Back to Teaching, YES!

A couple of Wednesdays ago I returned to UMASS-Boston to start the Fall semester. Out of all the modalities within the addiction/psych field that I am engaged in, this is far and away my favorite.

My students range in age from 18-88 (really, 88!) My Wednesday class is a practicum class in which I have five students. We meet every other week. In class they will present weekly from the journals that they keep what they have been encountering and participating in at their practicum sites. I will also call their site supervisors from time to time to get their 'read' on how the student is progressing. This class is usually one that they take towards the end of the program.

When I arrive to the campus I usually will head over to the student union building hit the cafeteria, grab a large ice tea with lemon, then head over to my 'perch.'

This seat at a high-top table looks out over the main drive through the campus and out at Dorchester Bay. Here I will look over the material one last time before I present that evening. If you had told me twenty-seven years ago that one day I would be an educator, I would have laughed at you. I was still on the Boston Comedy scene. Comedy writer by morning at WBCN, stand-up comedian by night all over town.

In December of 85' I guess you could say I decided I had had enough of the 'party' scene in Boston and the price I was paying because of it in all areas of my life. People who know me understand what I am saying. Another spot on the campus that I like to hit if I arrive early enough are these three trees where there is a concrete bench that overlooks the bay. Just a really nice contemplative spot that I enjoy.

Hmm, 'three' trees, sort of reminds me of 'Father, Son, Holy Ghost,' or, 'Baby, Adult, Old Age.' Guess I have been reading too much Joseph Campbell again and his fascination with three's, lol. I highly recommend the book, "The Power of Myth" as a primer to this remarkable man. Well, time for me to get some other 'work' done so I will leave you with this final shot from the campus. I wish you all smooth sailing.

Return to my Psych/Addiction Roots - “Inpatient”

A couple of weeks ago I filled-in for the head of social work in the locked psych/addiction unit across the hall from the partial hospitalization day program that I usually work in.
After starting my career working for three years in a public detox where I was always fascinated by the patients that never slept, those that seemed to never get out of bed, and those that would be carrying on conversations with, well, people that were not there, I found myself spending the next fourteen years working the locked units.

My compassion and empathy are on ‘over-drive’ when I work on these units. I more often than not find myself drawn to the people with Bipolar Disorder that are either in a manic, depressed, or in a mixed state of mind.
Being a person with Bipolar Disorder (Type II) I can understand probably better than most of the staff what they are going through.
This is not to say that I believe “only” people with Bipolar Disorder can work with those that have Bipolar Disorder. Quite contrary, I feel the need to be careful so as not to disclose or share my personal experience in order to maintain a therapeutic relationship as a professional, rather than a ‘mutual’ one.

You have to love my brethren though. Talking to a patient that was in the tail-end of a manic episode, everything he was talking about made perfect logical sense. That is until his concluding remark to me. ‘Willy, do you think they will release me Friday? I have to be at the Boston Commons by 4pm on Saturday to catch the flight back to Jupiter!’
‘Hmm, maybe we should play that by ear regarding Friday, o.k? o.k.’ There is something about the camaradiere that staff share on an inpatient unit that you will not find in any other area of the Psych World. Due to the possible volatility of the patients at a moments notice, staff watches each others backs constantly. Sort of a professional hyper-vigilance. At every facility I have worked over the years all the staff was on a first name basis (yes, even the doc's). A nice human to human touch
So here I am wrapping up a weeks work inpatient with an hour and a half to go and it happens. A new admission decides that he does not want to be on a 'locked' unit and he literally, 'loses it.' Next thing I see in the hallway are two mental health workers on either side of the patient holding him as he is trying to break free from them and crash the locked-door. I'm thinking, 'wonderful,' as I race down the hallway to help them contain the patient. Most of my assistance is holding him from behind so he can't twist to the sides to get away. After what feels like an hour (real time probably 5-10 minutes) the patient calms down to the point where one of the mental health workers can get him to talk rationally.

I felt relieved that he did not have to go into restraints and was willing to take medication to further calm down. Nothing 'sucks' more on an inpatient unit then to have to do a four-point restraint. When I first began in the field if the patient was in an open area on the unit acting out staff would be assembled for what was termed in those days a 'show of force.' Really? A show of force? Now there is language just destined to escalate a situation, right? It's us, against them. That is why in the early nineties I changed it where I worked at the time to a 'Show of Support.' You know, human to human (and yes, I am taking credit for that phrase). I did enjoy getting back to my roots again though. I like to joke that I know I am doing a great job inpatient when it takes the patients a couple of hours to realize that I am a staff member due to my wild sense of humor. 'Hey, where did you get the staff name tag from? What? Your a staff member? You can't be, you are as crazy as we are!'

No, I am a human being just like you are...

A Reunion That Took Over 25 Years To Happen

In September of 09' there was a celebration at the "Paradise" Rock Club in Boston for all of us that had worked in one capacity or another for the "Rock" of Boston, WBCN-104FM.
That evening I left with my wife early and I missed seeing several of my old buds.

Last Sunday my wife Yvette and I attended the Boston "Comic-Con" held at the Seaport World Trade Center. Our two sons with several friends have a highly successful entertainment/pop culture website/blog (www.omega-level.net) and we were visiting them at their table.

We decided to walk around and take a look at some of the other exhibits. Yvette turned to me and said, 'Oh look over here, Billy West is going to be here in about half-an-hour for an autograph session.'

My heart started racing. I walked up to the people preparing the area for his arrival with a beaming smile and said, 'so Billy will be arriving in a little while?' A woman turned towards me, smiled back, said yes, then asked if I was a fan. I chuckled and replied, yes. Then I told her how we had worked together at WBCN in the eighties and that I had not seen him in more than twenty-five years.

She then remarked what a great surprise it would be for Billy to see me! She followed that by saying I will bring you and your wife right up front to chat with him before we let the crowd in.

For those of you who may not know who Billy West is think: "Ren & Stimpy," "Doug," the "Red M&M," "Fry & the Professor" on Futurama," "Cheerios Honey Nut Bee," "Warner Bros Cartoons," etc, etc, etc. Billy is one of, if not, "the" premiere voice talent in the world!

As we waited my wife seemed a bit uneasy. I asked her, anything wrong? Well, I am just concerned for you that maybe, you know, maybe he won't remember you. Those were pretty crazy days, right? He'll remember I fired back. I was on the Big Mattress crew for almost four years. Then I felt a slight uneasiness. I had not even remotely thought about that possibility until she broached it. Now my brain was spinning.

Ten more minutes passed (which seemed like hours) and then he arrived. Yvette and I were brought right up to his table as he was about to sit down.

He turned towards me and said, 'Hi, I'm Billy.' I smiled at him and said, 'Billy, Willy Drinkwater, it's been more than twenty-five years.'

"Willy!" "Oh my gosh, have a seat!" We started talking about some of the wild times we had at the station and around the Boston scene in those days gone by. At one point he turned to Yvette and told her how I was one of the few that he always liked. That I was there for all the right reasons, not looking to just promote myself and that I wanted to learn.

After chit-chat for another ten minutes I felt it best to wrap-up our discussion so his 'other' fans could see him.

Billy & I both made life changing decisions in 1985. Those that know us understand what I am referring to.

Billy went on to become an internationally known and respected voice talent, and I took my sense of humor and incorporated it into counseling and teaching.

Geez, it was Great to see him again!

Psycho-active Prescriptions & Your Primary Care Physician

I'm Back...

Let me start this blog with a statement from a recent CNN story on prescription drug abuse (http://www.cnn.com/2012/11/14/health/gupta-accidental-overdose). In the United States, we now prescribe enough pain pills to give every man, woman and child one every four hours, around the clock, for three weeks.

We have a population of 311 million people – you do the math. (Don’t bother, I already have. The number is: 39,186,000,000 billion).

This is just the pain-killers.

Why? I feel in large part this is due to the limited training our physicians are receiving in medical schools across the country on mental health and particularly with regards to addictions. Having been a preceptor for a medical school in the Boston area I can tell you first hand that the training is roughly thirty hours. Yup, that’s right thirty hours with most of that academic rather than clinical with patients. Ask them the next time you see them. I feel confident their answer will blow you away.

Not to mention the number of patients PCP’s see every day in order for their practice to survive.

Do you really want your PCP to be prescribing you a psycho-active prescription with that limited a background?

The insurers may think this is fine. I mean, after all, the person is an M.D. right? The real reason they do not mind this practice is that it saves them the cost of having the person referred to a specialist, a psychiatrist, a psych nurse practitioner.

Even in the case of say, anti-depressants, are you making sure they are connected to a therapist? It might be nice if they have an unbiased person that can detect changes from appointment to appointment (for better or for worse).

I am sitting in a conference right now being put on by Harvard Medical School in conjunction with the world renowned McLean Hospital and they are espousing the view that PCP’s do not get enough education on addiction and mental health (I’m on my lunch break, don’t worry, lol).

Soooo, what are we going to do about this????

In the case of PCP’s prescribing psycho-active drugs I would like to see an across-the-board policy whereby before writing ‘said script,’ the patient is given a urine tox screen. Does it not make sense to see what if anything is already on board and the amount? By doing this across-the-board one would find it difficult to claim they are being discriminated against due to a past or current addiction history. Scripts would be for one month at a time with a new tox screen being done before a new script is given. Scripts would be for one month at a time.

The prescribing PCP at the time of the first script would provide the patient with numbers and agencies where they can obtain a therapist.

Before the next script could be written (second one) the patient would be required to provide proof they are currently in therapy. The patient would have to have signed releases so both therapist and prescriber can communicate and update each other.

Post Holidays – Welcome 2013

Jeez, the month of December is over and I realized today that I did not write one single blog the whole month.

No excuse other than not making the time to do so.

I let life (particularly work) get in the way. The hospital where I have been working relocated us twice during the month; each move with its own set of nuances and complications (viewed as challenges – not problems by yours truly).

A wonderful, inspirational buddy of mine had made the suggestion prior to these moves to, “get yourself a latte machine or a basket of good teas…” Sue, I took your suggestion and all I have to say is, “Merci beaucoup.” Nothing quite like a good mug of tea with a squirt of lemon and a dollop of honey, eh?

Last evening colleague Vicki Glow and I were on the Jordan Rich Show, WBZ-Boston, 1030AM radio (nice range, 38 states). The topic was ‘prescription drug abuse.’ Of course due to addiction being such a multi-faceted issue the conversation weaved in and out the designated topic. Look for Vicki & me to do more this spring.

This past week found me interviewing with a hospital closer to my home for a position similar to my current one but with more opportunities to grow and develop as a professional. All parties involved are excited about the possibility of my coming on board (patient states, lol). Pending HR approval I should be receiving an offer in the mail this upcoming week (based not on my ego – based on the nurse manager asking me how soon I can start, again, lol).

I start back to teaching the first week in February and really look forward to it as always. I have been researching both the ‘pro’ and ‘con’ side of the “Suboxone” debate. In a future column I will present both sides of this controversial issue with corresponding links to articles that look at both the empirical studies and clinical observations.

This should raise quite a ruckus I imagine.

Well, I need to get back to working on my website and attend to a couple of syllabuses for February.

To my French Canadian Friends, “Jusqu'à ce que nous nous revoyions!

Peace, Out

Willy