Saturday, July 21, 2012

SV Giri at dock - Journal

Yesterday my lip swelled up like I'd had botox injection before a Mick Jagger look alike contest. Cellulitis.  I took antibiotics and antiiflammatories after a couple of days and increasing pain.  Now the tide's turned and I'm not having fluid slide out of the side of my mouth when I drink soda from a can.  If I had silicone breasts or penis enlargement or botox lips I'd expect I'd get used to it. Like those supposedly primitive people who started the trend putting plates in their lips and 'enhanced' their bodies with equally sublime entertainment. I'm just thankful for the antibiotics.  Being Mick Jagger isn't all it's cut out to be.
The boat is gently rocking. The sun has come out. My mood is better. I've finished reading the western novel I picked up. Nothing like Robert B. Parker to uplift one.  I'm drinking a Sanpellegrino blood orange beverage. Laura is in the head cleaning herself. She just cleaned the freezer after my friends working here let meat and whatever else spoil in it.  I have to get a refridgerator guy down here to look at the wiring and also add more junk to the compressor. I've done this a couple of times myself in the past.  Right now I have a report due for  work and 5 hours of a course to complete.  I'm bushed with another sick weekend wondering when I'll have a holiday without being sick.  Commiserated with a patient last week who had used up her vacation time as sick time after her sick time had run out.  Remember when I was in India and found out that people generally got 2 weeks off and if they weren't better someone else got their job.
Thousands more into the boat.  Boat world: "If you think about buying a boat, first stand in a shower tearing up $100 bills and watching them go down the drain. If you like the experience you'll be ready to buy a boat."
I was at the Mosquito Creek Marina yesterday.  We drove the boat back here after it had been on the hard getting the shaft seals replaced along with the bottom zincs with new epoxy and antifouling done.  Boat was back at it's regular cruising speed and handling like a ship not a barge.  I felt comfortable in the Mosquito Creek Marina.  It's a community. Here I'm in an industrial site.  No restrictions on boat work so it's fine for now but I miss the community "out of the city in the city" feel that goes with the recreational marinas.
So much I could be doing on the boat.  Top decks need a new paint job. All the ropes need cleaning. The netting and lines around the boat need repair and cleaning. Even the upholstery in the boat would benefit from some replacement where the cat's claws have done their damage. I do miss Angel at times .
As soon as one thing is fixed a dozen other things that need improvement come to mind. Mostly it's the cosmetics now. The main functional boat improvements have been taken care of these last couple of years.
Gilbert is stretching.  I was up at 4:30 am with a sore mouth and took him for a walk on the dock. He pooped and returned feeling better. I read until noon and napped.  I made toast early and ate this marvellous Sechelt jam on toast I was given.  Later Laura made fried egg sandwiches.  It's good to hear from my brother Ron that Dad is better. I like seeing what the nephews are up to on Facebook  Andrew is up near the arctic and Graham is making movies out east, doing a day of shopping with Allan.
We've talked about going to Canadian tire today.  We'd planned to be out on the water but the heavy rain deterred us. Then tomorrow there's a service for the newcomers who have joined the church. I'm one of those , changing churches last year, because this church welcomed my working dog, Gilbert. I thought I should come up to the altar and accept the welcome.  Having attention placed on me almost caused me to consider joining another church but it's purely voluntary.  It's the least I can do.  I tend to just be thankful there's a place to go that's welcoming.  I've participated in churches alot in the past, held roles and taken office but these days it's all I can do to make as many services as I can and be thankful. I feel it's a daily battle to be a doctor in Canada, it takes all my energy, so it's hard  to get out in public on the weekend.  The anger, entitlement and fear is palpable these days with the growing economic crisis.
Two more people were belligerent and threatening last week.  One didn't pass a urine test and proceded to blame me for their using drugs.  Very hostile threatening, lots of swearing and calling me down. I was exhausted.  It's all you can do to get out of the room to safety.  They know they can hit you and yet if you hit back you're in trouble, even in self defence.  The government living in another galaxy and another time zone protected by denial and pomposity blame you for 'upsetting' patients. At the same time you have to inform them their urine is 'positive' and that there are consequences. That's when they take it personally and figure if they shout and swear and slam doors they will change your reaction. It doesn't but it always reminds me  of the times I've been hit practising medicine outside of the boardroom, the kickings and the punches,  the time I was held hostage, the time my dog was murdered and the days my windows were shot out or the late night phone calls and phone threats.  It's part of the work. If a person's job, or freedom depends on their not being on drugs and they use they tend to 'blame the messenger'.  The trouble is the 'system' especially the 'authorities', those so far removed from reality they can't find their ass, blame you too.  It's the same with the guys I've committed to hospital. They've come out and accuse me of 'ruining their lives' but I've committed them because they were threatening to 'gut' their girlfriend because their God to them to, or that they were going to kill their boss or the  prime minister.  At these times I miss being a family physician and certainly miss the days of being a psychotherapist to the rich and powerful.
I 'm exhausted in moments by the desire to just walk away or go one on one with them. Thankfully this day the other doctors I was working with were having their bad days as well with one telling me "my guy walked out shouting I was a lousy doctor because I had too many patients and couldn't work fast enough so kept him waiting'.  The other guy had had a relapse too and this guy had blamed the doctor. It would be funny it's so predictable.  The psychosis of drug addiction is that it's everyone else's fault.  And there are all those people protected miles from reality who actually believe that if these people had the right drug or the doctor 'listened' to them, they'd suddenly be better.  I watched this show about women who want murderers and rapists for lovers and stalk them when they're in prison.  When you work like I do saniety is rarer but it's the administration that are sickest because they're so ignorant but grandiose and pompous in their utter stupidity.  They actually believe their lies.
Then the fellow who abused my secretary for my running late,said I was 'just shuffling papers ' and 'disrespected him for not being right on time."  20 minutes.  I try to explain to people that half the people I'm seeing today, a few years back would have been in an institution. That day I'd had a guy threatening to kill himself and everyone else and I'd gone a half hour over ensuring myself that as in all the other times he's been like this it's not serious.  Since I sent another guy to St. Paul's Hospital emergency a couple of months back, he'd said he was suicidal and  jumped in front of the bus , they just discharged him an hour later regardless of his risk to himself or everyone on the bus, I've been a bit overwhelmed by these kinds of threats. Nobody cares anymore.
So many patients talk violence either suicide or homicide and it's a harder and harder call to assess risk  especially when the next visit may be three months away. It was a whole different game when I saw people twice weekly or had some spare time I could see a person in again. All my spare space now is taken up with acutely suicidal people who are facing some crisis or other. I'm trying to change medications in the community with people on a dozen pills seeing half as many specialists and know that at the university they'd never do this sort of thing in the community. It's such an ivory tower with the College who condemns all the doctors and is above the law themselves smug in their superiority.  I miss the old guys who knew what it was like in reality. More and more my compatriots are leaving.  Pharmacists are dispensing medicine.  Doctors right out of school with next to no experience, real experience that is, are going into upper echelon beaurocratic positions because they know not to 'rock the boat' and want a 'safe job'. No one has any time for patients. Those who do are either the 'enemy' or the 'target'.  Not surprising so many doctors now either work with a lawyer at their side or a bodyguard.
I loved hearing the American nobel prize winner for literature say, to paraphrase "I remember when everyone was a citizen, then we became just consumers , and now we're only taxpayers, and that's not even said in a positive way."
Of course I could cherry pick and treat the worried well or go where the money, fame and priviledge is.  The new young doctors are opting for all the 30 hour week salaried glory work but this work I'm doing is really more rewarding.  To actually turn around a suicidal patient and see them get off the death road and take the life path is redemptive.  I corresponded with a woman I saw 20 years ago who'd spent a year suicidal till I met with her and spent weeks with her and her family. She's an amazing woman today.  I love getting the alcoholics and addicts out of the slavery and bondage. It's a miracle. It's like watching a Lazarus experience. I'm where I can help but the bad days are bad.  The sex addicts are a different lot too. Increasingly ,there's always the law sitting right there threatening to throw the doctor in jail if he doesn't protect society. I reported a man whose woman said he had sexually abused his child and now I'm being sued for relaying the woman and child's concern. Some animals are more important than others,  in the Animal Farm, we're living today. If I'd done nothing I might have been damned then too. Damned if we do and damned if we don't by the armchair quarterbacks that have turned this country into a prison where they are the guards and the rest of us inmates.. So many critics.  So many who make the rules but don't abide by the rules and aren't themselves accountable to the rules. Makes me think of Gordon Lightfoot's song Don Quixote. I 'm always charging windmills.  It was what doctors once were supposed to do. Now the abortionsists get the Order of Canada and soon the euthansia folk will be getting the country's top awards as 'doctors'. I'll have to pray more for my enemies especially those authorities calling for the Charge of the Light Brigade all over again. I'll have to get down on my knees more like Martin Luther King said, it's a tough day.
I'm looking forward to my upcoming medical conference IDAA.  Always this time of year I'm spiritually bankrupt and then I usually perk up after spending time with the people I know there who really make being a physician seem worth it. I'm so honoured to be among a group of psychiatrists there who I can truly admire as they too care and are themselves struggling with the same concerns I have.   It's gets back to whether I'm a spiritual being living in a material world or just a material being and the one with the most money and toys is the best.  The judge I met this spring was just such a TS Eliott Hollow Man and it's so demoralizing to see such people abusing such powerful positions.  Everyday there's more evidence of the old call of radical fascism or communism masquerading under new names.  

I'm thankful for the sun today. I'm thankful for my boat no longer leaking. I'm thankful for my dog. I'm thankful for my legs and arms and heart and lungs. I'm thankful my lip's size is reducing and the pain is going. I'm thankful it's not raining. I'm thankful I have friends and family who I love dearly. I am thankful for Netflix and the Life tv series I'm enjoying each night now. I'm thankful for the good books I'm finding to read. I'm thankful for the advanced scientific research I'm able to study. I'm thankful for light. I'm thankful for my fingers. I'm thankful for summer clothing. I'm thankful for the ocean. I'm thankful for Vancouver and British Columbia and Canada. I'm thankful for God and Jesus and church and fellowship.  Thank you

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