Archive for the ‘Chemical Dependency’ 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

 

 

saving-drowning-man

“Sometimes our inability to control our instincts gives us a level of courage we don’t normally have.” -Jason Whitlock

We all try to hide ourselves with the mask, even if we do not know we are doing it. However, there are times that we cannot hide our true nature. It is usually in a crisis or a moment when our instincts take over. The true self bursts out despite our best efforts. Usually, it is a beautiful thing to witness. It is like seeing a picture of love. It is a rare occurrence. I was thinking of this example the other day and decided it might be a good moment in my life to share.

The courtroom was full. The custody battle has been long and complicated. Judge Harrington has heard this go on in his courtroom for months. Everyone was finally done presenting their cases and the evidence. It was full of emotion but silent. Judge Harrington is to address the court and the hundreds of people that are there with an emotional, vested interest.

He stands up and says “Tom, you are the mother’s father, you have been here for every single event in the courtroom. You have come to all the conferences and meetings. You have missed work for this, you are a dedicated man. What is your opinion on what should happen with the child?”

What? He is asking Tom what he thinks. He is the Judge and he is asking Tom what Tom thinks? Tom was the father of “Ally” who is the mother. “Ally” was his only daughter. He has one grandchild, and that was Kayla. He has been a large part of Kayla’s life up to this point. Kayla is the child in question here, she is 5 years old. Kayla and “Ally” live close to Tom, Kayla goes fishing with him, and she knows him so well. She hugs Grandpa Tom every time she sees him. He loves having Kayla around, she brings life to everyplace she is, like most 5 year old little girls.

Tom and his daughter “Ally,” have a great relationship. She has gotten involved in drugs recently, and he is trying to help her. He has always been a loving father. When “Ally” was young, she was emotionally abandoned by her mother, who never wanted children. So Tom raised her most of his life and was a loving, caring man. He was not perfect, as none of us are, but his heart was pure.

Is this why the Judge was asking him? I didn’t know. I did not like it. I was the one on the other side. I wanted my daughter and had been waiting my whole life for this moment. Her mother, “Ally,” was a full blown drug addict, and had been failing drug test after drug test. This should be a slam dunk. I was very upset that the Judge was asking Tom this.

I yelled at the Judge, “What the hell is this Bull****, why is it up to him? Why are you even asking him?” My heart was trembling in fear. I was shaking, I was sweating and nervous. I looked back at my mother and her lower lip was quivering. My father was standing in silence. All my siblings were looking. We were all so young. Ages from 16-24. No one had been in a situation like this.

Judge Harrington said “I suggest you settle down or you will be held in contempt of court, do you even know what that is young man?”

My lawyer had me leave the room. He said, “It may be best if you are not here for this, you are too emotional and you will be perceived in a poor manner.”

I am thinking to myself, “What the heck is going on here. I am not the one addicted to drugs. I am the one trying to go to school, I am recovering for my daughter.” My daughter was gone for years in Florida, then she had come back. I had started to get better and prepare for this. Now it seemed everything was falling apart right before my eyes. “I am going to lose this thing now,” is all I could think.

After doing the right thing, after going through the pain of losing Kayla, then getting her back in my life. Then I dedicate myself to bettering myself to become a good father. I tried to help her mother “Ally,” get into treatment, and still after this I am still going to lose her again? My heart was broken and I was in distress. The anxiety, fear, anger, sadness, embarrassment, and everything from my past was all coming up, and making me look to Judge Harrington like an out of control emotional kid. I had already lost her, my child, once, and I had thought forever. Now this second chance was being taken from me is what I felt.

Why was I so afraid of him asking Tom? Well in the beginning, I was good friends with Tom. But I was also a 17 year old punk that got his 16 year old daughter pregnant. We then fought for years. I said some horrible things to him and was rude and a jerk to him. He was the same to me. He did not like me and it was clear. Now he was going to decide my fate? How is this justice?

When “Ally” came back to the Midwest, and was getting involved in drugs. I was not trying to take the child away. This got Tom to respect me a little bit and earn a little trust. I was trying to get her in to treatment. I was trying to help. However, when you are not healthy yourself, and you are trying to help someone it is much like if a surgeon is bleeding while they are doing surgery. You are trying to help, but really you end up just injecting your own poison into that person.

I had no idea about addiction, mental health or anything. Yet here I was trying to understand it all and help someone who was a full blown meth addict and shooting up daily. I couldn’t understand why someone would leave their child for weeks at a time. I couldn’t understand why someone would say they wanted treatment then ditch out when they realized the cops were not after them anymore. I didn’t understand why someone would keep using after all the consequences. I didn’t know who this person was that was neglecting, and abusing my daughter.

The “Ally” I knew was a caring, and loving person who had been abandoned basically by her mother emotionally her whole life. Then her mother left for Florida when she found out her 16 year old daughter, “Ally” was pregnant. “Ally” was abused in many ways as a child, physically, emotionally, and sexually. But her heart was pure. I could not understand this person she had become. I was trying to help her. We all were. However it was not going well, and speaking for myself only, I was making it worse and I did not realize it at the time.

Tom was surprised that I was not coming down and just trying to get custody. We started to talk, we bonded as we tried to help “Ally” together for the child. Tom loved his daughter “Ally” and was a great father. We were so frustrated, she was calling everyone names, bringing up everyone else’s dirty laundry. We didn’t understand. Tom saw me prevent her from being arrested. Eventually, I had given up and we were now in this long drawn out custody dispute.

It got to a point that I bailed “Ally” out of jail once, and Tom had become mad at me for helping her too much. Everyone really was doing their best but we were all brining our own stuff into this situation and the years of mistrust and fear and anger were all present.

As I look back now, I realize we were all fighting because we all wanted to love this child. If you take away the fear, anger, anxiety and other negative emotions, we could have solved this ourselves. But here we were in a recess at court after my blowup in the courtroom with the Judge asking Tom of all people what he thinks. This was it, I was the crazy one. This was all going to be taken away and I knew it.

I sat alone in a room at the courthouse. I refused to talk to everyone. I was alone. This was one of those points in my life that I realized I really have no control over anything what so ever. It was not a painful thing. Well, at first it was frustrating, I could not talk my way out of anything, I could not throw a fit and get my way, and I could not manipulate. I could not take Kayla and run, I would be in jail then. This was completely out of my hands, I had no control. The funny thing is, we never do. We only think we do. Control is a human illusion.

This was one of my first forced third steps. Forced to surrender. I would forget it later, but also go back to it throughout my life when it was needed. I was receiving a painful gift. I got on my knees and I cried, first about how unfair it was, then about how mad I was, then about what I was going to do if things didn’t go my way. Then when all the garbage was out, it was just tears. Crying and hoping for the best. I was hoping that the best happens and just trusting that if I am a good guy and my intentions are pure and I do it with love in my heart that it will turn out ok. I surrendered that day. I was not mad, instead all the anxiety, fear and negative emotions were gone. What I felt was a freedom I had not felt before. I realized that I was allowed to love my daughter regardless of where I was or who she was with. No one could take that from me. This was not going to be the end. No one can take my heart or my soul. I felt an immense freedom.

I was calm and came back to the courtroom. I apologized to the Judge. The Judge continued, “Before we were interrupted by the outburst, I had asked Tom what he thought. Tom, where do you think Kayla should be. With you, with the uncles, or the mother or the father, what is your opinion?”

Tom stood up, everyone was looking at him, He had tears in his eyes, and his voice was shaking. This was a large man, he works on the railroads and has his whole life and loved life. His voice trembling as the courtroom was in silence, he said, “She should be with her father.”

Whoa, that was me. This man could have said his daughter “Ally”, and believed he could get her help. He could have said his son, the uncle, or himself. He did not. To stand up in a courtroom and say something like that when it held so much weight was one of the most amazing acts of unselfishness I have ever seen. This was true love. He had no idea if I would ever let them see Kayla again if I had custody. We had a rough history which was getting better. He knew this could be the end of his family and ever seeing his only grandchild. He still said what he thought was best for her.

Because of this I was granted custody. There are times that we cannot hide our true nature, we all try to hide ourselves with the mask, but at times, the true self bursts out despite our best efforts. Tom’s true character is that of one of the best most amazing people in the world. He is pure. He is real.

Why did the Judge care about what Tom thought so much? I was told this story after the fact. When Tom and the Judge were 6 years old. The judge was drowning in a lake. No one was around. Tom was the kid that pulled him out of the water and saved him. Tom had shown his true character before to this judge, so he knew he would get the truth. It was a small town, they grew up together.

Kayla still to this day, goes and sees Grandpa Tom all the time. He has been a major part of her life since that day. Tom and I used to talk a lot until “Ally” got out of prison. When ”Ally” went to prison, Tom saw Kayla every other weekend and summers and talked all the time. He was able to keep their family involved for when “Ally” eventually got out of prison.

The rest of the story is for another day.

Thank you Tom for showing me what love and unselfishness looks like.

Thank you Judge Harrington for showing me to treat everyone with kindness at all times, you never know when the tide will turn. To love each other always.

Thank you that day for forcing me to surrender my will for a moment, so I would have that to go back on later in my life when it was needed.

Thank you crisis. You helped awaken me.

On this day, I saw what real love was.