Saturday, January 30, 2010

another upbeat week

Let me repeat, as I may have said it before, and that in itself is part of the problem, I mean, me saying it before, and again. And what I'm saying is, that sometimes, part of it is, that growing old kind of sucks. And I'm not even that old, or even in bad shape or anything. But there are the things you don't know, and can't even think of when you're young(er). You can't know; and you don't think you will get like this, but you will, even with super-growth-hormones.

"Old man, take a look at my life, I'm a lot like you are." I remember that song from when Mr. Young and I were both 23. Now, we are getting to be (get that,only getting to be) the old man.

But that's OK. The getting old is OK. What makes it hard is that everything just comes around again. Just when you gather up enough hope to think it's better, it gets washed away. How many times? Many.

And I feel like a sucker each time, that's what hurts more. Each time I get riled up and think maybe I, we, they, have figured out a way, to make it better and to make it last. But then it gets washed away, like the castle in the tide, and now the hard sand on the beach is all flat again.

Does it matter? Not really, to me, directly in many ways. I'm still OK, my kids are OK. I am basically healthy (but slower) solvent, no real debt. The house is warm and dry. I have more 'stuff" than I know what to do with. The internet works fine. I could spend the rest of my left playing Soduku. Who would notice? My wife doesn't really know what I do up here anyway. I gave up porn years ago when I saw what could have been one of my clients in one of those movies. Really freaked me out.

I heard an early Dylan song also. He was running down the road because someone called him a Communist. They still chase you down the road even if the think you're a Socialist.

And who get hurt? As I said not me. Yes, people get hurt, many. The same ones. The ones in the cheap houses, with no credit to get the pipes fixed when they freeze. They live on the low-lands near the river and get flooded when the snow melts and the river rises. They lose their jobs when the factories move to China. Their kids have to drop out of college because they are smart enough to get a $10,000 scholarship, but college costs $47,000. So they go back to selling Toyotas, and now even they are busted.

Or they live in Gaza city.

And so many more people are getting on the State Insurance now, just like people were afraid of. State run stuff, can't be good. And you know what? That's true too. The state pays me less and they send out new, incomprehensible rules every day.

Private insurance companies are greedy. They lie, cheat and swindle. They take your money and throw you in the gutter. Public insurance is complicated, incompetent, and inefficient. They take you taxes, put you in a dirty bed, and leave you there.

The problem is that they are both run by people. THAT's the problem.

Can't blame people though, because that's who were are: cute, lovable, well-meaning, but flawed.

Can't just sit around either. That makes me feel as if I've given up, kind of useless, old. Don't want that.

So, I guess it''s back at it. Or at least it will be on Monday.

How's that for a happy ending.

Saturday, January 23, 2010

my brain made me do it

And speaking of political turns of events, those of us here in the over-educated belt are kind of shocked to see that a good-looking "regular-guy" defeated an older, not overly charismatic, but very articulate and intelligent woman. There were lots of factors that led to his victory, and one of the major ones was his "No new Taxes" pledge -- the pledge of every conservative since Reagan. The pledge that has led to huge deficits, and then, under Bush W, to huge differences between the sinking middle-class and the fewer and fewer who have more and more.

But brains do that -- us humans are somewhat programmed to take the short-term over the longer term. We always seem to have a sense that there may not be a long-term so lets take what we can right now. That is part (again, only part) of the reason people have affairs. When the heat gets turned up, it is very easy to convince yourself to enjoy what the moment has to offer. Your mind can jump to the idea that it won't matter, you won't get caught, or simply that you will deal with it later, but right now is RIGHT NOW!

This is certainly the thinking (and lack of logic) that goes with addictions. When something is what you want, what you crave, the future consequences seem to diminish, if not disappear entirely.

So it isn't surprising that people who feel that they have less money in their wallet, will vote to keep it there, and try to avoid thinking that we are all turning into California, where even their great university system, which is part of why Silicone Valley was so successful, is crumbling, and they still don't want to pay.

Long-term planning takes maturity. Even Freud defined part of being mentally healthy as being able to delay gratification. But, we can always do that later.

Friday, January 22, 2010

The Supremes

The new boys have spoken. It seems that Mr. Roberts couldn't get there fast enough to do his big corporate buddies a favor and turn the apparatus of government over to them. And where was Clarence!!

Let's be clear about this. For those of you Socialists who ran around thinking that Freedom here in Amerika means that Individuals have rights to their own thoughts, speech and actions, and to elect their own representatives -- well no wonder you guys can't even run Cuba.

Freedom means that American Corporations are free to make as much money as possible. That is what is in their charter. It is also clear that if anything as repulsive as an elected government should do anything to limit that freedom, well corporations have the god-given right to spend whatever it takes to change that government. Government should do nothing to obstruct that freedom.

It is the duty, right and privilege of every American citizen to buy whatever it is the corporation is selling, whether it is a bad mortgage, highly sedating drugs, an expensive insurance policy that may not pay the benefit, a credit card with a 33% interest rate, an SUV that gets 14 mpg, a crib that could chop your child's head off, a Big Mac, a Whooper, or an entrepreneurial woman in Las Vegas.

America is about the money. The freedom of those who have it to get keep getting more of it. Anything that gets in the way of that goal is Socialism. And that is BAD. As bad as a Clemson loss in a bowl game.

Buy stock in United Health Care. They will own at least five Senators.

Saturday, January 16, 2010


If I didn't know better I would be really surprised at what is happening right here in my progressive, liberal, sometimes caring state. But I do know people and I understand. I see them every day and often spend hours listening to crazy logic, based on half-truths and lack of information.

It isn't the lack of information so much that is the problem. It is the lack of desire to go and find out; the information is there. It is the pervasive willingness to settle for a simplistic sound-bite, a winning smile, and a sprinkling of fear.

I mean really, we had Rudy Giuliani here yesterday talking about how fighting terrorism is our #1 priority.

Yes, and no. And who are the terrorists here, and there? === Not to minimize that there are crazy people in other places that really do hate us.

Anyway, there seems to be a real chance that some guy who is running as the male version of Sarah Palin could get elected here in one of the bluest of the blue.
If he wins, the real reason will be because he is a big, handsome, physical guy who is running against a smart, articulate woman. America, and probably the rest of the world, rarely looks to smart, articulate women to protect them and solve their problems.

We find it easier to go to war to keep the peace.

Saturday, January 09, 2010

Who is brave?

Let's think about three appointments I had in a row last week. Let's call them 10, 11, and 12.

10 is a woman in her early thirties who has been seeing me for several months because she had a series of bad panic attacks. She doesn't have too many full-blown attacks any more but she is constantly afraid that she will. This makes her afraid that she has lost control of her mind and that she is about to go completely crazy. She won't, but she thinks about it much too much, and with too much intensity.

She had been telling her husband about her fears, but after a few months of trying to reassure her, he just tells her to get over it.

I want her to take some medication. I think it would really help. But she is afraid that once she swallows the pill she has no control of what it will do to her mind, and that the pill will push her over the edge. She is a brave, tough young woman and she fights her fears all the time. You would never know that she is constantly fighting off thought of a mind explosion.

11 is a man I have also been seeing for a while. He is finally beginning to make progress battling a terrible depression. He has spent months in his house, mostly lying in bed trying to find the energy, and in his mind, a reason to get up. He has a lovely wife and a beautiful daughter and he stares at them, knowing he should do more to take care of them. He has been taking many pills, and they have helped a little.

He lost his job months ago. He is behind on his bills. He feels like a failure and is just beginning to get passed hating himself for it. There are some very complicated and involved reasons why this all descended upon him, but no one can see those. People look at him and wonder why he can't just go back to being what he was two years ago.

He is making progress. The thoughts of suicide are less frequent. He is bravely fighting through the dark clouds that have filled up every room of his life.

12 drags herself in on crutches. One leg is worse than useless to her, as it also causes her almost constant pain. Her ankle is not only busted, it is deteriorating, as are several of the bones in her spine. This deterioration has put pressure on her spinal chord and caused seizures. The seizures have caused her to fall and re-injure her ankle, as well has her knee and her wrist.

The pills she takes, and the devices she has implanted in her serve to somewhat diminish her pain. She can take more pills, but then she will sleep all day and all night and not be able to finish a sentence. She does that some times.

There are things she can have done to her that could help. There is a list of three more surgeries. They could relieve most of the pain, or they could paralyze her, or even make her heart stop.

She has one hand and arm that works without pain. She uses it to bravely kill hordes of zombies that attack her through a video game.

Tuesday, January 05, 2010

The future has arrived

I got a good glimpse of the future today as a big package arrived from one of the managed care companies I try to avoid dealing with. They informed me that they have taken over two of the state's biggest contracts -- the ones that are sure to get bigger as more people turn to The Commonwealth Connector to get the insurance they are mandated to have. There was a nice letter congratulating me for being invited in to the select group of providers. I can now accept patients from two of the state sponsored plans that previously only could go to semi-private under-funded full-service clinics staffed by pre-licensed social workers and non-English speaking psychiatrists. Now, it is my privilege to see these multi-problem families at a low rate of pay, with a high co-payment, thus insuring that many will drop out of treatment when they realize what it will really cost them.

Since I have already adopted the attitude that going to my office almost qualifies on my tax forms as a hobby, I will probably sign the contract, and in that way I will be able to see all of my old patients who had gotten laid-off and lost their good insurance.

The truth is I really would not mind working this way, as long as I could be sure that the people who run this managed care company were getting the same hourly rate that that I am. Probably not the case.