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.

Work breaks, back logs and psychosomatics

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

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

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

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


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

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

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

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

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