There is a museum in the vicinity of Harvard Yard that houses pieces of Art from the Eastern and Western worlds pre-1200 AD. The museum is named for its collector, a known Philanthropist who made 14 Billion dollars off of one product. He is famous for a quote, “I’ve often said I approached collecting as a Biologist. I want enough data to be able to draw valid conclusions. Art is a passion pursued with discipline. Science is a discipline pursued with passion. You have to really pursue the object, you don’t just sit there and have the objects come to you. You want to be a great collector, you better think of the fact that you’re gonna commit yourself to a real passionate treasure hunt.” Recognize it? Ok let’s try this one, “The drug isn’t the problem the user is the problem.” Still drawing a blank? The museum is named after Arthur Sackler, owner of Purdue Fredericks, later Purdue Pharma, the company that introduced the world to OxyContin.
To be fair, Sackler wasn’t alive when Oxycontin was released in 1994. But he would have been proud to know that his background in Medical Advertising, in which he created “new and innovative ways to ways to make ill people into regular customers”, was passed on to his younger Brother Richard after his death. As the owner of MS Contin, a slow release Opiod (slow delivery due to its shell, Contin =Continuous) used largely for end-of-life care and in Cancer Patients, Richard Sackler of Purdue was painfully aware that the patent was soon running out and they would need a “Blockbuster” drug (take a second to absorb that concept) to recover their revenue stream. They came up with taking the much stronger opioid Oxcodone and blending it with the slow release Contin to create a more powerful and long lasting pain killer. Herein lay the dilemma; the market for End of Life and Cancer Care didn’t provide a large enough customer base for a long enough period of time. So they improvised. Purdue shamelessly hired a Doctor within the FDA, spent 3 days in a rented room and wrote a blatantly deceptive application for approval that they were assured by their FDA indider would easily pass. The application included false research and outright lies about the lack of danger of long term dependency and addiction. It passed. Thus began the crime of the Century. After their marketing campaing, perhaps more appropriately dubbed “push”, in which slick Pharmaceutical reps with uncapped bonus plans incentivised reluctant Dr.’s through any means, legal or otherwise to get the new drug to be described to a wider demographic for ailments as innocuous as knee pain. There is not enough room on this page to list the unfunny comedy of errors that occurred as Purdue relentlessly pushed this product through any means, misinformation campaigns or greasing the palms of all-too-willing Congressman (who looked away as their own districts were collapsing under the weight of the epidemic) happy to lie to their constituents and peers about the extent of the problem. It is a truly disgusting story of Corporate Greed, Political power through dirty money donations, manipulation of Government regulations and the frightening power of the media as evidenced by “America’s mayor”, Rudy Giuliani taking Purdue’s filthy money to make commercials praising Purdue’s commitment to assist those Americans who suffer from chronic pain.
It worked. Tragically well. At its high point 125 million Americans had a prescription for Oxycontin. That is half of the estimated population of this country. If you weren’t in pain, there were plenty of Doctors in Ferrari’s that could set you up in their “pill mills”. Even CVS got in on the game. 20 years later 500,000 Americans had died of overdoses. For reference, as many Americans die EACH YEAR of Opiod overdoses as perished in the entire Vietnam Conflict.
So let’s look at a segment of Richard Sackler’s quote again, “You have to really pursue the object, you don’t just sit there and have the objects come to you. You want to be a great collector, you better think of the fact that you’re gonna commit yourself to a real passionate treasure hunt.“
Purdue didn’t wait for them to come to him, they went on a real passionate treasure hunt. 14 Billion dollars worth of treasure.
I always knew it. I’ve known it for years, but I didn’t want to admit it. But after diving into the model of addiction as a profession, I’ve realized that I am no different than the people I work with. I am an alcoholic.
All the signs are there. As we say, the circumstances vary but the progression is the same. There is no exact template; you don’t have to drink every day, you don’t have to have hit “rock bottom”(I believe absolute Rock Bottom is death), you don’t have to lose everything, you don’t have to have experience “blackouts” nor do you need to have crushing consequences of alcohol use. You merely have to admit that alcohol has affected your life irreparably and that is a problem that you have no control over. That’s me. I have been drinking at an unhealthy level for 40-plus years. I haven’t always consumed alcohol every day and I haven’t always gotten drunk. But it has been a destructive force in my life. I have drunk at the expense of my health. I have lost my temper with my family and other loved ones. I’ve driven intoxicated more times than I can count (the words “incredibly lucky” come to mind) and I know that I have set a terrible example for my children. I have made an ass out of myself in front of friends and co-workers more than I want to admit and I have wallowed in shame and regret more often than I care to consider. Even now that I’ve been able to achieve long periods of sobriety, I think about it every day. Not a day goes by when I do not think about going to buy a bottle. When I do buy one, I may not get plowed that day but I will drink out of it every day until it is gone. That means that working out, blogging, preparing meals and any other worthwhile pursuit will be left by the wayside as I feed an old, tiring habit. And I get zero value or reward from it. It’s time for a change. I feel good about it. I don’t enjoy it anymore, I rarely get intoxicated, and when I do I beat the hell out of myself emotionally during and after.
Alcoholism is about control. I no longer have control over it. Being able to avoid it is a mild accomplishment but I need to change my mindset and work towards a healthy and fulfilling life. Yes, I already crave this, anyone who knows me can confirm it. But I can do better.
I always tell my Clients that the key to embracing recovery is to not look at it as a continuation of the Old Life, but instead to look at it as a new beginning. It has occurred to me that I may be full of shit when I offer advice but I know I’m not. I am knowledgeable of the model of addiction and can speak with some conviction. But I need to go one step further and join them in doing the work. I can live the life that I want for them by joining them in the battle.
Today I am beginning the 1st of the 12 steps of Alcoholics Anonymous. I am admitting that I am powerless over the lure of alcohol, and that I currently live a life that is unmanageable. This is an important step in my overall goal of being an honest, accountable person of substance. It makes sense finally.
Tuesday was one of my worst days to date as a Case Manager. It was only exacerbated by my anxiety being in full flare. The stars collided perfectly and tragically, as it were.
Case Management in Addiction is a numbers game. Simply put, while there is never an expectation of 100%, if the successes outnumber the losses (we don’t use the word failures) then it is a rewarding use of your time. Even a ratio of 51/49 is fairly aggressive. For the sake of this conversation, success is a patient who buys in, makes an effort to dedicate themselves to healing, or at least surrenders (addiction treatment is about relinquishing control above all else) themselves to the process and completes all or most of the recommended continuum of care. We have ZERO control over what happens after they leave us but the numbers support that a full stay tends to lead to a more positive likelihood of positive outcome. Tuesday I myself seemed to have ZERO control of ANYTHING. I was pushed to my absolute emotional limit. I went home questioning everything. Fortunately, I didn’t go home alone. I had Miss Anxiety with me and she was piling on. You should quit! No, I love my job. Then why are you so upset? Because I have no control. Like your patients? They have to be there… You think you do too. Maybe you don’t? I can handle it. I think. Can you? Fuck you, I have skills. Not today you didn’t. You’re right… Of course I am, I’m always right. Especially when I tell you that you suck. Tomorrow will be better. LEAVE ME ALONE BITCH!
I questioned everything and argued with myself for hours. I was low, lower than I’ve been for a while and it bothered me. Then it came to me. Late of course, as it always does. Change your mindset. Do what you tell your clients. Worry about what you can control, put behind you what you can’t. Stop trying to save the world, help the ones that let you.
For the last 2 days I managed to keep the duct tape over the mouth of Miss Anxiety and focused on positivity. It must have oozed out of every pore of my aura because the last 3 days were so much better. I came home tonight knowing that I did some good and at the very least did nobody harm. Perhaps most importantly, I know that I did the absolute best that I could. And that, on a anxiety-free day, is all that matters to me.
I was warned when I started my job as a Case Manager in addiction, that there will be times when my entire client list would catch fire.
The addiction patient comes in several forms, ranging from first-time in recovery, young or older (sometimes in their 70’s) to the “readmit” who has been in multiple times (I have one young man in his 30’s who has been in rehab 41 times). Some are very motivated and others are counting the days. They come to us for many reasons. Some are court-ordered and others made the brave choice to change their lives and are willing to make bold moves to do so. One thing I have learned is that there is no room for assumptions about outcomes (that is obviously way beyond our scope) and there is no connection between willingness, enthusiasm and cooperation and stability during treatment. There is no such thing as a stable patient. Any patient can turn on a dime in one day, often defying every expectation. The addiction patient is dealing with a plethora of internal forces that pull and tug at them. One day there are doing fine; motivated, encouraged, and on course. The next day they may decide that it’s too hard, that they are needed at home, that they can deal with their addiction on their own, that getting back to work is the key, and my personal favorite…they think they are ready. Even when they are not. It is the mental push/pull that comes with making major change against a force that is larger than them. I attribute it to the dichotomy of human nature. Think of it as the scene in the Flintstones when Fred has a little devil Fred on one side and a little angel Fred on the other.
When this occurs, the adrenalin kicks in and the push to keep them from leaving begins. I know it sounds awful, but we know what is good for them even when they don’t. We have at our disposal the research to support it, compiled over millions of patients worldwide. We are trained, and we have the additional resource of many co-workers who have been through recovery themselves. We are armed with every tool, backed by sheer good intentions to help them recover. When we tackle this obstacle, it is exhausting. At least to the new guy, which I am, and my more experienced colleagues are more able to cope with it than I. While these waves of change occur in nearly all patients, it happened with too many of mine this week.
I approach my position as I do my own matters. aggressively and with passion. I challenge, poke and prod, tell the truth, and insist on reciprocation. While I am not a clinician, I get the information we need and I learn the ins and outs of the person in front of me. I invest, and I am here acknowledging that I do so at the sake of my well-being, of myself into my clients. I know it sounds corny as hell, but I care about people and despite my best efforts to dial it down, I can’t. Sue me, I give a shit. I need to know at the end of each day/week/month that I did the absolute fucking best that I could for those in my charge.
Greetings from West Palm Gardens, FL. As I write this I am poolside enjoying an 80 degree day. This is relevant because I should be on a plane right now. When Mom asked me to drive her to her new Condo in West Palm (she doesn’t fly the dog) my original plan was to drive two days and fly back the next. After all, there is work to be done. But then I thought about it and checked my calendar at work. I’ve been there for a year now so I must be due some time off. Oops, I was looking at the wrong column, I was looking at the “feels like” column. I’ve been there 3 months it just feels like a year. I don’t have paid time coming to me but I’m taking a few days off.
Work has been a lot. Life as a Recovery Case Manager is rewarding, challenging and exhausting. If you do it right, and by that I mean give a shit, then Empathy deprivation is possible and burnout is expected. My supervisors have continuously warned me against doing too much and I did what Bill does and ignored their warnings. At my own peril. I’m exhausted.
Today I am going to take a nap after I publish this. Then I plan to eat something bad for me, go to bed early and fall asleep while binging Netflix in the AC. Tomorrow I am going to connect with a lovely friend from High School and her Cougar friend. I plan to have dinner and drinks and a late evening. Then I plan to sleep late even if I have to do it alone. I have earned it. My Clients are well taken care of. All of their outside needs and distractions are handled and I attend to everything that I can to make sure they attend to the business at hand…recovering from their addiction and the often horrible consequences. I am a good Case Manager because I give everything I have to my Clients. Now I am doing something for me.
For the almost 6 years that I spent sick and out of work, I missed a lot of things. One thing I missed most was working. For better or worse, my work was closely tied to my identity as well as my self-worth. I was always known as a hard worker, most of the time I was the best at what I did among my peers, and it wasn’t always about money. I actually got off on the feeling of accomplishment. My last great job before I got sick was a great opportunity for me. I got to be a part of the higher-level decisions, I made a good living and I was able to turn my role into one that actually helped people. I wish that the company never closed. I was busy as a one-armed paper hanger but I was comfortable and relaxed about my position and confident of my worth. What I didn’t know was that in the series of unsuccessful jobs that followed, I would learn something about myself that I hadn’t realized before. I was a neurotic and paranoid knucklehead once taken out of my comfort zone.
I don’t know when it happened. I was always confident, cocky even. Then, suddenly I worried about what other people are doing, about perceived inequities, that I wasn’t getting treated fairly. I was never mean-spirited or petty, I just cared about things that previously had not occupied my mind. I suppose when my entire life was collapsing as I dealt with divorce, foreclosure, and kidney failure it naturally follows that I would be a little insecure, even paranoid. After all, when I go to a football game, I don’t think, I KNOW that they’re talking about me in the huddle.
Now that I’m healthy, relatively unconcerned about money, and too low on the totem pole at work to worry about being knocked off, I worry about the neurotic side that has emerged. I am a Recovery Case Manager. I work with people trying to recover from addiction. There are no performance metrics other than documentation. The rest consists of managing your own caseload with empathy and efficiency. There is no competition, we all run our own affairs with adherence to general protocol and a lot of individual styles. Management is supportive and largely hands-off. And I am fucking good at it. My clients are well-served and have everything they need handled. So why do I care how many cases the woman who started after I did has? Why do I immediately assume the worst when my manager sends me a simple email telling me that they want to go over something with me? Why do I have to remind myself that by all accounts I am doing really well? I can handle a lot, and my job gives me a lot of satisfaction. I sure don’t do it for the money. So why do I always wonder if I’m in trouble?
I hate this side of my personality. I love my job and I am really really good at it. I wish I knew where it came from so I can stick a stamp on it and send it the fuck back where it came from.
There’s a woman I’m interested in. She checks a lot of boxes. She’s kind, down to earth, pleasant, and also possesses a lot of the qualities desired by the superficial male. I’m fairly certain that should I ask her out I will get the right answer. She’s a pharmacist, so I already have the line I’ll use. I’ll pick up one of the million scripts that I’m on, call her over under the guise of having a question about the medication, and then say, “Will this medication interfere with the dinner I want to take you out for?” At which time she would of course be incredibly charmed, quit her job, her panties would immediately fall off and BOOM I’m in. That’s some Barney Stinson shit right there.
It’s too bad I’ll never actually say it.
I think I’m done with dating. I’m damaged goods. I have never had a successful relationship. Every relationship I’ve ever been involved in has ended in the friend zone or just plain ended. Never mind the age-old kiss-off “It’s not you, it’s me.” I really think it’s me.
As my ex pointed out to me as she was in the process of simultaneously fucking with my head, cutting off my balls, and tearing out my heart; apparently I’m “a lot“. At the time, I took it as a negative, as I’m sure it was meant. But months later I have a new attitude.
“If I’m a lot then go look for less.”
Fuckin’ right I’m a lot. I’m a lot as a friend, as a son, as a Father, as a worker and co-worker, and as as a Samaritan. I will do great and terrible things for the ones that I love. It’s a privilege to be part of my life because I’m as loyal as a puppy dog and as fierce as a pissed off Pitbull. I will not betray or speak behind your back, I will talk shit to your face and defend you when you aren’t around. I have one speed and that is straight out. I do this because I care, A LOT. I am weary of having to defend my actions as I continuously give a fuck about things.
Nowhere does this come into play more than in a relationship. In that situation, I AM a lot. I just haven’t met a woman who appreciates it. I’m unapologetically chivalrous without a whiff of chauvinism. I want to hear about her day. She always (cough cough) comes first, in that room and others her needs come before my own. And like in other areas of my life, I don’t look around at what I don’t have, I look in front of me to enjoy what I do. I’m grateful for everything, I appreciate the small things and I always find something to smile about. I give all that I have, I’m a people pleaser. That’s probably a detriment. Here are a few more. I don’t have my own place. I don’t have hair. I don’t make a lot of money. My health is good for now but who knows the future? All or some of these have resulted in rejection in the world of Online Dating.
I am not optimistic that I am going to find the person who is a fit for all that so I’m going to do myself a favor and do the tried and true thing; shut myself down before I can be rejected again.
If I’m too much, then go find less. There is plenty of “less” out there.
This was his favorite mountain. He had come here with his Dad since he was a small boy. “I can’t believe I’m skiing alone”, he lamented aloud to his audience of none. He inhaled deeply the cold, thin air and deliberately exhaled, studying the vapor trail of his breath. A childhood memory dashed through his frontal lobe of putting two fingers to his lips and exhaling “smoke”. It took so little to amuse us back then, he mused. The difference between those days and now, besides the lack of worries that have plagued him his entire adult life, was the absence of friends “smoking” and laughing with him. But it is a nice day. And it’s not so bad being alone. He enjoyed his own company. As if you have a choice? His inner monologue, whom he nicknamed “Annie Xiety” was pissing him off today. He refocused and studied the magnificent landscape around him. He slowly looked up and around. He was notorious for asking anyone who would listen if they ever did that. If they ever just looked around. Looked up. Or just looked away from their fucking screens for a second. People thought he was poking fun, “cracking wise” as his beloved Grandfather used to say. It was unfortunate that people chose to react that way, to assume that he was being negative or critical. He was just trying to help people learn what he had learned after his first brush with “the bastard”,(The bastard” of course was death, who occupied significant space in his head) that life is fleeting and merely existing isn’t enough, that Life is to be taken in like the cold air that was burning his lungs at this moment. The Shawshank quote by Brooks dashed through his mind, “The world got itself in a big damn hurry”. Yup, it sure did. He wished that they knew he wasn’t being critical or snarky, he just wanted to share what he had learned. To help them. But nobody listened, they just rushed on with their lives. They passed him by like so many opportunities he had missed in life.
He focused his attention on the slope below him. The grass was starting to show through everywhere. It would be Spring soon. A time of renewal, of rebirth, a fresh start. It occurred to him that he would need to be a hell of a skier to dodge those grass patches.
He reached the summit. The air continued to burn his lungs. A helpful attendant helped him disembark from the chair. He nodded a thank you and made his way, struggling with the skis, beyond the launching spot where the other skiers were starting from. The attendant called to him, “Sir, there’s no trail over there!” He dismissed the attendant with a wave, not even looking back at him. He then took off his skis and walked to the edge of the trail and looked down at the face of the cliff below him. He unzipped his jacket, reached into his shirt pocket and took out a piece of paper labeled Lab Results. He briefly looked at it, crumpled it and threw it into the cold air, watching it drift and bounce in the frigid air until he could no longer see it. He looked up at the sky, hands on his hips and stared at the treeline for a moment and said aloud, “I just don’t see why people don’t look up and around more often”? He thought about the bare spots on the slope. They would be challenging. Perhaps for someone else. It was not his worry. His chairlift ride was one-way. He would be exiting the mountain another way. On this glorious afternoon, he would accomplish two things; he would face his crippling fear of heights, and he would end his time in this fast-moving and superficial existence. He would be in the way no longer. He took a deep breath, closed his eyes and fell forward.
“If youth is wasted on the young, then wisdom is wasted on the old.” –George Bernard Shaw
I agree that youth is wasted on the young. They don’t know what they don’t know. But I have to question the second part of this otherwise brilliant quote. How is wisdom wasted on the old? Most older people can’t wait to share their experiences and for the most part, are ok enough with their past to effectively share what happened, why and the end result. My theory is that it can only be wasted on the old if a)they care not to share it, or b) nobody wants to hear it. I know when my dad tried to share it, I mostly brushed it off. I didn’t want to hear it. Of course, now I find myself talking to his stone, telling him how right he was about everything. His wisdom was not wasted on me, it just had a tape delay.
I like to think I have some wisdom to share with anyone who wants to listen. My wisdom stems from a wide variety of fuck-ups in my life. My scars, of which I have plenty, all have a tale to tell. Even the ones that you can’t see. I am a walking cautionary tale. But it’s a tale I will gladly tell. But someone needs to solicit it because I am not one to offer up anything unless requested. Maybe that is how it is wasted, young people who tend to “know everything” are unlikely to ask therefore the available resource of wisdom is untapped and therefore wasted.
We have a world of information contained in a single cell phone, yet we live in the most uninformed and uneducated era in recorded history. Similarly, the older amongst us contain a veritable treasure chest of knowledge about how things happen, why, and how to prevent them. But unless asked for, it will die off.
If my experiences can help just one person avoid a life-altering mistake, then all of my scars will have been worthwhile. Not wasted.
I blogged about legacy recently. I came up with what I consider to be the components of a life well lived. A life well lived is a good legacy after all. Here’s what I came up with.
Who are you? What is your purpose? What are you doing to achieve that purpose? What do you stand for? How did you make people feel?
I touched on the whole “who are you?” question. Now I want to explore purpose. For as long as I can remember I have asked big questions within. While I never outwardly projected as particularly educated, worldly, or intellectual, I always knew that I was capable of deep spirituality and able to ask profound and meaningful questions. Unfortunately, I did it within myself. So as I outwardly led a somewhat meaningless life I was at all times looking for my place in this world. I’ve always believed that everyone has a purpose, well maybe not everyone. Some people seem to occupy space without offering anything that resembles rent. But then it also occurs to me that maybe someone thought that about me! So touche’ I suppose. But I digress.
Finding one’s purpose is the ultimate goal of existence. If you are a believer in any higher power it logically follows that you are here for a reason. It is our obligation to realize the why, learn the how, and then put it to work. The first mistake you can make is to assume that one’s purpose is large in scope. A tiny rock thrown into a lake creates a ripple that grows and grows. One person standing up can start a movement that can topple a regime. One act of kindness could save a life and inspire a movement. And apparently, a shitload of cliches and platitudes can become a blog. Sorry, I had to.
God gives everyone a purpose, it is up to us to find out what it is. I found my purpose around the time I found my identity. When I dropped my hardass image, my Limbaugh-Conservative anger, and the “I’m in control and don’t-care-what-people-think” persona and recognized that it’s ok to be a nice guy with a good heart and open mind I found liberation. Nothing less. All of it occurred due to my story.
“He [God] doesn’t promise our stories will make sense, but He does promise they’ll find their greater purpose if we’re patient.” Father Stu.
There it is. My story is who I am today. It didn’t make sense to me for a long time. But “why me?” eventually evolved into “why not me?” and the humbling journey into the pit of chronic illness taught me lessons that nothing else could ever have. I have lost almost everything in my life and I found positives in all of it. I will not lie and tell you that I was always upbeat but I always found a way to claw my way back to it. In the process, I became a person that some found inspirational. My story, and the consequent person that I became from it, became my purpose. Now, I use the new attitude of gratitude to help other people. I can only do so because I have finally found peace with who and what I am. To hell with big houses, big bank accounts, and big egos. Here’s to living within my means, seeking just enough, and small gestures to make the world a better place. I have found my purpose.