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The Doctors Dilemma 2012

Excerpts from:

THE DOCTOR'S DILEMMA: PREFACE ON DOCTORS

BERNARD SHAW (1909)

It is not the fault of our doctors that the medical service of the community, as at present provided for, is a murderous absurdity. That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. But that is precisely what we have done. And the more appalling the mutilation, the more the mutilator is paid. He who corrects the ingrowing toe-nail receives a few shillings: he who cuts your inside out receives hundreds of guineas, except when he does it to a poor person for practice……….

………..Science becomes dangerous only when it imagines that it has reached its goal. What is wrong with priests and popes is that instead of being apostles and saints, they are nothing but empirics who say "I know" instead of "I am learning” and pray for credulity and inertia as wise men pray for scepticism and activity...……

………...Lest this should seem too rhetorical a conclusion for our professional men of science, who are mostly trained not to believe anything unless it is worded in the jargon of those writers who, because they never really understand what they are trying to say, cannot find familiar words for it, and are therefore compelled to invent a new language of nonsense for every book they write, let me sum up my conclusions as dryly as is consistent with accurate thought and live conviction.

1. Nothing is more dangerous than a poor doctor: not even a poor employer or a poor landlord.

2. Of all the anti-social vested interests the worst is the vested interest in ill-health.

3. Remember that an illness is a misdemeanor; and treat the doctor as an accessory unless he notifies every case to the Public Health authority.

4. Treat every death as a possible and under our present system a probable murder, by making it the subject of a reasonably conducted inquest; and execute the doctor, if necessary, as a doctor, by striking him off the register.

5. Make up your mind how many doctors the community needs to keep it well. Do not register more or less than this number; and let registration constitute the doctor a civil servant with a dignified living wage paid out of public funds.

6. Municipalize Harley Street.

7. Treat the private operator exactly as you would treat a private executioner.

8. Treat persons who profess to be able to cure disease as you treat fortune tellers.

9. Keep the public carefully informed, by special statistics and announcements of individual cases, of all illnesses of doctors or in their families.

10. Make it compulsory for a doctor using a brass plate to have inscribed on it, in addition to the letters indicating his qualifications, the words "Remember that I too am mortal."

11. In legislation and social organization, proceed on the principle that invalids, meaning persons who cannot keep themselves alive by their own activities, cannot, beyond reason, expect to be kept alive by the activity of others. There is a point at which the most energetic policeman or doctor, when called upon to deal with an apparently drowned person, gives up artificial respiration, although it is never possible to declare with certainty, at any point short of decomposition, that another five minutes of the exercise would not effect resuscitation. The theory that every individual alive is of infinite value is legislatively impracticable. No doubt the higher the life we secure to the individual by wise social organization, the greater his value is to the community, and the more pains we shall take to pull him through any temporary danger or disablement. But the man who costs more than he is worth is doomed by sound hygiene as inexorably as by sound economics.

12. Do not try to live for ever. You will not succeed.

13. Use your health, even to the point of wearing it out. That is what it is for. Spend all you have before you die; and do not outlive yourself.

14. Take the utmost care to get well born and well brought up. This means that your mother must have a good doctor. Be careful to go to a school where there is what they call a school clinic, where your nutrition and teeth and eyesight and other matters of importance to you will be attended to. Be particularly careful to have all this done at the expense of the nation, as otherwise it will not be done at all, the chances being about forty to one against your being able to pay for it directly yourself, even if you know how to set about it. Otherwise you will be what most people are at present: an unsound citizen of an unsound nation, without sense enough to be ashamed or unhappy about it.

Why - an attempt through fiction

Lest we Forget - Wouldn't happen to ME

SATURDAY, DECEMBER 15, 2012

HEALTH / NEWSI Am Adam Lanza's Mother

posted by LIZA LONG on SAT, DEC 15, 2012 at 10:51 PM

• Michael with a butterfly.

This has been reposted from The Blue Review.

Three days before 20-year-old Adam Lanza killed his mother, then opened fire on a classroom full of Connecticut kindergartners, my 13-year old son Michael (name changed) missed his bus because he was wearing the wrong color pants.

“I can wear these pants,” he said, his tone increasingly belligerent, the black-hole pupils of his eyes swallowing the blue irises.

“They are navy blue,” I told him. “Your school’s dress code says black or khaki pants only.”

“They told me I could wear these,” he insisted. “You’re a stupid bitch. I can wear whatever pants I want to. This is America. I have rights!”

“You can’t wear whatever pants you want to,” I said, my tone affable, reasonable. “And you definitely cannot call me a stupid bitch. You’re grounded from electronics for the rest of the day. Now get in the car, and I will take you to school.”

I live with a son who is mentally ill. I love my son. But he terrifies me.

A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7- and 9-year-old siblings knew the safety plan—they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.

That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn't have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.

We still don’t know what's wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He’s been on a slew of antipsychotic and mood altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.

At the start of seventh grade, Michael was accepted to an accelerated program for highly gifted math and science students. His IQ is off the charts. When he's in a good mood, he will gladly bend your ear on subjects ranging from Greek mythology to the differences between Einsteinian and Newtonian physics to Doctor Who. He's in a good mood most of the time. But when he's not, watch out. And it’s impossible to predict what will set him off.

Several weeks into his new junior high school, Michael began exhibiting increasingly odd and threatening behaviors at school. We decided to transfer him to the district’s most restrictive behavioral program, a contained school environment where children who can’t function in normal classrooms can access their right to free public babysitting from 7:30 a.m.-1:50 p.m. Monday through Friday until they turn 18.

The morning of the pants incident, Michael continued to argue with me on the drive. He would occasionally apologize and seem remorseful. Right before we turned into his school parking lot, he said, "Look, Mom, I'm really sorry. Can I have video games back today?"

"No way," I told him. "You cannot act the way you acted this morning and think you can get your electronic privileges back that quickly."

His face turned cold, and his eyes were full of calculated rage. "Then I'm going to kill myself," he said. "I'm going to jump out of this car right now and kill myself."

That was it. After the knife incident, I had told him that if he ever said those words again, I would take him straight to the mental hospital, no ifs, ands, or buts. I did not respond, except to pull the car into the opposite lane, turning left instead of right.

"Where are you taking me?" he said, suddenly worried. "Where are we going?"

"You know where we are going," I replied.

"No! You can’t do that to me! You’re sending me to hell! You’re sending me straight to hell!"

I pulled up in front of the hospital, frantically waving for one of the clinicians who happened to be standing outside. "Call the police," I said. "Hurry."

Michael was in a full-blown fit by then, screaming and hitting. I hugged him close so he couldn’t escape from the car. He bit me several times and repeatedly jabbed his elbows into my rib cage. I’m still stronger than he is, but I won’t be for much longer.

The police came quickly and carried my son screaming and kicking into the bowels of the hospital. I started to shake, and tears filled my eyes as I filled out the paperwork—"Were there any difficulties with... at what age did your child... were there any problems with.. has your child ever experienced.. does your child have..."

At least we have health insurance now. I recently accepted a position with a local college, giving up my freelance career because when you have a kid like this, you need benefits. You'll do anything for benefits. No individual insurance plan will cover this kind of thing.

For days, my son insisted that I was lying—that I made the whole thing up so that I could get rid of him. The first day, when I called to check up on him, he said, "I hate you. And I'm going to get my revenge as soon as I get out of here."

By day three, he was my calm, sweet boy again, all apologies and promises to get better. I've heard those promises for years. I don't believe them anymore.

On the intake form, under the question, "What are your expectations for treatment?" I wrote, “I need help.”

And I do. This problem is too big for me to handle on my own. Sometimes there are no good options. So you just pray for grace and trust that in hindsight, it will all make sense.

I am sharing this story because I am Adam Lanza's mother. I am Dylan Klebold's and Eric Harris's mother. I am Jason Holmes's mother. I am Jared Loughner's mother. I am Seung-Hui Cho's mother. And these boys—and their mothers—need help. In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.

According to Mother Jones, since 1982, 61 mass murders involving firearms have occurred throughout the country. Of these, 43 of the killers were white males, and only one was a woman. Mother Jones focused on whether the killers obtained their guns legally (most did). But this highly visible sign of mental illness should lead us to consider how many people in the U.S. live in fear, like I do.

When I asked my son's social worker about my options, he said that the only thing I could do was to get Michael charged with a crime. “If he’s back in the system, they’ll create a paper trail," he said. "That's the only way you’re ever going to get anything done. No one will pay attention to you unless you’ve got charges."

I don't believe my son belongs in jail. The chaotic environment exacerbates Michael's sensitivity to sensory stimuli and doesn’t deal with the underlying pathology. But it seems like the United States is using prison as the solution of choice for mentally ill people. According to Human Rights Watch, the number of mentally ill inmates in U.S. prisons quadrupled from 2000 to 2006, and it continues to rise—in fact, the rate of inmate mental illness is five times greater (56 percent) than in the non-incarcerated population.

With state-run treatment centers and hospitals shuttered, prison is now the last resort for the mentally ill—Rikers Island, the LA County Jail and Cook County Jail in Illinois housed the nation’s largest treatment centers in 2011.

No one wants to send a 13-year-old genius who loves Harry Potter and his snuggle animal collection to jail. But our society, with its stigma on mental illness and its broken healthcare system, does not provide us with other options. Then another tortured soul shoots up a fast food restaurant. A mall. A kindergarten classroom. And we wring our hands and say, “Something must be done.”

I agree that something must be done. It's time for a meaningful, nation-wide conversation about mental health. That's the only way our nation can ever truly heal.

God help me. God help Michael. God help us all.

Liza Long is an author, musician, and erstwhile classicist. She is also a single mother of four bright, loved children, one of whom has special needs. To read more from the Blue Review, click here.

Christian Marriage

Christian Marriage : an alternative view.

Most theology as experienced by fundamentalists arises out of the experience of the Reformation.  That period of time represented the breaking away of Christians from pseudo-piety of the medieval church.  Subsequent 20th century churches have evolved from that tradition, but in doing so have often reverted back to an Old Testament interpretation of the life of Christ.  --  “throwing the baby out with the bathwater” !!

The early church celebrated actions not things.  Jesus created no new rituals or celebrations.  Events had been distinguished in rituals for decades and centuries before His life.  The mystical significance of water, light, and the breaking of bread, had been celebrated from nearly the beginning of Man’s existence.  “Communion”, the breaking of bread in fellowship with other Christians, was a way in which the ordinary Christian celebrated his or her communicating with other members.  Christians were a group of people with a common awareness of their life in Christ.  Ministry was action that applied to each individual Christian, not just the Elder or Bishop who orchestrated the celebrations.

As the sense of fellowship declined, so did the sense of being church decline.  The celebration of, for example, initiation into the Church, or communion with other members became “things” that you “went to church” to “receive."  Marriage became separate from the shared story of a couple’s gradual coming together and the couple became recipients of a thing, rather than celebrants in an ongoing “mysterium” celebrating the union between man and woman (Ephesians 5:32).  This letter clearly refers to the marital relationship not the ceremony, a celebration of the love of God experienced and related to one’s own story, a sacred reflection on experience.

For many centuries marriage has been seen as a contract, the liturgy centering around the exchange of consent and the terms of specific legal bonds.  However for Christians marriage is a covenant, a celebration and ceremony that “seals” the couple’s commitment.  If the couple’s coming together is a gradual process of growth, accommodation and acceptance; then the meaning of their union lies in the shared experiential understanding, not in the thing of marriage.  One can conceive that this whole process should be celebrated, not just the final legality.

Thus living together, sexual intimacy would become part of the process of relationship that would eventually lead into the Covenant of Marriage, celebrated within the body of the whole Church.  The ceremony would be analogous to a Rite of Initiation into a new aspect of reflection, and a new “life” within the Body of Christ on Earth — the Church.  The grace, or Holy Spirit, flowing from that celebration would be intimately bound up with individual desire for that spirit, awareness of the process by which the person comes to that state, and conscious choice towards the covenant of man with woman, of the couple with God.

Many moral Christians feel that they need to experience that commitment growing within their relationship before they can stand before a Christian community and call that community to witness the solemn and binding covenant of marriage.  The couple want to discover that there is a sacrament before they can celebrate it.  Genuine Celebration is seen as action rather than object.  The Covenant made between two people is a loving and infinite promise made more meaningful with the understanding of the original Covenant made between God and His people and renewed by the Coming and Resurrection of Jesus Christ.

O death, where is thy sting?  O grave, where is thy victory?

The sting of death is sin; and the strength of sin is the law.                    I Corinthians 15, 55-56

seernnadivad Description and Fees

seernnadivad

Existential Phenomenology:              Existentialism: As an existentialist my approach is that I try to view the world as it is without preformed concepts or theoretical preconceptions. The human person is a being in the state of "becoming" or emerging. The other can only be understood by recognition that he or she is self-conscious, capable of responsibility and integrity and on a journey to authenticity and self- appropriation.I am concerned with establishing a desire-based encounter with the world and limiting need-based guilt. I perceive for-give-ness as an active giving to the future by being authentic and compassionate in the present. Confrontation is not always the best communication! Intentionality is conscious, meaningful and always present. A no choice is still a choice!  The prevailing ethic of reciprocity is the same ancient rule that exists within all religious or philosophical groups: .One should treat others as one would like others to treat oneself. Be with the Other.  Being there is not always enough. See through the eyes of the Other and come upon oneself as Stranger.  Phenomenology: The study of human awareness as it is authentically revealed without assumptions and bias from abstract objectivity and one's own agenda. It implies the use of intelligent subjectivity by authentic individuals in an encounter that is primarily dialogic. It's importance lies in the issue that one can then attempt to "look through the eyes of the other" and then (ideally) experience the other with compassion and situated acceptance. The other then reflects back to us and we "come upon ourselves as stranger". As with children looking in their parent's eyes, we see ourselves to learn, and to be gifted.                       Consultative fees (all communication options) Description   Fee 1 full hour 60mins (individual or couple sliding scale $60 thru $100.00 1hr - nuclear family 4 persons sliding scale $65 thru $110:00       group consult (non-nuclear) 3-6persons first hour $75:00 per hour group or family consult (non-nuclear)  subsequent 30mins $30       report/letter under 8 pages $70.00 All options and fees are subject to discussion between client and consultant.  Do not be afraid to discuss.

E-P1

Existential Phenomenology:

Existentialism:

As an existentialist my approach is that I try to view the world as it is without preformed concepts or theoretical preconceptions. The human person is a being in the state of "becoming" or emerging. The other can only be understood by recognition that he or she is self-conscious, capable of responsibility and integrity and on a journey to authenticity and self- appropriation.
I am concerned with establishing a desire-based encounter with the world and limiting need-based guilt. I perceive for-give-ness as an active giving to the future by being authentic and compassionate in the present. Confrontation is not always the best communication! Intentionality is conscious, meaningful and always present. A no choice is still a choice!

Phenomenology:

The study of human awareness as it is authentically revealed without assumptions and bias from abstract objectivity and one's own agenda. It implies the use of intelligent subjectivity by authentic individuals in an encounter that is primarily dialoguic. It's importance lies in the issue that one can then attempt to "look through the eyes of the other" and then (ideally) experience the other with compassion and situated acceptance. The other then reflects back to us and we "come upon ourselves as stranger". As with children looking in their parent's eyes, we see ourselves to learn, and to be gifted.