INTERNAL MEMORANDUM, Directorate for Metabolic Affairs, Regional Health Secretariat, Rome. Circulation: District Coordinators, Pharmaceutical Liaison, Archivist. Filed off-world by Xylar Veen, Editor-in-Chief, Alienzine.
FINDING 1. Medical societies report approximately 5,000,000 residents of Italy live with diabetes and that 1,000,000 of them are unaware of it. Finding 1(b): the unawareness has become load-bearing. The injectable glucose medications developed for type 2 diabetes are now celebrated locally as slimming instruments, and demand attaches to the syringe rather than the syndrome. A diagnosis triggers blood panels, dietary counselling and placement on a waiting list, defined here as the queue of the queue. The pen can be bought at a pharmacy. Physician associations report booming uncontrolled acquisition, Form 47-D, "Attestation of Having Already Begun," available at the counter in packs of ten.
Dr. Marisa Colombo, Coordinator of the Directorate's Diabetes Awareness Programme, writes: "We begged the public for a decade to check their blood sugar. Now they arrive requesting only the pen. Last week a patient declined a follow-up appointment because he had not yet fallen ill enough to qualify for one, and asked if we could book him retroactively."
ESCALATION. Note the reversed flow: the treatment is pursued first and the illness is treated as its paperwork. The Directorate therefore proposes an awareness campaign informing one million citizens that they are unwell, so that they may become eligible, via proper channels, for what they already possess. Projected enrolment: 3 percent. Prof. Aldo Ferrante, President of the National Endocrine Circle, assesses: "A million undiagnosed patients is an emergency. A million undiagnosed patients already buying the medicine is, administratively, a success we simply failed to schedule."
For scale: one million pancreases currently operating outside supervision exceed the crew manifest of any exploratory fleet this desk has reviewed, monitored chiefly by vending machines and rumour. Remediation plan: campaign "Know Your Glucose," launch third quarter next fiscal year, budget under review, projected reach four percent of targets before seasonal wardrobes render the injections fashionable again. Recurrence risk: high. Whenever a condition's benefit can be purchased separately, this species purchases the benefit and files the condition under pending.
DECISION OF THE DESK: monitoring continues until the patients agree to exist. Of the 5,000,000, one million will be notified of their eligibility by the third quarter; the remaining four million are presumed to be self-medicating, and the desk declines to audit happiness. Coverage will continue until morale improves.
