?” John managed to meekly query through a mouthful of noodles and shellfish.

“Docter I sent a message to. ‘Tinking I can get him to join us.”

“He open to it?”

“Dunno, just heard back from him.”

“What’s it say?”

Kehwan breezed through the email, muttering as he went. It was professional, he didn’t seem like a scam. Had a website, some patient testimonies…and a couple videos. He googled the account and found a few blockchain transactions that verified he was indeed being paid for medical services and at one point was verified as a professional.

“Seems like he’s legit…just the usual stuff, how to schedule a meeting and all that.” Kehwan shoved another mouthful of sea snail into his mouth without looking up. “I’m just setting up a telemedicine call for tomorrow.”

“Is he part of any free-med clans?” John sounded cautiously hopeful.

“Doesn’t say. He does take a bunch of different web currencies though. USD, too.”

“Hope he does!” He sounded less hopeful now, more realistic.


The rest of dinner continued without much fanfare. After being at home for four months there was scant to talk about. They gossiped a little about a reality show they had just gotten into and the tone was a bit lighter than in previous weeks. There was a faint bit of hope and they were going to ride it for as long as they could.

“…so it didn’t say on your website, but are you part of any free-med groups?”

The doc seemed competent, friendly even. They took Kehwan’s description of John’s condition seriously and had even offered a few OTC meds that could ease his symptoms. Not much of it was new but it was encouraging to hear. However that warm feeling of hope that Kehwan had been kindling began to fade as soon as he saw their face drop in response to his question.

“No, I’m sorry….I’m still part of the system here, I have to get some sort of payment. I accept a wide range though – do you have anything? Maybe some renminbi or something?”

Kehwan shook his head. They were trying, he could tell that even through the video call. But they just didn’t have enough; his clan didn’t have a large resource reserve yet, they were still too small and too new.

“No, I…I’m sorry.”

The feeling was dead. The doctor on the other end of the call looked at him with a pained expression in their eyes.

“I do have a friend in French Guiana…she might be able to help you. I’m not sure what groups she’s a part of but if you give me a second I can call and ask.”

“That would be great, thank you.” Kehwan was struggling. They were so close. He had no hope for this friend. Maybe…? No. It’s best not to hope at this point.

The vidcall shifted to a black screen with the doctor’s name. By the time they returned it had felt like a half hour had passed but must have only been half that time. They were smiling, which seemed like a good sign?

“Hey Kehwan. So I just got off the phone with her and her group does have some openings. Their group is free-med, I think they only ask for reciprocal membership and visa sponsorship.”

Kehwan perked up. This might be something.

“Do you want to talk to her? She asked me to give you her number.”

Now he was struggling to stay composed, vascilating between despair and joy. All he could manage was a tert “Yes, thank you!”. He dutifully wrote down the number and thanked the doctor profusely. It was too good to be true – the high. So it probably wasn’t – the low. He waved goodbye and punched the keys in on his cell.

“Hello, this is Lucy?” Her voice was tinny and distorted, much worse than the crystal clarity of Internet audio.

“Hey Lucy, this is Kehwan? I just got off the phone with Dr. Brichard, they said you had some openings?”

The tin voice on the other end smiled in recognition when she replied.

“Of course! Yes, we do. Where are you located?”

“I’m in St. Thomas, USVI! Dr. Brichard said you were free-med?”

“Yes! I’m part of a medical collective called Pueblo Verde. Our collective is a gathering of South American and some North American doctors. All we ask is for reciprocal membership and visa sponsorship.”

Kehwan thought about it. Their group was incorporated as a worker owned company, like most clans in their home countries. They could offer the visa, if he vouched for the traveler. He offered in response;

“We’re small so the visa could be hard but possible. We do offer minimum basic income, equal voting rights, production quota shares and a currency conversion service…but we also require membership parity as well, is that ok? I’m not sure how many people you have in your group.”

Lucy nodded.

“That’s pretty normal. We have quite a few people and we have space for more. Sometimes things get a bit backed up but we’re open to time banking to help get some people higher in the que.”

“Do you need any manufacturing or trade work? Most of our people are like that.”

“I might and I know a few others do. Like I said though, we have some space so it shouldn’t be an issue right now.” She paused. “What’s your email? I’ll send you some documents to review and you can send them my way if everything matches with your group.”

Kehwan gave her the information and they hung up.

What followed were months of a dream-like trance. John got a monitoring bracelet, which let Lucy track his condition from afar. They got a couple LIDSR webcams so the two of them interact in virtual 3D and Lucy could conduct the exams. Kehwan was there to help take his temperature but otherwise with the VR goggles it was like they were two incoporal forms inhabiting a perfectly sterile exam room.

Kehwan did some time banking and collected some raw material for the matter to energy electric plant. With the tokens he got he was able to trade them for USD, which allowed him to get John into an MRI machine.

Their clan started to grow as well. With the reciprocal membership they were able to entice more members to join with the promise of free healthcare.

By the time the winter months came around, the view from the bedroom was the same but the atmosphere was brighter. John was on the mend and Kehwan was turning the clan’s MBI into down payments on a fishing boat from the boat builder’s guild. John barely even got seasick their first time out – and Kehwan managed to keep the prosecco cork from going overboard. It’s glued to the dashboard now, a memory of when things got better.

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