Saturday, October 31, 2009

The 12 Steps of AA - Step 3

3. Step 3 - "Made a decision to turn our will and our lives over to the care of God as we understood him."
This is called the "surrender' step by some. It's also a committment step. It denotes choice. "Made a decision." It's not like life is 'acting on us' anymore. Booze isn't in the driver's seat and we can't abdicate responsibility. We made a decision. We acknowledge we have will. We still have lives. The idea of "God as we understood him" is critical. This isn't a church God per se. It's rather a home made God. We have to define our own God. We have to individually figure out what God means to us and what God we can trust with our will and our lives.
What kind of 'unseen power' would we trust and what character would this God have. We can't select one off the rack. We can't have one tailor made. We must do the work of spiritual seekers and theologians down through the ages. We can have help. We can talk to all those who we think may know God. We usually get an idea of this through the outward manifestation of their lives. It's not like it's a test which we have to come up with all the answers by ourselves. Indeed the AA program encourages us to communicate with other human beings. That tends to discourage people from becoming legends in their own minds.
The first AA's talked a whole lot about God, certainly alot more than those who have trouble today staying sober. The God that they needed was one who could perform miracles. The first miracle their God had to perform was to take away the craving for alcohol. If a person was having difficulty staying sober he wasn't praying enough, talking to other AA's enough, not attending meetings enough, not reading spiritual literature enough, and not at all 'turning his will and his life" over to a higher power. The early AA's saw the problem of alcoholism as 'self will run riot' and the solution was to comprehend the idea of "thy will be done."
Sam Shoemaker, the Anglican priest helped the early AA members, not only letting them meet in his church but discussing God and a spiritual life with them. Father Dowling, a Catholic priest became a close confidante of Bill Wilson. Dr. Bob Smith the other cofounder of AA was an active member of the Oxford Group started by Frank Buchman, a Lutheran minister who had begun work with the YMCA. Emmett Fox, a theologian of the day who wrote the Sermon on the Mount was just one of the many writers whose ideas about God were discussed by early members . James, a favourite book in the Bible was so discussed by early AA's , that the organization almost became known as the "James Club".
As AA has spread around the world and time has passed AA's have looked to local and modern understandings of ancient ideas. There is no consensus on God in AA. All that is asked is that we turn our will and our lives over to the care of God as we understand him. Throughout the Big Book there are adjectives that describes aspects of this God, 'loving' and 'higher power' being the foremost.
The program of AA is a spiritual program and alcoholism is considered a spiritual disease. Anxiety is said to be a measure of our distance from God though it's equally a fundamental aspect of our humanity. Whereas booze and drugs separated us from God and peace and love and other humans, the program of AA aims to restore the balance and bring us closer to God as we understand him.

Moving IV

It's the last day. The hazmat suits are on. I've used whips and tazers to get the suitcases to move towards the front door. This is no orderly exodus. We've lost the cat somewhere in the midst of the little boxes. A couple of sweaters were crushed when the pots panicked and pressed forward en mass escaping the dying kitchen.
Laura made the last bacon sandwiches. Mark and Rod are getting last Rites and purifying in sweat lodges before the final foray between apartment and storage locker. I just found my summer clothes from last year neatly packed in a box. I didn't need the new shorts and sandals obviously.
An air raid strike has been called for the afternoon. Painters have been by but had to duck incoming mortar fire. It's a toss up for management to renovate or enshrine.
The walls are screaming 'don't go, don't go', breathing in and out while the carpet is belching and burping and the ceiling is grabbing at my hair. The bedroom just told me, "You're like all the others, come in here and promise you'll stay but then you just use me and leave." The faucet is ashamed of herself after all she's given me. The toilet asked that I put the cover down before I leave to hide his shame. The balcony has said too, "You're going to tell all your friends what a good time you had here too so others will come and take advantage of us. You're just like the all rest!"
Meanwhile I'm hoping neighbours will begin to gather around a large stain I found on the drapes. I think it's coffee but it may be a portrait of the Lord. One way it will bring new tenants. The other way it will definitely affect my damage deposit. It looks more like a sheep to me than a face of Jesus on a shroud. I'm hoping others have more imagination.
Looking at the cat hair clumps on the carpet that I've finally found I can see the merit in dirt floors.
A freezer full of venison and grouse is now at the office. I hope it won't offend psychic vegetarians. It will need to be transferred to the new home freezer but for now the object is to vacate this place. Stuff is ending up in the storage locker or office that belongs elsewhere. Laura told me on one of her family moves the new tenants were moving in while they were moving out so her movers took all the new people's kitchen cabinets to Laura's new place.
They have to burn incense and paint here to disguise the cat's daily transdimensional cat world visitations. I knew she was up to something looking so smug when I got home but now that I'm leaving people all around have told me my cat was the ring leader for the all year Halloween activities that have gone on here. Many have seen their cats disappear and walk out through the walls of my apartment mid day. She looks so innoscent.
Imagine I'm moving on Halloween. Fitting. Vampires witches and were wolves will be out on the street when this place if finally behind me and the new digs will take on a life of their own. I just had a flashback to a 60's move and am really thankful no one has suggested mushrooms on this move. There's a whole lot of advantages to being sober and/or mature.

Friday, October 30, 2009

The 12 Steps of AA - Step 2

2. Step 2 - "Came to believe that a Power greater than ourselves would restore us to saniety."
In AA insaniety is called 'stinking thinking'. The essence of stinking thinking is "poor me". "Poor me, poor me, Pour me another drink." Any thinking that would make me less than is sufficient to the task. The task is to create a scenario whereby I can rationalize or justify having a drink or taking a vacation from reality because I'm a victim. As a victim I have fears and resentments. The best philosophy or theology for a drinking man or woman is that they are alone against the universe, one pitted against the many, unfairly deserted by God and fellow men and women, afraid with nothing and no one in the immediate environment that can understand and make it better but the nipple of a bottle of Bushmills Whiskey, pills, booze, smoke, drugs, something that will help me handle life.
In AA we say that our "head's have a contract on our ass" and that our "mind's are a bad neighbourhood we should never go into alone".
Always the alcoholic wants others to 'cut them a little slack'. Others shouldn't be so 'up tight'. So I'm alone and alcohol isolates me. I may sit with others in a bar or at a party but we're not really together, each of us is in his or her personal alcoholic delusion. It's worse with marijuania where everyone is 'blatto' together but they might as well we watching different movies. Their bodies are in the same room but their minds are elsewhere. The crack house epitomizes this and finally the opium den is just an asylum ward by another name.
Alcohol is the gateway drug. The other drugs aren't really necessary since alcohol will do everything the others will do but not necessarily so fast or so smoothly. Alcohol has been said to be the great erasor as it takes everything in your life and removes it. It's also called the superego solvent.
Insaniety is persisting doing something despite negative conseqences and alcoholics compulsively persist in drinking while their life becomes a country and western song of 'poor me' which of course justifies and rationalizes more booze. One of my favourite groups in AA is the 'whine and snivel' men's group. Whenever a guy sharing starts to play the victim and start the 'whining' poor me song the other guys throw teddy bears at him.
I stopped going to as many mixed AA groups because in west coast Canada too many women were going to the fellowship of AA without doing the program of AA and taking offence when someone would say "get off the cross we can use the wood." My friend Julie says the women in her step group can't stand the women in the mixed groups playing the poor me pick up lines either, looking for a man to rescue them and solve their problems, continuing to blame, but she said her group didn't like the guys at the Alano club with their "will you be my mommy" stories either.
The reason people are told to have sponsors is so someone can talk to them when they begin to use the podium to sell this particular brand of insaniety. And of course there's nothing like a good AA meeting to test your own serenity, tolerance and spiritual development. We joke and say if you haven't got a resentment then you're not going to enough AA meetings. Anyone can be a spiritual guru alone or with their own people but it's a whole different equation when you get in a group of very strange bananas and coconuts.
My particular justification and rationalization was the women I got involved with. Now being raised Christian in a sober non drinking home with a grandfather who was against drinking and parents who were sober, wholesome and good middle class folk I naturally found good Christian girls boring and unnattractive. If I'd dated and married them I'd have had no reason to drink. Looking back at my life sober I see now,especially looking at the pictures in the albums, that those Christian girls were hot, good looking and everything a sane guy would have wanted to marry.
But they were not aetheists, drunks, drug addicts, promiscuous, shopaholics, materialist, liars or party girls snf I quite simply preferred bad girls. They were 'easy'. When and after I was with them I could say 'poor me, poor me, poor me another drink' . They were that much more 'entertaining.' The insaniety of the alcoholic is that they have to arrange their life in someway to be a victim so they can drink. It's ass backwards. The alcoholic's thinking is 180 degrees wrong. To themselves they're a victim but to others they're the 'victimizer'.
I remember it wasn't very long after I had this perfectly good drunk of a wife and there I was dragging her into a church and complaining she wanted to go to a bar. I got my dope addict wife to go to meditation classes with me and was taken the drunk stoner to tai chi and church. Of course they'd rather be with me than the psychopathic boyfriends she'd had before me or worse the guys they'd dated who didn't drink. We were the best of drinking buddies but they could never have children because alcoholic and drug addicted girls simply don't want to face 9 months of trying to be clean to have a baby. Alot of abortions go on so party girls don't have to face up to their addictions. They know that their drinking would hurt a baby so they abort the baby rather than give up the drinking. Eventually I'd complain there was no family and that we were always getting drunk or stoned and yet the very thing I found most attractive about them was that they were drunk stoners. Naturally they didn't like me either at that point. Which always gave us both reasons to drink more.
Like attracts like and alcoholic friends and alcoholic girlfriends, husbands and wives are the normal. When an alcoholic sobers up he thinks everyone drinks like him because usually his wife or her husband and their friends do. I even went to a doctor who drank like me and found a psychiatrist who said I could drink a bottle of wine a day and because my wife was such a problem addict told me I should smoke dope with her to help the marriage. In retrospect it's astonishing how I found such a great psychiatrist for me when I know today that at least a hundred others would have told me to stop drinking and smoking dope and get wife and myself into a treatment facility. Naturally I'd asked my drunk psychiatrist friend who he'd go to see if he'd needed a psychiatrist and he'd recommended his addict friends.
It was astonishing to me to learn that a third of adults don't drink at all and another third don't drink more than 2 or 3 glasses at any one time and rarely at that. 10% of the population drink 80% of the booze and in the end those were the guys and gals I liked. Today I still like them but only sober.
As for dope smokers they've never amounted to even that percentage but I liked the daily dope smokers and thought the girls who smoked dope daily were 'sexier' than those didn't. Smoking dope is the second most common reason for enterring treatment centers today because of the denial , lying and difficulty getting clean that goes with addiction to dope. First you deny the problem, then you lie about the problem, then you forget the problem and you never can get motivated to address the problem so you lie about the problem to deny the problem.
The alcoholic is the problem but to the alcoholic others are the problem. Like Keith Richards' famous line, "I don't have a drug problem, I have a police problem." The halcion cry of the alcoholic is always "it's not my fault" and finally "if you had my troubles (or my life) you'd drink too." I said if you have my wives you'd drink. But who created those troubles. Who picked the girls. It wasn't even my fault I naturally I looked for women who were promiscuous, non Christian,drunk, lying, drug addicted from drunken materialistic homes where everyone was some kind of victim and the family lied but loved to 'party'. What I liked most in a woman was that she drank and did drugs was downright dirty alone.
When I married the worst of a bad lot I was a victim and cried 'poor me' because they were so selfish and self centred and unloving, lying and didn't want to have a family, go to church, or God forbid , stop drinking or drugging. And they got really really really angry when I left because the party stopped and they lost their excuse for drinking and drugging. But that usually doesn't stop though divorced people who can usually nurse their resentments sometimes years and thereby justify their drinking and drugging long after they've lost their excuse.
In addition I'd go looking for the toughest most thankless job, be a workaholic people pleaser and feel sorry for myself because I'd be underpaid overworked and just your good old garden variety martyr. In AA we say, "get down off the cross, we can use the wood." Being a perfectionist people pleaser I set mysself up for being taken advantage of. I was the popular perfectionist doctor that everyone wanted until I was sober began to say 'no' and set 'limits'. I may as well have been wearing a sign beat me because only when I was down could I really enjoy a good drink feeling afraid and resentful and alone, drinking at you and all my troubles.
Of course my partner would be drinking there with me because that's what we really had in common. My wives and friends and I were all united in the religion of drinking and the church of booze supporting the government of alcohol and celebrating poor me and 'stinking thinking'. When I stopped buying the booze and having booze at my house all those 'friends' and the women stopped coming around.
It's a fairly universal observation in AA for those coming in. The drunks run with the drunks and when you stop drinking they are not quick to support you. Indeed they more often than not do anything to drag you back into their familiar circle.
The Big Book of AA was originally called a "Way Out" and that's not what an alcoholic wants to hear or see. Being around sober people you really see how much you need your booze crutches and you get really resentful when they're laughing and having a good time and they don't 'need a drink' to do that. Alot of alcoholics when they stop drinking would find themselves alone were it not for AA.
Many of us came from a culture of alcoholism. I came from the university. My particular alcoholic circle was doctors, lawyers, politicians, salesman and businessmen, entertainers and engineers. Getting sober is kind of like the Superman comic with the Bizarro world because one day you leave a group of friends who are drunks, you're alone, and then you're with a group of friends who are sober but this new group is doctors, lawyers, salesmen, businessmen, entertainers and engineers but they don't drink. Yet when you were with the first group, the Bizarro World, you didn't know this other world existed. Yet in this other world we all know about the drunks and drug addicts.
At a party we tend to leave early as they're cranking up and in the morning at work we see the tell tale signs. When you're in the problem you simply can't see the solution. It's the alcoholics and addicts that are always having problems and somehow missing the big picture too. They just never understand 'why bad things happen to good guys (and girls) like me".
Step 2 of AA says that we 'came to believe', not that we 'believe' but rather that we came to believe. We came to AA because we were powerless and our lives had become unmanageable and that we'd sought help. We believed that something outside of ourselves was needed to break from the insaniety in our head, our thinking and our lives. For whatever reason we had a moment of clarity and we reached out. We 'came to believe'. Intrinsically the alcohol and life we were dying with our drunken fairweather friends and the fears and resentments, the victims and victimizers, paranoia and battles royal just weren't cutting it.
I was as tired of listening to the chronic complaining of the women I was with, their utterly depressing litany of woes and wrongs, mostly problems with mothers and other women, and complaining and complaining and complaining as I was listening to my own whining, mostly about other guys. I was fed up. In AA terms I was experiencing "incomprehensible demoralization".
In the prodigal son parable I was suddenly aware that I was eating the pigs slops and that there had to be something better. I remembered what it was like in my father's home. I literally called my mother and father, said I was sorry, that I was wrong, and I was going to get help. They said, "we're glad, Son."
I said I couldn't work though it was amazing how hard it was to get away and how ill you had to be as a doctor before anyone would let you quit. Finally I just quit. I thought I'd had a heart attack but with Canadian health care what it was it took me a month or two to get an EKG outside a hospital. It wasn't an emergency so I wouldn't go to emergency. I continued to drink because alcohol is good for the heart. right? In the end I never did get to see a cardiologist. As a doctor I got about the worst medical health care one can imagine till I was shipped to another province where I was treated as a normal patient for the first time since I admitted I needed help. At the time the Christian psychiatrists were the only ones supporting my not drinking. I didn't have a heart attack. I had an alcohol problem.
I came back to the church of my childhood and said that really there'd been nothing wrong here. I went back to the beginning and retraced my steps and came to the conclusion that I'd had a pretty good life overall until I started drinking. I'd loved the learning at university, not the drinking, and finally even concluded later that working as a doctor hadn't been all that bad because I'd had a really good life sober as a doctor and my drinking was only on holidays. I was always a binge drinker. Things began to go awry in psychiatry and after I became a psychiatrist because I began to drink with some pretty drunken drug addicted perverted psychiatrists as addicted alcoholic exs and their families drinking and drugging began to affect their thinking and emotional stability. Alcohol is fun, then it's fun and trouble and finally it just progresses to plain trouble. The trick is to get off the roller coaster as early as possible.
Of course I met really fine upstanding psychiatrists, some who were my teachers, but being an alcoholic becoming I found them as boring as the good women had been in my life. I preferred the 'fast' crowd. I was 'hip, slick and cool' and the drunks I hung out with then were just as 'hip, slick and cool.' I thought my wife and I and our friends in the way the girls on "sex in the city' might see themselves. Sober though I heard that others just saw us as shallow, materialistic and drunk and stoned, and arrogant, much the way I saw the 'sex and the city' show.
My workaholism and people pleasing and all that other shit was still a problem but it would eventually serve to fuel my "poor me-ism" that would contribute to my justification for have another drink". If you worked as hard as I did and sacrificed as much as I did you'd need at least another drink too.
In Step 2 the Higher Power I came to believe was at first AA. I didn't think that I was insane so the second part was difficult. I knew that I'd turned my back on God and saw the Higher Power as the God of my childhood. Not the god of fire and brimstone but the God that my mother taught me to pray to on my knees as a little child beside the bed - a friend, rescuer.
The Higher Power of AA was a Loving God. Though AA was wholly rooted in the trimmed down spirituality of Christianity it would not even require any God per se. Aetheists and agnostics were members of AA. The key understanding of the Higher Power was that you were not that higher power. As Jesus said, "where two or more are gathered, there am I". Rather than a conversation with a bottle, in recovery an alcoholic talks with another human realizing that two minds are better than one. They leave the song "I did it my way" with all the gangster associations and romantic silliness implied at the door. It's a 'we" program. As we say, "our best thinking alone got us here." Recovery is a community. It's coming in from the cold.
The great jewish philosoper and theologian Martin Buber called the equation I and Thou. Instead of 'me and it' I arbitrarily (on faith) decided to look at life as if maybe "me was the problem" and You were the solution rather than the stinkin thinkin of alcoholism that 'you are the problem and me is the solution". Eventually you becomes 'thou' and 'me' becomes "I" and we call spirituality, 'growing love inside' and recovery an "inside job'. Instead of "me and it' I had a moment of 'faith' and came to AA hoping to believe that there was a higher power or God that would restore me to saniety or help me find my way back from the abyss. There was help outside, in communication with others, and the problem was my perception.
There's a song 'desperado' and frankly I knew I'd been out riding fences too long and I was thankful that people in AA welcomed me back and that the program of AA offered me more than the insaniety that I'd come to learn existed in the world of drink.
As a fellow shared at a meeting last night, 14 years sober, I went back to the people and places where I was drinking and they were still doing the 'world tour from their bar stools', still complaining, still flirting with the bar maids but now they were in their 50's and it didn't look so good any more. He said it didn't matter where in the world he'd gone when he was drinking or who he'd been with because when he was drinking he just had to alter that reality to suit himself by adding alcohol to creation because he couldn't live 'life on life's terms' . He couldn't exist in reality. He had to delude himself with alcohol and alter his perception of reality to make it palatable. Like a baby gets its' mother to chew it's food he had to have alcohol chew the food of his life before he could swallow it.
I realized sometime after I was sober that alcohol is really just liquid valium and my friends and their wives and my wives and I had all needed maybe a hundred valiums to be together with each other supposedly 'having a good time.' A party was a place where we 'passed out' or got drunk enough to tolerate reality or each other's company.
Today I don't drink and I have faith. I believe in a Higher Power I choose to call God and really in my case I even call this higher power Jesus but that's my particular brand of saniety. In saniety we don't all have to believe together. We can tolerate differences without feeling threatened. All the program says is a 'god of my understanding'. And of course, the higher power can't be you alone, it must be something more than your ego or your 'stinking thinking'.
For now that's my understanding. And it's changed with sobriety. In sobriety too I've had former friends join me in AA and we laugh looking back at the drunken life. Because I believe in a higher power I believe my ex's and former friends are being cared for too and that we're all slowly moving forward. Some take two step back and one forward, but eventually we get it. In AA we call it "spiritual progress, not perfection". That's the kind of world I like to live in today. It's a world of Faith.

Thursday, October 29, 2009

The 12 Steps of AA - Step 1

Step 1. "We admitted we were powerless over alcohol, and our lives had become unmanageable." I certainly had difficulty with this two part statement. First I didn't consider myself powerless "over" alcohol but rather 'under' the influence of alcohol. Under the influence of alcohol I was positively legless. Often I drank more than I intended. I made decisions I later regretted. And yes, I 'struggled' with alcohol. Sometimes it was to 'sip' my drink. Other times it was to keep my eyes open after I'd had a drink. Other times it was to focus my attention on those around me.
The first men of AA were fresh from the wars and personified alcohol as "John Barleycorn". They saw themselves in a fight with alcohol trying to get alcohol to fulfill that first promise to them which it had made, the promise of peace. At first alcohol was fun, then fun and trouble and then just plain trouble. Peace of mind, which came at the beginning of drinking was no longer possible as more and more problems arose as a result of drinking. More and more drinking didn't work. Increasingly it became more difficult to 'wrestle' some pleasure out of alcohol or life in fact. Alcohol is a chemical depressant and in time it leads to depression though often the depression is of the bipolar irritable kind, mood swings, snappiness, intolerance, mean words, and generally orneriness.
And the key to all compulsive disorders is to first stop the behaviour. "Don't pick up the first drink," is the key motto of AA. Don't struggle with whether or not to have the 5th or 17th drink but rather decide while sober not to have that first drink and do everything in your power on a daily basis to avoid that first drink. Without alcohol's interference the natural relationship with self or one's higher power corrects. The depression lifts, the fatigue goes, the 'poor me' syndrome lets up and increasingly one becomes open to learning new information. One can't 'think' their way into new actions when it comes to compulsive disorders, one must act their way into new thinking.
We don't say no to the 2 year old who insists on playing with the family pots but rather we re- direct him to the other cupboard where he can play with his pots. Similiarly "just saying no" is only enough if an alternative exists. Certainly AA provides that alternative. The detox's and treatment centres can help begin a new life course of action.

The second part of the equation , 'our lives had become unmanageable' is usually a whole lot easier for people who come into AA. It's not what most people plan on doing early in life but follows some mishap in their lives which involves drinking or seems to point to drinking as a problem. I personally couldn't maintain long term relationships with women and found that I was attracted to those who drank and together we had a grand time till the war of the roses or whatever came along and naturally we blamed each other rather than the bottle. Today I know that alcohol is at the root of so many of society's problems. That's certainly the evidence from the prospective Grant study which George Vaillant, MD studied extensively and showed how alcohol undermined jobs and relationships.
Not ironically in sobriety the plane of one's life seems to go better to the plotted destination without a drunk for a pilot.
That's what step 1 is kind of a bout. There's much more but that's usually found in the small group studies and the one on one work with sponsors.

Wednesday, October 28, 2009

Axum Ethiopian Restaurant

Ever since Ethiopian nurses cared so lovingly for my mother in her final days, have I wanted to know more about these people and their country. It's taken 2 years till I've actually eaten at an Ethiopian Restaurant despite passing the Axum on dozens of occasions and saying to whoever was with me, "I really want to eat at that restaurant." It's right on East Hastings at Clark.
Well, tonight I got my chance. It was well worth the wait. The cozy little restaurant was bright with light and colour. The beautiful hostess and chef welcomed us warmly. The menu was vegetarian and meat with chicken, lamb and beef. We started with fresh mango drinks and when it came time to order quickly were asked, "Is this your first time eating Ethiopian." "Well, yes. " Beaming with pride and pleasure, our delightful ambassador told us all we needed to know about what was in store for us.
Not long after we placed our order, the feast began. There was this huge piece of dough almost like an extra extra large pizza base and the spicy lamb and spicy beef we ordered with the mixed vegetarian was poured all over this. Then these little rolled up towels of bread I'd thought at first were for cleaning up served for handling the food. Tearing off bits of them like cloth I used this unique bread to pick up mouthful of exquisite food and literally stuff my face.
Laura used a spoon and ladled her delicacies onto the bread. I was having far too good a time eating with my right hand that I ask the hostess if we had to use the spoon. "Whatever you want," the handsome man with her said, "We like to experience the food with our hands as well in Ethiopia". So I went on with my wanton ways while Laura continued to use her spoon and daintily wipe her lips with one of the many napkins.
All the while people came and went with take out. "This really would be good as take out for watching a movie, " Laura said. "For sure," I answered, hardly looking up.
I was amazed at the beef and loved the potatoes and spinach. The lamb, always my favourite was actually surpassed by the extraordinary spicy marinaded beef. It's not curry. It's something utterly unlike anything I'd eatten before. Ethiopian. And wonderful.
"It's all good for you too," Laura said.
I was busy with my fingers and glorying in the taste and the full feeling growing in my body. Too involved to be thinking about anything else but the next bite. Soon I was literally glowing and with a contented smile pushed myself back from the table stretching my legs, I admitted "I can't have another bite."
The only thing I can say against the Ethiopians is that their chairs don't become recliners. That's the only thing I needed at the end of that meal.
It was only $40 for a feast. There was enough left over for both of us to have another meal for lunch. Our hostess had it all packed up for us to take away when we thanked her praising the food and chef. "I'm so glad you enjoyed our food, " she said.
"We'll be back". Laura said.
And that, we will!

2010 Winter Olympics

With the fall rains in Vancouver and snow all over the province of British Columbia, the Winter Olympics are becoming more than just an idea. I bridled sometimes at the hype and objected at times to the politics but when it comes right down to the games I'm impressed. What a rush! The athletes, teams and coaches are gearing up all over the world.
I remember the Pan Am games in Winnipeg as a kid and how I loved meeting the athletes. Here were the world's best coming to town to compete. Now I'm in a city and province where all the Olympians will be gathering. Yes ,I'm excited.
I've already bought an Olympics pin and some of the other Olympic merchandise. Why not. I'll not miss having the t shirt and ball cap (togue) for this one. It's one of the world's greatest oldest festivals and we're at the centre of it. Blackcomb. Whistler. Vancouver. This is it and it's really something.
I remember being a provincial champion athlete on provincial champion teams and what it meant to me. My Vincent Massey High School Volleyball team was sensational. All the early morning workouts paying off that final game. Next year it's the 50th anniversary of the old school and no doubt some of the old team will be there replaying the games. The chiropractors will be working overtime after that.
My YMCA coach, Don McQuaig taught us the value of excellence. The competition was never with another but with ourselves. We were out there to find out what we could do. That was in gymnastics, where individually I'd compete alongside a couple of the guys who went on to be on the Canadian Olympics team . They were that much more talented than me but really what it came down to was dedication. So many who are born stars lack the motivation and will power and sheer "stick to itness" discipline to be among the best. Keith Carter was our favourite back then. We'd all have gone for showers and swims and come back to find he was still practicing to be the fastest moving human pretzel. He was committed. He became a Canadian champion and taught all of us who knew him that hard work was rewarded and that there weren't any short cuts.
The Olympics is about those who not only have talent but among the thousands with equal genetics these all have the drive and purpose to go beyond what was previously humanly impossible. Records are always set at the Olympics which are an earthly kind of NASA.
As much as I like to knock politicians and poke the businessmen who so often want to add a cigarette or beer ad to a church wall, the Olympics is about a whole lot more. It's about a whole lot of people, organizers and athletes, governments, businessmen, and tourism, roads, restaurants and hotels and a myriad of services that a great gathering call for. I love watching all the names at the end of a Hollywood movie. Sure it may make millions of dollars but each movie employs hundreds and thousands whereas the Olympics is about millions. All over the world and here there are those involved in this event.
This is going to be something spectacular. Sure there will be traffic jams in Vancouver but we've lived with the Sun Run and the nude cyclists here already. This is world class. This is beyond continental. This is international. This is the Planet Earth. This is the Olympics.
I'm proud we're hosting it. I'm thankful I was in Montreal for the World Fair nearly half a century back, at the Pan Am Games in Winnipeg, and the World Fair here. Now I'm going to get a taste of the Olympics. And I like it. I can say I was there.
Who would ever have guessed that Vancouver would be a city so cosmopolitan or Whistler Mountain so world reknown that all the world's greatest athletes and supporters would want to come here. I remember the first time I came to Vancouver it was little more than a village and I've actually met people who claim they used a tow rope to get up Blackcomb. Makes one think that Vancouver could one day be the centre of a space station and no one would think anything of it. The sky is no longer the limit. The Olympics teach us that.
British Columbia is fortunate indeed to have the vision and awareness that knows our young people will forever be affected positively by the experience of being at the very centre of it all. I know I felt that way when I volunteered at the Pan Am Games.
Few of those I competed with back then continued in sports but so many of the athletes having tasted excellence physically took the meaning of that experience into their academic, business, professional and political life. Some of the doctors I trained with were once champions. It's all in the attitude. So many Canadian Olympic Medallists I've met have said that for them it was the experience of the world village, meeting all the other athletes from around the world and sharing friendship.
Hand shakes span oceans and continents. Facebook, twitter, text messaging and internet. It's going to be an Olympics with more participation than any before.
And what it comes down to is really, the world's greatest Peace Festival. Even the guys and girls shooting rifles won't be shooting each other. The Olympic is all about getting along and show the world's leadership and all the people of the world that it's possible to get along and even facing the toughest challenges. The Olympics is about good sportsman ship. The Olympic athletes, our greatest ambassadors for peace, have always shown that humans are more than hate slogans and differences. The Olympics are all about diplomacy, team manship, friendship and celebration of life. It's young people doing their best and old people singing their praise.
It's coming here. The 2010 Winter Olympics are already incredible. By the time they actually arrive they're be right over the top. Blackcomb Whistler, Vancouver, British Columbia. Canada. Hooray for the 2010 Winter Olympics.

Gigi's Pizza Spagetti House

There's this great Italian restaurant across from Mountain Coop on Broadway, Gigi's Pizza Spagetti House Probably everyone knows about it but me. It looked at little like a joint the Godfather guys would eat at. Great simple decor. Basic hard wood floor tasteful table and chair diner place. Bar at the back. I think they have this big business in pizza delivery at the back too. I passed it on the way to the really clean rest room.
We sat in the restaurant at the front by the big window. Terrific woman serving us. Sensitive. Friendly. Family. Daily specials and I had the Tuesday. Roast chicken, ribs and spagetti with salad and garlic toast. $15. I didn't ask for megasize but it came that way. Scrumptuous. Haven't enjoyed a restaurant meal so good in so long. Mother food. Maybe it was me. But my partner said the same. She was as impressed. Wholesome food. Just a good unpretentious welcome friendly feed. Great view of Mountain Coop too.

Tuesday, October 27, 2009

Fellowship of AA

There is the fellowship of AA and there is the program of AA. The fellowship is meetings and association with others seeking sobriety. The only requirement for membership in AA, ie the fellowship of AA, is a desire not to drink. This means that you can go to AA while drinking despite relapsing and you can go to AA sober or after having had a drink. If you go to AA when you've been drinking you're welcome if you don't create a disturbance and generally people who have been drinking on the day they attend a meeting of AA pass if they're asked to share because really they're there to learn about not drinking. In meetings the membership 'share' their 'experience, strength and hope" regarding 'what it was like, what happened and what it is now'. What it was like was clearly not good or they would still be drinking. That's called the 'bottom'. What happened refers to their decision to give up drinking and how they sought help and what it is like now refers to the improvements that have occurred in their lives since not drinking. Now initially the third part of that equation is often difficult because it takes a while for one to 'feel' good when one has depended on alcohol for 'feeling'. Yet 'carrying the message of AA " refers to this third part which certainly comes easier with increasing sobriety. Some people just 'whine' and 'complain' and that's certainly not what AA is 'all' about. Yet whining and complaining is where alot of people begin their recovery and slowly with exposure to the AA fellowship and certainly following working the program of AA they recognise that recovery is about more about the 'positive solutions' and less about the 'problem'. As one person succinctly put it, drinking I was killing myself, not drinking I'm beginning to live. I like to tell people what living I've done today more than the dying I used to do. The fellowship of AA carries alot of laughter because in recovery we realize that no one was forcing us to drink but we persisted because that's what addiction is. Doing the same thing, expecting different results despite negative consequences. We laugh in the fellowship with each other because the solution, though frankly obvious, "don't pick up the first drink and you won 't get drunk' is often the hardest step any individual will ever make in their life. However it's the first step on a glorious road that begins one day at a time and progresses to a life of recovery 'beyond one's wildest dreams'. No one is ever laughing 'at' you but rather they're laughing with you in the fellowship because frankly, we've been there and 'we don't want to go back'. So being reminded of what it was like, given the nature of denial, is a powerfully strong way of avoiding the isolation and 'stinking thinking' that comes with not going to meetings and too commonly precedes relapse.

Boundary and Class

Fundamental to boundary violation is a notion of class. The ideas are directly derived from power relationships of Marxist ideology. Here those in power, ie. bosses, doctors,lawyers,men, etc have the power and secretaries, nurses, women, etc do not have the power. Historically women since time immemorial have sought to improve the future potential of their children by marrying those more powerful. Today this is a boundary violation.
Not only will a nurse not be able to marry a doctor related to her by work or a secretary a boss related to her by work but the authorities will strip her aquisition, the man she married, of his power. This will occur whether she complains or not as the 'class' (profession) has moved to act on it's own behalf.
Seen in this light the new boundary violation legislation is distinctly similiar to the historic feudal class legislation that stripped the king of his power when he married a commoner. (Distinctly at variance to the female foreplay pornography called romance genre and supported realistically by the WWII King of England having to abdicate his throne when he married a common actress).
This legislation then ensures the power of the existing class and threatens anyone who would access that upper class by sex and marriage. In contrast to radical feminist ideology the upper classes have long ago thought outside the box of gender and acknowledged only power as defined by wealth, family, armies, and alliances. The upper classes have never been feminist and the upper classes are defined solely by power, with survival of the fittest coupled to all manner of protective legislation and action to ensure the status quo remains in power..
The wealth and power of a family may reside in father , mother or grand parents and the mother of the king has always been a most powerful position. Indeed in the foremost matriarchies of all time the women controlled power by working from behind the throne using male puppets while concealing themselves from direct retaliation (see Iroquois Federation.).
Radical feminism was never truly about male and female relationships but has been an ideology of daughters and more commonly individualist women (historically a daughter or aunt) who saw themselves at variance with mothers and family related women.
Further radical feminism has been an ideology of individualism and served the state which has been dominated by the family systems of the upper classes seeking to destroy family systems of the middle and lower classes by divide and conquer. In the equation the state versus the individual the state always wins so the state necessarily supports individualism but is threatened by any alliances commonly called conspiracy against the state while of course state power is by nature as 'conspiracy against the individual" or conspiracy of the majority against the minority.
This latest legislation now 'shuts the gate' that allowed an influx of women through marriage into the upper classes. Marriage no longer legitimizes the sexual mobility of women who historically 'chose' their mates based on their power. Arranged marriages are likely to be strengthened and restored placing power in the hands of mothers and fathers rather than the children.
The daughters of the radical feminist movement find themselves today the mothers in the upper classes, or at least the women of substance supporting the class system status quo and do not want to lose their power to lower class women. Mostly they are more priviledged servants of the upper classes if they are single or barren and in this way form a new variation of the old "eunuch" servant class.
It appears therefore that this is an interesting mechanism whereby mothers of the upper classes can ensure the 'purity' of their class by denying daughters of the lower classes access to these rarified realms by marriage, as marriage can no longer legitimize carnal relationships or the offspring. Historically 'marriage' validated sexual union but 'boundaries legislation' would strip the couple of the power acquired sexually. "You can't make a boundary violation right with marriage." With no value of marriage, children born of the 'love match' ie sexual social ladder climbing, will remain part of the historic 'bastard' class.
Seen in terms of power dynamics Boundary legislation is potentially a way to restore the Caste System that long served the Indian upper classes, the Apartheid System that served the South African upper classes and generally the Feudal Class system which democracy tried so desperately to destroy but appears to have be revived by the politics of courts, corporations and beaurocracy superceding the power of the democrat. Certainly Plato had a great deal to say about this as later so did Cusa though Machiavelli has always been a far racier read.
Inherrently marriage is further devalued and another coffin nail is driven into the middle class and lower class family system whereas the upper class family always a feudal business arrangement of strenghthening power alliances remains untouched and probably stronger as it gives upper class mothers there even greater power over their sons mate choices.
Fundamentally boundary when viewed in light of the age old classes isn't terribly new but it does propose to restore the rigidity of caste and deny the upward mobility of lower class and middle class females while protecting the sons of the upper class mothers and giving those mothers greater power over errant sons.
Indeed it will reward lower and middle class females with monetary tidbits while denying them the greater slice of the pie ie inclusion in the class or caste or upper class family system. This has always been the way with the upper classes, the families brokering a monetary settlement for the bastards and the lower class women being bribed into silence when the king or his courtly lot 'get caught'. Interestingly these monetary 'brokerages' between the powerful and powerless, aren't subject to the same ideology of power that permeate the sexual legislation.
The monetary 'buy off" is small price to pay and ensures that the big prize in the wealth and power of the upper class family isn't touched by allowing 'illigitimate females' sexual access to the upper 'caste' 'class' or 'upper class family system'.
The untouchables then are seen to remain only touched sexually and bought off financially but the 'gene pool' is not sullied by eugenically unappealling contribution from the masses. The new eugenics however interestingly may not be so much about genes as the appearances of genes since the advent of the new sexual tourism trade and exploitation of artificially insemination, fertilized eggs and alternatively wombs for hire, the closest proximation with the 'upper class' appearances being sufficient to gain the higher prices.
This is further complicated though by the declining fertility of the upper class females in comparison with the increasing fertility of the lower class females. The 'arranged marriage' may allow selection of fertile females for the lesser sons of the upper classes as in feudal times but this would only be done as a kind of American idol 'reward' for service and likely tied in with some kind of idea of eugenics as was done in the Caribean class system, the 'whiter' black girls being selected as more 'suitable' house servants while the 'darkies' were segregated off in the plantation fields. The hope therein was to lessen the risk to that particular household woodpile.
The decision will clearly have to be made before sex and abortion will assure that lower class females aspirations can be 'nipped' in the bud. Upper class males will be suitably punished or stripped of their power and wealth so that the caste or class or upper class family doesn't lose power or resources.
This may be a necessary caste mechanism as increasingly the 'servants' and workforces of the upper classes are being brought in from third world countries and what were historically called the 'lesser races' and 'inferior religions'. Tightening of the reigns on the zippers of the sons of the wealthy has always been as much a concern of the mothers as the fathers of the upper classes.
While racism is seen too often as white and black it's just as significant in tribalism within any group, as seen in Kenya today where there are black 'inferior' and black 'superior' tribes and intermarriage is restricted based on power dynamics. Similiarly it was acceptable for an Englishman to marry a German at one time whereas to marry Irish was frowned on.
The key in these Tamany Hall considerations is who has the power at the time and then how to establish societal mechanisms to maintain the status quo. The mechanisms remain the same regardless of who uses them. The names however may change though their key purpose may not.


Thank you, Lord, for sleep. Thank you Lord for dreams free of nightmares. Thank you for nights of peace and days and nights without pain. Thank you Lord for friends. Thank you Lord for friends who laugh. Thank you for humor. Thank you for the rain. Thank you for sunshine. Thank you for silence. Thank you for freedom. Thank you for fond memories. Thank you for mothers. Thank you for fathers. Thank you for children. Thank you for families. Thank you for differences. Thank you for similarities. Thank you for colours. Thank you for movement. Thank you for music. Thank you for scents. Thank you for sights. Thank you for sounds. Thank you for smell. Thank you for thought. Thank you for conversation. Thank you for mist. Thank you for deserts. Thank you for high country. Thank you for mountains.Thank you for low country. Thank you for the north. Thank you for the south. Thank you for seas. Thank you for the east and west. Thank you for fair winds and following seas. Thank you for mariners. Thank you for hunters. Thank you for librarians. Thank you for farmers. Thank you for doctors. Thank you for engineers. Thank you for occupation. Thank you for teachers. Thank you for students. Thank you for knowledge. Thank you for love. Thank you Lord for blessings. Thank you Lord for forgiveness. Thank you Lord for electricity. Thank you Lord for medicine. Thank you Lord for relief. Thank you Lord for rescue. Thank you Lord for cats. Thank you Lord for dogs. Thank you Lord for books and movies. Thank you Lord for the trees and grass. Thank you Lord for ice cream. Thank you Lord for venison jerky. Thank you Lord for potatoes and rice. Thank you Lord for vegetables. Thank you Lord for furniture. Thank you Lord for plenty. Thank you Lord for you and me. Thank you Lord for us. Thank you Lord for sleep without nightmares. Thank you Lord for peace. Thank you Lord for women and men who dream of peace. Thank you Lord for hope.

Monday, October 26, 2009

Bipolar Disorder

There is a lot of confusion these days when the term Bipolar Disorder is used. Historically Bipolar Disorder referred to one of the most serious psychiatric disorders and a relatively rare condition called "Manic Depressive". A normal 'mania' of the manic depressive disorder could last up to four months and lead to death from exhaustion and over activity. As one person who developed mania later said, it was "like being on constant cocaine without the cost of the drug." During frank mania the person is grandiose, experiences surreal highs, is delusional with hallucinations. They literally talk to God and can be extremely violent. The depression of Manic Depression was the most likely to be associated with suicide so was very dangerous. The Manic Depressive disorder was a hospital based disorder.
Today Bipolar Disorder refers to the idea that all mood disorders are part of a spectrum. Bipolar II refers to a person who has days of irritability and mood swings so that in fact Bipolar Spectrum Disorders may be any variation of mood from a steady state of euthymia or 'feeling okay'.
At the same time the whole idea of mood "disorder" must be considered in the context that Bereavement or Grief that persists longer than 6 weeks is considered pathological despite the fact that parents routinely say they never get over the depression of losing a child.
Today Bipolar Disorder can refer to the worst and the least of psychiatric conditions. Where once it was 'necessary' for a person with Bipolar disorder to be hospitalized and treated with medication there is no need for hospitalization or pharmaceutical treatment of the Bipolar Spectrum Disorders. In deed, it's been found that aerobic exercise can be equivalent to prozac in the treatment of depression and psychodynamic psychotherapy has long been shown to be equal if not better in the treatment of depressive disorders which are now subsumed by the Bipolar Spectrum Disorder definition. Further if medication is considered a wide range of medications can be used including the traditional antidepressants which explains why today it's more common to see medications used in common that once were considered 'uppers' or 'downers', the idea being that the medication is modulating the illness rather than changing it from one 'state' to another'. That said the vast majority of bipolar disorders today are not treated with hospitalizations and epidemiologically most who might fulfill the diagnosis of having a Bipolar Spectrum Disorder will not be on medications. There are indeed some who argue that the antidepressant medications in some cases caused bipolar disorder though most would not accept this.

Political Abuse of Psychiatry

It's important to note that we are unlikely to see "political abuse of pediatrics", "political abuse of family medicine" or god forbid, "political abuse of surgery'. However all over the world and especially locally political abuse of psychiatry goes on. Psychiatry is a marvellous tool but it can be used like no other weapon. Not just homosexuals have been labelled deviant and subjected to all manner of re conditioning and 'treatment' but women, minority groups, geniuses, and anyone the state deems as a threat. We can hear about this in China or the Soviet Union whereas in a foreign country you are most likely to hear about this abuse in Canada. I have seen it and I have reported it and I've been frightened by the power of it.
Power corrupts and absolute power corrupts absolutely. I do believe though and am hopeful that whereas this is very common in some places it is less common here. Civil liberties movements have reached out to protect inpatients however the very 'diagnosis' of a mental illness can be a punitive action. Having seen a psychiatrist in Canada remains a reason to deny a person a firearms license however a history of violence, the surest likelihood of future violence, may not.
Where once seeing a psychiatrist was for a major psychiatric illness only, increasingly people see psychiatrists for minor illnesses such as variants of bipolar disorder which were once simply called 'mood swings' or 'pms' but now have this clinical term attached. Much of psychiatric diagnosis remains 'subjective' with limitted 'objective ' findings in contrast to a dermatological facial rash that all can see, a rash that may also have significant associated lab tests.
Conversely a person who is suicidal and homicidal may only tell their doctor and no one else might know. Yet this very issue means that a doctor, with a conflict of interest, may say that a patient said he was 'homicidal or suicidal' when he wasn't. Who do we believe? In forensic psychiatry and addiction psychiatry there is even more denial and frank lying.
There are people who become homicidal or suicidal when they drink and yet when they're sober are normal. Some even experience this in a black out so don't even know that drunk they're homicidal or suicidal. One patient I knew who had temporal lobe epilepsy still has difficulty accepting the grocery store video tape that showed him in a black out after two beer beating a man with a baseball bat.
That said, it's still a major concern that individuals civil liberties are protected. This can involve protecting people from 'false labelling' and 'punitive psychiatric labelling' and further it can involve the protection of the civil liberties of those who are mentally ill. Part of the problem of being labelled mentally ill is that the mentally ill are most open to abuse and misuse in society, marginalized, denied employment, disbelieved, 'self fulfilling prophecies' applied, etc. In the US the Americans with Disabilities laws have been very powerful in protecting the mentally ill from the kind of abuse that can still go on in Canada and other western countries where similiar legislation doesn't serve as well.
Legislation is part of the solution but awareness and education is an even more important part of the solution. Further, while in Canada, in most provinces lawyers are available to those 'certified' or 'committed' or subjected to 'compulsory psychiatric treatment' only after a period of time of incarceration. In contrast, I had the priviledge of working in a far more advanced American system in which a lawyer was assigned immediately to anyone who requested legal aid at the point of 'compulsory psychiatric care'. This system worked far better than our system here. Not ironically patients were more cooperative from the outset because they had met with counsel and judges in these situations and understood the reasons for the 'compulsory care' and saw it as a 'state' function rather than a 'medical' one. Their alliance to the psychiatrists and psychaitric system was maintained. Further abuses by families and by the state were nipped in the bud. Nothing like a good lawyer to protect a person who is being abused by their community especially given that psychiatrists in general have a very limitted understanding of civil liberties and sometimes tend to ridicule the likes of psychiatrist Thomas Szasz or find the patient's movements more a threat than an adjunct to the best quality of care. These legal precautions further ensure that those who aren't don't find themselves falsely labelled as such and if a mistake is made in maintaining a person's freedom it's a judicial decision given the weight this system routinely gives to considerations that can impact community safety.

Sunday, October 25, 2009

Moving III

The movers came and I didn't have boxes for the contents of the bureaus and book cases. So the clothes, books and stuff got dumped on the floor. I'll be sorting and filing them today. I was lucky to find my lap top this morning and a tv dinner table to set it on. I'm convinced the landlord is selling tickets and showing interested parties, "how a psychiatrist lives".
It's taken a week of moving to arrive at a state of disorder I routinely see in adolescent bedrooms. I have never lived like this. It would take a highly ordered rigid mind and vast memory to exist in this chaos.
Meanwhile my mother in heaven has all the angels looking down on me right now and she's telling them, "I knew he would come to this. I was always reminding him to clean up his room when he was 5. It was just a matter of time."
Yesterday I found the source of the little moths in the storage locker. I had a persian rug there and the little beggars had found it scrumptuous. Everything changes. Everything deteriorates. If we don't care for it regularly it will return to nature. Entropy. Lack of love. So much for possessions. Thoreau had a lot of good advice.
And all the obsolete electronics. They get to me. Zip drives. I look at the old cd's and movies though and hope to have the time to listen and watch. Memory lane. It's often said that people in third world countries are happier than we are and I can see that they're not cluttered and distracted by 'stuff'.
A simple life is a freer and necessarily happier life. Montaigne, Cicero and others have spoken to the need for 'less' rather than "more" , so there's time for friends and sacred solitude. Things too often stand in the way of relationships.
Yet I loved oiling these old cabinets which reminded me of Persig's, Zen and the Art of Motorcycle Maintenance. The joy is not in the accumulation but rather the caring for. My new motto is that if I'm not willing to dust I'm not going to have brick brack. If I'm not going to polish, I don't have silver. Sadly there's little time for the caring these days and it's hard to make the time. I'm sufficiently caught up in my boat and motorcycle and the myriad tasks of office work life that I can make little time for polishing. Yet without polishing, dusting and caring 'stuff' deteriorates.
Today I ask why do I need 6 chess boards? How come I have 4 guitars? Do I really need 3 laptops and 2 VCR's. Of course there's the principle of back up. And my one Weber barbecue didn't work the night of the dinner party so I got another one and now I've fixed the first one. Everyone tells me to use eBay and Craig's List. Make the time.

But it's really my parents fault. Raising me in a home they kept for 50 years gave me a false sense of permanence. Having the basement and the attic taught me terrible things that have impeded my development for years. If they had only moved like modern people and had no basements and attic I would have been prepared for this existence. The modern person moves on average every 5 years. I'm a victim of being brought up in the age of suburban culture.

Settle down. Don't get yourself worked up. You know this is just a way justifying pouring the gasoline out of one of your 2 honda generators and torching all the files and discs and clothes on the floor. You've already phoned friends. They will be here shortly. You will get through this. Take deep breaths. Pray. Say mantras. Screaming uncontrollably from a fetal position is not going to get the clothes in the suitcases. Stop shaking. Friends are coming.
I know you said you'd never own another thing when you first moved 35 years ago but you forget. You said you'd never move again several moves back but you forget. It's like love. You'll never going to do it again and then you forget. Face it, the next move could be worse still. Enjoy this one. You're getting older. At least you've stopped buying the 3 ton furniture.
Too bad your friends smoked back then. That great idea you had in the 70's for inflatable furniture might work today. Didn't last that first party. Everyone sitting on plastic on the floor an hour into the party. None of your friends smoke today so consider next time the inflatables. That's just another thing the tobacco companies should pay for, all the inflatable furniture cigarettes have killed over the years.
I think the futon frame you gave away yesterday is the 5th or 6th one you've given away over the years so buy the cheapest one next time instead of the fancy ones. At least you don't have a water bed anymore.
Hold on. You're going to have to pay for running your head through the wall. Some one is going to have to pay for the plastering if you continue head banging. Go back to the fetal position. You'll get through this.
You can't do drugs. They don't make things any better. Remember that move your friends and you drank and smoked dope on and you decided the stairs were way too long and that they were moving with snakes on them so you threw the stuff off the 5th floor balcony. Then you had to deal with your ex wife's response to all the carpets and clothes on the lawn. Something about her not being happy finding a bra hanging on the branch of the neighbours tree. Dumping the drawers over the balcony always seems like a good idea after a joint. But it wasn't any good , was it?
So don't throw your stuff off the 17th floor today. Besides the dumpster divers would be on it like flies on shit today thinking it was raining manna from heaven.
Wait, your friends will be here soon. They'll bungee cord you to a chair and put something in your mouth so you stop chewing on your tongue. Just keep away from the balcony and gasoline until they come.
It will be over soon. You've moved many times before and you know it's always so much better when it's over. You'll get through this move too. Now put down the axe and don't go chopping up the furniture into smaller pieces to more easily chuck it off the balcony.
This is all God's plan to teach you patience and serenity. How do you think you'll learn these things without opportunities to test all your training. All that meditation and prayer and sitting cross legged. No you can't get your money back. Imagine what state you'd be in today without all that behind you.
The tv will not survive being thrown from the 17th floor. Put it down and go back to the fetal position. Now isn't that better. Just keep sucking on blankie till your friends arrive.

Saturday, October 24, 2009

Boundaries, Ethics and Professionalism

I just completed the two day workshop on Boundaries, Ethics and Professionalism offered by the College of Physicians and Surgeons of BC. Dr. Glen Gabbard, internationally reknown psychiatrist and author of Psychotherapeutic Treatments and the classic work Boundaries in Psychoanalysis and Dr. Maureen Piercy, Deputy Registrar of the CP&SBC chaired the meeting with facilitators from colleges across Canada. About 50 doctors attended and the workshop took place in the very pleasant offices of the College.
If one gets around the idea that everyone in our society now needs a lawyer and an administrator to accompany them in every human interaction to avoid complaint or lawsuit, (accepting these normally socially immature professionals ie lawyers and administrators ,who without their professional power couldn't 'relate' their way out of a wet paper bag,) then the workshop was very good. The idea however that these "protected" and "priviledged personnel" who make the laws and are commonly above the laws are needed in 99% of relationships between doctors and patients to protect the 1% of patients from the much fewer than 1% of doctors who have problems is central. Further the type of problem is rarely anything of great significance to the patients life and overall well being. But then police are more often tax collectors than chasers of murderers and thieves.
Metaphorically, if we accept that Saddam Hussein's poor treatment of the Kurds justified the invasion of a soveriegn country, overall destruction of that country and the removal of their oil and wealth then perhaps its understandable the many must suffer for the few. So line up 10 random people from the village on the hour and shoot them because there's a bad one withholding information and helping terrorists somewhere. The fallacy of this argument is 'the ends against the middle". It's the great poison of our present times.
My tendency therefore was to see Dr. Gabbard and Dr. Piercy as the problem, capitalizing on this new industry which costs physicians onerously and ruins collectively the doctor patient relationship. I had chosen to attend the workshop as a necessary evil in these insane times. Boundaries and such ideas promised to replace natural and well accepted "norms" with new codified and 'artificial' agendas based on political correctness (ie social communism) and often driven by radical feminism. As one sexist leader commented, "we're past the days of patriarchy" and I had to object to that language, saying I personally refer to the 50's as the age of "parentalism" and our present day as the age of 'individualism". Sexism cuts both ways and the College actually did a very good job of being gender neutral as well as acknowledging the Gay Lesbian and Trangendered person specific issues.
However I have a tendency to paranoia when it comes to the State these days after they developed weapons to wipe out the whole of human race, are jailing everyone willy nilly and have an army of brownshirts called 'homeland security'. Freud did say, "maybe the paranoids are right."
That said the conference was excellent in advising physicians of the new "laws" and the new "guidelines" and warning us collectively how to avoid what Dr. Gabbard aptly called the 'daily minefields." This included how to avoid entrapment by patients, how to recognise sexual advances of patients as well as how to protect patients, how to recognise personal risk factors and how to ensure patients got the best care intended. It was clear throughout that everyone there was a doctor and that individually and collectively that we'd gathered here for this workshop to help patients get the best care, and help us as physicians to help them. Dr. Piercey did a superb job of keeping this idea central when it must be remembered that the College of Physicians and Surgeons is in many ways like Internal Affairs of Police. We all know from cop shows what cops feel about Internal Affairs. They're usually in bed with the corrupt mayor's office and screw up the anti heros like Clint Eastwood.
A major part and extremely valuable set of lessons lay in the prevention strategies and the early recognition of being at risk. Times had changed a great deal since I started medicine 25 years ago and multiculturalism, media induced fear mongering, increasing costs, decreasing resources, long waitlists, and the internet had all impacted on the practice of medicine.
Unfortunately discussions of perfectionist doctors and doctor burn out and doctors cherry picking patients while the rest of the doctors did the lion's share of difficult work didn't offer any real strategies for change but more of the usual platitudes. One always has the feeling that people are out of touch with the trenches when they say "refer patients to other doctors," 'refuse referrals', "tell patients you're uncomfortable and unwilling to do certain things", "refuse services" , "talk softly with patients threatening your life" and "tell women who are walking about in lacey bras to put their clothes back on." It all sounds so 'academic' but I couldn't help but remember how much more difficult it was disarming a big guy swinging an axe at my head and how angry the psychotic woman became when I asked her to put her clothes back on and said I couldn't 'accept the shirt off her back' as a gift. Further there's no one else to see patients and when you refuse to see a patient you're often the 'end resource' since so many patients in Canada can't see a family physician and waitlists for psychiatric consultations are months. Sometimes patients can wait years before a psychiatrist is available to do therapy and no one is arresting the administrators and politicians who are taking the money that tax payers are giving for health care but which goes anywhere but.
The critical factor was that this meeting was 'blame the doctor' in only that sense. More so it addressed how the doctor could survive in a nightmare war zone of high patient expectations and horrendous lack of health care resources.
A key discussion that was extremely useful was the ethical consideration of intent versus outcome. An interesting clinical example used in small group discussion was of a male Ear Nose and Throat Surgeon listening to a woman's heart under her blouse and her complaining he'd been sexual. All the doctors understood the need for the exam and none felt he was anything but a good doctor but we all equally understood a woman in for sinusitis examination wouldn't understand the need for stethescope auscultation under her blouse. (ie touching her left breast). As one doctor said, too many people were watching doctor shows where for family television the stethescope is placed over the clothing and besides to the patient what would a chest exam have to do with sinusitis. We knew but we understood very well how the poor patient would be confused. Collectively we all realized we needed to be more willing to explain as we went along what in fact was the reason for various procedures.
Dr. Piercy gave an excellent review of a kaboodle of such examples of physical examination mishaps which at times had the group of us laughing or crying considering the misperceptions implicit and how a complaint would arise.
Dr. Gabbard's presentation had excellent clips from movies showing problems that even Hollywood had picked up on. From my point of view his best recommendation though was ," When in doubt, act human".
In the end that was the key message that the College presentation was trying to get accross. A colleague recently said that he now had so much paper work that he hardly could look at the patient but the patient couldn't possibly know what expectations the College, the law and the clinical charting record required. Among the clinical doctors everyone expressed their sense of pressure and overwork and frustration with the payment schedules which didn't in any way acknowledge the increased 'documentation' demands by government. However one clinician did say that the salaried doctors were being given time and paid for these activities allowing them to focus once again on the patients. This hasn't translated to private practice yet but it certainly provided a ray of hope for us in the front lines.
Both Dr. Gabbard and Dr. Piercy covered well the concerns with impairment in physicians with regard to drug and alcohol abuse. It was clear that early warnings could lead to early prevention and appropriate intervention appreciated by the doctors and protective of patients. Dr. Gabbard, Dr. Piercy and the BC Physician's Health Program were all committed to keeping doctors working while clearly ensuring safety for the patients.
While discussion of the predatory sexually exploitative male doctor was addressed the course did an equally good job on looking at the more common female physician problem of material exploitation of patients, the acceptance of extravagant gifts, innappropriate business adventures etc.
It was made clear too that the fiduciary relationship of doctor and patient excluded sex entirely and that "love" wasn't ever enough despite the all the songs. As Dr. Gabbard made clear Ethics is about behaviour and while sexual relations (despite Clinton's idea on the subject) were behaviour, love wasn't.
The difficulties of the small rural practitioners were well addressed with everyone being their patients and all relationships being in many ways enmeshed. Some excellent guidelines came out of the lecture and small group materials, while physicians themselves had an opportunity to express their concerns and share ideas about solutions. I was delighted to hear how other psychiatrists and addictionists dealt with problems I'd thought at times I alone was facing.
Representatives of the Physician Health Program were present and gave some excellent suggestions as well. Dr. Gabbard encouraged consultation and colleagial discussions as well as mentorship and joining local physician focus groups. Both he and Dr. Piercy recommended early consultation with a colleague, even if just by phone or email, of any difficult situations or patients. Certainly I've phoned the College and the Canadian Medical Protective Association and found them to be extremely helpful in 'sticky' stituations. Belonging to 'cyberdocs' an on line international physician support group has been extremely beneficial for me as well. I was delighted to hear that the addiction doctor attached to Physician Health was wanting to locally form a group for those of us working with addicted patients.
Amazingly Dr. Piercy and Dr. Gabbard and all those on the faculty became less a part of the problem than a real source of solutions as the workshop went on. Both Dr. Piercy and Dr. Gabbard disclosed amusing stories of their own short comings and how they'd handled difficult clinical situations, if not in the best way, at least humanly.
Society may well be going to hell in a handbasket with litigiousness and more than 60% of health care costs being legal and administration. Alot of the ideas presented however were just good medicine and got to the crux of difficulties that arose between patients and doctors. Dr. Piercy won us all over when she finally described a pair of predatory patients working in tandem to hustle doctors and the talk moved to the male patient masturbating on the female physicians. I remembered my hostile patient threatening me and me thinking there must be limits on what a doctor is expected to do in psychiatry. 50% of psychiatric residents were still being physically injured in their training. One day soon it appeared that patients would be more accountable and responsible for their health and behaviour when they weren't acutely ill or psychotic but just bullying or behaving rather badly. The one sided idea of the all powerful doctor and the poor little female waif patient may one day be more balanced.
As it stands the message is that the doctor must act professionally and humanely. Considering that in psychiatry often the "behaviour is the disease' it's well warranted but that doesn't get around the profit motives and hidden agendas of some patients who are more sociopathic than sick and the complaints process costs physicians dearly in time and resources that otherwise would be put to patient care.
I suspect this will come when there are more complaints against lawyers and administrators and they get their own back.

Dr. Piercey and the College of Physicians and Surgeons are to be congratulated for putting on a really fine workshop. It's always great to hear Dr. Gabbard. The organization was terrific and interactive small groups very well facilitated. The catering was superb with great soups and sandwiches, lots of fruit, yogurt and finally Hagen daz ice cream bars. Not one participant was taken into a side room and tortured to rat on other physicians and the taster I employed assured me that the food did not contain any salt petre or long acting psychiatric medications. Indeed it was a most helpful workshop and would benefit most doctors working with patients today.

New Day

Violet clouds slip slowly down a dark blue sky
As thin light streaks in from the eastern edge.
It's a new day, ripe with promise and hope
My heart soars to meet the rising sun.
Peace on earth, good will to all men.
Is this the day the messiah will come?
May I find enlightenment among multitudes,
Understand the meaning of this universe,
Know love for one and for all
Unconditional and forever.
Forgive you and be forgiven.
Laugh till tears stream freely down my cheeks,
Ascending whatever ladder I can reach.
Let the sky fill with angels singing Hosanah,
And guns and missiles be turned into plows forever.
Spaceships streaking across the galaxies
Underwater villages exploring the deep,
No chronic pain or misery,
Disease free and longevity assured.
A fountain of youth with fusion energy for all.
This is the day of Revelation.
This is the day of Grace.
This is the day of infinite possibilities.
Lets embrace the best for all.
Hallelujah! Hallelujah! Hallelujah!

Friday, October 23, 2009


Liberty is so hard to have and so easy to lose.

"Liberty is liberty, not equality or fairness or justice or human happiness or quiet conscience."
Isaiah Berlin

"The people never give up their liberties except under some delusion." Edmund Burke

"The condition upon which God had given liberty to man is eternal vigilance." John Philpot Curran

"Freedom is always and exclusively freedom for the one who thinks differently" Rosa Luxemburg

"What is freedom of expression? Without the freedom to offend, it ceases to exist." Salmon Rusdie

"A free soceity is a society where it is safe to be unpopular." Adlai Stevenson

"You can calculate the worth of a man by the number of his enemies, and the importance of a a work of art by the harm that is spoken of it." Gustave Flaubert

"Better to have him inside the tent pissing out, than outside pissing in." Lyndon Johnson

"Those who are caught in mental cages can often picture freedom, it just has no attractive power." Iris Murdock

"Politics is the art of preventing people from taking part in affairs which properly concern them."
Paul Valery

"A liberal is a conservative whose been arrested." Tom Wolfe.

"I always had the impression that real militants are like cleaning women, doing a thankless, daily but necessary job." Francois Truffaut.

"The citizen's first duty is unrest." Gunter Grass

"Never forget that only dead fish swim with the stream." Malcolm Muggeridge

"Without deviation from the norm, progress is not possible." Frank Zappa.

"Is it progress if a cannibal uses knife and fork." Stanislav Lec

The Disruptive Person

If you are not a team player,
And object to the killing of innoscent babies,
Or say that your corporation shouldn't pollute the water for profit,
Or god forbid, are a whistleblower ,
And point the finger successfully at those killing who should be healing
Or those taking kickbacks and are corrupt,
Then we have a new name for you:
Disruptive person, (pants on fire, poopoo butt, pissy face)
And soon we'll have a pill and
Justification for incarceration.
You disruptive person, you!
Bad boy. Naughty girl.
Not a team player!
Won't take a little money to be quiet like the rest of us,
Won't agree the ends justify the means.
Won't see it our way.Just don't get it.
Either you're with us or agin us.
Skeptical is next to cynical,
But what we need is your total agreement.
Are you willing to lie, cheat, maim, corrupt, kill, gas, and self immolate?
Are you loyal? Do you love God? Do you love your country and your corporation?
Do you love your parents? Do you love children?
Do you love fast food and nuclear weapons?
Do you love pollution and central authority and prisons for profit?
Do you love health care and cosmetic surgery for the rich and powerful?
Do you love slums and gated communities?
Or are you a disruptive person, poopoo butt, pissy face.
Well what are you? Pants on fire!

Boundary Crossings

Once you accept that there is a boundary and not a membrane
And you except that a crossing has been made
Rather than a transfer.
Then you're well out of the realm of science,
And deeply in the mire of politics.
So don't talk of truth,
But lets just agree to pick the best liar
And be done with it.
Politics is about picking the least bad alternative
While the last I looked
The sciences were still about picking the best.

Professional Boundaries

1. Dress professionally. For men this is a 3 piece suit with tie, preferrably a tuxedo. Golf shirts are now out. Women should wear burkas. The transition to this apparel will be gradual and will begin with pant suits and otherwise total body covering. No cleavage or legs and certainly no 'tight' burkas. There is no aggreement on what is "professional" however it is understood that there are those who are dressing 'unproprofessionally'. Possibly tattoos. Possibly earrings and other piercings. Shorts have to my mind always been unprofessional and men wearing shorts will be summarily dismissed. Clearly those who object to long hair on men and short hair on women will be more likely to define 'professional' and their complaints will hold the greatest sway. Possibly the "hidden majority" could express themselves regarding the continued militarization of society and the insecurity of the class structures that demand rigid codes of dress. That said, if our colleagues were going to work in underwear , we'd be expected to do the same, so we should be thankful. God forbid though we're increasingly being expected to dress like politicians and used car salesmen.
2. Behave appropriately. There is no clear definition of appropriate and all are guilty until proven innoscent in the court room of political correctness and popularity however being 'appropriate' is critical to be professional. When the leader says kill we must chant kill in unison and if he says peace we must chant peace in unison. As King Lear pointed out this 'courtly' behaviour is wholly dependent on proximity to the throne and those who are most stylishly appropriate in all things are those most courtly. Note that substance is out and superficiality is in. Think media and sound bites. Rich are appropriate. Powerful are appropriate. Poor are innappropriate. Weak are innappropriate. America is appropriate. Africa is innappropriate. First world is appropriate. Third world is innappropriate. Urban is appropriate. Rural is innappropriate etc. I'm appropriate. You're innappropriate. You get the picture.
3. Don't talk about sex, ask about sex, mention sex, or even treat sex. Sex is out. Out. Out. Out. All women to be seen by women and lesbians by lesbians and all men by men and homosexuals by homosexuals. Otherwise you risk complaint. No sex, please, we're English. Don't touch genitals. Don't look at genitals. Don't discuss genitals. It is better for patients to die of breast cancers with unexamined breasts, pelvic cancers for unexamined pelvis, rectal cancer for unexamined rectums and kill themselves keeping the secret of their sexual abuse or rape,impotence or sexual addiction than that a professional risk his income and career and reputation by having a sex discussion. Thinking about sex is bad. Talking about sex is evil and doing anything sexual is harrassment. Indeed the smart professional will hence forth self castrate male and female and gay and run out of the room if anyone mentions sex within a hundred mile radius.
If sexual discussion is inevitable there must be chaperones. Chaperones are special paid and trained individuals who must be taught to watch the genitals and other sexual parts while professionals look elsewhere and touch elsewhere. A special screen with a hole for examination will be required in every examination room. Further there will be no direct converation between clients and professionals of different sexual preference but rather there will be person of the same sexual preference who can relay communication of the profession to the vulnerable one so that sensitivity will be maintained.
As one radical feminist pointed out, the laws of political correctness are indeed Victorianism but for the right reasons. It's not just that women must be protected but men must be too. And don't forget the children.
All professionals are rabid sex crazed psychopaths and the public must be protected from sexual congress among themselves as well as discussing even that with professional. Discussing sex is unprofessional even for sexual professional. It doesn't matter that most professionals are too old or too burnt out for sex and frankly bored by sexual conversations, the law of the 'ends against the middle' prevails and a homeland security units will be necessary soon to accompany and protect every client from the potential sexual advances on all professional visits. The war against drugs may have been lost and no weapons of mass destruction found but the war against professionals must soon begin to employ all the personnell left over from previous silly engagements.
Sex is out. Out. Out. Out. Meanwhile while it's 'innappropriate' and "unprofessional" to discuss sex, and anything related to fertility, reproduction and especially passion, it's highly encouraged to discuss euthanasia, abortion and death. Sex for pleasure is out too. Indeed anything remotely sexual is out even if it's a lotus blossom or cucumber. We are no longer alive culture but a dead culture.Death is in, Sex is out, out, out, out!!!
No sex please, we're English, well multi cultural Canadian and sensitive to everything but sex.
In French Quebec sex however is okay, encouraged even, and those who do not act or do anything sexual are considered behaving in an English manner and are promptly investigated by the French cultural police.
No jokes. Sexual jokes are certainly out. Warrants will hence forth be issued for examination of all professional hard drives on suspicion of sexual humor while of course confidentiality must be maintained by the professional. Hard drives obtained for sexual purposes will of course be scanned confidentially for all other purposes.

Don't laugh. Laughter is unprofessional. We're watching you. Yes, you. And no we're not looking at your genitals. Our chaperones are doing that. So be professional and act appropriate and bend over. What we're doing is not sexual. It's just inevitable, so you might as well enjoy it. We're already doing it to your clients.

Thursday, October 22, 2009


Tendrils of light weaving up through the clouds
Waking hulking buildings of glass and steel
Animating them with colour
Toy Cars wind slowly in lines below, head lights still on
As cyclists speed past congestion.
The cat is proud she has woken me again
And ingeniously acquired a can opener.
The coffee is tasting good as a warm shower beckons.
I am infinitely grateful for these brief mercies.
Soon I'll be in the morning and the day will take me
Sucking me into the bedlam of expectations
And eternity of routine.
There will never be time enough
But dusk will come and darkness will follow
And so much will be left undone,
Especially the impossibilities.
Till again I pray alone
For the promise of dawn.
The sun has risen.

Wednesday, October 21, 2009


You said how much you loved men who cried
And I thought you were so sensitive and loving
Before I knew you used men's tears
To judge how much blood they had.

And when you left I had no more tears.
And the note read, "Happy Halloween!"


Cheaters written and directed by John Stockwell is a quiet genius of a movie. Maybe that's because the story is about the 1995 Steinmetz High Academic Decathalon Cheating Scandal in which the lower class students obtained the tests before competing with the upper class schools going onto win the Illinois Championship only to be exposed for 'cheating'. The movie depicts the 'fixed' unfair nature of these 'competitions' and exposes the 'cheating' that pervades modern American society. Highest paid lawyers admit to cheating as Presidential lying is exposed verbatim. The question asked, is do the public schools prepare people for "real" 'corporate America' or perpetuate the class rule by promoting one Biblical interpretation for the lower classes and a different for the upper classes. Written in 2000 it's more true today in light of the epidemic of 'cheating' by the leaders of American society and the lies of 9-11 and the Iraq invasion. For America to maintain it's reign begun in moral and spiritual high ground will it need to persist in it's barbaric devolution or will it maintain it's place by ascending out of it's recent pitiful mire. Jeff Daniels portrayal of Dr. Gerard Plecki is sensitive, powerful and believable. Jena Malone playing a brilliant student ring leader Jolie Fitch is sensational, sexy in that special smart girl way while oozing innoscence and impish rebellion. All the actors and actresses are amazing in this moving film intimately bringing home the terrible angst of adolescence without camp and truthfully portraying teachers and students in these most difficult years. John Stockwell has captured so much in this film.

The United States Academic Decathalon is itself a remarkable achievement. Developed by Robert Peterson of Orange County in 1968 it became nationwide in 1981. It's original plan was not only to provide an academic competition for high achievers but also encourage participation from the C level students. The ten events are art, economics. language and literature, math, music, science and social sciences. In addition to multiple choice tests the judges grade essay, interview and speech.

In many ways the movie reminded me of my undergraduate and medical school study and exam experience. I didn't cheat but had class mates who did. One particular student was infamous for roaming the city and literally stealing all the library books that were necessary for any given assignment. Where does one draw the line at 'unfair advantage'.
Forming study groups I had the advantage of benefitting from the collective wisdom of our group. Were it not for this I'd not have learned of the national "exam" reservoir or even contributed to it. Old exams existed and we prepared by these but accross the country students like myself wrote down what questions we remembered after our exam and sent them off to the be re distributed to the next year's students. The idea was that there was a fairly standard bank of questions and by preparing using these questions we stood a good chance of covering material that was likely to be examined. Commercial booklets were sold that did the same but the banks of questions which students distributed were the best.
At the time I thought "we all know of this" and were clever but in fact the isolated students would most likely not have. I only learned of the 'study guides' that were commercially available when I was overwhelmed by trying to study the text that the professors gave us, the collected reading "required' being inconsiderately more than an individual life time. When the class divided and we had lecturers I had a major dimwit one semester while I lucked out on a good one next. Insider trading of information about the quality of staff was just one of many things that could impact profoundly on one's success.
My ex wife had the benefit of my having done all the exams before her and naturally sharing as much information as I could. Half the students had family who were doctors so had a differential advantage, many being raised in medical terminology which was another language to the minority of us who didn't have family or work experience in medical fields before entry.
I did knew of one person who attempted to use 'social position' to sway a medical judge in an oral exam only to be failed by the woman doctor who having worked hard to achieve her own place wasn't about to share it based on supposed "blue blood " line. Her position in medicine was more important to her than her position at the country club.
Meanwhile in retrospect most of the examinations and studies were sound and when I went out into country and general practice I was deeply thankful to my teachers for their thorough preparation of me for real medicine where I was alone facing gunshot wounds, myocardial infarctions, kidney failures, massive auto accident and industrial trauma , breech deliveries and all the horrors and surprises that medicine is. Four years before I would have been a danger to self and others in 99% of these situations and thanks to my medical school and the faculty and examinations I was prepared for the daily life and death encounters and we survived.

I can only think that the students who participate in the Academic Decathalons would be even better prepared.

Today I heard a professor tell me he'd told his students that they experienced a rush for mid terms and then could look forward to a break and then another rush for finals which he hoped would prepare them for the daily mid term and final exam experience of the real world professional life.

Aint that the truth! I thought, remembering how 'unfair' it was that I was up all night delivering babies sick with the flu myself and doing a final exam with no sleep in 36 hours. Not a year later I was thankful for that experience as I spent days and nights without sleep with nurses working beside me during a meningitis epidemic on an Indian reserve.

As to cheating, I always remember this other kid in elementary school trying to trip me when I was passing him in a race. I saw the terror and shame and failure in his eyes. I passed him but I knew that in trying to trip me he'd forfeited the race to me. He knew I was a better runner. It didn't matter what the outcome was after that. On the other hand if you believe that the guy with the most toys and the stupidest plastic surgery barbie is the winner, maybe cheaters do win. There are however some toys I would certainly appreciate and could use a nip and tuck myself.

In the movie Grand Canyon, 1991 Mack is played by Kevin Kline while Danny Glover plays Simon the tow truck driver being held up Rockstar played by Shaun Baker. They shares these immortal lines:
Grand Canyon (1991)
Simon: This neighborhood is gone to shit.
Mack: This country is gone to shit.

Simon: I've gotta ask you for a favor. Let me go my way here. This truck's my responsibility, and now that the car's hooked up to it, it's my responsibility too.
Rocstar: Do you think I'm stupid? Just answer that question first.
Simon: Look, I don't know nothing about you; you don't know nothing about me. I don't know if you're stupid, or some kind of genius. All I know is that I need to get out of here, and you got the gun. So I'm asking you, for the second time, let me go my way here.
Rocstar: I'm gonna grant you that favor, and I'm gonna expect you to remember it if we ever meet again. But tell me this, are you asking me as a sign of respect, or are you asking because I've got the gun?
Simon: Man, the world ain't supposed to work like this. I mean, maybe you don't know that yet. I'm supposed to be able to do my job without having to ask you if I can. That dude is supposed to be able to wait with his car without you ripping him off. Everything is supposed to be different than it is.
Rocstar: So what's your answer?
Simon: You ain't got the gun, we ain't having this conversation.
Rocstar: That's what I thought: no gun, no respect. That's why I always got the gun.

When I was young and omnipotential with straight A's in arts and science, as likely to be a succes in banking, law, medicine as any one of the professions I chose medicine. I was gymnast,martial artist and street fighter, well trained in wilderness survival, weapons and hunting. I could have as easily excelled in the military, become a mercenary or a terrorist but I chose academia. I even specialized. But for a society to have specialization and academics and doctors they have to be willing to protect them. I don't feel safe today. Fewer do in this society. The cheaters and liars never did feel safe or know peace so they're doing even more cheating and lying. Just as the bullies are doing more bullying.

As Simon says. "Everything is supposed to be different."