He had talked of his success in real estate, retiring to Mexico for a number of years only to return and again be successful. “I’ve made heap loads of money,” he said. The problem arises when they ask what I do. I answer, “physician’. If it were stopped stop there it would be fine. But they go on to ask 'what specialty or interest?” And I answer, ‘psychiatry and addictions’. This time I said, “neuropsychiatry and addictions’. Yesterday I’d been treating head injuries. I believe I’m ashamed of being a psychiatrist.
I felt so proud and good doing surgery and later as a country gp. When I think of psychiatry I think of abortion, adultery, sexual abuse, homosexuality, drug abuse, divorce, constant surviving corrupt administration, seeing the underbelly of the beast. Psychiatry took my innocence, what little I had . Now I’m nearing the end of my career and I don’t feel like I’ve accomplished much. I thought I’d somehow know God and plumb the depths of human existence in some way, and I have. It’s been a mostly thankless task as was promised. I remember that first interview, the psychiatrist wondering why I wanted to be one, as much asking me as asking himself what he was doing.
Psychologists amuse me. They seem so proud of themselves. There’s a proximity to the sciences that bring confidence in the arts crowd. Yet here I am feeling so different from my colleagues in the world of ‘real’ medicine. It’s a matter of validity.
I think I saw my surgeon friend from Saipan in Chilliwack. I recognized him and shied away as I do from all I recognise but don’t know instantly. I fear they are a patient and that there will be an awkwardness. When I was a gp patients were glad to see me but as a psychiatrist I bring up issues often forgotten and gladly left in the past. We dig up graves in my work, examine the bodies and bury them again. I’m a reminder of the grave robbing, the night time tasks.
The surgeon is a Christian. An artist. Adept with his hands and mind. A wonderful wonderful man. I so admired him but I was distracted, trying to get all the bits of a strict learning fast learning curve together and ‘miles to go before I sleep’. We were in a grocery store Friday night. I believe he was with his wife but I did see him looking at me and I still hadn’t figured out who he was, until I’d paid and was leaving. Then it dawned on me. A colleague. I’ve known only a few well, avoiding them since I had sex with my psychiatry professor. I love the Third Day song, “I carry the shame”. For decades now I’ve straddled the chasm that time opened. I left heterosexuality and became intersected then. “He tried to breed you,” my friend crudely commented one night when I was sharing. It was a wound but I’ve never known if it was a wound like the broken cup or the crack repaired the Japanese saints speak of. I became binary then. Double minded. Demon possessed. Alt gender.
This surgeon operated on my anus. Repaired the tears. I was again a tight ass for years after till once again “I shared a bum’. I was no longer drunk or stoned but anxious, afraid and so very very stressed. There was comfort there. I worried then about sex addiction. Would I do this again or was that just a test, the ‘hair of the dog’. Most think of me as heterosexual, but that’s true of all of us who have been abuse, the ‘confused’ and what euphemistically are sometimes called the ‘curious’.
Was I merely a hedonist. Was this just seeking pleasure in all it’s form. The Apple core experience. I’d left the alcohol and marijuana. I’d thought I might be trans. I’ve thought so often about a sex change known it’s not so much about sex as identity. Like the Leonard Cohen song, "Lover, Lover, Lover, come back to me…..I want a new face.” I want a new identity.
I pray to God to free me of the shame.
“Taking estrogen for me was like smoking marijuana. I lost the edge I’d had. I became more accepting, less driven.” she said.
I wondered then if I missed smoking marijuana, that sense of ‘blatto’, the feeling of being female or receptive, yin rather than yang. I used to smoke marijuana and play guitar or want to languish in sex for hours at a time. Sober it was a more rushed affair. I don’t ooze through life. The edges are sharp. Testosterone is ‘testy’. It’s demanding.
“I never wanted to cheat on my partner till I started this testosterone,” he told me, “Now all I want to do is mount young girls."
I play with my nipples and wonder if the pleasant feeling I experience releases prolactin and increases my maternal instincts. In a Brave (and frightening) New World, men will breast feed children so their wives can manage abortion clinics.
I can hear a colleague, saying “Get over it. Get on with it. Make a decision. You’re either he or she. Decide.” He’s a little square box man. He’s lived safely in control and authority. I see the terror in his eyes. I frighten people with the breadth of possibility.
Psychological mindedness is the ability to tolerate the tension between opposites. I”ve stood in the middle of everything since psychoanalytical training, seeing ‘both sides now’ to quote Joni Mitchell. I envy the ‘solids’ , those ‘black and white’ , ‘concrete thinkers’, Piaget’s ‘pre abstract’ set. They’re in this world. The boy with the most toys wins. They’re the chivalrous ones. They care for their women and children and have certainty. Their seed is planted in good ground.
I’m the ‘other’. Alien. Priest scientist. My struggle is with me always and I limp away from the combat on a daily basis. That’s why I like addictions. I understand the core debate. St. Paul said it, “I do that which I don’t want to do and I don’t do that which I want to do."
The division between body and mind. The man condition. It’s not just sexual for me. It’s everything. Split person. I reflect on that anal intrusion. I’ve not done that to a man though a woman asked for this. I’ve done what women asked and regretted it. They’ve taken houses and lives and played with me like I was Ken doll in their make believe world without a sense of shame or concern for consequence. I’ve been thrown away. I feel they’re wired differently. I thought it was just one but I’m not sure any more. Their love of children is a wholly different thing from their love of partner. I called them ‘babe’ and they liked it but I wasn’t their baby. I was mostly a tool to that end. A stepping stone. But the abortion lingers.
So much death. At the end it’s the death that remains. The parts are linked in various ways. We make a story. A narrative. We say A lead to B. The abortion did this or the adultery did that or the lie lead there. The shame is the conscience. So many lack that level of morality. What feels good, do it. The opportunities are lacking for those living ‘lives of quiet desperation’ but I became unhinged from the pack early. Maybe that was the effect of drugs, or leaving home or being expelled from school or failing. The cost of difference. Being a genius. Being an adventurer and explorer. I dared to be different and it lead to psychiatry.
I loved surgery. It’s a thing out there. Like the motorcycle this weekend. I’m not the machine. The machine is something I manipulate. In surgery I was not the body or the knife but removed, separate. But in psychiatry I’ve joined with the patient. The psychopharmacologists are afraid. They throw little coloured pills at the disease. But I’m a psychotherapist. I wanted to heal with relationship. I wanted to change the course of the person’s life through psychotherapy. The pills were a tool in that process, not the thing. I truly ‘walked a mile in their footsteps’, entered their ‘nightmares’ and laughed consoled, convinced them that life was worth living. I’ve stood alone on the edge of the abyss so it was nothing to stand with them and admire the view. Without that insanity I couldn’t really help the insane. I could put a band aid on it but I wanted to free them. Not of the human condition but of the fear. I joined them in that point of fear and anger.
My sutures were laughter often. Black humor. Whatever works. Whatever gets us to walk away from the edge. Back to the hewing of wood and carrying of water. There’s a death waiting all of us. Why rush it. Slow down. Smell the roses. I entertained my patients and they came back for the next installment. Eventually they lived with me and then moved on to live independently again. Broken minds so little different from broken minds. I was glad to treat them both
I guess I wanted your approval God. I know I have your love. But would you validate me. I think that having children does that for people, maybe not women as much as men. It gives purpose. It gives belonging. Even my dog Gilbert joins me with life. I would not suicide today because he needs me. A relationship with a plant can bring life. So much of it is getting out of self. Egocentric. Narcisism. I call the drug addiction mental masturbation. Isolation rather than participation. Rejection of the community. Rejection of the government. Rejection of fellow man. My patients play with fentanyl like a child playing with a very sharp knife. I see cutters too. They isolate the artery on their wrist and wonder in the blood. The demolition man blew up things. The sadomasochist was fine hurting himself and then began hurting her.
I like the blue jays in the wiley spruce tree before me. The tree stands close to the rushing river. A massive upheaval of rock and soil forms the mountainous hill beyond.
God man. That’s what we are. Our minds capable of any range of fantasy but our bodies limited in space. There are consequences of decisions. They are outcomes to be considered. My mother would have wanted me to marry the girl in the church and had some babies as she and Dad had done. Like Cat Steven’s long, “settle down, get a job’. I wish that I was that way inclined. I tried marriage and I tried to have a job and now I’m nearing an end. Alone in this space. With my blind dog sleeping beside me, at this campsite. I liked the name Picard. Captain Picard of Star Trek inspired me. “To go where no man has gone before.” And to confront the Borg. Communism and Democracy. So often it’s played as ‘communism and capitalism’ but really it’s ‘communism and democracy’ But the naming of the thing was what Adam did with God. In the garden.
We name things disease and disorder. Those in control cut the bad things out. They’ve made a clear choice. In administration the conquerors are surgeons, they destroy the cancerous rebels to make their revolt work. Control. Dominance.
When he mounted me something was crushed within. Seduced he’d say. But then he was victim of terror. Afraid of the night. I walk in day and night. The moon was full and the camp so quiet last night when I woke and decided to let my blind dog walk a bit. He doesn’t know what time of day it is. We both stumbled about in the dark. I had a flashlight I could use. I’d put a light on the back of his harness so I could find him. I called and he came but big boulders and bushes got between us. Returning to the camp I carried him. He’d had enough and was glad to go back to sleep. As was I. To sleep. But to dream is the rub.
God is the dreamer and I’m a co dreamer. Each of us dreams. I can leave it as a nightmare or embrace it as a moment of learning. If it doesn’t kill you it makes you stronger. I’ll ride my new motorcycle today. The KTM. Austrian. The Nazi’s invaded Austria first. They were so similar and so many welcomed the Fuhrer. There were those who didn’t. That was nationalist socialism, but socialism all the same. Central authority. Control dominance. Upper hand. Goose steps then gulags. Fascism and communism two faces to the same totalitarianism. One sidedness.
Now I surrender to God. God is my saviour. A light breeze washes my face. Later I’ll ride the motorcycle and it will be wind therapy. A couple of times I nearly crashed yesterday. Fishtailing in the sand. The uncertain road. The speed necessary to get through a patch too much for the next. The delicate challenge of balancing forces.
I am a psychiatrist. I prefer being a physician. But I am a psychiatrist. And an addiction medicine specialist. Hierarchies and economies. Right now I’m a camper and one day I’ll be retired. That’s what people ask me now, “Are you retired.” And I don’t remember when the first time that question preceded, "What do you do?” So often I’m not paying attention.
The blue stellar jays have flown away. The crows remain. I’m due for another coffee. It’s morning and other campers are up. Making breakfast preparing to carry on. I like that I prefer the company of others. At least here, at a distance, in our own space. It’s taken a long time to come around here again. The blue stellar jays have returned.
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