Weekly Angel/Devil Fight: Love everyone

This is my weekly (biweekly, snarls my devil) blog about the arguments between the devil on one shoulder and the angel on the other.

Do I really see an angel and a devil? Well, no. But we all use archetypes and we all have all of the archetypes within us. So when I have a dilemma or something comes up, I call the angel and the devil to the internal conference table of my mind and ask for their advice. They are going to give it to me whether I ask or not, so it’s more effective to be polite!

Ok, sometimes it isn’t a conference table. Sometimes it’s a hell scenario with bubbling lava or the fire forest from A Princess Bride… or it could be a field with daisies and a blue sky….

Today I am thinking about what we are supposed to do: Love everyone.

How good are we at that? Not very! Or are we?

My angel: You can love everyone. (The angel is kind and completely confident.)

My devil: Yeah, til they knife you in the back. Right. Go ahead, love them and they’ll treat you like dirt!

My angel: You can love them anyway.

My devil: Paula Pell said, “Be nice to all assholes because it disables them!”

My angel: Yes. You should be nice to those people too. (She doesn’t approve of swearing.)

Devil: sulking.

In my job, I get to love everyone. That is, as a doctor I want to be able to treat everyone and anyone who walks in my office. They can be talking about aliens or refuse to do what I suggest or they can say, “I hate doctors especially YOU.” and I am still supposed and do try to help them. Sometimes it doesn’t work very well. Sometimes we don’t connect or they are going to do the opposite of whatever I say or they return to using heroin. But I still get to try.

In my personal life, I would like to be the same. I am not there yet.

Devil: yeah, and don’t want to be….

Angel: keep trying….

But I can bring something from my job to my personal life. I don’t have to love what people DO and they can be MEAN and I don’t have to LIKE IT. But that is separate from the person themselves: I can still love the person even if they seem to be acting like an idiot and my devil wants to strangle them…..

Devil: oooo, strangle, I like it

Angel: separate the person from the action. Love them anyway.

Keep on trying…..

Sophistocated Noder

The picture is my daughter years ago. But hey! That’s how I am feeling at the end of the Blogging 101 class! I am a sophistocated noder! I know stuff! I know a lot more than I did a month ago! I have met other people! I have made another page! I have Big Plans!

And…. I am still a clueless newbie really, but it’s been very fun.


This photo is really my brand. In 2009 my rural county hospital dismissed me as a physician because I argued against the daily 18 patient quota that they said that Congress had set us. I said, “I will go argue with Congress.” I was not sure how I would get to Congress or when.

Meanwhile, in Oregon, a group called the Mad as Hell Doctors was readying to hit the road. Two weeks before the Mad as Hell Doctors hit the road to go across the country to give talks about single payer healthcare and to listen to citizens talk about their healthcare experiences, a friend called me.

The friend had gone to the Mad as Hell Doctors’ first program, a practice run in Sequim. It was well attended because the community had a controversy over the word “Hell”. The friend said, “It’s a bunch of older white males. They need a woman. You’re off from work: you should go.”

I researched them and called a friend who is a very experienced agitator. He said, “Do it.” I called them and my father drove me to the Bremerton ferry. I got off the ferry in downtown Seattle and was picked up on a street corner to join the Mad as Hell Doctors. I had never met any of them. That evening I was part of the program.

I was and am mad as hell and often sad, frustrated, appalled and incensed by the healthcare industry in the United States, that leaves people without care and dying in spite of costing each and every one of us twice as much as any other country in the world. And all of the CIVILIZED countries have single payer. Am I saying that the United States is uncivilized? Yes, frankly, I am. We are a country run on greed by corporations currently and I am fighting it.

The Mad as Hell Doctors traveled California in 2010 and I was there for a week of that trip. In 2011 they toured Oregon. We continue to work locally, at the state level and at the national level for single payer healthcare, medicare for all. I think that it will happen and hopefully during my career.

We ended the first trip at Congress and the White House. I sent a postcard to my former employer saying “See? I said I would go to Congress.” We haven’t won the health care battle yet but we will.

Here is a ten minute program that I did in Sequim, WA in (2012) at the American Awakening event:  Enjoy. If you want to see WHY we are Mad as Hell, watch “Health, Money and Fear” and the other videos at this site. For more information Physicians for a National Health Care Program is excellent and Health-Care Now! is also excellent.

You can make a difference. Do you know anyone who has lost their house, not gotten care soon enough because they didn’t have insurance or were under insured, or has been harmed or died because they were not able to afford or access care? Gotten sick and lost their job and lost their insurance? You, too, should be Mad as Hell and fight to change this.

Many thanks for Blogging 101

The photo is the wrong season, you think. Well, yes, but I like it and I am putting it up as a thank you for the wordpress.com blogging 101 course. It has taught me a lot, I feel much more comfortable maneuvering around the wordpress sites, plus I have gotten to meet some wonderful people virtually! Hope to meet them in “meat-space” some day, or at least some of them.

I always enjoy getting this creche out. The other figures are paper mache and turned up this summer, and I thought they fit. They are much thinner than the three kings, and probably quite poor. I hope that they survived….

Fraud in Medicine: Pain cream fraud

I got a call at home saying that there is a new topical pain medicine for chronic pain. I pressed the number to talk to the agent. I talked to Shawn. He said he was with “Health Advisors”. He asked if I have had chronic pain for long.
I said “Oh, yes.”
He said, “Can I get your name and number to have one of our associates call you?”
I said, “Can I get your number so that I can call you back? My daughter needs me.”
Shawn: “I will have to call you back.”
Me: “I am not giving you any information. Does your company have a number I can call you back?”
Shawn: “I will have to call you back.”
Me: “No way am I giving you any information.” Hang up.

The phone call started by saying that I could get this great pain cream, my insurance would cover it and I don’t even need a prescription…. I just have to give them some information. Right. How much do we want to bet that there is a little fee to cover shipping and handling and they need my credit card or bank information? DON’T FALL FOR THIS SCAM!

I looked on line for “Health Advisors”. I did find an insurance company. Nothing obvious about a pain medicine cream. I looked for pain medicine creams and found:


Live chat representative
My Pain Cream MD Live Chat
Chatting with Ben
Ben: Hello, thanks for contacting My Pain Cream MD. My name is Ben, may I have your name?
Visitor: Are you connected with Health Advisors? I just got a call about a chronic pain cream that my insurance would cover.
Visitor: They wouldn’t give me a number to call, so I thought it might be a scam.
Visitor: What are the active ingredients in your cream?
Ben: One of our representatives can discuss this in greater detail. Before we proceed, may I have your name, phone number and email to better assist you?
Visitor: No, I don’t think so. You have not answered my question. Why would I give you any information?
Visitor: Pass me on to the representative. Or if you require that information first, then I will sign off.
Ben: I am an internet agent representing the company for visitors to their website. I would be happy to pass your contact information on to a representatives who can answer more specific questions and assist you further. Would you like to speak with someone in the office?
Visitor: Are we talking live chat or are you requesting my number? Last chance … live chat and you can’t have my name.
Ben: Unfortunately, that feature is not available. I’m not a representative and am not able to answer your questions. May I have someone from our office contact you? They can assist further.
Visitor: Tell your company to go jump. Information in exchange for email and name and all? Over my dead body. Scammers.

And looking for “Health Advisors” I found:


Well, how nice. “Mr. Robert Carr for the past forty years has enjoyed tremendous success in law and pharmacy.” Um. This is an attorney, folks. “Rob designed and built the original concept specialty compounding pharmacy, United Prescriptions Services in 2002.”  Lovely. How reassuring. Don’t you just want to use a compounded medicine? Comes with free fungus…….

And my family practice medical advice?







Don’t fall for the “neutraceutical” crap. Hello, it’s food that has been extracted in a lab into pill form. What in the heck is natural about that? I have never seen a pill grow on a tree, though the way things are going….. if they grow a pill on a tree, I personally won’t take it. And you shouldn’t either.

The picture is because these scams, trying to get to people with chronic pain, make me so HOT!

Linking social media

OOO, today’s assignment for Blogging 101: Plug in to social networks.
I am not ready to attach fully to Facebook, honestly.
I also lurk on Sermo, which is a supposedly “secure” site for physicians, though why anyone would imagine anything on the internet is secure… dunno. I have found advertising aimed at companies that want to reach doctors, saying advertise on Sermo. So I am a bit careful of what I do there. They offer prizes for doing surveys, but I figure that that information goes right to the pharmaceutical companies. I don’t participate in the surveys….I’ve written on everything2 since 2005, well, really didn’t do much until 2007, but anyhow….
Got a Facebook page, go to Linked in occasionally, and have email…. AUGH!! I don’t want to be too wired. Reminds me of when we got our pagers in medical school, third year. We were thrilled. That wore off pretty darn quickly on call. Also, I date back to voice pagers, then numerical pagers and now people can text…. change change change….

I will think about the Facebook connection, but I am not ready yet. Also, my teenage daughter says I share too much on Facebook anyhow. Particularly dance videos. I LOVE TO DANCE. Couples dancing since, well, since I was a 17 year old exchange student to Denmark…. and that’s another story.

Sunrise! A new day! More change!

Lit up

I stayed in Seattle Monday night. The city is lit up with excitement about the Seattle Seahawks. I stayed at the MarQueen hotel, which is lovely and old, and went to the coffee shop in the morning. I asked about the lights in the picture: the block next door was lit up blue and green.

“It’s a park,” said the counter woman.

“Is it always lit up?” I asked.

“Oh, it’s blue and green for the Seahawks!”

It was a lovely stay.

The Tiny Soldier Part 4 (Flash Fiction Chain #5)

Here is my addition to trablog’s flash fiction chain 5, thanks!

Character List :

Rick – a not so ordinary ten year old

Jenna – a social service employee

Mrs. Montgomery (ma) – the foster mom

Jake – Mrs. Montgomery’s only son

Sun – The monkey


Read the first three parts before venturing this part.

Part 1 : Written by Abirami

Part 2 : Written by Sona

Part 3 : Written by hiddenstarsfiction

Part 4

Rick settled on the ground and Sun stood on the wires above him.

“I think better in motion, O Best Beloved.” said Sun. “You desire to know how I became the monkey? The first monkey?”

“Oh, yes,” said Rick. Books were his hiding place and passion and escape as a foster child, but to have someone TELL him a story….  He tried not to think about it or hope. They would probably be interrupted.

Sun looked up at her namesake, starting to warm the dry courtyard. “A’Tuin, the giant turtle who swims, you know of him?”

Rick nodded. “Discworld.” he said.

Sun frowned. “Oh. This isn’t Discworld, is it.” Rick shook his head. “You know that there are many universes? And many stories. Which is your origin story?”

“This is earth,” said Rick reluctantly. He often wished it were Discworld.

“Many stories.” said Sun, “You know many origin stories. In the Garden, Eve was made from the rib. That is what the book says. That is part of the story.

After Lucifer left heaven and became the Snake, Lucifer wanted power. Adam and Eve were to be thrown from the Garden, all for eating the Apple from the tree in the center. Adam and Eve had covered themselves and were hiding. They had named the animals and plants that were present but there was no Monkey.

Lucifer Snake wept out of frustration and rage. “Eve is too weak. She is only a rib. She can’t bear the children and bear the blame for the apple as well.” One of Lucifer Snake’s tears fell into the dirt. It held some of Lucifer’s remaining power from Heaven. The tear and the dirt shuddered and…”

“What are you doing?”  Jake was standing in the sun, his shadow falling over Rick.

Rick scrambled back. “Nothing!”

“Yeah?” said Jake. “Nothing? Stupid.”

“Isn’t your show on?” Actually Jake had shows all day. He did nothing before school but watch tv and after school he alternated. TV. Movie. TV. Movie. Ever since the game platform had broken. They couldn’t afford a computer or internet right now anyhow.

“Power’s off.” Jake muttered, head down. He was kicking at a pile of dirt.

Rick knew that Ma would not get the check for another two days. Then there would be a fine to turn the power back on. It had happened twice in the last five months. Eleven foster kids and Jake, but there was never enough to go around. Ma might be able to get help from the church, but she’s said she couldn’t use it too often or they’d cut her off.

“Army,” said Jake. “I told Alf and Wheeze that they are playing too. Now.”

Rick got up. He didn’t dare look at Sun and he didn’t want to get pounded. He wanted the story. He hoped Sun would understand.

In bed in the dark, tired, he worried that Sun would not come back. They were out of bananas and really out of most things other than oatmeal. At least they had that.

And the deep voice woke him. “The tear and the dirt shuddered. I rose out of it. I didn’t know who I was or what I was for. Lucifer looked at me and started laughing. “Go to them. Go to Adam and Eve and get your name.”

Adam had done the naming, but he had fallen asleep in the terror of the Apple. I went and there was Eve. She looked at me and said, “Hello. You are Monkey.” I threw my arms around her neck and cried. My tears carried Lucifer’s power and dripped onto her shoulder. The tears entered each cell and added power, and Eve passed them down to each child.  Through the mother, only. You too have Eve‘s mitochondria.

And that is one story of how I became the Monkey.”

Rick was crying a little. He hoped Sun couldn’t tell. He didn’t remember his mother. He wished he did. And he was tired, he didn’t like playing Army with Jake and Wheeze had skinned his knee and bled and Ma had been upset. “We are out of band-aids!” She used soap on the scrape and Wheeze had cried. Rick had tried to do what Jake said without getting hurt, but he didn’t like Wheeze getting hurt either.  He was also so glad that Sun had come back that he could hardly bear it.

“Will you tell me more stories? Please?” he whispered.

“Yes,” said Sun, “Now sleep….”

Part 5  by : Austin

Part 6 by : Phaena

Part 7 : Written by Tobias

Part 8 : Written by  Priceless Joy

Part 9: Written by Raskmik

Part 10 : Written by Manvi

Part 11 : Written by Sweety

Adverse Childhood Experiences 2: Out on a Limb

We are approaching a seismic shift in psychiatry. I am now going out of a limb to predict the direction we will go in.

The allopathic medical community will resist, including many psychiatrists. But it is the neurobiologists and brain imaging and psychiatrists who will prevail. If the creek don’t rise and we aren’t hit by a giant asteroid, nuclear winter, devolve into fighting over the remaining arable land as the world heats up….

I have been thinking about this all through my career, but especially since the lecture on adverse childhood experiences, which I heard in Washington, DC about ten years ago. I wrote about that lecture on January 6, 2015. The lecturer was a woman. She said that it appeared that the brain formed differently in response to childhood adverse experiences. She said that we don’t yet know what to do with this information.

Staggering understatement. I went from that lecture to one about ADHD. The lecturer was male. He said, “Children diagnosed with ADHD have brains that are different from normal children on PET scans and functional MRIs. We don’t understand this.” He sounded puzzled. I thought, he didn’t go to the previous lecture….

Childhood adverse experiences are scored zero to seven. I score a five. I am at high risk for addiction. I assumed this when I realized at age 19 that my father was an alcoholic and my mother was enabling. I was very very careful about alcohol. I tried pot twice and didn’t like it. I refused to try anything else, and refused benzodiazepines when I was depressed: they are addictive. With an ACE score of five, I am also at higher risk than a person with a score of zero for ALL mental health diagnosis: ADHD, depression, bipolar disorder, obsessive compulsive disorder, etc. People with a score of five had a 60% chance of being diagnosed with depression compared with a 10% chance in people with a score of zero over the life of the study. In the last fourteen years I’ve only been diagnosed with a “grief reaction” which is a temporary reaction to grief. It is also called an adjustment disorder. High adverse childhood experience scores are also at higher risk for morbidity and mortality from heart disease, emphysema, arthritis, basically everything and tend to die younger.

What this means, I think, is that our brains are plastic in utero and in childhood: the wiring is put down in response to the environment. This is adaptation. I have crisis wiring: my mother had tuberculosis when I was conceived and born. Really, from an evolutionary standpoint I AM weird: babies whose mothers had tuberculosis died. Quickly. I was saved because my mother coughed blood one month before I was due. A lot of blood. She thought she had lung cancer and would die. The fetus is bathed in those stress hormones, grief, fear….

I was removed from my mother at birth to save my life. I then was removed from people at 4 months and at 9 months. I grew up trying to be independent and highly suspicious of adults.

I predict that we are going to revamp all of our ideas about mental health. The brain wiring is set up depending on the environment, physical and emotional, that the child grows up in. My friend Johanna was outraged in college when we learned that the fetus and placenta basically take over the hormones of the woman for 9 months. “I’m not letting some baby grow in me and do that!” Johanna said. “I am going to figure out how to implant the pregnancy in a cow. You take good care of the cow and you can drink beer through the whole pregnancy! The cow won’t even notice when the baby falls out!” She has three children, an MD and a PhD in genetics. She did not use a cow.

The brain wiring is an adaptation to the environment. If there is war or domestic violence or addiction or mental health problems, the child’s brain kicks in emergency wiring. This is to help the child survive this childhood. As an adult they are then more at risk for mental health disorders, addiction and physical health disorders.

In the end, the sins of the parents, or the terrible circumstances of the parents, are visited upon the children. We have to take care of the children from the start in order to be healthy.

And people who have low adverse childhood experience scores don’t understand. They grew up with nice people and in a nice environment. They wonder why people can’t just be nice. The fear and grief and suspicion and emotional responses that appear maladaptive in adults, that is what helped people survive their childhoods. That is what I remember each time I see an addict in clinic, or someone who is on multiple psychiatric medicines, or someone who is acting out.