Tuesday, 15 October 2019

Poor Parenting!

Incompetent parents and Rapacious Lawyers.

The parents of two children in Canada filed a legal notice against Epic Games that likens the hugely popular game to major narcotics.  They claim that the game ‘Fortnite’ is as addictive as cocaine, morphine, fentanyl etc. They are being encouraged by money hungry lawyers to launch a class action lawsuit. 


   "Epic Games, when they created Fortnite, for years and years, hired psychologists - they really dug into the human brain and they really made the effort to make it as addictive as possible," Alessandra Chartrand, a lawyer with Calex Legal, told the Canadian Broadcasting Corporation.  She went on to claim that the merchandisers of the game did all they could to make the game as desirable as possible (isn’t that what every manufacturer does with their product?) and that the poor parents who came forward said that if they knew it was so addictive they would never have let them start playing the game or at least they would have monitored it a lot more closely!  They went on as though they had no role or responsibility for any of this, when they were clearly the enablers. 
   A word about these parents.   After fifty-five years of general practice I know a thing or two about this topic.  I would have been able to identify the syndrome when the family brought the kids in for their pre-school check up or for their immunizations.  When some families came in to the office, it quickly became apparent that the kids were the boss, not the parents. I remember one mother giving her three year old her cell phone to shut him up so that she could talk to me.  I remember the kid throwing the phone (a considerable upgrade from the one I was using) across the room. I remember saying “he’ll wreck the phone” and the response,”it’ll keep him quiet for a while!!” I remember I used to keep my kids civilized by giving them a slap on the bum when necessary!  Not often, but when it was necessary to prevent them from running into the ongoing traffic, both literally and metaphorically.  
    Ah yes, I am proud to have been ‘politically incorrect’ for much of my life.
    So, I would say to the ‘Fortnite Suers’: “look at yourself, you bought them their the games, or at least sanctioned them and failed to control their use.  If you didn’t recognize that they were spending hours gaming everyday you are either incompetent or indifferent or both. Or maybe just glad to get them off your back. If you did recognize it and failed to stop it you were worse than incompetent.  Perhaps it took the smell of litigious wealth generated by some rapacious lawyers combined with the relief of shifting the blame for your negligent parenting to the gaming company."

The parents case:
"They knowingly put on the market a very, very addictive game which was also geared toward youth. In our case, the two parents that came forward [said], 'if we knew it was so addictive it would ruin our child's life, we would never have let them start playing Fortnite or we would have monitored it a lot more closely."


Ms Chartrand likens the case to a 2015 class-action lawsuit against big tobacco companies that accused the firms of not doing enough to warn consumers of the addictive nature of smoking. No comparison!

   Let's see if our legal system will continue to reward inappropriate behaviour.  I'm afraid I already know the answer!

Thursday, 10 October 2019

Parking in Toronto - a cautionary tale!!

Parking in Toronto - A cautionary tale!
  
    A few weekends ago we went to Toronto to spend a couple of days with some family who were visiting from the other London.  We know them well and looked forward to catching up on all the sort of family news that we ex-patriots often miss.  We booked into a hotel that we know and that is fairly central.  As  Irene and I were only staying overnight, the plan was to chat away for a couple of hours in a large foyer area behind the hotel and then go out to dinner.  My daughter and son-in-law live in Toronto and since there were four visitors and four of us we were taking two guests in each car and heading out for the restaurant. 
    Parking in Toronto as in most big cities is a nightmare. The underground parking lot for the eighteen story uptown hotel we stay in is huge being shared as it is by the hotel, the public library, several businesses, banks and a myriad of other establishments.  It burrows underground for four stories, in extremely tight corkscrew turns and every time we have stayed there part of it is under construction.   The exits are hard to locate and open into several different buildings and several different streets.  I always have great difficulty in locating my car no matter how carefully I document the letters and numbers that are supposed to lead me to it. 
   Bill, on the other hand leaves his car on a side street across from the hotel.  He has always parked there and seemed to find a place relatively easily.  So much so that I have contemplated parking my car there to avoid the inconveniences of negotiating the parking lot.  Fortunately, I have never done so.
    After innumerable coffees and chats we decided it was time to head out to the restaurant where we were dining.
    "I better come down to the parking lot and help you find your car," said Bill considerately.
    "Thanks," I said, happy that the big city guy was going to help this country bumpkin to find the car.  Or so I thought.
    We burrow four levels underground sand emerge in a metal concrete cemetery the size of two football fields.  All the directions I had so carefully recorded are totally meaningless.  We walk around and around to no avail. There is not another human being in sight.  Just as we are beginning to despair a young woman pulls into one of the few parking spots available in that huge jungle.  We walked towards her careful not to appear threatening.  (After all two old fogies advancing on a young woman in a deserted lot.).   Fortunately she was unperturbed.
   "We've lost our car," said I. "I thought I had this lot mapped out.  We have no idea how to find it. Can you help us?”
   I showed her the map I had drawn on a piece of paper.  She looked at it and laughed. “I’ve been parking here for five years, your map isn’t too good but with the letters and numbers I have an idea where you might be.  The easiest thing will be for me to take you there.”
   She did.  Thank’s Ma’am, or we might be still there!
   “Okay,” I said to Bill. “I’ll meet you up front where your car is parked and we can load up the two cars.”


   With considerable difficulty I wended my way up four very tight spirals and eventually merged into the street.  I pulled up outside the hotel where my three passengers were waiting, loaded them into the car and waited for Bill and his three passengers to draw up in his car.  We wait and wait -no car, no Bill. Eventually he appears leading the other three.
   “Stan, I left my car just over here, didn’t I ?  Or was it around the other side of the hotel? I can’t find it.”
   “You left it just over there.” I pointed.
   “Well, then it has been stolen.” he said.
   I got out of my car and we crossed the street to a row of parked cars where we thought he had parked his car.
   “Unless it has been towed ?” he said anxiously, “but there isn’t any no parking sign, is there?”
   “No”, I said, looking around carefully.   Then I saw it!! A very tall light pole extending almost to heaven.  Right near the top was a postage-stamp sized sign that read: No parking 3pm -5pm.  It was barely legible to these old eyes, but there was a sign so no basis for appeal.  Instead of just ticketing the car, the miserable SOBs towed and ticketed the car leaving no notification of where it might be towed to.  It was getting late so we called a cab to take the carless group to the restaurant, and poor Bill spent the dinner time on his cell phone trying to track down his car, which he eventually did.
   Cost of car retrieval: the towing company charged $300 to release the car, the City of Toronto added a parking fine of $150.  

Bastards!!

Parking in Toronto - A cautionary tale!

Friday, 27 September 2019

Butterflies and Computers.

The Butterfly and the computer.


       He had been my closest friend for years, through all our school days and beyond. We had lived right across the road from each other and were inseparable. Although our paths diverged dramatically after that, and we no longer had anything in common, whenever I came to Ireland or he came to Canada or the States, we went out of our way to get together. I guess we still had enough left between us from the old days to feel close.  Now that I was established and comparativelt I stayed at the Gresham, a fine Hotel I couldn’t have imagined in my younger days. Later he told me his only previous evening at the Gresham, was a visit t o a rich grand uncle who reputedly died of malnutrition, because he was too mean to eat.  
"It's nice to see you," I said, trying to remember the last time I had seen him.   I think it was the bar at the Lincoln years earlier, or maybe Davy Byrnes. Both were a safe bet..   I had phoned him a few days earlier, asking if he’d like to get together with me for a drink. He arrived alone.
 "and how is Anne?" I asked, surprised that she wasn’t present.
  "Oh, she's fine, asks to be remembered to you." 
"Good,” I said, though I wondered if something might not be quite right between them.  He seemed a little uncomfortable and when you are a psychiatrist specializing in marital issues you anticipate problems everywhere.
“Oh no, Things are going well between Anne and me, but I’d like to talk to you about my brother, Matt."  
   I remembered Matt well. He was the younger brother who was always hanging around and getting in the way when the big boys were having fun.    He had gone into the small upholstery business their father had built. 
"Yes, I seem to remember him re-upholstering some furniture for me when I was a resident.   What's he up to these days?
"Things are not good, he's getting a divorce."
"No!”
"Yes."
"Oh dear!" I understated, surprised "And they had three or four kids? What happened?"
"Four kids, I don't really know what went wrong but I know Matt would really like to talk to you. He always thought the world of you.   He always said that if he had the chance, he would have become a psychiatrist himself.
   "Ah yes" I said ironically, "lots of people say that. So what happened?" 
   "None of us really know.   They always seemed like the perfect married couple.    Even their names had a rhythm, Matt and Mady. None of us in the family had ever heard them raise their voice to each other.  In fact everyone in the family, and I think, outside it too, thought they had the perfect marriage. 
   But one day, Mady came  home and apparently said, out of the blue, "I want a divorce." When I asked Matt what went wrong, he said he said that Mady had fallen out of love with him some time earlier and that  he didn't want to talk about it. Then, when I heard that you were going to be in town and I mentioned it to him and suggested half jokingly that it mightn't be a bad idea for him to talk to you, and to my surprise he said he thought that it would be a good idea, So I wondered  if maybe for old times sake you might see him. He's in pretty poor shape."   


  Matt came to see me and sat across the table from me in the bar at the Gresham.  It was the perfect therapeutic milieu and after the usual niceties, we got down to business. 
   “You know, Rory, she was seventeen and I hadn't quite turned sixteen when we started going out together. Everyone said we were too young to get seriously involved. But you know what it's like when you are that age.  You just know that you're madly in love and the raging hormones do the rest. I had planned to go to University but by the time I was 18 I couldn't see us waiting another five years to get married. In those days, you didn't get married until you could support a wife.   So I went into my father's business which was doing quite well in those days. We got married right after I turned 21 and thought we were going to live happily ever after. Unfortunately, it didn't work out that way. I don't understand it. We were so madly in love.   
  Mady desperately wanted to go to University and wanted to get a degree. I'm not sure exactly sure why, but it seemed to me like a little more than being simply a quest for knowledge.  Perhaps it was something to do with self esteem. She always seemed to feel that life owed her something."
   I interrupted, "were you doing badly financially then?”
   "Things were not going as well as well as we expected, so we were having a bit of a struggle," Matt answered.
   "And what sort of home had Mady grown up in?"
   "Her da was a small businessman the same as mine, although considerably better off.  He was a nice little man and I always quite liked him. Her Ma was another kettle of fish altogether.   She was a real basket case and thought she was a fancy lady who had married beneath her.  
   Meanwhile, the kids kept coming along and by the time  we had three, Mady still wanted to complete her BA degree.  What she intended to do with it was anyone's guess. 
   "I don't get it, what did Mady want?"
   Matt was silent.  He seemed deep in thought. 
   "I'm not sure," he said, somewhat pathetically.
   "So what happened when she finally did get her degree?" I asked.
   "I asked the same question myself," Matt said. "I thought she might want to go out and get a job and help us to pay our bills.  When I suggested that she seemed shocked that I could have such expectations.
  ' I need to get a Master's before I can do anything like that, she said indignantly.'
   So what could I do? " 
  "How did she relate to kids?" I asked, changing the subject. 
   "She was great with them," Matt said.  "She had a certain child- like quality herself, a sort of naïveté that could be very endearing.   But along with that went certain peculiarities."
   "Such as?" I asked my curiosity piqued.
   "We were never allowed to discuss age in our home, it was an unmentionable.  Then, she developed some very peculiar friends at university. Don't forget she was older than many of the kids she was friendly with..  So she had a quite a few followers who were in our house more than in their own. To be honest, I sometimes found it quite irritating, I think it  flattered her that they loved to hang around her and thought everything she said was so profound. I found our friends growing reluctant to visit and I was tending to spend more time with the boys at our local pub. ”
   “You told me a few minutes ago about how madly you were in love with each other.   There must have been some point at which you both realized that things were changing.   When was that?” I asked.
  Matt thought for a while.   “I don't really know, I can't think of any one thing.   We both always wanted kids, and enjoyed the same sort of things.    Somehow we seemed to go two different ways, despite that. Sometimes, I thought it was because I didn't make enough money, and life was turning out to be tougher than we had anticipated.    I had always planned to go to University too, and even when I went to work in the business I had some really unrealistic ideas about making enough money to save for me to go to university and by that time Mady would have got her degree and would help me just like I helped her.   Sometimes we'd talk about that, at least I would bring it up, and I could see she didn't like it. Sometimes, it would end in a bit of a row, and she would say I resent it because she is going to university and I'm not. When I got to thinking about that I could see that maybe she was right, and that made me even more resentful.   So I thought maybe if I could make a bit more money I could put some away and then I'd be able to afford to do what I want. I started working a bit later in the evenings and sometimes going back to work after supper. After a while I began to get annoyed that some of those evenings when I made it home, there was no one there, or worse, a bunch of kids sitting around that I had to get rid of.  .Later when our kids started coming along there was often a babysitter and a note for me to say my supper was in the oven or the fridge, and to help myself. So I started going for supper with a couple of the lads who scooted down to the local pub for a pint or two and some fish and chips or some bangers and mash. Eventually we were both spending more time apart than together, and often, even when we were in she had some student friends over, or I had a couple of lads over for a game of poker.   Much of the time when we were together we were fighting anyway, and the rest we were doing duty things, family and kids, you know what I mean.    
   "I was spending more and more of my spare time with guys I worked with or other business associates.  In particular, I was palling around with Frank Hodgkin’s, a guy I had employed three or four years earlier and made him manager of the business which was growing slowly but steadily .   Frank was always making suggestions about how to modernize the business, and for a long time I would give him a polite hearing and then forget about it. Now, I was paying more attention to what he had to say. Modernize, modernize, modernize were his three favorite words.  I wanted my business to thrive And now I was interested and paying attention to what he had to say.
   "We need to computerize, Matt," he would say.   "We have to get into the twenty-first century."
   "I don't know anything about computers, Frank.   I don't see how they can help an upholstery business."
   "There are lots of ways.   For instance, remember when we were held up three days completing an order last month because we had run out of spring units and it took that long to gel them.   Now if we had a computerized system, that could never happen because you would be automatically made aware of a low inventory."
   "Okay, So what else can your computer do?”
    "What do you want it to do?  That, Of course is the crucial question.   Some people want computers to play games, others want them to make their business more efficient.   For instance, even you must how noticed that almost every business now has a web site. Now, why do you think that is?"
   Matt thought for a minute as though there must be a catch in such a simple question. 
   "Advertising!" That's what we need to do -advertise!"
   "Yep! It's as simple as that. And we've got to get with it if we want to survive."
   So get with it we did. 
   And that’s when I really started working on how we could use computers as a tool to start making our business more profitable.   Up to this time I had nothing much to do with computers, or technology in general. In fact, my father had this antiquated idea, that if you built a better product, people would be beating a path to your door and success and fame would await you!   Instead, the business slowly but steadily declined and our competitors were getting into prefabricated units that cost half the price. Sure, they weren’t the same quality, but who cared if the product was cheap enough.   
   To cut a long story short, I began to immerse myself in computer technology and the technology of our business.   Now that I realized what Luddites my father and I really were, I determined to make up for lost time.
   First, I registered for a couple of courses in basic computer skills and it wasn't long before I was ready for elementary web design.  When I got our website up and running I soon started seeing some business coming in, in response to the advertising. So between work and web, Mady and I saw less and less of each other.   Sure, we had meals at the same table, but with the kids yelling and competing for attention, we seemed to have less and less time to talk about ourselves and even when we did, it mainly took the form of bragging to each other of our respective achievements in our chosen fields.  We both talked, but no-one listened. Occasionally, we made an effort, and with the best of intentions we went out to dinner together. I suspect both of us had a certain amount of anticipation that we would resolve some of our issues and go on to a better future together. Instead, after a little beating around the bush, and avoidance of unpleasantries, and a few glasses of wine, we both seemed to come to the conclusion that avoiding any of the delicate matters that might spoil the evening was the most important thing.   Nothing should prevent the prospect of the evening ending in blissful sexual union that might solve everything, forever. So we concentrated on the wine and sex and that solved everything, for a day or two! Our fascination with our interests, our careers and ourselves was all- consuming and by the time we had taken care of the kids, we had nothing left over for each other. I guess I would have been satisfied to drift on like that forever. I had an uneasy awareness that things were not ideal, but I managed to sublimate that without too much difficulty.    I was totally astounded when Mady announced that she wanted a divorce.   
‘A divorce?   Why would you want a divorce?’ I asked her.
‘Because there is nothing left in our marriage anymore’ she replied.   ‘We are like two strangers. Sure, we have not bad sex, once in a while, but there’s no real warmth there, no cuddling, no holding hands, no holding each other close, just because we want to be close.   You resent that I want to make a career for myself instead of just being a good little wife. You can’t help it, you don’t even know you resent it. But I can feel it. I just don’t want to live like this for the rest of my life.   I want someone I can share my life with." 
         I had been listening to him without comment for several minutes, now I asked,
         "Why were you totally astounded?”
          "I just didn’t think things were that bad.   We were both doing what we wanted. We shared the kids and I think I did my share of the day to day household chores.  So I thought we weren't doing too badly and that eventually things would settle down and that we would carry on as before.  I really had no idea that Mady was so desperately unhappy. When I realized that it was too late. I talked to her about it and even suggested that we go for counseling.   She said that our marriage lacked all warmth for a long time and that it couldn't be repaired."
         "You know, Matt," I said, ``There's a story about a butterfly and a rock.   The butterfly is flying around the rock looking for somewhere soft to land, but the rock doesn't have a soft spot to offer, so it may never be possible for them to live together in harmony.   Maybe that’s the way it is with you and Mady."
          “Maybe it is,” he responded. “But what should I do about it?” he asked naively.
   I gave him the standard psychiatric parry. “What do you want to do about it?”
           “I don’t really know,” he said.
    Right there and then I really did know, but for once, I remained silent, because I knew I could do nothing to help.


       It was about a year later when I heard they had gotten a divorce.


Tuesday, 24 September 2019

Just Plain Poor Health Care - the decline continues!

   I am reblogging this piece from two years ago, prompted by some of the horror stories that have been shared with me lately that would indicate that the decline continues, nay accelerates!
I will share some of these stories later, but it would not be appropriate to do so right now.  Meanwhile, just re-read and if you have any horror stories (or wonderful ones!) share them with me.

 Someone finally had the guts to come out and say it!  Brian Lee Crowley, of the Financial Post, on July 5th had the appalling honesty to say what many Canadians know but don't even like to mention, or hear mentioned by others, that we have one of the worst, if not the worst health care system in the developed world.  The heading of Crowley's article is :
     "This report just shredded every myth claiming Canadian medicare is superior - or fair"
  The report he refers to is the report of the Commonwealth Fund comparing health care systems in the rich industrialized world and it is regarded internationally as being highly reliable.
  The humiliation of having deteriorated so rapidly from  among the best to the present sad state is so damaging to the pride and hubris of those who boasted 'one of the best health care plans in the world' that they can't cope with it.   There are some who still think that, but it only testifies to their lack of knowledge or contact with the system.  I know that occasionally folks have good luck but the majority of people who have to depend on the health care system are poorly served.  I also know that there are those who know how to manipulate the health care system and that there are the 'elites' who push their way to the head of the queue.  No politician or bureaucrat or their army of administridiots stand in the line with the rest of the folks.  Oh yes, they will claim all are equal, but as George Orwell said, "some are more equal that others!"  The fairness that they boast of doesn't exist.
   How is it, you may ask, that we declined so rapidly from the best to the worst?  Regardless of the fact that we spend a fair amount of money we get poor value for it.  A very disproportionate amount goes to paying armies of civil-servants, many of whom are neither civil nor serve very well.  Most are not health care professionals of any kind and of those who are, few have real experience serving in the front lines.  They attend meetings where they like to hear the sound of their own voices and are frequently resentful of health care professionals who are wiser and more experienced.  Large amounts of money are sequestered to provide generous pensions and benefits. 
   Many of the administrative services that were intimately related to health care were for years provided by doctors and nurses on a pro bono basis - they did it without any personal reward other than that they cared.    They were committed individuals, usually with extensive experience in many aspects of health care.  Most of them knew what worked and what didn't.   Today many hospital administridiots have come up through the financial/business ranks and know nothing about health care but consider themselves experts anyway.  
   Because our government is not interested in individual health (unless it's a glamour story) but in votes, they have directed resources away from individuals and towards populations from whom they think they can win the most votes.  They play the 'statistics game' and the 'evidence based medicine game', they reward doctors for doing what they and their 'statistical experts' tell them will be cheap and effective and they penalize physicians for spending time on individual patients.  The fee schedule has been manipulated to make doctors do what the government want them to do and the Canadian Medical Association  and the licensing bodies has kow-towed to them. 
   The privilege that most free and prosperous societies  enjoy of allowing citizens to spend their own money on buying their own health care services is too threatening to the Canadian government, because they don't want the population to realize they are now getting second-rate care.  This would save money because some of those closed down operating rooms and wards would become productive, bring more money into the system and shorten waiting lists.  Think the government wants that?  It is that very lack of competition that allowed the disastrous deterioration to occur virtually without  public notice in the first place.  
   The decline will accelerate as the government brings in more and more unscreened refugees, hands out tax payer dollars by the millions and throws away opportunities that could make life better for all Canadians.
   They just want you to go on thinking we have the best health care system in the world!  

 

Saturday, 7 September 2019

Slick Lab V Slack Lab.

   I find myself increasingly quoting Ronald Reagan: "I'm from the government and I'm here to help!" are the most terrifying nine words in the English language.  Anyone familiar with waiting around hospitals for X Rays or lab work cannot fail to be impressed by the efficiency of the private sector when compared with the civil service mentality of the public sector.  Viz my visit to one of the private labs for some blood work this week.
   I pulled into the parking lot and parked my car in a designated complementary spot clearly labelled as such.  At the hospital even a short parking stop would be $3-$4.  I made my way to the lab and since it was 10am I was not surprised to find it crowded.  A large monitor mounted on the wall listed the twenty or more patients ahead of me by first name and the anticipated time of their wait.  I checked in anticipating a fair wait and since there was a coffee shop not more than a few feet away,  I slipped in and bought myself a large coffee.
   I am a rather impatient individual so I always bring some tasks with me to keep myself amused.  With my coffee in one hand and my National Post in the other I settled myself down in one of the rather comfortable chairs to enjoy my coffee and catch up on the news.  No sooner had I settled down than I heard my name being called out.  Impossible, must be a mistake, I thought.  I looked up at the screen and saw "Stan.......waiting time ........0!  I was directed to the torture chair, where a pleasant lab tech took my coffee and placed it safely for me while she took my blood.
   I had gone into the lab at 10 am and was back in my car sipping my coffee at 10.29.
  That never happened at a hospital!!
  I suspect the whole health care system might benefit from a healthy dose of competition.

Monday, 2 September 2019

Turn on, Tune in, Drop out!

Turn on,
Tune in,
Drop Out!
Blame the Doc, blame Big Pharma, blame the Nurse, blame the health care workers, blame the porters, blame the cleaning staff. Blame everyone, that is except those most to blame, Those who most manipulate the health care system for their own ends. Those who purport to be health care experts while knowing little about health care other than how to manipulate it for political or financial gain. Maybe we should blame the society that nurtures addiction by failing to accept responsibility for the role it plays in perpetuating it and in minimizing it and enabling it for so long, Recently there has even been a move to change the terminology of addiction because those words are not acceptable anymore: they attribute responsibility to the addict, their enablers and to societal attitudes in general and that is not politically correct. How can we resolve a problem that we don't want to accept responsibility for let a!one our role in its generation through ignorance or apathy or both? Addiction and drug abuse problems have existed since long before medical records were kept. Humans realized early on that ingestion of certain substances brought about immediate resolution of all the pains and problems of the world. No, more than that. Instant gratification, instant ecstasy. Some decided that they would not settle for anything less, regardless of the cost. After all, surely a few years of ecstasy tops a long life of hard work, suffering, responsibility for oneself and others and the gradual loss of all the strength and independence one works so hard to maintain. Life is not easy and growing old is a long and painful experience for most. Unfortunately the dawn of the permissive age resulted in the decline of that ability good parents have tried to give to their children to accept responsibility and self discipline. Actions have consequences. and we have replaced that irrefutable truth with the concept of instant gratification trumping all. That was easiest avenue for the parents to take, particularly in the sixties and seventies, but there was also the misconception that it was good for their children too. It wasn't.
Nevertheless, it was the idyllic objective of most physicians to prevent or cure disease and when that end is not possible to relieve pain and suffering to make life as tolerable as possible.  At least, it was in those days. Medical students spent their youth in gaining understanding of and insight into illness, physical and mental and most of us did succeed in doing just that.
At least, that is the way it used to be until the politicians and their administridiots took over!
And make no mistake about it, they have taken over.  
So what has this to do with the current addiction catastrophe? We have to go back a number of years to grasp how we got here.
When I was a young man studying medicine in the 1950s the prescription of narcotics was not lightly undertaken. Physicians were very much aware of the risks entailed and most of them prescribed carefully and judiciously. Sometimes perhaps a little too stringently but always with the intention of providing as effective relief was possible. Physician prescribing patterns were monitored by a variety of methods of varying efficiency. At some point the Heath care administridiots aided by many of the professional associations decided that they knew better. Physicians were not treating many patients aggressively enough and were instructed to be more 'generous' in their prescribing of narcotics, failure to do so was negligence. Most patients who are being treated with narcotics for pain want to get off them as quickly as possible. Precisely those patients who were at greatest risk of becoming addicted, many of whom could be adequately treated without narcotics, were demanding narcotics and cautious physicians were often admonished for withholding them, by groups who had no special skills or knowledge in this area of patient care. Patients referred to pain specialists for help in treating their addiction often returned to their family doctor on more potent medication, than they were originally on. Dosages patterns grew larger and in my senior years of practice I frequently saw narcotics prescriptions for doses that would have resulted in loss of license in my younger years. The growing permissiveness of society towards street drugs in general and opioids played no small part in the increasing flood of drugs pouring into our country. Then we act surprised at the death and destruction that ensues. And how do our politicians and administridiots react. By legalizing marijuana! Some recommend much more than just pot..

No wonder they want to blame J&J, and Big Pharma, and anyone but themselves.
Look around, "Turn on, tune in and drop out," didn't work out too well. Timothy Leary did a lot of damage!

Monday, 19 August 2019

Sad Story

                                                             Sad Story
                             
            When I heard that Don had been admitted to hospital again I dropped in to see him the next morning.   He was lying in bed and  I could see he was quite agitated. 
            "How are you?" I asked feeling rather inane.  It was obvious he was not good.
            "Not so good, I'm glad you dropped in." he said. "I wanted to talk to you".
            "About what?" I asked.
            "Well, remember the last time I was in hospital and you came to see me?"
            I nodded, "Yes".
            "I told you that there were three major problems that were troubling me.”  
   I nodded again.  Somehow I had become his reluctant confidente.
            "I told you about two of them, One was the upsetting circumstances around my father's death, and the other related to a medical malpractice case, still ongoing in Australia."
            "Yes, I recall," I said, although he had never shared any of the details of the malpractice case with me.  He wanted to leave that in Australia, but it seemed to be following him.
            "The third issue I've never told you or anyone else about," he said gravely. "It's causing me great grief."
            He said he'd never told this to anyone else before.  I wondered why he had decided to tell me.  We always got on well enough together, but we'd never been particularly close friends.  A fellow department head, he'd been recruited a year earlier as the head of the department of Neurosurgery.   His credentials were exemplary and his references were sublime and that's how Australia got rid of him and Canada got him.  Everything  appeared to be going well for a while, until Don started becoming increasingly depressed.  We had socialized a few times and I suppose I was the only family doctor he knew, so I was consulted.  It quickly became apparent that he needed psychiatric consultation.  I arranged it and it he was admitted to hospital by the psychiatrist.  He responded well to treatment and now, less an a year later he was in hospital again.
            "I'm listening," I said, not being able to come up with a more appropriate rejoinder.
            "I was about 28 at the time this took place and I'd had a really bad couple of bouts of depression, that had required hospitalization.  I had decided I would never get married and that I certainly didn't ever want any children to follow in my footsteps.  It took a lot of talking and psychiatric consultation and recommendation to manage to convince one of the urologists that I should have a vasectomy. Eventually  the vasectomy was carried out and I went on with the business of living."
            He looked at me as though expecting some sort of comment.  I said nothing.
            He continued, "Soon after that I met Maggie and fell head over heels in love with her.  We had a whirlwind romance and I asked her to marry me.  I told her I'd had some problems with depression, which, in retrospect, I probably minimized.  She accepted my proposal and we began making our plans.   I really meant to tell her that I'd  had a vasectomy, but I didn't.  I thought I'd get it reversed because I knew that techniques for reversal now had an impressive success rate."
            He stopped, took a drink of water from the bedside table and then continued.
            "I talked about a reversal of the procedure to a urological colleague about six months after the marriage, he agreed and we set a date for the surgery.  I made up my mind to tell Maggie that very weekend and to talk about starting a family.  I made a reservation so we could celebrate at a fancy restaurant that I knew she'd like."
            His eyes glazed over as he thought about the way things had unfolded. He had come home ready to keep his secret until the weekend.  He said it was a Tuesday night and he came into the house as the sun was setting. 
            "Hi darling," Maggie called.
 Was there something different in her voice tonight, he wondered?  Had the urologist called to talk to him and let the secret slip.  Couldn't be.
            "Hello," he said Putting his arms around her as she stood at the sink.
            “Darling,” she said, “I have some wonderful news for you.” 
            He had no idea what she was about to tell him.  He waited anxiously.
            “Oh what? He asked, with a cheerfulness he did not feel.
            “Darling, I went to see Dr. Woolfe today and guess what.  I'm pregnant!”
            The room rotated vertiginously and he thought for a moment he was going to faint. 
            He stopped his narrative and came back to the present.  He looked at me for a moment as if he couldn't remember who I was and tears welled up in his eyes.
            Then he went on.  “I couldn't say anything to her for a few moments, then I told her I was delighted.  We went to dinner that Saturday night and Maggie had a wonderful evening.”
            I inadvertently looked at my watch.  I had a clinical conference due to start five minutes ago.
            He caught me.  “Just give me another minute,” he said, “There’s worse to come.  The pregnancy progressed normally and we had a normal little boy.  I knew it couldn't be mine but I grew to love him anyway.  Then, just before he turned two, she got pregnant again I didn't say anything then either.  Of course I hadn't had my vasectomy reversed and so here I am with two children who weren’t mine and a wife who doesn't much care about me."
   Their kids, by the way were delightful, no matter whose gene pool they originated from. 
            The story certainly surprised me and I didn't know what to say.  I muttered that if there was anything I could do, to let me know and I've got to go now.
            A couple of weeks later Don seemed to have responded well to his treatment and seemed to be functioning normally again.  I wondered if he was going to be able to function normally as the head of the department.  When I talked to my friends who worked in his department, they said the department members seemed to have serious doubts as to whether he ever was or ever would be fit to head a department.
            Some days later, I was sitting in my office going through the mountain of useless mail that department heads waste a great deal of time reading carefully in case of missing something of vital importance that some misinformed  administridiot wanted to slip through. I was not disturbed by a knock on my office door.
            “Come in,” I said relieved to be interrupted. 
            The door opened and Hugh Dalton, the previous head of the department and current interim acting Head peered it.
            “Listen. old man,”  he had an Oxford drawl.  "I hope it’s not inconvenient but can I have a few moments of your time?”
            He surreptitiously pulled his still smoking pipe out of his pocket stuck it in  his mouth and sucked deeply.  This was just at the beginning of the days when the witch hunt against smokers was gathering momentum.
            “Certainly, sit down,” I said. “Can I get you a cup of coffee?”
            “No,” he said. "about Don; I know you're a friend of his.”
            “Somewhere between a friend and an acquaintance,” I said, self-protectively. “but we have had some social and professional interaction and he does confide in me on occasion.”
            Hugh looked serious. “As you probably know, the department members are not wildly enthusiastic about him as a department head.  I think they're prepared to give him a chance to show his colors but they are certainly not unanimous in their support for him.  They think he is not quite all there.   Recently there have been some funny goings on and as a previous department head they asked me to look into the situation,” 
            “What sort of goings on, Hugh?” I asked.
            “Well there was a Hospital Board Meeting on April 1, to discuss the future of the neurosurgery department.   Right after the meeting at which Don was reported to be more than a little upset, he had an operation to perform.  When Don finished up operating, he excused himself for a few moments, apparently for a bathroom break and then came back and remarked with a grin on his face, in a very deprecating manner that April Fools day was a very appropriate day for the Board to be meeting.  Just as he was saying this an acute emergency call came over the intercom directing the 99 Team to an emergency in the boardroom.  Of course all the emergency measures were put into action and when the emergency team burst into the boardroom with the crash cart and all the paraphernalia, the astonished Board members assured them that no one was ill or had collapsed or was in danger.  After the confusion subsided it was recognized that this was someone's sick idea of a joke”.
             He paused and a grave look crossed his face. 
            “The problem is, dear boy,” he continued, “that one of the operating room nurses who was passing by the phone outside the operating room heard Don making a call and overheard the words “emergency in the board room”.
            He stopped and looked as though he expected me to say something.
            “What you going to do about it? I asked him.
            “Look Old Man,” he said pulling his pipe out of his pocket again, “do you mind if I smoke?.”  Hugh made sure the door was closed properly.
            “No I don't mind.” I said. I still enjoyed the aromatic smell of pipe tobacco although I had given up my pipe years earlier.
            He tamped down the partially smoked tobacco in his pipe, pulled out his matches and puffed pleasurably at his pipe, all the time in deep thought.  For a moment he seemed to vanish in a cloud of bluish smoke and then he continued. 
            “To tell you the truth, the members of the department really want to get rid of this fellow.  To make things worse, he recently wrote his Canadian Fellowship and failed.  Since his license is only provisional, the question arises as to whether it will be renewed at the end of the year.  I really don't know what the outcome of this will be.”
            I had promised Don I would tell no one of his personal problems and didn't know how much of his history if any, Hugh was aware of.
            “Perhaps,” I said,” the solution would be to have him step down as department head and to function as a surgeon within the department.  I think all this administrative responsibility may be just too much for him.”
            “That's another problem,” Hugh said, “his surgical skills are also in question, at least by some members of the department.  We also recently found out that there is some medico- legal matter in Australia that is still unresolved.
            Of course I knew about that too but said nothing and was thinking about how to reply when there was a knock at the door.
            The nurse opened the office door, looked shocked at the cloud of smoke within, and had the obligatory coughing spell that non-smokers feel compelled to display in the presence of a smoker before speaking.
            “Dr. Smith,” she said, “you have patients waiting.” 
             I said, “I’ll be right there.”
            Hugh stood up to leave stuffing his still fuming pipe back into his pocket.
             “I better let you carry on with your work,” he said and a thin line of smoke followed him out of the room.
            “Yes,” I said "Keep me informed and went back to work.
           
                                            
                                                          Chapter 2

            When I next ran into Don, he exuded an air of boyish insouciance.
            “How are things?” I asked him
            “Just fine,” he said cheerfully. “I’ve just been to see my lawyer.  Did you know that they're trying to get rid of me as department head?”
             Indeed I did but I feigned ignorance.
            “I hope things work out all right,” I replied and we both continued on our own ways.
            My encounter with Don continued to play on my mind throughout the day and when I got home that night I told Anne about it.
            Why don’t we invite them over for dinner?” Anne said.  It will give us an opportunity to see if there is anything we can do to help.”
            “I think that's a great idea, I said.  “Now, what’s for our supper tonight?   Whatever it is, it sure smells good.”
            Two weeks later Don and Maggie and their two children Kenny and Elizabeth, neither of whom looked like either their father or their mother arrived for dinner. They looked like a typical happy family.  Kenny a mischievous little five year old and Elizabeth a couple of years older with a mature, reserved manner, smiled as they walked in into the warmth of  the hallway from the cold outside. 
            Don handed me a bottle of wine and Maggie looked for somewhere to put down the cake she had brought for desert.
            Greetings were exchanged all around.
            “Have a drink before dinner,” I said.
             Having filled our glasses and provided the children with soft drinks, we chatted for a while.  I don't know if it was just my imagination, but throughout the evening I couldn’t help noticing Don's lack of warmth for the kids.  It was as though they were someone else's mildly irritating kids. Which is perhaps what they were.  While most of the evening he seemed sociable and communicative every now and then he seemed withdrawn and brooding.
             “Coming from the sort of climate we left in Australia we really find the winters here are hard to take,” Maggie said, as we sat chatting over coffee.  “I think we should be looking for something in Vancouver.  My brother lives there,” she added.
            No word about Don's plight and the fact that he might soon not be able to get a license in Saskatchewan let alone Vancouver.  Frequently, Canadian graduates couldn't get a billing number that would allow them to practice in Vancouver. Don said nothing.
            “My brother would love us to move there,” she added. 
            Again Don said nothing.
            “But first,” Maggie said, “I think we will go back to Australia for a while.  Don has some business to complete there.” 
            I had heard that the business he had to complete there was related to maintaining his license to practice medicine following communications between the licensing authorities here and in Australia.
            “Oh, you really must be looking forward to a reunion with your family and friends,” Anne said enthusiastically.
            “Yes we are.” Maggie answered.
             It didn't take much to know that things were going badly.  I drew Don aside.  I wasn't quite sure how to do this.
             "Look," I said.  "If there is anything I can do to help, let me know."
             He looked me straight in the eye.  "Oh no, everything is under control.  I am sure that once I get back to Australia and straighten out things with the licensing authority everything will be fine and we will move to Vancouver.  We really need to move away from the harsh Saskatchewan climate!"  
That was that! 
             We rejoined the others and continued chatting for a little while and then  Don and Maggie and the two kids bid their fond farewells and left.   We saw them briefly once more after that, without much more than brief salutations..

                                                    Chapter Three.

            Three or four months later that I received a call from Randy Stern, a young Australian orthopedic surgeon who came to Saskatoon a little time after Don.  They had been friends since their University days.  He dropped a bombshell; Don had returned to Australia and shortly thereafter had committed suicide . This is the story he told me. 
            Randy saw Don and his family just before they left because Don wanted someone to talk things over with.  He had gone to a meeting of the Provincial Licensing body with his lawyer and came home worried and depressed.   They had refused to renew his medical license.
            “It looks as though there is nothing I can do,” he said.  “They won't renew my license and worse still they sent a transcript of the whole hearing to the licensing authority back home in Australia - and now they are going to hold their own hearing to see whether they're also going to revoke my license.”
            “Oh Don,” Maggie had said, “surely they wouldn't do that.”
            “I'm going to have to go back to Australia to defend myself before the licensing committee.  Ever since I lost the medical malpractice case they are out to get me.  Now after that I really won't have a chance.  I don't help much left to live for.”
            Maggie went to put her arms around him but he shrugged her off.
            “Darling, you have everything to live for,” she said, “We’ll get this sorted out and you have me and two lovely children to stand by your side whatever happens”
            He raised his voice angrily. “Those children are not really mine who are you trying to fool?”.
“What?” she said, taken aback, “you really are crazy.  How can you say something like that?”
“I had a vasectomy when I was 28, before we were married.  I was afraid to tell you in case you’d have called the whole thing off.  I had arranged to try to have it reversed and came home one night to tell you about it.  It was that very same night that you told me you were pregnant.”
She looked at him in amazement.  “You bloody fool,” she screamed.  “You're accusing me of having our two children by someone else.  All these years you’ve lived with us harboring a grudge and never had the guts to say a thing about it.  I’m not putting up with this for another minute.   Tomorrow I’ll phone my brother in Vancouver and the children and I will go and spend some time with him. In the meantime you can go home and get yourself out of this mess  You better see a psychiatrist first.  You are stark raving mad!.” 
“You bitch,” Don yelled furiously, "you know those two children  are not mine!”
“Listen to me, you lousy bastard, “ Maggie screamed back,” we’re going to resolve this once and for all by DNA testing.  Meanwhile you go back there and you get yourself out of this mess.  I’ll need some time to think if I ever want to see you again.”
            The next day, she and the children left for Vancouver, but not before she had dragged the sullen Don for a DNA test.

Don went back to Australia.  He pleaded his case to the Medical Board and lost his license to practice medicine.  Soon after he overdosed with his antidepressants and was dead on arrival at hospital.      Maggie had got the DNA results shortly before she heard of his death..  It proved beyond any reasonable doubt that both the children were Don's.