100thCelebration

(This post was revised as of 7 January 2010, 13:45 PST.)

This is post number 100. A commemorative essay about all the wonderful things blogging has taught me seems in order. But I’m not in the mood.

Mystical themes come to mind. More of my transcendent moments demand to be shared. I’m brimming with ideas about peak experiences. But yesterday sucked. I don’t ‘feel spiritual’. (Note: see the comments on this post regarding the distinction between emotional feelings of spirituality, and the moment-to-moment fact of our spiritual natures.)

The problem was my appointment with an ophthalmologist. As it happens, she started working at my old department at Kaiser soon after my departure. We’ve spoken several times, but yesterday she seemed to have forgotten. I was ‘just another patient’, which happens more and more as time passes. Before, most of the doctors and staff at my local Kaiser recognized my name. And when you’re a Kaiser physician you get a gold-colored membership card to identify you. So the service used to be, well, gold-plated.

What a difference a decade makes. Now I get treated like everyone else. It should have been like that all along, of course. If Kaiser doctors could see the system through the eyes of ordinary patients, they might work harder to improve the experience. Until recently, it was difficult for me to understand why so many people complain about Kaiser. Now, without the coveted gold card, I feel like ‘just another body’.

The technicians were brusque and dismissive. The visual field operator refused to show me the results of my study. He was neither polite nor apologetic. When the next technician came to put dilating drops in my eyes, I asked her if we could dispense with the dilation, because it would cause me to lose a day of writing. She told me dilation was ‘required’ by the doctor, and necessary for good photographs. A moment later she lined up the camera and took pictures, long before the drops took effect.

Later, during a quick exam, the ophthalmologist used two lenses that I know require dilation. But I also know that she could have assessed my issue without those instruments. Nauseous and unable to read or write, I came away with deep resentment about how the technician did not slow down, get the MD, and allow for a reasoned discussion about the need for drops. The fact it was my own fault for not being assertive left me feeling even more frustrated.

The doctor spent less than five minutes with me, and seemed confused about why she sees me every year. I understood she felt harried, and she did not do anything technically wrong. Still, I disliked the assembly line style of care.

In truth, grief and regret were the real reasons the saga bothered me. Ten years have passed since the last time I worked as a physician in that department. All the old people are gone. No one remembers me. Instead of being an important guy, a subspecialist getting referrals from all over Northern California, I’m just another patient who gets pushed through in minutes. Although I sometimes think my ego has toughened, and can thrive without those old props, it is clear that part of me still hurts. With a hard-won career in ruins, it’s troubling that others perceive me as nothing but a washed-up surgeon with a crippled neck and major psychiatric problems, living on disability.

No matter how much progress my psyche makes, it remains vulnerable. Careless words, bored facial expressions, abrupt treatment in the clinic, all these things get to me.

Anyone watching my trajectory for the past four years would say that my condition has greatly improved. Consider what happened over a short period starting ten years ago: I lost my career; nearly committed suicide; spent time in two different mental hospitals; suffered a psychotic break; learned that my severe chronic pain could not be cured; had reason to believe my spinal cord had been damaged; almost lost my marriage; had a lawsuit settle against me; moved out of the city I’d called home for sixteen years; and began accumulating distressing medication side effects. Over the subsequent six years, my body grew into an obese caricature of its former shape, I failed at three new career directions, and dreadful hormonal imbalances struck at the core of my identity as a man. My father, two good friends, and my stepmother all died (losing my abusive stepmother led to a lot of emotional conflict, complicated by anger that her will deprived my sister and me of most of my dad’s estate). My spirits sank and sank. In recent years, thankfully, I’ve started to turn things around. I’ve lost fifty pounds, gotten at least some of my sexual identity back, and have learned to forgive myself for the early retirement. I’m writing regularly, and beginning to see how my wife and I might scrape by financially. My flight path is climbing, and most of the time I soar above the clouds.

But yesterday hit me hard. By the time I returned home my mood had plummeted. Everything looked blurry and my stomach churned. Unable to sit at the computer, unable to read a book, unable to go outside (too bright, even with sunglasses), I became bored and angry. Most of the afternoon passed with me curled up on the guest bed with one of the dogs. We laid together in the dark, and felt sorry for ourselves. (Actually, Ralphy probably felt fine, getting all that attention.)

So it wasn’t a banner day. I would feel fraudulent writing about grand spiritual ideas after an afternoon like that. And celebration is more fun when you feel celebratory. Today, I feel hammered and bruised. But the morning is just getting started. I’ll walk the dogs, go to the gym, spend the afternoon writing, and try to get back on track. As they say in AA, “Progress, not Perfection.”