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.

Tuesday 6 August 2019

The Dopey Dope Peddlers under the TrueDope !

   The first Drug Pushers in history to lose money is the Canadian Government.  Despite all their marijuana malfeasance and their legal manipulation, the illegal pushers can still market the pot significantly cheaper than the Government can: of course the government is simply bleeding the taxpayers dollars and not their own.  Buying votes is the governmental priority and they certainly saw this as a cheap way to buy the youth vote.   They also saw it as a vast source of income because everyone knows that selling drugs is the way to make a fortune (under honest crooks, in contradistinction to the dishonest ones in government).   But when Ronald Reagan said, "The nine most frightening words in the English  language is 'I'm from the Government and  I'm here to help' he was right on the ball.  No one but the government could lose money pushing drugs, but that is nowhere near the worst of the damages they have perpetrated.   The medical consequences of long term use of pot are by no means fully known.  The legalization of marijuana was passed by a government that had not adequately investigated either the health consequences or the business mechanisms necessary to produce the end product as a source of income rather than a liability.  Our Prime Minister has probably had more experience of weed in his early years than most and HE thinks he's okay!  By all accounts his mother was no amateur either!
  After all it is only the taxpayers money that is at stake.Instead of replacing the black market marijuana that manages to produce and sells at about half the price of the legal product the Dope was not smart enough to realize that a government requires at least a rudimentary knowledge of the danger of a product that they are unleashing on the public and the necessity to produce the evidence that it is relativity safe to the user and not a hazard to the public at large.  This government does not.    The tragedy is that the Dope's move to hurriedly implement the program is going to encourage the illicit market to grow bolder, has no real safeguards against driving and other hazardous activities while high on weed, or worse still on a combination of weed and booze.          The great pride that Canada Health has voiced in reducing tobacco smoking is likely to be overwhelmed by the increase in weed smoking which is just as damaging to the lungs as cigarette smoking.  Smoke from pot contains the same toxins and carcinogens as tobacco and tends to be inhaled more deeply and held in the lungs for longer.
   Other long-term effects of marijuana include such non benign effects as temporary hallucinations, paranoia and worsening of symptoms in patients with schizophrenia.  Some studies have demonstrated that weed use is associated with reduced volume in certain areas of the brain that are involved with memory, learning and self control.  
   A large New Zealand study found that long term use starting in adolescence results in a loss of six to eight IQ points.
   The endocannaboid system is known to play an important role in the proper formation of synapses during early brain development.
   Memory impairment from marijuana use occurs because THC alters how the hippocampus, a brain area that is responsible for memory formation, processes information.   As people age they lose neurons in the hippocampus which decreases their ability to learn new information.  THC accelerates this loss in rats significantly. 
   There is considerable evidence that pot is a gateway drug and serves to introduce its users to other more potent drugs.  There is also evidence of a link between pot and psychiatric disorders.
   These are a few of the long term problems created by the premature legalization of marijuana.  With the passage of time we are like to find significantly more.
   Next time we'll take a look at the havoc and damage the short term effects can have.