Notes from the office; being afraid of the wrong things.

I routinely encounter patients who are afraid of the wrong things. An elderly patient announced  he won’t be getting his covid19 vaccine as he heard tell three people in England died after receiving theirs. This same person smokes cigarettes at a pack a day. Patients are not the only ones afraid of the wrong things, out course. One of my brothers refuses to take medication for high cholesterol on the (rare) chance it could cause side effects but he regularly buys lottery tickets hoping that pays off.

You get the picture. People are notoriously lousy at assessing risk. 

I hear the number of people who die each year from shark attacks can be counted one or or two hands, but we had to be dragged kicking and screaming into wearing seat belts to safeguard us from the far more likely chance someday we will be in an accident.*

I think I am pretty good at discriminating neurotic fears from legitimate ones. The biggest fear I ought to have – and do have – is cardiovascular disease.  I am far more likely to have a heart attack or a stroke than being attacked on the street.  This is why I feel the need to exercise and I do feel the need to carry a gun.**

Don’t think I am above stupid fears. The monkey part of my brain still goes immediate to full panic at the sight of a scorpion in the house before the wiser part (near the front) reminds me no one dies of a scorpion bite and they do not jump, so knock it off. 

One may not be able to stop being afraid of the wrong things but with some logic one can lay off the Lotto tickets and use the saved money to buy more vegetables. 

Then there are the folks who aren’t afraid of things when the ought to be.Elderly male patients often won’t get rid of their guns even though statistics support they are far more likely to use the gun to kill themselves than on an intruder. 

I must hold my tongue to ask the mask-less man on the street if you are not wearing a mask as you are putting your trust in G-d, why then do you feel a need to carry a gun? 

It is an ongoing process, trying not to be afraid of the wrong things and being fearful of the right things. 

Wear a seat belt!

Stop smoking!

Wear a mask and wash your hands after using the restroom!  

Get exercise!  

And stop eating crap !

 

*Seat belts have a grim history that when they were first considered the auto industry was heavily opposed to putting them in cars as it implied their product was hazardous. Later on when they were installed there were ads encouraging drivers to buckle up for their own good.  These ads were a flop. Then it became law, and only then did people buckle up – and the deaths from car accidents plummeted. It is an example of forcing people to do what’s right pays off when simple encouragement fails.

**These fears seem to be flipped in Trump supporters, at least by how they look anyway. They often look heavily armed and grossly obese.  

Spo-reflections on writing

I get up every day at 5AM (more or less). This gives me a few hours to myself before the work day begins or on weekends when Someone wakes.  This precious time is dear that I am by myself, things are quiet, and I get things done without distraction. So far I’ve set up my work day, I’ve attended to the dishes, and I started a load of laundry. Before the flood gates open at work at eight, I can do some writing. 

Mornings are when I like to write most. I’ve heard tell many writers did their writing early, either out of discipline or necessity (before their ‘day jobs’ started). That said, I often like to write at the end of the day to finish the day as it were.  The Muses et. al. either don’t have regular work hours or they live in a different time zone* that there’s no rhythm to when they pop by to plant an idea into my gulliver. This usually happens when I have no pen and paper to write ideas down, not when I am sitting at the screen waiting for inspiration. 

Sometimes my ‘have write something” is doubted by others in the household. After all, it is a hobby I am told. It is one thing to have to do a job but having to do a hobby makes no sense. True enough. The difference between rolling down grass hills (my other hobby) and blogging is I feel I really do have to write – regardless of the contents or quality. It feels as necessary as breathing. 

The daylight is enough now for me to put this down and take Harper for her morning walk. Work begins in less than an hour. I’ve done all the necessary ablutions to start the day right – and this includes writing something. Thank you for reading and being part of my morning.

Spo-fans: when do you like to write? Do you have a fixed time of the day to do so?  Do you feel a ‘need’ to write? 

 

 

*Somewhere in Eastern Europe, I imagine. 

Spo-bits on Sunday

Today I made my first ‘over-the-ear’ masks (3)  instead of my usual ones I tie about my head in the style of Jacob Marley. This sixteenth Japanese design is perfect for going to sushi restaurants – which I haven’t done since last March. 

Someone regularly tests for covid19 and his recent test last week was again negative. When he tests negative, I suppose I am negative too. There is some erroneous presumption to this way of thinking. He gets his vaccine in early February.

Yesterday I made my first-ever marmalade. It was some job. I followed the recipe, but my intuition tells me this is didn’t literally gel. I find out soon. I should get some English muffins as there is nothing in the house upon which to spread such. The back up plan is if  failed-spread is runny it will be used as a topping for ice cream. 

Last weekend I did such as good job cleaning the master bedroom and bathroom it inspired me to tackle the formal living room. I dislike this room as we never use it. It is reserved for ‘formal entertaining’ for our gentleman callers. Like going to sushi restaurants, this never happens. Even when we had chums over we all congregated in the kitchen anway. The formal living room and its contents is a conglomerate of dust-collectors. It seems every time we’ve bought a house there have been too many rooms, some we never used. Next time I want to get a place with ‘just enough rooms’. 

I recently heard a story I thought I would share. A friend of Socrates went to The Oracle at Delphi and asked “Is there a man wiser than Socrates?“. Instead of getting the usual cryptic reply he was told “No”. When told this, this friend was amazed by the answer. Socrates spent his whole life emphasizing he knows nothing; we can’t know anything for certain. He investigated what The Oracle meant. What he came up with was other men know nothing, but the don’t know they know nothing. Socrates on the other hand knows nothing, but he knows he knows nothing -and that’s not nothing. So maybe that’s what made him wiser than others.     hohoho. 

*Made from grapefruit, of which I have plenty.

Notes from the office: ten questions psychiatrists hate answering

I recently watched a YouTube video made by an Icelander titled “Ten questions Icelanders hate answering”.* I thought it would be fun to try this myself.  

“Ten questions psychiatrists hate answering”

1 – Are you a real doctor?  Yes, I went to medical school and after I graduated I did a year of internal medicine and then a year of neurology prior to going into psychiatry. I became a psychiatrist because I wanted to, not because I couldn’t make it as a ‘real doctor’. Indeed, I was headed towards cardiology but it was boring. This is more exciting.

2 – Where’s your couch? This is not your grandfather’s psychiatry. The couch was when the only tool psychiatry had was psychoanalysis. It is like walking into your primary care doctor’s office and looking around and wondering where are the blood letting tools.

3 – Is everything due to my mother? Not even Freud believed everything was due to Mother. People and their psychologies are complex. Those looking for a single matter to explain things are going to be disappointed.

4 – Do you do anything besides prescribe meds? I spend most of my time trying to get people to do things and solve their problems by NOT using meds. The irony is I am usually the one on the receiving end of someone who wants a prescription rather than a lifestyle change “gee, can’t I just take a pill for that?”

5 – If I say something crazy sounding, will you lock me up? Unless you are at immediate risk to kill yourself or others it is nearly impossible to get people committed to hospital. Again there is irony I am often asked by a patient’s loved ones pleading with me to ‘lock him/her up’ for their welfare. It is hard explaining to folks one can be bat-crazy and going to heck in a hand basket and I can not prevent this. There are no men in the white coats with straight jackets.

6 – Do you ever ‘turn it off’? Yes I do. One of the first things you learn in shrink school is do not become a therapist to your spouse/friend/child etc.  It is a sure-fire way to ruin your relationships.

7 – (Asked at party or social setting) Oh! I better be careful! You’re analyzing me, right? I either tell these folks “Not for free I won’t” or (if I am being catty) “Hmmm, I sense you are anxious about something, tell me more about your childhood and your relationship with your mother”.  

8 – Are you in the pay of big pharma? No I am not. If a psychiatrist is being paid by a company to do research or talk about their products these doctors are required by law to disclose this up and front so the listeners know this. In thirty years of doing what I do not once has a pharmaceutical company tried to bribe me. There are no handsome stud reps throwing themselves on me in exchange for me to push their product.

9 – Can you prescribe me my( pain meds/blood pressure pills/birth control etc.)? No harm asking I tell them but I won’t. I am not up to date on the proper protocols of treating high blood pressure or menstrual problems, and I am not a pain specialist.  Get these things for your body docs who know what they are doing.

10 – Will you write me a letter for me to take my python on an airplane as a therapy animal? Oh the pain.  I no longer write these letters as there is little evidence I am aware therapy animals work any better at assuaging anxiety than holding a stuffed animal. The use of ‘therapy animals”  is quite abused. I tell folks for every person I’ve written a letter to take Fido on board a plane I have another patient being treated for PTSD from being cooped up in a plane with said animal towards which they have allergies or flashback memories of trauma.

*For thems interested, the six I remember:

Are you a Viking? no

Aren’t you always cold? no

Aren’t you all related? no

Do you know Bjork? no

Do you believe in elves? no

Do you have igloos? no

Five on Thorsday

#1 – I woke this morning for the first time in four years wanting to hear the news. Everyday for the past four years I have waken dreading what may happen. The dreadful apprehension was not unlike those someone has who is living with a violent person whose actions you cannot predict. Those feelings were gone this morning. It felt good. I think of the Ferryman in the Russian folktale “The Luck Child”, who was trapped in his job, only to learn how to be released from his sorrow:

“For the first time in years, hope fires the Ferry-man. A smile is forming in his mind, a tiny smile growing, getting ready to be born”.

#2 – There are shenanigans afoot in the blogger world that I am not always able to leave comments for thems using Blogger.com.  Perhaps the website is in cahoots with my laptop. I hope I can figure this as I hate dropping by without leaving a comment lest folks think I am not reading their prose.

#3 – Would anyone would like some Jello-salad?. The Board of Directors Here at Spo-Reflections over-estimated the attendance at last night’s ball at Heorot Johnsons, resulting in leftovers. Heaps in fact. Act quickly as cottage cheese and Salmon mold isn’t likely to keep. Also, there are a few Tupperware containers without masking tape labels. 

#4 – Alas, Babylon! I won’t be having any free lemons this year. The lemon tree that overhangs the public sidewalk was severely pruned back last autumn and there is no sign of any fruit. Uncle Albertsons has lots of lemons but they are not as juicy as thems that fall off the local trees. I was worried I wouldn’t get any grapefruit as these are brought to the Mesa office and I haven’t been there since March. I thought to travel there to get some, when lo! a neighbor down the street set out by the curb eight bags of grapefruit, all for the taking. I took two bolsas, each filled with a dozen medium-sized yellow gems. I am a happy man. I must look up to see which way these lovelies effect my blood pressure meds. I am either going to stroke-out or drop from hypotension, depending which way the wind blows on the grapefruit/Rx interactions. Either way it’s worth it.

#5 – Speaking of five, I recently found on YouTube “The five Chinese brothers”. This story was a favorite in my youth; I was thrilled to hear it again. I remembered every picture. Oh the horror; oh the pain! It is so stereotypical it makes me squirm. It is along the line of ‘what on earth were we thinking?”  I wonder how many other childhood story books of mine are now considered rude and racist? How times have changed – and I think for the better. The story remains a good one, so perhaps someone can redraw it with less discomfort.

 

Spo-bits on Wotans Day

Oh the horror! I just posted an entry replete with photographs and then when I went to edit it the contents disappeared like one a Samantha Steven’s relations. Now I am too peeved to try to recreate it right now. Perhaps later.

This morning feels like Christmas for me, but the sort when you wake up excited about getting that pony or cha-cha heels (black ones) but you are not certain if it is actually going to happen.

For four years I’ve been dealing with folks with depression and anxiety who resemble women trapped in a domestic violence relationship with a brute. I am curious to see if my patients will feel the same relief PTSD-types feel when the perpetrator is finally removed.  Better people than I have written about the vile actions of the past four years so I won’t say any more. It is hoped the nation isn’t so degenerate it is beyond repair. Let us hope so.

In the future if I ever refer to that loser wannabe- dictator, I will use the sobriquet “Florida Man”.

Speaking of healing, I finally started exercising. Other than dog-walks I’ve done nothing for a year and I am quite out of shape. I started yesterday with a quick walk around the block and did some pushups and then some abdominal actions using a small wheel.  It isn’t much but it is a start. I hope to do something daily and hopefully by summer I will feel less of a ticking time-bomb for a coronary.

Someone works for the city of Phoenix, so he qualifies for the vaccine, lucky fellow. He gets his first shot in a few weeks. Arizona seems to have made a mess of things. The elderly/snowbirds have been clamoring for shots, and their howls resemble an orchestra of scorched cats. I sense it will be many months before my turn arises.

I will be working nonstop today so I will miss the swearing in but I am looking forward to the headlines “President Biden”. Wednesday – or Wotan’s day as The Board of Directors Here at Spo-reflections calls it, is the busiest day of the week. I am amazed how many Scandinavians speak English and so well. TBDHSR does a fair job in their enunciation (thems with most of their teeth do the best) but they can’t seem to get the names of modern days of the week right.  The tongue-tied dears declared today a holiday.  Heorot Hall is bedecked with party trimmings and fresh heads of road kill for what they are calling ‘The inauguration ball”.  If your invitation got lost in the carrier raven post, don’t feel bad. After reading my latest entries The Munificent Board composed a smorgasbord Jello-molds, pasta salads of suspicious substances, rats on toast, and rotten oranges. I have to be more careful what I write here.

 

Spo-reflections on a bowl of pasta

I often listen to medical podcasts on the topic of cardiovascular disease, which are usually conducted by some great expert for the edification of other great experts in Internal medicine. The leitmotif humming through these lofty lectures is the ‘evil’ of carbohydrates, sometimes called ‘carbs” and often abbreviated as CHO. I remember too long ago it was fat that was the bogeyman of our existence and we were to avoid grease at all costs but nowadays it is carbohydrates. From what I get out of these talks, for all the damage CHOs do, we might as well be eating ground glass. Some carbs are more sinister than others (sugar and white flour) but all CHO seemed lumped into the common category of ‘bad for you”. Oh the horror.

This is a pity as I was pondering starting “Pasta Wednesday”, to go along with “Meatless Monday’, and “We-just-got-home-from-show-tunes-at-the-bar-and-are-too-tipsy/tired-to-cook-so-let’s-eat-what-we-can- quickly-microwave-Thursday”. If I could get away with it I would have some sort of pasta every day for I love it so. The shapes of pasta, multiplied by the toppings, equals an infinite number of ways to serve the stuff. Hot puppies! I have heaps of recipes aching to be made. Alas, Babylon! I have to limit myself to only now and then and not too much in a sitting. Stirges.

My Italian bestie Rita, A.K.A. Sweetie Darling, finds all this amusing on many levels. For her, ‘cutting carbs’ means using a pizza wheel.  No meal is complete without some pasta (and wine for that matter) but it was never the front and center as an entrée. Indeed, eating meatless pasta dishes is what you did at the end of the month when the money ran out to buy meat. For her, paying a lot of money for pasta makes no sense.

Getting back to the pasta shapes for a moment., I like long string-like pasta such as spaghetti and linguine, while Someone goes thick short types like rigatoni. Overall we don’t pay much attention to what toppings go with what type of pasta. I’ve learned is an absolute horror to a few folks I know. They have strict rules as to what sort of macaroni goes with the sauce, although I can never get a clear reason ‘why’ this is so. I am told if I dare order the wrong pasta type with the wrong topping people will think me an idiot and an object of suspicion. Oh the horror.

I think I will go ahead with “Pasta Wednesday” to the horror of all except Rita who promises to send me some super-good proper Italian recipes (no rubbish)  – provided I don’t substitute the pasta with the wrong type. In the recipes if I dare substitute the pasta type it will result in her having a heart attack. Perhaps that what is really behind all those medical lecture about the dangers of ‘too many  carbs’.

Spo-fans:

1- How often do you use pasta?

2- Do you have strict rules as to what sauce goes with what shape of pasta?

3-Do you have any scrumptious pasta recipe for my first run at “Pasta Wednesday”?

 

 

 

Spo-reflections on a dusty room.

Yesterday Sunday I woke determined scour the world of grime and filth – or at least the part of the world that is my house. I’ve been sleeping badly lately, partially due to nasal congestion preventing me from breathing. If you are like me, being able to breathe is a vital element for a good night’s rest. So, I took a deep breath, channeled the ghost of Agatha Morley, and got to work. 

It is both horrifying and amazing how much dust accumulates around here. The worst places were the ones I would not expect to find dust. The ceiling fan may look lovely from below but on top of the blades were dastardly layers of filth. How can this be when the fan whirl about so?  Another culprit was the lampshades, which had to be taken out of doors for a good shake. The oddest spot was the walls. One has to admire dust its cheek to accumulate on the walls. 

“What’s the big rush all of sudden?” said Someone, (or words like this). I told him; I’d been talking to him along be before he arrived in the room to investigate what was all the racket (I dust noisily). We were going to clean up today – at least the bedroom and bathroom. I shepherded him all day as a dog drives sheep. Between us we did countless loads of laundry including quilts and armchair covers (filthy!). I got up on ladders to attend to the tops of the bathroom lights and the frames of pictures (dens of dusty inequities all of them). Working from top to bottom, I then shook out the rugs in the spirit of generations of women (and menfolk too) who took up arms against the loungers and loafers and lead-butts who are all too willing to accept filth as OK. It was tough work but then it was done. “Come into the bedroom,” I told Someone, “and look and smell the clean.”  I slept well that night, knowing things were good and dust-free. 

Spo-reflections on soup and uncertainty

“And you all know security is mortals’ greatest enemy” – MacBeth.

Yesterday I made a pot of soup, using this-and-that found in the fridge and in the pantry. There were vegetables near past their prime and some beans of questionable age in an unmarked glass jar. Someone had taken from the freezer some beef ‘to use somehow’. All this sounded like soup – but which one to make? After many months of learning to cook ‘the right way” I was challenged that my ingredients didn’t fit any specific recipe. So I did something I have never really done before: I made it up. I used ‘applied learning” to put things together, not following any particular recipe. You see where this is going: the soup was marvelous. I realized I had succumbed to – and in all places, the kitchen! – one of mankind’s biggest banes: the need to be certain. The soup had to be ‘proper’ and what I was doing was to be done ‘right”. 

I haven’t written about the horrible happenings in DC but I will say something now. I think these villains were mostly driven by the need to be certain about their beliefs. A belief is an answer to a question, and nowadays many are asking the questions (albeit not consciously, alas) who am I, who are we as a nation, and where are we going. When faced with the uncomfortable realization your belief is false or faulty it is so hard to admit to such and admit what I believed was not true and now what I am left with is uncertainty.

In times of doubt we often turn to narcissistic grandiose experts and leaders who tell us ‘I am certain; this is certain. Put your belief onto me and let me do your thinking for you and all your uncertainty will be appeased”.

History shows this never turns out well.

I don’t know if Life today really has any more uncertainty than in times before. It sure feels this way sometimes, but this may be merely the poison of social media. The truism remains the more we allow ourselves to live with uncertainty the less likely we will make a muck of things, hence the quotation from MacBeth.  

Today I have a sore throat, which may be allergies or covid19. There are three days to inauguration day. I have a legal matter at work. At 58 I don’t know where I am going.Yet, if a crystal ball in which to see the future was set before me I would run from it as if it were contagion. 

I am looking forward to my soup, which cannot be duplicated but I can make something just as good if not better the next time I try such. I make do with what I have, at the time I have it, and I won’t try to be so certain in the kitchen anymore. 

Notes from the office

It’s been a rough week. 

This week at work a legal matter had me involved in a zoom-interview that was part deposition and part disquisition but mostly felt ‘inquisition’. I suppose I shouldn’t say more about it so I won’t.  It’s been a major source of stress for me, a matter for months, and apparently ‘not over’.   

At home I have some sniffles and aches, which is probably allergies or a mild cold, but of course I am wondering if I picked up covid19 on my travels. I need to be tested. I always ask my patients ‘Did you have any medical matters since I last spoke with you?”; in the past four weeks I’ve heard more reports of covid19 than in the past six months.  AZ resembles 1347 Florence. 

There is one ‘positive” at work: my work EMR (electronic medical record) has a dashboard that tells me how many unsigned documents I have. It feels good to get this down to ‘zero”. For many months it thumbs its proverbial nose at me taunting me I have ‘one” to sign – with no evidence there is any.  The inability to get to ‘zero” was driving me to distraction, enough to call the help line on the matter. They were most empathetic and after some detective work we found the culprit. Last summer I wrote a telephone note on a patient of The Other Doctor. I sent it to him. He left the practice and didn’t ‘sign off”. To remedy this sore, I had to get the house manager to resurrect him from the dead as an active staff member, then I impersonated him to go in and sign the damn thing. Hot puppies! this worked!  Unfortunately by becoming The Other Doctor (even for five minutes) this resulted in me becoming inactive and worse – nonexistent. It was very ‘1984’.  Eventually I was resurrected ala Dungeons and Dragons and I am back in the saddle with a dashboard showing ‘zero’ for unsigned charts.

One gets ones jollies where one can.