IDAA 2019 Knoxville Tennessee, Part 2

It’s Sunday. I’m sitting in the Knoxville Market square.  I’ve just come from hearing Lori share her experience, strength and hope. She’s a humble heroine of the soul.  What an amazing story of hope,  growth and humor.  With epidemic suicide rates among doctors I’m so glad she found her way here.

 My personal nemesis has been sociopaths and psychotic people in power. I’ve fulfilled my contract, doing the best possible healing,  with the best training. I’ve served, reducing  “morbidly and mortality”, fighting disease and saving lives. 

Today that’s of little importance compared with ‘political correctness.’  Today,  the patient can die so long as the ‘chart’ lives. It’s all about spin and who you know. 

My police friend described her leaving the force saying, “I became a police woman to ‘fight crime’ . At the end end all I was allowed to do was ‘record’ crime’.  I feel like I joined the best hockey team in Canada. However today the  coach  only excelled in writing memos. Instead of firing coaches, doctors are required do more laps of the ice.

Lori’s challenges were family, sense of loss and betrayal traced back to childhood. I suspect my anti authority issue could relate to  being caned and strapped in school for ‘talking back’. 

 IDAA is always a time of deep reflection.  It’s not a place to ‘blame’ as much as I enjoy that. We discuss ‘choices’. 

In the psychiatry breakout meeting we talked of retirement, hearing among others, from my favourite retired psychiatrist,  his joy in welded art. Others talked of ways of winding down. Meanwhile the youngest heard  our stories and shared their own struggles with their new careers and their aspirations. 

It’s sadly the only place in the profession today that we talk openly and honestly without fear of retribution by the authorities or ‘loss of face’.  I attended the national medical meeting and enjoyed the didactic ‘fact’ lectures somewhat but felt so much ego. I was glad I’d worn my suit and tie. 

At IDAA most everyone wore shorts and Hawaiian shirts except for the banquets. The girls looked great in sun dresses. The ladies were so elegant. The group cleaned up well. Every conference there’s a thousand present plus or minus a hundred or so. Some 40,000 plus are active members. 

Saturday night banquet Merve gave the most succinct and moving banquet speech. He described his journey of recovery as a series of interventions  of divine and human love. He ended his extraordinarily miraculous talk with a quote from the Doobie Brother’s “Without love where would we be now?” “Without Love where would we be now!”. 

Of course,it was a medical conferenece too. That day I’d attended a terrific CME discussing reward centers, the amygdala, nucleus accumbens, the pre frontal cortex, and effects of dopamine and oxytocin. which drugs did specifically what. We even learned the genetic codes associated with predisposition to alcoholism. 

The Friday CME was especially good. I loved Dr. Michael Baron’s talk, Prescribing and Pain. In Tennessee the doctors prescribing opiates must attend two hours of CME on addiction and opiates. I was privileged to attend this, truly appreciating the combination of neuroscience , public health and common sense presented. 

Abstinence remains the treatment of choice  but Dr. Bill Haning's talk, Cultural Aspects of Addiction,  on Culture of Addiction emphasized that treatment  isn’t just stopping a substance but involves significant life changes to prevent relapse. The work addressed in this CME was about harm reduction and abstinence.  The speaker talked of the great benefits of AA fellowship but also discussed a variety of groups which also help. 

Having dealt with so much grief, such mind numbing, debilitating, heart rending sadness , I simply enjoyed the  Dr Jes Montgomery's talk on grief and recovery. It was healing personally and certainly gave me tools to help with patients.

Our small group discussion of illnesss and recovery, dealing with pain without opiates, avoiding relapse when opiates were needed post surgery, was highly informative.  I’d thought this group of doctors who were so good looking and smart were immune and immortal.  We all discussed  various illness we’d had and various treatments. .One had just had surgery. I’d had a dental implant. Another had arthritis.  It’s one thing to read  the textbooks some of which were written by people in the room, but a whole other thing to hear what people actually did.  

As a psychiatrist we learn about the ‘self’ , the false self, the ego, and  ‘persona’ . Quite frankly IDAA is the only place I really get to talk with other physicians,but especially psychiatrists. The other docs and specialists say it’s the same them..  I loved my colleague from a small town saying this was the only time he’d spoken truthfully and meaningfully with another psychiatrist in ‘years’.  

Training as an analytic psychotherapist  I’d early enjoyed bearing my soul and gaining  useful insights . But here it was even better because I knew that the psychiatrist I was sharing with had been divorced like me. No one claimed to have the answers here. No one was holier that thou. I just love the lack of hypocrisy. There certainly wasn’t any pomposity which seems to thrive elsewhere. 

Dick didn’t pretend he didn’t have feel pain walking. Cheryl didn’t conceal her love and concern. No one was just ‘fine’ (that’s an acronym which ‘fucked inside, nice exterior’ ).  Everyone’s hurting sometime. But here everyone knew that and also also shared their love and their joy. 

I heard the most wonderful stories of trips, travels, children and grandchildren, recovery and successes in work.I was so pleased my young Canadian friend was now on the national board. Several other docs I knew had completed fellowships, while others had become heads of programs and hospitals. 

Through the year I read about the ‘greats’ in our fields who I meet here.  World renown plastic surgeons and cardiologists with the rankest sense of humor continue to inspire me.  The most beautiful brilliant elegant ladies talking intimately about their disease and finally asking for help touch my inner being. I laugh and tear up more in these days than I do all year.

It was also so moving to be among the many there with incredibly long term marriages.  What examples these 30, 40 and 50 year married doctors provided. My friends Art and Carole have 53 years together but seem like high school sweethearts.  

I loved seeing Adam and Corinne when Corinne celebrated the Jerry Moe program sharing what it meant for her son. I loved seeing the Jerry Moe kids and the outrageous teens.  The babies and toddlers there represented hope and faith in the flesh.  

Overall I felt again I’d entered an adult learning place  of genius and creativity beyond the limited world of bean counters and administration that saw health care as commodity. I was able to discuss difficult patients and changes in treatment over coffee and in  hall way consults.  

The whole relevance of ‘sign in’ CME came up for discussion in our little group where the actual definition of a professional was so reminiscent of what I’d signed up for. “I learn from a patient. If someone comes in with something I don’t know, that triggers my research and consultation.  I don’t pay attention to all this other stuff that does’t apply to me and my area of work.”  The anesthesiologist shared.

That was exactly what I thought.   I will never forget administrative doctor shouting ‘doctors should never learn from patients’ they’re there to teach the patients’. By contrast,  at times over coffee,  it seemed like a ‘barter market’. I was sharing psychiatry jewels I’d been bequeathed to get in return dermatology pearls. This is the  way ‘adult professionals’ learn. But then we wondered if this only worked because we were in this IDAA bubble where it was okay to be to not know everything’, to be vulnerable, and to share. I joked about sitting at the ‘in table’ with Art and Dick and Graeme.  

It was fun to be at IDAA.  I emailed a friend who I hope to see at next year’s high school reunion saying, “IDAA  iwas like being at a doctors ‘ elementary school reunion’ . It could only be better if Jerry Moe and the kids let’s us join their program. All that was missing was the dance with the mirrored balls hanging from the ceiling.

Next year it’s Spokane. IDAA2020 Spokane.

I love the town of Spokane and already know some brilliant psychiatrists there.  I’m thinking of riding my Harley down and certainly wearing boxers even if they do ride up my ass.  I’m all signed up.  IDAA is like the love story “same time next year’.  

I know I’d never have been able to stay a doctor and especially a psychiatrist without IDAA.  I might not even be alive.  I certainly wouldn’t have this life beyond my wildest dreams.  I may not have the spaceship I want but I can truly say with the deepest gratitude I’ve had times of being rocketed into the fourth dimension.  I can’t wait to read the cyberdoc on line discussions (and gossip)  in the coming weeks.  I love hearing  Hugh, Nathan,  Zeke and Dave . I actually talked to two doctors Saturday  who had been to Antatica. One who worked there and the other wanted to see penguins. There’s something about belong to a group of doctors with characters like that.

God bless.

. 

Physician Burn Out and Suicide

I often feel alone.  Like a soldier on the front lines.  I’m working in clinical medicine with patients increasingly desperate with the lack of physicians and waitlists.  Of course I sometimes believe we have the largest bureaucracy in the history of health care with Committee Cancer and all the other waste of mismanagement.

Pamella Wible MD has been studying physician suicide.  Apparently our ‘perfectionism’ and ‘conscience’ are problematic especially when we aren’t given the support to achieve the unreasonable expectations of patients and leaderships. Increasingly the patient wants us to heal them while the authorities want us to do the least at the greatest saving to the system.  It’s like being a soldier again, on the front line, and they are handing out 3 bullets and telling us not to shoot.  The patients always turn their attack on the physician they see because the elite are so far removed in Space Stations feeling their Ivory Towers were no longer safe.  

It was great to learn too that the ‘disruptive physicians’ are indeed being scapegoated in most cases for the broken system. The principle problem is indeed the ‘blame and shame’ management of administration. Rather than address the crisis they persist in their antiquated 19th century management approach to law and administration by standards ‘cover your own ass’ bureaucratic strategizing and looking for an ‘indivdual to blame and shame’.  

The burnn out figure for physicians is 40% and often more than 50%.  That means there are literally hundreds of thousands of burnt out physicians functioning all across the US and Canada.  These are primarily the people in the front line. The worst hit are emergency doctors. The quip on the tape was ‘you don’t see many 60 year olds practicing emergency medicine’.  Dermatologists are by contrast fairly happy like pediatricians because of job satisfaction and reasonable re imbursement. As long as I’ve worked their has been ‘wage control’ on doctors with all the savings of our increased training education and skill being skimmed off to pay the outrageous costs of swaggering smiling CEO’s.  Burnt out physicians are at highest risk for making mistakes, depression, suicide and alcoholism.  No surprise, the ‘stress’ of the work causes addiction behaviours.  Not vice versa. PTSD is prevalent and it was found in the military the guy who bayoneted the other guy was at highest risk of developing PTSD and a third of these front line folk got addiction disease without any genetic contributions being found.  So despite what the ‘suits’ say it’s tough seeing patients.  The least likely to suicide are those in administrative medicine and doctors who have least contact with patients like radiologists or lab doctors. I expect pathologists have a pretty good gig too. 

But of course, the ‘blame the victim’ mentality prevails.  Instead of compassionate consideration that there is an endemic and epidemic stress level individuals who speak out about the gross inadequacy in leadership and often actual corruption these ‘whistle blowers’ are literally hounded and punished severely to maintain the delusions that the ‘emperor has new clothes’.  A brilliant study of the last Liberal Ontario Provincial government showed that the administration literally wasted ‘billions’ of health care dollars  by having a little chair shuffle on the Titanic.  No improvement in health care before or after the several years of changing names and meeting places for the duplication and triplicating of self serving leadership.

The suicide rate in the military was considered an epidemic when it rose past  23/100,000 but doctors are dying at a rate of 40/100,000.  And all they get is ‘blame and shame’.  They are also encouraged to exercise. 

The reason I’m happy to hear this is because I’ve been reporting the ‘systemic’ problem and the gross mismanagement of resources for years with constant back lash sometimes by individuals actually diverting clinical care money into their own pockets.  All the while I’m told I’m a bad doctor and that I shouldn’t  swear.  (I’ve been known to pull out my hair and scream ‘fuck!’ Or “I”m not going to take this shit anymore.    I love my female colleagues who have taken to keening in the hallowed halls.  We’re considering consulting those fellows who have learned to talk with gophers, chimpanzees and dolphins and such in the hope that they might learn how to communicate with management.   We need a Star Trek Unversal Translater or a Hitchhikers Guide to the Galaxy Babblefish because they don’t seem to be hearing the screams on the people.  “Give them cake,” is no longer a good answer even if today the new twist is  ‘Give them pot’.   There one skill appears to be pointing fingers and apparently they are selected for this one quality.  These are people who haven’t seen a patient in decades, see selective patients from Potempkins Villages  and are surround  themselves with echoing sychopahts., so out of touch with clinical reality as to be deemed psychopathic or psychotic, all the while Rome burns and Nero plays his violin.

Yesterday I listened to this presentation driving the 1/2 hour commute to and from work that because of the construction and bike lane chaos in Vancouver is now 2 hours making my previous 9 hour day job 13 hours a day.  

So I have hope.  Maybe physicians can finally stop metaphorically pouring gas over themselves and setting themselves on fire to bring attention to the systemic failures. Dr. Robert Hare studied Corportate Leadership to address the tendency for certain types of systems to promote sociopaths to leadership. The problem too was ‘bullying’ by physician leaders of physicians. This same problem had been noted in police organizations.  Wow.  Someone is  seeing the envy and petty small mindedness for what it is and naming it and actually looking for the ‘identification for the aggressor’ types who make the best ‘Capo’s’,  a term used to describe management strategies used by the Nazi’s. 

  

One step a head of the crowd and you’re a leader, two steps ahead of the crowd and you’re a martyr. I was thankful hearing the presentation as I felt less like a voice crying in the wilderness. The American Medical Association is putting millions into addressing this problem now and the take home point was simply that the whole of the present health care system was about to collapse unless management did something to address their own inhumane abuse of physicians.  In my minds eye I saw the German Army in Russia in winter and Hitler shooting the ‘messenger’ who told him ‘you have to send the troops overcoats.”  It was said that the British won the war because they cared for their people.  

I have hope.  Despite the commute, tt was a good day in the clinic.  

Molar Root Abscess and the Toxic Workplace

It’s not easy to admit to being a whimp.  I had an appointment to have a crown put on by Dr. Douglas Lovely, my amazing dentist New Westminster.  I admit I’ve loved going to him for 20 years because he’s literally painless. As a child our dentist didn’t believe children felt pain. It left as lasting aversion to dentists.  Doug’s work is the best.  It helps he’s a sailor and that all my doctor friends see him too.

The day before the crown my face flared up. A horrible night of sleeplessness and pain.  I was so glad to have the appointment.  My face was slowed and Doug did the xray showing the tooth was cracked and a “pea size“ abscess at the base of the second root.  The crown wasn’t anything but it was on a cracked tooth as well.  My gnashing my teeth in my sleep at night was catching up on me.  Doug gave me antibiotics and recommended high dose ibuprofen.  He had to bring the swelling down to extract the tooth.  Extraction was set for a week later.  

Tha night was awful. I don‘t do sleepless nights well anymore. Too many years of call.  First surgery and deliveries and later suicidal calls and drunken calls.  It’s been years though that I’ve had to go to a hospital. Still it’s hard to get back to sleep.  And a tooth ache didn’t help.  Doug warned me it might get worse before it would get better.  But I’m a whimp.  My face swelled out like a chipmunk with nuts.

I had to take the afternoon off work because I was just simply too fatigue. Fortunately the last morning of work was slow.  Doug had contacted me when I sent a picture of my lopsided face and expressed my abject misery. ‘It’s almost as bad as a man flu’ summed it out.  A lot of cowering and shaking by men all round.  Drum roll in the back ground. Images of the grim reaper. Women thoroughly insensitive.  ‘Tooth ache. ‘. ‘Man flu’.  Really? 

No one God has them deliver babies. I’d never do it.  I also concluded yet again I’d never make a spy. The first mention of torture and I’d give up anything to stop the pain. I was beyond Motrin and Alleve and ASA. I was on a cocktail of all three at three times the recommended dose.  I was a toxic waste dump of NSAD’s.  I understand and always have why people who aren’t treated sufficintly for pain by doctors turn to the street vigilantes services for pain defence.  Pain is thoroughly underestimated by bureaucrats and anyone who has not known it’s bite.  

I couldn’t bite either. Soft foods and soups and embarrassing drool out the side of my face.

Bleak.  Suicidal. Rethinking euthanasia.  Paranoid moments. Wondering who might have caused the toothache. Was it the Russians. Was it radioactive.Did Trudeau do this. All else evil in Canada today can be placed at his stupid feet. Why not my tooth ache.  3 and 4 am arre ripe times for vivid imagination.  Was the chip some government lab had placed in my tooth finally needing a battery change. I’ve heard all the best ideas from schizophrenic patients. Even Freud concluded they might be right.  Doug would tell me if I had a chip in my tooth and the battery needed replacement. He said he’d take it out and then do an implant.   I don’t have dental care.  Only illegal immigrants get that in Canada.  Who cares what the cost is when your eyes are bulging out. I even thought of going to the hospital emergency for morphine but remembered this was Canada and I’d wait for 10 or 20 hours in the waitroom for a shot of morphine exposed to all the latest virus bacteria and the hell of Canadian ER’s.   Light would come soon.

Doug was in Whistler but called my pharmacist who gave me Dexamethasone and Flagyl to add to the Clindamycin.  Dougs voice is reassuring.  He calls after all his work.  He still cares. Doctors are punished today for caring.  The administration is swaggering and arrogant, the worst in the civilized world, 20 times what is needed, doctors hated by government here, the fewest in the civilized world, longest wait lists.  







 I watch a video of the Ontario doctors speaking out against the Liberal government there. I think of all the patients who are so desperate and angry and how little we have to give them anymore now that all our health care resources are devoted to government administration and doctors are condemned for unprofessionalism because they won’t kill themselves fast enough. The paper work and the endless rules and committee ivory tower bullshit destroying us as the patients cry and come in angrier and more and more in despair. Everyone has gone without to pay the outrageous taxes and all the money goes to debt and administration. It’s so depressing on the frontlines.

I’m thankful that dentists are still free of the scourge of Space Station administration arrogant in their ignorance of the death they cause from distance and negligence.  

I’m unhappy.  A Christian biker died.  He was a friend as much as anything.  He loved his gal. He loved Jesus.  I’ve not adjusted to the dying these last couple of years.  Family, friends and the epidemic of fentanyl. It was bad enough working front lines through the AIDS epidemic. This is worse.

The government blamed the doctors for the opiate crisis.  I read last week they were totally off. Their calculations all wrong. Their false accusations like all the other fake news right out there.  It turns out that the fentanyl is just another Chinese attack and part of the drug wars. ‘Whatever minor factor ‘overprescribing’ is ,is the least concern. But there goes our government demonizing doctors and our dying patients .  They’re in the business of marijuana and euthanasia now.  

My pain had dropped with the sleep and hope the added anti biotic brought.  I had homework to do.  I just lay in bed.  I had all this stuff that was to be done but another weekend devoted to getting ready to go back to the wars.  Any female patient can lie and falsely accuse a male doctor if he doesn’t agree with breaking the law and lying for her and a committee will destroy the doctor because that’s their agenda.  It’s not paranoia. They do the same to female doctors.  All the doctors realize now that any patient , especially the psychopaths,  have the power of complaints, any of which cause the doctor to lose $10,000 with no cost to the patient.  There’s a totally skewed power dynamic and it’s all a lie.  There’s no cost in Canada for perjury.   

Indeed multiculturalism denies the value of truth or knowledge.  It’s no longer about anything but feelings and power and men are all wrong and white men are all racists.  Every doctor I know, male and female, in the front lines tries to do the least now. No one wants to take on an unknown patient.  We’re working like our administration which is collectively destroying the practice of medicine. I’m entering an age when I may need medical care. I’m afraid of hospitals because the workplace is utterly toxic because of the administration and the anti doctor government. The nurses are being reduced too so we can have more politically correct administration.

I don’t have the reserve for a tooth ache.  I don’t have the reserve for sleepless nights.  My friends are all struggling with normal life and the workplace is killing them. The demands on doctors have skyrocketted while the fat cat administration is swaggering with self praise, making the rules for their dream jobs and constant vacations and giving themselves raises upon raises but never visiting the front lines. It’s WWI all over again and we’re the machine gun fodder.

The patients get less. We’re all condemned by a cruel and perfect government judgmental to the core Everyone is ‘offended’ all the time and the standards of perfections and political correctness are beyond the pale. You can kill with negligence but don’t dare swear or raise your voice or object to lacks of beds or deadly wait lists.  And then you hear they’re going to give more ‘free health care’ to immigrant families as more doctors suicide under the strain and in response to the cruelty and insensitivity of the administration.

Another night of sleep. More ibuprofen, more antibiotics.  The swelling’sdown. I can eat. I think of my colleagues working after having babies and having surgery.  I know so many stoics. I admire so many I know facing the deluge of demands one on one face to face in the front lines and those far from the front are shooting them in the back and fearing that they might ever have to go back out there .  They ‘ve played it smart, got the cushion jobs, moved to the back, played politics, not kept up with medicine, medicine just a stepping stone to power and control.  They never really cared for patients. They’ve seen so few and risen so fast. 

I’m feeling better. I get to church.  I’m humbled by Jesus.  Laura and I watched Monty Python reruns. Laughter therapy.  Communion was good.  The god kids were like herding cats.No one can afford to live in Vancouver.  The criminals and government have turned the city into an unliveable place except for jet setters.  I’m just the ‘Help’’.  Laura laughed to read the book about the ‘help’ and what the help said about the masters.  The destruction of the middle class is taking place. Only the elite are well here. The Mayor actually said something like it being reasonable to pay $3500 rent a month while a miserable shack costs a million anywhere.  The television constantly shows pictures of the rest of the world and the refugees are so happy as scab labour but given the benefits don’t seem to want to work.    

Those of us native Canadians who worked all our lives are leaving major gaps in services as we retire and no one is foolish enough to work in Canada. The whole work ethic is a farce when you see the leadership off on vacation and never working seriously before getting the best leadership job on who his name is.  Work doesn’t pay is the Canadian idea. Entitlement and social justic warriors and activists are all the rage. No one wants to do physics and chemistry or cut lumber or take risky jobs with axes and such.  It’s a talk world.

I type more today than I did as a secretary.  But I get paid for all that I know of biochemistry and psychopharmacology and diagnostics though naming things is quickly going out of fashion. Everything is fashion

I am comforted by the words of the priest. I’m thankful for the sweet sounds of Barry’s music.  I am thankful for all the friendliness of the people we meet here. Downstairs having coffee in the church I remember my mother and father. Dad helped put a new roof on the old church.  Mom always helped make meals and coffee.  We all did the dishes.  The coffee is fine. I’m thankful I don’t drool out of the side of my mouth.  I’m looking forward to camping.  

After everyone is gone. I walk Gilbert along the river and watch a green headed mallard land on the stream.  The  trees are all budding. There a bunting today.  A robin is in a bush with fresh green buds.  Lots of tulips and daffodils. I must focus on the good things. I’ve been depressed with sleepleness and death and a toothache.  I’m a whimp.  I think I once was more.  I sailed solo across an ocean. Faced charging bear.  White water canoed. Walked frozen across tundra after our skidoo went through the ice.  I saved a few children. A woman thanked me for saving her eye.  A few people told me that I convinced them not to kill themselves.  Thousands are sober. Thousands didn’t kill themselves on my watch.  I’ve done a bit of good in my time but it’s all unfashionable today.

I talked to my female colleague and she’s being punished like me for working with the people Jesus used to hang with.  We’re silly not to have been the doctors for the wealthiest. I turned down the job and so did she. We’re working with the really sick, the end of the road, and the feral.  It’s a single party insurance scheme and we’re not supposed to keep these people alive. More and more we’re co opted by insurance companies to write reports to courts and to keep people out of their toxic workplaces and to give them a chance at the legal lottery.  ICBC , our auto insurance plan thanks to government mismanagement is on the brink of bankruptcy. Wherever government gets involved there is horrendous waste and mismanagement in Canada. Rapidly a third world country. Not the meritocracy it once was.  But you know you’re getting old when you talk about the good old days.

I’m insignificantly significant and significantly insignificant.  75% of my colleagues wouldn’t recommend medicine in Canada.  It’s still a beautiful spring.  Today’s sunshine was miraculous.  My face no longer hurts.  I laughed to watch Monty Python’s absurdity, « Always look on the Bright Side of life.’  

It really is funny.  You must stop taking yourself seriously.  It was just a tooth ache. Not nearly as bad as a man flu.

Gratitude Friday

Thank you God for my night of rest. I have known countless nights awake on call in hospitals and community. I have been a wake nights at sea through storms unable to sleep for slept meant death.  I have had so many nights with nightmares, the faces of the dead and the constant judgement of the ungodly perfect superiors.  I have played to you Lord but being a people pleaser I have tried as well not to offend the devil.  The devil rules this land and I am sorely afraid.  But I beg for your mercy. These are the times Isaiah prophecized of the “long necked women and their boys”.  There have been so many nights sleepless at the bedside of sick and dying.  My dogs loss of his remaining eye this week has been terribly trying, but it is good that he is well now.  Thank you for the night of rest.
Thank you for the recovery of my dog. Gilbert. He was only awake once last night. Whimpering for attention. Lonely and afraid.  I am pleased each day as his life is restored.  I am thankful that his life is no longer being threatened.  I am thankful that he is recovering. It was such a gift this morning that George, the rescue cat, came out into the living room, walked up to Gilbert and put his head inside Gilbert’s cone of shame and rubbed noses.  Gilbert’s tail wagged. He’s been bored more now. Unable to play with the cone on.  Frustrated, and here was George making contact.
Thank God we are not alone. Even if this is a mental created illusion of me and others it’s better than that deep sense of despair that I feel at times when I touch the isolation and existential angst.  Thank you for the Holy Spirit, the advocate sent by Jesus to comfort us who are Christians.  I find comfort in that sense of connection with God.
“In the beginning was the word and the word was with God and the word was God.”  John 1.1
Thank you for the word.  Thank you for the silence and the word. Thank you for the contrasts.  Even now thank you for the rain after the glorious sunshine.
Thank you for the coffee and the oat meal. Thank you for the Red River Cereal I bought and ate a bowl of last week. Thank you for the brown sugar which I bought for the Red River Cereal but have now enjoyed with Quaker Oats.  Thank you for this keyboard and this couch and this table. There is so much I take for granted.
Thank you for all those I disparage and criticize especially the institutions and government. Thank you for the Prime Minister if not this satanic buffoon but for the position and the hierarchy. Thank you for leadership and beurocracy and ministries of health and communication and defence and finance even when I disagree with them.
Thank you for the courts and judges even though I feel increasingly they are becoming tyrannical and removed from the world of fairness and justice. Thank you for objectivity and the people who will put an end to the tyranny of ‘emotional abuse’ and ‘sexual harrassment’ and ‘racism’ and all the weaponized words and invasion of leftist communist aetheist ideology.  Today is the anniversary of the Un American Committee that reviewed Hollywood and black listed communists infiltrated into the arts community with the agenda of subterfuge and destruction.
I  enjoyed reading the article of Putin's time as a nihilistic KGB agent infiltrating the European 'hippy' scene, undermining peace and recruiting operatives. I remember meeting such an operative when I was in the Peace movement and wanting disarmament but suddenly this focussed fellow insisted we should unilaterally disarm and demanded it. It was so strange and I'd not trained as a group psychiatrist then so didn't know as I witnessed it, this hijacking of process.  The whole group had been promoting bilateral disarmament and then this fellow began to speak up vociferously, well trained, and insisting with much emotional and shame that good people would lay down their weapons first and that we could trust the aethesist communists.  They were just like us.  Everyone wanted peace, he said. I know today that's not the case that so many want war.  They profit from it, like Lenin and the UN. Many like to play with it and see if they can 'control' it and direct it's forces. I see it all like a cattle stampede and the young wealthy sons and daughters of the elite riding to the front and having stampeded the cattle now try to direct it to where it profits them most.
Today it’s Harvey Weinstein. There was no consequence to the woman who complained that Trump groped her 40 years ago. There is no consequence in the courts or in society today for ‘false accusations’.  There is no consequence for all those who through sins of omission and through 'enabling' supported the Harvey Weinstein's of the world.   The fake news, lying on the grandest scale is huge profit.  Fake news  has been caught repeatedly as the alt-left, CNN and CBC have worked their propaganda angles doing fifth columns from within. No one is punished for lying.  Goebbels reigns and it's all just 'white washed as marketing'.
“J’ACCUSE!” “J’ACCUSE!” “JACCUSE!”
Under French law, the false accuser must pay the penalty that would have been paid by the accused if the accuser was truthful.
I self reported that I was smoking marijuana and went to AA to address my smoking marijuana and nicotine and drinking. The drinking was a minor issue relative that when I drank I smoked marijuana and hence had to stop drinking because by definition this was alcoholism, as I persisted in doing a criminal act which held risk despite my realization of this. I saw a psychiatrist who recommmended I smoke marijuana and discussed my wine drinking with him as I was considered a wine connoseiur at the time. He felt that I didn’t have a problem but understood the ethical and moral dilemna that’s I had with ‘breaking the law’.  Marijuana was against the law and so many I knew had gone to jail and otherwise had their lives ruined by their contrary behaviour.  I could get get my ex wife to seek help as her behaviour was far far worse and that impaired she was a danger to herself and others but refused to seek help.
I don’t believe Justin Trudeau sought help with his addiction to marijuania and I don’t believe Morneau is seeking  help with his addiction. If anything I expect both are speaking to lawyers and marketing agents to improve their  lying and dissembling.  They lack remorse.  So the elite see lawyers and the poor see counsellors.  I doubt that Harvey Wallenstein or Bill Clinton will any time soon attend one of those mandatory sexual behaviour group counselling sessions the Justice Institute sells so vociferously for huge profit.
Now I’ve held myself to the highest standards of ethics and morality despite the constantly moving end point of political correctness.  I’ve never raped or sexually violated a woman.  I have fought for women’s rights and been ridiculed and shamed and beaten for supporting 'equality' and 'fairness' and  meritocracy. I've insisted gender, sexual orientation and other such factors should not decide who flies the plane.   I’ve been celebrated repeatedly for my “non discrimination”.  I've challenged based all the false flags and false values. I've have faced the wealthy and powerful on behalf of the principles and poor.  I have been physically attacked repeatedly for defending women and LGBT members and yet today the lies pile on and on. The cost to me personally has been in the tens of thousands of dollars.
Increasingly the “emotionally abused’ insist that they are ‘more’ harmed that those who have been shot and beaten and raped.  This is of course the age old demand for the girl who has it all to claim that she is a greater victim. It’s Sense and Sensibility.The courts have been taking smoking pot or are grotesquely power hungry like our present Government and are  increasingly removing them selves from the realm of objectivity to subjectivity.  Objectivity is all that the poor have had to balance the power of institutions, corporations and the elite, despite the latter's capacity for manipulations of 'evidence'.  The Judge becomes all powerful in the court of 'subjectivity'. This was what was once called the Kangaroo Court and was what always reigns in Communist revolutions.  The judge plays to the crowd and fears for his position so is politically correct.
The Assistant Registrar at the College of Physicians and Surgeons said “Women Don’t Lie About Sex”.  This is not out of context. This is reality. This kind of narcissism and arrogance and ignorance was confirmed at the Gomece trial where the Judge found the accused ‘not guilty’ and hundreds of women insisted that the judge was wrong and ‘women don’t lie about sex”.  Those who forget history are doomed to repeat it. We had a decade when children who were used as weapons by parents in divorce cases were said “not to lie about sexual abuse.’  This is tribalism. It’s primitive sociopathic behaviour.
A sociopaths is a person who is of a group that has rules they obey within their group but not with outsiders who belong to the larger group. The Hells Angels theoretically wouldn’t steal from another Hell’s Angel but would steal from a Canadian citizen. Canadian Citizenship before the traitorous Un Canadian PM Trudeau took office superseded other social groups. Now however the courts of Canada are separated into some for us, Sharia Courts for Muslims and Indigenous Courts for Natives. Under Justin Trudeau there is no longer one law. Morneau and Trudeau are not held accountable to the same law as I am.
There is in CAnada like in the Middle East where the courts are uniformly corrupt, like the UN which is a den of theives, one law for the rich and one law for the poor.  The poor as we know in Canada now include the middle class. Because of social communism and the socialism of Globalism there is now an Elite, these are politicos and administrative class bean counters and paper pushers. They’re otherwise useless incompetents with lust and addiction to power.
Everyone lies. That’s why we have big brains.
Thank you God for my Big Brain.  Thank you God for my capacity to lie.  Yet thank you too for the Ten Commandments that demand in a society that I do not bare false witness. There are white lies and black lies, good secrets and bad secrets, good lies and bad lies. I have been sneaking pills into my dog in his food all week. If I didn’t disguise them he would not take them.
Thank you God for the Balance of Power.  Thank you for winter as it cleans and sterilizes the ravages of summer, the insect infestations and fires and dirt in the street.  Thank you for the pendulum that swings. Thank you for all those who see in Justin Trudeau the same megalomania that was in his father, Lenin, Napoleon,  Hitler and all those historical figures who demanded centralization of power.
Capitalism is decentralization of power
Socialism has been in effect centralization of power.
We have a mixed economy.
 Wall Street is just a huge casino. It  is rigged so the house always wins. " Steal a little and they put you in jail, steal a lot and they make you king."
For women, the most popular "50 Shakes of Grey" , more loathsome insidious overt pornography than ever Hugh Hefner stooped to, would be an episode of Criminal Minds were it not for the perpetrator being a billionaire.
I don’t trust Ottawa, Victoria or Washington or Moscow and especially I don’t trust Bei Jing. Brussels is distinctly evil.  Merkel played them all so well with her 'migrant armies' and 'scab labour' and overall threats.  She's East German. Her moves are so like the Cold War operatives.  There's that old guard world domination group left over from the Cold War and they're still so powerful with their secret cabals and wealth dating back to the Nazi wars and before.  A few families of elite playing with the world like a single family can control the politics of a country.  Corporate monarchies.
Thank you God for Faith. There is faith and anxiety.  Anxiety is a measure of one’s distance from God.  I have been too anxious with Gilbert's surgeries and the deaths of patients from Fentanyl.  There's a war on Canada by the Chinese who are marketing death for the west just as Canada was a conduit for terrorists against America.  Trudeau paid a terrorist 10 million dollars rewarding him for killing an american soldier and making bombs to kill Canadians.  All the gobbledygook legalism and disgusting disrespect for Canadian people still doesn't allow pot head pretty boy Trudeau to claim that 'two wrongs make a right'.  Even now as the Canadian dollar plummets further and the value of the country devolves to third world standard and our health care system caves, Canadians ask why is Mr. Trump playing hard ball with Justin Trudeau over trade.  You don't bite the hand that feeds, silly.  Stop the flow of heroin into the US through Vancouver and stop terrorists going into American and stop paying people for killing American soldiers.
I had hoped that Good Women would stop the Vagina Headed women and insist that these Subjective Nutbars join greater society. We have watched the Left with extreme violence attack the law and order of society and increasingly introduce new ‘justifications’ and ‘rationalizations’.  The whole ‘divide and conquer ‘and lack of willingness of the judges and the parliament to stop this raging insanity is diabolical. Always the marketing propaganda lies. Mr. Trump says he's going to stop 'illegal' immigration and the Left , the deceitful CBC and CNN say Trump is against Immigration.  Bill Clinton and Obama said 'stop illegal immigration' and no one said they were against 'immigration'.  They profited by saying one thing and doing another.  The democrat voters were dominated by illegal aliens.
According to the Charboneau Enquiry Quebec, the political home of the Liberals and Justin Trudeau, is ruled by Biker Gangs and Mafia.  Canada is no longer 'strong and free' but ruled by criminals whose incomes come from gambling proceeds, selling drugs, alcohol and pornography taxes. Why shouldn't young people kill themselves.  They're born into a rigged system and their value is only as consumers. Consumer fentanyl.  Nihilism.
Every person I know who has been physically (objectively) abused has been equally if not more ‘emotionally abused’.  You can have ‘emotional abuse’ without physical abuse but you can not have physical abuse without emotional abuse.  So where are the voices of women responding to this insanity.  Where are the voices of men. Where are those who say, sorry you don't get to claim 'equal suffering' and insist on 'safe zones' for 'bad words'.  Dr. Peterson in Canada must fight to live. When will the heads of universities that have allowed this debacle of education be challenged.  When will the university stop being a propaganda outlet for communism and sharia.
White privilege is a crock.  In India I had no 'white privilege' and in Africa they're killing whites .  The 'ruler' and his 'class' have superiority for a time. The Chinese are the most racist of all and each successful Chinese revolution has put their people in place. Now this lot is killing any indigenous people.  Jews were killed but now are ruling Palestine with an iron fist having see what they themselves did as revolutionaries. The ideas of Marx came from their ghetto existence, their years in Babylon.  But the Chinese are ethnic cleansing the Tibetans.  So here the uprising of blacks demands that whites give them what they earned.  George Soros profits from social war so supports Black Lives Matters. The Muslims massacred the Christian Kurds and the UN supported the genocides because the largest armies of the UN are muslim.  Money going to the UN goes to outfit the Muslim army of Bangladesh. Wahabi Sunni muslims kill other muslims.  The Saudi's killed the equivalent of the Shiite Pope in their country, out right murdered the man, no different than if Trudeau had ordered the Dalai Lama killed.  The steamroller narrative and marketing of fake media CBC and CNN hardly burped.
When is the pendulum going to swing. Do we need to return women to Burqas and declare the whole ‘women’s liberation’ and ‘meritocracy’ movement a dismal waste of time and failure.  Pierre Trudeau with his strong arm Mortgentaller aborted the catholic and Christian babies of Canada in the tens of thousands insisting that there was no room for children and unwilling to pay for mother hood. The women’s liberation movement was a movement supporting Women not Girls.  Mothers were included. Marriaed women were included. Feminism hijacked the Women’s Liberation and Suffragete movement and made it Social or Cultural Communism - women against men and girls against mothers with the abortionists killing more people than wars. Now Justin Trudeau who with his most un feminist wife just like his father with his addle brained drug addicted wife like Stalin with his crazy suicidal wife insists that we need to take refugees.
His SCAB VOTER campaign.
As much as I admire Sikh’s it’s clear our Defence Minister is a crazy ego inflated lwho insists he wins wars single handed is not representative of Sikhs in general.  His turban doesn't conceal his long hair but a swollen head.   What country in the world has a Defence Minister who wasn’t born in this Country?  Trudeau is selling citizenship and voting status en mass.  That’s what traiters do. This country is under siege and who cares.
Thank you God that I am old and slouching towards my dying end of life.
My father told me in his 90's  if he’d known that this was what Canada would become he’d never have fought in WWII. I’m utterly disillusioned .  I now know why he loathed the Trudeau family as evil as the Clintons, satanic and deceitful with arrogance galore.
Thank You God that I am nearing the dying end of life. . There are few years to remain.  I feel sadly for the next generation enslaved to the elite, Canada as increasingly an extension of the corruption of the  Middle East, Canadians collectively like Saudi citizens.  Trudeau would have us have a Sharia Bank already having introduced Sharia Courts. 1984 told it all. Some pigs are better.
I loved singing the Canadian anthem as a child, "True North Strong and Free" But they’re destroying the statues.  IF this was India and Trudeau was Prime Minister,  the Taj Mahal would have to be destroyed. ISIS destroyed the churches.  I learned recently when Ragga fell that there were videos of the ISIS fighters beheading Christian martyrs as Ragga was a Christian town.  The blood of Ragga Christian martyrs was then put in vials and ships en mass to Saudi Arabia. Muslims are told to Jihad and if you are too old to physically jihad then you are to send money to the jihad and that way be apart of the jihad. So this blood was payment to Saudi from Isis Jihadists to the money backers. And the video showed these old men, the brothers of Saudi elite Obaman bin Laden washing their hands in Christian blood. I am a Christian and Jews condemn me for defending my faith today. I have never criticized Jews for defending Israel against the hoards of muslims wanting to annihilate Jews in the middle east. Yet here in Canada I defend my fellow Christians and find no solidarity, no voices of support from the so called 'multi cultural' country, this land where we have tolerated the screaming raving atheists, the whining and self pitying of all the other religions of the world but when Christians are beheaded and their blood is sent to Saudi Arabia so bankers can wash their hands in it, well Justin Trudeau just gives my tax money to Muslims and celebrates terrorists.
The Civil War Statues are coming down in the States. If this was England then the Tower off London would be destroyed by Black lives matter.  Communists destroy history.  In Moscow they are rebuilding all the churches that Lenin destroyed if only for the tourist value. Aethesists would destroy the Louvre.
Wake up.  Wake up. Wake up.
Gratitude. Thank you Lord for those who will right these wrongs. Just as Pierre Trudeau was sent to the ashes and four prime ministers tried to clean up the mess he left with his communist ideology and arrogance so too will this pass. Just as they are building churches again in Moscow, the Muslim Jihad was stopped in Vienna, and Brexit is countering the Brussels beurocrat dictatorship revolution.    The despicable destruction by Justin Trudeau of all that is Canadian, the culture of Canada and values of Canada so well stated by Dr. Kellie Liethc,  and all respect for Law and Order, this criminal law breaker, will one day be gone as that greatest criminal Mao and Che and Castro went.  Please God let Trudeau go before Canada is reduced to a communist wasteland like Cuba and Venezuela and it's jails swell with independent thinkers , like the Gulag, Auschwitz and the jails of Mecca,  Tehran and Venezuela.  Canada is fast becoming a  country of lawless , a pirate’s den today.
Patriotism is the last refuge to which a scoundrel clings.
I have no home. Jesus said that too.  My kingdom is not of this world.
I will go to work and serve my patients even today as Abortionists make more money and have more acclaim than those who heal.   Abortionists are rewarded more in Canada than  obstetrician.  The government now pays and celebrates more the doctors who do euthanasia than their colleagues. The College of Physicians and Surgeons has never published sanctions against any abortionists and hell will freeze over before we read of a doctor practicing euthanasia being sanctioned.
Where have you gone Dugald Christie?
Thank you God for all I have been given. Thank you God for your love and the promise of escape from this veil of tears. Thank you God for those good people who do the good fight and see clearly today. Thank you God that I am old and my days are numbered.  Thank you God for my teachers and friends and family and those who have passed on before me.

Black Market, Taxes, Politics, Elections

Our government has grown like a cancer.  There is an absolute need for bureaucrats just as there is an need for doctors, nurses, teachers, farmers, ranchers, miners and all manner of trades.  There is a need for lawyers as well.  Unfortunately the ‘administration class’ in the present burocracies has multiplied with no evidence that layer and layer of administration has in any way improved performance.
This is the fundamental flaw in socialistic/communistic governments.  The ancient feudal system involved a war lord getting in power and by brute force maintaining a relative slave class, serfs, ruled by him and his cronies.
Mr. Harper has made powerful enemies by trying to reduce the upper levels of this administrative class. He has attempted to maintain the front lines yet has been demanding evidence that layers and layers of bureaucratic cronyism are necessary.
Prior to the Conservative capitalist leaning government we were faced with years of increasing taxation and increasing layers of administration in government.  We had regulators regulating regulators.  Under Chretien and Mulroney we had the massive advertising scam with every aspect of government getting glossy photos and booklets that spawned more and more paper.  Recently we’ve had the internet with the necessary map upon map to navigate through the layers and layers of government administration.
“Keep it simple” is not a slogan developed in government.  The legal profession are masters at obfuscation.  The more words the more money the more confusion the more need for more judges and more court rooms.
On a farm I plant x amount of wheat and sell it and because of demand I plant more and sell more to a point where the ‘market’ is ‘saturated’.
There is ‘no saturation’ point in the ‘service’ market.
I worked on a Indian reserve where the nurses hired to serve a thousand individuals were expected by the Aboriginal “Sultan" Chief of the tribe to provide daily massages. Beautiful young women were providing him this service once sometimes twice a day because he ‘liked’ it.  I couldn’t get the nurses to provide respiratory care to child if it conflicted with the chiefs ’need’ for a soothing massage that day.  The division between need and want has never before been so obscure.
There has always been taxation.  But taxation was once related to providing roads and buildings and water and sewage disposal.  There was a collective agreement of the needs for the community at large.
The beauty of architecture and the grand churches of medieval time was that architecture was the ‘art of the people’ . Everyone enjoyed it and the pyramids, castles or cathedrals were of benefit to all. Taxation served public works and it served to maintain armies that provided defence.
Now we have an endless ‘imposed’ legal system with laws upon laws governing and controlling every aspect of life.  It’s Confuscean.
Maybe everyone would benefit from a massage.  But Mr. Harper and the Conservative government showed that taxpayer money going to the First Nations was bottlenecked at the level of so many chiefs who had palatial homes, off shore accounts and took millions of dollar salaries while the lowest people, the sick and old and marginal in the reserve communities went without running water and heat.  This was directly a consequence of poor monetary management of resources. Yet when the ‘transparency’ laws showed the tremendous nepotism through the north and in the Indian bands, the criticism of the government became focused where it truly belonged.  Mr. Harper and the Conservatives had dared to do what no one else before for fear of political fallout. He shone a very bright light on the Jenny Kwans and the Mike Duffies of the Aboriginal people showing who was stealing money and where the slush funds were.
He made powerful enemies.
The executive of the CBC and his cronies make hundreds of thousands of dollars, more than doctors and more than parliamentarians. These leftist ‘marxist flag carrying’ hypocrites have long given up on journalism and used their office not for the benefit of truth and the people but solely for their own protection. Not a News item for months has presented a sound piece of journalism when it comes to the upcoming election. Yet CBC can produce the best of radio with Tapestry and White coats Black art and other world renowned programming.  The News is worse than the worst of Pravda. It is pure disquised peckish retaliation against the gpvernment for questioning the administrations high salary and endless perks.
Mr. Harper and the Conservatives have made powerful enemies.  Majority governments always do.
He has stood firmly behind American trade policy.  We have a fighter plane deal with the US and countless NATO countries. The United States is our principal trade partner accounting for 80% of our exports.  They take natural resources, meat, farming products and manufacturing. Our greatest musicians are marketed by their powerful industry. Our actors rise to world fame with their industry. We make movies with them here and there.
I remember when we had a childish government that essentialyl told our biggest contributor to piss off and tried to make a sweet deal with France.  Yet France accounted for only a few percentage points of trade.  And their leader came to Canada and screamed “Vive le Quebec Libre! Meanwhile the present boy Troudeau’s father had declared martial law and brought tanks into the city of Montreal pointing artillery at all the people of Canada because one terrorist had kidnapped a bureaucrat.  Today Mr. Harper and the Conservatives are criticized by the pot smoking Liberals for ‘security’ concerns despite the fact that it was the son of a Tunisian Jihadist who shot the Engineering women en mass and recently a terrorist actually shot up people in our parliamentary buildings.
Meanwhile terrorism is on the rise around the world and is occurring in the very nations with the greatest gun restriction laws.  And when the son of the Tunisian jihadist shot up the Engineering women we never heard about his racism and moslem origins but instead the Liberals turned their attention on ‘disarming’ women and outlawing guns as if ‘guns’ were the problem.  All the while all the nations with the least guns in citizens hands have rising problems with terrorists.  Criminals are always armed and they are today better armed than our RCMP who were shot en mass by one terrorist in the maritimes.
Mrs. Campbell as Conservative PM brought in the toughest gun sales and licensing law. The Liberals at a promise of a million dollars instead spent 2 billion dollars creating a massive bureaucracy for Liberal cronies to essential spy on anyone who had seen a psychiatrist. What the general population was not told was that ex girlfriends and ex boyfriends and divorcees and psychiatrists were being canvassed by droves of police like bureaucrats treating anyone who owned a gun or wanted to buy a gun as a criminal and an insane one at that. All of this travesty of justice was perpetuated to protect people from ‘suicide’ whereas I as a psychiatrist knew that countries without guns had equal suicide stats to countries with guns. Worse I’d worked in countries where people jumped out of coconut trees to kill themselves.  These lies upon lies were perpetrated because people like the Liberal Mr. Ignatieff had never known a westerner or lived in the north or in rural regions to know that everyone owns a gun ,usually an old shot gun, or 22 simply because of animal pests.  The Liberals with their history of alcohol association and now their pot for votes have always appealed to the uptown city crowd and well heeled elite not the rural and northern parts of the country where the NDP and Conservatives are better represented.  The gun registry was just targeted taxation.
The taxation was the issue. Taxation gets jobs for party friends. It’s the horror of the senate at it’s worst but it’s seen in the courts upon courts and law school turning out masses of lawyers far beyond any societies need. In a civilized world they would be ‘philosophers’ and teach freely ‘enlightened thoughts’ but as lawyers they are another layer of social control. There’s the military that defends our borders and the police that maintain law and order within the borders. The courts no longer serve but have been wholly coopted as purely an instrument of taxation.
The pot legalization issue isn’t about health care but instead it’s purely about taxation, short term gain and long term loss. Taxation on cigarettes and alcohol has never recouped more than 10% of the cost to society that they have caused.  Yes, we will get tax money from marijuana sales. Whoopee. But the cost in accidents, health care, motivation, and loss of youth will cost 90% in long term loss.  The simple law of drugs of abuse, established in elegant research a quarter century ago at Harvard and always confirmed is that the more available, the more abuse.  There’s a saturation point.  10% of the population consume 80% of the alcohol.  10 % of people roughly have major problems with drugs or alcohol. The same holds true with gambling.
Gambling is a major form of government revenue today.  Canada is a casino, a booze hall and soon will be a drug haven.  Already we have ‘drug pubs’ paid for by tax dollars at a million a year. The Hells Angels sell junkies heroin and occasionally they shoot up in the classy facility with nurse waitresses.  It’s better than what Molsen’s provides their customers, only we pay for it.
Now all this leads to the Black Market.  Years ago McGill University did a study that showed that the higher the taxes the more Black Market. It didn’t surprise me. I’d read the history of Scottish Culloden.  I knew that the more the English demanded when they were rapacious war lords and killing my Scottish and Irish forebears, my greats took to hiding their potatoes.  The English didn’t care if the Scottish and Irish starved in the winter.  There will be no Truth and Reconciliation Commission for us.  The Maga Carta was only for the nobles.  It took the French and the Americans to free the word ‘equality’ from within the ranks only of those who were allowed to bear arms.  The peasant classes throughout medieval times could not.  Massacres occur en mass by the government when the citizens are disarmed.  Russia killed 60 million in a few winters.  China has killed a hundred million in recent past.  The Pol Pot wiped out half of Cambodia in the 5 years of killing fields and millions dead.  The United Nations has proposed Agenda 21.  Atheists are the greatest killers of all time. Statistically the chance of me being killed by a rampaging lone gun man is next to nil but historically the likelihood of government greed stealing, starving and killing is a sure bet.  Hence the American constitution.
Now in the US they take their constitution to mean that the local neighbourhood church and synagogue and temple can have howitzers and militias and the police there have tanks.  In Canada no one cared because the country people had a 12 gauge shot gun for hunting.  The vast majority of ammunition sales in Canada is for birdshot. Rural Canadians aren’t en mass waving AK47’s.  So when our government gets its knickers in a twist about boys with bb guns, smart people wonder what the hell is going on.  The answer is taxation.  Targeted taxation.
And overnight I learned that Aboriginals and rural folk were burying guns and very very anxious about the urban government’s agenda targetting them. Because a gun is a necessary ’tool’ in the north and rural Canada.  The 3 year old girl was killed 2 doors down from me by a cougar.  I chased a hungry bear away from my dog.  City activists love wolves but 4H country kids don’t like to see their calves killed by packs in their back yard so we all have guns.  The city with it’s parking lots and high rises is the centre of waste and cause of climate change.  The “hot air” problem is not just politicians but the density of people.  Dispersion is a solution but stupidity grows in proximity.
And criminality.
Right now the taxation is at a cancerous high and as McGill said, the more taxation, the more crime. It pays more to break the law than to be a good citizen.  All around me I know criminals who have broken the law.  In fact the Liberals marijuana laws has as a secondary goal ‘sanctification’.  All the drug dealers and growers overnight will become ‘right’ and all those who followed the law ‘wrong’.  All those who made fortunes from ill gotten means will be safe. All those who paid the taxes that made the criminal life so attractive with health care and good roads and schools will be the duped ones.
So that’s what it comes down to.  Taxes and the black market.  I’m frankly libertarian.  My friends are angry at me because I’m voting Conservative.  The Liberals and NDP literally promise more government, more taxes and more crime.  I don’t know who they’ll tax more. The government gets in by giving jobs to friends.  In the old days it was giving a job to the slow cousin.  Now we know that the health care system has 20 times the administration as Germany’s health care system.  So we’ll get more bureaucracy and less actual product.  I saw a very expensive advertising booklet and realized this was where the health care dollars went.  Nobody read this silly book but ti cost a million or so.  Meanwhile no one got to see doctors and nurses which is what health care was once about before the political spin turned it into something else.
My friends are all earth huggers and civil libertarians and ex hippies like me.  But I’m a self employed businessman. I know the actual cost of things. I’ve always spent a lot of time fighting corruption and deceit and people that kill people in government.  I’ve front line experience.  I’ve seen the corruption daily first hand.  I am burnt out and jaded.  I am voting conservative because I want less taxation and less government.  I know that whatever government does these days they do at premium cost.  It’s like the department of defence in the US where a wastepaper basket cost $700.  When government is going to pay for something the price goes up and the quality goes down. Yes some people benefit but I’m not one of them.  I don’t benefit from the Black Market.  I’m not on the government pay roll. I’m not in a union.  I just pay more and more taxes and see that more and more people are getting free government hand outs while working under the table tax free.
I don’t trust government with my money and I don’t trust them not to turn guns on their citizens.  I don’t trust that I won’t have to move north and live off the land as my friends told me they did in the last depression.  “I fed my family with venison with a 22 rifle.  Everyone else was starving.” he told me.  I’m old enough to remember the tales of my grandparents.  I think the young are naive and trusting.
Thankfully most people I know are good and good is mightier than bad.  So Canada survives despite government because most of the people in government and elsewhere in Canada are good people. It’s not that way in the black market. Our criminal population is as bad as any.  I know. I’ve worked in the jails.  I think our judges are more afraid of the criminals than they are of citizens.  I think judge cowardice these days explains why violent offenders have been repeatedly given light sentence.  Increasingly the risk of crime is from a ‘repeat offender’.
Most of my friends also have never changed their votes. My communist friends have been communist since teen agers. My socialist friends have been socialist since teen agers.  My liberal friends have always voted liberal. My NDP friends have always voted NDP.  Even my Conservative friends have always voted Conservative. I’ve voted Liberal NDP and Conservative. I actually was a staunch liberal for years until I saw the corruption in that party.  I felt deeply betrayed by the gun registry lies and the destruction of health care under the liberals.  I was most disturbed when Paul Martin said he’d not register his boats in Canada and wouldn’t hire Canadians.  I thought I’d like to be an elite Liberal. It’s what I heard when Troudeau was smoking pot and hanging with Mark Emory. I ‘m a doctor and I can’t do that.  Every doctor has a political party regulator called by the pseudonym College of Physicians but here is their boss smoking pot and no one is urine testing him.  Excuse me!!!!!
And Mulcair is a lawyer.  I’ve seen parliament stripped of it’s power year after year by the courts making laws. yes. making laws.  They call it ‘interpreting’ but the courts are making the law now in Canada and it’s principal function has been to serve them and increase taxation.  So Mulcair frightens me.  But if I was a union member I’d vote NDP because unions in Canada have become so strong.  Government unions and private unions are Big Unions.  They have clout. I envy them but I’m not in a union.  So nothing the NDP are offering helps me. I want less taxes and less government , not more.
Mostly I want less Black Market Economy and less crime.  The only way I can see moving in that direction is less governnment and less taxation. It’s a little twisted, I know, but government is a pretzel these days.

Floaters, flashes, and pain

Reading lying down is a dangerous sport. Yesterday, on the couch, I was hit smack in the eye by a mis-tossed rubber ball, the dog quickly retrieved while I held my eye closed, letting the pain subside.
The pain was 5 out 10 and 'sore' initially but I did feel like my eyeball had been compressed, the ball smacking into the open eye.
My vision was unaffected but later in the evening I began seeing frequent flashes in a circle around the periphery of my vision.  It was irritating.  Tiny pinhead lights flashing on and off rapidly then with diminishing frequency.  Floaters came next. That concerned me.  I didn't think anything of the flashing lights because they'd gone from every minute to minutes.  But the floaters moving about and not obstructing vision bothered me.
I am a doctor.  I don't react appropriately to injury.  I do most of things I tell my patients not to do. I live in denial. I depend on denial. I minimize matters to the maximum.  If I even considered for a moment the risks I take daily in my work, sick strangers with unknown diseases,  ex convicts, ex murderers, HIV, Hep C, psychotic, drug crazed, delirious, lice ridden, MRSA, new diseases, flus, coughing, wet sores dripping……that's good days. I'm now one of those unknowns and some doctor will see me. Like soldiers walking through dangerous enemy controlled territories doctors (and nurses) face the unknown routinely.
When I've been injured, ill or sick, I don't want to know what it is. I believe that if I think something is bad I make whatever it is worse. I believe in mind over matter. I'm now a psychiatrist.  I did rural and emergency physical medicine, started in Surgery , but today I know it's all in my head. If only I pray right or ignore something sufficiently then I'll be healed. Isn't that what SECRET and all that NEW AGE stuff implies, as well as HEALTH and WEALTH Christianity.
Lots of Yuppies and Baby Boomers live circumscribed lives of quiet desperation avoiding risk and stress. Their God is money and the talisman health supplements and political correctness group think. The Money Conscious Superstitious Chinese wear face masks and now teen agers are avoiding shaking hands and bumping elbows because the environment is unsafe. Like cave men before them the superstitious are random targets of a merciless world. They don't even have Karma to protect them but live in an arbitrary atheistic reality where their insignificance is their vulnerability. Even the rich most consumer capable can't hide sufficiently from life. And I'm a front line worker and people think my recreational life is risky.
Disease is not to be invited. I've limited my 'dare devil' escapades especially now I'm older. I avoid some adventures I might have earlier indulged in ,but there I was lying on a couch reading when I was nearly blinded.  Smaller harder ball and I wouldn't have needed a tv villain to crush my eyeball with thumb. The random tossed ball would have done the trick.
I know a man who was blinded in one eye when a champagne cork hit him as a friend 'popped' the top without consideration of trajectory at a wedding.
Accidents happen. Whether they are accidental, attracted or brought on by masturbation in one's past , it's not certain. Judges in high court would declare a 'culprit', blame being more easily 'ascribed' than 'proven'. Truth isn't so conveniently man made.
JOB is still the most interesting book in the Bible, least read and least preached on. It overturns all manner of prejudice and theological crap.  Today Job would have HIV and Hep C as would his family but we can't talk of that.  Job wasn't homosexual so no one in some churches wants to reflect on Job. The Old Testament explanation of disease or even Jesus and the 'demons' doesn't fit as neatly as stigma. Lepers live among us but they have a different name. We have our distances and districts.
I'm not innoscent.  I have a whole lot of sins. I'm a doctor.  No doctor is without imperfection and we all know it.  We pit ourselves against death and disease and we don't always win.  We won when we competed against exams and each other but not when we wrestle with the devil and advocate with God for our patients.  We try desperately to change the direction of life and death, extending it or relieving pain. As psychiatrists we mess with reality.
Maybe someone deserves to experience rats gnawing their genitals according to their own ideas and culture but we change that.  We stop the rats and the rat like thoughts.  We do things.  We act.  I touch my patients.  I move out with them into community.  There are institutions and associations that cause disease.  To help my patients I must stand with them. The stigma of mental illness and addiction is passed on to the caregivers as much as the patients.
Today I woke up and the flashes were still there.  There were more floaters.  Denial wasn't working. This really could be a retinal detachment or retinal tear. If it was, an opthalmologic surgeon could just zap it with a laser and "cure' the process that could otherwise lead to blindness.  Jesus used mud to cure the blind.  The son of man and healer of all time. Now doctors have supernatural skills and talent.  I might not be able to think myself out of this injury.  I might have to ask for help.  I hate asking for help. I hate asking for help from physical doctors as much as they hate asking me for help with mental illness.
I would rather have gone to a psychologist, a shaman or a minister.  Maybe prayer would work if I got someone else involved. St. Thomas is a scientific sort of doubting saint. My kind of guy.
I asked my brother to drive me to the hospital.  He wanted to take me to the optometrist. He had to take my dad to the hospital dozens of time and wait hours and hours every time till someone our elderly father with heart disease and kidney disease.  He'd taken his children and his wife to hospital. He told me about one seizing in the seat where I was.  I realized how diabolical the governments health care rationing and consequent  'wait lists' were. Not just the ill were off work and in limbo, so were the caregivers.  
I heard him tell me about taking his children to the hospital,when I told him "I don't want to see a fucking optometrist or optician, I need to see a doctor."  I knew that even the ER doctor, if he was like me, might want to have me seen by a eye surgeon.  I knew all the time my brother had devoted to my father in the final years.  I loved him more for his love and sacrifice.  My dad was special like my brother is.
It's just that that's what these symptoms say one needs. Ophtalmologic assessment. I know. I've sent patients to ophthalmologists and they've had emergency eye surgery within an hour of my seeing the retinal detaching with the fundoscopic examination.
I needed a fundoscopic examination now. Once the denial stopped working,  I couldn't hold back the gates of despair and fear any longer.  I began crying.  Doctors make the worst patients. It's because it takes so much denial and so much energy and we know so much about so many really bad things.  If I even let my mind off the chain leash I was blind and dying .  I hold back the gates to despair.  I rationalize and convince myself moment by moment everything is going to be okay.
But these days I'm under attack by bureaucrats,  lawyers, judges, and the media and all those people who are so far removed from reality they couldn't find their ass with both hands. They even know what is right in their mind even years ago because they can ignore and choose all manner of what they think is relevant.  They're also easily duped by sociopaths or maybe incompetence or maybe they just sell out.  They think it's okay to 'bear false witness'. At least the military courts respect the 'fog of war'.
They, all these institutions, defend the wealthy who lie and blame me when I tell the truth.  I'm a truth teller and it's not a healthy trait in a deceitful society where our leading politicians admit to breaking laws, smoking dope,  and everyone thinks that that's okay.  It's okay if our leaders break laws in office and  do drugs.   But I don't do drugs. I tell the truth but even that doesn't protect you here.
And I'm afraid of hospitals.  Because my life was threatened by a doctor who was a friend of a doctor who I reported for killing a patient and I've never been forgiven for 'doing the right thing'.  All the doctors who are 'loyal to the group' and 'covered up' the killings were promoted to high position. I may well be the last surviving witness.  As a witness to the truth I live in fear. I know judges who despise me for telling the truth.  I know doctors who hate me.  I know nurses who think I shouldn't have stopped a serial nurse killer but then most people don't know the truth. The media is propaganda and cover up.  I've seen the bodies.  I don't think of all the good people and good doctors and good judges and good lawyers and good experiences in hospital.
I'm afraid of being sick.  I've seen too much sickness and disease and death.
I'm not afraid of dying. Being dead has it's own attraction.  It's the getting there.
I'm  afraid of dirty doctors, dirty hospital administrators, dirty judges, and dirty nurses.  I know they're rare. They're as rare as HIV but I can't wear a condom when I go to the hospital.
I'm crying.  I'm terrified.  My brother drives me to the ER. Queensway Carlton Hospital, Ottawa Canada.
The nurse is some kind of really beautiful, she has a row of earring on her right lower ear lobe.  She is efficient and caring and asks all the right questions.  The equipment is older. The waiting room is full.
I am thinking of the dead man in the Winnipeg Health Science Emergency.  He sat dead for 34 hours before someone noticed him. I'd taken my dad to the Victoria Hospital emergency there after he had a car accident. The seat belt had crushed his chest. He'd had chest pain. He's had a heart attack. He'd had multiple physical injuries and back trauma in his life working as an engineer, doing hard mechanical work, and now was hobbling and worried about his breathing, chest pain. He has a  pace maker. He was in his late 87 at the time. We didn't see a doctor for 9 hours.
I never tell people I'm a doctor.
I never tell people I'm a doctor, well, mostly.
I watched a senior bureaucrat from the Ministry of Health in Manitoba get a hospital ward cleared for his care alone, very special, very special, very privileged health care. He was sick and needed the emergency care but I didn't like that beds were closed for him to have more privacy.  I believe that the deterioration in the Canadian Health Care system which has gone on these last 20 years is directly a consequence of senior levels of government being able to bypass the health care system and get care across the border or with special insurance get private care.  If the officers eat what the men and women eat then the men and women are going to get better grub.
I know the way things are is right in a certain way.  I have patients jump queue all the time. Queues in medicine are to be decided by 'need' but increasingly people are 'buying' the 'express lane'.  In medicine that means someone is dying. It's not like airplanes and first class. It's different but the fact is I can pull rank and I have.  It's a hard call and 'baksheesh' in Canada is 'institutional."  I believe doctors need to be the ones who make the call based on the 'emergency' of the case, not on 'money' alone.  I know that my symptoms are 'emergency' material. I couldn't deny them and haven't described all of them.  They are the kind of thing that gets attention.  Some people now read the internet and get all the symptoms then present to the emergency with classic hypochondriasis.  They don't know as I do that hypochondriasis can get you killed. I have a healthy respect for 'investigations'.  Do enough and something will be wrong and if something is wrong then someone will try to put it right. I err in the other direction.  I  depend on denial to breathe.
I know some animals are more equal. It's not right but looking for justice in the courts is like looking for love in a whore house. Just as our courts and health care system are better than most alternatives I'm blessed beyond belief.  God is good.
When my father was in congestive heart failure and had pylonephritis and was delirious and the woman at the front desk was doing her nails and superciliously obnoxious, telling us to take a seat like sick people were inferior,, well,  she'd call a doctor, but I watched her and watched my father and 15 minutes later knew she'd just continued her union job talking on the phone to someone, not a doctor. She'd not called a doctor. I was watching.
Well I did, walk over, tell her who I was.  I don't like to tell people I'm a doctor to get special care but I sure let people know I'm a doctor to get appropriate care.  Walk softly but carry a big stick was the way my grandfather figured. I told her that if my father with the swollen feet,  short ness of breath and increasing heart rate,  I'd told her,  with his rapid breathing getting worse, if he died because she was fucking talking on the phone some other fat cow,  I'd hunt her down myself so she would beg me to call a lawyer so I wouldn't take matters into my own hands. The doctor, a very good doctor, quite amused by the response, obviously aware of the weak "union' link in the 'system' saw my dad immediately and had the lasix in minutes later. My father's breathing and colour improved immediately. I don't know what happened to the woman but I hope she left health care.
I'm afraid of petty women with power.  I'm afraid of the Borg.
I'm afraid a lot but really afraid when I'm now thinking I might go blind. It's possible. The denial hasn't worked and there aren't a lot more defences.
The nurse really was beautiful and efficient and competent. I knew because she asked exactly the right questions and did exactly the right thing. It's like watching a Canucks game when the doctors and nurses are doing it right, and you know because you're in the league.
Then the girl who took all the money information had that bit done.
And another nurse checked my vision.
And then a doctor arrived and he did the history and asked the right questions, and was calm and examined me with the fundoscope and told me what he saw, as I hoped. There wasn't a detached retina. You can see that with a fundocope and you can see blood.
And he referred me to an opthomological surgeon. He did that because otherwise he'd have to dilate my eye. When I was alone in the north and didn't have specialists to refer to I dilated the eye to look more closely. It's hard to see. I had slit lamps and all that stuff too. I've actually seen retinal detachments and tears in the opthalmoscope. It's not that common.  I've been around.
But if you're going to see a surgeon, he'll do all that dilation stuff and then you don't do it.
It was vacation and I'm on my way to see an ophthalmologist on call at the eye centre. No one was at the hospital available but that's okay, I'm not going to blind.
The pace of everything has changed to  okay now. I can see. I'm not going to be blind today.
When the doctor was discussing his findings with me I told him I was a doctor, had been an ER doctor, and was now a psychiatrist.  He understood I understood and could just send me on my way without a much longer explanation.  He was a very good doctor, Dr. Chandria, I think his name was, really fine young doctor.
I'm going to see the specialist in an hour.  I"m not going to be blind.  The pace is slower. There's no emergency of minutes or hours. Maybe days. Maybe there's a concern today but it's not like a sneeze is going to make it worse now.
I'm going to be able to get back to denial mode soon. I can feel the panic backing off.  It was silly of me to swear and cry.  A better person wouldn't swear or cry.  All the superior people I deal with so often,, they'd not swear and cry.  I know they're perfect. I'm not. I'm going to be okay, though.
I've got half my smell and am only a bit of a gimp, chronic pain and getting older.  I worry way to much about my patients.  I'm a mess.
But I'm able to see and write and I will still be able to suture someone up if I need to and I'll be able to see if they're anemic and watch for jaundice and study their expressions when they are lying to me or holding back something essential, because they're afraid.
It's going to be okay. I 'm praying. I m breathing. I don't think I was breathing normally there for a bit

addendum
I was seen by Dr. Thomas K. Lee, MD, FRCSC (2211 Carling Avenue, Ottawa, Ontario, K1Z 8R1 - tel 613-226-7061) at the Retinal Centre of Ottawa in Ottawa General. He and his colleague were the epitome of professional competence and concern.  They were extremely thorough in their examination.  They said that the retina was fine, I could fly home and that things should be okay but if they weren't I could contact the UBC Eye Centre. I told them that my ophthalmologist was Dr. MacIntosh. I said I'd be sure to tell her that their examination had caused psychosomatic retinal healing of my retina by inducing my placebo response. They laughed and I was really thankful.  Dr. Lee and his colleague saved my sight today.

The Eye Clinic had had 15 patients book and was inundated with another 50 emergencies. The staff were as amazing as the staff we have in our Methadone Clinic in DTES Vancouver. The patients, though were better behaved. We all waited hours and when I left there were more waiting.

My brother picked me up. With dilated pupils I was thankful for the shades my sister in law had offered as I left.  Driving home I remembered the incredibly good care I got in Winnipeg General the time I was hit by another car and mine bounced head over heels before rolling sideways and righting itself. Then I remembered the time I was on my bicycle and hit by a car going through a stop sign.That day the UBC hospital doctors saved my life. The ER care was beyond good.  Now I'm going to live I'm able to see that whole catalogue of great doctor experiences I've had. I can remember all the good nurses and know that I was working there for years and helped countless people myself in a half dozen different hospitals.  But on the way to hospital, all I could remember was the horrors, especially the corruption.  Perception is so keyed to emotion.

Dr. Lee may well be a world renowned retinal specialist but he's a pretty good psychiatrist too.