Back Yard Musings

I had a dentist appolntment this morning.  I have a myriad of details to address. Everyday I'm worried I'm missing something. Calls comer in from everywhere.  Everyone is complaining it takes so long to see me.  Pharmacies want everything yesterday.  Beurocrats and lawyers put 'URGENT" across the top of their communications.  I'm seeing patients who don't come back the next week because they're dead. I feel I have 15 minutes to make a difference. All that training in motivation therapy, all the inspirational work, all the 12 step facilitation therapy learning, DBT and CBT and I don't know if I'm getting through.
I remember being in Jerusalem when the Palestinians were attacking the Israelites. They'd blown up something and burned down something and there was gunshots happening in that other part of the city, over there. Where I was it was business as usual.  It's estimated 3000 will be dead locally by the end of this year.  That's an epidemic.  A thousand dead already.  But there's this sense it's 'over there'.  I looked out my hotel room and saw the smoke a few dozen blocks away.   I'm sitting here now in Suburbia planning on leaving for another shift in the DTES this afternoon.
A hospital administrator said we don't need more doctors and nurses.  Canada has 20 times th administration of the German health care system.  Doctor ratios are much the same the world over. Where there's more than 1 to 500 to a 1000 costs go up where there's less deaths go up.  Administration is excessive and bloated in peace time.  Everyone and their family at the public trough.  No one able to find their ass with both hands.  Pot heads like arrogant communist Justin Trudeau giving money to enemies and foreign nations corruption is greater than Quebec Canada as hard as that is to conceive.  It's wearying .  The media no longer sells news. It's always propaganda with a spin. I remember when there were facts but not there's just money talk.  It's all above my pay grade. But I don't think they see the addiction. They're looking at cashing in on the victims like the tobacco companies that still make great deals. They're now getting into marijuana big time.
I don't like the news. I reacted to the lies of Justin Trudeau. His personal attack on freedom of speech and favouritism of religion by promoting the harrowing lie of Islamophobia.  It's like calling my patients "Rapaphobics'. I see to many Shiites and Sunnis who aren't Wahhabi.  Trudeau likes the Saudis.  I like Tarik Fatah.  There's a fatwa on his head but not on Trudeau's. Terrorists love Trudeau.
I'm half Irish but I didn't like the IRA bombing. I know that government's won't deal with moderates without the threat of the extremists.  Were it not for the Black Panther Martin Luther King would have not been someone government would deal with.  It's about positioning.
I'm tired. I don't sleep before dental appointments or breaks from routine. I stayed up late reading. I've been enjoying reading these days. I have been an avid reading all my life.  Mostly it's heavy.  Texts and science. I just reviewed a dozen journals. I'm skim reading for the new. So much is old for me now.  I like the immunological treatments of cancer.  There are paradigmatic shifts.  Even in my field the understanding of relationships.  So much of the intellectualism of the sterile Marxist ideology is passé. We're listening more to Victor Frankl than Freud in some ways.  The magic bullets remain.
I have difficulty living at times. I'm worn down by the constant criticism, the constant failure, the never good enough, the messages daily of decreased income, more taxes, less resources. Someone gets rewarded. It's not doctors.  The administrators are high on the hog or perhaps we should say say sheep because even bacon one of the great joys of life is under attack. Everything is bad for you and only the government is to be trusted but there's this pot head at the top who refuses urine testing and I just don't know when he's with us.  Who is doing the talking
Multiple Personality Disorders were studied and addiction was seen as an abbreviated condition, Dr. Jekyll and Mr. Hyde. The two administrators on the same computer. Who on.  It's like the Twin Spirited in the Bisexual world or the Transexuals who are au femme and au drab.  There's the stoned and unstoned.  The trouble with drugs is they are psychoactive for long periods in some cases in the human body. Pot acts on an individuals brain for weeks.  Not like alcohol whose effect was days at most.  Of course there were the daily drinkers and we knew them as 'functional alcoholics' but most of the pot smokers , the ones who smoke once a week or once a month are addicted too and best described as 'functional addicts'.  But the question Tom Waits raised was who was writing the songs.  He wrote the amazing song "The Piano has been drinking' and said he quit drinking because he thought the booze might be writing the songs.  That's the question I ask of this government.  Which drug is running Ottawa.
But it's a distraction.  There's sunshine here. The dog is rolling in dirt beside me. I've just read this exciting book about sex in men's and women's prisons and the effect of transexuals on the group dynamics there. It sounds a bit like Gr 8 and 9 with all the hormones but certainly a difficult job with few guards and more division.  I'm also reading about Oxford, remembering times in the city, punting and checking out the libraries, staying in Magdallen College.  I hope to return.  There's a conference of doctors I'd like to attend. Then there's Aberdeen where my grandfather lived and I've not been there so I've got a book on that area of Scotland.
I lunched with John Wylie the great author and finished one of his historical fictions  books recently.  I had lunch that same day with Diana Garabalden and bought her book on audio tape listening to it while I drove my truck about the back woods on Vancouver Island looking for suicidal deer.  I just finished Cry Wolf by Wilbur Smith , the story of the Italian invasion of Ethiopia.  I have been following the persecution of the Coptic Church, in Egypt and Sudan and reading about the cliff churches in Ethiopia. For years I've wanted to go there. My friend is a missionary in South Sudan. I enjoyed reading of Churchill's days with sword on horseback in his autobiographical book, River War.
With travel the world has grown smaller but this summer I've been most enamoured with the back yard.  Gilbert and I have so enjoyed it here.  But time to head to work.
My mind is a muddling mess. I'm glad for work and focus.  Since Zuckerman took over Facebook to pollute it with his brand of advertising and his left wing elite propaganda I'm subjected to this political nonsense daily and find myself forwarding the Alt. News because everyone seems to be selling the kool aid and drinking it.  After glancing through Facebook, not my friends shares, but the stuff Zuckerberg algorithms generate I'm definitely begging Scotty, "for the love of god beam me up!"
But I'm thankful for coffee and yoghurt and work and dentists and especially Gilbert my little joyful one eyed partner.  Thank you Lord.

Fentanyl Epidemic

“I’m a doctor just like you,” he said.  I knew him in passing.  A good fellow.  Well intentioned. Most of his life a drug addict.  Now he and a friend like two teen agers going fishing patrolled the Downtown Eastside with Narcan kits they got free from the pharmacy.  Instead of trout he caught life slipping away in the gutters. Occasionally, he brought it back with drama and flourish.
“I’ve saved a dozen lives,” he said.
It was good entertainment. He used himself. The suboxone helped him and only a few times a week did he ‘party’.
 “We like the fentanyl because it’s strong enough we can push through the suboxone.” he said.  The patients liked the oral methadone and suboxone because it stopped the withdrawal sickness.  They could have a life separate from the daily grind of finding the money and getting high.
Their faces linger in my memory.  Only weeks ago I saw them.  A couple of young Caucasian women, in their 20’s with boyfriends.  They came as couples to get their opiate replacement medication.
I talk up a storm about AA/NA/SMART, the non pharmacological treatment groups, Detox and Treatment Centres and Recovery Homes..  We really only get paid for the prescriptions. The doctors break into two groups. The rich ones who write a lot of prescriptions and the poorer ones like me who do counselling and try each time to push the patients closer to recovery.
Recovery isn’t Harm Reduction.  Recovery is a proactive program of wellness leading to abstinence from mood altering substances.  Harm reduction is supposed to be a step on the way. But now our Prime Minister is so vocal about smoking pot and all the tobacco company wealth is back in the business of smoke everyone in the DTES is either smoking marijuana or cigarettes or both.  The trouble with drug addiction is that it really dulls the senses and their addiction to smoke is seen as nothing compared to the heroin and crystal meth and crack cocaine.  Then there’s the sex addiction, gambling and pornography and crime.  It’s a smorgasbord of free choice in the DTES.
But mostly they tell me they don’t want God or any of that spiritual or religious stuff.  They want drugs.  Addicts are materialist hedonists.  They are sometimes even like the monkeys we studied back in school with the electrodes in their amygdala pleasure centre who would live to pull the lever of pleasure.
More and more they tell me they don't want any of the recovery options. "I just want that free heroin. Can you direct me to where I can get my injections for free.  I don't want to stop using. I just want to get the stuff free."
Each of the women was demure with whimsical smiles and street smart eyes. College drop out. They’d been into opiates only for a year or two at most. They’d started with pills they got at parties and then became hooked. With their boyfriends they now needed fentanyl pills every day, at least one or two, sometimes more. They ground up the pills and snorted them.  They smoked marijuana too.  A lot of the marijuana had been sprinkled with fentanyl so the herb was hurting folk bad.  Even the organic shops marijuana had been tested and come back positive for fentanyl. I imagined with the fentanyl so cheap dealers were going about sprinkling powder here and there to increase their clientele.
Drug dealers are lizards who want to be your friend.
The Fentanyl was coming from China.  It was sold on line and brought in over the border en mass.  My hypochondriac patients complain that it and crystal meth are in the air in the DTES.  The paranoids are afraid of the food outside in the markets. They’re crazy but no more so than the neighbourhood.
It’s just that their faces linger. The two women from last month. I've mostly forgotten the patients that died before them.
Sometimes I remember Gordon Lightfoots song, “Only a go go girl in love with someone who doesn’t care.”  I think of their mothers.
They’re dead now.
Their boyfriends each on different weeks came in and told me the same story.
“We got high together and overdosed.  I woke up but she didn’t”.
They were sad but it hadn’t changed their own drug habit.  If anything they did more.  Running from the demons. Burying the pain.
“Sometimes you see the shadows out of the corner of your eye,’ the older guys tell me.
I talk about higher power and participation.  I repeat till the cows come home that it’s a disease of relationship and that they have to find a way to associate with people that don’t use.  I hand out pamphlets and point them to all the different groups and services that we have.  The government pays for drug and alcohol counsellors but it’s like getting adolescent boys out of gangs, one on one care doesn’t work. They need a new group, a new club, a new association.  Their religion is addiction. They see their drug as god and their dealer as their priest.  It’s high ritual.  The language doesn't tell you that but it's there as bold as the body bags.
I ask him if he’s stopped using.
“Not yet. “ he says telling me about the great feeling saving a life gives him with his free narcan kits.  I think of it as band aids.  It’s like a lone medic in Afghanistan. Every life counts.  Don Quixote charges another wind mill.  There has to be a Dulcinea.
I expect the feminists would call me chauvinist because I remember those two women more than the half dozen more young men I’ve known who are just as dead in these last few months.  It’s wrong to even speak of gender. Freedom of speech is dying as quickly as youth.  It's only okay to speak of what we're told to speak.  Designated truth or fake news.  More illusion of choice. There are so many divisions today.  I worry I’ll offend someone even by asking them to live. The Prime Minister is proud of his new physician assisted suicide programs.  They’re opening more and more needle injection sites with dilaudid and some are even giving free heroin.
They once assisted the Tong, Euro Gangs and Hell’s Angels who brought in the Heroin profiting by the government taking care of providing drug clubs, keeping their business alive with safe injection sites  and carrying all the costs of bad drugs.  Now they’re actually going toe to toe with pharmaceutical grade product versus the ‘shit they call down’, the gangs provide.
“It’s not heroin anymore.  It’s not been for a long time. Synthetic shit. That’s why the fentanyl is attractive. Cheaper and it does the trick better.” he said.
The uppers go with the downers.  Jib, or crystal meth is everywhere as well. Not as much crack smoking as doing jib these days.  There’s a lot of doing jib then heroin to get to sleep and then getting onto straight heroin and maybe cigarettes or pot. After the drugs get happening big time the alcohol which may or may not have been there in the beginning becomes less important.  Some say drugs account for 80 or 90% of the material theft.  The insurance companies are not suffering.
Legalization which is what our Prime Minister was pushing means that a drug could be sold in a school candy machine. If it’s legal, it’s legal. Like mother’s milk.
Decriminalization is accepting the disease model and treating the whole matter not as a moral issue but rather as an epidemic.  Harm Reduction, really palliative care, a term with a marketing twist came out of the cancer treatment and then the Aids Epidemic.
Harm reduction may not be that good for the individual. Individuals do best if they get into AA or NA , treatment, recovery houses or join a church.  When they look at people 20 years abstinent individually they mostly work,  belong to spiritual organizations and have replaced their previous habit with community participation and love.  Love of God, love of family, love of fellow man and woman.  Drug addiction is at best mental masturbation.
The Harm Reduction is good public health and ultimately may be preventative as the profit in drug sales moves into the public purse. It’s hard to say if there’s any less gambling today but the government gets the money rather than the Mafia.  Now one then wonders what’s the difference between public sector crime and private sector crime.
But I’m a medic in D Day and the enemy in this case, the drug dealers, they don’t provide medics for their ‘side’.  I still think I'm on the good side. I just don't know some days if I'm doing righteous work or enabling.  There’s a whole lot of other types of medicine I could do.  But I’m down here in the DTES with more and more young people. When I began in the 80's working in a detox the clientele was mostly in their 50's.  Not a lot of really old people in this work.  Living past 60 not so common here as in the suburbs.
My patient is going off with his buddy to look for more bodies in back alleys in hope he can revive them.
I’m just doing what doctors do, pushing life, where the profit always seems to be more in pushing death.

Thursday Morning Journal

I woke to a warm squirmy furry body.  I’d dreamed of dancing in India.  It was a good night of dreams like the sailing dreams or the family dreams.  Good recollections and positive themes.  Dancing in my dreams.  I like that. I miss the word not taken often.  Here I’ve spent my life fighting the authorities to heal the sick and I wonder what it would have been like just to dance or act or write.  Instead I engaged in trying desperately to get the resources promised to my patients from the very people who made the promises.

Walking the dog I smelt spring in the air. There’s a lovely pink cherry tree where today he chose to deposit his morning offering. I like that tree.  In the back was blue sky.  I rode my motorcycle to the post office last night. It was a break from constant rain and gloom.  The cold is over. The tulips are blossoming.  

I’m going to the Turning Point Gala tonight. Brenda Plant is amazing.  Turning Point provides some of the best recovery homes in the province. Again yesterday I met an alumni years off heroin after being in their loving disciplined community.  I have friends in health care who began their journey in recovery at Turning Point.  Its a model of what recovery homes should be and a joy to support and celebrate their accomplishments.  

I am looking forward next week to the Christian Medical and Dental Society weekend.  My friend Laura is taking care of Gilbert that weekend and watching over my home. It’s good to have caring trustworthy friends. I’ll be glad to see nephews this month too as they’re travelling. One is returning to school, another is going overseas for more studies and another is making robots.  It’s amusing to hear what they are up to.  Just like learning about the God kids, this last week their walk in the forest with their parents facing the challenge of herding these little cats along the trails.  

I’ve faced more deaths.  People I knew, having passed on before.  The Downtown Eastside Fentanyl crisis and that horrible sense it’s all preventable and predictable.  I don’t doubt what I am doing though it’s common to front line medicine, patching up the civilians caught in a much bigger war. A friend has fallen to the struggles of competing dualities.  I struggle to trust God and remember Dr. Willi Gutowski’s ever repeated statement, “Jesus said, Do Not Be Afraid…that was a command….not a statement.”  We laugh then,

Dr. Seligman out of Pennsylvania has put out a course on Coursera.com on Positive Psychology.  I wonder about taking it though consider all my higher education has repeatedly put me at variance with the stupidity of government officials whose arrogance and safety surrounded by walls and guns and pretention has prevented them from being present.  I guess this will always be the way. Those furthest from reality have the greatest certainty about what is needed and actually believe in their own imaginations they know best because their insanity is not challenged by reality. I’ve known my whole career that I am but a human buffer for those who fear and deplore the mentally ill and addicted.  

I am grateful that I will be driving a sports car to work.  I’ll be able to have the top down if the rain doesn’t return. The Miata M5 is as close to a motorcycle as a car can be, like the MG of my room mate Fern back in our early 20’s when we performed on US television and worshipped girls.  

I often think of the Czeckoslovakian classic, the Incredible Lightness of Being.  I finish a day of work so burdened and weary.  I experience mental fatigue on Friday afternoon.  I remember the physical fatigue as a young man of a 12 hour day doing construction work and this is like that.  Yesterday the calls and meetings seemed overwhelming.  We’re using Oscar in the clinics and the distraction is monumental. I look at a screen rather than the patient and type into designed boxes with the machine shutting off if I don’t keep typing. I’ve always typed discretely into a lap top but this program and especially the pharmacist driven medication format are so demanding of attention.  I feel more and more like a Parts Department clerk and laugh at how the administration and lawyers have coopted the whole medicare process.  I remember meeting with a patient and listening and talking and writing a script and putting down one word diagnosis and a few scribbled notes.  Now we, the doctor and patient, are the least important part of this machine that serves especially the legal administrative process.  

I don’t have enough cherry trees and blue skies to counteract the anger and stupidity that dominates the media.  I pray every day to increase my faith.  I am not surprised to see more and more Canadians young people turning to drugs and death rather than listen to this government’s fear mongering corrupt Climate Change Cult and the horrid lies and disinformation coming out of the Prime Minister’s office.  Meanwhile the poverty of socialism is destroying Venezuela as it did all the communist countries before it.  And the Bernie Sanders are the richest fat cats blow hards of them all, little different from the Liberal Socialist Hitler, a great anti capitalist orator.

Now I’ve slummed in politics.  This is the world of paranoids. Them against us and reductionism.  It’s a verbal war as opposed to a physical war and yet I’m striving to be spiritual. I want to see the God in all . I want to feel that God is in charge and Love is the glue of the universe. I’m not Pollyanna. I see the Islam migrant wave of young men as invasion. I was never taught to die. I was always taught Love your neighbour as yourself but that didn’t mean suicide.  Homicide is justifiable self defence.  

Homicide is justifiable self defence.

 

If I let a person kill me I have caused that person to be homicidal and I have been suicidal.  Two wrongs don’t create a right. If I kill a person who is homicidal I have cancelled their homicidal tendency by living. My own intent is not to kill anyone and I’m not suicidal though often the thought passes these days that death is good too. Wherever I go God is there but I must do Thy Will. And Jesus did not suicide but died like a man saving his wife and child. He died like shepherd protecting the sheep. He died knowing he would rise from the dead.

I was reading a Mithra and the Persians last week. The Zoroastrians were a great group before murderous Mohammed killed them as Lenin  killed so many of the religious that stood in the way of his atheism megalomania. 

Live and let live.

I have so much I’d like to read. I dream of sitting by streams like the Buddha and meditating under a tree.  I dream of sitting like St. John of the Cross and studying the great writings like Buber.  I imagine writing some day and regret how little I’ve played my guitar this spring.  

It’s so much work with the dead lines and demands and the government threats backed by guns and jails to comply with even their littlest issue.  Harsh Roman Empire language coming out of Ottawa increasingly these days.  I think of the Irish and the Scots hiding potatoes to survive from starvation. 

A lovely Christian lady told me of Faith for Potatoes. I watched Hillsong’s lovely movie. I must find time to watch the uplifting South African movie.  Soon the sun will be shining most days.  Even Wall Street turns optimistic when the sun is shining.  

Now to work. I’m so thankful to be of service and I really do struggle to pay for my truck so that I will be able to tow a trailer to sit beside a river or the lake some summer in the near future reading and drinking coffee and thinking like Lear and Cornelious of ‘courtly things, whose in whose out.”  

Thank you Lord for this new  day. Please help Gilbert’s eye resolve and ensure he is, though blind, not in pain. Protect his other eye from this tragedy.  

Facing Friday Morning.

The snow is almost gone. It’s been raining steadily. Today though it’s just grey. Gilbert crawled into bed with me and lay down beside me , licking my cheek. Now he stands at the end of the couch looking out onto the street.  I am so thankful for his presence and friendship.
I so busy and overwhelmed with the office closure business. I can’t express my anger at the Landlady for renting me a suite without proper zoning. I’m equally incensed by the City for refusing to consider a psychiatrist office like a psychologist office but holding it strictly too the medical office definition. The zoning is there only related to the numbers and were it a medical office of general practice it would mean fifty people a day 5 days a week but I’ve only worked there half time seeing at most 30 patients a week.  But beurocrats have the dubious distinction of dealing with their rules and regulations never having to face reality or humanity.
It is no surprise to me that Confuscianism was countered by Daoism and Buddhism.  The Confuscists know nothing of the ‘Way’.  The bureaucrats have lost their way.
I have struggled to hold true and with the kindness of friends have found places where I can continue to see patients in clinics of friends.  Now I’m dispersed to three clinics.  I’m letting go of my staff and moving out records and furniture.  In a week I’ll see my last patient in the old place.
I’ve had these living room spaces of healing I’ve created for over thirty years.  I started though in a medical examining room. As a country gp I did my first psychotherapy and hypnosis in a room where I also lanced absesses and did examinations.  It’s like that again.  A sterile environment, functional.
Today’s beurocratcy doesn’t like couches.  It’s gone Sharia. Every man is a rapist. Every doctor is a sex offender. We’re all guilty and the ugliness is everywhere.  I have focussed solely on healing. I’ve struggled with the wonder of creation and the struggle of life.  I’ve insisted that I’m a healer and not a policeman while watching my colleagues in high places run in terror from the front lines of disease and suffering where the uncertainty abounds ,to the safety and security of the humourless committee rooms filled with cowardice and pomposity.
I am comforted though by the humans in my new surroundings. Other labourers in the healing process. We’ve not sold our souls to the policing controlling superior safety of the beaurocratic insanity.  There are more and more regulations with less and less evidence of value and less and less time in healing with more and more time in writing.  I hardly have time to look in the face of the sufferer and yet those who make the rules have long ago rejected contact with the hoi polloi.  The machines are more interesting. They love the numbers.  The human touch of hand on wrist is disgusting to them.  They develop ways and means of gathering data electronically.
We are fast becoming lifeless.
There is a death smell in the system where fewer and fewer heal and more and more give orders.  We carry a burden of disease in beaurocracy.  The cancer of the incompetence of administration is profound.  It is said that peace time is forever condemned to the corruption and expansion of the useless bureaucracy until war forces efficiency and relevance on the force with overnight paring and reduction.
I’m struggling with my resentment to the powerlessness I feel facing untreatable diseases, dying patients, dying family.  I’m alone at times in a foxhole and the messages that come in from headquathers where the perverted fatuous party goes on day and night with endless resources and countless bodies is at stark contrast to how little we have on the front.  I don’t know if it’s them I am angry with or God.
In my own dark night of the soul all I can ask over and over again is God help me to forgive the bureaucrats, their grotesque sins of omission, their Nuremberg mentalities and self righteous posturing and utter utter stupidity.  Please God forgive me and help me see them as the angels they are.  Help me again to face the disease with my patients and give me strength to stand by and touch them even as the Judges and all the august tell us to not touch, not look at, not be seen by the sick.  The sick are all lepers to this administration. Their contribution is solely abortion and suicide. They don’t like life other than their own.
But I’m raving.  I’m catastrophising. It’s just the grief speaking. It’s just another death by fentanyl that’s hurting me today.  I’ll go and talk to another person who has lost a friend and miss the person who isn’t coming today that I saw last week but isn’t coming today. So many don’t return these days and I hear they are at the morgue.