Saturday, July 25, 2015

Journal - Saturday

I couldn’t believe it.  Gilbert let me sleep in. Everyday, around 6 or 7 am he lays his little body across mine.  This weight wakens me and when he sees I’m away he attempts to squirm forward and lick my face.  I counteract this and push him away.  Normally this results in a delay. He lets me sleep a few minutes or a half hour later.  It’s the snooze bar on Gilbert.  When he comes back the next time, he slinks in and goes right for the sloppy face licking alarm clock routine.  During the week when I have to go to work this usually works and I get up before the actual alarm. Gilbert is ecstatic at my wakening and jumps on my chest and crotch making the getting up part for me a tad complicated.
This morning I only recall pushing him away once maybe twice.  I never got the face licking.  I got up when he was lying on top of me and got through the happy dog gauntlet. On the other side of this morning welcome I looked at my watch and found to my surprise it was 9 am. I’d gone to bed around 10 to 11 so I must have been really tired.  As I ‘ve aged the long days at work, sometimes still 10 and 12 hours really whack me.  I get home and collapse after making and eating dinner.  My mind feels like my body used to feel when I did construction. By Friday I’m drained.  Often I have difficulty concentrating on detailed numbers and avoid doing reports Friday now, fearing making errors in complex details.  My work week continues to be about 50 hours of patient contact. There’s administration and research and calls on top of that.  I can’t get over how the paper work has multiplied and ads so much to the burden of work.  I’ve dozens of faxes from mostly pharmacists and then there’s all the reports that are necessary.  My assistant is always on me for notes. The courts and college have an endless demand for more detailed notes and more irrelevant reporting. So much doesn’t serve the patient or me but is the political correctness beaurocratic ‘fashion’ of  the week.  When I see these latest demands for documentation I am certain without a doubt that the committee that came up with them didn’t have enough work of their own to do or they wouldn’t expect others to do such petty and ridiculous recording.
The failure of the legal system of the west is found in the fallacy of the ends against the middle. One person burns themselves in one location on a too hot cup of coffee and everyone everywhere has to have a ‘beware of hot coffee’ sign written on the cup.  One day in the future the scientists will conclude that space flight and colonization of the solar system, all poverty and all disease in the world would have been possible before 2000 if it weren’t for the stupidity of the peace time legal and beurocratic systems that continue to work as if time was not a factor in their activities.  Where all judgements occurred in hours to at most a week, judges today take years to come to a decision.  Beaurocracies work at snails pace. Government works move at a tenth of the pace that those in private industry work.  Some have said that wars exist to revolutionize the legal and beaurocratic systems which become increasingly ineffective over time.  Work at the legal and beaurocratic levels expand to fill the time available.  As someone else usually is paying in the court and the bureaucracy there’s no incentive to move at anything faster than the slowest speed. Only in war is this changed when the winners of wars usually are those whose legal beaurocratic processes were superior as much as technologically.
This is a resentment.  It’s an institutional resentment.  Defensive medicine accounts for as much as may 90% of the cost of health care.  When I look back on my life I see this onerous costly soul destroying process of interacting with legal beurocratic systems that seemed primarily to parasitize the central process of doctor and patient and the ‘medicare model’ .  The frustration of my work for a decade has been getting patients what their illness warrants by fighting individuals and systems who have grown with the pure intent of delaying.  Legal beaurocratic systems are principally covert aggressive systems.  They become rich by attrition and siege.  I can’t recommend anyone go into medicine anymore because the frustrations far outweigh the compensations. If I was young again in this present system I’d do what so many of the young doctors do, which is the least possible.  Increasingly medicine and psychiatry are defined by reductionist processes and cherry picking and avoiding sick people is the most rewarded.  Indeed the richest doctors increasingly are doctors who don’t actually see patients but focus on administration, policing, and business aspects of care, not the clinical basis.
Now where the hell did this nonsense come from. I was just thankful that I slept in.  I was really happy to that I got dressed in shorts and t-shirt and runners and ran with Gilbert for a couple of miles.  Maybe it’s a mile. I don’t know. It’s about a half hour of running and I used to walk 5 miles an hour.  When I was younger I ran a ten minute mile.  More and more I’ve been actually running the whole distance. Today I walked for a few minutes halfway because Gilbert met another dog. I pull him on a leash. He wants to piss and sniff everything which we do when we walk but running is all about forward motion.  Today I was dragging the poor little guy, thanks to his crying wolf stops before that, and here I looked back and he was of course squatting and trying to shit.  We have his daily walk for a shit in the early morning which he’s very happy with but the long walks or the runs are an added delight.  I feel badly though when he gives me that face he gives me when I realize he’s stopped not because Fifi left a love message but rather because his bowels are active.
I have been thinking about the boat and the RV and houses.  I write more on land.  I loved sailing and anchoring but I ‘m not as relaxed and able to work in the sailboat as I am when I’m on land.  I do my writing here. I can do reports and work on land better. I can read and watch tv and relax and journal a bit on the boat but I don’t tend to do the kind of writing that I do on land. Flying I’ve written a number of short stories that went on to be published.  I’ve been blogging for a few years and naturally I can do that. But I’ve also been working on books and that doesn’t seem to progress on the boat.  I used to hate stationary living but I’m beginning to really enjoy it.
When Laura’s been over for the weekend I’ve really enjoyed sitting outside with her and the simple cooking and cleaning around the RV.  I find myself incredibly nostalgic about my first house, a little 2 bedroom bungalow with yard and one car garage in Riverheights Winnipeg, that my Dad helped me pick out.  It was so very functional and not that different from the house I grew up in.  I’ve had huge houses and acreages since but that’s the one that I think I enjoyed the most. I did love the acreage and turkeys and chickens with the clinic on site but today I’m just enjoying this RV and think a lot about that first house.  I’ve not particularly liked apartments though my last one I have fairly fond memories of.  I think my feelings about it began to change with the crazy neighbour coming around and complaining about noise when I hadn’t been home.  Then getting away every weekend the storage locker and the elevator problems in a first class apartment buildings, it all got to me. I loved living on the boat after that.  The condo I had was really nice.  I loved the elegant living. That was in Riverheights in Winnipeg too and I liked it better than the house in Shaughnassey.
Now here I am after a run, having really enjoyed the morning coffee, having had a shower, dressed in t shirt and underwear, my favourite clothing combination next to t shirt and sarong  or skirt. I just loved wearing wraps in Mexico and the Marianas Islands.   My favourite all time clothing was my worn sailing shorts.  That’s all I wore sailing in the heat and it was freeing.  We sailed nude in the Sea of Cortez but kept our wraps handy for chance encounters with other sailors.  Nudity is great.  But I’ve resisted the temptation and kept out of jail or public records.  I loved the halloween costumes and dress up as a kid.  I fully understand the kids and adults who are running around in superhero costumes.  My favourite halloween costume in recent years has been the witch.  That came out of a costume I wore for a night at Rocky Horror Picture Show.  The most fun was when the girls and they guys all got into costumes and went to dances and parties.  There’s always been someone socially incompetent who doesn’t dress for the occasion but more and more there’s been participation in the those who are good sports.  Even at hockey games it’s seen in those who go the extra little bit and wear team colours.  Gilbert had a canucks sweater which he doesn’t like to wear.  He doesn’t like to dress up at all.  My nudist friends have said how onerous it is to get back to clothes after a weeks retreat.  I wish I’d done that when I was younger and my body was toned.  It’s not really about that though. It’s a state of mind. It’s about maturity and freedom.  I miss the YMCA days when we all swam naked as guys. The best times were the nude swimming with the girls in our 20’s and 30’s .  The girls were so beautiful in the moonlight. I remember those times so fondly.  It was fun too.  I imagine if I ever stop working and retire I’ll get back to the simpler life and times, those camping and canoeing weekends and weeks.  Now I’m outfitted with RV’s and quads and trucks and motorcycles. Then it was hiking with a back pack or canoeing. My father got into canoeing again in his 70’s and 80’s loving it until it was too much trouble to get the canoe off the van.  I imagine seeing myself doing that. There’s a fellow I met who had sailed the Atlantic ocean back and forth a few times in his 80’s. He was so inspirational. 85 years old when I met him. I imagine doing that. I hope I can do that.
My lifestyle is fairly expensive today yet I had the finest time in my student years.  Travelling on bicycle and staying in youth hostels was incredibly inexpensive.  I suppose when I quit work I’ll scale down and have time to breathe.
I reflected last week on work and realized that there are hundreds of people right now whose lives I make easier.  I’m not indispensable but I’m an integral part of their lives.  I have a lot of very sick people I care for and have known for many years.  Theres’ importance to this longevity and reliability.  I’m wanted. I’m the known substance.  I’m trusted.  I might not be the best but I am far from the worst.  I’ve been reliable and often I’ve ‘saved’ lives. I’ve certainly gone above and beyond the call of duty, and always been unconventional. I regret this some days because I could be a millionaire today if I had done what I was told rather than doing what I thought was needed. Certainly more people would have died but I’d be richer and more successful.  I’ve given far more time to people than the system paid for. I even have some people who think they’re very clever in taking more time than allotted insisting on it only as an entitlement but we’re working on that trait.  It’s been a problem of how I see myself. The woman at the College of Physicians and Surgeons of BC condemned me for caring so much for my patients insisting ‘It’s just a job, Dr. Hay”.  I had this weird sense of ‘calling’ and have always thought the profession was more than a ‘job’ but those who treat medicine and psychiatry as “Just a job” have become rich and been promoted to the highest ranks. Those who practice the ‘business of medicine’ giving the ‘least for the most reward’ and focusing on the ‘maximum profit’ are now the ones who mock me.  I’m a has been and my life is a waste.
Then I think of how my marriages failed because I focussed on my work over my home and if I’d just gone to work like it was just a job I could have been a better husband . I could have had more money to buy women gifts and had the time to meet their demands for attention and luxuries.
I’ve roughed it a lot in my life.  Living on a sailboat for years. Living now as trailer trash.  I wonder now what my life would have been like if I’d just stayed in that first house.  Sedentary. None of the adventure and experience.  Safe.  None of the risk and perils that I’ve known.  But at the end of the day when friends and family seem more important I find myself nostalgic for high school reunions and family suppers.  This moment I don’t even want to get in the truck yet I have to go over to the boat to pump the water out of the dinghy. We have had a lot of rain these last couple of days. It’s necessary for the vegetation and to stop the forest fires.  It just means I have to make a trip to the boat when I’d rather lie about and maybe watch tv like we did as kids on a saturday when the black and white westerns were on.  We didn’t do it often but it was a treat like going to the BDI ice cream parlour, the hike there along the river bank making the ice cream sundaes even better.

Now I’ve written a chapter of the book and blogged this drivel. It’s time to get dressed and do something else, or maybe just lie down for a bit and read more of Cornwall’s Waterloo.  I love historical fiction.
Yes I think I’ll make lunch and read. Apart of me is counting the days till IDAA, the annual addiction medicine conference I attend where I get together with mentors and colleagues and celebrate working and being alive another year.

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