Emotional Problem Solving

I always wondered why my parents talked about the weather so much but now I know.  Grandad was a rancher and dad was an engineer.  Grandmother was a farm woman and mom was a journalist home maker.  They had a whole lot of experience between them.  They paid attention to the world around them and people.  They drew on this  vast wealth of ‘traditional’ and ‘conventional wisdom’ .

When something wasn’t right with them they first considered the WEATHER.  They didn’t think that they should kill themselves, divorce or change their jobs.  They just knew that commonly people are affected by the Weather.  It’s even been shown that on Wall Street trading increases on sunny days and decreases on rainy days.  It’s really not rocket science.
Next thing the old people talked about was the GOVERNMENT. Whenever anyone felt badly and were uncertain of the cause they considered the influence of Government on the overall well being of people.  Government decisions can make or break a country and can destroy individuals lives with their wars, tax programs, corruption, graft and deceit.  Throughout history next to the natural catastrophes caused by Weather, Government is the greatest source of catastrophe and illness.  That said we all know that if the Government is good and respectable and responsible there really can be peace and love in the valley.  When Governments are mature and thoughtful and productive not wasteful the society as a whole improves with general well being spreading through the land.
Old people also realized that FINANCES were a major source of anxiety and depression.  Not only research but common sense tell us that the poorer one is the more one is at risk for negative events and the more negative events one encounters.  This was truer before the social ‘net’ of modern societies which ‘catch’ people when they fall.  There’s loans, disability, welfare, food lines and charity, all manner of resources that protect one from the ravages of starvation and ‘debtors prisons’.  In some Moslem countries slavery still persists so it’s really not in some distant past that financial problems lead to really bad outcomes.  We really take this granted often simply because our education has been basically shoddy and substandard.
Naturally most of these social security developments in the First world are not present in the Third World. Their development also did not occur in a variety of cultures and historical societies but are increasingly taken for granted in the present day democratic societies most of which began in the enlightened Christian cultures which believed in ‘second chances’.  By contrast this was not a part of the ‘law of the jungle’ or ‘social darwinism’.  It’s a whole separate history to follow the rise of ‘charity’ for ‘strangers’ not just family and tribe but ‘outsiders’ and consider this by culture and religion because again it’s something most simply take for granted not realizing how unique and extraordinary this is.
That said there’s a serious issue of ‘relative wealth’ in that people adapt to certain ‘incomes’ and ‘financial capacities’ and experience loss of ‘status’ with any reduction in FINANCIAL SECURITY.  So old people had savings and made sound investments and recognized that ‘bad times’ could come. Farmers had to save for bad weather years, the droughts, and families ‘saved’ for sickness as sickness was commonly associate with loss of work capacity.  When a person felt badly they commonly recognized that they were fundamentally anxious because of FINANCES and set about remedying this by reducing unnecessary spending and looking for ‘extra work’ to increase savings and security.
HEALTH is commonly discussed by middle aged and older people. Young people are generally healthy unless they have chronic illness from childhood. Most take their ‘good health’ and lots of energy and ability to go without sleep or meals for granted yet as they get older commonly they don’t realize that their well being is directly related to their overall physical HEALTH.  When a person sees a psychiatrist the first thing the psychiatrist considers in investigating a person’s anxiety or depression is whether there is a physical cause for negative change, how long that negative change has been developing and if this might not just be a product of a temporary illness, like a flu or ‘something that’s going around’.  Old people with a variety of chronic illness, arthritis, diabetes, heart disease, bowel diseases, lung diseases will simply consider that a bad day or week or month may be because their physical illness is worse. Chronic physical illness, like all psychosomatic illness responds to external stresses but can be it’s own source of stress.  When I’m well a hemorrhoid might not bother me but when I’m already anxious or depressed the bleeding hemorrhoid, a really minor health problem, may be the straw that breaks the camel’s back. It’s because of this that people faced with general malaise, anxiety or depression, or just a lack of well being and a sense they’re not happy as they might be, commonly go to their general practitioner and discuss their health concerns with them or talk about their HEALTH with their friends and family.  Maybe an antibiotics which cures a urinary tract infection is all that is necessary to right the problem. Maybe a change in diet or exercise or an increase in an anti inflammatory medications is sufficient.
Successful people faced with lack of happiness, a sense of feeling that they are not enjoying life, feelings of emptiness, or too much anxiety and maybe a sense of depression consider early their RECREATIONS.  All work and no play makes Jack a dull boy. The World Health Organization took Freud’s simple definition of Mental Health, ‘the ability to work and love’ and extended it over two full pages but really only added that Mental Health is the ‘ability to work, love and play”.  A lot of people have really barren personal lives yet somehow expect they should be happy. The adage is ‘Misery Loves Company’ and as we are ‘herd animals’ we need social outlets. Maybe our work is not that social or our family just not enough. A major proportion of todays’ divorces occur because young people want their partners to be their ‘all’, (friend, parent, therapist, lover, cook, parent, cheerleader, etc ,etc).  We all come from a tribal society where everyone was interconnected and all had close to dozens, a hundred or more people to turn to.  Today often people’s lives are sterile.  They work and eat and sleep and wonder why they suffer anxiety or depression.  Really , they need to get involved, take up some ‘sport’ even if it’s just, walking with a group.  There are countless clubs, activities, ‘MEET UPS’ on the Internet, and community organizations, and schools, churches and temples.  Really, commonly a person’s life is ‘boring’ because they are ‘boring’ and don’t have any activities in their life because of their narcissism and selfishness and unwillingness to ‘SHARE THEIR TIME”.  These people are time hoarders but like most entitleed people want something for nothing.  Yet a problem shared is a problem halved and loneliness in modern society is so often described as ‘anxiety’ or ‘depression’.
FRIENDS are either as source of joy or a drain. Some are down right ‘soul suckers’ and others are chronic ‘kafetches’.  Many are ‘takers’ and ultimately one has to seriously consider how much time one has to be an emotional cheer leader of those who haven’t a minor or occasional problem but have a chronic recurrent unrellenting series of crisis.  In life saving the lifeguard is taught to swim out to help but not let the drowning person pull them down with them.  Whole communities are alcoholic or drug addicted and frankly some people need to get right out of these hell holes to get away from those who would drag themdown.  In Canada and in communist countries in general there is a phenomena called the ‘tall poppy’ syndrome which means that the ‘group’  because of some ideology actively stop those around them progressing.  They chop down the ‘tall poppy’ or ‘chop off the heads of others to make themselves look taller’.  In some tribal communities those who are doing well will have their homes broken into and wealth stolen or even have their house burnt down.  Many communities of ‘friends’ are gang like where the expectations of the ‘group ‘ is for the ‘individual’ who succeeds to ‘share ‘ his success yet this ideology destroys initiative.  Why should one person ‘work’ at an extra job and then share the reward with those who didn’t put out the effort.  A lot of individual lack of success is associated with ‘friends’ who are negative and ‘belittling’.  Being around people who say ‘nothing is going to change’, ‘life suck’s’ and various other ‘depressive statements’ is Depressing.  By contrast those who succeed and are happy commonly are surrounded by positive people. People who are enlightened are generally encouraging and supportive of those who wish to learn and excel but shy away from those who live by stealing and fawning relationships.  It’s often that we don’t have to  ‘end’ a relationship but rathe that we need to ‘distance’ ourselves or ‘spend less time’ with people who are ‘wallowing’ in their negativity
WORK is often a source of anxiety and depression but few throughout history had the LUXURY of NOT WORKING or even CHANGING THEIR JOBS.  So many accepting that work is principally to pay for the physiological needs, and provide fundamental food, clothing, and shelter simply accept their work.  They stay in less than perfect jobs because they see that those who jump around from job to job commonly ‘take their own selves ‘ with them.  PERSONALITY DISORDERS are primarily identified by the inability of an individual to stay at one job for a year. A red flag goes up with those who are workers when a person can’t last a year in the ‘class’.  Our school system was supposed to provide this basic capacity.  4 seasons, one job.  Admittedly there’s many factors to be considered but there is a direct correlation of “success’ and ‘happiness’ and ‘general well being’ for those who ‘stay’ at a position. There’s even a thing called ‘position authority’ which gives status to even a bull frog in one pond that stays rather than jumping from pond to pond.  Work is not only associated with activity which by itself is healthy but its a place of socialization which is also healthy. Buddhists even designate ‘RIGHT LIVELIHOOD” as essential to enlightenment recognizing that a lot of jobs intrinsically are depressing, risky, unhealthy or simply dehumanizing.  Prostitutes collectively are unhappy even though many ‘chose’ the job for quick wealth  It just doesn’t have the long term benefits that teaching children has.  Survey a hundred prostitutes and a hundred school teachers and the evidence is overwhelming that prostitution isn’t a very ‘high quality’ job.  The whole job world is laid out in terms of education, financial reward, risk, and effort.  Entrance level jobs have the real advantage they need low education but they commonly lack security and rarely have long term financial reward.  One has to seriously consider their work in light of what they want and what their present and future desires and needs are. All too often people have been satisfied with a particular job and had a whole lot of short term benefits from that job only to find that one day the job didn’t have longevity. This occurs with athletes and commonly with dancers.  If one doesn’t have a fall back plan or a plan to progress then it’s not uncommon for crisis to arise which could well have been foreseen and prepared for.  In today’s world it is expect that people will have three careers minimum in a lifetime and those who are “coasting’ will likely encounter job problems. While the ‘coasters’ are blaming everyone and everything for their loss of work, the rest have been upgrading their skills and taking extra training at night anticipating that their job as a ‘steam engineer’ is less than permanent.
FAMILY is a fixed ingredient. Those who are fortunate are born in loving families and learn the ART OF LOVING (see Erickson) and know that LOVE Is not something that just “HAPPENS” but needs to be nurtured and maintained.  Successful happy families pass on the SKILLS for happiness to their children and commonly this learning leads to generations of success whereas the poor believe the success is only a product of the individuals in this segment of society starting with a ‘financial nest egg’.  If this were true then those who won LOTTERIES would be similar examples of personal and societal success.   However,  commonly those who ‘win lotteries’ lose them just as quickly.  One of the reasons AID works so poorly is that it doesn’t ‘teach’ people how to produce more successfully but only cares for their needs that one day. Often what a family teaches is the cornerstone to the success of the members whereas equally so a family can be perpetrating ‘self defeating’ ideologies.  It is important to remember if we had sent Einstein to a tribe of Cannibals they would have thought him a tough rooster at best and learned nothing about energy and relativity because they were simply not capable of appreciating the genius of the man.
 Therapy was not about ‘rejecting family’ or dishing parents but about sorting out the useful teaching from the commonly once useful but now outdated ideas.  A mother might teach her daughter to avoid black men because when she grew up black men were migrant and poor but today that very statement might be a limiting ideology if the majority of black men in the community were hard working successful individuals.  If a person is a live today it’s thanks to the parents simply not killing them when they were vulnerable.  Since life if fundamental and without it all else is nothing all parents are 50% good.  Fish eat their eggs and reptiles leave them to fend for themselves.  Therapy isn’t supposed to be about ‘blaming’ but rather about understanding and learning from the past to make the present and future better.  Therefore each individual must recognize the contribution of history and not dish it outright.  Further today people commonly judge the past by the yardstick of their own limited understanding.  Dickens said, “it was the best of times and worst of times’ and this is true for all times. The trick is to be selective, learn from and make valuable alliances. Family are the main stay of society and the STATE is threatened most by family. Alone individuals are likely to perish but the capacity to form networks and communities is central to the happiness of individuals. This begins with the family.  When I worked with the most mentally ill they commonly had the worst family relationships and least social skills.  If the family can be strengthened most commonly success for individuals follows.
The LOVED ONE, the PARTNER, the most intimate sexual partner has through all cultures and classes been associated with the greatest joy and happiness at some time.    Many a person has said that their life is made by the finding and nurturing of their soulmate.  This is the person they marry. This is the person we have sex with. Sexual relationships are limited to those who we are willing to be most intimate with, most vulnerable with, closest too.  A ‘casual relationship’ is never truly casual but marriages and long term sexual relationships define emotional landscapes for all.  The Loved One is the most important person in a person’s network of relationships. That person is commonly the father or mother of the children, the most important person in the family, and the one who can most affect a person’s emotional life positively or negatively.
IF mental health is the ability to love, work and play, then it follows that a person without work or school, without a Loved One or Family or Friends would at most register ’30’% generally on a happiness scale. Those who lack that most important cherry on the happiness cake , the loved and loving one, at best might only approach a “B” grade  in the overall likelihood of general well being. There are clearly exceptions, saints, heroes, hermits but generally speaking our sense of well being follows from this simple analysis.
Now the must successful and mature people do not ‘change’ their ‘loved one’ or their ‘job’ first but progress through an analysis of what is lacking in their lives by starting at the outside.  Maybe it’s just a bad hair lousy weather day and that one could consider buying and umbrella or taking a vacation to the hot spot or improving the use of sunscreen.  There’s a whole lot of solutions to the ‘weather’ problems. I took up cross country skiing when the ‘weather’ was forcing me to curtail outside activities and I felt a prisoner in the winter city.  My general well being improved immensely. My friend has made a point of cycling and winter swimming at Wreck beach at least twice a week ‘getting outside’ and ‘facing the elements’ and their sense of well being and decrease in anxiety is amazing to see.
Recently a whole group of people rioted because they didn’t like the government but studies showed that 70% hadn’t voted.  Most of these government activist complainer types commonly don’t even join a political party.  A friend is a professor of political sciences and I watched her acquire her wisdom and generally amazing calmness around matters political by gaining in depth knowledge about the mechanisms of government, anthropology, sociology and the misinformation of media and propaganda.  When she was a student government most upset her but today she’s probably the least ‘upset’ person I know in this regard because she is actively participating in government, making things better for herself and other individuals.
Countless times I’ve seen people’s general malaise and depression a product of something so simple medically as hypothyroidism.  Depression and anxiety are commonly the presenting symptoms of countless treatable illnesses. Increasingly most depression and anxiety I see has it’s roots in addictions, substance abuse, alcoholism, pornography, eating disorders.
Work problems arise in every job and in every life but rather the ‘take this job and shove it’ over the years mature individuals have formed unions, discussed the negatives of their job with co workers, counsellors and even the boss.  These minor changes in a person’s life can reap amazing results in solving emotional problems
Obviously spending less time with a ‘soul sucker’ , that constantly ‘needy’ , person always bitter and always complaining, will lead to less stress and more room for positive relationships.  Maintaining contact with family but modulating the time and distance of the relationships is a sure fire way of improving one’s happiness simply because these are the template of all relationships that follow and the source of so much joy for those whose lives are most successful.
Finally the most mentally ill commonly admit to having their longest intimate relationship as under a year, under five years, or under 10 years.  Relationships are like vehicles and if you keep crashing or trading in your primary vehicle for relational happiness then you really would benefit from seeing a psychiatrist not to discuss what the partner is doing wrong but to learn what others do right and what you are doing wrong.  The Gottman Institute “love labs’ studies successful happy couples and unhappy couples and scientifically came up with a set of rules that are simply not rocket science but really do give a decent basis for  setting up or repairing broken relationships before they get trashed by this ‘throwaway unhappy society’
The main reason I wrote this though was to simply encourage people to consider problem solving from the weather inward to work and loved one rather than dumping the job and life partner only to find it El Nino was all that was wrong and if you’d waited a year the weather would have improved and you could have saved the cost and pain of trashing work and love.
Finally spirituality is associated with the greatest happiness and joy for most people.  Research shows that spiritual people are overall happier and more prosperous with greater security and success. This doesn’t mean any one religion or any one moral prescription is right but it does tend to challenge atheist political idealogies that reject the spiritual community lives of the most successful individuals in society.  Perhaps when all else fails or earlier ,one might consider, as Victor Frankl, the psychiatrist who survived Auswitch, encouraged, asking yourself "what is the meaning of life”.  What is your relationship to God   Or  perhaps change the word, God, to  the GOOD.  What is the Good to you or what is the GOOD LIFE.  Often emotional problems solving follows ‘reframing’ the question'.
In the end it’s your life.  Enjoy.

TGIF - Thank God It's Friday

I love seeing patients.  I love helping and healing. I love listening and teaching and working one on one.  I loved working with groups as much too. 
Yet I've grown old.  I've been working the equivalent of three full time jobs for more than 35 years as a physician.  I began working part time at 16 and full time at 18.  I paid my own way through school working and  with scholarships.  I was denied a bursary because of my parents hard earned assets. I had to take some loans but not like the students today. I remember my parents both working from morning to night. My grandparents seemed to work even harder.  So I've worked.  Along time.  At very difficult jobs. 
Einstein said Genius was 99% perspiration 1% inspiration.
I am today tired at the end of the day.  Really tired. My body aches and my mind doesn't seem to want to concentrate on anything.  It wasn't but a few years ago I did two evenings a week of night school for years to eventually obtain an M.Div or Master of Arts in Theology, whichever way you want to call it.  In addition I have always done hours a week of medical and psychiatric reading directly related to my clinical work.  Lots of journals and searches. Lots of books specific to cases. Lots of neurochemistry, neurology , psychopharmacology and psychotherapy training. Years of applied formal study, writing and course attendance beyond my already advanced subspecialty training (12 years of post high school education and several more medical certifications).
This evening and weekend work boggles my mind today. I don't know where I found the energy.  I am exhausted by the end of my day.  I am up at 7 am and have a commute from Burnaby to Vancouver that fluctuates between 1/2 hour to 1 1/2 hour depending on city administration. 
At work my patients are collectively angry at me for  'running late'.  I am on call 24 hours seven days a week and have been most of the 30 years of work as a physician. Many years I was called into hospitals or clinics. For years I did home visits and answered emergency calls night and day. Now and for some years I rarely have to leave my home. I can answer most questions over the phone.  There's advantages to being in a big city but the generalist -specialist system in the province broke many years ago.  Every patient was supposed to have that Rockwell Painting Family Physician.  Now the patients I see so often are without a physician. They go to walk in clinics where the relationships they have with their doctors is less than they have with their shoe salesman. More often than not as a subspecialist, I'm doing specialist and generalist work.  More often than not I know my patients more than any other doctor.  That's supposed to be the job of the high paid generalists. Meanwhile they're just trying to manage the declining value of their education and their increasing costs of being any physician.
I have had 3 marriages.  Two of the those marriages I was the caregivers of sick wives with sick parents for half of the two ten year stretches with professionals.  I never escaped from work.  All day with depressives and all night and weekend with depressives grieving.  They were over worked and over tired  physicians too and suffered caregiver burden. I was going from work to home work to work.  I suffered 2 divorces in which I was blamed and condemned and punished and humiliated and ostracized and brutalized by society, women and the courts despite the fact that I'd actually entered Canadian marriages, one of the least attractive arrangements for men in all the world comparatively, three times.  Three times I made a commitment and did my utmost best to keep it and failed like 50 % of society who do marry as increasingly most don't.  I could have done better.   The majority of Canadians don't. I lasted 10 years at a time. Most marriages these days only make it to 5 years.  The blessed 30% of society that have long term marriages are rarely 'dual income no kids'.  The women mostly have children and the men are mostly better off financially. They're commonly associated with a strong faith and community support and have parents who stay together and are supportive. My parents stayed together, a loving hard working couple. I married women who came broken marriages with angry mothers or fathers who drank too much. My wives and I drank too much. A lot of Canadians drink too much.  Those who do have a much higher incidence of divorc.
Today men eschew marriage and sharing of their assets since the  great pillage of the 80's and 90's when Canadian women were called the 'best housekeepers in the world' because 'they always got the house.  They also got the children mostly and men collectively were called 'rapists' and 'dead beat dads'.  When men weren't being ridiculed and shamed as a 'class' and as a 'group' they were being told about their 'entitlement' going back generations.
Yet men had shared their work and wages with women and their children collectively.  When women became principal earners collectively they cared for their children but rarely cared for the man as well. A large proportion of the Yuppie women took their high earnings and lived the life they had disparaged in the 'playboy' man, themselves now the 'play woman' enjoying owning their own homes, travel alone or with groups, and some even hiring male prostitutes ('companions') or flaunting their younger (boytoys).   Hugh Hefner is scandalized while the Kardasians and Mila Cyrus are eulogized.  Penthouse letters were scandal whereas Harlequin romance became racy and '50 shades of grey" was the new female Story of O, a Babarella for the girls who celebrated the 'independence' of Hanoi Jane. 
I just went to work. As physicians, male and female, we talk about missing out on whole decades of cultural phenomena.  50% of my class were female doctors.  As male and female doctors collectively had the equivalent of 2 or 3 jobs. Among ourselves we noted that fewer women went into the tough heavy lifting of surgery with it's increased income and more went into psychiatry with it's light lifting flexibility.  None of us except perhaps the government doctors worked an actual one job equivalent.  All of us did the equivalent work in hours alone of 2 full time jobs and some of three full time jobs.  A full time union job is 30 to 40 hours a week.  They have weeks of vacation leave, maternity leave, and sick time.  We have consistently been recorded as working 60 to 80 hours and some of us  100 to 120.  In private practice this is direct patient contact.  We don't have paid leave. We don't have time off. We don't have maternity leave. We don't have sick leave. In public practice the 40 hours may well be half committee and administration.  I saw the least number of patients ever when I worked in government.
By contrast in private practice I'm running a business with increasing demands and costs and frankly given the hours I put into the work I've never made 'minimum' wage. Recently an MD MBA doctor in Ontario published his 2 year experience as a physician in private practice and closed his office and concluded that at most he made $25 an hour and couldn't foresee paying off his education debt working as a clinician.   I've made a half million gross one year but at the end of day I'd lived my work. I'd done the higher risk and most horrendous work a doctor could do.  I'd made myself ill with the stress of trying to meet the demand of patient ever ducking from the bullets shot at our backs by the administration and ministries.  They all 'lead' from behind like the Russian did in WWII shooting in the back anyone who faltered.  Medicine doesn't collectively have an advanced administrative model.  There are platitudes and laws  upon laws and pretty graphs and lying paper work but at the end of the day it's a very 'toxic workplace'.  Hospitals are apparently worse given the high turn over of staff.  All the surveys of medical 'well being' and 'job satisfaction' suck for front line workers.  The government and administration doctors and the high paid doctors who do some kind of lucrative 'procedural' medicine fair better.
More hours for me aren't like union jobs  with time and a half or double time , the work I did was lost to staff and overhead and increasing costs of work till at the end of the year I took home what a worker my age makes for a 40 hours job.  I'd worked over a 120 hours a week in high stress work. though.  My life has been threatened repeated. I've been attacked.  I've had psychopaths make false allegations and lying complaints that have cost me unmeasurably. I've caught deadly diseases and done things and seen things that wake me in the night screaming with horrible nightmares. I did not ever 'cherry pick' my practice.  I just did the work, serving where I saw the greatest need.
Like most people,men and women, who work, I've benefitted from my work. I've had houses and travel and vehicles and outward signs of success in some ways.  But I'm unable to own a house in Vancouver. I've bought houses and been an indentured servant to the mortgage, having no money but paying a mortgage instead of a rent and at the end of the day having 'no rights' with regard to my property, as opposed to houses in other parts of the world. Then there was property tax and a general sense that the whole home ownership 'scam' wasn't what it was like when my dad bought a home which profited him to own and he could do what he wanted on his property without police invasion or being accountable for people hurting themselves on his property.
I ve watched the corruption in society move from gambling and sex trades into construction with the Charbonneau Enquiry confirming what we all thought, that the Bikers and Mafia controlled the city and the construction industry was more corrupt than the sex trade.
I have sat year after year as I saw one person after another ruined by the corrupt system. Everyone pays exorbitantly to protect ourselvesfrom such horrors but the protection units and insurance agencies seems mainly there to collect money.  Taxes have skyrocketed as services have declined.
These generalization seem the stuff of hell. My perception is the half filled glass versus the half empty glass but I'm looking around at those who were criminals and those who took the easy road and those who shirked and I'm still working and still paying for them.
I have this sense, wrongly no doubt, that I am carrying the world on my shoulders and the fear that after all these years of working and being taxed more than 50 % , there's not going to be a bed for me to die quietly in , hopefully with my boots on.  I think horses are better treated than the working Canadians since they can be put out to pasture while physicians all around me live without a pension. Our government colleagues and those who got out of patient care did the smart business moves and got into the big buck jobs and the big pensions.  But the rest of us who saw the patients and did the heavy lifting, since the 'frontlines' are where the horror is, in medicine and in war, we had to rely on RRSP's but the economy collapsed twice and around me 70 year old doctors are selling their houses and returning to work because they lost their shirts in the financial collapse. Those with pensions were protected by the government and their problems buffered.
Those government politicians with 'trustfunds' and questionable morals and ethics did best of course.
Comparison is what ails me.  I compare myself with those doctors who see a dozen patients a week or attend one or two clinics a week.  The Quebec doctors objected to having a mandatory number of patients of 15 or 20 a day. I saw 30 a day when I was a family physician, sometimes a hundred a day in crisis, and as a psychiatrist it's not uncommon for me to see 15 to 20 people a day though theoretically I'm booked  only 8 to 10 hours a day.
I don't leave the office till 6 or 7 most nights, sometimes 8, rarely have lunch, sometimes eating a sandwich talking with a patient, don't get the requisite 10 minutes between patients or the 15 minutes to write notes and never the 15 or 30 minute coffee breaks.
And other than the thanks from my patients I am subjected to constant criticism.  I am in every way 'guilty until proven innocent', vulnerable and tired.
I'm tired. I go home at night exhausted and often look forward to dying to get away from the constant criticism. No doctor in Canada is 'good enough'.  There is no security.  I am not perfect yet there is an industry of lawyers and bureaucrats who are suboptimal at all levels who demand that the front line workers have a standard higher than any of theirs.  They hypocrisy is stifling.
Then i talk to my colleague in the army.  For every soldier who is in frontline combat there are 100 people making a profit from his sacrifice.  He is the lowest paid.  He has the highest risk.  He is lucky if he is killed by the enemy.  One third of soldiers are killed by 'friendly fire'.  One third are killed by the grossest incompetence of their superiors.  "Charge of the Light Brigade." "A Bridge Too Far".  Hitler sending the Germans to Russia without overcoats.  The list goes on. I laugh. My friend who is a psychiatrist in the American military answer to a little Napoleon of a social worker who knows bugger all about anything.  She has me in tears with her stories of this puffed up cock of the walk.  I talk to a wise man, one of the mentors and guru priests/ministers I lean on.  He reminds me that I'm 'worrying about the future'.  Of course I know God is in the present.  If I'm angry and irritable it's probably a fear or a resentment. Resentments are in the past. Fears are in the future.  If I get myself clearly in the day then I'm in the NOW and being in the NOW means I've WON> It's called the PRESENT because it's a gift of god.
My lawyer mind makes a case for 'poor me' and the judge mind compares me with all those selectively who seem to be getting a free lunch.  I describe the middle class in Canada as those who are carrying 2 blue collar babies under each arm and have a couple of white collar babies sitting on their backs while they're the only ones trudging along. Keep on trekking, we say.
And my military friend makes me laugh.  And when I'm whining as I'm prone to do I know all I have to do is throw my shoes into the pile of humanities and most likely despite searching through them all I'll take back those that fit me.  Other's successes come with their failures.  I'm got to stop comparing my insides with other's outsides.
God is good all the time. I have to accept this and have faith and surrender to his will and what he wants for me.  I am a worker and I have worked.  I have pulled my weight and them some.  Those who haven't are the first to criticize.  I find that the more I talk with others who have been there the less cognitive dissonance I feel. The more gratitude I have the better I feel.  There is so much more I have to be thankful for. I really must cultivate more gratitude.
TGIF - Thank God It's Friday!!!!!