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

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

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

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

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

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

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

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

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

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

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

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

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

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

Kierkegaard said ,” Life is suffering unto death.”

Much of trauma isn’t the actual event.

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

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

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

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

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

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

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

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

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

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

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

 “I want to fuck you up the ass?  “

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

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

When I was 45 years old I was in Homewood Treatment Centre and they asked me to list all the ‘events” that I ‘felt’ were ‘negative’ or ‘traumatic’ and to list beside them what alcohol and drugs were involved. I was then to make a list of all the things I most liked in my life and what drugs and alcohol were involved if any.

It was glaring evidence that while ‘shit happens’ most of the really bad ‘shit’ in my life happened when I was ‘drunk and stoned’.  Not a little drunk and stoned but as the girls proudly say to day. “Legless’.  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“LICK ABOVE, KICK BELOW”.

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

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

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

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

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

 He was schizophrenic.  I literally gave my new boss shit .”I dont fucking care what you were doing. You put a whole fucking hospital at risk of infection and this man was not eating and dying in a hospital. It’s pathetic. “ 

 I was told that it was unprofessional to use the word fuck. The College of Physicians and Surgeons heads a whole multi million dollar wing for bureaucrats to address real doctors who use the fuck word. Another multi million of College of Physicians and Surgeons is devoted solely to addressing real doctors who use the word”shit”. There are fewer afewer and fewer doctors and nurses as a consequence.

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

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

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

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

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

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

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

“ I just did.”, I said.,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

That’s was a living.nightmare.  

35 yo Riverview Psychiatric Asylum

I came back to Vancouver and began to work at Riverview Hospital, the British Columbia Asylum, made famous by the movie industry which routinely used the ward and building in front of mine for horror movies.  I’d be in charge of the Acute Care admissions ward, share responsibility for coverage of the ICU ward and consult to the brain injured ward. I’d also rotate and cover for other wards when doctors were away.

I got a condo in Burnaby.  The work would be steady with a few surprises.  I enjoyed the patients. I worked with the greatest nursing team. The head nurse was a great guy who bred dogs and had terrific stories.  I’d do experiments with high dose medications to see if chronic schizophrenics responded to these industrial dosages.  One or two did but the anxiety we went through taking the medication dosages into the stratosphere wasn’t worth the modest gains. I did become competent with neuropsychopharmacology and knew Schizophrenia and psychosis better.  

There was one fellow who ruled the chronic male unit.  I’d bring my dog, Shinto,  with me. He’d stay in my Vanagon during the day. At noon I’d walk him over the luscious grounds. Everywhere we’d find ‘bedding’ places, sometimes with condoms, mostly without, sometimes with drug paraphernalia, mostly without.

I noticed this one guy was canny.  I asked the others about him and everyone shied from eye contact.  Eventually one man told me he was afraid of him and he beat men up he did’t like.  I confronted him and asked why he was ‘acting crazy.’  He just got very angry.  The next day in the downstairs basement leading from one building to another he tried to ambush and jump me. I turned quickly enough and was apparently more dangerous than he hoped.  

“I’ll kill you if you interfere with what I’ve got going here. It took me a year to get moved. Every day I fuck the mentally retarded girls . I have the run of the place. The guys respect me. The nurses do as I say.  You’re not going to interfere with me, you hear.  I’ll kill you if you do.”

Fairly frightening little shit and very impressive knowing my routine and laying for me in the dark corridors.  I was even more ‘devil may care’ when I came back from the island. I was still doing martial arts too and carried a knife and the keys .  

The head nurse on this chronic dangerously insane men’s ward was aware of the guy, didn’t know what to do, one of several transferred from the prison to the regular psychiatry ward. It turned out the prison was using the psychiatric ward as an ‘extension’. This guy was clearly a psychopath. Mothers and fathers were leaving their mentally retarded sons and daughters in the asylum and these sex offenders were making their way through the back door to the sexual feeding grounds.

I approached management and surprise! they were simply not interested. “Everyone is thoroughly ‘vetted’. It couldn’t be happening.” Blamed the judges if it was.   

If there is one thing to know about the Canadian Communist/Governkment administration is their favourite go to psychotic response is ‘denial’ 

followed by ‘cover your ass’ 

followed by ‘somebody else’s problem’ 

coupled with ‘kill the messenger’ 

but mostly passive aggressive delaying and ignoring tactics. 

The worst which eventually happens is ‘they ‘ form a committee’ which then means the ‘problem’ will not be addressed for 2-10 years. 

I took away the guys off ward privileges.

He again tried to jump me in the downstairs halls having escaped from the ward. He had a knife this time. I suppose he called it a schiv. I pulled my knife. I was bigger than him and crazier and he backed down. I didn’t even have to cut him up.  Just a bunch of circling posturing and threats.

“I get you next time “ he said. Hadn’t expected a psychiatrist to be armed. 

I spoke to the great matron, there are these amazing women in asylums who are like great mothers who just want ‘right’ to prevail and don’t like kids being bad. She rather liked me too. When I described the second attack and the whole circling with knife things she said that the asylum had it’s own solution to such characters.  It turned out there was this ward of really dangerously insane men. Very isolated, very guarded and very back ward. She arranged the internal transfer.  No easy picking there. He’d probably rot his life away there.

The difference between the jail and the asylum was that in the jail there was a fixed time with potential for parole whereas in the psychiatry ward there was no fixed time, but rather you got out when you were ‘better’.  A Governor General’s Warrant was even worse as it could be indefinite.  People didn’t generally ‘get better’ on our backwards.  They were usually brain damaged and szhizophrenic, often dangerous, and everything had been tried . This psychopath was no longer ‘top reptile’. The girls were safe too.

I was really miffed that the jail was using the asylum for an extended wing too. Patients deemed “mad” are mostly not “bad” whereas the government was turning the foxes lose in the hen house. 

I’d spoken to the mentally retarded ward and found out that this was not an isolated incident. This was the height of Aids and there were no condoms in the hospital.  Sociopaths and psychopaths were bedding the mentally retarded girls and the mentally ill in the long grass and nearby woods. Everyone in administration was complicit but acting like it did’t happen. My campaign was for condoms and better vigilance with respect to the mentally retarded women.  

The atmosphere in government facilities is ‘stagnation’.  Any attempt to change anything was met with overwhelming resistance. Just getting condoms into the hospital implied that the mentally regarded were capable of sex and that inmates might well be having sex. Testing for STD was even more disturbing. Yet that’s what I did and it wasn’t at all ‘controversial’ outside the limited intelligence of the PC administration. Mentally ill patients were high risk for HIV and othe STDs and bullying.

There really was a One Flew Over the Cookoo’s Nest was the line up at the nursing station for meds. What was weird was  a similar line up at at the bus stop twice a week.  I’d prescribe antipsychotics at increasing dosage to decreased aberrant behaviour. The patients would line up at the nursing station twice a day for their pills. Some did the ‘Thorazine shuffle’ and many had Akithesia and Tardive Dyskinesia. Some of these same people would line up twice a week at the bus stop.  The ones who needed the most medication and had the most side effects of my medication were the ones who were at this bus stop line.  

I investigated as no one seemed to know, or want to tell me.  The head nurse told me after a few months that people didn’t like to let me know things as I’d do something about them. He  said they  liked me so didn’t like to see me get in trouble for ‘rocking the boat’.  It turned out twice a week drug dealers took the bus to the asylum and sold their drugs to their customers who would line up just like they did for the nurses.  These patients would go more insane and I’d have to give them more drugs and they’d have more side effects.

I approached administration again. I’d only been there three months and had encountered glaring problems, at least they’d be seen as glaring to a doctor but obviously weren’t ‘administrative’. 

‘There’s nothing we can do about that.!”  

Why not.

“The bus is out of our jurisdiction.

“Call the police. Have them catch the dealers.’

“We don’t’ want to get our patients involved.’

Nothing got done. More violence, longer stays, more tardive dyskenesia.  

The tobacco was always a source of conflict in the unit but no one was willing to make the ‘hospital’ wards’ ‘abstinent’. I was a smoker and I understood the addiction. Everyone was smoking. Major smokers in administration and nursing in government health care.  

All that happened was patients had cigarettes given on the hour.  The fixed incomes and increased costs of cigarettes really impacted the ward with fights and violence and more drugs and ECT until the great head nurses on their own decision began bringing large tins of Drum and letting patients without resources roll their own.  The nurses were like sergeants in the army and terrific at practical things. The hospital administrator was like an army general in peace time with syphilis of the brain.  The rest of us ‘officers’ were wise not to bother him. I bothered him routinely.  He was totally clueless and routinely didn’t even know what I was talking about.

The big administration act of the year was to remove the ‘doctor only’ parking in front of my acute care unit and put ‘administrator only’ parking there instead. I’d actually come into the unit for emergencies at night but this was a major administrative ‘coup’ . It showed doctors who was most mportant.  We as doctors were collectively required to park in staff parking a 10 minute walk to the unit while the administrative ‘fat cats’ now didn’t have to even carry umbrellas. I never saw any administrator move faster than the fastest lady walking their tiny poodle. The head actually waddled.  But now they could get into the buildings in case of an ‘administrative emergency’ while the doctors who were lean and mean would sprint from their cars to the buildings where people really werehaving  cardiac arrests and hanging themselves. Administration is all about status and symbols. 90% unnecessary they played all these adolescent games. 

The administrator took over a whole building. There were only about 5 buildings and one became the administrative building. At one time when patients mattered the administration was spread out through the buildings. But that was back when there were thousands of patients. Good medicine and scientific advances had reduced the patients to a rifth of their previous numbers and multipled the administration by as much. There were few doctors and few nurses but a whole building of administration.

Once the head administrator brought the Minister of Health round to view my ward. I immediately confronted him and said that Administration had not notified us they were bringing guests around which is required.  Further I’d never seen him before on the wards so couldn’t vouch for him as the Hospital Administrator.he’d have to provide proof , He would eventually provide some identification when he realized I wasn’t joking. .

As to the Minister of Health, I knew him and welcomed him and told him what a good job he was doing and how privileged we were to have him visit us . He was highly amused at the Hospital Administrators embarrassment but the truth was he’d never come round the wards.  I toured the Minister of Health around the ward.

Administration never left their building where they made paper forts all day with paper hats and ran about in paper costumes chasing the secretaries with crayons.

The nurses ran Riverview Hospital.  It was a great place for patients with immense compassion and competence on the ward and a really good place to heal.  The bars were on the windows to keep the insaniety out and for all the patients to have asylum.  The craziest building in the whole place was the bizarre perverted administration building with these really weird people who had all learned Monty Python walks to do their jobs.  

We had an incident where the girls on the ward started putting clown make up on their faces with crayons. I told them that they had told me they wanted discharge and yet the column the nurses filled in which said ‘personal hygeine’ and ‘behaviour’ now had ‘wearing crayons on their face’. I told them I couldn’t very well discharge them if they persisted in ‘acting crazy’. It wasn’t rocket science, act normal and I can discharge you.  

“Then you should let us into our lockers.” She screamed at me throwing a crayon at my face.  She was more insane than just crayoning her face insane. But I was curious so went to the head nurse and told him what had just happened.

‘What’s with the lockers.”

“We hoped the problem would be solved before you found out.” 

‘What problem.”

“The hospital got all these new lockers this month.”

‘What was wrong with the old lockers”

“Nothing’

“What’s wrong with the new lockers.

‘The locks don’t work.”

“Don’t work.”

“Yes, when the patients shut them they can’t open them again.”

“So all the girls make up kits brushes etc are locked in the lockers and they’ve all been looking like street people these last two weeks hecause they can’t get at their kits.”

“That’s about it”.

“What’s being done about it”.  

“Maintenance is going ward to ward fixing all the lockers. They’re due here next week .’

‘Why did we get lockers that didn’t work in the first place.

“I don’t know but there’s an election coming up and the old timers say that some big wig with a lot of lockers that didn’t work gave money to one of the government parties so he could get this government contract and unload all his lockers which didn’t work on us.’

“Really.”  

“That’s what they say. Makes more sense than anything anyone else can come up with .”

‘Administration knows.’

“Oh yes.’

“I wasn’t told.”

“Correct.”

“So for 2 weeks I’ve been holding patients accountable for behaviour well beyond their control and holding off dicharging them because they looked insane when the insaneity was in the system not in their individuals brains.”

“Correct’.

“Wouldn’t it be better to have told you.”

“Maybe, But we were afraid you’d do something. Everyone likes you and we don’t want to lose you. We were afraid you’d do something.”

“Bloody right”

Right there and then I picked up the phone demanded to speak to the hospital administrator and said.

 “Do you know about these lockers that don’t work worth shit and my patients can’t get their hair brushes for weeks because they’re locked in these fucking lockers that don’t work worth shit and you had them installed here?”.

“Yes. Dr. Hay. I’m fixing the problem. Maintenance is going around the wards making the repairs. “

“If you don’t have these lockers fixed immediately I’m getting a tire iron right now and solving this problem myself!”

Well, the administrator was a physical coward and very much a mommy’s boy , sort of drooled a bit when he had to think which caused a terrible strain on his very tiny but unused brain. .  Staff were all laughing shortly after because they’d seen his brown stained pants racing out the door and him speeding away in his Cadillac.  Word followed that he actually thought I was going after him with a tire iron. He told everyone that as he ran. 

His grandiosity was severely out of control. Not even a 5 year old kid would need a tire iron in a fight with that little girl.  

“Does any one seriously think I’d need a tire iron to fight him.Wouldn’t I just beat him to death with my bare hand?  I told him I wanted the lockers fixed today so I could discharge patients who didn’t need to be here. I was going to use the tire iron to open the lockers to retrieve their make up and hair brushes.”

I don’t know if the administrator ever got the brown stain our of his grey trousers but the lockers were fixed that day. The next day three women who’d been well for 2 weeks were discharged .  More beds were made available for new patients.

Where ever I went I reduced the length of hospital stay by usually half with active therapy.  

At VGH inpatient I had caused a scene when a patient was admitted  who became depressed and had a history of staying 6 months in hospital. He refused to leave his bed and insisted he wasn’t going to attend any of the ‘therapy’.  I lay down in bed beside him There were a dozen staff on rounds with me.

He looked at me , big bearded guy, ‘What are you doing”.

“I’m not working just like you.” I replied

“Get your own bed.” 

“I like this one “ I said. That got him out of bed.

There was a real shortage of beds. People were in the halls and streets and lying in front of doors and these hospital beds were at premium.  $2000 a day. Therapy wasmedication and a whole lot of psychotherapy, music therapy and physical therapy. Patients were here to attend therapy. Just like a surgical ward. We couldn’t have surgical beds full of patients who didn’t want surgery when there’s a line up for surgery.. It didn’t make sense. But nothing makes sense when the administration is working on some agenda of their own unrelated to patient care.

When He got out of bed, having no where else to go he got involved in our active therapy program. 

Meanwhile the VGH inpatient head nurse who was just getting to know me, had had already sent some one for the head of psychiatry to tell him Dr. Hay’s gone mad.. she told me months later that the head called the ward and she had rescinded the request for help. 

The guy who’d moments before looked like he was going to hit me had got out of bed and attended the therapy, 

We had 6 hours of therapy a day. When I came hardly any of the groups were full and most of the staff were working half time in their full time positions. After I was there every one was full time in therapy. The lengthy of stay went from 6 months to 3 months and 3 months to 6 weeks. The staff who liked doing therapy loved me. They had these really exciting groups and patients really improved. The staff who liked fucking the dog were angry now that they had work and hated me.

The female head of the inpatients was a brilliant doctor but she was doing three different jobs getting paid three times the rest of us using her time strategically with other activities. Her ward was the longest stay in the acute care. She filled it with ‘dependent personality disorders’ , women who were chronically needy, suicidal and hypochondriacal.  They loved her because she mothered them, let them stay for months and gave them what they wanted . A paid vacation.

I did an Amytal interview on a dependent personality disorder on the ward, the worst, most entitled , most demanding, and least ill in a psychiatric sense, though truly a narcissistic sociopath. 

 “My husband doesn’t make enough money to give me a vacation in Hawaii each year. Mommy and Daddy took me to Hawaii every year when I was young. My husband was rich when I married him but he’s no good at business. Not as smart as Daddy or me. Won’t listen to me. So I found that I can come to the hospital for 3 months and the staff will take care of me. They’re not as well trained as the waitresses and hotel staff I’m used to but it’s the best I can do. I’ve been coming here for a few years and thought maybe I’ll try a different hospital to see if they have better servants.”

This came out as a result of my simple questions. We discharged her shortly after. The nurse who was “offended” by the interview and sided with the patient claiming she was a victim, by her behaviour according to group analysis identified herself. I discussed her with the head nurse who disclosed a nurse was stealing narcotics. I said it was likely her and with the pharmacist set up a sting that caught her the next day. That was at the Asylum.m

The VGH head was displeased as suddenly her ward of very happy patients were complaining that I was requiring them to attend therapy rather than reading fashion magazine in bed and doing their nails. She actually asked me if demanding patients attend therapy wasn’t cruel and unusual therapy.  She caught herself and laughed. She certainly didn’t want  to see sick patients on the ward so transferred me to another ward. Her patients would be protected from the terrible demands of attending music therapy, yoga, CBT and all that other nonsense .She felt that beds were for patients to lie in while she gave them medication orders and 6 months later discharged them. She was really smart and she knew this gang of groupies who came every year were dependent personality disorders with dysthymia but she really had more important things to do than attend to hospital patients. That was the ‘wards’ responsibility’ .  The ward wasn’t going to do anything either because everything I proposed involved ‘work’. The whole work and cost of psychiatric hospitals was the admission and sicharve of patients. 

In Canada people get government jobs to avoid work.  That and the high pay and great pensions and powerful unions.  The minimum work gets done but only the minimum. There is absolutely no incentive for excellence or meritocracy in the Canadian Health Care System.  Infiltrated to the max by communist ideals everyone works to the least.  I was an aberration.

I arrived at the Asylum and the suicide rate was 30 attempts per year on my unit and 5 death.  The gp who I took the ward from not trained in psychiatry had been rewarding the suicidal patients with attention and interest and regular gold stamps. The women were killing tthemselvs for his love and adulation. A really nice guy but like having an untrained Monkey doing surgery. The trouble was a a system without respect for specialists.  In Canada doctors have been collectively reduced to being called ‘health care workers, comrade”.

 Having worked in Brandon Mental Hospital where I stopped the suicides and having stopped suicide epidemics on the reserves I trained the nurses in prevention and recognition and minimized the response to the suicide attempts treating them as fever rather than a rock star event.  Basic Skinneraian reward and extinction mechanism. Knowing  attention is the gold and favouritism is the platinum of the psychiatric ward, I change the economy to reward good behaviour., getting well, participating, making discharge plans etc. You give attention to ‘sane’e behaviour rather than ‘insane’ behaviour. Passes and everything were rationalized under the new regimen.  

When I left there had been no completed suicides on ‘my watch’ and ‘attempts’ had dropped from 30 to 10. 

I also had taken borderline personality disorder as my special interest on completion of psychiatry.  Borderlines were the best love/hate suicide/homicide folk. 

There was one girl who killed herself in the community. She had far more attempts in the hospital than in the community but I really regret not admitting her because she’d literally burnt out the community psychiatrists in the classic borderline pattern of destroying her hinterland of relationships and moving along to the next. She was 6 months in hospital and 6 months out. We’d learned that the short stay Unit was the treatment of choice for borderlines but I’d stepped back int the time before people realized these long stay only worsened coping and increased likelihood of death. I did the right thing but she killed herself in the community and while I avoided her killing herself in the hospital on my watch she remained one of my regrets. I could have done better,

In my house and in my care my year at Riverview was a great success. 

I had a lot more stories.

The drug research and an attempt to kill me were certainly interesting moments. But I’d also met my next wife there and was off to the proverbial races. Obviously you shouldn’t marry a girl you meet in a provincial psychiatric asylum even if she is another doctor. 

34 yo -35 yo. VGH, Comox.Aids epidemic, Terror, Love and Lust

I became the supervisor in the VGH Psychiatry Emergency.  I’d also work on a psychiatry inpatient ward and do drug research for pharmaceutical companies.  It was a very heady time. I’ve been blessed in the work I’ve found, stimulating, interesting, challenging, with good colleagues. Not the great teams I envisioned but good people.

The great team requires a commitment to excellence and meritocracy but communism had begun to invade the health care system with the increasing power of the unions and the lack of training of administration.  

I was there when the cleaning staff in the hospital refused to clean up blood.  This was the height of the AIDS epidemic so no one could fault them but it was also the beginning of the end of the Canadian Health Care System. Overnight highly trained nurses were required to do the job of the cleaning staff because the administration would not do it’s job. As leading health care professions, the highest trained individuals were increasingly expected to do the menial labour.

It’s not in the ‘menialness’ of the job but rather in the fact that no one could do our jobs. Our specialization and training entailed years of advanced education. I couldn’t be replaced tomorrow any more than a nurse could be. But with days or weeks of training a cleaning person could be brought up to task.  Rather than do that administration made a unilateral executive decision to remove the leading personnel from their necessary and irreplaceable jobs and have them do the lowest least least trained jobs.  

This is the failure of communism and the NDP in BC dominated the health care industry and played to the lowest common denominator for votes.  It was sad seeing that one day that doctors and nurses began to clean up the blood . I did that. Rather than seeing patients we were cleaning. I’ve cleaned alongside nurses for hours. All the while a cleaning staff person stood by and literally ‘smirked’.  

Today I’m doing all the work that once was done by administrative staff and clerical personnel and now administration is living a perpetual party going on and on in utter ignorance creating more and more self serving propaganda about their importance all the while morbidity and mortality and other medical and nursing matters are left at the wayside.

Rather than improve the plumbing in the old hospitals and put sinks in the hall way so staff will wash their hands administration goes on and on and on about getting people to wash their hands knowing as all of us who are researchers know the key to this is hallways sinks.  Repeatedly the research has shown that staff don’t like to use the patient’s wash room and that sinks at nursing stations are surrounded by files and charts so no one wants to wash their hands there. The staff washrooms have dirty handles.  While doctors are expected to be at the 21st Century cutting edge administration is somewhere in the 19th century swaggering and smirking and making a ‘killing’ in their jobs.

I increasingly am becoming aware of the graft and corruption in the system.  Repeatedly a few doctors are politically bought off and the rest suffer. This corruption in communist systems eventually erodes the whole.  There simply is no real accountability in administration and so much profit in anything but saving lives and doing real medicine.

The actual salaries now are seen as ‘base incomes’ with all the effort applied to ‘accessory’ income - getting tips as described in ‘trade’ but now these ‘extras’ are anything but the job the tax payer money went to.  

When I smoked dope and drank people liked me more because I was so easy going and didn’t particularly care.  We laughed when things broke down and crashed.  It was easy to forget about the disease and death.  That first year working in the Aids epidemic I didn’t think I was going to live. 

Police would bring psychotic HIV positive patients in the Emergency in chains and hand cuffs with bags over their heads and I’d go into the Quiet Rooms and talk to them as I took off their chains and took the bag from off their heads. They were spitting at us and trying to bite us.  I’d use all my compassion and hypnosis skills to soothe the raging beasts. I’d give injections and medications and still I’d not know.  Even now I tremble remember those times. I’d volunteered because I didn’t have children and I was single.  The cleaning staff were always laughing and smirking to see me the doctor on my knees doing their job after the patient was sedated.  The blood was in the halls and in the rooms. 

I’d be on my knees with a nurse and so admire her. The cleaning staff were always standing by talking to each other, pointing at us, leaning on their brooms and the administration never came to the wards. The administration were never ever was there.  

When HIV patients were violent and psychotic the emergency room staff would call psychiatry. A nurse and I would go. The problem was these young men and women were dying. The prostitutes had HIV. The Gay men had HIV. The drug addicts had HIV.  They’d come in with cuts and fractures and the emergency room doctors would need help.  As psychiatrists and psychiatric nurses we knew how to ‘manage’ the hostile and out of control better than security who were morbidly afraid of the HIV patients. I”d wrestle with one on the floor and no one would come to my aid because everyone was afraid of getting blood on them.  I got spat at so many times and cried cleaning blood off my face.  One person had a cut almost like someone was trying to scalp them. They were totally psychotic and flailing about. This amazing nurse somehow got the head board and strap on this fellow while I held him down with my body across their chest on the gurney. The ER doctor masked and gloved got the sutures in to hold the face and scalp together all the while the patients was trying to escape spitting at all of us, cursing.  

My surgeon friend died of AIDS from  a needle prick. A dentist I knew died. Our patients were dying.  What was happening in our Emergency was happening all across the country and continent while politicians and administration dithered. Lots of talk and posturing. 

One patient was a young gay schizophrenic prostitute who infected thousands of gay men.  I was involved time and again trying to get him kept in hospital. As soon as he went out he ‘cruised’ and he didn’t like protection. We petitioned this one judge repeatedly and he played that ‘civil rights ‘card .  I was a member of the Canadian Civil Rights at the time and had been in California in the Anti Discrimination League. I was a card carrying member and knew all the arguments. . In the end we figured this judge was homophobic and saw Aids as a means of cleansing the earth of ‘contagion’.  We were trying to stop the disease but we were never on the same pagewith the anti gay lobby. 

Equally evil was the refusal of the authorities to admit to the ‘tainted blood supply’.  Hundreds of innoscent men and women were infected with HIV by the administration, executive decisions, who ignored what the doctors told them. To this day none of these evil men and women in administration have ever stood against the wall and shot.  I had given gallons of blood over the years but stopped after I was anally raped.  I would ask to give blood again but by then they were asking. 

Have you had unprotected anal sex? 

They had had no problem asking, “Have you used a needle for drugs’ and looking for track marks before accepting blood transfusions. But the Gay Administration didn’t want to offend people so countless died. The scandal resulted in the Red Cross no longer being the agency that collected blood but the ‘rot’ was everywhere and increasing exponentially.  I’ve always felt unwholesome since being unable to give blood. Today science has moved forward finding new tests and ways to ensure the safety of the blood. 

I would go home at night and cry.  I’d expect every Friday night to be the night.  I couldn’t back down because the others on the team were courageous and strong. The head nurse in the psychiatry emergency was this beautiful wise woman who truly soldiered on, a regular Florence Nightingale. She was like a war nurse and kept the emergency taking patients in and passing them on. She was amazing. I would hold an HIV patient down while she gave the Haldol and Clonazepam or she would hold them down and I would give the needle.  The HIV patients would be psychotic on drugs or have head injuries and we’d have to get them settled to get the xrays.  I’d see her up close, this wonderful slightly older woman with amazing laughter wrinkles around her eyes. We’d be struggling with a patient trying to bite us. I can remember her pores and skin.  I’d be beside such a nurse and feel I just had to do my bit. it was a war. We were soldiers. We were standing together without staff, undermanned, gurneys in the hall, all our beds full and I’d just do my bit.  I ‘d get home and my hands would be shaking and I’d be crying and I’d pour a glass of wine and light up a joint and get some sleep before Saturday night.  The rest of the week was fine. Friday and Saturday night were always bad.  I didn’t think I’d survive. I was in constant terror. 

When I’d worked in London during the IRA bombings, my building was evacuated weekly and bombs were killing people.  I remember the security guard, an old veteran. He’dwalk around the building looking for anything suspicious. He’d enter rooms with a chair in front of him. I imagined if there was a bomb, he’d lose his legs and arms and perhaps even his head but his balls would be protected. I liked those old guys.  They were some of the bravest men I knew.

Now I worked with Psychiatry Emergency nurses and felt like I was the guy without protection. We had a gauze mask and gloves.  There were no hazmats suits like they show on television. There were no plastic screens or special clothes. Sometimes we’d be able to get into surgical clothes but mostly because of the pressure of patients and lack of time we were just winging it. One fellow broke away. He had scalp laceration and whenever he swung his head blood would splash on the walls and ceiling. With the help of security and the nurse we disarmed him of the scalpel he’d stolen. I always tried to hide my shaking. After these ‘events’ , a regular Friday night in those days, I’d have a tremor and sometimes shakes.  I had to hide them. Everyone else was so strong and brave and only I was scared. 

Then we’d have the patient sedated and 24 hours later the drugs worn off then he or she was taken and some crisis intervention and more medication we’d discharge him. 

Then the nurse and I would be on our hands and knees cleaning up the blood, trying to get it all so the Union Cleaners and Administration wouldn’t have a ‘raisin d’etre’., a ‘talking point’. 

I remember holding men in my arms who’d just been diagnosed with HIV and failed in their suicide attempts. I’d wonder about their tears in my jacket.  We did’t know at first how easily or hard it was to spread.  

I remember with a couple of nurses and a mattress charging insanely violent men, getting them up against the wall with them pinned behind the mattress one someone jabbed them with a needle as if it were a bayonet.  Then they’d collapse and we could get them in restraints.

It was always the same.  For us and the police.  We’d be trying to restrain them and so often they’d be trying to kill us, not intentionally but out of fear. All the while in the back ground administration was paying themselves more and more and swaggering about and giving orders beyond their limited intelligence.  They never were on the wards on Friday nights.  

We once got an “emergency lawyer on call” number so I convinced a patient to call it on Friday night. 

When he began shouting at the patient, I took the phone and explained that his name was on the ‘emergency lawyer on call’ in the Psychiatry Emergency. 

“I don’t care what you have there. I’m at a cocktail party and I don’t have time for this nonsense.”

He hung up.  No doubt he’d bill the hospital a thousand.  At least he came to see the patient the next day, obviously hung over but ready to help this poor fellow who had been locked up wrongly.

I had countless stories and cases from that year. They start popping up in my mind. The ugly ones first. I was in charge of medical student training in psychiatry and would go out to UBC for monthly meetings. I’d have a dozen medical students and interns following me about on the wards..I’d assign them with tasks and do all those teaching things which I was good at but didn’t particularly enjoy. 

The interns jobs were to exam the patients before they were admitted. We had a lady from the north and this arrogant medical student who had told us all he thought psychiatry was a waste of time and how he was going to be a cardiologist which was real medicine.  I hated attitude and we got a lot of it in psychiatry.  The fact always was the old ‘bad apple’. A hundred nice and fine people but one little scuzzbucket.  This guy.

There was a party that night. I don’t remember what it was but all the interns and residents were excited and looking forward to it.  The woman from up north had arrived late. I asked him if he’d examined her. He said he had. I Asked him for his findings read the chart and then because of this ‘intuitiion’ I have ,went round to see her.  Unfortunately she was already on the ward with 20 other women.

The intern had lied to me. He’d lied in the chart. He hadn’t examined her. He fudged the notes. The nurses confirmed he’d never come round. She was coughing up blood and her lungs sounded like freight trains.  The nurses were glad that I’d come by because they had been about to call me.

She had tuberculosis.  She had to be treated.  20 women had to undergo  a year of toxic antibiotic regimens including a couple of nurses.  The intern had never seen her. I wrote him up. I refused to pass him.

I was told yet again by administration that I was wrong. I was told that I would be fired if I didn’t change my grade and ‘pass’ him.  He snickered. His father and mother were wealthy powerful Vancouver ‘people’.  He complained to the college that I’d used ‘harsh language’  and ‘blamed him.”  

I was investigated and told I was ‘unprofessional’ saying that he’d caused a ‘fucking nightmare” for all these other people because of his gross negligence. The College person said, “didn’t you know who his parents were?”  Eventually my  “punishment’ ended. The bureaucrats never apologize, but let things slide, always leaving you with the fear they can come after you again. 

I’d get in trouble again when I refused to pass an East Indian princess who refused to ‘touch’ everyone . She would do a history and physical on the wealthy and clean but would only take a cursory history of the poor and homeless. She’d never touch them and falsified her findings physical exam, Pulse, BP etc.   

I confronted her. “They are ‘unclean’ “ she said in her defence.

                          “ I know they’re unclean but they can be sick and you have to exam them and you can’t lie about your findings.”

                          “None of the other supervisors have objected. They told me that I had to fill in the chart to make it look like I examined them.”

                          “No . You have to examine them. You don’t falsify the chart. “

                           ‘That’s not what he said.”

                            “That’s what I’m saying.”

                           “ I simply can’t touch them and you’re being a bully to expect me to. I must complain about you.”

So there I was again cited for being ‘culturally insensitive.’  I’d spent years as a fly in doctor working cross culturally. I had been to India and worked with the greatest Indian doctors.  She was a lazy entitled cunt. They exist in every race. She was passed and I was again told that I had to be ‘less demanding’. 

Dr. Brown, one of the truly greats of psychiatry, he’d been head of the Asylum, and had forgotten more about psychiatry and hospitals than others had ever learned. He’d become my mentor and try to teach me the ‘ropes’.  

“What you’re missing Dr. Hay, is that the system says that if any of us clinically fail a patient they must repeat the rotation.  If you think that young lady who didn’t want to touch ‘untouchable people’ was a nightmare on psychiatry you must realize our colleagues in Surgery and Medicine found her a hundred times more loathsome. Yet they passed her.  Why?”

“I don’t know.”

“She’s a lousy doctor. Probably one of the lousiest we have seen other that that little asshole  son of a rich man e had earlier this year.If Surgery or Medicine had failed her she would have had to repeat her rotation there so they passed her along knowing she’ll kill someone sooner than later. Because of her political clout and the spineless ness of the present administration class some doctor was going to pay for her error just like you did even for pointing out she’s a lying dangerous nightmare waiting to happen. We’re passing her so she doesn’t kill any of our patients because frankly her kind and the other guy are unteachable.”  

Dr. Brown was truly the greatest psychiatrist.  He’d object to me giving high grades to all my students.  He was old school. .I was giving A’s and B’s.  He was giving C’s and B’s.  Other than those two wankers the rest of the medical students and interns I taught were amazing.  Dr. Brown and I had this long discussion and debate about the whole idea of grading. I reminded him that these students were really good and that if they got an A in psychiatry which I felt they deserved they’d be more likely to want to be psychiatrists. I told them Family Medicine was giving out A’s by the bucket and that the old one person a year gets an A wasn’t true. It was a level of ‘competence’ not a ‘competition’.  Dr. Brown thanked me and after that began giving A’s and B’s rather than C’s and B’s .  

We had a suicide on the ward and rather than address it as I ‘d be trained, the administrations and lawyers arrived and said we couldn’t talk about it.  Weird legal beurocratic behaviour.  Suddenly the ‘post mortem’ that we’d done with all suicides so we could learn what we did wrong or what we could do better or just to mutually support each other was gone.  The administrator said,”we can’t have people thinking we did anything wrong because that could lead to law suits.”

The decline in the standards  of the Canadian Health Care system, now the Legal Administrative Meal with a little spice of medicine was truly greased to descend. The party at the top with the easy jobs, higher pay, lower education and glad handing just got better and better.

I was at a conference where a great American psychiatrist had fifty of us in a room. He asked if anyone had felt badly about the loss of a patient.

I immediately shared that I’d had a patient suicide and felt badly and felt even worse because we were told not to talk about it.  I felt the whole ward felt that way and in fact none of us had done anything wrong.  This was just a case of a patient stealing medication and over dossing secretly on the ward, everyone doing everything to the best of their ability but still it was sad. It was so much worse because we couldn’t talk about it.  Schizophrenics will kill themselves and will say they won’t and will take your saying we don’t want you to kill yourself as meaning that you do want them to kill themselves.

Well, this pompous psychiatrist then stood up, must have been in his 60’s and said very loudly and very smugly, 

, “I’ve never had a patient suicide.’

Dr. Brown immediately stood up and said, “I know Dr. Hay is practicing psychiatry but I don’t know what you’ve been doing all these years.” 

He then turned and shared that he’d had a suicide early in his career that still gnawed at him. Being the head of the asylum Dr. Brown had seen many suicides. I’d go on to stop a couple of suicide epidemics thanks to his wisdom but on this occasion the other psychiatrist went red in the face and stormed out. 

The American psychiatrist went on to discuss the suicide rate among doctors, especially psychiatrists, burn out and the ‘survivor guilt’ and the effect of suicide on those working in acute care like Psychiatry Emergencies, Schizophrenic wards and the new Psychiatric ICU’s.  I felt less burdened and other psychiatrists, older wiser came up and talked with me after. There was indeed a whole lot of younger and older paychiatrist exchange and support following this . If it hadn’t been for Dr Brown it would have remained with an incompetent inexperienced ass hole shaming the young guy. As it turned out it was one of the frankest discussions and warm collegial sharing I’d know at VGH. Increasingly the administration and lawyers were destroying this collegiality with their win all ‘divide and conquer’.  The ass would go on to a high position in administration.  I’d learn that Dr. Brown who was a clinician’s clinician had a long history of dealing with this guy who avoided seeing patients especially sick ones.

Dr. Brown’s wife was Rosemary Brown, the famous NDP Member of Parliament. They were a truly amazing individuals. Because of working with Dr. Brown and admiring his knowledge of the worst of psychiatry acquired working in the asylum I”d jump at the opportunity to work in the asylum again later in my career. I’d learned so much in Brandon but asylum work was considered the least sexy and not a good choice for career advancement.  I didn’t think in ‘career’ but always where the ‘greatest need’ was and ‘where I could learn the most’.  

I dated a nurse at VGH.  When I think of heaven I think of her.  Now I’ve been married and loved and been blessed in partners but this girl always comes to mind more like an addiction but truly a marvellous one.  She had been a gymnast and a dancer. She was incredible. Her body was perhaps the most unforgetably perfect. 

 This memory remains partly because I had a penthouse suite off the beach in Kitsilano. I had this great balcony where I did whole tai chi routines each day along with meditation. It was here she did dance gymnastic routines naked in the moonlight.  It was like watching Venus.  REally I’ve been spoiled.  I have been blessed beyond what any man deserves. To have one night with a nurse like her is the fantasy of every teen age boy on the planet.  She really was the ‘girl next door’. She was the Playboy fantasy come true.  She was perfect. Except.

She had a cocaine habit she at first hid from me.  She would be called a ‘borderline personality disorder’ by another doctor who’d dated her and everyone who knew her  called her ‘histrionic’.  I really wished I was 10 years older and a million dollars richer because maybe then I’d have the time to give her what she needed. As it was her constant demand for attention, mood swings, jealousy and frank insaniety were a distraction.  All my friends said she was the most gorgeous woman they’d ever seen until she opened her mouth.  A constant barrage of complaining and criticism and demands.  

Who cared?  Sex was spectacular.  

She was totally on or totally off.  She was passionately in love with me one day and the next she hated me.  She was Sophia Loren and her evil sister. She was always having major scenes screaming in the streets.  Marching out of rooms. Banging doors. I’d never dated a truly crazy lady. I now know I’d never dated a cocaine addict before but would years later and recognize the traits.  On and off and on and off. And always the man or someone else is to blame. Rage and passion.

I lasted a few months but couldn’t see continuing so tried to break it off.  We’d moved some stuff together to go to the next stage but I’d kept my apartment. In that first week she was up all night and I needed my sleep.Im a doctor. She was on shift. I had to function. She was truly out of it. I called a friend with a truck and took my few possessions home one day saying I loved her but I just couldn’t go without sleep and couldn’t take the rage and screaming despite the pleasure of ‘make ups’.  

That night she broke into my apartment, she’d stolen my keys and made copies. I woke to fists pounding into my eyes and her screaming “No man leaves me.” 

I threw her out all the while she was screaming waking the neighbours and saying she loved me and we needed to be together.  

Did I say the sex was spectacular?

Did I say she was like a puma?

Did I say just watching her walk caused my heart to beat faster? 

Did I say that when she wasn’’t in rage she was the most enjoyable funny companion , like the best friend , sister, girl next door, buddy. She was also extremely bright and a great nurse.   She was wonderful but catching her cutting the tips off the condoms had been bad.  When I’d confronted her she said ‘I’d kill myself if you left me. I want your baby so bad so you will stay with me.”  That was probably the night before I left and now I had two black eyes.

Then I hired a cleaning lady who climbed into bed with me one morning.  That was very nice.  Guys with morning hard ons.  I rather liked it. She wasn’t a particularly outstanding lady but young and pleasant and frankly ‘any ship in a storm.’  I’m a fool and slut and my little head is worse. 

The trouble is she never cleaned after that. She ‘d come over and fuck me and I’d pay her and she’d leave. Other times she’d just come for the money and leave. Then she’d just come for the money and leave.  I was a fool.  

I now had a Rabbit, my VW Bug having died in the rain. I was enjoying going out into the woods alone camping and hiking and mountain climbing alone. I loved British Columbia.  I’d had my firearms and hunting permit in Manitoba but got them all for BC.  Weekends I’d go out in the woods. In the fall I’d shoot grouse. I was supposedly deer hunting but wouldn’t shoot deer for another year or two.  I just loved the hiking and sitting in clearings in the woods.  

The nurse and I would get back together.

When I thought I was safe she showed up at my door in 4 inch heels and her black ankle length fur coat.  She begged me to let her in. I was smart enough to know that I was a mere man and the power of her sensuality would overwhelm me if I opened the door a crack. But she said, ‘at least let me use your bathroom. I have to pee.”

Only a cad would deny a girl the use of his bathroom.

I opened the door.

She flowed by me.  There was a long hallway. She dropped the mink on the floor as she walked to the bathroom door. She was gloriously naked except for the 4 inch heels.  She let her hair down and turned and smiled at me. She didn’t need to pee. We made love on the living room rug in front of the fireplace. If on call medicine taught me to dress fast this nurse taught me to undress fastest. 

We were off and fucking  for another 4 months. Who cared if she hit me?  

Addiction is on and off. Love is a steady thing. This was addiction. I’ve always loved the song, “Addicted to love!” She could have replaced any of those famous back up singers. Her every move was a dancers elegance.  I remembered the song ,When I was 21 it was a very good year, .....when I was 21 it was a very good year for city girls who lived up the stair with perfumed hair, that came undone when I was 21.

She’d come hunting with me too. I remember lying at dawn while guns were being fired around and above us and we were in this sheep skin sleeping bag I’d made and she said she was ‘keeping her head down.”  Whenever she was with me we didn’t get much hunting done but she’d laugh so whimsically.

I expect I left Vancouver as much to get away from her. 

I’d left VGH after the decision of the head of psychiatry caused a patient’s death but he tried to blame it on me. Having that ‘intuition’ I made sure he signed the orders for the ‘pass’ as I insisted I believed the patient only wanted to have a pass to kill himself.  I’d recorded that and yet the head because he was in the drug research program wanted to appease the patient and hoped to get him to continue. The patient killed himself. The head destroyed the chart then lied bold faced at the meetings of the psychiatrists saying that my physician error had caused the patient’s death. He further complained that the chart had gone missing.  There was all this ‘fake consternation’ and I remained quiet while everyone condemned me with their looks and looked askance at my poor clinical acumen. He really laid it on thick.  

I responded by producing a copy of the records and pointing to his lies, to his errors and with my typical good humor saying ‘go fuck it.”  It was the Morris Hospital Administrator all over and the Black nurse murderer.  I was told to wait it out but because I was having trouble getting away from Venus saw this as an opportunity to go to the country. I asked the College Registrar, a really good old guy if there was any need for a pscyhiatrist and was immediately told they needed one in Campbell River and Comox. What I wasn’t told was that the psychiatrist in Comox had succeeded in maintaining a veritable ‘monopoly’ on the North Vancouver Island by scaring off or ruining some dozen psychiatrists before me. The community had had 6 psychiatrists then he arrived and now there was one. Yet Comox was the mos desirable place in the country. 

God works in mysterious ways. In Campbell River the family physician who was most welcoming I’d learn later had been sober in AA for 30 years. My nurse girlfriend who had the cocaine problem hated this man who I loved . She instead loved the Comox psychiatrist and really encouraged me to take that position because she said she’d come to visit me there but not Campbell River. I really believe if I’d gone to Campbell River my life would have taken a more positive turn. It was a nodal point.  Like the several properties which I’d not bought which went on to be worth millions. I think also I really loved and lusted after my nurse friend and hoped someway we could make it work. Maybe if she did come to the country we could have a family. I just couldn’t let go and the psychiatrist in Comox was so svelte and deceitful.  

Life was too short for should have, could have.would have ‘retrospective falsification’.  Each decision we make is the best at the time with all the information we have at the time. Later with more or different information a different choice would have been possible. But it was already shown on multiple choice exams that mostly people who change their answer on uncertain questions from one to another will make an equal number of errors in the other directions. If I’d gone to Campbell River I might have got back into the church and got away from the alcohol and drug crowd but then I might just as well have been hit by a truck.  

I went to Comox.  I’d eventually no longer have those magnificent long red painted nails anchored in my back and I’d move on with a wealth of regret. She would tell me that she had once worked as a professional masseuse and that she’d not prostituted but used her voice and hands to pleasure men for considerable wealth.  That never left me and I always admired ‘professionals’ thereafter known that amateurs don’t have the same ‘skill set’.  All together I missed her and wished I could have been a better man to be able to tolerate her insaneity if only for the sex but as much for the fun times, the little sister quality of the relationship and her amazing enthusiasm for life and courage.  She was the definitive MASH nurse and leaving Vancouver for thecountry I also left the psychiatry emergency with a wealth of skills and now not as likely to be facing HIV and near death on a Friday night.

Rural psychiatry had it’s own set of skills and challenges.

I’d been flying up north every couple of months to Fort St. John,  Fort Nelson and Watson Lake. I’d go from there to surrounding Indian reserve having week long clinics. Dr. No one the Emergency Psychiatrist who would be my drinking buddy for a time would arrange the trips to the Yukon. He’d been to medical school with Said in Dublin. Hedy Fry was there with them. I’d campaign for Hedy and thought what a small world.

Said was the most amazing family physician I was ever to know.  He was everything of days of yore. The one man emergency doctor, the northern giant of a man, the great family man and father.  I admired Dr. No one for his family. He had a beautiful wife and lovely children and was devoted to their needs. These were the 50/60’s  men. The great providers and protectors. Joe and Said were an incredible pair. If there was ever a war I’d want to be on their team.  Joe had been in the military but Said was a grizzly bear hunter and we’d hunt together in the north where I’d see the kind of skill and awareness my father and grand father shared. His father had been a freedom fighter who fought guerrilla warfare. I think that’s what was the difference with Joe. He was a company man.  Hierarchal. Said by contrast would never have been a regular army sort being all round militia at best. I by then was feeling rather unique and thought if war occured I’d have to be a sniper at best. I didn’t think I could trust anyone very much.  

I’d certainly trust Said as a doctor. Truly the most amazing country clinician I’d ever know. Like Bob Manness but with more wilderness and surgical experience. There was simply no one else but him.  I’d meet other Yukon doctors and they all shared that Livingston’s quality. My later friend Dr. Willie Gutowski had been a missionary doctor and he had that same clinical comfidecne.  Said was truly a mensch. Skookum. And funny. Indeed joe and said were the two funniest most interesting friends and story tellers a person could ever have the joy to be with.  Joe was Irish which explains that a bit but Said was as crazy and East European.  Having worked in Chruchill and in nursing stations I really appreciated these men who worked and lived in the wilderness and their families.  It is so unfortunate that the city chair warmers in government and administration have such unwarranted power.  They simply could never do or understand what doctors like SAid did and do. 

I’d later join the Wilderness Medicine Society and meet many others like Said. A different breed. Renaissance men. Dr. Osler sorts.  Pioneers and adventurers. Watson Lake then was full of characters. Doing psychiatry in the Yukon was an eye opener because all the life stories were like nothing you’d hear in the south. 

I ‘d actually treat cabin fever. One trapper would be picked up by the RCMP in a blizzard naked worst frost bitten feet I’d ever treated and he’d be flailing himself with a chain near dead walking down the centre of the highway nearly hit by the guy who notified the police. He’d been a trapper for decades and his partner had died. They had a little one tiny room log cabin and he’d stacked his friend outside to take back in when the spring came.  It was months later that he went insane talking to his dead partner.

I’d treat more gunshot wounds. When I was in the north I was often covering Emergency when the doctor who was there was called out. That would leave me , the only doctor in town. Hence more experience with head injuries, gun shot wounds and respiratory and cardiac arrests.  

The joy of the north was everyone pitched in. It’s a paradise of humans in the harshness of the world. People worked together or died.  The nonsense of the south was never in the wilderness. It couldn’t survive.  

When I was in Comox I’d begin my northern outreach to Port Mc Neil and Port Hardy. I”d also do two days a week in Campbell River. 

I’d meet Ann and Marion, two of the greatest ladies in the world.  I would first know them as colleagues then be truly blessed to have them as lifelong funds.One wash a Scottish social worker,  the other a blond Psychologist from Winnipeg.  Anne would take me to my first Robbie Burns dinner.  When I visited Port Hardy and Port McNeil where she was in charge of Mental Health we’d play music. She was a classical violinist, I was a hack guitarists.  She’d also play the flute. What a joy it was to visit her. We’d have music nights like one reads about in the 17 to 18th century. Hours of candlelight and wine and making music together.

We’ d practice Gordon Lightfoot’s Song for a Winter’s Night, she playing the flute and me picking guitar , the two of us alternately singing. 

Truly I’ve been blessed. Truly I have no cause to be the terrible whiner and kafetch I can be. God had blessed me with companions and friends I have no right to have.

Marion was in Parksville. I ‘d come to know her family and friends. I’d eventually move into a house across from hers and have countless days and evenings of joy and fun.  She was a kind of brilliant hippie. Her house was the centre for artists and intellectuals and shakers and makers to come together. There was always soup or stew on the stove and children and fire places with logs burning.  She was always surrounded with beautiful younger people and truly gorgeous women around her.  

She told me that after she got her PHD She had taken a van and dog and travelled about  Mexico.  She spoke Spanish fluently and Mexican musicians and artists would drop by. The truly beautiful were the dancers. Clothing at times was optional. I remember beautiful young dancers naked on her lawn doing modern dance. I had just woken and gone outside to have a coffee. Horses ran free in the lot beside her homestead. There were the most beautiful young women naked in this extraordinary Canadian tableau. Peace on earth. Make love, not war. 

 I miss those days. I’m always blessed and uplifted to be with Anne or Marion. God got it truly right when he made such  extraordinary ladies.  I am truly blessed to count them as my friends.