Closure

  I am forced out of Journal Posting retirement today. . .

I made an entry a few weeks ago and clicked save and it was lost into that black hole of no return. I took this as a sign to take a break, which I did. Alternative outlets to writing had become chopping down trees and digging holes. Since I do it just for fun maybe writing isn't so bad after all. At least it doesn't cause tendonitis and back pain. The real reason for today's post is to hopefully provide equal time for myself. I spoke with the local newspaper yesterday and was informed that they would again be publicizing my situation with the Board today. Since I know that rumors will again be widespread, I want there to be at least one place where people can find the truth from the horses mouth.

I met with the Board on March 20th for formal sentencing and to put some closure to my four year ordeal for choosing to prescribe pain medications without following all of their criteria for every patient. They really had very little to make any case to be taken seriously until the media became involved last June and they were able to get someone to come forward against me. They then blocked my DEA number to prescribe bupenorphrine and accused me of prescribing it without a license. I began to realize that the deck was stacked and it was time to cut my losses and do whatever they wanted. I was fortunate enough to have an attorney who understands the Board because of once working for them. I received some personal validation from learning of this attorney's views about their loss of focus and mission and the way they do business. The doctor receiving his consent order before me pitched a fit and raised a little hell but it didn't make one bit of difference. It probably just made them angry. I was humbled by the experience. I told them I valued my license, I found myself in a difficult situation for a while, and if I knew then what I knew now I would not be before them today.

The way it stands now my practice of psychiatry will not be affected at all. I will have six weeks active suspension of my license during the months of May and June. Personally, that isn't a bad thing because I haven't had a real vacation in many years. I made a plea about not likely being able to find coverage for the time I'm out. That plea fell on deaf ears. If the ER or Mental Health Center have a problem with this I guess they should take it up with them. My hands are tied.

Most of all, I don't want my patients put into another panic like last summer and think that I am going out of business or going to prison for some crime. In my opinion, this is mostly political. I detest the role I have been cast into but there is nothing I can do about it but play along. I am not completely innocent here but the situation has been blown out of proportion and attention has been distracted from what the true problems are. On a much more grand scale this type of thing happened when the establishment went after President Clinton during the Lewinsky scandal. In the mean time, matters leading up to 9/11 were ignored or placed on the back burner. I see several new patients a week who are abusing opioids that they did not get from me. I haven't written a prescription in over six months for an opioid. The action taken against me has not made one bit of difference with that problem other than making other physicians more certain to avoid prescribing opioids at all. Perhaps heroin will make a come back. I don't have any answers but I feel like I understand the magnitude of the drug abuse problem better than any bureaucrat in Raleigh. I tried to do my part. I was unsuccessful. I am through with it.

Dr. Alex Deluca, Pain Relief Network

psychiatry

Thoughts About Race and the 21st Century

   Maybe we can find more understanding and healing. . .

in regards to the elephant in the living room of the race issue. This thought came to mind when I read a comment on a site that questioned why the President is always referred to as African-American even though his mother was Caucasian. The rule in our society has always been that any person possessing one drop of Black blood makes them Black by default. Yes, that rule is absolutely ridiculous but that has been the understanding for the last 150 years. Maybe one day it will eventually change and race really won't be a significant factor.

Change begins where denial ends. Many hold a misunderstanding of what the distinct differences between prejudices and racism actually are. Everyone has certain prejudices, whether they share them with others or not. Most personal prejudices are relatively harmless and insignificant because they don't infringe upon rights or cause emotional pain for the target. The Black Panthers of the 60's and '70's were extremely prejudiced against the white race and the establishment but due to the limited social status they could never be classified as racists. On the other hand the Klan, for many years, possessed the power to break the law without fear of prosecution. The power to do so was based solely on the race of the target. Lingering wounds from the Civil War were at the root.

My personal heritage includes Native American, Irish, African, and who knows what else but I was always taught that I was a Colored Boy, then a Negro, then Black, and lately an African-American. In my family as a child the topic of race was never really discussed. There would be an acknowledgement of what color a person was and that was it. Everyone seemed to know the rules and accept their place. Fortunately, I came along when things were starting to change and opportunities were opening. I could have never settled for the status quo of the '60's.

Africans were the only group to enter America in shackles and chains. The only group stripped of their heritage and self esteem. It didn't kill us but eventually made us stronger. I think much of that is based on the law of survival of the fittest. It is in our genes to overcome adversity. In my view, the only true race is the human race. The Black race has always been about inclusion instead of exclusion which is a good thing for all. This journey remains incomplete. It will require continued leadership and cooperation from those who believe in what is right. It will require perseverance and keeping our eyes on the prize. Dr. Kings' Dream is probably the best mental illustration of the journey which ends when America lives up to the true meaning of its creed, that all men are created equal. All men, women, and children will stand together and sing in the words of that old Negro spiritual Free at Last, thank God Almighty we're free at last.

We need to pray for our new President. Pray that he will be the catalyst to help us complete Dr. Kings' Dream. I believe, as obviously many others do, that he is the right man for the job. Lincoln said that a house divided cannot stand. MLK said we must learn to live together as brothers or we will certainly perish as fools. The opportunity to move forward awaits us all. For those who love challenge, it is a great time to be alive.

Self Reflection '09

        I've thought long and hard lately if I want to continue posting. . .

I feel mixed emotions for the most part. My soul searching of late has forced me to seriously ask myself if this journal serves a useful purpose any longer. I think my spirit just may have finally been broken or maybe I'm just suffering from a severe narcissistic injury. I don't think it is depression that I have been feeling but more of a loss of sense of purpose. Maybe this is part of entering the world of middle age. I hope it gets better with time.

As a teen, I learned to base much of my self worth on how accurately I could shoot a round ball through a hoop or how fast I could run from point A to point B on foot. I made much more of such things than my God given talent should have warranted. Will power can be an awesome thing. I have always thrived on accepting challenge. From an early age, I never saw regurgitating information taught in a classroom for a written exam as much of a challenge, and except for math it usually came easy for me when the motivation was there. In college I learned that doing so on a consistent and structurally organized basis could lead to earning a degree which actually had some value in making one's life better. Medical School was the ultimate challenge of my life. A challenge simply means either you beat me or I beat you, let's find out what happens. After making it through the basic sciences part of medical school it became less of a challenge and more of a destiny. Like many naive young future doctors I began to dream about making a real difference in the world one day. Somewhere between internship and the first few years of practice the reality begins to set in that being a doctor is really just another job. Yeah, your gross income goes up significantly but so do your responsibilities, expectations of others, and the number and amount of your bills and obligations. Nope, you will do very little to change the world as you once dreamed. But the world will likely do quite a number on changing you from the person you once were. I vowed I'd never change. That vow can be bad for your health. I can only speak from the perspective of a Psychiatrist since that is the only perspective I know.

Everything must change eventually. That is the only constant outside of truth. Change can be difficult. In the past few days I talked with patients struggling with great loss, from the young expectant mother who lost both twins late in the third trimester to the nurse who defeated severe major depression only to take up a battle against breast cancer to the woman attempting to understand why her husband left after 40 years of marriage. Their minister has no satisfactory answer for them and neither do I. Most of us can only believe that God is much too wise to make a mistake. Unearned suffering is redemptive, in the words of Ralph Waldo Emerson whom Dr. King quoted on more than one occasion.

I think I've felt most passionately about attempting to treat people in deep pain and people who chose to cope with life through abusing chemical substances. I was close to several people in my younger years who suffered from an addiction. All of them are deceased now. Even with the best treatment an estimated 70% of those with a serious chemical dependency will die prematurely. On the bright side, roughly 30% will recover successfully if they sincerely choose to and are given the help they need. That is one of the most valuable lessons I have learned over time, to help those who would help themselves. I feel in my heart that it is my calling to do that.

I accept that The North Carolina Medical Board is not on my side. I accept losing that battle, as I must. In time they will have to see and understand more clearly the true nature of the problem of drug abuse in our society. They will see that their approach to the problem is close to synonymous with trying to stop violent crime by making guns illegal. In essence, only the bad guys would have guns. If all the doctors become too afraid to prescribe controlled drugs it won't stop addicts from using, and more and more drugs will enter the country illegally.

As far as continuing to post, I will just play it by ear for now. I want to develop a different format that isn't so personal. I'll entertain that thought for a while. Happy New Year to All!