Friday, July 31, 2015

Is there a medical doctor on the plane?

“Is there a medical doctor on the plane?
I’m unlucky this way.  I’ve responded to a medical emergency in flight several times now in the past 2 years.  It is Air Canada this time.  The plane has taxied to the take off position on the run way.  I hope another doctor is on board. There isn’t anyone else joining the stewardess leaning over the man in the section ahead of me.
I walk up the aisle, identify myself.  The man is in the window seat.  He appears obtunded.  The two passengers beside him move out to let me slip in.  He is breathing slowly.  I place my fingers on his pulse talking directly to him. He’s moving very slowly, pupils midway.  He smells of alcohol.  Maybe something else.
I proceed to ask the emergency questions, talking to him, reality testing, conclude he’s disoriented, slurring words, fluctuating consciousness, disoriented.
The stewardess leans over and asks if we should take him back to the terminal.  “Yes, “ I answer that will be best.  He’s irritated and admitted he’s been drinking rum and tea before the flight. He’s a very poor historian given mental state.  It’s all I can do to engage his floating attention.  I don’t know if he’s just taken alcohol and whether the blood level is rising or falling.  It’s best that we return.
The airport’s emergency services come aboard when the pilot gets the plane back to the terminal .  I briefly tell the fellow the salient features and my diagnosis Delirium secondary alcohol and possibly drugs.  He engages the man, professionally and efficiently. It’s apparent this airport team is particularly time aware.  The man staggers and stumbles sailor walking the length of the stationary plane.
The stewardesses thank me.  I find a card, write down my college #, put my diagnosis on the back.  The stewardess are all young and beautiful. Throughout the flight they each stop to thank me.  I am rather happy to have beautiful young women smiling at me.  Bit of a novel experience at my age.
I love the irony or synchronicity.  Being a physician/psychiatrist/ and addictionist I couldn’t be better suited to this particular emergency.
The last emergency I helped with on Air Canada was coming back from Hong Kong.  Pseudo seizures secondary to  metabolic acidosis after panic attacks.  When I was a family physician I’d have been hard pressed to handle either of these cases.  Both were custom made for me today.
Back when I was a gp I was faced with a delivery on a train. Despite delivering a hundred babies in my day I was incredibly relieved   when an obstetrician came forward and  took over.  Personally I'd given a Doctor of Divinity a similar sense of relief when I came forward.  He'd been good enough to heed the call.  
I'll never get cocky though. Handling an angry psychotic  man on one flight had taxed all my skills despite my psychiatric expertise.
 This time I was lucky.  God was kind.
It was good to be of service too.
I rather liked all those  smiling grateful young stewardesses though.  Made me feel like Brad Pitt must feel always.  Not bad. Not bad for an old guy.

Paranoid Depressive Thinking

The key factor in paranoid thinking is that the person with the disorder is convinced beyond a shadow of a doubt that their problems are not of their making.  Once they have concluded that they are the ‘victim’  they are now ‘entitled’ to ‘identify’, often arbitrarily, what it is that is causing them to suffer.
Paranoid thinking can follow from genetics or brain trauma.  The person suffers and lacks insight into their causing the suffering of themselves and others.  If this was the only time paranoid thinking showed it’s ugly head it would be a limited condition. The percentage of such cases is relatively rare.
What is common though is alcoholism and addiction.  These are commonly associated with paranoid thinking.  It’s seen in the statements ‘you make me drink’.  “if you had my wife, you’d drink too”.  “With my job stress I need to smoke crack”.  “With my pain, I need heroin”.
It’s also seen in simple depression.  “Nobody knows the trouble I’ve seen’.  Indeed if you were a powerless peasant, an Irish man during the potato famine, sold into slavery or a black slave working in the cotton fields or a modern day teen age sex slave, then you would truly be a ‘victim’ and being ‘paranoid’ about your ‘owner’ or ‘pimp’ might well justify your paranoid thinking.
The trouble is, that today, people ‘justify’ their ‘depression’ because they don’t have ‘helicopters’ or ‘yachts’ and that’s ‘somebody else’s fault’.
Everyone has paranoid thinking at some times.  The issue is how sustained is it and how it responds to or doesn’t respond to ‘facts’.
When I feel I’m a ‘victim’ and become ‘paranoid’ ,thanks to the media, I don’t tend to think that I’m strategically misinformed by them for the sake of them selling communication, but rather I think the enemy is ‘government’.  Government is my first go to.  When you’re paranoid whatever the country or era the best object of your fear and entitlement to victimship is to blame your own ‘government’.
In times of war, government actually ‘externalizes’ the paranoia and the enemy, and source of all suffering is the ‘hun’, the ‘commie’, the ‘french’, al Quaida, Boco Harem,  the Americans, the Brits, the Chinks, the Japs, the Prods, the Jews, whatever is convenient.
Without a major war then naturally government wants to deflect frustrations from the rapacious taxation and create a ‘war on drugs’ which was actually a war mostly on ‘drug dealers’ or now a ‘war on terrorists’ which is indeed a war on terrorists only Terrorists are a bit like bed bugs, always laying eggs and hard to kill.
I like to think that the politicians who I can at least elect aren’t at fault in the government but rather some ‘faction’.  These are usually ‘eurocrats.’  I imagine some ‘in house’ group, a conspiracy by say the ‘appointed’ Supreme Court, or senior bureaucrats but that the elected members don’t know about it.  That’s the old idea that the King is good but the advisors are bad.  Melanie Klein showed that the paranoid didn’t want to believe mother was all bad so coined the term the ‘bad breast’.  The good breast gave milk when the child wanted it but the ‘bad breast’ didn’t respond with alacrity.  Black and white thinking, all good all bad is classic paranoia.
In democracies this factionalism comes out with partisan ship. The Republics are evil or the Democrats are evil.  Paranoids aren’t consistent.  They  switch camps too because they think they’re rational but they are indeed classic ‘emotional thinkers’.  Their allegiances are frequently affected by their feeling like the drunk who loves you in the cups and forgets you sober.
With an election there’s demonization of the other party too. Paranoids are like soccer fans only their home team is their own narcissism.  It’s really all about them.  You are their friend as long as you reward their insatiable need.
I have paranoid thinking when I become afraid for my future.  I fear aging vulnerability and can see the with the declining safety and likelihood of a respectable place for an old person ‘physician assisted suicide’ is going to look good.
Sometimes paranoids think it’s aliens that are messing with the world and with them.
Recently it’s been a war on the miners and fossil fuels industry.  Sometimes its a war on the lawyers.  Sometimes its doctors.  Corporations are a real easy target for the paranoid.  Feminists blame white men.  There’s a real hard on in the media for the religious.  Scientists are commonly the target  Indians blame the Residential School but not the laws and leaders and judges and prime ministers and their parties who created them. I’m a white man so I get paranoid about radical feminists at times.
I sometimes catch myself when I have these brief moments by thinking that the chance that it’s aliens is equally like to it being the prime minister or president.  Unfortunately aliens are more likely to be friendly than hostile and clearly if I’m having a touch of paranoia it’s because I’m feeling threatened.
If I was an american I would know it was the IRA.  Everyone knows the IRA are controlled by the CIA who in turn are controlled by corporate aliens.
My friend who is definitely paranoid considers corporations are poisoning her food.
The environmentalists collectively are my favourite paranoids because they’re sure that man is killing the planet.  They ignore the resilience of the shark, birds and cockroaches.  Maybe dinosaurs were walking ‘too heavy on Gaia’ so she extinguished them.
The United Nations Agenda 21 is paranoid about people and wants to extinguish 7 billion.
To the paranoid somebody else is always the problem.  What’s worse if if a paranoid is depressed then there’s a good chance the paranoid might want to suicide and take you with them.  They’ve got nothing to live with because the planet is going to die because of the Alberta Tar Sands or the Chinese are en mass converting to moslem and forcing atheist americans to accept sharia law or die.
It’s always perfectly reasonable whatever one thinks from inside the paranoid psychosis.
There’s no successful psychotherapy for paranoids .  While everyone has paranoid thinking at times paranoids live in their fear and resentment and suck that time like there was no tomorrow.  Terrorists are always fairly paranoid. Suicide bombers are definitely depressive paranoids.
Medications, anti psychotics have been highly effective in reducing the extreme edges of the paranoia.  A paranoid who spits on Jews for instance on medication is likely to maintain the idea that the reason for starvation in the world is the jews, they will likely stop spitting on jews. The behavioural expression of paranoia is best managed with medication but take the medication away and not uncommonly the particular paranoid delusional system will return.  With depressive paranoid thinking treating the depression with antidepressants and antipsychotics might in fact restore the person to normal where they look at their ideas that Napoleon is today  reincarnated as  Chinese general whose also a transexual might suddenly seem odd to the person. They say, I think I had some odd thoughts. They don’t seem to be bothering me .  In time with further enjoyment and good living they might let go of the paranoid ideation unless its trigger. The pure paranoid doesn’t get better.
The drug addicts paranoia doesn’t suddenly stop with the drug stopping.  it’ often takes a year or two for a person whose had paranoia as a result of their alcoholism , stimulant or mariuana using to actually have clear thoughts.  Mostly their thinking will remain impaired as long as they are around other drug addicts with crazy thinking. It’s always easy to relapse to paranoid depressive thinking.
In this regard paranoid depressive thinking has some elements of the dissociations that are associated with post traumatic stress disorder. When the latter as war vets see war on television they suddenly being to act and behave like they’re back in the battlefield.  All the paranoid depressive thinking person needs is a new story about Rothwell to get the paranoid juices flowing.
I m fairly reasonable right now but financial insecurity can quickly have me thinking the billionaires are out to destroy us. I helps to have insight. Humour helps even more Good friends and loving family are the best buffer.
 

Social Housing and Nimbyism

The Neighbour began violently banging on the walls at 6 am. I was quietly dressing to catch a cross country flight.  The banging went on for 10 minutes and was so forceful as to cause the pictures to fall off the wall.  My friend, who I was staying over with said,
“That’s the neighbour, she’s always banging on the walls and ceiling.  Everyone has complained.  I’ve even complained to the super.  Nothing is done."
Suddenly the banging is on the door.  My friend opens her door.  She is tired and in her housecoat. The neighbour is wide eyed, crazy, yelling.
“Stop banging on my walls,” she shouts.  My friend holds up her arm to stop the young woman from barging into her suite.  She backs up screaming ‘Don’t touch me. Don’t touch me.”  Every action, every statement is an sophisticated attack. She, the aggressor, is positioning herself as the victim.  “You bang on my walls every morning at 8:30.” It’s 6 am I’ve been getting ready quietly so as not to disturb my friend.  She usually leaves for work before 8:30.  But that isn’t the point, is it.  This is a distraction.  She’s attacking here and now.
My psychiatrist mind has flipped into gear because of the danger she presents. She’s either psychotic or a sophisticated borderline sociopath.  She’s sweating profusely. That could be from the banging or she may be in withdrawal.  Her irritability could be heroin withdrawal but such paranoid projection is more common with marijuana psychosis, crystal meth or heroin psychosis. My crystal meth patients become like this.
Of course she doesn’t look like the stereotype of the mentally ill or addicted. She’s well groomed, maybe 40’s, plain but not unnattractive.  My friend says she has a job.  The rent for suites here is standard Vancouver , well over a thousand. It’s a nice neighbourhood but no neighbourhood is safe from drugs or even sociopaths.
The whole idea of ’social housing’ has the drug addicted and ex convicts increasingly housed in nice communities because such orderly civilized environments ameliorate the insanity and violence of these populations. It’s like the distribution of difficult children in normal classrooms. The normal students provide structure for the ill mannered.  The alternative is the ghetto. The Vancouver Downtown Eastside is a breeding grounds for crime, violence, drug addiction and insanity.
Government agencies, civil and human rights associations, ex convict advocacy activists, mental health agencies, families of the ex convicts and the mentally ill, all serve to get their individual concerns cared for in the best of districts. At the other end of the spectrum the rich and privileged don’t accept ‘social housing’.  They have gated communities. They are protected by their wealth.  The middle class can no longer afford the same so increasingly they’ve turned to Nimbyism.  Not In My Back Yard.
The whole idea of ’social housing’ developed 50 years ago.  That was the height of community movements, middle class values, law and order. The police and authorities in general were widely supported by the citizens.  So many of the adults had returned from World War II.  They had seen up close what ‘chaos’ was like.  They’d seen or heard about the concentration camps. The Jewish doctors, gay composers, ethnic minorities and anyone different had been gassed.  The Soviets had raped everyone in their ‘liberation" especially teen age girls and boys.  After the long nightmare, everyone wanted peace and order.
It’s 2015.  The police have no authority.  My police friend left the force when she said “I set out to be a crime fighter.  I was reduced to being a ‘crime recorder’.  Police are simply not allowed to do anything. When they catch criminals red handed  rich lawyers  get privileged judges to let their clients off on a ‘technicality’. “  Justice is a revolving door.
I treat victims of physical sexual violence. They’ve lost limbs. They have nightmares for years.  They’re still in treatment for the horrifying consequences of their assaults when the criminals are being released back into the community.  They’re terrified. Some of my patients are the victimizers. They’re terrifying.
Increasingly the judges, once the admired back bone of society are being exposed by the rapacious media.  Everywhere the media exposes to the masses the one bad apple and demands an enquiry into the whole barrels. There’s no money for front line resources so police and mental health care givers are forever forced to cut corners or ignore all the while million dollar enquiries make everyone rich writing up more plans and protocols that no budget has resources to address.. Media logic goes like this.   One northern judge in British Columbia was caught for pedophlia so all judges are pedophiles. The former head of the Supreme Court of Canada was a slurring alcoholic so all judges are drunks and alcoholics.  The judges increasingly are throwing the police under the bus, more concerned apparently with popularity than justice.    Everyone in authority knows there will be no one to protect them in retirement.  When the police learned that the proposed new gun laws for disarm police on retirement suddenly the police were no longer en mass in favour of highly restrictive gun laws.  All those in the know want to be living in a gated community. Private security firms prosper like never before.
The industry of housing as “mental health and addiction’ treatment simply  takes the money from true treatment, psychiatrists, physicians,  nurses, psychologists, addictionists, counsellors, standardized scientific therapies and certified treatment facilities and certified recovery houses with treatment components. They give the money instead to ’slum landlords’. These smart businessmen raise the ‘rent’ on their unliveable facilities because they’re overnight called ’social housing.  When the tenants destroy them the landlords give the repair bills to the health care system.  When the facilities are repaired to a liveable state they rent them out at high priced Vancouver prices to ‘normal’ people who now will live in these improved bed bug and cockroach free apartment complexes. The money designated for addiction has paid for the upgrades.
Meanwhile with ‘social housing’ the violent, the insane and the drug addicted are distributed through communities. They’re ’somebody’ else’s problem”.
Psychiatrist used to be able to ‘committ’ for treatment the mentally ill who were violently insane and destructive in the community. Yet today the government has closed down all the asylum and mental health beds with the result that there are simply no resources. The ‘bar’ for admission to a psychiatric facility is raised so high that even psychotic schizophrenics who publicly chop off the heads of their neighbours are quickly discharged  free in the community.  The assumption is that these patients are taking medications that will stop them from being violent. The trouble is that there are so few resources that when patients stop taking medications its often months or another violent episode before anyone notices that they are no longer getting their monthly injections or following up with the treatment team.  The sex offenders from the criminal system are similarly placed in the community with marvellous ‘parole’ and ‘probation’ idealized recommendations.  These pretty documents no doubt make judges feel good about their ‘intent’. The trouble is with no jails and no community staff and castrated  police and a thoroughly unnaccountable destructive deceitful media and vigilantte Facebook justice, there’s no follow through in fact.
When I said to the crazy lady, “You were the one hammering on the wall. We both heard you and you need to leave.”  She shouted spitting in my face, “Shut the fuck up you fucking old man.”  I backed away.
I am old. I’m in my 60’s.  My friend is in her 50’s.  She’s focused her life on health care administration and raising children. She has no training in dealing with criminals or psychotics or violent young women who know all the angles and claim they’re the victim. They have a monopoly of victimship and can bring massive beaurocratic  governmental to bear on kindly innocent people like my friend, the sweet older quiet lady, who has never harmed anyone.  Everyone she has ever met will speak to her good manners and respect for others and loving nature. This woman likely has a rap sheet a mile long. Yet the courts and agencies no longer respect individual histories. Everyone is equal before the law.  Character doesn’t count in the courts. In the street Vigillante justice runs on how many people you know and how many hits you can get on Facebook by taking a video out of context.  Just be sure to sound politically correct.
I work in the mental health and addiction field.  People like her don’t ‘just happen’.  She had all the ‘lingo’ rehearsed.  The best defence is an offence.  She was like Hitler where claimed his destructive tank blitzkriegs were ‘defence.’  Politically correctness is all in the language. Get the right marketing jingo and everyone will believe you should pick up the lump end by the clean end and that this clean end exists and is apparent to all.  The neighbour went from loud to catastrophic. She’s a ticking bomb, a social terrorist. Now’s she’s hammering on walls and ceilings and doors. What will she do next.  My  friend admits that everyone in the building is afraid of her.  She certainly frightened me.
I’ve always been afraid of drug addicts. I know the neuroscience of drug addiction. I’ve watched my little cockapoo dog growl defensively, whenever anyone delirious on marijuana, crack or crystal meth approaches. Animals sense the unpredictability of people who are emotionally anaethetized  bubble boys and girls. These people are able to inflict all manner of emotional and physical trauma without feeling anything in return because they’re drugged.  They’re also always the ‘victim’. Right.
Theres’ a tug of war between the rich with ‘gated communities’ and the new ‘bunker houses’. These two or more story bunker houses were all the rage in medieval towns. Then a family home had to stand against the riots that plagued the city.   Few if any small windows on the lower floor with the big windows on the second or third floor. Reinforced doors.  That’s what the rich have begun to demand.
Barricaded private complexes are a response to the increasing decline of law and order. The public structures are all but collapsing into increasing chaos and brute force rule.  If my friend hadn’t put up her hand to stop this woman pushing her way forward she might well have barged in. Bullies take advantage when they see weakness.     This neighbour would have phoned the police  too and claimed she’d been assaulted if it was one on one. The first come first serve justice system gives the edge to the complainant.  Criminals and frequent fliers know the system.  Everyone knows in Canada that ‘false allegations’ are standard but that there’s never any consequence.  As one judge asked about slander said, “everyone lies in court, it’s my job to assess whose lying more.”
Everyone doesn’t lie and no judge can do what lie detector tests and countless psychological scientific studies have proved.  But what we do know in psychopaths can act better than the innocent. The innocent are no longer the victims.  Everyone is the new ‘victim’.  "Nobody is right when everyone is wrong."  The criminals all know the system and rule because frankly there is no other authority.
“Shut the fuck up you fucking old man!”
There is lawlessness here and now.  The question is when will the media do it’s job and report that.  Will parliaments and congress make the pendulum swing back to the centre. Will judges be supported in making the tough decisions.  Will the rich want to face the ‘peasants’ again.  Have they so quickly forgotten what saying ‘give them cake’ caused.  Do the corporate czars really think they can protect themselves from the Lennins of this world.  The middle classes, the truthful,  the educated, the professionals, the artisans, the engineers, the businessmen, all those whose represent the meritocracy, will they be protected because they don’t do well in chaos. The Pol Pot killed the doctors and university teachers first then killed half the country later throwing a once thriving country into the dark ages.
Hitlers first act was to make the Brown Shirts. The brown shirts became his personal army. They were made up of pedophiles, drug addticts, criminally insane and sociopaths, bullies.
A day doesn’t go by when I don’t hear of a person being brutalized by their neighbours.  The real fear of investing a million dollars in a Vancouver property is not the predicted tsunami and earthquakes but more importantly the very reall possibility of the dangerous or just offensive neighbour.  I know of dozens and dozens of such cases.
Personally I’ve lived the last few years in what is essentially a gated community.  After hearing so often of such complaints I witnessed first hand what is perhaps best called ‘evil’.  When the psychotic is powerful there is little language to capture the depth of insanity one must face.
I feel sorry for my friend.  I get to leave.  Her sleep has been disturbed many nights.  My day began with a threatening confrontation which my friend says is routine, If she’s not banging on her door she’s banging on the woman above her, the man beside her, shouting in the halls or threatening people coming through the vestibule with her.  She’s clearly way out of control and has been for a very long time.  No one is a bout to control her soon because frankly the system will punish the good rather than engage with this evil.  The system lacks the mechanism, resolve or even the intelligence to address it.  It’s not an individual.  It’s a disease.
If it’s not in your neighbourhood.  It’s coming.  It is coming to your neighbourhood.  

Wednesday, July 29, 2015

Wednesday Evening Journal

It’s hard to reckon how hard a start it was this morning. I wish I worked for someone else. I would have taken a ‘mental health’ day.  But then ‘mental health’ days become addictive.  I loved the program that allowed workers who were ‘sick’ to come to work and sit in the lounge but be present. Too many people in Canada are working two jobs.  As well, misery loves company. Most of mental health is made worse by isolation. And with the addiction incidence, taking time off is a way often to maintain an unhealthy lifestyle rather than get the appropriate treatment for the addiction. Or move over and let someone else have a better job.
Easy for me to say now that the bed is calling my name. I was fortunate.  Thanks to God and coincidence and the universe and the force it was a light day.  Welfare Wednesday always is.  The welfare cheque for so many is the ‘party money’.  And the question arises is it better to just maintain this lifestyle and morbidity in society or to have more formal structure.
I’m a hard ass.  I’m economically grounded. I have strange old fashioned ideas of community and public health. I was in the park today and there were more needles.  Suddenly the ‘needle exchange’ program became the free needles and proliferation of needles  and needles on sidewalks, parks and back alleys and one begins to wonder whose making all the money on this obvious waste and the creation of a public health hazard.
But I worked with others.  Patients were motivated and cooperative. I didn’t have those critical entitled people demanding more from a product that was already free to them.  I didn’t have any more threats or outburst or stuff stolen or the extortionist tactics. I didn’t have any attempts at sexual manipution or physical overbearing. It was just a normal day at the office. Some interesting pathology.  We gathered as doctors to listen to a chest which is likely pulmonary embolism.  We discussed what people would do if they had a gun placed on their desk like I did.  I explained why  I didn’t call the police.  I shared why I didn’t.  We had lunch and talked about the differences between women and men and how little women seemed to know about the world we lived in.  We discussed the way male and female patients had threatened us in our work and the standard patterns.  The triangulation of the women and the attempt to use a proxy while with the men it was always one on one.  The doctors expressed their fear of angry women patients and their experiences of delayed and indirect violence. We laughed about the irrelevance of media.  There was a certain camaraderie.  Staff joined us and we joked together about the demands of work.
It was good to vent together.  Black humour.
As the day wore on I didn’t feel so much alone.  Dinner with my doctor friend he shared his own sense of alienation.  We laughed about aging and how simply growing older made us less ‘attached’ to the things of this world.  Everyone was dominated by the environmentalists. Nothing could be done now without their unelected input. They seemed to be stopping everything everywhere and extorting millions if not billions from society but no one seemed to care that overnight this ‘conspiracy’ was all the vogue.  Every other ‘conspiracy’ was challenged by the lies upon lies of this latest collection of ‘cults’ some scientific, some pseudoscientific. All of them were ‘prophecizing but it was called ‘predictions’.  Isaiah would roll over in his graves to hear these priests with this mumbo jumbo.
Meanwhile I’m waiting for my $50,000 back pay and wondering when I’ll ever get the million dollars I lost in time playing bit parts in others make believe dramas.  I was the distraction. I was the scapegoat. I was the statistic that justified the powers turning their back on the baby killing en mass.  Lets keep an eye on this radical while the suits steal the bullion and kill as many as they can in the meantime.  Soften everyone up and make things so bad ‘physician assisted suicide’ will sell like abortion, marijuana and hotcakes.
The Israeli F35’s are being deployed.
China’s leaders have stated through their media proxy that they want to rule the world and that they must be prepared for war against the west.  They’re threatening war against everyone of the neighbours and continue to kill feminists in the womb while creating an excess of men.  Sunni terrorists expand everywhere and security becomes more and more difficult to maintain.  It’s a fragile thing this thing called freedom.  We’re on the verge of war with the threats of catastrophic earthquakes and tsunamis pending.
I’m older. Tired.  Glad to have got through this day.  I’ve prayed and even meditated. The gloom didn’t lift till dinner.  There were moments of light but the burden was ever present.  I don’t like this chronic adult hood.  There doesn’t seem to be any freedom on the edge of life.  We talked of our caution.  I shared my planning the Atlantic Expedition.  I can see myself sailing the north Atlantic islands .There’s something to the purpose. This slow moving continuation of the incomplete sail to cross Mexico or Panama disrupted then by lies and addiction.  Such a major set back.  Now the South Chinese seas are full of pirates and further along there are Somali Moslem killers. Everywhere Christians are being persecuted but the news refuses to talk about this.  It’s politically correct to kill Christians.  One can kill white men too.  It’s especially good to kill old Christian white men or even old Catholic white men.  Just don’t kill lions.
We talked about the effort to survive that the old are faced with now.
It’s been a long day.  I will sleep and this day will be over.  I showed up for it.  The meeting was good.  I was glad to be among friends.  Full house tonight.  Some military folk.  Doctors movie people business people, beautiful people.  Moments of bittersweet nostalgia.
Thank you Jesus.

Ego Surfing

I have surfed every channel
On my ego mind
There is nothing worth watching


Wednesday Mid day Journal

I've made it to work. The drive was fine.  No major traffic problems. No strange obscene extraordinary patient issues greeted me. A day in the life. I'm running on fumes in a way.  Trying to think of all the contingencies that can be considered for me being out of the office a few days.  Disruptions in routine.  Back up of demands.  Worrying I'm missing something. Considering what deadlines are out there. Still training administrative staff. As yet not sure they're on top of things.  They are but they're not communicating what they're doing enough to still my anxieties.  Takes time to trust.  Half my colleagues have stopped hiring staff because of the high cost of turn over.  It wouldn't be the same but the incredibly intrusive high accoutability demanded of physicians in comparison to others is burdensome.  I feel increasingly that we're measured against perfection but we're sent out into the war zone with a broom handle instead of a gun. Meanwhile the smug beaurocratic leadership brag to their superiors of how many cowards they shot in the back each day.

(A text message from staff answers all the unanswered question, my worrying mind moves on looking for other things to latch onto)

And I must pray more. I'm struggling to maintain optimism.  It's a sunny day. Gratitude.  My dog is well. I'm here. I'm about to leave for another clinic.  There's too many moving parts.  I'm just got to do the next right thing.  I'm moving in molasses.  It's a strange week.  One night I woke at 4 am and today I've slept through the night but woke kind of depleted. Dreamed of a bear within easy shooting range. A nice dream but I only had a handgun and left my rifle in the holster of the horse but I'd switched to a harley and didn't have the rifle in a holster but I could walk back and get it. When I returned the bear was still there.  And I was wishing it was a deer.  Aiming and trying to visualized a deer because I like venison more than bear meat.  Then the alarm went off.  The dog had nuzzled me sometime but backed off and the alarm woke me instead.

Now I'd curl up in bed and start over. It's that kind of fetal position foggy head going through the motions kind of day.  Work is good. 

This after noon it's addiction medicine.  Mostly like general practice. Protocol driven.  Not like specialist work with 'why am I still unhappy" and "I know we've tried everything known to man...don't you have anything else....yes,but.."

So I'll be facing the 'you don't care.'  "It's your fault I'm not getting off drugs'.  "You don't have very good bedside manner."  "I'd like a better doctor."  "I want a better medication."  "The government should pay for me to do drugs." "Why are you late." 

I'm raw I guess.  The constant barrage of criticism has got under my skin.  I don't seem to build up character armour fast enough. All the backstabbing of the authorities coupled with the chronic barrage of complaints in front of me and me don't getting any relief.  "I relapsed because ....(chose any number.).

"I'm depressed." 

You're depresed because you're doing crack and crystal meth.

"My other doctors give me valium. I need more oxycontin.  My other doctors gave me oxycontin for 10 years and now they won't see me and you won't help me with my pain.'

They're sometimes from the streets. The worst are wearing three piece suits.  Well dressed, well educated. Same song and dance. Better costumes . Better set.

I'm enjoying watching Halle Berry in Extant - She's incredible.  But the idea of this alien taking over people is like my work.

I talk to people one day and they're reasonable and appropriate and easy to be with then they're relapsing and doing drugs or hung over and drinking more and suddenly they're super sensitive and critical and looking for someone to fight with. It's eggshells and I'm ducking and dodging all the venom and beaurocrats are just begging to tag team into the fight to beat up on the doctor because they hate caregivers, they hate the front line workers and would destroy all the police, doctors and nurses who are seeing people and take their bows because their organizations kept the corrupt system going by throwing another sacrifice to the mass media. 

I'm gathering myself up. I'm preparing to face the music.  I'm probably going to have a great day. Mostly people are fine. It's just the one person that hurts.  One person makes it their mission to really hurt you and the trick is to be bland and vanilla and robotic and not be individual because any individuality will attract attack.  White coat your whole personality. This is the day of corporate automotron.  Fall on your sword.  You've lost millions becasue you had a conscience. You lost millions because you cared for patients. Remenber what the leading beaurocratic doctor told you."Patients are the enemy'.  Always practice 'defensive medicine'.  You went into the wrong field. Like all the engineers, doctors and accountants and other professionals you needed to take a law degree and martial arts courses to prepare for todays workplace. Everybody's wrong when nobody's right.

Egads.

Gratitude. Look for the positive.  Seek the good in the day. Remember the lovely woman with a month off crack. She's no longer prostituting. The young man is a year off pot. But the government is pushing pot so every person you got off pot is now going to be joined by dozens more on pot so that some politicians and their aids can get rich.  Get your head down. Think of the person in front of you. Forget the big picture.  Be an army doctor. Heal the patient with the gut wound. Stop the bleeding. Don't ever question the killing. Don't ever say, 'don't you think they should be given body armour.' 
Don't be silly.

HALT - hungry, angry, lonely, tired. Have some lunch.  Walk the dog. Get a move on. Stop procrastinating.  Get onto the next thing. Don't be sitting at the computer vomitting your brain into the abyss.  Be positive. Do something creative. Be thankful for the car you're driving. Be thankful for the clean shirt you're wearing. 

Pick up the phone and connect. Make that 'cold' car.  Stop procrastinating. All shall be well. Pray. Ask God to get you through the next minute, hour day.  Get on with it.  It was iffy this morning and here it's already noon.  You're progressing. You can always do far more than you think you can. Just do it. Stop thinking about things. Do things.  Get out of your mind. If you talk the talk, walk the walk. Just do it.  Yes now.  Move. 

Thank you Jesus.  Thank you.


Wednesday Morning Journal

I’m feeling a failure.  It’s something that comes over me in waves.  I’ve got this aging thing happening. Like I’ve had my time and blown it. There were so many dreams and they’ve gone past. The first was family. The decisions and abortions took those. The glass is half empty. I had this belief that I’d save the world in some way in medicine, make things better. I was a cog in the machine. I served my time. I did my part in a thousand little ways but I was plagued by the complaint that always comes to those who want to change something. The reformer is the enemy of all who benefit from the status quo.  The corruption and deceit in the system is putrid to the max and yet others move along stepping around the cesspools. I waded right in and began with a bucket to no avail.  There’s a cesspool swamp in every system. I learned that too late. I look back on years of frustration. There was always this really scummy dirty ignorant person in a position of leadership.  They were killing people and I couldn’t stop them because there was always someone holding me back.  Mostly that was to save my life. The amount of money in killing is amazing. Healing gets a fraction. The big boys and big girls dish out death like it was a fashion designer item.
Spirituality teaches me to look for the positive. Use both hands and pull my head out of my ass. Look back on your life and see the successes.  You’re still alive. Others have died. You’ve been in multiple crashes and walked away. Others are missing limbs. You’ve known incredible stress especially dealing with the corruption of government and the lies of authorities and the theft of the finances meant for services but you’ve not had a heart attack. The stress has been countered by exercise and meditation, family and friends. Others are dying of chronic disease because they’ve had to deal with these same assholes in their own worlds. Cancers come from stress as do all the diseases.  Acute stress is what our bodies are built for not the chronic debilitating stress of endless legal cases and beaurocratic miasma’s that go on for years.
Daily I’ve been required to make a decision , a diagnosis and a recommendation in less than a hour.  I’m on the front line.  Step back one leadership position and they form a committee to make a lesser decision. Step back one more leadership position and they have an enquiry. Step back another leadership position and they have a review. All of these ‘processes’ are to ensure that nothing gets done till maximum graft has been taken from the system and that the ones deepest in the shit have been able to get out and move to more lucrative grounds.  I get paid x for making a decision.  The next level gets 2 x and then 3x and 4 x.  The longer one can delay making a decision in the courts and bureaucracy the more money and power one has.  We’re living in a world of siege mentality.
And every year I’ve tried to stop someone killing some baby somewhere. And I’ve been punished and humiliated and shut up year after year.  I feel like my life could be called one baby too far. I’ve just tried to save one life too many and someone a whole lot higher wanted that life killed. It’s the Morgentaller system. The whole abortion industry of our times. It’s a metaphor.  Like Solyent Green.
And spirituality calls this my personal ‘black dog’. , my ‘depressive thinking’.  I must daily struggle to focus on the positives. Today the worm of despair entered my mind when I read in the papers how a colleague I know as the most deceitful and psychopathic is being rewarded.  It’s like the Aliens with a hidden head and no heart have a little gift ceremony for their cronies and this guys name comes up.
I see it with mixed envy and horror.  It’s like Hitler getting the Nobel Prize. Who can want a Nobel Prize after Hitler gets it.  I see this and wonder as always am I wrong. Was this fellow a good guy. He’s rich and famous now and I knew him as the liar and cheat. I personally know a fellow who let people die and ensured that others were seriously hurt, who sold out everyone and he got ahead.
So my cognitive behaviour therapy teaches me that I have to focus on those who are good people.  I can’t let the drop of ink discolour all the water. I just heard a lovely woman I know won a beauty contest.  A fellow I think is great got a job. My favourite person in academia got a professorship.  Another friend’s book was awarded. There’s all manner of positives there if I can just focus on them.
I wake up now and drag myself out of bed. There’s a whole lot of aches.The dog is ecstatic. He bounces on me.  When I get his leash he barks.  He’s exuberant. He’s loving life. He’s showing me what we both should be doing. I walk him outside down to the park. He sniffs up a storm then has a marvellous bowel movement.  I scoop it up and put it into the container.  He’s happy to walk back with me pulling on the leash.
I think maybe I’d better stop reading the medical news in the morning.  I’ve all but stopped listening to CBC.  I feel like increasingly I’m becoming monastic turning away from the insanity of the world.  I see that a whole lot of the folk I went to school with are hunkering down. They’re retired and kind of preparing for death.  They’ve taken what ever crumbs they’ve been offered and have got out. They don’t plan to do more and are kind of like kids on summer vacation. They don’t think of the future. They don’t particularly care what’s happening in politics.  They’re prepared for Armageddon and mostly just looking to their individual comfort.  I remember dad began fishing seriously when he was my age.  Fame is foolish.  Fortune makes more sense but it’s pretty obvious most of the casinos are rigged in some way. The house always wins.  Maybe next time around the karmic reincarnation cycle I’ll have more tools to win against the bank.
I read about St. John of the Cross in prison for 11 months being flogged every week or so for the entertainment of his fellow monks, the ones who didn’t like the reforms he’d tried to make.  It’s in failure that we find Christ. If I had a room full of sex objects, cocaine and bags of money and a personal army and world leaders dropping by to give me prizes I’d not think of inward riches, those infinite glories that surpass death.  Here it’s about the temporal. I’ve been given all manner of awards and made fortunes.  I’ve delivered babies and had so many children treat me with love and respect. I’ve a full life. I’ve been blessed beyond my wildest dreams.  If I measure my success from the bottom up. It’s success. But if I measure my success from the top down, from my not being an astronaut flying to Mars for instance, then yes my life is a failure.  I haven’t written the great canadian novel, found the cure for all cancer or developed a faster than light space ship.  I’ve been humbled by the reality of limitations.  I’ve done my part. I’ve contributed. I’ve paid taxes. I’ve worked and been a good man when the temptations were overwhelming to be other.  I’m not particularly wanting to be flogged every week so that I can compose the ‘long dark night of the soul’ to point the direction to the infinite. I’m kind of focussed on comfortable. Now I must get to work.  Mid week.  A few more days to go.  The weekends are always down hill.
Thank you Jesus for opening an individual door of communication with the infinite.