Thursday, August 27, 2015

Gratitude Thursday Journal

Yes, I'm grateful.  I slept well.  It's a bit like being an underwater diver when I'm using the CPAP machine.  The air is bad though.  Forest fires smoke still blowing into the valley.  I've got a summer cold on top of that.  Without "Advil Cold and Sinus" and CPAP I'd not sleep through the night.  So I'm really grateful for sleep and breath.
When I put on the CPAP my first breath starts the machine. There's a pause though. I'm momentarily without air.  It causes me to feel the suffering that asthmatics and others with lung disease know. It's also the greatest fear in dying.  I've bagged dozens back to life and know the terror in their eyes up close.  Scuba diving first hand I've felt the panic of not being able to get air, the faulty system, struggling with panic, fixing the problem or once buddy breathing to the surface.
I'm really thankful for breath.  The breath of life and mostly we take it for granted. Smokers even shit on God with their tobacco and marijuana, blaspheming the Holy Spirit in the most ignorant suicidal way.  Like eating poop.  The psychotic stupidity of smoking isn't beyond me. When I was as schizophrenic as any average cigarette and marijuana smoker I didn't care for God or spirit or breath or life.  I actually took pride in 'learning to inhale' the smoke.  Like a little girl priding herself on cutting her wrists and making the blood flow.  I smoked.  Just thankful it wasn't longer.
Last night I dreamed of sailing. I love those dreams.  Like the dreams of my parents or the dreams of old lovers or the dreams of my former dogs.  I miss the flying dreams.  Haven't had those for a while. Remember Freud called flying dreams, dreams of sex.  A female psychiatrist countered him saying that sex was dreams of flying. Can't remember what her name was.  Maybe Karen Horney, when Freud said women had penis envy, she responded by saying men have womb envy.
I'm certainly thankful for my little dog.  Yesterday was National Dog Day.  I posted a picture of Gilbert the cockapoo.  There's a huge extended network of us who only know each other by the name of our pets.  It was the same with sailboats cruising.  We didn't remember each other's names, just the name of the sailboat.
China's market crash flattened out yesterday. I'm thankful for that.  There was a rebound too. Don't know how much money I made or lost. My accountant says I should keep track of these things.  I look back and realize that studying psychiatry was silly. Maybe reading the books to get the exams and have a job but all that other study. It's never made me any money.  I made more money as a general practitioners.  4 years of study and countless evenings and weekends reading the literature. Yesterday I "looked up" a dozen things and read a couple of articles. It's almost daily.
Smart people, don't read science and literature but follow stocks and bonds.  I wish I could do both.
But these days I'm not doing much.  9 am to 930 pm Monday at the office, no lunch, no breaks, coffee maker in my office. A half dozen emergencies.  Not suicide.  Bureaucrats, insurance agents and police 'needing' a letter from me or my patient would be denied work, income, or freedom.
It wasn't like this.  I treated individual illness when I began.  Today I'm always treating systemic failures with the patients more and more just evidence of the deconstruction of society.  I'm still ashamed at all the gouging of students for their education.  It must have been a half dozen or so last year I helped through their bankruptcies.  I don't know how anyone survives in Vancouver.  The young women admit to prostitution. There's a host of names for it but it's just prostitution.  Having roommates makes it's difficult.  Everyone is juggling housing space.  It's a national election issue.
Smart people made 'medicine' a government issue and contractors gouged and became billionaires doing incredibly shoddy work with their leaky condo scandals, all the while benefitting from 'free' physicians.  In another world I'd 'nationalized' housing like "they" nationalized medicine.  Then everyone would have a house or condo.  I'd write ads saying "People shouldn't go bankrupt to have a roof over their heads".  A third of my patients are living in 'shelters' .  And everyone knows if you want to get rich you get into construction, real estate or estates.  Donald Trump wasn't stupid enough to become a doctor.  I feel like I should stand in solidarity with my Ontario doctor brethren. They're facing 'claw backs'.  What an interesting term for government 'theft'!  Steal a little and they put you in jail, steal a lot and they make you king.
It's all too far about my pay grade. I'm thankful for this trailer. I'm thankful for the new tools I've learned about from research, a new medication, and some new ideas of how to address my patients addictions.  I really have to focus my energies though.  I was taught early that when you're doing more work than the patient you should back off yet that's when the patients complain. I live in constant daily fear of patient complaints. Medicine is totally a 'popularity' contest with everyone struggling to be mediocre because any originality and any enthusiasm is destroyed by complaints - judges, bureaucrats, human rights commissions, advocates.  Some patients come with a huge gang.  The room fills with their 'allies' and dozens of unemployed 'critics' desperate for a cause.  I'm bent over double in abeyance praying I do as I"m told.  The patients tell me what they've read on social media, the arched eyebrow and threatening tone let me know what they think of my opinion about whatever it is is this weeks fashion.  I'm supposed to do what Gabor Mate does or the Kardashian twins.  Only with celebrity medicine am I going to please some.  They've got the complaints line on speed dial.
Now I'v missed the physician assisted suicide discussion. The majority were concerned about it.  I loved that most were concerned about the real practicalities.  I just wanted to know how the College was going to prepare for the complaint from the patient who I refused to shoot between the eyes until they paid for the bullet. Naturally people wanting physician assisted suicide will want it 'for free' and then how will I get the body out of the office. If I had two offices it would be a bit more practical but with only one office what will the patients in the waiting room feel as the last patient is wheeled out. The supreme court is always so high and mighty in Canada that they never dirty themselves with cost or details that the real world has to deal with. Certainly killing people will transfer a whole lot of health care resources to the death column.  Same happened when the incredibly lucrative industry of abortion caused cut backs in obstetrical care and delivery resources.  It's always a choice. I choose life but the system more and more chooses death. Death is cheaper.  I wonder when we're finally have a referendum of Article 21 and Death Care versus Health Care. But just the same as with abortion the spin doctors will call Death 'health care'.  Personally I'd rather the killing came out of the city sanitation budget. My patients don't have enough money for their medications as it is and can't afford housing so maybe a crypt is an advancement.
I'm thankful I don't have to lead this country. It's election time and Harper, Mulcair and Trudow are all vying for leadership again.  Given the Canadian superior know it all media those three men must be masochists.  I think they're all brilliant and incredible individuals but the policies they're offering though all fairly centrist or left of centre may or may not help us old people in the coming decade of aging baby boomer decline.
I've got to get dressed for work. I'm grateful I have a job to go to. I'm certainly grateful for my teachers, and all the learning that helps me be helpful.  I'm really grateful for the experience, 30 years and tens of thousands of patients.  Everything that used to scare me and seemed so difficult today rarely concerns me.  I remember when I worried about a patient with one disease.  Hilarious. Today my patients have a dozen diseases and I'm working with a half dozen other doctors who are amazing and we're somehow helping these aging jalopies get another lap.  So many though tell me that they're so thankful for their time because they can be longer with their grandchildren.
Time to shower. Thank you God for running water and heat and the car that will get me to the new office and staff and books and computers and the whole vast organization called civilization.  Thank you God.

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