Monday, September 26, 2016

Cancer

Cancer is  that which we can say in no other way.

Cancer is the scream in the night.
Cancer is silent rage.
Cancer is always  betrayal;
Always  love and hate,
Fear and Forgiveness.

Cancer is pain, fatigue and forgetting.
Incomprehensible demoralization
Bewildering.
Why me?

Cancer is disillusionment for the secular man
Whose religion does not begin with:
ELI, ELI, LAMA SABACHTHANI?

Life is suffering unto death.
This world is but an illusion, Moksha
Death is divine for those whose life is punishment.
Cancer is incarceration.

Cancer is slow suicide
In a world of free will without determinism
Otherwise it’s just an accident or fate.
.
Cancer is life with partial death
Cancer is the drama of one downmanship
In the competition of disease
In the community of denial and apartheid.

Cancer is one way of dying in a world
Anxious and alone
Always In shit and piss,
As we were born.

Death comes to us all.
Cancer is but a gift of premonition.

Spontaneous remissions and miracles, just names
The cure, within and without, but more within within.
And never permanent.
Life is temporary, a rental,  at best, a lease.
Laughter is all that is free.

There is no darkness in the light.
There is no hiding place,
Not even in cancer.

Disease is ever metaphor,
It begins in an idea ,
And ends in a period,
Perhaps a comma,
Certainly a question mark,
Always an exclamation point:

Aha!

And I am crying too.
We are not alone.




Saturday, September 24, 2016

Canadian Psychiatric Association, Toronto - Religion in Psychiatry

Religion and Psychiatry: issues around practice , therapy , and therapeutic implications,
Shabir Amanullah, MD FRCPC
Fiona McGregor , MD FRCPC
Gary Chaimowitz, MD FRCPC
Kupuswamy Shivakumar, MD FRCPC

I was glad to see the topic “Religion in Psychiatry, Issues around Practice, Therapy and Therapeutic Implications.” It was one of the most important presentations that attracted me to this conference.
In “Spiritual Brain”, Montreal Neuroscientist Mario de Beuregaard speaks eloquently of the pseudoscience of atheism and secularism.  Jeffersonian division of State and Church was not about silencing religion but rather about ‘power’.  The major  political externalization of aetheism to date is the  genocidal communist regimes.  Religious people, especially Christians, are the most persecuted in the world.   So many of my patients speak of their abuse, especially the torture victims,  and the disregard they experienced for their spiritual practices when they went to psychiatrists who ignorant of what moved them most.
Shabbir Amanulla MD FRCPC was most  enlightening. I so enjoyed the medical and psychiatric evidence that Dr. Amanulla presented. He is from India and described the diversity and respect that exists there with regard to medicine and religion. That’s exactly what I saw in this old culture when I was there visiting with the psychiatrists in Mumbai.  There was none of the arrogance of youthful Canadian culture in that old and diverse country.  I loved his stories he told cringing of his patients there and here.  I made notes of his slides. They’re a poor representation of the fullness of his elegant presentation.
Dr. Amanulla presented:

1.4 % of world is atheist

12% of Britain - Non religious

Canadian study by Baetz
54% of psychiatrists reported belief in God compared with 71% of patients

Psychiatrist less likely than patients to attend religious services
47% indicated it was appropriate to include spirituality as part of assessment
50% often or always did
17% of patients reported that their psychiatrist often or always did

Dr. Amanulla commented on the discrepancy here and wondered about the difference in perception of psychiatrists and patients.

47% reported that would like to know religious orientation of their psychiatrist

24% - a consideration selection of a psychiatrist

US Study - Curlin 2007

Psychiatrists versus physicians 
1144 multiple specialities from across USA
psychiatrists less likely to believe

Physician Inquiry re Patients spiritual beliefs
nearly half of patients may have spirutal/relgious belief
  • physician having belief would be more trusted

Mental Health

Dr. Amanulla commented on the prresentation yesterday on Yoga and psychosis 
Mind body activity
He noted that in India - people know the incredible power of prayer
Gandhiji’s Talisman -Bhajan Vaishnava Jana To
Vayshya vacant
He spoke of the power of spiritual music to calm  -Music therapy drawing on soothing religious sources

Mental health - definition, individual definition, internet, information
  • had patients draw their idea of mental health
He spoke to discussing how their religious supports could help them to wellness
Encouraged the study of the patients religion and understanding their ideas and beliefs, a search for ‘meaning’ ( I couldn’t help but think of Victor Frankl)
He discussed some practices (mindfulness meditation, rituals, groups) which could be useful
Encouraged talking with religious leaders important to the patient, arranging consultation with the permission of the patient if that was indicated.
He discussed boundaries at length

Dr Amunullah opened the floor for discussion with many stories and thoughts shared by audience individuals.  An atheist quoted Neitze but acknowledged the ‘usefulness’ of religion, Another quoted Thomas Szasz,.  A psychiatrist spoke to her work with a Catholic patient’s belief, a Muslim resident spoke of her anxiety about boundaries and thankful to hear where the line was etched in the sand today.  I spoke of the need for spirituality training for psychiatrists working in addiction and referenced Dr. Carl Jung and Dr. Rabbi Twerski’s in this regard.  

Dr. Fiona MacGregor

Dr. MacGregor presented on  the western predominantly white Christian movement to the separation of church and state and the arrival of Secularism. She quoted Charles Tayor who’d written a Secular Age. (I remember well when our pastor, Rev Peter Elliott, Christ Church Cathedral, spoke of this in sermons he gave some 10 years ago. I bought the book which is a tough read and hard to unpack.  Hitchens is more entertaining but I still preferred the lessons that followed the Bertrand Russell and C.S.Lewis letters, I learned long ago studying  philosophy and theology.  Much of the presentation was ‘history’ but provided a superb basis for the overall discussion.   It brought to mind Field of Blood the glorious history of church and violence written by Karen Armstrong and pointing its finger firmly at the political. 

Dr. MacGregor was really at the cutting edge of discussion in psychiatry and spirituality.  Again I took notes which are a poor representation of the much broader presentation.   Dr. MacGregor only used her headings and slides  as points to lead to broader discussions of psychiatry and cases.  

History
Priory of St. Mary of Bethlehem built in London 1247 to house “distracted people’
1547 replaced by Bethlehem Hospital , secular authorities take over, increasing abuse
1796 -William Tuke and Quakers start “Moral Treatment” The York Retreat
1813 Friends Asylum, Philadelphia
Phillippe Pinel Paris

Modernism allows us to see the universe as a system before our gaze whereby we can grasp the whole in a kind of tableau - Charles Taylor

1517 - Martin Luther
John Calvin - work is just as sacred as the Priesthood
John Locke - theory of the mind - separation of church and state - father of enlightenment
Adam Smith - Labour Theory of Value - influence on economics and capitalism

(I’ve thought of these critical events in western civilization but so appreciated the way Dr. MacGregor summarized them)

Secularism 
a move from a society where belief in god is unchallenged and indeed unproblematic, to one in which it is understood to be one option among others - the result is a radical pluralism which, as well as offering unprecedented freedom, creates new challenges and instabilities - Charles Taylor

Patients say “I’m not religious. I’m spiritual’….what’s the difference - we’re all individuals"

You have to be ‘true to yourself’  so commonly heard today but derived from the 17th century

Our patients have all sorts of beliefs and we have to wonder where that is coming from

Manifestations of Religion -Allport 1958

Institutional Religon - beliefs and practice conducted in community for example attending services or attending study groups of sacred texts

Interiorized religion - Beliefs internalized, the individual


Dr. Amanullah and Dr. MacGregor didn’t just present theoretical academic material but went onto provide practical suggestions. 

Approach - (from KOENIG 2008)
  • taking a spiritual history

Our biggest problem is concern for boundaries - come with powerful role - must make sure we’re not putting our views on someone else (I thought of proselytization and how my patients objected to this from Christians, Jews, Muslims, Hindus and Atheists.)

FICA (Puchalski 2006)
How do we assess them  
Do you have spiritual beliefs that help you cope with stress
 What role do your beliefs have in regaining health
Are you part of a religious or spiritual community, Is this a support to you and how
How would you like me as your caregiver approach this

An Anthropologist meeting another person from an unknown culture - griffith and griffith,  2002
what sustains you through this illness
 What gives you hope when coping with this illness 


At times you must challenge their belief
  • when they are suicidal?
    • when they believe suicidals will go to hell?
    • father image of god as punishing 



    Dr. Amanullah presented several cases which which showed the limits of conventional therapies with the need for these to be explored first and then the consideration of a more holistic approach to the problem within the context of the patients religious beliefs.

  • We don’t have to be of same faith.  Interesting cases regarding that.

    Shabir presented case of a nun - Depression , GAD 
    -SSRI’s SNRI’s etc been tried
    -some improvement , not much
    -always pleasant

    Case - depressed Nun
    Asked her how you use the Rosary
    -I said, you’ve tried all these medication and explained the use of rosary, looked at scriptures, Saul, follow up in  months, nurse accompanying tried behavioural techniques - came back and had no panic attacks, interacting with other nuns,

    If I had used conventional approach I would have treated her as ‘unresponsive depression’
    Should we not be meeting people where they hope? (I loved this beautiful expression of Dr. Armanullah’s “Should we not be meeting people where they hope?! Pure psychiatric brilliance.  Yes meet people where they are but also where they hope)

    Case - the priest
    Shared a humbling letter - after counselling - a patient born in Belfast, mother jewish, was raped repeated by priest, very angry , used mindfulness techniques, became a priest, came to see me , was angry with church, and with god, - I deferred any spiritual approach because of the College and not wanting trouble as it can be unfriendly towards this - but after all the conventional approaches, medication ECT, behavioural  were used I asked him about his family ,his father, he began dcrying , asked him about being repeatedly rape, then asked him to tell me about the stories in the Bible, he became calm….you say god is such a bad person, I said, ,  but you enjoy coming into see me and talking about God - this one question caused an incredible change in the patient after all the conventional approaches had failed.


You don’t do meditation techniques with pre psychotic patients just as you wouldn’t start psychoanalytic techniques with psychotic patients.

Case - Muslim woman
Grieving widow
Son, a nurse
Both very religious 
10 years of grief and sadness
prayed through the nights
man in white gown seen
every night after her prayers
scary - 'looked like my husband'

 I didn’t change medications
encouraged her to get out each day
had told her allah didn’t want us to stay in room always but to live our life

 She got out each day and a year later the depression, which wasn’t depression but complicated grief, resolved. 

Dr. Gary Chaimowitz wrote the position paper on Religion and Psychiatry for the CPA.  He did not have slides prepared but talked about the damage he’d experienced as a Jew growingup in South Africa. At the time it was  dominated by the Christian Dutch Reform with discrimination of a ‘dominant religion’.  He was afraid of ‘dominant religions’ and felt that religions had much to offer but could go awry when they had too much power. He saw this with the Catholics at St. Josephs in Halifax and spoke of his sincere desire that no one seeking help would be turned away because of their religious beliefs or the religious beliefs of the practitioners.  Again I offer my notes which do little justice to the breadth of his discussion but offer something of the gist. 



Anecdote -  (regarding the position paper I was more asked to write a paper ‘freedom from religion’

I’m from south africa

Saw dominance of culture

saw dominance of religion

More attuned to need for separation of religion and state

think of Aghanistan, syria

if you are part of dominant culture you are often blind to other

-grew up in atmosphere ‘forget about religion’ 

-dutch reformed 

-they believed they were chosen people, deeply religious people

-created massively discriminatory system



as privileged white person in school who was jewish 

I was forced to go to religious classes

complained and was taken out of classes and put in room
humiliating, demeaning.

-teachers in this liberal university were racist against me as a jew


 there are beautiful things in religion but there’s a tipping point

I think of St. Joseph’s in Halifax

Psychiatry is a religion too

It has the same delusional ideas that underpin religion

Religion when dominant can be incredibly destructive
I spent 25 years flying to James Bay and every once in a while the pentecostals came up against me. the older I get the more cynical I get
if you ask people about religion you have to be careful because they can feel shaming
I worked at St. Joseph’s Hospital with crosses on the wall
Religious organizations were there, crosses on the wall

Abortion is not our business
Physician assisted suicide is not our business

Problem is we work from public purse

Early warning sign - beginning of quest - patients picking therapists of particular gender or religion - sounds good - but organizationally a nightmare  - 

If you as a consumer - seeking out a healer - you’re not purchasing something in a store - you are entering a relationship - you are choosing help - you should be able to get care - you should be able to get care where the belief system of the provider does not interfere


This lead to the delightful discussion with the three leaders encouraging the sharing and offerings of the audience.  I dont know where Dr. Shivakumar was.  Just a trinity left.  And  no mud slinging. No arguing. Lots of individuals ‘sharing’ from their experience and the centre of themselves and their lives.  


Given the potential for controversy and debate, I was thoroughly impressed with all three presenters and the audience.  

Since the American Colleges have recommended psychiatrists have training in spirituality and the British Psychiatric Association began it’s Special Interest Group on Spirituality and Religion I have hoped that the Canadian Psychiatric Association will move forward.  This workshop at the CPA conference was definitely a reason for me to join.

 I am really glad the three presenters met me where I hoped!






Friday, September 23, 2016

Canadian Psychiatric Association 66th Annual Conference

I am truly enjoying this Canadian Psychiatric Association conference.  The last conference I attended in Vancouver I so enjoyed Dr. Trevor Hurwitz presentation but then I always enjoy Dr. Hurwitz and hear him frequently at UBC.
19 years ago I joined the International Doctors in AA and have really enjoyed the psychiatrists  and psychiatric presentations there. That was mostly because of the spirituality.    I'm also connected with the Christian Medical and Dental Association and truly enjoy the psychiatrists I've befriended there. I’ve attended the World Congress of Psychiatry and International Society of Addiction Medicine and various other conferences where psychiatry and psychiatrists congregate but I really feel I might have enjoyed attending more CPA.
The CPA Journal did get a new editor, with the result it stopped being a publishing place for academic psychologists and began again to be relevant to me as a psychiatrist.  Reading the journal more is how I read the notice of this meeting.   I’ve been a member of CPA for decades and haven’t felt I got nearly as much bang for the buck as I get from the Christian Medical and Dental Society, until now.
This  CPA conference  is truly outstanding. I am beginning to think my issue with CPA might have less to do with transference and more to do with counter transference.  It’s like that time in therapy where your realize the therapist really might have something more to offer.  I hate to think this is solely my aging and increased wisdom.  I've wanted to attend this CPA since first I saw the line up of topics and speakers.  There are just so many excellent clinically relevant,  valuable and timely presentations.
Having to be at Kingston Hospital yesterday for a family meeting,  I missed that day, sorry to have not been present to hear Sidney Kennedy on Major Depression. I’d really wanted to do the advanced motivational interviewing course as motivational interviewing is something I do a lot of in my DTES clinical work.There was a new Canadian ECT Standards presentation and as I’ve referred several patients with intractable depression for ECT with good results (it’s been 25 years since I’ve given it myself,).  I really thought this was b important for me to review.  There were also some courses on use of social media which is extremely important and relevant. Given the mess the DSMV made of Somatic Symptom Disorder I had also looked forward to hearing this expertly addressed.
Today’s presentations made up for Thursdays academic loss. Being with family,  knowing love first hand and seeing the excellence of clinicians and a wonderful care team in action at Kingston made today’s presentations all the more poignant.
Today I was delighted to attend the ABC of DBT, Applying Principles to the Care of Patients with Substance Use Disorders.  Having treated a former professor of dialectics and discussed DBT extensively in therapy I’d studied it in journals,  on line and seen the excellent research findings of it’s benefits for the SUD populations.  Ketan Vegda, and Wiplove Lamba were truly awesome.  Their presentation alone was worth the price of admission.
I absolutely loved their role play.  It made sense of the theoretical material they had presented very well.  Watching and listening to the role play I felt  that I’ve  ‘got it’ in a way I’d not untill then. Next week in my clinic I’ll be applying simple variations on my well honed eclectic approach to therapy with patients.  Now that’s not something that I can say happens often given years of psychoanalytic psychotherapy training, group psychotherapy training, focal therapy training, CBT training starting in the 80’s, motivational therapy training, former hypnosis training, family therapy training and 12 step facilitation therapy training.  The fact is these young guys really know their stuff. It’s now obvious why and how DBT works and why patients with SUD would appreciate it.  I even went out and bought the recommended text, DBT Skills Training, Handouts and Worksheets by Marsham M. Linehan.  It’s not the same old same old repackaged thing.
I’m skeptical of advances in my field since so much of psychology is ‘renaming’ the old things. One young ‘person’ in the audience commented on the feelings of the therapist in relationship to the patient and how she appreciated the comments about this. I couldn’t resist later saying, “we used to refer to that as ‘counter transference’.  An older woman beside her laughed. It wasn’t against the young person but rather in amusing at the two of us being older and from a different era.   Not that that’s bad.
It was amusing later listening to books and names being bandied about by younger colleagues.  I hoped they still knew Freud, Jung, Karen Horney, Seligman, Kohut, Kernberg.  I did feel though that the ‘pop stars’ of today are a generation beyond my own pantheon. The classics obviously remain but not the lesser stars.   The field is just so broad too today.   It's like my days of Elvis, the Beatles and Rolling Stones.  I remember looking at the line up of a local rock festival and realizing I didn’t know a single entertainer.  I’m still listening to the Guess Who.
I loved the booths and papers and lounge area.  I spent literally  an hour on two separate occasions talking to medication representatives, military forces personnel,  treatment centre personnel, recruiters, banking and insurance folk and regional representatives.  I go to trade shows these days, mostly to do with motorcycles and boats.  But I like to look at what’s being offered and sometimes really enjoy chatting with the folk there.   I always love meeting the Edgewood folk.  Interior BC Health and BC recruiters were terrific.  I love learning that Ability,  a medication I use  extensively in tablet form has come out with Ability Maintena, a monthly injectable form.   I didn’t even know about Latuda (Lurasidone hydrochloride) which is apparently much more used in Eastern Canada. It’s real attraction for me as an antipsychotic was the lack of QT complications.  The Pristiq rep showed me that Pristiq had few side effects than high dose effexor and was well tolerated when used with other meds. I also met the folks from the Medical Psychotherapy Association of Canada.  Having talked with them and learned about MDPAC, I really think this is a group I need to belong to.
Everyone loved the keynote speaker, Clara Hughes, Open Heart, Open Mind. There was a line up forever of folks, who having bought her book were happily waiting for an autograph.
The book selection provided by two sellers was awesome. I tend to down load e books mostly these days reading everything on my Ipad but even so I came away with a Medical Clinics of North America Travel and Adventure Medicine.  I used to attend those conferences when I was more focussed on off shore sailing, having sailed solo to Hawaii in winter.  I loved the whacky doctors I there, no psychiatrists stick out except some fellow who liked the places ‘above where helicopters go’. We related to how our work caused us to enjoy time in extreme wilderness.
I mostly like conferences for networking. I  talked to several psychiatrists I liked instantly.  There was a real international flavour to the conference with every colour of skin and a multitude of accents represented.
The Royal College of Physicians and Surgeons had a terrific young man answering questions about MOCOMP. I love MOCOMP and Mainport our continuing medical education service. I bored the young man with my pet peeve but really otherwise love MOCOMP.  He was there to present on the new ‘competency’ approach to following careers.  Given that Mainport is an excellent reflection of my ongoing study which I like as a journal, I think the very smart and creative folk at RCPS are going to keep astounding us. Who knows, they may address my libertarian pet peeve.  The engineers have rebelled and done a masterful job of facing the gun toting political bullies. I don’t mind recording my study as a professional but am questioning ‘administrators’ arrogance with their self serving money driven  ‘educational accreditation’ processes.  I will probably ‘forget’ to fill in some form about this CPA conference and some supercilious shit will object that I didn’t get my ‘attendance’ cosigned in triplicate. I remember I lead an insurrection against the hospital management wanting clinicians to use a ‘time clock’.  I think this is something I discussed at length in my psychoanalytic therapy in training years.
Unfortunately the Transcultural Psychiatry workshop I’d wanted to attend overlapped with the Chronic Pain, PTSD and TBI workshop I really felt I needed to attend.  So much of my work is specifically trauma,head injury and pain related.  I’m often called upon to be an expert witness and sometimes actually undertake that role voluntarily.  Zohar Waisman MD FRCPC and Adam Little LLB were incredible!  They did a role play with discussion by themselves and incorporating the audience.  Zohar, “performed” as doctor expert witness and Adam as lawyer in a case which had actually occurred.  The audience discussion and the points made and the nitty gritty of expert witness/clinician was humorously and pertinently discussed.  I commented later that their presentation had been so ‘like’ the 'real thing’ I was having ‘flashbacks’ of my own worst moments in court.  What a great presentation! Well worth attending the conference for the learning in that session alone.
I am pissed that I missed Susan Abbey and George Jarvis.  I even missed Harry Kaplinsky!  The CPA Conference is as  bad as going to an ice cream counter and having to choose.  I get Cherry Ice Cream but must forgo the Pistachio and Green Tea flavours. It’s not fair!.
I was also highly responsible and chose Advances in Diagnosis Treatment and Prevention of Dementia, not just because I personally need to know how to prevent it, but mostly because I’m seeing more elderly patients in my practice. Having thoroughly enjoyed the presentations of Tarek Rajji, Zahinoor Ismaiel, Amer Burhan and Sanjeev Kumar I feel more confidence, recognized a couple of mistakes I’ve made which I can address next week without harm to patient,  but now I mostly know where to turn.  I really am going to change my practice for the better.   I have answers to questions I’d had put to me by patients and family which I’d not been able to answer. Now I can.  I really liked the humanity of these fellows too. Yes they were researchers and published internationally accredited papers but it was clear that they cared for people.
So that was the day.  Tomorrow I have a whole day more of really great psychiatry learning. They’re even going to feed me at a Thing called the President’s Gala. This Westin Harbour Castle Hotel in Toronto is really fine too.  I love my view of the Harbour. Now that my sailboat is in these fresh waters I can imagine one day anchoring somewhere out there. I see an island and wonder if it’s the same one where I was swimming as a teenager and participated in rescuing a drowning woman.  Toronto is a favourite city with so many memories for me. Another reason I was glad to come to CPA.  2017 the Conference is in Ottawa. As so many close family are there, I believe I’ll be attending the CPA again.  I’m really enjoying this conference.
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Tuesday, September 20, 2016

It's Strange and Gratitude

I have just recited St. Patrick’s Breastplate.  I like St. Paul’s put on the armour of Christ.  I feel safer when I pray these prayers as the sickness in my family distracts me and makes me vulnerable. I feel like the rats come out to attack whenever I am not perfect. One can never be perfect in that sense but the expectation and demand is there.  I pray to God to protect me.  I love the psalms because they are so often the prayers of David on the battlefield surrounded by his enemies.  The more good one does or tries to do the more one is attacked. I take comfort in knowing that the Lord was crucified and so many of his followers. I know that Christians are persecuted more than any others.
My Hindu friends find so often it’s their own people that are attacking them from within.  This is the experience of Christians as well.  The jews were so often plagued by betrayals.  The Taoists developed martial arts to defend as much against their own as against others.  The Hebrews building the wall of the temple found they had to split their company in two with one holding swords while the others picked up axes and shovels.  Whenever a person picks up a pen there is someone who is picking up a dagger to assault them.  Islam is at war again, invading while the Saudis finally admit they back the extremists.  Corruption is so far reaching that the Clinton Foundation sounds like something out of the House of Thrones.  Justin Trudeau’s backers have millions invested in street drugs and drug pushing.  Politics makes strange bedfellows.  Trump has the strangest hair do.
The communist have succeeded only by promoting perpetual war, the essence of Marx, with Sharia Communism, two philosophies of perpetual war until all are conquered coming together today in the strangest of sexual congresses.  Extremists fight in the street.  Feminists ironically support the backers of ISIS who call for sex slavery of women.  Reminds me of the Donovan song, “Must be the season of the witch, beatniks are out to make it rich…and its strange, so strange."
I’m praying to God to protect me. I work with very angry frightened sick people.  Many are just sad. So many are beaten. But some are sociopaths and psychopaths.  Even sadder.  I remember the oaths I’ve taken as a doctor and feel a dinosaur.  The government calls my patients ‘customers’. That seems worse than ‘clients’ as neither reflect the covenanted relationship. There is no spirituality.  I was told by senior government doctor that they’re the ‘enemy’.  Even now I know a person who would ‘kill the messenger’. I tell people they can work and they hate me.  I remember the pedophiles that hated me when I had them locked up. It’s all matters of degree but no longer are the police or doctors protected by the selfie taking Trudeau who has his personal body guard of armed men and trust funds and multimillion dollars given by tax payers.  The new politicians of the left live in dachas and palaces. I fear frightened living in Communist Canada.
Every communist country killed millions and stole the wealth of their neighbours.  They took over beautiful churches and made them into halls like the churches that I saw made into mosques in Constantinople.  All that beautiful painting painted over. Thank God for Ataturk restoring these works of art as museums.  Now ISIS Muslims destroy the architecture of the ages like the censorship pornographers who destroy books. I week thinking of the loss of Alexandria.  Ancient losses while today we are struggling to archive so much for posterity.  I like the ‘cloud’ but the bonfire of vanities remains.  Everything is fleeting.
I’m aging.
The young are savaging the old.  Experience, once so valued is no longer. Old white men are the worlds bain say the mouthpieces of the old red, brown, black and yellow women who never forgive send their children to war as white women sent theirs, all of us living under queens, the conniving genius behind the ‘strong man’.  Alexander would be nothing without his mother.  The feminist lie of the weak little woman, a chivalry icon of the pregnant.  Now in abortion culture the fascist feminists tie these girls to the railway tracks and deny them weapons and self defence ,promising them protection for exorbitant prices.  In Japan more and more remain virgins, men and women.  it’s a weird world.  With education women have only three children regardless of religion or race or culture.
Protect me God from the insanity of politics, the convoluted illogic and emotionalism of todays twisted comic book media.  Protect me from all the strange and weird and frightening alienation of the drug addicted intellectualism and the power hungry gluttony of greed.
Thank you Lord for the light and this earth. Thank you for family. Help them to be well. Protect and care for them now. Be with friends and comfort and protect them this day. Help me dogs and the dogs and cats and other pets, even the snakes, and especially my fish Lord.  Keep them safe and healthy,
Thank you for your dreams and my dreams. Thank you for the 10 fingers and 10 toes. Thank you for digestion and indoor plumbing. Thank you for running water and heat and waste disposition. Thank you for my vehicles. Thank you for Love. Thank you for family and friends. Thank you for work. Help me be a better physician and more caring thoughtful psychiatrist. Help me in every way to help others as you help all.  Guide me in my daily endeavours to serve and work.  Thank you for the teachers and books and the research and internet and the iPhone and Epocrates and Merck and 5 minute consults and PuBMed and my offices and colleagues. Thank you for the institutions that serve to bring care and kindness to all in need. Thank you for communication and distribution centres and trucks and trains and supermarkets and street markets and the Bay and the banks and all those who are working today.  Help the disabled. Help those who can work work. Thank you for work and for vacation and leisure. Thank you for boats and motorcycles and 4 x 4’s Thank you for Gilbert. Thank you for this place I call my home. Thank you for the hot tub and it’s healing my back and thank you for the swimming pool and walks in the woods. Thank you for airplanes. Thank you for the ocean. Thank you for the Garden, the birds and animals and all the plants and flowers and trees. Thank you for the green of Burnaby and the bustle of the city.  Thank you for this day Lord. Thank you for all your blessings. Thank you for Grace.  Thank you for life. Thank you for consciousness. Thank you for senses.  Thank you for perception.  Thank you for life.
Thank you Lord.

Tuesday, September 13, 2016

Psalm 5

Lead me Oh Lord in your righteousness
  because of my enemies -
   make your way straight before me.
Not a word from their mouth can be trusted;
  their heart is filled with malice.
Their throat is an open grave;
  with their tongues they tell lies.
Declare them guilty, Oh God!
  Let their intrigues be their downfall.
Banish them for their many sins,
  for they have rebelled against you.
But let all who take refuge in you be glad;
  let them ever sing for joy.
Spread your protection over them,
that those who love your name may rejoice in you.
Surely Lord, you bless the righteous;
  you surround them with your favour as with a shield.
Psalm 5, Holy Bible NIV

I am put upon by those who lie to make money for themselves, who would deceitfully harm me for their riches.  Their shameful greed and deceit and lies have reached out to include me in their grovelling worm like disgusting life of feeding on others, angry, self righteous, purulent, demonic biters of the hands that feed, self justifiers of their own arrogance and enmity.  I know my orubunga teeth are just biting my ass while my own hand slaps my face and I seek to disconnect from the autonomous self destructive thanatos limb of my existence. I attract this.
I prayed on the mountain. I meditated in the deep woods.
But a voice said to me it is easy to be with God alone. It is easy to be in love with the Lord when the Lord is with you and you are with God and people are far away in the maddening crowds.
The Chinese attacked the Tibetan monks until all were dead but those who held British 303’s shooting back at the modern machine guns of the Borg like commies.  The Dalai Lama fled to India.  He continues to complain.  The greatest genocide of peaceful people continues make the Israeli Palestine media extravaganza look like kindegardens.  Justin Trudeau embraces the Chinese Leader as his father did before him.  Meanwhile more settlements occur in what was once the land of the Holy.  Canadians are killers and their leader of death an avowed abortionist.  And all the abortionists and killers of babies unite in a new one world order of death.
And Hillary staggers. She wanted third trimester abortions to go on.  Viable infants dragged from their wombs by the rich and powerful who deny mothers the means of existence giving them no choice but to kill their babies.
And they lie.
The media is more insane today in it’s cacophony of paid propaganda that even the Pope appears the Anti Christ and we are given little choice as to what to believe when so much is deceitful that Caligula might as well be in charge and Nero playing his lute as Rome burns.
It does seem so hopeless when one watches the news.
So don’t watch the news, old lies.  CBC news the worst of all.  Misinformation and political can’t masquerading as truth, soft sold, hard sold but all a putrid pile from eastern Canada’s increasing wasteful spending machine, forcing the country into millennial of debt while stealing money to save us all from heat proposed to be a risk in a thousand years or more while today there is no fuel for children, no food, no heat, because the playthings and palaces of the well dressed dictator class want more and more.
Depression would loom if we all were not as those in Nazi Germany in 1939 before the war was declared and the agenda was disclosed.  Civil war is upon us as virgins are raped here and no one waits for heaven any more.  Heaven is Christian created and all can reap the benefits of decades of sacrifice by the Godly of every religion.
Save the planet and kill the babies. Feed Gaia monster with the entrails of infants.
Mothers cry out for their babies as our leaders demand their children.  Once the leaders waited till their children were young men and then they took them to machine gun them in trenches but now they sacrifice them for stem cells and eugenics and immortality.
Huffington Post says he’s very well dressed.  Vanity Fair says he’s so very young.
No one commented on Churchill’s appearance but they did say Hitler wore nice clothes.
What insanity is this vanity.  Ecclesiastes comes to mind.
Wake up!!!!
Wake up!!
The fool is no longer on the hill. He’s not in the asylum.  The monkeys are in parliament. The senate is a stable.
Don’t ask where are you Joe DiMaggio?  Ask where are you Isaiah?  Where is Krishna. Where is Buddha.  Where are you Jesus? Yes, Jesus, son of God, killed by the men who would claim they know what is right for you, but all they know is what is right for them.
And I ask you God will you guide me this day. Will you show me where the mines are in the minefield of angry people looking to find offence with all the activists and other ‘ists’ looking for an excuse to expiate the guilt of the blood of infants and the mass slaughter of the children while young men in gangs rape the white women who no one cares about any more.
Please God be with me today.  Show me the way. Let me be protected by your shield. Let me forget the infamy of social media with the forced news and advertisement that now pollutes the family album and the notes from friends.  I would see a laughing child without struggling to shut out your cacophony of fear and lust advertising.  Let me alone.
But I came down from the mountain because a wee small voice said, as to Job, it is only Love of God if you can work among the poor and remember me in all your activities.
You are never alone.
We are always together.
Look for Jesus here not there.
Practice the presence of God in the midst of others.  Love God as God is in all of us and in this world as much as alone on the mountain.  There will always be war Krishna told Arjuna, and the war will always be family, but the question is only will you participate or isolate.  And there is no straight lines on this globe.  I sailed away for 25 days but came ashore again. I go off into the wilderness for weeks on end but come back to this Sin City.  There is always Babylon. There is always Vancouver. There is even Toronto and London and Paris is burning.  Washington is Rome.  Moscow and Beijing have never been closer together and farther apart.
But you are to serve me in all your affairs.  You are to love the un loving.  It is spiritual to ‘do unto others as you would have them do unto you’. The great law of karma and retribution exists.  There is love in all the dark places but walking in the light is only right.
Come with me today. Get up and take your cross.  It’s really very light considering.  Look where you are going. All you need to do is ‘suit up and show up’.  Pray ceaselessly as St. Paul said.
Surely God will help the righteous.  Surely God will shield the righteous.
Thank you Lord. Hallelujah.  God is great. God is love.  God is here and there and all around us. God be with me. Jesus be behind, beside, beneath, above , within and on the lips and in the eyes of all I meet today. May I be a channel for your peace and love. Help me today Oh Lord.  Guide me, be with me.
Thank you

Monday, September 12, 2016

Chinook

I saw you standing there in the  thaw
The ice turning slush
Slash as I might I could not stick the puck across
Then I tried to push the frozen canoe to you
But it would not budge
We smiled across  distances
Waiting  the chinook to decide
Would we play hockey or canoe
I so much wanted to play with you again.

Sunday, September 11, 2016

Bungalow Cabins, Harrison Lake and more "View and Release Hunting".

We love the Bungalow Cabins at Harrison Lake!   With swimming pool and beach view Bungalow Motel is  the best  accommodation. It’s great spring and summer too but for close to 25 years I’ve also been coming up in the early fall for hunting season.  I confess I’ve not shot much  game here but it sure is one of my favourite places to hunt.  That’s because of these great little rustic cabins, with kitchenette,  hot showers, quiet, comfy bed, and cable tv.  The owners are the best hosts too.  It’s really ‘roughing it” hunting at it’s toughest.   We added a new harsh twist to our regime this year, getting our thermos filled at the Mall Expresso service, Americanos with Cream.
There’s also the public hot springs pool.  The pizza in Harrison’s is the best though there’s only pick up.  We loved their cheese pizza this time but the meaty ones have been fantastic too.  Again we’ve had the mall morning breakfast sandwiches.  Everything is close in Harrison’s so I’ve walked down from the Bungalow to bring back breakfast for the gang.  This time I also brought back two dinners from the fabulous Hotsprings Steakhouse Restaurant.  We all loved a roast beef dinner one night and another night had the steak and prawns special. The mashed potatoes and gravy was delicious too.  Laura doesn’t mind when I bring back my days “kill’ cooked with potatoes and veggies and blueberry pie.
While Tom and I were out messing about back country with our Honda 500 Pioneer side by side ATV we’ve named “Charles’, Laura was  in the cabins doing her nails and reading novels.  She had Gilbert with her the first day because we were bow hunting and don’t like Gilbert about the razor sharp arrows. He also tends to bark at bear which limits our hunting opportunities.  I actually got a shot at rather  large partridge.
In the world of guided hunts, one pays $10,000 dollars at times for the ‘shot’ at game.  I’ve had several ‘shots’ at buck this fall bow hunting and missed.  The bucks departed just as I registered they had horns and got away before I pulled the trigger. Now a swaggering great partridge did the same.  Tom watching said he’d seen my arrow from the Excaliber Max, most powerful of cross bows, part the feathers on the partridge’s head. I was really sorry we didn’t have a wildlife videographer along for that incredible moment. The partridge utterly bored with me trying to cock my bow for another go walked off into the woods giving me a final feather.
We got back in time to indulge a major soak in the glorious  “sacred” “mineral’ “ waters’ of Harrison’s.  I feel like a new man each time I come out of the womb there.  We had two such ‘treatments’ and my skin is tingling hallelujah still.
Sept 10, Rifle hunting proper opened.  We were up in the dark before dawn and drove the Ford F350 with Charles on the back up to the top of Harrison’s Lake. There with dawn breaking we found that we’d lost one of ramps for the unloading of the ATV. It must have slid off the back while we drove up a hill hell bent for leather, bouncing over potholes.  Tom, ever the engineer, and Evil Kenevil managed to drive Charles off the back of the tailgate onto a mound.  Getting it back up onto the truck without a ramp was even more impressive. I’d wanted to use the winch but Tom insisted he could manage without the ramp.  He’d amazingly taken the remaining ramp apart creating two short  5 foot ramps out of the remaining long ramp.
All the game had received their annual message.  I was sitting hiding in ambush watching the sun rise with Gilbert happy to sit on my warm belly all the while the animals watched us from hiding. The annual email says, “Beware of men wearing came and carrying guns. They are out to kill and eat you." All deer bear and even some partridge get the message.”  Sept 9 we saw game. Sept 10 they were all in hiding.
Still we got to drive Charles up to the top of the mountain and through streams and dales.  The Honda 500 pioneer is truly an amazing machine.  There’s more than enough room for 2 hunters and even Gilbert sat half on the seat in the middle with his chest on either of our knees.  Getting in and out in a hurry was just fine too.  On the straight logging road I was doing 50 km on my own whereas climbing and travelling in the back woods we did the standard hunting travelling of 5 to 20 km an hour, just loving the little machine as it chugged along over boulders, through mud and across logs. The roof and windshield kept the rain out and the engine under the seat kept the cab warm in the early morning.  My favourite ATV to date.  Gilbert loves it too.  When we are alone he sits in the passenger seat bolt up right watching for grouse.  We saw a half dozen or so but only one waiting for me to shoot and that one got away.
At night Tom Laura and I watched the cowboy movie, Unforgiven with Clint East Wood and Gene Hackman.  What a great movie to watch on a hunting weekend.  Silverado was on the next night.  Laura is ever a trooper and enjoyed the weekend with the guys. She loved finishing her Harlan Coben,  Fool Me Once novel saying it’s his best to date. She had a walk and shop round the little town too while Gilbert was off with the boys on the rifle hunt.  The most excitement for me was watching Tom back straight up a cliff so he could descend into the truck bed with the shortie ramp.
“Do you want to go?” Tom had asked.
“No, “  I said,  “I’m a doctor.  If I tried that, whose going to care for me while waiting for the ambulance?"
The views of Harrison Lake from the Slocum trail we’d taken that night were spectacular at dusk.  Other’s hike here and some were camping up in the hills.  It really was beautiful. The fall colours are just beginning to appear.  A young couple were tenting on a ridge with their little car.  I thought of myself, romantic and young once.  I liked seeing the kids out in the fall.  Harrison Lake is grand central station in the summer but it quiets pretty quickly in the fall.  There were still a number of tents along the beach and the rustic will be out until well into October.  Bungalow Cabins was still full and we’d  booked early in the week. In the summer bookings are often made ahead of times though I’ve been fortunate to have cancellations.
It really was a great weekend.  “View and release!” is our motto. We just take the guns and bows along for the selfies.
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