My personal nemesis has been sociopaths and psychotic people in power. I’ve fulfilled my contract, doing the best possible healing, with the best training. I’ve served, reducing “morbidly and mortality”, fighting disease and saving lives.
Today that’s of little importance compared with ‘political correctness.’ Today, the patient can die so long as the ‘chart’ lives. It’s all about spin and who you know.
My police friend described her leaving the force saying, “I became a police woman to ‘fight crime’ . At the end end all I was allowed to do was ‘record’ crime’. I feel like I joined the best hockey team in Canada. However today the coach only excelled in writing memos. Instead of firing coaches, doctors are required do more laps of the ice.
Lori’s challenges were family, sense of loss and betrayal traced back to childhood. I suspect my anti authority issue could relate to being caned and strapped in school for ‘talking back’.
IDAA is always a time of deep reflection. It’s not a place to ‘blame’ as much as I enjoy that. We discuss ‘choices’.
In the psychiatry breakout meeting we talked of retirement, hearing among others, from my favourite retired psychiatrist, his joy in welded art. Others talked of ways of winding down. Meanwhile the youngest heard our stories and shared their own struggles with their new careers and their aspirations.
It’s sadly the only place in the profession today that we talk openly and honestly without fear of retribution by the authorities or ‘loss of face’. I attended the national medical meeting and enjoyed the didactic ‘fact’ lectures somewhat but felt so much ego. I was glad I’d worn my suit and tie.
At IDAA most everyone wore shorts and Hawaiian shirts except for the banquets. The girls looked great in sun dresses. The ladies were so elegant. The group cleaned up well. Every conference there’s a thousand present plus or minus a hundred or so. Some 40,000 plus are active members.
Saturday night banquet Merve gave the most succinct and moving banquet speech. He described his journey of recovery as a series of interventions of divine and human love. He ended his extraordinarily miraculous talk with a quote from the Doobie Brother’s “Without love where would we be now?” “Without Love where would we be now!”.
Of course,it was a medical conferenece too. That day I’d attended a terrific CME discussing reward centers, the amygdala, nucleus accumbens, the pre frontal cortex, and effects of dopamine and oxytocin. which drugs did specifically what. We even learned the genetic codes associated with predisposition to alcoholism.
The Friday CME was especially good. I loved Dr. Michael Baron’s talk, Prescribing and Pain. In Tennessee the doctors prescribing opiates must attend two hours of CME on addiction and opiates. I was privileged to attend this, truly appreciating the combination of neuroscience , public health and common sense presented.
Abstinence remains the treatment of choice but Dr. Bill Haning's talk, Cultural Aspects of Addiction, on Culture of Addiction emphasized that treatment isn’t just stopping a substance but involves significant life changes to prevent relapse. The work addressed in this CME was about harm reduction and abstinence. The speaker talked of the great benefits of AA fellowship but also discussed a variety of groups which also help.
Having dealt with so much grief, such mind numbing, debilitating, heart rending sadness , I simply enjoyed the Dr Jes Montgomery's talk on grief and recovery. It was healing personally and certainly gave me tools to help with patients.
Our small group discussion of illnesss and recovery, dealing with pain without opiates, avoiding relapse when opiates were needed post surgery, was highly informative. I’d thought this group of doctors who were so good looking and smart were immune and immortal. We all discussed various illness we’d had and various treatments. .One had just had surgery. I’d had a dental implant. Another had arthritis. It’s one thing to read the textbooks some of which were written by people in the room, but a whole other thing to hear what people actually did.
As a psychiatrist we learn about the ‘self’ , the false self, the ego, and ‘persona’ . Quite frankly IDAA is the only place I really get to talk with other physicians,but especially psychiatrists. The other docs and specialists say it’s the same them.. I loved my colleague from a small town saying this was the only time he’d spoken truthfully and meaningfully with another psychiatrist in ‘years’.
Training as an analytic psychotherapist I’d early enjoyed bearing my soul and gaining useful insights . But here it was even better because I knew that the psychiatrist I was sharing with had been divorced like me. No one claimed to have the answers here. No one was holier that thou. I just love the lack of hypocrisy. There certainly wasn’t any pomposity which seems to thrive elsewhere.
Dick didn’t pretend he didn’t have feel pain walking. Cheryl didn’t conceal her love and concern. No one was just ‘fine’ (that’s an acronym which ‘fucked inside, nice exterior’ ). Everyone’s hurting sometime. But here everyone knew that and also also shared their love and their joy.
I heard the most wonderful stories of trips, travels, children and grandchildren, recovery and successes in work.I was so pleased my young Canadian friend was now on the national board. Several other docs I knew had completed fellowships, while others had become heads of programs and hospitals.
Through the year I read about the ‘greats’ in our fields who I meet here. World renown plastic surgeons and cardiologists with the rankest sense of humor continue to inspire me. The most beautiful brilliant elegant ladies talking intimately about their disease and finally asking for help touch my inner being. I laugh and tear up more in these days than I do all year.
It was also so moving to be among the many there with incredibly long term marriages. What examples these 30, 40 and 50 year married doctors provided. My friends Art and Carole have 53 years together but seem like high school sweethearts.
I loved seeing Adam and Corinne when Corinne celebrated the Jerry Moe program sharing what it meant for her son. I loved seeing the Jerry Moe kids and the outrageous teens. The babies and toddlers there represented hope and faith in the flesh.
Overall I felt again I’d entered an adult learning place of genius and creativity beyond the limited world of bean counters and administration that saw health care as commodity. I was able to discuss difficult patients and changes in treatment over coffee and in hall way consults.
The whole relevance of ‘sign in’ CME came up for discussion in our little group where the actual definition of a professional was so reminiscent of what I’d signed up for. “I learn from a patient. If someone comes in with something I don’t know, that triggers my research and consultation. I don’t pay attention to all this other stuff that does’t apply to me and my area of work.” The anesthesiologist shared.
That was exactly what I thought. I will never forget administrative doctor shouting ‘doctors should never learn from patients’ they’re there to teach the patients’. By contrast, at times over coffee, it seemed like a ‘barter market’. I was sharing psychiatry jewels I’d been bequeathed to get in return dermatology pearls. This is the way ‘adult professionals’ learn. But then we wondered if this only worked because we were in this IDAA bubble where it was okay to be to not know everything’, to be vulnerable, and to share. I joked about sitting at the ‘in table’ with Art and Dick and Graeme.
It was fun to be at IDAA. I emailed a friend who I hope to see at next year’s high school reunion saying, “IDAA iwas like being at a doctors ‘ elementary school reunion’ . It could only be better if Jerry Moe and the kids let’s us join their program. All that was missing was the dance with the mirrored balls hanging from the ceiling.
Next year it’s Spokane. IDAA2020 Spokane.
I love the town of Spokane and already know some brilliant psychiatrists there. I’m thinking of riding my Harley down and certainly wearing boxers even if they do ride up my ass. I’m all signed up. IDAA is like the love story “same time next year’.
I know I’d never have been able to stay a doctor and especially a psychiatrist without IDAA. I might not even be alive. I certainly wouldn’t have this life beyond my wildest dreams. I may not have the spaceship I want but I can truly say with the deepest gratitude I’ve had times of being rocketed into the fourth dimension. I can’t wait to read the cyberdoc on line discussions (and gossip) in the coming weeks. I love hearing Hugh, Nathan, Zeke and Dave . I actually talked to two doctors Saturday who had been to Antatica. One who worked there and the other wanted to see penguins. There’s something about belong to a group of doctors with characters like that.
God bless.
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