Company Doctors: Professionalism and Political Correctness

Historically, physicians among professionals have had the highest rating for trustworthiness and truthfulness.By contrast lawyers have been at the bottom of the heap.  Some actually say it’s sad that 90% of lawyers give the other 10% a bad name.  My old lawyer friend had insisted that this was  a product of the rise in social legislation that followed Prime Minister Pierre Trudeau’s reign.  My friend, an  old man, had  practiced law in Scotland before coming to Canada.

“I was proud to be a lawyer. It was a very honoured profession in my youth. Today I sometimes feel it’s just because of the money lawyers are perceived so negatively. I did well enough but if money was the sole criteria I’d not be thought as good a lawyer as some of my colleagues who sought celebrity and seemed only interested in the fame and fortune.  When I became a professional I saw it as a duty and service and frankly most of my colleagues saw it as that too.  We were there to serve people. Our independence and autonomy as professionals allowed us to protect our clients from governments and corporations alike.”

It wasn’t long after I heard him say that, that  a lawyer at my church told me “I think you can still can be a lawyer and a Christian in Canada but I no longer think you can be a Christian and a Corporate lawyer in Montreal.”

I can say the same is increasingly  true for doctors.  The lowest slur a doctor could make against another was to call him a “company doctor”. 

The ‘company doctor’ reached it’s a nadir during the years of the asbestos mining.  Miners were coughing up blood and dying all the while the doctors hired by the company and were paid exorbitantly essentially to lie and insist the problem wasn’t the  asbestos at all.  The miner instead, in classic ‘blame the victim’ was told he had ‘weak lungs’. It became the  great scandal of the era exposing corrupt courts, government, corporations and the doctors involved..  Science eventually prevailed as today we know and diagnose “asbestos lungs’. 

It should be understood that a doctor may give his opinion in court ,which remains a 19th century rationalist construct and sees the world in black and white as opposed to the multi factorial quantum universe considerations of 21st century rainbow science.  The ridiculousnesss of such ‘opinions’ was highlighted best by the farce of the OJ Trial with all its dream team and ignorance of DNA. 75% of the fruitfly DNA is the same as Human DNA. 

In British Columbia “Moynihan’s Law’  was enacted essentially to reign in the competing claims of ‘expert witnesses”.  Moynihans’s Law insisted that expert opinions be predominantly objective and serve the judge not the solely the lawyers paying them.  Some of the insurance company expert witnesses were paid so exorbitantly as to make the ‘company doctors’ of the asbestos mine era look like altar boys.   Tragically I was obliged to teach a judge the history of this in recent years, as he appeared to have missed out on the insanity of the courts that required a specific new “Moynihans’s law” to reign in the ‘expert testimony ‘ of competing factions.  Perjury laws have always existed but do appear to be rarely used as increasingly the courts move away from the ‘truth’ standard of old.  “The truth, the whole truth and nothing but the truth” is no longer associated with the modern court but rather remembered as a line from the Perry Mason era. 

The judge appeared unaware of Dr. Jay Lifton’s seminal book, the “Nazi Doctors” which addressed the whole issue of the ‘company’ or ‘government doctor’ in exquisite horrifying detail.  

It should not reflect badly on this judge because we’re collectively seeing this phenomena today  in the ‘fake news’ . The media was once constrained by the idea of ‘fact’ but today has  lost all track of the very notion of  ‘objective’ and now sells ‘facts’ as ‘opinions’ to the highest bidder.  Judges, themselves, have historically been considered’ corrupt’ as their opinions have been on occasion bought as readily as world soccer players.  The remaining issue today ,as Canadian culture devolves into multiculturalism,  increasingly,  is not whether someone will sell out their integrity but at how low a price.

Around  the world in other jurisdictions and cultures the issue is not whether to bribe the official ther how little one can give without insulting   government representative. The whole idea of the ‘tip’ which once was only an issue in hotels and restaurants is the very basis of business and law in`many countries.  

The next worst ‘slur’a doctor could have against him was that he was a ‘pharmaceutical company doctor’. Some pharmaceutical companies hired doctors to promote their medications and rewarded those who ‘sold’ medications by down playing or denying risks while celebrating success.  I was hired only a couple of times by one drug company to give talks to family physicians about new produce.  I was subsequently   told by  that company that  I was ‘too objective’ and hadn’t ‘sold’ enough of  the product. . I took that a compliment but it caused me to look askance at some of my colleagues who took pride in being consider ‘trendsetters’ by some in the pharmaceutical industry. They considered it a compliment to be called ‘drug pushers for the multinationals’ and paraded their academic and financials rewards with gusto.   “Unhinged: the Trouble with Psychiatry” by Dr. Daniel Carlat discusses this problem in depth. 

It became so egregious an issue in medicine  that physicians in academic settings and journals are collectively now required to give notice of their ‘conflicts of intererst’.   At the beginning of a lecture a doctor is required to put up a slide indicating which drug companies or businesses had paid him for this lecture or his research in this area.  

Unfortunately the licensing bodies for professions, in general, like the Colleges of Physicians and Surgeons, have not as yet had such a renaissance. The conflicts of interest that influence hiring, appointments,committe membership of non professionals,  their  political and fashionable decisions remain darkly opaque.

  

This practice has been in place for decades and naturally doctors wish that politicians and bureaurats would be required to do the same housekeeping regarding ‘conflicts of interest” and ‘lobby groups.” The partisanship of bureaucrats is a huge problem since they are required to be 'objective' but increasingly in Canada it has been exposed that government bureaucrats are Liberal biased.  To avoid this in many countries and eras the whole government apparatus was overturned and replaced by the followers of the winning party.

Given the scandals  over the foreign influence on Hillary Clinton and Justin Trudeau by Islamic countries and the alleged influence on Trump by Russia , politics seems mired like the media and courts outside the promises of the 21st century.  Escobar, the great drug lord used to brag that he had bought both the Republicans and the Democrats, hedging his bets, not that that did him much good in the long run. 

Doctors addressed this issue of autonomy first in the Hippocratic Oath of Ancient Greece.  I’ve taken the revitalized Hippocratic Oath of today since the ethical and moral foundations of professionalism have been increasingly eroded by government intrusion. The ‘do no harm’ clause is all but obsolete now  the ‘abortion industry” and recently  ‘euthanasia industry’ have completely won over the prevailing  government and their bureaucrats so reminiscent of the 'banal' of Arendt's writings.   Further, the various ‘codes’ of doctors in the western world were influenced by the “sanctity of life’ premise  inherent in Christian religion which inherited and refined the Judeo Graeco Roman traditions from which Western Civilization arose.  Other cultures have not had this notion of ‘sanctity of life’.

Further the ideas of where on the continuum the doctor sits regarding the collective and the individual are wholly different than what most Canadians assume.  Also the 'accountability' of the doctor in different countries is wholly different from the local ever changing responsibility of the doctor and indeed the health care system. This was never better reviewed than the greatest scandal of hospital administration of our time, the finding of the man dead for 36 hours in the Canadian teaching hospital and the abdication of accountability of administration.

There is also distinctly different ideas of cause and effect and accountability in eastern and western 'culture' which affect the very practice of medicine by doctors depending on training and background.

It was no surprise that Dr. Kellie Leitch, a brilliant physician and accomplished paediatric surgeon, should spearhead the importance of 'Canadian values' in this time when the dope smoking pretty haired selfie snapping Canadian Prime Minister Justin Trudeau was insisting there was no 'Canadian culture' and hence no 'Canadian values'.  Ironically he also said that Quebec French  speaking Prime Ministers were superior to English speaking Prime Ministers when his basic premise was that there was no such thing as a Canadian ‘culture’. While denying Canada 'culture' and denying Canadian 'values'  he insisted on the superiority of the French speaking. 

The word ‘culture’ derived from the Latin word ‘cultus’, ‘to care’ and from the French word to ‘cultivate’ or to ‘fill the ground’.  Well no one in their right mind would doubt that Dr. Leitch cares or is a highly cultivated individual who has done a lion’s share of work, there continues to be complaints about PM Justin Trudeau, simply not caring about Canada, and not by his personal history having much to do with cultivation and work.  Unfortunately Dr. Leitch’s insightfulness flew over the stoned heads of easily offended young followers of the Prime Minister. 

The ‘private’ physician retained their autonomy and worked for the patient just as the lawyer and accountant and engineer primarily served their client.  Historically the true ‘statesman’ served the country as a whole not the entrenched interests of corporations like Bombadier or the  urbans tastes of Montreal female voters.  

The ‘business’ of profession however always was tied to the idea of ‘he who pays the piper calls the tune’.  As the “private” physician was working directly for the patient even though an insurance company might well be paying the bill, the doctor’s greatest concern was the ‘patient’s health’.  This was before the Hydra of  Cultural Marxism's weaponized political correctness redefined 'health' like the 'renaming' of 'gender" as something other than the ‘morbidity and mortality’ of science.   

Today the ‘insurance doctor’ is the next greatest ‘slur’ that can be made against a doctor.  It’s a bit wrong as there clearly are good and bad insurance companies. But clearly if the patient becomes sick and unable to work and provide insurance payments it’s in the interest of the insurance company to ‘de list’ that member as they are no longer a viable ‘client’.  Further, the worst insurance companies use and abuse the courts to offer the least inclusive definition of health and spend fortunes on lawyers fighting claims. 

Canada is a single party insurance scheme so that the ‘government doctor’ and the ‘insurance doctor’ ‘slurs’ can overlap.  Historically in public and private endeavours there was this area where the public need for finance existed because of the size and ‘risk’ of the project and in areas where there was no likelihood of profit but that as a society we collectively saw a need to care for others in a way private sources could not afford to.  

Our present government appears to be giving billions to foreign countries while not caring for it’s own sick and old.  The sick and old and those who suffer catastrophic  injuries were the principle reason for development of the Canadian Health Care system.  Tommy Douglas and those who were  principally Christian doctors of the  Saskatchewan model would obviously roll over in their graves  if they were to see the actions of the ‘company doctors’ and ‘government doctors’ of today.  Government spending today,  is to those early men and women of Canada,  a total corruption of the ideals of Canadian traditions.  Not surprisingly, Liberals get around this by indeed,   denying Canadian culture or tradition.

The highest paid doctors today are government doctors  and cosmetic surgeons while the front line workers in all fields are policed to no end and treated as the enemy by their superiors because they have been given the unenviable task of ‘rationing health care’ while the government doctors and political doctors make endless promises that are simply impossible to meet.

Professionals say that there is no ‘autonomy’ or ‘profession’ any more because the structure of our present centralized communist leaning government which is totalitarian authoritarian and diametrically opposed to the freedom of the individual and wholly supportive of the ‘collective’.   Indeed many professionals have considered that the ‘unions’ which developed in a much more hostile relationship to government may be the answer to the failing health care system.  Some doctors have approached the Teamsters feeling the whole idea of ‘profession’ is defunct in face of government corruption and the cancerous growth of the government burocracy to the detriment of professions and their clients.  

Canada has a history of having had a purely ‘government socialist based’ health care system which was associated with the worst morbidity and mortality statistics in the Canada. This was the Indian Affairs government health care system which is now being used as a "model" for all of Canada despite is at times horrendous failures.  

Given that immigrant doctors increasingly come from countries which do not share  Canadian ‘values’ of ‘sanctity of life’ , the importance of the individual, freedom, and libertarianism and other such ‘pesky’ ideas it is increasingly no surprise that the government calls’ physicians’ not by their ‘professional designation’ but increasingly as ‘health care workers’ as a collective job title. Ethically there fore in the government eyes they have no difference from the cleaning staff in the hospitals.  

It concerns me as the corruption of government and media and the refusal of the courts to move forward that doctors medical professionalism is now defined solely by ‘company doctors’ and dominated by ‘conflicts of interest’ that soon it will be said of doctors that 90% give the 10% a bad name.  It is no surprise that 75 % of Canadian doctors would not recommend medicine at present in Canada. 

As a dinosaur doctor I am increasingly concerned about health care not as much as a provider but because I might well need services and can see from the desperate experiences of my patients that they are utterly frustrated, dissatisfied, and wholly crippled by the government callousness, Naturally their opinions never appear in the government propaganda media or are always attributed to the doctors and nurses rather than the top heavy administration.  They express repeatedly concerns about  inefficiency and corruption the feeling that their basic needs and values are not being met.

A company doctor explained to me that I ‘cared too much’ and must ‘lower my standards’ as well as ‘learn to lie’ as he did for he enjoyed greatly his well rewarded government company doctor lifestyle.  I personally have to consider every day whether I want to continue as a ‘company doctor’ or if I should, like the other dinosaurs of my era retire early and accept that Christians, godly people in general,  moral people and all the doctors of old, especially my most esteemed mentors, and Tommy Douglas, a politically incorrect Baptist minister, are all  no longer welcome in Canada.  Insurance company models also routinely reward the physicians who do the least for the patient and save the government the most money.

This was a 'joke' of my surgical training where heart surgeons and lung surgeons would compete among themselves as to who could use the least 'thread' as the administration had a fashion of the month campaign to get the surgeons to save money in the operations.  At the time I thought it was something out of MASH where no show better defined the oxymoron on 'military intelligence". Yet the surgeons explained that the administrators were more concerned with their budgets than the lives of the patients. Indeed I caused myself no end of difficulty complaining that a small town administrator had robbed the hospital budget for a baby incubator so that he could have a new desk and chair with better wood panelling.  

I do envy the migrants who routinely return to their ‘homes’ whereas I personally feel my own home and profession have been destroyed.  This feeling has grown strongest since  I was told that  Dr. William Osler is no longer considered a ‘professional’. Clearly Dr. Osler is no longer welcome in Canada and  should never  apply to work here.

Jesus, the greatest healer of all time, would not be welcomed  either.  Jesus  was vulgar, kept the wrong company,  swore and behaved badly, the epitome of a politically incorrect individual.  Politically correctness and professionalism were once diametrically opposed.  Today a doctor kills or heals as the prevailing mood dictates. It’s just fashion.  Medicine is theatre.  The Kardashian’s are the new models of medicine.    

If love is the answer

If love is the answer, then you would defend yourself and your family and friends.  I just watched Felon last night. It was a powerful movie about a man falsely accused and incarcerated for defending his family.  It’s message encouraged one to consider just how many people are in jail who are indeed not guilty.
False accusations are increasing exponentially with the rise again of socialism.  In communist countries ,the ultimate expression of socialism, the standing joke was when three people were gathered together, one of them was an informer.  In socialism there is always someone who believes they can improve their lot by accusing another to the authorities.
Those who do make false accusations are sometimes just garden variety psychopaths and sociopaths, more common than many believe. The other sort  are developmentally psychologically immature and falsely accuse their neighbours to please their mommy or daddy, whichever one they feel rejected by and to psychologically conceal their own ‘dirty’ secret.  Of course there are good citizens. But historically part of good citizenship was the ‘openess’ of knowing who your accuser was.  Today ‘mind your own business’ goes hand in hand with the realization that a life in ‘witness protection’ might not be what one personally envisioned.  The check and balance of ‘accusation’ among good citizenry was that it was not done ‘lightly’ as it is today with everyone ‘offended’ and everyone a ‘critic’.
In the Judeo-Christian view from which western laws derived it was taught ‘thou shalt not judge’ and ‘thou shalt not bear false witness’ was one of the 10 commandments along side ‘thou shalt not murder’.  Jesus taught that if you see fault in your neighbour you should first pluck the timber out of your own eye before trying to take the sliver out of another’s.
Yet today, with a society ‘externalized’ by Hollywood and other media celebrations of the evil villains and superhero’s , along with all the propaganda, self reflection is discouraged.  Blame is the name of the game.  Deny deny deny is the answer the lawyer tells the accused.  Notice it’s not ‘silence’ but ‘deny’.  This message to the innoscent and guilty alike is given again and  again in the ever more popular police stories.  From the earliest age children are taught to lie even if they need no encouragement.
If love is the answer, then one needs to beware of Canada’s increasing failure to address ‘perjury’ in the courts.  Further in beurocratic agencies false accusations are sadly apart of the industry of encouraging people to spy on their neighbours and report their neighbours to the authorities.
This is seen in the ‘anonymous ‘tip’ lines’ which are naturally commonly abused.  The extent of the abuse is seen in social services where disputes between mothers on the play ground for whatever reason are sometimes followed by that awful call to child’s services with the claim that one neighbour is doing something wrong.
That these are not being investigated and front and centre of any discussion reflects the need of authorities to maintain their autocratic positions by any means. The loss of ‘truth’ in society is just one casualty that follows this drive to war and anarchy created by the fundamental failing of law and order.
If there is no truth there is no real law and order. In communist countries truth died first.
We are seeing the ‘fake news’ of CBC news, Vancouver Sun and CNN.  These alt left and alt right media compete in lies. Harvard University reported that 75% of CNN news coverage during the recent election was highly biased (essentially ‘untrue’).
Truth is the first casualty of war.
If love is the answer, then truth is the question.

Prayer and Jesus

Luke 18
1.“Then Jesus told his disciples a parable to show them they should always pray and not give up.
2.He said, “In a certain town there was a judge who neither feared God nor cared what people thought.
3. And there was a widow in that town who kept coming to him with the plea, “Grant me justice against my adversary.”
4. “For some time he refused. But finally he said to himself, “Even though I don’t fear God or care what people think
5. yet because this widow keeps bothering me, I will see that she gets justice,
so that she won’t eventually come back and attack me!"
6. And the Lord said, “Listen to what the unjust judges says.
7. And will not God bring about justice for his chosen ones, who cry out to him day and night? Will he keep putting them off?
8. I tell you, he will see that they get justice , and quickly. However when the Son of Man comes, will he find faith on the earth?"

I am again being falsely accused. I am troubled that the courts in Canada have become like the Communist inviting  false witnesses to give power to the State and cause every truthful man or women to live in fear. Totalitarian and police states encourage all to report on their neighbours and celebrate those most those who lie and attack Christians and good and true officials.
I cry night and day “Grant me justice against my adversary”.  But I struggle to understand if my adversary is the individual psychopath or psychotic or the system that does not protect good men who do their work.
There are untold odious complaints and false testimonies against doctors who work with two types of patients
1) those with drug and alcohol problems.  If any one knows drug addicts or alcoholic they know well what vengeful and petty individuals they can be when they are in their cups or hung over.  The Big Book of Alcoholics Anonymous based on the honest assessment of their individuals in recovery noted that Resentment and Fear were central features of their universally immature character.  Resentment was the central fuel of their addiction.  Bitterness.  They commonly live in the past and hold grudges and their fear of retaliation is such that they are often paranoid for periods of time.  These are the people who are quick to complaint, easily offended, don’t like to cut anyone slack but demand it for themselves.  They fill the courts and their letters to the editor are endless. They are the cause of many wars ever waiting to restart some old conflict in the hope of getting even.
2) those who are involved are dissatisfied with their employer and are getting paid to stay home from work by an insurance company.. Their anger with their employer is more often concerning deep seated issues against authority tied to their earliest childhood, neglectful or outright abusive parents.  The doctor is called upon to write a letter to say that they cannot work because of some condition.  With physical medicine this isn’t as threatening for the doctor because when the injury heals there is obvious evidence that the patient is well so return to work should follow.  There are objective measures.  In psychiatry the issue is far far worse because the complaints are invariably about something ‘subjective’ such as “pain”, “dizziness”, “fatigue”, “depression”,  “anxiety”.  With Borderlines Personality Disorders, like Paranoid Personality Disorders, people are seen in black and white categories. Lawyers who defend people against sometimes callous insensitive greedy insurance companies are often as as difficult as insurance company companies who are occasionally callous insensitive and greedy.  There is a conflict inherent in this situation made worse by the inexperience or agendas of the lawyers and the insurance agents. The psychiatrist who is required by law to be as ‘objective’ and ‘impartial’ as possible is called upon to express an ‘opinion’.  The psychiatrist is however by ethical oath an ‘advocate’ for the patient.  He can not lie but he will be as supportive and understanding of her concern as possible.  To this end I report the patients concerns clearly and measure their subjective complains and write formulations that attempt to see the best in people, some of whom are malingering sociopaths.  I “diagnosed’ sociopaths and malingerers by the dozens in the past but I was told that this was unacceptable and really it was now a matter for the courts and judge to assess this. Further if I stated the obvious that a person was a sociopath,psycopath or malingerer in my opinion the patient would definitely complain to the College of Physicians who might well agree but punish me to the tune of $10,000 tying me up in a legal beaurocratic malaise that gave them raison d’être and made them and lawyers rich but definitively punished me to no end.  I have been punished repeated to the cost of hundreds of thousands of dollars for telling the truth as a doctor.
So I don’t diagnose people as sociopaths, psychopaths or malingerers anymore.  Naturally it’s like any doctor who is told that he cannot diagnose ‘appendicitis’ or some such not uncommon diagnosis in their field.  Our textbooks and diagnositic formulations all include these diagnosis but ‘smart’ doctors especially those most interested in ‘business’ just know not to diagnose anything that would be ‘unpopular’ with patients. Rich doctors must be liked and popular. It was for this reason and it continues to a lesser extent that most doctors won’t diagnose alcoholism, addiction or even sometimes mental illness.  They don’t want to lose the patient.
Regardless today I support patients and generally don’t think of them as psychopaths , sociopaths or malingerers because as their doctor I really want to ‘give them the benefit of the doubt’. Even when I learn they are unable to work because it’s too tough for them to sit at a desk for 2 hours because of their pain but they fly 12 hours to vacation spots and back, well it does seem suspicious but I am there to be helpful not to be a judge. The judge will sort this out because so often in these cases too the insurance company will hire a psychiatrist who will quickly see how ‘incongruent’ the patients statements are and even note that while the patient can’t do ‘their’ job they are nonetheless working under the table or doing things for family and friends which would constitute work.  One person who ‘couldn’t work’ had a family business running out of the basement. Anyone who has worked with insurance companies knows just how sadly common this is especially in those who do not share an ethical or moral basis  of the greater community.
When patients are angry with doctors because the doctor is perceived as a threat they don’t complain about the doctor specifically being a threat to their desire to get their‘ money for nothing’  because of deep seated issues of entitlement but rather will make their complaint ‘powerful’ as possible.  Single male doctors are therefore with women always ‘sexually harassing’ simply because there is no basis to ‘sexual harassment’ except a he said, she said complaint much like the subjective complain of ‘fatigue’.  One female theif who called her accuser ‘sexually harassing’ actually called the policeman who investigated ‘sexually harassing’ and the Vancouver police department would not follow up on the case because of the fear and cost of this complaint to date to their members.  In all cases there is no ‘objectivity’ to the complaint but it remains as a ‘character assassination’ and it’s done for profit as the patient in these work place issues is trying to get ‘money for nothing’ and ‘time off work’.
Many companies have successfully reduced these kinds of situations by allowing workers to be off work in a company club house or cafeteria but not allowing them to go home to be paid.  One of the sure signs of malingering or alternatively factitious disorder is the refusal of patients to attend group therapy or any group situation because when there is a group malingerers sociopaths and psychopaths know that their ‘sickness behaviour’ might be filmed or witnessed by others when they are not aware. In one to one interviews it’s easy to maintain the ‘sham’ but in the group process there are just too many variables and even a person with a decided limp might forget to do it in the complexity of groups. Naturally Insurance companies when they believe a person is a sociopath , psychopath or malingerer will want the person with the psycihaitric illness to attend a group. Further group therapy is to psychiatrists the very best of therapy and a central cornerstone of psychiatric hospitalization.  There is really little reason for a person not to attend group therapy.
Yet this is when the ‘I’m agoraphobic and I’m social phobic ‘ or “I’m too fatigued to get out of bed” . In the past they were hospitlized at this point and the ‘truth would out’ . One of my patients couldn’t ‘walk’ , but the nurse noted that he sneaked out of his bed at night to use the washroom so I diagnosed him as a ‘malingerer’ and naturally he complained to the authorities , right up to the Minister of Health, that I was a Fascist.  I miss the hospital as it was the very best psychiatric intervention for sorting this matter out.
Without hospital resources psychiatrists are now at increased threat and risk from dangerous patients.
Further in Canada there is a horrendous unconscionable lack of consequence for PERJURY.  The 10 Commandments says “Thou shalt not Bear False Witness’ but in this anti Christian, anti Bible, Anti Truth, Anti doctor country I have been utterly utterly frustrated and countless times in tears for doing my job and trying to help patients to the best of my ability with all my training and experience but only to be faced with complaints because I continue to work with people who have drug and alcohol problems and who are out of work and in conflict with their insurance companies..
The sad thing is that I have been able to help hundreds or thousands of people and the proverbial ‘bad’ apple is one in a hundred.  Most of my patients who have anxiety or pain or depression offered ‘group therapy’ jump at the opportunity. Patients who want to get better will do everything to so and yet there are those for whom treatments don’t work but they don’t pick and chose and refuse to be in any situation where they are under observation.  They welcome a chance to prove their truthfulness.
Patients with drug and alcohol problems are harmed by those who lie and enable their disease. I make the diagnosis as frankly as I do cancer. Being diagnosed with alcoholism or addiction is like being told you have cancer but if doctors don’t tell their patients the truth they patients are at greater risk.
I never think of patients as the adversary.  I thinks the system or the authorities are at fault because they know these aren’t ‘isolated’ cases yet they punish the doctors who work with these difficult groups. Most of my much smarter and more clever and more business oriented colleagues simply say no to seeing patients with drug and alcohol problems or work problems or with superego lacunae.  I see people who are murderers and prostitutes and often very dangerous and often very unclean and smelling very badly and I know my colleagues and the government in general denies them care by neglect or a countless series of barriers to treatment but I work with these people but I get upset, forgive me jesus, for being stabbed in the back over and over again by the very people who are supposed to be serving the same people I am.
I am not the enemy.
I am a Christian who when I was going to work in Africa was told by Dr. Jack Hildes Canada has as many people who are need missionary doctors because our health care services don’t treat the marginalized.  I have followed his advise and worked in the areas of ‘greatest need’ but I’m old and tired and reduced to crying by my bedside where my mother taught me to pray on my knees.
GOD GRANT ME JUSTICE AGAINST MY ADVERSARIES.