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!

Yes We Can

       What can I write this evening?. . .

The world became a different place a week ago. It was inevitable yet unbelievable as America rose up and opened the possibility to live out the true meaning of its creed. It is still too incredible for many to comprehend at times. The genie is out of the bottle and no matter what the future holds it cannot be put back in that bottle. Though I have done little to express it, I have never been more proud of my country nor more proud to be identified as an African-American. I was at the same time saddened to see many cling to the bitterness and ignorance that has divided us since pre Civil War days. But the good part is that it doesn't matter in the same way as it did before the 2008 election. John McCain's greatest moment, to me, came during his concession speech. He sincerely buried the hatchet and set the stage for healing and unity when he didn't have to. I will forever respect him for being gracious and showing class at a difficult time.

Scholars of Dr. King understand that the issue has never really been about black versus white but the true issue has been about an America that is fair for all people. Where a man such as Barack would not be judged by the color of his skin but instead the content of his character. Some, including myself, doubted it would ever occur in our life times. But the right man came on the scene at the right time and rose to the challenge. History was made. His most important promise was hope and he has already delivered. The rest is up to us as citizens to re-examine our personal selves in the way that JFK so eloquently challenged us to ask not what our country can do for us but ask what we can do for our country. To me, that is what true leadership is about. If each citizen threw into the pot the best they have to offer the possibilities would be endless. These words may come off as rhetorical but I find a rhetoric consisting of hope preferable to one based on fear. This is where I believe Obama will really make history. He holds the power to destroy forever all of the myths and stereotypical beliefs perpetuated to the world about the Black man. If you've never been a man of color you may not understand why I would even write such a thing. I'm so glad that America has grown and majority rejected the knee jerk reaction to lies of Obama being a terrorist, that he would change the national anthem, paint the white house, and to the extremely bizarre of him being the anti-Christ signalling the rapture in forty days. All of these ideas are totally nuts but there are actually people among us who believe such.

I am quite aware that it is a waste of time and rarely productive to discuss politics or religion. It can be enlightening, however, to do such with one who is learned. Even more so with one who is learned and passionate. Politics, I have found to often be a dirty, cut throat kind of game. The game is roughly 80% based on psychological principles which makes it interesting for me. Sometimes I don't feel fear when I should and I also have a burning desire for truth. I don't like being lied to or tricked. Give me the facts and let me make up my own mind. Religion is different from politics in that it is mostly faith based. You have to believe in order for it to have any real meaning or power. The facts often have to be interpreted in religion. The ability to incite the emotions of fear or anger within people is what makes politics and religion such volatile and controversial topics. Friendships have been severed and countries have gone to war over disagreements with religion or politics. Is it really worth it?

For the first time in quite a while, I feel no animosity and no anger within. I feel a sense of hope that I have never experienced before. I feel validated. My life is far from perfect. There is much work to be done. I understand that President Elect Obama is powerless without the support and efforts of the people. I sense forward motion and reject all negativity headed my way for the years to come.

Time for Change

I do take comments seriously. . .

thus the new look of the sight. The white letters on black background really had played out in addition to being harder to read than traditional white background with dark print. I have known that for a while but continued to procrastinate mainly because I didn't think anyone really cared. From the beginning of this journal I never really expected many people would find it worthwhile to read and I sometimes forget that there have been a substantial number of readers over time. Knowing that has provided me enough motivation to continue posting.

I understand that I have one of the most interesting jobs on earth and feel it important to share sometimes that which is appropriate to those who may be interested. I can say that no day is ever quite the same and that tends to make the feelings of stress and frustration bearable. Of most importance, my job has taught me limits over time. It is no secret to regular readers that the greatest challenge has been dealing with non compliant uncommitted substance abusers. The bottom line has become resoundingly clear that there is no help for those who choose not to help themselves. Our country has a dysfunctional system for handling the growing problem of addictions which greatly affect the the lower class and appears to be rapidly affecting the middle class. I still identify with that population because that is where I came from. I feel enraged at the fact that more isn't done at the entry level into the country for cocaine and heroin. Instead the focus is directed toward people like myself who are trying to help fix the problem. That is why I feel cynical about politics. No candidate has said a single word about the drug problem. It is as if it doesn't exist. It makes me wonder who really controls the country. Is what we see what is really reality? Follow the money. Who is really receiving the benefit at the expense of others? How do the drugs really get to the consumer? Maybe the jails and the court system and law enforcement need the users to continue using.

Some days I can't believe what has happened to me with this issue with the Medical Board. I did take the risk of seeing many patients that other doctors would not see or were not appropriate for the public centers that are supposed to treat addictions. Many of the addicts were actually created by our dysfunctional system which punishes doctors for associating with such patients. My case has been continued until February now. I think they realize they have a hot potato. All of the useful evidence that could be used against me is from over a year ago and most of it I told them willingly (which I now realize was a stupid thing to do). This is obviously a witch hunt, which serves the purpose of diverting attention from the real problem. I believe within my heart that there are indeed corrupt individuals within our legal and political systems. That is the true source of what is destroying the fabric of our communities. People need jobs, access to proper health care, and education.

Sometimes it may appear that I overinflate my self worth by associating my situation with the national agenda. I view it a bit differently and feel that the true enemy needs for people such as myself to be marginalized, discredited, suppressed, or neutralized for we are a threat to the status quo. I feel validated when people that I know, mainly patients, reject the smear tactics used against me. People who truly know me are aware of what type of person I truly am and that, most of the time, I actually am pretty good at what I do. I have worked hard to correct what the Medical Board deemed deficient. My reputation was attacked but it is not sticking. There are a few pharmacists who have gone out of their way to propagate the negativity but they are only hurting their own business. People have assured to me that my plight has been a part of their daily prayers. I feel confident that the enemy will not prevail here. If God is for us then who can be against us. For me, this is becoming a test of faith.

On the lighter side... Someone told me that cats are suppose to calm down when they are sterilized. That apparently is not true. My cat actually seemed to resort to the behavior she displayed when in heat. She's bolting out the door every opportunity and sniffing for the tom cat's scent. At least she loses interest after a few minutes and comes back in. I wonder how long this will last. I was afraid to admit that I had relocated Squeaky to my property in the country because I was afraid she might not adapt. She has some ferral cat tendencies and suprisingly has done quite well so far. There is a neighborhood scavenger dog that I was most concerned about. She has learned to evade him when necessary. She loves climbing the trees and exploring the proximal territory. The first time she climbed a tree she was stuck about 15 feet off the ground and afraid to come down. She started whining out of fear and confusion. Sounds like a job for the fire department. Yeah, right. They would have loved to come back a third time. Eventually she came down to a lower level and jumped. There was a considerable thump but fortunately she wasn't hurt. Live and learn.