THOUGHTS from The HEADoc

Lighter Side

Tue, 08 Jul 2008 05:41:57 GMT

Had a few days off for the 4th. . .

It has been really hard getting back into the swing of things. Lots of bad news lately, but I try to find silver linings where they exist. It's a bit more difficult to make fun of myself lately in my posts I suppose out of fear how it could be perceived by some. There is another side of me that really doesn't care that much what negative people think of me. My involvement with most of the patients I see continues to be as strong and positive as ever. That keeps me going from day to day as I seek additional ways to enrich my life and find the fulfillment of self sought by all humans. I find that adversity often challenges one to reconnect with or strengthen ones spiritual being and can provide enough humility to help one find perspective in ones life. So true yet so boring to write about.

I'd much rather write about my new fun activity of pulling stumps out of the ground with my 4 Runner. I never knew something so primitive could provide such exhilaration. Yee-haww! Or I could write about my newest restoration of the spring and the little stream where I used to retreat to when I was a kid and in trouble for misbehaving. It was always such fun to capture the tadpoles, crawfish, minnows, or salamanders. Once I got into even more trouble for capturing a baby snake in a coffee jar. My aunt gave me a scolding and made me throw the poor thing away with the lid still on. I worried about that snake for a long while. Snakes just seem to have always gotten a bad rap. Even today, they are the only creature that I instinctively kill, even though they probably represent no harm to me. It's somewhat interesting that I found myself retreating to that same little stream now over 40 years later when I'm involved in a much different form of adult trouble.

I could probably write a pretty good story about my cat giving birth to kittens last week, as well. I think that's an experience everyone should have at least once, but probably not in the way I chose to allow it to happen. In 2 months I have become experienced in feline sexuality, labor and delivery, and the behaviors of early nursing. Nature did all the work with minimal assistance from me. I had barely finished reading my online article about cats in labor before I actually accepted the fact that my cat Oreo was showing exactly the signs I was reading about. Before I knew it there was a piercing scream coming from the bathroom followed by a higher pitched squeal. As I rushed in and peered into the tub we both looked at each other dumbfounded as the 1st born lay helplessly at her side. It had been almost 18 years since my OB-Gyn rotation. (not that it would have made any difference) Too late for hot water, the cat had already beat me to thinking of that commonly suggested first maneuver. So I ran to get towels and a box. I was too slow. She had already taken the baby kitten to her secret hiding place. All I was really needed for was to help clean up. So I'm just staying out of the way until she brings the kittens out of hiding. Her behavior is totally back to normal other than her having less time for me. She actually talks to me when she needs something, so I don't fret. So far, I've found a future home for one kitten. And yes, my cat will be spayed before having the chance to go into heat again. I have definitely learned my lesson there.

As many people already know, nature provides endless opportunities for escape from the stressors of ordinary life. The Serenity Prayer teaches me to ask for the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. These are two of my current coping tools that I look forward to putting to additional use in the future.

Posted on Mon, July 7, 2008 at 10:56PM by HEADoc in Weekly Blog Entry | Post a Comment | Email | Print

Time to Cut and Run?

Thu, 26 Jun 2008 10:00:14 GMT

This has been one of the weirdest weeks in my life. . .

as far as the thoughts and feelings I have experienced. The predominant feeling has probably been fear and I know that if there were no fear at this time I would truly be out of my mind. The thought has dawned upon me that it isn't too late to cut and run. I could just tell every patient that I prescribe a pain medication to that I can't treat them anymore. I would still maintain over 80% of my practice. I could walk in to my hearing on August 20th and state to my accusers that the problem is solved, goodbye, hope I never see you again. No hard feelings, right? That could be the beginning of the end of my nightmare. I could then try and slip back into anonymity, even though there would still be many who would see me as that bad doctor from the smear attack who did all of those terrible things that time. At least my livelihood would be protected.

I have seen during the week that the vast majority of patients, pain and non pain related, continue to support and believe in me and actually do understand how the government and the media work together to exert their will and control for their own causes. Even those that don't understand things that clearly do understand the concept of standing for a principle and know the difference between right and wrong. I saw a patient a couple of days ago who had been referred to me from a local pain clinic to help him cope with the loss of his ability to earn a living and other stressors associated with having a chronic pain condition. This was the third or fourth time we had talked and he trusted me to manage all of his pain medications along with his antidepressant treatment. We ended up on the topic of illegal substance abuse and the negative impact it has on us all. The conversation ended with him commenting about that Dr. Evil that was on the news last week who had been dispensing narcotics to all of those patients without seeing them. That's when I realized how insane this whole thing has been. How could the very same patient entrust me with his very life and at the same time have a fear of a despicable monster that is also me? I think that moment reassured to me what is truth and what is not truth. It is not I who is the real enemy.

I contacted a leading expert in the War on Pain Doctors and educated myself more through his website and have begun to understand more about the politics of this whole thing. I don't really know how I got here and I'm not sure if I want to be here or not, but I am here. I was most disappointed from the learning that the Medical Board is not an organization of peer physicians but more so an organization more loyal to the DEA and the government. I realized that I walked right into their trap without any legal representation three years ago. I also realized that it's not much of a war when one side has all of the ammunition. At least the side of the doctors has truth with it when it isn't allowed to be smeared or tainted, which has become the primary job of the media. There are hardly any journalist who investigate enough to really seek the truth. At least the newspaper did make an effort to get my side of my situation. The TV news did no such thing. They just used the press release in the manner it was intended to be used, assuming the accused to be guilty as charged. That type of thing is scary enough when thought of as conspiracy theory. It can take on another dimension when it really happens.

Should I cut and run now and leave 20% of my patients to make it the best way they can? This could all be over in less than two months if I do. My self preservation instinct says that is absolutely what I should do. My core values and moral obligation, however, would never allow me to do such a thing. If I were truly a corrupt individual I would have money to buy fine lawyers and wouldn't really need to work anyway. Since my situation is quite the opposite I am going to conclude that maybe I am not wrong in taking a stance here. My patients have stood by me and I continue to pick up new patients daily. They are the reason I do what I do. I have to continue to let my conscience be my guide. Dr. King once said that a man not willing to die for something isn't fit to live. I don't plan to die but I think that phrase symbolically captures how I feel.

Posted on Thu, June 26, 2008 at 04:14AM by HEADoc in Weekly Blog Entry | Post a Comment | Email | Print

Thanks to My Supporters

Sat, 21 Jun 2008 13:24:22 GMT

I will drop the third person routine due to the seriousness of the current situation...

I couldn't have made it through the last week if I didn't know there were people who supported and believed in me, so I must thank those of you who made the sympathizing comments on both sites. The situation is much like a death in that my reputation has been attacked and killed in an underhanded an unnecessary manner. When one knows they have done wrong and are caught is much different from when one makes an effort to do the right thing and others use their power and influence to make that person appear to be wrong.

I don't want to use words such as "witch hunt" or "framed" but those words in a sense could be seen as appropriate. Since this has happened to me I have researched the history of the issue and read about the Harrison Act of 1914 that led to thousands of physicians being arrested and jailed for treating patients with opioid medications for medical reasons. That was almost a hundred years ago. I thought things might be different now. The technique is different with the media available to reach so many people in a subliminal manner today. I suppose if I read and heard the things that were published about me I would assume the subject to be a terrible person as I'm sure many people do. The funny thing is that for those who aren't aware or that support me it doesn't make one bit of difference or makes the alliance even stronger. I feel worst for those who are divided such as my family who I never shared with the fact I was trying to resolve this issue with the Board for the past three years. They find out on the evening news and of course are shocked and devastated, mostly from a lack of understanding of what it all means. They just sense that I am in a lot of trouble.

I am thankful it is the Medical Board and not the DEA since they are capable of being more fair about things and they were until they decided to go ahead with this consent order. The only real problem I have is feeling betrayed by being forthcoming and providing them everything they asked for and them cherry picking just the things that would support their case, much of which is inaccurate information, some provided from drug addicts who became hostile when not given what they wanted. I was wrong to assume that the Board would side with me. They are a governing body and politics always play a role with governing bodies. This whole thing is more about them appearing to do their job and has very little to do with me and my patients because most of us are happy and content without their intervention. I do feel it to be unfair because I do know of doctors who have done things that have actually hurt people and it never made the news.

All I can say at this time is that I'll let my conscience be my guide and I'll try and practice what I preach to others. When I'm counseling others I often say that a lot of good can come from the bad situations we face in life. For one, it lets us know who our true friends are for they will always stick by us and never doubt us no matter what others say. I love practicing psychiatry but I hate the climate I have to practice in. There are so many forces to contend with. The comments I received have reassured me that not every force is adversarial and for that I am thankful. Regardless of the outcome of my situation I believe in the long run it will make me a stronger and a better person. I have committed no crime and have been charged with no crime. I have done my best to practice according to the Hippocratic Oath but this is not the day of Hippocrates. It takes a whole lot more than just good intention in this day and time.

Posted on Sat, June 21, 2008 at 07:57AM by HEADoc in Weekly Blog Entry | Post a Comment | Email | Print

War on Pain Doctors

Chronic Pain Treatment (Is it Worth the Risk?)

Sat, 14 Jun 2008 20:21:57 GMT

It troubles the HEADoc to make today's entry. . .

but he must as a matter of principle. A reporter from the local paper was courteous enough to contact The HEADoc before printing information about a Consent Order from the NC Medical Board to run this weekend. Gossip usually doesn't bother The HEADoc for he knows that the truth always wins with enough time. There are always two sides to every story with the truth usually caught up somewhere in the middle. A consent order from a board is equivalent to an indictment in the traditional criminal court but should not be equated with a criminal act. It simply states that there it has been determined that there is sufficient evidence for a case to be heard in the appropriate legal forum for the purpose of settling the complaint. The accused could be dealt with any number of ways. It could be determined that nothing further is required to remedy the situation or problem. Sometimes a doctor's license is restricted or suspended for a set amount of time. In the most serious cases a doctor will have his license to practice medicine taken away. The process serves to promote self regulation of the behavior of all members in a profession basically by public humiliation of the one accused of violating or deviating from what has been deemed the norm for that profession. Having information available on a website is one thing but editorializing it in a public newspaper is another. This is why the HEADoc must speak for himself. He has nothing to hide but just wishes to be treated fairly and understood from his own point of view. He will allow his reputation to speak for itself and those who truly know The HEADoc will stand by him because they know his heart and his devotion and intent to strive to do the right thing at all times. Those who don't really know The HEADoc can make up their own minds, if they even care about the matter at hand. The haters can think what they want.

One of the HEADoc's traits that has tended to cause him difficulties in the past has been a tendency to over extend himself for the sake of others. He chose the medical profession and psychiatry in particular because he didn't like seeing people hurt and suffer. The HEADoc is not ashamed to say that he believes himself to be gifted in the area of connecting with those suffering emotionally. He did not learn that in medical school. Even if he weren't trained as a physician, that would still remain. Being a physician has in a sense provided the necessary authority that those in need would have trust. The HEADoc believes in helping patients grow spiritually. Self destructive behaviors and addictions are the greatest hindrance to this occurring. No person can change such behaviors until they decide for themselves they are ready to let the denial go, seek and accept appropriate help, and make the necessary commitment to work toward their goals.

So what does any of this have to do with the Medical Board one might ask? The Board became involved because a pharmacist didn't think The HEADoc should treat chronic pain patients with methadone and made a complaint. The HEADoc knows of multiple cases of chronic pain where the use of methadone has given a much higher quality of life to that patient. The Board itself has encouraged physicians not to undertreat chronic pain due to fear of being disciplined by them. On the other hand, North Carolina is 5th in the nation in overdose deaths from methadone. This problem was major before The HEADoc even knew what methadone was. That's where the Board comes in. The facts are that 80% of the deaths are from wreckless or naive polysubstance abusers who weren't prescribed the drug from any doctor. When tested on autopsy such a person would have at least 3 other drugs of abuse in their system. Who is truly responsible here? Is it the government who continues to cut funding for mental health and substance abuse treatment? Is it society or is it that people should be more accountable for their own behavior? The HEADoc takes accountability that he did not document his treatment in the manner the Board thought that he should. At times addicts have been skilled enough to pass themselves off as legitimate pain patients, which the HEADoc regrets. Is not the more important question why are people so desperate that they would go to any length to obtain narcotics and other mind altering substances? Is The HEADoc responsible for this?

For a period of time The HEADoc found himself amidst a town that was recently voted to be in the top 5 best places to live of the nation. This is perplexing in that illegal drug use seems to be completely out of control and very little done about it in this great town. Is society that blind, that this problem can be that easily overlooked? Is it the HEADoc who has delusional thinking here? And what has the HEADoc done in the name of self accountability? Since everything will be exposed publicly this weekend he may as well speak for himself in regards to this. The HEADoc has got the heck out of Dodge, with Dodge being the town mentioned above that was voted one of the 5 best in the country to live. The HEADoc witnessed mostly despair economically and emotionally for many people. Being the only provider accepting Medicaid or Uninsured may have led to a skewed view but what The HEADoc saw was real. While reporting to the Board since 2005, The HEADoc set up policies in his practice that included a written agreement with patients prescribed narcotic medications for their medical condition. Violation of the agreement would lead to termination of treatment and referral to the appropriate substance abuse treatment facility or pain clinic, none of which really exist in a functional capacity. Well over 150 patients were screened and dismissed from the practice through policy enforcement in the years 2006 through 2008. The HEADoc attended a 13 hour course at Portland State University on appropriate prescribing of controlled medications to please the Board. On his own he did 20+ hours of self study and attended several lectures involving the management of chronic pain. He recently completed training for office based opioid dependency treatment with Bupenorphrine. In the new office all patients with suspected addiction problems receive routine drug screening. The HEADoc knows that discharging those who violate their agreement with referrals to places they won't even go to or won't accept them anyway is a futile gesture but it puts him in compliance with the Board. Those patients will return to that pool of patients doctors have been conditioned to avoid until another doctor accepts the risk of trying to treat one of their many problems.

So let the unofficial record state that no matter what you read in the papers about The HEADoc, he is not a quack. He is not a drug dealer or murderer. He abides by the law of the land. He has made every effort to work with the Medical Board in the past and present. He has tried to make a positive difference and he has done so with many patients. He is learning to recognize his limits and acknowledge that some problems are too big for any one person to tackle and attempting to do so can be self defeating in the long run. The HEADoc knows that the Board is the ultimate authority and will be well aware of that at his hearing on August 20th. He may be ordered to stop treating chronic pain or his license could be restricted or suspended. Whatever happens to The HEADoc will have little bearing on the real problems that have led to this situation. The HEADoc knows that the world is not a perfect place and he feels good about the patients he has helped in the past. Not treating chronic pain patients will actually be a relief for The HEADoc but he worries about many who won't have access to such treatment. From a political standpoint the Board may feel that it has done its job and publicizing this case will certainly put fear into other doctors of what to avoid doing in their practice of medicine.

Posted on Sat, June 14, 2008 at 01:11PM by HEADoc in Real Life Story | Post a Comment | Email | Print

Tags: prescribing pain medications, treatment of chronic pain, NCBME, Burlington Times, Consent Order, HEADoc, Q4S

War on Pain Doctors

Risk of Violence in the Workplace

Sun, 01 Jun 2008 22:11:24 GMT

Every now and then The HEADoc finds himself in an undesirable inescapable situation . . .

Last week The HEADoc was trying to forge an alliance with the most delicate of cases; a teenager facing the difficult reality of the first psychotic break of Paranoid Schizophrenia. Failing to make a trusting bond with such a patient could adversely affect his future treatment outcome in many ways. This is the type of case that can truly test the psychiatrist's clinical abilities. As the patient made an effort to let down his psychological walls of defense for the first time, a ruckus was undeniably overheard coming from the front. The situation seemed to be escalating. It was a drug seeker unable to obtain his drug of choice from the local ER after claiming to have unlikely side effects from what he had been prescribed by The HEADoc the previous week. Profanities shouted at the nurse and receptionist along with racial slurs and demands for something to be done immediately could no longer be ignored or overlooked.. Thus, the limit was reached. "In the words of Beyonce', "he must not know 'bout me." In the field of psychiatry, there are times when an emergency arises that cannot wait for reinforcements to arrive.

So The HEADoc finds himself in quite the predicament. He is in session with his most vulnerable case while being disturbed by his least desirable patient type. His staff is being verbally abused and his waiting room milieu has been disrupted in the most rude and disrespectful manner. In a previous entry where the HEADoc wrote of violent behavior becoming imminent in the office setting, a commenter criticized his angry confrontational manner of handling a 16 year old girl who was threatening violence. The commenter suggested offering her something to eat or drink to help calm the situation. In some situations the textbook must go out the window. Risk management is crucial but mental health care is a risky business. Statistically, over 80% of those who work in ER's or Mental Health clinics will encounter violence at some point during their career. One really doesn't know what their reaction will be until finding the situation arise for them. Restoring order with minimal harm then becomes the ultimate objective.

So how did the HEADoc react? Hint: not with milk and cookies. This person had crossed the line clearly and the negotiation/compromise stage had expired into the enforcement stage. There does exist a legitimate career known as a bouncer who provides security to certain establishments. Most businesses just hope that situation where someone must be physically removed from the premises never arises. The police are not readily available and are a non factor in most of these situations. Without providing details, the violator was removed and threats to take out assault charges against The HEADoc were made. That is just a case that will have to be proven in court. The HEADoc describes the whole incident as regrettable and unfortunate for all involved but feels he did what he had to do and will do it again if the situation calls for such an interventive measure.

Feelings of guilt usually follow feelings of rage or anger, in normal people. How could The HEADoc return to his session with the young man he had to excuse himself from to try and restore the peace? Interestingly, the young man was not at all emotionally traumatized by the events. He in fact was able to see The HEADoc as a real human being with real emotions. The patient offered the doctor empathy and understanding and an avenue opened for him to discuss some of his own thought content in a therapeutic setting. Thus, a potential disaster turned into something positive.

Posted on Sun, June 1,2008 at 12:02PM by HEADoc in Real Life Story | Post a Comment | Email | Print

HEADoc Concedes (Adventures of The HEADoc)

Mon, 19 May 2008 18:36:21 GMT

The HEADoc has made the decision to concede. . .
from his 4 month one on one campaign of taming nature which he referred to as a challenging but enlightening experience that had therapeutic benefits in all 3 spheres of mental, spiritual, and physical health. The most devastating blow to the campaign surprisingly was not the 2 fires or the constant myalgia but turned out to be the escalating effects of the imminently approaching scorching summer sun in conjunction with multiple chigger bites in uncomfortable places and finally a tiny deer tick found attached with the characteristic bulls eye rash that often precedes Lyme’s disease. The HEADoc did learn that all ticks don’t carry the pathogen but even when infection occurs it is usually completely curable if treated with a course of doxycycline or amoxicillin for 3 weeks.

Joe Thomas’ Land Clearing of Silk Hope, NC was contacted for relief and brought in the Bull Dozer and Track Hoe. In 2 days time 2 acres were completely cleared, a task that would have required perhaps a year of Saturdays for the HEADoc to complete alone, were he to actually survive the ordeal. The HEADoc states that if he had it to do all over again, that except for a blunder or two, he would choose the same course of action. He found a certain sense of satisfaction in reconnecting physically with a place of so many cherished memories from a different time period. Talks with his mother, who is the last living member of her generation of the family are more special now than if a contractor were just hired to have done the job from start to finish. So Operation Land Clear has been deemed a success.

The cat is back home, calm again and grounded for life. The HEADoc was scolded by a commenter for never having her spayed. The HEADoc will accept that responsibility and accountability. He understands that it is the right thing to do since this is his 6th time adopting cats and all the previous pets were sterilized properly except one who got pregnant at 10 months of age. Maybe it’s a Freudian thing, and The HEADoc understands the word humane but just the thought of cutting out reproductive organs can be quite repulsive. I suppose it must be viewed as a necessary evil.

The HEADoc received 8 hours of Continuing Medical Education on Saturday, May 17th in the area of Buprenorphine treatment for opioid addiction. Not that The HEADoc needs any more chemically dependent patients, but he just needs to be prepared in the latest techniques for managing this condition. Two of three case discussions involved cocaine abusers, and The HEADoc made his strong felt disdain and negative counter-transference for many crack users well known among some of the top experts in the country from Boston . There were some nice academic discussions and the naïve individuals present allowed their hearts to bleed a bit, but the ultimate answer was to define your limits of how far to go with patients who cannot comply with treatment agreements or with the law. The HEADoc draws the line at telling lies and smoking crack, although that is usually a package deal and the lying is actually worse than the crack.

Basically no one has an effective and practical solution for handling most of these refractory crack and crystal meth addicts who choose not to sincerely seek rehabilitation but thrive on manipulation and deception. Their brains have been so badly damaged that oblivious self destruction is hardwired into their behavior. The HEADoc’s policy will continue to be to identify and dismiss ASAP allcrack users who won’t admit to having a problem with using crack, for it is pure insanity for a doctor to try and treat such a person without effective extended support.

Posted on Mon, May 19, 2008 at 11:40AM by HEADoc in Real Life Story | Post a Comment | Email | Print

More Adventures of The HEADoc (Spay and Stay Away from Power Lines)

Sun, 04 May 2008 06:23:10 GMT

My cat has lost her mind . . .

and I have no training in feline psychology. She's 3 years old now. What's that in human years, 16? Erroneously I thought I could keep her locked indoors and avoid having her fixed. Not! As a kitten she once ventured outside and got lost for a couple of hours. A neighbor returned her and for the next couple of years she didn't try that again. The first time she went into heat I had no idea what the heck was happening. She also had worms at the time, so I thought her behavioral changes had something to do with that. The injection at the vet cleared up the worms and he told me not to worry about the estrace cycle. Having her spayed could take care of the problem. I procrastinated. No, I just didn't do it.

I got pretty accustomed to her running to the door to greet me upon my return home from work. Sometimes she could be quite annoying by clinging to my every action. This Spring she developed a habit of running past me when I open the door. Once outside there would be an obvious look of confusion as if she didn't really understand why she did what she just did. She would then sniff the rug a few times and run back inside the door just as fast as she ran out. After seeing an apparent stray calico tom cat hanging around outside, I started to become suspicious. He was probably communicating to her through the door while I was away. He was perhaps planning a not so secret rendezvous. Two weeks ago she ran toward me as I opened the door to come in. This time she didn't even look back as she ran off into the darkness. There was no response to my meow calls for the next 4 days. Just when I was about to give up on her, she presents to the door meowing as if nothing has happened. She has lost considerable weight and seems to be starving. I figured she had learned her lesson. I was wrong. She's been away for 2 days so far this time. Anybody want a kitten, or two?

The HEADoc has become pretty crafty with his Chainsaw. . .

and Beaver Saw brush blade through his Saturdays land clearing project. He's learned quite a bit about felling trees over the past several Saturdays of practice. During the last episode of Adventures of The HEADoc the pyromania party was crashed by the Siler City Fire Department. The HEADoc felt this was unnecessary. Oh what a difference a month can make.

This Saturday, The HEADoc experienced an apparent slip in judgment as he attempted to defy the laws of gravity and balance. He seemed to forget how recent it had been when he knew nothing about operating a chainsaw or cutting down a tree. Today The HEADoc would attempt to make a professional cut that at some point becomes the mistake of most amateur lumber jacks. Today he would make the tree he planned to cut fall away from the power lines in a controlled cut. Half way into the cut The HEADoc became acutely aware that he was in over his head. The hinge cut caused the chainsaw to be pinched firmly into the tree as gravity and balance refused to cooperate with The HEADoc's plan. As a public service The HEADoc wishes to remind all amateur chainsaw operators that this is the point to call the power company and swallow your pride. Tell them you are in the process of screwing up big time and need them to bail you out. They have the equipment to right the situation.

That said, most readers can probably assume that the HEADoc probably did not follow this prudent advice. He did learn a valuable lesson that will power is no match for physics. Yes, you guessed it. The HEADoc used the other saw to finish the cut. The tree refused to fall in the direction planned. The tree fell directly onto the power lines. The 4th of July came on May 3 for The HEADoc. The sparks and explosions were spectacular. The display culminated in a real fire this time. The HEADoc was not calm and collected this time because the situation was not under control. A passer by and a neighbor lended a hand to help control the fire until the Fire Department arrived. The passer by offered the humiliated HEADoc some consolation by admitting that the same thing had happened to him before. The neighbor's father had once felled a tree onto their house. Maybe this behavior is encoded in the Y Chromosome.

Posted on Sat, May 3, 2008 at 10:13PM by HEADoc in Real Life Story | Post a Comment | Email | Print

Suicide by Cop

Mon, 21 Apr 2008 08:56:16 GMT

A few hours ago . . .

I learned of the fatal shooting of a 22 year old man in Greensboro

during a traffic check. The family of this young man is well known

and close to my family. He was unarmed but shot 6 times in the

chest by an officer. Seventeen years ago, at age 29 his father met

the same fate but only received 4 bullets to the chest when the

police arrived at the scene of a domestic disturbance. Those not

intimately involved with such a case seem to have little difficulty

making such comments as "they got what they deserved" or that

"the officers had no alternative than to kill them." I wonder if these

people would make such comments were it their relative or friend

who was executed. I feel justified in this stance because I know that

neither of these young men were killers and did not necessarily have

to die in the way they did. True, there was a problem with anger and

defiance, but does that warrant death?

I wish that race weren't a factor but race is always a factor.

Traditionally, the police in most metro areas are perceived more

as a threat than a friend by the average black man. This often adds

to the frustration the subject might already feel. Being a black man

in America is itself a risk factor to developing mental instability,

in my view. One must learn over time to become desensitized to

the expectations or prejudices of many of the majority culture.

Critics of my words here will be out of touch with the reality I

experience each day and see me as being wrong in a sense. I

have learned to try and enjoy the dual role that comes with the

territory of being a doctor and being black.I think it's even quite

different from being Asian, Latino, or another ethnicity. In general,

other such ethnic groups don't quite have the same built in stigma

to overcome. The treatment received in stores, restaurants, banks,

from real estate agents has been quite frustrating at times. My

situation is unique in that I do get to experience the good side of

things in my other life as a doctor. So I reallycan't complain about

my life.

I do understand what many other blacks who don't

have the luxury of being more than black may experience. I also

understand well what Senator Obama faces in trying to win enough

support to win the Democratic Nomination and the Presidency.

There will perhaps never in our lifetime be a Black candidate

and few non-black candidates who are any more capable of

doing good things for America. But because of his race, some

people are willing to do anything to block his progress. McCain

can make gaffs all day without consequence but Obama's every

word is scrutinized to find anything to use against him to cause

more fear and confusion among the impressionable. After GWB

the qualification card is a moot point. The time is right for us to

finally start to move beyond race.

Back to my original point... Many people are affected when

a life is taken. I read where the officer who shot the young man's

father 4 times developed emotional problems afterward. I know

personally how deeply the family of the deceased were affected

from that fatal intervention in 1990. I hoped that maybe such a

tragedy would at least never happen again. But it has. I went to

school withthe father and I believe there was some mental illness

and probablysome self medicating but I do not believe for a minute

that he was a killer. In essence he did commit suicide by cop. Was

this his intent? We may never know. Was this the intent of his son

last Friday? Should cops have alternatives to lethal force when

placed in situations where they might be used in an impulsive

suicide attempt by a mentally impaired individual? Will this officer

suffer from emotional guilt or is he one of the cops who lack a

conscience after ending a life by choice? I do know that this was

a family of good people and they hurt. They hurt even more because

of the unanswered questions. I don't think people should judge or

make smug or insensitive comments about the situation unless they

have been in that situation themselves.

Reference: The Trouble Maker Blog

Tags: suicide by cop, headoc, quest4sanity, mental health

Why I Blog

Sun, 13 Apr 2008 22:28:59 GMT

Why ?

The most appropriate answer to that question is probably the reply given by President Clinton when asked why he did what he did with "that woman." "Because I could," he replied to a probing reporter. I started posting almost 4 years ago because I could, and never really expected that many people would take interest in what I write. I really just needed a place to vent and explore and express my ideas from time to time. Other than my work, I have shown more commitment to this journal than any other project I've undertaken. My writing style is intentionally original and at times incorporates controversial ideas which on occasion may evoke emotional response from a commenter. I know my perspective on life is unique, mainly because of who I am and what I do for a living. When I feel passionately about something I will fight with everything I have to win the cause. Most people I associate with either love me or misunderstand me or may be in transition.

Validation of oneself is crucial but can be detrimental or meaningless if the validator is invalid. I think with my journaling I have sought validation, in a sense. There are other ways besides blogging to vent and to express oneself. So validation has been a source of motivating me to continue posting here. I was thrilled and in disbelief when Author Neale Donald Walsch actually read a few entries and used the word "intriguing" to describe his opinion. Last month Blog Burst and Reuters posted my In Treatment and Intervention article nationally in their entertainment section. Didn't get a lot of clicks but it did feel good to be accepted as a legitimate writer instead of just a novice. Sometimes the thrill of the chase is much more exciting than the capture. Strangely I feel less motivation than ever before to continue posting. I'm really not mad about much anymore. There were several personal crises over the past couple of years but they have only made me stronger and helped to clarify where to go from here.

At times I have tended to displace my frustrations on to politics. The Bush Administration made that quite convenient as an option. I think most people capable of critical unbiased thinking have seen for themselves how bad this President was for the country, in general. Due to the ending of an era I must redo my Satire Page. I think I'll focus less on politics, unless McCain wins the election in November.

I guess my reason for this post is to state that I will probably be making fewer posts in the future. I don't want to shut completely down at this time. I still have a lot of thoughts.

Posted on Sun, April 13, 2008 at 12:23PM by HEADoc in Weekly Entry | Post a Comment | Email | Print

A Word on Stress

Wed, 02 Apr 2008 01:26:56 GMT

What if there were no stress?

There might then be no such thing as mental illness. People such as me would be out of work. I don't think I'd like living in a world with no stress at all, for our lives would become quite dull and lack excitement. I often wish that death didn't exist but then I remember that our reality is based entirely on the fact that an opposite is essential for anything to have value. Without bad, good could not exist. Without hot, there could be no such thing as cold. Without large, how could there be a such thing as small. So this world is meant to be transient. When we are aware that our time is finite, we should appreciate the opportunity to make the most of each day. I believe there is a place known as eternity and a thing known as infinity. I can't wrap my brain around the concept of either for I am contained within them both. Nothing is impossible within the realm of eternity and of infinity. If you can imagine it then it already exists. The minds of the greatest scientists have been blown by such thought.

The Big Bang Theory proposes that our rapidly expanding universe was birthed from the explosion of a singularity point of reference that was infinitely small. That means it was so small that it continues to get smaller forever. Imagine that! What happened before The Big Bang? Even Einstein is clue less on that one. When man became aware he had a conciousness he eventually gave birth to religion and to science. On the other side of the beginning of Creation or the Big Bang most of us believe God exists. Since God is believed to be the source of all. it is inherently impossible for us to escape our creator. Of all creatures on earth, only man is believed to have the ability to exercise a will that is completely free. Even the metaphorical Satan lacks this ability for he can do nothing that is sincerely good, despite a milliondisguises to appear good. Angels may do only what they are created to do. But man can cause the greatest pain and suffering for others or choose peace. love, and happiness. Free will is what gives real meaning to such actions.

I began this entry because of thoughts I've had about the stressors faced by many of the patients seen over the past several days. Sometimes I'm given more credit than I deserve by patients for the understanding I seem to show involving the plight they may be facing at a given time. After doing this a few years a therapist/psychologist/psychiatrist develops an understanding of the most likely behavioral options for almost any person in a given situation. Humans respond emotionally to any stressful situation. There are only 4 basic emotions: happy, sad, fear, angry. Happiness is a derivative of Love. All other emotions are derived from the core emotion of Fear. If one can control a persons' fear then one pretty much has control of that person until they are no longer afraid. Fear usually trumps anger because fear will keep one alive much longer than anger alone. Sadness seems to exist basically to validate happiness or may be experienced in the absence of joy.

The human experience entails each of these emotions at the appropriate time and place. An emotional imbalance results in mental illness or mal adaptation. An emotional imbalance is precipitated by what is known as psychosocial stressors. There is actually a hierarchy of these stressors that was first proposed by Maslov or some other important Behavioralist. I do know that Maslov proposed the basic needs paradigm which essentially states that you won't get much done with treatment if your patient lacks a source of food, clothing, shelter, and love. Even when the basics are met, certain life stressors challenge ones coping mechanisms. At the very top of the stress hierarchy is the death of a child. Patients I know who have survived this emotionally catastrophic event and put them self back together are exceptionally strong. They have passed the ultimate personal emotional test of enduring personal loss and pain. They have proven that whatever else befalls them in life can never hurt more than what this experience did for them. Second only to the loss of a child is the loss of a parent, sibling, or spouse. Further down the list are other major life stressors such as loss of health, loss of job/finances, relocating, and of course going through a divorce. Even pleasant events such as getting married or having a baby can tip the scales the wrong way at times.

Coping mechanisms are crucial in surviving the stressors of human life. Stress can be thought of as rain. How can one stay dry in a heavy down pour? Certainly not by trying to push the raindrops back up into the sky. Using an umbrella or other means of shelter is much more feasible. With stress we cannot always avoid it or hope it will not return for it is guaranteed in this life. The better coping skills one has developed or inherited, the better one copes when the storms of life start to rage. Sometimes healthy coping may exist simply of accepting help when it is offered. Or resisting the urge to withdraw in fear and isolation when those negative emotions try to take over.

Posted on Mon, March 31, 2008 at 10:45PM by HEADoc in Weekly Entry | Post a Comment | Email | Print