At some time in our lives, we all need to be told we’re good or shown the way. A simple story about giving kids from Oakland’s toughest neighborhoods a chance to rise above the violence in their communities strangely touched me and compelled me to write. As I do this, I am not that far from Oakland. I have heard enough to tell you that the culture of violence described is not exaggerated. Patients who see me for marijuana permission are happy and delighted they do not have to drive there.
So there are children who grow up in a culture of violence. I see adults. Not too long ago, I was seeing adults for social security evaluations in Los Angeles. Many of them had been caught in crossfire, perhaps shot on their way to the supermarket or even in front of their own homes. They told me they did not know why or by whom, and sometimes they still had bullets in them somewhere. Other times it was just a memory that so overwhelmed them that the quality of their post-traumatic stress disorder was like the sort of thing that you see in Vietnam veterans. Read more on It Takes So Little…
Filed under Family, Government, News, PTSD, Violence by on Jan 25th, 2013. Comment. 
A few days ago one of my patients called me “Dr. Pollyanna.” He told me this was a reference to the fact that I would not validate that his pain, from old injuries, would be lifelong and without useful treatment. This is what his primary doctor had told him. “Dr. Pollyanna” was not wrong; but maybe, not quite subtle enough. I try to sneak ever so gently into patient’s thought patterns and convince them there is a way out of their problems. There always is, especially since I have been dishing out marijuana permissions. Read more on A Positive Message for Veterans…
Filed under military, News by on Jan 24th, 2013. Comment.
Nobody, but nobody, including a president of the United States, can tell a doctor what to ask about in an assessments.
Assessments are supposed to be in the strictest confidence, for openers. Anything else would be against the rules of medical confidentiality. Patients have a right to be seen alone. The doctor has a right to decide what needs to be said.
I can imagine the 2nd ammendment rights activists bursting a blood vessel if doctors are reqiured to survey patients about the guns they own and how they use them. The requirement to have doctors do this would be — most everyone will agree — anti-American.
This being said, a question about firearms is and should be standard psychiatric practice. When you are dealing with suicidal patients, which happens all too often in psychiatry, and the patient says that he or she is thinking about this, then it is absolutely essential to know if that
Filed under Government by on Jan 23rd, 2013. Comment.
I’m getting getting ready to send out my first private-list email of the year — and it is long overdue!
If you are not already on my mailing list and want to make sure you receive this newsletter, you can still sign up.
Just fill in the form in the top right-hand corner of this page and click the button. You MUST opt-in to receive this letter, it is sent directly to your email and not available on the web for public viewing. Of course, you can opt-out at any time, if you wish. But this is a non-commercial, non-spam type of newsletter. It is chock-full of my personal opinions and details on what I’m doing in various parts of my life.
You won’t want to miss it — and it is free — so try it out and see. I predict that by Monday, it should be delivered and ready to read.
Take care and be happy — enjoy your weekend.
Dr. G
Filed under News by on Jan 17th, 2013. Comment.
Like many others, I am of the type who has been made to feel less. Less than healthy, less than human; whatever, the kind of feeling that sells diet food and diet plans. Read more on A Few Extra Pounds Might Not Be So Bad…
Filed under eating disorders, Nutrition, Psychotherapy, Self-esteem, weight by on Jan 17th, 2013. Comment.
The Catholics have a history of making heroes out of those who suffer the most. I really don’t know what kind of reaction this young man should expect from his “very Catholic” grandmother when she finds out he is using medical marijuana.
My patient is 27, on dialysis, and looking for a kidney transplant to stay alive. He takes medical marijuana to increase his appetite and well being, as well as minimize the pain and anxiety of his situation. I have promised that I will not stop trying to help him. We will go as far as we need to, raising funds if necessary. My help will likely include taking him “public,” using the media. Read more on How Can We Explain Medical Marijuana to a Catholic Grandmother?…
Filed under Alternative Medicine, medicine, Religion, Research by on Jan 16th, 2013. Comment.
When I was an undergrad at Boston University, I took a course in the department of sociology in “medical administration.” I was compelled to understand the social context of medical practice, for whatever reason. I remember little of the course itself. There was a very attractive older woman sitting next to me who amused herself by “adopting” me, which she thought gave her a right to criticize my then overweight figure and poor clothes.
I remember more about her than I do about the professor, a wacky guy the university had seen fit to import from New Zealand. He had published a couple of relevant papers down there, but was still pretty new to the American health care system. He told us that New Zealand had lots of sheep and was a big wool producer. He talked about this great wool magnate who had this neat wool mill — a big one — and how it was he actually became quite wealthy. This was someone who knew about the tremendously loud machines that were used to process the wool. The wool mill owner decided to hire only deaf people. They asked for little; generally, they had problems finding jobs. They were really happy and thankful to be able to work, so they worked hard. They did not have any kind of a problem with the very loud machines.
That struck me so much then that I remember the story now, 50 years later. Even then, I already felt that I would be in some kind of a management position as a physician and could do something that clever, becoming as rich and powerful as that New Zealand guy. The professor had said something about Americans not thinking that way. The opportunity has not really presented itself.
Probably the closest I ever came was when I was running the day treatment center at the Veterans Affairs Medical Center in Oklahoma. I had a lot of schizophrenic gentlemen who were not rich in social skills, but many of whom liked computers better than people. Certainly, they related to computers better than they related to people. I tried to get them computers, maybe even a little training. Read more on How to Employ an Individual with Asperger’s…
Filed under Asperger's by on Jan 15th, 2013. Comment.
When human lives are at stake, there is simply no room for emotional decisions based on pseudo-science. But since when does anybody listen to anything I have to say?
Individuals are being removed from organ transplant lists because they are users of medical marijuana. Most recently, a staffer at a dispensary that is kind enough to refer people to me for medical marijuana prescriptions told me about a 30ish young man who is in renal kidney failure. He’s been taken off the list because –you guessed it – he is a user of medical marijuana. I’m afraid it’s more common that I’d like to admit. Read more on Denied a Kidney Transplant for Taking Legally Prescribed Medicine?…
Filed under medicine, News, prescription drugs by on Jan 14th, 2013. Comment.
Most of my early drafts of blog posts start with “I was minding my own business, surfing the net….” That is something I often do; “surf the net,” I mean. Not “minding my own business,” something which my Mother-of-Blessed-Memory would attest I haven’t done since the beginning of high school.
This time I was thumbing through a copy of the “New York Public Library Desk Reference.” In my lap as I write, it’s a 1989 edition — Simon and Schuster, New York, of course. I have wanted one on and off for a long time, despite the presumed omniscience of the internet. It showed up in our favorite local thrift shop, evidence of how the universal intelligence of the, well, universe works. The first thing I had to check was anything calendar related, which would obviously be the limitation of the book. Surprise — a universal calendar with days of the week through 2076. This is as omnipotent as a book can get. Read more on How Brominated Vegetable Oil Found Me…
Filed under News by on Jan 5th, 2013. Comment.
In this life, everything should be as simple as it is, but not simpler. That includes this questionnaire study about marijuana as an “exit” drug for substance abuse. This article hit a nerve because there are issues here I have come up against before. And I mean “against.” I don’t mean to say it isn’t “good science;” it is. I’m talking about the emotional resistance to the idea that detoxifying from a medication can be comfortable, painless, and effective. I see this coming like I see the sun rising in the morning, because I have been to this place. A few years ago, I found myself in an informal banquet room across the parking lot from a hotel type establishment in a touristy part of San Diego. There was a woman rep from the drug company, Hythiam. She wasn’t an ex beauty queen like most reps, but a fairly credentialed therapist who actually knew what she was talking about. My husband was there with me; a younger, chubbier, and more naïve me – therefore, less authoritative.
These Hythiem/Prometa folks had a great schedule of IVs that removed physiological cravings for various substances of abuse, including methamphetamine. Basically, they use safe and older type drugs intravenously for a lovely pharmacological intervention. The cravings stop, and the person does not “need” to use the drug. Neither they nor I was stupid and naive enough to think that was all you had to do. Aftercare was important and I was ready to jump in. They recommended vitamins — I recommended lots of vitamins, high dose, and chelated to cross the blood-brain barrier. But these addicted folks needed “prosthetic lives.” When all you can muster goes to satisfying a craving or a need, there are not many hours left in the day for work or relationships. I helped with this, too. Some people had problems, but they were mostly because of the psychosocial void left when they did not go for drugs, and their inability to fill it. I worked my damnedest with these folks; and like the company, was eager to be accepted into the addiction community. There was this reception, and they had invited people from every substance abuse program in town. I was there and ready to go to bat as the only physician who had experience with these folks locally. Two people showed up. One was an older, fatherly type. The other was a young sidekick who was presumably learning from him. This older guy said something that rings in my ears now. “You got to earn your sobriety.” Read more on Time to Stop Judging and Start Healing…
Filed under medicine, News, Substance Abuse by on Jan 4th, 2013. Comment.