psychiatry

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Why do I Keep Living? – Chronically Suicidal.

trainwrecklife

Carl D’Agostino is a retired high school history teacher. His interests include woodcarving and blogging. Cartoon blog at carldagostino.wordpress.com.   Cartoons published in book, “I know I Made You Smile, Volume I.”

Marvin lived hard for years, used up his bank, his talents used up like putting a flame to his wick.  He was wired to live in the moment. Living that way, when he had gifts galore freely given, living was different than when those gifts were used, diminished, and broken. Marvin was smart enough to rationalize his way into a chronic suicidality thereafter.

What is the point of living, after all? Marvin asked this question, answered it, and asked it again, to the point that it separated itself from Time and place. It is a question that is infinite anyhow.

Sometimes Marvin, with this infinite question, this question that occupies the time of God, kings, and beggars, Marvin would sit in my office with this infinite question in his nicotine-stained and inked fingers, and he would in this bring together the infinite with the finite. I remembered that the whole point, the meaning of the infinite and finite, is increased in value by the other. Marvin, living in the moment, even now years after his coin was thus reduced, was living in the infinite.

Why do I have to keep living? I just need someone to tell me it’s going to be ok if I die.

Marvin, If you are looking for a doctor to help you die, you need to go somewhere else. I will always choose life.

(It seemed like that “FYI” was in order.)

“We” made a plan …that Marvin wasn’t entirely in agreement with. I told him he could not come back to my clinic if he wasn’t engaged in that plan.

Marvin, we are just going to do what the data tells us will work. We don’t have to feel it or even believe it. We have the data at least.

Every time I have ever seen Marvin, I took a hard look, memorized him, knowing this may be the last time. Setting boundaries with him was freaky. It felt like trying to hold broken glass. Would Marvin be back? If not, I knew I’d be hurt.

The patient-doctor relationship is unique to each patient. It is unique to each doctor. For me, in my patient-doctor relationships, if it wasn’t for the hard grip I keep on the seat of my chair, I’d have too many of my patients in a big, but likely awkward, (and my Academy tells me, “Inappropriate”) hug.

This flashed through my mind in fair warning again. I compromised, saying instead,

You matter to me, Marvin.

I think Marvin’s lip actually curled and his canines grew. And I quote,

How can you say that? I just don’t get it.

This was a moment of road’s diverging, 31 Flavors, coins in your hand in front of a mother-loaded vending machine. I could see philosophers, all over the now and then of the ages, slobbering like they were at a nudie bar.

Once, when I called 911 on behalf of a patient who needed to go into the hospital for safety, the police person looked like that, bouncey even, on her toes. I had to check her feet to see if she was actually standing on a pedestal, she sermonized my poor patient so thoroughly. I think she was even eating a candy bar as she left my office, satisfied, (without my patient, by the way. Apparently she thought her tonic words had medicinal powers.)

Marvin was fishing me. There were so many ways to lose with that question. He was hoping I’d flop around with straining gills sucking air for hours while he tugged on the hook.

I’ve done that often enough, and will do it many more times. We can count on mistakes. What took me by surprise was, this time I did not.

Well, I’d guess it has something to do with me and something to do with you.

Yup. It surprised me. The surprise brought a wave of gratitude. “Thank you God.”

And if you aren’t as surprised or grateful by that liner, I can only explain that it was right at the time. Marvin lost his handlebar lip curl. I lost my grip on the chair. Marvin’s still alive, (I know everyone’s worried about the “for now” part of that.) And our universe cares, finitely and infinitely.

To the Marvin’s of the world, the wasted, the used, and the squandered, work your programs.

To the lonely and distorted, to the ones who have tried to die, to you who don’t know why you keep living, follow what the data offers by way of direction.

To you who may not get the same freely given gifts in this life that are now gone, you have good things coming.

We choose to live with you, than without. We choose you again. We choose, every time, what Love will bring. Keep on.

Questions: Have you ever asked yourself and/or others, “Why do I keep living?” What has your answer been? What is your answer now? For yourself. What would you tell your own Me?

Self-care tip: …I think I waxed on and off enough already with that – smile.

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Walking in on me after my massage.

walking in on me

I never realized, until this experience, that during a full body massage, one’s “girls” seem to swell and grow,… and no, the “girls” were not directly handled.

What brought it to my attention was the door opening. That misty moment hung in the air – between the massage ending, the masseuse leaving the room, and the sheet coming off my body just before getting re-dressed. The salon’s hostess stood there and squeaked,

Oh! I sorry!

First reaction, should this happen to you, is to laugh a little. This is what you will do. “Ha-ha.” Then you will think, “What? Did I just laugh?! Oh. Those must be ‘comedy boobs.’ …Can I have my virginity back?”

And then, “Is this covered in the insurance?” 

I’m simply really glad it was not more than one lady who was at the door. It could have been a crowd. And I’m not implying any of them would have liked it either. (Boys, shush. You don’t have to remind us that a male’s response to a woman opening a door on him when he is naked is entirely different.)

But I should have known this would happen. When I was being “roomed,” the hostess wandered her facility like she was on an easter egg hunt.

Is this the place? No? Here?

‘Oops! I Sorry!‘

How bout behind this door?

Yep. You got that. She did walk in on someone else while trolling around with me. I was forewarned. Yet, did I leave? No. Rather, I deferred with, “She’s mortified. This is the bottom of her career, poor thing. She’ll never do that again! I’ll act like I didn’t notice.” Optimism rears its perky head.

During our room-hunt, we came upon a large one with many cots. It appeared to be a community massage room.

I’m all for community. Community, NAMI, connection – you’ve heard my spiel. But this was a different definition of “community.” I thought,

These massages must be cheaper.

Because who wouldn’t wonder, “Is that relaxing?!”

Again. Males are different, I’m sure, but really. All you do is smell feet. Or maybe it’s like the swingers version of massage therapy. You might not walk out with the same wife.

Finally roomed, stripped and prone, my masseuse came in. She had such “rolling-pin” strength in her one arm… “She must work out.” 

Bone…still bone. Yup. You’re still on bone.

My face went numb pressed into a doughnut, but I kept on. (I once got an award for being “The Most Tenacious.” I think I was like ten. How did they peg me?) My back was getting worked over, and I had faith, at some point, it would feel wonderful. Just like I thought no one would walk in on me and my restored, and more than, decolletage.

I never actually saw her. My masseuse. She came in, did her rolling pin thing and was gone. No face-to-face. The experience was difficult to identify. What shall we name this?

But you know the next part of the story. The door opened.  

I don’t have a self-care tip to share today. It could be to go get a massage. Or not. I, with what looks like a more full than empty glass, thought this experience was too rich not to share with my friends.  Keep on.

Question: When has your optimism v. pessimism steered you wrong!? Please spill. Please. Spill.

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Love to Pee

peeThe little boy was standing in the tennis court by the fence, facing out.  Doing what?  Sure enough. 

“I’m nature peeing,” he said.

Have you ever seen as much happiness than in the faces of little people peeing?  Well, I love to pee, too. I think most of us do. That is until we pee inopportunely. Or poo. Ahem. 

I’m getting older and realize that my happy peepee-ing days are numbered.  Three kids later, into my forties, and like the garden faucet outside with minerals crystallized around a corroded fixture, dripping “will,” (ahem,) start. Soooooooo, sooooooome day, …urine will yellow my underwear. Kids, without discretion, will announce that I smell. And for the innocent, and a once happy pee gone horribly wrong, I will be ashamed.

The pelvis is like a woven basket. Muscles criss-cross in a wonderful design between a supportive frame, like plant fronds and wood. 

When I was an eleven-year-old, I travelled to the African continent.  It wasn’t every country, wink, but a few on the southern side. I don’t remember enough of my childhood. Who knows why. But I do remember, in every African market place, I looked on women and children weaving leaves and grasses. They didn’t even have to watch their projects. Their fingers had memory of their own.  Instead, their eyes were watching us watching them. Brilliant more-than-white smiles in chocolate black skin, turned their curious faces up.

My Mom, a lover of all things lovely, looked. She loved them all – the people, the baskets, the freedom of being in Africa, and more. Then the blood of generations of hagglers and market yellers whipped through her Lebanese veins with increasing energy, distracting her from a bigger picture.  She wished mightily for baskets.  She would have purchased every one and made us carry them all back to our home, eleven hours by airplane, if she could. (Those were the days when people smoked inside airplanes. You and I understand what that meant. That air inside airplanes was the same air everyone inside breaths. It was a long flight.)

A decade-plus later, World Market opened. I wondered about all the faces and fingers it must have taken to make all those gorgeous creations, now for sale in Temecula, CA, for twenty some dollars a piece.

How could I be so clueless as a twelve-year-old, but I was, and I didn’t know about the fingers that deftly moved, the brilliant plant dies, the tight strength that remained in a basket, like hands clasping, between each fiber. The baskets held memory.

These are the baskets I think of when I think of the marvel that the pelvis is.  These are the baskets I think of when I think about how much I will despise losing continence. When losing continence, I will also remember that little guy making “nature pee.”  I will pull the backing off another panty-liner and say, I used to really like to pee. 

Our emotions and behaviors are similar to the joy of peeing and the pelvic basket. We at one point in our life may have loved to live, loved to speak with friends, loved our hobbies and our stamps, and our cooking pans. Some day later, we wake up, and people notice the difference, like the urine smell in incontinence, people notice our emotions and behaviors “leak.” Kids point, even, “Mommy, why does Bridget’s Mom always wear those sweat pants? She’s in the same sweat pants every time we see her!”

It’s awkward. People don’t know what to expect from us. Our emotions and behaviors are not what is socially acceptable and they stop knowing how to speak to us. Our professionals who are supposed to help us don’t even know how to speak to us. They shorten their visits with us. They tell us how to feel, “Just decide. Make a choice. Choose to be happy.”

When people don’t know what to expect, it divides us and separates us and is uncomfortable for all. This discomfiture, (less often consciously aware,) is a barrier in knowing how to speak to a psychiatric patient. It takes a heck of a lot of self-awareness on each party’s side to look inside ourselves and figure out where our discomfort is coming from.

What will you think of when you “wet your pants?” Or of someone you are with? Feel your energy get sucked into the earth by a depressed colleague? Notice acid escaping your stomach into your throat when an angry child’s emotions fill a room? Your thoughts start to buzz when the white noise of anxious Dad comes around.

Remember the pleasure that came back in the day, see into our Me, identify the nidus of discomfort, and then let it lose it’s power over us – then the unexpected with be an encounter of mutual respect.

Knowing how to talk to a psychiatric patient, means that we are okay not knowing what to expect, not personalizing what isn’t about us, and allowing for a context that is in many ways unknown. With this, we will pull the backing off a panty liner and get on with it.

Questions:  How has the unexpected behaviors of your, or of others you know, been treated by your medical providers? How have you treated yourself in those scenarios? Please tell us your story.

Self-care tip: See into your Me to be better at speaking with the unexpected.

Get a clue – Community
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Get a clue – Community

community

There are some things that must be experienced to have a clue.  If  you have never had a rebellious teenager, if you have never felt a full panic attack, if you haven’t grown old, been pregnant, been fat, if you’ve never, you won’t know.

If you have never been thin and beautiful, or large and virile, if you haven’t jumped from a plane and felt the free fall before the shoot, if you have never held a graduation diploma after working harder than you ever have, if you haven’t, you will never know.

So how can you?  How do we understand, give advice, and how can we be present.

There are common thoughts and common feelings, like the air we breath.  Rejection, hope, the intersection of thought with emotion with soul, our 6 senses; sight, hearing, touch, smell, taste, emotion, these we may be able to understand.  We may not be able to understand divorce but we will know rejection.

The sense of accomplishment, being the first in generations to graduate from college for example, is in each of us in our own context; picked for the team, sleep through night after days of preoccupied thought absorbing up the early morning minutes into hours, aware of self-value after chasing it over hills of bullying and comparisons.

Comparison is the thief of joy. – Roosevelt

There are going to be a lot of things that we will never understand in others.  But we will understand how to be present, stand beside someone, allow you to have your unique experience but although unique it is with commonality.   Everything we go through has commonality.  We are designed for just that point in time, for connection.  It is the pursuit of a lifetime.

Self-care tip:  Seek and engage in community.

Questions:  What is it that you feel alone in?  What do you believe is unrelatable?  Or Why not?  Please tell us your story.

“I’m Making You My Business!”
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“I’m Making You My Business!”

It is pervasive.barriers

We talk about salvation as if it is an event, a diploma, a point in time, something with a frame and boundaries and a rejection of everything else about us.  Salvation is not this.  Salvation is pervasive.

Same with carrying your cross, going out into the world, and so forth.  Salvation and all these life axioms are in the divorce we are suffering, the depression, the trouble with sleep, the courage we demonstrate going into public, the fear we succumb to, the freedom we give up to anxiety – this is all about salvation.  This is what going into the world means.  It’s not one or the other.

When we say, the world will fall away, it is saying that there are no dividers any more.  If you’ve ever heard the term, the best way to get rid of an enemy is to make her a friend, this is the same idea.  God who is and who is personal takes away the dividers and makes us Her business.

God who is and who is personal is important for self care because She is all about Me.

Self-care tip:  Let the barriers go and accept the presence of Love.

Question:  Does God improve your self care?  Do you see dividers between your personal stuff and what is, who is, God?  How does that serve you, Me?

Keep on people of courage!

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There is no self-care without Love

grieving

Reggie showed up without his wife.

The wife was a short woman.  She had some practices that usually increased the space she occupied – the smell of tobacco, the size in her chair, the volume she laughed with, her large wiry curly bouffant, and her hope-filled aura. 
“Where’s your wife Reggie?” 

Reggie had sat down with his usual socially acceptable moderate expression. 

It was common for his wife to accompany him to my clinic and if she wasn’t there, it was only for purposes of work.  She prioritized him, it was clear.  However, her work was inconsistent, money was always tight, and she would most often have to travel when the opportunities arose.  Being a temp in nursing was like that.  Reggie was so proud of her and looked at her in that mix-matched role that any relationship between one person and another always is.  In Reggie’s case, sometimes she was his parent, lover, friend, enemy, caregiver, and now, what?

If you’ve been reading this blog for long, you know I love the concept of Time.  I fantasize a little about separating Time from space and yes, at some moments, think I am all that. (Wink.)  When I asked Reggie, “Where’s your wife?” I might have done it, though not pleasantly.  Something happened there that was inter-dimensional.  Because he was transformed.  His face didn’t melt or droop.  There wasn’t a process to it.  Rather he was sitting like a normal Reggie and then he was wasn’t.  Between normal and transformed, to me, reality changed.  The between was a crack that was a different reality.  A black space without Time.

Reggie cried,

“She left me. She left me.  I begged her not to, and she did.”

Reggie’s wife had done something personal.  She went and died. 

Even when Reggie stopped crying, he looked bewildered, raw and like the faucet was going to poor a lot more.  We did get to start talking a bit about how much his wife loved him.  We speculated about the love remaining after she died. 

“I wish I knew!  I wish I knew she was somewhere good and I wish I knew if she could see me.…” 

Reggie wished he could remain connected to the love. 

During our treatment together for over a decade, Reggie complied with our medical treatment in the context of that love.  Reggie honored his wife by taking care of himself.  He even lifted up his illnesses like an offering to her.  I was struck with the concern of what kind of treatment compliance Reggie would shift to if he thought he was living without love.  I was concerned that he would not value himself, including the respect he was able to show his illness without the company of his wife’s value and respect

The way that we honor those we love and those who love us, is by honoring our own selves.

It is intuitive in our nature to believe that we can’t live without love.  Where does love go when we die? 

This brings us to another premise in, “God and self-care,”  – there is no self-care without Love.

The argument psychiatry has with the concept of Love is that sensing it, knowing it, perceiving it, is all a part of our modular brain, therefore no more than grey matter.  Thus implied that it is diminished. 

Question:  Does it diminish Love for you, knowing that our perception of Love is as mapped out as that, even able to be man-handled, turned on or off by neuronal signals? 

Please tell us your thoughts.  Keep on.

Self-care Tip:  Find Love for self-care.

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Don’t Save God

saving God

A danger I don’t want to be confused by here is the temptation to save God.  I recognize I have dabbled there.  But, I am not saving God.  The agenda here is not to prove or disprove, to champion Her, or to drag any of us through the cutting edge of knowledge on dark matter. 

How much I get out of having God in psychiatry is all about me.  It’s good for me, my psyche and my self care.  I like who I am through the eyes of God, who is and who is personal.  I like what it does to me and my relationships.  This is how I see God in my life – home, biology, work, disaster, accident, gardening. 

She cannot be quantified.  If you can imagine it, God may be that and more. 

If I were a plumber, than God would be in plumbing for me.  It just so turns out that I am professionally, a psychiatrist.

Most people whom I’ve heard speak about God don’t have much that I want.  God did not employ them, from my perspective, any more than He did to me in mine.  Or the opposite is just as true.  She did.

Rob the pastor needs to do what is best for Rob. Instead, I hear Rob turfing off the disappointments in his life on God. 

Why do I do it, bring God into my self-care?  Because I want to.  Embracing that there is more knowledge than there is now in humanity, is part of Her and my relationship.

Question:  What do you want?  Why do you include or disclude God from your self-care?  Please speak!  It’s healthy for you.  It’s healthy for me.  Keep on.

Self-care Tip:  Don’t save God.  Start with Me.

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God Exists and God is Personal

God and me

As there are so many views on what “God” means, and because that’s not what we want to debate here, we have a useful premise. 

God exists.  God is personal. 

Nor is our purpose to worry over the function of religion, to roll between index and thumb the business relationship between us and God, nor to tidy up the religious wars between our nations. 

The purpose here is to discuss how to be a better friend to Me, in the context of the premise, God is and God is personal to Me. 

If God is, then He is personal.  Otherwise, there is no point to God, as far as you and I are concerned.

Question:  How do we treat ourselves well in the context that God is personal to Me?  If God exists and isn’t personal, what is the point of Him?  How does working under the premise that God is and God is personal improve the way you care for yourself?  Please speak out.  We need you.

Self-care Tip:  Accept that God is and is personal to you and keep on.

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Sweaty and Worried – Generalized Anxiety Disorder

Hank had to sing an Italian song for his tests.

His music instructor did not believe that he had been practicing two hours a day. When Hank asked his voice teacher to sign off on those hours, his voice teacher still did not believe him.  He had nothing to feel shame about.  “Then why did I?” Hank wondered.  Card in his hand, signed off, Hank resentfully kicked at the rocks covering the path back to administration.

Looking out over mostly empty hard wooden seating in the music hall, Hank slaughtered the song. Even so, it was still the best performance he had ever done.  His father was there in his stained tie and largeness.  His mother in her too many colors, smiled loudly.  She was tone deaf.  Frank’s shame followed him.  He had practiced.

Hank’s older brother dressed in silk shirts, a big gold medallion, a tuft of hair coming out of his barely suppressed neckline.  When they prayed, Hank heard these smacking noises, and thought, “Pray for my nausea,” hoping they would stop kissing.  His brother always had a girlfriend.  The girlfriend was at his recital.  There were noises.

Everyone was scared Hank’s brother would marry too early and maybe marry for the wrong reasons.  His dad was always like, “Wait, wait!” But with Angie, Dad was like, “Get married now!”  Angie was the best in a long line of noisy kissers.

They asked Hank to sing at their wedding.  They insisted.  His brother, his brother’s girlfriend, his parents – they spoke in harmonics all at once.  “Hank!  You sing like Sinatra! Don’t worry so much! You should sing!”

In a rented tuxedo, Hank sang.  The mike didn’t work.  Aunt Augusta told him to sing louder.  Aunt Augusta didn’t hear well, even if there was a mike.  Hank forgot his words and had to start over.  Sweat filled his shirt and he thought about the dry cleaning.

Hank has never had a girlfriend and he is almost twenty-five.  Standing in front of all those people without the song lyrics, the only words that came to him were, “I am like a sweaty doorknob.”  His brother, facing a battle of his own between his ruffled shirt and his manliness, did not help.  Hank thought, “He is probably waiting for prayer so he can start kissing.”

The second year of college, Hank got caught with pornography.  “Hank!” His mother pulled his ear, towing him while she shook the fisted magazine through the house.  He didn’t listen to her words.  He only listened to his memories asking his music instructor for his signature. Was it as bad as the wedding?  Talking to Sarah or walking across the campus greens were bad. He fingered his worries like a beaded necklace.  He worried a lot.  Worry and shame.  He wished he could have a girlfriend but thought that was a hopeless cause.  Hank was already planning on buying a new magazine before Mom had thrown that one in the garbage.

It is so easy to explain away why Hank is the way he is.  We have heard enough to say, his parents, his brother, his isolation, his treatment from teachers.  We can use these to say, “Who wouldn’t be anxious, worried, down, and isolated, when going through these experiences?”  If we did though, we might miss the generalized anxiety disorder, the medical.  Conceptualizing the medical in this way can be so difficult.  We could call it, “the un-reasons why” we feel and do what we do.  So then we don’t have to deny it.  The un-reasons why don’t have to make sense.  They are un-reasons, after all. We don’t have to deny them by our inherent need to point at the cause and effect, or explain into uselessness the reason we are this way.  We don’t have avoid eye contact just because they can’t be seen.

Hank, like so many of us, is included in the statistics that generalized anxiety disorder, or GAD, is one of the top reasons why we don’t get intimate with others.  The anxiety is distracting.  It isolates us.  It preoccupies our thoughts.  It fills us with self-doubt and develops over time, almost inevitably if not treated, into depression.

Getting by with something as subtle as GAD, or other brain illnesses such as degrees of depression, have potentially devastating effects on what occupies our life-line.  The moments that construct the overall devastation may be explained away by one injustice or another, by what are thought to be personality quirks, or simply by neglect of self. But they could be different. The moments, the otherwise same moments, could be different.  The same rude, distrustful teacher, the rejection from Sarah, the quiet mike – those moments could have been different with the same guy, different only in his brain health.  Brain health makes the sameness different.

As Nancy A. Payne, of New York University (NYU) Silver School of Social Work, wrote about treating brain illness,

“There is tremendous satisfaction gained from facilitating the transition from profound illness to equally profound recovery.”

The life-line takes courage to look at.  It takes courage to believe that the effect of our negative thoughts and distorted perceptions could indeed have that pervasively profound effect.  It takes courage to consider that medical treatment can likewise, profoundly change our quality of life.

Hank tried to take his life with a rope before we met.  I’m so glad he didn’t break his neck or die.  He is now well treated and his disease is in remission.  His life-line has changed.Bo-J0zyIEAA_Y3h

Questions:  What are you brave with?  What do you spend your courage on?  Tell us about it.  We gain so much from community and connection.  Keep on.

Self-Care Tip:  Look also at the un-reasons, at the reasons less apparent, at what isn’t seen – look  into those reasons of why we feel and do.

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Between Me and Thee While We Are Apart

apart

I woke up and thought, I love and am loved. I heard the birds. I recognized different songs. I know “our” birds outside our door. So grateful. The morning noises in the house, kids – This is what I pray about when I pray, “Be between me and thee while we are apart one from another.”

Every day takes us.  We go toward and away.  We connect and disconnect.  What do you hope stays close when you weave your pattern?  When you are taken into your day?

It may be a day.  It may be education.  It may be divorce, bankruptcy, or a change in condos that takes you.  It may be as simple as getting a haircut.

As hairstylist Jane said, “I see people come in here all day trying so hard to be unique, and I can’t believe that they don’t see just how un-unique they are.”  She was noticing that “unique” implies disconnect. Those of us in this condition may be grooming toward disconnectedness and missing that even the pursuit of this is inherently a connecting force between me and thee.

Let us acknowledge the connections, not fear them.

Back in the day, there was Laban and Jacob, who had shared space for many years.  When they separated, they artfully practiced connection.

Now therefore come thou, let us make a covenant, I and thou; and let it be for a witness between me and thee.And Jacob took a stone, and set it up for a pillar.And Jacob said unto his brethren, Gather stones; and they took stones, and made an heap: and they did eat there upon the heap….And Laban said, This heap is a witness between me and thee this day. And Mizpah (“watchtower”); for he said, The LORD watch between me and thee, when we are absent one from another.

Here, many centuries later, we remember our declaration of independence from Great Britain on July 4, 1776.  It is our watchtower of sorts, a time when we celebrate our freedom, beautifully crafted into what brings us together.  Freedom is not synonymous with disconnection.  It is the ability to choose, to move in and out, to live with boundaries that are made of ribbons rather than walls, to have distance and still remain close to where our heart is.

Questions:  What connections over Independence Day weekend are you celebrating?  Please speak out.  We need to hear you.

Self-Care Tip:  Let your uniqueness and freedom be a connecting force in your life.  Be a friend to yourself.

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Media Used Educates

media

Me:

Jasmine, I’m so honored to collaborate with you on this important post juxtaposing the various ways media shapes stigma and your own testimony.

Guest Post from Jasmine:

I love old ads, Victorian, retro, apothecaries…  not only are they works of art, but are full of the funniest jokes.

1cigaresdejoy_custom-8b4912a13fbe70c4f74f8af5108bc2b25c35078b-s6-c30

It would be a lot easier to laugh at the ad agencies if it wasn’t for the fact that we buy it.  These ads are proof that our health depends on our willingness to look at more than media.  Just because we read it on the internet, see a commercial on TV, it doesn’t mean it’s the right path.

I look at my bottles of pills.  “Of course it’s safe, otherwise they wouldn’t be aloud to sell it in the grocery store”, I think to myself.  Or, “they must be okay because my doctor said so.  Somebody would have gotten in trouble for it by now, if it was bad”.

That kind of thinking gives away our power.  We are no longer responsible when we make it everyone else’s fault if something bad happens to us.  Even if the doctors and companies get sued, it is Me who will suffer the most.  There is nothing more important than our health.  How can we deal with life when we are distracted with health issues?  How will we treat people the way they deserve, when we’re not feeling well?

The point is that what we see in popular culture isn’t there to educate us.  It is there to entertain. Or make a sale.  Or push its other entrepreneurial agenda.

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I’m trying to focus on smoking because there is no way anyone could deny they hurt you in some way.  Pills are different because there is a different mindset with that, and I’m saving that for another day…  But smoking clearly isn’t healthy.  My dad was one of those people who smoked 1-3 packs a day and said that it’s a myth that people are getting lung cancer from cigarettes.  He jogged everyday and worked out… with a cigarette in his mouth.  If he was alive, I would like to ask him if he thought he would be a better athlete with more stamina if he at least didn’t smoke while working out.  I know the times are different and we know more now than we did back then… But I smoked enough cigarettes in my day to know that I would hack up a lung every morning and had a regular cough, until I quit.

Questions:  How do we tell people what to listen to?  Not just listen to other dramatic people and what we want to hear… not kid ourselves and run away from the real solution, whatever it may be?

-Jasmine (I’m 39, a wife, a mother and I’m cRaZy!)

 http://lakeelsinorelife.com 

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Self-Care Tip:  Use media material for entertainment and look in better places for education and counsel.

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Love comes out of that?!

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Hello Friends.

I write to you so many times “in my mind,” which makes me a great writer! Wink.  But even there, I am grateful to have you to write to.

I just got done watching, Fault in Our Stars, with our local hospice team and, oh my word!  I had to breathe through it.  I was terrified I would lose it several times there.  Not being one of those damsels who cries pretty, I was seriously grateful to be sitting in darkness.

So where have I been?  Trying to figure out this friend to yourself thing.  Still.

I had one of my favorite discussions with a patient the other day on where and why good comes out of bad.  Do I love this conversation because it is about an epic force, an energy and a Truth that wins and kicks bad stuff, like, fungus armpits, dead children, divorce, broken friendships, finding yourself alone in a huge space, depression and a brain that you’d rather not be living?  Do I love this discussion because I feel so freaking right?  I do.  Do l love it because I need to participate in it one more time, now, and now?

Probably.

I’m hoping I’m not right though.  I’m pretty sure that even these eyes see dimly and the Truth is even better.  I’ve been told I don’t know it all.

The chat goes something like this,

(Context is status post some real, personal, bleak disclosure.  I’m facing them, and sometimes they look at me.  I sit in an erect chair with a lap desk and laptop computer between us.  Just enough.  Sometimes my service dog, Timothy is present.

One of us inevitably brings up a curving effort toward hope.  Maybe,)

…Love is stronger.

Yeah…

But I don’t know if there is a question mark or a period at the end.  It sits there in the room with us, like it is a squirrel scratching at its whiskers.  It can go in different directions.

Where would it go for you?

Does Love bring good out of bad as if it needs the bad, like dirt around its roots?  Does Love turn the bad into fertilizer, and grow into some apple tree?  We know Love is stronger than bad.  We know Love wins.  But we think, do I have to be loved like this?!  Rather not.

Tevye, the milkman in Fiddler on The Roof, said this view well,

  • [to God] I know, I know. We are Your chosen people. But, once in a while, can’t You choose someone else?

That is a pretty rough idea of Love.

Love is and Love brings good out of us in any context because where Love is, there it is. Think about presence.  Honest self-awareness.  When you found it was more important to still be able to walk than care if your t-shirt was inside out.  Love is more true than that.  It is more true than looking into her eyes, than hot water over skin.  Love is.

As Green says in the voice of Hazel Grace, “I hope this enough for you.  This is your life. And I love you.”

Question:  What is stronger in your life?  Why?  What happened to disclose such honesty?  Please tell us your story.

Self-Care Tip:  Love wins, even for you.  Keep on.

Sending a message to the hope out there, to the love I know exists, to the friend who knows me, the place I can always call part home, part critique, part play-fellow, counselor, walking stick.  Hello.

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Caregiving and Selfcare

Fallen_tree2Being a caregiver is, well, …giving!  There is a need.  We respond to the need.  We give.  There is taking from what we give.

When we talk about this, some of us hear the tap, tap of a bookkeeper balancing ins-and-outs.  Tap, tap, take, take.  We feel dangerously close to objectifying what is Magical.  Objectifying what we get from giving loses at this point in our thoughts the bigger circle of love that motivates us.  Let’s acknowledge and respect that.  The bigger reasons are so worth aspiring to and treasuring.  You who believe in what is more than the numbers of our motives and behaviors, please continue to nurture us with this wisdom.  Be patient as we wander in the corners and cracks and in the places we don’t understand so well.

The point of giving, others pursuing the caregiver’s story later respond, is what we receive.  The love, the satisfaction of observing what our efforts contributed to in another’s rescue.  Perhaps, knowing we participated in saving a life.

Am I a caregiver?  Are you?  Well, maybe we think we are excluded from this category because we don’t liaison between one suffering life-being with the world around.  But are!  We all are caregivers by the definition of what is means to be living.  Living is connection.  We, each of us, are connected to the Universe and the different points from there to here where we stand.  Connection is inherent to living.  To live is to be connected.  To disconnect is to die.

This is somewhere along the philosophical thought experiment of, “If a tree falls and no one hears it, does it exist?”  I am told by those who might be wiser that it does not.  I don’t get it and what does that say about me? 😉

Observation vs. reality.

Connection is like that.  It is not perceived sometimes, and sometimes it is perceived.  This is important to Me.  To the part of each of us that is more than our senses.  More than Time and the condition of our health.  More than brain illness.  This is important to caregiving because by increasing our self-awareness of our role in connection, and thereby caregiving, we have an opportunity to increase our ability to combine the Magic of it with the “accounting ins-and-outs.”  Thereafter, we are lead to increase our transparency to others, increase our connectivity and increase our experience in Life Quality.

Magic is compatible with that which is known.  More even, they are not divided, whether we know it or not.  Magic and that which is known, just are.  We are arrogant people any way we turn the talk, of course.  None of us without agenda.  None of us without projectile pride.  But despite this, we have Grace and whether we hear the tree or not, Magic and knowledge have made allowance for us.

Caregiving comes with connection.  We give, we receive, and we do it with agendas.  Increasing our self-awareness through the process, although it feels at times like ringing out a cash register, and feels soiled by the sound of that which taking brings, – self-awareness of our agendas brings more freedom.  We are more free to give by choice rather than martyrdom.  We give without perceiving ourselves the victim to those to whom we give.  We are more free to give to our other agendas.  We are more free to consider our own needs as needs-of-value from one who is also Loved and valued, Me.

Question:  Might increasing our consideration of our “Me” increase our giving well to others?

Do you consider yourself a caregiver?  How so?  Please tell us your story.

Self-Care Tip:  Give well to yourself to give well to others.  Keep on.

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What is The Difference Between Self-Care and Selfish Care

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So what’s the difference between self-care and selfish care?

We hear this a lot here at, Friend to Yourself.  It is a question that can feel like an attack but also an opportunity.  Some people laugh when they say it.  Others do more of a huff.  Self-care shares with selfish care the condition of taking.  That has potential to be confusing.

Let us start with musing, what happens when we give to someone who doesn’t value themselves?  We give and give and they take and take but there lacks the receipt of value, only matter.  The person receives.  The person however doesn’t perceive the, Why?

Once there was Fred.  Fred asked Carl, “Hey man, would you please ask him for me?”

Carl has a childhood school friend he has stayed in contact with through the years.  Carl’s school friend, whom he used to call “Weasle”, is now Attorney at Law, Craig Anderson.  As Carl has nurtured the relationship through the years, sometimes it was easy and fun, and sometimes he nurtured it because it was just smart.  They worked in the same circles.  Once they had shared love of basketball and although they no longer meet on the court, they still meet up.  Carl saw in Craig someone worth investing in through the years, sometimes what Carl invested into Craig was intuitive and other times more deliberate.  Carl considered Craig a valuable contact.

Fred said to Carl, “I just need some information.”  How did Carl respond?  What Carl had with Craig is friendship.  However, he also has “social collateral.”

I remember when I was growing up trying to understand how much money my dad had.  I’d ask him about it, which I now realize is not completely appropriate.  He’d always tell me he was rich because of all the friends he had.  He said, “People are always the best investment.  The people you know, the friendships you have, will always bring you much more than money will.”  It was an early sight into “social collateral.”  I did not get it then.  I didn’t see the appropriate and natural intermingling of what is personal with what is bank.

Fred was asking Carl for his hard earned bank.  Before handing this over, Carl wondered, “Toward what purpose?” “What will that take from the social collateral I have?”  “What will I get from this?”  Fred had a sense of these concerns but he pushed the thoughts away.  He didn’t bring it up openly.  He asked without planning on accounting for what he was asking for.  Is Fred doing selfish care?

Let’s put Fred and Carl on the other side of this page for now.  Let us introduce Susan.  Susan is Lucy’s sister.  Lucy is known as “Floozy Lucy” amongst certain company.  Susan has rescued Lucy many times from life-threat, from financial ruin, from chaos.  Susan gives emotions, money, time, and once even her car to Lucy.  As Lucy continues to self-sabotage, however, we have a word for what Susan is doing – “enabling.”  What if Lucy valued herself more? How the dynamics between Susan and Lucy might be different.  Lucy taking from Susan would be more of self-care perhaps.

Our culture says we need to give give give and the taking is more whispered about.  It is not applauded like a big donation to the church.  It doesn’t consider what taking had to occur to allow someone at some point in their life to be in a position to give.

Over Easter this year at a small church in Corona, CA, I saw one of the best resurrection plays I’ve ever seen, including that compared to what I saw at the Crystal Cathedral years ago. The music, the props, the acting, all amateure.  However, the energy in the room, the connection between the congregation and the stage, and especially the awareness of our Higher Power was intense.  Out of all of this, what hit me the strongest was that the Judeo-Christian culturally celebrates everything about our God who sacrifices, who lives for others, who gives gives gives… but the whole point of what S/He did and does is Me.  Everything about God is His value for Me.  Without Me, that whole story is pretty mute.

Now put God in Carl’s position with Me.  Put God in Susan’s place.  Why would God want someone who gives to others but doesn’t take?  And take well, know they are a person of value.  The taking reflects quite a bit on the Giver.  The taking reflects quite a bit on the taker as well.

Take to grow your sense of personal value.  Take with increased self-awareness of your personal value.  Take to reflect on your connections well.  Take to be a better giver.

These are thoughts I’ve been rolling around.  What do you think?

questions:  What’s the difference between selfish care and self-care?  How do you take with a sense of your own value?  How does taking reflect on those you are connected to?  Please tell us your story.

Self-Care Tip:  Take to be a friend to yourself.  Keep on.

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Know You Are Blessed

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Think of the worst of us.  Think of the worst about us.  Think of those with self-loathing.  Those with low self-awareness, the violent, and the violated, think of them.  Where is the blessing?

Blessed are the depressed and anxious.

Think of the healthy.  Think of the diseased.  The misunderstood, the ones who live miles apart from connection, who ever push like a dingy from the peer into waves and self-destruction, think of them.

Blessed are the poor and lonely. 

Where is the blessing when your real estate is brought low by the creeping up of low-life.  Where is the blessing when you get cancer just when you might retire, when your own body calls you stupid, when you lose your eyes after training as a surgeon?

Blessed are those whose bodies are dying.

Think of every corner, every shadow and open space and the turns you still don’t know about inside of your life.  Think of the unacceptable, the character you wrestle against to moderate away from extreme.  The rope you swing on and try to bring to rest, think of the grey you think you will never achieve.  This bit and chapter, this part of your construction, this surprise in how you deliver is Loved.

There is no aberration from the norm that can separate you from that Love.  There is no addiction or misdemeanor or illness or mutated cell that can lose blessing.

This is fact.  Our life is to live with it.

Blessed am I.  Blessed am, “Me.”

Question:  Where is the blessing in what you like least about yourself?  Please tell us your story.  We need to hear you! Keep on.

Self-Care Tip:  Be your own friend in adversity as in prosperity.  Know you are blessed.

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What to do!? On-Line Physician Bullying.

I’ve been to this great APA meeting, great that is, because of the people!  Wow!  The fellow attendees, the exhibitors, the speakers – just, WOW.

I’m going to try to share content with you but it will take me time.

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For today, “Are You a Sitting Duck Online?,” reminded me of our earlier discussions on the doctor-patient relationship and a previous post, on July 11, 2012, that went like this:

Hello Friends.

Please tell me how I’m doing on this.  Just out,

Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice

This is important to me as I treasure both my medical practice and our community, connection, exchanges on-line.   I don’t want to do anything that jeopardizes either, nor the implication that if I did, that means I would have mistreated a patient.

Thank you for this, what I call, a “good problem” to have – the joy of medical practice and participation in social media/networking.

So many of you resonated with this and engaged.  I am still super grateful.  I’d love to continue with you in further discussion and with your comments!

For me, one of the many reasons I was so excited about this recent talk at the APA is because of the mucho online stuff connected to my name that affects my patients and the dynamics in our patient-doctor relationship.

In my practice, these are just a few sites that have wrong information (demographics) on me:

  • healthgrades.com
  • vitals.com
  • betterdoctor.com
  • ucomparehealthcare.com
  • insiderpages.com

They didn’t ask to clarify my demographics.  They didn’t ask me if I wanted them to become an on-line reference on my behalf.  They use my practice information to drive “eye-balls” to their site so they can get advertizing money and more.  They impose incorrect information about my practice, knowing that in so doing, I will be pressed, (I call it bullied,) into contacting them with my correct information.

If I don’t do this expensive effort, (money, time, emotional expense – all in limited supply, to correct what they post incorrectly,) patients will continue to tell me that they couldn’t find my contact information.  When they Google me, instead of my website coming up, these other sham pages pop up.

Some patients call dead numbers or even drive to incorrect locations to find treatment.  Instead of whomever is behind these websites being held responsible, the medical providers are.

These are the notes I took from my colleagues, as I heard them say.

Unfortunately, I was late to the meeting so I missed two of the four speakers.  Even so, this is worth it.

Dinah Miller M.D., Author of “Shrink Rap” and writing regularly for Clinical Psychiatry News.

Dr. Miller told us about the difficulty of “patient” (or nonpatient, i.e., sham-patient) reviews online.

Who can review the physicians?

  • your patients
  • Friends and lovers
  • enemies
  • trolls – a negative internet stalker

Every practitioner has an idea that they are a pretty good doctor.  So it isn’t easy for any of us to hear otherwise ;).  After getting unsolicited feedback from a person who took the time to write a comment on a site that listed her, a site that listed her profile without asking her, Dr. Miller chose not to play the victim.  She decided to call “Health Grades,” and with her persistence, they took her information down.

On “Vitals” – she got an answering machine with a person’s voice mail and no name and number.  So she called CEO, Mitch, who stated she wasn’t able to take her profile down.  She didn’t ask to open herself up to trolls.

Dr. Miller asks, what shall we do, as physicians?

  • do nothing
  • write a response
  • try to call the company

There are many whose livelihoods depend on public opinion.  For example, waitresses/waiters – many lose their jobs if they get even one negative reviews.

The practitioners in the group responded with resonance with Dr. Miller’s ideas.  They also had thoughts that if left alone, the democratic process would win out over time, truth would come out and such.  (Maybe the nearby statue of Liberty played into our thoughts :).)

Paul S. Appelbaum, MD, Dollard Professor of Psychiatry, Medicine & Law, Columbia University

Principles that Might help physicians Identify Constructive Responses

  • Responses should be Effective
  • Practical
  • Compatible with medical ethics
  • Positive rather than negative consequences

Problematic Responses by Individual Physicians

  • Request removal by website – typically declined.  Saying you’re writing a public article on it might help.
  • Contact the patient who wrote a negative response to request removal – Patient not likely to remove response, many patients post anonymously, most websites won’t allow patients to remove them
  • Flood site with fake positive reviews – deceptive, embarrassing if discovered, ? inducing a person to rely on a statement that may be used to their detriment (fraud)
  • sue patient for libel – identify patient might be difficulty, people have a right to their opinions – would have to prove statements untruthful and not merely opinion, $$ in money/time/and emotion

Encourage Satisfied Patients to Post Reviews?  We could refer to a firm to do this.  $$

Some sites, similar to “Vitals” offer the option to the practitioner to respond to a posted review.

Negative Reviews:

If we do respond – how?  We don’t want to come across arrogant or insulting.  We fear violating patient-doctor confidentiality. In the end, we recognize we don’t have the last word.  We may respond with a soft word of concern.  “If you would call my office, I’d be happy to schedule at no fee to speak with you about this and see if I can help.”

Can Patient Reviews Be Controlled?  There once was a company that tried this.  “Medical Justice” developed a form that gives control over of copyright of all reviews to MD.  – Didn’t work.  See article, “Company tries to stifle online reviews with patient ‘gag orders’.”

Another idea is that medical practitioners help themselves by coming together to develop an internet ombudsman.  This would be a medical/mental health professional not involved in care of patient.

  • Independent (unrelated party) investigation of physician about the case.  A successful investigation may give a third party opinion.  There’d have to be a reason for the world to trust this opinion.

It is difficult for healthcare professionals to protect themselves from inaccurate complaints about their care.

Positive Reviews

Does it put undue pressure on the patients?

A sign in waiting room perhaps.  Make the information available w/o practitioner knowing if they have or have not commented.

There is a dissonance between the position of being a business person that says we must practice democratically and compete fiscally, yet stay in congruence with what tradition holds us to.

The issues addressed in the talk weren’t specifically about being bullied by sham-websites, but it included that idea, along with other difficulties physicians are experiencing in the rapid transition of 3000 years of tradition as a healthcare providers to spending the majority of their time serving patients first to now, the reckless $ burden of running a media vulnerable business.

In the practice of psychiatry, a traditionally extreme-private practice, this is dissonant to many.

Q:  How do we treat the extremely delicate practice of psychiatry as a business when we are held to currently minimally defended standards like this?  Please speak out and let it flow!  We need to hear from you!  …and, Keep on.

Self-Care Tip:  Deal with internet sham-sites and reviews in a method that is consistent with Me, and temperament, while doing the least damage to oneself. It will be better for oneself as well as others.

 

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Turn Toward Something Better

Had a great time at, “Seams of Gold.”  Great example of how community is friendly to “Me.”  Met a wonderful man.

Me:  Hi!  I’m Dr. Quijada!  I’m a psychiatrist.

Him:  I’m Frank.  I’m a recovering Alcoholic.

Got to love love that kind of company.  Thank you to all who participated and volunteered.

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Found after our evening, was thinking about that darn “justice” ever skirting so much of Me.  The way becoming the victim to abusive treatment drives “Me” into helplessness all around us.  Things like money turn us to blame and ugliness.  In the end, telling our story, we hear from our own selves more about the behavior of the curmudgeon than would ever leave cause/change/control space for an innocent like “Me.”  Yep.  It’s them.

Using the behaviors and emotions of others is never useful to explain/justify the emotions or behaviors of “Me.”  We are as free to choose to be a victim as we are to not.

Programs like, Seams of God, and people like Frank, remind us that turning toward something better is, Way!  It is way, like opening a window to a hot room, like turning the lights on, like biting into a ripe home-grown cherimoya.  Turning toward something good rather than away from “bad” is choosing to be free.

Be free. Everything starts and ends with Me.

 

Keep on, dandies.

your own,

Q

 

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Join us at, Seams of Gold!

The University Surgery Center, Department of ECT, and myself will be joining our community at Seams of Gold, where we will share life changing stories of ​resilience, restoration and hope.

Thursday, May 1, 2014  

​6:30 pm to 9:00 pm, Doors open @ 6:00 pm

“Event is Free”

PLEASE COME!  🙂

 

A Father’s Lament  contopolos

On May 29, 2010, we lost our 26 year old son, Nick, after a 14 year struggle to find long term, affordable, quality recovery and care from mental illness and addiction. During Nick’s brief life, both he and those of us who loved him were left with a fatal absence of hope while we struggled, as do many others, to navigate our society’s haphazard, fragmented “system of care”.

Months after Nick had died, I recalled a former broadcast on CNN with a woman who had suffered enormous loss after Hurricane Katrina. The interviewer was asking this lady how, in the face of such loss, she was able to continue on and now help others. She said, “at some point, I stopped asking “why me” and began asking “what now”. That statement, in conjunction with an honest admission from my pastor that “during Nick’s life, he had absolutely no idea how to understand nor how to help us”, was what led to the “what now” of Seams of Gold community service events.

Seams of Gold is named after the ancient pottery art of “Kintsugi”. In this ancient art form of Kintsugi we find the inspiration in how we respond to the fragile beauty that surrounds us.”

Seams of Gold is a FREE multi faith, multi denominational community service event. All are invited.

We are asking that all who have been affected by mental illness and addiction as well as those who love and serve them, to come and be inspired, informed, educated and equipped. Join us, as through the prism of our tears, we pilgrimage together towards a “better day” of empathy, compassion and care for those who suffer.

Recovery is Powerful, it is Possible and it is Beautiful! 

                                                                                                                                  –  Jim Contopulos

 

The beauty of the Santa Rosa Ecological Reserve in southern California provides the backdrop for a father’s lament. Seams of Gold founder Jim Contopulos invites the viewer to join him on a journey as he reflects upon losing his beautiful son to addiction and mental illness.

“Birthed from Pain… Inspired by Art”

                                                                   

http://www.youtube.com/watch?v=VGZ1ESOlvbM

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Violence and Originality for friendship

Guest Post!

…keep reading…

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Learning new ideas and concepts releases Dopamine, the “feel good” neurotransmitter/messenger.  I find this theory consistent with my personal experience as I am studying for the boards.  The new concepts, when I grasp them and link them to things I already know, do seem to bring a tiny packet of fell goodness.  So, as I study, i really try to capitalize on this mechanism of feel-goodness.  Maybe I can get addicted to learning.  That would be a great addiction.  I think in some ways, I already am.

Using Dopamine in enhancing our everyday life and getting addicted on life:  Creative expressions can cause release of Dopamine – proven by both science and by our everyday observations of living our life.

Gustave Flaubert, of Madame Bovary, famously said:

Be regular and orderly in your life that you may be violent and original in your work.

To me, this fits.  I find I don’t need to lead a wild and dangerous life.  I don’t need external thrills.  I get my Dopamine from being able to be violent and original in my thoughts and ideas – Quite the thrill.  The regularity and order I try to effect gives me the time and space to be just that – violent and original.

The most cutting truths live in works where the artist is violent and original.    Flaubert, of Madame Bovary, said, “be regular and orderly in your life so that you may be violent and original in your work. “. He is fiercely unapologetic in the way he worked.  I like that.  Be violent and original in one’s work, all the while freeing one’s mind to achieve that end by being regular, mundane, and orderly in one’s life.  The creative juices that thusly pulsates in the artist’s veins more than makes up for the seemingly boring and orderly exterior.

Questions:  What role has learning played in your “feel good” self?  What helps you be violent and original in a way that is friendly to Me?  How do you channel your ferocity in the most friendly way?  How has the boredom otherwise affected your quality of life?  Please comment and tell us your story.

Self-Care Tip:   Be violent and original in a way that is friendly to Me

 

Dr. Chin Tang is in his last year of psychiatry residency training, on his way to Fellowship in psychopharmacology through University of California, Irvine.  He is happily married with much adored children.

Dr. Tang says he likes being my friend because in so doing, he is more “emancipated to be as weird and eccentric” as he is, by nature, meant to be.  Dr. Tang really knows how to make a girl feel great.  Thank you, Dr. Tang! 🙂  Keep on.

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How Do We Age Well?

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Ella Rose

In preparing for retirement, for aging, we put money away like Smaug The Dragon who knows his coin.  We imagine we will gain freedom, retain vitality, interest, and motivation, perhaps enjoy the affection of those we served through life.  But do we prepare for what is really coming?

I’ve been asked, how do we age well?  And guess who asked.  An aged man.  I tugged on my chin a little to hide my discomfiture.  After all, I would like to sit at his table and listen in on his story of doing what he had inevitably done, grown old.  I’d like to hear what he is pleased with.  And what he regrets.  I’d like to hold up the memories, like picture slides to the light, and see if I recognize anything.  Maybe something I might relate to.  Something I might more deliberately emulate.  I might feel more secure, knowing what he has done before me.  Maybe I’d think I am safe.

Remember that song,

A foolish man built his house upon the sand, A foolish man built his house upon the sand, A foolish man built his house upon the sand and the rains came a tumbling down.  The rains came down and the floods came up, The rains came down and the floods came up, The rains came down and the floods came up and the house upon the sand went splat!

(The hand motions make the song.)

But why ask me about aging?  Do I look so old already?  What the!?  Fine then.  I’d like to say, grow old continent and stock full of Botox.  Nah.  That wasn’t it.  (Mind wandering already you see.)

Or maybe, we who are aging wonder quietly if this person, or that might have a trick of doing it better.  This person wants to hold up my picture slides to the light and gather security to them.  That person wants to do more than hoard coin, and another doubts the vitality and wonders if she’d know what to do with it if it were waiting there for her after all in the end any way.  “How do we age well?”

Start with Me.

Me, where there is freedom to choose, the chance of change, the place where cause begins.  (The 3 C’s done our way at Friend to Yourself :).)

As a psychiatrist, it’s easy for me to think first of the biology of aging of course – brain health over time and to recall that the brain is connected to rest of the body.  I could tell this aged man that he’ll be wanting to get oxygen to his brain at night and use his cpap regularly.  I could speak of motility and exercise, of caloric intake and sleep hygiene.  We might spend some time on medical care for psychiatric illnesses common in again, depression, dementia, anxiety, and so forth.  We might speak of the inevitable process of losing friends and family, aging past a child or losing pets.  But as many so often remind me, psychiatrist’s only have the truth that their perceptions allow.  😉

A dear Obstetrics and Gynecology specialist told me the other day that she has become more convinced than ever that the processes of coming into the world and that of leaving the world are the same.  Having delivered countless souls into life, she has been marked, as if the luminescence of so many branded her.  She carries the knowledge of their entry and of those who have already died.

I remember my niece who died at 9 years and 28 days.  Not so old.  Not so aged.  Some how we think of death when we think of aging, not when we think of nine-year-olds.  However my niece did age well.

I suppose aging is like any system, as strong as its weakest member.  The wonder is that if we believe in aging, we believe our lives run on a line, on Time, which is after all, a human construct, a philosophy and based on Magic. Aging well as implied by my OB-gyn colleague, is looking at it from both ends, looking at what is in between, and looking at what is outside of birth and death.  Aging well includes exploring the essence of Me, what bit of Magic came before Time and before zero and numbers and philosophy turned into math.

How do we age well? Does aging imply disease? Aging is linear. They’re different but definitely paired… Help me on this?

keep on.