Hey, I was home today. It was a gift of a warm day and we went for a nice walk around the lake two towns away. I also got new tires for when it gets cold and snows. The rest of the time I spent "working" from home.
So many of my patients, especially the men, but not only men, many of whom are unemployed, underemployed or have never worked a full month in their lives spent time like this, sucked into the Internet. The day can pass quickly, seamlessly. I learn about things I never thought about. I looked at things that I always think about. I read book reviews, movie reviews, stock reviews, politcal garbage and sports reports. I read your blogs and now I'm writing on my blog.
We are all part of a world that was unknown ten years ago and is overwhelming now. The input is constant and addicting. If you stay away fro three hours then you begin to feel the world has changed and you're missing it.
I can't tell if the world is changing or if it is all a lot of sound and fury signifying nothing. (catchy phrase that one).
But it certainly takes up time, and a lot of emotional space.
Tomorrow I will return to my office and sit with people, facing em, listening to them, watching them cry and laugh and breathe, and for almost an hour they will have my entire attention I will have theirs. That's something special in the world we have today.
No wonder there is such a demand.
No wonder insurance companies don't want to pay for it. So low-tch, so unmeasurable, so unaccountable, unreliable, unstructured and open-ended.
Yet, for so many conditions, it is the best treatment.
That's why I write about it on the Internet.
Monday, November 28, 2011
Wednesday, November 23, 2011
Thankful
Tonight he is sitting by himself watching TV. The big picture window now looks out into absolute darkness. Perhaps there are a few lights twinkling on the hillside across the late, but they are far away and difficult to see. Tomorrow morning when the sun comes up he will be able to look across the water at the green hills and the taller mountains behind them. He will make some coffee and sit alone, waiting for his son and daughter to come and join him. He has not been able to have them over for a Thanksgiving meal for ten years.
He is divorced from their mother for about fifteen years. He ran through about thirty women since then. Mostly he ran through about 1000 bottles of Jack Daniels and a couple of pounds of cocaine. That all ended him up in jail as the result of several incidents that he has no memory of being a part of, but that doesn't mean they didn't happen. He realizes that being in prison saved his life. Three years, four months, twelve days.
He's been clean and sober ever since. He has a job now, doing what he knows how to do. At first he went back to the woman who waited for him; the woman he loved in high school, the woman he was with on and off when he was married. But somehow she wasn't that interested in him when he was sober, working, and trying to be stable.
Thankfully, he chose being sober, working and stable instead of great sex and good times. He has run away from six other women during the three years since he was set free.
He found this place. He pays the rent. He breathes deeply and looks at the mist rising from the lake. Tomorrow morning he will put a turkey in the oven and know what thankful means.
I hope everyone else can enjoy the holiday too.
He is divorced from their mother for about fifteen years. He ran through about thirty women since then. Mostly he ran through about 1000 bottles of Jack Daniels and a couple of pounds of cocaine. That all ended him up in jail as the result of several incidents that he has no memory of being a part of, but that doesn't mean they didn't happen. He realizes that being in prison saved his life. Three years, four months, twelve days.
He's been clean and sober ever since. He has a job now, doing what he knows how to do. At first he went back to the woman who waited for him; the woman he loved in high school, the woman he was with on and off when he was married. But somehow she wasn't that interested in him when he was sober, working, and trying to be stable.
Thankfully, he chose being sober, working and stable instead of great sex and good times. He has run away from six other women during the three years since he was set free.
He found this place. He pays the rent. He breathes deeply and looks at the mist rising from the lake. Tomorrow morning he will put a turkey in the oven and know what thankful means.
I hope everyone else can enjoy the holiday too.
Wednesday, November 16, 2011
It's a blur
I can no longer tell the difference between sports, at all levels, The Republican Presidential debates, and Dancing with the Stars. It seems like it is all the same people doing the same things.
Is that Hamid Karzai dancing with Khloe Kardashian?
Is that Michelle Bachmann pitching to Chad Ochocinco?
Who can tell?
Is that Hamid Karzai dancing with Khloe Kardashian?
Is that Michelle Bachmann pitching to Chad Ochocinco?
Who can tell?
Sunday, November 13, 2011
something to worry about
Shelia was referred to me after she spent a night in an ER, with a bad panic attack. She is twenty-seven ears old, and her mother came with her to explain two things that she wasn't sure her daughter would tell me. The first was that when Shelia was nine they thought she was going to die from meningitis. Then, ten years later she was in a car that crashed into a pole, but she had a seat-belt on, and except of slight burns and scrapes she was not hurt. The driver broke about seventeen bones and was in the hospital for months. Her mother said that Shelia had spoken about each of these things once.
It took less than thirty seconds for Shelia to begin to tell me about these two incidents, and then several others that her mother didn't know about. She had gotten drunk and fallen off a roof. She had skied off cliffs, and had done several other dangerous things, clearly not caring about the chances of survival. She knows she had the panic attack when she learned that her friend's mother was diagnosed with cancer. She feels that another person is going to die. Everyone will die.
Shelia told me that although no one said anything to her, she knew when she was in the hospital when she was nine that everyone expected her to die. She has expected to die ever since then. Every night when she tries to go to sleep she is afraid to close her eyes because she is afraid she won't wake up. She told me that they love her at work because work distracts her and if she stops to think about anything else she wonders when she is going to die, so she works hard every minute.
Why bother to live when you're just going to die? For Shelia, that question always hangs there.
She is quite an attractive young woman but she has never dated anyone seriously because she feels like she will die and leave them soon. "Life is kind of useless isn't it? You live for a while, and then you die, so why put all that effort into doing all this stuff?
She told me that she knows she should have developed an appreciation for life. She knows she is lucky to have so many chances. But she doesn't feel that way. She feels as if she has only delayed the inevitable.
I told her that I know how scared she is, but next I said that I know what's even worse is how lonely she is. Then she just cried.
We have a lot of work to do, because I really can't answer a lot of those questions, but at least we have made a start.
It took less than thirty seconds for Shelia to begin to tell me about these two incidents, and then several others that her mother didn't know about. She had gotten drunk and fallen off a roof. She had skied off cliffs, and had done several other dangerous things, clearly not caring about the chances of survival. She knows she had the panic attack when she learned that her friend's mother was diagnosed with cancer. She feels that another person is going to die. Everyone will die.
Shelia told me that although no one said anything to her, she knew when she was in the hospital when she was nine that everyone expected her to die. She has expected to die ever since then. Every night when she tries to go to sleep she is afraid to close her eyes because she is afraid she won't wake up. She told me that they love her at work because work distracts her and if she stops to think about anything else she wonders when she is going to die, so she works hard every minute.
Why bother to live when you're just going to die? For Shelia, that question always hangs there.
She is quite an attractive young woman but she has never dated anyone seriously because she feels like she will die and leave them soon. "Life is kind of useless isn't it? You live for a while, and then you die, so why put all that effort into doing all this stuff?
She told me that she knows she should have developed an appreciation for life. She knows she is lucky to have so many chances. But she doesn't feel that way. She feels as if she has only delayed the inevitable.
I told her that I know how scared she is, but next I said that I know what's even worse is how lonely she is. Then she just cried.
We have a lot of work to do, because I really can't answer a lot of those questions, but at least we have made a start.
Friday, November 11, 2011
11-11-11
Today is 11-11-11. I have several clients going to weddings that will happen on this mystical day.
The original 11-11-11 was in 1918. It was the day and time to mark the end of hostilities on the Western Front between France and Germany.
It was the end of the War to End All Wars.
It certainly isn't fashionable, but the best I can say is "Sure, Thanks, Whatever."
It didn't end all wars. We aren't saved, things got worse. Perhaps in the last thirty years things have gotten a little better, but not that much.
I am not really grateful for the men and women who died, and the millions more whose lives were ruined and disrupted. I am very sad and sympathetic.
War is a waste. It always was, always will be. The poor and the foolish die to keep the rich and powerful rich and powerful.
Yes, there are crazies out there now who want to randomly disrupt and even kill innocent people in this country. There are also rich and powerful people in other countries who want to get an advantage on the rich and powerful people in our country. It is now, and always has been a blunt and heavy-handed way to gain an advantage for resources, money, energy, and sometimes sex. Often religion has been thrown in to raise the passions and confuse the situations even more.
All I can say is that if I had lost any of my kids, or even myself, fighting in some stupid war, especially something like Vietnam, Iraq or Afghanistan, or really any of them,
I would really be pissed.
So, if you really want to help all the folks in our armed forces: End the Wars.
Saturday, November 05, 2011
From the Left and the Right
This is what I have learned from working in a working class mill city: Everyone is right, everyone is wrong. Or, once again, things are complex; too complex for our political system to handle.
Recently I've begun to see a new patient, Ray (not his real name). He's 23 years old (no he isn't, but let's say he is). He is from one of the local minorities; we have many different minority groups in this city. He came to me because he almost lost his temper and beat-up his cousin. His cousin, who was strung out on various drugs, was pushing his girlfriend around and calling her a whore. The cousin and his girlfriend already have a baby. They live off the money she gets from the state to pay for the child. They don't do much else. They don't seem to want to.
Ray lies with his mother, who works at the big chain store. His father is in NYC somewhere. His father comes home about three times a year. Ray dropped out of H.S. One day when he was bored he signed up to take his GED. He passed it all that day. Ray works, making $8.50 an hour cleaning up a pizza restaurant. He wants to go to college but he doesn't have the money. Two of his sisters already went to college. One is an LPN and works in a nursing home. The other got pregnant, dropped out, and owes about $15,000 in student loans that she will never pay. Ray isn't sure that going to college will help get him a job that will allow him to pay back the money he needs to go.
The politicians on the right say that giving money to poor folk to pay for college is a huge waste of money. Many of them drop out, or get ripped-off by these on-line private schools, or private trade schools. They say government programs waste enough money. They have a point.
The politicians on the left say that the only real way out of poverty, and to get Americans working again, is through education. $8.50 an hour won't pay for a car, not to mention a wife, a kid, a house. People need an education, a good education, life skills, job skills, thinking and problem solving skills.
I say, don't give or lend people money, make college free. Sate colleges should be totally free. They should also raise their standards so that when people graduate they not only know something, they know a lot. There should be free remedial programs for those who do not have the skills for college.
The money for those colleges should come from taxes. Everyone should pay taxes. It's like investing in our country. If you have, you should give. If you take, you should pay back.
But what if you're lazy? But what if you're crazy?
Recently I've begun to see a new patient, Ray (not his real name). He's 23 years old (no he isn't, but let's say he is). He is from one of the local minorities; we have many different minority groups in this city. He came to me because he almost lost his temper and beat-up his cousin. His cousin, who was strung out on various drugs, was pushing his girlfriend around and calling her a whore. The cousin and his girlfriend already have a baby. They live off the money she gets from the state to pay for the child. They don't do much else. They don't seem to want to.
Ray lies with his mother, who works at the big chain store. His father is in NYC somewhere. His father comes home about three times a year. Ray dropped out of H.S. One day when he was bored he signed up to take his GED. He passed it all that day. Ray works, making $8.50 an hour cleaning up a pizza restaurant. He wants to go to college but he doesn't have the money. Two of his sisters already went to college. One is an LPN and works in a nursing home. The other got pregnant, dropped out, and owes about $15,000 in student loans that she will never pay. Ray isn't sure that going to college will help get him a job that will allow him to pay back the money he needs to go.
The politicians on the right say that giving money to poor folk to pay for college is a huge waste of money. Many of them drop out, or get ripped-off by these on-line private schools, or private trade schools. They say government programs waste enough money. They have a point.
The politicians on the left say that the only real way out of poverty, and to get Americans working again, is through education. $8.50 an hour won't pay for a car, not to mention a wife, a kid, a house. People need an education, a good education, life skills, job skills, thinking and problem solving skills.
I say, don't give or lend people money, make college free. Sate colleges should be totally free. They should also raise their standards so that when people graduate they not only know something, they know a lot. There should be free remedial programs for those who do not have the skills for college.
The money for those colleges should come from taxes. Everyone should pay taxes. It's like investing in our country. If you have, you should give. If you take, you should pay back.
But what if you're lazy? But what if you're crazy?
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