Monday, August 7, 2017

IDAA 2017 - Snowbird, Utah -Closing Comments

IDAA 2017 Annual Meeting has concluded for another year. I loved Cliff Lodge in Utah.  The venue, other than the altitude at 8100 feet, was spectacular. The views were incredible, mountains, pine trees and spruce. We had blue sky and sunshine.  People who hiked the trails encountered moose, elk and deer.  I love the little ground squirrels called pot guts. 

I loved the 5 k run. It got me outside in the early morning.  I enjoyed jogging down hill on the trail and by the day of the run I’d acclimatized enough to walk up hills without a myocardial infarction. Later I loved sitting in the outdoor hot tub and then swimming in the pool.  The view really was incredible.

I was moved to tears to see so many faces I knew. I loved that they smiled back.  We hugged and bubbled over with news.  A year had gone by. I spoke of the death my brother and friends. I heard of deaths of others I knew.  We grieved together.  There were struggles with practice and licensing bodies and we laughed at those struggles knowing they too would pass. There was an emphasis on the spiritual , the  immutables.  Some talked of babies born. Lots of white hair and wisdom and young doctors still full of innoscent enthusiasm.  

I arrived scarred and fatigued, burnt out, on my  more than 19th nervous break down, just short of pulling my hair out and running naked through the halls of the high school. It’s ever like this. But this time I knew how it worked,  More people arrived. More friends.  Amazing doctors. Sharing together in psychiatry  meetings, discussing the systems, the challenges, the research, the feelings, the changes, the difficulties.  We supported each other. Like minded doctors.  Representatives come from several continents.

We listened to a  talk about the 25 million who suffered from addictive disorders in the US and the 2 to 3 million in Canada. Each country had it’s incredible numbers and the fentanyl epidemic was killing people everywhere.  It was sobering.  

I enjoyed the speaker who said, “I’m in recovery and I vote.”  The need for public awareness was never more important.

I sat mostly in the 12 step meetings. I love the format. Running parallel with the conventional CME each year a doctor or sometimes two discuss the steps 1-12 and how they matter personally and professionally.  
The genius of Dr. Bob and Bill Wilson and the contributions  of Dr. Talbot,  Dr. Paul O and Dr.  Hal Marley and so many others come to be reflected on and discussed in the open time following the formal presentations.  Presentations run 20 minutes then the discussions run for another 30 minutes. Sometimes we split in small groups around a table. Other times we walk up to the mike to make our comments.  The discussants aren’t just anyone but doctors of the highest order for family medicine and all the specialities with experience and intimate knowledge and profound insights to share.  The leaders of treatments centres from Betty Ford to 12 alone come together in these amazing discussions. 
This is the real CME for me. This is the language of the heart. This is what I know personally and what I understand the first 50 men and women who wrote their experience strength and hope in the Big Book of Alcoholics Anonymous had learned.  I love learning the Steps this way.  
Sometimes the Nucleus Accumbens and Amygdalla make their way into these discussions. No one is pontificating. It’s different from the didactic. It’s observations and suggestions and insights. It’s a man or woman relating the step to his family and children.  Another talking about emotional development and family and marital therapy.  I love it. People who are themselves 30 and 40 years abstinent and sometimes 40 and 50 years married talk of the program in terms of family and relationships.  I learn so much here. I am astounded at the genius of my colleagues. 

I get up for the 7 am meeting. That was Hal Marley’s Attitude of Gratitude meeting where the new comers are encouraged and a lot of surgeons show up not knowing what to do with themselves  when others are content to sleep.  I loved Dick and Art’s guidance and Cheryl’s comments. Gordie always has the most rewarding insights. I believe it’s partly because he’s a retired surgeon and the rest of us are waking up.  It’s a tough time for the psychiatrists. I loved meeting Larry, an ophthalmologist. A neuro surgeon provided brilliant commentary. The psychologist soft spoken added her insights. It’s all so inspiring and sheer brilliance.

The resort coffee and breakfast and banquet food was excellent.  The new comers banquet is where the scholarship recipients come forward and remind us all of our first meetings. Then the Al Anon banquet shows the work of Jerry Moe and fills us with hope at the brightness of youth.  The family is central and we view this world as a systems phenomena.  Elsewhere the reductionism is stimying whereas here we look at all comments and hear from every angle of the solution. 

Mel B was the Saturday night speaker and a thrill to hear.  His leadership in the field has long been felt but what a joy to hear the ‘story’ of how it had all come about.  We’d only just applauded the 4 men in the countdown with forty plus years each of continuous abstinence. My mentor and psychiatrist colleague Hugh was among them. We are a group that appreciates life long contribution of members and even honor our dead.  It’s a community and a family in ways like no other place I know.  

George was dear to me as we talked  between meetings, as we’ve talked year after year, Tom and Bobbie, Nathan, John and Dave and so many others. There were 700 or so there, or more, and as many are already signed up for Reno next year.  It’s often a thousand or more.  The meeting moves each year, east and west and north and south with the Local  Committee organizing the event. It’s no small deal.  I was amazed at just how many volunteers were needed for a simple 5 k run let alone all the different meetings and banquets and events that go on which I don’t participate in.  I specialize in the 5 K run/walk while I know Dick is always finding the best golf course in the neighbourhood.  There are competitions and general fun.  I loved the jazz band in the south and the country singer in Phoenix.  Here folk enjoyed taking the tram to the top of the mountain  where they hiked and took photos of wild flowers.  

Every year its the same, the core program with variations of region and characters.  I love it.  I’ve loved the food and music of all the different cities the meetings have been in America.

But it’s the people, Stephen, and Alistair from overseas and Jan and Bry and Brent .  It’s a special high school reunion for me, a ‘same time next year’ love affair without the sex. It’s the most profound learning time.  

I liked meditating this year with Katie, the California psychiatrist who specializes in mindfulness meditation. I so liked listening to the depth of Penny’s insights into people and cats.  

It’s all over too soon.  Yet it’s a spiritual boost. I don’t know what happens but I’m ready for another year. I’ve learned about my most difficult clinical problems, discussing them with my most learned mentors, discussed my administrative issues, discussed electronic record keeping, business practice and government beurocracy and legal concerns.  Every issue too tough to deal with alone has had a chance to be put through the Cray  computer of shared knowledge.  Then there’s talk of love and relationship and loss and confusion.  

We are open with each other. All the hippocracy and gamesmanship I know in other groups are absent as mutually vulnerable we turn to each other for wisdom and give what we gain. It’s here I find that wonderful collegial sharing that first attracted me to academia in Oxford England.  I still feel  this vibe sometimes in  the clinical workplace but we’re all too often pressured and stressed to really take the time to address matters. Here that’s what we do.  

It’s another year.  I feel like I’ve had a transfusion of gratitude and now will give what I can. I feel like I’m  a search and rescue plane whose flown far and wide and finally come back to the mother ship to be refuelled for the next stretch of caregiving.  It’s all about the Spirituality  of Imperfection and I mourned the loss of Ernie Kurtz.

So many books to read, so many new references.  

Macdougall was the spiritual speaker. An awesome breakfast supplied by the resort then this amazing Methodist preacher shared an impossible journey of hope telling stories which would be too crazy were  they not true.

Then it was over.  I’d laughed till my sides hurt and cried.  I’d hugged dozens and dozens, only  a few of whose names I’ve shared.  We touch and greet and hug and I realize I don’t hug other doctors at all the way we hug each other here. I don’t hug colleagues.  Doctors touching anyone even themselves is increasingly verboten. 

At church I hug other professionals.  It’s not something approved of by the increasingly sterile government.  I loved watching my  friend Art put his arm around the shoulder of a man crying over sharing his loss and what it meant to him. Julie hugs me each year and she’s from New York.  

I am so grateful. It’s been so good to be a member of IDAA.   I remember when I thought to leave psychiatry when an academic  evangelical fundamentalist aetheist told me that ‘meditation harms your brain’ and ‘prayer damages the mind.”  I’m so glad the research these last 20 years have proved him dead wrong. Here I am able to pray with psychiatrists and other health professionals to a higher power and God of my understanding.  I love the ecumenicalism of this place and the ‘live and let live’ mentality.  IDAA 2017 was a true blessing for me and I so look forward to same time, next year in Reno, Nevada at the Peppermill Hotel. 

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