April 22, 2013

Book Review: This Is How: Surviving What You Think You Can't by Augusten Burroughs

I hate self-help books. It's not just because I feel they are basically about taking advantage of other's misfortune or on the whole useless. No the real reason I hate them is what the words self-help implies. It always sounds as if you don't get better after reading the book it's your fault because you don't want to help your self. Calling a book self-help is like saying to your readers you can cure yourself if you really want to. Which carries with it the cavil of, if the book doesn't help you it's not the author's fault it's yours because you didn't really want to be well. Nothing better than making someone who has serious problems feel guilty about them on top of everything else.

I'm a recovered substance abuser, have dealt with post traumatic stress syndrome brought about by being sexually abused as a child and live with a chronic pain condition. I had lots of help from two therapists, a yoga teacher and a acupuncturist with the first two issues and I see a doctor regularly for treatment of the latter. There was, and is, no quick fix and I might never completely heal. The one thing I never did was consult a self-help book. I read a couple of books by people who had been through things similar to what I had survived, but that was it. They made me realize others in the world had had similar experiences and had found ways to recover.

All of which might make it sound strange I would be interested in Augusten Burroughs' latest book, This Is How: Surviving What You Think You Can't, being released by Picador Books Tuesday April 23 2013. However, in spite of it being promoted as a self-help book, all that I knew and had heard of Burroughs made me suspect it wasn't going to be anything like the "I can cure you if you do exactly what I tell you to do" crap lining the shelves of every book store in the world. I didn't even have to get through the first chapter before I knew my suspicion was right: this is not a self-help book at all.
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What it is is a book for people interested in really helping themselves instead of looking for some sort of band aid which will make them presentable to the world. I knew I my first impression of Burroughs was right when he made the claim so called positive affirmations do more harm than good to people with low self esteem. I've never believed standing in front of a mirror telling yourself a lie in the hopes it will convince you to feel better about yourself would benefit anybody. Burroughs not only agrees with this, he quotes a peer reviewed scientific study which proved affirmations actually made people with low self esteem feel worse about themselves. The only people affirmations actually work for are those who already have a high self-esteem. The rest of us only feel like failures when we can't live up to the lie the face in the mirror is telling us - which doesn't do anything for our self-esteem.

Burroughs rips through the New Age gobbledygook pop psychology bullshit that has been permeating the airwaves since some moron said "I'm OK, Your OK" back in the 1970s and passed it off as a cure for what ails us. He shreds jargon with humour and compassion and dispels the myths we have been conditioned to believe about how we're supposed to feel and what our relationships should be like. Along the way he talks about love, death, illness, dieting, addictions, child parent relations and almost every other hot topic you can think of. However, don't come to this book looking for platitudes or expecting to find ten simple steps to a happy life. What you will find are some very simple, basic, common sense truths which might not make you happy, but will certainly make your life better or, at lease more fulfilling. However, be prepared to face another truth, they're might not be anything wrong with your life at all and dealing with that might even be harder than anything else.

Unlike most people who write one of these books Burroughs doesn't have a plan for you to follow. Instead he addresses each of the topics mentioned above individually and head on. He doesn't mince words or sugar coat anything when he gives his opinions. Instead he dissects everything about the subject and lays bare some very simple but breathtaking truths. If you've been dieting for twenty years trying to lose twenty pounds maybe it's time to question your obsessive behaviour? Or as he puts it "If you spend twenty years trying to get something and still don't have it, is it admirable to keep trying. Or did you pass admirable several miles back and it's getting close to straightjacket time" (Burroughs, Augusten -This Is How Picador, New York NY 2013 p. 31)

If dieting hasn't worked after twenty years isn't it obvious by now its never going to work? His suggestion of stopping dieting and just eat what you want and accept the results may not be what people want to hear. However, the reality is you'll be a lot happier and healthier. As he points out once you allow yourself to eat whatever you want (as long as there are no health issues etc involved) you will first get bored with overindulging and second, your body will take care of itself. The reason, he says, diets don't work is because we only want them to work, we don't need them to work. You must want to lose the weight more than you want the comfort you derive from eating.
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Of course this applies to almost anything. If you want to stop drinking, if you want to stop smoking, if you want to stop whatever, you must want to more than you want what ever pleasure you derive from the thing you're trying to stop. It's in this chapter on dieting he says one of the things which convinced me Burroughs knows what he's talking about. "If willpower is required to achieve this goal, that's how you know you don't want it enough on a deep, organic level. Mechanical failure will eventually occur." (ibid. p.35) I've been able to give up drugs and alcohol because I wanted to more than I wanted what they had given me, but I've not been able to give up cigarettes. Willpower got me through the first few months a few times, even a couple of years once, but each time the need for the comfort they provided has sent me running back to them.

Burroughs throws truths like this up in our faces all through the book. Sometimes it makes it extremely uncomfortable to read because, whether you know it or not, you start looking at yourself in the mirror he holds up. However, what's wonderful about this book, is you never feel like you're being judged. Its filled with humour (I now know the two things you never say to an Italian man about members of his family and they both make my wife laugh until she pees), but most of all you can feel his genuine compassion in every single word. Reading this book is like having a conversation with that friend who has never been afraid to tell you the truth but always does so with love in their hearts.

Burroughs doesn't have any letters before or after his name nor does he make any claims to having some great mystical insights (thankfully) into the mysteries of human behaviour. What he does have is a seemingly innate ability to draw upon personal experiences and observations of other's behaviour and distill from them carefully thought out conclusions. Occasionally he backs up what he's saying by quoting a scientific study, but even without substantiation you can't help trusting what he says. Best of all, while he's a firm believer in individuals taking responsibility for their lives, he never once makes you feel inadequate or in any way to blame for your circumstances.

We live in a world of instant gratification. Financial empires have been built around the reducing of human emotions to a commodity sold and packaged on day time talk shows by modern day snake oil sales people. Public self flagellation is not only encouraged, its rewarded with Andy Warhol's fifteen minutes of fame. So when someone like Burroughs comes along and says what he has to say many will not want to listen. Of if they do, won't like what they hear. However, for those who are willing to listen they won't find a more understanding and compassionate voice anywhere. No one book will instantly make your life better, and neither will This Is How. However, it will point you in the right direction so you can begin whatever journey you feel you need to take. Which makes it worth its weight in gold.

(Article first published as Book Review: This Is How: Surviving What You Think You Can't by Augusten Burroughs on Blogcritics.

February 6, 2011

Music Review: Susan McKeown -Singing In The Dark

You'd think we'd have matured enough by now we could talk about mental illness openly and honestly. Instead the stigma attached to even the most basic of emotional difficulties is so great most people are still loath to even admit they're seeing a psychiatrist or therapist. All you have to do is watch people squirm and try to change the subject when you bring up the fact that you've been seeing somebody to help you deal with emotional problems to understand what I'm talking about. The only thing worse than dealing with the rest of the world's reactions to your circumstances are the way the majority of the medical profession - especially those who treat them specifically - deal with mental illnesses.

They see their job as doing their damnedest to take your square pegged self and make you fit into the nice little round holes society wants us all slotting into. The problem is that far too much of the time its been trying to fit into those little round holes that have caused you all the problems in the first place. The usual answer offered by the profession is to medicate the crap out of you so you don't notice the shit that caused you to slip off the rails. So if you've been having the perfectly normal reaction to the tensions of living in our world today of having anxiety attacks they'll pump you full of pills to deaden your emotions and turn you back into a mindless sheep content with career, house in the suburbs and the ability to swallow what you hear and see in the media as the gospel truth.

While for some that might be the answer to their troubles, others might find that a cost their not willing to pay for easing their minds. It's probably no coincidence that throughout history artists, specifically poets, have been troubled by what we would call mood disorders. What has been commonly referred to as the "artistic temperament" may actually have been an indication of something deeper: depression, manic/depression, anxiety or some other form of emotional imbalance. During their lifetimes a great many poets lived lives of intense suffering and poverty as they were shunned by "normal" society and it was only in their art they were able to find solace. The insights into human nature and emotions which have been the hallmarks of some of the world's great poetry, ensuring their places in history, are in most cases a result of the writer suffering from some sort of trouble of the mind.
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When singer/songwriter Susan McKeown began researching her family tree she was startled to discover the high incidence of disturbances among the creative members of her ancestry. Fascinated by this correlation she set out to discover more, and soon realized her family wasn't an anomaly. In an effort to try and reduce some of the stigma attached to people dealing with these issues McKeown has created an album adapting the work of poets who wrote about those feelings. The result, Singing In The Dark, is a beautiful and haunting collection of work capturing both the emotional highs and lows experienced by the creative spirit.

McKeown has gathered together the work of poets throughout history whose work either reflects their own struggles with emotional imbalances or has something to do with the subject. Trawling through the ages she has reached back into our earliest works, "Mad Sweeny", whose origins lie in the 5th century and travelled through to modern times and Leonard Cohen's "Anthem". Along the way she pays her respect to writers on both sides of the Atlantic including Lord Byron, "We'll Go No More A Roving" and John Rowland, "In Darkness Let Me Dwell" from England; Nula Ni Dhomhnaill, "The Crack In The Stairs" and James Clarence Mangan, "The Nameless One" from Ireland; Theodore Roethke, "In A Dark Time" and Anne Sexton "A Woman Like That (Her Kind)" from America and Spaniard Violeta Parra, "Gracias A La Vida" (Thanks To Life) amongst them.

As you can tell from their titles these songs, poems, go places most of aren't used to, or interested in, going when listening to music. However, there's a reason these works have survived and are around today for McKeown to have adapted, and that's because no matter how depressing you might think the topic at hand is, there is something uplifting or compelling about each of the works. Part of that is McKeown's abilities as a performer and her incredible command of her voice which allows her to sing one song, "The Crazy Woman" by Gwendolyn Brooks, in an aching tenor and another, Cohen's aforementioned "Anthem" in a rich alto.

The material isn't hurt by the fact she has surrounded herself with what is obviously an amazingly gifted group of musicians and technicians who have helped her bring her vision to reality. I mention the latter because as I was listening to this disc I couldn't help but notice how cleanly the songs have been mixed so each instrument sounds like its been nestled in a cocoon keeping their integrity intact while still being obviously only one small piece of a much larger picture. With the variety of instruments being used it would have been easy for the sound to have turned to mud, instead it is crystal clear.
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Musically she also has some surprises in store for listeners. Upon reading the disc is composed of songs adopted from poems dealing with mental illness, one could almost be forgiven for assuming the material is going to be full of sweeping electronics, melodic strings, and other typical means of creating atmosphere. So it comes as a bit of a surprise to hear the amount of fuzz being used on the electric guitar on the Roethke piece opening the disc and the rocking lead guitar searing through the adaptation of Sexton's piece that follows. While in the opening track the fuzz serves as a contrast to McKeown's voice, on "A Woman Like That", she develops the roughness of voice to match the guitar. I like the irony of her dealing with a topic that's been subject to so much misconception by shattering a great many of the preconceived notions most people would have had about how this type of material would be presented. Just because its poetry doesn't mean its going to be pretty or precious. Of course if you think about it, with such gritty subject matter it makes sense for the music to be equally real.

However, no matter how interesting and well played the music on the recording is, its still the words which lay at its core. Here's where McKeown shows her amazing capacity for understanding the various aspects of emotional conditions. The material reflects not only a variety of experiences but the diversity of emotions felt by those who deal with them their whole lives. Again expectations are probably going to be dashed as in spite of what anyone might think, people suffering from emotional disturbances, even sever ones, are still quite rational and aren't necessarily depressed or manic all of the time. In fact one of the more prevalent emotions you can hear being expressed on this disc is hope. Whether its in the firmness of the convictions expressed by the woman in the "The Crazy Woman", "I'll not sing a May song/A May song should be gay/I'll wait until November/And sing a song of grey", or the knowledge that even when the darkness seems complete light still has a chance as Cohen's "Anthem" makes sure to point out, "Ring the bells that still can sing/Forget your perfect offering/There's a crack in everything/That's how the light gets in/That's how the light gets in".

There's no denying though, there are some pretty torturous paths being followed by the minds of some of the poets she has drawn upon. However when you read about their life stories, or the history surrounding a specific piece, as described in the CD's liner notes, you will see how a great many of these writers were pushed into darkness by their circumstances. Too often we tend to look at someone's behaviour and judge them without searching beyond to see what might have caused it. The number of abused women who are punished for being overtly violent, put into anger control programs, or worse, for lashing out at those who have been torturing them is only one indication of how deeply we are failing those dealing with emotional disorders.

Easing their burdens shouldn't be so difficult, and Susan McKeown's is another voice being raised on their behalf in an attempt to demystify these types of "illnesses". Not only does Singing In The Dark offer moral support, a portion of the proceeds from its sale are being donated the following groups helping people: National Alliance on Metal Illness (NAMI), Fountain House, BringChange2Mind and The Mood Disorders Support Group (MDSG). This is an album of spectacular singing, great musicand intelligent lyrics in support of a good cause - what more could you want?

(Article first published as Music Review: Susan McKeown - Singing In The Dark on Blogcritics.)

October 16, 2008

Book Review AIDS Sutra Various Authors

In 1860 a British act of parliament declared that sex between men was illegal and punishable by a jail sentence of up to ten years. The law went into effect throughout the British Empire including its largest colony, India. Unfortunately, when the British government repealed section 377 in 1967 it couldn't take back what it had imposed on its colonies the century before, and to this day homosexual sex is still illegal in India. (Speaking to a gathering of Indian delegates at last summer's, 2008, International AIDS conference in Mexico, Indian health minister A Ramadoss lent his support to the repealing of Section 377, but as of yet nothing has been done to do so)

The Bombay Police Act of 1951, which covers everything from frightening cattle to public decency, gives police the power to fine and arrest people they believe are behaving indecently. As the act does not define what is indecent, it gives police the arbitrary power to arrest virtually anyone they feel like. While in theory the act is to be used to curtail prostitution, the fact that the average police officer makes less than a maid results in widespread use of the act to shake down sex trade workers for money. Of course the constable on the beat has to give a cut of whatever he takes in to his superior officer. In fact if the lower grades among the police force ever want to advance up the ladder they are expected to pay off their higher ups on a regular basis thereby encouraging the practice.

Its reading disheartening facts like these, and other far worse anecdotal tales, that makes the new book AIDS Sutra, produced by the Bill & Melinda Gates Foundation and published by Random House Canada (available in India through Ramdom House India) so depressing. For all that India tries to present to the world the shiny face of a modern technologic giant, judging by what you read in AIDS Sutra when it comes to sexuality its stuck in the dark ages. One of the things this book makes clear is just how much these attitudes impact HIV/AIDS prevention and treatment.
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For AIDS Sutra the Gates Foundation gathered together sixteen of India's best writers and sent them out among the various communities in India affected by HIV/AIDS. AIDS Sutra tells the stories of everyone from orphan children living with the disease to women, men, and transgendered people forced to sell their bodies as a means of survival. Salman Rushdie, Kiran Desai, Vikram Seth, Nalini Jones, and twelve other authors have each contributed a report for the book that as fiction would be heartbreaking while as non-fiction are heart-sickening and horrifying in their implications.

The overall impression that you get from reading these works is that in general India is the same place North America was in the 1980's when it comes to their understanding of HIV/AIDS. There is still wide spread ignorance concerning how the disease is spread and it's only been recently that even the medical profession has begun to treat those suffering from the disease with something approaching the respect offered anyone suffering a serious ailment. Reading the story of Dr. Tokugha, as told by Nikita Lalwani, that opens the book prepares you for some of the ugliness to come. When he tested positive for the virus instead of informing him of the results, in a horrible breach of patient confidentiality, the hospital told his brother in law, a government minister. It was only six months later, a week before he was to be married, that his brother in law let him know he was positive.

Reporting on sex trade workers in various places around India Kiran Desai, Sunil Gangopdhyay, Sonia Falerio, and CS Lakshmi all draw similar pictures of women who have been pushed into circumstances by forces beyond their control. While some of them, mainly the younger and prettier ones, are able to command a degree of respect, the majority of them face the attitude of one police officer interviewed who said any woman who sells her body is bad so should be beaten, and wants sex, so should be raped.. Even more disquieting is new legislation being proposed by the government threatens to send them even further underground, making it harder for medical authorities and Non Government Organizations (NGOs) to work with them to help prevent and treat HIV/AIDS.

While the police in major centres like Mumbai (Bombay) are now starting to make attempts to educate new officers about the reality of AIDS, ingrained habits and conditioning will take years to overcome. As no records have been kept in the past there is no way of knowing how many police officers have been infected with the virus from exercising their "rights", raping sex trade workers instead of arresting them, and then in turn infecting their wives and other partners. The only group more difficult to monitor and help than female sex trade workers in India are men who have sex with men (MSM).
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With homosexual sex acts still illegal the stigma attached to being gay is such that many men are forced underground. Since sex is illegal they are continually at risk of being arrested and are routinely subject to harassment and extortion by the police. However according to articles by Salman Rushdie and Mukul Kesavan that's nothing compared to what happens to MSM sex trade workers. The police routinely set up entrapment ploys for them by sending a "client" out looking for sex in one of the regular cruising areas. When the client goes to leave the area to take his partner of choice somewhere they can have sex, the sex trade worker is arrested. If he's lucky he'll only have to pay off the police, but quite often they will be hauled back to the station house where they are gang raped by police officers and tortured.

As it is illegal to have gay sex, how do you set up programmes that will deal with preventing the spread of HIV/AIDS among that community? There are NGOs that do work with the MSM and transgendered communities in India, and as it stands the best statistics available show that 20% of MSM's are HIV positive. How many are still going undetected because of their reluctance to go public with the reason for them requiring testing is anybody's guess, as are the number of police officers who may be positive after participating in a scene as described above. Until the act making sex between men illegal is repealed in India, there can be no way of knowing the true numbers of people infected with the disease, and no way of mounting a seriously effective prevention campaign.

It's never a good thing to try and impose your own moral code unto another culture or to form judgements on it based on observations conducted by eyes conditioned to another value system. However, when a book like AIDS Sutra, written by people who are native to the culture, paints as devastating a picture of India's preparedness for dealing with HIV/AIDS, it's no longer a question of morality, it's a question of human rights. No one, no matter what their sexual orientation or gender deserves to be treated in the manner the people we meet in this book are treated. Even worse is the fact that the way they are treated not only endangers them, but endangers the population as a whole.

Reading AIDS Sutra one is forced to draw the conclusion that not only is the Indian government unprepared for dealing with preventing the spread of HIV/AIDS, the situation is such that there is no way of knowing the extent to which the disease is spreading across the country. For the country that gave us Tantric sex and the Karma Sutra, and whose pantheon of Gods and Goddesses contains a transgendered deity (Ardhanarishvara the half woman god) India seems to have somehow become stuck with horribly Victorian attitudes towards sex and sexuality.

In the West our governments ignored HIV/AIDS until it was almost too late because of bigotry and prejudice. India can't plead the excuse of ignorance when it comes to the disease as far too much is known about it for that to wash as an argument any longer. However, judging by the articles in this book the government which should be leading the fight to save the lives of its citizens is allowing conditions to continue that will only encourage the spread of the disease. The tragic conclusion one reaches reading AIDS Sutra is that India is headed the way of East Africa of ten years ago and risks allowing AIDS to reach pandemic proportions.

AIDS Sutra can be purchased directly from Random House Canada or an online retailer like Amazon Canada and in India from Ramdom House India.

August 13, 2008

HIV/AIDS: Sex Trade Workers, American Blacks, And A New President For AIDS International

Well the 17th International Conference on AIDS wrapped up in Mexico City over the weekend and despite being attended by over 22,000 delegates from more then 170 countries, not much of anything happened or was said that hasn't been said or done before. In fact aside from the appointment of a slightly controversial figure as the new president of AIDS International, the only event of any real importance during the Conference was a plenary session featuring a representative of an Argentine Sex Workers association as it marked the first time that anybody from the industry was given standing at the conference. In fact it was so inconsequential an event that the biggest news of the week regarding the disease actually took place outside of the Conference with the release of "Left Behind" a report from Black AIDS Institute on the impact of the disease on their community.

Julio Montaner of British Columbia, and the director of the B.C. Centre for Excellence in HIV/AIDS was confirmed as the new president of the International AIDS Society at the end of last week's conference. He brings not only a wealth of experience to the job but an outspokenness that's seemed to be sorely lacking amongst AIDS bureaucrats for too long. Dr. Montaner came to Canada in 1981 after graduating from medical school in Argentina, and began working at St. Paul's Hospital in Vancouver, British Columbia. As well as his residency he also began a research project involving the then obscure disease known as pneumocystis carinii pneumonia, which we now know as AIDS.

It was Dr Montaner who started treating the disease with corticosteriods, worked on the first clinical trials for zidovudine (AZT) that was standard treatment for HIV/AIDS for over a decade, and helped pioneer the use of antiretrovirals, the drug cocktails that keep people with the disease alive far longer today then anything else has yet. He also has led the way in making the B.C. Centre an international leader in the field of HIV/AIDS, and making St. Paul's Hospital one of the best treatment sites in the world. He's also a very strong advocate in support of Vancouver's safe injection facility for intravenous drug users, Insite.

His support of Insite, and his general outspokenness, has drawn the ire of Canada's conservative federal government. Federal Minister of Health Tony Clement has even gone on record as criticizing Dr. Montaner by saying he and his colleagues have crossed the line from being scientists to being advocates and activists.

Dr. Montaner's response to his critics was best summed up by his speech at the closing ceremonies of last week's conference where he said that the world's failure to work more resolutely to combat the global epidemic is tantamount to a crime against humanity. He continued by saying we know what causes it, we know how to prevent it spreading, and we've even learned about ways to treat it, so what really matters now is taking action. In others words it's time to shit or get off the pot folks and take some direct action by doing what we know works in order to keep people alive and prevent the disease from spreading any further.

One of most common ways the disease is spread in many parts of the words is through the men, women, and transgendered folk who make their livings selling sex. Up until now nobody has thought to include a representative of the industry at these conferences, which hasn't stopped many organizations from deciding they know what's best for them and often causing more harm then good. This year Elana Reynaga, executive director of the Argentine Association of Female Sex Workers (AMMAR) didn't mince any words when addressing the conference about the current situation facing people around the world in the sex trade.

While her speech was peppered with statistics about the rate of infection among sex workers, its primary focus was to stress the following concerns: people working in the industry be recognized as being legitimately employed, workers be involved in the organization of any programming that impacts on their lives, and that there be an immediate ceasing of passing moral judgements on them as individuals and the nature of their work. In denying them their legitimacy and trying to forcibly "rehabilitate" sex workers, agencies like the International Justice Mission (IJM) who are funded to the tune of millions of dollars by the Gates Foundation to prevent the spread AIDS by fighting prostitution, cause more harm than good.

By coercing governments to crack down on prostitution, they get the American government to threaten to remove states from favoured nation status when it comes to receiving foreign aid, the sex trade is forced underground and the chances of infection increases exponentially. On the other hand, Ms. Reynaga sites the example of Brazil where the government collaborated with the Brazilian Network of Prostitutes on a public health and rights campaign called "No shame girl you're a professional" and the Ministry of Labour now includes prostitute among the list of recognized professions as part of their efforts to combat the spread of the disease.

The continued stigmatization of sex workers and the denial of their rights as individuals places them more at risk then anything else. In some countries sex workers aren't even able to carry condoms as police will use them as evidence of prostitution and threaten to arrest them. As Ms. Reynaga so bluntly puts it, sex workers are dying because of a lack of health care, a lack of condoms, a lack of treatment, and a lack of rights - not because of a lack of sewing machines. (IJM suggests that sex trade workers be taught how to sew so they can get "decent" employment - of course well paying sewing jobs are just lying around waiting to be snapped up aren't they)

Sex trade workers have always been one of the groups at highest risk when it comes to HIV/AIDS, yet instead of helping them organize in their own defence, money is actually being spent on programs that puts them at more risk than if we were to do nothing. Isn't it time people grew up about sex and accepted the fact that people are always going to be willing to buy and sell sex? Instead of trying to pretend it doesn't exist, or pretend we can make it go away, why not ensure that the people involved are as safe as possible by helping them help themselves?

While sex trade workers finally getting a public voice and International Aids selecting a president who will hopefully push for more direct action on fronts that are actually effective is a good sign, the biggest news of the week concerning AIDS didn't come out of the conference in Mexico City, but from north of the border. The Black AIDS Institute's report "Left Behind" revealed statistics that make it obvious that the disease has reached epidemic proportions in Black America. While African Americans only make up thirteen percent of the total American population, 50% of Americans with HIV are African American.

In every single risk group black people are more far more likely to be infected than whites: gay men who are black are twice as likely to be infected as white, more then half of infected drug injectors are black, black people are more likely to be diagnosed late then white which contributes to a much higher death rate - in New York City a black man with HIV is twice as likely to die as a white man with HIV. With black men seven times more likely to be imprisoned than white men, and the percentage of prisoners in the US with access to condoms hovering at 1% of the inmate population, jail represents another real risk to black men for infection.

Unlike other "countries" Black America not only sees a high infection rate among it's at risk population - men who have sex with men and intravenous drug users - it also is showing signs of having symptoms of a generalized epidemic - where the whole population is at risk. While only a quarter of black men have been infected by unprotected sex with women, three quarters of black women have been infected by unprotected sex with men. With black women reporting having multiple partners in a limited time, the chances of the disease spreading among the general population increase dramatically. The report warns of this danger and admonishes black men to be more responsible when it comes to sex.

What must be the bitterest pill for the authors of this report to swallow is the fact that prevention accounts for only four cents out of every dollar spent on domestic programs for HIV/AIDS. Even more ironic is the fact that although the US government insists that countries it funds help combat AIDS have a strategy in place before they receive a penny of aid, America has no strategic plan to combat its own epidemic. It seems like the government of the United States would like its citizens to believe that HIV/AIDS is only something that happens to other people, but not to Americans.

When you combine the statistics reported in "Left Behind" with the disturbing revelation that the U.S. Centre For Disease Control and Prevention has been low balling it's estimated number of new cases of HIV by around 16,300 annually for the last ten years, it starts to look like government has been ignoring the problem in the hopes it will go away. Even worse it looks like they have been cynically hoping as long as they can keep it contained to minority populations, not enough people will care for them to have to do anything about it.

Although if you take these figures in the context of the current American government's policy of allowing their moral agenda to trump actually achieving results with regards to HIV/AIDS funding in foreign countries, their attitude on the home front isn't very surprising. Would you expect them to fund money to hand out condoms or clean needles to prostitutes or intravenous drug users in the United States when they won't over seas? "Left Behind" concludes by saying that as long as we continue to allow political or moral issues to dictate the way we deal with HIV/AIDS people will continue to die.

The numbers don't lie no matter what country or continent you live on. Every year more people are still being infected with HIV/AIDS then are receiving treatment which means not enough is being done to actually prevent the spread of infection. While there was some sign of movement towards a more accepting attitude with regards to sex and the disease at the most recent International Aids conference, and a renewed call for action over talk, we have delayed taking action for so long that it could take decades before we are able to climb out of the hole we've dug for ourselves.

August 7, 2008

New Words To An Old Refrain At The 17th International Aids Conference

The 17th International AIDS Conference, taking place this year in Mexico City, kicked off on Sunday August 03/08 with the President of Mexico, Felipe Calderon Hinojosa, officially welcoming around 22,000 delegates from 175 countries to the gathering. While Mr. Hinojosa's appearance makes a change from 2006 when Canadian Prime Minister Steven Harper refused to attend the Conference taking place in Canada, it looks like nothing much else has changed from two years ago when it comes to actually dealing with the disease.

Of the 22,000 or so people who have shown up in Mexico City, one has to hope that they are all aware that HIV/AIDS can only be spread by an infected person sharing bodily fluids with an uninfected person. So in order to prevent the spread of the disease all you have to do is reduce the chances of that happening. Statistical evidence gathered over the past twenty years by organization such as UNAIDS and the World Health Organization (WHO) shows that making condoms available for sexually active people and supplying clean needles to intravenous drug users are the two most effective ways of preventing the disease from spreading as those are the two most common ways the disease is spread. (Please see Elizabeth Pisani's reference page at her Wisdom Of Whores web site for support documentation and statistics)

However, judging by the way things are shaping up at the conference people are either reluctant to talk about the issue of prevention directly or even worse oppose the means of ensuring delivery of preventative measures. For example instead of talking about condoms and needles, the latest refrain is "prevention by treatment". While it is of course inexcusable that only four million out of the thirty-three million people world-wide currently estimated to be infected with the disease are receiving treatment, arguing that ensuring everybody infected is treated will prevent the disease from spreading is a fallacy.

Although it is true that once a person is on the anti-viral medication used to prolong an AIDS sufferer's life expectancy they are less infectious, they can still transmit the disease and need to take the same precautions that anyone else does. The problem is that statistics are showing that once people start taking the medication they believe they aren't a threat anymore and stop taking preventative measures.

Other problems with this approach is what do you do about people who are infected but don't know it? If you don't know you're infected with the virus you're not liable to be taking the anti-viral cocktail of medications required to fight the HIV/AIDS virus are you? Now consider that in light of recent statistics that show 1 in 5 of homosexual men in New York City who test positive for the virus already have full blown AIDS. Considering how long it takes to develop full blown AIDS after you have contracted the HIV virus - sometimes ten years - it means these men have been infectious for that length of time without knowing.

What makes that statistic truly alarming is that the gay community of New York City has been one of the most effective and organized in combating the disease and educating its membership about the dangers of unprotected sex and the importance of early testing. If those conditions exist among as an aware and active community as that, you have to wonder how many other people around the world are walking around un-diagnosed. The normally reliable U.S. Centres For Disease Control and Prevention just announced that the figures they released detailing the number of new cases of HIV in the United States for 2006 was off by 16,300 as there were actually 56,300 not the 40,000 they had originally estimated.

What the hell's the good of using treatment as prevention if we don't even know how many people are even sick, or if they've been sick for any number of years before they even obtain treatment? Anyway the whole idea smacks of closing the gate after the horse has escaped the barn. If you can prevent someone from getting the disease they aren't even going to need treatment. It seems to me the folk recommending this new plan really need to remember the old adage of an ounce of prevention equalling a pound of cure. Especially since we don't even have a cure, only treatment that will prolong life - not save it.

Of course the real problem isn't the people who are pushing this new strategy, the problem is the people they are trying to do the end run around. The biggest problem faced by people working in the HIV/AIDS field has been having to work around politicians and religious leaders who still live in caves and wont fund anything to do with needles, condoms, sex trade workers, or homosexuals. In order to secure funding they have had to convince these folk that "innocents" (women, children, and straight men) are at risk and talk about everything but the people most at risk and the ways that can best prevent the spread of the disease.

Just look at what happened yesterday, at what is supposedly a conference on how to fight HIV/AIDS. Canada's idiot Health Minister, <Tony Clement, gave a press conference attacking Insite, the safe injection site for intravenous drug users in Vancouver British Columbia. He chose to do this in spite of the fact that it completely disregarded the information released by WHO spelling out how effective such sites are for harm reduction, specifically the spread of disease. His government's reason for not liking Insite or any other safe injection site? They can't arrest the people who use them.

Is it any wonder that HIV/AIDS new infection rate still outstrips the number of people receiving treatment by a ration of 5:2 (according to the latest statistics from UNAIDS, for every two people receiving treatment there are five new cases of HIV/AIDS reported) when we're dealing with people with this type of attitude? For the longest time people have even tried to avoid saying which groups are most at risk from the disease for fear of marginalizing them even more than they are already.

Thankfully people like Stephen Lewis, former UN special envoy to Africa for HIV/AIDS, and Joe Amon, health and human-rights director at Human Rights Watch, are at least demanding that the rights of those most at risk must be protected and steps taken to ensure their access to treatment. It's a small step, but at least it's a step in the right direction. Still it's a sad state of affairs when at a conference dealing with a disease for which there is no cure and no vaccine, they can't talk about the best ways of preventing its spread in the opening addresses.

I know it's early days yet and the 17th International AIDS Conference still has a way to go, but from the looks of things we're no closer to dealing with the reality of HIV/AIDS now then we were when the first conference was held. As long as we continue to allow a moral code based on bigotry and hatred to dictate health care people will continue to die and the disease will continue to spread.

August 1, 2008

New HIV/AIDS Figures - Same Old Story

Well, for a change there's a little bit of good news in the world. The 2008 Report on the Global AIDS Epidemic by the United Nations agency responsible for AIDS, UNAIDS, shows that efforts around the world are finally starting to pay off as there are declines in both the numbers of people being infected with, and dying from the virus. On top of that the number of people living with AIDS has stabilized and more people are receiving proper treatment as well.

While Paul De Lay, director of evidence, monitoring, and policy at UNAIDS, said that the increased efforts in teaching people prevention methods are beginning to make a difference, as shown by the drop in the infection rate, he also cautioned that the epidemic was not over in any part of the world. The number of cases may be stabilizing - i.e. not showing any increases - but that number is still very high, and there are parts of the world and marginalized communities where the virus continues to run rampant. As an example he sited the figure that two of every three new cases of AIDS occurs in the Sub Saharan region of Africa.

While some of the figures the report sites show improvement on various fronts: actual number of people living with HIV/AIDS 33 million, new infections down to 2.7 million from 3 million in 2001, total deaths down from 2.2 million in 2005 to 2 million in 2007, number of children infected down from 410,000 to 370,000 in the same period, and the percentage of infected pregnant woman receiving anti-viral drugs has risen to 33% from 14% in those two years, they also show just how far we have to go in order to bring the disease under control. With a new infection rate of 2.7 million people each year and no cure in sight for the disease, it means that any let up in prevention efforts could see the numbers spiralling upwards again.

An example of the breadth of the problem that's still being faced can be found in another figure quoted by Dr. De Lay: for every two new people receiving treatment in the world there are still five new people contracting the disease. Treatment is very expensive, and according to Purmina Mane, deputy executive director of the United Nations Population Fund, the cost to supply everybody currently infected with the disease would be 11 billion dollars American annually. That's a cost that will continue to rise substantially of course, unless something is done to reduce the annual infection rate.

While it's possible that the United Nations might reach the target date of 2015 for achieving an actual decline in the numbers of people living with HIV/AIDS, it's goal of universal access to treatment, prevention, care, and support for all those living with the disease by 2010 is not looking good. That makes me wonder how much of the first goal will be met by people currently infected dying, and how much by any actual reduction in new cases of infection? If we can't provide universal prevention, how can we possibly stop the spread of the disease?

The problem is that universal prevention isn't going to happen given the current political climate in the world. The simple facts of life when it comes to HIV/AIDS is that nothing has changed since the 1980's and in order for the virus to spread you need an infected person, an uninfected person and an exchange of bodily fluids between the two of them. The most common ways that happens is through unprotected sex and intravenous drug users sharing needles. Theoretically it should be easy to prevent the disease from spreading, simply ensure that neither of those events occur.

Unfortunately there is quite a bit of disagreement on how you prevent unprotected sex or intravenous drug use. According to the Catholic Church, the current American administration, certain conservative Christian groups, and various Muslim sects the use of condoms is worse than spreading disease, so they recommend abstinence. Actually, they insist on it, at least as much as they are able to. In the case of the current American administration that includes refusing to fund any program that advocates condom use anywhere in the world.

While some countries have remarkably sane attitudes towards ensuring a supply of clean needles for intravenous drug users, Iran has needle dispensers on the streets of Teheran and a needle exchange program in its prison system, others are like Canada and the United States where needle exchanges are barely tolerated and they refuse to admit that drug use even exists in prison. Of course the prisoners don't have sex either, so there's no point in supplying them with condoms.

The solution offered by these folk is for everybody to abstain from pre-marital sex and using intravenous drugs. While the second suggestion is noble, and a good idea, the former is utterly ridiculous, and both deny reality. In the United States itself only twenty-seven per-cent of those people who sign so-called abstinence oaths promising to refrain from pre-marital sex, actually follow through on their vows. Even more unfortunate is the fact that the majority of those who succumb to temptation don't use a condom, so not only risk contracting a sexually transmitted infection, but the other, more traditional, side affect of sex, pregnancy. If the programs success rate is that poor in the U.S. among those who are supposedly willing, what does that say about it's validity as a means of prevention elsewhere?

I started off by saying that there was some good news for a change, and have pretty much gone on to refute that statement with the balance of the article. However, any signs that inroads are being made against the spread of HIV/AIDS are positive and a reason for hope. The problem is that the position is still very precarious and it's not being helped by those who willing to risk other people's lives by imposing their morality on the world. If you don't want to use a condom when you have sex that's your choice, but don't force somebody else to risk their life for a little pleasure.

As former UNAIDS employee Elizabeth Pisani says commenting on the report at her "Wisdom Of Whores" web site, "...somewhere between two and three million people are still getting infected every year with a completely preventable disease that we are spending over 10 billion dollars a year on. That’s a scandal that no amount of report-writing has been able to change."

We've known for close to thirty years how to prevent the spread of HIV/AIDS yet the disease was allowed to reach epidemic proportions because of so called moral issues and those attitudes haven't changed. The miracle is that there has been any decline in the number of deaths and infections - thank God for the immoral people out there passing out condoms and making a difference.

July 9, 2008

Interview: Elizabeth Pisani Author Of The Wisdom Of Whores & HIV/AIDS Advocate

A few months ago I wrote a review of Elizabeth Pisani's book The Wisdom Of Whores which recounted her work combating the AIDS epidemic in South East Asia. In the book she talked candidly about issues that most people are still afraid to speak about openly when it comes to the disease. A great deal of what she talked about is the need to ensure that the world doesn't become complacent when it comes to the issue of AIDS prevention.

As more and more drugs have come along that can extend a person's life once they have contracted the disease, and money is being poured into searching for a vaccine, less and less is being said and done about the nitty gritty of AIDS prevention. Most political and religious leaders would rather talk about how much money they are spending on a vaccine instead of talking about making sure intravenous drug users having clean needles or transgendered prostitutes have condoms.

Even sillier are the ones who start postulating about how things as unrelated as Global Warming, are causing the virus to spread. While there is some truth to the fact that poorer countries are hit harder by AIDS, economic factors are not the major contributor to the spread of the disease that people would like to think. For the disease to be transmitted it still requires an exchange of blood to occur between an infected and an uninfected individual. Unprotected sexual activity and sharing dirty needles are still the two main reasons that the disease is spread.
The Wisdom Of Whores cover.jpg
Elizabeth Pisani called me from London England on Tuesday July 8th to talk about the Wisdom Of Whores. She had just retuned from a three week tour or the United States promoting the book there. When we had set up the interview she had suggested waiting until after she was done with her book tour of the United States so we could talk about the reactions to the book. Things didn't quite go as planned, as you'll see, and we ended up having a rather free wheeling discussion about the state of HIV/AIDS prevention and policy around the world.

You've just finished an extensive book tour of the U.S. for Wisdom Of Whores, and you're still among the living, but I'm guessing it wasn't without its moments

Well to be honest, there was almost no public reaction at all. (laughs) Which in itself says something. There seems to be a huge amount of reluctance on the part of the media to deal with confrontational issues.

Well what about reviews - the New York Times and the other big papers - nothing?

Nothing - there was only one review that has been published in the mainstream press since the book was released at the beginning of June. That was in the Philadelphia Enquirer, and it was a very positive review too. There has been quite a bit in the blogsphere though, and I had some radio interviews on National Public Radio (NPR), but that was it.

Even in cities like San Francisco, where you'd think they'd notice a book about AIDS, there wasn't anything at all in The Enquirer or any of the papers. I did have a meeting with the head of one of the grass roots organization in San Francisco, and that was good. He and I don't always agree on everything but I have immense respect for the work he and his people have done.

So no, there are no real "Moments" to talk about that happened in any of the public meetings. Interestingly enough though the book is selling better in the States than it is in Britain where I've had all sorts of press. It was strange to go from being in the pages of The Financial Times to nothing - but there it is.

Where I did get some reactions was in the private meetings at places like the World Bank, The Gates Foundation, and USAIDS.

Well that was a question I was going to ask you a bit later on - so I might as well ask it now. What has been the reaction of places like that to the book

I was scheduled to give a sort of brown bag, lunch time talk, with questions and answers at World Bank headquarters in Washington DC. I had been told not to expect many people, maybe ten or fifteen, but it ended up being standing room only - so about sixty people, which was quite wonderful.

What was the subject of the talk?

The interaction between prevention and treatment, and how we in the AIDS profession are still getting it wrong by not focusing our energies where they are truly needed which is on the high risk groups; men who practice anal sex, the sex trade, and intravenous drug users.

I don't get it - way back in the early days anybody I knew who was aware of the disease knew those were the people most at risk, and we also knew how the disease was transmitted - why is it still so hard for people to get that message?

There are really two issues at hand here, one is partially the fault of us in the AIDS industry and the other is the concern over the stigmatization of those in the affected groups. Unfortunately there is a very real concern when it comes to the latter; by saying men who have anal sex, people in the sex trade, and intravenous drug users are the ones most at risk for transmitting the disease you set them up as pariahs. As these are also people who already exist on the margins of most societies, or are a minority already subject to harsh treatment, labelling them most at risk for transmitting the disease increases the chances of them being ostracized.

Knowing full well that politicians weren't going to want to put up money for gays, sex trade workers, and needle users, the threat to people outside the high risk groups was stressed in order to secure any money at all. The trouble is that the money isn't being spent on the areas where it's most needed. It's all very well and good to have programs for people in the low risk groups, but if we don't spend the money on those most at risk what are we really doing to stop the spread of the disease?
For example in the Bronx, the borough in New York City, they've just announced a program where they are going to test everybody over the age of fifteen for the virus. That includes people who have been widows for twenty years and the celibate - people who are at no risk of getting the disease. We already know who are at most risk, and wouldn't the money be better spent on testing them, providing them with treatment and setting up programs to stop them from spreading the disease?

In New York City one in four of gay men who are coming in to be tested are not only HIV positive but they are already in the throes of full blown AIDS - which means they are waiting for symptoms of the disease to show before they come into get tested and by then they are at the most infectious. There's something seriously wrong with that, and its because we're not doing enough to work on prevention.

In Canada we just had the recent furor over a safe injection facility in Vancouver British Columbia - Insite - that the federal government was going to close, but thankfully a judge in British Columbia ruled they couldn't because it provides a health care service. The attitude from the government was one of - I don't care about junkies

Right and that's the vicious circle people working in the world of AIDS are dealing with. If there was ever an under serviced area in the world right now it would be the East side of Vancouver. I've seen some pretty bad spots in the world and that's just horrible. The people there are trying so hard to do something but they have so little to work with. Insite is only able to cope with 5% of the people injecting on the street.

Here's an irony for you, when the people opposed to Insite found out that figure they tried to make it part of the argument against keeping it open by saying, well they can't be doing much good if they're only servicing five per cent of the population. Of course all that means is they don't have the resources to do any more.

Well you can make statistics say anything can't you?

Oh yes, you can torture numbers to say what you like easily enough, but it doesn't change the reality of the situation. We know that there are only very specific circumstances required for the HIV/AIDS virus to be spread; an infected person, and uninfected person, and an exchange of bodily fluids. So obviously you have to prevent the spread of bodily fluids from the first to the second.

Yet, I was at USAIDS saying just those things while I was in the States and the director says to me: "I never thought of it that way before". Maybe I'm a little too Pollyanna, but I hope that by constantly keeping pressure on the people delivering services that we can at least get them to spend the money in the areas where it's needed. Go ahead and do all your studies and set up your programming with the other groups, because of course its needed, but don't do it at the expense of the people who are at most risk of contracting and spreading the disease. Unfortunately that's the situation we are currently in.

Even before I read your book I had the impression that people are very defensive when it comes to AIDS prevention - and any critical evaluation, no matter how constructive, is treated like an attack. Is this a valid impression and if so how did this fortress mentality come about?

I'd like to say it's not true, but unfortunately it does exist. There are two types of people who get involved in HIV/AIDS work; those who give a shit, and those who are there because that's where the money is. Those of us, like me, who are in because we give a shit want to to believe we know what works. We know the communities we work with and how to best reach individuals within it - who is going to react positively to what incentives to use what prevention methods. I think if we didn't have that belief we wouldn't be able to keep doing what we are doing - you have to have the feeling that you're making a difference otherwise how could you keep on doing it?

The result is we only want to hear good news, we don't want somebody like me coming in from the outside saying well you know this isn't working because of such and such. It's so hard to get funding for programming that you fear that anything negative that comes up will adversely affect the programming you know that is working well, or that you believe should work.

For example I know, I firmly believe that there is a co-relation between preventing the spread of other Sexually Transmitted Infections (STIs) and preventing the spread of HIV/AIDS but the data just doesn't add up. No matter how I look at the statistics I can't prove that working on one helps the other - yet I know that it has to be true.

Of course the second group of people, those in it for the money, want to show they are doing a good job so they can keep on getting their funding and have jobs for themselves.

Recently there's been talk by the Canadian government of refocusing the direction of their HIV/AIDS funding away from grassroots organizations towards putting it into research on a vaccine. To be honest I'd never even heard talk of a vaccine before this - how realistic a goal is that?

The vaccine has become the latest pet project, the Gates Foundation has been sinking a lot of money into it. While I wouldn't say we should give up on the vaccine, it's so far been a very disappointing failure. Of course it's very safe politically, because you don't have to say anything about the money being spent on anything controversial like needle exchanges in prisons, but it looks like you're doing something. If I may be so bold, for the amount of money that Canada would be putting up, it wouldn't really accomplish much and would be better off spent elsewhere. Huge amounts of money are already being spent on it by Gates and the World Bank

Yeah well Gates has more money than our GNP, so if he's putting money into it what difference would our few dollars make?


How are other countries dealing with the three high risk groups. Especially countries that we in the West might consider resistant to talking about sex and drugs

Well one of the biggest success stories working with the sex trade was in Cambodia, where the government had worked out an arrangement with the brothel owners so that condom use was being promoted among all the workers. Unfortunately the US government, under pressure from the International Justice Mission (IJM), who I call Cops For Christ, threatened to remove Cambodia from their donor list if they didn't crack down on the sex trade in the country.

Cambodia did have a serious problem with child prostitution, that was simply shocking, and that needed to be dealt with, but instead of just targeting those specific cases, the government was forced to close down the whole system. The result was that the all the brothels were raided, the girls were raped and had all their savings and gold stolen from them by the cops, and the trade has been driven underground where there is no government control or regulation. It hasn't stopped the sex trade

(In her book The Wisdom Of Whores, Ms. Pisani goes into details about the events in Cambodia and the problems the IJM create where ever they go. The girls they "rescue" from prostitution have no means of making money and are dumped on local service agencies who don't have the facilities to deal with them. IMJ are despised and distrusted by the local police and the sex workers for making the problem worse not better. The girls are forced to take re-education courses - like sewing - for six months during which time they are not paid. There are many cases of them using ladders and rope made out of their bed sheets to escape the shelters they have been sent to after being rescued. As one prostitute put it to the author "Look, if I could afford to be going to school for six months without pay I wouldn't be selling sex".

The final tally is that by the end of 2005 fewer then 1000 girls had been successfully rescued from a life of prostitution, and the IMJ had received five million dollars from the Gates foundation to fight prostitution and the HIV/AIDS it was supposed to spread. On the other hand the Cambodian government's program had ensured that an estimated 970,00 Cambodians had used condoms when they bought sex by the same date.)

The real big surprise is in Iran, where they have set up needle dispensers on the streets of Teheran so that anybody who needs a clean needle has ready access to them. They also have needle exchanges in prisons there.

It's been reported in the Western media that Iran claims they don't have any homosexuals

Oh, most of the Middle East is still really bad when it comes to the issue of Homosexuality. In fact in Egypt they arrest anyone with HIV/AIDs because they take it as a sign that you're gay, which is illegal. I thought we'd grown up somewhat and were beyond that. It was just as bad in Africa where up until a short while ago in the sub-Saharan area they denied they had any homosexuals at all. Of course there homosexuals are probably no more at risk than heterosexuals when it comes to contracting the disease as it's so widespread.

Africa has obviously been the worst case scenario for the AIDS virus. At one time people were predicting that India was another Africa just waiting to happen - do you know have any information about that situation?

I've not worked on the ground in India since I was a reporter so I don't have any first hand experience but I do know the data and some of what's been going on there. UNAIDS, on the last World AIDS day - December 1st/07 - actually revised the projected number of people infected with the virus downwards by two million, from five to three million. It was a classic case of not looking at the right groups and using misleading data to base their estimations on.

The data that the figures had been based on was collected from a couple of hospitals where all the difficult cases were being referred to, and these hospitals had a large number of pregnant women coming to them with the infection. From that information they postulated that pregnant woman were a high risk group for infection across the country. At the same time they were almost completely ignoring the people in the high risk groups. This of course skewed the original tally badly - it take make it better politically to be able to say that pregnant women were at risk, but it meant nothing was being done for those who really needed treatment.

At one point there was only one web site providing information for people in the sex trade and something like two for homosexuals and one for intravenous drug users - or is that the other way around - at any rate this in a country of close to a billion people.

Thankfully, this is one country where Bill Gates, bless him, has done something useful. He offered the country 110 million dollars on the condition it be spent on prevention programming for high risk groups. When the federal government dithered and held their hands up in horror, he by passed them and went directly to state and municipal governments who gladly took the money and began implementing programming. What's even better is that other states have seen the success they've had and are creating programs based on them.

So now that you're no longer in the sex and drugs business, what are you going to do now for excitement?

Well I don't really feel like I've completely left the business, what with the book and all. I'm still out talking to people about the issues and I'm still doing the occasional consulting work, and reviewing articles for journals. To be honest what I miss is the most is the number crunching - the excitement of discovering something new or finding the proof that what I believed to be happening was actually happening.

Well this didn't turn out quite the way we planned - I still have a hard time believing there's been so little notice given the book in the press and there was so little reaction at all in the States

Well there was one good story I can tell you, it was during a radio call in show in Illinois on the NPR station. I took this one call from a gentleman who was very much in agreement with a lot the things I had been saying. At one point he said, well wouldn't it make sense to legalize prostitution? What was really surprising was he was a State Senator for Illinois.

Thank you very much for this Elizabeth

Your welcome.

Well I have to say that I had had visions of hearing tales of Ms. Pisani receiving death threats over the phone and being denounced from pulpits across the South or something similar when we set up this interview. Here she was, a woman who took great pride in saying she worked in sex and drugs going to the country who ties foreign aid to their version of morality. The fact that the book is being completely ignored is probably even scarier than it being the subject of debate or her the object of hatred. Although I'm not sure if it's as scary as hearing that the director of USAIDS had never thought about the correlation between how the disease is spread and how to prevent it from being spread.

The good new is that people are buying the book in spite of the lack of acknowledgement in the press that it's been published. In the United States the book is being distributed by Norton Books and in Canada through Penguin Canada. If you're interested in keeping up to date on information pertaining to HIV/AIDS you can check out Elizabeth's web site.

May 29, 2008

Insite - Canada's Safe Injection Site Reprieved By Courts

Insite, Vancouver, British Columbia's safe injection facility for intravenous drug users, has been granted a stay of execution, and possible full time salvation. On Tuesday British Columbia's Supreme Court ruled that users and staff be granted a permanent constitutional exemption from Canada's drug laws. In his ruling Judge Ian Pitfield declared that allowing addicts to inject drugs in a safe, medically supervised environment is a matter of sensible health care and they should not be under threat of arrest.

By declaring Insite a health care facility and exempt from drug laws, Justice Pitfield took the facility's fate out of the hands of the federal government. Under their current arrangement, Insite's temporary exemption from Canada's drug laws was due to expire on June 30th, and it was widely suspected that the current government was preparing to close the facility down. In his ruling the judge gave the government until June 30th 2009 to redraft Canada's laws to reflect his findings, giving Insite at least a year's reprieve.

Well there's no word from the government on whether they will appeal the decision or not, federal Health Minister Tony Clement's reaction made it clear they were preparing to close the facility. He said that the government was disappointed with the ruling, and they believed that the best way to treat addicts was to prevent them from "getting onto illicit drugs in the first place", and that they didn't consider it the best health outcome to keep people in a position to inject illicit drugs. He continued by saying the government is examining their options, and that the Justice Minister will announce whether or not they will appeal Judge Pitfield's ruling.

In his findings Judge Pitfield disagreed with the government's position on the role that Insite and other facilities of its kind has to play in the treatment of addiction. He said that while society can't condone addiction, in the face of its presence it has an obligation to manage it. According to his findings, addiction is an illness and he praised Insite's philosophy of harm reduction aimed at saving lives and reducing the spread of infectious diseases. While agreeing with the basic tenet that there is nothing to be said in favour of injecting controlled substances, he argued that there is much to said against denying health cares services that will cure addicts of their condition.

Insite was first given exemption from the federal Controlled Substance and Drug laws in 2003 by the previous Liberal government. After its initial three year exemption expired, the current Conservative government granted it two, temporary one year extensions, claiming they needed more time to gather and study information about the success or failure of safe injection sites around the world, and Insite specifically. Considering this government's history of taking a hard line on illicit drug use, and recent announcements implying they didn't care what the research said, (when a government study showed Insite in a positive light, Minister Clement said the decision on its fate would be based on more than "just science"), it was widely believed that they were not about to extend the facility's life any further.

However, if Judge Pitfield's ruling stands, and safe injection sites are considered as health care facilities, not only will Insite stay open, the possibility exists for safe injection sites to be opened across Canada. Indeed, British Columbia's Health Minister has already gone on record as saying that not only is their government glad to be able to continue to fund Insite, but they are prepared to start opening new facilities across the province as needed.

Safe injection sites have been saving lives and reducing addiction levels in countries in Europe for years, and it looks like Canada is set to join the ranks of those nations taking a more humane stand on the issue of addiction treatment. As Judge Pifield reasoned in his findings, society doesn't condemn the individual who chooses to drink or smoke cigarettes to excess, or deny them access to a range of health care services, so there is no rational or logical reason why the approach should be different when the addiction is narcotics.

May 19, 2008

Logic & Reason: The Latest Victims Of HIV/AIDS

There's an old saying about health care that follows along the lines of something like an ounce of prevention equals a pound of cure. That's probably not it exactly but you get the general idea; preventing an illness is a heck of a lot more effective a means of health care than curing it. It only make sense, once somebody gets sick there's no telling what could develop and how serious it could get, so it's best if they never get sick in the first place.

It seems to me that it would make even more sense when it's a disease as fatal as HIV/AIDS. There's no cure for HIV/AIDS, but there are many ways which to prevent the spread of the disease, even among those at the highest risk. Condoms for people who have sex with multiple partners and clean needles for people who inject intravenous drugs isn't a hundred percent guarantee that HIV/AIDS won't be passed from one person to another, but it's a heck of a lot safer than any of the alternatives out there.

What about abstinence you ask? Well sure, if everybody, everywhere in the world, stopped having sex before they were married and only ever screwed one person in their whole life, it would go a long way to preventing the spread of HIV/AIDS. However, I don't know what world you're living, but for the one I live in that's not what I'd call a realistic proposition for even the heterosexual population. In fact according to statistics reported in Elizabeth Pisani's wonderful book on HIV/AIDS The Wisdom Of Whores in North America alone 70% of people who sign abstinence oaths end up having pre-marital sex. As an interesting aside the majority of those people also have unprotected sex, as nobody seems to have bothered educating them about condoms.

So with evidence like that you'd think that it would be a no-brainer for there to be a concentrated effort the world over to ensure that we focus on getting condoms to people in the sex trade or in other high risk groups, and ensure that intravenous drug users are given every opportunity possible to get clean needles. Unfortunately there are people who think that people dying of a horrible disease is less important than forcing everybody live by their moral code. So the Catholic Church, conservative Christians, and fundamentalist Muslims the world over have formed an unholy alliance to ensure that people don't commit the horrible sin of practising something that could be construed as birth control or that we even give the appearance of condoning drug use..

According to these good folk the only reason to have sex is for procreation, and if you're having sex for procreation than you don't need to use a condom. Which is all very well and good, but when was the last time you knew of a prostitute having sex for reason of procreation? Or how about gay men; do you think they have procreation in mind when they have sex? Of course homosexuality is probably an even bigger no-no than birth control in the eyes of the previously mentioned trinity, so you can't expect too much in the way of compassion from them on that front.

In fact for supposedly compassionate religious people, and both Christianity and Islam have great swathes about being compassionate in their holy books, these folk seem pretty vindictive. It's amazing how many of them seem to be of the opinion that intravenous drug users and other deviants are only getting what they deserve. What's unfortunate is how many people think like this and control the purse strings when it comes to the fight against the spread of HIV/AIDS.

Everybody knows by now how not a single penny of the money that George Bush has allocated for HIV/AIDS is allowed to be given to any group that hands out or recommends condoms as a means of fighting the spread of the disease. Now it seems like his fellow traveller, Prime Minister of Canada Steven Harper, is going down the same path. His government is planning on cutting HIV/AIDS funding to community organizations that do front line prevention work to the tune of 26 million dollars and redirecting it towards the development of a vaccine.

This comes on top of the cuts which last year saw Quebec's funding reduced by 30%, Ontario's by 24%, and Alberta only being funded for six months. What worries people most is that the cuts are going to be to the programmes which focus on prevention to those people considered to be most at risk; intravenous drug users, prisoners and gay men. While nobody is arguing that funding research to develop a vaccine to prevent HIV/AIDS is a bad thing, taking money away from programming aimed at preventing the immediate spread of the disease to do so is dangerous and irresponsible.

So why is Steven Harper's government doing this? Well in the last election he ran on a platform that included a promise to try and repeal Canada's same sex marriage law, and once elected cancelled the previous government's plans at decriminalizing marijuana. If that doesn't give you some idea of this government's mindset, how about this quote from our honourable Prime Minister when it came to the question of harm reduction among addicts: "If you remain an addict, I don't care how much harm you reduce, you're going to have a short and miserable life."

This is the same government that is doing it's best to manipulate figures to show that a trial safe injection site in Vancouver British Columbia has led to more people using intravenous drugs and has caused more harm than good. The actual truth of the matter is that every time a person shoots up on their own in a controlled environment they will not be sharing a needle and not risking the spread of disease to anyone else. There is also statistical evidence that intravenous drug users who come to safe injection sites or needle exchanges are far more likely to enter into treatment programmes than people who don't, as they are in constant contact with people who will help and encourage them to rehabilitate.

Logic, reason, and statistical evidence all point towards spending money on programmes geared towards preventing the spread of HIV/AIDS is currently the most efficient and effective means we have of controlling the disease. All the statistical evidence points to the fact that needle exchanges, safe injection sites, and the use of condoms are the most effective preventative measures going, therefore it only makes sense that those are means we should be using to prevent the spread of the disease.

Unfortunately it seems that logic, reason, and statistical evidence mean nothing to people like the Prime Minister of Canada and his fellow travellers. It's obviously much more important for them to impose their morality on the rest of us, no matter how many people they kill in the process.

References to statistical evidence in this article are supported by the work of epidemiologist Elizabeth Pisani's work as sited in her book The Wisdom Of Whores. You can find a listing of all her references at the reference page of her Wisdom Of Whores web site.

May 8, 2008

Book Review: The Wisdom Of Whores Elizabeth Pisani

It's close to thirty years ago since British rocker Ian Drury had a hit with the song "Sex And Drugs And Rock And Roll". Somehow or other nobody had strung the three together in quite the catchy way he had before, and his little ditty's title caught more then a few people's imaginations. In those innocent days prior to AIDS and the "War On Drugs", it became the catch phrase of choice for a great many people to sum up what they needed to make them happy. That Drury might have been satirizing the rock star image with his song was lost on ninety per cent of his audience, who had latched onto the title as a lifestyle definition.

The world spins around and ten years later, in the 1980s, I couldn't read the obituary pages of my local paper without reading that a man of my generation had died of unknown causes, leaving behind special friends, but very rarely, a wife or parents to mourn him. AIDS was very much a mystery in those early days in the mid to late eighties, but even then we knew it was caused by sharing bodily fluids and the quickest way of catching it was through unprotected sex and sharing a needle. It was only a matter of time before it spread beyond gay men. Sex and Drugs were "very good indeed" no longer.

When the Canadian Red Cross came clean about not testing their blood properly and giving hemophiliacs infected blood, (and oh by the way if you received a blood transfusion between these dates you really should get yourself checked), the "innocent victim" syndrome in AIDS reared its ugly head. Just what the world needed - another way to stigmatize people who were dying because they had sex or shared a needle. The Christian right in North America had already labelled HIV and AIDS as the wages of sin, and being able to say they only have themselves to blame, while others are blameless, only added fuel to the pyre they were building to burn the sinners.
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In the preface to her book The Wisdom Of Whores, Elizabeth Pisani says that when people ask her what she does for a living she cheerfully replies "Sex and drugs" as it's easier than having to explain to people that an Epidemiologist studies how diseases spread in populations. For ten year of her life, starting in 1996, Ms Pisani worked on the front lines of HIV/AIDs research looking for patterns in how the disease was spread, developing ways of curbing the spread of the diseases, trying to figure out how many people were potentially at risk, and of course dealing with the political fallout that always seems to accompany sex and drugs.

In the course of her work she has run police roadblocks in Indonesia carrying blood samples and used syringes, sat on street corners with prostitutes in the border towns of China and Tibet discussing the economics of their trade, worked with the transgendered prostitutes of Indonesia, argued policy with officials from the UN, the World Health Organization (WHO), Muslim Clerics, and brothel owners in Thailand. The Wisdom Of Whores are the conclusions she has reached after these ten years of field work about what works in the fight against HIV/AIDS and what doesn't work. These conclusions are backed up by not only her years of personal observation, but by the data she has crunched charting the growth of the disease and the effectiveness of the various means used to prevent it's spread in different countries and among different social groups.

One of the most frightening things about this book is, at the time it was being written, the amount of influence being exerted on HIV/AIDS programming by people with political and religious agendas. From Muslim Clerics in Africa and South East Asia saying that not using condoms proves how faithful you are, the American government going so far as prohibiting their staff from having access to research that proves the effectiveness of condoms in preventing the spread of sexually transmitted diseases (STD), to American policy that tries to prevent any agency, whether they receive American money or not, from advocating the use of condoms as a preventative measure; it's more important to these people that their view of the world is adhered to than the disease be prevented from spreading.

In spite of the statistical evidence that Ms. Pisani cites, that over 70% of the people who sign pledges vowing to abstain from pre-marital sex end up having pre-marital sex, the American government still preaches abstinence as the answer for preventing the spread of HIV/AIDS. The fact that the majority of these people also practice unprotected sex is even more damning. That those figures are from the US, and not a country with a flourishing sex trade, makes the whole abstinence argument even more spurious.
In spite of what any number of groups might want you to think, according to Ms. Pisani's research very few people are sold into the sex trade of South East Asia as slaves. It's more a matter of simple economics; a women can earn more in a half hour as a prostitute than she would for making 150 t-shirts in a sweat shop. If people are really so concerned about women in the sex trade maybe they should consider paying a little more money for their brand name t-shirts so these women have a viable alternative to make money to feed their families.

In all of these countries where condom programs have been implemented within the sex trade infection rates have been halved and continue to decline. The programs that work best are the ones like the one implemented by Thailand. The government allows the brothels to operate as long as the women working there use condoms, if they don't the government closes it down and the owner loses his source of income. By routinely randomly testing all the women working in the brothels for STDs the government is able to tell if condoms are being used. Not only has this helped prevent the spread of HIV/AIDS but it has also cut down on the spread of all STDs among clients, brothel workers, and all of their families.

The sharing of needles by intravenous drug users is of course the other big way that the virus is spread. In spite of this, resistance to needle exchanges as a means of prevention still runs high. Those who believe in the war on drugs are convinced that needle exchange programs encourage drug use and don't want anything to do with it. Yet statistics presented by Ms. Pisani shows that needle exchanges not only help prevent the spread of disease, they work to help people get off drugs. Two or three times a week they are in contact with social workers who can give them referrals to treatment programs and provide them support in quitting drugs and a good many of them take advantage of it.

The other big issue that Ms. Pisani raises is the need to balance treatment and prevention. While nobody wants to see anybody die when there are drugs available that could prolong their lives for as much as ten years, the problem is now that too much of the HIV/AIDS budget is being spent on treatment and prevention is falling by the wayside. As a result people are still being infected in spite of everything we know. Politicians are much happier when they can say they are giving money to treat pregnant women so they don't spread the disease to their unborn child, or to treat a child who was born with the virus, than they are in announcing money to help people who have sex and use drugs from catching it.

The Wisdom Of Whores is like a gale of fresh air being blown through the musty smelling bullshit that has surrounded the whole HIV/AIDS issue from day one. It's not just the holy cows of the right Ms. Pisani takes on either in her battle to save lives. Everything from peer counselling to confidential testing is put under her microscope for analysis; saving lives and preventing the spread of the disease is what concerns her not what people think is right. I'm sure this will get a lot of people's backs up, but it's hard to argue with her statistics about rates of infection.

It's hard to imagine a book about a subject as dry sounding as epidemiology being a page turner and entertaining, but Elizabeth Pisani has managed to do just that. She is irreverent, but never irrelevant; by turns angry, compassionate, and frustrated, she is a refreshingly human voice among so many speech makers. Sex and drugs might be taboo subjects for most people, but they are Elizabeth's bread and butter, and according to her they are at the root of HIV/AIDS. The Wisdom Of Whores paints as true a picture as possible of the fight against the spread of HIV/AIDS and where it stands today as you're liable to ever read. As well as the book you can also go the Wisdom Of Whores web site to receive even more up to date information and join in the ongoing discussion on how the world is doing in its fight to keep people alive.

The Wisdom Of Whores can be purchased directly from Penguin Canada or an online retailer like

January 17, 2008

Book Review: Brave Faces Nasra Al Adawi

It's when we take things for granted that we are in the most danger of forgetting their value. When we forget somethings value, when we forget how important something is, we are also running the risk of having it taken away from us. It's easy for us to forget, for instance, the stigma that used to be attached to any open discussion about health issues facing a woman. In the not too distant past a young woman entering into her menses received no education about what to expect, and was convinced that any discussion about her body and its natural functions were taboo.

While the women's movement of the seventies managed to change some of the attitudes that had made it difficult for women to feel comfortable even talking to her doctor about the issues, the current backlash against women in North America could see even those small gains rolled back. Having taken for granted that they had won control over their bodies through land mark cases like Roe Vs. Wade in the United States, and the Supreme Court Of Canada declaring any law that hindered a woman's right to abortion unconstitutional, women in the United States have gradually seen control over their own bodies taken out of their hands.

Given prevalent attitudes towards women, and sex education its easy to see a return to the days when women's health issues, no matter how life threatening, are no longer considered topics for public discussion. It shouldn't take an act of bravery on the part of a woman to talk about the state of her health, but there seems to be a new chill descending over North America designed to silence woman's voices. Thankfully, any woman who is searching for a source of inspiration, an example of bravery in those circumstances, doesn't have to look very far.
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Nasra Al Adawi, a poet of Omani and Tanzanian heritage, has just published Brave Faces a collection of poetry and prose in tribute and honour of the African women she has met who are coping with either Breast or Cervical cancer. The prose sections of the book are either written by Nasra based on her meetings with individual survivors of cancer, individual patients recounting their stories, or by medical professionals discussing the state of female cancer patients in Africa and the disease itself.

With only two exceptions, all the poems are the work of Nasra (Nasra Al Adawi is a pen name), and are without a doubt some of the most purely emotionally powerful poetry I've ever read. In the opening chapter the book, "Breathing Africa", Nasra talks about how the death of her father from cancer roused in her the courage to become a bold poet, and his desire to be buried in his native Tanzania ignited her desire to leave her home in Oman and travel back to the country she was born in.

"I am not sure if poetry is a sensible way to fight cancer" she says in her introduction. While it may be true that words on a page or spoken aloud can't heal a body, there is no way of measuring the impact of the intent behind them on the spirit of the listener. Can you imagine the lift it would give to you knowing that somebody cares deeply enough about the circumstances of people in your situation that they are inspired to create poetry that speaks to your experience?

Nasra's poetry does just that. Without presuming to "know" what any individual is experiencing or feeling, her poetry speaks of universal truths that all of us can identify with. They're about the journeys of self discovery we all must take in order to grow and thrive, finding the strength that's needed to do what we want, and finding the means to keep going when the reasons aren't always obvious.

While Nasra says that the women she met in the Ocean Road Cancer Institute in Tanzania have been an inspiration to both her poetry and her life, the poetry she writes is inspiring to anyone who has ever questioned themselves. There's no false sentiment or cheery platitudes contained within the lines of her work. Instead she offers the gift of her own struggle with doubts, the hope of her dreams, and the compassion of her empathic soul expressed with eloquence and just the right amount of pride.

Those of you who have read my work before know that I deal with an acute, chronic pain condition.While, unlike cancer victims, I have the comfort of knowing its benign, if I were to allow myself to dwell on the fact of its permanence I could easily succumb to despair. Nasra's poems spoke to the struggles I cope with as if she had access to my innermost thoughts.

I can't speak for others, but reading her poems was like balm to a wound in my spirit. Hearing understanding from the voice of a stranger is an incalculable gift and one that I'll always treasure. I can't help but believe that the women who she has read these and other poems to receive the same presents of hope and understanding that I received.

But if it's examples of courage your looking for, the Brave Faces of the title, the prose pieces of this book are where you will find them. Here are the stories of individual African women who have had to struggle not only against the disease, but societal taboos that inhibit their ability to talk about their illness, let alone seek help. "I was ashamed", "I was alone", might be how they felt, and what their circumstances were, but that didn't stop them from taking care of themselves. Even if it meant questioning a doctor's opinion, travelling to foreign countries for treatment because Tanzania's state run hospitals are under-equipped and underfunded and only the very wealthy can afford the private hospitals. (Let's give a big round of applause to the policies of the International Monetary Fund (IMF) and the World Bank. It's their insistence that developing countries like Tanzania cut funding to health care and other "frill" programming if they want debt forgiveness, that make these circumstances possible)
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But even more important is the bravery that each of these individual women have shown in standing up and telling the world their stories so that other Africans can learn from them. The message they are trying to impart is a vital one for women in every country, not just the countries of the developing world. Your body is nothing to be ashamed of, do not be embarrassed to seek help if you are sick - it's not your fault, it really is better to lose a breast than to lose your life, and you will be no less of a woman for its removal.

Reading the individual stories I could not even begin to understand the struggles they endured in their attempts to seek treatment or the difficulties they faced. To hear one woman casually talk about travelling first to India for treatment, and being so sick she could barely walk, but coming home anyway because she couldn't afford to stay any longer was heartbreaking enough. That the same woman was only able to continue her treatments at home because she purchased the medicines required for treatment herself, was incomprehensible. For a person used to free access to fully equipped state of the art hospitals its impossible to even begin to understand the level of courage any of this required.

Brave Faces is not only a book of poetry and prose about the courage to live one's life to the fullest no matter what is thrown at you, and it's also about people working together in common cause. Look at the opening pages of the book and who has paid for it's development and creation. Everyone from the Prime Minister of Tanzania, who wrote the forward to the book, private corporations like Avon and DHL, and medical professionals have come together on this project. Than there are the people who translated the book into both English and Swahili so it could be read all over Africa and around the world. Most importantly though, are the women themselves who volunteered to tell their stories, for without them there would be no book.

Breast Cancer is the second leading cause of cancer death in the world after lung cancer, and the most common malignancy among women. The incidences of breast cancer have increased steadily from 1:20 women in 1960 to 1:7 in 2007. It is an epidemic among women and nobody knows why. The only positive is that if Breast Cancer is caught early enough, the chances of survival are high, which makes being able to comfortably talk about it and access to screening procedures vitally important.

In North America we like to think of ourselves as forward thinking and enlightened, and in the past have been condescending towards the people of developing countries and their "backwards" attitudes when it comes women's health issues. Brave Faces not only refutes that opinion, it stands it on its head. The women we meet in Brave Faces are every bit as sophisticated and brave as their counterparts in the west, and the government officials and medical professionals, a great many who are men by the way, show a compassion and caring for these women that you hardly ever see in North America anymore.

Brave Faces was written to bring hope, encouragement, and education to the women of Africa when it comes to dealing with Breast and Cervical Cancers. In an attempt to help the fight against cancer all proceeds generated by the sales of this book will be donated to Cancer Awareness in Tanzania. However I think this book will be of benefit to anybody who reads it for the message of hope, courage, and faith in the face of seemingly insurmountable obstacles that it delivers. We all face various challenges in our lives; Nasra's poems and the women we meet through her will inspire all of us, no matter what we are dealing with.

October 31, 2007

No Excuse For Addictions

You don't know how much of an asshole you've been as an addict until after you're well into recovery. It's one of the more crushing of the revelations you have to deal with when the scales finally drop from your eyes and you see just what a self-centred, whining, little git you've been. If it wasn't about you it hadn't mattered, and didn't everyone know that the world revolved around you anyway?

Oh there are all sorts of excuses for becoming an addict, I should know having used most of them with varying degrees of justification over the years, but there aren't any excuses for the behaviour and other shit that you did while addicted to whatever it was you needed to make your existence seem meaningful. It's amazing the rationale you can come up with for stealing anything you need to feed your habit, and the lies you tell yourself to pretend that it's not stealing.

I mean to replace this, I really will replace this money as soon as I'm able, I'm owed this money so it's not really stealing, look at all I do, if there were any justice in the world this would be my money anyway. Nothing like the self-righteous resentment of an addict, it allows you to justify anything.

Then of course there is the unpredictable behaviour of addicts. Talk to anybody who grew up the child of a drunk and they'll say one of the most vivid memories they have of childhood is being told to be quiet and not do anything that might upset the drunk. There's always the potential for violence when you're dealing with some drunks, and the not knowing, walking around on tender hooks when you're around them, is almost worse than any violence they might perpetrate.

I don't normally wallow in those parts of my life that I'm not proud of; it doesn't serve any purpose that I can see. I've always thought people who spend their time talking about what drunks and drug addicts they were still haven't recovered because they still want the world to revolve around them. Oh poor them they were drunks and we should all feel sorry for them.

As far as I'm concerned, the only people anyone should feel sorry for are the people who suffered because of their actions as a drunk or a drug addict. Nobody can say they didn't know what they were doing when they took their first drink, stuck that first needle in their arm or whatever. It was their choice to live like that and if they had wanted to stop they would have.

What, you think they had no control, that they couldn't stop? Anybody who tells you that is a liar. How do you think they stopped when they finally did? They did so because they were able to and chose to, not because anybody forced them to. Unfortunately, the truth of the matter is that usually the only way an addict stops is because of the most selfish act of all – self-preservation.

If they had cared about the effects of their action on the people they supposedly loved they would never ever have started in the first place, or at least stopped when they first realized the pain they were causing. So there is nothing saintly about anybody making the choice to go clean, and if anybody even implies otherwise they're lying. But as it's the only way most of us have of getting clean, I guess we should be grateful that at least one of our negative characteristics can be responsible for helping us to at least start to heal.

Making the decision to go clean is of course only the first step; you still have to do it after all and that's where things get difficult. Not just because of your own desires, cravings, wants, or whatever you want to call them, but because we have to live in one of the most addicted societies in the world. In fact, most of our economy is built upon the premise that we are addicted to the products that are produced by our manufacturing sector.

Every media outlet we watch, read, or, listen to is filled with advertisements trying to convince us why we should spend money on their product not somebody else's. All the commercials we hear act as though it's not a question as to whether you are going to spend money, if you have it or not, but to convince you to spend it on their version of

Of course than there's the way we treat the rest of the world, as if we are the be all and end all and everything revolves around us. Between Canada and the United States, we account for the most fossil fuels and other non-renewable resources used per capita annually and we produce the most non-biodegradable waste per person. Most of us don't even have the decency to be embarrassed by these facts, preferring to point out how environmentally conscious we are because we participate in our communities recycling programs and on Earth Day we pick up garbage in our neighbourhoods.

Of course, the rest of the world also has to give us everything we need to ensure that we can continue to live like we do. If they don' we'll just come and take it. Remember what I said about not wanting to piss off the drunken family member because of the potential for violence? Well the majority of the world treats us like we're that belligerent bully, trying to keep us appeased so we don't get mad at them and get violent. All they have to do is look at what we've done to Afghanistan and Iraq recently, and other places around the world prior to that, to have a fair idea of what happens to anyone who defies us.

One of the things they tell you when you stop drinking and doing drugs is your going to have to change the people you hang out with. You're going to discover that you're not going to have very much in common with them anyway. What's even harder then that to cope with though, is how much you have to change the way you live period in order to rid yourself of addictive behaviour.

There are no half measures, you can't just stop drinking or doing drugs and not deal with the behaviour that are characteristic of the addict. It means changing yourself significantly at a personal level in terms of the way you treat people and the world in general. You can no longer assume the position of being the centre of the universe, or act without thinking about the consequences of your actions.

Simply going from one day to the next without having a drink or doing drugs is not stopping being an addict; it's stopping drinking and doing drugs, which although admirable, hasn't done anything to cure you of the problems that started you doing them in the first place. It will only be by figuring out the root causes of your addiction that you'll be able to start dealing with the behaviour that is the result of being an addict.

There's never an excuse for being an addict, but there's always an explanation.

October 30, 2007

Jay Gordon: A Different Type Of Hero

I just finished re-reading two of my favourite books, the first two parts of the Eldarn Trilogy by Robert Scott and Jay Gordon, The Hickory Staff and Lessek's Key, in anticipation of the publication of book three of the The Larion Senate. For some reason I happened to glance at the acknowledgement page in Lessek's Key and realized I must not have done so before. I'm sure I would have remembered seeing my name prominently displayed in the acknowledgments before.

After the initial thrill of seeing my name in print passed (hey you never know when and if it will ever happen again, so you clutch at some pretty paltry straws in the name of providing balm to a bleeding ego), I finished reading why my name along with three others were being offered separate distinction.

Last year (2005), while Jay and I were busy telling Steven Taylor's story, there were many people who took time to tell Jay's. His family and I are indebted to all of them by my sincerest appreciation goes to Heather Nicholson, Tali Israeli, Sam Altman, and Richard Marcus...I know Jay appreciated their efforts as well. Acknowledgment Lessek's Key Robert Scot and Jay Gordon

Jay M. Gordon was diagnosed with Amyotrophic Lateral Sclerosis (ALS) or Lou Gerig's Disease in 2002 and shortly after began work on the writing of the Eldarn Sequence with his son in law Robert Scott. When he died in November of 2005 The Hickory Staff had just been published, Lessek's Key had been handed in to the publishers, and the first draft of The Larion Senate had been finished. What had started as, "I've always wanted to do this and since I now have the time" project ended up becoming an Orion/Gollancz publisher's bestseller garnering praise from critics on both sides of the Atlantic. (Unfortunately Orion had not managed to secure American distribution rights at the time of Jay's death and as it stands I'm still not certain if you can purchase any of the series in his home country)

I've written about Jay before – hence the acknowledgement – but there had to have been a reason for me being so forcibly reminded of Jay again. Perhaps it's the time of the year, when the days are shortening, and what so many call the "Days Of The Dead" approaching; days that we set aside to remember and honour those who dispensed with the encumbrance of their physical form.

Of course, that could all just be a bunch of metaphysical horseshit, but I do know that ever since I read the acknowledgement a few days ago I've wanted to write about Jay again. With all the bullshit you read about people with guns killing other people being heroes, I thought it might be nice for people to be reminded what real heroism is. Although I'm sure Jay probably would have denied being any sort of hero, most people who perform acts of heroism on a daily basis usually aren't aware of it anyway, because to them it's called life.

I live with a body that can't do all I want it do because of a medical condition, and I know the frustrations that I experience. However, that pales in comparison when I try to imagine what Jay had to cope with for the last year or so of his life. ALS destroys your body but leaves your mind intact. Depending on how lucky you are the deterioration of your body will proceed quickly and include your vital organs so your death isn't lingering and your suffering is minimal.

Unfortunately, for a lot of people that's not the case and they will experience muscle failure sufficient to incapacitate them to the point where they can not even sit up on their own or talk for an extended period before the release offered by death. Think about what total muscle failure entails on top of that.

It's like being returned to being a newborn with none of the benefits. You can't support your own head to even sit, let alone turn it from side to side, if you're lucky you might be able to move your eyes so you can read a book. But of course you hands don't work so how are you going to turn the pages? Holding a conversation is difficult when your jaw can't open and close on it's own because the muscles don't work anymore. You'll be lucky if you don't just sit there with your mouth hanging open.

Communication is reduced to spelling out words on a tablet with a pointer held in the mouth when you still can hold things with your teeth, then what?. Losing all muscle control means losing all muscle control, and that of course includes bowel and bladder, which means you are forced to endure the indignity of wearing a diaper on top of everything else.

Its also more then likely that your lungs won't work on their own, so you will have one tube that will be constantly sucking fluid out of them, and another tube up your nose that will be continually forcing air into them. If your lungs don't work, there's a really good chance that your swallowing mechanism has failed and your oesophagus won't carry food into your stomach anymore. That means another tube up your nose that's carrying some sort of liquid puree to give you enough of whatever to keep you alive.

Maybe I've over exaggerated the symptoms, and by that time everything fails like that, you will be dead, but if that were the case, you wouldn't have people who asked to be put out of their misery through assisted suicide. They are so incompetent they can't put the pills in their mouth, let alone swallow them, than I would think that they are dealing with substantial system failure.

The other thing is that the whole time this is going on you are also in pain because your nervous system has been damaged. When you have any type of Sclerosis or Dystrophy, what happens is your system is still trying to send the messages to your body to do what it's supposed to do. When it gets no reaction, it thinks something is wrong.

Remember pain is the brain's means of letting you know there is something not working properly, or that something needs fixing. Therefore, when it realizes nothing is working it responds in the only way it knows how, by sending out pain signals. If the condition doesn't improve, it keeps trying to send out the message that there is a problem, and it keeps getting louder and louder, increasingly painful.

In spite of this, Jay kept working on the Eldarn sequence to almost the end. According to Robert, even when Jay couldn't write he was contributing by providing feedback on the chapters that Robert would write. That way Robert was able to stay on track with what information needed to be revealed and when. Jay's name is not listed as author as a courtesy; he was one half of a two person writing team that created one of the better fantasy trilogies I've read in a number of years.

I struggle everyday to find the words sufficient to write articles like this. I can't even begin to understand what Jay would have to overcome mentally, emotionally, and physically to do what he did everyday just by opening his eyes and dealing with his situation. The fact that he was able to help in the creation of anything is amazing, that it was good enough to be published it incredible, and that it is superior to so much of what on the market today is nothing short of miraculous.

So where ever you are right now Jay, I'm waiting as patiently as I can for part three of the Eldarn Sequence to be released and thank you for being a really bright spark of light in a world where there are far too many fake stars.

October 18, 2007

Change And Fear Of The New

Routines are something all of us depend on, if it wasn't for routine, I'm sure half of us wouldn't be able to get out the door and get to work everyday. You get up and you go through the same sequence of activities that you do every other weekday, from going to the bathroom at the same times each morning to eating your toast only after finishing reading last night's game results in the sports section.

Your routine is all about timing, without even knowing it probably, it's your routine that ensures your day runs like clockwork. Each little component just naturally fits into the one that follows it, in your mind at least – others may not appreciate the connection between the second cigarette and the trip to the bathroom – but for you they are all essential cogs in what makes you tick along.

God forbid anything should go wrong in the routine; you're screwed if it does. One day the paper isn't delivered and you go to eat your breakfast and you can't figure out when to eat your toast, drink your coffee, or have your cigarettes. You get so flustered that you lose track of time and you leave home late and miss the bus you usually take to work.

Because you missed that bus, you don't have time to have one more cigarette before you go into the office for the morning and that means you're distracted and in a rush. You go through security and forget that you have to sign in everyday, and they stop you and make a big deal of reminding you, even though it's the same two jerks who've seen you for seven years, five days a week.

So now you've been held up as a figure of ridicule and you're late for work, something you haven't been in all your years of working for this company. Of course today is the day that the CEO has decided to make an example of people who are habitually tardy, and you happen to burst into the office conspicuous in your lateness, just as he's half way through his speech to the assembled office staff on how much it costs the corporation in dollars and cents for every minute a person is late.

Fuck, right about then you wish the floor would just drop out from under you as you make your into the room with the eyes of all fixed upon you like lazar beams. The day of course gets progressively worse, because by now you're as jumpy as cokehead at a southern cop convention and when your boss comes up behind you to commiserate over what happened, he startles you so much that you throw your coffee at him.

As that went down such a treat, you decide to spend the rest of your day finding ways to screw up that defy believability. You have no logical explanation for why you were caught with your fly stuck in the fax machine's send button or one arm past the second bend inside the pop machine on the second floor. By the end of the day you're just grateful not to have been fired and to still be alive (the bit when you were about to board the elevator only to find when the doors opened the elevator had gone somewhere else will feature in nightmares for weeks you figure)

It really makes you wonder how much of history has hinged on somebody's routine being screwed with and them ending up having an awful day. Maybe Caesar's paper wasn't delivered on that fateful 15th of March when he ended up looking like a pincushion? Who knows, he might have had it a little more together and noticed the guys closing in on him with knives drawn if only he hadn't had his routine messed up?

Is it any wonder than with routine being so important that most of us are terrified of change? Routine represents order and control, a way of ensuring that we know exactly what will happen at almost any given moment of the day. If we change anything about our routine, it means we open ourselves up to the possibility of anything happening, or at least something that's never happened before.

But the real problem is that there is always a part of us that desires change; that is frustrated and bored with the day in and day out routine of our lives. It might not be something that we are even aware of, but periodically it will express itself either through depression or what we call a mid-life crisis. In the latter case, a person will let the pent up frustration act as a catalyst for making a drastic change in their circumstances. Its most common expression usually comes in the form of leaving a longstanding partner and establishing a new and supposedly different relationship.

The depression usually comes about due to our inability to make changes in our life. It's not unusual for this to coincide with the Fall, all around there are visible signs of the world changing, while you're staying the same. I know people usually link seasonal depression to the depletion of light as winter approaches, but the loss of light is just one indication of the overall changing of the season.

The majority of cultures still consider Fall the end of one year and the beginning of a new. It's the period in temperate climates when our year's growth is ready for harvest and the world is preparing to become dormant. It doesn't matter how far removed we are from the rhythm of the planet; Fall is one of the few changes we can't help but notice as everything around us appears to be dying.

What more tangible reminder could you want of how life is passing you by than seeing the world change while you stay stuck in the same routine that you've followed for years? All of a sudden, what seemed like comfort and safety becomes a trap from which there appears to be no escape. Is it any wonder that people become depressed?

Yet, we continue to fear and resist change as something dangerous and unwanted in spite of the evidence that change is good for us. Maybe if Julius Cesar had walked a different route to the Senate that day and come in an hour earlier or later then normal he wouldn't have been bumped off?

After that horrific day at the office where everything had gone wrong, because your routine had been screwed up, you decide you can never face those people again. You accept a severance package and take a year off work in which you finally write that book you've always meant to. You're happier then you ever were and you discover that you quickly establish a routine wherein your able to do a certain amount of writing each day and have plenty of time for yourself.

Of course, if anything happens to mess up that routine...

October 16, 2007

Willing And Disabled

When someone says they are disabled what does that make you think? Do you automatically get a vision of a person who is confined to a wheelchair? What do you think if you meet a person who has been described as suffering from a disability but they have nothing discernibly wrong with them?

Do you find yourself stealing glances at them when they're not looking to see if you can spot what's wrong with them? Like they might have an extra arm they've secreted around their person, or some other sort of deformity that you failed to notice at first glance? Do you talk to them slowly and in short sentences because maybe they suffer from a mental deficiency that has robbed them of some of their intellect? Or, do you worry that they are suffering from a mental illness and every time they laugh you check them for hysterics or other signs of an unstable mind?

When you suffer from a chronic condition that is disabling to the extent that you can't work, but that hasn't incapacitated you completely, you get used to a wide variety of reactions. I get the feeling that some folk are disappointed on meeting me when they discover that I look like a reasonable facsimile of normal. I'm not missing any limbs, nor am I in a wheelchair, foaming at the mouth, falling down in fits, or bursting into tears inconsolably for no reason what so ever.

If you meet me at home the only thing you'd notice out of the ordinary is that I don't seem to be able to sit for any length of time, or that I spend a lot of time stretched out in bed. Other than that, around the house I don't seem any less capable then the next person. Of course you don't know that I haven't been able to get into a shower for close to five years on my own, or any of the other things that happen behind the scenes that are the result of my symptoms.

To be fair I'm just as capable of forgetting myself as they are of misinterpreting my appearance. When you've established a routine that allows you to utilize what few resources you have to maximum efficiency it can be easy to forget that you suffer from limitations. It's only when you push the boundaries of your comfort level that you are forcibly reminded that you are disabled.

What's really upsetting is that no matter how many times this happens, each time is as unpleasant as it was the first time. Somehow or other I forget the previous experiences and suffer through the disappointment and frustration of the failure with the same intensity. It could be something as simple as not resting in the afternoon for a couple days in a row and forgetting what happens as a result, or the difference between writing while sitting up at a desk and lying in bed writing on my laptop that shoves my face in it.

It doesn't matter what the cause is, because the result is the same, and it takes a number of days to recover both physically and psychologically enough to get back on that even keel where I look "normal". While the body doesn't usually take any more time to heal from one occasion to another, the head is another story. The less it takes to remind me of my disability, the harder it is to overcome it's debilitating effects psychologically.

As I have a chronic pain condition caused by damage to the muscle wall of my pelvis, there is normally a direct correlation between the amount of physical activity I do and the amount of pain that I'm in. When I can logically tell myself that I'm feeling worse today then yesterday because of what I did I have no trouble accepting the consequences, and can usually believe I'll be better in a day or two.

But sometimes there is no logical reason that I can see for the pain to increase, and in those circumstances the feelings of frustration are such that it is difficult to believe myself capable of accomplishing the simplest of tasks. That is a dangerous place to find myself in, because those times are when it would be easiest to surrender to the condition and let it define my life completely.

Nobody expects a disabled person to do anything; you're given an allowance by the government and pretty much forgotten about after that, except when they decide to check and see if you're still incapacitated. (As a friend of mine who had lost the majority of one hand in an industrial accident put it – they want to make sure my hand hasn't grown back) So, if I were to retire to my bed for the rest of my life to take analgesics and gradually turn into a vegetable I'd merely be fulfilling everyone's expectations.

People talk of acceptance, as in accepting your limitations or accepting who you are and your situation in life. But what you have to decide is what you are willing to accept. Since I'm not willing to accept the definition of disabled as being unable, while at the same time I can't say that I'm fully able, I have had to develop my own standard of what is acceptable.

The hardest thing to accept, and I still don't do a very good job of this, is that there are times when there will be rationale explanation for how I'm feeling. It won't matter if I had done barely anything or walked two miles the day before, and I'll still barely be able to get out of bed and need to take my pain medication on a regular basis. On those days, I have to accept that I can't do very much and that it would be foolish to make the effort and waste the energy.

At the same time, I have to accept that it will require a little extra effort on my part even on the good days to do the things that I want to. If I want to write, I will have to exert myself to focus through the pain, but learn how to pace myself so that I don't overdo it one day and end up unable to accomplish anything the next day. Since some days it's impossible to tell how difficult it will be to accomplish anything, I have to be willing to accept the fact that I could have to stop what I'm doing, whether I want to or not, at a moment's notice.

What it comes down to in the end is having the ability to accept the fact that I can't predict from day to day how I'm going to be, and that I have to accept whatever it is each day gives me, whether I like it or not. It's either that or become what most people imagine a disabled person to be; and that's unacceptable.

August 24, 2007

Take A Leap In The Dark

The name that I've used for my personal blog, "Leap In The Dark", was chosen for one reason, but as it happens, it's turned out to be much more relevant to my life than I ever could have known. When I chose the name it was because of the connotations for creativity, not being afraid to take risks and not letting fear of failure prevent me from doing something.

That was all very well and good, and has stood me in good stead for reminding me not to be complacent with my writing, to fear looking like a fool, or to worry about what other people thought, and most especially not to worry about change.

I don't know how many of you are familiar with the Tarot, but one of the cards depicts a man, usually dressed sort of like a beggar with a hobo's stick and bundle over one shoulder, his head in the air not looking at where going, and one foot is on the verge of going over a cliff. He's known as The Fool in the more traditional decks and I'm sure there are all sorts of interpretations that are attached to his appearance, but I've always been attracted to the card and taken it as a sort of personal talisman.

He might look like he doesn't know where he's going and to be heading for the proverbial fall, and I'm sure more then one person has looked at me with the same thoughts in mind, but to me he has always typified the ultimate in the living life in the moment and not fearing for the future. He's not afraid where his foot is going to land having supreme confidence that whatever he does will be the right thing to do.

That doesn't necessarily mean that what happens is going to be nice or particularly pleasant, but it is what needs to happen. In some ways there's a type of blind optimism that everything will work out for the best, I won't deny that element exists, and that can get a fool in trouble if he isn't careful. But the times they do happen are when he or she loses track of who they are and tries to be what other people what him or her to be.

You can't step blindly forward into your future when you are trying to fulfill somebody else's vision of who you are, because you don't really know what it is you're trying to be, and it's not who you really want to be in the first place. Of course, you don't need anybody else's help in getting confused about your direction; we're all capable of doing that well enough on our own.

Unfortunately, those are the truly terrifying times because you can wander lost for ages and not know it before it's almost too late. There are so many things that can distract you from your own goals that you could possibly live your whole life very unhappy without ever understanding why. In a lot of people, it comes out as what we love to call a middle age crisis, when a man or woman will seemingly lose his or her mind and try to regain their past in the arms of a younger person or a sports car.

If they were to stop and think about it, they'd realize that it wasn't their youth they were trying to regain, but the missed opportunities to do what they wanted, or be who they wanted to be. According to the rules we are all supposed to live by we must surrender ourselves to follow the path that's been laid out to keep the wheels turning over.

Otherwise known as growing up or accepting responsibility, you can be assured that for must of us it will involve giving up a part of ourselves. Any time you do that you lessen your chances of living live the way you would have chosen if you kept all your options open. The more that happens the more chance you of have of being one of those unhappy people who feel the need to blow up at mid life.

When you end up that lost and confused, you lash out in a desperate attempt to find your way back to where you started. Instead, by that time most of us have forgotten how to live and are lost without a map leading us back to where we should have been. It's only if you have the courage to stop completely and look at yourself dispassionately that you can find a way home.

Every time we consider making any change in our lives, no matter how small takes a degree of courage, because it always involves a step into the unknown. Deciding to change your life takes more then just a step; it's a leap – a leap into the unknown – A Leap In The Dark.

If you've ever seen a high wire act when the person walks along the a wire suspended hundreds of feet in the air, and watched them take the net away and felt that sensation in the pit of your stomach that's part fear and part excitement then you have a good idea what's it like to consciously change your life. Even if it's to change from being the victim of an abuser, to stop using drugs and alcohol, or any other change for the better there is fear involved because it is going where you've never been before.

No matter how horrible it is, the familiar is at least a known and there is a degree of comfort that can be drawn from that fact. It's why so many people don't leave their abuser, not for fear of retaliation, but for fear of the new. Not knowing what the future holds is scarier to most people then the fear they have in the present.

Living is a terrifying experience and it's very easy to give in to the fear and not live at all. It so much easier not to feel at all than risk being hurt, so much easier to do nothing than risk being a failure, and so much easier to continue on the safe path of the familiar and not change. So why change at all, why take that risky step off the cliff into the unknown?

Not being able to speak for anybody else, or feel like I have the right to tell anybody else what to do, all I can do is tell you what guided my choice. I needed to leave behind old habits and ways of being that were governed by what happened to me in the past. It meant surrendering all the coping mechanisms that had kept me safe from hurt and stopped me from feeling. It also meant having to deal with all the reasons why I had developed all those habits.

Once I made the choice I felt like I was free for the first time in my life. Of course there were moments of absolute fear, depression, and feeling completely lost. There are times when I'm still beset by doubts, but each time those moments last for shorter and shorter periods. But the thing is, all of these moments were mine and weren't governed by anyone else or their perceptions of how I should be. I was free of my past and free to choose my own path and I was, and am still willing, to risk a little pain as the price I need to pay.

Taking the first step off the cliff is always the hardest, after that gravity takes over and it becomes easier. It may sound like a joke and I guess it is somewhat, but in all seriousness there is a momentum that builds when you take the decision that works just like gravity and you aren't able to stop the process whether you want to or not.

Now when I look at the title of my blog, "Leap In The Dark", not only does it remind me to take risks creatively, but it also helps me to remember to keep moving forward no matter what I think I fear, or think will happen to me. I long ago reached the decision that I'd rather feel something uncomfortable than feel nothing at all, because what's life if you don't feel?

August 20, 2007

Disassociation Blues

All of us do plenty of things throughout the course of our day on automatic; where we just let our hands or whatever body part is involved get on with the job while we think about other things. Usually it's mindless jobs like washing the dishes, sweeping the floor, or anything else we can pretty much do by rote.

I'm sure that most of you are also familiar with the sensation of all of sudden becoming fully aware of what you're doing and how much of a shock that can be. If you're washing the dishes with a good chunk of your brain shut down and all of a sudden your hands slip and the dish you're washing makes a loud noise as it bangs against the side of the sink your reaction is unusually strong considering the circumstances.

Having been in an almost meditative state the abrupt return to reality is the most likely reason for your shock. The noise was the trigger that caused you to be returned but wasn't necessarily what you reacted too. Suddenly finding yourself standing at the kitchen sink with your arms up to their elbows in soapy water and a sink full of dishes after you had been daydreaming about who or whatever is bound to catch you more then a little off guard.

Now here's something else to try and get your head around, and it's sort of akin to the sensation I was just describing, but a little more extreme. First suppose that your whole life has been similar to the way you feel when washing dishes; that here but not here sensation. But, and this is where it gets tricky, you don't know you're in that state of mind.

Well, it's something like that anyway; you're not in a state of mind where you're blanking things out while doing something mindless, you're blanking things out that you don't even 'know" exist. Of course since you don't know that you're blanking things out, you can't be said to be blanking things out at all – or can you?

Damn this is harder than I thought it would be, all I've probably done is confuse the crap out of everybody. Maybe I should try a different tact…hmm how about this? Have you ever been in a situation where you've wished with all your might that you were somewhere else or that you can't believe what's going on is happening to you? All of a sudden everything begins to feel like it's taking place a long way away and you begin to feel disembodied? Its like your body and you have separated and you're able to watch the proceedings without being involved.

If that's something you've ever felt than you have experienced what it is like to disassociate at its most basic. Disassociating is a reaction among people who have suffered a severe trauma at some point in their lives and can be as short lived as the scenario described above, or can be as long lasting as being in a permanent state akin to the one you've achieved while washing the dishes.

Disassociating is also the name now used to describe what used to be known as Multiplicity, or Multiple Personality Disorder. In this worst case scenario a person, usually someone who was habitually sexually abused as a child for on ongoing and protracted basis by their nearest and dearest caregivers, would disassociate so completely as to cease to exist in that moment and another "person" would live through the horror. Dependant of the severity of the trauma a person could have from a minimum of two up to, well I know one woman who was diagnosed with at least forty personalities.

There has been a lot of bullshit written about Multiplicity or Disassociating to the point where people expect some sort of Jeckle and Hyde, or other obvious manifestation in a person suffering from this illness. The truth of the matter is that most of the time nobody would ever be able to tell the difference except if they were intimately familiar with the person or the person was triggered by circumstances that brought one of her abused selves to the surface. (My use of the feminine pronoun is deliberate because the majority of cases where sexual abuse has been severe enough for these circumstances to develop have been in women)

Some of what you've heard about the illness is true; in most cases the person has no recollection of what happens from one personality to the next, a person suffering from severe trauma can "switch" between personalities right in front of you, and a good many people who suffer from this disease do themselves physical harm. While there is no hard and fast rule as to why a person 'cuts' themselves one of the theories is that the personalities who suffered through the abuse lack the ability to communicate their anger and fear and are lashing out at the person they blame for abandoning them to their abuser, their core self.

Among women who were ritually abused, (their abusers used them as part of perverted religious ceremonies ranging from Satanic rites to Christian sin cleansing rites) there is a tendency to mutilate their sexual identity. The child personalities know it was something to do with their being a woman that made them a target so they try to remove signs of femininity, or damage themselves sufficiently to reduce their appeal.

Recovery is a long arduous process known as integration where the patient and counsellor work to try and get each personality to communicate with everybody else and the core person. In most cases this involves controlled switching so the therapist can find out what each personality requires to feel safe again. With these sessions being taped the client can familiarize herself with her other selves fears and begin to devise methods of offering assurance that their fears are no longer valid and the personality is no longer needed for protection.

Of course multiple personalities are an extreme form of disassociation. More commonly it will take the form of a person believing so strongly that an event isn't happening that they will enter into a state similar to shock in order to escape the experience and will also not remember it happening. Sometimes they are so successful that they forget that it ever happened at all.

All of us have disassociated on occasion, whether from boredom or shock, but for most of us the experience ends when the moment that caused it finishes. But for other less fortunate people it can haunt them for years to come and is a symptom of having suffered traumas too horrific for the human mind to cope with. Like all defence mechanisms it served a purpose in it's time, but will quickly outlive its usefulness and needs to be deactivated before it causes as much damage as that it was originally protecting against.

After all, it's not just the unpleasant things that you lose out on, you lose out on everything.

May 24, 2007

Book Review: Animal, Vegetable, Miracle Barbara Kingsolver

Some Facts:

  • Each item served in an American meal has traveled an average of 1500 miles before it reaches the dinner table

  • After automobiles food production ranks at the second biggest consumer of fossil fuels. Americans consume about 400 gallons of oil per citizen per year directly related to eating.

  • Almost 75% of all antibiotics used in the United States today are used by Concentrated Animal Feeding Operations – 1152 chickens can fit into a 6 X 8 foot room

  • If all the products with corn and soy included in them were removed from your grocery store the shelves would be next to empty – even packaging is now made from corn starch

  • Over 70% of the Midwestern United States farmland now only produces commercial soybean and corn

When author Barbara Kingsolver and her family made the decision to try and survive for a year only on produce they either grew themselves or were able to buy locally they were committing an act of near food heresy in North America. Government policy dictates that tax dollars in the United States subsidize the system of food production that results in the facts listed above.

Attempting to swim against that stream of government endorsed eating habits is as difficult as salmon trying to swim upstream to reach the spawning grounds. The advertising dollars of multimillion-dollar corporations have inundated us for years with messages that quicker and more convenient is better, until we've almost reached a point of no return.

But it comes at a price; increase in type two diabetes, obesity, heart disease, and malnutrition. Still, could you give up your chocolate bars, your potato chips, your out of season fruit, and microwave dinners? Would you even want to? Why should you?
Barbara Kingsolver.jpg
In Animal, Vegetable, Miracle Barbara Kingsolver and family not only describe their year doing just that, but spell out the whys, wherefores, and the rewards for and from doing it. At the beginning of the book they clamber into their car and leave the American South West desert where they've relied on food from all over the continental United States to begin a journey that will take them further then just the miles they travel across the country.

While most of us would look upon this as a voyage of deprivation and hardship, the way Barbara lays it out for us it becomes a glorious and exciting adventure of exploration and discovery. Who would have thought that there could be so many varieties of Tomato? Or that it's possible to have a party for a hundred people in May only eating locally grown produce and stuff you pulled out of your garden?

Why do such a thing though? Well through out the book she builds her argument using facts like the ones I started the article off with of course, but there are even better reasons. I have a friend who runs an organic garden. He has an acre of land that he has cultivated and sells shares in each winter. As the produce ripens he harvests it and delivers to the people who bought shares.

I helped him out for a couple weeks one summer picking beans, cucumbers, tomatoes, and anything else that was coming into season. For lunch we'd wander the rows and pick something fresh off the vine or straight from the earth. Have you ever tasted a carrot that came out of the ground ten minutes before you've eaten it? What you buy in your grocery store might as well be carved out of wood for all its similarity in taste.

Now imagine you have that from April to Octobe, from the beginning of the growing season to the end. Leafy greens that haven't been frozen and shipped a thousand miles and actually taste green; (I swear I know what green tastes like after eating fresh lettuce just grown in my backyard one year) wax and green beans that are so crisp they snap like kindling when you chew them; tomatoes that are so juicy and sweet that you just want to eat slabs of them forever; and corn that tempts you to eat it uncooked.

Of course if you are fortunate like the Kingsolvers to have bought some land that has generations of fruit tree on it, a cherry that's just turned black the day you eat it is nothing like the pulpy things you would buy imported in mid-winter. Once you know how something is supposed to taste chances are you're going to be more than willing to wait for it to come around on the calendar again.

Preparing for winter is a time consuming task it's true; canning, freezing, drying, and preparing proper root storage will eat up days in the fall. But on a cold rainy September or October day standing in the kitchen with the fruits (or vegetables as the case may be) of your labour and imagining how much better they are going to taste than anything store bought can make even the nastiest job seem pretty attractive.

In Animal, Vegetable, Miracle Barbara Kingsolver with an assist from her husband Steven Hopp and her daughter Camille Kingsolver have put together answers to all the arguments we all have been able to come up with about living a sustainable life. It's too expensive, it's too time consuming, and the food is so boring are all rebutted with a mixture of facts and anecdote.

Barbara has the zeal of a missionary but it is tempered with the soul of an artist and a woman who raised a child by herself. Not only does she advocate the lifestyle and share its wonders, she also has reams of practical advice on how it can be achieved no matter what your financial situation. Most of us don't have the options of raising our own livestock, or even growing our own vegetables like her family, but we probably all have access to a farmer's market where the produce from vegetable to meat is local.

This is a well written, fun, entertaining, depressing and optimistic book all at once. It's depressing to realize that while the government on one hand is telling us to eat a balanced diet they are propping up an industry that grows only two crops, both of which make up the lion's share of all pre-packaged food sold, The optimism comes from knowing that we can make a difference in our own lives and that we don't have to play by their rules.

If we are what we eat I would rather come from Barbara Kingsolver's garden or its equivalent than the shelves of my local grocery store.

May 16, 2007

Hidden Dangers In Zodiac Spot On Flea Control

How many times have you purchased a product, let's say a cleanser or a bug spray, and in big bold colours they display the various warning signs. Toxic, flammable, carcinogenic or whatever are in large enough type so there is no way that you're going to be able to miss it.

Or how about when you get a prescription you've never had before. The pharmacist, if he or she is any good, ensures that you know all possible contradictions and their symptoms. In fact most of them even provide a print out with which once you read you wonder if the stuff is going to kill you before it cures you, but at least you know what could go wrong.

Then of course there is now the grocery store where more and more packaging are carrying not only a products' nutritional value, but lists it's potential for allergies as well as any foods it might have come into contact with that could cause an allergic reaction. In fact everywhere you go you can see health warnings on the outside chance that something could harm you.

Whether it's because companies are terrified of being sued, new government regulations, or simple decency it doesn't matter. These warnings are now accepted as course and you expect to see them. The days of having to make use of magnifying products or having to pore over acres of small print in order to find out what exactly it is you're using or eating are long gone.

At least I thought they were, or maybe what applies to humans doesn't apply to pet products. That's always possible seeing as what's been going on with cat and dog food recently and other feeds in the past that have been discovered to be deadly. Heck mad cow disease was first started by adding sheep brains to cow feed, because the illness actually forms in sheep not cows.

Every spring I usually treat my cats with Revolution Blue, a medication I buy from my vets that gets rid of fleas, ear mites and other insects that bother them. They are indoor cats so that's all they usually need. Revolution is a great product that's easy to use, as you just squeeze a small tube's contents into the space between your pet's shoulder blades and it takes care of the rest. I think the natural oils in the cat's hair carries it around the body.
Zodiac Product.jpg
With our vet moving beyond comfortable walking distance I haven't been able to get out to pick up the medication for my cats in a couple of years but they'd been fine anyway so it hadn't seemed to matter. This year thought they started to display symptoms that they might be picking up mites or fleas; they can come in on my wife or I, if we have been around an animal that has them, easily enough.

So I went to a reputable pet store and bought Zodiac Spot On Flea Control for Cats and Kittens which promises to kill flea eggs in the animal's fur. You apply it just like the Revolution. So we did this on Saturday to all four of our cats.
By Sunday one of them was sporting a bald spot between his shoulder blades. Although we had noticed that it had aggravated them we had put the medication on their shoulders for a little while after, we didn't make any connection between what was happening with him and the Spot On until we noticed his skin where the hair had fallen out looked like it had been burned it was so bright red and weepy.
Pip closeup May 15th.jpg
His hair had fallen out in little clumps in that area, I found it lying in a cluster on the carpet. It wasn't like it had shed or anything because it wasn't loose hairs, you could see it formed into clumps with the roots and everything. He's a shorthaired cat so we've been able to monitor him closely now and it doesn't look like the damage is spreading any further.

But yesterday I was walking through the hall and found a pile of hair from another one of our cats. His hair is thicker with more layers so we hadn't known anything was wrong until it all just fell out in a clump. It was like he had rolled over onto his back like cats do and had left his hair behind him when he got up.

Even before that had happened we had begun to suspect the Spot On might have had something to do with it. I looked over the packaging and saw something that said what to do in the event of a problem with humans. But didn't see anything else on a scan. The type is very small and it had been hard enough trying to read the instructions for applying the material. I had had my glasses on that were what I used for reading normal sized type face and even smaller, but the type was not much bigger than this.

My wife went over the back of the packaging with a magnifying glass and finally found first aid instructions for cats. While the first aid instructions for humans had its own subject heading and started a paragraph – for the animals it began mid way through the paragraph on human first aid.

It was the only place that they actually used the word pesticide in the packaging. "Sensitivities may occur after using any pesticide for pets" They go on to say if sensitivity occurs wash your pet with mild soap and water, and rinse with large amounts of water. If it continues seek medical attention – taking the packaging and P.C.P. number with you.

Of our four cats only the two boys showed any signs of "sensitivity". Have you ever even thought about washing a cat, let alone a cat that's not in the best of moods? Neither of our boys are small either; the black one weighs in at around 25lbs and the grey one is about fifteen but is affectionately known by the vets as "live wire" for the difficulty involved with taking his temperature (I've worn him as a hat with a thermometer hanging out of his butt when he was a kitten)

Nowhere on the packaging is there any warning that this stuff may have an adverse effect on the animal except in this first aid treatment area hidden away in small print. By then it's too late to decide that you don't want to risk your animal's health by rubbing something potentially dangerous into his or her skin. The last thing you want when you think you've done something good for your pet is to see its hair start falling out in clumps

A warning is something you put on packaging that a person can see so that they can make a considered decision. It's not something you bury in small print under first aide treatment. Especially when earlier on they tell you to make sure not to let the pet take the medication internally, or to keep it away from their eyes and genitalia. You'll think that the first aid treatment is for that eventuality– not in the event of something happening they haven't warned you about.

They don't even tell you what form the sensitivity could take. When do we need to seek help from a veterinarian? When all their hair falls out, when a little clump of hair falls out, when their skin turns pink, or when their hair takes on the texture of someone who’s done one too many home permanents and burnt their hair so that it feels like straw?

Wellmark International, formally known as Zoecon is the manufacturer of this and other insecticides that are used for everything from mosquito larvae control to the fleas on your pet. In a world where we are gradually starting to ban pesticides for their known toxicity and dangers to the planet, don't you think that a company that provides products to consumers that contains those toxins should be forced to warn them properly?

What would it cost them to print in legible lettering on the front of the package something to the effect of: Some animals have more sensitive skin than others – your cat may not be right for this product. Is that too hard? Think of all good will that would generate, and all the ill feelings it would prevent.

I bought Zodiac Spot On as an attempt to provide my cats some relief from a problem and have ended up causing them to develop problems. There is something wrong with that equation. That needs to change.

April 19, 2007

The Fight Against Aids: One Step Forward - Three Steps Back

In what seems to be a part of the pattern when it comes to progress in fighting AIDS world wide, specifically in Africa, the little glimmer of hope offered by some good news is offset by the reality of what's still needed to be done. For although the cost of much needed first line drugs has dropped and countries are coming up with innovative means of reaching their people, the number of people not receiving care still out numbers those receiving care by as much as 90%.

Pregnant Women and children are still horribly at risk; with only 15% of all children and 11% of all pregnant women world wide receiving care it's hard to get exxcited by stories of the small advancements being made. Even more depressing is the fact that the region hardest hit, Africa, is still the region where care is the least adequate.

Ninety per-cent of children who have AIDS live in Africa right now as do the majority of the two million pregnant women who suffer from the disease. Each of these women is of course a threat to pass the illness onto their children in the womb if they don't receive pre-natal care.

One of the major reasons for the short fall in treatment currently is because most countries in Africa simply lack the facilities to properly care for their people. In order for a pregnant woman to be treated she of course has to be diagnosed, which means having access to a proper health care facility with a lab for processing test results. Even that isn't adequate on it's own, there still has to be continual care until the woman comes to term or she could still be infectious.

A similar situation exists for children in Africa. Half the babies born with AIDS die by the time they are two, but during those years their symptoms are impossible to distinguish from other diseases without testing. Unfortunately the test for someone under eighteen months in complicated and expensive, which means most infants die untested let alone treated. (As to why these countries lack health care facilities, they depend on the International Monetary Fund for loans to keep their countries afloat, and one of the conditions of being a loan recipient is that countries cut spending on social programs like health care)

So even though the number of people who are receiving medication has risen thirteen fold since 2003 (100,000 to 1.3million) its' really only a drop in the bucket. Especially when you consider the fact that these figures are based only on reported cases of AIDS. Fear of being diagnosed, ignorance of the facts, and the social stigma surrounding the disease keeps large numbers of people from even being tested and the disease continues to spread close to unchecked.

The availability of less expensive first-line retro viral drugs has probably been responsible for the majority of the gains made in the fight against HIV/AIDS in places like Africa. But problems still abound with ensuring people have access to the drugs they will need. The second-line drugs which people on long-term treatment need are still priced out of reach for most African health care systems to afford.

In Canada, in spite of the fact that a previous government tried to create a law which would allow a country access to the drugs they need at generic prices, very little of the drug actually leaves the country to go where needed. In fact not one pill has left Canada at all.

The problem is red tape and the incredible pressure put on governments around the world by the powerful brand-name pharmaceutical industry that is firmly against generic products. The way the system works is that a company that produces a generic version, or even adaptation of the patented drug, must receive permission from the owner of the patent to sell it. As if that were going to happen.

So when the company with the generic version is turned down it's up to individual countries to apply for a special two-year permit to buy the generic brand. But according to Richard Elliot, deputy director of HIV/AIDS Legal Network, this becomes a problem because a country will have to identify itself in the application.

Mr. Elliot continues by saying that every time in the last decade a country has tried to force the issue they have been swarmed by the pharmaceutical industry and their buddy the American Government. Mr. Elliot claims that the American government simply threatens to cut off trade with any country that tries to make use of the compulsory licence, effectively rendering the program and generic drugs useless.

The truly depressing thing in all this is the fact that there is proof when the drugs are made available, and the systems are in place to administer them, they make a big difference in a short space of time. But because a few men have decided that the money they make from controlling the drug is more important than the lives of millions of women and children people will continue to die in huge numbers.

The current Canadian government's health minister had the nerve to say that the program wasn't working because countries weren't making requests to have patents waived. Of course it was a previous Conservative government that extended pharmaceutical patents to twenty-five years, but that wouldn't have anything do with that comment would it?

Until governments around the world are prepared to stand up to the pharmaceutical companies, and demand the International Monetary Fund stop insisting on decimating social programming in debtor nations we will continue to fight a losing battle against the spread of HIV/AIDS in Africa and other parts of the world. It's not a war we can afford to lose – it's not a war we should be losing, but we are being betrayed by our own side

April 8, 2007

Bisphenol A: Birth Defects In A Can?

If it's not one thing it's another when it comes to packaged food and drink these days. If it's it not what they are using to improve the flavour that will make you sick (monosodium glutamate or M.S.G. as its more commonly known) it's what has been used to give it extra weight. The food industry has take to bulking up frozen packaged foods with soy protein.

Thankfully people are starting to catch on, including the food regulators. So instead of the old warning labels on packages, with only peanuts as a potential allergen, the list now includes soy, wheat gluten, and sulphates. People with food allergies are used to having to read any item's label in order to ensure their safety and well-being.

Well now instead of having to just worry about what is being put in our food being dangerous to our health, we may have to start worrying about what our food is being packaged in being a danger. Bisphenol A is a chemical known to act like a synthetic female sex hormone used in the manufacture of plastics and tin to prevent the taste of the container from being transferred to the food or liquid its holding. The only problem is that far too many test results are revealing something is not right with this wonder chemical.

In fact what scares scientists the most is that it seems the lower the amount of chemical present, the greater the danger. This has to do with the way hormones interact with our bodies. Hormones latch onto cells and at low doses stimulate vital biological processes. At too high a dose the cell's receptors are overwhelmed and shut down. This of course turns the theories of toxicity that state that the higher the dose the worse off you are on their head.

How bad is it? Well a geneticist at Washington State University, Dr. Patricia Hunt, was so appalled by her findings that she immediately went home and threw out all her products containing Bisphenol A. She had found that female mice exposed to low levels of the chemical had the unfertilized eggs in their uteruses so scrambled that if they had been humans the result would have been birth defects such as Down syndrome and miscarriages.

It's only been in recent years that the chemical has become widely used, even though we've known about its existence since the 1930s, and started using it in the 1950s. But we live in an increasingly pre packaged age so there is more call for this type of product then before – who wants to taste plastic in their food and drinks? Usually a product containing Bisphenol A is marked with the recycling number 7 inside a triangle. (Interestingly enough that's one of the plastics my local recycling company won't take)

Just how pervasive is this stuff? Well in the United States urine tests found it to be in 95% of all people tested, and in other parts of the world it has been found in the blood, in placenta, and in birth chords.

One of the other very interesting characteristics of Bisphenol A is that test results are dependant on who has done the testing. Every single test conducted by the plastics industry and those who manufacture container products have found it completely safe for human consumption. On the other hand 95% of independent tests have produced results so terrifying that those conducting the test never want to touch goods that come in those products again.

Spokespeople for the plastic industry say that there is nothing wrong with the chemical and that scientists are using flawed methodology. The scientists respond by saying the plastic industry is splitting hair in their results when they say that Bisphenol A is weak form of Estragon because it triggers reaction in far fewer cells then other forms. It still affects enough cells that are responsible for many of our biological functions.

One of the big five plastics companies in the United States, GE, has just decided to phase out that aspect of their business. They claim their timing has nothing to do with the first of what promises to be many class action suits brought against the manufacturers of plastic. A group in Los Angles is filling suit alleging harm from the chemical was caused by plastic baby bottles.

GE claims that their plastics division isn't growing as rapidly as others and is not fitting into their current business mode, so they've put it on the market. Their spokesperson dismisses talk of risks from Bisphenol A as "speculation" saying that it has never been shown to have any risks to humans.

If the chemical is so safe why have scientists from Health Canada and the Ministry of the Environment classified it as inherently toxic? Why are they conducting an assessment of how it used in the manufacturing process where they are starting with that premise that it is a risk to humans and industry is going to have to convince them otherwise? Normally it’s the other way round.

When Health Canada set its acceptable limits (the amount of trace elements on a parts per million scale that is considered safe for human consumption) back in 1999 they didn't take the less is more factor into their calculations. Some scientists are now saying this chemical needs to be considered on a scale of parts per trillion for a clear picture to emerge.

Since Health Canada set their limits, there have been a dozen studies that have shown adverse affects at amounts lower then the limit. One study using a sample 1,000 times less potent then Ottawa's limit showed the chemical able to change breast tissue to make it more predisposed to breast cancer. Scientists believer that there is a correlation between the increase in the number of cases of breast and prostate cancers and the increased prevalence of Bisphenol A in our food.

I don't know about anybody else, but I'm not predisposed to trust anyone from industry to tell me the truth about pollutants and toxics in our food. They after all have a vested interest in the results, not the scientists. I'm more inclined to believe the scientists who are so scared by the results that they getting rid of everything in their houses made with Bisphenol. It's not like they're getting paid to replace all the food and baby bottles in their houses made from the stuff. I think from now on I won't be bringing anything into my house with the number seven stamped on it.

Industry doesn't have the best record with the truth when it comes to pollutants and I see no reason to give them the benefit of the doubt on this one. Remember these are the same types of companies that dumped Mercury in our rivers, all the while assuring us it was safe. That is until children in Japan and Northern Ontario were born with horrible birth defects, linked directly to the Mercury that had poisoned the fish their parents had eaten.

Industry has always played fast and loose with the truth when it comes to issues of pollution and safety. Why should this time be any different?

March 7, 2007

Food Suplements: What Are They Good For?

The last time I was in seeing my pain specialist we discussed the idea that I should consider taking a supplement called Malic Acid. According to the one trial conducted using doses of Malic Acid with Magnesium there is some indication that it might assist people with Fibromyalgia, although it is unclear how the way the body metabolises Malic Acid has anything to do with it. Because I suffer from a type of chronic pain similar to Fibromyalgia he hoped there might be a chance that this could also play a role in treating my condition.

The results of the one clinical study done on the combination of Malic Acid and Magnesium as a means of alleviating the symptoms of Fibromyalgia, was inconclusive. A double blind study using placebos at low doses for four weeks (200 mgs Malic Acid and 50 mgs Magnesium three times a day) was followed by and open label test (subjects knew what they were taking) for six months where the dosage was increased to six tablets a day.

While the initial double blind test showed little beneficial results, when the dosage was doubled and the patients knew what they were taking, more noticeable relief was indicated. As of yet there is no means of finding out what if any contradictions there might be from taking high levels of Malic Acid for any length of time as it has never been done before.

According to proponents of Malic Acid it works to help the body detoxify itself of high levels of Aluminium and Phosphorous absorbed from other foods and plays an essential role in the production of energy. It's the latter effect that is supposed to have the pain relieving attribute for those of us suffering from various chronic pain conditions; although no one is willing to go out on a limb say just how it increases energy, or why that increase in energy would alleviate my pain.

Now I think it's wonderful that I have a doctor who is ready and willing to look into alternative ways he can use to treat his patients. I wish more doctors were like him, and open to a more holistic approach to medicine. (Don't panic, holistic just means treating the whole body not just the symptoms and makes sense when you're dealing with long-term acute conditions) But neither of us really knew anything about Malic Acid and he doesn't have time to do research, so he knew that by planting the idea in my ear I'd check it out.

Does the expression, "An apple a day keeps the doctor away" sound familiar to anyone? Well guess what, Malic Acid is the acid freely available in apples and all fruit. In fact it's referred to as the fruit acid by a lot of the literature. When you check the ingredient list on the side of a bottle of Malic Acid it says: Apples, plus a list of non-medicinal items.

Apples, you know they are round, come in colours ranging form bright red to yellow to green, and are found on the shelves of most grocery stores? So why are they being sold in a pill form and being advertised as the latest, and greatest medical breakthrough? To me it just sounds like the latest in a long series of supplements for inadequate diets.

It seems like vitamins have been around forever. As a kid in the 1960's I remember my mom making me take one a day plus iron because I didn't eat meat and the doctors scared her into believing I was anaemic and suffering from a deficiency of iron. But that's about as far as it went with food supplements in those days.

Our diets were either better in those days, less processed foods on the market and more whole foods, or nobody had figured out yet how bad all this processed and packaged stuff was. The convenience of being able to thaw supper rather than having to cook it from scratch was still too much of a novelty to question what was being left out of the equation aside from labour.

Considering that it was the 1960s and 70s that saw a proliferation of frozen and processed foods I would say that the world was too busy being excited by progress to worry about any bill that might come due further on down the line. (You can apply that theory to probably most things, not just diet. It really wasn't until the late eighties that some people became aware of the costs involved from the post World War Two industrial boom)

Today, not only do drug stores stock shelves full of vitamins and supplements for the diet, (who had ever heard of Omega Acids thirty years ago) there are specialty stores catering to just those items. Health Food stores that sell nothing but organic, whole grain, fair trade, non-dairy, gluten free and meatless products now also carry every sort of pill and powdered concoction possible as compensation for deficient diets.

For those not satisfied with those facilities there are stores dedicated solely to the sales of oxidants, minerals, molecules and electrons (at least that’s how it looks) that will tone and buff your cellular makeup. Why bother going to the gym and beautifully sculpting your muscles and the spa to revitalize your appearance, it you don't have the energy to stand up because you haven't bothered to leave time to eat properly?

But that's okay because now you can buy work out regimes for your molecular structure. If you don't eat enough green vegetables there is a program you can follow for a couple of hundred dollars. Anything you're missing can be replaced.

As I mentioned earlier the idea behind a holistic approach to medicine is to treat the whole body and not just the symptoms. When a holistic doctor notices that a patient is deficient in iron for instance, the doctor will recommend the patient take a supplement temporarily until a balance is achieved again. The doctor will also treat the various other ailments that are causing the client's illness and give suggestions for a change in diet that might prevent underlying conditions from recurring, like the iron deficiency for instance, that may have contributed to the problem.

Supplements are not used as replacements for anything that can be readily obtained through eating properly. Some individuals can have temporary deficiencies, or in chronic cases long term ones, where it would be impractical to correct them using diet so the use of a supplement makes sense.

But far too often now these items are being used instead of people eating properly. We don't know enough about the molecular structure and how some of these supplements work on the system to know what sort of long term affects large doses will have. We've already seen the disasters that can happen when people abuse herbal remedies thinking they are harmless because they come from plants.

Ephedra is an asthma medicine that people were taking for weight loss and who knows what else. It is only to be used in very specific conditions; otherwise it can be harmful and potentially fatal. Well too many people found that out about Ephedra by dying of strokes because it was misused and sold under false pretences.

There should be no need for people who are not suffering from some illness or chronic condition to be taking food supplements. But as our foods have become more and more refined and processed the parts that are of value to us in them have been eliminated. For the majority of us supplements can be avoided through the simple expedient of eating a properly balanced diet of proteins, carbohydrates, grains, fruit, and vegetables.

It's not rocket science, it just takes a little pre planning and exerting a little effort in taking care of yourself. Maybe instead of one of your trips to the gym why not do some meal planning? Instead of paying a couple of hundred dollars on a substitute for green leafy vegetables, buy a head of lettuce and make a small salad with your meal. Think of the money you'll save.

I'm going to report back to my doctor what I've found out about Malick Acid. I know that I don't eat enough fruit; my wife is allergic to the majority of fruit – something about the sugars they produce – so we don't normally have it in the house. So I'm going to try eating an apple a day, or its equivalent in apple sauce, and see if that helps any.

Maybe it will help keep my doctor away!

February 28, 2007

Yet Another Sexually Transmitted Disease

For those of you still under the delusion that HIV and the AIDS virus are the only sexually transmitted diseases out there that you need to worry about, the Centre for Disease Control and Prevention's latest report should be a good wake up call. According to their recent report one in four women aged fourteen – fifty-nine are infected with Human papilomavirus (HPV). The percentage reaches nearly 50% when the age range is dropped to women age fourteen – twenty-four, with prevalence increasing on a per year basis within the range. After twenty-four, outside the age of greatest sexually activity, the rate of infection decreases.

HPV is known to bring about anything from minor skin irritants to being a prerequisite cause for cervical cancer. About 100 different variants of the virus have been identified, of which approximately thirty are sexually transmitted. There are about a dozen known types that can result in a woman developing cervical cancer.

Doctors and researchers concur that the only way to correctly diagnose the virus, and to ensure that any embryonic cancer growth is detected, that women have a yearly cervical exam commonly known as a Pap Smear. A Pap Smear is able to detect the presence of abnormal cells that could be a precursor of cervical cancer. As long as testing is done on a regular basis the chances of a women dying from cervical cancer are reduced dramatically.

One only need compare the incidences of death from cervical cancer between countries in the developed world where Pap Smears are available to those of countries where they are not to see what a difference they make. While around 3600 women will die from cervical cancer in the United States, hundreds of thousands die worldwide with the majority of those deaths occurring in countries without proper gynaecological treatments.

While a Pap Smear can be used to catch HPV after the fact, it would be better still if there were a means of preventing its transmission in the first place. Since abstinence can't be enforced except through turning every male into a eunuch at the first sign of sexual maturity, other more valid options are available.

The regular use of a condom offers about a 70% chance of preventing the virus' spread, plus there are assorted antibacterial creams that can be utilized which will help. Remember that sexually transmitted diseases are not limited to the genital areas only. HPV has been seen as a factor in anal, throat, and mouth cancers, so precautions need to be taken during all sexual activity.

Best of all though is the new development of a vaccine that has just received FDA approval in 2006. Gardasil has been approved for women aged 9 – 29. Not only is it effective against two of the cancer causing sexually transmitted variants, it's also effective for use against non sexually related types of the virus that are responsible for planters warts and other uncomfortable skin conditions. So don't go flying off the handle about encouraging pre-teens to have sex, it's just a vaccine that has a multitude of positive functions.

If there is something that should be making people upset about this vaccine or about the report in general, is why the other half of the equation hasn't been tested or studied. In most cases of heterosexual relationships it's not just a woman involved. For a woman to contract HPV she has to have caught it from someone.

But instead of examining or testing men for the virus medical research has focused it's efforts on women when it comes to prevention. Why not look at ways that men can prevent the transmission as well? Women maybe the ones most at risk so there is an obvious need for them to be tested for that reason, but why not go to the source of the risk for testing and prevention?

Yes a man can wear a condom and cut down on the chances of passing a sexually transmitted disease, but why not develop a vaccine that he can take? Wouldn't it increase the chances of safety if men as well as women had securer preventative techniques?

But it's just like with the matter of birth control. The onus for prevention is still placed squarely on the shoulders of the woman and not the man even though a pregnancy can't happen under normal circumstances without both participating. The old line of if men could get pregnant think of the advances in reproductive technology that would have been made by now when applied to sexually transmitted diseases becomes even more appropriate; men do get and transmit disease just as readily as women.

Maybe it would help men take more care if they knew facts like certain types of HPV are responsible for over 50% of penile cancers? Although less common then cervical and vaginal cancer, it still occurs. But since no studies have been done on the incidences of men with HPV those figures could be higher. If we don't know how many men have HPV how can we truly tell how many cases of penis cancer have been caused by it?

You'd think the lessons we've learned from AIDS, that sexually transmitted diseases are indiscriminate, would have been absorbed by now. Even though news stories are full of facts and figures about how women are affected by HPV it doesn't mean men aren't part of the picture.

Even if they were to find that the virus has little or no bearing on the health of men, which they won't because of the previously mentioned penile cancer link, shouldn't men take it upon themselves to bear some of the responsibility? Could you really live with yourself knowing that because of your carelessness someone you loved died of cervical cancer?

Sexually transmitted diseases don't have to place anyone at risk no matter your level of activity. All that needs to be done is ensure proper education protection, research not limited to only one gender, and everybody taking responsibility for their actions. But somehow that simple solution seems to keep eluding us and until we achieve it people will continue to die for no reason and there is no excuse for that.

December 5, 2006

Emotions: What Are We So Afraid Of?

When did emotion become a dirty word? Okay I know with our uptight society people, especially men, have always been encouraged to suppress their emotions, but now a-days it seems to be bordering on the ridiculous.

While doctors have always had that old stand by valium to hand out to women with "nerves" they now have a plethora of anti-depressants, anti-anxiety, and a cornucopia of other mood altering drugs. In the old days if you wanted that variety of ways to alter your perceptions you'd have to hope to know a good chemist, now all you need is a doctor and a prescription pad.

Of course there are differences now; nasty occurrences while taking the medications are no longer called bummers or bad trips, but are given the lovely euphemism of side effects. No matter what you call them, cramps, headaches, bathroom troubles, and the risk of nightmares seem to be a heavy price to pay just to control your emotions.

Before I go any further let me say that there are times when these types of medications are a necessity. For the person who just can't cope with whatever their own personal demons are they can provide the needed respite that will allow them to work with a therapist. Anti-anxiety medications are especially beneficial in those instances as they allow the patient and doctor to work at finding the underlying cause without increasing the symptoms.

Of course there are also those people whose only chance at normalcy comes from taking medications. Those who have been correctly diagnosed with schizophrenia and bi-polar disorders must rely on drugs or find themselves institutionalized, where the drugs are guaranteed to steal more then they give back.

But there comes a time when we have to deal with emotions, and not suppress them or we loss a part of our humanity. Compassion grows out of empathy and empathy can only exist if we experience emotions. How can you empathise with someone's tears if you have never felt sadness, or their joy if you've never felt happiness?

When you're walking down the street and you see a child in tears your first instinct is usually find out if its hurt, lost, or anything else that could be bothering it. Why is it so different when we see an adult in the same circumstance? How many of us can honestly say they don't feel a little twinge of fear if they see an adult they don't know, or even one they do know in some sort of extremity of emotion?

Or if not fear how about embarrassment; doesn't some part of you wish they just wouldn't make a scene in public? Conversely why is it if a person laughing is fit to burst, laughing until tears are running out of their eyes, people will ask him or her if they are alright? Or if they are with the person, look on with a bemused, almost tolerant expression on their face that comes as close to denying acquaintance as you can get without actually running away.

I hate to sound trendy, but maybe the blame for it lies with Freud, or at least as far as women are concerned. He was the one who decided there was such an illness as hysteria, most often found in women of course because they were weaker and has less control over their base emotions. But of course he was just writing about his society and the ways people were "abnormal", what the causes were and how to integrate them back into being useful members of society.

Early twentieth century middle class/upper middle class society in most of Europe and North America was hideously repressed and it was considered bad form to show any extreme of emotion. This in spite of the world just having been through the biggest trauma ever jointly experienced by most of humanity: World War 1. Very few countries escaped that conflict without some scarring, yet everyone was insisting that showing emotions was wrong, or a sign that you were ill.

After an event like that would you think that a few tears, or even constant sobbing, would actually be a healthy reaction? Don't you think that some anger would be justified on the part of those who had lost their children or their husbands for reasons no one could really adequately explain? Then there were the tens of thousands who lost family members due to the outbreak of the flu that followed right after the war.

But it was in this atmosphere that Freud and others of the new psychoanalysis profession came up with their theories of hysteria and what is normal and abnormal emotional behaviour. Even though a lot of his work and theories have been discredited Freud's legacy lives on with doctors today in their motivations. Their job still remains trying to make you as an individual become a comfortable, functional cog in the wheel.

You can go to a zillion encounter groups that teach you to get in touch with your feelings and it won't change the fact that someone else's display of emotion will make you feel uncomfortable. Once you've gotten in touch with your feelings it's supposed to ensure that you know where they come from so that you can control them.

Control is the name of the game these days, with public displays of emotion only allowed for reasons of patriotism and in other large sanctioned gatherings. But one person crying their eyes out on the street, because some grief or other overcomes them, is seen as a pariah. One person laughing uproariously at some joke or thought that tickles their funny bone is considered either unwell or perhaps drunk.

Was it Freud who decided it wasn't proper for people to be demonstrative in their displays of emotion? Or was he just searching for the means to explain why were emotional and what could be done to control it? How is it that after two world wars, countless genocides, famines, and other horrors that the world has witnessed in the past hundred years that instead of becoming more empathetic to other people's emotional reactions we have made emotions more and more of a abnormality?

What are we so afraid of, that we may actually see there is something about our lives that isn't perfect? That there is a very good reason to cry almost every day of the week but we don't? How much longer can we continue to cover everything under the rug of medication and pretend there's nothing wrong with the world, but something wrong with the person honest enough to cry? How much longer are we going to continue to be afraid?

November 12, 2006

Were You Aware Of National Pain Awareness Week?

What do you do if you hold a party and nobody comes? Well there are a couple things you can do as a post-mortem including accessing your own popularity and why people may not have bothered with you. But more importantly you need to know whether or not the people who would actually care about the event knew about it and were given sufficient reason to attend.

The week that just passed was National Pain Awareness Week in Canada. (The official close date is today but I don’t' think this one day is going to increase people's awareness that much) Although I read one of Canada's largest newspapers on a daily basis on line, it took an email from my mother on Thursday for me to even find out about it.

Having a personal interest in the issue of chronic pain, I suffer from it, I decided to check out the web site of the organization that was sponsoring the Awareness Week The Canadian Pain Society, and see what they were doing to mark Pain Awareness Week, as well as what they did on an ongoing basis.

Well according to the only information I could find on their web site when I checked on Thursday November 9th/06 half way through their Awareness week, was that there were three events scheduled to happen. One, whose date and time were still to be announced as of Saturday, was a To Be Announced Gala Reception; and the two with set times were a lecture on pain in Senior Citizens, and a fundraising reception between 7:00 and 10:00pm Thursday evening.

Heart pounding stuff don't you think? Really guaranteed to grab people's attention, build awareness and let people know all about the issues and the conditions that lead to non-malignant chronic pain. (I believe it is important to distinguish between cancer induced, palliative care pain situations and non-cancer related pain. The simple reason is in the former the primary concern should be to ensure the patient's absolute comfort no matter what the cost to cognitive abilities and in the latter circumstances a client's ability to function must be balanced with the need to control pain) They didn't even co-ordinate it with this years Global Day Against Pain – September 12th/06 – which would seem to have been an ideal keystone to have built the week around.

Even the two events they have scheduled won't have done much to spread awareness about the condition where it's most needed, in the general population. I can't see the point in holding such an "Awareness" event if the only ones who are going to be interested are those who are professionals in the field of pain management. Talk about preaching to the converted and being just a little self-congratulatory.

In fact the more I read through the site, the more that I came to realize that this was primarily geared towards health care professionals and others in the field of pain management. The aims of the group only includes as almost an aside a statement that says they will inform the general public about advances made in the treatment of pain.

Now there is nothing wrong with an organization with the goals and objectives as outlined by this group, but what I object to it the fact that their name and the title they gave to this past week, both imply a service they neither offer nor deliver. While there is of course a need for an organization co-ordinating the work of those working with chronic pain patients and those researching the same subject, there is also a need to educate the public at large and other medical professionals about the realties of chronic pain.

The employer with the employee who suffers from chronic pain is less likely to think they are malingering if they understood what the person was suffering with and attempting to work at the same time. (I was incredibly fortunate in this regard having had an employer who was exceedingly patient with me while I was being diagnosed and tying to continue working. They did their best to accommodate the condition and me until the very last day that I worked there.) Even family and friends need to understand that a person with chronic pain is like anybody else with a severe disability that limits their abilities. Because you don't look unhealthy it is very hard for people to get their heads around the fact that you are.

But where education should be a priority is amongst medical professionals who need to be able to treat their clients with the proper medications while they are seeing a specialist in an attempt to find a cure. This includes understanding that there is no crime in prescribing opiates to those who need them for pain control, and the chances of them becoming addicted to them is minimal if properly prescribed.

Drugs like morphine are not addictive as long as they are being used to fight pain because they are merely assisting the body's own abilities. If properly administered the drugs will do nothing more than provide relief from pain, and the need for the drug will vanish along with the pain. How opiates can become addictive is if they are not given in sufficient dosage, leaving the body constantly craving them for relief, or if the drug is of insufficient strength in the first place to cope with problem.

In order for the drug to work effectively a person's body needs to establish a threshold of pain control using a long term or long lasting version of the medication that gradually release the medication into the system. Once the patient has taken enough doses consistently of the right strength his or her need for the much more addictive "fix" of the short-term medication is reduced.

The addictive craving only comes about if there is an appreciable positive result from taking the medication. If the body gets used to "feeling better" from popping a pill every four hours it is going to start wanting that pill, and begins wanting higher and higher doses in order to obtain that sensation as a tolerance is built up. With the long-term medication this craving is eliminated and the short-term drug is used only when the pain spikes and not on a scheduled, regular basis.

There are still far too many so-called medical professionals who will refuse to prescribe morphine because they don't understand how it is utilized and are denying their patients relief that may make a huge difference to the quality of their life. Yes there are people out there who are going to attempt to abuse the system and obtain drugs through false pretences, but that is no reason to make those in genuine need suffer.

I would think any organization that calls itself by the name of The Canadian Pain Society is being remiss in its duties if it does not place equal emphasis on public education in an attempt to ensure that those it claims to speak for are cared for with compassion and understanding. There is nothing worse in the world than being treated like a drug addict by the very people who are supposed to be helping you.

Living with pain is a formidable enough challenge without having to overcome other people's prejudices in order to get the treatment you deserve. The Canadian Pain Society should make it their responsibility to assist those who suffer so they don't feel like they are in this alone. Is that too much to ask?

November 2, 2006

Sudden Indfant Deaths: New Study Finds Cause - Or Merely Symptom?

I don't know if I can think of a worse nightmare for parents then walking into their newborn baby's room and finding their infant dead. Sudden Infant Death Syndrome (SIDS) was a horror that first started rearing its ugly head about twenty years ago. At least that's when the medical profession started to categorize the mysterious unexplained deaths of infants under the age of a year; who knows how long it had been occurring in the years prior to that.

Crib deaths, as it is also referred to, are characterized as the unexplained death of an infant under the age of a year while sleeping. A perfectly healthy child was put to bed by its parents and would simply stop breathing in its sleep for no apparent reason. Parents of course would be guilt ridden as well as grief stricken blaming themselves for what they saw as a seemingly preventable death.

Finally there might be at least a partial explanation for this mysterious horror. Researchers in the United States have compared the brain autopsies of 31 SIDS victims over the past ten years with those of ten infants who've died of other causes and noticed an abnormality in their brain stems that might effect breathing. The defect seemed to affect the brain stems ability to regulate serotonin, the chemical that helps to control vital bodily functions.

While this in no way can be seen as conclusive evidence due to the small numbers in the study, it does go a long way to supporting what doctors at Sick Children's Hospital in Toronto Canada have long suspected; that some brain function in these children has been inhibited in order for the deaths to occur. Dr. Ernest Cutz, who has studied the disease, believes that the discovery is one step towards removing the mystery surrounding SIDS, and hopes it will help improve prevention and perhaps even lead to a way of eradicating it permanently.

Aurore Côté of Montreal's Children's Hospital and a specialist in SIDS is the one who cautioned that the sampling in these test results is too small to be conclusive in any way. Besides which she says the two major risk factors involving the syndrome are already established – putting babies to sleep face down and tobacco smoke during pregnancy.

In Canada education campaigns have been highly effective, reducing the number of SIDS related deaths from over 400 a year annually a decade ago to 100. Even in this recent study it was shown that 65% of the deaths were babies that had not been put to sleep on their backs. In other words there is still a worrying lack of awareness of basic prevention methods among parents in the United States.

It seems to me only a question of common sense. One of the first things you are told when handling a newborn infant is to insure that you always support its head. The head is the largest single part of the human body and the baby's neck muscles are nowhere near developed enough to be able to support that weight. If the child is laid face down in its bed it will never be able to move in order to take a deep breath if required.

But that also leads me to wonder about something, and that is has this study found a cause, or have they merely found another symptom? If the weight of a child's head causes the brain stem to be placed under undue strain because the muscles of the neck can't protect it, does this increase the likelihood of the lack of serotonin control? Would the baby laying on its stomach cause its oesophagus to close, resulting in decreased oxygen to the brain, which in turn would cause the brain stem's effectiveness to depreciate resulting in reducing the control of serotonin. In other words, effectively cause suffocation and the failure of the body's alarm system ability to warn of that potential simultaneously.

Might it not be possible that this new study's findings are simply a report of cause and effect instead of being any major breakthrough? The question that the study needs to answer is whether the lack of serotonin control was a pre-existing condition or simply an ancillary result of the cause of death – gradual asphyxiation caused by the collapse of the infant's windpipe due to its inability to support the weight of it's own head.

Was the baby born with the brain defect that allowed for the impairment of the serotonin or did the defect develop because of the causes of death over its short lifespan and influences during gestation? It's easy to say oh look, this number of infants died and they all have X wrong with them and conclude that X is the factor that causes that death. But to do so without ascertaining the cause of X is sloppy science.

Try a simple experiment on yourself: let your head fall backwards so that your chin points to the ceiling and your neck and the spinal column within it are compressed. While your head is in that position do you notice that you're not breathing as deeply as you should? When you return your head to its normal upright position you may experience some dizziness or light-headedness, caused by lack of oxygen to the brain. But you didn't receive any warnings that you weren't breathing normally did you?

The results of this latest study showed that 65% of the infants had not been sleeping on their backs. There has been no report of whether or not there were any other mitigating factors, like smoking during pregnancy or second hand smoke, considered that would have impacted on the other 35%, and that is important to find out. If all 31 infants in the study were exposed to high-risk situations of some sort it would be negligent to ignore that fact.

While it would be wonderful to say that the cause of this heartbreak has been discovered, it seems to me like there are too many question marks surrounding this latest study to raise anyone's hopes. Before we start rushing out to fill prescriptions for infant serotonin regulators I think far more study needs to be done on when the brain defect developed and its cause.

Right now there is as much likelihood that they've discovered a symptom of SIDS as a cause. For real peace of mind about SIDS see your family doctor and get educated on all that you can do to prevent it. That seems to be still the best cure.

October 15, 2006

You Know Your Body As Well As The Doctor - Listen To It

Why are we always so quick to surrender authority to someone else when it comes to decisions about ourselves? Specifically why is it that as soon as we are in the presence of a person in a white coat we automatically assume they know more about our state of being than we do ourselves? Wouldn't you think it would be the opposite, that we are going to know how our body reacts in certain situations far better than someone who has only met us once or twice?

"Nobody has any problems with that…" or my personal favourite, "Now that's strange I've never seen that before… are you sure you've done everything I told you to do?" Implying that it could never be there fault that you've swollen up like a bright red balloon after having an allergic reaction to something, something that you had warned the doctor about to which he had replied "Nobody has any problems with that"

I've had sort of a hit and miss relationship with the medical profession over the years, I've been accused of exaggerating the amount of pain that I'm in after knee surgery by some arrogant prick of a resident and been told to stop being a baby and that they're going to send me home. Then when he goes to recast me (whoever had put the cast on after surgery had forgotten that there might be some post surgical swelling and my circulation was cut off so badly my toes turned black until they got someone to loosen the cast) he discovers an infection in the incision that would account for the amount of pain I was in. Oops the patient was right not the doctor.

The latest fad in hospitals is to reduce stays as much as possible. All in the name of the almighty dollar; get that patient in and out as fast as possible, or heck, don't even keep them if we can help it. Let the family deal with them at home. So what if they can't walk. Procedures like gall bladder removal, hernia repair and appendix yanks that used to require a minimum of a day or two in the hospital are now Day Surgery, in and out the same day, or at best an overnight stay.

To be fair the doctors don't set a lot of this policy, it's just the guidelines they are forced to follow by the hospitals. I'm sure they were asked what, under ideal conditions, was the minimum amount of time needed for recovery for each of those procedures, and were then instructed to adhere to that schedule. My complaint is that perhaps the doctors could take each patient into consideration as an individual instead of treating us all as a singular mass.

I believe that these new guidelines are probably costing them more money in the long run than if they had kept the patients in for the amounts of time they had previously. If they were to examine the numbers of patients who have to come back to hospital within days of being released and be readmitted or treated for extensive time in emergency they would probably find they are spending the same if not more money on patient care now then they were before.

Let us use me as an example. Friday morning just past I went down to the hospital to have a hernia repaired. This procedure that used to involve a hospital stay of a couple of days is now done in Day Surgery under a local anaesthetic. You don't even get knocked out anymore. Perhaps for somebody who is in perfect health and has no other complications at all they are able to go home a couple hours after the surgery and be fine.

Now the doctors were well aware that I have a pre-existing chronic pain condition in the same vicinity of my body but didn't seem to think that warranted any special consideration. So I was sent on my merry way an hour after surgery was over. By mid-afternoon I was in so much pain I couldn't move. None of my oral analgesics, 10-mg. morphine pills taken two at a time, were giving any relief at all.

In the province of Ontario, Canada where I live we have a twenty-four hour health line that we can call to speak to a Registered Nurse at all times for a quick consultation. When I phoned that line at 7:30pm that night she told me she would check with a doctor on call and either he would phone me within a half hour or I should get to emergency as quick as possible. Fifteen minutes later they phoned back to tell me to go to emergency at a specific hospital and they would be expecting me.

I was at that hospital until 1:30 am and during that time they pumped as much morphine into my body as they could in an attempt to bring the pain under control. But because they are not an in patient hospital they had to ship me by ambulance to another hospital across town. There was a surgical team on call there who needed to examine me in case I was bleeding into my abdominal cavity or my wound.

I ended up staying there until 2:30pm Saturday when they finally managed to get the pain under control enough that I could lay at rest in comfort. The conclusion that they came to was that because I suffer from chronic pain already, my tolerance for pain is less than other people's and conversely my tolerance for morphine is higher. If I had spent the night in hospital receiving proper pain management to begin with, there never would have been any of these problems.

So I ended up taking up two beds in emergency, one in each hospital, an ambulance ride, between the two hospitals, a huge amount of intravenous morphine, and finally a bed they had to book for me in case they needed to admit me to the hospital. (When my wife phoned looking for me on the Saturday afternoon as I was heading home in a cab she was actually told that I had been admitted and was passed up to the room I was supposedly in. It took her talking to six people to find out that I was already in a cab on my way home)

What is disturbing is that I'm not the only person that this happens too. Even if you cut the hearsay accounts in half concerning people who have been released from hospital and then had to be rushed back in again a few days latter, the numbers are too high. Of course there are bound to be a few people where unavoidable complications occur after the fact, but for so many people to have to be readmitted there is something wrong with the system.

Doctor's have to stop treating people like they are all the same and to not treat anything as routine. Cutting a human body open is never routine, especially when you are inserting a foreign object like a piece of mesh in the body as they do for hernia repair. If they have any doubts about a person's ability to recover they should automatically be admitted to hospital and err on the side of safety rather then expediency.

But the responsibility is also ours as patients to ask questions and make sure that all our concerns our being addressed. I don't know if it would have helped or made a difference if I had reminded people about my other condition, or asked for assurances that it wouldn't make a difference in my recovery. But I should have trusted my own knowledge of my body over that of the doctor's opinion and at least tried to say something.

Until we have the courage to take control of our own bodies and reduce our dependency on someone else's opinion on how we are feeling, we will continue to find ourselves in situations that might have been avoided. Of course it also depends on the willingness of the doctor to listen to you. But if fewer of us were to treat them like gods, perhaps they would stop thinking of themselves as ones.

September 19, 2006

Rebuilding Your Life From The Past Forward

"You can't live in the past".

"Time heals all wounds".

"It's time to get on with your life."

These have got to be three of the most common things said to people who are in recovery from crap that's happened to them in the past. People who have no understanding of what it means to try and rebuild yourself from the heart outward and the ground up are most often the "caring" individuals who spout these absolutely useless words of advice.

Whenever I hear someone saying any of the above, or any number of variations on the theme, I feel like grabbing them by the shoulders and giving them a good shake. Maybe that way their brain will start firing on all cylinders for a change. After I'm sure I've got their attention, I would calmly explain a few things to them as per their trite little aphorisms.

First of all what the hell are they implying when they say stuff like that? Most times they are "subtly" telling you're being self indulgent and you need to stop wallowing in self-pity. That really becomes evident when they follow up their earlier words of wisdom with "everybody's had a tough life – look at me" as if that would settle the matter.

Hey guess what, not everybody is the same. I know that's a difficult concept for some people to get their heads around but it's true. We all have different aspirations, desires, and psychological make-ups; and that's only a start. They also seem to be able to ignore the fact that some things are harder to recover from than others. Nope they are the litmus test against we are all to be judged against.

The phrases themselves have very little meaning, or are comfortably ambiguous at best. Nobody actually lives in the past; sure time heals all wounds, some of them kill you eventually; and how do you know someone is not getting on with what he or she consider to be a life. Just because they don't do what you do, how does that make them a zombie?

Let us look at some harsh realities of people in recovery from crap that happened to them in the past. First of all the longer you've put off dealing with it, for whatever the reason, the harder it is to recover and the worse it beats the stuffing out of you. It doesn't matter to you at that moment in time that time may or may not heal that particular wound; it's wide open and gaping at that precise moment and sucking you whole soul into its depths. Finally, just what is recovery anyway if it isn't trying to get on with your life?

I can tell you from personal experience that being in genuine recovery is not something you do for fun and want to do for any longer than you have to Implying that you can turn the process off and on at will and all of a sudden be better is not only insulting it shows an ignorance of what the process entails. Any person who can blithely say "get on with your life" has never done the work, no matter what they claim to have overcome. The fact that they have that attitude at all is the first clue.

In my experience the people most inclined to say things like that are still too scared of that process and feel threatened by anyone who has the courage to even contemplate moving beyond who they once were to become who they could be. When I use the word recovery, I'm talking about the recovery of the self that lives in the realm of potential not about getting better from something.

I've written about the work Dr. Jeffery Young has done in past posts but I'll recap for those who haven't read them. Each of us has been shaped irrevocably by what has happened to us during our formative years. Our means of reacting to circumstances, the people we are attracted to, what we expect others to do from us, what we think we have to do in order to be accepted, and so on were all imprinted dependant on what happened to us mainly in pre-pubescence.

Dr. Young has worked out various patterns of behaviour, what he calls Schemas that can be caused by a variety of potential circumstances in a home life. If you were the child of alcoholics you will grow up expecting to be treated in a certain manner, and continue to use the behaviour patterns, or copping mechanisms, that got you through that time period.

Sometimes, because that's what you are used to, and equate it as what is normal, you seek out those same circumstances over and over again throughout you adult life. The familiarity of the situation is comfortable for you because you can predict what will happen down to even when the relationship will be ended.

Co-dependency has the benefit of allowing you to tell yourself that you are doing something good, because you are trying to help somebody else. In reality all you are doing is helping to make the hole all the much deeper to climb out of for both of you.

Sometimes it takes a traumatic event to realize the trap you're in, other times you hit bottom, and sometimes it just seems to happen for no apparent reason except some part of your brain has decided enough is enough. Whatever the reason you have committed yourself to the complete overhaul.

The problem, or the great thing depends on your mood that day, is that once you discover that things need fixing you can't stop until you're done. The first, and sometimes hardest step is finding someone who you can work with to help you along the way. Even if you can do the work on your own, and you should anyway, you need to have a professional ear to bounce shit off of. Someone who understands how the brain works so you don't end up just fooling yourself.

Personally I think this whole process of recreating oneself is the closest thing to a miracle each of us can perform. Giving birth to a child and raising it is taking an empty vessel and filling it up; re birthing yourself is looking at what you are, completely, honestly, and dispassionately and excising all that's unhealthy.

Then you have to figure out who you would have been if you had been allowed to, and find the means of becoming that person. Each reaction that you have to an emotional stimulus has to be analysed to see if you are reacting to the present circumstances or the past. Which voice are you listening to, the one that belongs to the person standing in front of you or the one that called you a useless shit thirty years ago because you bought the wrong brand of beer?

When I hear people dismissing this type of journey with meaningless catch phrases because they don't have the guts to do the same thing, are willing to live blind and deaf to the possibility of giving voice to their true self, or because they need to hold on to having somebody else to blame for their troubles, it makes me appreciate those people who attempt it even more.

It's not living in the past to strive to overcome it's effects on your present; not waiting for time to heal your wounds takes a lot more strength than simply sitting back and being a martyr; and what else could you call reclaiming your if not getting on with it? Perhaps that's the problem, those who say those types of things need to understand what they are talking about. Or it is that too much to ask?

Rebuilding Your Life From The Past Forward

"You can't live in the past".

"Time heals all wounds".

"It's time to get on with your life."

These have got to be three of the most common things said to people who are in recovery from crap that's happened to them in the past. People who have no understanding of what it means to try and rebuild yourself from the heart outward and the ground up are most often the "caring" individuals who spout these absolutely useless words of advice.

Whenever I hear someone saying any of the above, or any number of variations on the theme, I feel like grabbing them by the shoulders and giving them a good shake. Maybe that way their brain will start firing on all cylinders for a change. After I'm sure I've got their attention, I would calmly explain a few things to them as per their trite little aphorisms.

First of all what the hell are they implying when they say stuff like that? Most times they are "subtly" saying you're being self indulgent and you need to stop wallowing in self-pity. That really becomes evident when they follow up their earlier words of wisdom with "everybody's had a tough life – look at me" as if that would settle the matter.

Hey guess what, not everybody is the same. I know that's a difficult concept for some people to get their heads around but it's true. We all have different aspirations, desires, and psychological make-ups; and that's only a start. They also seem to be able to ignore the fact that some things are harder to recover from than others. Nope they are the litmus test against which we are all to be judged.

The phrases themselves have very little meaning, or are comfortably ambiguous at best. Nobody actually lives in the past; sure time heals all wounds, some of them kill you eventually; and how do you know someone is not getting on with what he or she consider to be a life. Just because they don't do what you do, how does that make them a zombie?

Let us look at some harsh realities of people in recovery from crap that happened to them in the past. First of all the longer you've put off dealing with it, for whatever the reason, the harder it is to recover and the worse it beats the stuffing out of you. It doesn't matter to you at that moment in time that time may or may not heal that particular wound; it's wide open and gaping at that precise moment and sucking your whole soul into its depths. Finally, just what is recovery anyway if it isn't trying to get on with your life?

I can tell you from personal experience that being in genuine recovery is not something you do for fun and want to do for any longer than you have to. Implying that you can turn the process off and on at will and all of a sudden be better is not only insulting it shows an ignorance of what the process entails. Any person who can blithely say, "get on with your life" has never done the work, no matter what they claim to have overcome. The fact that they have that attitude is the first clue.

In my experience the people most inclined to say things like that are still too scared of that process and feel threatened by anyone who has the courage to even contemplate moving beyond who they once were to become who they could be. When I use the word recovery, I'm talking about the recovery of the self that lives in the realm of potential not about getting better from something.

I've written about the work Dr. Jeffery Young has done in past posts but I'll recap for those who haven't read them. Each of us has been shaped irrevocably by what has happened to us during our formative years. Our means of reacting to circumstances, the people we are attracted to, what we expect others to do for us, what we think we have to do in order to be accepted, and so on, were all imprinted dependant on what happened to us mainly in pre-pubescence.

Dr. Young has worked out various patterns of behaviour, what he calls Schemas that can be caused by a variety of potential circumstances in a home life. If you were the child of alcoholics you will grow up expecting to be treated in a certain manner, and continue to use the behaviour patterns, or copping mechanisms, that got you through that time period.

Sometimes, because that's what you are used to, and equate it as what is normal, you seek out those same circumstances over and over again throughout you adult life. The familiarity of the situation is comfortable for you because you can predict what will happen down to even when the relationship will end.

Co-dependency has the benefit of allowing you to tell yourself that you are doing something good, because you are trying to help somebody else. In reality all you are doing is helping to make the hole all the much deeper to climb out of for both of you.

Sometimes it takes a traumatic event to realize the trap you're in, other times you hit bottom, and sometimes it just seems to happen for no apparent reason except some part of your brain has decided enough is enough. Whatever the reason you have committed yourself to the complete overhaul.

The problem, or the great thing depending on your mood that day, is that once you discover that things need fixing you can't stop until you're done. The first, and sometimes hardest step is finding someone who you can work with to help you along the way. Even if you can do the work on your own, and you should do as much as possible on your own anyway, you need to have a professional ear to bounce shit off of. Someone who understands how the brain works so you don't end up just fooling yourself.

Personally I think this whole process of recreating oneself is the closest thing to a miracle each of us can perform. Giving birth to a child and raising it is taking an empty vessel and filling it up; re birthing yourself is looking at what you are, completely, honestly, and dispassionately and excising all that's unhealthy.

Then you have to figure out who you would have been if you had been allowed to, and find the means of becoming that person. Each reaction that you have to an emotional stimulus has to be analysed to see if you are reacting to the present circumstances or the past. Which voice are you listening to, the one that belongs to the person standing in front of you or the one that called you a useless shit thirty years ago because you bought the wrong brand of beer?

When I hear people dismissing this type of journey with meaningless catch phrases because they don't have the guts to do the same thing, are willing to live blind and deaf to the possibility of giving voice to their true self, or because they need to hold on to having somebody else to blame for their troubles, it makes me appreciate those people who attempt it even more.

It's not living in the past to strive to overcome it's effects on your present; not waiting for time to heal your wounds takes a lot more strength than simply sitting back and being a martyr; and what else could you call reclaiming your if not getting on with it? Perhaps that's the problem, those who say those types of things need to understand what they are talking about. Or it is that too much to ask?

September 18, 2006

Canadian Politics: The Case Of The Missing Kyoto Accord Part Seven

The bump on the top of my head was starting to make me wish for bed and a cold compress, and the last thing I wanted to be doing right now was sitting in a dank cellar chatting with the two folks, no matter how good their intentions had been, who'd made me feel like this. Still there was something compelling about the way her lower lip trembled when she was emotionally distraught that made me want to investigate how she reacted to other stimuli.

But those were idle thoughts suited to other occasions, and even contemplating them made me wince with pain. Anyway, they looked like a couple of nice earnest, concerned types who wanted to save the world, and from previous experience I knew that was one road better left un travelled. They weren’t casual about anything, and politicized sex was always on the low end of the enjoyment scale for me, especially when working on a migraine.

I suggested that we keep in touch and if they thought of anything more, or if anything happened, that might lead me to an answer about who croaked the professor and what happened to the Kyoto accord. I told them if I ever did get any answers that I would make sure they were filled in, if for no other reason so they could stop bashing people over the head that came into the store asking about the Kyoto accord.

Couldn't be good for business if you kept hauling concerned environmentalists down into a cellar and giving them the third degree. Unless they had a sideline in headache remedies: "Hey does that store of yours have anything for a wicked headache, induced by a minor head trauma?" I asked her pointing at the point on the noggin he had tried to stave in.

He had the good grace to look embarrassed and mumble another apology, while the smile she bestowed made me start reconsidering my earlier resolution and thinking a little tender loving care administered by her capable mouth might not be such a bad thing after all. But when my eyes made contact with daylight, it was still only mid afternoon, when we reached the street all thoughts of anything but lying alone in bed with the blinds drawn and me out cold quickly vanished.

Even her bashful, eye's down looking up at me through her eyelashes, "Is there anything else that I can do for you…" only elicited a request for a cab. Her suggestion as she shepherded me into the cab that she'd call tomorrow to see how I was doing, was laden with meanings, but all I could do was smile weakly and mumble my address to the cabbie.

His initial reluctance on driving me was quickly overcome by my suggestion that the quicker he got me home the less chance there was of me puking on the back of his head. Mentioning the names of a couple of gentlemen I knew in the people cartage business who were known for their efficiency in dealing with those who upset their friends helped to overcome the last of his doubts.

It also ensured I was spared the usual commentary on the state of the world that cabbies seem to believe is their prerogative to deliver. By the time we pulled up to the office whatever placebo she had given me was slowing me down sufficiently that I tipped the cabbie a twenty, which led to the unprecedented site in Ottawa of a passenger having his door opened for him by the driver of his hack. He also did me the favour of pointing me in the right direction of my buildings door, so I didn't wander dazed into traffic.

Harry the day doorman had seen me in quite a number of states before this, but even his eyes showed some concern as he clocked the state of my pupils and the discreet swelling on the back of my head.

"You want me to check on you every couple of hours or so Mr. Steve, to make sure you haven't slipped into a coma?"

"Actually", I told Harry, "a coma sounds pretty attractive right about now. Just get me on the elevator and hit the button for the right floor and I should be able to take it from there." The last thing I needed right now was to be mother-henned by six foot–seven-inch, 300lb, ex linebacker with one eyebrow, a shaved head, and a gold loop earring the size of a hoola-hoop. Nope I just needed my bed and a lot of pitch dark.

Which I almost didn't get until I remembered how a key and lock mechanism worked, after surviving that challenge, navigating through the clutter of the office to the private room in behind was nothing. The only distraction was the flashing red of the answering machine light, which caused a momentary fixation, quickly overwhelmed by the intense pain its pulsation produced in my skull.

I let the back of my knees hit the side of my bed that allowed it to welcome me into the comfortable bosom of its embrace. I wish I could say I slept like a log and didn't feel anything until I woke the next morning, but I was disturbed all night by wild dreams that featured Ms. Magnesen and the environmentalist cutie literally tearing me in half; Professor Magnesen lecturing both of my parts on separate occasions on how to control emissions; and in amongst it all was the sound of people pounding at my door and yelling for me to wake up as they were the police and it was long past time that decent people were awake and at work.

Unfortunately that last part turned out to be true, (I don't want to think about the implications of the other parts thank you very much) and I eventually had to stagger to the door so as to prevent the noise from continuing. It was only as I turned to lead my old buddies from the crime scene back into the apartment that I realized the ten o'clock I had read on the dial of my bedside clock meant the next morning, not later that same evening.

"I didn't even know you drank tea, let alone took sugar in it" was followed by harsh laughter from behind as the assholes chortled at my misfortune. "Was that one lump or two?" That ain't the kind of shit you deal with before coffee on the morning after the day I had had yesterday. I couldn't even muster the energy to give them a baleful stare, let along a snappy retort.

I didn't know what I had done to deserve the honour of a home visit, but I figured I'd better be slightly somnambulant before trying to cope with the excitement of it all. I pointed in the general direction of where I remembered my bathroom as being, and received a leering grin and a sweeping, be my guest, arm gesture in return.

It was only after I had held my head under the cold tap for five minutes that I began to realize the potential for trouble that a visit from two cops, who were being overtly genial, could forebode. For two guys like McIntosh and Gates to show up at my door without kicking it down first meant they had either come to gloat or…I couldn't think of any other reason.

If they were going to arrest me they would have kicked the door down and hauled me away, that would seem more their modus apprehenda- so to speak- over this polite routine. Of course this all could just be an elaborate game of good cop bad cop, as I noticed Gates hadn't done anything except show his teeth at McIntosh's jokes. Like with any wolf that could mean he's laughing or readying himself to go for your throat.

When I could look in the mirror and only see one of me looking back I figured I could just about cope with the boys in bad suits and headed back out to the office area. Still studiously avoiding any sort of contact with them I headed to where the coffee pot that was my morning cup awaited. From the damage inflicted upon my kitchen and the depreciation in the level of the pot, I could see my guests hadn't hesitated on making themselves at home.

"You must have finished the lumps off last night" Gates called through " We couldn't find anything but these packets of "nude" sugar. Oh and your out of cream." It's a good thing I like black coffee cause 25 years with no chance of parole is a long time to spend behind bars, and guards inside don't like cop killers.

After gulping a first cup, burning the roof of my mouth and finishing the process of returning to consciousness simultaneously, I poured a second cup and headed out to meet my early birds, hoping I wasn't the worm awaiting eating. From the way Gates was looking at me like a side of beef I couldn't help feeling that prospect was pretty good.

"Who gave you the love tap?" McIntosh asked pointing his chin at the lump on my head.

"Someone who wasn't as genteel in looking for information as the police officers of our nations capital. Now what can I do for you boys, I wouldn't want to think I'm holding you up from serving and protecting the good people of Ottawa" I tried to look at them with as much innocence as I could muster with my eyes still slightly crossed and the knowledge that the last time I had seen them a dead body with a machete in its back had plopped at my feet weighing heavily on my mind.

"It's what we can for you chum" Gates was licking his lips, hopefully licking off lingering drops of coffee but it was hard to tell what was going on behind those beady little eyes. "We thought you might like to know the identity of the stiff who fell at your feet the other night. We thought hearing his name might jar your memory, although I see others have tried less subtle means. Which reminds me do you need to report a crime, we're police officers you know and we're here to protect the public." He laughed a horrible little laugh that sounded like a cross between a growl and the wind blowing over a grave on a cold November night.

"That was just a misunderstanding, and why should hearing the dead guy's name jar my memory?" I was trying to think if I had given beautiful anything like my card which she could have given her dad which would take some explaining if it were found on his corpse.

"The crime scene boys found this", he reached into his pocket and pulled out a plastic baggie of the type you use for sandwiches, pot, and evidence. This one held a piece of yellow paper torn on two edges so it had obviously ripped from the bottom corner of a larger page. "Your ad in the yellow pages was found in Mr., I should say Dr./Professor Magnesen's jacket pocket with the name of the bar scrawled on it, and the words "last brass pole on the barkeep's side" written in the same hand."

He paused and looked at me, and just in case I hadn't caught the implications of what he was suggesting, spelt it out for me." We think you were arranging to meet him there, and you've holding out on us for some reason and we want to know why?"

I took a sip of my coffee and looked up at him. "Well that's better then your usual average, batting .500 could almost make a person think you know what you're doing. Yes I was supposed to be meeting him at the bar, but I wasn't holding out on you because until you just told me I had no idea that the corpse at my feet was Dr. Morgensen.

We had only talked on the phone up till that point, which is probably why he had the directions on where to find my scrawled on my ad in the yellow pages. I just figured he had shown up after the murder and found the bar locked up and him not able to get into seeing me. I've been hoping to hear from him again since, but now it looks like that hope is a pretty vain one…"

It's always good to leave a thought or sentence hanging when talking to cops, they don't like to think you know everything, and it gives them the illusion that they have some room to manoeuvre with you even though you've built a pretty thick brick wall up for them to run into. And if they do have something in reserve, you can always hold on to I hadn't finished.

I wasn't going to have to worry about that this time, because although it was obvious they didn't like it, they didn't seem to have anything more than that piece of paper connecting me to the dead doc. If they thought otherwise, obstructing a murder investigation would be the least of my worries. I'd have to start worrying about my name finding its way to the attention of individuals I don't want knowing it.

They had finished their coffees by then and knew their chances of refills were non-existent, so they'd have to head over to Tim Horton's and have an official coffee break if they wanted any more. Gates was out the door and McIntosh was close behind him, when he turned and looked back.

"This is more than just a divorce case gone bad, peeper, it's even more than just a homicide. There's a lot of pressure on us to get results, but results that end it without it going far. There's talk of not letting it go further than this room, unless something else shows up soon.

Everybody's called the chief today from the horsemen, to the spy guys, and somebody from Parliament Hill to ask that we keep them posted. Everybody's walking around the station house right now so uptight that they're scared to fart. Whoever worked you over last night was an amateur compared to these boys from up high. I've heard that they can make it so you get to the point that you want to tell them what they want to hear just so the pain will stop."

He nodded at me then and closed the door behind him. Have a nice fucking day. It looked like my time on this case was running out fast no matter what I wanted, so the option of another day in bed, however tempting was a no go. The problem was that unless something fell in my lap pretty soon this case was no go as well.

I had to hope that someone was having more success than me or I could be looking forward to a long time away from home.

September 7, 2006

Honey don't look he's schizophrenic!

There aren't many illnesses left that carry quite the stigma that mental health issues do. True it is now socially acceptable to go and see a psychiatrist, but even then that's only for something safe called analysis. Once a week you go to the doctor and complain about how awful your life is and he or she sit there and take notes.

In some circles it has become almost a status symbol or a badge of distinction to say, "Oh yes I'm in therapy" They might not be able to tell you exactly why, or if it's done them any good, it's just one more thing to do in a week. To be fair more and more people are seeking professional help for dealing with the ever-increasing amounts of stress that seems to be a prerequisite of living in today's society.

Depression and anxiety are no longer considered "abnormal" as nearly one in four people are now being medicated for one or the other. Hell when the big drug companies are taking out television adse and buying up miles of page space in attempts to sell you the latest be happy pill you know that whatever it is they are for is pretty damn mainstream.

It's when you begin to deviate away from the "normal" abnormalities that the looks start. The slightly fixed smile and the freezing of facial muscles are usually accompanied by a shifting of body weight onto the back foot so in case you start frothing at the mouth or acting in any manner that might be construed as dangerous, they can execute a quick get – a-way.

There's nothing quite like the words bi-polar or schizophrenia to bring a conversation to a complete and stuttering halt You ever want a little personal space in a crowded room all you have to do is work sentences like "my doctor says I'm in a bit of a manic phase right now, but he's hoping the adjustment to my meds will enable me to cope." Grin a little wildly and add a touch of mania to your eyes and you'll find yourself alone in the middle of the room in no time flat.

People with schizophrenia or diagnosed with bi-polar become immediate pariahs to those who were their friends and even some members of their families. If you had any decency at all you would go off and get yourself put away in a mental home and not be such a burden on your friends and family. They'd all be more than willing to help you commit yourself – for your own good of course – if you would only come to your senses and do the right thing.

The convenience of you being shut away is of course all theirs; out of sight and out of mind is how most people would prefer sick relatives or friends. But that sort of behaviour is almost bearable when compared to the abuse some patients are subjected too. Far too often it is family causing the abuse, aided and abetted by the complicity of a society that doesn't care.

When a person suffers from a mental illness one of the assumptions society is quick to make is that no matter the severity of their disease, their ability to assess circumstances has been reduced. When they are living at home and their primary caregiver is a parent, anything the patient says is judged against the parent's description of the same circumstances. A parent could be stealing from his or her own child, be caught and accused by the child but nothing will happen. All the so-called caregiver has to do is suggest the child was off his or her meds for a day or two – and everything the client says is immediately suspect, and will be passed off as paranoid delusions.

Let the child become angry and try to stand up to their parent, and it will be suggested that the patient is becoming dangerous and hard to manage, and the doctor's will up the patient's medication. Let me give you an example of this sort of thing in action.

My wife and I have a friend who is his early thirties. Five years ago he was headed for a nervous breakdown due to stress and other factors. Instead of his mother trying to get him treated for the obvious stress he was undergoing she convinced him he needed to commit himself to a psychiatric ward in the local hospital. While he was there they diagnosed him as schizophrenic.

Since his release from the hospital he has been living with his mother and she has been making his life miserable and he has not a single means at his disposal for resisting. At any time she can arrange a competency hearing that could see him declared incompetent and lose what little say he does have in his life. On a whim she can decide that he's not allowed to have friends or leave the apartment unless it is run errands for her.

Even though she is reaping enormous benefits from his living with her, she continues to act like she is the ultimate martyr and he owes her for all the sacrifices she's made. The truth is that she owes him for quite a bit, the least of which is a guarantee that half her rent is paid for each month by the government of Ontario through our friend's disability pension.

There is also the slight matter that is only paying 30% of the listed rent of "her" apartment because our friend ensures she is entitled to a two bedroom geared to income unit when under normal circumstances she would have had to settle for a single room apartment. So it to her advantage that he continues to think of himself as dependant on her and that he's not capable of surviving a day on his own.

Towards that end, she continually insults him, runs him down to others when he is present, and talks about him in the third person when he is in the same room. Whenever he becomes friends with anyone who encourages him to take pride in himself and his accomplishments she demands that he stop seeing them.

The poor man is so frightened of her and how she can make his life a living hell that he always goes along with what she tells him to do. Like so many other mental health patients he has no one he thinks he can turn to for help and is trapped in a situation where he doesn't have a chance of getting any better.

He is not alone in these types of circumstances. The particulars might be different in each set of circumstances, but the end result is usually the same. There are advocacy groups for mental health patients, but they have to know that they exist before they can contact them. Even if someone manages to establish a contact for him to one of those groups, the patient has to want to change his or her circumstances. In some instances they just feel too frightened to do anything any more.

When a patient is diagnosed with schizophrenia there is no monitoring of their situation done other then a semi annual check up with psychiatric personal to ensure their medication is still working. They are not given access to any ongoing therapy to help them cope with any problems they may be having and are either left to their own devices or the tender mercies of their care givers.

The medical profession makes very little effort to help those patients suffering from schizophrenia once they are released back into the community. Perhaps if there were a more concentrated effort on everyone's part; government, advocates and medical profession this could be changed. Until then people like my friend will be subject to a living hell.

August 19, 2006

Canadian Politics: Why An AIDS Conference?

Last Sunday, August 13th/06, 24,000 people descended upon Toronto, Ontario Canada from 130 countries worldwide. To gather that many people from that many places and from so many different strata's of the population usually requires something pretty important. This was no exception: the 16th International AIDS Conference was being held there until Friday the 18th of August.

These conferences are convened every other year by the International AIDS Society, an independent organization of HIV professionals with 7,000 members from countries all over the world. Aside from thousands of men and women who work with and suffer from the disease figures from politics, business and the entertainment worlds were on hand to give speeches and lend their support. Governor General Michaelle Jean of Canada (a Haitian by nationality, one of the countries hardest hit by the virus), U .N. special envoy for AIDS Steven Lewis, former Microsoft C. E. O. Bill Gates and his wife Melinda, former United States President Bill Clinton, and actors Richard Gere, Sandra Oh, and Olympia Dukasis.

Notably absent from the proceedings was anybody from the host country's Conservative Party of Canada's government. In a lot of cases the host's country's leader will make an appearance, at least to make it look like he or she cares, but Steven Harper couldn't even be bothered with sending a representative of his government. In fact his Minister of Health, Tony Clement, went out of his way to discredit the conference by referring to participants as activists and "so-called experts" who have skewed dialogue towards grandstanding political demands.

I wonder if Mr. Clement and his fellow Conservative Party members even noticed what the title of the conference's theme was this year; Time To Deliver. The whole purpose was to offer opinions on how well governments and non-governmental agencies were following through on promises and what if any progress was being made in the fight against the disease worldwide.

Politicians of all stripes, left, right, and moderate, have equally abysmal records when it comes to fighting the disease either in their home country or abroad. Whether it's because of political reasons like owing the pharmaceutical companies for their support in an election or so-called moral issues where talking about sex belongs in the home not in public for the right, or being too damn wishy-washy to do anything at all for the liberals, it hasn't mattered. Millions of people were allowed to, and are still being allowed to, die needlessly.

Before I get too hot under the collar. I should warn you now, if you haven't guessed already, I'm one of those Mr. Clement would accuse of skewing the dialogue towards political grandstanding. If by calling for governments to get off their fat asses and put their money on the table or be honest enough to say they don't care if people die or not is political grandstanding than I'm guilty as charged and proud of it.

The world has known about AIDS since the late 1970's and clued in to the fact that anybody could get it, not just a few blacks and gay men in the mid 1980's, but look at the statistics. Nearly 40 Million people are currently infected with the AIDS virus and 25 Million have died from it already. All this while the majority of politicians fund studies on how to best spend money on the disease or give money to research that will discover drugs that most patients won't be able to afford for twenty-five years when a generic drug comes on the market.

The thing is that no matter where a government claims it stands on fiscal responsibility, in all reality it is far easier to throw money at something than to actually commit to doing anything. But that's what makes a disease different from most other problems a government faces; people can't forget about it if it disappears for a few days from the front pages, because somebody is always going to be catching it and dying from it.

Throwing money at it in the hopes that will distract people will only work for so long before you actually have to do something practical. For AIDS, just like any other disease there are three avenues open for action: prevention, treatment, and cure. Not that difficult to figure out is it, but the real problem comes in the implementation, especially for number one on the list, prevention.

Everybody, repeat after me: "How is AIDS transmitted? Through the exchange of bodily fluids". Of course there are many different ways that humans can exchange bodily fluids but two of the more common ones are sex and the sharing of needles. Actually it's a little more complicated than just an exchange of bodily fluids, because the fluids have to enter into your blood stream. It can be the smallest of abrasions or scratches, but if those fluids don't meet up with a blood cell somewhere they won't be transmitting any disease.

As a quick addendum; in recent years we have started to see the horror of children being born HIV positive because their parent was infected during their pregnancy. But this is still an example of a means for bodily fluids to be exchanged as the foetus is nurtured inside the mother's womb via the body. I don't know if it's been figured out at what point the foetus becomes infected with the virus in terms of development and length of time in the womb, or if the egg itself is infected.

Would an in-vitro pregnancy (one where a fertile egg from another source is "planted" in the womb) become infected if the host parent were HIV positive? I would assume yes, because of the nature of how the foetus is fed, but I don't know.

In any event prevention in areas where human intervention can occur, is the big hot topic issue facing the world right now. One argument takes the view that since pre-marital sex is wrong and shouldn't occur and that birth control is a sin, the only way to prevent the transmission of the disease is through complete abstinence until you find the person you plan on spending the rest of your life and procreating with. While that's all well and good for those who believe that, and more power to them because we should respect everyone's belief systems, the problem is that these people seem insistent on making others follow their own rigid code of behaviour.

But since the vast majority of the world doesn't live that way it's highly unrealistic to demand that they do, and in fact to do so is the equivalent of saying we don't care about anyone who doesn't believe in what we believe. It wouldn't be so bad if it were only a few individuals who were like this, who didn't have any real power, but unfortunately it happens to be two of the wealthiest and most powerful forces on the face of the earth that are against advocating the use of condoms as a means of preventing the spread of AIDS.

Neither the current United States administration or the Catholic Church allow a cent of money to be given to any organization that admits people might actually be having sex outside of marriage. Okay that's not really fair I know their argument is that they believe having condoms available will increase the likelihood of both pre and extra-marital sex.

The Catholic Church even goes one better by saying that the only reason for you to have sex is to procreate so why would you need condoms anyway. Sex isn't for fun, or an expression of love towards another person, or just because you happen to be horny, it's part of your obligation to God to go forth and multiply.

There's no point in even trying to talk same–sex relationships with these folk, because the obvious procreation element is missing from the equation. Probably gays can go ahead and use condoms because their souls are going straight to hell anyway, so in for a nickel…

The same, if it's not available people won't do it logic, is applied by the majority of these same parties to the issues of needle exchanges and safe injection sites for intravenous (I. V.) drug users. These folk are probably the lowest on the sympathy totem pole for the public at large. "Gays can't help themselves, they're perverts, but these guys choose to become junkies – to hell with them". Now I admit I'm not the biggest fan of junkies myself, but that doesn't mean they don't deserve my compassion.

Safe injection sites will keep them off the streets, will cut down on the number of dirty needles left laying around for people, especially kids, to be hurt with, and give users access to help to get clean. Most addicts are addicts because they figure nobody cares about them, perhaps it’s a long shot, but if they're shown some compassion they may start to take an interest in surviving and kicking the habit.

I don't think knowing there is a ready supply of clean needles is going to convince someone that heroin is all of a sudden their drug of choice. True it is aiding and abetting an illegal activity, but I bet if you ask a street cop if he or she would prefer junkies off the streets in a place where they aren't causing a problem, or shooting up in a park and leaving their used needles laying around they would go with the former.

Aside from prevention the next big issue that needs addressing is treatment. There are two parts to this problem; the task of taking care of the patient and the availability of the drugs needed to treat the disease.

For most of us in North America or the rest of the "developed" world, patient care might seem sort of obvious so we take it for granted. But for the countries hardest hit, like Uganda, and other African nations, poverty and lack of education are two of the biggest stumbling blocks preventing individuals from getting proper home care, and can actually contribute to the spread of the disease.

What is needed, and what is being attempted by such organizations like the Steven Lewis Foundation is the setting up and funding of local neighbourhood facilities that provide basic materials like sterile disposable gloves and cleaning materials for tending to patients in the home and instruction on how to go about tending to the specific requirements of an AIDS patient. These types of front line programs aren't very sexy but they are what's most needed in the small rural communities of Africa that might not even have running water.

The next step in the equation of home care is ensuring a consistent supply of medication. There is no point in giving people only enough drugs for a while, they are going to need it for the rest of their lives or until a cure is discovered. This means governments the world over need to apply pressure to pharmaceutical companies to surrender their patents on AIDS medications or cut their prices down to level of the generic companies.

Finally public funded research needs to be ongoing until a cure is found, and a means of ensuring that everyone who is infected with the disease is given access to that cure. It can't be a patented medicine someone will make a fortune from that poorer countries can't afford. It has to be readily available to all who need it; otherwise the disease will continue to spread.

As we have learned from other viruses the longer a disease is given to spread, the more likely it is to mutate into new and more virulent forms. If that were to happen with the AIDS virus we would be right back where we started from thirty years ago when the first cases were being reported.

Are conferences like the International AIDS Conference of any use? Are they just opportunities for people to "political grandstand" as Mr. Clement put it? The answer to both questions is yes. They are of use because they are opportunities to political grandstand.

Due to the attitudes of people like Mr. Clement and others who seem to think that imposing their beliefs, or financial and political considerations are more important than the health of 40 million people infected with a virus, grandstanding may be the only way to save lives and prevent the spread of the infection. At least they care enough to not stand on the sidelines and watch like the Canadian government did this past week.

Have you noticed when governments disagree with what a non-government organization says or does, they use words akin to what Mr. Clement used in an attempt to diminish their credibility. I'm not sure which people he was referring to as "so-called" experts: the Governor General of Canada, The U. N. special envoy for AIDS, thousands of health care workers, or the people suffering from AIDS?

The Canadian government had a wonderful opportunity to unveil their new policy in regards to AIDS during this past week at this conference. Instead they chose not to send a representative at all, had the Minister Of Health publicly criticize the participants and the conference findings, and will announce their plans for AIDS funding next week.

I would say be afraid very afraid but it's too sad to be funny anymore. What will it take for these people to notice that millions of people have died and millions more are infected and could die? What will it take for them to be compassionate?

August 7, 2006

Chronic Pain: The Next Level

What do you do when your body fails you? When it becomes impossible to do even the minimum of things that have been keeping you sane for the last couple of years. I'm hoping that I'm never going to have to find out, but in the last couple of days I've gotten glimpses into how bad it can be.

I've talked in the past about suffering from chronic pain and how debilitating that can be. But with the right amount of drugs and some perseverance you can carve out some kind of life for yourself. As long as you are able to keep the pain within the parameters of what you are capable of coping with you are fine.

Part of that are drugs of course and maintaining a proper dosage so that you are functional but pain resistant. It can be a fine line to walk at times, but usually as long as you keep to your dosage things are manageable. There are always going to be bad days of course where you're not able to do much about it except try to keep yourself as comfortable as possible.

The other important part is to know your limits. Know what you are capable of doing and how much at any given time that you can accomplish. If you try and do too much you are going to have to pay a price in either an increase in pain or a decrease in what you are going to be able to accomplish in the days after. You learn to govern yourself accordingly.

For the last few years that has been the pattern I've been able to follow with some success and accomplish a number of things that I've wanted to do for the longest time. I've been blessed or lucky enough to be given opportunities that I've never had before and I've been able to take advantage of them because of the gift of time that I'd been given. Sure there have been limitation place on my life but they haven't been things that I have suffered overly from missing out on.

But in the last few weeks there has been a change, and although I've been assured it is temporary and can be corrected with some minor surgery – I've developed a hernia in my lower left side – it has made life exceptionally more difficult. It's become harder to control the pain levels with medication and I'm able to do less and less of what I would normally take for granted.

It takes far less activity to aggravate things to the point where I have to return to bed in order to alleviate the pain. I have to take more and more "breakthrough" pain medication because it is peaking beyond levels that allow me to rest comfortably for any period of time. In short I'm losing the ability to control my body and have any say in what I can and can't do.

I'm sure a lot of you have experienced this temporarily during an illness when you've been too sick to get out of bed, I know I have on occasion in the past, but there has always been the assurance that it will get better soon. I've been given similar types of assurance on this occasion, that once I've recovered from the hernia surgery I'll be fine.

But it doesn't feel as reassuring as I'd hoped. The longer it takes before the surgery the heavier the pain is becoming and the harder it is getting to cope. There is a huge gap between what the mind is told and what the body and the emotions believe on occasion, and this is one of those occasions.

Nobody knows what effect having this type of surgery will have on my existing condition. Perhaps it will improve things because they will be able to relieve pressure on the myofacial system that surrounds my pelvis by correcting the hernia. But on the other hand it could also do more damage, simply by having to cut into tissue in the area again, and to fiddle around with the myofacial at all.

I don't know and nobody's saying anything except that the hernia has to be dealt with. It's already advanced to the stage where surgery is no longer elective, but necessary for my body. Anyway as long as it's possibly affecting the existing condition it's become impossible for my pain doctor to do any treatments on me because we don't know what is being caused by the hernia now and what is normal (if you want to call that normal).

When if first became obvious what I'm suffering from was going to be of a permanent nature I would always count my blessings; it's not fatal like cancer, it's possibly treatable, and I am able to have some semblance of a life. I was able to be as positive as possible in spite of the circumstances and look on it as an opportunity to do things that I'd always wanted to.

I'm still grateful that it is nothing fatal, but I'm far less doubtful about the later two sentiments anymore. Sitting, writing this, as it is taking more effort than it should to keep my mind clear enough to think through the pain and pushing past the fuzziness caused by the pain medication, I have to wonder will this be what it will be like from now on?

If so will I be able to get used to it enough to go back to how I was only a month ago? Or will I have to learn new rules that my body wants obeyed? If it's the latter how much different will things be then they are now? How much different will I be?

July 28, 2006

NAFTA, The Environment, And You!

Back in the old days when the governments of North America were still negotiating the North America Free Trade Agreement (NAFTA) one of the major concerns raised by opponents of the deal was its environmental impact. The primary concern was that companies in one country might be forced to bend their environmental standards in order to compete with businesses working in an area with less stringent rules.

At the time, in these pre Kyoto accord days and greenhouse emission targets, it was primarily Canada and the United States concerned about whether Mexico's standards would be so slovenly that they would be able to produce products far cheaper than corporations in either of the two biggest players.

Environmentalists were concerned that there long, hard fought battles to regulate aspects of manufacturing that dealt with environmental impact would be for nought as companies slashed budgets in these "non-essential" areas, leading to a return of the bad old days. In an effort to appease both the business communities and the environmentalists a side deal was struck allowing for the creation of the Commission for Environmental Co-operation (CEC) to monitor how well environmental standards were being maintained.

It interesting to note how some things never change for business people, it doesn't matter whether they are dumping Mercury poisoning in the English River system in Northern Ontario as the Reed Paper mills did in the seventies, if it ensures they can compete with polluters elsewhere. The same arguments are being use against the reduction of smokestack emissions and other poisonous wastes into the air we breath, as a reason by the Bush government for not signing the Kyoto accord and the Harper government for reneging of Canada's signature.

We can't compete, they bleat like lost little sheep, we can't compete. What about all those countries that don't sign they say, we can't compete. That argument is as spurious as it selfish. First of all for any country outside of North America who doesn't sign on the dotted line to abide by the Kyoto accord, slap them with such huge tariffs that our borders would be effectively closed to them. Watch how quickly they'd sign on and fall into line.

Within North America the means for ensuring that all countries and companies are complying with the aims of the accord, and that everyone is suffering equally from having to pay for the one time retooling of their equipment exists. That's what the CEC was created for in the first place, right?

Well in theory yes, but in practice it seems not to be the case. First of all there is the matter of their budget. With the money they receive they are supposed to conduct investigations, hire staff, perform research, etc. etc. Activities that are going to run in double digit millions per annum are still being covered by the same $9million dollar budget they were given in the year they were established.

Although they were officially designated as an independent body, in reality they are very much controlled by the three countries party to the treaty. Aside from the 40% reduction in real spending power they have had to endure because of inflation and zero increases in budgets, they are dependant on the respective governments for the data they use in formulating their reports.

As an example, The Globe and Mail newspaper cites the instance of the report on environmental impact of the concrete industry. The information they used to compile their comparison between the American and Canadian industries was supplied by the respective governments, who in turn had been supplied by the industry in question.

So the governments, and everybody involved, are counting on the industry people to step up and say, "oh by the way we went way over the top last year and polluted like crazy – sorry about that". Even the CEC realizes that this makes their findings a little suspect and added an addendum to the report saying that it doesn't fall within there mandate to investigate the provenance or integrity of the information supplied for the report and findings should be judged accordingly. In other words take this side of fries with lots of salt.

It's conditions like this that have environmental specialist and University of Ottawa professor Stewart Elgie thinking the committee is next to useless because they are hamstrung by the governments they are supposed to be checking up on. Instead of being a watchdog he says they have become a house pet, implying they work only to the limits their masters allow.

The outgoing chair of the committee, with only a month left on the job, William Kennedy freely admits there are problems that make their job next to impossible. The primary reason for their inadequacy he says is down to the fact that they were created as window dressing to allay the fears of the public, not because any of the governments actually supported the idea of their creation.

They dare not open their mouths on greenhouse gasses, because the Bush administration would block them issuing the report because it doesn't follow their line of thinking. It's probably safe to say given Steven Harper's decision to ignore parliament ratifying the Kyoto accord that the current administration in Canada would be of the same mindset.

The CEC already ran into hot water when they were able to commission a report on the dangers to Mexico of genetically modified corn. Although the report was written by some of the world's leading agricultural scientists, it's recommendation that a cautious approach be taken so as to preserve wild strains of corn in Mexico, was denounced as fundamentally flawed and scientifically unsound by the Bush administration.

That the American food industry is anxiously trying to sell genetically altered products in markets all over the world wouldn't have anything to do with that reaction would it? With most of the world's markets already resistant to the idea, a bunch of disagreeable scientists could only make matters worse by clouding the issue with facts that seem to offer support for their position.

NAFTA was designed to allow the businesses and people of all three countries freer and greater access to each other's markets. In theory this was supposed to allow the manufacturing and resource industries of each country to flourish, but in practice has fallen far short of that objective.

Never has it been harder for people from Mexico and Canada to cross the border into the United States, especially if they are looking for employment. Canada and America have been locked in a bitter dispute over duty that the Americans have been collecting on softwood lumber being sold by Canadian companies in the U.S. for close to five years now.

Instead of the intended result of countries thinking in terms of one big happy business community working together to strengthen the economy of North America as a whole, more then ten years after the signing of the pact everybody is still as protectionist as before. Is it any wonder that their environmental watchdog pretty much reflects that outlook?

It just wouldn't do, now would it, for one country to admit that they are actually polluting more then their counterparts in another country or that one of their businesses practice's could be detrimental to another county's welfare. The environmental business of our businesses is nobody's business but ours has become the official environmental policy of the North American Free Trade Agreement.

In the meantime instead of studying the impact of 145,100 tonnes (metric) of cancer causing materials into the atmosphere on the health of children, the CEC concentrates on providing reports that their sponsoring governments can really support: energy-efficient buildings. According to Mr. Kennedy there's a lot of support for it and that the agency has got a real winner with it.

If that's the winner, whose the loser?

July 24, 2006

Shadow Land: Where The Past Lives

There's a certain amount of serenity that can be found sitting in a darkened room. Where the only light is what the window allows of the streetlight outside to spill across the floor and walls, so that everything is comfortably shadowed, and the only sound the muted sound of tires grinding over snow and asphalt. But there is also a certain amount of fear.

Looking around the room see the pale mirror that your television screen has become; depending on the angle of your approach different bits and pieces of your world make themselves seen in the screen behind your ghost. Probably the most realistic show appearing all week: welcome to The Shadow World.

There's no turning on lights or lighting candles when you sit at this hour of the morning, long after midnight and long before dawn, trying to look into the parts of your life lurking just beyond sight. They won't offer anything in the way of true illumination; that will have to come from somewhere else. Turn the lights on now and you'll be left with a flat, two-dimensional world that lacks substance and your ability to see will be diminished.

Books, records, curios, and furniture blur together as indistinguishable lumps until you stand right on top of them. Even than their colour remains leached from them as the pallet is reduced to the variety offered by combinations of black and white, although even those distinctions are absent.

No, there is nothing clear-cut in your world when you have woken to be drawn into this place surely only a step removed from dreams. A part of you briefly wonders if you were to go back to the bedroom if you'd find your body asleep in your bed, curled up in a foetal position where you left it. Perhaps you don't check because you are afraid of what you might find there, or is it that you aren't sure what you want to find there?

Wander around for a bit, unsure if you want to commit yourself to this faded reproduction of your life, pick up bits and pieces and see that they are indeed solid in spite of appearances. You feel some little bit of fear right now and retreat to the couch in an effort to regroup. There is something comfortably familiar about how rough it is against the skin of your thighs through where your bathrobe has ridden up.

That and your feet rubbing the worn, low pile carpet or slapping on the cold tile are all that make you feel like you are present physically. You know that you are here because you can see the shadows and hear the various noises of the apartment settling into itself.

You sit on the couch hunched forward, curled up protectively around yourself while lighting cigarette after cigarette. But instead of providing the comfort you seek in the nicotine and habit their smoke only serves to add another layer of texture to the shadows and deepen the mystery.

Unable to pierce the gloom and sitting alone in the dark that little bit of fear you felt when wandering through the shadows returns. It settles in the pit of your stomach like an unwanted houseguest, but familiar all the same. But, you say to yourself, I've never been afraid of the dark.

A voice whispers, what about the shadows that come out of the dark? The shadows from where your father appears to stand beside your bed in the middle of the night when he comes for you; the shadows that the memories of those events rise up out of; and the shadows where the feelings of abandonment grow ever stronger each time he leaves you behind in your room

The anger wells up in your throat; at yourself and at him. Abandonment; I want to hate him not feel like a jilted lover. But it's right there for all to see who want to see and hear at this moment that you feel like that. He was always there telling you how much he loved you and how you two had a special relationship – different from the one he and your brother had, different from the one you and your mother had.

You were the only one willing to show him how much you loved him. You are such a good boy because of that, a special boy. But, he'd always warn you, if you were ever to tell anyone about us, well he'd never love you again and he would stop coming to you. You wouldn't be special anymore, just a bad boy who he wouldn't be able to love at all.

Do you remember how guilty you felt the time when you tried to tell somebody? How scared you were that he would find out and stop loving you. You had only told because he had hurt you that first time he put you on your stomach. You didn't want to feel pain.

It still hurts now when you think about it or close your eyes and have it come to life again within you. He had said he didn't want to hurt you, but that sometimes you had to be hurt to show how much you loved somebody in the special way that you two loved each other.

Oh the heat of your guilt when he came the next night and asked if you had told anyone. It was so bad that you almost told him yes, but said nothing afraid he would stop loving you. Why did he stop loving me anyway you wonder? What did you do wrong? Hadn't you been a good enough boy doing everything that he asked you to do even when it hurt or made you feel sick?

You sit on the couch in tears and angry as the shadows swirl around you whispering the past into your ears. You hate him, you hate yourself for the feelings you are still having, the feeling of being abandoned. How can you feel abandoned by your rapist? What kind of sick fuck were you, and are you to miss that?

And you sit on the couch smoking a cigarette with tears running down your face staring, looking for answers to your questions and nothing is there but the shadows. Everybody tells you it is in the past, he can't hurt you anymore. Hell you saw the casket going into the crypt they say, what is there to be afraid of? It's in the past.

But the past is still alive for you isn't it? It hasn't gone anywhere when it comes to your head and your heart during those hours before the sun comes up and after midnight when the shadows rule. You've tried to avoid the truth but you can't, not here, not now, not anymore.

You know the truth of the matter it was all a lie. He didn't love you, not one single little bit. You were a tool for his vengeance against the world. He took out his anger, his frustration and his feelings of inadequacy on you who couldn't fight back; you who could be made to believe that you should be doing this. You are not to blame for anything, he's at fault for everything – you know all that and yet still…

Still you find yourself on this couch, every once in a while, fighting with the demons he left planted in the shadows of your mind. You tried ignoring them, once upon a time, but that ended up in a disaster worse than dealing with them.

Shadows are only as substantial as you believe them to be and they are most believable when they stay in the shadows. You have to be willing to walk among them in order to see them for what they are: nothing but the insubstantial cast-offs of reality. Confront the shadows of your past and find the reality they have buried and the pain will start to diminish and the past will start to retreat.

Your present is a lot different from your past, and it's up to you to write a future and decide on what it will and won't include. Everyday in the present is a day you can use for giving yourself a better future with fewer shadows for doubts and fears to hide in. Use the days well and the past will become just a memory.

July 19, 2006

A History Of Abuse

That creaking sound you hear in the background as you start reading this post is the sound made by the runners of my Hobby Horse rubbing along bad kitchen tiles as I climb into the saddle and prepare to ride one of my favourite pet theories into the ground. The fact that this theory springs from my view of the world should be warning enough that it will be one sided and completely biased, unlike the even handed and rational approach that everyone has grown to expect from opinion pieces on the Internet.

Those of you who have read my writing with anything approaching regularity will know that I make no secret of the fact that I'm a survivor of incest – sexual abuse by my father and a recovered substance and alcohol abuser. Thankfully, while I may have emotionally abused some people along the way, the majority of my abuse was self-directed.

Unlike my father, or his father before him my self-loathing and fear never found focus on an external target. What damage I inflicted on others was caused by the inevitable backwash of somebody hitting bottom; imagine a the whirlpool created by a boat sinking and the damage caused to those craft at the periphery of the vortex and you'll get a general idea of what I'm talking about.

I've done my best to make my peace with myself about that by understanding why it happened. Not using the abuse as an excuse, but finding in it for myself the explanation for abhorrent behaviour that I was never able to understand, was a huge relief. There can be no feeling worse than not knowing where a compulsion comes from, or doing something in spite of the voice in your head yelling "It's wrong"

As to what causes somebody to abuse another person, either sexually or otherwise, there are certain generalizations about the character of abusers that that I think are safe to take as givens. One is that the chances are that the abuser had him or herself been abused without ever having been treated for it.

This would create a person so full of resentment, anger, and the need to exert power over someone else, that at the first signs of things going wrong in their life they would find a target, or object of blame, who would become the outlet for all those emotions. This goes a long way towards explaining why men, who are conditioned to repress their emotions, are most often the abusers, and children, the most vulnerable people in society, are most often victims.

Sexual orientation has nothing to do with sexual abuse. It's about exerting control and power over something in your life because you have no control over how the world makes you feel. Resentment at having been treated badly and what you perceive as repeated slights against you gives you the justification for your actions.

If they can do this I can do that is taken to extremes a rational mind wouldn't even consider. Think about any time you have felt resentment towards another person, or about something that had been done to you, and magnify those feelings by the largest number you can imagine and you might get an inkling as to what goes on in the mind of an abuser.

Having experienced those feelings myself whenever I used to justify doing the things I knew would hurt another I can vouch for their seductive qualities. Even now it can take some effort on my part to overcome the path of least resistance that it allows. You never have to worry about standing up for yourself, fear being rejected, or have the validity of your feelings questioned. You just wallow in feeling hard done by until you find a means of venting that repression on someone else.

After I was well into my recovery process and was able to start talking about my father the person, beyond just his role as abuser in my life, I began to remember things that happened to my father as a child, and what his father (my grandfather) had experienced as a young man. I started to formulate a theory about the interrelationship of abuse with the last 150 years of history.

The world my grandfather was born into in Europe of 1898 (Family history note: my father's family name was Chalmers and his father was born in Scotland, my last name is different as I legally changed it to my mother's last name of Marcus) bore eerie similarities to our current world situations both socially and politically. Nationalism had been on the rise for the previous fifty years as the Austro-Hungarian Empire was beginning to come apart at the seams.

Italy and Germany both had become unified countries, instead of a collection of independent city-states and regions. Russia was a seething mass of discontent as the many were becoming tired of the few controlling their lives. The Balkan states were in their usual state of unrest as the myriad ethnic groups all had their own nationalistic desires.

While this was happening politically the world was also trying to come to grips with what at that point was the most accelerated rate of progress ever experienced. The Industrial Revolution was the birth pangs of our free enterprise system of capitalism and although it increased the fortunes of some individuals, and solidified the middle class, it created a vast underclass of working poor.

With coal providing fuel for everything from home cook fires to factory furnaces the air quality in major cities like London was worse than any contemporary circumstances one can consider. Most of the working class lived in a squalor of raw sewage, unsafe drinking water, and violence that we can't even begin to imagine.

For a society that had been mainly agrarian based previously the rapid shift to industry and commerce was far more traumatic than our current progression into the automated computer age. I can't even begin to imagine the levels of stress this must have induced in people and the long-term implications it must have had on family life.

In 1914 the first Great War began and at 19 my grandfather was a medic at the Battle of the Somme in 1917 when he was wounded in a gas attack that cost him a lung. In those days the closest term they had for Post Traumatic Stress Syndrome due to war was shell shock. Even that was so suspect that people suffering from it were on occasion shot for treason as deserters because they were unable to fight anymore. They were able to do a decent enough job of patching people up physically from their wounds, but nobody received any mental medical treatment for the trauma of seeing destruction on such a wide scale.

My grandfather was one of those who could have used treatment, because after my father was born in 1929 he never worked another day in his life. I don't know the extent of the abuse my father suffered at the hands of his parents. At one point he did let slip to my brother that the only memories he had of his childhood were being beaten by his father.

My father's abuse of me was only the continuation of the abuse that had begun back in the 19th century where the conditions that made abusers possible were fermented. Treatment for women who suffered from sexual abuse only really began in the 1970's while it's probably still not commonplace with men.

We are the first generation of people who are dealing with the fallout from the birth of contemporary Western Society. The mantra that is common to all of us is "The Abuse Ends Here". Instead of continuing on the legacy of our sick families, we are seeking to change that inheritance. Not only are we willing to deal with these circumstances, but there are also people and facilities available to treat us, as never before.

Unfortunately that won't make much of a difference for the rest of the world, aside from our immediate families and friend. Conditions in the world haven't changed all that much in the last 150 years, except for on the scale of how things are done and the increase in numbers of people affected. Are we planting the seeds of abuse in the mind of some child that will germinate over generations like so many others before him? Think of the young men and women who detonate their bodies as bombs, the children being turned into soldiers, and the ones surviving the bombings everywhere from North America to Indonesia.

We would never dream of allowing conditions to exist that allows the fermentation of disease, but that's exactly what we are doing with the current path our world is following. If we had set up a petrie dish in a laboratory we couldn't have created conditions any more ideal to create abusers.

July 18, 2006

Ain't No Pill For Memories

Being held captive by the past through your own memories is a horrible existence. Whether you are constantly reliving events through flashbacks, or simply haunted by occurrences from long ago, they can impede your health and happiness. Memories can repeatedly traumatise a survivor of a horrendous event and are a cause of Post Traumatic Stress Syndrome.

Psychiatrists, therapists, and councillors work to help patients suffering from Post Traumatic Stress Syndrome by reducing the amount of influence memories have on their current situation. If the memories can be put into their proper context so that they are simply reminders of the past, than a survivor is able to accept that the events remembered aren't happening today and increases their sense of well being.

Conventional means of doing this currently involve varying methods of processing the memories and desensitizing the survivor to the depicted events. One of the newer and more successful means employed is Eye Movement Desensitization and Reprocessing, better known as E.M.D.R..

In E.M.D.R. a client is asked to visualize a memory and place themselves in it. On a scale of one to ten they then define how upset this memory makes them feel, what emotions they are experiencing, and where do the emotions physically manifest in their body. A light hypnotic type trance is then induced either utilizing rapid eye movement, an alternating pulse in the palms of the hands, or an alternating tone in the ears.

It usually depends on the individual client as to what is the most effective method as different people respond better to different stimuli. Once the patient has settled into the memory the doctor than talks them through the memory, having them tell the story as it is happening to them.

The theory is that instead of simply reliving the event and re experiencing the trauma, this controlled situation allows them to step away from participating and begin to deal with the emotions that were generated by the circumstances. For example people who have survived a situation where other's have died, will often feel guilt because of that and not be able to break free from those moments until they have dealt with that emotion.

The trauma won't be forgotten, but it won't be constantly relieved either, the person can get on with their life and live without the dominant negative emotions that the flashbacks invoked. While E.M.D.R. does involve working directly with the memory it does not utilize desensitization to the extent of other forms of therapy. Some literally have the patient relive the moment over and over again until they no longer feel the same initial intensity of reaction

The client will make a tape recording of their voice recounting what happened, and this will be utilized for the desensitizing process. This tape will be played repeatedly to the client during their sessions with the doctor until it loses all meaning to them. It is hoped that on some level or another the client will cease to be affected by the trauma because it will no longer have the same level of impact when thought about.

The human memory is an amazingly complex system that serves more than just the obvious purpose of letting us remember what to pick up at the grocery store. Memory and pain receptors share the same neurological paths in our brain, allowing the body to learn how to keep itself safe.

One of the more obvious examples of this is of course the child and the hot burner on a stove. A child touches the hot element of the stove, his hand tells him it hurts, his brain remembers the pain, and the next time the child goes to do the same thing he remembers the pain and will stop herself.

This connection between memory and pain is also responsible for the condition known as phantom limb. A person who has had a limb amputated will swear they can still feel either their toes or their fingers even though it may have been years after the surgery or accident that saw them lose that limb. The memory of it being there is imbedded so deeply that the mind is unable to forget its former presence.

Memory plays a role in other learned, but unconscious behaviours like breathing and other involuntary body systems. Some Alzheimer patients, or dementia sufferers of one kind or another, have died because they have literally forgotten how to breathe or swallow. (My father chocked to death on his saliva in his sleep because he forgot how to use those muscles)

With memory affecting so many different aspects of the body and its functions you'd think it would be the last place you'd want to start messing with. But somebody has come up with the bright idea of utilizing a pill to do the same work on flashbacks that existing therapies already do.

Researchers at McGill University in Montreal Canada have begun human trials utilizing the beta blocker propranolol, currently in use for treating high blood pressure, as a means of dampening an emotional reaction to an event. Patients were asked to write out their stories of trauma and were then given either the propranolol or a placebo.

It had already been discovered that administering the drug to patients who have recently experienced a trauma interferes with the transfer of memories from the part of the brain where they are experienced, the hippocampus, to that area where they are stored to come back as flashbacks, the cerebral cortex. What wasn't known was whether patients who had experienced a trauma years ago would receive the same benefits as those newly traumatised.

Since people who suffer from flashbacks relive the memory completely, the test cases who wrote their experiences out began to re–experience the emotional traumas all over again. In other words they had recreated a circumstance within themselves that closely matched those of a recently traumatised patient and should therefore be able to benefit from an immediate administration of the drug.

A week later the patients were called back to listen to a reading of their scripts. They were all monitored for anxiety symptoms, and an overall twenty percent reduction was noted and their trauma level was less elevated then the group who taken the placebo. This group is considered too small a sampling to provide an indication of how successful the treatment is, but the doctors involved feel that it is sufficient evidence to encourage them to keep investigating.

The doctors freely admit they have no idea what amount of risk the patients face in the dampening of other memories. Will happy memories be affected, or will it just be the memory that is foremost in the mind at the time the script is being written. It's obvious a person just can't take the drug and the emotional impact of their bad memories will decrease. They have to be in a controlled situation where they are administered the drug while at the height of the emotional experience for it to have any effect at all.

Now at first blush this sounds like it might be something useful. It's not doing anything like erasing memories, just easing their emotional impact. But I can see two problems, one obvious and one that has more to do with long term treatment implications for a patient.

The obvious hesitation is nobody can have any idea what other affects this drug utilized in this manner could be having on the memory. If a patient only experiences minor improvement the first time and elects to continue the drug therapy, what will the cumulative effect on the memory be?

Everybody is so different when it comes to our emotional and psychological makeup that it could be almost impossible to make a generalized prediction on how people will react to it. There would be no way to guarantee there won't be contradictions for those taking the drug.

Aside from those concerns there is the problem of the steps it omits from a patients recovery process. Especially for those patients whose trauma was such that it has caused deep-seated emotional problems and behavioural abnormalities an essential part of dealing with these memories is coming to an understanding on how they have impacted on our present day behaviour.

I have been undergoing E.M.D.R. therapy for the past year or so in an effort to mitigate the damages of extensive childhood sexual abuse. Each time my therapist and I have dealt with a specific memory or flashback, the process of working through it has uncovered clues to why I am a certain way, or where behaviours come from.

By understanding these ways of being are reactions to events in the past I have learnt to recognize that they are no longer appropriate to my situation and can safely discard them. As long as I was experiencing the memories of being raped, part of me would still believe that I still needed to act like those were my circumstances. It has only been by working through the memories that I have been able to change that mindset.

If at some point a patient is just given this drug to diminish the memories but does nothing to process the information, they are only doing half the work required for a full recovery. You won't know how these memories have affected your day-to-day existence if you just walk away from them. You are still the same person who was experiencing the flashbacks and really no further ahead then before you took the drug.

There are no shortcuts to mental and emotional health, and I worry that a pill like this will tempt people into believing that they will be able to solve all the problems caused by traumas in their past just by taking it once or twice. That is an unrealistic and false expectation (and hope) to be giving people.

July 9, 2006

Anorexia: More Than Just Starving

There's a new trend happening on the Internet that is worrying doctors who treat patients who suffer from eating disorders. Sites are popping up on-line for people suffering from either anorexia or bulimia that are encouraging them in their behaviour by calling it a lifestyle choice rather than recognising it as an illness.

Visitors to the site are encouraged to write about their accomplishments in losing weight, eating little or no food of caloric substance, and generally exhorting them to be thin. Features include what products; laxatives, diet pills, enemas and purgatives, work best in what situations and list heroines of the cause like Kate Moss and Mary-Kate Olsen twin.

Being thin is a legitimated aspiration for life, and anything you can do to accomplish this goal is well worth the effort. What has the doctor's so worried is not that it's just sending the wrong message, but that it encourages thinking that makes it even more difficult to treat the victims of the disease. The biggest obstacle that doctors claim they have to overcome when treating sufferers of anorexia is convincing the client that there is anything wrong with them; that starving yourself to death is not a lifestyle choice but an illness.

A preliminary study of these websites by four doctors who work with clients with eating disorders has resulted in the rather lame warning that doctors shouldn't discount the negative impact these sites have on their ability to treat clients. The primary reasons for the danger is that they provide sufferers of eating disorders with a community, a sense of belonging.

In talking with one young woman about her former "pro-ana" (ana being a pet name for anorexia) site she spoke about the feeling of control it gave her to be able to write down how little she had eaten each day. She also made the comment that she didn't believe her site encouraged anybody to continue on with an eating disorder because "I know I would have done what I've done even if there weren't websites out there encouraging people to have a pro-ana lifestyle.”

Despite claiming to have given up her "pro-ana lifestyle", it's interesting to see her refer to eating disorders as a lifestyle choice still and not a disease. As I mentioned earlier this is the attitude that has doctors so worried; how do you treat someone who doesn’t think there is anything wrong with them?

The trouble with anorexia nervosa is that it is more than just an eating disorder. The starving oneself to death is a symptom of even deeper underlying problems. Look at what the young woman said about how dieting made her feel she had control of her life. Think about what the doctors have said about these sites giving visitors a sense of community. The other thing that the doctors have found that these sites have in common is how much they focus on the feelings of self-hate that the visitors harbour.

When my wife and I got together she had long ago defeated the eating disorder aspect of her anorexia. As a teenager she had starved herself so much that she had stopped menstruating and was close to death. The only thing that saved her was guilt and her belief that others were more important than her. She had to stay alive to make sure her mother continued to receive mother's allowance checks. In a sense the disease saved her from herself; because she thought so little of herself she sacrificed her plan of starvation for somebody else's desires.

The problem she had was that even though she had managed to overcome starving herself, all the mental/emotional baggage that had caused the eating disorder in the first place still existed. The primary root being she did not believe herself worthy of anything positive; love, affection, and nurturing. When you don't believe you deserve anything good in your life, or that even thinking of yourself and what's good for you is wrong, guilt becomes a constant companion.

Feeling guilty of course only deepens your self-hatred and you spiral downwards to the place where you no longer even believe you are deserving of nutrition, so you stop eating. You will do anything to win the acceptance of your peers, whether it's people you know, or people who you haven't met yet but know there is no way they will want to have anything to do with a loser like you.

In his wonderful book The Deadly Diet Dr. Terence J. Sandbek Phd. talks about what he calls "The Voice". This is what he calls the continual negative reinforcement that happens in the mind of a person suffering from an eating disorder, a one sided dialogue that whispers things like how can you expect anyone to like you? .

Dr. Sandbek outlines in his book the ways in which a sufferer can combat these voices by learning to identify them and recognising their ridiculous nature. Of course this is a lot harder than it sounds, and he recommends that patients create two lists: one that itemizes all the negative beliefs the voice reinforces, and the other positives and proofs that the situations the negative beliefs arose from no longer exist.

There's a catch to doing the work that Dr. Sandbek recommends, you have to be in circumstances where none of your negative beliefs about yourself are being triggered. If you are in an abusive relationship, be it either emotional or physical, your chances of recovery are limited. Every time you're either hit or made to suffer in other ways your self worth takes as much a beating as anything else.

Anorexics are looking for acceptance and are going to take it where they can find it. For those who don't have it at anywhere else, the type of web site described earlier in this article is going to be heaven sent. Not only do these sites accept them, but they are also confirming everything that the voice in their head says.

What my wife and I discovered is that because I was willing to accept her unconditionally she was able to deal with all the underlying feelings that caused her to stop eating in the first place. Now that she had somewhere safe to belong she had the strength to challenge those beliefs.

If a young woman (or man, although rare there have been cases of men with eating disorders) has sufficient cause to start having the eating disorder symptom of anorexia nervosa than it doesn’t' surprise me they will look for some sort of acceptance, no matter what the source.

What mystifies me is that the doctors still do not understand that basic truth about the disease. Instead of panicking about these sites they should be looking at them for clues as to how they might be able to counter the mindset that creates the conditions that fosters the eating disorder. Worrying about whether these sites are causing eating disorders is a pointless exercise because the only people they will appeal to are those who are so inclined already.

In the article linked to above it is reported that across Canada incidences of eating disorders are on the rise, and as that is only the number of people who are actively seeking treatment the numbers are probably quite a bit higher. These "ana-sites" are giving sufferers a place where they feel accepted and know they won't be judged. For what maybe the first time in their lives for some, they feel like they belong.

Without being able to provide an alternative means of feeling good about themselves, or overcoming their sense of not belonging, doctors are not going to have much of a success rate amongst people with eating disorders. Just getting them to eat again is only half the battle, getting them to change their minds is even harder.

July 3, 2006

Turning A Deaf Ear To Yourself With Noise

What are people so damn afraid of hearing that they have to make so much noise all the time? Whether it's having their televisions or radios on all the time, roaring around in cars with special attachments to make them louder, or continually talking at the tops of their voices they always sound like they're trying desperately to drown something out.

They can't go out into their gardens without taking some sort of power tool with them; hedge trimmer, lawnmower, weed whacker, leaf blower, or chain saw. Heaven forbid they should actually sit still and enjoy the restful attributes of a beautiful garden or a secluded yard. It's as if they only created the places as arenas for utilizing the latest in lawn gizmos and excuses to make even more noise.

Gone are the idyllic days when husbands had to be booted out of the hammock, away from their beer and rest, in order to mow maybe trim the lawn. It now seems that nobody can wait to get out there and get at it to make some noise. Did they misunderstand that KISS concert they went to all those years ago when they urged to make some noise? Instead of recognising it for the same old rock star bullshit they have taken it as their personal mantra for middle age and beyond.

You can almost see their lips moving, repeating the magic words "make some noise, make some noise" over and over again. Perhaps they think that by chanting the words in accompaniment to the actions of churning out hundreds if not thousands of decibels they would be able to reclaim some of their lost youth. Who knows?

It's not just men either, women can be just as bad, and they even have more ways of drowning out the world around them at their disposal aside from garden tools and electric saws. Vacuums. Good lord some of them are as loud as power sanders and probably have the same effect on carpets as sanders have on wooden floors. Stripping layers of carpet away and not just lifting the dirt off.

Of course they also have the television on while they are vacuuming. In order to hear over the noise they make while sanding their carpets, they have to crank the volume on the set so high it throws the sonar of passing airplanes out of whack and sends them off course..

I used to wonder why people standing next to each other were shouting loud enough for others two blocks away to hear. It's because they've gone deaf from their damned noisemakers and can't carry on a conversation anymore without shouting.

On more then one occasion I have heard people complaining about the noise of somebody else's machinery and wince when they hear it. But they will think nothing of turning on something of their own that makes an equal if not louder noise. Is somebody else's noise always louder than your own? Or is it that our noise is justified because it accomplishes its task by drowning out whatever thoughts we don't like we might be having at the time?

When I was younger I liked loud music, and I used to go out to bars and stand right under the speaker stacks, but I stopped doing that by the time I was in my mid twenties. But even when I was doing that it was only for a specific instance in time and not on a continuous basis. It was stupid fun to leave a bar with your ears ringing very faintly and feeling like your head was in a fishbowl because of the pressure increase behind your eardrums.

I watch these kids drive around in their little Hondas made to sound like Ferraris, and see the whole car vibrating as it drives down the street because of the massive bass speakers in the trunk. I wonder how loud is it inside that little box of tin if I can hear and feel the bass from over two blocks away?

Even if they were sitting in a basement somewhere shooting crack into their arm they couldn't be doing any more damage to their ability to think and be aware of the world around them. Why are all these people out there desensitizing themselves with noise? What are they so afraid of feeling, or hearing that one way or another people of all ages have turned the volume up past ten?

I know from living next door to noise junkies and experiencing collateral damage that even at a distance it's almost impossible to hold on to coherent thoughts. Trying to write or think up ideas on what to write while that cacophony is proceeding is next to impossible. What must it be like for them?

When I was abusing alcohol and drugs I was doing it to shut my brain down so I wouldn't have to think about things that made me uncomfortable. It desensitized me so that I couldn't feel or remember anything. Now I'm not saying that all these people have personal stuff they're running away from but they sure seem to blocking out something.

Seeing how most of the men in my neighbourhood are on early retirement, perhaps they are trying to avoid thinking about the days to come. But what's going to happen with them when the future arrives and they haven't prepared mentally and emotionally for it? There's no point in obsessing on the future, but that doesn't mean you ignore it.

The young people in their cars are escaping their realities as well. They may have jobs, but what do they pay, and what kind of future do they hold? What do they have to look forward to? When that nihilism is combined with youth's belief in their own immortality, and immunity to danger it goes a long way to explaining the flash and desperation of their lifestyle.

They seem to be attempting to cram danger and excitement into their lives in an attempt to deny the bleakness of their future and the banality of their jobs through their music and vehicles. The voice in their head that is telling them they are being cheated out of something can't be heard when they are crammed into a small tin box that is exploding with sound.

They know it won't last forever, that they will be absorbed into the great maw of society that will devour and turn them into their parents. The louder the music the less chance they have of hearing the voice of doom until it is right in their face.

The trouble with avoidance as a philosophy of life is that when you finally do get around to facing up to stuff, it's become that much harder to deal with. Whether you've deadened emotional pain with narcotics, drowned your heart with alcohol, or blocked out the warning voice of reason with noise it will all come home to roost one day like Turkey Vultures and the shock will be severe.

But so many people seem to not care that what they don't do today will come back to make their life worse in the future. No matter how loud you make your life, you may be able to avoid listening to your problems or thinking about them for a while but not forever.

So why not try to make a little less noise now and than, and hear a little better. Maybe, that way when the future arrives it won't be as bad as the thoughts you've avoided were leading you to believe it would be. You also might find that there are a lot of nice things to listen to in the world. Consider that a bonus.

June 26, 2006

To Bleed Or Not To Bleed

When I was a kid, and for a few years after that, the food company Del Monte ran adds which featured the tag line "It's not nice to mess with Mother Nature". Needless to say that was meant to assure consumers that the product was as near fresh picked as could be possible for something bought in a can.

It's just a pity that the same catchy slogan can't be stapled to the foreheads of people in the employ of pharmaceutical companies. They seem intent on seeing how far they can push the human body away from the natural order of things. This is especially true in the case of women's menstrual cycles.

The latest attempt comes from the pharmaceutical giant Wyeth and their new birth control pill Anya which would complete eliminate a woman's menstrual cycle. Unlike previous versions of the pill that had a seven-day off period that allowed for a woman's period, Anya would be taken every day for the course of the cycle preventing menstruation.

Instead of releasing the traditional almost 50mg of estragon a pill, Anya would release 25mg, but over a longer time. Thus preventing the menstrual cycle without increasing the amount of estragon being taken by the patient. Currently the only drug on the market that is available for women that will stop their period is Depo Provera a three-month hormone shot.

Initial informal polls done at the Museum of Menstruation in Maryland showed that four out of five women who visited liked the idea of not ever having to have a period again while 50% of the women polled in the medical magazine Contraception also shared that opinion. (The Menstruation Museum closed its doors in 1999 and exists online only and this poll was conducted online as a request for letters in response to the question, "Would you stop Menstruating if you could?" The only references to Contraception Magazine I was able to find online were either offers for magazine subscriptions – over $200.00 per year – and references to articles being published in the magazine.)

Naturally there is some debate among the medical and research profession as to the value and dangers of this product. According to Dr. Robert Reid, a professor of obstetrics and genecology at Queen's University in Kingston, Ontario there is no more risk in taking Anya than in taking regular birth control pills; if you're a smoker it will increase your chances of stroke and heart attack for example.

He also sees nothing wrong with a woman stopping having a monthly menstrual flow, and said in Saturday June 24th's Globe and Mail that a woman's period actually might increase her chances of infection each month and that "there's no evidence that you're getting rid of toxins in your body"

Dr. Jerilynn Prior, an endocrinologist and the scientific director of the Centre for Menstrual Cycle and Ovulation Research at the University of British Columbia is highly critical of this pill, and in same article explains that most of her concerns come from the fact that we still don't know the extent of the side effects caused by the original pill. She also brings up the whole "Don't mess with Mother Nature argument."

She points out that menstruation is an "intricate cycle… and a vital sign of our health." Messing with it at this level, she believes is a horrible thought. She thinks that the continuous use pill is just a way for the pharmaceutical companies to jazz up an old product.

What it sounds like is that Health Canada will approve this drug with certain provisos. The basic one being that all women who take the drug will have to enrol in a program where they have to have medical follow-ups every six months. There is no mention about how long that program will in place for, or what Health Canada deems to be long enough to gauge whether or not their will be any ill effects felt by women.

Not being a woman it may not seem appropriate for me to comment on this product, but being appropriate has never been a problem for me before so it's not going to stop me now. I'm sure the appeal for most women will be the convenience; no more having to worry about what you can and can not wear for one week out of every month, no more horrible cramps, no more having to strap on or insert something inside of you every month to mop up blood.

Put like that it sounds just great doesn't it? Free of the curse, as it has been so nicely called by some segments of society. No more thinking of yourself as unclean once a month as so many societies call it. The stigma that's been attached to a woman's cycle for so many years has reduced one of the major distinguishing characteristics of being a mammal to being something dirty that's not talked about in proper society.

There have been many societies where this has not been the case, where a woman's cycle has been taken as a sign of her power of creation, not as a curse. In some Native American nations the women were released from all responsibilities during their cycle. They would gather in a special lodge set aside for them so they could spend the time away from the cares of their day-to-day existence and do whatever they wanted.

If that meant sleeping, sitting up and talking, or praying, it didn't matter, and was left up to the individual person to decide. Instead of trying to hide the fact that women bleed it was recognized as being part of life and accommodated. It was understood that they might need to rest, that their hormones would be out of balance, but most of all they weren't made to feel dirty or unclean.

But a whole industry has been built around convincing women that one week out of the month they are less than perfect, there is something wrong with them, and they have to take steps to ensure that no one knows. Imagine growing up having that being driven into your head all the time?

Think about it guys, how would you feel if something you had no control over made you, at best, an object of derision every month, down on through being told that you have to hide away a part of what defines your gender. What is it about that one bodily function that makes people so uptight and afraid? Everybody always talks about the miracle of birth, but nobody seems to want to admit that it might be because of a woman's bleeding every month that it happens.

Well you know what, I'll let you in on a secret; you can't have one without the other. Shocking news isn't it. If a woman doesn't menstruate she won't have babies. Okay so that's a little sarcastic, but sometimes you have to wonder if the sellers of all this stuff covering up or preventing menses don't want you making the connection between the two.

Why else would they make it something you want to hide, or get rid of, like it serves no purpose? Perhaps because if we admitted how important menstruation was in the grand scheme of things we might end up not treating it with such disdain and actually according the cycle of life some sort of respect.

So that brings us back to the whole issue of stopping a woman's menstrual cycle through the use of drugs. These drugs somehow prevent the woman's uterus from producing eggs and negating the need for the sloughing off of the extra tissue that's produced each month because of it.

If there is no need for the cycle why is it that women who are on estragon therapy have to go in for routine D and C's to clean out the build up in the uterus? I've known women who have had to take Depo Provera for medical reasons and they swell up like balloons because of water retention and some have had their blood pressure go through the roof as a result.

How can stopping a body's normal process from occurring before it is time to stop be said to be without risk if we've never done it before? Nobody has been on it for long enough to know yet what's going to happen to them if they ever want to have a baby afterwards. What effect will it have on a woman's cycle when she wants to start it up again?

When my wife and I got together we knew we weren't going to have children, so I went out and had a vasectomy so she didn't have to take the pill. It took close to six months for her cycle to start to return to normal, and ever since it has been heavier and more debilitating then it was before she went on the pill.

I know that's only one person, and strictly anecdotal evidence, but than how much more proof do any of the companies offer that there will be no problems down the road with something like Anya. Or how about Yasmine, which went on the market in the States in 2002 amid promises that it would reduce a woman's weight. Despite evidence that proofs it has no real effect, women continue to buy it without even considering what about it could cause the weight loss.

The human race doesn't have exactly an exemplary record when it comes to our attempts to mess around with the natural order of things. What evidence is there to support anyone's claims that anything we do makes things better instead of worse? There was probably a good reason for our bodies being designed to function the way they do. There's a lot to be said for the old adage "If it ain't broke don't fix it"

Perhaps that's the other saying the pharmaceutical companies need stapling to their foreheads.

June 20, 2006

Recovery: Memories Of Fear, Fear Of Memories

There is nothing quite like the feeling of living in fear of your own memories. Not the things you can remember, but the events you can feel lurking like shadows on the periphery of your consciousness. It's like seeing something at the extreme edges of your peripheral vision; a teasing glimpse that plays on your awareness.

For twenty years, and more now, I have blocked out memories of my childhood; memories of being sexually abused by my father. Disassociation at the time of the events, coercion from my father at the time in the form of threats and promises, and alcohol and drug dependencies from thirteen onward all were factors in the repression and denial of the events that took place over a period of at least ten years.

While it may be obvious to most people how my substance abuse ensuered I could avoid dealing with realities that were unpleasant, in truth it was only was successful in masking the fact that something had happened in my childhood that I didn't want to think about. It was also an expression of the loathing I felt for myself due to those incidents.

The actual burying of the memories was caused by my sense of self-preservation, and the influence exerted by my father. You don't often stop to rationalize why you are an addict while you are in the process of becoming one, you don't wake up one morning and say, "I think I'll get addicted to drugs and alcohol". So even though the result is the same as if it were a conscious decision, that's not how it works.

First of all you're in denial about being an addict so you're not going to have "decided" to become one, and secondly if you remembered what had happened you would have no need for the addiction. The drugs and the booze are compensation for something that you think is missing from your life. They offer solace and comfort that you don't seem to be able to get from any other source, be it a person, belief, or endeavour.

You don't have any memories of the childhoods that so many others around you seem to have. Where they can talk about things they did with their fathers, you only seem to have blanks, and can't remember anything about being alone with him. Or when you force your mind in those directions you either come up against a sense of fear, or the feeling that if you say anything you'll be betraying something.

So what happened to the memories? Have you ever noticed in times of extreme stress that you may start trying to convince yourself that whatever's going on isn't happening? As if you believe hard enough that it's not happening it won't. But as adults our rational minds are far too developed, most of the time, for that to occur. (If it does we call it amnesia)

In a child whose mind is not as developed and socialized, instinctual reactions are closer to the surface. The younger the child the more they rely on instinct; a baby who is hungry yells for food until that need is met. So when faced with circumstances that are as terrifying as being raped, a child's mind will disassociate from the event in shock and fear. It doesn't want it to be happening so it isn't.

Now obviously this plays into the hands of the abuser, but most abusers aren't going to know this so they usually have some means at their disposal of preventing their victim from talking later. There are two approaches that I can remember being used on me: The "it's our little secret approach" and the threat approach. It doesn't seemed to have mattered very much to my father which one he used, as far as I can remember he used either one pretty indiscriminately, but to my mind the first one was the most damaging and effective.

You see it involves distorting and twisting the idea of love between a father and child. It plays on a child's desire to please their parent by insisting that all children do this for their father if they really love them. They also make it into their private, "special" relationship, which if the child ever told about would prove they didn't love their father.

"It's our little secret" makes the child an accomplice to the rape, and even a willing participant. So not only do they have the implied threat that if they tell anybody their father will stop loving them, but they also know, on some level, that what's happening is wrong. Therefore they are also ashamed of their participation and won't want to talk about it or think about it

Complementing this form of ensuring silence are of course direct threats about the dire consequences of telling anybody. From what I remember this took the line of, if you tell anybody they won't believe you, they will call you a nasty little boy, and you will be sent away to reform school.

You have to remember this was in the 1960's and early 1970's when this didn't happen in good families, especially father's raping sons. Who was going to believe me if I told them? In spite of this I do remember trying to tell twice, once to my mother and once to a teacher at school. My mother didn't believe me and said I was a nasty little boy and threatened me with all sorts of dire consequences if I ever said anything like that again.

The teacher I think believed me, but she went to the principle, who even if he did believe it didn't want to have anything to do with it and most likely shut her up because nothing ever came of it. Needless to say all that positive reinforcement went a long way to preventing me from either wanting to talk or even thinking about it.

Combined with the disassociation that blocked out actual specifics of the rape, leaving behind only memories of my father looming in my bedroom, by the time the abuse ended I was left with nothing but emptiness and feelings of unease that I wanted to run away from.

When I first started to recover memories it started with nightmares about my father appearing in my bedroom. Then came the flashbacks of the physical sensations of being raped. My body was remembering the things that had been inflicted upon it before my intellect. Over the past eleven years more and more memories have come back, and each time they are as disquieting an experience as they were the first time I remembered anything.

It's always the same sort of build up, the feeling that something is trying to claw it's way out of the back of my mind into my awareness. There is always the accompanying sensation of unease and nervousness that comes with them, but sometimes there is an undercurrent of fear.

Recently I began working with a new doctor who has been helping me deal with the resurgence of flashbacks that I began experiencing a couple of years ago. What we do is process the memory of the specific incident that the flashback depicts, so that I realize it happened in the past and isn't happening to me anymore.

But that means I have to confront the memories head on and think about them. It's the only way to ensure they won't come back in a form that causes me to relive them, to re-experience the rape. But that doesn't stop me from being scared of them. It will mean that I have to talk about the details of the event, or at least think about them.

Even though I've done this countless times already, it doesn't lessen the fear, or make it any easier. If there were any way of avoiding it I would, but the only way to destroy the power they have over me is by confronting them. I've already proved that avoidance doesn't work, twenty years of booze and drugs only put off the inevitable.

I don't go out searching for these memories, why would I, they surface on their own. As long as there is something that I need to deal with from that time, whether an emotional or mental issue, or an inappropriate coping mechanism, this process will continue.

Anybody who insists that a person should just get over it and get on with their life has no understanding of what it's like to go through the experience of gradually recovering your past. There is nothing I would love more than being done with these circumstances, but it's not in my control.

What enables me to get through it all, to conquer the fear, is the awareness that each time I conquer a memory it's one less thing from my past that has power over me. It's one more step on my road to freedom. Now that's worth dealing with a little fear.

What those new agers who talk about coming to the light don't understand is that there is quite a bit of darkness you have to go through before you can have any relief. The light can take of itself, it's in the dark that fear lurks, and where you need to travel in order to have any peace of mind.

June 19, 2006

Chronic Pain: In Defence Of Morphine

I've talked about my own chronic pain a couple of times in this space in the past, so I'm not going to go into details of my own condition again. Having dealt had one case of acute pain cured, and now living with what looks like a far more intractable situation, I'm well aware of the difficulties presented by the circumstances of the condition for both the sufferer and their caregivers.

Sufferers of acute non-malignant chronic pain, in other words you're not going to die from it, very often have nothing discernibly wrong with them. Nothing shows up on any type of scan, be it x-ray, nuclear medicine, or any other test they can think of to inflict on the patient. As a result the sufferer is sometimes faced with the additional burden of having to prove the veracity of their claim to illness.

Most Family Doctors are not in a position to treat chronic pain. Even though they can play a key role in the treatment of a patient's symptoms, they simply do not have the wherewithal to do more than monitor pain levels and prescribe analgesics. But if a client's doctor is unsympathetic towards the patient, or of the belief that non-malignant pain is not worthy of proper medication, a person could find them self suffering far more than necessary.

It is quite amazing how when a patient is admitted into hospital, or even held in emergency for any length of time, and experiencing pain, they have no hesitation in giving them morphine to relieve their pain. They never seem to worry about you becoming addicted, even if you spend an extended period of time in their care. They're just trying to make you as comfortable as possible.

The first time I was hospitalized for my pain condition, I expressed concern to a nurse about being given morphine. I have a history of substance abuse and figured the last thing I needed was to risk becoming hooked on anything. She told me that there was nothing to worry about because as long as I was in pain I wouldn't develop a psychological dependence on the drug.

From my own perspective I've never enjoyed taking the drug, and can't see how anybody would want to utilize it for getting high. When taken for immediate relief it will most likely cause you to fall asleep, thus allowing you to escape from the pain that you are in. In some instances it can actually cause you to feel like you are disassociating, separating from your body, so you still know that you're in pain, but don't really care.

The best way to prevent any sort of addiction from happening is to ensure that the body is never placed in the situation of having to crave the medication. In the case of painkillers like morphine it is essential for the client who will be utilizing it on a long-term basis to have a pain threshold established. What amount of the drug will maintain a comfort level for them on a daily basis?

This can easily be established by discovering how many doses a day a client is needing to take of the five to ten milligram pills in order to be comfortable. Once that is established the patient is switched over to a slow release product that maintains their comfort level at all times. They are given a supply of short term medication for periods when the pain peaks – "breakthrough" – but it shouldn't be necessary for those to be taken more than once or twice a day. If they do start having to use the breakthrough medication more often than that, their long-term medication is adjusted accordingly to reflect that usage.

In this manner the person doesn't develop a "need" to take morphine on a frequent basis and the possibility of addiction is removed. Of course that doesn’t mean it won't occur. There are always people who will abuse a situation, and there are doctors who won't make the effort to work out a proper drug maintenance program with their clients, both of which could result in a client becoming addicted.

But since that scenario is a possibility with drugs other than morphine, muscle relaxants and tranquilizers for instance, I really can't figure out why people get so freaked out about it. It's not so surprising from lay people, I was nervous about it because I had believed everything I had been told about how dangerous it was, so why shouldn't others be. What shocks me are the medical professionals who are still perpetuating that myth, and refuse to prescribe it for their patients unless they are dying, and even then they worry about addiction.

I kid you not. I have friends who are palliative care nurses who have had to argue with doctors to increase the dosage of people dying from horribly painful cancers. Here's an instance where the best thing a doctor can do for their patient is to make the passage out of this world as easy as possible, maybe even prescribing them heroin, but they won't because they are worried about them becoming addicted. (In Canada, as far as I know-this may be hearsay- it is legal for a doctor to prescribe heroin in certain circumstances for pain, but because doctors haven't in the past, the pharmaceutical companies won't carry it, so even if a doctor wanted to utilize it for a patient now he couldn't because it wouldn't be available) How ridiculous is that?

Thankfully there are fewer and fewer people in the medical profession who have such antiquated beliefs, but unfortunately you still run up against them now and again. Nothing quite does your self-esteem as much damage as to be in agony and be treated like a junkie at the same time. It's probably no coincidence that these are invariably the same doctors who tend to say things like "It's only a little pain, what's your problem?"

A few years ago my wife was having one of her wisdom teeth extracted. To say she was a little nervous about the procedure was an understatement; she hadn't had very pleasant experiences with dentists prior to this time. Five minutes after he was started the dentist was finished and she hadn't felt a thing. He also made sure to give her a prescription for pain medication in the event that she needed it.

When she made some comment about the difference in treatment that she had received this time as opposed to previous occasions, the dentist responded by saying, "In this day and age there is no excuse for anybody to suffer from pain." Now he was only referring to dental procedures, which is a refreshing enough attitude on its own, but that should be the refrain of the whole medical profession.

With the medications at our disposal, and the increased sophistication of their delivery, (you can now get a morphine patch which works like a nicotine patch and the drug is slowly absorbed into your system that way) there should be no reason why anybody need suffer from untreated pain. Whether you have a chronic condition, or it's only temporary, you deserve to have your suffering alleviated as much as possible.

It doesn't matter if you are suffering from a chronic pain condition, or you are watching a loved one being crippled by pain, there is nothing worse than knowing that the means of reducing that suffering is being denied. Whether pain is a symptom that will clear up when a solution is found, or it is caused by some permanent damage to the system that may never be resolved should be immaterial to it's treatment.

Only recently has non-malignant chronic pain been considered serious enough to warrant specialist attention. But even now the only medical professionals who work in the field are usually anaesthetists. Since they already have one specialty, the amount of time they can put into this work is limited, (the doctor I see has only one clinic every two weeks), and waiting lists to see them can be substantial.

The fact that they have chronic pain clinics is a step in the right direction, but it's not enough. The study and treatment of pain needs to be recognised as a distinct branch of medicine, not merely the secondary practice of already busy people. Until chronic pain is seen as a legitimate illness at all levels of society, and outmoded fears and prejudices are abandoned, people will continue to suffer needlessly.

June 5, 2006

The Hippocratic Oath And Genital Mutilation

Hands up everyone who knows what the Hippocratic Oath is? My bet is that most of you have at least a vague idea that it has something to do with a code of conduct for doctors. That it implies they will put the good of the patient before all other considerations is probably the most widely understood meaning of the oath.

It was written down by Hippocrates, or maybe one of his students, in the 4th century B.C. and aside from the prayer to Apollo that opens the oath, and some modernizations to accommodate our changed world, its still a pretty darn good set of guidelines. I won't give my patients medicines that will harm them, I won't do any procedure that I'm not capable of, and I will never do harm to anyone are all things we'd like to think our own doctor would adhere to.

Of course you have to wonder these days the way some doctors run their practices if they ever heard of that Oath or any one of the modern variations that they now have doctors recite. Especially the part about medicines that will cause people harm; how many class action law suits are going on right now because of prescription drugs that caused sever contradictions among patients?

Sure some of them are the fault of the pharmaceutical companies and the regulating agencies rushing some wonder drug on to the market without giving it proper testing. But there are also the instances, far more common than you'd think, of Doctors not bothering to check a patients medical history to find out hey have high blood pressure and the medication they've just prescribed isn't supposed to be taken under those circumstances.

Then there are the doctors who look at their patients in terms of how much money are they worth and how much work do they involve. The ideal patient for this type of doctor is the one who won’t take up much of their time, but needs to see them on a regular basis so that billable hours can be increased.

There have been cases reported in Canada where doctors are refusing to take on clients who are elderly, or who will require extensive amounts of treatment, while not allowing the doctor to charge extra billable hours: so much for treating anyone in need.

But at least that's only a case of neglect and not a case of subjecting a patient to unnecessary and harmful treatments like what has been discovered happing in countries that still practice ritual female genital mutilation. The World Health Organization (W.H.O.) has released a report that reveals more and more doctors in developing countries are participating in these procedures.

While calling for the procedure to be stamped out as soon as possible, the W.H.O. reserved some of their harshest language for trained medical people participating in what they refer to as the torture of innocent victims. While conceding it may be helping to cut down on the risk of AIDS by the fact that clean instruments are being used, they liken it to using a clean knife to kill someone.

Three million girls under the age of ten are subjected to this procedure every year, which involves the cutting away of parts of the clitoris in an attempt to dampen their sexual appetites and increase their value as a wife. Lest we be in any rush to point the finger at any particular faith, it seems to be done equally amongst Muslims and Christians; yet another way in which the two faiths seem to agree on the place of women in society.

So what's the big deal about doctors taking part you may be asking? If it's going to happen shouldn't it at least be done safely? Putting aside the simple morality of condoning torture by being present, the long-term health issues of the procedure should be enough to prevent any doctor from participating in the operation.

Depending on the severity of the mutilation the risk of haemorrhaging during childbirth increases by 70%, the neo-natal death rate by as much as 55% over women who have not been tortured. In countries where the infant mortality rate is already high you would think doctors and other health care professionals would be mindful of such results wouldn't you?

If a doctor is making the spurious claim of participating because he has the patient's best interest at heart, then I would ask him wouldn't the patient's best interest be for the procedure not to take place at all? Wouldn't you as a respected medical professional better serve your patient by explaining to those, most likely the father of the child, that want the procedure performed they are actually decreasing the woman's chances of coming to term safely?

People who would do this procedure to their daughters, with the purpose of making them more attractive as wives, might think twice about it if they knew that daughters might not be able to fulfill their sacred duty of dropping babies that live after having their vagina mutilated. When dealing with stock, you always want to make sure it breads effectively, otherwise it might affect the sale price, or dowry as the case maybe.

Any doctor having anything else to do with these procedures aside from fighting against them as barbaric, and claiming to be doing it for the good of the patient, is in my mind akin to somebody saying they assisted at a death camp because they wanted to make sure that the Jews got the fairest treatment possible. There is no excuse that can validate the action.

I've not always agreed with W.H.O. and their classifications of disease and ideas on treatment. But on this issue they are right on the money. The practice of genital mutilation has no place in our world, and any doctor who takes part in that disgustingness deserves nothing but our condemnation.

By lending the authority of their profession to the practice they are giving an air of legitimacy to a barbarism that should have been outlawed years ago. Only by isolating and ostracizing this behaviour will it be ever stopped, seeking to make it more palatable only encourages its continuance.

Any doctor who willingly participates in one of these procedures needs to re read his Hippocrates: at least the bit about not doing harm.

June 3, 2006

Condoms, Needles, And AIDS

Question: How is the HIV virus that causes AIDS transmitted? It has to travel from an infected blood stream into another blood stream. What are the two most common ways that this occurs? Unprotected sexual intercourse and the sharing of needles between intravenous drug users are still the most common means of the disease being transmitted.

What, than, is the answer to the spread of HIV and AIDS? Well there are two, either abstinence, which given this world is an unrealistic expectation, or educating people on the use of condoms and not re-using or sharing needles when injecting drugs. Obviously in the case of the intravenous drug user you'd wish for abstinence, as there are so many other health risks involved with shooting up. But if we can't get them to stop, we can at least prevent them spreading disease and putting a strain on health care systems.

To some people what I've just said in the above paragraph is the proverbial red flag in front of a bull. Some people, from the depths of their Christian or Islamic compassionate hearts, will say things like their sinners and criminals so whatever happens to them is just a case of reaping what you sow. Well unfortunately the more people who have the disease the more likely the chances of it continuing to spread to the so-called innocent victims.

It just takes one pint of blood getting past a screening process and making it out into circulation for a person receiving a blood transfusion to contract the virus. It only takes one police officer or paramedic getting blood in an open cut accidentally for there to be a chance of the virus being spread. Then there are the babies of the infected mothers being born with the virus because their mother's hadn't know to use a condom or not to use the needle that six other people had already used.

By the way, there is no such thing as an innocent or guilty victim of a disease. A virus doesn't sit in judgement upon the people it infects, its just looking for a new place to live and grow like the rest of us. The only things that judge people are people. If anybody is guilty in this mess it's those who, for whatever reasons, would rather see people die then, heaven forbid, teach them how to use a condom or give them clean needles.

Aside from those folks who knowingly infect others, (including the ones who continued to sell blood products which they knew could be tainted), the only guilty parties involved in the spread of the HIV virus are those refusing to allow anything but abstinence be described as a preventative. Anyone who seriously believes that is an effective policy for the population at large is either woefully naïve or dangerously narrow minded.

I have nothing against abstinence, but that's a personal choice made by individuals. I'm probably more abstinent than most of you out there advocating it, as I haven't had a drink in twelve years, or anything else for that matter. But that was my decision, not something somebody forced on me, nor one where there was another alternative. If non-alcoholic beer really were alcohol free (its not) I would drink it because that would be a safe alternative to abstinence.

It's one thing to make a personal choice on how you want to live your life, and another thing altogether to try and impose that on other people. It's ironic that so many of the people who advocate imposing their point of view on others, are the same ones who scream bloody murder about governments interfering with their rights as individuals. They won't accept a government's legal authority to enforce laws, but have no problem interfering in the way others lead their lives by claiming moral authority.

The issue of what can or cannot be taught or offered as means of preventing the spread of HIV and the AIDS virus has been a thorn in the side of the international aid community for years now. On one hand there are the Muslim countries unwilling to cede rights to women to allow them access to information on prevention. On the other there is the current U.S. administration's policy of linking funding with stipulations against the advocacy of condom use.

While some European nations recognize the necessity of needle exchanges as a means of controlling the spread of disease among intravenous drug users, other countries are reluctant to endorse any plans that suggest those programmes. That these and other issues are still prevalent today is being made clear at the United Nations' High-Level Meeting on AIDS. The purpose of the meeting is to try and reach an agreement on a global strategy for fighting the spread of HIV/AIDS from now until 2010.

In light of the reports recently released by the United Nations (U.N.) AIDS office that 40 million people are living with the disease and 25 million have died from it; that only 9% of pregnant woman in poor countries are receiving care to help prevent mother to child transmission when the goal had been 80% by now you'd think there would be a more concentrated effort to find a solution.

The one simple goal of this meeting was to try and set 2010 as a deadline for ensuring that anybody anywhere who wanted treatment for AIDS would be able to obtain it. But civil groups fear that they'll be lucky to escape these meetings without losing any of the gains that were made in 2001 on prevention, let along treatment. All the old stumbling blocks have surfaced again; countries refusing to sign off on anything mentioning gays, prostitutes, intravenous drug use, and condoms.

In an effort to guide people away from old arguments UN General Assembly President Jan Eliasson put forward a proposal mentioning everything by specific name and also calls for money to ensure the availability of the treatment. It is estimated that nearly $25 billion will be needed in 2010 to fight the disease.

While there is of course a great hue and cry over amounts of money involved, it must be realized it's been the continual inaction on the part of too many countries that has ensured the crisis level we are now at. There has been far too much self-righteous condemnation and far too little compassion from far too many people. Every year that heads remain buried in the sand is another year the numbers increase among the dead and infected.

There may come a time when it's all a matter of too little too late, hopefully we haven't reached that stage yet. If the countries involved with this meeting can at least agree that any and all methods are important, and not to hinder ones they may not personally agree with, it will be a good start. Until that sort of agreement happens hope for a resolution to the disaster in Africa gets fainter and fainter.

The longer we wait the higher the costs rise, both in lives and money. Isn't it about time that we grew up enough to be able to realize that our way is not the only way? It's a matter of life and death.

May 24, 2006

In For The Long Haul

If somebody had told me twelve years ago what I was letting myself in for I seriously wonder if I would have believed them. Of course that raises the question of whether or not I would have attempted what I've done if I had believed them? You see twelve years ago I made the decision to change my life from that of an addict to whatever it is I'm now.

I had plenty of excuses for being an addict, that's the great thing about being an addict you can always find a reason for your behaviour. It's usually someone else's fault that you're the way you are not your own. You never made that decision to take the first drink, smoke that first joint, or whatever.

Of course there are mitigating circumstances that can drive a person to try and hide from the pain of their existence by numbing themselves. Anaesthetic that comes from a bottle, a needle, a piece of blotter paper, or any of the other many a splendid means at your disposal, is the easiest route to take when you're thirteen, scared and alone.

As a teenager in the seventies it was far easier to obtain drugs than alcohol; no one is going to ask you for identification when you buy it and in those innocent days a nickel bag was actually five dollars. It wasn't until the American government, in a fit of moral outrage, starting spraying the Mexican pot crops with the pesticide Paraquat that pot prices jumped from twenty-five dollars an ounce to $120.00 for Columbian Gold. (Not to be confused with the Columbian white powders that was worth more than gold in the 1980s)

But whatever the price I seemed able to spend my high school years in a complete fog, and by the time I entered my second last year I made the jump to the big leagues and began chemical usage. Making use of the stuff that passed for L. S. D. in those days was always a risky proposition unless you knew the chemist. Potency, and contents were wildly divergent even within the same batch.

Still, it was inexpensive, at most $5.00 a hit and lasted a good long time. If you worked it right you could stay high all day long for as little as $20.00 and not even be too incapacitated to work. I spent six weeks in the summer of 1979 doing just basically that when I travelled out to Western Canada to work in a resort hotel in Banff Alberta.

As the legal drinking age in Alberta was eighteen at the time, unlike my native Ontario's nineteen, I was also able to begin drinking seriously at the same time. Now that's a pretty lethal combination, a steady diet of acid and booze does not do much for one's mental health. It's been known to have a detrimental effect on your cognitive abilities.

Thankfully I had enough sense to realize this and deciding a change of scene would be healthy, caught a red-eye flight back to Ontario after six weeks. Sitting on the plane, strung out and hung over, unable to sleep I looked out the cabin window to see the sun rising like a ball of red fire and momentarily thought a nuclear bomb had gone off somewhere in Northern Ontario.

I was so far gone that it took me almost five minutes to recognise what it was that I was seeing. Wiser men than me would have taken that as a sign that changes should be made. But unlike my contemporaries, who as university approached and the real world beckoned, began to change their habits, mine became more deeply entrenched.

For the next fourteen years I continued to work on keeping myself comfortably numb for as much of the time as possible. People who work in the arts are hard drinkers and livers anyway, so my behaviour didn't seem as outlandish as it would have in other circumstances. I had also learned how to make sure that the worst of my excesses weren't on public display.

If I was always slightly stoned it was no big deal because I was doing my work and getting things accomplished. But I was beginning to bottom out without realizing what was happening. Even after the summer of 1992 when my behaviour became so abhorrent that I lost all my friends it took my two more years to realize I had a problem of any sort.

My stroke of luck came about via circumstances most others would look upon as bad fortune. At other times I have written about having reconstructive knee surgery in 1992 that resulted in my contracting sympathetic dystrophy in the left leg. After two years of living on Tylenol three (30mg codeine tablets) and hashish to deaden the pain I reached the point where I was desperate for help.

From the knee down my left leg had turned grey as the circulation disintegrated. As a thirty-third birthday present a friend arranged for me to see an acupuncturist. Thankfully the woman who I went to see was extremely generous as well as gifted. My leg was going to require extensive work and would take weeks of sessions, time that I would not have been able to afford to pay for, so she didn't charge me for the treatments.

After the first treatment I began to have nightmares; after the second treatment they got worse; and after the third treatment I began to have flashbacks of my father raping me as a child. I thought I was losing my mind. Why did I wake up every morning believing I was five years old and that my father was raping me?

Somehow or other the treatments for my knee had freed up the memories. When I asked my acupuncturist about it she said that it was quite normal for deep nerve trauma like mine to have some emotional trauma associated with it. She also advised I seek counselling as soon as possible to help me recover, because that was beyond her capabilities.

She made one more suggestion, that I should consider stopping my use of street drugs, as they would only hinder my recovery. At the time that was not advice I was prepared to listen to, as they seemed to be one of the few things I could count on for a modicum of comfort. That the comfort was the ability to escape the emotional pain and anguish made it all the more difficult a habit to give up.

The therapist who I began seeing days worked with helping survivors of abuse, and other Post Traumatic Stress Syndrome recoveries, to correct their inappropriate coping mechanisms to healthy alternatives: Behaviour Modification in other words.

Our first sessions involved me just spilling out the traumas of the past week, flashbacks, memories, and other incidents that had left me reeling. As I gradually began to regain my footing in this, my new reality, we began to look at the variety of means that I employed to keep myself from remembering what had happened in my past.

By this time I had already begun to realize the negative impact that drugs and booze were having on my life. How, even though initially they might have seemed to be the ideal way of protecting myself from the horrors in my past, they had become the fount of many of my behavioural problems.

Resentment, anger, self-pity, and self –loathing were all lurking beneath the surface, ready to seep out like poison from a wound when the scab is torn away. It was a pretty ugly time, believe me, one that I wouldn't want to go through again, but am glad I did.

When you begin to feel like your making it, when you begin to feel free of the chains that had been binding you for years, the feelings of relief, and jubilation are extraordinary. This initial feeling of exultation can carry you quite a long way, but eventually it will wear off and you 're brought back to earth.

The real tricky part about being a recovering addict is not starting the activity again, drinking or drugs, because a craving can be recognised for what it is and dealt with. It's the long-term effects of feeling like the world revolves around you and the emotions that thrive in that atmosphere that become the real trial.

When you have no means of comparing what is right and what is wrong, you are like a young child again, learning to understand and control the feelings that rage and cry inside of you. It is easy to fall into the trap of feeling resentment and self-pity, which will than lead you into self-loathing because of your disappointment in yourself for the perceived failure.

As the years pass it gets easier, but I still have to be vigilant so that I don't fall back on the habits of old. Of course things aren't made any easier by the fact I'm still also dealing with residual effects of the abuse coming back to haunt me periodically as well. Perhaps once I have finally laid the demons to rest that caused me to look for an escape, I'll be able to put these feelings behind me as well

I do know that it is a damn good thing I was woefully ignorant about what I was letting myself in for when this all started. It would have seemed an insurmountable task. Rebuilding your life from the bottom up isn't easy, but even if I have to spend the rest of my days on it, it will have been worth it.

February 15, 2006

The Dangers Of Herbal Medicine

I've long been an advocate of what I call complimentary medicine. That is using techniques not normally utilized by your family physician to compliment the work they are doing. I refuse to use the word "alternative" to refer to things like acupuncture, herbal remedies, or massage therapy because that creates a connotation both unsafe and untrue.

The word alternative implies that these treatments can be used instead of, or isolated from, the ways in which our medical system does things. While it's true I might make a cough medicine out of a couple of plant leaves that I know will help as much as any over the counter stuff, I'm still going to go see an orthopaedic surgeon when I break my leg.

Somehow or other the word alternative has come to be equated with harmless when it is used in regards to medicinal practice. People have gotten mighty confused over the meanings of the words natural and organic. Just because it wasn't made in a lab it means it won't hurt you. Tell that to Socrates and the bowl of Hemlock Tea he had to drink.

Herbals are not some new fangled remedy. They were used long before we had pharmaceuticals, and have gone in and out of style with genteel society over the generations. Victorian era society women would have a tisane to help calm their nerves and men would take tonics to restore their "vigour".

It wasn't really until after World War one that people began experimenting with ways of synthesising remedies in a lab. Synthetic versions were thought to have the advantages of being easier to mass-produce, and the standardization of doses.

Herbals do have the disadvantage that from plant to plant a variety of factors can affect their potency. Soil conditions, rainfall, and exposure to sun can all come into play. The other advantage to man-made medicines was the insurance of a constant supply.

All plants have a very specific growing season and harvesting schedule. Some plants, like Dandelion, to have medicinal use can only be picked before June, while others in the fall. The other consideration is that in some instances the root of the plant is called for, and not only could it take years for the root to develop in size, once used the plant has been destroyed.

So, while some people may still have been using herbals, during the post World War two years the use of pharmaceuticals took off. They were convenient to take, and had quick results. Two things that were of major importance in our new faster paced world. People wanted not to be bothered by being sick and needed to get back to work fast. They couldn't afford to take the time it took to heal using herbals.

It wasn't until it became apparent that there were problems with some of the prescription drugs in terms of side effects that people began to rethink that attitude. When women who had been taking the anti nausea drug Thalidomide for morning sickness during pregnancy started to give birth to children with birth defects, it was the first sign that these drugs might not be as safe as was previously thought.

As more and more cracks started to develop in the corporate drug world, and as the sixties progressed, people began to "discover" other methods of dealing with illnesses. Unfortunately, too many people had come to expect the quick fix provided by the synthetic drugs as the standard for treatment, and demanded similar results from herbals.

This has resulted in a willingness to overlook the potential for abuse that exists in herbals as much as it does with any drug. One of the best examples is the way in which Echinacea angustifolia has been misused. The root of this flower had long been known for it's anti microbial properties, and works well to fight off low level infections such as fevers brought on by colds and flu.

But it is a remedy not a preventative. Somehow or other people started to believe it was some sort of miracle drug that they could take to prevent themselves from getting colds or the flu. Would you take an anti-biotic before you got sick? No because it would be dangerous to your health.

But that's exactly what people are doing when they take Echinacea and they have nothing wrong with them. What's even worse is that the demand for the root of this flower has been so high that it has now become an endangered species in the wild. It takes four or five years for an Echinacea plant to become fully developed and it was not given sufficient time to replenish.

Open any decent Herbal Book and not only will it tell you all the properties of the plants: what ailments it should be used to treat, what part of the plant is used, when to pick it, and how to best utilize it (tea, tincture, or compress); it will also tell you it's contradictions. What medical conditions make what herbs unsafe, if you have high blood pressure don't use any liquorice root in a tea for instance, and they always say consult your doctor to see what long-term affects this medicine could have upon any other medications you are taking.

It's been a number of years now since herbals have caught the public's attention again, and have zoomed in popularity. So much so, that you can buy them everywhere now. But even after the idiocy of using an asthma drug in diet pills (ephedra) caused people to have strokes, people don't seem to be learning the lesson that these are potentially dangerous.

It depresses me to see that Health Canada still feels the need to hold conferences on the dangers of mixing herbal remedies and prescription drugs. That they still have to spell out for people that natural does not mean it can't be harmful after all these years of them being on the markets is a sign that the people who are prescribing herbals, and the companies manufacturing them are failing the people they are supposed to be serving.

It's because of the abuse and misuse of herbal remedies and medicinal plants in general that we've already seen some of the more effective treatments become harder and harder to obtain. When it was shown that ephedra and it's derivatives were causing strokes when used in diet pills, it became a proscribed drug.

In every Herbal book, that I've ever made use of, it explicitly states that people with high blood pressure should never use it, and it?s sole purpose is for the opening of bronchial tubes to help relieve asthma attacks. Why companies started to put in into diet products is beyond me.

Herbal remedies have been used for centuries as medicines. Until they were saddled with the label alternative they were treated like we would treat any drug prescribed to us from a doctor. But now, all of a sudden, they have become safe as compared to what our doctor's offer us.

If those of us who make use of these medicines aren't able to change that perception soon, we are gong to find governments moving in to ban the sale of loose herbs, and only allow pre-packaged pills and doses to be sold. That would be a shame, because part of the pleasure of working with herbs is having the ability to circumvent buying a product and making your own remedies.

In a world where we have so little control over so many things, being able to have a say in the medicine I take, even if only in a small way, is a privilege. I would hate to have to give that up.


August 30, 2005

Eye Movement Desensitization And Reprocessing (EMDR)

I don't normally talk about personal issues. I have a wife and a therapist for that type of stuff, besides most people have their own shit that they are dealing with and don't need to wade through mine. But since I want to talk about a type of treatment, and give a first hand account of its effectiveness, you are going to need some background to better understand what I'm talking about.

This won't be one of those, oh my life is so hard things, so don't take it like that. I've lived with it for my whole life and I don't think that, so there is no reason for you to either.

As a child I was sexually abused by my father for a period of about ten years: infancy to until I was around twelve years old. The dates are bit unclear, because I am unclear about the whole time period. You see I had blocked everything out until I was thirty-three.

Drug and alcohol use started when I was thirteen, and closing down was pretty easy with their assistance. My folks wondered why I was so fucked up and kept sending me to shrinks and a variety of councillors when I was in my teens and early twenties. But nothing ever came out of those meetings except some of those glib assessments one associates with seventies psychobabble.

One of the reasons everything was so buried were the coercive tactics of my father to ensure his secret was kept safe. Another was anyone else's refusal to believe me when I told them. The one time I worked up the nerve to tell my mom, she called me nasty and threatened me with reform school.

I was a problem child: shoplifting, lying, etc, traits which continued on through until adult hood, along with the addictive behaviour I picked up as I aged. You must remember this was the sixties, I didn't really understand what was going on, except that talking about it was bad, and my father wouldn't love me if I said anything.

Imagine what that combination would do to the mind of a kid, and you can see how I ended up not remembering. It was a lot easier than having to figure out what to do, at least that's the way I see it now. Anyway didn't everybody's father act like that? Who was I going to compare notes with?

Okay, fast forward to when I've just turned thirty-three. I'm a mess; emotionally and physically. When I was thirty-two I had undergone a fourth surgery on my left knee, a previous reconstruction and two arthroscopies. This last reconstruct was to reverse what they had done in the first one. (Don't ask) Well there was only so much my leg could take and I developed a form of nerve damage known as Reflex sympathetic dystrophy

By the time my aforementioned birthday had rolled around the skin on my left leg from my knee down was turning black and I was in continual agony. As a birthday present a friend had arranged for me to visit an acupuncturist to see if there was anything that could be done that way to assist me.

Do you know what a healing crisis is? It's when the body kicks into overdrive in order to solve its own problems. It usually means you get a whole lot worse before you get better. It often occurs in the holistic methods of healing that rely on the body's corrective abilities to effect a cure.

Well I knew nothing about it at the time, so on the day after the treatment and it felt like I was going to die from the pain to say I was shocked was an understatement. I phoned the acupuncturist to ask what the fuck? That's when she explained the concept, apologizing for assuming that I knew what to expect.

But I don't think even she expected the nightmares I would start having. It was like opening the proverbial Pandora's box. When the flashbacks started I thought I was going crazy. There's nothing like reliving rapes that you don't remember to make you question your sanity.

I was lucky. I had a housemate at the time who worked for a sexual assault crises centre in town, and although they only dealt with women, she recognised what was happening and lent me the book that saved my life The Courage to Heal Written for women, I changed the pronouns and finally understood what was going on.

I went through my first bouts of therapy than, and it helped me with some of the behaviour modifications I needed at the time. I stopped booze and drugs, and thought things were going great. In fact they were, I met the woman who has since become my wife a couple of years later and started to really get my shit together.

Than a couple of years ago it all fell apart again. To ensure that I'd never forget his loving attention, it seems my father has managed to inflict permanent damage on the muscles of my pelvic wall. For years I had been troubled by mysterious pain in my lower abdominal region that no one had ever been able explain.

In 2001 this pain elevated to a crippling level. After having the right half of my colon removed failed to solve anything, (the surgeon had warned me in advance that there was little hope of success but I was desperate) it was finally diagnosed properly. The pain had only been representing in the abdomen, not originating there.

Than the flashbacks started again. They were trying to treat my pain with nerve blocks, which meant injecting the effected area with a mixture of steroids. That could have set them off, but maybe they were just waiting for a chance to come out again, and like a time bomb whose clock strikes they went off.

It was the doctor treating my pain condition who first mentioned Eye Movement Desensitization and Reprocessing (E. M. D. R.) as a means of treatment. Fortunately enough I was able to find not only a therapist who practiced the treatment, but also one who was covered by my medical plan.

Now for the $64,000 question? What the hell is E. M. D. R.: how does it work, and does it work? Well I had no idea about it and quite frankly if anybody aside from the doctor who suggested had told me about it I would have probably dismissed it out of hand. As it was, I was inclined to believe it was just another one of these pop psych. bullshit things like: I'm O.K. and You're a Fuck Up!

Keeping that open-minded approach in place I went on line to check it out. The more I read, the better I felt about it. The best place to start of course is with the person who started the whole thing: Francine Shapiro Phd. This site gives you the theory, the history and all the information you require to get a good understanding of what it is all about.

In a nutshell it is a process similar to hypnotism but different. The idea is to allow the client to analyse the flashback without reliving the experience. When you relive it you stay stuck in that moment and continue to experience all the emotions and stress that the original event caused.

The client selects a "target" for working on. This could be any scene that they remember that causes a severe emotional reaction. He or she then identifies the emotions it triggers and any physical reaction it causes. Does it make your stomach cramp? Does your chest hurt?

Once the target is established the client is asked to picture the event. When they are ready the therapist begins the process of alternating stimulation of both sides of the brain. By either inducing the eyes to move from side to side, using hand pulses, or listening to a tone in alternate ears over headphones the client should be able to "watch" the memory play out dispassionately.

By watching instead of re experiencing a person is able to escape the trap of endlessly reliving the same moment. By processing, analysing and keeping track, of how you feel between sessions, and discussing those results with your therapist, you begin to connect the behaviour and coping mechanisms that have resulted from your abuse

Therapists love to say, and for good reason, awareness is half the battle. Knowing that your fear of the dark is caused by the fact your father used to sneak into your bedroom late at night and rape you in your dark bedroom gives you a logical explanation for something you could never explain before.

With E. M. D. R. neutralizing the effects of the flashbacks you can combine that with your knowledge of where your fear came from, and overcome it. The rapes were in the past, not now, so there is nothing to fear. That is a rather simplistic example but it gives you the general idea.

E. M. D. R won't work for everyone. A good indication that it will work for you is if you are able to meditate with any degree of success or have proven susceptible to hypnotic suggestion. There's also no guarantee that it will work on every occasion either, it all depends on your state of mind that day.

I have found that on days when I've over tired, or am dealing with some other external distraction that I can't control, like my pain level being too high, that there is no point in attempting it either. You have to be able to concentrate or hold a point of focus to some degree.

E. M. D. R. has worked wonders for me. I have accomplished more working with my current doctor in less then a year, than all the years of my previous therapy combined. It's not a miracle cure by any means, but what it does is establish the things you need to work on.

Unlike behaviour modification therapies, you go deep enough to find the root of what causes you to behave in a certain manner. It's much easier to change inappropriate behaviour when you know there's no longer any need for it.

It's been a difficult year, thinking about shit that I haven't really wanted to think about, but E. M. D. R. has made it easier. The onus has still been on me to want to change, but at least I feel like I'm really doing it this time, and won't have to go through this again in five to ten years time.

Every year seems to bring a new sure-fire cure onto the market. From Chicken Soup for your Gall Bladder to I'm Hot Stuff, Your Not somebody is always willing to guarantee they know how to make you "feel good about yourself". E. M. D. R. doesn't come with any guarantees, and it's definitely not a self-help therapy. What it does do is offer you a means to find your way clear of a past that could be crippling your future. For that I'm eternally grateful.



July 9, 2005

Misconceptions About Anorexia Nervosa

There are a lot of misconceptions about anorexia nervosa that should be addressed. I'm not saying corrected because I'm a layperson and can only offer opinions and observations culled from living with a person with post-eating disorder anorexia.

Anorexia has long been identified with body image. A woman feels inadequate because of how she looks compared to the images presented in the media. To be accepted she must somehow assume the shape or size of those she sees presented as the ideal.

The presumption is that from this motivation alone the person will begin starving herself. But this leaves too many holes and doesn't cover all circumstances. Yes body image and media examples play a role in encouraging starvation, but something else has got to come into play to cause a person to loathe themselves to such an extent.

This theory does nothing to explain why some people stop eating as young as five. In other words they are almost born anorexic. A controversial, but successful, practitioner Peggy Claude St. Pierre, who works with anorexics in Victoria B.C Canada, was the first person to reveal that there was more at work then simple body image. In one interview she was accompanied by a five year old boy who had stopped eating.

With his limited communication skills it was hard to decipher what had caused the ailment, but it eventually came clear that he was suffering from a surfeit of guilt. From what little he said those treating him understood that he could not bring himself to eat while he knew that others were going without. What made him better that he should deserve to eat when someone else wasn't able?

The full story of that young boy was never revealed, except to say he was recovered. What had destroyed his self esteem to that point of degradation wasn't said. Perhaps he was being sexually abused, or ignored by his parents. Or it could just have been as simple a case as he claimed. As young people we have not yet built up shields to defend us from the horrors of the world, and sensitivity to another's plight could become over exaggerated in the mind of one so young.

As a teenager the woman I love was starving herself to death; she had stopped menstruating, her heart rate was stopping, the full deal. She had the strength to pull herself out of that hole and carry on. But there has been more to her recovery then simply starting eating.

We were both getting on in years when we got together, at least by today's standards, thirty-five, so we had already ruled out the prospect of children and decided on a life for the two of us. Neither of us had had what could be called easy lives up to that time and we looked on each other as safe havens in what had been stormy waters. This is what precipitated the events that followed, events that have led the two of us to understand how a so called eating disorder is far more then that.

When you have spent your whole life running, looking over your shoulder for the next horrible thing to happen to you, and you finally can stop and sit and catch your breath, you start to think, and you start to remember. We had a lot of sleepless nights those first few months. She would wake up crying, or not even be able to get to sleep, from the whirring of her brain. Gradually a picture began to appear, a portrait of a person in pain.

It was not pain caused by the others wounding, rather pain from others wounds. Her empathic nature is such that she feels other people's hurts, they leave scars on her soul. She has been like this as long as she can remember. With this sensitivity comes the desire to make better, to take away the pain and make everything alright. When she can't she feels guilty, and it becomes her fault that this person is in pain. That's only the beginning.

You take this person and place them into a dysfunctional home: her parents were nineteen and seventeen respectively when she was born. Her father is an alcoholic, and her mother ignored her. Whenever there were problems in the home, which there were on a weekly basis, they became her fault. She was not the cause, but because she could not fix the situation it was her fault.

It was when the inevitable happened and her parents split, that she entered the eating disorder stage of her anorexia. She must pay the ultimate punishment for her failure. She did not deserve the nourishment necessary for survival. Ironically it was only guilt feelings about abandoning her mother that saved her. It was not self preservation that started her eating again but the same feelings that had made her stop in the first place.

To assuage the guilt of that first failure she spent the next twenty years looking for people to heal, people to save from themselves. In the process she was beaten, raped, and emotionally abused. Through it all she felt guilty. She must be doing something wrong in order for people to treat her so bad, otherwise how else could you explain their behaviour.

Even if they were bad people it was her fault because how could she have been so stupid as to have gotten involved with them in the first place. How could she have listened to the voice that told her that she should try and help these people, even if they were beyond help. What was wrong with her? Who did she think she was anyway believing she could heal everybody?

Those were a few of the things the voices in her head were saying. Some of which people on the outside were only too glad to reinforce. Looking at the abuse they would question her judgement, thus they perpetuated her feelings of inadequacy and guilt and drove her deeper into herself. Maybe they were right and her desire to help people was wrong, and so she questioned that which motivated her whole being.

We can say that her initial motivation for healing was selfish, i.e. to make her home life better as a child. But how can you blame a child for wanting to have a happy house? How can you blame a child for wanting to stop her father hitting her mother? That is not selfish but self-preservation. What happened was that instead of looking for people who wanted to get better she kept looking for chances to heal her broken family, and thus searched out those who were least likely to respond in her endless quest to heal her parents.

After years of trying to fix everyone else's problems she started to help herself. She's had to retrain the way in which she thinks, learn how to tell the subconscious soundtrack in her head to shut-up whenever it gets out of hand, and replace it with positive thoughts.

Coming to respect and like herself was the first and most important step in the healing process. From there it became a matter of going beyond adequacy and getting back to having a life, for the first time ever, that was based on what she felt and wanted. Not on her misconceived notions of what she should do for others.

When we went looking for assistance there were few books out there at the time which offered any help or insight. Few people had published anything that offered the care giver a course of action to follow to assist those afflicted.

There don't seem to be any hard and fast theories on how to treat anorexics. In fact the different courses of treatment are as much a controversy as the disease itself. The afore mentioned Peggy Cloud Pierre has often been at the centre of this because of her tendency to ignore conventional wisdom and at the same time achieve remarkable results.

The first thing that she advocates is complete separation of the client from her family(As this is still a disease that primarily effects women I will use the feminine pronoun throughout). Clients come and live in her facility, and until the staff decide, they are allowed no contact with relatives.

Since the family situation usually has played a significant role in the generation of the illness it is considered essential for the client to be free of all potentially negative influences. Families had to agree to this at the onset of treatment as a condition for acceptance into the program. Not surprisingly this is was what caused most of St. Pierre's problems, families complaining they were not being allowed to see their children.

Too many people are still unwilling to believe that a mother or father can be the problem in a child's life not the solution. Having heard some of these parents or read quotes of what they have said, I have come away feeling that there are good reasons for the child to be apart from them. Their words were never about worry for the child, but about themselves and how they felt.

When someone says things like "It's a Mother's role" or a "Parent knows their child", and that same child has been starving to death for three years you question what role that mother played or how well she knew that child. If that truly were the case why did you need to turn to someone else for help in the first place and agree to their terms? In my mind these people sound embarrassed: initially by the disease and now by the fact that they are being seen to be responsible for the illness to some degree.

Those motivations are the precise reasons that separation was deemed essential. A person who is willing to let herself starve to death has to really hate themselves, or think so little of themselves that they don't care whether they live or die. How can that be countered? Pierre and her staff would counter with unconditional love.

No matter how they acted or what they did and said they would be continuously told they were worthy of love and affection. That's not to say they would be allowed carte blanch in their behaviour and get away with everything, but they were treated with respect and dignity. Everything and anything possible was done to ensure the restoration of their self respect.

While this may sound overly simplistic in its methodology, in practice it's another story altogether. To break though the walls that an anorexic has built around herself takes patience and perseverance. Years of self belittlement and guilt must be chipped away slowly and carefully. Pushing too hard and showing the slightest impatience will spoil any hope of establishing the trust so essential between care giver and client.

The first step is to build the client back up to a place where they are willing to fight for themselves. There comes a point when they must be willing to try and fight the impulses that cause the symptoms and to start seeking out their root source. But that will only happen when they believe they are worthy of living. Even then it is essential that positive reinforcement be a continual part of their lives. Without it the chances of relapse are high.

Due to a high number of complaints from parents, testimony of fired and vindictive staff, the British Columbia medical board rescinded Pierre's license to run her facility. The pity of it is that she of anybody working with anorexics had the highest rate of success without relapses of any facility or doctor on record.

I never knew my wife when she was in the throes of her eating disorder, only when she had started dealing with the mind set that caused its onset. I witnessed the struggles she went through and still goes through these days, and am grateful for the inspiration that Ms. Pierre provided and still provides us. Without the key she gave us through her example we may never have unlocked the door that had prevented my wife from living the better life she has now.

My wife and I liken being an anorexic to being an alcoholic; everyday is a struggle against the compulsion to fall back on bad old habits and beliefs. But everyday your clear of it is another step closer to freedom. There is more to this disease then a desire to look like a fashion model, although their example feeds the self loathing, and the sooner we start treating it for what it is the better.

It's a pity that the woman who was doing the most good for people was closed down over the belief that family is the be all and end all in our society. Too often the cause of anorexia rests in the home, not the pages of a magazine. Until we wake up to this fact there will be too many young girls continuing to starve themselves near on to death.



May 6, 2005

Some Simple Truths About Reiki

I have touched on things to do with New Age and complimentary medicine in past postings, and I believe that I've mentioned that both my wife and I are Reiki Masters(meaning we can give treatments and teach) in Usui Tibetan and Karuna style Reikis. Recently I've become frequently embarrassed to admit that I have anything to do with these modalities. While my opinion of their validity hasn't changed, I'm finding it harder and harder to associate myself with others who are practitioners and teachers.

Maybe at heart I'm a conservative when it comes to certain matters, but it seems to me that when you are given a present as potent as Reiki to work with a certain amount of humility should accompany the gift. Instead too many are beginning to believe in themselves as on some sort of divine mission to heal the world, and in a effort to validate themselves have begun to incorporate religious symbols, icons and imagery into their practices. It has come to the point that numerous brands of Reiki are springing up all over the place: Be attuned to the angels; feel the divine ray of purple light; ascended master are with us and so on. The original concept of what it was all about has been forgotten, its become more important for too many people to become attuned to the latest fad brand then to actually due anything with their education.

Reiki was designed to help facilitate self awareness and growth. A serious of symbols acting as a means to aid a person in tapping into the universal flow of energy and stimulate energy centres in your body in order to focus intent. Gradually it was expanded into a modality that could be used for treatments along the same line. The facilitator and client would agree upon an intent, and then the former would utilize the symbols to focus energy, and work with the client to fulfill that intent. There is nothing magical or mystical about it, no divine intervention was promised that would change your life or make you a new person.

The process of becoming a Reiki Master is a matter of being "Attuned" to an increasing number of symbols. These serve the purpose of aiding in focusing and channelling(I don't mean talking for some star being here, but the original meaning of the word: acting as a means of passage) with ever increasing ability universal energy. By keeping the practice without basis in any religion this allowed individuals to utilize their own beliefs to formulate the means to create a way to do this that was most comfortable to them.

The four levels of Usui-Tibetan Reiki; one, two, Advanced Reiki Training, and Master, are a process involving a minimum of two years of study and practice. Like any of the meditative arts it was considered essential that a student spend time with each level of study learning and assimilating, before continuing. In order to become a Master a student must be willing to under go changes that free themselves to be more open receptacles of universal energy. Ideally they will learn to be nothing more then a transmitter, allowing a unadulterated flow to pass through them to who ever they are helping. Ego and any other motivations ulterior to this purpose have to be set aside to successfully obtain this goal.

Karuna Reiki is a more recent evolution of the older form. It was developed by the International centre for Reiki under the leadership of William Rand. This organization has been dedicated to the preservation and teachings of Dr. Usui's family for over twenty years and William Rand is one of the few people in North America who was taught directly by Dr. Usui's wife. When I first heard of Karuna Reiki I admit to having some skepticism, oh great someone trying to cash in and make a name for themselves. What they are though is a series of symbols that help to focus energy to deal with the traumas specific to twentieth century western culture. They are a legitimate addendum to the original work and have made the whole more applicable to our society. The Reiki Centre will only allow people who are proven Usui-Tibetan Masters learn Karuna Reiki, and they carefully monitor the certification of all teachers and practitioners, ensuring the integrity of the modality.

You may wonder why they are so uptight if as they say they want as many people as possible to experience Reiki. Like me they have become increasingly disturbed by the dilution of Reiki's character through the birth of so many bizarre hybrids. By strictly controlling the issuing of licenses I think they are hoping to distinguish themselves from a host of pretenders, and not lose the respect the modality has earned with other fields through the actions of flakes. With Reiki being accepted by hospitals as legitimate therapy, some even having practitioners on staff, the last thing that needed is to have its credibility strained through association with the worst sort of new age Babel speak.

Reiki is not a religion, it won't change your life unless your already working on changing it, and its not going to save the world. What it can do is help you focus your mind, attune you to the universal energy that flows through all life, thus strengthening your own abilities to aid yourself and others through the same process. But remember, there is no such thing as a quick fix no matter who or what anyone claims to be channelling.

April 20, 2005

Complimentary Medicine Not Alternative

If you happen to look through my interests you'd have noticed the first one listed is complimentary medicine. I thought this was a fairly normal way of describing an interest in different modalities used in compliment to the more standard health care practised in North America today. A catch all phrase within which to encompass things like the use of herbal remedies and energy work like Reiki, both of which I practice with varying degrees of authority. Imagine my surprise when I searched out others who shared that interest and found no one but myself. How do other people categories these practices I wonder?

Most likely people are using the appellate of Alternative Medicine to describe these practices, a name I believe misinterprets the philosophy of these practices. The use of the word Alternative perpetrates a misrepresentation. Alternative used as an adjective implies the replacement of one thing with another, a dismissal of the usefulness, and these days, the implied judgement, that what is being offered is somehow not just different but healthier. It also implies abilities that are not truly available. Whilst it is true that many practices can alleviate similar problems that so called conventional medicine deals with, there are instances, no matter what people claim, where one needs to utilize the abilities and technology that accompanies that practice. Nothing I do could replace a surgeon removing a tumour, setting a bone, performing a vein graft, or replacing a hip joint.

To me offering oneself as an alternative is dangerous and we have to be careful with our usage of that word. Some herbals, golden seal, and other anti-microbials for instance, work as antibiotics for certain types of infection, but to say that they can be used in all instances of decease instead of prescription drugs is not only false but dangerous. Or Reiki can be an excellent method to help people deal with emotional, and spiritual trauma, but to offer it as a replacement for psychological therapy is nonsense.

The other notion that must be dismissed, this is a mild digression, is that our practices are somehow safer then others. While it is true that most herbals and energy modalities offer less risk of contradiction then pharmaceuticals they can not be said to be risk free. The worst danger is to believe the myth that because it's natural it's harmless.

HERBS ARE DRUGS. I don't care if it's flower, a leaf, or a root it's a drug that changes the chemistry of your body and misuse can hurt you as bad if not worse then pharmaceuticals. In fact the misuse of herbals is responsible for all the problems and health warnings one reads about. The two biggest examples of misused herbs are the ones most often read about, Ephedra, and Echinacea. In the case of the former we hear about it being pulled off the market because of causing strokes and other problems from being used in weight loss products. Opening my herbal book I find a big warning saying it should never used in cases of high blood pressure or anxiety, and that its primary function is to relieve asthma and associated conditions due to ability to relieve spasms in the bronchial tubes. It may also be use in cases of low blood pressure and circulatory insufficiency. That's it, that's all. Son the deaths and damage caused by it have by people using it for the wrong purposes. Just as worrying for different reasons is the use of Echinacea as a preventive. It is an anti-microbial to be taken in instances of infection only. To take it in when one is health is equivalent to taking antibiotics when one isn't sick. Who knows what long term damage is being done to people's immune system because of this application(as a side not: because what is being used for medicinal purposes is the root of the plant, the over use of echinacea has resulted in its virtual extinction as a native wild flower in North America)

The risks involved with energy modalities are not as severe but still worth noting. Any instance of energy work is accompanied by what is known as a healing crises. This is where one initially feels the effects of the trauma being treated to a high degree while the body clears itself. These contradictions could include an increase in emotional distress, physical pain, and mental anguish. If a client is not prepared for this eventuality it could cause them needless anguish as they will have no understanding as to what is happening to them.(I have experienced this when undergoing acupuncture treatment for nerve damage in my left leg, and as the nerves healed the pain increased a hundred fold and emotional blocks were broken) As practitioners we must prepare our clients for the fact that this is not a pain free process no matter how organic and natural it is.

So what is my point anyway after all this. Well it's simple really, I don't believe we are an alternative in the complete sense of the word to the more mainstream practices of medicine, or actually any safer. We can supply alternative treatments to some things offered in the way of drugs and additional methods of helping people deal with trauma, but we can not replace the role of the surgeon or family doctor. As more doctors are beginning to recognize the legitimacy of complimenting their practices with other modalities, we must also draw in our horns of arrogance around the idea that we are somehow better then they are. By offering ourselves as an alternative we not only mislead people but we defeat the very purpose that we share with all practitioners, which is to help people cope with whatever trauma they are dealing with. Lets compliment each other, not antagonise.

For those who are wondering I'm a Reiki master in the Usi-Tibetan system and am a registered Karuna Reiki master through the International Reiki Centre of William Rand. I've been studying and working with herbal remedies for the past ten years but have no certification and thus do not consult, supply remedies, or prescribe any treatments.

April 7, 2005

Oil: The End Is Nigh - Thank Goodness

All good things must come to an end, and even those things which were never that great to begin with will finish eventually. And this looks like its the beginning of the end for oil as a source of power in our world. The amazing thing is the shock people in North America are feeling as the price of pumping fuel into their steel boxes on wheels rises on a weekly if not daily basis. We have lived so long in our artificial cocoon of cheap gas that having to face the reality of paying the true value of fuel is hard to bear(I remember travelling in Germany in 1980 and seeing the price at the pump being @ 75 cents a litre)

But what is truly scary is the fact that our governments seem to be trying to placate these fears with promises of more bounty buried throughout the earth. Instead of speaking the unfaltering truth that we are nearing the end of the usefulness of petroleum as fuel, and that as the inevitable happens prices will continue to spiral upward, they are full steam ahead in the exploitation of more and more environmental delicate oil exploration projects. The Alaska wildlife refuge, and offshore drilling off both coasts of Canada are just three projects that will risk more then they can ever deliver on. The costs involved in the development will continue to out weigh the increase in availability so prices will never come down again( When have you ever known a price increase to be significantly rolled back)

Through greed and short-sightedness our society has become oil dependent(George Bush calls the Alaska Wildlife Refuge exploitation "protecting America's oil requirements" when it should be called "protecting my family and friends wallets") Transportation, heating our homes, the manufacturing base, plastics, and who knows what else are all dependent on a ready supply of oil. We are about to have to go through a period of radical change over the next few decades, with no plan for a future without oil.

I would like to offer a simple solution that will not only reduce our dependence on oil, but would have the added benefit of allowing every nation on the face of the earth to meet its Kyoto accord gas emission reduction goals, and then some. Ban private ownership of fuel based cars, except in the case of business. Metropolitan Centres already have public transport infrastructure in place, and the auto manufacturers can be retailed to produce more mass transit vehicles. Outlying communities can have publicly owned fleets of cars that are available for us on a needs only basis; business commuters on short hops can access these same types of vehicles, and so as to prevent wastage businesses can schedule people's travel to coincide with others so as to enable car pooling.

Think of the other side benefits: a reduction in noise pollution with less cars on the road, less auto related deaths(both human and wildlife), people will actually be brought into contact with each other instead of being isolated in their own private boxes, and we can rid ourselves of a lot of the ugly concrete that desecrates our landscapes by scrapping a lot of now useless supper highways. Imagine being able to hear the sounds of nature, not traffic. Smelling fresh air not carbon dioxide and seeing the sky not a brown smudge in late August.

I know it sounds ridiculous to most of you, and you can't even picture what it would be like to no own a car, but in the long run it may well be the only hope we have for salvaging something of this world.

April 2, 2005


If you are a person who is in favor of a woman's right to choice what is done to her body please boycott the Bank of Montreal. For the last ten years they have had an affinity MasterCard with the group Life Canada who not only argue against a woman's right to choice but use lying scare tactics to frighten people from their choice. On their Web site they claim that having an abortion increases the likelihood of a woman contacting breast cancer. According to the Canadian Cancer Society there is no link between the two.
Shame Shame on the Bank of Montreal!!!!!
In response to this flagrant greed driven agenda at the expense of the rights of woman I call upon all people who are pro-choice to end what ever business they have with the Bank of Montreal. If you discover any other banks which have affinity cards with such groups please post this information somewhere so others of us can act accordingly.