I Just Don't Know...Wait, Maybe I Do Know

So everyone has been asking me why I haven’t written about all this universal health care stuff. It’s that I just don’t know what they are talking about. Not one news outlet or congressperson has been able to succinctly say what the heck the health care bill offers. So what is everyone yelling and screaming about? That I do know! Everyone is yelling and screaming out of the fear of the unknown. Mass hysteria about a vague idea referred to as some type of federal health care. And there are some more things I know. I work in the trenches, I’m in the emergency room, taking care of the haves and have nots. There is absolutely no difference in care for the haves and have nots. Everyone waits, everyone is treated with respect, everyone’s complaints are answered, and everyone gets a bill, whether they have insurance or not, they all owe something. But for some reason, people don’t think they should have to pay for health care. I don’t get that. We agree to pay for groceries, houses, cars, clothes, plumbers, lawyers, electricians…why don’t people think they should have to pay their doctor bill? Another thing I know, I have excellent health and dental insurance, and every year I get a lovely raise, but that raise is erased by my rising premiums. It’s like I didn’t get a raise at all because my premium goes up a ridiculous amount every year. Oh, and despite my excellent coverage, I now have a $2000 dental bill because the dental work I needed wasn’t covered. Yes there are three zeros after that two. My excellent insurance coverage paid $97 of that $2000. I know you all have similar stories. And I know you are all saying WTF with me. But is the answer that the government should take it all over? I don’t think so. Everything President Obama is taking over feels like a punishment from a father. He is being an overbearing father, not letting us figure out our own way. Father Obama is too controlling. And parents who do everything for their children regret their children’s overwhelming dependency on them. Maybe all these worries about socialism really should be worries about an emerging patriarchy. A patriarch enforces his power and control by intimidation and discrediting efforts to organize and resist. Hmm… we see that happening now don’t we? We see it happening as the democrats and Obama try to discredit the protests at Town Hall meetings. Democratic Senator Tom Harkin, who was interrupted several times at a recent meeting by critics in the audience said, “There is a nationally coordinated effort” to disrupt the meetings. And remember in 2008, when Obama said, “If they bring a knife to the fight, we bring a gun.” Classic patriarchal scare tactics! Capitalism will work it out if given the chance. There would be competition for our health care dollars. We could shop around for the best coverage, or tailor our coverage to what we want and need. Why can’t the insurance companies restructure and offer a bunch of different plans. Oh I know why…because Father Obama says, “don’t worry people, we will take care of it all, just relax, let Papa take care of you.” Well I don’t want him to take care of me. I want the choice to dump my wretched insurance coverage and buy a different plan. I want the choice to have insurance or not. And if I choose not to have insurance, then I accept the risk of a life-altering bill that may financially devastate me. But at least it was my own dumb choice! Here’s the catch…there must be plans that anyone can afford. Plans based on a sliding scale related to people’s income. That is the only small piece that needs regulation. To ensure that the 12 dollar an hour worker has the same choices that the 100 dollar an hour worker has. Capitalism works. Freedom of choice is America. Competition breeds excellence. So go to those town hall meetings...don't be scared...organize and resist...say NO to Daddy.

Nurse Practitioners to the Rescue

Given our current focus on health care reform, now is the perfect time to reintroduce you to Nurse Practitioners. We've been hearing the panic out there right? The panic that there won't be enough doctors to take care of us! CNN reported today that the Family doctor is "an endangered breed." CNN said that in the past 10 years most medical school graduates picked higher-paid specialities like orthopedics or dermatology, and only 10% chose primary care. CNN barely mentioned that Nurse Practitioners provide primary care. All CNN said at the end of the article was..."should nurse practitioners fill in the gaps?" What it's really about is educating the public about Nurse Practitioners and what we do. OK, there's more to it than that. Nurse Practitioners are forever butting heads with the AMA (American Medical Association). The AMA and MD lobbyists are constantly trying to manipulate policy makers into believing that MDs should somehow supervise Nurse Practitioners. The AMA is afraid that NPs will "take over." So here's what a Nurse Practitioner is: a registered nurse with a master's degree and licensed to diagnose and manage illness and disease and to prescribe medications. We can care for you and we can cure you. The regulations differ from state to state. But I practice in Connecticut and I have a license, I am board certified, and I can prescribe medications. Unfortunately, I am forced to "collaborate" with an MD. In other words, the AMA and MD lobbyists have used their powers to convince government and policy makers that Nurse Practitioners "need supervision." We do not need MD supervision. And some of it is outright extortion! In order to practice in Connecticut, we have to have an agreement with an MD, and in most cases, that MD charges us a ridiculous fee just to list them as our "collaborator" on the agreement. Some Nurse Practitioners have to pay MDs hundreds of dollars a month just to use their name on the state-required agreement! As a Nurse Practitioner, I give you a full physical exam, I do a complete history and review of your body systems, I listen to your concerns, I order lab tests, xrays, ultrasounds, whatever tests you need, I prescribe medications for you, and here is the important part...if I find something wrong with you that is more than I can help you with, I am trained to identify it and refer you to the correct specialist. In other words, we are trained to realize what is "out of our scope of practice." I don't need to ask a doctor what I should do for you. I know what to do for you. And if I don't know what to do for you, I make sure I get you to the right specialist who does know what to do for you. So go visit a Nurse Practitioner for you care! And to all the NPs out there, let's keep the fight alive in the government, let's keep fighting for our independence...we work side-by-side with doctors, not beneath them!

Ode to the Wooly Mammoth

People are stressed out about everything these days. I’ve had numerous requests to help people with their stress levels. Money, jobs, health care, and of course…your carbon footprint! The social pressures to “be green” are just plain dumb. Yes I said it…dumb. If I have to hear anymore from Al Gore about the demise of earth, and the notion that it’s my entire fault…well, I’m going to puke. Stop stressing us out Mr. Gore! I don’t know my carbon footprint, I drink bottled water, and I drive a gas guzzler…so there! That makes me an outcast! I feel the disapproving stares of my neighbors as I drive away in my 5.7liter hemi. I might as well wear a fur coat to a PETA rally! So what’s a girl to do? I know…remember the Wooly Mammoth. Think back to elementary school when you learned about the ice age and those fabulous creatures known as the Wooly Mammoths. They even have a cool name! Hmmm…the ice age, remember that? There is tons of research over decades that can explain why the ice age ended. Was it global warming? I’ll summarize the well-studied and replicated data for you; scientists were able to determine the end of the ice age some 19,000 years ago, and said that the melting began in the higher latitudes and worked its way down to the tropics. Yes, elevated carbon dioxide levels were involved…just like the global warming theory of present day. But here’s the more important fact…the principal driver of climate change is the sun. True! Gee…it even kind of makes sense. We learned about the sun and its powers in elementary school too. So the scientists said that the end of the ice age happened because there were temperature increases brought about by the orbit of the earth around the sun, which then warmed up the deep ocean, and that in turn released carbon dioxide into the atmosphere, and the carbon dioxide simply enhanced the temperature increase that the sun had already initiated. Really simple right? Is anyone getting it yet? Could it be that the climate change, if it is happening now, is related to the earth’s orbit and the sun and not my 5.7liter hemi? Back to the Wooly Mammoth…it is extinct because of two things, climate change and a change in human hunting patterns. And today there are many animals that are also on the brink of extinction…due to climate change and human patterns. My point, it is inevitable that species will become extinct and it is inevitable that the climate will change. But it’s evolution; it’s not a man-made-guilt-ridden-hysterical-state-of-fear-alarmist-buy-a-hybrid-stop-drinking-bottled-water-know-your-carbon-footprint-or-the-world-is-going-to-end-phenomenon! Hear this, the global warming theory is just that…a theory. And a theory is simply an abstract thought, speculation, a hypothesis, an unproved assumption. There are currently over 18000 scientists who signed The Oregon Petition. It is a petition stating that there is no evidence that global warming is a man-made occurrence. And to President Obama, please don’t make America a part of the Kyoto Agreement. The Kyoto protocol was signed by 141 nations and it entails the “stabilization of greenhouse gases.” The financial burden of instituting the changes would be devastating to the United States. Remember…the sun and the orbit is tried and true science. Don’t buy into the global warming thing. Don’t start making major life changes because of Al Gore and his social pressures. Sit back and really analyze it, take a good look at your elementary school science book about the ice age and about the sun and the earth’s orbit. And I’m going to drive my gas guzzling 5.7liter hemi into the sunset.

And the rain turned red

We have been waking to daily rain on the east coast of America for what seems like the entire spring season. It’s been beyond obnoxious and inconvenient! Talking about rain, looking at it rain, driving in the rain, walking the dog in the rain…it has taken over my mind and spread negative energy throughout daily life. And as usual, I decide to analyze all this rain and what it means to us. And there it is, right in front of my face…its raining over the social networking web sites too. Streams and gobs of video and raw, bone-chilling red rain…pouring from the bodies of our fellow men and women in Iran. There is chaos in the streets because the people believe there has been ballot fraud. Mahmoud Ahmadinejad was declared the winner of the elections. But the people don’t believe it was a fair election. Khomenei declared Ahmadinejad a “divine assessment,” and his election is “divinely sanctioned.” The Iranian people say NO to this declaration. And they are saying no by opening the skies and calling on the red rain to speak for them. Moussavi leads the way telling the people they have a duty to keep the hope alive, and he is “ready for martyrdom” and “continue the protest.” This needs to be heard by the world. I hear it, and I remember American history and how our forefathers fought for our freedom. Dorothy Thompson said, “When liberty is taken away by force, it can be restored by force.” And Clarence Darrow said, “You can only protect your liberties in this world by protecting the other man’s freedom. You can only be free if I am free.” And so I embrace the rain. I respect and support what the rain represents. And although the rain falling in America is crystal clear now, it once was red. It once was as bright red as the rain falling in Iran now. We must support the fight of our fellow freedom-seekers. Twitter was beyond crowded by the video of Neda, a young Iranian woman who died a bloody death in the street. She was a young woman who showed all of us the power of the red rain. As video streamed across twitter, we all watched as the blood came from her head and body, watched people trying to save her body, but what they were trying to save was their freedom. And her blood is our freedom. And it covered the streets, just like the rain. And now I walk in the rain without an umbrella. Because I am free. I hope that the Iranian people will soon walk in the rain without an umbrella. Ferdowsi said, “And the blood of brave men and women was shed like unto the shedding of rain from a black cloud.” The world is watching it rain. Henry Wadsworth Longfellow said, “The best thing one can do when its raining is to let it rain.”

We Should Suffer

In my profession I attempt to ease personal suffering. It is a daunting and often unsuccessful endeavor. I accept the burden of empathy and willingly dole it out on a daily basis. And so I often suffer with you as you tell me about your physical and mental pain. To help you and myself, we should take a look at the concept of suffering. There are many philosophical and religious approaches to the mystical experience of suffering. Some religions explain suffering as a test, a test of piety and if you maintain faith, you will eventually be rewarded. Scientists say that suffering is an evolutionary mechanism. We’ve all heard of “survival of the fittest” right? In other words, if you can avoid or overcome physical and mental suffering, you will survive. Then there’s the Buddhist philosophy that says suffering can be surpassed if we recognize the source (our attachments and desires) and then meditate to achieve a desire-less state. How hard is that?! In our society most of us are always trying to avoid suffering. Think about the debate over stem cell research and abortion. Both topics evoke extreme reaction; a reaction to the perception of human suffering is what it’s really about. Thomas Merton, a religious monk said this, “The more you try to avoid suffering, the more you suffer because smaller and more insignificant things begin to torture you in proportion to your fear of being hurt.” I can relate to that…it can be a vicious cycle that leads to paralysis! So what do we do with our suffering? I’m thinking we absolutely can’t live without embracing our suffering because it always seems “worth it” to have suffered. Think of all the beautiful music and artwork that has been the result of suffering. Suffering a broken heart, suffering the death of a child, suffering severe illness, suffering poverty, suffering from hunger…all this suffering has led to people helping each other, and to significant advances in making things better for future people. Martin Luther King Jr. said it best, “Human progress is neither automatic or inevitable…every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.” And that’s why I willingly journey with you through your suffering. Because together we can explore what goodness will come from it, and accept it, embrace it, and use it in a positive manner. If we can’t suffer, we will never experience the overwhelming tears of joy when there is triumph. I just can’t live without sappy love songs or movies about personal triumphs over extreme misery…can you?

She Said What?

I can’t resist but to throw out some quotes and thoughts about this whole Sonia Sotomayor controversy. You know the issue, way back when, she said, “I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion that a white male who hasn’t lived that life.” Wow, if she said that to me at a cocktail party, I’d think she’s totally conceited, grandiose, pretentious, narcissistic! And if I had at least two glasses of Pinot, I would throw my gauntlet down and engage in a civilized debate about just what she meant by that. Of course we know she must remain silent during this courting phase of the nomination. The opposition to her nomination isn’t necessarily attacking her, but rather asking for clarification. The White House dude Gibbs didn’t help when he tried defending her by saying she was “simply saying she has a different background that could lead to different conclusions.” Because guess what, a “different” conclusion may not be the best, most ethical, most unbiased conclusion. So here’s the spot where I have to stick in a quote from a famous white guy…Benjamin Franklin said, “A slip of the foot you may soon recover, but a slip of the tongue you may never get over.” The point here is, what she said was not a racist remark; it was a remark about herself, about her excessive appreciation of her own self-worth, about her lack of empathy…a revelation of her character. On face value, her comment speaks to her belief that she is unique, better, above others. On face value, her comment speaks to her narrow view that others may not have lived the kind of life she has, and that her life experience was “better.” I keep using the word “better” because that is what she said. Another great quote from a white guy…Ralph Waldo Emerson said, “People seem not to see that their opinion of the world is also a confession of their character.” We all say stupid things, even people who graduated second in their class at Princeton! Everyone keeps talking about her intellect and college resume, but all the intelligence in the world doesn’t make up for innate character flaws. Let’s wait and hear what she says about it. Another white man quote…Albert Einstein said, “Only two things are infinite, the universe and human stupidity.”

I Think I'm Gonna Be Sad

I think I’m gonna be sad…Karen Carpenter sang that line in her song Ticket to Ride. I love that line because it reminds me I have choices. I can choose how I will react to a situation. I’ve recently returned from a stellar conference on depression. There were reviews of the latest medications and treatments, but the one thing that stuck with me the most was the discussion about patient self-ratings of their mood. I started wondering, what if on that particular day they chose to be a bit sadder than the day before, and how does that sway the rating? And how does that rating effect the treatment? The most difficult part of treating people with depression is figuring out its origin. Depression is a symptom. Just like chest pain is a symptom. Are you depressed because your brain neurotransmitters aren’t working right? Are you having chest pain because you are having a heart attack? Are you depressed because your spouse died? Are you having chest pain because you are about to have a job interview and you’re nervous? So maybe there are times we can’t choose. You can’t choose not to have a neurotransmitter malfunction and you can’t choose not to have a heart attack. So what’s Karen Carpenter singing about? She’s singing about perception. Who knew she was an undercover philosopher posing as a fabulous singer! Most of my depressed patients need medication, and it is often a long road to finding the right one. But I’m walking the road with you, and we are simultaneously working on the philosophy of perception. What does perception have to do with depression? Perception is the effect or product of perceiving…and perceiving is to become aware, to attain awareness. The Dalai Lama said, “Pain is inevitable, suffering is optional.” Karen Carpenter was right! She chose to be sad that day…that day she sang about her man leaving. The lesson here is simple…don’t miss your therapy appointments! The medication alone will not make you feel your best. You must work on your perceptions and reactions to outside events. You can choose to suffer, or you can choose to learn, grow and move on. Shakespeare said it best, “There is nothing either good or bad, but thinking makes it so.”

Secrets and Karma

May 3, 2009

I’m not sure I wanted to know about waterboarding. Who’s with me on this? Did we need or want to know about the action known as waterboarding. The American Civil Liberties Union thinks we should know and see waterboarding. They filed a lawsuit in an effort to expose pictures and interrogation notebooks. What I know right now is that I’ve felt safe since 9/11. I’ve felt that my government did what they needed to at that particular moment in time to keep us safe. Even President Obama acknowledges that the information gained from Abu Zubaydah after he was waterboarded most likely disrupted major al-Qaida attacks and saved us all. But then Obama said, “waterboarding violates our ideals and our values.” There is even some sort of official secrets act from the Senate Intelligence committee that made it a crime to disclose any type of classified information. I’m so confused! Was it the right thing to do or not? Like it or not, President Obama has guided us into the world of “transparency.” So now we have to grapple with waterboarding. Truthfully, I liked it better when it was a secret. Solomon Ibn Gabirol said, “Your secret is your prisoner; once you reveal it, you become its slave.” Is waterboarding worse than the death penalty? Is it worse than shooting three pirates in the head? The names of the men who developed and implemented waterboarding were released to the public, mug shots and all. So do we get to see the people who shot the pirates in the head? How about mug shots of all the people who gave a lethal injection? We can all remember times in our lives when we heard a secret and it was detrimental, even painful. And after learning the secret, were you better off than before? Most likely…just scorned. To me, revealing the waterboarding secret is not about justice. Justice is a man-made concept based on reward and punishment. It’s really about karma. Karma is the natural law of cause and effect. It is a response in the moment, a response based on how you feel at that moment. So waterboarding seemed like the right thing at that moment? Maybe. So it seemed like the right thing to do when President Obama gave the order to shoot three pirates in the head, right? Three people died to save one. Is that ok? Just as it seems like the right thing to do when we kill a death row inmate? There’s two points to all this. Think long and hard about the effects of transparency before you tell a secret, and, remember the natural laws of cause and effect. Listen to how you feel in the moment, and ask yourself if it feels like the right thing to do.

Doubting and Faith

April 26, 2009

My Dad keeps advising me to remind everyone, including myself, to turn off the TV, turn off the social networks, and turn off everything that feeds us information. To take a break from all that. I always ask, “why?” Why would I want to be cut off from knowing, hearing, from “being in the loop of life.” I’ve GOT to know what’s going on! So many things to consider, what’s happening with our new president, what’s going on with this swine flu epidemic, and how is it going to impact my life. Who doesn’t want to be up on these things? Well, my Dad has said it for several weeks in a row and so now it’s my duty to analyze it! What is he really trying to tell me? Am I simply over-stimulated? Are we missing more important things? Two people came to mind as I reflected, President Obama and the philosopher Soren Kierkegaard. How could these two possibly have anything in common? Let’s take a look…Kierkegaard spoke of the “leap of faith.” Faith is definitely not a decision based on evidence. It involves making a commitment without the scientific method. Kierkegaard then said if you have faith, you must also have doubt. Doubt is the rational part of your thoughts. It’s the little voice in your head saying “how can that be true, you have no evidence.” Yet people make the leap of faith all the time. So when the majority voted for President Obama, it was a leap of faith. We had no evidence that he would be a great president. And it was some in the media who planted the seeds of doubt and convinced us that our leap of faith may be faulty. The media is a great place to get some doubt in your life! But I feel conflicted, because having doubt is important, and if we didn’t doubt, we wouldn’t have faith. So confusing! President Obama said, “You know, my faith is one that admits some doubt.” So President Obama and Kierkegaard are kind of buddies, right? They both understand our doubt. And we have faith, the confident belief in the trustworthiness of a person, thing, or idea. So now what? Do I keep flooding my senses with information, continue hearing the doubt, or do I turn it all off and have blind faith? Buddha gives us one answer. Buddha said, “There is nothing more dreadful than the habit of doubt.” Make your leap of faith if you feel it inside you, temper it with some doubt, but don’t allow the doubt to ruin your faith. Dad, I’m going to keep on watching the news…and I’m going to thoughtfully address the doubt, but I’m going to have faith that President Obama is a trustworthy man.

Rise Above...Learn it, Live it

April 19, 2009

Ms. Rita Levi Montalcini turns 100 years old. How cool is that! But what’s even better, is how she got there. It’s a little something we all have stirring within us…resilience. You see, Ms. Montalcini is a Nobel prize-winning scientist, and at her 100th birthday party, she sent a shout out to Mussolini. She said she wanted to “thank Mussolini for declaring me an inferior race.” You see, back in the day, when Ms. Montalcini was working at University, steadfastly breaking the boundaries of science with insight and experiments, she was suddenly considered an outcast, along with all the Jewish people at that time. And like many, she took the challenge. She set up a lab in her bedroom and worked. Worked, lived, loved, prospered…despite significant oppression. She is an inspiration to me. She reminds me that we all can rise above and prosper in the face of wretched circumstances. There’s been quite a bit of research about resilience. Resilience is an ability to recover from or adjust to misfortune or change. You know we can’t change the fact that stressful things happen, but we can change or adjust how we react to them. Just like Ms. Montalcini, people are confronted with horrid situations, and they more than survive, they thrive. Research shows that we are not born with resilience, it is not a trait, and that resilience is not extra-ordinary. It’s actually quite ordinary and learned behavior. So here are a few tips on how you can get it. Start with the relationships in your life. Are you surrounding yourself with positive successful people? Are the people in your life encouraging and supporting? Find a role model, a mentor. Do not continue to blame your mother or father! So your parents weren’t the best…remember the research…resilience is not inherited! Find someone who is an inspiration, a success, a person you want to emulate. Next, look in the mirror. Tell yourself you are a confident and successful person. Tell yourself you will be successful, you will work, you will persevere, you will rise. Believe it when you tell yourself these things, and soon it will be. Two more tips; remember in high school, when you were wondering how algebra and all the other nonsensical assignments were going to help you in real life? Here’s the answer…critical thinking and problem solving skills! My 14 year old daughter rolls her eyes when I tell her that! But it’s true. Learning critical thinking skills allows you to analyze and overcome any issue. Practice problem solving. Read about how other people solved life puzzles. Take yourself back to all those word problems and reading comprehension quizzes…it wasn’t just about the math problem or essay content, it was about learning critical thinking skills. One of my new friends reminded me of the fun of conundrums! Conundrums are not just fun drinking-game riddles. They are intricate and difficult problems to solve. And working on them helps you develop critical thinking and problem solving skills. I can’t resist…here is one of my favorites: If you try to fail, but you succeed, which have you done? Go ahead…work on that and post your answers! And now for the last and most difficult tip to achieve resilience: you must manage extreme feelings and impulses, or you will not be able to think! Do not allow that garbage to overtake your wise mind. Now take the four tips and face your next challenge! Learn to be resilient. Follow Ms. Montalcini’s advice: “Above all, don’t fear difficult moments…the best comes from them.” I’m ready…are you?

Worrier or Warrior...chose to be one

April 11,2009

I like quotes, there are so many great quotes and I admit I’m jealous that none of them are mine! But quotes from great thinkers often represent very meaningful positions for us. It often happens that you read a quote and say, “Yes…that is exactly what I think!” So I guess you figured out that I’m about to throw a quote at you…well here it is:

If you believe that feeling bad or worrying long enough will change a past or future event, then you are residing on another planet with a different reality system.
- William James

Mr. James was a pragmatist and a medical doctor. A pragmatist has a practical approach to life; they like evidence and the scientific method, and they are most concerned with the success or failure of their actions. Definitely not cozy with dogma. Many people label President Obama as a pragmatist. I guess I can see why. He doesn’t like to make decisions until he hears all sides and thinks about what his next step should be. I like that….very unemotional…President Obama is a warrior, not a worrier.
So how about you? I often see patients who are stuck in that spin cycle, worried about what they said or did yesterday, worried about what to do tomorrow. I prescribe medicine but with cautious words, because medicine alone is not going to turn the machine off. So with the medicine comes talk. It’s called therapy in America, but to me it’s a philosophical journey with a patient. I walk with you through the original development of your core beliefs. Exploring how it is you became a worrier. And helping you move forward to be a warrior. You are not the unwilling victim of circumstances. Let’s think like President Obama. First, you must thoroughly understand how your mind and your body work together to produce worry. Go to your primary care nurse practitioner, doctor, or PA and get a physical exam and some basic lab work. Sometimes there are medical reasons for your current state of being. Then do some research and spend time meditating…thinking about how it is you believe what you do. Is it what your parents taught you, or your religion, or is it what your best friend believes? Then think about the person you want to be, the things you want to do…your dreams of what you want your mind and body to be. I know this is hard, but keep going, draw your rainbow with the pot of gold, not mere coin, but rather a pot filled with the characteristics of the person you want to be. Use visualizations and affirmations to change your self-image….so you are confident, not fearful. Here are some of my favorites: “I picture myself looking healthy and relaxed.” “I like being in control of my actions, I can choose to do whatever I like.” Then my favorite step…”fake it till you make it!” Act as if you already are what you want to be. Don’t you think President Obama engages in this? Of course he does, he can’t possibly know everything that’s happening in the world, but he sure looks like he does! When issues and events present to you, be pragmatic, be rational and positive, not emotional. So hard to do! It takes practice. And the most important step involves your spiritual self. Ask your unconscious to bring you together with your spiritual self. This is very personal and different for everyone. Maybe it’s a religion, or a creative power, or a God, or a universal consciousness, or enlightenment, or none of that. But you will recognize it when it comes. Finding joy, peace, and calm is a worthwhile struggle. Be a warrior.

Why Are You Here

April 5, 2009

Tomorrow is my 43rd birthday and my Mom called to remind me of my character flaws for the 43rd year in a row (just kidding ma…sort of)! So she spoke about how I need to budget my money better and how I remain afflicted with…poor impulse control. And after the reminders, I felt it was my annual duty to once again analyze myself, where I’ve been, and choices I’ve made. As my mind wandered through all the junk in my memory, I found the category labeled “people.” I opened the imaginary file and saw faces….faces of everyone who has come in and out of my life. Why were they there? Why were these people in my life? And then the dim light that had been fading finally grew brighter. People come to us to help… to help us learn about ourselves. If we don’t pay attention to this, we miss golden opportunities to grow. My officemate is this wonderful colleague who gives me reason. She is the one who reminded me people come to us for purpose. She and I worked together many years ago, moved on, and have recently reunited in a different capacity. I have a thankful tear in my eye. And I owe a big thank you to my officemate (who wouldn’t want me to write her name!) because she is my voice of reason. She has saved my ass over and over at work, preventing me from displaying my poor impulse control. When my affect takes over, and I start decompensating into a “well I’ll tell them what I think” mentality, she stops me, and reminds me of the consequences of that attitude. We are all afflicted with less than optimal coping skills. But if we look around at the people touching us, we can overcome our weaknesses by listening to them. By watching how they deal with things. Even the people who have passed through us for just a moment…deeply dig and you’ll find that they served you in some way. I have a successful career, and it’s partly due to my officemate.
But what about my poor impulse control. I kind of like that part of me (my Mom is cringing now!). I tend to jump into things and take risks. I embrace it! It has led me down many life paths that my wise mind would not have approved of! I have had relationships and jobs that have rewarded me with insight and self-reflection, and that has been invaluable in my quest for the meaning of life. So what are we to do? Do what others tell us or follow our own instincts? I guess a little of both. Don’t lose yourself in others recommendations, but don’t blindly fly to the stars without thoughtful input. Listen to the people in your life and listen to your gut…they are both right.

Complacent and Passive No More

March 29, 2009

I remember in history class, learning about how working Americans rose up to their oppressive managers and created unions to establish fair and equitable treatment at the workplace. There have been movies made and songs written about our fight for wages and benefits, our fight for rights. So what happened to us that we didn’t do that over the past decade? Why didn’t we start protesting when our health insurance companies began cutting us off for pre-existing illness? Why didn’t we start protesting when we noticed our bosses doing unethical things? Oh, thanks for the reminder…we instituted the “whistle blower laws.” But guess what…it didn’t work. A civilized placement of a law encouraging workers to “speak up” when they notice bad behavior is not how we obtained the rights we have now. Have you ever tried to approach the wrong-doing in this civilized manner? I have, and people I know have, and it didn’t work. It didn’t work because the people you report the evil to are just as evil and probably getting kick-backs to hush you up. The whistle blower law doesn’t work like a good strike works. It is true what they say…there is power in numbers. Enron, AIG, Madoff… as the list of evil bosses grew we continued to be passive, allowed bad things to happen to ourselves. And now we want the government to bail us out? What happened to the spunky Americans who forged ahead and picketed and went on strike, organizing us to stand up for our rights, giving their lives for us? We need a leader of the people. We need a leader within us, like Martin Luther King, like Norma Rae. Where are these modern organizers? Are we all really that afraid of losing our jobs, or being arrested for protesting? I’m disappointed in myself and I’m disappointed in all of us who saw what has been happening to America for all these years and did nothing. And now we pay the price for not voicing our collective thoughts that we silently agreed on for all these years. We need to get together. We need to tell the bosses and the government how things are going to be. We need to right the wrong. No longer should we continue to be complacent and passive. No longer should we allow the government to do things to us, not for us. Maybe it’s too late yet again as we passively watch our fate be dictated to us on the TV.

Dear Mr. President...

March 21, 2009

As a Nurse Practitioner, if I think I should order a lab test on a client, then I should be able to order it. I went to school, I’m a seasoned clinician. But sometimes I can’t order or provide diagnostics, even if my clinical judgment and training provides solid rational for why. Huh? Well here it is, I have worked at several hospitals, and guess what, they all put the heat on you if you are ordering too many things for patients, or if you are ordering “non-essential” tests. Are you surprised? So all of us trying to help you, all the doctors, nurse practitioners, physician assistants, we are being reprimanded on a daily basis for driving the cost of health care up because of things we order for you. And as for “universal health care,” it’s been here for years already! Medicare, Medicaid, and private insurance companies have always been dictating to the health care providers what we can and can’t do for you. Sometimes I need to admit a patient, but the insurance company says no. You all need to know we fight on the phone for hours to get you what you need and deserve. You wonder why you are sitting in the ER waiting so long to be admitted for psychiatric services…it’s because we are in the back office arguing with the insurance company to approve the admission. So Dear Mr. President, here is the answer to the health care crisis…give the clinical control back to the health care providers. Let me order what I know my patient needs. Let me take care of my patient the way I feel is right, and compensate me for that service in a fair, equitable manner. Sure we will need “watchdogs” and some distant level of oversight, but don’t tell me I can’t order a B12 level on my depressed patient……..just don’t.

March, 2009

I Need A What…!?!
So I had my annual gyn exam, all you ladies know what I’m talking about! And I am so happy it’s over and I’m thinking I did ok. But a few days later I get a call from the gyn’s office and it’s the nurse saying, “I’m calling to schedule you for a trans-vaginal ultrasound. I’m silently freaking out wondering what the heck is wrong with me that I need that! For those who don’t know…it’s a probe and…well, it needs to go in the Netherlands and take pictures of your insides! Ladies…you know what I’m talking about here. So I’m sweaty and losing my grip on the phone and I finally ask the nurse, “What do I need that for?” And she has no clue…she said, “The doctor ordered it.” So I tell her I want to know what I need that for and back and forth we go on the phone and I get no answer from this nurse! But as you all know…I too am a nurse and I think back to my appointment with the doctor and how he told me I really should get my ventral hernia fixed (I’ve been putting it off due to my “know too much about what goes on in the hospital and I don’t want to die yet” attitude.). So it clicks in my nurse brain…this lady on the phone means a hernia ultrasound (above my bellybutton) not a trans-vaginal ultrasound. So I tell her this information. And do you know what she says!?! She says, “Well, I saw that the doctor wrote ventral hernia ultrasound, but I only know how to order a trans-vaginal ultrasound so I just figured that’s what the doctor meant.” So the lesson for the day…don’t go get a medical test unless you know exactly what it is and what it is for!

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