Wee hour peanut butter and jam

I am having a peanut butter and marmalade open sandwich.  It’s 5 am.  I woke up at 330 am to pee and now have peed twice, said prayers, petted Madigan and read university on line course offerings.  I completed my winter adventure and the spring now waits. I have a course to complete on driving and driving training to do. I continue my studies in gender.  I’m attending church and AA.  I could play guitar and sing again now that I have hearing aids.  

I’ve a day of work tomorrow.  I’ve paperwork to gather for my accountant to complete my taxes. I’m been whittling away at such tasks. I’ve laundry to pick up and drop off. I’ve not yet returned to doing my own loads in my own washer and drier given the bags of laundry I’ve been doing.  The Merry Maids came yesterday and did a marvellous job of leaving the place clean and tidy. It’s uplifting to have that feeling of being cared for each time they come and go.  I slept from 10 to 330 in a well made bed with clean sheets and comforter. I have been using the electric blanket and enjoying the warmth of bed. It was snowing/sleeting yesterday.  The temperature has been very low and my propane heating costs very high.  

The 10 week 10 hour a week course on prehistoric ritual and religion appeals to me. I considered the history of medicine and history of art too but keep returning to archeology and anthropology in my on going training in spirituality.  

WPATH is meeting in Lisbon.  I’d thought of attending. Portugal is appealing but what as far as I can tell my bucket list now is only Venice, Vienna and Berlin.  Southern Ireland and Scotland are forever calling now.  I always think a bridge too far and must reign in enthusiasm.  I enjoyed reading the philosophy of mind course addressing the mind-body issue andd yes I’d like to take that.  I enjoyed studying Biblical Hebrew from the University of Jerusalem but the problem then was poor broad band connection with the internet I received on the boat at dock.  Now my Starlink is really serving me well.  My home is back to normal with too much clutter.  All I need is available but I do need a run to the storage locker and I have that nagging feeling I have to seriously reduce the cost and collection.  I have too many old clothes.  Given how little I needed this 2 1/2 months in the south I really don’t need all of what I have here or especially what I have in storage.  I enjoyed putting bags of excess clothing in the diabetes clothing bin behind my Ford dealer.  

So here I am with my mind considering all that I have to do.  I did drink strong coffee at the meeting last night.  George told me he’ll be 82 next month and shared tales of his younger years travelling about partying with friends and losing jobs and changing jobs with his portable skills in waiting and bar tending.  I reflected back to those days when I enjoyed the freedom of having a ‘job’ compared to the ‘career’ I have today.

I enjoy my work on line.  I’ve been back in the clinics and will be back at docside next week.

I thought of doing a series of papers on psychopharmacology and doing a simple utube presentation of the studies.  

I also reflected on those folk who watch documentaries and learning channel, History and National Geographic.  I do that very little, my principle night television watching a recent movie, a thiller or war or spy, or detective.  Last night I watched another episode of NCIS and enjoyed Gibbs.  I’d earlier watched an episode of Star Trek.  I feel inspired not only to learn but to write and create but so far all it comes down to is I can’t sleep and I’ve now had a peanut butter and jam sandwich so should get back to sleep with the hope of another hour or two.

Maybe I’ll read in bed for a bit.  

I’ll fill out the university application tomorrow. I resisted doing it today. It’s the same course I contemplated a year ago.  The British Museum exhibit of early man excited me as did my archeology studies in undergrad of the Minoans and Mycenaeans.  I was blessed to visit Knossos.  

I was glad to get back in touch with Bob, his accepting a referral I made. I really ought to arrange for coffee and discussion .  I’d love to keep up with what he is doing and enjoyed our discussions in the past.  

I’m 72.  I was thankful for all the birthday wishes on Facebook. Otherwise it was a non event that is still dawning on my. 71 was a very good year.  I’m grateful for the blessings I’ve had .

I don’t struggle with Jesus as son of God.  I appreciate Yahvew as being and creator.  I understand Jesus as the human face and the Holy Ghost as a motherly force but the idea of Jesus ‘dying for our sins ‘and Paul’s Judaic ‘blood sacrifice’ though is lifted out of the primitive religions I wish to study. Like Golden Bough.  I find that interpretation of the Life of Jesus stilted.  I more easily relate to the mysticism of Jesus and Christianity.  Knowing God. Prayer and meditation.  Sin means to miss the mark, the imperfect.  I like Kurtz , the Spirituality of Imperfectin and Cohen’s the crack that lets the light in.  Our Brokeness but the ‘sacrificial’ no so much which is why I guess I am attracted to this course. In addiction the person is killing self and turning their back on life and God.  

We discussed faith and fear last night.  FEAR - Fuck everything and run or Face everything and Recovery.  George shared another I’d not known False Evidence Appearing Real.  

I have knee and back pain.  I have been careful because I need to be able to walk to serve my dog.  We had roast chicken tonight.  

Well, another try at bed.  

 

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.

John Rauls and Academic Fame

My friend is a philosopher who lectures college students.  She gave me a copy of John Rauls decades back. I duly read it, mostly because she is extremely beautiful and worried she'd quizz me about it at sometime in the future.  When I'm not reading about neurochemistry and Higgin's particles I'm more often than not reading theology.  I liked that Rauls said to paraphrase, justice is to social institutions what truth is to the individual.'  I've always liked the 'as above, so below' connection between macrocosm and microcosom. I just didn't realize that John Rauls, Theory of Social Justice would become so important. It was written in the 70's and I read it in the 90's and today I learned it's one of the most cited of social philosophers.
I've had this experience with individuals before. I read Harvard's, George Vaillant's book on the Grant Study, wrote to him a very appreciative letter in the 70's long before I knew he was one of the 'grand men' of our age.  I was just delighted that he corresponded with me and later I had the opportunity to meet him, a truly wise and remarkable man, a few years ago.  I read Thomas Kuhn's, "The Structure of Scientific Revolutions' a few years after it was published in the early 60's .  Today paradigm is a garden variety word thanks mostly to his book.  I read Turing early in my interest in computer programming when I was writing in Basic and MS Dos long before I cursed program language realizing I could speak swahili, punjabi, mandarin and spanish if I had devoted my attention to learning living rather than techno language. I still enjoy learning spanish but will likely die before I ever  learn swahili. There is simply not enough time for learning all one wants to and so much interference in the study of what really matters.  
Recently I read Jared Diamond's first books and happened to share the tastes of the world as that great genius has also gone on to acclaim he deserves.
When I travelled I used to carry a copy of the Bible and I also had a copy of Plato. I enjoyed in my 20's  reading the discussions  of Socrates.  Over the years I'd routinely read three texts, one about some aspect of sociocultural world, from the  arts , a scientific text, which might be from any aspect of science, medicine or psychiatry, and finally a novel which commonly discussed matters of importance in the other fields.  I've loved the writings of physician writers like Michael Creighton and recently Daniel Kalla.
I loved Love in the Ruins and the Joshua Tree.  I've loved those books that spoke to our times and culture, like Robertson Davies trilogy.  Obviously reading Thomas Mann's Magic Mountain was an insight into asylums, tuberculosis and the human spirit just as that other nobel prize winner Magister Ludi caused consideration of meaning as much as Victor Frankl's writing does.  Recently I was reading an economics text, a physics text and an evangelical theology text side by side getting relief from them by reading the antics of Flashman by Macdonald as he boisterously raced through the hot spots of history.  Most of the ideas of science fiction a hundred years ago and even only 50 have come to pass.  I laughed because several of my patients were called insane for thinking exactly the same way as  characters out of a William Gibson's novel.  I thought meeting these exotic creatures some of my colleagues should get out more.  Not at all insane by global standards but definitely beyond the mindset of Georgia and Howe.  
An old friend, the father of my dear friend, before he died told us how he'd supported himself in the latter years. He'd had very little or modest returns from all the best stocks and investments. However he chose to invest in an obscure company because he thought what they were up to was rather brilliant. This man was a scientist in chemistry himself but chose to buy stock in this obscure little start up.  "It was called IBM. It's provided more returns than all the other blue stocking stocks put together and allowed us to live as we did after retirement." he told his son.
I feel like I've invested well intellectually.  There's a kind of 'social justice' in that.  It's the truth.  John Rauls was a good read even if my brilliant and beautiful friend never asked me about it later.  But today as his name has achieved an even greater popularity I am thankful to her too for recognising gold in the dross.