"I am a great writer, a conviction I kept private for fear of sounding obnoxious."
--Jessica Knoll in "I Want to be Rich..." The New York Times
If only I could tell that to myself at night.
Monday, April 30, 2018
Sunday, April 29, 2018
Layers Beyond the Hurt
"Ever since I was a little girl, my fairy tale ending involved a
pantsuit, not a wedding dress. Success meant doing something well enough
to secure independence. My something was my writing...I decided I could not consider myself successful unless I was somebody
powerful, somebody nobody could hurt. Success became a means to wrest
back control, literally to increase my value..."
--by Jessica Knoll, "I Want to Be Rich and I'm Not Sorry," The New York Times
While my mother and I were driving home, my mother mentioned that I used my intellectualism as a shield, to keep people at a distance, to keep from being hurt.
"That's exactly what my last therapist said," I remarked.
--by Jessica Knoll, "I Want to Be Rich and I'm Not Sorry," The New York Times
While my mother and I were driving home, my mother mentioned that I used my intellectualism as a shield, to keep people at a distance, to keep from being hurt.
"That's exactly what my last therapist said," I remarked.
Nice to Have
"When someone says they have nothing to say to me, I'm out of there. That includes everyone in my life, not just you."
--from The LSU Professor's email, written 10/17/17
My response:
I just read your email five minutes ago.
Nice that you have your pride.
For me, only a brittle of that exists in me.
A mere illusion.
--from The LSU Professor's email, written 10/17/17
My response:
I just read your email five minutes ago.
Nice that you have your pride.
For me, only a brittle of that exists in me.
A mere illusion.
All Roads Lead--Somewhere
" [Jae],
It may be better to discuss at our next appointment since I am currently on the inpatient pain service. But to answer your specific question, I would not recommend tramadol for you based on its frequent interaction with drugs like duloxetine as well as many others. In addition, I do not think that tramadol is less or more addictive than other opioids, Addiction is a complex disease that depends on many individual-based factors as well as exposure/accessibility to opioids. I hope I have answered your questions to your satisfaction.
Be well, Dr. [M]."
I decided to talk their language, and quoted some research papers on why Tramadol is used for treatment of FM (fibromyalgia). I sent the doctor at Stanford Pain Management Clinic a list of studies, with a quote from each on the decision to use Ultram.
The doctor didn't care. She emailed me back the same day, within hours, saying she couldn't recommend Tramadol because it is known to interact with Cymbalta (see above).
I received her message, and then I sat down at the desk and cried miserably for an hour.
It may be better to discuss at our next appointment since I am currently on the inpatient pain service. But to answer your specific question, I would not recommend tramadol for you based on its frequent interaction with drugs like duloxetine as well as many others. In addition, I do not think that tramadol is less or more addictive than other opioids, Addiction is a complex disease that depends on many individual-based factors as well as exposure/accessibility to opioids. I hope I have answered your questions to your satisfaction.
Be well, Dr. [M]."
I decided to talk their language, and quoted some research papers on why Tramadol is used for treatment of FM (fibromyalgia). I sent the doctor at Stanford Pain Management Clinic a list of studies, with a quote from each on the decision to use Ultram.
The doctor didn't care. She emailed me back the same day, within hours, saying she couldn't recommend Tramadol because it is known to interact with Cymbalta (see above).
I received her message, and then I sat down at the desk and cried miserably for an hour.
Women's Anger
"One area of focus in the original edition was patient as victim; by the
second edition, women were no longer characterized as victims of doctors
— at least not so loudly. But they weren’t their equals, either. In the
early editions, women were medical subjects, objects of study. Learning
to challenge institutional knowledge, and their treatment by those
institutions, was as important as learning about their own bodies."
--https://www.nytimes.com/2018/04/28/opinion/sunday/the-forgotten-anger-of-our-bodies-ourselves.html "Our Bodies, Ourselves, Our Anger" by Elizabeth Gumport, The New York Times
--https://www.nytimes.com/2018/04/28/opinion/sunday/the-forgotten-anger-of-our-bodies-ourselves.html "Our Bodies, Ourselves, Our Anger" by Elizabeth Gumport, The New York Times
Tuesday, April 24, 2018
Of course in those more bitter moments, I picture him picking up his phone and dialing me. Before he even speaks to me, I spat, "Well....well...well...if it isn't the world's leading expert on health and happiness....You know what? You only care about three things: one, making money; two, sticking your dick into something wet and warm, and lastly, drinking."
Then, I hang up. A man's entire core personality summed up by three little desires.
Then, I hang up. A man's entire core personality summed up by three little desires.
The Lady's Last Thought
I learned through a few private sessions with Stanford's psychologists on the unit, going through all the messed up shit that happened before my semester even began. I also attended group meetings on the ward, and that helped also. Although these "gifts of insight" never come as planned. They just happen.
When you talk about core beliefs in cognitive behavioral theory, I really believe that you're ventured into psychodynamic territory, which is refreshing. What's a core belief you have about yourself?
I learned that I had two that governs my everyday experience. One, is that I'm stupid. Two, is that I'm unattractive.
The idea, though, is to change these harmful beliefs. How? Maybe you have a good couple of years, you lose weight, you finish graduate school, and then in some twist in your life story, all those fears come right back up--it starts small of course, some extra ice-cream because work is stressful, with the thought that "I'm not equipped to handle this, and my peers are doing much better than me."
I love my greatest rationalization: I might as well eat.
An enormous amount of my day is spent worrying about my physical appearance . Every women knows that a impulsive need to touch the dress they are wearing--is to admit, in some way, that the dress frightens them because social expectations are surrounding that dress, and you pull on the skirt because it's just too short.
When you talk about core beliefs in cognitive behavioral theory, I really believe that you're ventured into psychodynamic territory, which is refreshing. What's a core belief you have about yourself?
I learned that I had two that governs my everyday experience. One, is that I'm stupid. Two, is that I'm unattractive.
The idea, though, is to change these harmful beliefs. How? Maybe you have a good couple of years, you lose weight, you finish graduate school, and then in some twist in your life story, all those fears come right back up--it starts small of course, some extra ice-cream because work is stressful, with the thought that "I'm not equipped to handle this, and my peers are doing much better than me."
I love my greatest rationalization: I might as well eat.
An enormous amount of my day is spent worrying about my physical appearance . Every women knows that a impulsive need to touch the dress they are wearing--is to admit, in some way, that the dress frightens them because social expectations are surrounding that dress, and you pull on the skirt because it's just too short.
All Roads Lead to Hell, Part IV
Of course, the issue is that the patient feels invalidated. The pain management doctors do not ask how you're doing (and if they do, they're not interested in the answer), They don't ask, "Tell me about your pain" or "What has helped your pain in the past?" or "What can I do to help you?"
Instead, decisions are divorced from the account of the patient to the god-like grip on an hammer as he slams down his orders without even caring for whom those orders were for in the first place.
They don't even see faces, they just see a diagnosis, and even that is often times boring to them. Shouldn't a patients' feelings and opinion matter when the doctor doles out treatment?
Instead, decisions are divorced from the account of the patient to the god-like grip on an hammer as he slams down his orders without even caring for whom those orders were for in the first place.
They don't even see faces, they just see a diagnosis, and even that is often times boring to them. Shouldn't a patients' feelings and opinion matter when the doctor doles out treatment?
All Roads Lead to Hell, Part III
I feel like going on some rant, explaining that we do a better job at pain management with companion animals than we do with humans, simply because doctors aren't afraid to give suffering dogs strong opioids when needed because--why?--all the political bullshit hasn't hit vet clinics yet.
Of course, I could rant and rave, but as they say, people with little knowledge are the most dangerest, and to argue with well-educated Stanford doctors appears (on the surface) to be folly and futile.
But I just might anyway.
Of course, I could rant and rave, but as they say, people with little knowledge are the most dangerest, and to argue with well-educated Stanford doctors appears (on the surface) to be folly and futile.
But I just might anyway.
All Roads Lead to Hell, Part II
Dear [Jae],
I appreciate the question. Opioids, like any other treatment, have to be initiated, continued or discontinued based on a benefit to risk ratio. In your case, and again this is my personal risk/benefit stratification, the risks outweigh the benefits given the impact of opioids on mood, hormonal balance, respiratory drive, constipation, immunity, etc. I am happy to chat with your general doctor ( with your permission of course) if need be .
Best,
[Dr. M.]
All Roads Lead to Hell
While visiting the Stanford Pain Management Clinic, probably the best in the entire West, my new doctor said within moments of meeting me that he really didn't like using opioids for chronic pain. He never gave justification for that statement, and I was too slow at the time to question it. Everyone in the health profession is concerned about opioids and addiction, but no one talks about it.
I didn't like the man, even though he was probably one of the brightest people in medicine, but when you get use to Stanford's levels of excellence, in life, in general, you learn to be more critical. You can sort out the extraordinary from the lowly "only-above-average." Dr. Daniel Mason (look him up!) is not only a writer of two novels (in an interview he complained about not being able to decide to be a writer or a psychiatrist), but--this part always amazes me--he graduated top of his class in Biology at Harvard.
My mother doesn't like him because, as people have noticed, his bedside manner sucks.
I caught him in the hallway of the psychiatric outpatient clinic, and he actually smiled at me (I felt blessed like God-himself was gracing him with his presence).
This doctor at Stanford's Pain Management clinic is young, and according to Dr. Mackey, all of his staff understands that pain is subjective, and that people can look rather ordinary, and yet be in severe pain. My doctor there at the clinic, well, I don't think he took this idea to heart like perhaps Dr. Mackey wanted him to.
This young doctor looked at me like I was simply a case, and an uninteresting one at that, although he assured me that a team of doctors looked over my documents, and came up with the best solution possible.
Do you want to know what the big revelation was?
Physical therapy.
When I returned home, and saw my GP, his initial reaction was that if Stanford knew I was on opioids and didn't think it was a problem, then he would continue to prescribe the medication (My young doctor at the pain clinic said that he wouldn't prescribe it himself because he wants someone local to me to manage it).
Then my GP's assistant mention that in the case notes from my visit at the Stanford Pain Management Clinic that this young doctor suggested I titrate off the Norco completely.
Immediately, my GP was telling me about how this was what was best for me, and he said he would prescribe 10 pills every ten days for a month, and then cut that to five pills for every ten days for another month.
That was a joke, so I decided to avoid the power plays and the bullshit and just stop taking the Norco completely on my own without dragging out the process over two months.
So, I returned to the Stanford Pain Management Clinic to see Dr. Mackey himself, and his fellow, Dr. M.
Dr. M and I discussed the opioid prescription, and she suggested that if it was helping me stay active then it was worth it to continue.
That's great, but my GP isn't going to believe it unless it's written down somewhere, so I made that request, and haven't heard back.
It's been a few days now without Norco, and at several periods throughout my day, I'm in serious pain, which starts out localized and then spreads outward like coming down with a bad flu. The first 24-hours were the worst. I spent the day on the couch, and Mom suggested that I drink a lot of water, and I did so.
I made an appointment with J. my physical therapist (after I paid off the clinic, a sum of $390), but then I canceled at the last minute. I was too ashamed to go. He's beautiful (single or not single?), and I hate myself for being fat. I realize that this is twisted logic (wouldn't someone who's overweight want to get in better shape?).
I didn't like the man, even though he was probably one of the brightest people in medicine, but when you get use to Stanford's levels of excellence, in life, in general, you learn to be more critical. You can sort out the extraordinary from the lowly "only-above-average." Dr. Daniel Mason (look him up!) is not only a writer of two novels (in an interview he complained about not being able to decide to be a writer or a psychiatrist), but--this part always amazes me--he graduated top of his class in Biology at Harvard.
My mother doesn't like him because, as people have noticed, his bedside manner sucks.
I caught him in the hallway of the psychiatric outpatient clinic, and he actually smiled at me (I felt blessed like God-himself was gracing him with his presence).
This doctor at Stanford's Pain Management clinic is young, and according to Dr. Mackey, all of his staff understands that pain is subjective, and that people can look rather ordinary, and yet be in severe pain. My doctor there at the clinic, well, I don't think he took this idea to heart like perhaps Dr. Mackey wanted him to.
This young doctor looked at me like I was simply a case, and an uninteresting one at that, although he assured me that a team of doctors looked over my documents, and came up with the best solution possible.
Do you want to know what the big revelation was?
Physical therapy.
When I returned home, and saw my GP, his initial reaction was that if Stanford knew I was on opioids and didn't think it was a problem, then he would continue to prescribe the medication (My young doctor at the pain clinic said that he wouldn't prescribe it himself because he wants someone local to me to manage it).
Then my GP's assistant mention that in the case notes from my visit at the Stanford Pain Management Clinic that this young doctor suggested I titrate off the Norco completely.
Immediately, my GP was telling me about how this was what was best for me, and he said he would prescribe 10 pills every ten days for a month, and then cut that to five pills for every ten days for another month.
That was a joke, so I decided to avoid the power plays and the bullshit and just stop taking the Norco completely on my own without dragging out the process over two months.
So, I returned to the Stanford Pain Management Clinic to see Dr. Mackey himself, and his fellow, Dr. M.
Dr. M and I discussed the opioid prescription, and she suggested that if it was helping me stay active then it was worth it to continue.
That's great, but my GP isn't going to believe it unless it's written down somewhere, so I made that request, and haven't heard back.
It's been a few days now without Norco, and at several periods throughout my day, I'm in serious pain, which starts out localized and then spreads outward like coming down with a bad flu. The first 24-hours were the worst. I spent the day on the couch, and Mom suggested that I drink a lot of water, and I did so.
I made an appointment with J. my physical therapist (after I paid off the clinic, a sum of $390), but then I canceled at the last minute. I was too ashamed to go. He's beautiful (single or not single?), and I hate myself for being fat. I realize that this is twisted logic (wouldn't someone who's overweight want to get in better shape?).
Sugar and the Bitter Truth
I've told myself over and over that I want him to be happy, but when I'm tired, and I'm slipping away into sleep, all I can hear from myself:
"You can't forget me because I made you the happiest, I am not replaceable..."
Then I wish misery and sorrow...
"You can't forget me because I made you the happiest, I am not replaceable..."
Then I wish misery and sorrow...
"Damn your love, damn your lies..."
--Fleetwood Mac
He can trivialize our relationship, he can minimize it to a fuck buddy-type situation, and he can deny all sorts of things, but even though I've lost 99% of all memories of him, I still remember the way he looked at me, the way he said my name, when he whispered "I can't stop thinking about you..."
In relationships, we're bound to occasionally say things we don't mean--either positive ("That hat looks great on you!") to the negative ("I hate you!") after a particularly bad argument.
Maybe he said a bunch of things that he never meant--maybe they meant something in the moment, and then they faded away like the way a bright shirt will become grey after too many warm washings.
Did I remember the events so much differently than he did?
He can trivialize our relationship, he can minimize it to a fuck buddy-type situation, and he can deny all sorts of things, but even though I've lost 99% of all memories of him, I still remember the way he looked at me, the way he said my name, when he whispered "I can't stop thinking about you..."
In relationships, we're bound to occasionally say things we don't mean--either positive ("That hat looks great on you!") to the negative ("I hate you!") after a particularly bad argument.
Maybe he said a bunch of things that he never meant--maybe they meant something in the moment, and then they faded away like the way a bright shirt will become grey after too many warm washings.
Did I remember the events so much differently than he did?
Three Months and So Many Days
I don't want to end up one of those "bitter ex's."
I suppose that the line "how can I contact you" was his way of testing what mode of communication would be best when delivering the bad news--phone, TXT-message or email?
This is not to say that he had a plan of what he wanted to say. He might have wanted to start the conversation with one intention, and then--something led to a different course.
I am, of course, proof of all that can go wrong in a marriage--how someone could be overcome with lust, forgetting for minutes and hours and days of the respectable ways of living. I am some bad reminder of relationships being confusing and hurtful. Perhaps all he wanted was to get rid of me before I manage to fuck up his next relationship with this girlfriend.
He doesn't want to feel guilty, so he'll twist the situation into whatever suits him best. I never loved him, therefore he doesn't have to love me back. He wanted me to go away, he told me that we could only be friends, he said this and that, and yet, I ignored him, and continued to cling. He took no part in encouraging me, because that would be unfair. He's blameless because he told me.
I've asked myself for many times, usually at night, am I trying to make him into a villain? Or am I just now seeing the truth? There's no quick, suitable answer to that.
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