Thursday Alive and Stylin

I woke feeling better.  Last weekend it was touch and go. I remembered that weekend years back I was just as sick or worse. I bought the Buell Blast needing something to live for.  This last weekend I bought a little inflatable fishing platform.  Very inexpensive by comparison but same idea. An anchor thown into the future to kedge with. I was so sick I slept 16 hours.  2 days ago I began to revive and yesterday got a half day of work in before the fatigue took over.

This fall I got sick on the plane from India.  Then I was flying to Ottawa and back.  Plane flights seem a common theme this year. Also the nocebo of the coronavirus pandemic.  I’m in that age range where a flu can take me out. Malthus was right about poverty and disease.  

Nothing keeps me going forward more than the prospect of camping. I live to camp.   Talking with Laura this week about planning the first trip with the Adventurer Camper out to Harrison Lake. Must call to make reservations 3 or 4 days weekend. If I don’t take the rest and time off well planned I’ll only collapse and cause chaos with sickness.  I just don’t have the stamina or the foolhardiness.  

I’ve been fiscally responsible and worked hard all my life only to watch this government just waste money relationships and resources.  These blockades are causing billions of dollars loss. There’s milllions of dollars of foreign money coming into Canada to disrupt the country.  Everyone is breaking laws including the PM and the Police are sitting eating donuts.  Meanwhile I believe if I jaywalk a thousand police and the who judicial system will fall on me or any other law abiding Canadian citizen.  

The oldest law is the Chinese law of the fish. There are big fish and little fish. The little fish must be fast and numerous.  I’m tired at work of seeing everyone trying to get paid not to work and get me to validate their ‘choice’.All the doctors I know are sicker than so many of their patients but come to work only to be abused by patients angry demanding and entitled threatening and frankly increasingly frightening. There’s an incident weekly if not daily. Unrealistic demands and covert threat of retaliation.  I can’t can’t shake the image of people threatening to kill me and my dog and the lack of concern and in fact the implication that I must have attracted it.  Yes, I do. I’m working. I’m in the public view.  Laura tells me she fears attack on the buses downtown every week and street people grab at her beccause she ‘s small.  Fewer and fewer doctors want to be on the front lines.  Now there’s these criminals blockades and tent cities and tax paying citizens are called the problem. We lack compassion and won’t give up our homes. Meanwhile the activitists are making more money than I am and the natives are even being paid.
It’s tax season so I’m depressed to see my incomes halved and given to Victoria and Ottawa for KY Jelly and Lip gloss, dope, and booze.  Party city for Policians and I feel deeply betrayed.  My taxes going to pay for terrorists and worse.
Weinstein in jail.
Meanwhile there are babies being born and infants thriving. It’s wonderful to see the children.

Gilbert is well and a source of constant entertainment.  

The women in the workplace are positive and humorous.

I like my work. I’m kind of in limbo.  I’m at that retirement age but enjoy making money and fear if I stop I’ll not return. I’d seriously like to pay off my truck.  Never have I known as much as I do today and the challenges at work are always old news. I remember the first scarey time I saw something but now that was 10 or 20 cases ago. Seems a waste to step down and yet I get sick and feel I need a breaks. I need to go camping. Lying on the lawn chair in the sun.  I need the sun. The winter’s are always too long here.  The rain wears.  The days are sunnier though. I’ve no reason to complain. Just bad attitude.  Give your head a shake.  Give thanks. Stop with the self pity.  

I like walking the dog and sitting in the hot tub.

I really want to go camping. I really am looking forward to the wood fire and the barbecue.  I love sleeping in the peace of the deep outdoors   I like walking Gilbert in the woods. This year I’ve this crazy idea to fish more seriously.  Yet I’m looking forward to riding about on the motorcycle with the rifle target practicing.  

I pray. I meditate. I exercise. I’ve really enjoyed sleeping and dreaming. My dreams are so rich in old friends and family and dogs.  I’m often sailing.  There’s always water.  Sometimes there ‘s meetings too.  Even better I’ve met my grandmothers in my dreams.  Lovely ladies.

I really am blessed. Thank you Jesus.  Thank you for all the gifts.  Thanks for the care and love. Thanks for restoring me to life.  Thanks for getting me through the fever and delirium.  Thanks for the faith and hope.  

Can’t wait to be camping.  

Work breaks, back logs and psychosomatics

I'm a week back from a couple of weeks in Istanbul and Turkey.  It was an incredible learning experience with daily touring and education in mosques, churches, museums, art galleries. I really felt like I was in an "immersion" program, far more intense that my medical study programs.  I had read extensively and taken multiple audio courses before going. Then while I was therein addition to have a guide I was reading and writing daily.
Returning home I was most afraid of the dreaded post overseas airplane 'flu'.  So often I've caught a cold travelling. Once I returned from the third world with dysentry but mostly I've just developped winter colds because of the stress of long flights and contact with so many different people in closed spaces.
Many doctors I know and many businessmen don't take time off from their work, simply because the back log is overwhelming when they return.  I've resisted the temptation to stay in the harness and cope with the excessive daily work.  Instead I take these study breaks and even go on vacation.  Extended weekends don't cause much back log but whenever I'm away from the office more than a week it's bedlam when I return.
When I return from Russia last spring my staff had left and returned to inform me they'd decided they didn't want to live in Vancouver.  The backlog combined with staff turn over was murderous. I worked weekends for weeks and late into the night each day.
There haven't been sufficient psychiatric resources in Vancouver in decades.  If people with physicial disease had to face what people with mental illness do on a daily basis they'd go insane themselves and add to the overwhelming backlog.
When I graduated I saw people weekly and had a waitlist of a month or two.  Now I'm more likely to see people at 1 to 3 month ,sometimes 6 month, intervals and had a 2 years waitlist till I limitted patients to my very specific subspeciality area and also more commonly accepted patients from family physicians I knew.  Increasingly general practitioners and especially walk in clinics want to cherry pick their patients and 'dump' more complex or complicated cases (see psychiatric cases) on the specialists.  All the 'cream' has long been taken from medicine by the midwives, psychologists, counsellors and health food stores.  The 'worried well' just aren't the issue they once were in the standard medical practice.  Probably because they want 'strokes' and only the 'alternative health care folk' have the resources of private funding to entertain the 'worried well' or 'walking wounded.'  Too often the public health care system is serving only the most desperate.  Everyone that pays taxes should have access but often government health services 'triage' resources for the most desperate meaning everyone else is waitlisted months to years.
When I began in psychiatry my patients rarely had more than one or two diagnosis.  Today it's more common for my patients to have multiple psychiatric and physical diagnosis and often major social and financial issues.
When I go away there's no one I can refer to.  It's been 20 years since I could have another specialist 'cover' my practice.  Last year I saw several patients from practices of my cohort clinicians who were simply 'orphaned' when their doctor retired.
In the British Columbia model every patient seeing a specialist must be referred so when the specialist is away the family physician is supposed to provide the care alone.
The irony of this is that only last month it was made public that Quebec doctors on average were seeing only 10 or 11 patients a day whereas the physicians in the rest of Canada were seeing at least 30 patients a day.  Most GP's I know are seeing more like 50 a day in Vancouver.
There's just not any 'fat' in the frontline systems.  Of course this doesn't speak to the Monday Morning Quarter backs.  The Canadian health Care system compared to the German Health Care system has 20 x the administration with no evidence that any of that administration is improving health care delivery or services.
I think I'm just belly aching because despite my best efforts I fear I may be getting a 'cold'.  A facebook cartoon went around about the "ManFlu" with the proverbial woman asking the sick guy in bed, 'can I get you anything, orange juice, soup, kleenex, your balls, maybe?"
I got back last week and all I could do was face the deluge of work that was waiting for me. I was in the office till 7 or 8 each night and missing lunches and hardly taking time to pee.  I had a series of other obligations but the emergencies and despiration demand just took precedence. All I could do was go to work, 'put one foot in front of the next', 'do the next right thing', then get home and sleep. Jetlag was a problem because I was waking at 3 am.  I'm thankfully back to a good nights sleep but now I've the dreaded post nasal drip.
People have cancer, bullet wounds, bankruptcies and alien abductions. Meanwhile I'm here swallowing to see if the throats any rawer.
The fact is it's all psychosomatic.  I'm a whimp. I have 'self pity' at having work, I should be grateful and thankful and glad to have a purpose and use. So normally when I 'overwork' I get sick because as a child being 'sick' was the only way I could miss school.  There were no 'mental health days'.

I have a resentment at the government services too. Alright I admit it I've a resentment at Billionaires. Inflation being what it is I want Bare Naked Lady to put out a new song, If I had a billion dollars, just to keep up with the times.  There's just so much waste and misuse in the system and no one asks me to be Sultan or Emperor. Instead we have millions being made on heroin and cannibis and I'm here like the proverbial dutch boy trying to get people off drugs when the real money is getting people addicted.  Self pity.  Poor me.

It's the January in BC blas and I've been on vacation. Imagine the poor sods who just have to live through January.  Worse is those Climate Change Deniers in Winnipeg and the prairies who have lost all faith in spring with the snow deeper and streets dirtier.

All I've got to complain about is post nasal drip. But I'll milk it.  I'll whine.  Tonight I'll go to bed early. I missed the first week back onslaught of disease but fear I've taken a shot on the second week.  Soon I'll be in medical student ichthitis, convinced I'm dying and certain I've a new Canadian ebola strain when all I have is at best the 'manflu'.  It's so embarrassing.
The other thing that gets me is lice and scabies.  I'd rather run from polar bears. Except I'm feeling lethargy.


Well I'm here, not contagious, not coughing, but sharing my evil thoughts rather than singing hallelujuahs and praising the Lord.  Maybe a trip to Japan for a little radiation would save me from that horror of horrors, the 'man flu'. A man flu can need a dose of Chernobyl.

Really I just think I should have a nap. Nap time should be mandated for all over 50.  A little nap would be good right now.  If I wasn't self employed I'd get the union to lobby for comfy cots and afternoon nap time.  Imagine as a kid I didn't like the kindergarden 'nap time'.  What a fool I was.

I think this blogpost started out as something meaningful and now has devolved into something pitiful. Patients have come and gone and between them I've added disconnected lines. Gilbert is groaning below the desk.  We've had a walk together.  I just "think" I may be getting a cold.  I can't remember how many times, this time of the year, I've been gargling vinegar, dousing myself in vitamin c, sometimes on antibiotics and always gargling and drinking endless soup.  Maybe I've got PTSD from living years in Winnipeg in January and just have flashbacks out here on the coast.
I got the flu shot.  I prayed. I'm a good man.  Why am I being punished? I can feel that tickle in the back of the throat like jalopeno snot just building there.  I remember when I would switch to smoking menthol cigarettes when I had these 'throat ailments'.  It's the big scnoz weakness. If I had a smaller nose maybe I could keep infection out better.

Can't I just go back to bed, pull the blankets over my head and come out when the crocuses and tulips come out.  Here that's only next week or the week after.  I'll shake this off somehow.  Typically, I'll think I can't afford to be sick.  Get thee behind me Satan.  I cast the demons out of the schnoz and pray for healing sleep tonight.  Maybe it was just the propane heater last evening.  Another source of self pity.  They're cleaning the mould in my winter home.

 Maybe I'll get some Vicks and wrap my psychological throat in socks and remember my mother caring for me when I was a kid.  Those were great days and I didn't fully appreciate them at the time.  I miss my parents and aunt as I get older. I think a good reason for death is to get together again with all the folks that have gone.  Grand dad and grandma were others I took for granted.  Now I'm older I wished I'd talked and listened more to them.

Sick

I've got a "cold".  It began with post nasal drip and a sore throat. It's progressed to full sinuses, difficulty sleeping, fever, much more post nasal drip, plugged ears and fatigue.
I know biologically this is a product of a virus, most likely, possibly some streptococcus or staph bacteria allied with the virus which starts it. I expect the viral culprit is a Respiratory Synctial virus but it could be influenza.
My normal protective immunological system has been down a few counts because of the extra stress at work.  Work is always stressful.  It's the most stressful work I can imagine doing.  Right up there with bomb disposal.  People are like that.  I'm always on egg shells but no one is perfect enough. It's a complaint society too and the people doing the most complaining aren't doing much else.
I've always figured sickness physically means I've not warded off the disease psychologically.  Last week I felt like a guy surrounded by zombies in a vampire movie with cannibal extras. The beaurocracies were in a shark feeding frenzy.  Point fingers and demanding perfection.  I'm going to die not good enough for everyone all the time.  My job is the complaints department of life and the people making most of the shit expect everyone else to keep the niggers down. Nigger in this case is no longer a racial slur but a metaphor for anyone marginalized.  John Lennon once said Women are the Niggers of the World.  Today it's beyond gender. It's the addicts, the mentally ill, the sick and those who treat them.  The 'winners' would just as soon line them up against the wall and shoot them.  They're holding back progress.
So I think my negativity and fear these last two weeks weren't sufficiently addressed. I spent a whole lot of time meditating and praying and being with other loving physicians cared for and caring but it wasn't enough.
Environmentalists would say it was just that I flew to Edmonton and back and took on the bad air in planes and the jet lag and all the other physical stresses of change of location without the slow aclimatisation that would occur if I'd driven my car up to Edmonton and back making the journey in days rather than hours.  I thought of that but there was just too much pressure at work. Everyone complains I don't see them enough or they complain I don't see their family enough, or they complain I don't see their patients enough. I've read two letters from beaurocratic psychiatrists who stopped actually doing clinical work years ago say "it would be good if Dr. Hay would see these people a couple of times a week'.  I'm seeing them every few months.  I'm stretched to the breaking and all the resources are going to guys like these two high paid 'critics' who long ago pulled their thumbs out of the leaking dam and put them somewhere else.  I'd like to have the family physician spend a half hour with the patient like I did but he's only got 3 minutes a patient today.  Then the counsellors aren't paid to see anyone but the suicidal and my patients fall in between.
But now I'm sick. I know it's because of stress and self pity.  I'm also sure I'm dying.  I 've already gone through a check list of all the other physical ailments, aches and pain, really bad pain in joints and stuff you just say is aging and rheumatism but I'm a doctor so I can link all this together into rare tropical diseases, slow virus, brain tumours, sexually transmitted diseases acquired in the 60's, the late effects of smoking marijuana then too, lack of an essential vitamin, lack of sun, lack of rest, lack of sleep - my brain has thousands of rare diseases I've seen and touched stored there and I'm holding it back like I hold back a huge dog near a bitch in heat.
So I keep it simple. I've got a cold.
Now what to do.
If I had a salaried job and worked in an office and had the ability like all bureaucrats to push aside the work for a day or a week because it's really just paper - I'd not go into work , stay in bed, get better. But most of my patients are sicker than me, even psychologically which takes a lot of work and physically I'm really interested in the guy I did an ultrasound on his abdomen last week because it felt like the Alien.  He wouldn't go to hospital so I'm the point man on his possible deadly disease. I just want to know what it is and when I do I can fix it. I love medicine. I love curing people. I really liked cutting but they don't let me have a knife any more.  Prefer my mind.  And that's only good because it saves lives but saving lives is increasingly politically incorrect.  All the money in the system is moving into addicting addicts more, enabling, euthanasia and the really lucrative endeavour of abortion.
So I become depressed and fearful and it's a vicious cycle. All the sadness floods in when I'm sick. I want to curl up in a fetal position but there's work to do. I'm not infectious really.  It's not like I'm doing surgery or dentistry.  I'm at a distance. Thank God for Advil for sinuses and Reactine.  I can put the symptoms at bay. Drink a lot of fluids.
And probably I'll just do the work I need to do and not do the other responsibilities.  Now I've got to get in the shower and get all this sick sweat off me and fake it till I make it.
I've just got a 'cold' and we make too much of these things. But them I'm older and we always said 'pneumonia was at the old man's friend' because it kills sweetly.  I'm morbid and my job is to be positive and reassuring and intelligent and caring and supportive and I miss the nurse who drove me home that night in the ER telling me I was sicker than all the children and she needed me the next day.
Fact is, I heard of a death yesterday and I'm devastated.  It was so wrong.  But at least that person so tormented will have peace. They'll be in heaven.  But it's a tragedy and so sad and it's old news.  Maybe because I'm getting older I'm more affected when I hear of the young dying.  My friend's funeral was last week but I was working and didn't make it.  We're to take care of the living.  I would have liked to have been at the funeral though.  He was a good man too.
Now I've got to rush. Always rushing.  Never enough time for all the demands.  The authorities are always upping the ante and putting deadlines on things that don't need deadlines then the man with cancer has a recurrence and there's no choice and the pregnant woman needs an answer she doesn't have any control over her time. I'm always prioritiizng but more and more bullies are telling me they need to go first. I'm tired of being threatened. One person threatens my life, another threatens my job, another threatens my security. Everyone demanding and pushing and I'm dreaming of being alone at sea again with a thousand miles and weeks between me and another human being.  God that was good to get away from the beepers and cell phones.  We talked about that on the weekend, the sense of relief we each feel when we can find a way off the grid.
It's an excuse to be imperfect. I may as well wear a bandage around my head, a black arm band as I let my nose drip and flaunt kleenex.
But I'm late. I must go.  I'm not that sick.  My guts aren't spilling out on the floor and CSF isn't leaking out of my head.  Most of my colleagues are maimed and sick and injured and they're in the play, They celebrate the hockey players when they do that for a day but all the doctors I know are struggling with illness and yet caring for others too so they're my inspiration.
Sick is a metaphor.  It's all in my mind anyway.  Please Jesus be with me today and help me to do your bidding. Help me help others in your name. And please let this foggy headedness not interfere in my decisions or memory.  Thank you that it's really nothing and not something like real morbidity and mortality, like the deaths I learned of this week.  Be with them and their families in this time of grief.