How Not To Be Depressed, Part 2a


2. Intentionally live a healthy life.

If you want to not get depressed, then live a physically healthy life. Go to bed early, eat a healthy diet and get plenty of exercise. Your emotions travel the biochemical and nerve routes of your body. A healthy body is a precursor for a healthy mind. There actually was a time and a place on this planet where the body and soul were accepted as a single entity. Contemplate that concept, why don’t you? Now, in the United States, the psyche has been divided into mind, emotion and spirit with separate specialists for each one. The body is an entirely different matter.

It doesn’t work. The mind and the body are parts of a single whole and what happens to the body affects the mind. Nobody knows where the body stops and the mind begins but some people are trying to sort it out. Consider the fellow who traveled, studied, and created a yoga center. Then, at age 32, he went to medical school because he wanted to learn more about the mind/body connection. Dr. Gerry Edwards now practices a particularly understanding form of family medicine. Would God that all physicians were so diversely trained.

Two things that are known about the mind/body relationship are that the immune system and points in the nervous system correlate to depression. Lower back pain goes hand-in-hand with depression. I first saw this during the many hospitalizations I experienced at St. Joseph’s Hospital. St. Joe’s was a general hospital where people would go to be treated for their back problems and then find themselves transferred to inpatient psychiatry for treatment of their depression and nobody realized that the two were connected, but there were too many bad-backs-with-depression for it to have been a coincidence.

Then a friend called me for counseling: her son, who had frequent episodes of depression, was now suicidal for the first time in his life. After much woman-talk about the fellow’s feelings, his mother just happened to mention that her son was a construction worker and three days prior had injured his lower back in a work accident.

You can’t learn anything new until stop you stop doing old things and leave vacancies for new things to enter. Last year I utterly renounced physical medicine and opened the door for new treatments to enter. One of the things I found was craniosacral massage.

According to Wikipedia, “Craniosacral therapy (CST), or cranial-sacral therapy, is a form of bodywork or alternative therapy focused primarily on the concept of ‘primary respiration’ and regulating the flow of cerebrospinal fluid by using therapeutic touch to manipulate the synarthrodial joints of the cranium. To do this, a practitioner will apply light touches to a patient’s skull, face, spine and pelvis. Craniosacral therapy was developed by John Upledger, D.O. in the 1970s, and is loosely based on osteopathy in the cranial field (OCF), which was developed in the 1930s by William Garner Sutherland.

“According to the American Cancer Society, although CST may relieve the symptoms of stress or tension, ‘available scientific evidence does not support claims that craniosacral therapy helps in treating cancer or any other disease’. CST has been characterized as pseudoscience and its practice has been called quackery.”

Unless, of course, you’ve actually experienced craniosacral therapy, as I have. I was physically wrecked and knew it, so I got a physician’s referral for physical therapy and—lo and behold—what the physical therapist offered was not a series of bending, stretching and lifting exercises: what he offered was craniosacral therapy (CST). (A brief aside here: off and on for about three decades I have used the services of a physical therapist who does the bend-stretch-lift stuff. When I went in search of him this year, his group told me that he’d left and they didn’t know where he currently was practicing, hence I met this new fellow who does CST. One wonders about God’s direction in one’s life.)

So physical therapist Chris Scanlon entered my life and, as he gently began to massage me back into some semblance of goodness, he explained that depression is associated with three points in the body: a spot in the middle of the skull, the OA joint (which is where the spine enters the skull), and the sacrum (which is at the base of the spine). According to the learned Chris, tightness and strictures in any of these three places is consistent with depression. If you can, through the subtleness of CST massage, release the restrictions in these areas then you will also be relieving the depression. Hey, works for me, babe.

According to Chris, the complications in the OA joint in my neck were among the worst he’d ever seen. He said that the problems to tendons, ligaments and muscles can be caused by distress at birth, whiplash in a car accident, and many other things. There’s no telling when or where the damage came from but it’s certainly there. Likewise, it is “there” in the lower back—the sacrum—after a construction accident.

A sensitive and thoughtful practitioner of craniosacral therapy can lightly lay hands on these places and subtly apply pressure until the cramped-up joints start to release and let natural healing take place. There are no negative side effects. Positive side effects may include thoughtful, hour-long conversations with a nice man who is kind and full of interesting ideas.

So if you don’t want to be depressed, take good care of your spine—top and bottom—and if you have some kind of accident then go see a craniosacral therapist. And read the rest of the Wikipedia entry: http://en.wikipedia.org/wiki/Craniosacral_therapy. The American Cancer Society should confine itself to talking about cancer, not “any other disease.” It doesn’t know dick about depression.

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How Not To Be Depressed, Part 1


1. Choose your parents carefully.
There are two issues here: first, genetics and, second, child-rearing practices. According to the National Institute of Mental Health’s research, there is a gene for depression and it comes in a long form and a short form. Get two of the short-form genes and you could be in for a lot of depression.

This may or may not be true. You may have a depression-vulnerable gene but it still takes something to activate it, to trigger it. Like alcoholism, you may inherit the gene but not turn it on. For example, if you grow up on a farm and then become a farmer, and the nearest bar is a long ways in town, you may never become an alcoholic. On the other hand, if you grow up in a family that drinks a lot, get a job in sales or advertising, and your office is next door to a bar then you may trigger your alcoholism gene. Genetics do not determine your life; rather, they give you a particular vulnerability.

Depression is repressed anger, so choose parents who know how to deal with anger. A young woman had a little boy whom she disciplined for doing something wrong. It made the little boy angry, which was understandable, but what the mother did was nothing short of amazing. As the angry child stomped off, his mother called him back, held out both her hands, palms up, and told the boy to hit her hands. In his anger, he at first refused but she insisted so finally he did, then went off to play. The child was too young to understand his anger and have a good chat with his mom about it, so what she did was simply acknowledge that he was angry, and accept—indeed, insist—that he express his anger. What is most amazing about this is that the woman was my sister and she had been raised in a home where anger was totally unacceptable.

My parents were both disappointed in their marriage and therefore perpetually angry with each other. Like the man said, “I can tell if my wife’s mad at me by the way she smacks the pans.” Yepper, yepper, yepper. When there is anger then its message permeates a home. My parent’s anger made me angry. I wanted to yell at them to STOP IT! Get over your anger! Love each other—love me—I can’t stand this constant bickering!

But any sign of anger from me resulted in my mother snapping “Don’t talk to me that way, young lady!” This would be followed by “Don’t use that tone of voice” and “Take that expression off your face.” So if you don’t want to get depressed then get parents who can tolerate your anger and work with it. Like the man said, “The best preventative psychiatry is having children at the right time for the right reason.” A friend of mine believes that children and their potential parents negotiate the terms of their relationship before they are born. I have no idea whether or not this is true but it certainly does raise some interesting questions. If you chose the losers who parented you, then why?

Depression is taught. If you had parents like mine then you were taught at a very early age that you were not to show any signs of anger. Americans are very ill at ease with their anger. They don’t want to feel it or know it. “Anger be gone!” is the rallying cry of modern Americans. There is the common belief that everything—marriage, job, love, life, et al—will fall apart if anger is acknowledged. There is the pretense that if you don’t see or hear anger then anger does not exist. In other words, stuff it inside and it ceases to exist. Except that it now turns up as depression. You have been taught depression and you have learned the lesson so well that you may carry it with you for the rest of your life.

You must dare to admit your anger to consciousness. So what is there to be angry about? The perception of powerlessness. That little boy who got angry at his mother didn’t see anything he could do. She was bigger than he was, and she’d disciplined him. She had power and he didn’t—but she gave him power. “Here,” she said, “go ahead and hit me.” And years later, when he grew up and got words, he could say to his wife, “Hey, lady, I’m really angry at you. We need to talk.”

Growing up is all about embracing power, and good parents carefully and thoughtfully prepare their children for having power, which is very different from simply denying them power. The kid turns 16 and wants his driver’s permit but his parents won’t let him get it because he’s “not responsible enough.” What did his parents ever to do teach him responsibility? Or did they just wait around, expecting him to acquire responsibility all by his little self? The wisest parents I knew believed that their children belonged to God and had their own lives to live, and that God had just loaned them the children for 18 years to get them ready to be independent. Contrast this to parents who believe that children are their possessions and the children’s most important activity is to make their parents look good.

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So What’s New?


The biggest news is that I finally have a home health aide. She is five feet tall, top-heavy, and 58 years old. She has eight children, 24 grandchildren and 3 great-grandchildren, and there’s no nonsense about her. She knows what needs to be done, how to do it, and does it. Her theory on young black girls and old white women is that today’s young girls, regardless of color, have no desire to work and do everything they can to avoid it. I have no regular contact with young girls so I can’t assess whether or not this is true but after waiting eight months and going through four girls who didn’t work, I am almighty glad to have this lady. She snarks around my kitchen muttering, “Didn’t any of them ever clean anything?” My apartment is slowly getting really cleaned, and the pressure is off me. I no longer wake up thinking, “What do I HAVE to do.” Actually, I woke up from a nap this afternoon thinking, “I want to write something!” Except I don’t actually want to. Mostly, I want to HAVE WRITTEN something.

There’s the piece about “Wheeling the Westcott,” a piece about depression, one about Centro, and another on how bad Upstate Medical Center is. I have a 74-year-old friend who is underweight and has a colonostomy. Upstate made her put on a paper gown and sit on a metal folding chair in a back hallway during the winter for over an hour. That’s my enduring image of Upstate: cold, heartless and unsympathetic. But I’m not much in the mood to discuss it.

Mostly, I regret the passing of summer. Today is cold, gray, overcast and the first day of fall—equal parts darkness and light. It is about time to get out my lightbox. N.B. Readers: if you start to sleep a lot, can’t wake up in the morning, have changes in your bowel habits and feel irritable then you’ve got seasonal affective disorder (SAD). If you do nothing about it now then in a couple months you will feel depressed. Your doctor will prescribe antidepressants, which probably won’t do much good. The fact is, you are suffering from SAD. Syracuse has as little sunlight as Nome, Alaska, in the winter. Check out the statistics: we have, like, no sunlight. Get a lightbox with full spectrum light and reintroduce sunlight into your life. All living things need sunlight to grow. (At this point I would go on the Internet and give you some facts about lightboxes but a friend helped me fix my computer and now I can’t get on the Internet at all. Does anybody know a computer guy who works cheap?)

I’m seriously considering getting out of bed and cooking. Tuna macaroni salad? Tossed salad? Brownies? All of the preceding? Despite the horrific turnover of aides who can’t cook, I have managed to stay off Meals on Wheels. The MoW people are, by and large, very nice and they provide good meals for Food Stamps. Not great meals, but good enough. Problem is, after while I got to craving the old family recipes. Aides would advise me of different/better/healthier ways to cook; they just didn’t get it that at 67 and after a year of nursing home/hospital/Meals on Wheels, I just wanted things to taste like my mom cooked them.

MY chili con carne is Old WASP Chili and has one pound of hamburger, two cans of diced tomatoes, two cans of light red kidney beans, one onion, some salt and some chili powder. Period, end of discussion. That’s the way I want my chili. And vegetables! Do you know that the Iroquois Nursing Home, Crouse Hospital and Meals on Wheels think that one-quarter cup of canned or frozen vegetables is appropriate? Me, I think two-thirds of a cup of fresh vegetables twice a day is proper. Once I stopped eating junk food back around 2001, my palate cleared up and fresh vegetables without additives became tasty. Carrots, green beans, beets—do you that no home health aide has ever seen or heard of a fresh cooked beet? Canned beets are only good for pickling—fresh beets are the bomb.

So here’s the deal: I’m muddling along just fine. Emotions are stable; cognition is fine; tiredness is usual. I met with the homeopaths today and they advised one dose of remedy and report in two or three days. I have been adequately taking care of business—buy new bras, go to the Westcott Festival, call the cops on the Syracuse University kids. S.U.’s the No. 1 party school? Not on my watch. Saturday while we were losing to Maryland about two hundred kids congregated behind and between apartment buildings and in a vacant lot next to the Temple across the street from me. Two hundred kids are a pretty noisy mob and they were trashing the vacant lot. That just ain’t right.

Now here’s a really good thing: at the Westcott Festival the library had a used book sale and I got ten murder mysteries for $6.50. That’s righteous.

I think I will go integrate the new books with the old books. I, being reasonably peculiar, like to read my books according to publication dates so I will go organize them so I have a good winter’s read ahead. It is not unlike a squirrel stashing nuts. And, by the way, yesterday I discovered that a squirrel can out-run a power wheelchair. I was coming home through the park and the squirrel was on the top edge of a fence. Instead of breaking to the left or right, it stayed on the fence-top and ran like heck. The only other thing that can outrun a power wheelchair is a young man on a bicycle. Old guys can’t do it.

So I wish all the best to you—a warm bed, fresh brownies and a good murder mystery. Winter is icumen in.

Namaste

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And Now the Idiot du Jour’s Boss


[Consequent to http://annecwoodlen.wordpress.com/2014/09/07/dr-w-c-elliott-the-idiot-du-jour/%5D

Dr. Michael Iannuzzi, Director
UHCC Adult Medicine

MR Nephrology Dr. Elliott

Dear Dr. Iannuzzi,

I am in receipt of your letter of Sept. 10 regarding the above-captioned matter in which you threaten to terminate my health care because of unspecified “inappropriate behavior.”

My people have been Americans since the mid 1600’s. Perhaps you are unaware that the American way is (1) to presume innocence until proven otherwise; (2) to require a bill of particulars of the alleged wrongful acts; (3) to hear both sides of the story, and (4) to have an impartial judge. You have set yourself as judge based on what one of your doctors told you without regard to my statement of events.

For my side of the story see the enclosed complaint to the NYS Dept. of Health, Office of Professional Medical Conduct.

I will sign your required Patient Bill of Responsibilities after I receive—in writing and signed—an apology from you, and a statement of wrongful medical practice from Elliott.

Meanwhile, I have advised my health care proxy that Elliott is never to attend me, even if I am at risk of death.

Sincerely,

New York State Department of Health
Office of Professional Medical Conduct

COMPLAINT

Explanation
In April 2014 I was referred for catheter change to the Nephrology Clinic at Upstate Medical Center. I had to wait five months for a new-patient appointment.

At the appointment, Dr. Elliott walked into the treatment room, gave me his name and shook my hand. He then stuck his face close to mine and asked me if I knew who he was. Puzzled by the question, I replied, “A nephrologist.”

Then he asked if I knew where I was.

This was not a standard new-patient appointment; this was a non-psychiatrist beginning the interview with a complete stranger by asking questions intended to elicit orientation to place and person. It was inappropriate, unnecessary and rude. Nevertheless, I replied, “The Nephrology Clinic.”

Dr. Elliott then sat down and stated, “You don’t have diabetes insipidus.”

Stunned, I said, “What?”

Elliott repeated, “You don’t have diabetes insipidus.”

I asked, “On what do you base that decision?”

Elliott replied, “I read your lab work.”

I responded to Elliott’s illegitimate statement by sputtering, “Bu—bu—but, Dr. Moses! This hospital . . . international expert . . . tests!”

Elliott repeated that I do not have diabetes insipidus. I asked him to please open the door so that I could wheel out of the treatment room and away from him.

Back in the 1990’s an internist, a nephrologist and an endocrinologist each independently did testing and arrived at the diagnosis of nephrogenic diabetes insipidus.

Around 1991, I was urinating all the time, consequently I got sent to a primary care physician who ordered a 24-hour urine and blood tests. When the results came back, she told me I had diabetes insipidus. I cheerfully replied, “You can fix it can’t you?”

“Um, no,” she said. “It’s permanent.”

Then I went to a nephrologist, Dr. Green, who admitted me to hospital and did a dehydration test, which consisted of denying me liquids overnight and weighing me every hour all night. I lost ten pounds just from producing large quantities of urine.

A healthy person excretes less than two liters of urine in 24 hours; I was putting out twice that amount just overnight. I had diabetes insipidus. “Diabetes” means large quantities of urine; “mellitus” means sweet-smelling; “insipidus” means odorless and colorless. Diabetes mellitus is a disease of the pancreas; diabetes insipidus is a kidney disease. Diabetes insipidus means that you are basically excreting clear water and not concentrating urine.

My next stop was Dr. Arnold Moses at Upstate Medical Center who is an endocrinologist and an internationally acclaimed expert on diabetes insipidus. He put me in one of his research programs and reported that my 24-hour urine output was 9.6 liters—about five times normal.

Diabetes insipidus comes in three forms: neurogenic, nephrogenic and psychogenic. Neurogenic means that the posterior pituitary gland in the brain is not putting out enough antidiuretic hormone (ADH). Nephrogenic means that the kidneys are receiving the ADH but not responding to it. Psychogenic means you’re crazy, therefore you drink too much, therefore you produce too much urine.

Dr. Moses did some horrific test that simultaneously checked all three types of diabetes insipidus and reported that my diabetes insipidus was exclusively nephrogenic. My kidneys had been damaged by lithium, prescribed by a bad psychiatrist, which is the most frequent cause of diabetes insipidus.

I went on to nearly a quarter of a century of treatment by various endocrinologists, nephrologists and emergency medicine specialists. The treatment was DDAVP—which cost about $10,000 a year—and the diuretic hydrochlorothiazide (HCTZ). About every six months, I would dehydrate into the Emergency Room. Then, in 2001, I stopped taking physician-prescribed pharmaceuticals and I stopped dehydrating.

In the following ten years I had to urinate about every two hours, including all night, and I was dying from lack of sleep so about three years ago Dr. James Tucker, chief of hospitalists at St. Joseph’s Hospital, prescribed an indwelling catheter so I could get some sleep.

And this month Dr. Elliott informed me that I don’t have diabetes insipidus, based on his reading of lab work.

1. There is no relevant lab work extant. No 24-hour urine has been done in this century. Upstate didn’t start computerizing their lab work until long after the last 24-hr urine.
2. Absent a current 24-hour urine, Elliott did not order it or any other tests.
3. Elliott did not interview the patient.

Nevertheless, Elliott made a diagnosis, albeit totally wrong.

4. Several days after the interview, I was notified that Elliott had ordered a renal ultrasound. Both the Mayo Clinic, and me and my 23 years of experience, know that an ultrasound is not an appropriate diagnostic tool for diabetes insipidus.

Dr. William C. (a/k/a W. Clayton) Elliott is grossly incompetent, inappropriate and rude. Please discipline him accordingly. With 37 years of experience, perhaps he has lost his professional acuity and is in need of rapid retirement.

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Black Girls and White Women (Part III)


A couple weeks ago, a new aide and the director of her agency sat in my living room for the first time and the director said the aide and I “needed to learn each other.” I agreed, but didn’t have the wisdom to ask “How?”

A young black woman—a complete stranger—is put into my home to work. She listens to how I talk, sees how I dress, looks at the furnishings of my apartment, hears how I talk to people on the phone. She learns me.

I, on the other hand, have no context in which to understand who this woman is, what her values are, or how she relates to other people. For years I have wished that, before I hired an aide, I could visit her home. What level of housekeeping does she maintain in her own home? How does she talk to her friends and relatives? What do her home decorations say about who she is? Is she really like me?

Yesterday a black man was doing maintenance in my apartment and he started snapping at me. A couple minutes later, he was using kind words to me. Did the snapping not mean what I thought it meant? In the world I come from if you snap like that at someone then you’ve got a serious relationship problem. Is that true in the world he comes from? Or is the snapping just the same as scratching a minor itch?

A black woman friend and I went to a coffee shop on the Southside where we ran into a black male friend of hers. As I listened to them talk, a story developed. His wife had shot him. He was in the hospital for a while, then in rehab. They took him to court—in his wheelchair—so he could testify on behalf of his wife. He told the judge that it wasn’t her fault—it was his. He was in a wheelchair for a time longer, then his wife started getting together with him. Now he’s all better and he and his wife are back home together.

Honey, where I come from, if you shoot your husband then the marriage is over.

Another story: a young black couple on the Southside got married. After a while, he hit her. In no uncertain terms, she explained to him that he never, ever, was to lay violent hands on her again. After another while, they were in the kitchen. She was washing dishes. He hit her again. She picked up a knife and stabbed him in the side. They still are together and he hasn’t hit her again.

In my home of origin, nobody ever, ever engaged in physical violence against anybody else. We used words to hurt each other.

A couple years ago, I had an epiphany. White people aren’t necessarily right. The laws in this country aren’t necessarily right, either—they just were made by the largest group. White men made the rules. Among other things, they did not treat women equally if the crime was rape. Among other things, they discriminated against black people because whites are the biggest group. The laws are not the laws because they are right; the laws are the laws because the largest group says so.

The laws are supposed to be applied equally to black people as well as white, but they may be living in two entirely different cultures. A black physician or professor who lives in suburbia may be entirely comfortable living with the white man’s laws, but what of the Southside, where a long-standing and far-reaching different culture exists? Is the Southside culture unacceptable simply because it is, relatively, so small that it can’t fight back?

In other words, does the plantation owner get to make the rules for the people who live in the shacks and dance around the fire? Who says the plantation owner is right and the fieldworkers are wrong? They are just different. Just because I am offended by the black people who stand in the lobby of our apartment building and say “fuck” a lot doesn’t mean they are wrong. By my standards, they are wrong, but my standards are born of white culture. Is it considered bad conduct on the Southside?

We are two generations beyond the passage of Civil Rights laws. In all the most important ways, blacks and whites now enjoy equality under the law. But in sociocultural ways, we have made significantly little progress toward equality.

When a special service was being planned at a local church, the chairman of the board of deacons of the dominantly white church proposed that the only black person in the choir lead some gospel singing. Those of us who knew her cringed. She had been raised in a middle-class suburb, grew up in a white church and now was a librarian. She would have been better able to lead us in opera than gospel.

Administrators of the home health aide system repeatedly say that they cannot discriminate in hiring or in placement of young black aides with old white clients. But it does not work because we come from different cultures. Young black aides do not do what old white clients expect them to do. Whites see it as a problem of blacks. Blacks call whites racists.

How are we to learn?

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Dr. W.C. Elliott: The Idiot du jour


So I am sitting in a treatment room in the Nephrology Clinic at Upstate Medical Center when Dr. W. Clayton Elliott walks in and introduces himself. He is a late-middle-aged man who used to be known as Dr. William C. Elliott, and he used to work at Oswego Hospital, which is close to the end of the known medical universe.

He asks me if I know who he is.

‘God?’ I wonder. ‘The latest in a long line of medical assholes?’ I wonder. “You’re a nephrologist,” I say, puzzled by the question.

He asks me if I know where I am.

This son of a bitch is doing a basic psych evaluation—is the patient oriented to place and person! It is unnecessary, inappropriate and fucking rude. Any good physician begins the new-patient interview with one minute of social courtesy, then says “How can I help you today?” The patient begins to tell her story and—according to research studies—12 seconds into her story, the doctor interrupts for the first time. They do not listen.

Dr. Elliott goes way beyond not listening. He doesn’t even ask. He sits down and states “You don’t have diabetes insipidus.”

WTF? Shocked speechless, I mumble and mutter something indistinct. Elliott repeats: “You do not have diabetes insipidus.”

Back around 1991, I was peeing all the time. I told my psychiatrist, who did nothing, so I demanded a second opinion. She sent me to another psychiatrist who actually knew what he was doing, consequently I got sent to a primary care physician who ordered a 24-hour urine and blood tests. When the results came back, she told me I had diabetes insipidus. I cheerfully replied, “You can fix it can’t you?”

“Um, no,” she said. “It’s permanent.”

Then I went to a nephrologist who admitted me to hospital and did a dehydration test, which consisted of denying me liquids for 12 hours, starting around 8:00 p.m., and weighing me every hour all night. I lost ten pounds, just from producing large quantities of urine. Imagine losing ten pounds overnight! My grandma always said “A pint’s a pound the world around” so ten pounds is more than a gallon.

A healthy person excretes less than two liters of urine in 24 hours; I was putting out twice that amount just overnight. I had diabetes insipidus. “Diabetes” means large quantities of urine; “mellitus” means sweet-smelling; “insipidus” means odorless and colorless. Diabetes mellitus is a disease of the pancreas; diabetes insipidus is a kidney disease. Diabetes insipidus means that you are basically excreting clear water and not concentrating urine.

My next stop was Dr. Arnold Moses at Upstate Medical Center who said that the overnight dehydration test was “barbaric” and no longer much in use. Dr. Moses is an endocrinologist and an internationally acclaimed expert on diabetes insipidus. He put me in one of his research programs and reported that my 24-hour urine output was 9.6 liters—about five times normal.

Diabetes insipidus comes in three forms: neurogenic, nephrogenic and psychogenic. Neurogenic means that the posterior pituitary gland in the brain is not putting out enough antidiuretic hormone (ADH). Nephrogenic means that the posterior pituitary is putting out ADH but the kidneys are not responding to it. Psychogenic means you’re crazy, therefore you drink too much, therefore you produce too much urine. Dr. Moses did some horrific test (talk about “barbaric!”) and reported that my diabetes insipidus was exclusively nephrogenic. My kidneys had been damaged by lithium, prescribed by a bad psychiatrist, which is the most frequent cause of diabetes insipidus.

I went on to nearly a quarter of a century of treatment by various endocrinologists, nephrologists and emergency medicine specialists, usually DDAVP—which cost about $10,000 a year—and the diuretic hydrochlorothiazide (HCTZ). About every six months, I would dehydrate into the Emergency Room. Then I stopped taking physician-prescribed pharmaceuticals and I stopped dehydrating.

I had to urinate about every two hours, including all night, and was dying from lack of sleep after ten years of this so about three years ago Dr. Tucker, chief of hospitalists at St. Joseph’s Hospital, prescribed an indwelling catheter so I could get some sleep.

And Dr. Elliott, the idiot du jour, has just informed me that I don’t have diabetes insipidus. He comes from the medical backwater of Upstate New York and probably has never seen a case of diabetes insipidus in his 35-year career. The incidence of diabetes insipidus is 3:100,000; Oswego County has a population of about 120,000.

I ask Elliott on what he bases the judgment that I don’t have diabetes insipidus and he says—wait for it [drumroll]—“I read your lab reports.” He did not interview the patient. He relied entirely on what tests other physicians, such as the rheumatologist, had seen fit to order.

A 24-hour urine collection is where you start if you suspect diabetes insipidus. There is no 24-hour urine lab report in my file.

Back in the 1990’s an internist, a nephrologist and an endocrinologist each independently did testing and arrived at the same diagnosis. It was before Upstate Medical Center began to put test results on computer. No 24-hour urine collection has been done on me in this century. Neither has there been any ADH test.

I sputter, “Bu—bu—but, Dr. Moses! This hospital . . . international expert . . . tests!”

The asshole du jour repeats that I do not have diabetes insipidus.

I leave the room, and the hospital, probably forever.

And here’s what I believe: I believe that the asshole du jour read my psych history and, based on multiple fallacious notes by psychiatrists—whose “diagnoses” are based on opinion, not any objective tests—he decided I was crazy and, since he is fundamentally incompetent, he did no testing to validate his opinion, which is that of a bigot.

Posted in American medical industry, drugs, Medical care, Mental Illness & Health, Pharmaceuticals, physician, Values | Tagged , , , , , , , | Leave a comment

Black Girls and White Women (Part II)


Black girls, like everybody else, want esteem and authority. They are unprepared to do anything else, so they work as aides and I think they are ashamed of it. Couple that with their eagerness to tell the rest of the world how to behave, and you have a problem. My guess is that with most clients, a black aide flares a couple times and the client becomes silent and subservient. Not me. I do not back down when pushed into confrontation.

My friend who has Medicaid aides is currently working with a young woman who worked—albeit briefly—for me. She is black and she does not have attitude. She also cannot read, cannot write cursive, and doesn’t know how to double ¼. In other words, she cannot cook from a recipe or make up a grocery list. She does not own an alarm clock or a watch and, therefore, never showed up for work on time. This was a problem for me because I actually have a life and make time commitments with other people. My friend is still in thrall to the medical industry and is, therefore, sick all the time and always at home whenever the aide gets around to showing up.

I only see two ways out of this problem. The first is that aides absolutely need to be paid more. They are providing the most basic, necessary services; they are essential. Hamburgers at Burger King are not a necessity; cleaning the black mold out of my toilet is. Taking care of other people should not be a minimum wage job. If all the doctors and all the aides went on strike, who would you miss first and the most? How long has it been since the pay rate for Medicaid aides has been raised? PAY AIDES WHAT THE JOB IS WORTH!

Second, I would make it mandatory to link aides to education. Reconfigure aide work as the first step, not the last step. The medical industry provides a clear ladder from Certified Nurse’s Aide to Licensed Practical Nurse to Registered Nurse to Nurse Practitioner. Link aide work to education. Let the agency pay for the education on the condition that the employee will continue to work as an aide for a period of time. When employees can see that superior performance on a menial job is their way up to a better job, I would expect it to be reflected in a change of attitude.

Finally, I would ask for compassion for the clients. By and large, we are old white women. There comes a time in our lives when we should no longer be challenged to change to accommodate the culture of young black women with whom we have nothing in common. At this times in our lives—old, and too sick to take care of ourselves—we should be allowed to rest in the comfort of the known and familiar. Can you please get me an aide who looks like me?

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