Friday, January 31, 2014

Taboo - the naughty and nice sex show

Taboo - the naughty and nice sex show is happening at the Vancouver Convention. Last week Mission Festival was here but I sadly missed that.  The Convention Centre gets all kinds.  That certainly was what I saw at Taboo.
I certainly wasn’t the oldest there but the majority were 20 to 50 years old.  More women than men, or maybe that’s just what I saw.  The body painted girls were the best.  Reminded me of the Sturges Motorcycle Festival.
I didn’t touch anything.  Sex toys in all kinds of materials.  Silicone, glass, steel. A lot of things were inviting, in a kid wanting to hold and feel plastercene kind of way.  Breasts, vaginas, penis, buttocks.   All looked really life like, but I tried not to stare.
I couldn’t shake the feeling someone might know me and see me.  I was comfortable, at my age, with being there.  It’s just that I felt staring might give the wrong message if someone was watching me.  I envied the younger folk who seemed much more relaxed.
The fact is, the room was full of beautiful young individuals and all manner of handsome and stunning folk walking about in that way sexually confident people have.  The kind of people who can still remember when they last had sex.  The idea that anyone was looking at the old guy, trying not to stare at anything in particular, was pretty far fetched.
I did talk to people at different booths.  They suddenly appeared and began talking about their products.  I was polite.  I listened, looked and acted interested, while kind of wanting to escape. It was kind of like last week at Vancouver Boat Show last week.  Only there the salesmen were bringing my attention to their motors and such. It was the same sort of thing but different.  They weren’t selling outboards.  Nothing gas operated like a Harley. Mostly battery operated. I’d seen some of the those new chargers for the electric cars when I walked through the parked,  and naturally, wondered.
The fashion was awesome. All the clothing that’s Victorian bedroom, with bodices of all kinds and all colours.  A lot of the sales folk were dressed in particularly fetching ways.   A lot of cottage industry seamstress cottage industry work.
One even had a terrific purple doggie bodice. It was so cute.   I didn’t think Gilbert would go for that at all though.  Hard enough to get him to wear a Canucks shirt. He was just being a good sport when the staff got him  to wear a pink hoodie for our cancer fund raiser.
Lots of bondage paraphernalia.  Dungeons seem an odd trend given the effort people go to to stay out of jail, and get out, when they’re there.
I liked the paint guns, though. I relaxed when I found the paint gun exhibit. There was a church group there too.  Found myself thinking about the Comedian Barr's quip, "Christian Rock? What's coming next, Christian Porn?"
Even though there were a lot of single people it seemed like the couples were having the most fun.  The older couples were laughing a lot.
There were booths for massage products with all manner of oils.  Even a couple of chiropractors were on hand.  I liked that.  Looking at all the contraptions for hanging and different positions, I could see where a chiropractor could come in handy.  I did like the pillows and variety of sheets and various types of bedding.  Egyptian cottons with high thread counts or satins seemed most in demand.
Now that people have recognized that gluttony and sloth are the greatest sins of our times I wonder if  people are revisiting sex as a way of combatting the obesity epidemic.  I don’t think it’s good for the climate change folk. Definitely this is a place where it's cool to be hot.
IMG 4663

Coal Harbour in Winter

Gilbert and I just took a fast spin around Coal Harbour with the 20hp honda on the hard bottomed boat. Saw only one other boat out there whizzing about. Lots of freighters.
We filled up with at the fuel at the fuel dock. Now we are at Bean Around on Lonsdale Quay. There is a corky sitting outside watching its dad intently. Gilbert is on a leash in his life jacket looking at everything.
The chai latte is terrific. Sitting outside on a sunny winter day. I came from riding about in my miata with the top down.
Talked with Darren over on Granville. Had just bought a North Shore Round Up ticket from Antonnio. Good to see the guys. D-has a table for Turning Point. Ive got 6 tickets. He said it was good we were all stepping up for Malcolm. Always enjoyed Malcolm at the Turning Point Gala.
Someone, I won't mention who, (said they'd already been) told me that Taboo, Naughty and Nice, is on this weekend. I missed the Mission Festival last weekend but it looks like I might actually be able to swing by Taboo, no pun intended.
I had planned to drive down to Seattle or out to Harrisons this weekend since I cancelled the trip to Maui. I'm enjoying Vancouver with this awesome weather too much to get away. Maybe tomorrow or the next day I say. The city certainly has its attraction when the rain stops.
I didn't like downtown, Hastings and Main, the kamikaze drunks and addicts are increasing in zombie numbers. Twice I had near hits when guys stumbled out of my blindside from behind to try and cross in front when traffick was stopping and starting.  Frightening.
Better for me to be out on the ocean. Much more peaceful.  Scenery with snow in the mountains sensational.  Blues are just so blue in winter.   Thought of going out on English Bay but it is still too cold. I'm warm in my mustang integrity floater jacket but I didnt bring gloves. Hands are chilly in the wind, the way they are with motorcycles and ATV.
Well time to get back to the boat and head out for a little more water time.

- Posted using BlogPress from my iPad

Thursday, January 30, 2014

William Hay, Psychiatrist

I am thankful for my name. Wiliam has served me well.  I use the formal, long version, though have been nicknamed Bill or Will throughout my life. The name Hay is a name I acquired from my parents.  My grandfather was a Reeve and my father a man admired as a leader.  The problem for me was ‘psychiatrist’.
I had no problem being, William Hay, Physician.  Today I still commonly introduce myself as such.  The stigma against the mental ill which is so prevalent in this country also applies to their caregivers.
I’m proud to tell people that I was accepted into surgery and did a year of the three or four required to be a surgeon.  Mine was a surgical internship and my electives had been in plastic and orthopaedic surgery as a student.  I had concluded in my training that I wanted to be a missionary doctor and that best equipped missionaries were surgeons.  I was reading a lot of turn of century history at the time.  The problem was my wife, another doctor, by the time I was an intern, didn’t want to be a missionary. She wasn’t even a Christian per se.  She wanted to work in the university and stay in the city.  She wasn't adventurous and certainly didn't like camping when I introduced her to the wilderness.  Our marriage never did work out.
In those days, and the tendency remains, I thought if something was ‘good’ , like obviously being a missionary to me was, others would see it as such.  Today I know a whole group of people think missionaries are idiots.  My wife hated the idea of my becoming a psychiatrist.  She loved the idea of being married to a surgical resident.  She didn't like psychiatrists, possibly because she'd grown up surrounded by severe mental illness and wanted a life as far away from that as possible.
When I announced I wasn’t going to return to surgery and wasn’t going to stay a family practitioner, but rather I was going into psychiatry, my wife was ashamed.  My medical colleagues collectively expressed their astonishment.  The jist of their concerns were summed up in these repeated exclamations,
“You’re such a good doctor, you don’t have to be a psychiatrist’.  When I entered psychiatry it was thought to be a place where only the lowest level of doctors worked.  Often immigrants entered the country by agreeing to work in asylums because even psychiatrists didn't want to work in asylums in those years.
“You can be a surgeon, you don’t have to be a psychiatrist”.  The hierarchy in medicine was from the ‘seen’ (surgery is so obvious) to the ‘unseen’ - the work of psychiatry is by far the ‘subtlest”.
“You’re a real physician, you’re not going to get along in that quackery’.   As a ‘real physician’ this meant, that I was a scientist.  I’d come into medicine with a mixed arts and science background.  My arts background made me ‘suspect’ to those students whose only interest had been science or technology.  I felt I had to ‘prove’ myself as a ‘scientist’ and that having done theatre and arts and english, liking music and writing, well, I was suspect.  I ‘proved’ myself with outstanding performance and knowledge in biochemistry and a gift for surgery.  So having ‘proved’ myself, here I was’ forfeiting’ my ‘membership’ in the ‘elite’ medical group of the ‘scientist doctors’ or ‘surgeon doctor’ to become somehow ‘less than.'  This 'elite' group has made an ironic comeback with in recent years as the respect for medicine declines and everyone is turning to superstition versus science in the true quackery of so many 'alternative medicines' and 'health food stores'.  People don't want 'scientists' or 'technicians' as much as they want 'physicians' but I never could explain my decision to be a psychiatrist because that was what was most "needed" back then and I can't explain this to them now.
The real ‘money’ in medicine was in surgery and internal medicine.  The psychiatric patients were predominantly poor in comparison.  The richest doctors were surgeons and internists and the poorest were often psychiatrists. The billing schedules from the start were always against the psychiatrist.
We were often mixed up with ‘psychologists’ and psychologists were considered collectively as ‘flakes’.  Mostly the psychologists were girls and the counsellors were usually people who couldn’t do the heavy lifting, like radiology technicians so ‘just talked to people’.  They were likened to ‘high school teachers’.  Doctors were university men.
As a family physician and a flyin doctor in the north I’d seen that the ‘greatest need’ was in psychiatry and addiction. I’d become interested in ‘non compliance and ‘non adherence to medical regimen.  This was only addressed at my university by psychiatrists.  It was called ‘resistance’.
Alternatively I considered ‘immunology’, a fledgling speciality pre HIV, because it too discussed the idea of the organisms' ‘rejection’ of transplants, and ‘immunological vulnerability’ to disease.  
In surgery and infectious disease, the emphasis was on the terrible external environment.  Bad things like bulletts entered good bodies and good surgeons took out the bullets and returned people to wellness.  Bad bugs entered good bodies and good doctors made good drugs to kill bad bugs and restore people to healthiness.  I consider 'regular' medicine like playing chess (I played chess at university) whereas psychiatry was like three dimensional chess. In psychiatry I was juggling a lot of ideas whereas in medicine I was usually just following protocols.
My first patient who died that upset me so much had been given excellent care. His doctors had all given him good drugs and he had good education and all should have been well but he and his family rejected the ‘education’ and he didn’t take his medication and therefore died.  Nothing all the kings soldiers could do would put humpty together again.  I felt a personal failure despite having done above and beyond the call of duty.  I 'd pulled out all stops to save this man and in the end it changed my interest from surgery to understanding 'noncompliance' and 'resistance' and a renewed interest in 'spirituality'.
That’s when in research  I learned first that 30% of all patients are ‘non compliant’ and another ’30% of patients spontaneous remit.  I'd always been interested in 'placebo' effect and became even more interested in 'psychosomatic medicine' when it was a fledgling idea. Further in a lot of populations 50% of patients didn’t follow their treatment and in psychiatric patients the number was as high as 80% of patients. 80% of patients didn’t take their medications.
My  colleague, rich, and loved by drug companies always saw a patients lack of progress directly a consequence of the medication so he prescribed a newer more expensive medication. I went to the patients homes and found that their drug cabinets were full of unused medications.  I asked why they didn’t take their medications and learned a wonder of information about how humans behave which was wholly overlooked in the pharmacy training at the university.   I remained poor and eventually didn't even teach whereas my colleague because the richest and most admired and favoured physician and psychiatrist because he was the principal representative of the pharmaceutical industry. Their greatest promoter and richest retainer.  I continue to look in drug cabinets and do home visits and believe thats where the real money of medicine is.
I also saw that the most difficult patients to treat in my family practice were the ones with mental illness. They were the challenge and the businessmen doctors didn’t like these patients because they didn’t get better like ‘good’ patients did.
There was a fine line between ‘bad’ and ‘mad’ and everyone, despite their expressed ‘liberal’ and ‘politically correct sentiments’ about the ‘mad’ ultimately treated them as ‘bad’.  They were ‘non compliant’ and ‘resistant’ and ‘difficult’ and as doctors became family men and businessmen and pharmacists vied to prescribe, all people wanted to make money and have a good job and go home to their families with patients who came sick, got better quick and went home themselves. No one wanted psychiatric patients. And no one wanted addicts. These groups were complainers and angry and didn't get better.  This was the time before 'lifestyle disease' became a fashionable word.
Most mental illness is life long.  The ‘chronic’ diseases are a waxing and waning sort. They have relapses and recurrences and there is a ‘vulnerability’ that causes patients with psychiatric illness to often slowly deteriorate overtime or not quite get back to where they were. Or, even if they do succeed very well, whose to say they won’t have an episode a decade or so down the road.
Whereas we never looked at people who had recurrent respiratory infections as having ‘weak’ lungs because of the ‘bad bug’ idea of infectious disease, we tended to look at people who had recurrent depression as ‘weak’ because psychiatry focused on the ‘vulnerable’.  Indeed psychiatrists who focused on 'trauma' or 'stress' or 'toxic workplaces' were no more welcome than were jail doctors who faced with treating bones broken by guards questioned the breaking rather than just setting the fractures. There's 'preventative' medicine and 'preventative medicine'.
Psychiatric patients were therefore called them ‘weak’ and especially those  with addiction, a part of psychiatry.  They were told  ‘buck up’, “man up’, ‘quit your crying’, ‘toughen up’.  Don’t be silly.
It’s 25 years later and I’m still calling myself, William Hay, Physician, without any concern but when I say, I’m William Hay, Psychiatrist, I’m hesitant.  When I am an ‘advocate’ for a patient who has heart disease or is in a wheelchair or has infection, I’m seen as ‘doing my job’.  A physician is supposed to be an advocate for his patient.  It’s part of the code of ethics for physicians.
I am an advocate for my patients.  As a Christian I am a healer and know that Jesus was a healer and he was also a teacher and advocate.  Part of my becoming a physician, when I could as easily have been anything else, I was a straight A student in Arts and Science at the university, the golden boy, a very large part was that I was a Christian. The finest doctors I’d known were Christian to that time in my life.  When I studied the history of medicine I saw that the truly religious, not just of Christianity but of every religion were the ones who made the greatest contribution to the healing sciences.  Religions in general took care of the sick.   My hero was Albert Schwietzer.
But to be an advocate of a psychiatric patients, worse, an advocate of an addict, or even a former addict, was to be akin to the "despicable."  Even St. Peter denied his association with Jesus when Jesus was condemned by the courts.  I saw that psychiatric patients and especially the addicted were condemned by society at large.  I was condemned by ‘association’ from the time I said I wanted to be a psychiatrist.  25 years later I am still condemned by association. I’m the modern equivalent of the ‘leper’ doctor.
Advocating for the addicted and mentally ill makes one ‘bad’ and as everyone knows psychiatrists are ‘mad’ already.
So William Hay, Psychiatrist is still a thing I hesitate saying despite years of experience, years of healing, years of amazing restoration of health of thousands of individuals and the overwhelming evidence that what I’ve done as a psychiatrist is deeply ‘good’, I’m still afraid to be associated with the ‘fallen’ .  Just like Peter, I fear ‘association’ with Jesus. I fear association with the mentally ill and especially those in recovery because they, and we are punished.  
This is today, when all surgeons and all internists know that they are working in the area of 'chronic illness' and that their patients all suffer mostly from 'psychosomatic' illness. As psychiatry has learned it's somatic aspects with MRI and beneficial somatic treatments like surgery and medicine, the rest of medicine and surgery has had to come to grips with it's psychiatric aspects and especially address the issues of non compliance and non adherence to medical regimen.  
William Hay, Psychiatrist.
William Hay, Advocate of the Mentally Ill and Addicted.
It still doesn't sit as well as William Hay, Physician.
Some days William Hay, Psychiatrist is a truly frightening thing to call myself.   It's like putting a target on.  It's like wearing general’s stripes on a helmut in a war zone. It's  like painting a red cross on an ambulance in a war with people who see illness as weakness and weakness as something to be exploited. That’s like saying to the rich, I’m poor, and waiting for the condemnation and laughter.  That’s not something one says openly in a world of ‘survival of the fittest’.
William Hay, Physician. That’s something societies at large have grown to accept and live with. Physical illness isn’t viewed superstitiously or as ‘malingering’.  But mental illness is.
Mental illness and those who treat mental illness and the advocates of the mentally ill are actually ‘threatening’ to those who are the most mentally ill themselves but conceal this as people who have secrets and lies do.
People who are hiding mental illness, especially those with alcoholism or doing cocaine,  for instance, or pedophilia, or sex addiction, or sadism, like to ‘punish’ the mentally ill to distance themselves from themselves.  But that’s something psychiatrists know.
William Hay, Physician. I can live with that.  William Hay, Psychiatrist, most days I’m too cowardly to say that.  Just like William Hay, Christian, is hard for me to say.  Christians are the most persecuted group in the world.  So what’s worse in a secular insane society, William Hay, Psychiatrist and William Hay, Psychiatrist and Christian.  Might as well, lock oneself up in the asylum.  When I worked there and lived there I knew as we all did that the bars on the wall were to protect us from the outside.  We didn't want patients to escape, not because they were so much a risk to society but because society was so harsh on them.  Jails were where people were locked up to keep them from escaping by comparison.  Jails protected society from criminals.  It's a subtle difference but then psychiatry is 'subtle'.  
Anyone who ‘advocates’ for the mentally ill and the addicted has painted a bull’s eye cross on their forehead for enemies to take aim at.
Much easier to be William Hay, Physician.
William Hay, Psychiatrist.  I don't know.  It takes a better man to wear that title.  I think I'll wait for the cock to crow a few more times.

Monday, January 27, 2014

Saints and Soldiers: Airborne Creed - the movie

I just watched Saints  and Soldiers: Airborne Creed  on Netflix.  What a moving and multifaceted movie. Romance, philosophy, theology.  Action that was reminiscent of the black and white movies of my childhood. Not about the blood and guts. More about the relationships.  And more about the families of the soldiers woven into the fabric of their day to day existence as paratroopers fighting with the french resistance.  I liked it.
I confess I was looking for a mindless shoot em up but what I got instead was a deep and appealing look at sensitive warriors and resistance fighters.  Ryan Little directed this. Actors Corbin Allred, David Nibley Jasen Wade and French resistance fighter Virginie Fourtina were the stars.
The Nazis weren’t dehumanized but everyone was simple and real. It’s sad and a tragedy there is war but those who fight aren’t monsters.  This movie doesn’t romanticize war but it does a service to the military and those who resist tyranny.  It also depicts truly how the ‘enemy’ is rarely that much different than us no matter how the propaganda machines of each side plays it.  I liked the line in this movie, “I hate that uniform.”

Chronic Relapsers Misinformation

These are some rough estimates and truisms.. 10 % of people will have problems with an illicit substance. A proportion of those who avoid problems ‘spontaneously’ quit.  The earlier one quits substance abuse, the greater the success rate. Drugs and alcohol and other addictions are ‘fun’, ‘fun and trouble’ and finally just plain “trouble’.
Abstinence is the most successful ‘treatment’ for addiction. The WHO advocates that all harm reduction approaches should only serve as stepping stones to abstinence. There have been countless horror stories associated with ‘controlled drinking’ and clearly to date there are no good stories of ‘controlled crack’ use. The whole ‘control’ movement is as historic as ‘just say no’.
In studies of those who do ‘abstinence based’ therapies up to 80% achieve 5 year or more recovery. Dr. Marc Gallanter’s Harvard studies of doctors in recovery in AA shows 80% recovery up to 50 years after the last drink, decades of abstinence.  I personally know hundreds of people who once had severe addictions that cost them health, jobs and relationships but today are decades drug or alcohol free with successful careers and relationships.  Most of them are members of 12 step programs or churches.  Indeed addiction is described as a ‘spiritual disease’ by some and ‘cancer of the brain' by others.
The first ‘remission’ marker is one year.  The DSMV considers a person in full remission with a year of abstinence.  Most others including Dr. Vaillant of Harvard saw that the disease effects were significantly present for 5 years of abstinence when finally  a person potential for relapse was no greater than an as yet unidentified person’s risk of developing addiction.
In a famous Montreal study, 50% of those who returned to drinking, were able to avoid returning to their previous level of drinking, somehow maintaining ‘harm reduction’ without descending into their former abyss.  Interestingly a Holland study showed that people abstinent for 15 years who returned to drinking, 70% were able to maintain ‘harm reduction’.  While one in two odds of redeveloping a life threatening illness aren’t actually encouraging, and even a 30% chance of devolution at 15 years doesn’t look bright, this does suggest that the original disease appears to ‘burn out’ with abstinence over years.  The modern research on neuroplasticity and adaptation certainly takes into consideration the increasing information of the effects of ‘intoxication’ on the brain.  All research to date shows that those who achieve abstinence have the best life course, physical and mental health.
Note the word ‘toxic’ in intoxication. Addiction is associated with altered consciousness, dissociation and impaired mental capacity, the effects of which can last hours or days or , with marijuana for instance, weeks after the chemical brain trauma.  By contrast with alcohol, where there is social drinking where a person does not drink to toxicity (1-2 drinks)  with drug addiction, all drugs are used for the ‘effect’ :’chemical drunkeness”, “getting high”, ‘being stoned’.  People drank as a beverage whereas drug abuse is done to achieve 'toxicity'. Drug abuse alters consciousness. It impairs brain functioning. Enhancement of one function is countered by loss of other capacities as with drunkeness.
Addiction is like slavery.  A person is freed by abstinence but with relapse return to their slavery with the attendant lack of hope, lack of faith in their ability to get free, increased cynicism about their potential but more significantly increased negativity about ‘freedom’ itself despite the high success of those around them.  Their relapse and the associated depression that is usually concomitant in time is associated with severe 'cognitive distortions'.
Fruitflies were the great genetic tool of genetic research since they shared 70% of human DNA and had short life expectancy. Thanks to the overwhelming success and the extraordinary numbers involved in the recovery from cigarettes, Cigarette addiction and recovery have taught us as much about ‘addiction recovery’ in general as fruit flies taught us about human genome.
When people relapse they have already progressed through the Motivational stages of Prochaska from Precontemplation, Contemplation, Determination and into Action.  Unfortunately ‘relapse’ commonly throws a person back from the Action phase to the pre contemplation phase for a period of time.
In this phase they tend to be extremely negative and blame the treatment failure on a variety of usually inconsequential or irrelevant factors.  Rarely will they early acknowledge that they were no longer following a program.  Relapse is the outward manifestation of the 'thinking disease'  which is the precursor to actual substance abuse.  Mostly people begin by minimalizing their own previous difficulties with alcohol or drugs, begin to grandiosely believe that things will be 'different' this time round and delude themselves into believing that they can 'control' their drinking or drug use despite no personal evidence of their being able to maintain this in the past.
One of the prime criticisms of Alcoholics Anonymous was ironically the ‘god’ issue.  Addicts worship their alcohol and substance, living a ritualistic religion surrounding their death bound existence.  However in research with obese people, 12 step programs weren’t initially recommended but rather it was suggested that the grossly obese go to the gym. In contrast to alcoholics and addicts who are highly adept at ‘excuse making’ (the disease of alcoholism being personified as ‘cunning, baffling and powerful) the food addict, those grossly abese, simply said, “I don’t want to go to the gym’.  When advised to go to Overeaters Anonynous, they never mentioned the 'god problem's but  simply said “I don’t want to go out”.  It's refreshing to work with obese people in that they don't tend to waste their 'energy'  on 'excuses' despite their equivalent difficulties with stopping their compulsive food use.  At best they'll tell you they have a 'metabolic' problem.
It has long been known that alcoholics and addicts will go anywhere for a drink or drug and never complained about crosses in the room or pictures of the queen or president as long as their drug of choice was available there.  In the ‘contemplation’ phase of motivation they would complain about the colour of the paint if it convinced people they personally were the exception to the rule that recovery is good. The fact is, a person who has relapsed, has lost hope in themselves.
Psychiatrists long ago knew that with those who were ‘suicidal’ and had similarly lost hope in life, especially the chronically suicidal, needed the psychiatrist to ‘lend them their ego’.  We make decisions that suicide is not good for a person.  Similiarly those working in recovery who are successful maintain the idea that recovery is good for a person, much like thinking oxygen is.  Those who don’t, have been found to be associated with a very poor outcome measures as we saw with those who had a poor view of the suicidal. Outwardly the caregiver could go through the motions but at the covert and passive aggression level they were and are best recognized by their high death rates.
Much of the push for ‘harm reduction’ has been associated with a similar phenomena. The caregivers and those who promote harm reduction most are often ‘burnt out’ or always had a very negative view about the addicts and alcoholics.  One psychologist described this as 'caregivers and victims'.
It's even worse when those promoting harm reduction have an obvious 'conflict of interest'.
A recent Welsh study showed that Harm Reduction proponent counsellors  gave the success rate for recovery of their charges at less than 20% , but when these same people were in ‘abstinence’ based programs they achieved greater than 60% success.
This separation between those caregivers with hope and those without was also shown in cancer treatment.
Palliative Care is a program developed first for cancer therapy where the person’s disease was so severe and all alternatives for cure were tried without success and no successful treatment was known for the type of cancer the person had.  Palliative care is compassionate but it would not be if it was offered as a first choice or 'alternative therapy'.
Lack of success is not the case in addiction therapy.  Alcoholics anonymous has an 80% success rate 5 year and decades beyond but the ‘program’ is like the ‘birth control pill’.  If one takes the birth control pill once it is highly likely to fail.  This is the reason research did not identify the factors of high success in AA. Researchers simply asked people if they’d been to AA or NA. It’s common for people to go and not return, like those who asked if they used the condom for birth control might say they had but leave out that they’d only used it once in their life, and not the year they got pregnant.  The Navy Pilot program showed that 5 year 80% success with AA required a minimum of 3 meetings a week. The recent Scottish study which confirmed the 80% success rate included ‘home group’ and 3 meet ings and having a sponsor for instance to indicate ‘actual involvement’. As one person commented, a lot of people attend basketball games but you're more likely to find out how basketball is actually played and become good at the game yourself if you join the folk down on the court with the ball, rather than talking with drunk in the bleachers.
Relapse was associated with:
1) stopping or  reducing frequency of meetings. I often think this isn't different from any form of education since I meet people who despite having gone to university haven't read a book since and seem a hell of a lot stupider than people without a university degree continued studies.  With HIV treatment we need people to continue to take medication or they will die. We don't question the validity of the life saving 'medications' because people are 'noncompliant'.  We work on improving follow up and compliance but we are most impressed with our 'success' in developing treatments for HIV and Aids when at first there were no treatments. Since the 1930's we've made major strides in developing successful treatments for addiction and recovery.  Commonly people's lives are enriched in recovery and complacency returns.  Then stress occurs.  That's when all the 'tools of recovery' are thrown out.  I personally love the Dr. Martin Luther King quotation. "it's going to be a tough day so I have to spend more time on my knees".  When people have more stress, activity, change or success in their lives they usually need more 'recovery' activities, not less.
 2) Returning to previous association with drug abusers.  Recovery has been shown to be as “contagious’ as addiction. Having one abstinent friend in ones friendship circle reduces the chance of relapse by 25%.  People who relapse commonly begin to associate again with 'slippery people, places or things'.  Dr. Bob and Bill Wilson recognized that alcohol was ubiquitous in their society so said that recovery had to occur in the community. However it was also true they didn't recommend people avoid people in recovery and spend their nights in 'speakeasies'. In treatment today people are advised to avoid crack houses, dealers, and especially paraphernalia, as we know that 'jonesing' something not seen so much with alcoholism, but common in cocaine addiction does occur for up to a year after abstinence.  This phenomena is like we see with PTSD and the 'trauma' of addiction and the associated lifestyle. People with addiction today are often starting their addictive lifestyles earlier and have a world of hurt by the time they get into recovery with much less life experience, education or positive communities to fall back on.  
3) Commonly people recover from addiction but then have ‘expectations’ which are highly unrealistic.  Expectations have been called ‘preformed resentments’ and while AA and NA and other recovery programs treat the disease of addiction they specifically describe the need for members to get outside help with other issues.  These issues commonly include financial management advise, job advise and job training,  relationship counselling, pastoral care, anger management and a wide range of ‘maturity’ issues which are not achieved by addicts whose addiction stunts emotional, intellectual and social growth.  A person who has been hanging out with ‘potheads’ may stop their addiction but it takes time to develop a strong and positive friendship network , the kind that gives meritorious advice that makes life in general more successful and rich.  Increasingly the isolation of addiction is associated with the isolation of the internet following the positive experience of recovery in treatment.  Internet addiction then leads back to chemical addiction.
4) Attending a treatment centre may help establish abstinence and break the slavery to addiction but commonly just as with education there is a need for more advanced treatment education. Some treatment facilities like Betty Ford have programs for continuing education and also are set up for return of ‘sober’ or ‘abstinent’ members to work on more advanced issues like ‘emotional sobriety’.
5) Commonly ‘cross addiction’ leads to relapse. This is especially true with sex and gambling addictions which then lead to a return to chemical addictions.

It is critical to recognize that the ‘excuses’ that addicts and alcoholics give for relapse are usually time and ‘disease’ specific.  I’ve asked people who achieved abstinence after several initial failures what was the key. Almost invariably  I have heard that they really didn’t want to stop their addiction but had only planned to stop for a while to get somebody off their back. It's hard to accept having a lifelong disorder. I see the same difficulties with diabetics. No one questions the benefit of 'insulin' but all those who treat adolescent diabetics have seen the same problems we see addicts have coming to terms with the limitations of disease and the need to learn new methods of self care.
Often people in recovery get success but then the ‘boredom’ of everyday living lacks the ‘drama’ of the previous chaotic lifestyle and they solve the ‘little problem’ by creating a ‘big’ problem. Anyone who has 'worked on long term relationships' knows how the 'little things' if not addressed can grow into bigger things.  So often over time the 'little resentments' and 'lack of honesty' and 'living a lie' grow to a point where they taint the good life and recovery and relapse follows.  Recovery isn't a white knuckle affair but a lifestyle which is 'happy, joyous and free' because life is to be 'lived' not merely endured. This has been called 'emotional sobriety' and 'spiritual awakening'. It was always recognized that people who drank or did drugs has an 'underlying' predisposition or greater level of anxiety or sensitivity and had to learn new coping mechanisms for fulfillment.  When a person becomes an addict it is 'normal' for them to drink, drug or abuse. It is not 'normal' to be abstinent for an addict or alcoholic. To be abstinent requires them to daily live a life which promotes well being beyond that available by their previous lifestyle which 'lead' to addiction.

The ‘treatments for addiction’ are to date superior than most of the treatments for physical illness when they are applied and managed as recommended.  The problem which occurs with addiction is the same as doctors are finding with all the chronic diseases or diseases of lifestyle.  Indeed the treatment of chronic disease is increasingly learning from the successes first seen in addiction. The advances brought forward by 12 step programs are actually being translated to ‘accountability’ groups and used in the "normal' work place.
AA and NA introduced the concept of ‘anonymity’ as a ‘spiritual foundation’. They didn’t want people to speak of their personal success at a time when people’s relapse caused people to question the success of prevention and abstinence treatments.  Today there is overwhelming evidence of success of prevention and addiction treatment but increasingly vocal chronic relapser misinformation.
We used to hear “I stopped smoking but I didn’t feel any better’ in the first weeks of people quitting smoking.  They then used this ‘excuse’ to continue smoking.  However, now, with millions having lasted that first year of recovery we hear endless numbers of former smokers saying what a relief it is to them to be no longer be a slave to cigarettes. This is true of 80% of those who maintain abstinence from substances for five years.  Then those who relapse stand a very good chance of achieving long lasting recovery with appropriate treatment and relapse prevention programs developed for the individual relapser.

I liken this in my work to people with bladder infections. The vast majority get better with one antibiotic. A number relapse and the the antibiotic works again but there are those who need a different antibiotic and even those who we simply find it best to keep on antibiotics indefinitely.
The one week detox program has now had the 28 day program and there are recovery treatment programs which last 2 years. This was the same with mental illness where patients with similar psychosis were unsafe for themselves or others even with 1 week, one month or 3 months programs and they benefitted for a year long recovery in asylums.
All of these approaches standard in the scientific medical treatments are the same as we use with great success in the treatment of addictions.
Part of the success in treatment of mental illness was the recognition that substance abuse, like marijuana, alcoholism or harder drugs were all interfering with the learning and recovery process from mental illness. When I reviewed the suicide completion statistics in one program I found that though there were many who were at one time suicidal it was almost only those who had addictions
that completed suicide.

I’m commonly asked to see people suffering from depression or anxiety and almost all the time the family physician and especially the parents,( especially the mothers) , rarely know how severe the patients addiction to alcohol or marijuania, crack, methamphteamine or heroin is.  The patients tell me because I ask very directly and am highly trained in recognizing the signs of dissimulation that the alcoholic or addicts uses to ‘guard’ their ‘secret’.  
Relapse is treatable but the best solutions to treating relapse are to be found from those who once were ‘chronic relapsers’ and succeeded. I liken this obvious reality to our collective human experience with climbing Mount Everest. For centuries people ‘failed’ and we learned ‘how to fail’ from the ‘failures’ and eventually when people climbed ‘Mount Everest’ we learned how ‘best to climb Mount Everest from those who "succeeded."

Today the ‘harm reduction’ groups are arguing not only that Mount Everest can’t be climbed but that we should listen to people who either have never seen a mountain or may never have got to a base camp.

Insite - Safe Slavery

The Insite - Injection site license is up for renewal.  The location is a major concern for development in the area because this is where the drug addicts and dealers congregate.
The deterioration of the neighbourhood due to drug dealing and drug addiction resulted in Chinatown losing business to Richmond. The merchants in the downtown are plagued by the dangers in the streets and fears people have in that neighbourhood due to the  lawlessness associated with drug addiction. .
The elderly ‘cruise community’ tourists would gladly walk to China Town except for the stretch of No Man’s Land, a veritable gauntlet of drug dealers and cigarette pushers, hefty unemployed young men, who block the corridor between Gastown and China Town.  Insite is the “castle” of the drug abusing community and frankly, given the financial support of government and various other “enabling’ agencies, it's a feudal bastion to abuse.
By contrast, the world renowned, amazing fensui place of “natural" high, The Sun Yat Sun Gardens, is strangled by the proximity to Insite and the deterrant to development Insite creates.  All the restaurants, apartment complexes and all my poor patients who don't do drugs see no benefit from the presence of Insite in the DTES.  Yet no one asks them and Insite with its captive population of drug slaves promotes itself.  Everyone I talk to in the DTES  who doesn't do drugs and especially those who pay taxes considers Insite a major threat to the safety and development of the community. Who wants to raise children near a facility which support heroin addiction by promoting it's 'safety'.  What teen ager hears that Heroin is dangerous and IV drug use is the principal public health threat for HIV and Hepatitis when instead they see that major marketing ploy 'SAFE".  There is no safe injection site. As Dr Fay says it maybe 'safer but it sure isn't safe'.
The Hell’s Angels, Tong, UN gang and other allegedly criminal organizations associated with drug trade are the principal beneficiaries of Insite .  Their "customer base" is maintained and the message that injection drug use can be ’safe’ is promoted not only locally but nationally and world wide.  Labatt’s doesn’t demand tax payer money for the provision of pubs so drunks can consume in public.  People who use Insite get their drugs from dealers and use them at Insite or on the street in back alleys.  Insite's funding should not come from tax payers. If it is to be funded at all, it should be taken from the monies collected by the state when they raid heroin shipments or take the assets of dealers. Let 'harm reduction' be funded as a percentage of that 'take' but not from taxes.  Taxes should be used to prevent and treat addiction not to support crime.
There could well be a place for Insite in the overall scheme of things but instead Insite has taken the funding and falsely claims ‘credit’ for successes in treatment in the DTES which have been a direct consequence of religious organizations and the traditional methadone/buprenorphine substitution programs that are stepping stones to abstinence.   The success of the latter programs was that they restored individuals to work and relationships whereas a needle injection site marginalizes and maintains individuals dependent on drugs.  It's a slavery support system, not "therapy' and certainly 'not recovery'.
I love the advertisement that says it doesn't matter how you 'dress' up a place, if the message still stinks. Now we see Insite putting in detox and treatment facilities to 'perfume' the heroin injection facility'.
When the truth about the individual and community dangers of tobacco smoking came out people tried to ‘localize’ smokers but it was realized that even in cafe’s, second hand smoke remained a problem and the health costs of smokers to the community was overwhelming. This resulted in the widespread abstinence programs, everything being done, leading solely to that goal.   That has had the greatest success in the treatment of addiction.  People ‘cut down’  then went onto quit with the use of patches, nicotine gum and champix.  They weren’t ‘encouraged’ to use ‘safe smoking sites’.  Instead millions ‘quit’ with the traditional and successful scientifically proven approaches to stopping cigarette smoking.  Vancouver would do better to declare the city a heroin free city than promote injection sites.
The sad fact about the safe injection site is that it has kept too many people enslaved to drugs and this ‘group of addicts’ is an increasing political force. We all saw how the big tobacco companies co-opted the smokers to write letters on their behalf and misinformed them about the opposition to addiction.  Suddenly the tobacco company was seen as the ‘victim’.  The same has occurred with the wealthy and highly financed Insite. Questioning the existence of Insite, demonstrating it’s lack of validity, and Insite in sites it’s member to riot.  And riot they do with personal attacks on me for promoting the proven alternatives and questioning strongly why our government, provincially especially, and urban as well,  is providing so much money to ‘harm reduction’ and not providing equivalent funding to abstinence recovery.  There aren limitless numbers of people who will speak out about the horrors of heroin. The Anonymous People movie is just one of many examples which show what heroin does.  The 'safe' tobacco smoker folk were 'beatten' soundly by government ads that showed what tobacco smoke did to people. The Odd Squad made movies of the lives of heroin addicts in the DTES.  It's not pretty but it's not getting the funding or support from CBC and other media that as johnny come lately eventually got on board with the anti smoking campaigns that told the truth about nicotine addiction.  The same truth has to be told about heroin addiction.
What do we hear in the media, but Insite ‘drama’ whereas the quiet sincere effective successful messages of Alcoholics Anonymous, Narcotic Anonymous, the Harbour Light Treatment Centre, the Catholic Church;s most impressive initiatives, the first United Church, thework of Salvation Army and Union Gospel, the street mission of Father Mathew, the countless other street churches. These are discredited or ignored and all that is spoke of is Insite.  Believe me I would rather sing the praises of the amazing work of volunteers and spiritual people but their quiet message of strength and success is being blocked out by the cacophony of Insite loud speakers and fancy funding.
 Everyone working in the field knows the outstanding work of individuals, groups, churches and communities but the media and government seem blindsided by this very sexy expensive idea of curing drug addiction by supporting drug addiction. It has that kind of spend your way out of debt  attraction to the addict, brain damaged, temporarily or permanently by addiction.
We love ‘diversification’ in medicine. We love alternatives and multiple pathways to recovery. I simply object that the least effective most dangerous and truly frightening approach to recovery is demanding not only all the money but all the glory.  This is not scientific and it’s simply not true.  The ’so called’ research is anything but ‘unbiased’ . It’s threat to the community and threat to the youth is massive by contrast.
We heard about the famous Canadian actor dying after buying drugs outside Insite. Everyone in the community now knows where to get heroin, crack or methamphetamines. Just go down to Insite.  The dealers love the place.  It’s drug central.  A visiting friend walked by there last week and was offered drugs twice in the Insite block. But the police are discouraged from ‘policing’ the area because of the powerful politics of the entitled and the financial support they have.
Ironically, with the help of methadone and buprenorphine, NA and existing treatment services, the threat of IV Heroin was no longer the concern it was until Insite showed up at the time when crack and crystal meth were becoming the growing concern.
There is no ’safe injection’.  Even when I trained as a doctor to do injections I knew this.  There is no ‘elective’ reason for injecting people with a ‘recreational substance’. That’s disease and it’s enabling when anyone ’support’s’ and even ‘promotes’ it’s use.  The cost to the community of opiate use was so great that China banned it  more than hundred years ago, before the British invaded so they could ‘push’ it again in the Opium Wars.
It’s as nauseous historically as ’slavery’ ,  yet here we are promoting something akin to ’safe slavery’.  Let’s reinstitute slavery.  All we need is a  nurse to make visits to ‘plantations’ or today's equivalent,  ’child  sex slavery sites’  so we can promote  ’safe slavery sites’. Because the fact is, an addict is a slave. He doesn’t need a place to do needles but a place to get off drugs, Slaves don’t need nurses to watch them be slaves,  they need ‘freedom’.
Abstinence offers ‘freedom’.  Insite sells slavery.  At a very high price. I would be glad to see this place out of the DTES if only for the community and the people who live and work there.  We all want to have  safety for our homes and businesses.  I personally want freedom. Democracy depends on people being 'free' to vote.  Homes, businesses and communities grow in freedom.  Stop slavery.

Sunday, January 26, 2014

SFU Pipe Band Robbie Burns Dinner 2014

My Scottish Canadian friend, Anne, introduced me to Robbie Burns Dinner decades back in Courtenay on Vancouver Island.  She was a brilliant and beautiful social worker in Port Hardy when I was the young psychiatrist in Courtenay.  I’d never been to a Robbie Burns dinner but loved all things about my roots.  I’d read Robbie Burns poetry in my teens and carried a little collection with me when I’d travelled Europe on bicycle.  Thanks to Anne I was introduced to haggis and have never been the same since.
My friend Lorne Kay's father introduced him to Robbie Burns dinners as a child.  Lorne got tickets for us and the girls one year. That’s how I first heard the SFU Pipe Band.  They’re world champions 6 times over. That Tattoo I attended by SFU was reminiscent of the great tattoo my chambermaid aunt in Holyrood got me into. I was visiting Edinburgh as a young man and didn’t know what a chambermaid was, let alone a tattoo.
This year Lorne’s partner was in Australia and I was without a date.  The Moray and Nain Robbie Burns dinner I really like to attend has much dancing usually with the Mad Celt.  Lorne and I would be both dressed in kilts but neither would defer to dance the lady’s part.  Hence my idea that I get us tickets to the SFU Pipe Band Robbie Burns Dinner.
After hearing the Pipe Band first with Lorne I’d bought their records and played their grand music in my sailboat a thousand miles from land crossing seas.  Nothing more rousing for the spirits than well played Scottish bag pipes. There’s the drums too.
At the dinner we sat at Falkirk table with a couple of the mothers of the band’s Snare Drum players.  It caused me to pay special attention to the drums and they really were something.
It’s all about the haggis though. The piping in of the haggis was indeed the best I’d known.  The reek of the haggis was perhaps the best I’d known as well.  Then the Address to the Haggis was done with admirable flair. Our MC Jim Gallacher not only recited the poem but threw his whole body into the hacking of the haggis.  Great theatre.
The Selkirk Grace was followed by a superb buffet dinner put on by the Executive Plaza Hotel, North Road.  A lovely young lady whose name I missed sang the Star of Robbie Burns flawlessly.
There were pipers and dancers and a great silent auction.  The MLA and Mayor were there.  I remember one was Stewart and thought that admirably fitting for a leader.  A tribute to the Pipe Major of 36 years had been done by Simon Frazer University.
The conversation at our table was marvellous.  The attractive woman beside me had just learned to skin a deer and her partner had very funny stories of early days with a power boat.  Lorne, “the Laird”, talked of chess and his time in Australia.
Having eaten haggis again, with the finest of bagpipe music playing, I was simply in heaven.   The SFU Pipe Band do know how to host a Robbie Burns Dinner.   I even scored a pair of Canucks tickets in the Silent Auction.
“Fair fa’your honest, sonsie face, Great chieftain o’ the pudding race!
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Measure for Measure

The Honest Fishmongers present Measure for Measure by William Shakespeare at the Pacific Theatre.  It was a fine play with terrific acting and good fun.  Much theology and philosophy and humour as pertinent today as then.  In keeping with the times the actors use candles to light their faces when they spoke. Unfortunately after a long work day this tends to make me sleepy. I’m known for snoring in the symphony if the lights go too low.  Others loved the ambience true to history.  I loved the actors and the production. Having studied the play at University of Winnipeg and seen productions of it before I loved Shakespeare all over again.  Thanks for a lovely night of classical theatre done well. The Honest Fishmongers are a delight.IMG 4595IMG 4596IMG 4597IMG 4600

Vancouver Boat Show 2014

It’s been almost 25 years since I began going to the Vancouver Boat Show.  A half million dollars and more in boats and accessories later.  So much of that I first saw here and often bought then or the following year.
I enjoy most that first look at the main floor.  There are all the new boats, shiny bright, polished, just begging for a buyer.   I’ve had my offshore sailboat since the 80’s, rounded Vancouver Island a couple of times, sailed to the Charlottes, down to Mexico, solo winter sailed to Hawaii, sailed the Hawaian Islands then returning with a crew, jerry rigging a mast after mine broke half way across the Pacific.  Since then it’s been more of the glorious Gulf Islands.  I love sailing to Victoria, Desolation Sound, Saltspring, Montague. We have so many incredible protected harbours along this coast.  No wonder the Vancouver Boat Show is such a big event here in boaters wonderland.

I enjoyed meeting Eric Molendyk (Sam Sullivan Disability Foundation,, with the Disabled Sailing Association of British Columbia ( (604-6886464).  We work together at the Old Electric Building but I never knew he was a sailor.  Probably that goes with the stigma of a wheelchair.  We always underestimate the disabled.  I volunteered for a week with these extraordinary courageous men and women who sail in races off Jerricho Beach each summer.  They are the best of folk, greatest of sportsmen. All the help they need is someone working the hoist to get them into their boats. Then they’re off doing amazing sailing with more guts and strategy than the best of us able bodied racers. They're always glad to have sailor volunteers. The atmosphere is so much better than that in regular races because there’s just more ‘fun’ involved and never so much ego. These women and men are competitive but know more than anyone about competing with themselves, surpassing the limits of accident and birth, all the while having a good time while they are at it.

After looking at all the beautiful boats, I talked to the folk with Yanmar Engines. I’ve had a Yanmar for a quarter century and it’s been the most reliable engine.  My ‘iron jenny’ as we sailors like to call them. My Yanmar has been more reliable in the Strait of Georgia than the wind.  Invariably when I cross the Strait there’s no wind so I am forever using my engine on the outward bound trip, only to have all the wind I could want on the return.  If I get wind going out there’s no wind coming home.   In the old days the sailors could wait but weekend English Bay and Strait of Georgia sailors depend on the engine to get them back to work in the city.  I also use my Yanmar for trolling and have caught so many scrumptious salmon just motoring along with a Scotty down rigger dragging my hook behind the boat.

The accessory floor is boaters heaven. All the latest advances in materials and equipment is reaching out for your wallet as you walk about that ‘toy store’.  A lot of its fashion too.  One just ‘needs’ to get the latest Musto jackets. Then there’s all the fine cooking ware and the incredible footwear.  I’ve bought GPS, radios, radars, depth sounders, barbecues and all manner of paraphernalia here in past years. The prices are the lure. Boat Show prices are the best.

I can’t get by Stevestons without stopping. I miss the old man (he's my age).  I used to go to Stevestons because he always welcomed me personally and asked me about my sailing. I've bought so much equipment, epoxy and paints there.  He guaranteed his staff were the most knowledge, like the years he had offshore sailor Eric, there.  But now it’s the son.  The Old man and I have grown old.  He knows me as a ‘good customer’. We had that ‘relationship’ and ‘trust’.  Steveston has ‘good product’ but I don’t know these young people.  The son isn’t the father or the uncle.  He’s got that love of the rich man feel.  Thanks to the hard work of his father’s generation he’s been raised in the lap of luxury.  No doubt a good man. But not his father.  I think the father and uncle got their respect from the commercial fishermen they first served and made a name with. They served the early offshore blue water community. Those were the days when equipment failure caused death and the old men of Steveston knew the commercial fishermen and us blue water sailors personally and would suffer themselves if anything befell us.
Today it’s more about business and volume sales.  The majority of sailors don’t leave English Bay and the fishing fleets aren’t what they used to be.  How can you tell a person's getting old, they talk about the good ole days.  But I swear by all the good equipment I bought at Stevestons. I put it to the test in northern winter storms and am forever thankful for the care and concern the old man gave me and those like me.  People who depend on their boats to keep them alive because they're out and beyond where dragons dwell and no human has gone before.  In those places of sea monsters, aliens and superstition when just getting through the night is all that matters I've been so thankful for quality gear and good advice.    
I don’t have children to pass on to. Theirs is one of the truly great families of Vancouver. Someday a book will be written of the accomplishments of the brothers and businesses they built through relationship and caring.  They have offered so much to the boating community.  I love that their children are following in the huge footsteps of the parents.  My friend, Ganesh,  is introducing his son to the family gold business and occasionally pulling out his hair at ‘youth’.  That son is as cherished and loved as sons can be.  My brother cares more than anything for his sons. Parents simply can’t protect them forever or teach them all the hard lessons they learned to succeed.  It's all about relationships.    Old men want so much for their sons. My father did with me.  Even at 94 when he was dying he was trying to pass on the lessons of life he’d learned but feared I would not learn in time.  There’s never enough time.
Nostalgia is that way.  We’re old men and one day some old man who won’t even know his father will be saying of his son that he’s not like his father.   The sea is old. It's been there for longer than all of us and will be there that much longer.  It requires respect.   We all loved Hemmingway's, Old Man the Sea because it captured something of that.  That's also why we say, if you haven't found religion, you'd best go to sea.
I don’t buy anything here on this floor, today. I’ve Iridium satellite phones and life boats and the latests in safety equipment.  I was looking for a surface air supply but learned from one of the old guys the makers have not come to the boat show for a few years.  He told me how I could find them on line.  It’s a compact air generator that has a tube that allows you to go 30 feet down without tanks and scuba gear. It makes cleaning boats and snorkelling effortless.  I’ll look on line.  The Boatshow wasn’t thought to survive with all the on line options but this year it’s thriving mainly because of the relationships and dreamers.
I met with a friend who’d sold his boat. We both were finding it was costing more and more with less and less joy.  Among boaters its always a love hate relationship. Then one day  you hear of a the mistress or wife (i.e. the boat) being sold and some other fellow seeing all the possibilities and loving the incredible second hand deals available in the boat world.  But those deals come with whatever was the reason we were letting go of the thing in the first place. Craig’s List abounds with boaters nightmares. So we all love the shiny new well engineered and safe certainties that are at the boat show. I actually looked at a new gadget once to see what it was supposed to work like before I 'fixed' it worse than it was before I broke it.
I said hello to the beautiful and amazingly accomplished Liza Coupland. I’ve read all her extraordinary books of her families offshore sailing trips in their magnificent Beneteau boats.  She and her husband know more about cruising than anyone and his knowledge of boats is staggering.
Anthony Dalton, that grand adventurer and writer was at the table of BC Authors.  I bought his Amazing Stories, Sir John Franklin book and his new novel, Relentless Pursuit. As a former expedition leader he’s now giving seminars on Cruise Ships and enjoying the luxury. We laughed  reminiscing about days of youthful hardship and how much we look for easier ways to avoid those days of steep learning curves.
I’d just talked with the folk at LateSail, the worldwide discounted yacht charters. I figured I could fly somewhere for $1500 then rent a 36 foot sailboat for $1-3000 a week and avoid the trials of long passages.  Alternatively I admit I've been looking at Cruise Ships like Anthony seminars on because there's a whole lot to be said about being 'crew' after one has been captain of ones own ship for so many years.  I don't regret the adventure and experience but today I'm just not as excited about double reefing a sail in a stiff blow in northern winter seas.  What a rush at the time though.  Maybe....
I did get caught up in the new electronics and had to convince myself that what I have will satisfy me another year. I’d only bought my  latest floating VHS hand held radio with beacon a couple of years back.  I liked that the Coast Guard and RCAF had booths. The water is so much safer than it was only decades back thanks to these amazing folk.  I also like SeaTow Insurance and have used them for more than a decade.
There was a place to take the boating license there too.   But it just takes reading a pamphlet and paying a minimum fee and then one can rent the boats at Granville Island or drive a million dollar yacht bought at the Boat Show.  Us boaters just want everyone to know what the navigational signs mean and who has right of way. If you know than you can get a boater's license. It's not rocket science.
I stopped at Coopers too. That’s where I took my first Basic Sailing Course and later Coastal Navigation courses, celestial navigation and such. I love to thank them. They were the best teachers and all the basics they taught me proved so true for the advanced knowledge I built on it with my own offshore solo sailing. A lot of people like Power and Sail but I swear by Coopers. More than once what they taught me early days saved my life and crew years later. I saw the Blue Water Cruising Association booth but didn't recognize the fellow there. It's been years since I was on the executive and I don't recognize many of the new people.  I loved when I first began and all the people who had sailed solo around the world and the families like Liza Couplands who'd sailed for years offshore were there. They inspired me to sail offshore and I thank them for the knowledge that helped me cross oceans in a little boat.
The real space age item, the Boat Show usually has a few cutting edge moments. This year it was the underwater one man Transformer like suit.  Incredible. Now that's the ideal way to stroll along the bottom of the ocean then skip up to the waiting boat above.  Beats even what James Bond had.  I couldn't help but think of Colonel Hadfield when I saw it.
Thank you Vancouver Boat show for a great afternoon of dreaming. It’s a joy to see the hope for the world in the amazing work of engineers and designers and the awesome sales personnel who bring these extraordinary space age creations down to the real world of everyday folk.  The million dollar yachts might not be in our budget after Christmas spending but the canoes, dinghies and kayaks are available for anyone. I started my boating life white water canoeing in northern Ontario when I was a student with little more than pennies to rub together.  The Vancouver Boat Show has something for everyone.  It sure has a lot of great memories for me and more dreams to come.
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Steam Clock, Vancouver Gastown

My photographer brother Ron was in town borrowing my truck for a Grand Canyon trip. He’s supporting three kayakers doing a trip down the river there.  I took him for lunch and of course he had to get pictures of the famous Vancouver Steam Clock in Gastown.  So I got a picture of the photoIMG 4570grapher, photographiIMG 4571ng, the steam clock. IMG 4569

Saturday, January 25, 2014

Underground Solution to Global Warming, Environment Change and Population

All the concerns of the ‘doom saying’ environmentalists and population explosion propagandists can be solved by admitting the principal ‘problem’ is the ‘above ground cities’.
I was recently called a ‘denier’ by a  colleague scientist and was annoyed.  I don’t deny the need for change on earth but I do deny the validity of any of the silly and short sighted expensive and usually self serving solutions presented today by urban academic activist environmentalists.  They are almost all critics who live and work in the city or university and their solutions usually involve everyone else, not themselves, making the first sacrifice.  I don’t like that.
It’s is a simple fact that administration and government are hundreds of years behind the advances of scientists and science.  The lack of education of the masses is despicable.  The evidence of the mass stupidity of the planet is the nature of political debates and the presentations of the media especially the ‘talking heads’ portions.  The news commentaries are little better than the sports commentaries and now the weather man has rebranded himself as an environmentalists so we’ve yet another ‘entertainment’ device masquerading as intelligence.
In the quiet north, not the vocal south, people have been increasingly building their cities underground to solve the problems of wasteful heating and harsh environment.
The greatest risk to the planet would be a solar flare.  Skip the need for bunkers when we all felt a Superpower temper tantrum would incinerate us.
The technology is available for building mines and oil wells and amazing underground cities of the likes that Buckminister Fuller among others have envisioned for oceans and seas and lakes. Our mining engineers, the trolls of Texas, and diggers of the north, have been honing their skills in search for gold and oil. It's time to put these tracking folk to a true test.  Have them build holes to house cities.
There is room on the planet for billions more even without sending the young explorers off the planet (Columbus et al did it) leaving the ‘known’ world and going interplanetary and intergalactic.  The potential and hope for human expansion is unlimited no matter how the fearful and angry would "deny' it.  L'Chaim.  Life!!  To be or not to be!
The problem though is right now we have parking lots and roads and cities on our very very best market garden, forest, pasture land.  Where I live in Vancouver, all the best farm land and forest land of the lower mainland is now utilized for urban housing, mostly of bureaucrats and executives and office buildings all of which could be better placed underground.
There is technology today for light and air shafts and wonderful underground living even a politician would find acceptable. It is far superior to the living space on the space station that Colonel Hadfield thrived in.  Underground dwelling is not a space station. It's indeed back to our roots. We began as cave dwellers.
Our ‘hot house gas’ problem would be solved with this highly ‘green’ solution.  Put MIT, Stanford, Harvard, Yale, and all the newer universities underground.  I think there's a place for saving Oxford, already a mental museum, and sites like Jerusalem but Tel Aviv can go underground as could Cambridge.  Build a forest onto these.  Leave the White House and Lincoln Monument but put the Pentagon and all the office buildings and even the museums underground.  The Kennedy Centre's acoustics would improve underground.  
In Old England , the ‘commons’ was the area where everyone could use the ‘wilderness’ space above ground for whatever.  Instead of Central Park being a few blocks of space in miles of above ground buildings of New York,  there would be a few building and miles of Central Park.
To achieve this end, we’d simply require that no new buildings above ground be accepted in urban areas.  Every new complex would have to be underground and a forest and pastureland or commons above land would be incorporated into the city planning.  We have various city ordnances, like nuclear weapons free zones, or the ‘bike lanes of Vancouver’.  So what’s wrong with ‘no above ground building’.  No ‘sky scrapers’.  And when sky scrapers come down, a 20 or 40 story underground development goes in.  Even if we replaced the 2 and 3 level above ground accommodations with 3 or 4 level below ground accommodation the capacity of the city would multiply exponentially.
Further, all existing ‘parking lots’ would be required to have trees planted around them turning this horrible eyesore and waste into a marvellous solution, until they were placed underground and surrounded by mushroom farms.  Joni Mitchell’s song, “they paved paradise and put up a parking lot’ would be history.
No more sky rails but underground subways everywhere.   Subways built with the consideration of earthquakes and tsunamis if we really are concerned about ‘climate change’.
From this day forth, I will not listen to a ‘environmentalist’ who hasn’t converted his urban high rise office or academic building with a ‘view’ ,into a basement suite. Everyone should boycott above ground environmentalists and "deny" listening to any 'weatherman' (rebranded environmentalist) if he is not broadcasting from below ground with free range chickens running above his head.
People living in basement suites today are the true saints and heroes..  Rural dwellers also to be applauded.
Once the city becomes pasture and farmland the cost of transporting all the food from the hinterland to these obese consumer ‘critics’ would be solved. They’d get their ‘ greens’ and euthanasia fanatics hankering after 'solyent greens' would be silenced.
Even space aliens would be confounded by this beautiful planet, it's cities fully camouflaged with forest and farm lands,  without the horrible acne infestation above ground cities and suburbs. Ban the above ground urbanites and suburbanites!!!

All those people who have done horrible damage to the planet and planetary resources so they could get a ‘view’ , so their apartments and offices could sit on ‘prime real-estate’ where a farm belonged or a sheep herd,  would no longer go to environmentalist hell. Instead of shovelling shit they could shovel the earth and build a home for themselves rather than continuing to proselytize doom and gloom.  Each of us is dying but the human race has never been more alive. The world's future has never been brighter if we could only get bankers to get their heads down where their asses are and wake to the earth's potential.

And those in LA and New York and Paris and Madrid would only have to come to Winnipeg or Edmonton to learn how to live ‘naturally’ with true 'respect' for the environment.

I love David Suzuki for all he has done for Vancouver, creating jobs and building an empire but I’m not going to listen to another word until he puts his money where his mouth is and moves into a basement suite.  It’s hard to believe, but in contrast to the evolutionary advanced Edmontonians there are,  in supposedly hip and green Vancouver,  worse in Seattle and San Francisco,  actual houses that don't even have a basement.  What a horrible self centred waste. I'm not saying the owners of these obscenities should be lined up and shot ,but I do think that all houses without basements should be the first to be bull dozed to make room for the underground future.

9-11 was a wake up call. The era of the skyscraper is over. As the great poet writer of Ironjohn said , the skyscraper was the final epitome of patriarchy, it’s time for the true ‘womb’ like experience of the safe secure ,environmentally respectful , ecologically advanced underground city with the potential of countless billions more living in earth. As spiritualists have been telling us all along. The answer is 'within'. The present day womb like shopping mall may as well be underground for all the light it sheds.

Urban and suburban above ground dwellers, especially the bureaucrats, executives and academics must change in face of this concern for the environment.  They must set an example by giving up the high rise executive offices, haciendas, dachas and above ground mansions with swimming pools.

The first tax should be on executive suites.  Basement dwellers should be awarded compensation for their adventurous demonstration to their lesser evolved suburbanites that underground living is good for the human race. It has long spawned students and artists and the greatest creative minds.  When people, have risen with the Peter Principle, they have usually been given higher and higher offices where there are more and more like  ‘air heads’.  They have all manner of power but rarely think with the gravity and genius those do who live in basement suites.

Mostly we need the universities and government buildings to be buried to save the planet. Free range chickens, goat herds, vegetable lots, forests,and cows where campuses, government offices and parking lots once were.

Thursday, January 23, 2014

Marijuana Smoker

I see addicts all the time.  Mostly they come to me complaining of ‘depression’.  More commonly than not they have seen a colleague of mine who has given them an antidepressant.  The colleague has usually avoided asking any details about lifestyle and especially glossed over addiction.
Most medications were tested in non alcoholics and non addicts.  If my colleague called the pharmaceutical company that made the drugs he prescribed they’d say they were not  tested in combination with 2 bottles of wine  a day or 1 to 6 joints a day of BC Bud.  If there were justice, my colleague would be faulted for 'lack of due diligence'. All manner of patients have difficulties with combined pharmaceutical drugs and street drugs.  It's a common cause of "side effects' and 'death'.
Most of my colleagues don’t know that Amsterdam after 40 years of experience with marijuania has lifted the standard famed ‘BC Bud’ marijuana to the most dangerous drug category, alongside Heroin and Cocaine. The Dutch 'experiment' with drugs has been a failure and is being reversed.  Pot Cafe's are now highly regulated.  Portugal decriminalized drugs but made treatment of addiction central.  Everyone except Canadian Teen Agers and Children, are getting off drugs.
Most of my colleagues and Canadians in general seem ignorant that the marijuana that the Beattles smoked in the 60’s had a THC content of possibly  1 whereas todays BC Bud is as high as 15 to 30.
When a person comes into the office and says that they are irritable and having trouble sleeping and feeling negative and have self pity and negative ideations and maybe even are suicidal, the first thing I wonder is, are they drinking or doing drugs.  My colleague would say, I think they’re depressed.  Yet I was in charge of a suicide ward and was a supervisor in a psychiatric emergency and reviewed all the completed suicides I’d known and lo and behold they were almost all associated with drugs and alcohol.
Suicide is under almost all conditions a severe brain disease.  If you see a mouse running repeatedly head first into a wall trying to kill it self you don’t at first consider Nietze and philosophical things. Even a veterinarian thinks, Brain Disease, meningitis, brain timor, etc.
So similar real doctors are taught when they see a person with symptoms, especially of depression, to think first a foremost of ‘organic’ causes, especially if the disease is so severe as to be ‘life threatening’ as suicide is.
Just as a person could have lung cancer without smoking almost all lung cancers especially the horrid oat cell carcinoma were found in tobacco smokers. My famous Califorinia respirologist friend says, 'there would simply be no department of respirology were it not for cigarette smokers'.  We now learn that hypertension and heart disease are diet and alcohol diseases, diabetes most a diet disease.  Once called mental illness, most departments now are called "Mental Illness and Addiction".  There's less and less mental illness and more and more addiction but we can't 'blame the victim' and the rich doctors never tell the emperor he has no clothes.
Yet, just because depression is common and increasingly with the increasing drug (specifically marijuana) abuse and alcohol abuse, suicidality is ‘common’ .
But today patients who are diagnosed with addiction or alcoholism may face consequences.
1) They lose the ‘sympathy’ of the ‘depressed’ patient.  “Just Say NO” campaign, while being true, and helping countless people, also minimized the difficulty that addicts and alcoholics have stopping drugs and alcohol.
Most people who have come to me with ‘depression’ and ‘alcohol or drug abuse’ have indeed tried to stop.  The CAGE Screening Test, the simplest 4 question test of all, asks ‘have you ever considered cutting down’.  Not surprising people who don't use or even don't abuse drugs and alcohol have never considered 'cutting down' but some 80% of those who have turn out to have the disease of addiction. It's a marvellous red flag.
Most patients referred to a specialist like me for depression who also have alcoholism or addiction have indeed ‘tried’ and are ‘defeated’. They have ‘hopelessness’ because their lives are ‘unmanageable’ with their addiction.  Yet they don't like the name 'alcoholism' or 'addiction' and were 'alcoholics anonymous' called 'stress stop' they'd go their in a minute. It's just that 'honesty' is lost early in the addiction cycle, for the addict and alcoholic, and for the enablers and for society.  Everyone avoids talking about the 'elephant in the room'. Especially if they've seen an angry elephant.   Historically addicts and alcoholics excelled young in the navy and army early in their disease. The air force began to have a problem with addiction when they got into jets and today alcoholism and addiction are identified early in the military but very late in politicians and others farther from the 'front'.  Artists rarely get diagnosed as alcoholics and whole generations of artists have been influenced by pedophiles, just as an example, likening sex with infants to an 'addiction' and showing how it can be promoted as 'okay' and 'normal' especially by 'addicted' artists.  But when I asked marijuana smokers if they wanted their neurosurgeon on marijuania they said no. Today I prefer artists who aren't intoxicated.  Tiny bubbles is very passé.
Chemical addictions, like alcohol and marijuana ‘short circuit’ and ‘disrupt’ neuropathways.  It’s like splashing a circuit board with water.  The computer screen will show all manner of entertainment and flashes and gibberish just like the ‘delirium’ state caused by intoxication.
Here I note, a person can have 1 to 3 glasses of wine without ‘intoxication’.  Note the word ‘toxic’.  Drug experience is ‘on or off’.  One can drink without getting ‘drunk’ but one smokes marijuana and gets ‘stoned’ .  Drug addiction is ‘digital’. It’s on or off.
The ‘state’ has been described as ‘dissociated’ , two personalities, and over time the ‘dissociated self’ can ‘consume’ the well person, in the Doctor Jeckyl/Mr Hyde way all of us see who work in addiction.  Recovery is to a very large extent the recovery of the authentic self and the expansion of the potentiality.  The addict person is a very abbreviated reduced person with limited access to higher brain function and major loss of control.
The ‘sympathy’ component of addiction was associated with traditional ‘disease’ categories.  A person had a ‘heart attack’ and it was thought to be ‘involuntary’ whereas a person showed up drunk in the Emergency and that was ‘voluntary’.
The ‘rage’ in ‘pharmaceutical medicine’ is the treatment of ‘involuntary’ disease.  Fundamentally there is ‘fate” and “free will”.  In our society we ‘take credit’ for our good deeds and ‘blame’ others or the universe for the ‘negative’.
Insurance companies excluded alcoholism and addiction (because they could get away with it and knew they’d save fortunes in the insurance lottery) but kept ‘heart disease’ and ‘lung disease’ as ‘involuntary’.  Today we know that those who had heart attacks and lung cancer more often than not got them as a consequence of drinking alcohol and smoking tobacco.
Today we call them ‘diseases of lifestyle’.  Life ‘style’ is such a politically correct ‘fashion favourite’.  In the Bible they said the ‘sins of the fathers and mothers will be passed on to their children’.  In the East they called it ‘Karma’.  But in Consumer Corporate society it’s just called “marketing’.  More often than not my alcoholics had parents who were alcoholic and the smokers had parents who smoked.
But nobody wants to be ‘honest’ and no one including the doctors, government and corporations want to do anything but ‘collude with the dying customer’.  Indeed when the smoker gets lung cancer the covert aggression of the manufacturer and friends was to offer him a cigarette.  Alcoholics on their death bed are given more to drink.  It’s comforting.
So my ‘johnny come lately’ junior colleague has a wholly ‘addiction’ practice so that only ‘addicted’ patients are sent to him. This ‘selection bias’ ensures that he not only doesn’t have to make the diagnosis he’s politically correct and leaves the heavy lifting to the first doctor who says, “I think your diagnosis is alcoholism or marijuania addiction."
The beauty of heroin addicts and crack addicts is that the ‘prohibition’ society makes everyone’s life easy because these people know what they are doing is ‘wrong’ and no one has to ‘convince’ them they have a heroin or crack addiction.  They just may or may not be ready to address the problem.  Drug addiction and alcoholism are ‘fun, fun and trouble and trouble.’  The sooner you get off the train bound for institutions, early death, disease, jails, the easier the fall, but as that train speeds up and descends deeper and deeper it’s more frightening to jump off and much harder to crawl back to where you are no longer down.
Chemicals such as alcohol and marijuana and eventually all drugs of addiction, which mostly over stimulate and damage the dopamine (happy, think ‘dopey’) circuits are ultimately depressing.
The initial euphoria is a product of the ‘disinhibition’ of the loss of the frontal lobes which are the latest and most human structure of the brain associated with judgement and editorializing, delayed gratification, planning.
The buzz diagnosis in the pharmaceutic industry for the 'mood swings' of addiction is 'Bipolar II" disorder. Addiction and alcoholism are the 'great chameleons of mental illness because ever 'symptom' of mental illness can be seen in the addict, from the usual 'anxiety' to the final states' early 'dementia' or 'schizophrenia' like' psychosis.  All intoxications are 'delirium like 'or 'cognitive impairments' and 'mood disorders'.
Spiritual teachers recommended a once a lifetime or once a year ‘drug experience’ to have this experience of being aware of the more primitive ‘childlike’ thinking but especially the notion of ‘time’ as a critical factor of ‘assumed’ thinking.  Meditation is a ‘timeless’ experience but so is ‘drug abuse’ and ‘drunkeness’.  Immediately in the altered state one loses ‘time’ awareness.  In the proper ‘context’, historically and culturally established by tribes and medicine men one could have an induced religious experience. This ‘dangerous’ rite of passage, as described in Huxley’s Perennial Philophy and known to Indians in the “Peyote” experience is wholly different from the ‘abuse’ of substances seen today.  For one these 'religious drug experiences' are a cultural and community and 'controlled and regulated by elders 'experience. But mostly they are just 'once' or at most 'once' a year.  There's nothing 'religious' or 'spiritual' about daily or weekly 'intoxication'.
It’s all in ‘dosage’.  To the addict or alcoholic ‘more’ is better whereas in fact the value of alcohol to ‘enhance’ a meal as often encouraged by gourmands is at most a glass. Two glasses of wine ‘dulls’ the palate’ just as with the heart, which is made better with 1 glass of wine is made toxic with three.  Huxley suggested it would be beneficial for people to have an hallucinogenic experience once in their life. Not to live their life as Mr Hyde.
Whereas alcohol biological effects wear off in a matter of days, marijuana or cannibis last weeks to months.  A person’s perception and interaction with others, relationships being most sensitive to drug and alcohol abuse, as with higher tasks of work and play, are not just affected in the ‘intoxicated’ phase but also in the ‘withdrawal’ phase.  Weekend binge drinkers are in ‘withdrawal’ in the middle and end of the week.
One wonders about jokes about being careful with work done by governments and union workers at the end of the week.  The ‘withdrawal/craving’ cycle is all part of addiction.  With the classic white collar martini drunk Judge his ‘decisions’ made late in the day were commonly less favourable as opposed to those mid day.  Astute lawyers timed their clients cases against the judges daily evening drunkeness.
The WHO has long held that one is only clear of drugs and alcohol if one has been abstinent for one year.  The DSMV says a person is in 'remission' if one is one year abstinent. All 'harm reduction' strategies are only 'valid' scientifically and culturally if they are leading and directed ultimately to 'abstinence.' Otherwise they may well be enabling, and a doctor takes an 'oath to do no harm'. Enabling is harmful. If one is only providing 'palliative care' one should indeed tell the patient that they are being treated as if there is 'no cure'.  Abstinence is a 'cure' for addiction.  So it's ironic that people are so often offered 'harm reduction' sometimes even first offered 'harm reduction' rather than given the true facts especially those that say that the people working in predominantly harm reduction  are usually the most negative about their clients potential.
There is no ‘healthy’ or ‘medical’ smoke.  All smoking is ‘unhealthy’ and ‘not medical’.  When a person tells me they use ‘medical marijuana’ I routinely ask them if they ‘smoke’ it, knowing that the estimate that 95% of British Columbia ‘medical marijuana’ establishments were for pleasure purposes.  Smoking marijuania is 'recreational use'.  The cost/benefit medicinal value of any marijuana is negated by smoking it.  Only marijuana consumed without smoking is potentially of 'medical benefit' given the burden of disease associated with marijuana.

2) The patient who has been diagnosed as having addiction or alcoholism is suddenly fased with not being told to take ‘a pill’ as alcoholics and addicts have been pharmaceutical industries greatest friends.  The last alcoholic drug addict that died whose pill cabinet I went through, had every prescription and over the counter mood altering substance known to man.  Indeed if one was cynical one would consider that the ‘drug doctors’ avoid asking about addiction with any care, concern or ‘due diligence’ because they know they run the risk of losing a very valuable customer. These ‘prescription pad’ doctors would rather throw another drug into the mental soup of the insane patient than ‘make the diagnosis’ of alcoholism and drug addiction because this could ‘anger’ the alcoholic and drug addict.  Freud considered alcoholics and addicts to be 'orally addicted' He thought these people were fixated on the 'breast'.  He thought the damage psychologically was done in the developmental phase when one is being 'weaned'.  He was probably right.  However sex addiction and gambling addiction are not oral fixations so addiction to alcohol and smoke might well follow Freuds observations but overall addiction appears more a behavioural disorder of impulse dyscontrol and regulation failure.  Cognitive therapists see marijuana and alcohol as potentially like 'computer viruses'.  We know now drug addiction and alcoholism are 'contagious' but better still we know that 'recovery' and 'abstinence from drugs and alcohol' are equally if not more 'contagious'.  Groups get better  whereas those who isolate are the least likely to recover.

Why doesn’t anyone want to ‘anger’ the alcoholic and drug addict? Ask a wife or husband what their response was when they told their partner they thought they were drinking too much or smoking too much marijuana. It's not usual a Rockwell moment. There's nothing cuddly about an addict or alcoholic  who is questioned or even criticized. The whole development of the 'motivation' interview was to avoid questioning or even' addressing' the addict or alcoholic in the 'denial' phase of addiction.  Alcoholics Anonymous told people to come when they reach their 'bottom'. A bottom could be anything from loss of marriage or loss of job or just feeling stupid on marijuana and having had 'enough' . It's said you can get off at any floor , you don't need to take the elevator all the way down.

Note, I have had a dozen complaints to the College of Physicians and Surgeons solely by making the correct diagnosis.  I have had my car windows broken by alcoholics. Marijuana smokers have murdered my dog. My life has been threatened repeatedly and my windows have been shot out.
Judges, probably drunk, agreed that it was okay if a man killed another ‘under the influence’ , the courts being the prime enablers in the country for drug addiction and alcoholism and the best friend of the tobacco companies.  Ask Mothers Against Drunk Drivers who their greatest enemy is.  For years it was the judge and the courts.  Doctors working against the widespread promotion and sale of tobacco especially to children literally fight the government and courts to stop the killing.

When I last diagnosed a marvellous old chap with alcoholism and refused to give him ‘valium’ for his ‘nerves’ and indeed told him the ‘combination’ was dangerous and that I couldn’t in good conscience prescribe him more drugs for his ‘anxiety disorder’ and ‘depression’, he wrote scathing ‘rate your doctor’ comments for 2 weeks after the visit.  The difficulty with rate your doctor is that when I fired a secretary who had relapsed on crack she too wrote a number of ‘comments’ about my character, practice.
Alcoholics never say they don't want to go to alcoholics anonymous because they want to continue to drink. That would be a very politically incorrect thing to say to a boss, for instance. They always say they don't want to go 'because of the God thing'.  That's because the 'god thing' works today. 30 years ago they said they didn't want to go because of fears of anonymity.  My favourite complaint is that they don't like the colour of the wall. Everyone knows that Alcoholics Anonymous membership would sky rocket and be as popular as the pubs if they served alcohol.  No one complains about picture of the Queen in the pubs and no one complains about drinking in Christian establishments and the very best drinking goes on at religious funerals.
I had one pothead complain that I was a man. They never said that I'd told them to quit pot. No one ever tells family what the doctor said truly when he tells them to stop watching porn, stop drinking or stop smoking pot.  They tell the referring doctor if they're a woman, "I think I need to see a female psychiatrist'.  If they're a man, 'they say I didn't like that psychiatrist, could you refer me to another'.  The most popular psychiatrists prescribe the most clonazepam and ritalin to the addicts and alcoholics.  They collude. Addicts and alcoholics love those who collude.Theres a great book called the Alcoholic Republic that gets down and dirty with the problem of collusion.
Alcoholics and addicts are nasty people in their disease.   Dr. Jeckyl and Mr Hyde. They’re at first jolly but addiction is like making love to a gorilla, at first it might be cuddly but it’s not over till the gorilla says its over.  So after the honeymoon the meanness of the addict or alcoholic comes on.  And that’s any time but the increasingly briefer period of ‘okay’ feeling that the person gets with the abuse.  The Chinese coined a term to describe searching for this elusive moment as ‘chasing the tail of the dragon’.
So the Government and the College and academics all spout ‘platitudes’ about not prescribing dangerous combinations of drugs with active alcohol or drug abuse( and there are countless measurement tools and assessment tools for assessing drug and alcohol abuse) but mostly people 'avoid' asking and 'cherry pick' and 'collude'.  Everyone can then say they were 'well intentioned' even though the 'outcome measures' show this as often as not supports and even promotes'.  It's a start though so better than nothing. Platitudes are sweet sounding at least.  Like 'lifestyle disease'.  Very PC.  It’s not even easy to speak to a family member or friend about a person’s alcohol or drug abuse (given that the second question of the CAGE is ‘has anyone ever suggested you might have a problem with alcohol or drugs, has anyone  "annoyed" you by suggesting you cut down).  The Government and the Colleges of health care are by nature 'PEOPLE PLEASERS" so they are grossly in effective in addressing addiction because people with addiction (especially marijuana smokers) are so easily 'annoyed'.
Meanwhile the richest and most lauded and most successful psychiatrists are those who the drug companies reward for prescribing the most pills too.  Addiction psychiatrists by their very nature, tell people to stop prescription drugs and abusing illicit drugs.  We're poor by comparison and we're the ones who get the complaints not the 'drug pushers'.  The police are beat up by the drunk, never the drug pushers.  Drugs and alcohol impair the memory and protect the source.  People rarely roll over on the drug pusher. Goddam the drug pusher!!!!
And today they tell people to stop smoking marijuana.
All doctors tell their patients that smoking mairjuania is unhealthy.
All doctors tell people to stop smoking.
Not very adamantly.
Not strongly.
But they're telling them.
I remember when we offered patients cigarettes in the office or bummed a cigarete from the patient or nurse in the hospital.
Addiction can be cured.  Look at how addiction therapy has 'cured' smoking.

With all the gains we've made at high cost addressing tobacco smoke I'm sorry but I don't want to have the smoke epidemic start all over again with 'safe' 'herbal' 'medicinal' 'marijuana. Is every one stupid. Just look at the marketing of tobacco. It was sold as a means to have smaller easier deliveries because smokers babies were smaller. Women were encouraged by tobacco companies and their paid doctors to smoke during pregnancy.
Everything the marijuana crowd and their bully boys are saying is what the tobacco industry said 50 years ago.

But a day doesn’t go by in my office where someone smoking marijuana daily or weekly doesn’t tell me that I’ve got a problem suggesting they have a problem with marijuana.

Indeed any doctor who is being a healer in the western world of ‘lifestyle’ disease i.e. principal diseases are addiction diseases - gluttony i.e. over eating, smoking, over drinking, lack of exercise poor diet, workaholism etc, is going to get complaints.

Indeed when I ask doctors, have you had a complaint to the College of Physicians and Surgeons, and they say, “no’, I know that they are good businessmen, jolly good fellows, wearing rose coloured glasses, lying, playing it safe, but they’re not ‘healer’s and they’re not physicians in the true sense and they’re not ‘psychiatrist’ especially by any definition of the word. Or they have a very circumscribed practice where they can do medicine, like pathologists do, knowing all the ills of addiction but never having to face a living patient and tell them how to delay ending up in the morgue.

I'm PRO LIFE and condemned for it as a doctor today. The Euthanasia doctors and single government health care insurance with it's conflict of interest loves euthanasia.  Euthanasia is good for you because it saves the government money.

First ‘do no harm’.  The greatest harm that can be done other than actually killing a person is to watch, thereby, encourage, them, killing themselves. We call that ‘enabling’.  Stop filming the terrorists. The media black outs of terrorist demands dramatically stopped terrorism campaigns of the 70's.  Stopping advertising of tobacco stops it's sale.  Stopping advertising marijuana and especially promoting 'safe heroin injection' ensures that there will be an eventual reduction in addiction.  We are winning with stopping smoking tobacco. We have addressed the greatest public health concerns of the day. We are finding cures for HIV.  To promote smoking today would be like say have promiscuous safe sex.

Yet so man individuals and most institutions in our society enable and encourage addiction.
It’s the elephant in the living room.

My friend who is one of the most successful and entertaining men in the field of gambling addiction gets millions of dollars of research money from the casinos and probably from the MOB. He laughs when he says his ‘mandate’ is  not to ‘cure’ gambling but to find a way to ‘stop’ a gambler after he has lost his house, job and marriage,  from coming to the casino and making a nuisance".  His job is to address the ones who are bad for business. Indeed this genius recognizes that promotion of gambling is tied to the taxation system and may well be preferable to those who don't gamble as a means to fund bridge building. This doesn't say good things about the 'stigma' attached to addictions but it speaks to the reason why people want to be called 'stressed' or 'depressed' and diagnosed with 'PTSD" rather than "Addiction'.
No military doctor has ever advanced his career by suggesting that stupid military commanders shouldn’t waste their assets.

Indeed the most recent example of this was a brilliant loving caring wonderful human being of a military doctor who tried desperately to stop the wholly unnecessary ‘waste’ of ‘friendly fire’ only to be fined and pilloried by every official organization in the country.  In my mind the man is one of the greatest heroes of the day and were our society not so sick , he’d be awarded the medal of honour for his courage and genius which surpasses mine and most of my colleagues.

Locally we have a ‘SAFER INJECTION Site” called “INSITE “ which I say should not be funded by ‘TAX PAYERS” but rather by the gangs like ‘allegedly’ the TONG and Hells Angels, who ‘allegedly’ are behind the distribution of heroin. Just like my gambling doctor friend the Insite crowd clean up the ‘mess’ caused by the addiction to Heroin.  Insite makes Heroin look good, puts a pretty face on addiction and helps the gangs market their goods, protecting the industry of drug addiction just as my gambling friend is given money to stop the loser from returning to the casino when he’s lost his assets.
When I was a bar tend in England at 20 the pub owner threw the drunk without money out on the street.  Now they call an ambulance. The cost of the health care system is exorbitant because of addiction.

10% of all people who abuse develop some level of addiction.  Addiction is diagnosed by it's negative consequences at first to the individual and later to their society.
10% of marijuana smoker will develop addiction of some kind. The more available a substance is the exponentially higher rates of abuse occur. It’s not madness that had tobacco companies wanting to put cigarette dispensers in schools and it’s no surprise that the western world has an epidemic of obesity with all the carbohydrate ‘chips and nachos and chocolate dispensers’
Sabet in REEFER SANIETY shows very clearly that the taxes never pay the cost of addiction.

Indeed taxes are like the apocryphal proverbial Mexico City Police.  When I was there I was told by locals if I was robbed I have to think twice about calling the police because they often apparently figured that since a ‘robbery’ had occurred and a gringo was putting in an insurance claim ‘anyway’ then they should help themselves to anything the thieves had forgotten to take. So the ‘taxation’ argument goes , since the ‘drug pushers’ have taken most of your money and life the government now can take whatever is left by ‘getting a cut of the action’.

Indeed in Canada in a famous referendum, all gambling and liquor and drug ‘revenue’ ‘sin tax’ was only to be allowed by government if the assets went directly only to health care and education because the corruption of government would occur when ‘sin tax’ went to the income of the politician and courts and bureaucrats. This is the case today which makes it hard for my patients to understand ‘what’s the difference between the RCMP arresting you and collecting tax for marijuana smoking” and the gangs charging you and beating you up a bit if you didn’t pay your debts.

A colleague psychiatrist,  a favoured doctor-businessman, a great ‘corporate scion’ of medicine, says that the problem isn’t with heroin being sold on the street or cocaine being sold on the street or marijuana but rather that ‘we’re not selling it’.  He sees no problem with ‘prescription drug addiction’ and indeed promotes speed, oxycontins and ativans and clonazepams better than any ‘street drug pusher’ I know.  He doesn’t like the ‘competition’ which he sees as ‘unfair competition ‘ because the marijuania drug pushers ‘don’t pay taxes’ and ‘aren’t regulated by the College and Government’.  Imagine the complaints department for The College of Marijuania Producers - every childs mother would be complaining daily to that place.   But the College of Physicians and Surgeons is the enforcer of complaints by addicts about their doctors who have diagnosed their addiction with the negative consequences that has for their insurance or work or marriage.  Stopping their addiction and getting in recovery would help everything especially their health but in the interim it's easier to complain and be nasty.

So Justin Troudeau says he smokes marijuana and smoked marijuana while working.  Whats new about that. His father said he didn’t swear but said ‘fuddle duck’.  The acorns don’t fall far from the tree.
But Clinton said he put a marijuan joint to his mouth and didn’t inhale and Obama said he smoked marijuana contritely.
The fact is, Clinton could well have done just what he said. When a joint is going around , to be part of the crowd, and to be a politician like Clinton became, you learn to ‘fit in’.  You are kind of a Nazi among the Nazi’s and Kind of Communist among the Communists and Kind of a Jew among the Jews and Kind of a Christian among the Christians. This is the essence of political correctness.  You are without ‘substance’ and as a new ‘opinion poll’ peace time politician you’re like the addled brained weak kings of the feudal world who had syphilis of the brain and were loved by all the powerful men until faced with an American Revolution.  So Clinton caught in the act, with the photographic evidence, and testimony, not dissimilar to when he was caught with pants down, may or may not have ‘inhaled’ but he wasn’t ‘proud’ of his behaviour and tried like the marvellous Flashman of the Flashman novel  series to weasel out of it. He knew right from wrong.  Just like he knew it was wrong what he was doing on the job with Monica, his being married and collecting government funds for working but indeed was ‘distracted’ by Monica.  We don’t hear much from her but Clinton today is the highest paid ‘speaker’.
Obama did drugs. He admits it and ‘apologizes’ for it.  He ’s ‘contrite’. it's all in the attitude.
Justin Troudeau isn’t contrite.  It's his attitude of entitlement that offends.  That’s the problem.  He ’s like Mayor Ford.  They are two very entitled elitist white men who don’t seem to understand that this country is a ‘democracy’.  We believe in laws for everyone. I'm waiting for an apology from Troudeau for breaking the law and essentially 'bragging' about it.

My friend got caught for smoking a joint.  He went to jail. He didn’t like authority and was claustrophobic. 10 years later, raped and beatten and life changed irreparably he came out and joined a criminal gang.  I met him years later. To the best of my knowledge he’d killed people by then.  He’d been no different from me. We’d come from the same background. I smoked banana peels one day thinking it would get me high. He smoked ‘grass’. The police caught him. I got sick. He went to jail. I went to university. We met up in our 40’s.  He deals marijuana.
I’m sure he thinks Justin Troudeau is a chump.  He hates pompous poofs like the Troudeaus.  Can’t stand them.  To him they’re just feudal lords, ‘dandies’ is what he calls them. He reads a lot, was brilliant as a young man.  Today he's rich. He could be the lead in Sons  of Anarchy. He’s that sort of guy.  He was only supposed to go to jail for ‘possession’ of marijuana.  He was only supposed to do ‘6 months’.
Justin Troudeau wasn’t arrested for ‘possession’ and he would never have done time. As Animal Farm told us ‘some animals are more equal than others’.  The communism of old man Troudeau, the great atheist religion, has turned out to have killed more millions in a mere hundred years than all the religious wars in the thousands of years before.
Communist countries have devolved into gangster run states and the democracy of Canada continues to muddle along despite the ubiquitous corruption of Quebec.  The satire of the recent Quebec investigation, had one of the leading politicians of the province saying ‘I only took 5 million dollars, I could have taken millions more, everyone else was taking millions more’. That’s the moral relativism of this ‘class’ of characters.  What might have been called in Casblanca, ‘todays’ cast of ‘usual suspects’.
My other patient was caught with a few joints and put in jail. He was young and blond and it was before the drug courts. So he was supposed to just do a few months and leave. He was gang raped and died of HIV Aids.

Everyone wants decriminalization.  Decriminalzation makes the problem a health care problem and addiction and alcoholism ‘disease’.  Legalization is what the gangs want. Already people like Emory are counting their millions. These pothead promoters are the new CEO’s of Tobacco Companies.  They are addicted to power and money.  No one cares about the addict. No one cares about the 10%  - the losers.

The marijuiana smoker is toast.