Drugs

I’ve been thinking about drugs this week. Actually, in my line of work, the subject of drugs comes up quite frequently. A drug/alcohol profile is part of every patient’s history and physical. Every clinic patient on narcotics is monitored carefully after signing a narcotics contract, promising, among other things, to get refills at one and only one designated pharmacy. Patients admitted to the hospital who have been known or suspected to be regular moderate to heavy alcohol users are monitored for signs of withdrawal. ER providers as well as clinic providers are always on the lookout for drug-seeking behavior. Oh yes, drugs are a big part of a medical transcriptionist’s life.

Once I get home, though, I’m faced with them again through the news. Maine is known for a low crime rate, but one of our rising statistics is illegal drug use and illegal sale of prescription narcotics. I often wonder how people know where to go to buy drugs “on the street.” If, for instance, I had a hankering to get some OxyContin, I would have no idea whom to approach. How do you tell someone is selling drugs? Do you just happen to have a friend who is addicted, and he gives you a seller’s name? Do you go by your nearest cheap motel and ask around? This under-the-radar (to me) social networking seems so complicated, it is a wonder it thrives at all. But thrive it does.

I have never been a black-and-white person; I am usually in the “gray” area. By that I mean, I am smart enough to realize that society has complicated problems that are not easily solved, and any politician who promises to quickly and easily solve them is either lying or naive. The drug culture is one of those complex problems with no simple answer. I have wondered, however, about two things.

I realize that law enforcement is trying to go after the “big” people - the pushers, the growers, the providers. All well and good. However, in any society, there is a law of supply and demand. If there were not a demand, the drug pushers would have to change their line of work. I only hear about jail times, methadone clinics, and undercover arrests. I have heard few people ask, “Why are so many people hurting?” That’s the root of the problem. As long as people need relief from emotional pain, illegal drugs will be in demand. If you have thousands of people in the United States who need relief from emotional pain, you will have thousands of growers in South America and elsewhere who see an opportunity.

Many folks have asked Ed through the years how he stopped drinking cold turkey and how he managed to stay sober since 1984. In a nutshell, he always says, “God hit me upside the head with a 2 x 4 and told me to wake up to who I really was. Once I learned why I was hurting and the inner pain was healed, I didn’t need the anesthetic any more.” He said he could have been a drug addict instead of an alcoholic, but alcohol was "my anesthetic of choice." It is interesting that he always uses the term “anesthetic” for alcohol. After all, in the old days they used to have patients get drunk so they could operate with less pain. Anesthetic numbs feelings - physical and emotional. Of course, it’s only temporary, the feelings come back, then you must re-consume the anesthetic agent. Why are our young people and adults hurting so much that they have to anesthetize themselves with drugs and alcohol? Why do they think their lives are so despairing that they don’t want to feel anymore? I’m sure it’s a combination of things, especially in Maine. It’s hard to find a good job that gives a decent wage, for instance. Families are hurting financially, and that continues on for generations who feel hopeless and helpless about their situation. And the beat goes on, unrelenting. The drug lords realize this. They know a good thing when they see it. They know hurt and pain and desperation. They have a addictive product to sell, and plenty of hurting people who want to be numb. If only we could heal all that pain in a more constructive way! Take away the market - the need - and the drug pushers would have to find some other way to make a living, and these victims can’t “just say no,” when they don’t see any other viable alternative.

My second question is short. Why do we insist on separating alcohol from other drugs? It is just as addicting, just as powerful, just as deadly (more so in driving), but it is legal and sold in every grocery store. What’s up with that? Why is it acceptable and heroin not? I have personally seen the devastating effects of alcohol in our family and others. They use the acronym DUI for “driving under the influence” instead of the old DWI for “driving while intoxicated,” but in 99% of cases, that influence is booze. I’m not saying to make drugs legal or alcohol illegal. I’m just confused.

So this week I am hurting in my own way - for society, for our apparent inability to get to the root of these problems and bring some kind of hope - tangible hope, not some rhetoric - that will help them wake up to who they really are, children of God, and as a result, help them discover that life is to be lived fully awake, not emotionally numbed in a haze of anesthesia. It would take the cooperation of the spiritual community, the psychologists, the psychiatrists, the counselors, the economy gurus, the corporate community, the teachers, the doctors, the social workers, and countless others to agree to address the root - not just legalities - of this complex problem. At least it would be a start.

It's the THOUGHT

A few weeks before Christmas, I got a call from our daughter, Rachel. I heard the sob in her voice immediately, and had to calm her down so she could tell me what was wrong.

“I’m making you a Christmas gift,” she sniffled.
“How sweet! What’s so upsetting?” asked.
“Because I’m screwing it all up!” she cried. “I don’t know what I’m doing!”
I smiled. “That’s OK, honey,” I said. "Don’t worry about it! It’s the thought that counts.”
“You don’t understand!” she wailed. “I’m having problems with it and you’re the only one who can help me, and I can’t ask you because I want it to be a surprise!”
I laughed a little. “Sorry, honey, wish I could help. Just forget about it.”
She was not about to do that, and she was not pacified, but she calmed down a little and we talked about other things.

Later, I wondered to myself what on earth she was trying to do. I had a vision of her back in high school, in her one and only year of Home Ec, when she made a pillow with a football player motif. I hope she’s not sewing, I thought. She’s probably making me a pillow. That pillow project frustrated her so much she said she hated sewing and never picked up a needle again. Surely she wouldn’t be sewing! She doesn’t even own a sewing machine!

A few days later, I received another call. An increasingly frustrated Rachel was on the line.
“It’s getting worse and worse! Each time I put it down I tell myself to throw it away because it’s hopeless!” she lamented.
“Don’t worry about it, Rachel,” I repeated. “It’s the thought that counts. Just put it up and tell me about it at Christmas.”
“But it’s so hard! It’s something I’ve never done before!” she sobbed.
We again changed the subject and she seemed to calm down a little.

My curiosity was aroused more and more. Something she’d never done before. Hmmm. There went my working hypothesis, since she had made that pillow back in high school. What on earth could she be doing?

The next day, ring, ring, and as soon as I heard her voice, I knew she was still trying to complete that darn gift.
“I’m determined to finish it, but I’m at my wits’ end!” she cried. “I wanted so much to make a gift for you, and it’s the perfect gift - the perfect gift! I was so excited!” She named off all the people she had talked to for advice, apparently unsuccessfully.
At this point, I said, “Look, Rachel. It’s no big deal. It’s the thought that counts, right? Just bring the unfinished gift to me on Christmas Eve, show it to me, and I’ll finish it myself, since apparently it’s something I know how to do. No big deal!”
She was unappeased. “No! Ask you to finish your own gift? That’s terrible! No! I’ve got to figure out how to do this!” She fought back tears again.
“Rachel, Rachel, Rachel,” I replied resignedly. “It’s the thought that counts. Just bring the project, show it to me, I’ll be impressed, I’m sure, at whatever you’ve done, I’ll thank you from the heart, then I’ll finish it, and we’ll laugh about this in a few years!
Apparently I’m dense.
“You don’t understand!” she cried. “I’ve hardly done anything on it! You can’t even tell what it is!” I could sense that she was starting to get a little hysterical at this point. She continued as her voice rose in increments. “It’s...it’s....it’s as if I were building you a house, and brought you to a patch of land where I had shoveled a couple of scoops of dirt, pointed at the land and said, ‘There’s your present! Don’t you recognize it? It’s a HOUSE! NOW YOU FINISH IT! MERRY CHRISTMAS!’”

At this point, I had to laugh. My mantra, “It’s the thought that counts,” was obviously falling on deaf ears. This was the most intriguing puzzle I’ve had to solve in a long time.

Finally, Christmas Eve came, and the family all gathered here for chili and to exchange gifts. Rachel took me aside. “I gave up on your present,” she said. “I just couldn’t do it, it was driving me crazy, and I just had to give it up.”
I had to ask what it was, as I was dying to know.
“It was a cross-stitch project,” she replied. “I’ve never done cross-stitch in my life, but I know you have done lots of cross-stitch and would have really appreciated a homemade gift that was perfect for you. It said, ‘LIVE LIFE SIMPLY.’” She paused. “It was perfect for you,” she repeated.
I hugged her and expressed delight and told her that it indeed was the perfect gift, and the idea that she would tackle such a complicated project just for me - one picked out for its timely message that reflected our simplicity journey - made me very happy, whether it was finished or not.

Mystery solved, we got down to enjoying our family Christmas.

The whole thing reminded me of being in the grocery store with my parents when I was a child. Greeting cards are expensive today, but I guess relatively speaking they have always been expensive, at least for my family to splurge on, and I can remember my parents not wanting to waste money on a card that would be enjoyed but immediately thrown away. So they had a mutual agreement. When my dad’s birthday was approaching, for instance, Mother would spend some time in the card display picking out the perfect card. Then she would show it to him, he would laugh or smile, express appreciation, then Mother would return the card to its place. The underlying communication in this ritual was, “I can’t afford to buy you a fancy card, but if I could, this is the one I would have picked.” No money was spent, the card was enjoyed, and that was that. It was the thought that counted.

That still rings true. Rachel took our chosen lifestyle into consideration as she chose her pattern. Then, she spent an extraordinary amount of time struggling to master a skill that she had never even tried before, reaping only frustration and disappointment. That was indeed a labor of love. I love homemade gifts, and I especially love homemade gifts picked out just for me. Rachel kept thinking the cross-stitch project was the gift, when all along it was the THOUGHT and EFFORT that constituted the gift.

I still haven’t seen the project in question, but when I do, I may decide not to finish it. I may just frame it like it is, where “you can’t even tell what it is!” Then every time I look at it on the wall, it will make me smile with the memory of this special Christmas and my special daughter. Those “scoops of dirt” are full of love in every little stitch - and the gift of love is the most incredible gift of all.

Ladies and Gentleman...

As a medical transcriptionist and a lover of the nuances of language, I have been disconcerted recently over what I perceive to be the misuse of the word “gentleman.” Health providers are sometimes challenged when they try to describe patients. Usually it’s straight and to the point: “A 53-year-old female (or woman).” “A 42-year-old male (or man).” Sometimes they reference age with an adjective: “An 83-year-old elderly man.” “A 14-year-old adolescent female.” Often it is race: “A 30-year-old white male.” “A 72-year-old Hispanic female.” These are objective descriptions that anyone could agree with.

The challenge comes with abusive, drunk, stoned patients - the “bums,” the “losers,” as I have heard them called (it even pains me to type that). The provider certainly doesn’t want to come across as judgmental, and he/she, of course, cannot give his/her true opinion of the patient’s state. Sometimes the patient is just referred to as “unfortunate,” a catch-all umbrella word which covers cancer patients as well as alcoholics, and on that we can all readily agree. However, I have noticed a trend in these instances - and that is to call them “gentlemen.” “This 44-year-old gentleman” turns out to be an alcoholic who has been admitted umpteen times in the last year for detox, who gets sent home, set up with outpatient counseling, never goes, starts drinking, and comes back again for another week’s admission for detox. In an effort to avoid insulting these patients, the providers are making extraordinary attempts to be ridiculously complimentary. I don’t want to sound judgmental here, as I myself have lived with an alcoholic for many years and I understand the torture this disease inflicts. That patient would be unfortunate indeed, but I would not confer the title of “gentleman” on him.

The first definition of gentleman is “a chivalrous, courteous, or honorable man.” Unlike the stereotypical British gentleman with a pearl-handled walking stick, impeccable suit, hat, and gloves, the above definition of gentleman doesn’t mention wardrobe or outward appearance. It talks about attitude and character.

If I think back on my 53 years of life, I can name several men I have known that I would unhesitatingly call gentlemen. It’s not a distinction I would confer upon just anyone. My grandfather’s friend, Mr. Gordon, was a gentleman. He not only had the attitude and character, but the suit to go with it. He was not related to us, but he lent his presence to many a family holiday celebration. My high school French teacher, Mr. Knight, has always been a gentleman. My high school friend Mark Williamson was a gentleman. My cousin Mike McDonald was a gentleman. My father, Ensley Tiffin, was a gentleman. And the list goes on.

Some of these men were dressed to the nines; some were more casual. But gentlemen they will always be.

Now the word “lady” is different. Although its first definition is “a woman (used as a polite or old-fashioned form of reference),” its second definition is “an informal, often brusque, form of address to a woman.”

I was called a lady once. I was taking my very first plane flight, had just made a will for the first time, had just bought a house in another state, and had just turned 40. Talk about a tumultuous year! Anyway, I was scared to death to be in that plane. The whole trip, even though the flight was smooth in beautiful weather, was a nightmare for me. Apparently it was also a nightmare for the man in front of me. As I sobbed, tried to sing opera under my breath, vocally displayed my angst - anything and everything to try to distract myself - the man in front of me finally turned around, looked me squarely in the eyes and said, “Lady - if you see me break this window and jump out and run, then you can get worried. Until then, just SHUT UP!” (I think he was using the second definition.)

It’s too bad the word “gentlewoman” has become archaic. I love the sound of that word, and I think that would be the perfect way to describe some ladies I have known. Mrs. Underwood was one. My friend Audrey May is another. My mother, of course, is one of the most “gentle-women” I have known. Again, too many to name here.

As there seems to be a shortage of common civility, kindness, and respect in society these days, it pleases me to think back on all the true ladies and gentlemen I have met. Their character will never go out of style, and I am honored to have been a part of their lives.

I still think about that poor man on the plane. Well, at least he called me a lady!

Flight Plan

Today’s my day off. I wanted to sleep late, but for some reason I woke up before it got light outside. I peered at the clock. 6:10 a.m. Too early. I closed my eyes, snuggled up, and decided to wait for the sun to come shining through the window.

That never happened of course. I mean, the sun eventually showed up, but by that time I had been up for an hour. The older I get, the harder time I have getting back to sleep once I’ve awakened. My brain just starts racing.

When medical practitioners assess patients, they sometimes dictate, “The patient has flight of ideas.” One definition of this is “streams of unrelated words and ideas occur to the patient at a rate that is impossible to vocalize despite a marked increase in the individual's overall output of words.” This is what happens to me, not verbally, but in my head. I have so many things I want to do, a limited amount of time, so many ideas, a limited amount of energy, so many quilts I want to make, a limited amount of money, etc. Sometimes I just can’t wait on the sun.

I was asked to write a few paragraphs about my professional highlight for 2007 for a Medical Records industry magazine called Advance. These days, when I have to write something, including this blog, I always extract every essence of what it has to teach me, and this assignment was no exception. The highlight, of course, was passing my CMT exam. As I typed out the details of the long year’s journey toward actually taking the test, the procrastination and excuses, I suddenly realized that passing that test was more momentous for me than it first appeared. Something I did initially only for my professional career expanded to touch every part of my life, a highly unexpected outcome! Because I passed this test, I became acutely aware that I can achieve much more than I think I’m capable of. I have been allowing financial or time constraints to restrict me in ways I don’t even think about. I, the one who has always joked about being a procrastinator and “unfinisher,” was able to set my mind and energy to doing something - and I actually did it! The question that inevitably follows is, “Hmm...what else do I think I can’t do but I really can?”

That’s really my only New Year’s resolution - to push myself, believe in myself, act as if there is nothing to prevent me from creating, quilting, cross-stitching, reading, playing the harp, writing, making gifts - even exercising - and that I possess right now the ability, time, money, and energy to accomplish all I desire. If I can keep that wonderful mindset, this year will certainly be a productive and satisfying one. I need to take my flight of ideas, put them all one one plane, make an amazing flight plan, and just take off.

I think it is true that more limits are placed on us by ourselves than are ever placed on us by the outside world. I was looking at a catalog yesterday from a store that sells distressed-looking country signs. One said simply, “What Are You Waiting For?”

What indeed? It’s a “Blank Slate for 2008.” I’m ready to fill it!