Archive for the ‘Alcohol’ Category

dickens

 

” .. Since I knew you, I have been troubled by a remorse that I thought would never reproach me again, and have heard whispers from old voices impelling me upward, that I thought were silent forever. I have had unformed ideas of striving afresh, beginning anew, shaking off sloth and sensuality, and fighting out the abandoned fight. A dream, all a dream, that ends in nothing, and leaves the sleeper where he lay down, but I wish you to know that you inspired it.”-    Charles Dickens

Every interaction we have matters. We may not see it, but it does

Here is a story of how one patient saw 2 different doctors. With the exact same problem. The reaction was completely different, and so was the result. You do not have to be a doctor or social worker or health care worker to have this impact. It is just this example. Every day we encounter people that as simple as it may seem, just a hello or a smile can make the difference. Sometimes, just knowing someone notices you are not doing well is a big deal.

Patient walks into Dr. D’s office. Patient is a 29 year old. He has depression, has a history of suicide, drug use, and addiction. He is in good physical health. He has not asked for help for a long time. He was in the psychiatric hospital as a teenager multiple times.

Dr. D comes into the office right at 8 am as the day starts. He gets his coffee, and asks for his first patient. He walks into the room and looks at the patient. He says “what can I do for you today?”

The patient says, “I am very sad, I have low energy, and I do not feel normal.” The patient is shaking and is embarrassed to be at this point in his life.

The patient says, “I have struggled with drinking and drugs and do not feel good about myself. I am scared to talk to anyone about anything, but especially this. I am at an end, I have to get help or I am going to die.”

Dr. D says, “Ok, well let’s draw some blood. Have you ever been checked for diabetes, low blood sugar, or thyroid problems?”

Patient says, in a trembling voice. “No. I don’t seem to have any of the other problems that would go with diabetes though. I work in the health care field.”

Dr. D says, “Well I am going to run some blood tests. I also see you once had a positive PPD test, so we will give you some INH.”

A ppd test is when you are tested for exposure to tuberculosis. If you are positive it usually means it is in your system but not active.

So Dr. D has the patients’ blood drawn and has given him the INH. The blood tests come back normal. No problems.

The clinic nurses call the patient and state everything is ok. Dr. D said to follow up if you have any concerns. They as a clinic have so many patients, they forgot why the patient came in the first place. They get a list of lab results, so when they see them come through, they never think of the patient. They see the results and make the call that they are ok. This is not their fault. They are completely overwhelmed with a huge volume of lab reports of patient’s to call.

This patient was anxious and depressed and afraid to ask for help to begin with. Now with this call and this response,  the patient is basically pushed aside, IF the patient wants help, he will have to make the call again and go through the embarrassment and shame of asking for help again.

Now, the patient does not go for the INH. He is now feeling hopeless. He never even went for medical problems, then when the results came in, the clinic never even thought that it was to rule out anything. The patient got lost in the pile of papers. Basically became a number, not a person. This is normal these days. They want the Doctors to see as much patients as possible, as fast as possible. So give them a pill and get them out of here. It is our medical system, and it has become a business.

In this case, the patient now goes on another binge, and gets more depressed. If anyone has been through this they know any binge can result in death to self or someone else. Thinking again about suicide month later, the patient calls up the clinic. The patient has lost hope in Dr. D. However the patient is afraid to ask for another provider. Because he will be considered “difficult.”

The patient, using all the courage that they have, gets another appointment. This  is months later. So at this next appointment, Dr. D walks in, and he does not recognize the patient.  He treats him as if he is a new patient. He asks again if he has any medical problems.

This time. Dr. D says “Let me draw blood for some things” once again. Checks his heart. He does not know the patients name, or occupation, or any of what had happened before.

The patient is a number, he now feels worse and is upset that he even came back. He gets his blood drawn.

The patient gets a phone call back. He is to come see Dr D again, he must come in to go over the results. They cannot tell him over the phone the results. However, there is also some hope. He feels that maybe they found a reason he has felt like this his whole life.

The patient is scared, he knows if you have to come in to go over results it is not good. Saturday morning Dr. D walks in as he is the on call MD this weekend. His eyes are bloodshot and red, Dr. D did not sleep last night you can tell. He does not recognize the patient, his name, or anything. He feels he is just seeing all emergency patients as they are the Saturday clinic this month and he is on call. Dr. D has no idea he is talking to his own patient.

He then asks the patient, why he is here.

Then Dr. D still not knowing the patients name says “oh yeah, well, looks like you have chronic fatigue syndrome and there is really nothing we can do. Maybe go to groups, or exercise.”

Just what the patient wants to hear right? You are chronically tired and out of luck. You are not depressed or any of that. Sorry, go to groups.

The patient puts his head down, that’s it. You can see him, the thoughts are something like, “I guess I never was depressed, I’m just tired,” that is what he is feeling.

Any of us can tell these things in watching people if we just watch and are truly present with them. If we take time for one another it is easy.

Then Dr. D says well I can give you Provigil to keep you awake during the day and trazodone to help you sleep. SO let’s do that and check back in a few months. We are now giving a patient with severe anxiety a pill that they used to give to pilots to keep them awake during long flights.

The patient gets the pill to stay awake. His depression and anxiety have still not been addressed. He has learned that this is what happens when you ask for help. The patient now feels hopeless, sad, anxious, and like a fool for asking for help. There is nothing they can do for him.

First they tell him he has tuberculosis, then its chronic fatigue. They spend 15 minutes with him each time because management wants doctors to see 4 patient per hour so they can bill for that. Then they make more money. Dr. D is considered more productive if he sees more patients in a day because he makes the clinic money then.

The patient then with this depression history, drug abuse history, has made his last ditch efforts to get help. It took everything he had to even ask for help. He was pushed aside, they didn’t know his name. He got lost as a number. Then he was told different things by the same doctor each time he went in.

Why would someone go seek help after this? Dr. D never even asked him about his depression or anxiety or his history. He was a number, and he pushed it off like it was not depression. Just give him a pill and get him out. I don’t blame Dr. D, this is our system. I have seen Doctors get scolded for taking too much time with their patients.

This patient would then go into severe depression and his drinking and self-destructive behaviors would intensify over the next few years. He had many near death experiences, he got a DUI and spent more time in jail. He got to a point in which he almost died and his family had given up on him completely. He was basically going to fade away to the world. You could tell, he had given up on himself and everyone else had given up on him.

About 3 years later after Dr. D. This patient called the clinic. They said “So you see Dr. D, would you like to see him again.”

The patient has an opening and says, “No anyone is fine.” Simple stroke of luck.

The patient is set up with Dr Broeker. This is his real name he still practices for Allina. It is at the end of May. The patient has made up an excuse to go in he says he is having urinary problems.

He is in the clinic office in the room waiting. Dr. Broeker knocks on the door, he says, “hey XXX, I just want you to know I am running a little bit late but I will be in as soon as I can.”

The patient is shocked, Dr Broeker knew his name and just knocked on the door to tell him that he was running late.

Then during their meeting, the patient is comfortable, and feels at ease. Dr Broeker comes in and says his name, what his experience is and does not have a clipboard. IS not looking at the computer. He asks “what are you here] for?”

Dr Broeker then says “what else can I do for you?”

The patient starts to cry and says “I am anxious, nervous and afraid to ask anyone for anything. I hate myself, I cannot stop drinking and I want to get help for feeling depressed.”

Dr Broeker spent the next hour talking with this patient. It was amazing. He talked to the patient about life. Dr Broeker talked about his time as an MD and how he wants to get this right. He explains the depression scale, the anxiety scale and fills it out with the patient.

It was like this patient had been waiting years for someone to say, “It’s ok to be sad, let’s talk about it.” Finally after, years and years of internal torture. Dr. Broeker had released this man from his own internal prison. It was amazing. Words will never do it justice what Dr Broeker was doing for this patient.

It was supposed to be a 15 minute appointment. Dr Broeker knows the patient has been seen by Dr D because he read the chart, he says “why were you tested for all of this?”

The patient says,” I don’t know that’s what he thought.”

Dr. Broeker says “well, ok, let’s start you on celexa and come back in 2 weeks to make sure you are not having any side effects.” Dr. Broeker did not judge the other physician and was respectful and kind about what the other MD had done. When someone is truly great like this, they do not need to question anyone else. He is pure, there is no competition for people like Dr. Broker, he practices out of love, and he is a doctor for the right reasons.

The patient was so much at ease with Dr. Broeker that he was able to tell him everything and open up about the drinking, drug use and all other issues that he was facing.

Dr Broeker wanted him back in 2 weeks just to check on side effects. The patient felt he had a new lease on life.

Then in 2 weeks Dr Broeker pops in and knows the patients name. He talks to him for a while like they are old buddies and shakes his hand and is friendly with him.

This patient has had a history of no shows throughout his life, but never with Dr Broeker. Usually if we have a patient with no shows, we label the as non-compliant or as not really wanting to get help. But, could it be that the problem is in the provider and how we treat patients? Or at least say it is 50/50? In a few months the patient was in rehab, and able to look at people. Dr Broeker then eventually recommended therapy to this patient.

This patient was willing to listen because he trusted Dr Broeker. He believed in him. The same recommendation could have come from another Doctor and it would have gotten a different reaction. The difference is in the relationship, not in the knowledge. Dr Broeker took time, he did not care about the 4 patients an hour.

Dr. Broker is special, he is in it for the right reasons. He takes time. That is true productivity.

He saves lives, He saved this patients life.

 

I know this, I watched it. The patient was me.

The Doctor is Dr Michael Broeker.

He saved my life. He is one of the “fab 5” that I refer to that changed my life. That is number 1. The magical Michael Broeker.

 

If it was not for him, I would not be alive today. The patients that tell me I saved their lives and changed them forever, my friends and family and everyone that I have touched, it is all not possible without him.

 

I almost died and did not want to ask for help ever again. He sat down and listened. And talked. He didn’t follow the 15 minute rule. In my moment, lost in the woods, he gave me the light and pointed me in the right direction. All because he took time to get to know me and did not judge me.

 

I am alive today because of him.

 

Thank you Dr Broeker.

 

The End

 

 

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“Nothing in the world is permanent, and we’re foolish when we ask anything to last, but surely we’re still more foolish not to take delight in it while we have it.”

If you take an onion and cut it as close to the roots as possible, without cutting the roots, it can grow larger and larger every time. We are like this, we grow and become wiser and more loving by giving away what we get, as long as we keep the roots. This is a lesson I never believed to be true, I thought how can you gain more by giving things away? I thought I needed to keep it all to myself. That is what we are taught. This is the story of the day I realized I was much like an onion.

These toasts and things are common at weddings. They are also common at graduations and other special occasions. It is so bizarre to me that we only talk like this about each other at these rare times and usually when heavy alcohol is involved. Then we forget. We forget to tell each other how we truly feel. We are afraid, or embarrassed.

Dave grabbed his drink and stood up. Everyone listened as Dave spoke. “I remember one time, we were playing video games when we were kids, and it was so important for Bob to have the best team, that he went and bought a 12 pack of mountain dew and stayed up all night creating this master team so he could beat us. He always wanted to win, ever since he was a kid. But when he was done, then he worked on everyone else’s team.”

Everyone laughed and hollered. It was a great toast. After the laughing was done. Dave continued, “Bob is amazing, he is a rare person, and I love him and am lucky to have grown up with him. There was a time that I was driving without a license and crashed. He didn’t think twice, he jumped in the driver’s seat and pushed me aside and took the blame for the accident.”

Then after that, all of a sudden Jacob stood up, this was unexpected. He taps his glass and says. “Bob, Bob, Bob, he loves borrowing other people’s cigarettes.” Everyone knows this to be true and has a good laugh. Jacob continues, “But what Bob never bragged about was the time he had only 5 dollars left and gave it to me because he knew I was struggling. He never told anyone. He is kind and a humble man.”

Then Brian stood up and held up his glass. This was turning into something rare for us. Brian was not one to speak in front of a group like this, Brian says, “Bob and his heart. When I was in the middle of my addiction to heroin, Bob came and got me and drove me 6 hours in the middle of the night to treatment. Then I ditched it. He still came the next time I called. He missed work, and family time. He just took the heat. I love you Bob.” That one got everyone’s attention. People were getting emotional. Brian recovered from addiction, but none of us knew that part of it. It was starting to seem like Bob did a lot of things for all of us. We all had these stories. Brian’s was very strong because we all had pretty much given up on him, well, except Bob. We had wondered how he had finally beaten the addiction, I guess Bob had given him what I call “psychological life support.”

Danny stood up now. “I hate Bob. He makes us all look bad.” That was how Danny was. He then got serious, which is very out of character for Danny, and he said, “I got kicked out of my parents’ house and Bob came and got me every day, and he drove me to work for a month. Never asked for anything.” We all were surprised, we thought they hated each other but dealt with each other. They were kind of the arch rivals in our group that were always fighting.

Jim stood up and said. “I don’t have a story like any of you. However, I’ve seen Bob with opportunities to be unfaithful, and he was not. His loyalty, it really is something that changed me. In a hot tub, with women all over him, he left to go to his ex-fiancés house and be with their kid. They were no longer together at the time, and she was seeing other people. But he did not care. His love is strong. He is probably embarrassed by me even telling this story, but I think it tells you all you ever need to know about Bob.”

So I am sitting there, thinking about them saying these things. I am hearing words describe Bob, like humble, kind, caring, loyal, considerate, and unselfish to name a few. Wow, we all liked being around him all the time. I never had heard these things before. I felt like I should say something. I sat at the corner. This had become a moment that we were all speaking of our relationships. It was my turn it seemed.

I stood up. I said, “Bob is amazing. I remember one time we were walking in the city at night. There was a homeless man and Bob gave him his shirt and jacket. Bob went and got another one for himself. Everyone else was mocking the old homeless guy. But Bob made sure no one was watching. He did not do this for show, he means it. All heart.” Everyone agreed.

But listening to all this about Bob was hitting me hard. So I decided to say more.

“I was just wondering if anyone has ever said any of this to Bob’s face. Because I have not. I do not know why either. This feels good.” Is what I said.

Dave said, “No. I have never said this any of it. Why? I do not know.” Everyone else shook their heads in agreement. It was sad to hear that, everyone had the same look on their face. Why not? Why haven’t we?

Well, in this case, it was not Bob’s wedding, it was not a graduation either. Bob had died at the age of 26 about a week prior to this. He was in a boating accident. We all were just at the funeral 2 days ago, and no one mentioned a thing. Everyone was in shock. His best friend was Joe. Joe would later take his own life. He was emotional and crying and kissed Bob as he lay in his casket. No one else said a thing. I think we were all in complete shock. This was 15 years ago, I was 24. You do not expect things like this to happen when you are 24 and you are thinking you are invincible.

A couple days later, as we sat at this restaurant, just sharing stories, we were having his real funeral. This lasted until 5 the next morning. I sat that day, when it was over, thinking to myself if I ever see something positive about someone I am going to tell them. At first when I did this my face would get all red, sometimes I would tear up and my voice would crackle. Then I started to see the impact it had on me, and on others. I was growing more each time I gave more away. Much like the onion.

It doesn’t work if it is not genuine. But when it is genuine, it is amazing. It is almost like I get more out of it than the people receiving it. The more I give away, it seems the more I get given to me. By that I mean love. If I give it away completely, it seems that I get more placed in my heart.

I think people believe that it takes away from them if they give it away. They may think it will be scary or they will be rejected, but if it is pure, it is amazing. If it is a manipulation, and you have a hidden agenda, it does not feel the same. It has to be real. Even if the person already knows it to be true, it is good for them to hear it. I remember when I started doing this, my brother said, “I wish I could talk to people like that.” I said “you can.”

Anyone can do this if they want to. Try it. That is the key to growth, is doing things that you are uncomfortable with. If you only do things you are already good at and are strong in, you will never truly grow. That is fine if you are satisfied with the way things are, but if you want to grow, the way is by doing things that are hard or uncomfortable.

Imagine it is raining outside, and everyone has a bucket, if you try to keep all your water to yourself, and hold the bucket close to your chest, you will not get very much. If you take your bucket and start pouring what water you have into other peoples cups, someone is going to say, “Hey get that person a bigger bucket.” You will start to see more opportunities come, and you are never depleted. As weird as that may seem, it is true, the more you give, the more you get. Our minds do not think that way. Because we were trained otherwise.

Removing the outer layers of the onion brings tears. In fact, it can be so painful, people publish articles as to how to get to the core of the onion without the tears including cutting under water, wearing goggles, or freezing the onion first. Similarly, we freeze or emotional feelings with things such as alcohol or drugs for an easier way to get to our core. Freezing vegetables, or feelings, similarly creates changes in texture and we lose the natural flavor.

This was what came of Big Bob’s death to me. Some people look at me weird, which is ok. I do not want to leave love left unsaid or undone when I go, I want to leave it here in the world. So it can keep being passed on forever. That will stay forever, regardless of where my body goes.

I hope Bob heard us that night. He never did when he was alive.