My mind on sabbatical

On the Threshold of Eternity

On the Threshold of Eternity (Photo credit: Wikipedia)


As with my paper journals, sometimes it shocks me to visit my blog and see how much time has passed since my last post. Obviously, the habit of documenting my life remains a work in progress.

At the beginning of this year, I lost my father suddenly. I continue to struggle with grief and with futile attempts to make peace with the resulting void in my life. For the past several months, my  “thinking time” allotment has been consumed by more mundane aspects of life, such as chronic pain and severe depression.

Considering that the treatments for both tend to dull my intellect, it’s remarkable that I manage any higher-order thought at all. Letting my thoughts escape becomes even more troubling.


Published in: on 2012 11 15 at 06:06:50  Leave a Comment  
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This is My Mind on Crutches. Any Questions?

For the past two decades, I have grown accustomed to having my body let me down. A shipboard accident at the age of 18 left me suffering from knee injuries that never resolved and devolved into osteoarthritis and other degenerative joint conditions. That disability cut my Navy “career” extremely short – if my knees had failed while I was working in my normal workplace, a carrier flight deck, my life and likely others’ would be endangered.

After leaving the Navy honorably due to my knee disability, my life was without direction, and I was still coming to grips with the fact that I was limited to desk work for the rest of my life. I had a hard time psychologically, going from a literal lean, mean fighting machine to someone facing a limitation I had thought of a concern for old age, and it was hard for me to even grasp old age.

Given my reliance on my intellect throughout my life, it isn’t really earth-shattering that I would end up working with my mind, rather than with my muscles, but the sudden closing of all of those doors was extremely depressing. I was fortunate that a family friend was the Chief of Police for a small city in the Atlanta area, and his department was in need of a dispatcher. It turned out that I was very good at the work, and, like my service in the Navy, I had the personal satisfaction that I derived from public service. The job turned into a career, culminating in my working in the communications center of the state Emergency Management Agency, a position which let me turn my lifelong interest in computers into one of my duties: information systems administrator for the communications division. I was given a lot of leeway in developing applications. I was proud to develop the software that the communications division adopted for statewide  incident management. It remained in service for several years after my departure and marked the point when my career really changed from public safety or emergency communications to information technology, especially infrastructure systems and database administration. The same small city where I had started as a 911 dispatcher years earlier hired me as its first IT manager.

Actually, I was the entire IT department, and although the city had created the position, it had made no preparation for me to actually start work. I had to find or commandeer literally everything I needed: an office, computer, telephone, furniture – everything. The city’s computer systems and network were completely undocumented.  The flipside of having to do literally everything myself was the rare opportunity to design and implement everything from the ground up.

I had enough on my plate to justify at least three full-time-equivalent positions, supporting the life-critical 24/365 operations of the 911 center,  fire/rescue, police, and jail.  Since those additional l FTEs didn’t exist, I was never truly off duty. I stayed so engaged that I didn’t recognize the toll it was taking on my family life. The heavy work pressure seemed necessary to support my family, and, as long as I had a good, hands-off supervisor (the city manager), the extreme stress felt like “good” stress. It was rewarding.

When circumstances changed, particularly the replacement of the city manager by a new one who had never held that position before, my ideal career quickly started to unravel. The new city manager was a micromanager in the extreme, made worse by his mistaken belief that he knew anything about information technology and his habit of praising performance one day and condemning the same performance the following day.

My major depressive disorder, which had been chemical/organic in origin throughout my adult life and well-controlled by medication for several years, began to become reactive to external life situations – a development with which I had no experience and for which I had no coping tools. In addition,  I began suffering from acute panic and anxiety attacks. I began finding reasons to work at night or at locations other than my office in city hall. Within a few months, the anxiety/panic reached the point of my seeking medical attention for it, and my psychiatrist starting me onto anti-anxiety meds (benzodiazepines).  As I continued to worsen, I was compelled to seek an ADA accommodation and formally notified the city of my intention to take FMLA leave. I was utterly speechless when the city manager fired me the following afternoon with no warning. I suggested to my then-wife that she might want to go ahead and take the kids to her parents’ – I didn’t want them to see Daddy have the complete breakdown that followed – one from which I still haven’t fully recovered, despite improvement with the anxiety disorder. The separation from my family…and then the marital separation…there seemed to be no bottom to the abyss of my depression.

Enter the knees again. They continued to degenerate, as my daily life had sunk to the point that muscle atrophy was inevitable, and my orthopedist referred me to a pain management clinic, adding OxyContin and then MS Contin (due to intolerable cognitive side effects with the former) to the potent mix of psychotropic drugs I was already taking.

Despite  the generally effective antidepressant and anti-anxiety regimen (and the generally ineffective pain regimen consisting primarily opiates due to an allergy to NSAIDs) and the addition of therapy with a psychologist, things have remained fairly constant over the past few years – unpredictable depressive episodes, often with suicidal ideations, persist, and I still experience cognitive effects such as short-term memory loss. The military and other organizations have a maxim that “if it’s not in writing, it doesn’t exist.” For me, that has become literally true. My memory can’t be trusted, which is part of why I write down what many consider Too Much Information. Putting it in a publicly-accessible location allows me to reach it from any computer, and, perhaps more importantly, it might let people in similar situations know that they are not alone.

It took me years to fully come to grips with my physical disability. The awareness that my mind is letting me down, and that it MIGHT not get better, is a much tougher pill to swallow. My life feels like someone in a waking coma – the machine is still working, but it is very difficult to control the input/output: focusing my mind on a new problem or adding new capabilities is often beyond me.

I have worked hard throughout my life to make the contents and capabilities of my mind valuable, not just to myself, but in the marketplace, and if I’ve lost that,  I can’t envision a Plan C.

Published in: on 2010 08 01 at 09:11:35  Leave a Comment  

More Thoughts on Healthcare

The current state of healthcare isn’t literally about healthcare at all. It is about the enormous and continuing rise in the cost of healthcare due to the separation of healthcare consumer/patient and the entity that pays for the care, typically an HMO or the government. To give an example of “HMO-driven inflation,” before transferring my care to the Veterans Health Administration (VA), more than one of my providers had a “standard” rate at which they billed HMOs and presumably Medicare, and a second, significantly lower rate that they charged to individuals without health insurance or other third-party payer. I was shocked to find an example even within the VA. Under certain circumstances, such as lack of available bed or inability to provide a service in within a mandated time limit, the VA contracts with private healthcare providers to handle their overflow (at no cost to the veteran – the cost is billed directly to the VA). I had occasion to be treated by a private provider on behalf of the VA, and I came to learn that my care was billed to the VA at a rate that was TWENTY-FIVE PERCENT above the standard rate that was billed to HMOs or other payers. As shocking as that is, I suspect it’s more of an example of the government ironically being price-gouged because its needs are frequently immutable, rather than being a major contributor to “HMO inflation.”

The problem and its causes are no great mysteries. More important are solutions that avoid a massive new Federal government entitlement (when some major current programs are of questionable sustainability) and pricing healthcare out of reach of more Americans, straining non-profit hospitals by further turning the ER into a primary care clinic. I don’t advocate the abolition of HMOs, but I do propose doing away with absurdities like the “sky’s the limit” surgery in exchange for a $20 copay.  We need to look at reviving features of “traditional” 80/20 insurance (which has never gone away for small businesses or the self-employed), such as DEDUCTIBLES and a reasonable, realistic (for patient and provider) percentage match. Nothing onerous that would prevent a person from obtaining needed care, an amount sufficient, if only symbolically, to restore the patient/consumer’s awareness that increased consumption of medical resources costs proportionately more, a basic lesson of economics that seems to function normally until someone with a lab coat and stethoscope enters the picture.

Published in: on 2009 08 16 at 01:25:12  Leave a Comment  
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