Monday, January 2, 2017

"How patients with addiction problems showed me a better way to cope"

Sept. 12, 2016 "How patients with addiction problems showed me a better way to cope": Today I found this article by Alana Hirsh in the Globe and Mail.  It was an inspirational article.  We should have more compassion and help others:

In the discussion about Canadian drug policy, the unspoken question is: Why should we take care of drug addicts? I have had to ask myself this because my job is taking care of people with drug dependence and mental illness in the Downtown Eastside, Vancouver’s notoriously drug and disease-ridden inner city. What does society gain from assisting people who engage in illegal activity, who bring their diseases and, with increasing prevalence, their death, upon themselves?

I am a McGill and UBC-trained family and emergency physician, and have practised in Canada, the United States and West Africa. I have delivered babies, treated trauma victims, managed chronic disease, and comforted dying people.

And, the truth is, in spite of having had my prescriptions forged, my car broken into, having been threatened and lied to, I enjoy and feel privileged to treat people afflicted by drug dependence. Drug addicts are my favourite patients.

I stumbled into addiction medicine during a period of disillusionment in my medical education. I was leaning toward specializing in plastic surgery, and had arranged to do my family medicine rotation in Vancouver, mostly for the chance to explore the West Coast. I discovered on my arrival that the doctor I was shadowing worked mainly with pregnant heroin addicts. Sometimes he just sat me in a room with them: “Ask her to tell you her story,” he instructed.

Josie was 16 and pregnant. She had long brown hair and a childish, angelic face. She came from Winnipeg, where there was a warrant out for her arrest. The only person she knew in B.C. was her boyfriend, the father of her child. She was on a methadone program, but was giving half of her dose to her boyfriend to keep him off heroin (he was unable to get a doctor). As a result, by midnight every night she would experience terrible withdrawal symptoms.

Withdrawal has been described to me by addicts as “feeling like you are going to die,” and the physiologic effects of it actually did put her fetus at risk of death. So she would sell her body to get money for drugs.

She had no family to turn to – her mother had been shooting her up with heroin since she was a baby. She was so skinny – only 106 pounds in her seventh month – and so desperate. “Man, don’t ever do heroin,” she advised me with a rueful smile. She was a good person, a child, trapped in a horribly addicted body.

Since then, I have listened to hundreds of stories. Debra, born to parents who were addicts themselves, had a father who sold her to his friends for extra cash. Jeff’s mother died when he was nine months old, and his father was an alcoholic who beat him. Ryan’s mother tried to commit suicide four times before he turned 10, once by putting her head in the oven.

I had little in common with these patients. I came from a loving, upper-middle-class family, and my main exposure to drugs during my youth was when the police came to school to disseminate the Just Say No campaign. However, I was raised on my mother’s stories: born on a forest floor in Siberia while her parents fled the Nazis during World War II, enduring poverty and malnutrition during her formative years in a displaced-persons camp in Austria. I understood that I had won the jackpot in the privilege department. As undeserving as I felt of my privilege, these people seemed equally undeserving of their misfortune.

Not only did working with this population feel meaningful, it was fun. In the early 2000s, I volunteered with a group called VANDU: Vancouver Area Network of Drug Users. The first time I entered their office I felt like I was walking in to Theatre of the Absurd – heroin users nodded off around the table, while stimulant users bounced off the walls. But as I sat in the corner and observed, I was humbled and impressed as they stuck to an agenda addressing compelling issues: a health network they were forming to do alley patrols and needle exchanges, a protest they were planning to bring attention to the need for supervisedinjection sites. They gradually became my most formidable instructors in public health and grassroots advocacy.

Their methods reflected the candour and compassion I came to expect from drug users. When a member who had been kicked off the board of directors requested to rejoin the group, it was suggested that they go around the table and have each member say how they felt about it. “Larry, you can’t ask girls for sexual favours in exchange for a clean needle,” one explained. I marvelled at the no-BS approach – if only such transparency existed in all groups.

They challenged me to reassess my perceptions of right and wrong. They asked me to steal supplies like Band-Aids, gloves, gauze and needles from the hospital, and to supervise the illegal supervised-injection facility (SIF) they were starting (at the time the Canadian government still opposed SIFs) – a room with a single bathroom where users could inject themselves. Concerned for my reputation and licence, I bought myself time by suggesting that I do some research first. After studying the literature, which showed evidence of morbidity and mortality reductions with SIFs, and having dealt with the consequences of unsafe drug use among my patients (HIV, hepatitis, severe skin infections, heart infections, overdose etc.), I realized that it would be unethical not to provide this service for people. They helped me see that just because something is a law does not make it right. Years later, the government confirmed their prescient public-health measures by opening Canada’s first legal SIF in Vancouver.

Amidst the suffering, I witnessed great capacity for community and relationship. Mary was a sex worker and lived in a bedbug-ridden hotel in the Downtown Eastside. Despite her outwardly depressing life, she was a ray of sunshine. Her short blond hair tufted out like a baby chick, and she had a little girl’s voice and mannerisms. “Doctor Alana!” she would happily shout down the hallway when she saw me, and would run over excitedly to hug me or share news. She always thanked me for coming to the office: “It’s just so amazing of you to work with us, we love you so much!” She died of AIDS in her early 40s. At her funeral, a young transgender woman cried, “When I had nowhere to go, she took me in. She taught me how to wear makeup. She was like a mother to me.” For many who have never felt welcome anywhere, the Downtown Eastside is a place where they feel accepted.

The first time I felt parallels between my life and those of my patients with addiction issues, I was in my late 20s, going through a difficult breakup, unsure of the future. One day I looked at my schedule and found that I was working three jobs, and I had booked myself to work 29 out of 30 days. I couldn’t face my pain, so I was drowning it in my work. My patients echoed my own thoughts, “I just feel like such a failure,” and I began to resent their relapses. I left my practice and dove into an Emergency Medicine fellowship. Fast paced, not a moment to spare, saving lives, no time for weakness – the perfect field for a doctor avoiding introspection.

For so many drug users, whose stories of trauma and neglect often began in utero, and who often have untreated mental illness, drug use begins as a reprieve from suffering. Years later, my own coping strategies of escapism and perfectionism had helped me to achieve the “perfect life” I had dreamed of: I had an amazing husband, two beautiful children and a dog, lived in a beautiful home, and worked as an ER doctor. But just as the drug user’s solution eventually becomes their downfall, so my efforts to be successful caught up with me. The stress of multiple moves between countries, life changes, sleep deprivation from shift-work and babies, and a job that left no room for weakness took a toll. By the time I was diagnosed with postpartum depression after my second child, I had been experiencing anxiety and sadness for at least a year, taxing my marriage, distancing me from friends, making work an exercise in exhaustion. It took me too long to seek help, because I was ashamed. To not be enjoying my beautiful life, to not be not coping better with the stress it entailed, to be suffering from a disease that I learned I had my own stigma toward.

According to writer and addiction doctor Gabor Maté: “We lack compassion for the addict precisely because we are addicted ourselves in ways we don’t want to accept and because we lack self-compassion.”

My opinion: I'm going to put that in my inspirational quotes.

When I finally admitted that I needed help, I was ushered into the arms of incredibly supportive and effective care by the medical community. The most surprising thing I experienced when I opened up to my friends and colleagues about my diagnosis was how often they responded by sharing their similar struggles. Some were being treated, some were afraid to ask for help, many were self-medicating. Medical literature suggests that physicians may have higher prevalence of depression than non-physicians. In the United States, about one physician dies by suicide every day.

Self-improvement is noble and what we all strive for, but are we only loveable and worthy if we change? What if changing requires self-love? I met Debra, who I mentioned above, in her home many years ago, when I visited her with a social worker. Formerly a hard-core injection-drug user, she was off all street drugs, living in an apartment out of the DTES, and had recently been granted custody of her child. I asked her what had made her change. She told me how, one day, when she was working the streets as a prostitute, a john assaulted her in an alley. She was so beat up that she was confined to her apartment and couldn’t turn tricks. But she was still addicted to drugs and needed money to support her habit. So, from her room, she started cutting hair for people. One day she was well enough to go downstairs, and the lady who worked at the fruit stand told her, “You know, you have a real talent for haircutting.”

“That moment,” Debra told me, “was the first time in my life that I saw myself as something other than what my father told me I was: a … whore. Suddenly, I was more. I was a hairdresser.” It was the start of a miraculous transformation.

My own effort to practise selfcompassion contributed to my husband and I moving our family back to Vancouver from the United States a year ago, closer to family, to socialized medicine, to nature. I found myself back in the DTES, working at a similar job to what I did before practising as an ER doctor, with people who have difficult lives, challenging dependencies and mental illness. When I work with them now, I don’t just see people who are suffering, I see myself, and all of us: human and fragile and needing support to thrive. And I do not feel ashamed of this. I feel connected. I feel freed.



Dec. 24, 2016 "Becoming Santa Claus": Today I found this article by Colby Itkowitz in the Edmonton Journal.  It is a very heart-warming story:


Adam Rush’s son was ready. So, the Texas father sat his 9-year-old down and he let him in on the secret of Santa Claus.

A jolly man didn’t traverse the globe in one night leaving gifts, he explained. But not because Santa doesn’t exist. There just isn’t only one Santa, he told the boy, but there are Santas everywhere. And when someone is ready to become a Santa, they’ll receive the message and be activated, like a soldier.
This year, he told his son, Tristan, he was ready to be a Santa.

If the story sounds familiar, it has been shared all over social media this season. It begins decades ago when Adam’s mother — rather than killing the spirit of Christmas by revealing to her children that Santa wasn’t real — told her boys it was their turn to be Santas. She wrote:
In our family, we have a special way of transitioning the kids from receiving from Santa, to becoming a Santa. This way, the Santa construct is not a lie that gets discovered, but an unfolding series of good deeds and Christmas spirit. When they are 6 or 7, whenever you see that dawning suspicion that Santa may not be a material being, that means the child is ready.
She goes on to tell the story of her 7-year-old son; how she took him out for “coffee” and reminded him of ways that year he’d been empathetic or considerate of others’ feelings. She told him that his “heart has grown so much that I think you are ready to become a Santa Claus.”

That Christmas it was his job to identify something a person not in their immediate family may need and then surreptitiously leave it for them. Her son picked the “witch lady” down the street, who yelled at the neighborhood kids when they were playing too loudly near her house. He noticed she always got her morning newspaper in her bare feet, so he told his mom he wanted to buy her slippers. They purchased a warm pair, wrapped them with a note, “Merry Christmas from Santa” and her son left them on her driveway. As the story goes, the next morning he watched as the elderly woman came out to get her paper in her new slippers.

The woman who shared that story is Leslie Rush, 57, a high school history teacher in El Paso, Texas. She wrote it 10 years ago in response to an online forum query about how to handle when kids begin asking whether Santa is real. The little boy in her story is her son, Adam, who is now 32 years old, and this year passed along the gift of becoming Santa to his own son Tristan.

It originated with her husband’s mother, whose own grandfather turned her into a Santa during the Great Depression.

Rush can’t say why her family’s story suddenly went viral so many years later, but perhaps therein lies the magic of Christmas: giving people what they need when they need it most. The idea that there are Santas living all around us feels especially comforting after this year.

“These days everything is so fast, I feel like it’s a way to make personal connections that get lost in this digital age. You have to look into people’s eyes and use your eyes instead of looking at a screen,” Leslie Rush said in an interview. “Making that personal connection, you learn something more about someone … It also teaches about doing for others without getting credit. You have to be thoughtful, put yourself outside of yourself.”

Her decade-old post was rediscovered by a woman who shared it on her Facebook page, and it was picked up by outlets such as Upworthy, the Today Show and The Huffington Post. Even actor Ashton Kutcher shared it. But it wasn’t until last week that a friend saw it going viral and remembered it as Rush’s story. That’s when Rush learned that probably millions of people all over the world were reading her words.

It’s also quite a coincidence that this would happen on the same year her adult son had planned to pass the Santa secret on to his own child.
For Adam Rush, the attention has made him reflect on what his mother’s gift to him, and later to his younger brother, meant to them. It instilled in them the power of giving. No matter how small the gesture, generosity can have a profound impact. It’s a simple act that transcends politics and religion and race and nationality. It’s about being human.

“I believe it to be in the spirit of St. Nicholas. I don’t believe he had supernatural powers, but the message within his actions, it supersedes religion, it supersedes a lot of the separations we encounter,” he said. “Putting that into action, something as simple as to take the time to do something for someone. They call it the spirit of St. Nick, and it is.”



Dec. 27, 2016 My opinion:

You don't have to have an important job to make a difference in someone's lives like in the medicine or education industry.  You can make differences in small ways like the stories above or donate like $10 a month to a charity (if you can afford it.) 

Or donate things you don't want or need to Value Village.

I know this, but the stories above was a good reminder.

Maybe someone will come on my blog and read this and be reminded of that.

My week:

Dec. 27, 2016 Rogers Place: This place is creating a lot of jobs.  2 of my co-workers at my 1st restaurant job got jobs there.  I see on Indeed they are hiring a lot of positions.

I have mentioned before that I would prefer affordable housing, school, or a hospital there, but I see that Rogers Place is pretty good with creating jobs.

Job psychology: I like these job psychology articles (like this one I posted today) on how to change your attitude to be more positive and productive.



Work in Non Profits: I was looking for a job on Indeed and it lead to this.  However, there are lots of jobs in Edmonton like the Boyle Street Community services, but they are hiring social workers with a social work degree.  Most of the jobs there need degrees.

You can donate to those Edmonton charities.



George Michael's death: When I found out he died, I was a little sad.  I'm not a fan of his, but I do like that Wham! song "Last Christmas."

Carrie Fisher's death: I'm a little sad about that too.  I'm not a fan of hers or Star Wars, but I'm sure a lot more people are big fans of hers and are sad about it.

Dec. 28, 2016 Step Up actress found dead 'in suspected murder-carjacking': Hollywood actress Tricia Lynn McCauley has been found dead in her car in a suspected murder-carjacking.

The 46-year-old actress, who played the stand-in for main character Jenna Dewan Tatum in the 2006 film, had been missing since Christmas Day, and her worried family had alerted police.


Dec. 29, 2016 Debbie Reynolds, ‘Singin’ in the Rain’ Star and Mother of Carrie Fisher, Dead at 84: Debbie Reynolds, the indefatigable star of Singin’ in the Rain, who bounced back time and again on the strength of a career that spanned the golden age of the Hollywood musical to the new golden age of TV, died on Dec. 28 at the age of 84 in Los Angeles. Her death came just one day after she endured the cruelest blow possible, when her daughter, Star Wars actress and writer Carrie Fisher, died on Dec. 27 at age 60, following a heart attack.


Ricky Harris: He is an actor on shows like Moesha and Everybody Hates Chris.  I don't really remember seeing him.  I watched that sitcom Moesha in the late 90s.  I only saw the last bit of Chris, because it's right before The Simpsons were to come on.



Dec. 28, 2016 Mini-MBA: I was going through my old news clips and I found this Metro "Learning Curve".  The date is not on it, but it could be 2014.

"It's for managers who have come up through a functional route like sales, finance, marketing or engineering and they're moving into their first real general management position," says Hugh Evans, director of executive education at the Hankayne School of Business at the University of Calgary.

The business essentials program runs for 15 day sessions cover main management practices.  Applying what students learn when they go back to work.

Mini-MBA is $8,500.  Executive MBA run about $60,000.

Evans: The phrase I use, it's MBA thinking without the crushing time commitment."

My opinion: I like that the education is applicable, and not too much time and money spent on it.  It's kind of like me reading the newspaper.  The business section I learn a lot from.

Leadership Communications: There was an article here:

EXLDR5621
Leadership at all levels depends upon communication. Topics may include: persuasive communication; generating buy-in; internal and external communications strategies; influence and influencing others; and communicating through conflict.



Athabasca University: There was an ad for it there with this:

Ghandi: Live as if you were to die tomorrow.  Learn as if you were to live forever.

None of the programs stood out to me.




Dec. 29, 2016 Taylor Swift surprises 96 yr old fan:

Taylor Swift is known for surprising fans with one-of-a-kind experiences  — showing up at weddings, bridal showers, and even inviting them over for dance parties at her house. And on Monday, she continued the tradition — surprising a 96-year-old World War II veteran with a visit to his Missouri home.
Cyrus Porter had made headlines for being the oldest “Swifty” — telling Ozarks First that he’s been to multiple Swift concerts, using his love for the 27-year-old singer to bring him closer to 20+ grandchildren.

“I’ve been to two concerts,” he said. “Memphis and St Louis. Look what she does… she puts on a show no one else puts on. I just enjoyed going to see ’em and her. I would as soon go see her right now as anybody!”



My holidays:

Dec. 19-Dec. 23: I was working at my 2nd restaurant job and it was so quiet.

I didn't expect this, but my boss there gave all of us Bath and Body Works present of a 8oz fragrance mist and a body lotion.  I didn't want the body lotion so I traded mine for my co-worker A's fragrance mist.  It's from the Holiday collection there.  I have Twisted Peppermint and Gingerbread Latte.

Last Christmas when I worked there, she gave me a Christmas card with cash in it.

On Thurs. Dec. 22, I stayed 1hr 30min later (till closing) because I was helping them move stuff.  I didn't have anything planned so I can stay late.  It was still the afternoon.

On Fri. Dec. 23, we closed early and my shift was cut short by 30 min.  After we closed, I and co-workers also got a lot of free food that weren't sold.

On Sat. Dec. 24, I worked in the morning at my 1st restaurant job.  It was busy.

On Sun. Dec. 25, I worked in the morning.  We had a buffet for the staff in the staff room so I had some turkey, salmon, and mashed potatoes.
I had the afternoon off so I went and watched Guardians of the Galaxy that I had on my DVR.  It was a fun movie.

At work, one of my managers A gave me (and I saw a co-worker Sw) a box of Rocherro chocolates.  It was very nicely wrapped with red and white paper, a black blow with a candy cane of the outside.  A said he wrapped it.  I didn't expect a gift either.

On Mon. Dec. 26: Then my manager G gave a box of cookies to P.  He then gave it to me because he didn't like these kind of cookies.  I worked in the morning because it was only open then.  It was pretty busy.  I thought people would want to go shopping instead.  In the staff room there were plates of turkey dinner left over in the fridge for the staff.  I had one for lunch.

Then I had to work in another dept. in the afternoon.  After that I took 2 plates of turkey dinner home so I can eat it later that night for dinner and for the breakfast the next day.

Dec. 27: It was my day off because the 2nd restaurant job was closed.  I read the newspaper and looked for a job.  I did watch 2 Vampire Diaries episodes that day.  I usually watch 1 episode a night for a week.

Dec. 28-30: Another quiet few days at work.

Dec. 31: I worked at my 1st restaurant job as usual on the weekends.

Jan. 1, 2017: I worked at my 1st restaurant job.  It was busy with the reservations.  My co-workers Sw was sick so I covered her.

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