Showing posts with label doctors. Show all posts
Showing posts with label doctors. Show all posts

Saturday, June 22, 2019

40 years old Vancouver, Psychiatry, PTSD, Jewish Spirituality,

I don’t remember turning 40. I don’t remember a lot of chronology of these years.  There are these major bomb craters, where some the trauma occurred. Around them is a fairly routine life.  A good life.  Unfortanately because of the bomb craters I don’t see all the green with pretty flowers in the surrounding landscape.

I describe PTSD as a time of experiencing trauma, being in some kind of intense emotional warfare.  All around you people like important relationships, ideas, beliefs are being metaphorically killed, tortured, maimed.  At the time because of the pressure of time and the intensity of experience all one can do is bury shallow caves, put on bandaids, do amputations, store treasures.  It’s only later when the war has passed and one is in the between times that there is some peace. During these times it’s possible to remember. Indeed one is often forced to remember because there are ‘triggers’ from the past. I have described these as the earth settling and bones stick up from the shallow graves.

Therapy is digging up these bones that are interfering with moving about one’s only mind.  These bones that trip one up take one out of the present. They need to be exhumed. The bodies need to be identified.

The critical thing then is that a new grave 6 feet deep needs to be dug and the remains buried.  I’ve done this hundreds of times with patients and watched them soar after therapy. I get angry with voyeuristic counsellors, the poorly trained, the inexperienced. They love to cut up a person and exposed the kidneys and liver and leave these tortured organs hanging on the outside of the patient.  

It is normal for a person to heal by scarring. The metaphor we have for tubucuolosis is good. The immunological system walls off the terrible.  This is happening every day with an abscess. But the idea of just cutting into something and letting the pus out is childish. A surgeon knows that the sack must be taken out so the pus doesn’t come back. The bodies of memory must be re buried.

Part of that process has been journalling. In 12 step programs there’s exposing resentments which followed unrealistic expectations. These are found and reviewed in the light of today and forgiveness is the process.  Sometimes confession or sharing heals as Carl Rogers noted in the original relationship therapy. But PTSD is usually deeper and more horrifying.  Much of present research has shown that counselling has most commonly entrenched the trauma by causing a person to ‘relive’. 

I just watch people talk about their trauma after they’ve had years of counselling and want them to go back and get the counsellor to give them their money back.  Mind Body Therapies, one of which is EMDR, but there are others, and group therapies, psychodrama and certain rituals and thought blocking techniques coupled with a variety of ‘new techniques’ are ‘effective in treating PTSD but the end result is that the trauma that so often ‘identified’ one must be let go.

Sadly thanks to poor counselling and a society of consumerism and luxury there’s a veritable industry of trauma such that a psychologist friend called American/Canadian mental health care as ‘Caregivers and Victims’.  Victimology is the new ‘norm’ with victims vying for who was most victimized and who has greater victim status.

There was a reason that combat warriors didn’t talk much about their experience in war.  There’s a reason there’s a millions counsellors wanting to do ‘trauma’ therapy with ‘sex victims’ but so few wanting to work with veterans.  The book On Killing by Lt. Col. Dave Grossman, psychologist is a classic in the field of understanding PTSD.  

I was diagnosed with PTSD.  I was thankful for the diagnosis because a friend of the colleague I’d reported for sex with students and others was trying to convince me I was schizophrenic and telling me I should drink and take pills when I”d decided things were so bad and confused I couldn’t afford to drink and drug because I needed all my wits about me.  There were so many people lying at the time , to cover their assesses and to work their agendas, that it was really good not to drink and not to smoke pot.

What I learned at the time is that there’s never ‘one bad guy’. The bad guys are a ‘nest’. They like to talk about Hitler but it wasn’t Hitler. It was Goebbells, Goring and a nest of them.  Lenin had Stalin, Trotsky, Molotov.  They’re a ‘nest’.  

I actually bought a book on ‘insects’ to better understand the ‘hive’ behaviour of these people at the time.  I would actually trust someone and share what I thought were ‘secrets’ and they’d use this ‘knowledge’ as ‘currency’ and ‘a weapon’.  It was all ‘insider’ training and everyone was working the pump and sucking whatever they could get up their proboscis .  It’s a very sick society. We think of things ‘up’ but that materialistic view of consumerism might well be upside down. I found studying St. Francis, Merton, Brother Lawrence, St. John of the Cross, and St. Theresa increasingly more informative than a lot of the recent writing on an old malady.

Buddha said ‘Desire is the root of all suffering’.

Kierkegaard said ,” Life is suffering unto death.”

Much of trauma isn’t the actual event.

I was fucked up the ass by my professor.  That event, being sodomized by a narcissistic superior isn’t rare. The problem for me was the ‘nest’ and being told that this was ‘Jewish spirituality’. It was also in the context of my residency and training and left me believing psychiatrists collectively are homosexual.

These perceptions were confirmed not surprisingly be cause of ‘selection bias’.  Because there were lots of Jews I had to conclude Jews were bisexual, they had wives and children but were gay or lesbian on the side, a kind of secret society.

My patient had an experience of a group of Masons where this was the ‘norm’ and he thought this was the collective group experience.

It’s natural to extrapolate from experience.  Yet I had the competing idea that Jews I knew were the most monogramous and altruistic. Certainly there are a group of Jewish doctors I’ve worked intimately with and they never made a pass or suggested they were that way inclined.  I’d go to Israel partly to have this discussion with the holy men of that land. Is it necessary to be gay to be spiritual. Was Jesus homosexual.  Was my professor enlightened or just a fuck.  

Bob Dylan was asked, “Why do you promise to make us girls Princesses but we always end up feeling like whores.  

So the actual initiating event was less ‘traumatizing’ than the following, leaving my marriage, leaving my city, avoiding Jewish men for years, and questioning Jesus.  

All of that was a fall out.  I even sought out Rabbi Twerski a brilliant psychiatrist for clarification and only with the most wonderful loving orthodox Jewish psychologists and rabbi’s did I find the answers I was seeking. I would be privileged to know Dr. Sam Sussman a deeply spiritual Jewish psychologist who would restore my faith in my fellow man ion so many ways.

“You want this.”  The professor had said. He ascribed the ‘desire’ with me.  He was psychotic. I did not initiate sex. I didn’t want sex. I said ‘no’ to sex.  Sex with him was not a ‘transcendent’ experience . I didn’t know ‘god’ but I did feel like a whore. And I know from my work with the ‘victims’ of holy men of a variety of religions that these people who blur their roles and have sex with people are doing the same disservice that counsellors,lawyers and judges and jailers do. They are ‘abusing’ their authority.

I believe this which was “trauma’ for me might have been a transcendent thing if I was simply asked.  I know I would have said ‘No thank you, I’m married and I’m too busy preparing for my exams and finishing my decade of training to play with your little penis.  I have more important things to do.”

There was no such discussion.  I had a mouth put on my penis and frankly my penis is a whore. Marvellous little fellow but deeply unconsciouonbale.  He’s a bit of partridge too. In fear he freezes and doesn’t react well. If someone grabs my genitals the first reaction is to freeze.  Now predators take advantage of that.  I shoot grouse before they take flight.

I was traumatized by the person, typical of psychopaths, denying that this activity is ‘their idea’.  We teach people like my professor who was psychologically underdeveloped despite his august position and authority to use ‘I statements’. 

 “I want to fuck you up the ass?  “

“No sir, I don’t want to be fucked up the ass.”

That’s all very well but the other aspect which is my ‘own part in it.”  I was drunk and stoned. I make bad decisions drunk and stoned. 

When I was 45 years old I was in Homewood Treatment Centre and they asked me to list all the ‘events” that I ‘felt’ were ‘negative’ or ‘traumatic’ and to list beside them what alcohol and drugs were involved. I was then to make a list of all the things I most liked in my life and what drugs and alcohol were involved if any.
It was glaring evidence that while ‘shit happens’ most of the really bad ‘shit’ in my life happened when I was ‘drunk and stoned’.  Not a little drunk and stoned but as the girls proudly say to day. “Legless’.  

Lots of bad things happen to good people. When I was shot in the leg I was doing absolutely nothing wrong. The hunter on the other side of the pond was doing wrong. I was ‘pure’ victim. This wasn’t ‘date rape’. There was absolutely ‘no consent’.  Of course if I wasn’t hunting at all I’d not have been shot. My friend was riding her horse during hunting season and was thrown by her horse because of gunshot sounds.If she hadn’t ridden horses she’d never have broken her arm.

So cause and effect is also about ‘terms of reference. ‘. We actually do this stuff academically. Everyone on the ‘Victim Gravy Train’ doesn’t seem to remember Culloden or the patato famine or the white slave trade. It’s all about ‘selection bias’ , politics and money.’

I had these recurrent nightmares. This was part of the PTSD. I couldn’t sleep because I’d be woken by these ghoulish faces of people I’d seen dead. They were the suicide victims I’d attended. I was having this thing when I went on vacation and while I was gone the patient would go to the hospital and they’d reject them and they’d suicide. My colleague didn’t take holidays for decades because he didn’t like the punishment of borderline patients. ‘Fuck you’ suicides are a problem.  

I am sensitive. If I waszsn’t I would have been an accountant or a exterminator.  I could have even been a banker if I wasn’t sensitive. There may well be sensitive bankers but there are rarely insensitive people choosing medicine. I was straight A’s sciences and arts. I was ‘omnipotential’.  We all knew the money was law, accounting or banking. Choosing medicine meant choosing to ‘touch’ people. 

I have an accountant friend with ‘germ phobia’. He couldn’t be a doctor. My big hearted Jewish surgeon friend told me that his multimillionaire Jewish family members prided themselves on being able to ‘count’ the number of people outside of family they’d actually ‘touched’ other than a handshake.  Pierre TRudeau was notorious for his dislike of touching people.  I shook his hand and it was really cold and slight. By contrast Chrétien had the most robust handshake. HE would have hugged me if I wanted.  Pierre Trudeau was not a loving touching person. He’d never have made it as a doctor despite French people in general often being more ‘earthy’ than the proverbial English. 

I had these recurrent nightmares, night after night. Horrible nights of not sleeping. I liked drinking and smoking dope at the time because those were the only nights I didn’t have nightmares.  

Working with thousands of people with drug and alcohol I’ve found almost all have traumatic pasts. It’s simply not rocket science. Drugs and alcohol address anxiety, more anxiety, more drugs and alcohol.  More insomnia. More pain.  The more drugs and alcohol the more addiction.  

The critical factor which Kernberg and Kohut discovered was you couldn’t do therapy with people doing drugs and alcohol. Change didn’t occur. The more insight in therapy the more pain , the more drugs and alcohol.  Millions of dollars of research and there are still counsellors doing uncovering thereapy with people with active additions. OF course this makes the addiction worse and it makes these counsellors. Lots of counsellors make themselves the tit and thrive on Co dependency.

The classic insight error, “aha my mother fucked me up”, now there’s another good reason to drink and drink more” says the Irish drunk.

The key was learning that one had to abstain first.  Dr. Nady El Guebaly did research on trauma and the idea was that one needed anywhere between 3 and 12 months clean and sober before ‘insight’ or ‘trauma’ therapy could actually work without doing more harm.  

For a doctor it’s not complicated because we routinely see patients who obviously have a bullet in their brain that needs to be taken out. But we know that we have to address the blood loss first.  Counsellors without practical wisdom and grounded metaphors miss this basic lesson and do horrendous harm and they deny responsibility.

I met one poor woman who’s accidental killing of a drunken native had resulted in a decade of counselling and no forward progress in her life. A man I saw literally stopped living after his son died because all the counsellors wouldn’t let him heal.  They kept opening the old wound.

No wonder the military combat veterans don’t want to talk to civilians about their experiences.

I felt dirty after I had anal sex. I had this other man’s sperm in my body. I was ‘bred’.  I was like a woman rape victim who wants an abortion to rid herself of. the baby that the rapist planted in her. I went for ‘exorcism’. Really, there I was with a group of men praying for me.

I liked anal sex and I liked sucking cock but I like fucking girls and cunninligus more. That ‘feeling’ issue and ‘liking’ issue is a completely different matter from what I ‘wanted’. 

I was married at the time and didn’t want to ‘cheat’ on my wife.  I was struggling to be monogamous with the reward supposedly promised , as eventually , a child. My professor had children.  I didn’t have children. What he did deeply affected my having children.

The whole issue of children is why people in society have been anti homosexuality .Lesbians get off easier because they commonly have children. Historically children were the principle avenue of wealth. They were the workforce and the army.  They were inheritance and they were the principle means whereby people felt they could avoid  fear at death,irrelevance and mortality and oblivion.  “My children will continue me” they said. A classic in Psychiatry is the book, Denial of Death”..  70% of marriages with children stay together. The ACE studies show divorce is a principe ‘trauma’ for children. Women who have abortions are at much greater likelihood of developing depression and even greater likelihood of developing addictions.

Anxiety has been defined as a measure of one’s distance from God.  It’s equally a measure of one’s humanity.  

My wife had multiple sexual partners and I had multiple sexual partners. In DNA testing of children of the divorce 50% are not the father’s . The majority of men are shocked. Women lie more and more effectively about sex. June Kaplan Singer , the greatest female sexual researcher showed that women’s sexual research was deeply influenced by what she called a ‘social acceptability scale’.  Have you sucked cock asked by  a blonde got a greater positive response than when asked by a brunette.  Cultural patterns of sexuality are extraordinary. I interviewed African women who’d had sex with six hundreds parners. I have had highly successful male patients and lowly gardeners who have had more than 500 sexual partners. Ghengis Khan and his family have a famous gene variation that has been carried through the ages and suggests that the brothers had sex with millions of women.  

Sophie Trudeau was just on television talking about her and her husband’s infidelity. This was done obviously politically since her voting group were attracted to these young people who though married were fucking around and fucked around. It’s actually a factor factored into voter  marketting strategies today.

Yet it’s not a necessary component of enlightenment. I’ve now met dozens of adult virgins and though they’ve all had a certain sensitivity and anxiety they’ve been no less ‘enlightened’ than my sex addicts, indeed the sex addicts have been more confused.

I’ve visitted monasteries and learned at the feet of great celebate monks.  I was blessed to spend time with a monogamous Jewish Rabbi in Safed. A true mensch.

So after a lot of work I can say that my professor was full of shit when he fucked me when I was seeking the enlightenment found in Jewish tradition.  I have lunch and coffee routinely with the father of one of our local great psychiatrists. He’s an orthodox Jewish doctor and he doesn’t confuse loveand lust and of course we know they can be together.

But I was at the university paying money,  I was paying for this professor and I asked for Jewish spirituality. I went to his house and had a deeply moving Passover dinner with him and his family. If that had been it I’d have got what I’d asked for.  Instead I got that then I was drugged and fucked.  

Homosexuality and Heterosexuality are not ‘necessarily’ part of ‘spirituality’ .  I know this today.  I know this and frankly think my professor was simply a stupid idiot. My favourite Jewish psychiatrist here was Dr. Solomon and he would clarify and sort and separate ideas just as I am here.  He wasn’t confused like my drunken dope smoking Jewish professor.

I actually thought that ‘if Jewish men’ are ‘necessarily’ fucked is this because they as a culture practice ‘genital mutilation.’

What does circumcision do to a child at this young age and how does it psychologically bind them to the ‘tribe’.  There’s this marvellous ‘pain and pleasure’ thing that my Sadomasochist patients are into. There’s an actual spirituality in their practices which involved the infliction of shared pain and then the relief and then this is combined with orgasmic reward.  

I let my friend hit my butt once with a ping pog racket and didn’t get turned on at all But she said she liked it.  She didn’t like sex and pain herself having been hit then had sex. There’s a spirituality in all this.

Now spirituality and religion get mixed up and spirituality is made to mean everything  There’s always this problem of ‘naming’ things,  

When you smoke dope you are righteously ‘inclusive’ and the words are all blurred and everyone ‘loves ‘ and it’s just like when everyone is drunk together.  The problem arises when we ask who had what and whose going to pay for the drugs, meals, whatever.

Spirituality is said to be ‘God made’ and religion ‘man made’.  Spirituality is the love to the lust of religion.  Looking for justice in the courts is like looking for love in a whore house.

It’s why the ‘constructivists’ and the ‘post modern groups’ with their relative truths are the greatest ‘critics’ abut create little.  Destruction is easy. Creation difficult.  

I was having these nightmares of all the dead faces I’d known so proceeddd to write down my dreams and name the people and remember them.  

This was critical. I was being asked in a way by the dead  for their attention.  The ghosts were around me all the time at this period in my life.  Late 30’s constant nightmares. I was seeing them in the end like playing cards, all these disembodied faces looking down at me from the ceiling.  I laboriously methodically worked my way through the whole lot, considered each , the circumstances, what I’d done,what could have been done. 

The engineer that died because I trusted the ‘hierarchy’ and did what my superior told me ‘to do, still bothers me’.  I was right, He was wrong. A Person died and I had nightmares because I’d followed authority. I did as I was told. I was like Arendt’s banal evil. I participated and yet I knew the decision was wrong. I was like Pontius Pilate washing my hands of the decision, passing it back to the mob.  In Almost all I’d done the best and yet lost.  

My favourite example of a suicide of my patients to illlustrate this.is as follows:

I had a chronically suicidal patient. I don’t have patients who are suicidal once. I have patients who’ve been hospitlaized dozens of times, who’ve made dozens of attempts, who are chronically suicidal. I have patients’ who think of suicide daily for decades.  This isn’t what Hollywood is about. This isn’t even in the world of the pristine College of Physicians and Surgeons administrator doctors who simply don’t have sufficient experience to find their assess with both hands. You are either a combat soldier or a chair warmer. You can’t be both and when you do take a chair because you’re warn out you don’t know diddly squat about what’s going on today because the world has moved on. Old men are invariably fighting yesterdays wars and until they kill off a whole bunch of people they don’t get replaced by people whose brains aren’t stuck in the past.

This man this day jumped in front of a bus. My secretary happened to be coming to work and ran out on the street and pushed him out of the traffic. I was coming to work and watched this miraculous act of heroism. I’ll never forget the white knuckled bus driver or the whole tableau.  I ran to assist. The secretary called the police and ambulance. I completed one document of the certification process and he was taken to the emergency.  He was ‘discharged’ an hour or two later. He hung himself in his apartment an hour or two after that.  

Most of my suicides were patients I’d told to go to the emergency if they were suicidal and they were refused by a general practitioner or a nurse or an emergency doctor. They didn’t make it to a psychiatrist or spend a night on the psychiatric ward. I’d been the supervisor of the Psychiatric Emergency and Short Stay Unit and these were what these were for but when I was in the community repeatedly my patients were discharged and killed themselves hours later. I would be away at the time, at a conference or on holidays.  I returned from vacation a half dozens times to such ‘gifts’.

My interest was borderline personality disorder, chronic suicide and drugs and alcohol. These are the highest risk classes. I can ‘cherry pick’ and ‘select’. One of the staff at the College of Physicians and Surgeons was such a ‘cherry picker’. They’ve seen nothing. Like the Ottawa chair warmer my combat soldier punched in the face after seeing his child bayoneted to his door.  There are a whole lot more chair warmers than real people. They proliferate and multiply in big institutions and love to swagger and act and play act and make gobs of money.

I finally had this dream of this one guy I’d totally forgotten. I’d been an intern and called when passing the adolescent psychiatric unit to help the psychiatrist cut down his patient. I had had this clammy feeling sensation recurrent in my hands and a rash on my arms. These were somatic hallucinations that came on in severe anxiety situations.  I’d been curious about them.  They came and went. Sometimes I’d take an antihistamine.  This night I saw the face and remembered clearly holding this boy’s wet clammy cold dead body while the psychiatrist cut him down.  I remember the weight of his body and his skin touching mine.  

I know bureaucratic general practitioner College of Physicians and Surgeons arrogant know it alls who’ve never cut down a dead body. It was the way kids hung themselves on Indian reserves. I was called in twice to stop suicide epidemics among adolescents. I’d stop them but in the first couple of days I’d not be up to steam and had to deal with the end of the rush of suicides that occurs when people don’t know how to deal with them.  This arrogant grandiose stupid College of Physicians and Surgeons puppet had never pulled a ‘floater’ out of the water and made the mistake of tugging on the body so getting the flesh with out the bone in your hand.  She’d been a control freak and guarded herself in her ignorance and kept the patients are a distance while focussing on wealth and privilege 

I learned a marvellous term for these College of Physicians and Surgeons Administrative sorts (not the good ones, there’s always good administrators, there needs to be, but the present lot of useless unnecessary ignorant hangers on sucking on the dying tit of socialist waste and police state wannabe’s ) anyway this is their mantra.

“LICK ABOVE, KICK BELOW”.

At the very end of my career with death over the horizon I am just now learning how these ‘nests’ work and how these ‘sociopaths’ got their power which they abuse because they’re godless frightened sick people. I pray for them today. I struggle to forgive them. I know it’s my fault. I know I’m not perfect like they are. Today it’s always a conversation with God for me.  

The cards with the free floating faces ,  the next night, just fell into place and receded into this great filing cabinet. I never had a nightmare about suicides or dead people or dead faces after that. I saw more suicidal people. I held the dead in my hands again. I lived and went to work but the nightmares stopped.  I’ve had other nightmares. The sexual nightmares still recur rarely. I have the nightmares about being the one without the answer, everyone knowing what books and what the test is and I’m the one who studied for the wrong thing. I’ve got the washroom nightmare. I think that’s just travel. I’m trying to shit or piss and in my dreams the floor is covered in shit or piss or their no toilet paper. I doon’t even think of those as ‘nightmares’ just bad dreams. I’m embarrassed like the time coming out of the Heathrow airport washroom where the previous travellers who’d never used indoor toilets had shat on the floor and I’d walked out leaving a trail of poop prints, my main concern being that people would think it was my poop or that I’d pooped on the floor in the toilet.  Always the poop and pisss stuff like childhood or looking for washrooms. This is travel stuff and now I’m older I’m going to be returning to this Depends world one day soon..  

I remember bleeding in the chair in the cafe talking with the girl who liked me and was so sad when she saw me hemorrhage and look like a girl whose had her first period. I’d had anal surgery because of the tear that’s I’d got with anal sex from the professor and years later trusted a fine Christian surgeon to make the ‘repair’ knowing he wouldn’t judge me and would do his best and I could admit to him that I’d had this tear since I’d had sex with the professor and that it recurred whenever I was constipated.  I’d open it and then have to treat the infection and have the pain recur. The surgeon gave me years of relief but when they admitted me to the psychiatry ward I was bleeding and in such pain and they did nothing. Blood on the sheets and nothing done.

I was always infuriated when I found psychiatrists who had forgotten their medical training just like now I’m infuriated by the masquerading doctors in administration who have forgotten their medical training.

In this one ward there was a patient who refused to wash and the psychiatrist and nurses had not done anything. So I came on the ward and found he had lice and his room was infected . His body was scabbed and it was horrid. 20th venue and this man may as well have been in a 19th century insane ward. Utter neglect as some kind of ‘analytic’ technique by the psychiatrist in charge, my new boss, and my first job I gave myself was to grab this man and take him into the shower and wash him. I was fully clothed and scrubbed him. Then called house cleaning and had his room exterminated and put him in new clothes.  I called infectious disease.

 He was schizophrenic.  I literally gave my new boss shit .”I dont fucking care what you were doing. You put a whole fucking hospital at risk of infection and this man was not eating and dying in a hospital. It’s pathetic. “ 
 I was told that it was unprofessional to use the word fuck. The College of Physicians and Surgeons heads a whole multi million dollar wing for bureaucrats to address real doctors who use the fuck word. Another multi million of College of Physicians and Surgeons is devoted solely to addressing real doctors who use the word”shit”. There are fewer afewer and fewer doctors and nurses as a consequence.

The man washed and clean and fed brightened right up. He gave me his brother’s phone number. A famous family in Hong Kong. They flew over immediately. The brother a famous internist reviewed the records and thanked me for caring for his brother, an autistic boy, who had schizophrenia and had been lost.  He’d been neglected on the ward for a month or two. Unbelievable this shit.  I transferred. I was disgusted with this tunnel vision man who with his doc Hollywood designer sun glasses showed disdain for me.  I didn’t understand twhat he was doing . He was doing nothing.  He was neglecting the patient. He was making a whole bunch of money and giving talks about shit.  HE was doctor Hollywood. I was just doing my job and fed up that I kept running into assholes. 

But I didn’t keep running into assholes. This was the only asshole I probably met that day.  My fucked brain replays the assholes like the dead people, those dozen or so folk out of the hundreds of suicidal I’d seen and the thousands of psychiatric patients. My fucking brains keeps going round in circles like the faces hovering over me taunting me to find the answer. The answer in that case was that I had to pay attention and remember everyone as a human being, they wanted my attention, they didn’t want to be forgotten. They needed to be remembered. I needed to dig up the bones and identify then and then they needed to be put in ‘zip ‘ files condensed and stored.  

It’s like the College of Physicians and Surgeons here. I don’t focus on the great guys and girls I’ve known there. I keep coming back to the arrogant stupid asses that have been so nauseating and yet are hardly puke worthy.

I remember this friend of the Primier’s one of the richest men in Canads coming in and telling me he was going to kill himself.  He delighted in this power thing. I’m suicidal. Doctors are fools. No one can stop me killing myself. I’m fed up with my wife. I can buy you. I can buy this stupid building and you can’t do anything about it so you’re no good as a psychiatrist.

I picked up the phone and called the police.  With him in the office, I said 

“I’ve a suicidal man in my office who insists he is going to kill himself .I need a unit to come and take him to the hospital”.

“You can’t do that., “ shouted at me flashing his rolled watch in his Armeni suit.

“ I just did.”, I said.,

“I’ll ruin you≥ I’ll fuck you over so many way. You won’t know your ass from your mouth, you little shit. “ he responded.

“The police are coming If you want me to phone them back you just have to tell me , give me your word really , you aren’t going to kill yourself.”

“No fucking way. You piece of shit.You’re not going to force me to say or do anything You are a nobody.”

“I’m just doing my job. If your’e suicidal you can go to hospital and explain to them why you need to be discharged or not admitted. I can’t deal with you here.”

“I can fucking say whatever I like ,you nobody. I’m the friend of .....(.and he listed the names of the shakers and makers of the world) ...I’m leaving here. You’re the worst psychiatrist I’ve ever seen . You should never have been allowed to pass. I’ll ruin you I’ll speak to the minister of health and have you locked up in a psychiatric ward. You’re crazy. Do you even guess what I can do. Who I give orders to. You’re so stupid you don’t know how not to be afraid. I play golf with......(list of famous men with criminal associations)

(All of what he was saying was true. He was who he said he was.)

“,Fine,” He said.”I’m saying that you can say you’re not going to kill yourself and leave but if say you’re going to kill yourself the police will come and I’ll send them after you and sometime today somebody else will sort this out.”

“My lawyer will see you in hell,” he said..  I’ll have my lawyer talk to whoever lets you practice in this province since you’re the most dangerous doctor I’ve ever met.” 

“Why am i dangerous. “ is asked curiously “ You said you’re going to kill yourself. I said I’m going to stop you. You’re thedangerous one. I’m just doing my job. I took the hipocratic oath. “

(The trouble with the hipoocratic oath and the attraction of Justin Trudueau Medicine over Hippocratic Medicien is today Abortion doctors get paid more than Obstreticians and Euthanaisa Doctors get more pay and glory than shit jobs workers like me.  If I was one of the Liberal progressive glory boys and girls I could justify killing shits like this ass but instead I took an oath to save his life just so I didn’t give into my personal desire and act like our present College ADministration sorts who no longer believe in the Hippocratic Oath though most Canadians weren’t allowed to vote on this ‘bureaucratic change’. Executive decisions being what they are.)

The police arrived and cursing me ,arguing with them , they took him to the hospital, Rolling their eyes. 

Now this is the bit I wanted to share. I called the Registrar at the time,  one of the great old guys that preceded the ‘idealogues’.  I told him the story and of course he knew ‘whose who’ and he laughed and laughed.  

“Thank you Dr. Hay . I love your calls and the problems you encounter. I don’t think there’s anyone I know who could have had such a situation and no one knows better than you how to handle it. I just love being reminded how difficult it is in reality. I’m up here in ivory tower living the good life safe and serene away from the trenches and gunfire of real medicine.  Let me just tell you. No one to date has been prosecuted for saving a life like you’ve done. The Good Samaritan law defends your actions. I think you did the right thing. He’s suicidal. You’re supposed to send him to hospital .At least you’re get a second opinion. He may well ruin you. He’ll try. He’s got a bad reputation as a nasty bit at times, not a wholly bad guy but a bit Zeus like given to rage and such so I wouldn’t ignore his threat about lawyer but frankly Harper Grey are the best lawyers I know and they’ll have your back. I don’t think anyone could have protected you if you let him leave and he killed him self. His family really is powerful and they’re very protective so doing nothing in this case could have got you into a lot worse situations. It will all work out so I wouldn’t worry.  That’s the best I can offer. If you have any more questions give me a call. You do see the most extraordinary cases.  “

Today the junior administrators and their gps colleagues actually think they know more medicine than the wizened war torn doctors who have spent years in the trenches. These pretty boys and girls haven’t even got scars. They are being selected today for their arrogance and fear. In the old days, and I hate to say the old days because it makes me old, they were the kind of men like this who were incredibly helpful and honest and collegial.  

The man was assessed by a colleague. After a dozen years of threatening suicide when he wasn’t threatening to kil people he learned that if he threatened violence he’d be taken to the hospital.

His equally famous and incredibly wise and powerful wife phoned me and thanked me for what I did, apologizing for her husbands behaviour and promising that the family were thankful that he’d no longer be pulling the ‘suicide’ card when he was angry at not ‘getting his way.’

“He’s a really fine man as I’m sure you guessed.A truly great man who I love dearly but he’s become angrier in the last couple of years and he’s fired any of your colleagues who tried to help and he wont take any advice. But after what you did he’s agreed to follow the Doctors’s orders because we were all afraid he was going to have a heart attack or stroke when he gets this angry.  I just want you to know that I’m glad you took him seriously. I’m glad he’s alive and getting the treatment. I understand he can be frightening but he’s a good man and I think he already realized that you really cared for him more than other people who he’s bullied. He’ll respect you and my family are thankful so don’t worry.  I just wanted you to know I love my husband dearly even if he can be eccentric at times and today you’ve been a good doctor so we thank you.”

I’ve had the privilege to serve a dozen or so of the countries shakers and makers and while an individual can be sick in the group this conversation reflected my experience of these “elite good families’ that are the very back bone ofour country. They love each other and have problems like everyone else. They control armies and have extraordinary influence but as a doctor you see that they can have a cut just like the next or bad flatulence or become suicidal..

I was impressed when one of the richest men I knew in the world phoned me up and asked me to see his son.  

“I was given your name Dr. Hay and would appreciate it if you could see him this week. We want an intervention done on him. He’s spent 10 million dollars in the last couple of months on cocaine,gambling and prostitutes. He had an argument with his wife. The family have addressed that but we need to get him into help before he can even accept what he was upset about is not even an issue any more. “

So that’s how I did an intevention for this wonderful Jewish head of a world bank whose son was having a bad day.  

I did my job. I convinced the son to go into treatment and spending a few hours with me he accepted getting into the limousine with body guards and others who came to my office to pick up a man who’d just gone through 10 million dollars in a couple of months on drugs and hookers. I was truly impressed.  

He was my personal largest losss of income to cocaine in my life history. Normally people lose a million at most to drugs. Addiction is a country and western song. You lose your wife, your job, your truck and finally your dog.  If you are wealthy the truck you lose is a hummer not a Chevy.  It’s just the disease.

What I love and will always remember is this wonderful Jewish father, now dead, a mensch in the world and his love for his son and daughter and concern for the grand children.  I was so glad to help.

It’s not ethnic. I’ve had an East Indian Hindu man ask me for help exactly the same way though the cost of addiction in that case was only hundred of thousands.  I’ve had the same from Christian parents and Muslim parents. It’s all about the love you see of parents for their children. I’ve been approached by wives and husband and lovers.

I asked the College of Physicians and Surgeons for help with my wife. At the advice of my psychiatrist I’d sent her out of the country when her cocaine addiction was so bad she was approaching my patients for cocaine  and not going to work and staying in bed again. The politics of the day were different. I had a different set of enemies politically.

I couldn’t get help with my wife and all I asked was for her to get treatment for her addiction.  

“Women don’t have addiction” the college psychiatrist said. “ Their problem is their relationship. “  she got the latest greatest feminist addiction treatment flavour of the month, divorce.  

The College supported  psychiatrist was a feminist who didn’t believe in addiction and thought all men were bad.  The problem was men. She either was a cocaine addict herself or an alcoholic or she didn’t know anything about cocaine addiction.  

That’s was a living.nightmare.  





Sunday, August 5, 2018

I have learned

I have learned again that I have a great group of colleagues and friends from around the world and that I can call them at any time and know that they will listen and help me with any problems I might be encountering.  In retrospect I’d be wiser to reach out sooner rather than stew and worry and jury rig solutions on my own.  I know I have friends close to home but these friends I’ve known and shared with for 20 years have insights into similar problems and concerns. In one case what I thought was a local insane administrative problem reflects some ideological move which is happening far and wide and causing untold suffering for patients and doctors. Yet it’s an idea that has infiltrated the wee pee sized brains of the stupid and taken root like the holy words of Marx.  Some as yet unidentified health administration ‘prophet’ has infected these folk causing sickness in middle management, a kind of arrogant brain fever.  I am not alone. I felt so alone.  Yet British doctors and Australian doctors and doctors all across America and Canada are seeing the same insanity and the victims of the mental aberration don’t even perceive themselves as having this idiocy.  They collectively lack insight and react aggressively to anyone who tries to point out their derangement. They are definitely not willing to change and in the precontemplation phase regarding any willingness or motivation to change. So we do best to detach with love. Most of us can’t leave or don’t want to.  All of us seem most to love helping patients and serving our fellows so its a bit of a muddle right now for a wide variety of reasons, mostly the lack of education of management, their faulty models, aging populations, chronic disease and unfunded political promises. The tendency to ‘blame’ the individual doctor for systemic flaws simply reflects their own fear and aggressiveness.  It is best to stay safe.
I have learned that there are new medications that are indeed curative despite their side effect profiles and well worth a trial where all else has not been working. The costs of the new research are high but the cures are indeed amazing. There is hope for much with modern medicine. In the field of addiction where the reward site of the nucleus accumbens and dopamine tone are identified genetic studies and new medications are coming along. Some 10% of the population, maybe as high as 20% are affected severely by isolation and shaming. The existing legal approaches to the disease are wholly counter productive and politically there is a need to educate politicians, judges, and various others to appreciate the effects of shaming and isolation.  Primitive administrative models which rely on shaming and isolation, focusing on making individuals feel less than, are indeed the social mechanism that fuels addiction.  The monkey models of the effects of isolation and making one feel less than are amazing. The animals have no desire for cocaine before the mistreatment but after exposure to such regressive management become rapidly addicted.  The cost of addiction is simply widespread and misrepresented because of the tendency to see different organ or illnesses as separate when they have the same underlying abnormality of the reward mechanism.
I have learned that there is much benefit in exercise and that mobility should be more the focus than being free of pain.  Mobility is central to the human condition and once mobility is loss a wide range of illness follow.  Addiction is tied to loss of mobility so work with pain must emphasize mobility foremost.
I have learned that street fentanyl is a misnomer compared to the pure fentanyl used by anesthetists. The nature of the ‘fentanyl’ or ‘down’ used by patients is more akin to animal tranquillizer than opiate. I feel remiss in not being on top of the chemistry of these agents and will when I am home research this more as there may be insights to be had regarding addiction and substance.
I have learned more about the models of health care delivery and that there is a political buzz word ‘universal health coverage’ which doesn’t mean anything like people think it means. I have learned that Americans in general have no idea what the Canadian health care system functions like. It is apparent that the various health care systems around the world including the American handle emergencies and acute illness well but the problems arise in chronic care and rarer diseases.  It was truly fascinating talking with front line workers like myself about what would actually be done for individual cases and how similar the deficits were for the homeless and that access to medical care varied dramatically especially for the rural folk,  It was a wholly different discussion than the political disinformation and misinformation ideologically driven by media.
I have learned that I really like having discussions with colleagues about religion, politics and health care, and all manner of matters because not one of them belittled or abused me for an opinion different from theirs.  It was interesting that there were so many differing political opinions regarding the present President, those who clearly hated him and those who loved him but no one became violent or offensive but instead stated simply how the regime change was affecting them personally.  I was fascinated by how down to earth the people were and how gracious, more than me by a lot, those were who had been exposed to the 12 step. I found the parents and grandparents even more gracious and just a true joy to be around.
I have learned that the vast majority had benefitted from 3 to 5 year monitoring and that a restrained approach consistent with other socially affected models which didn’t demonize patients was truly effective.  Given that many diseases affect performance it was enlightening to see alcoholism and addiction compared with other illness and the kinds of monitoring which were appropriate for these.
I have learned once again that I learn more talking to colleagues with similar experience and training in a hallway than I do in a lecture theatre at my level of experience and age.  I am so thankful for the many conversations I had with senior colleagues, most now retired, two of my favourite psychiatrists sharing about their retirement this year, what they are missing, why they left, what their plans are.  I also learned that several enjoyed cutting back their practices and continue to work. I noted that most had moved away from the soul sucking models of management and were less driven by monetary concerns as by respect. I laughed at a colleague describing reducing his day because he realized he was too old to live long after treating more than one ‘death star’ patient a day whereas in his previous model of care he was treating a half dozen of these unmotivated chronically angry and demanding patients which he aptly named ‘death stars’.  I liked that together we could talk honestly and that political correctness was eschewed because we all were in the front lines and our compassion wasn’t just the matter of fancy word, virtue signalling and sound bites but reflected years of compassionate care and service.  Among ourselves no one derailed the conversation with the stuff that duels dealt with in the past but rather we discussed better what to do with ‘death starts’ and how best to survive and manage the experiences.  Interesting to me they were not limited to psychiatry but a common concern of specialists, if not more so than generalists.
I have learned that my colleagues are accepting care from their colleagues and many have had really good medical care, knee surgeries and heart surgeries and investigations and are alive today because of the success of medicine today.  That gives me hope as I age and fear the politics of health care and am afraid of dependency.
I have learned that I have been short and inconsiderate at times, allowed myself to be over extended and been insensitive to others. I have learned that I must review my own behaviour and responses daily and that I must apologize for my omissions and errors more quickly. I am aware that the deaths of my brother, my best friend and another close friend plus the severe illness and insanity of two close friends, the surgical removal of my dogs eyes has all caused me to be less attentive to those around me but that while I feel I'm running on 6 cylinders rather than 8 I'm not alone. Those others around me are normally equally stressed though differently. I have examples around me and an idea of the person I would most like to be and while the demands have escalated exponentially, and the number of angry and threatening and entitled people is disproportionate there is much I can do about my response. Daily review is something I have let slip and I need to be more proactive about this self reflection. My greatest mentors have died or are sick themselves so I must do more about shoring up my defences. Meditating more and praying more are showing benefit but I must exercise and surround myself with more positive relief from work given the death and disease where I am.  I must if I am to continue say no to the outrageous demands of the needy and co dependent and accept the adage physician heal thyself and be proactive and say no more not less. I have to put a premium on my spiritual well being and on my life because the truth is there are too many today who have not been socialized and they exist in low and high places.
I have gained so much hope and appreciated most the examples of my superiors and the laughter.  I loved learning all the personal challenges friends had and that they carried on. I am left wanting to emulate these men and women who have so often as indivduals and doctors set the example that has helped me carry on when I’ve been overworked, stressed, lonely and afraid.  I have learned that if they can carry on, so can I so I’m near the end of this conference looking forward to return.

Friday, August 3, 2018

IDAA Reno 2018 Fun Run

This is my annual cardio exam.  The Fun Run is guaranteed to have emergency doctors and perhaps a cardiologist or cardiac surgeon. I feel safe.  It’s been decades ,really, since Bobby and Carole convinced me to come along and walk with them on that first Fun Run when Cheryl, our sky pilot, flew by at Mach II. Her example inspired me to actually try to run in following years.
Skip sets a mean pace once the run starts.  Cheryl did sort of pull me forward   to give  me some momentum  at the beginning.  I  ran along beside her for a bit quite amazed that she and her running companion could actually talk and run.
She said, “I just started going for a walk around the block whenever I wasn’t feeling right. Then sometimes two blocks. It helped especially when I was feeling angry. Eventually I began running.” She’d done 8 or more marathons by this time.  I didn’t hear any more.   There was a slight incline, maybe 1 %  so I had to reverted to walking. I’m specializing in ‘flat’ running’ and only walk on the incline.  
On the second lap around the lake another couple picked me up.  A plastic surgeon and a dentist.  They inspired me to run for a bit too.  But soon I was walking again.  I begun walking and talking with an emergency doctor who had not got to the level of running and walking at the same time either.  We  walked and talked just fine. .  Interesting guy.  Miles and days passed as we conversed.
Still I ended last.  John then ran around the Virginia in a couple of minutes to check for bodies in the bushes. They gave us red t shirts to assist with this.
Alex and Dorothy guided me back to the hotel.  Dorothy said she’d started an exercise program only months before. She glowed.  I dripped and slouched on.    My body was barely working and my mind was intoxicated with blood and oxygen.  I felt immense gratitude. I was still alive.  I’d  passed another annual cardio exam.
I took 2 naproxen when I got back to the hotel room,  even though a dozen dilaudid and a fentanyl chaser with scotch might have been better. I drank another bottle of water and headed for the hotel hot tub by  the pool.  I expect Neil Armstrong felt a bit like I did then when he said.  ‘one small step for man….".
Since I’m still walking after this year’s IDAA Reno 2018 Fun Run I've  signed up for next year's IDAA 2019 Fun Run in Knoxville Tennessee. Maybe this year I’ll practice. I don't think Sloth and Gluttony are my friends.

Tuesday, July 18, 2017

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.

Wednesday, July 29, 2015

Wednesday Evening Journal

It’s hard to reckon how hard a start it was this morning. I wish I worked for someone else. I would have taken a ‘mental health’ day.  But then ‘mental health’ days become addictive.  I loved the program that allowed workers who were ‘sick’ to come to work and sit in the lounge but be present. Too many people in Canada are working two jobs.  As well, misery loves company. Most of mental health is made worse by isolation. And with the addiction incidence, taking time off is a way often to maintain an unhealthy lifestyle rather than get the appropriate treatment for the addiction. Or move over and let someone else have a better job.
Easy for me to say now that the bed is calling my name. I was fortunate.  Thanks to God and coincidence and the universe and the force it was a light day.  Welfare Wednesday always is.  The welfare cheque for so many is the ‘party money’.  And the question arises is it better to just maintain this lifestyle and morbidity in society or to have more formal structure.
I’m a hard ass.  I’m economically grounded. I have strange old fashioned ideas of community and public health. I was in the park today and there were more needles.  Suddenly the ‘needle exchange’ program became the free needles and proliferation of needles  and needles on sidewalks, parks and back alleys and one begins to wonder whose making all the money on this obvious waste and the creation of a public health hazard.
But I worked with others.  Patients were motivated and cooperative. I didn’t have those critical entitled people demanding more from a product that was already free to them.  I didn’t have any more threats or outburst or stuff stolen or the extortionist tactics. I didn’t have any attempts at sexual manipution or physical overbearing. It was just a normal day at the office. Some interesting pathology.  We gathered as doctors to listen to a chest which is likely pulmonary embolism.  We discussed what people would do if they had a gun placed on their desk like I did.  I explained why  I didn’t call the police.  I shared why I didn’t.  We had lunch and talked about the differences between women and men and how little women seemed to know about the world we lived in.  We discussed the way male and female patients had threatened us in our work and the standard patterns.  The triangulation of the women and the attempt to use a proxy while with the men it was always one on one.  The doctors expressed their fear of angry women patients and their experiences of delayed and indirect violence. We laughed about the irrelevance of media.  There was a certain camaraderie.  Staff joined us and we joked together about the demands of work.
It was good to vent together.  Black humour.
As the day wore on I didn’t feel so much alone.  Dinner with my doctor friend he shared his own sense of alienation.  We laughed about aging and how simply growing older made us less ‘attached’ to the things of this world.  Everyone was dominated by the environmentalists. Nothing could be done now without their unelected input. They seemed to be stopping everything everywhere and extorting millions if not billions from society but no one seemed to care that overnight this ‘conspiracy’ was all the vogue.  Every other ‘conspiracy’ was challenged by the lies upon lies of this latest collection of ‘cults’ some scientific, some pseudoscientific. All of them were ‘prophecizing but it was called ‘predictions’.  Isaiah would roll over in his graves to hear these priests with this mumbo jumbo.
Meanwhile I’m waiting for my $50,000 back pay and wondering when I’ll ever get the million dollars I lost in time playing bit parts in others make believe dramas.  I was the distraction. I was the scapegoat. I was the statistic that justified the powers turning their back on the baby killing en mass.  Lets keep an eye on this radical while the suits steal the bullion and kill as many as they can in the meantime.  Soften everyone up and make things so bad ‘physician assisted suicide’ will sell like abortion, marijuana and hotcakes.
The Israeli F35’s are being deployed.
China’s leaders have stated through their media proxy that they want to rule the world and that they must be prepared for war against the west.  They’re threatening war against everyone of the neighbours and continue to kill feminists in the womb while creating an excess of men.  Sunni terrorists expand everywhere and security becomes more and more difficult to maintain.  It’s a fragile thing this thing called freedom.  We’re on the verge of war with the threats of catastrophic earthquakes and tsunamis pending.
I’m older. Tired.  Glad to have got through this day.  I’ve prayed and even meditated. The gloom didn’t lift till dinner.  There were moments of light but the burden was ever present.  I don’t like this chronic adult hood.  There doesn’t seem to be any freedom on the edge of life.  We talked of our caution.  I shared my planning the Atlantic Expedition.  I can see myself sailing the north Atlantic islands .There’s something to the purpose. This slow moving continuation of the incomplete sail to cross Mexico or Panama disrupted then by lies and addiction.  Such a major set back.  Now the South Chinese seas are full of pirates and further along there are Somali Moslem killers. Everywhere Christians are being persecuted but the news refuses to talk about this.  It’s politically correct to kill Christians.  One can kill white men too.  It’s especially good to kill old Christian white men or even old Catholic white men.  Just don’t kill lions.
We talked about the effort to survive that the old are faced with now.
It’s been a long day.  I will sleep and this day will be over.  I showed up for it.  The meeting was good.  I was glad to be among friends.  Full house tonight.  Some military folk.  Doctors movie people business people, beautiful people.  Moments of bittersweet nostalgia.
Thank you Jesus.