Powergirl takes off

The photo yesterday is of my daughter on the beach, but she is in the air. She is not touching the ground at all. And today the picture is my son airborne at the beach. I wrote this poem in 2005. When I found each of those photographs, I thought of this poem.

Why, you say, does this poem leave the articles out? I went to high school in Alexandria, Virginia. Yes, I was a Titan and graduated from there. In Alexandria when we were really angry or really passionate, the articles got dropped. I try not to talk like this in the northwest, because people get scared. I am also influenced by Walt Kelly’s Pogo and all of the messing around with language and spelling. Stephen Fry on language (https://www.youtube.com/watch?v=J7E-aoXLZGY) is a lovely comfort!

Previously published on everything2 August 25, 2009.

Powergirl takes off
Powergirl have wings
to fly
She related to
Superfly
She scared when
baby almost die
She scared and yes’n’she
do cry

Husband say she much
too strong
He say she most allays
wrong
He sing and dance de
same old song
He rather she put on
a thong
He played too much with
that old bong

Now man he working
ooh he big
He have no time for
little kid
Not that he ever
really did

She research kidses
summer camps
She study schedules late
with lamps
Pay de money, lick de
stamps

Husband say she got too
much power
He say it nearly every
hour
He grumpy sullen and really
sour

Powergirl got wings
to fly
She look with longing
at the sky
She look at husband
wonder why

She finally realize he
a pain
She take a saw to
ball and chain
Husband he whine and
complain
She wonder why he
goddamn insane
She learn divorce lawyer
nice name

Husband lie on ground and
moan
He whine and bitch all on
de phone
Powergirl leave him there
alone
He drink and fuck and get
real stoned

Powergirl have wings
to fly
She rising rising
in the sky
Kids light as she is
hollow bones
They scared to leave
familiar home
Ride on her shoulders
in the sky
She hopes that they will
learn to fly

mermaid

This poem is related to yesterday’s post about learning to keep my temper. I wrote it in April 2012.

mermaid

when I was born, they took my skin

i had no skin
i was frightened
i wept

a witch came
she studied me
i turned my head from the spoon

“Good,” she said, “You may refuse it if you want.”

She gave me the gift of anger

it was the only defense I had

but over the years
I studied and thought
and I found my tears
and I found my fears

i made my skin of tears
this took me many years
one tear for each hair

at last it is done
my skin
is complete

i smile at the sky
as i don it

i slip into the water
and i am gone

If you have to cry, do it on the boyfriend who wants you to be angry instead of sad

I used to have a temper that could be set off really really easily.

I had a boyfriend right out of college that said that I didn’t get angry “right”. He had a PhD and I was a mere done with undergraduate person, so what did I know? I went into counseling for a year.

Finally I said to him, “The counselor and I have tried presenting anger to you in every possible form and none of it is acceptable. So now she says you need to come to counseling too.”

His response: “What I want is for you to never get angry at me again.”

Mine: “You are dreaming.”

And so he broke up with me. Immediately. And said I was an ogre when I was angry.

I went back to counseling and was depressed for a year. Then I cheered up, met a boyfriend and went to medical school. I worked on my temper, remembering the ogre comment. I did not want to be an ogre. My boyfriend became my husband and he really liked my dark side and my silly side.

My sister was the person who could set me off angry the most easily. She and I fought like pitbulls, like honey badgers. Once we were in Colorado with my husband, her first husband and my parents. The two husbands had an imitation pretend fight acting as me and my sister. They were vicious. It was horribly embarassing and also funny, because they nailed us both.

In residency in Portland, I had a breakthrough. My sister was divorced from the first husband by then, and with the no meat, no dairy, really pain in the butt boyfriend. We were having a big party, lots of people, grilling salmon and cooking in a group. My sister walked in.

“Oh.” I said, “You didn’t RSVP.”

She fired up instantly. “What? Why does that matter? Do you want me to leave?”

I did not fire up. I held my breath and then said, “No. But if you are here with No Meat No Milk, I didn’t make any food for him, because I did not know you were coming. There is lots of food. You are both welcome to stay, but he will have to figure out his own food.” Then I held my breath again.

There was a long pause. My sister had her breath drawn in and held. She looked like she was going to explode. But I had answered quietly. She really had nothing to explode at.

“We will stay then,” she said, grudgingly. And there was No Meat No Milk. I was pretty happy when she ditched him. But I was also happy that I had not exploded back at her.

That was when I really got control of my temper. Not that I never lost it again, but I was no longer an ogre. I could hold it with my sister. My husband could set me off, but when I stepped back and started recording what he said and my responses, I could hold it there too.

After we divorced, I had one boyfriend who moved in. I had joked to a friend that my family had a lot of enablers and enablees, but that the latter lived longer. I said if I had to be one or the other, the latter seemed better for longevity.

And that boyfriend showed up immediately. I had just been “strongly encouraged” by my employer local hospital to open my own private practice. That is, I was not seeing patients. I was writing a business plan. I met him in a bar, salsa dancing. He said I was cute and I said, “No, I’m prickly.” I swear, it was that sentence and my dancing that attracted him. I always grin like a fool when I’m dancing. I love it. It lights me up.

Anyhow, I got mad at him exactly twice before he moved in. Boy did he come down on me for getting mad and punished me very thoroughly. By now you are wondering why I let him move in and frankly I was too. But my intuition was running the show and I just let it.

Well, he had kissed me like crazy at the start of the relationship. He stopped kissing me, almost as he moved in. He had insomnia. He’d fixed up one of the two upstairs bedrooms. He started sleeping with me less and less and sleeping in the other room, on cushions.

I would wake, worry. I started moving too. I moved to the guest room. I moved to the couch. Once I was out of the theoretically shared bed, I could go back to sleep. He protested that I shouldn’t move. Why not? I was getting insomnia from worrying about him leaving more and more.

He said we’d need couples counseling eventually. I said, ok, and scheduled it. He said, “I didn’t mean now!” I said, “Well, seemed like we might as well get it out of the way.”

He told the counselor I needed to either cut my sister off or do what she said, but instead, I was present and disobeidient. My sister had metastatic breast cancer and we came from an alcohol addiction family. Can you say complicated relationship?

I explained to the counselor that I thought many patients with cancer end up in a “cancer bubble”. Everyone tries to do what they say because they have cancer. This isolates them and does damage to the relationship. I was trying to stay present and real. That is, I did not obey. I was getting pressure from other people to obey, because my sister would complain about me. Whatever.

The counselor thought I was reasonable. I brought up the sleep issues. The boyfriend cancelled the counseling, saying that he needed a break.

At six months living together, he was saying that he might need to go back to the city to work. Two hours away. And I still was not doing what he wanted re my sister.

Counseling again. Again my behavior to my sister was examined. Same story. I turned to him. “I hear you saying you may need to return to the city for work. I hear you saying you may need to move there. What I don’t hear you saying is darling, we will get through a long distance relationship. Are you breaking up with me and not telling me?”

Long silence.

The counselor said, “You need to answer her.”

He finally said, “I wasn’t going to tell you until after I moved.”

I cried. We left. I kept crying.

He said, “You are angry and you are going to throw me out on the street.”

“No!” I said, “I am sad! You move out when you are ready! We will remain friends!”

So then I cried buckets. I cried on him, buckets. I cried every time I saw him, I cried daily, I cried about him, about my sister, about alcoholism, about the hospital getting rid of me. I cried about everything. I cried on him daily.

For six months. He kept saying “You are angry. You are throwing me out.” But I didn’t. I just cried more.

He moved out on the weekend I returned from seeing my sister in hospice for the last time. Her birthday was March 23. I saw her last on March 22. My birthday was March 28. She died March 29. He moved out on the 26th and 27th. I was not mad, I just cried and cried and cried.

I think that he was looking for an angry girlfriend. He thought he’d found her when I said I was prickly. He would have been the enabler and I would have been the angry dysfunctional enablee. It turns out that I was not really interested in being an enablee. Now I want a healthy relationship.

So that is my recommendation. If you have to cry, do it on the boyfriend who wants you to be angry instead of sad.

Evolution

I like this poem: http://seshatwuji.wordpress.com/2014/10/07/birth-of-the-global-brain/

I am posting a poem that I first posted on everything2 on June 6, 2014.

Evolution

The boys keep building machines
They get more and more complicated

The girls use the machines, some

The boys plug in
wire up
log on

The girls tweet
Sometimes they twerk

Some boys twerk too
And some girls log on

The boys write more languages
more programs
they translate from one to another
it all moves faster
They play games where they kill bosses
Online in groups
By the tens of thousands

It all looks a little insane

Don’t worry
Don’t fear

The boys keep building

In hopes that they will come

Some girls build
They hope they will come too

The girls are the Borg Queen
Some boys are too

“We will assimilate you,”
they say

The boys and girls say,

Yes

Please

Yes

Opiate overuse: a change in diagnostic criteria

In the DSM IV, that is, the Diagnostic and Statistical Manual of Mental Disorders, opioid dependence disorder and opioid addiction disorder are separate. Everyone on a chronic pain medicine for a length of time was expected to be dependent, but not addicted. Addiction was considered rare and was thought to be mostly people who abused opiates. Who took them for pleasure. Oxycontin, heroin, vicodon. Those bad people who were partying. Got what they deserved, didn’t they?

That has changed. My feeling was that it’s been a long time coming, but no one asked me.

In the DSM V, opioid dependence and opioid addiction have been combined into “Opioid Use Disorder”. They are no longer considered separate. They are a spectrum. Anyone who is on chronic opioids is on that spectrum. This is a big change. It has not really penetrated the doctors’ consciousness, much less the patients.

It is quite simple to score. There are 11 criteria. They are yes and no questions. Score and add up. The patients are scored mild, moderate or severe.

Here are the criteria:

Opioid Use Disorder requires meeting 2 or more criteria; increasing severity of use disorder with increasing number of criteria met.

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.

2. Recurrent substance use in situations in which it is physically hazardous.

3. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.

4. Tolerance, as defined by either of the following:

(a) a need for markedly increased amounts of the substance to achieve intoxication of desired effect.
(b) markedly diminished effect with continued use of the same amount of the substance.

5. Withdrawal, as manifested by either of the following:

(a) the characteristic withdrawal syndrome or
(b) the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.

6. The substance is often taken in larger amounts or over a longer period of time than intended.

7. There is a persistent desire or unsuccessful efforts to cut down or control substance use.

8. A great deal of time is spent in activities necessary to obtain the substance, use of the substance or recover from its effects.

9. Important social, occupational, or recreational activities are given up or reduced because of substance use.

10. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

11. Craving or a strong desire to use opioids.

Mild substance use disorder is yes to 2-3 of these.

My chronic pain patients ask, “Why do you treat me like a drug addict?”

The answer now is, “Because you are on a chronic opiate.”

I am starting to use the criteria in clinic. When I get a new chronic pain patient, I give them the list. I let them tell me.

It is hard because they often recognize 3 or 4 or 5 or more things on the list. They say, “So this is saying I’m addicted.”

“I’m afraid so.”

They grieve.

I am posting this because people are dying. The number of people dying from prescription medicine overdoses taken correctly has outstripped illegal drug use deaths, approximately 27,000 unintentional overdose deaths in 2007.

Here: CDC Grand Grand Rounds: Prescription Drug Overdoses – a U. S. Epidemic.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm

The CDC article says: “The two main populations in the United States at risk for prescription drug overdose are the approximately 9 million persons who report long-term medical use of opioids, and the roughly 5 million persons who report nonmedical use (i.e., use without a prescription or medical need), in the past month.”That is “approximately” 14 million people.

Please tell your friends and those you love about this. Thank you.

first published on everything2 on June 4, 2014.

Don’t be perfect, ok?

This reminds me of a kid’s book I had, or possibly have. I may still have it. I don’t exactly know where it is. I’m not perfect. Anyhow, the book is about Peter Perfect, who did everything right. The drawings of the other kids being “bad” were fabulous. At the end the secret is revealed: Peter Perfect is a robot, with a large wind up key in the middle of his back.

I got this link from Big Red Carpet Nursing’s blog, about perfectionism being a big risk for suicide. Many thanks!

http://psychcentral.com/news/2014/09/26/perfectionism-linked-to-suicide/75399.html

In preparation

I wrote this on 9/26/14 in the midst of much frustration and my lungs still hurting three and a half months after I got sick. I am off from taking care of patients, but still have to try to get my business covered and my patients taken care of. I think there is a component of my vocal cords not working because I am told that I am wrong and to shut up so often.

Favorite example is a Seattle Infectious Disease doctor that I called to ask for help with an infection in our town. He said, “You are a rural Family Practice Doctor. Why would I listen to you?”

I said, “I’m a girl too.” and hung up in frustration. That attitude will not win him any referrals from me. On my permanent stupid moron list, along with an amazing number of specialists. They are either respectful or they aren’t.

Currently I am on no alcohol at all, because I have to do a special diet before a 24 hour urine test. Means no caffeine either, ouch, headache.

In preparation

Today I will start drinking
now
even though it’s only 9:40
in the am

I will stretch two beers
through the long hours
as the alcohol
blocks the receptors
and numbs my aching heart
and lungs

and I will stay home alone
today
so that I won’t talk

time
to rest my voice

in preparation
for the next round
of talk

where I am told
in no uncertain terms
to sit down
and to shut up