Tuesday, December 24, 2013

2013 - my year's highlights in review

I'm sitting here after a cold walk in Ottawa with Gilbert.  He three legged it a bit, his little paws chilled by the icy salty street at times.  Overall he loved the walk, especially smelling cold preserved dog poops in snow.
In my brother's kitchen at the table, Adell is sewing her son's new stockings for the mantle. The old ones were apparently tasty in the garage to some little critter.
Walking Gilbert I thought of the year in review.  Can't even remember where I was last year. I mixed up Christmas with Thanksgiving. That's when I was l here fall last year. I just realized I could consult my blog. There's a record there but that's the 'facts' and what I'm remembering is a whole different calendar of importance.
Adell sorted out that I was here 2 Christmas ago but last year had worked at the Methadone Clinic then taken Gilbert for a couple of nights in a dog friendly luxury hotel in Seattle.  I remember how pleasant that break was.  Especially loved the fashion in Seatle.
I worked all year. My office in the Old Electric Building had a steady flow of patients with more wins by far than losses. In chronic disease treatment, the aim is to stop deterioration and maintain levels of competence. Occasionally you can actually reverse the process. I like the addiction work, because anyone you can bring into abstinence restores a life and saves the health care systems hundreds of thousands an individual at least.  Stopping alcoholism stops heart disease, bowel cancer, liver disease and dementia.  Stopping marijuana smokers reduces lung disorders, adolescent psychosis and emotional disorders and work and relationship difficulties commonly.
Getting heroin addicts off street drugs is a joy because without injection there's no further risk of emboli, overdose, infection or spread of diseases like HIV.  The cost saving to a community of a methadone clinic is millions of dollars of health care costs and similar millions saving in crime prevention. In contrast the Insite centre, sexy as it is to the liberal media, serves the illicit drug crime industry and because people keep injecting they inject when they're not at the In Site site.  Drug trafficking persists and deaths occur off site as does spread of disease. it's good for the drug trade. I love Steppenwolf, the Canadian rock group whose song, "Goddam the Pusherman" still gives me shivers.
So I feel good about my work, with patients, knowing that I'm directly affecting morbidity and mortality and helping individual patients with the quality and quantity of the lives.  My psychiatry work focuses on trauma, head injury, addiction and change.  A third of my practice comes from the highest walks of society and have the greatest motivation to change for the better. It's often humbling to work with these highly functional individuals who have a glyph in their systems. I sometimes describe my work as 'ferrari human mechanics- sometimes I'm tweaking engines, sometimes I'm overhauling they're all ferrari's."  I like my now dead friend who said, "God doesn't make junk'.  I've attended funerals this year and heard of more death. The baby born was a joyfulness.  We're getting older and more often than not my friends children are having children or dying themselves.
I've been blessed with Hannah as an assistant. She's been so trustworthy, competent and caring. All the patients have appreciated her too.  That's been the same for several years thanks to Aim and Joanne before her.  Mostly I've been blessed with tremendous assistance.
It's the same with family physicians and specialists, psychologists, counsellors, lawyers, judges  and pharmacists I' work with. 99% of my interactions are highly positive with all these people but there's those one or two people with a negative interaction and it's hard to focus on the positive given the damage I've experienced with individuals.  The 'system' maximizes the damage potential of social terrorists too. But that's a personal mental process too.  The inability to focus on the positive requires exercise and work whereas it's so much easier and lazier  to let the negative colour one's experience.  Some call that depressive thinking, others alcoholic, others Irish blood, or sour Scottish phlegm. It's a lack of gratitude and I'm thankful for a program and church that remind me that I must always look at the half filled glass rather than see the glass as half empty.
My accountant Anil and my brother Ron made life less confusing when it came to finances and business management. I'm certainly thankful to the the managers at Scotia and TD banks for their sound business advice.  So focused on patient care I've lost a million or more because I simply don't focus on finances, sales and all that manner of stuff.  So much of the difficulties of practice are the confusion of taxes and books, with clinics and various insurance and private fees.  It's become worse every year with higher overhead and less services.
I've never done as well as I did financially as a family physician but I've continued to be able to work in the areas of greatest need while managing overhead and a good life by world standards.  I can't afford a house in Vancouver and worry sometimes with all the corruptions and billions made here by crime and drug dealing that my neighbours if I did own a house might likely be a dealer. While others though were suffering because of the financial collapse and younger and older folk were having severe difficulties I was getting by thankful to have work and a modicum of security.  Nonetheless I remain a survivalist and enjoyed the full range of zombie movies the year brought.  I'm ready. If apocalypse happens or www III then I'll be the go to guys. There's a lot to be learned from zombie movies too.
I was blessed to go to Mexico last year. I attended the Family Practice Trial Lawyers of BC conference, an enjoyable affair, looking at medicine in terms of liability and costs.  Then the diagnostic issues in areas of conflict were informative as well.  Mostly I enjoyed the good humour of the judges and lawyers in a mock trial as well as the discussions by judges and lawyers of the interface between health and law.
On my own time I went for lunch with a traveller after a meeting in town discussing the value of sober judgement and the conflicts we had personally with the chemically dependent.  I'd shared my work and he'd shared his. He went on to show me where they served great chicken locally.  I enjoyed the horse back riding, galloping on the beach, and scuba diving the fresh water caves. I enjoyed a root canal there which didn't disrupt my overly busy Vancouver life but took little time out of a vacation. It's like shopping, something I only seem to do travelling these days.  I've no time or desire to wander a mall on a weekend back home but enjoy the novelty of this experience elsewhere.
Bear hunting wasn't successful in the spring from a bear kill basis. I was in Princeton before the bear came down from their hibernation. Riding my 250 Honda motorcycle in the backwoods with Gilbert on the back and plinking at targets was fun.
I love how spring comes so quickly on coast. Driving my Honda 250 in town and in the back woods was preparation for getting back my confidence on my Harley Classic 1600 cc motorcycle.  After the injury to my knee and foot I'd had doubts about my abilities on a bike but no problem.
I bought a new small boat with a big engine and we had a great time in the spring at Harrison Lake.  I do all this fishing and hunting but have little return but good pictures and good times. Gilbert loves the outdoors.  So much of life is about the journey.  Hunting and fishing and camping is contrast. It's like eating a variety of diet so you appreciate hamburger and steak. All of one is dull.  I love the variety in my life and seek to expand it.  My friend was sky diving and I could only think, when will I do that.  Another friend caught big fish off Mexico and I remembered the thrill of catching big tuna in the ocean and all the great meals.
I was out in my big boat in the summer.  I towed the new pontoon boat with 20hp enjoying fishing  south of Texada Island.  Beautiful country and boating.  It was on that trip I cast my cat Angels ashes to the sea.
I enjoyed riding around English Bay in the new little fast boat.  Moon, Randy and Tom were all out in it as I learned how to get it up on a plane and get the most speed out of it.
The summer addiction conference in Denver was the wonderful time this conference always is.  I was thankful to be asked to speak with friends present.  It was great to ride there on my Harley and on to Sturges the Big Harley Davidson festival in South Dakota.  Seeing the Dooby Brothers and Kid Rock was great but  I liked Steve Bell's music most on that trip. 5000 km on Harley, Washington, Idaho, Wyoming, Colorado, South Dakota and Montana.  Loved the antelope and buffalo and hot springs.
The Christian Medical and Dentist conference in Edmonton was amazing as always. I'm delighted to be among people who somehow manage to be the most moral and ethical doctors yet work in such difficult situations.  I'm always filled with hope and humbled by their examples.
Then it was a week of hunting just south of Prince George. Mostly I loved camping out in the RV and driving about in the truck with Gilbert. We got out on the motorcycle a couple of times but there was only partridge .The weather was perfect for camping but that's the problem. Hunting is best when conditions are horrible.  I did encounter a very big bear face to face when I was bow hunting this year and thought twice about shooting him even though I could have.  I worried my arrow might just piss him off.  He ran off probably after getting Gilbert's 'dog scent' and not being sophisticated enough to separate cockapoo dog from pit bull.
It was a real privilege to meet Prime Minister Harper.  What an amazingly accomplished low key gentleman he was.  I was touched with his personal concern and realized what an honour it's been for me to have met 4 sitting prime ministers and known so many amazing political leaders. When CBC especially gets me thinking the country is ruled by only corrupt incompetents I have to remember the great men I've met.  I found myself increasing pissed off with CBC news coverage and their supercilious attitude of superiority when the media in Canada is a glass house.  People in glass houses shouldn't throw stones .
All year I enjoyed the Canadian Authors Association executive. I also enjoyed the board of the Drug Prevention Network. Ben Nuttall Smith, Jean Kay, Margaret, Margot, Dennis and all the others.  I so enjoyed getting to know David Berner and the other executive and Recovery Day and the whole host of folk who worked on that.  It's just good to know people doing good for others.  I loved St. James Anglicah Church too.  It's welcomed me and Gilbert and helped structure my week with guidance and insight.
It was an expedition, driving the truck and RV all that way and back to Prince George and the logging road with the trailer..  Each of these passages is a trial of organization and endurance with lots of new skills to be acquired and steep learning curves but a whole lot of fun.
The real joy was being invited by Dr. Phillip Ney to attend the Hope Alive Conference in Baku Azerbaijan.  The counsellors I met there were all so incredibly accomplished and inspirational.  I loved that time.
It was a great hunt weekend with Luke, Tom and Sonny, with enough equipment and fire power to take over a small nation and only one partridge raised by Gilbert to show for our hard work up before dawn facing blizzard winds that fell logs that had to be cut before we could carry on.  Great camaraderie.
Then Singapore with its international meetings, jungle train trip to Kuala Lumpur, meeting the east Indian and Australian doctors,  International Society of Addiction Medicine, folks from ASAM and CSAM, all a real joy.  The Batu Caves were a spiritual experience.  As was Cambodia's Ankgor Watt. What an amazing time and what a privilege to experience first seeing a part of the old USSR and then Malaysia and Cambodia.  It really expanded my sense of the world despite my having been around north america, europe, the middle east, mediterranean, northern africa, the polynesian, India and some of Asia.  I think what most amazes me is how intelligent and accomplished my colleagues are in these diverse regions and how little our media or our scientific journals represent their work. I loved the methadone clinic in a mosque with imans doing drug counselling.
Responding to medical emergencies on planes is fun.  It's been a year of adventure and now I'm here with family.
Thanks to Hannah and Ben Nuttall-Smith I even got a book done, collected poetry, Love between the Sacred and Profane. The book launch with the help of Mida and Hannah's family went superbly.
It's been a struggle supporting patients to the best of my ability only to be condemned for doing what is normal but seen abnormally. I hated the twisted view of caregiving that the unscrupulous give with cavalier arrogance in their gross ignorance.  It's still so typical of me that I allow this devastating attack to distract me from all the incredible work I've seen and done.  Again it's the perception that allows the wrongs of others to influence one's own correct and true action.  Only arm chair quarterbacks who are rich and above the laws that rule the real world can be so cavalier.  I fault them less that those who advise them wrongly due to incompetence or greed. I've seen the destruction and know the faces of the patients whose deaths occurred as much because of the horribly 'fucked' system.
I think of the man dead in the emergency of Winnipeg General 36 hours without medical or nursing attention.  I've three white patients dead this year because of failure of the system to hear their cries and the steam roller Gorgon destruction. I've no children and can't stand the abuse of children anymore. All the thousands disenfranchised  children and  broken families I've treated have left me raw. Adults are easier to deal with.  When the system fails them it's easier to be accepting.
I'm blessed though.  My friends George and John touch me to the core with their generosity of spirit. I've enjoyed blogging and all the friends in blogging world and Facebook and Twitter. It's been a good experience truly. I am so thankful to Jesus, the Holy Spirt, God of Gods.  Creator, omniscient, omnipotent, present and loving.
Here I am. Thank you. Another good and full year. Christmas Eve.   And the Hagmanny not here yet.

No comments: