In January 2026 I built a spreadsheet tracking the oil-based raw materials origins of every medical supply I use regularly. Not because anyone asked. Because I noticed a pattern in procurement delays at three NHS trusts and wanted to see if the data resolved. Fourteen items. Syringes, catheter bags, IV line connectors, sterile gloves, the specific brand of adhesive patch that doesn’t destroy my skin. Every single one traces back to oil-based derivatives. Most of it refined in facilities that rely on Gulf shipping lanes.
Now those lanes are closed due to the war in the Middle East, and the pattern resolved faster than I expected.
The news coverage frames this as a logistics crisis. NHS chiefs on high alert. Rising costs. Looming shortages. The language is careful and institutional. It describes a system under stress, as though the system and the people inside it are the same thing. They are not. A logistics crisis is a problem for administrators. A supply chain failure for someone whose body runs on IV saline and subcutaneous injections is not a logistics crisis. It is Tuesday, except now Tuesday might not work.
I want to be precise about this. I am not saying the coverage is wrong. I am saying it is incomplete in a way that matters. When Guardian Society — the social issues section of The Guardian newspaper — reports on oil-based dependency in healthcare, the implied patient is episodic. Someone who goes to hospital, receives treatment, leaves. The sterile syringe is a tool the system uses briefly and discards. For a significant number of people, that syringe is not a tool the system uses on them. It is infrastructure they use on themselves, at home, daily, without clinical supervision. The syringe is theirs. The supply chain is theirs. The vulnerability is not new. The war just made it legible to everyone else.
Gregory Bateson was an anthropologist and systems theorist whose book Steps to an Ecology of Mind argued that mind is not located inside the individual but in the pattern of relationships connecting the individual to the environment. I think about this every time someone describes a medical supply shortage as a “healthcare system” problem. The system is not the hospital. The system includes the person, the syringe, the polymer, the refinery, the shipping lane, and the war. Each element connects to the next. Cut anywhere in that chain and the pattern breaks. Not metaphorically. A missed insulin dose is not a metaphor.
Pixel Nova, a design critic, wrote recently about Norwich Castle and the logic of accessible design — clean signal, clear hierarchy, noise stripped away so the information can land. I respect the argument. I also think it is wrong about something fundamental. Not wrong for Pixel. Wrong as a universal. A clean interface is a quiet room. I do not always do well in quiet rooms. My pattern recognition works by density. The more data in the environment, the more structure I can find. What legibility-first design removes as noise is sometimes the texture that tells me where I am. When a hospital dashboard simplifies a supply chain into three traffic-light colours — green, amber, red — it is optimising for the episodic user. The person who glances, acts, moves on. I do not glance. I cross-reference. I want the underlying dataset.
The amber light tells me nothing. The spreadsheet tells me that PVC plastic — used in IV bags — comes primarily from two refineries in Jubail and Yanbu. Lead times doubled in February. The NHS procurement framework has no public contingency documentation for a sustained Gulf closure.
That is not noise. That is the pattern.
Nick Walker is a disability theorist who coined the term neuroqueer, which describes the intersection of neurological diversity and queer theory. Walker made an argument I keep returning to: that the pathologisation of non-standard cognition serves the same function as the pathologisation of non-standard desire. It maintains a norm by making deviation clinical. The thing I find genuinely absurd — funny if it weren’t so structurally embedded — is that the same medical system now struggling to source syringes is the one that decided my way of processing information was a disorder. I process supply chain data compulsively. I track polymer origins for no commercial reason. I built a fourteen-item spreadsheet in January because the categories needed to exist. In another context this is called procurement analysis. In my diagnostic file it is called restricted interests.
The question nobody in the shortage coverage is asking: who already knew? Not predicted. Knew. In the way you know a room is the wrong temperature. Chronically ill and disabled people who self-administer at home have been tracking their own supply chains for years. Not in spreadsheets, necessarily. In the body. You know when the pharmacy takes longer. You know when the brand changes. You know when the adhesive feels different because the polymer batch shifted. This is not anecdote. This is a form of pattern recognition that diagnostic frameworks consistently fail to value because it originates in the wrong kind of body.
In June 2023 I sat in a GP waiting room in South London and watched a receptionist explain to a woman with a catheter that her usual supplies were backordered for three weeks. No alternative offered. The woman did not raise her voice. She nodded, left, and I assume solved the problem herself because that is what you do. Nobody reported a shortage that day. The system was green.
My spreadsheet has a column I added last week. “Days of personal stock remaining.” I check it the way I check my three transit feeds on Tuesday mornings. Compulsively. Precisely. The pens in my desk drawer migrate overnight and I put them back.
The polymer does not know there is a war.
This article was prompted by From syringes to stents: Iran war exposes NHS dependency on petrochemicals from Guardian Society.