Wednesday, June 26, 2013

Insite - pros and and cons

Insite is a heroin injection site institution with millions of dollars funding and large staffing.  It provides heroin to heroin addicts (addendum - heroin the customers have bought from criminal organizations and bring to Insite).
The closest comparison that could be made to Insite would be a million dollar medical facility devoted to safe smoking for smokers.  Granted airports have 'harm reduction' glassed in chambers for smokers. The issue there is that there are no nurses or doctors to promote smoking as 'safe'.  These chambers privately funded and are not called 'safe inhalation' sites. They do not divert millions of dollars from acknowledged and scientifically proven treatments for smoking addiction.  As a consequence of the existing treatment for 'smoking cessation' millions have stopped smoking and the quitting smoking campaign has been spear headed by ex smokers and doctors and nurses committed to life.
At the turn of the century Sigmund Freud, the foremost psychiatrist of his day said that addiction was untreatable.  Carl Jung the other most famous medical doctor and psychiatrist of his day said addiction required a miracle.  Even today most countries treat addiction with jail and asylums.  Yet in the 1930's Dr. Bob Smith and Bill Wilson demonstrated that alcoholism could be cured through 'abstinence' on a daily basis and involvement with other recovering alcoholics in a group process to help others stay sober.  The Big Book of Alcoholics Anonymous was published in 1939 reported the remarkable success of 50 members recovered of chronic end stage alcoholism.   AA also espoused a 'higher power' which encouraged individuals to believe in a 'power greater than themselves' because to date they had been unable 'on their own' to stop their addiction.
Follow up research reported by the American Society of Addiction Medicine in the late 1990 showed that  those successful for 5 years or greater in maintaining abstinence  belonged to a group that supporedt their 'recovery', that they have a 'higher power' they believe is more powerful than their addiction or the object of their addiction, and they believe that personally the substance is harmful for them, in much the way a person would consider an allergy.
As a consequence of this group grass roots process millions of people have remained alcohol and drug free for their lifetime.  The AA movement spawned Narcotics Anonymous, Cocaine Anonymous,  and countless other anonymous meetings that have served to help millions more with a variety of addictions other than just alcohol.
As a result of this 'success' literally thousands of programs have developed to help the previously believed 'incurable' alcoholics and addicts.  Hospital based detox has been available since the beginning of AA when Dr. Silkworth and others treated individuals for the acute withdrawal of alcohol and drugs.  In 1986 I was the acting head of the Winnipeg Detox, a medical ward semi attached to the Winnipeg General Hospital.  Given the complications of overdose and medical complications of withdrawal including seizures, myocardial infarction, CVA's and kidney failure, these have been life saving facilities all but universally acknowledged for their benefits to individual and communities.
Since the AA movement began with the demonstrated success in treating and curing addiction, various treatment centres such as Betty Ford in the United States, Homewood in Canada, Edgewood and Orchard locally, to name just a fraction of a fraction have developed to start the process of recovery. It was long recognized that detox only treated the life threatening withdrawal physical illness and the biopsychosocial condition of addiction required months and years to overcome.  Religious organizations such as Salvation Army, the Catholic Church, and other Christian, Jewish, western Buddhist organizations have provided a powerful backbone to the recovery movement.  So often churches and temples provided the after care for patients who had been discharged from detox or treatment centres and now returned to the community.  The other cornerstone of follow up care usually modelled on 12 step programs has been the sober recovery houses where patients stay for months in a supportive non using group.
MRI studies show frontal lobe reversible damage that persist following cessation of drug abuse for up to three months. Cannibis is detected in the urine for up to three months as well.  Most treatment centres like the amusing movie of the same name only lasted for 28 days, though today it's not uncommon for programs to persist for 6 weeks, more consistent with the ideal stay lengths associated with other acute psychiatric conditions.  There is clear evidence that the longer the stay in the 'sober houses' the greater likelihood of persisting abstinence and prolonged recovery.  Some of the most successful programs have people stay for 2 years though members commonly in such houses return to work and reestablish themselves with family and  community.
Following on the successful model of AA group therapy, the leader dominated facilitated SMART group process developed along with other group follow up and on going therapy process with varying success and as yet not comparable to the overwhelming long term success associated with the AA initial group process.   Dr. Gallanter studied long abstinent AA members and demonstrated the success of AA and abstinence in those with decades of sobriety and success in community and work.
The gold standard of recovery success was the Navy Pilot Program with pilots whose training cost millions of dollars, flying planes worth millions of dollars, and because addictions knows no bounds, developing alcoholism and addiction. The program required first 28 days inpatient treatment followed by 3 meetings group involvement in AA, weekly counselling and monthly psychiatric visits. Greater than 80 % of pilots were flying successfully at 5 years follow up. These and other stats following from the initial success of AA treatment demonstrate without doubt the highly treatable nature of the disease of addiction. The success with treatment of alcoholism has through NA and CA been demonstrated with other chemical dependencies.
There are even a percentage of individuals especially as noted in the recent overwhelming success in the treatment of nicotine addiction, of spontaneous cures and individuals remaining abstinent from their chemical addiction simply by changing their social environment and abstaining from what they perceive is poisonous to themselves.
Dr. Ray Baker, a leading Canadian Addiction authority presents even more telling research showing that addiction is extremely successfully treated if the disease is "caught' in early stages, when the patients still have jobs and family.  Historically addiction treatment was criticized for its limited success with 'end stage' cases.  Dr. Baker, in his highly regarded lectures, given locally and internationally,   demonstrates well that addiction therapy treatment fares even better than other medical treatments for other chronic end stage diseases, such as kidney failures, obstructive disease and chronic heart disease.
My father and his generation believed that addiction was 'untreatable'.  It was called the 'cancer of the mind'  at the time when 'cancer' was considered untreatable as well.  Today cancer simply is no longer the big "C" and when I worked as a family physician I saw innumerable 'cures' that only a decade before would have been called miraculous.  I am thankful to day to have been treated successfully for skin cancer myself knowing that only a generation ago I might well have died from this malady but thanks to my family physician and dermatologist I'm cancer free though must "abstain' from extensive sun bathing.  This hasn't been that onerous this last year in Vancouver, BC.
Our generation, especially thanks to the tabloid lives of countless famous Hollywood alcoholics and addicts and national league athletes, is recognized by all as a treatable illness with great success.  The ubiquity of AA members is simply astonishing with every walk of life commonly having someone who has successfully "kicked the habit' with the help of others, often family, physicians, groups but  most important the positive belief that has followed from the success of abstinence based programs: AA, NA,  treatment centres, Sober House and increasingly the Drug Courts and Safety Sensitive Job movements. 
The recognition that abstinence based therapies are highly successful, that abstinent individuals save millions if not billions of health care dollars and account for the incredible advances in accident free workplace days, has created a ground swell of success building on success. . With this success has come mixed benefits, many more 'players',  increasingly government funding tied to other political agendas.  As a consequence of this recognition, publicity and success there has also been a  development of a major industry in which the alcoholic or addict is no longer considered 'sick' or a 'victim' or a "patient" but rather is called a  "consumer". These new and increasingly dominant business and socially engineered models have an inherrent conflict of interest since there is never any reason to 'lose' a 'consumer.
Insite is simply the kazoo in this great orchestra of science, medicine and recovery that was making extremely fine music before this latest 'sell yourself out of debt' scheme came into the works.
That said, this loud and rich, and arrogant voice, needs responding to.  The 'science' presented is highly controversial.   This is not a 'science project' but rather a very intriguing political program.  It is 'political'.  Very political. It is not surprising that it has begun in British Columbia whose principal crop industry is illegal substance. Insite has faced little scrutiny locally but has not surprisingly encountered resistance in the rest of Canada where the costs of addictions outweight the revenue of illicit marijuania sales and heroin trafficking.  When I was at an addiction medicine conference in Washington DC,  Vancouver Canada was identified as the most concern portal for illicit heroin import into the US. 
In terms of it's political aims this is all part of the Transhuman and other social engineering agendas that would  see individuals able to buy alcohol, marijuana, cocaine or heroin at the corner store much like one buys any other commodity. As a conservative libertarian I can't fault this agenda intellectually even though it does sound more like the kind of society most attractive to the Cheech and Chong elements without other responsibilities and limitted experience understanding that freedom comes with responsibility and license is a different thing altogether.     Unfortunately too the research of the great Harvard psychiatrist, Dr.  George Vaillant, who I will forever be honoured to have met, demonstrated without a shadow of doubt that the more available mind altering substances were the greater the cost to individuals and society. This is particularly concerning when in Canada we have an already overburdened medical care system with deadly wait lists and a 24 hour dead body being found in a teaching hospital waiting room in Winnipeg.   Expansion of availability of drugs and alcohol results in harm to the most vulnerable, brain injured, poor, homeless, jobless and the population that Dr. Gabor Mate so elegantly described in his book "Hungry Ghosts".
In contrast Drug Courts which to date are grossly underfunded despite their overwhelming evidence of cost effectiveness are just one of many scientifically proven approaches to drug treatment that are less heard about when the idea of encouraging heroin addicts to shoot heroin in their arms in the presence of nurses is just too sexy to compare with.
Now the famous Doctor William Osler treated his equally famous surgeon colleague, Dr. Halstead,  with morphine in his office near the turn of century when doctors simply approached the use of narcotics much like physicians to day do with pain treatment.   No institution is necessary and no multimillion research is needed to deal with appropriately trained and licensed  doctors who are already prescribing narcotics successfully without drama or politics to patients continuing to so so under the appropriate jurisdiction and guidelines provided by the College of Physicians and Surgeons and Federal and Provincial Ministers of Health.
To date Methadone and buprenorphone have been scientifically proven and not terribly controversial harm reduction techniques for people transitioning from addiction to needles to oral narcotics and eventually to abstinence.  The tremendous reduction in crime and spread of blood related diseases is directly a consequence of oral narcotics being substituted for intravenous drugs.  Such improvements in health of individuals and community and reduction in crimes, specifically theft have been demonstrated whereever appropriate oral narcotic substitution therapies have been instituted long before the introduction of Insite.
 I find it odd that I have personally had so much difficulty arranging for family members to give IV drugs to patients with cancer yet here is a program that supports already sick and marginalized individuals injecting themselves with highly questionable and often lethal substance bought illicitly.   Politically there may be a place for trained nurses and doctors to provide heroin IV to patients in offices though frankly I think such an approach to a treatable curable illness is disheartening and sadly abusive of patients who quite rightly would want a 'cure' if their doctors and nurses could 'believe' in them.
Harm reduction is indeed a fancy term which refers not so much to less harm for the individual , who indeed is often being written off, but rather to the community.  Unfortunately the present emphasis on "harm reduction" and the celebration and publicity of  institution injection sites may  well serve to perpetrate disease, maintain addiction and even result in withholding  funding the kinds of treatment that are proven curative.  I can't help but hear Marie Antoinette's cry, "Give them cake!" Indeed appendicitis is cured by costly surgery but it can be treated in a 'harm reduction' manner by simply giving antibiotics without surgery. No doubt there was a time when surgery was a hard sell too and people wanted simply a 'magic' solution to a life threatening disease. Thankfully our medical forefathers took an oath 'do no harm' and aimed for cure rather than watching the patient die slowly.
Palliative care is a probably  better term for Insite's  "harm reduction'.   It is a well established  medical term in the treatment of end stage cancer patients. Insite might well be considered a 'palliative care' unit for those for whom no hope of cure is expected and all that can be done is to ease the suffering of those individuals who otherwise die would die.  As it stands Insite appears to give the impression that it is doing something special and unique and helpful for addicts.
The World Health Organization has only acknowledge the benefit of "harm reduction strategies" so long as they are directly linked and lead to abstinence based recovery.  To date despite the claims otherwise I have not been convinced that Insite is such,  In contrast the Salvation Army and Union Gospel treatment centre and the Vancouver Daytox programs and such places as Last Door, Turning Point, Pacifica and so many other sites are clearly using harm reduction as a minor stepping stone to the greater world of recovery and abstinence.
Many doctors, judges, pilots have become successfully abstinent with the help of AA and returned to be leaders in their field.  To date the normal approach to doctors, judges, politicians, pilots, and  multi millionaires is to send them to  treatment such as Betty Ford and then encourage them to continue in an aftercare program either associated directly with the facility or to attend AA/NA or such 12 step self help programs. I would be more optimistic about INSITE if I heard that the Physician Health Program or the Lawyer Assistance Program is recommending their members to participate in heroin injection facilities.  Anesthetists who have developed opiate addictions have to date used methadone, buprenorphine and detox, then abstinence based treatment programs such as AA/NA and the recent SMART group follow up.  This has caused some to be reasonably concerned that INSITE is like offering candy to diabetics rather than insulin.

Now personally I really would like to "live and let live" and can only admire colleagues who find ways to become rich in their practices so long as their patients benefit alongside their wealth creation schemes.  However I have noted a strident loudness, much like the voices of drunks and drug addicts promoting the single handed success of free heroin injection sites in conquering all the dragons and monsters of addiction single handedly.  There are even those who believe that Insite is a truly important player in the recovery success in the Downtown Eastside community.  They overlook the amazing work of Harbour Light, Union Gospel, Doc Side Medical, Pender Clinic, Dug Out AA, the downtown eastside drug court and countless other individuals and groups that have for decades been working together for the increasing success in the community which comes as a culmination of scientifically based abstinence programs and harm reduction programs leading to abstinence.  This Insite kazoo is richly amplified but it's really not new, a variation on palliative care and highly controversial medically and psychiatrically.  I am not surprised that the world over all has not jumped on the band playing political wagon.  I like kazoo music I thought it might be important for others to remember that the poorly paid, often unpaid, huge and ever larger and more successful orchestra of recovery has been playing an increasingly happy tune thanks to years of work of countless individuals and the scientific approach to successful therapy of addiction.  The 4 pillar strategy was right on the need for prevention and therapy but seems to have done little for prevention and put an unholy emphasis on one questionable 'get rich quick' basket.

As a tax paying psychiatrist and addiction medicine specialist I'm not so sure this Kazoo is even in tune with the music of this new generation.  Last I saw they were into yoga, cycling, extreme sports and healthy food. Even Timothy Leary, the great GURU of the LSD generation said that 'if we'd had the computer and internet' we'd probably never have done drugs.  I don't think we should be doing anything given the winds of change to encourage anyone to put needles in the arms when all of life awaits them.  The success of the 'safety sensitive employment' programs, drug courts, public health measures for addicts, with truly drug free housing, detox, treatment centres, continues to show success which has been building since the breakthrough programs of AA began in the late 30's .

But please correct me if I'm wrong. 

Sunday, June 23, 2013


Thank you Jesus for this spiritual life.  Help me always to remember that I'm a spiritual being living in a material world. Thank you God for creation, for all the colours, and sounds, and smells that come to me every day.  Even when I think my life is a cartoon I appreciate all the time and energy that cartoonist have to put into just creating the characters and background. Thank you for the universe. Thank you for my dog Gilbert. Thank you for his health and enthusiasm and entertainment.  Thank you for my family. Keep the children safe and the adults fulfilled and growing.  Thank you for this wonderful country of Canada and may it remain something of what my father and mother lived and worked through world wars and depressions to maintain. Thank you for my friends. I am so blessed to have the wisest and biggest hearts and sometimes the funniest friends a person can imagine. I'm so thankful to for the daily inspiration of my friends on Facebook and the family and friends I would see and hear from less if it weren't for their sharing their journals and pictures. It's fun to follow Anne overseas, Susan down under, the nephews out east, my brothers amazing photography, the guys I know here in Vancouver but wouldn't see. It's extraordinary to watch Michelle's belly grow.  Were it not for Facebook I'd have to wait for another high school reunion to see Wes and there he is a new grandfather. I love seeing his backyard and remembering sitting with him there myself when I visited. I like the nurses I knew in Saipan, Joy's uplifting God messages, and just all the people I have known and now continue to know through this communication. I also enjoy the people I didn't know till we shared in social media or on cyberdocs or list serves for authors or caregivers. I just love meeting someone I've been reading for months. It's like meeting famous authors and sometimes they're that as well.  I love Marion's pursuits in Mexico and the contacts from the Sunshine Coast.  It's lovely to know I am not alone. I 'm thankful for the work and people in my life. I like that I have work that I believe is important and good. I like that I have much of the 8 fold path of Buddhism and know the Sermon on the Mount of Jesus in my life and can relate to the teachings of Hinduism and Judaism and Taoism. I'm so thankful to have the libraries and the digital books on my Kindle or in my phone.  I am thankful that I can remember when I had to go to a place to learn something and now I can google the correct answer, even just a dictionary, or a skin disease on my iPhone and have the answer to the question I was asking. Thank you God for the technology. Thank you God for money and the means to make it and spend it and save it.  Help me become better able to manage it and less likely to lose and waste it. I feel like after years of being a good steward with electricity, fuel energy and fresh water, and food and waste disposal on my sailboat existence where I so appreciate that if I break something I'll have to repair it in time and that everything has wear and tear, thank you now for helping me understand 'money' as a similar energy and that it's connected to time and thoughts and attitudes like all else in existence. Help me to be less wasteful so that I can serve you more in my day to day life.  Thank you for the travel I have known and for the routines. I am thankful for the sunshine today and the lake and the good service in this wonderful resort. Now I'm going to the hot springs once again and thank you for the relief from pain this brings and the opportunity for exercise in the pool. Help me to be able to swim more this year but thank you for the swimming yesterday and the scuba and pools and water and seas.  Thank you for the night and sleep and dreams and memories and help me to focus more and more on what is of good worth. Thank you for learning. Thank you for the teachers and the courses.  Thank you now for the languages I'm learning Spanish and now Hebrew. Thank you for Latin and French. Most of all thank you for English. Thank you God for all the gifts you give and the lessons I learn.  Thanks for this day and help me to live in such a way as to celebrate your creation.  Thank you God.

Saturday, June 22, 2013

AB Profile A12 Inflatable and Honda 4 stroke 30 HP Outboard Motor

I ordered my AB Prolife A12 Inflatable from Kits Inflatable Boats(‎) .
I first saw the AB Profile boats at the Vancouver Boat Show 2 years ago and really couldn't stop thinking about them. I looked at  slew of other boats wanting a fast fishing boat that would be able to also be used for hunting moose. At the Vancouver Boat Show in Spring I ordered one from Craig Frazer.  They were back ordered.  Very popular.  It was worth the wait.

I've just had mine out today with the new Honda 4 stroke 30 HP Outboard Motor ( from Marine Honda at First in Burnaby(
30 HP is the maximum power for the A12 but the AB profiles come in larger and smaller sizes that take different HP.  The Maximum weight for the A12 is 2,032 lbs or 6 adults.  I wanted the seat and console which Craig had installed when the boat came in. Then he took the boat over to Honda Marine where Lee and the folks there had the steering package installed.  Having bought off road motorcycles (Honda 250 CC)  from Honda Marine and knowing the people there, I trust them.
I love Honda 30 HP Outboard.
The Highliner trailer (model PWC 1) which Kits got for me has a swing tongue so it's more easily stored.  We estimate boat and motor at around 800 lbs.
The Honda 30 HP weight is 155 lbs. 552 CC engine.
It's amazing.
I had a heck of time getting the papers on Friday. The boat was all ready for pick up at Honda and the guys were great. I just couldn't find a 2 "" ball for the tow.  Lee offered to loan me his and after he'd got his off his truck I went back and found mine.  Typical!  I then had to borrow a license plate to get the boat home.
Craig was delayed because he had  had to get three of these AB Profiles off to Alberta because of the flood there. There was an emergency call and the guys at Kits put three together rush to put on the train to help people flooded out of their homes in Calgary.  Extraordinary flood situation. Downtown all out of power and thousands homeless.
Craig was kind enough to  meet me at North Shore  London Drugs to get the trailer plate just before they closed. I wrote a cheque for the final amount having paid for the motor in the fall and having put a hefty downpayment on the boat at the boat show. It actually came in as estimated which impressed me with Kits and Honda Marine. I'd had extra requests and all went well.
It was a late start but I actually drove out to Harrison Hot Spring Resort arriving just after midnight. I was tired but the truck and boat and even the Honda 250 motorcycle in back were all with me.  The rooms were great as usual, and pretty soon Gilbert had a mess of things on the floor to play with. Mostly he's of the belief my role in life is to throw his yellow ball.
I slept wonderfully here as always. I love the Harrisons Hot Springs Resort
While I had the trailer insured with ICBC I didn't have the actual boat and motor insured.  So I didn't want to leave them in the unguared lot by the dock despite the number of locks I put on the trailer and boat and motor. That was one reason why I wanted to come to Harrisons HotSpring Resort. Their parking is pretty secure and I could try try the boat out  in quiet fresh water before putting the boat in the ocean.  I also knew the boat launch at Harrison was really straightforward.  I didn't know the ocean boat launch on the north shore and didn't want to deal with tides and currents right off.
It was a good idea.
In the morning I drove to Chilliwack to get fishing supplies at Fred's
I needed a part for my down rigger and tow rope. I also stopped at Mountainview Harley Davidson in Chilliwack.
I had all my motorcycle gear except for forgetting a helmut. I found just the one I wanted but also got a Harley cap to keep the sun off my face out on the water.  
That was all the gear so I drove back to Harrison Hot Springs unable to put the launch off any more. I loaded the boat, checked everything out and then drove to where I was in place to begin to back the boat trailer up. I'm not very good at backing up with trailers.  It wasn't a pretty sight. It was eventually achieved without any damage to property or person. Yet another lesson in humility. 
The boat was afloat. That was the best part.  Just looking at it beside the dock was joyful.   Amazing!
Wow.  It really did look good.  Everyone has been telling me how great it looked out of water but it looked even better in water.  Driving up hill with just the trailer was easy.  Parking with the empty trailer wasn't a problem either. So much is perception.
Back in the boat, the motor started instantly then after a while in neutral it puttered out.  I checked everything then phoned Honda Marine.  Great guy at the store walked me through everything even though I've been around boat motors all my life. Listened to the engine over the cellphone.  Really figured it must be lack of gas. I'd thought so too and gone through the fuel supply. I checked the vent again and really opened it up.  It's a different kind of cap and I think it needed to be like the whole cap was open. The motor started with a turn of the switch then.  I learned from the fellow how to adjust the idle. That was a new system.  Different from the handle throttle I was used to.  I thanked Honda Marine.  Quiet motor sound but  so efficient too.  I untied from  the dock and put the throttle in forward. I was going okay, ploughing through the water but not really making any great speed. Maybe 5 to 10 knots.  So I gave it power.
I porpoised to a plane and then bounced like a skipped stone across the lake.  It was freaky. I was really concerned I was going to flip the boat. Gilbert was concerned too.  I kept accelerating nd getting to the plane and then backing off the power unable to stand the speed.
We travelled, not quite light speed: we achieved that later when I finally got the courage to do Full Open Throttle.  That was after I trolled all around the big main island in the middle of Harrisons. Now I know that people have their cottages there. I didn't catch fish but I tried out the down rigger, found out the boat does fantastic as a fishing trolling boat.  Realized this was going to do well hunting too.  Such a solid aluminium floor.  
Craig told me that I'd probably have 3 hours of travel time with the 3 galls of fuel and I'd picked up another 3 gal spare.  The 3 gal tank was the only one that fit under the seat.  I decided I'd had enough fishing after catching weeds with my flasher.  So I stowed my fishing gear.  That's when I found out how fast the boat can do on a Full Open Throttle on plane. It bounces, flies and soars.

I''ll get the plane fan for the outboard. I had one on the 9.9 hp when I was able to go at high speed in Mexico with my dinghy down there.  It helps get one up on plane at lower speed so it's more efficient and smoother.  This one  will do the same, I'm sure.  I had to stand when I was going on plane, leaning over the console, one hand on the steering wheel and the other on the throttle.  Trolling I liked sitting facing forward like I was driving a car. It really keeps its point too.
With all the sun and excitement I was happy to get back to the launch after a whole afternoon of boating.  I still had to be sure I could get the boat onto the trailer and out of the water.  This I did all the while Gilbert ran on the grass and visited another dog, telling him all about the big boating adventure he'd just been on.  He was wearing his yellow life jacket and looking very nautical as he smoked a pipe and leaned back against the fence.
Back at Harrison's Hotsprings Resort I could have crashed. I could crash now too.  But I left Gilbert, he's such a good dog, after feeding him and giving him a bone, and headed down for some body soothing hot spring waters.  Unbelievably perfect.  Sunshine was still out and I did a tour of the adult pool then swam 10 lengths in the cold water before ending up in the indoor cooker pool.  Lots of bikinis. 
Gilbert was glad to see me when I returned. I had planned to take him for a ride on the motorcycle but I'm going to order room service and watch a movie instead.  I'm exhausted with excitement, adventure, sunshine and hot springs.  I've walked Gilbert a couple of times too. What a great day.

I love the AB Profile and Honda 30 HP. Thank you Kits Inflatables and Honda Marine!
AB Profile A12IMG 0436IMG 0435IMG 3220
IMG 0437
IMG 0446
IMG 0444
IMG 0438IMG 3222IMG 0442IMG 0445

Friday, June 21, 2013

Friday Morning Journal

It's another early morning wakening.  I wonder if I have depression because I'm trained that every variation in pattern or routine could spell disaster. I'm trained to rule out all the catastrophes. After concluding that aliens aren't attacking, cancer isn't brewing, death isn't knowing scythe against door, or communist chinese disguised as Russian friends aren't jihadding through the neighbourhood, I probably just have to pee.  I'm older and getting up to pee isn't so bad or different.  It happens occasionally.  I hear from others it may begin to happen nightly.  Good night sleeps aren't appreciated like good bowel movements or soft fulfilling breathing, pain free moments.  It's the little things that make life wonderful. When any of these are awry it's like the horse flies at the beach or ants and mosquitos at the picnic.
I should be thanking God.  I'm forever grateful for this life when I'm not contemplating suicide.  It's a long time since I've thought homicide.  I keep hoping to get out of this incarnation without killing my fellow man. It's only one generation or so back,maybe two or three, that all grown men were engaged in killing each other to defend their women and children, doing as the local lords and bullies recommended.  It wasn't that long back we weren't eating our neighbours.  Some still do but not in the better parts of town.  Over there, in Africa or Vancouver Island, somewhere else. And when we learn the local pig farmers were cannibals we focus on the other aspects of the stories.  If we think in re incarnation terms, then it's not that long ago, a generation or three we were that starving person who defended their child from gang rape and having survived amazingly decided to eat their kill.
I became a doctor as much to help my fellow man as to still the passions within me as saints do.  I was meditating as a teenager, going to church and worshipping Jesus who was crucified for preaching peace.  This wasn't an enemy but rather done by the 'authorities'.  When Jews told me they were persecuted by Christians as the ones who killed Jesus, I was a kid who looked at the principal in my school and knew he was the local Herod and Pontius Pilate of my spiritual allegory.  Today the same is true for Obama.  Where I come from the 'friendly fire' is as likely from your own leader as from the enemy.
Which is why I like the alcoholic anonymous quip, "Your head's got a contract on your ass" and "my best thinking got me here".  So much for rationalism and intellectualism and politics of reason and maturity.  The age of Rationalism brought us the War to end all War and WWII and in my life it's been Vietnam and Afghanistan.  I don't blame the Moslem fighters since their women are all covered up and they don't have anything better to do for entertainment on a Saturday night than fight Americans.  It's us that I don't understand. We've got a whole lot more entertainment available than sitting at a mosque and praying the women will drop their veil and we'll get a glimpse of eye brow.
The fact is everyone wants Hollywood and would invade it and change it and take it home.  The criticism of the Roman empire was the same as it is today of the American. The cost of your roads and Pax Eternal is too much so we'll steal and raid rather than participate.  Meanwhile no one has any better idea but just criticizes what is.
I do. I'm a horrible critic. I'm living in paradise (except for the rain and clouds) and I've got everything a soul could desire, I have at some time or other, and I've never been satisfied. I've never been contented for a long time.  I've always sought adventure, or stimulation , or peace or meditation or something. I'm always on a quest. I've had women, friends, animals, homes, geographical changes, alcohol, drugs, rock and roll and religion and higher learning and one hell of a good heavenly life. But I'm still not satisfied. I know that death is the greatest passage and I'm only going to be satisfied for a goodly time in my grave.
Meanwhile I'm having a good time.  It's not like it's a life in the red or negative. Just that I've not known God face to face.  Adam walked with God in the Garden, actually saw Eve and knew the apple and the snake. I think that's got to be better than going down the the 7-11 and grabbing an apple from the bin and saying hi to the check out girl.  There's so many comparisons in marketing which make one's own existence moment to moment seem drab.  A picture in a magazine of happy faces on a Caribean cruise jumps out at me as I'm taking the garbage out.
I learned early about "no mind'" and the idolatry of 'ideas' and 'thoughts' .  I learned early that what I think is suspect.  Knowing things doesn't mean one can change them. Knowing theres a great conspiracy, probably by the Americans and the Chinese together, with the CIA and Jimmy Hoffa and Elvis Presley and John Lennon all in on it, doesn't change things.  I'm still going to have to wash and go to the office. I'm thankful I've got a job to go to.  It's just one of the too many things I take for granted.
I imagine some 'wonder job'.  Hanging out with Nicole Kidman and Angelina Jolie having my picture taken while someone says to the world my every word is wonderful and my bank account gets bigger and bigger. Today that's the Jim Croce, smoking a big cigar instead of working in the car wash kind of notion.  But I don't believe any more that living with Nicole Kidman would be any better than living with Roseanne Barr.  I get a half hour of Jerry Seinfeld and that's definitely the best half hour of entertainment I could have but more George and it would have to be too much salt in the soup of the week.  Yet for so long I just thought "if only I had more Hagen Daz ice cream" .  My mind tells me more and really less is better but when more might be better less seems right.
There's a moving target to the pleasure chase.  There's this karaoke machine of life with the bouncing ball that's supposed to be under the word to sing out of sync with the music.  In my dreams I end up at the fancy dress ball wearing a t shirt and jeans.
I'm often imagining myself wearing a chiffon dress at a biker bash where everyone else is dressed in leather. It's either that or I wake up and I've been pushing a Safeway cart with a wonky right wheel on some street where normal people are avoiding me.
I'm forever not quite fitting in and then not caring or telling myself "it don't matter'. There was a movie where all the soldiers in Vietnam chanted "it don't matter' whenever a friend died in some positively stupid way.
And I think if I focus on God or Love or Peace or something positive I'll get through the next moment without despair and maybe even have a better chance at winning the lottery which would just escalate my dissatisfaction by amplifying my choices.
The more money I've had, like everything else in life, from candy as a kid, to sex as a teen ager, the no greater satisfaction have I had in the end yet I 'think' I will somehow this time round 'get it right'.
And every day I get up and go to work and do my best and struggle nanosecond by nanosecond with what is the best, safest, most effective, word to say, action to take to help Grace or bring light into dark, or reduce the anger or danger, or convince a person not to suicide, or hopefully quiet their voice and body sounds and signs which are like grating fingernails on a chalk board, because frankly,  I just want to stop the bleeding..
And some nights I dream of the emergency room and not being able to stop the bleeding and the countless times I held electric paddles and I was impotent before the power of death. And I'm not surprised ad doctor friend is focused today on 'raising the dead' saying Jesus did.
Meanwhile there's thousands marching in the street about the food being altered and there's only paranoia right now.  Ludittes everywhere and the 'noble savage' and retreat into insanity. It's times like this that I want to go back to my hobby farm and spend more time with my sprouts and chickens.
But my work is in the city and I don't know how much longer I will live or what the next 'solution' will be because there's no going back and here and now is the answer.  Learning to appreciate what one has and loving the one one's with and figuring out how to get the authorities to stop killing God and get on with catching thieves.  It doesn't make sense having property after years of work and hours upon hours of labour if the police collude with the criminals and politicians to let them take your stuff while the banks are laundering drug money. The chaos is unsettling to say the least and only the police and criminals are armed and daily one thinks the fools are the 'law abiding, tax paying' targets.
It's easy to be jaded. It's easy to lose hope.
I think of my father and mother, who did 90 years in the service of the planet.
I've another third of life to go and I'm wholly unprepared.  I've never grown up. I've waxed poetic and clung to false beliefs way too long.  I have trusted the Attorney General and the Premier and Prime Minister when the smart folk have been growing marijuana and cheating on the Vancouver Stock Exchange.  I've spent my days doing everything in my power to help people get off drugs and the money and power and status has been in pushing drugs. I've kept people alive when all that is sexy is in euthanasia and eugenics.  I've been so often on the wrong side of the street, helping the underdog when the bully needs the help and would pay better.
I've liked this 'clean image'. I've played the 'nice guy' role. I've been the 'saint' and yet I've, like everyone else, merely dealt the cards I've been given and played the game and never known for sure how much was chance, how much pre determined, how much choice.
I've been the Doubting thomas and I've questioned everything and yet somehow hold it together while daily people try to convince me that killing themselves or others is the solution or that really something that happened yesterday justifies an action today or that the future is dangerous and not optimal or whatever the current sanity or insanity is in vogue.
I'm not sure I'm thankful that I know the name Kardasians or that I learned that Donald Trump was in town yesterday.  To me in the littlest corner of the world where I exist these names are no different than Mickey Mouse and Donald Duck, Zeus and Athena, Bill Gates and Warren Buffet.  They're all way above my pay grade, names of mythical creatures and monsters and polytheistic Gods.  I've spent days with Prime Ministers, hung out with multi millionaires, discussed research with Nobel Prize winners, talked sports with olympic athletes and known members of the Hells Angels, and talked with decorated combat veterans who did crazy things like charging machine gun nests to save their buddies. I've known women so brilliant and beautiful that no television or movie star could compare with the reality and enchantment they bring.  I've been blessed to know the brightest children and grandest pets. I've had experiences like this in passing, like television commercials.  Each has had it's moment in the sun and I have thought myself blessed at the time but then I've also lain in hospital beds or bleeding beside vehicle wrecks in places ambulances don't come.  I've experienced and participated in life but that's all its been.  Life.  I've been a Human and the great and small have all had their place.
I've always said "I'm the kazoo in God's symphony of life' or the 'fart in the necessary make up of reality which without the fart would be like a missing burp".  I've been the king of my creation. I've been the front row seat in my own existence. I 've seen all these great men and august Lords and Ladies of today and admired them from afar or briefly close up and am thankful for the seats at the concert. Recently I smiled at Stevie Nicks.
I don't know who knows me individually.  I don't suppose anyone really knows another more or less.  It's all an illusion when friends die or pass a way and all that are left are memories.  And now the ads warn against alzheimers and just as the thieves are grabbing the physical goods the mental hardware and software is at risk of departing in the night as well.
There's no end to possibilities for worry.
I pray and meditate and hope that 'quality time' and 'exercise' and 'diet' and 'balance' and all the 'catchwords' and 'rituals' of the present age will work half as well as sacrificing virgins did for an earlier age. Each and every one of us struggles against superstition and denial of death.
It's Friday.  Work has never only been in the office. I've been 'on call' most of my life. I've been doctoring day and night answering questions and giving advice, being that highly educated local resource for unknown numbers, woken from sleep so many times by emergencies or suicides and never getting the billing done.  There's a tax man counting sheep somewhere.  I know the details of my sub sub sub speciality in the complexities of my work where there ''s only depth and reach but don't any more seem to grasp the meaning of these people who hand out parking tickets you just pay because you were late saving a life.  I was late for work again because I resuscitated a man who was about to die on the street and no one knew what to do.
I raise the dead but I worry about it.  Like all the deliveries I did.  My government gave the great abortionist the Order of Canada.  Was I wrong or right.  Saving lives, restoring peace of mind, stopping the bleeding or holding back the chaos, and all that sort of Dr. House stuff. Is it right.  I watch cop shows and want to catch the thieves who are stealing from me all the time and wonder if I can do a lateral shift and become an armed school patrol. I understand when someone tells me they feel they've done okay because they protected their child today.
I've an office plant that's some 3 or 4 years old and the life expectancy of office plants is 6 months.  The fish are living in my tank and it's been years since I lost a fish tank. That was the one that froze when the hydro went out when I was away and while the plants revived the fish couldn't swim in the hard water.
I used to not say anything. For years I was silent. I didn't share. I didn't blog. I just listened.  Decades went by.
I understand why monks take vows of silence and married couples stop talking to each other.

Wednesday, June 19, 2013

Cognitive Behavioural Therapy - CBT

Cognitive Behavioural Therapy was developed first by Aaron Beck.  Feeling Good, by Dr. Burns is a book by Dr. Becks student that best summarizes some of the techniques developed by Dr. Beck. 

First, the principal of Cognitive Behavioural Therapy, CBT, was that 'what you think" is 'what you feel'.  Hence the program worked with the 'conscious mind' as opposed the psychoanalytic therapy that felt the emotional substrate was best accessed through 'unconscious' processes such as 'free association' and 'interpretation'. 

CBT was and is rather straight forward.  It's success followed it's simplicity and use by those trained in a limitted process.  It gave itself to reproducible formats and protocoled work books which could be used more easily in scientific research than previous therapies that often depended on the extent of training and experience of therapist.   Because it is essentially an "educational" model of 'relationship therapy' a counsellor could be taught how to do CBT, reducing costs of specialist services and it was commonly coupled with drug studies.  All manner of "work book' and 'take home' materials have been developped for accompany therapy.

I formally trained in Cognitive Behavioural Therapy as a psychiatry resident in 6 months weekly weekly psychotherapy supervision.  Because of the metaphor of computers and 're programming' the model of 'CBT' has had a currency that is as timely today as Freud's model was in it's scientific day.

Some standard examples of Cognitive Behavioural Therapy include the following:

1)  Identify the various 'negative self talk' that is used.
eg. "I'm no good" , "I'm a failure", "Everything is hopeless."  "Nobody cares for me"
(The list is endless)
2) These have been called "cognitive distortions'.  Often psychologists will take old ideas and repackage them with new labels.  The cognitive distorions of CBT to a large extent were first identified in philosophy and logic as "fallacious' thinking. There are various lists of common 'fallacies'.
3) In the examples given one would by oneself or with a counsellor reflect on the internal error in this self talk.  For instance , "I'm no good".  The word 'good' or 'bad' here is used as a 'generalization' and when one seriously breaks down the statement of what "I am" it's usually meant that I am 'no good at doing something' Ie 'pleasing my mother, pleasing my boyfriend, pleasing society, pleasing my boss".   
4) Each negative 'self talk' is explored rationally and then replaced by a more positive statement.  Eg.  "I'm no good" is replaced by "I am okay'.  Here the Transactional Analysis movement was a precurser in terms of Cognitive Behavioural Therapy and many of the ideas of Dr. Berne who developed this Cognitive Behavioural Therapeutic system, best described in the book "Games People Play', can be collapsed into standard CBT
5) Self talk is often done initially as a positive form of communication and one can write the short form of the outcome in columns.  So that whenever I say to myself "I'm no good" I don't again go through the whole process but instead say, "I'm okay" and possibly add to this "I breathe well, I've five fingers and toes, I'm a child of God, I macrame well, my hampster thinks I'm okay" whatever the list is to re inforce the positive counter thought to the negative recurrent cognitive distortion.
6) Other forms of CBT homework include writing out lists of all the good things I have done rather than focussing on all the negative.  To achieve this a criminal might say I was in jail 10 years but the therapist would say, 'you're 40 years old' so for 30 years you were not in jail.  If a matter like 'lying' behaviour is addressed, the person might list how many hours or days they didn't lie. 
7) Patient doing CBT are encouraged to read and record positive statements and positive reading material. It's not 'pollyanna' but rather optimistic. Depressed patients for whom CBT was first developped were so far out in left field that they didn't even have a glass to have it half filled so CBT is by nature 'optimistic' and 'positive thinking' in the conventional and traditional sense but realizing that the ideas might not be 'true' in a strictly rational sense but surely 'counter balance' the preponderance of negativity that people who use CBT first encounter.
8) The Behavioural aspect of CBT therapy looks at changing behaviour to change feelings. So if a person calls their wife names and she gets a restraining order, CBT would suggest that maybe this husband should not call his wife names if he wants to avoid a restraining order.
9) Another example of CBT is the writing of the events around trauma. Dr. Judith Wallenstein , the leading authority on PTSD at Harvard recommends that people who have experienced trauma write their "trauma story" as a kind of 'police report' then on the second line write the emotions that would be appropriate to the events.  During this process the person is to stop whenever they feel agitated rather than be 'retraumatised by the recall'.  This 'dissociation' recurrence is common in people who simply tell their trauma over and over again but never get on with life.  CBT encourages people to look at an event from 'multiple foci' rather than only seeing an 'event' from one perspective.
10) A typical CBT recommendation is to call a person when one is having negative thoughts rather than remaining alone with the negative thoughts.  There are Suicide Support Lines and Mental Health Support lines simply because "misery loves company' , a 'problem shared is a problem halved", the realization that one of the principle ways of breaking a negative chain of negative thinking is to talk to another person rather than 'nursing' the 'resentment' or 'bad mood' or 'negative thoughts'.
11) At one point for several years I had patients chart their moods with numbers 1-5 against other aspects of their daily life, eg sleep (hours), work (hours),  exercise (hours) , meals (number per day), positive meeting attendances (number per week or hours per week). In hospitals the nurses kept such graphs and we could see that patients moods, especially on geriatric wards, were commonly affected by lack of sleep or missing meals.  I also had as a family physician done several great detective hunts to find what was causing children patient to have allergic reactions or environmentally induced athmatic attacks. Given the CBT idea that changing the thoughts and behaviour would change the mood and ultimately improve thoughts and behaviour, this search for 'negative' triggers has often been quite fruitful.  People have found that certain 'friends' indeed were 'soul suckers' and didn't really want the patient to improve because they enjoyed their being down and as a 'sob sister'.  Often becoming emotionally well requires one to get away from emotionally draining people, not as a first resort, because more often than not we take our problems with us, but ultimately as a solution when others have failed.
I personally have to limit the amount of 'news' I watch because 'news' is marketted as 'depressing' and 'anxiety provoking. I once wondered why when my life was just fine I wasn't feeling a hundred percent and the answer was that I was allowing myself to be bombarded with all the problems of the world without any real way of my helping or changing matters.  One of the negatives of 'global community' is that much false information comes from a distance and we are commonly subjected to the insinuating blaming and begging that goes with 'enquiring minds need to know'.  So many of my patients have come in depressed simply because they are 'news aholics' and simply need to get away from the boob tube and computer screen.
12) Today in terms of Cognitive Behavioural Therapy I am as likely to recommend a person learn an 'affirmation' or positive prayer and use this as a 'thought blocking' technique when their mind is malfunctioning. I see the mind as either going forward with creative and  life affirming useful processing or going backward with past,  death, loss  and negativity. I see this is a car and that I have to simply change direction so use the prayer or affirmation as a kind of transmission neutral before I can get my mind on a forward track.  My favourite affirmations are 'All Shall be Well, All shall be well, and all manner of things shall be well,'  The Serenity prayer,  or sometimes just repeating the word 'peace' or 'one' as a meditation so well researched by Relaxation Response scientist, Dr. Herbert Benson.

The assumption in CBT is not that "I'm okay and you're not" but rather that I have mental 'skills' and 'techniques' and 'training' that help one's thinking and feeling'.  Change the thinking and behaviour and the feeling follows.  Further by disrupting these repetitive patterns of negative thinking and behaviour and feeling, the general result is a higher more functional form of thinking and feeling.
CBT was originally found to be most effective for mood disorders but has been used in all areas of mental illness with varying levels of efficacy. 
It has been extremely beneficially in treating panic attacks, phobias and a variety of anxiety disorders, though personally I'd say the insight therapies are probably of more long term and deeper benefit.

In addictions, Freud said that alcoholics were essentially untreatable and Jung said they needed a miracle.  Psychoanalytic therapy or "insight' therapy often made alcoholism worse as addicts tend to 'rationalize' and as they explored their personal history found even more reason for drinking. Dr. Jung felt that alcoholism needed a miracle.  Dr. Bob, co founder of Alcoholics Anonymous, said, 'Never deny an alcoholic the consequences of their alcoholism, because they only learn from consequences".  The recognition was that 'right behaviour lead to right thinking" given that MRI and various other evidences today suggests the brain of an alcoholic or addict is hijacked by the disease and therefore can't itself 'self repair' without a period of 'abstinence".  After a period of 'abstinence' there is the possibility that a person will be able to see their own behaviour and their situation from a wholly different perspective than the drug induced 'unreal' or even 'psychotic' perpsective.

Dialectic Behavioural Therapy is a form of CBT that has been found beneficial for personality disorders noting that personality disorders have a long standing pattern of maladaptive behaviour. The original adaption may have been essential at one time in that place but no longer serves a positive purpose. I found this most evidence in long term institutionalized patients whose 'jail house' behaviour had helped them survive but outside of the institution very much interfered with their ability hold jobs and establish relationships.  Dialectics is best consider in the Marxist Lenninist context considering origins but also it's been liked to Socratic method of investigation of the individuals behaviour pattersn. Again the 'rational' and 'cognitive' almost 'education' programing involved in these therapies is at variance to the original psychoanalytic therapy or even the Gestault therapies or Ericksonian models of therapy known to have high efficacy for behaviour change.

Eclectic therapy tends to incorporate a variety of therapies as does traditional and conventional 'supportive' therapies. CBT is commonly seen in this context as opposed t o it's purer more research based form.

Monday, June 17, 2013

Continental Coffee, Commercial Drive, Vancouver

Photo on 2013 06 17 at 12 11 PM
I'm sitting outside the Continental Coffee Shop on Commercial Drive.  The ham and cheese I ordered is delicious.  The regular coffee is even better, distinctive and robust. The atmosphere of the place is decidedly commercial drive, intellectuals conversings at tables beside beautiful people probably hooking up through on line services with the occasional computer geek working on something, or blogging like me.  The young and pretty blond is journalling. I wonder if she's in recovery or just a budding writer.  There's all manner of middle class on Commercial Drive.  Three decidedly gay men walked by with affected speech. An angry lesbian looked at me and smiled blowing all stereotypes. The ethnic Mediterraneans look like retired crime bosses but probably are just grandfathers.  Across the street the Italian Bakery is doing brisk business.  There's Wonderbucks trading company too. I've shopped there when I was furnishing apartments.
Right now I'm thinking of God.  Gilbert is lying on the sidewalk beside me hoping to smell ass.  A particularly attractive young woman just walked down the street with 30's style clothing and bright red lipstick.  I don't suppose she's horrny.  That's a pornography Hollywood myth in my experience.  Old guys sitting with MacBook Air computers at coffeeshops aren't at high risk of being molested even in Vancouver.
In the 60's and 70's the drug scene was more about awakening while today it's more about numbing.  The slogan then was 'Turn On'. Now it could be 'Turn Off".
There is a preponderance of tattoos on the street.  Even Gilbert has one for identification.
God either is or isn't.  The very question implies existence. You don't deny the Holocaust if it didn't exist. There's not a whole lot of folk invested politically in excluding Santa Claus from schools and court rooms.
It's called 'secular religion'.  A polytheism for sure.  Not a monotheism by any means. Rather 'man as the measure of all things' or to be politically correct and decidedly hip, 'woman as a measure of all things'.  All the promises of feminism seem not to have benefitted me and yet like so many causes I supported them.  Now I'm looking for the old dying white guy movement. I feel and think about death a lot these days.  Sickness does that to one.  Mysterious pains and aches and chronic stress combine to make for cracks where fear will enter.  Prayer and meditation stay hysteria.  A problem shared is a problem halved.
My friend George reassured me recently I was still insane.  I was concerned.  If I was sane I'd believe what the media was telling me.  The planet is dying. The world is overpopulated. The government is all thieves. The banks are criminal and lawyers are all nazis.  Communists and atheists are taking over the country and China is spying on bowel movements with nano cameras built into see through bum lulu lemon yoga pants.  The possibilities for fear are endless.
A beautiful long haired summer dressed woman is walking her leash pulling hound.  Gilbert is watching the dog.
God is an idea.  God is also an experience.  I've known spiritual awakenings and experienced the interconnectedness of all creation. I have seen the whole of the periodic table dancing in a whirling matrix about me with all the hidden names of chemistry labelling existence. The greatest of visions and beatific realities predated hallucinogens. Closed materialist psychiatrists attribute all this to early childhood sexual abuse, misfiring of synapses, or any number of explanations suitable for themselves. They're pseudoscientists at best, never appreciating the limits of our knowledge of even gravity. They're more afraid than I am.  That's what 'uptight' is all about. I prefer my friends praying to raise the dead. Why not.  Beats blowing up people with bombs.
An oriental man with red shoes and diamond earrings is talking on his cellular.  The mundane is so deprived of the sacred as to make science anything but holy.  I , like millions before me, have known telepathy. I know twins who knew each others thinking and anticipated calls half a world away. All such phenomena is disregarded by the main stream monetarists.  To even imagine a connection without an 'airway plan for profit' is a threat to the status quo.
God is the central exchange.
God is that hub in which all souls are connected, time is one, and all things impossible are possible.
To me it's called home and I've been too far away learning the things of this world and proving my competence with the heavy manipulations of this lower zone made lighter by the love of man and woman, man and man, woman and woman, children and dogs.  I feel as if I'm in a reality invented by a cat. It's serious that way.  Mario de Beauregaard's "Spiritual Brain', was only necessitated by the lies foisted on us all.  These days they deny the mind and say everything is the brain.  Why not deny God, in time we can deny man and return to pure aggression.
I envied the woman who passed with the long and healthy body moving in a single form fitting fabric like a futuristic dancer having landed in this world for a day of sight seeing. I'd love to John Malkowitch her body and mind and experience reality from a different locus.
God is in all the eyes of the world. We are his and her hands and feet.  God is one and many and , the one many and the many one. There are no words for the paradox.
Talking of God gets one locked up or crucified.  There are too many Christians these days without scars.  All one has to do is tell the truth and all manner of authorities will descend upon you.  The story of Paul is today.
The sun is out and  still I descend into the gloom of yesterdays.  Resentments and fears make up so much of the thoughts that circle the amygdalla like warriors about a wagon train.
She is passing with red hair and dark glasses, a slim but busty body and no need to wear black on this day.
Men used to wear cod pieces that brought one's attention to their genitals.  It is only when their penis is exposed that they become objects of sexuality. Women have done well to clothe men everywhere so that at least they can think in late spring without hormones distracting them any more than they already are.
Men's clothing conceals, mostly sloppy and loose fitting.  At least gay men celebrate their bodies.  The male suit jacket was developed from the design of British war uniforms.  As a man I've felt at war most of my life, competing with others daily, defending rights that are only rights if defended, begging resources promised but not given, refusing to accept the status quo which would have those I care for marginalized and why.  I was little once and fear that when I am old there will be no one there to help me.
But God.
I was in a hospital with a dangerous sadistic nurse.  She is memorable and yet all the others I have known so much more positively cannot erase the experience of her abuse of power.  But abuse of power is ubiquitous.  It's a subjective state in a greater whole and what Job was written about in the Bible.
My relationship with God is sadomaschistic.  The story of Jesus is one of faith and denial.  I have more faith in God than I do in myself.  I'm a regular Jonah refusing to go to Ninevah.  I'd rather be in Yaffa.  How many whales have I been swallowed by and how many times have companions felt threatened in my presence.
IA young girl walked by wearing a pink shirt "Love who you are."
My seat is bouncing for Gilbert is meeting another dog behind me and his leash is attached to the chair.  Now passing I see this was a pug.
There is a book of biblical Hebrew I need to study for this evening. I've a lesson to prepare and yet would rather look at  two pretty women scantily dressed walking proudly down the street.  "People watching" in Arabian countries must be boring in the extreme. Feminists loved to flaunt themselves in the day and then blame men for looking, before the lipstick feminist set made mockery of the their older dirty silly sisters.
I'd like to be at a nudist colony. I could go to wreck beach and see the phallus as privileged as the breasts of the city are.  The breast prominence is accentuated by all manner of wire and engineering. Stanfields offer me no such assistance.  No wonder men ride Harleys, yet women seem only interested in the cost of such machines and sociobiology prevails.  The egg is more dominant in behaviour.  I am reduced to the behaviour of my sperm.  Sociobiology is so much richer than the mythology of Marx.
A Harley has just driven by and I am aware I could be driving mine on a country road right now.
Instead I am here talking to God, thinking about God, conjuring God, praying for God, meditating on God.
Sexual orgasm is a sensation.  In my material world scale it's more exciting than a bowel movement or a pee but to one who has suffered limitation of either sex holds no comparison.  Sex can't compare with making money for the financially insecure or for someone who has been poor and equated poverty with powerlessness.
I've had ample opportunities and been blessed again and again by Grace. Luck is said to be God acting anonymously.
The sins represent excesseses.  Amorality revolves around sins.  Our laws speak most to sins.
There is the sin of gluttony.  All over the rich are obese and yet so are the poor.  Not perhaps in times of famine.  Historically some meat, like the physique of Marilyn Munroe has been preferred to anorexic Twiggy as defines against disease and famine.  Now our western world dies of excess. The narcissism about food acts out in all manner of variations, cook books, epicurean delights, restaurants, vegetarianism.  There's a regular pornography of culinary indulgence.
Yet, Jesus said, "man does not live by bread alone".  And so few fast when fasting was as sure a route to knowing God as prayer and meditation.  "Could I have a latte and a cucumber sandwich on whole wheat and flax bread, if I fast?"
Sex is dirty to the glutonnously filthy who have lost the feeling below their mouth and insist their daily involvement to all else in their 'taste' and 'gut sensation' is 'necessary'.
But yes, the experience of a good bowel movement is increasingly appealing to the aging population whose daily ritual is to look forward to meals. Not so much for social conviviality as the respite from thoughts and memories.
Sloth is another favourite sin these days with unemployment, welfare, rest, vacation, leisure, and sleep and all manner of industry related to the bed and couch and lazy boy.  Disability is another industry which revolves around late night preoccupation and late day rising.  Inefficiency is disregarded and whole government agencies are devoted to promoting a lethargy of sloth that all insist is necessary. And may even induced or coerced. As some who really would do other are obligated to join this 'state' of affairs for political gain ultimately of others, not themselves.  They have their reward in sloth.
And there my mind slips into criticism and negativity.
I turn to God to lift me from the malaise of thought which begs for something to gnaw on as many seek 'no mind'.
Gilbert has been petted quite a bit by passers by. He's enjoyed his time. I just realized my meter must have run out
But my meter calls to me.  It measures time.
God may I know you better today and be more with you.

Sunday, June 16, 2013

Plumper Cove, Keats Island, BC

I motored my Folkes 39.9 cutter rigged steel sailboat from Coal Harbour to Plumper Cove, anchoring Friday night .  We just had time to barbecue shish kabobs steaks bits and have with boiled potatoes and carrots.    In the morning after a marvellous breakie of fried eggs and hash browns from the left over potatoes, Gilbert and I got in the dinghy and rowed ashore.  I love the Plumper Cove Marine Park.  Great dog walk into the backwoods.  There's a creek that runs down the backside of the little hill.  Gilbert sniffed everything and peed on everything else.
Then we got back to the dinghy and rowed out to the boat at anchor.  It was a tough day of reading and napping and nibbling.  I had a shower at some point. The sun was so out that I put on sunscreen.  Despite this my face is red after the weekend.  I read Spirtual Theology by Diogene Allen and Inferno by Dan Brown. I even did a couple of chapters of Biblical Hebrew homework.  Four more to go to catch up.  I've a tutor planned as well.  All to be able to read genesis.  And hopefully visit Jerusalem again.  I loved the holy city.
Somehow with very little effort on my part, the day passed.  I fished a bit off the deck and eventually almost bored settled down for the night and slept another great sleep at anchor.
Today I weighed anchor early, well 9 am. I'd woke at 8 am.  On the way back I noticed i needed to add oil to the engine and everything was well after that. There's a harmonic on the shaft and prop around 2000 rpm but not there at fishing speed of 1500 or travelling speed at 2500 rpm.  It was a great moment when I caught a fish. Wow.  It was a cod and very quickly ended up on the barbecue.  I boiled some potatoes and peas to go with it and was delighted.
Gilbert even liked some bone free bits.
Then it was motoring home.  I almost put up the sail but I'm not that well stowed below. Besides I was enjoying reading Brown's book and sailing would mean running about on deck instead.  So lazy 'iron jenny'.   Great help from my neighbour docking.  A good outing.  Gilbert was glad to be back on dock.  IMG 0409IMG 0427IMG 0428IMG 0425IMG 0429IMG 0430IMG 0414IMG 0424

Plumper Cove , Keats Island, BC - journallingI

It's lovely here, anchored, sitting below in the cabin of my sailboat drinking coffee and blogging.  It was hot on deck when I went topsides and threw the dinghy overboard for a later row ashore with my first mate, Gilbert,  the cockapoo.  I'm grateful today.  Grateful that the sun came out and that the boat repairs were sufficiently complete that I was able to motor here easily.
I'd taken Thursday afternoon off hoping to get away. I vaguely thought of crossing Georgia Strait and going to anchor off Nanaimo.  That's best done as a three day trip given it's about 7 hours to get across the Strait.  I had errands to run and as usual at the end of a week my head isn't quite in the space it needs to be for starting an adventure. I wasn't even sure I'd take the boat though that was the plan. When the weather turned cloudy I thought of heading south in the Miata for a weekend in Seattle.  I imagined getting a pedicure and staying at some place with a hot tub.  Places like Harrison Hot Springs are the only way to recuperate when it's rainy and cold.  I fancied a massage even.
Alternatively I thought it was the end of spring bear hunting season and I could head out to the backwoods with a rifle and hike mountains in search of a freezer full of meat.  That was countered with the though I preferred salmon to bear meat and really a long drive in the truck on Thursday afternoon wasn't what I had in mind for r and r.  So I stocked the boat going with the first plan, clearing the decks of stuff that needed to go to the storage locker and provisioning for a weekend in case the weather turned.   I took Gilbert for a couple of walks.  We actually got dressed up with the idea of going out to a club but only got as far as taking Gilbert for a walk before returning and watching a movie seemed the better idea.  My mind is so ambivalent at the end of the week.  All week I've 'answers' and 'questions' but at the end of the week it's just a muddle for me.  I pray and ask God what I'm supposed to be doing. Know I'm supposed to be recovering and don't know if it would be better to just had a long nap or go for a walk.  Gilbert usually settles that by climbing on my chest when I lie down, looking me in the eye, and suggesting I reconsider. He does love drives in the Miata with the top down.  I look over and smile at his dog face in the wind hair blowing all over as he stands with his forepaws on the elbow rest and tries to get as much of his head out the window as he can.
Waking Thursday I was lonely.  I'm so much with people when I'm working, overwhelmed with the human predicament. happy to be with people, happy to share their lives but not particularly happy with people out of the office.
Thursday afternoon I'd sat for a late brunch on Commercial.  A very attractive woman had sat down beside me wearing the most red shoes I've seen.  It was like one of those black and white photos where someone had added red to the picture except that the world was in colour and this red was just really really red.  She had a contraption, a vaporizer for 'smoking' without smoking'.  Some nicotine delivery system that she proceeded to talk about at length without any sense of her addiction to nicotine focussing her attention to this.  I was thankful I'd quit smoking 15 years ago and thought it good she was struggling.  Sad though that something that was initially so attractive turned into a demon.  The conversation seemed fine for her but for me it was a bit like a bus man's holiday.  Especially when she began talking about AA and other addictions. She was so critical and unaware of her criticalness.  I saw myself in her, those times when I was negative and critical and found an external institution or event to vent my frustration on.  She was critical of life and God in a sense as well and I found myself almost back at work asking, what alternative is there. What's a better solution.  As is so often the case, there wasn't one.  All that time and energy spent in tearing down something and none spent in building.  It's an adolescent thing really.   I probably even said , "boys and going destroy, men and women create."
I think the anger and frustration comes with nicotine.  It's worsened by it really, fueled in a way.  It also could be youth.  She was younger than me by a decade at least, like everyone seems these days.  I was so 'opinionated' when I was younger, trying out new ideas, trying to figure things out, breaking down and building and hoping for a new age.  Hopeful really.  I'm probably just jaded.  I've turned a corner and don't have much hope for the world or is it for myself.  I don't think if I just change this , everything will be all right.  Now I'm mostly trying to change me and feel alright with what is.  She was mostly objecting to the 'spirituality' of AA and going on about Buddhism like most westerner do who haven't read 'Trungpa' or even Buddha.  Just like the communists of old who would idolize some distant land where 'real communism' worked, so she was celebrating a religion which was fine but not in comparison.  Or maybe I just didn't want to talk comparative religion after years of studying it and thinking always Buddha, Mohammed, Moses, Jesus would behave better together at a tea party than any of their disciples. She was pretty and enthusiastic and angry like so many young women.  Rebel's without causes.  I just couldn't help but think as I so often think listening to women is  that I heard men saying the same things 10 years before.  So is it a gender thing, women coming into their own, developing all the diseases of the workplace, dying the same as men once they left the protection of the home, suffering in the workplace, or is it just youth.  Was she no different from her male cohort and I was just registering the ideas we tore apart a decade or two ago when we were all so intellectual and all the 'ideas' seems so fine on the couch and in the coffeehouses before reality took over and messed with even the best of ideas.
There are so many 'binary' ideas, like all of the Marxist notions, all the I'm right you're wrong groups, my brain is healthy , yours isn't.  I tire of that paranoid ideology and want to hear the trinity, god, not god, and god and not god. Can't people even begin to grasp quantum physics and what is says about our minds.  The courts and politics are so often binary which goes with sports and choice. Maybe it's just me at the end of the week unable to think so well any more, weary with worry and concerns for those I'm privileged to care for.  I've read so many articles recently but none have the answers that I need in my work.  All the 'solutions' I see in the 'learned texts' have been tried on the people that I see.  The paradigms are exhausted.  Meanwhile all the government offers is marijuana and euthanasia and arguments again about the fat cat Senate.  I'd really like to  be a senator though I'd hate to be caught stealing and have to pay back all the money fraudulently taken. In my work if I did that though I'd lose my job or go to jail.  I miss  "security".  Everything seems to be hanging on a thread these days.
When she left to return to work where she obviously struggled with injustice and defended the weak I was glad to move on, thinking talking with people isn't really a break for me and that if I'd known the weather wasn't going to stay sunny I'd have best worked.  Better to be working on a rainy day than sailing though that's not necessarily true.  It's a Vancouver thing, the office buildings explode with people when the sun is out and we all scurry back to work inside when its raining.
Perhaps that's why all dressed up I preferred to walk the dog than go out to meet strangers.  I like the feel of a new shirt though.  One I've not had time to spill coffee or food on.
Thursday morning I was thankful for a meeting.  I knew some folk who get together at lunch time and decided that's just what I needed.  A little coffee and company would do the soul good.  The drive to Davie street from North Vancouver was a bit of a chore with the road construction but a convertible like a motorcycle makes that all tolerable.  I liked joining the discussion about homophobia.  Ingrid shared with me that she had not been invited to a wedding she thought because she was lesbian.  That may well be but as she knew it could be other reasons. We focus on the difference we struggle with and the sexual differences are most difficult.  I like this group.  Sitting in the coffeeshop beside Little Sisters on the patio where Gilbert could be with us we talked about relationships, homosexual and heterosexual and bisexual. Everyone had a relationship of their own to contribute with mostly light hearted humour.  The discussion even got into prostitution and much was said about money and energy.  I thought about Buddhism and 'right livelihood' and the strictest religious view in some Hindoo and Christian sects that sex was only to be used solely for reproduction and not to be much fun either. Very stoic in that sense but not at all epicurean in a Greek sense.  The thing I enjoy most about these friends is that their conversation is always 'us' and 'I' centred. We call it the 'language of the heart'.  Each person was sharing their difficulties and strengths and not criticizing some external agency. There's a truthfulness is the 'subjectiveness of experience'.  Each person spoke about what they themselves had experienced as opposed to the formulation of the intellectual and assumed objectivity.  I felt we all had shared Heidleberg and knew something of limitation.  The youngest too was in her 40's and waxed poetic about her home and garden.  Phil was good to see again. A handsome man who ran a hair salon.  For some reason I remember Charlotte's name most because she was talking about art and vision and expression.  We laughed together about the Lulu see through yoga pant recall, how the girls had objected but that when the story got out gay men were lining up to get a pair.  I was happy to see the fellow from the tax department enjoying our conversation about money as an 'idea'.  I'd hate to have him be having a bus man's holiday.
I had a parking ticket by the time I got back to the car but I didn't feel lonely any more.  Back at the boat I threw off the dock lines and was just heading out when I noticed I'd not disconnected the shore power.  That provided a little excitement, backing up, docking, jumping down, grabbing up the electrical cord and jumping back on board without hitting either of my neighbours fore and aft.  I got away with my heart pounding thinking how stupid of me.  But it's been a year since I took the boat out myself.  I'm experientially into so many complex and frankly dangerous activities that it's hard to remember every detail especially after gaps of months.  I just went through recertifying in scuba diving with a dry suit in cold water and had the same process. Now I was getting back into solo sailing.
The autopilot is a charm.  I love that it holds the course.  Fueling up I found I only needed 80 liters.  The forward tank was mostly full so I suspect I'm running off the back tank.
I actually got the down rigger out and fished on the English Bay side of First Narrows.  No luck but I figure if I do the right thing enough it eventually pays off.
I always enjoy passing Pt. Atkinson.  A pretty lighthouse.  I enjoyed passing Whitecliff where I scuba dove a few weeks past.  That was in Howe Sound.  The sea was fairly flat and I was making good time. I'd started late and thought to go to Plumper Cove but almost turned off to Gambier thinking I'd not get into Plumper till after dark.  Thanks to the clean bottom I've been getting 5 to 6 knots so decided to go for it. I made it to Plumper Cove while there was still light.  Anchoring went without at hitch.
Then I got out the marinaded beef shishkabobbs (spelling?) (beef chunks skewered on sticks).  Save on had a deal on them.  Gilbert was happy to have half.  For a little dog he can put down a lot of barbecued meat.  I boiled little potatoes and had those with sour cream and butter.  The hagen daz ice cream didn't stay frozen in my freezer but was tasty as a milkshake.  I watched the Ghost Writer dvd and figured I'd seen it before but enjoyed it once again.
Now I've slept a wonderful sleep at anchor and risen to make coffee I've enjoyed and written this journal, grateful for my day, my dog, my boat, my fingers and toes, this incredible scenery, the great british columbia outdoors and no real demands.  A trip ashore for a walk in the woods is all I've planned though I could go fishing too.  I think I'll make breakfast now. Another cup of coffee.
I' ve  been reading Dan Browns newest thriller Inferno.  I love the Tom Clancy writing like a good rock and roll song but in Dan Brown's case all the art and history and ideas are thrown in as well.  A delightful romp so far.  Thanks to the autopilot I got a lot of reading in yesterday evening. Nothing better than sitting on a boat reading a great mystery or thriller , looking up all the time to make sure nothing untoward is happening.  I remember when I studied the shore but now the gulf island are a bit like the drive to work.  I know them well and enjoy seeing the occasional eagle and maybe do miss things like deer on shore or a surfacing whale but the fact is I've seen a lot , am constantly looking about but enjoy so much reading at the wheel and drinking coffee while I'm doing it.  Gilbert lies at my feet in the cockpit and doesn't appear at all guilty about sleeping a whole lot.
I've also been reading Diogenes Allen's "Spiritual Theology'.  It's my second go round.  That good a book.  I loved reading last night, his quote from Walker Percy, "I have learned that the most important difference between people is between those for whom life is a quest and those for whom it is not."
Life is a quest for me.
Bolen texted me on the iPhone when I was in Howe Sound that he'd heard I had a poetry manuscript completed. He shared that he had too and we're planning on exchanging ours for a good read.  I liked the tech experience, the 'grid' experience.  I've got a 'Wind" "hotspot' here being generated by a little device they gave me.  I didn't know it was good here but sure enough I've got wifi.  The iPhone operates on the Telus network.  I was planning on checking out my internet satellite phone connection sometime too.  I've got lots of things to do if I ever feel like a task or two on this boat. I'll be lucky though if I simply read and get breakfast.
I'm behind in my Biblical Hebrew studies so planned to catch up on those this weekend with a few hours of study. Cohen at the online Jerusualem university has been a delight so far.  Not at all too onerous and I'm actually hopeful I'll get some ability to better understand Genesis.  I'd love read some parts of Isaiah and maybe learn a psalm or two too.  It seemed such an insurmountable goal when I realized it had it's own alphabet. I prefer the study of Spanish and French and Latin from that perspective. I've got some basis.  This is daunting in comparison but the teacher makes it 'seem' easier than it is.  I think with the sunshine though lying on deck with some sun tan lotion might be a better alternative.
Time to make a mother coffee. It's like a summer day as a child during summer vacation.  Then I'd ask my mom what I should do.  She always had ideas, some of which weren't at all what I was hoping to hear.  Now I'd just love to hear her voice and see her smile.  If Dad were here we'd be out fishing for sure.
Right now I think I'll have another coffee and read more of Diogenes.  I was meditating already this morning and pleased to have Gilbert join me thinking my cross legged position was a perfect place for him to rest his head.  Right now he's got his little bum pressed up beside me.  I know he'd like us to go for a walk or play ball but that seems a bit energetic as yet.  Another coffee and maybe some fried eggs with hash browns is the next order of business.  Decisions, decisions, decisions.
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