Tuesday, November 30, 2010

tough transitions

tough transitions is a book written by dr.elizabeth neeld and it speaks to the tough times in life that are driven by circumstances, mostly unavoidable. these times come and go in life. this is undeniable. undoubtedly i have not met the challenges at my potential at every given turn. to reflect on a transition that worked me instead of working for me, i look back to 1996. i had been pushing myself to get through my community service hours to satisfy my probation requirements for my dui. at the time i worked about 50 hours a week and then put in 8 hours on saturdays shelving books at the public library and finished hours out shelving at the school of mines. with all the pressing on, i became weary and overtired. i went to the doctor and my doctor ran blood tests- it was confirmed that i was hiv positive. the wanted to start me on meds to address the onset of viral replication.

since i had been confirmed positive once before in 1995 and kept that truth in the dark corners of my mind, there was once again a process of acceptance that was required. and i agreed to start meds, even though for the 11 years prior i had renounced the medical field because of their naivete around hiv and their willingness to prescribe and over prescribe. yet, here i was in 1996 imbibing meds that were not self-prescribed and had a nervous breakdown. i didn't sleep for a week, lost touch with good sense, and became paranoid and goofy. i finally slept after being diagnosed bi-polar and given more meds that helped bring me back into general focus(along with regular sleep).

funny thing was , after about a month on these new meds, i felt better physically and energetically than i had for as long as i could remember. and strangely, along with this renewed feeling, a very fearful sense that these past 11 years had been in vain as i had not really planned for any kind of future. yet there i sat with a bleak and black future in front of me. what followed was my usual practice in life- act on instinct. i quit my job of 11 years and started a new gig. i started partying heavily again, worked out a transfer with my new company to san francisco, and kept the party going. soon cocaine and meth were on the guest list, and i couldn't keep up with my own version of a grimm fairy tale that was reflected in my life. buildings in new york toppled after swallowing planes, economies tumbled like stacks of jengo logs, and realities shape-shifted just as quickly as my waistline did with 2 full years of daily meth use.

this transition in my life, the onset of hiv meds and the conquering of my denial, was an opportunity that was missed, or at least very painfully delayed. instead of being open to moving forward with my life, i became intoxicated with not feeling the strangeness that acknowledgement and treatment delivered. i kicked away my stability and concentrated on trying to rebuild a foundation, in lieu of remodeling an already sturdy casement.

according to dr. neeld, transitions such as these happen in our lives. and they will continue to happen. we age, we lose jobs, we divorce, we lose friends, we become ill, etc, etc..  and her insight is finding the poise to recognize when we are in a transition and find a way to look to the outcome in lieu of becoming lost in the process drama.  there are 3 questions she offers to guide us through highly troubled times. i believe that some of the power of change is in the asking of the questions, and some comes in our own answers.

How can there be any hope when we have already lost what we hold most dear? Where does hope live when we hear the words announced to us, “There is no hope”? We cannot bring the person back. We cannot return to life as it was.
For a long time people have been thinking about this dilemma. One of these individuals was Immanuel Kant who lived and wrote in the 1700s. Kant thought a lot about the kind of subjects we might label as “the eternal verities”: hope, ethics, God, morality, the meaning of life. Kant came up with three questions that he thought expressed the central human concerns. Here are his famous questions:
What can I know?
What can I do?
What can I hope?

this is an ongoing topic for me right now.... more to follow...


Saturday, November 27, 2010

a generic issue

as i muddle through my daily routine,, well aware that so many issues are far beyond my grasp such as ADAP funds in Colorado and nationally, budget cuts, dropping drugs from the covered formulary, co-pays for indigents living at poverty level, among other plans have spurned concerns around work and the state that perhaps we are not looking in the right place.

those concerns include the discussion of the patent expiration of 3TC. It is a drug that is not in that much use the past decade. FTC (chemically similar to 3TC) and Tenofivir are the drugs-du-jour when  combined as Truvada and also with Sustiva to make Atripla- the latter being the once a day marvel that has helped push bare backing out of the shadows.  3TC and FTC are similar enough (according to some doctors I work with) to perhaps interchange individually and could perhaps be used in combination with the other drugs on an individual basis.

the concern is that removing access to drugs may not be the the kindest, nor the most efficient with regard to caretaking our citizens. there seems to be a very very large channeling of funds to the biotech company responsible for the distribution of these drugs-du-jour. the question is how much loyalty and gratitude is required for the groundbreaking work that has been brought to the table. and at who's expense? to illustrate just a glimpse of what i am describing here is a list of revenues posted at gilead's (pharmaceutical engineer) investor site

Antiviral Franchise
Antiviral product sales increased 19 percent to $1.60 billion in the first quarter of 2010, up from $1.34 billion for the same quarter of 2009. The increase was driven primarily by sales volume growth of Atripla and Truvada.

Sales of Atripla for the treatment of HIV infection increased 36 percent to $692.9 million for the first quarter of 2010, up from $509.9 million in the first quarter of 2009, driven primarily by sales volume growth in the United States and Europe.

Sales of Truvada for the treatment of HIV infection increased 11 percent to $657.8 million for the first quarter of 2010, up from $590.4 million in the first quarter of 2009, driven primarily by sales volume growth in the United States and Europe.

damn that's a hefty income. no wonder when looking at truvada singularly, approximately 1/2 or more of all the combinations that are prescribed by physicians in the US include this blue pill. If 1/3 of these could be switched to a 2 drug combination with a generic,   then could the monies be diverted to address the waitlists and the mental health medication that is so necessary to support drug adherence in patients with mental health issues?

there is so very much of American ADAP funding going to this pharmaceutical conglomerate. is it impossible to think that we might try to save some monies here? how much does it cost to make equal access to everyone?  is health care reform still going to be for those who can afford it first? Generic lamuvidine is available outside our borders, but not here in the states.

there are currently around 5 companies in the US who have been approved for the production of the generic of 3TC. since there is currently very little demand for it, there is understandably little interest in producing it. but if the national ADAP offices were to be effectively looking for cost-cutting measures as most of American households are having to do right now, would the landscape on demand for 3TC change?

currently there are over 1000 Americans on waiting lists to start drug therapy for HIV. reviewing just one pharma's income for a year makes me wonder how much does the right to good health cost? perhaps if pharmas were to redirect their lobbying monies to patient care, there would be no waitlist or budget crunch. perhaps if the market were opened up a bit, the free trade tendency would drive down pricing to a level that didn't burst the state's budgets? can we count on our lawmakers to do what's best for everyone, and not just for a few? will we require low-salaried employies to pump out gads of paperwork to save the income of a select few? what is good business and what is over the top? when do we become "good americans" again?

Friday, November 26, 2010

i wish someone would care

i was googling and came across a list of r&b songs from the 60's. most were familiar to me, but there are a few that i haven't really familiarized myself with. the following is one of them. the recording artist is irma thomas and the title is "i wish someone would care". it was released in march 1963 topping the charts at no. 2. definitely worth a listen. here bio album is full of songs recorded throughout the years. have fun!

Monday, November 22, 2010

a little chicken

when i was about 18 years old i saw a film about the mass production of meat in america. in it, there was a film of a large chicken warehouse with the chicken coops stacked on top of each other and crowded in this huge space like an overcrowded prison. i also remember a small box that baby calves were kept in the dark with no ability to move to keep their muscles from forming.

i became a vegetarian for awhile after this. mind you, this was in 1981 or so. i became macrobiotic for a short while after that, working too hard to follow the teachings of george and michio kuchi by eating seasonal and local vegetables, no red meat or fowl, and only seafood on occasions. this menu included lots of salt and lots of pickled foods. pickled daikon radish, umeboshi plums, over baked plum seeds that became ashes, and baked carrots that were meant to be sweets. this particular diet was challenging. as you can imagine, hardly any of my peers practiced this dietary principle and it was excruciating to eat out or go to friends for dinner.

for me, however, the image of those cages stacked on top of each other so close they could be pigeons hiding from the rain, shitting on one another, unable to move, being fed vitamins and being pumped full of  steroids stuck with me. still does for that matter. i stopped eating chicken right after that meal. it makes my flesh crawl to think of even putting that meat in my mouth. turkey, duck, and quail don't affect me this way, but i don't eat them often either (turkey once or twice a year, duck and quail- never).

but chicken ghouls me out. sometimes i will see salads with chicken that has a gray tinge and i shudder quietly (and invisibly i hope).  today i was served such a salad. this has become a phobia for me. in addition to this idiosyncrasy, i have also developed and aversion to eating meat off bones. i haven't done this for years either. (no snickers please!:))

so t-day is just a few away and i am getting a little foggy about these boundaries again. we have purchased a free range, additive free bird from a local farm. it is small, and it will no doubt be more a tradition than a necessity. i will eat the veggies and the cranberry sauce more than i will eat the national meal. and that's just fine with me.

this clip really has nothing to do with this post. i am just feeling a bit melancholy and jane oliver takes me back to a time when hope was bursting at the seams. something to soothe my soul after looking at those pasty dried chunks of flesh today.

Sunday, November 21, 2010

thanksgiving..... and brighter days

photo credit.. fineartamerica.com

the week of thanksgiving has become a very strange time for me.  years of numbness have begun to unravel. am working hard to change what had become the tradition. it involves patience and awareness. but it really takes faith. i came back to the place that all that happened. i didn't realize it when i was making plans, but i wonder if i also was hoping to begin to see this holiday with new eyes.

but what i hadn't expected was to also see that pain and sadness are not unique to me. i don't have sole ownership of those emotions. i have traced a footpath here in my former hometown and discovered that all those i love carry their own share of such burdens. lance armstrong said "Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever.” i am beginning to understand his meaning. it has taken me so long to understand this. i am thankful i am beginning to get it now.
i am re-publishing a post from Nov 21, 2007. i can't write about it now. i can however, attest to the shift in my perception of it. it no longer causes me to close myself off. i don't automatically withdraw. instead, i am venturing out and trying to make new traditions and doing things differently.

one of the stories i will not hear this year is my last thanksgiving in chicago. i am going to write about it here and hopefully the tale will unravel itself a bit differently than it has in the past. i have spun this yarn on a few occasions, but i have always kept the focus the part where i am the victim. and honestly, thanksgiving still is a challenging emotional trek because of the drama on this day. it really is the day i stopped dancing. the last day that is until i started channeling velvet- but that's a tale for another day.

it was 1985, and i had gotten an apartment with my best friend paul the previous year. we had shopped and hunted for 3 months for that beautiful soon-to-be condo on logan blvd. 3 bedrooms, 2 baths, full kitchen, dr, front and back balcony. it truly was stunning. but on the day we were moving in, paul was completely tuckered. i remember him sitting on the back of the rental truck, saying he just couldn't move any boxes. He was exhausted. and before we finished, he insisted he go to the hospital. we complied, and he was admitted and was in the hospital for about a month.

i went to visit him in that place every day. the first couple of days, i donned a hospital gown, mask, and gloves, but soon decided to put them aside after that. i wasn't going to be looking at him dressed like an alien, or like i was afraid to be near him. i wasn't. i loved him. still do. and i wasn't going to cause him any extra anxiety. i would bring him meals from some of our favorite restaurants. the hospital food sucked, of course, and i knew he needed to eat. we had a very pleasant time being food snobs in there and would laugh together and became closer, without ever really discussing the elephant in the room. i couldn't go there emotionally.i now know it's called denial, but then i thought of it as survival. i remember one day going to visit him, and finding him in his room alone, with a fever so high that his body was convulsing, jumping up and down on the bed with no assistance. it scared the shit out of me, watching him jerking up and down like darryl hannah losing life in blade runner. i left in horror and came back a couple of hours later, never speaking a word to him about what i had seen.

my drug use started to escalate after this. the cocaine use was incessant and i drank vodka to counteract the effects of the cocaine. numbing became my priority. this actually caused paul to move back in with his parents, and my friend robbie (foxy)moved in. poor fox- he had no clue as to the mess he was entering. but that's another story.
fast forward to thanksgiving 1986. paul had been living with his family for a few months now. he had been in and out of the hospital. i had invited about 8 friend over for a holiday feast. i spent all day preparing the food. turkey rubbed with butter and tamari, baked with apples, onions, and cranberries, stuffing, brussel sprouts, home-made cobbler, etc. as the day progressed, the weather took a turn for the worse. a thunderstorm took hold. one-by-one calls with cancellations started to come in. it had become dark outside, and the last call came from my friend blue. i think he really had waited until he absolutely knew he couldn't get there. no cabs were running etc. i remember sitting at the head of the table, looking at the fitz and floyd and the crystal candle holders and feeling stunned. the phone then rang again, and it was paul's brother on the phone. he wanted to let me know that paul had passed a few hours earlier that day. he had gone peacefully and was no longer suffering. i returned back to my seat and looking over the empty but well laid table, clutched my wine glass and took a big swig. a huge lightning bolt back lit the entire sky, was followed by an earsplitting crack of thunder, and the power in my apartment was knocked out. there i sat in the dark, and found myself feeling more alone and more confused than i could remember. and i was a victim. and i had imprinted that pained mask onto myself and held it there for a good 20 years.
i managed to let go of that branding i did a few years ago. i honestly loved paul (and the rest of the veedubs), and was completely a mess having lost him. i laughed so freely with him, and he understood so many things about me that i always felt shame around, and never did anything but expect me to succeed. we dined out a lot. we danced. we went to the theatre, we saw films.  and we read a lot of books- mostly the classics, and the "gay" authors. we participated in salons of a sort with a few other friends, and would drink wine and read aloud from books like "To The Lighthouse" by Virginia Woolf, "On The Road" by Jack Kerouac, and my favorite "Orlando" by Woolf as well. We talked about Vita Sackville West and Virginia, about Paul Bowles and his entourage, Kerouac and his band of mary-men lol, Stein, Toklas, and the ex-pats....

this was my posse in the late 70's. a band of marys (and lulu) just making our way. you can find myself and paul in the upper left corner- me pretending to have a mustache and paul with glasses.

thanksgiving has begun to represent a new direction for me. i remember each year (and post this) but have realized how lucky i have been. not so much lucky for living or surviving when my best friend didn't. no, more because i have been fortunate enough in my life to have cared so fully for such a person. i was able to see the selfless side of myself early on in my life thanks to caring for paul. i found strength in myself i never knew existed. i learned how much better it feels to give than receive, although it was too short a lesson. i may never love anyone like that again.

today i see that life most certainly is a banquet, and i spent way too much time starving myself. melancholy somehow gets in step, but i have come through some deep merde.

i now sing a new song... brighter days have come... thankfully..

Saturday, November 20, 2010

Transgender Day of Remembrance 2010

Transgender Day of Remembrance 2010

rock a bye

Everything's gonna be all right

Rockabye, Rockabye

Everything's gonna be all right

Rockabye, Rockabye


the origins of addiction for many people most certainly lie in the concept of comfort. drinking and getting high feels good. it comforts. and it often relieves us from painful or difficult or uncomfortable situations or feelings. just think of how a cocktail or two after a hard days/weeks work can almost seem to wipe some stress away like on a dry erase board. mashed potatoes, mac and cheese, hamburgers and fries, a cold, cold pilsner, a dirt martini up with blue cheese stuffed olives, a short tumbler of grappa after a 4 course dinner on the continent. just a little vicoden for the back pain.

for the majority of people, any of these will simply be another in a long list of things that we allow ourselves to enjoy. but for that small percentage of souls, one of these (or all) are the only options that actually work when it comes to offering comfort. maybe they felt abandoned by one of their parents when they were  young, and weren't able to find balance. or perhaps they were  molested while still a child. or maybe their parents had a volatile or violent relationship and  internalized that it was because of them. of course there is also the possibility that they were born with a chemical imbalance, or grew up in an environment that fostered depression or a diet that enabled adhd. whatever the situation, for a small percentage of our species, the only self comfort learned by them is the addition of something, food, sex, drink, drug.

so it seems quite easy to follow this logic to the place we all know exists-overuse. this indulgence of comfort slips quietly (or not) into a dependence or addiction. as this occurs, any ability they had to comfort themselves slips into the mists of invisibility.and the chasing of this comfort becomes the order of almost every day. and instead of comfort, it becomes snippets of comfort and trying to comfort and the absence of this comfort is more important than the comfort itself, because the brain and its organic chemical processes have adjusted to accommodate this need.

self-comfort seems to me to be at the heart of the matter. a cup of tea, a burt bacharach album, an old hollywood film, a run in the park,  a good nap. these actions, just like journaling, reading, talking with a friend, need to be explored in a new way if self- comfort is to be revived. sounds easy, but if it were, then our comrades with these issues would be able to stop behaviors whenever they wanted. however they can't. who would lose their job and income if they could intervene? who would get arrested repeatedly if they had the ability to change their life's course? who would wander the streets at night, sleeping where they could, if they had a choice? who would choose any of these discomforts if they had a choice?
You see, we can't always be with other people. We can't always feel safe. What we do need to do is teach ourselves how to deal with our alone time and the thoughts that go on in our heads. How do those thoughts make us feel? Anxious, scared, panicky, nervous, jittery, lonely, sad, depressed? If we don't figure out how to be alone with ourselves, we are in for a scary trip to the end of our journey.....Susan Thom.... searchwarp.com

Saturday, November 13, 2010

why the pain

Hungry Ghosts:

Characterised by - Greed; Insatiable cravings; Addictions.

"I want this, I need this, 1 have to have this".

This is the realm of intense craving. The Hungry Ghosts are shown with enormous stomachs and tiny necks - they want to cat, but cannot swallow; when they try to drink. the liquid turns to fire, intensifying their thirst. The torture of the hungry ghost is not so much the frustration of not being able to get what he wants. rather it is his clinging to those things he mistakenly thinks will bring satisfaction and relief. The Buddha in this Realm holds a Bowl from which the 'gifts of the gods' are distributed. This is to entice the hungry ghosts to desire for the Truth which is the only way that the deepest longings and hungers can be satisfied.
Consider: 'Gollum' from Lord of the Rings; The obssessive nature of Video Games; Addictions of various sorts; We can be helped in this Realm by our willingness to 'look up', to see beyond our obssessions...... reposted from buddhamind

i went to a dinner hosted by the harm reduction action center in denver last night. the hrac work with injection drug users to reduce health risks and also inject human kindness into their worlds. the evening was also benefiting improbable pictures who have been filming the creation and development of u.s.e.d (underground syringe exchange denver) as needle exchange has been completely illegal in colorado until may of this year. btw, exchange has not been implemented anywhere in colorado to date, the only legalization was that local governments can now decide for themselves about appropriateness.

the keynote speaker was dr. gabor mate, a vancouver physician who has been working with idu (injection drug users) for 12 years and runs a residential program in that city. he recently wrote a book that i have previously written about briefly called "in a realm of hungry ghosts". it refers to a buddhist concept of the 7 realms that we move through in life. the realm of hungry ghosts is depicted by a very thin dark creature who is always eating and never full. his perspective on addiction and causation and treatment. he blends  20 years of addiction science with a sense of common sense and simple human kindness to highlight a whole new direction of treatment which makes the assumption that the reason someone is over medicating is due to pain. and he maintains that instead of asking individuals "why the addiction", we should ask the question "why the pain" and his experience demonstrates a completely different response. he frankly finds that all the female addicts he works with were sexually abused when they were young.

"why the pain" is a question that seems so simple, yet i don't actually think there is an easy answer at all.  i don't mean that the response "my mother abandoned me" or " my uncle molested me" or " my father abused my mother during my childhood" are not simple. the words are simple. not more than 7 or 8 strung together at one time. no, the complications are not in the expression of the concrete aspects of theanswer. the challenges in the answer come forward in the manner in which the individual comes in the treatment door.the bio-psycho-social factors that have brought them this far. they have a lifetime of (not) coping skills that have been built up. a trauma that happens early in life (especially when repeated or endured over time) can cause a person to shut down so as to stop the emotional pain.  it makes complete sense that these individuals would find external chemicals such as opiates or alcohol that help them feel (especially pleasure). what makes even more sound sense is that letting go of these compounds is not an easy task, especially since for most of them, they may connect to the only pleasure these individuals have felt for as long as they can remember. btw, they usually forget a lot of the pain that led them to addiction with good intention- survival.

for me, i look to the explosion of crystal meth use in the gay male population in the industrialized world in the last two decades, with the highest percentage being hiv positive. this reasoning brings clearly into focus an explanation of this madness. is it not common that gay men identify feeling love and intimacy through their sexual contact, and being hiv positive would directly inhibit this process. crystal meth no doubt allows men to circumvent this inhibition and refill their emotional coffers. but when the emotional coffers never feel full, happiness is elusive, and continues to be chased.

it's a simple question... why are they doing meth? to feel better. to connect with ohters sexually, to feel loved.  if sex is how we communicate- how else do they make this happen?  the only way they have known to feel loved has been diminished and neutered?

Thursday, November 11, 2010

it's nature's way (and john fielder's)

photo image john fielder donated to denver health

So many come to the sickroom thinking of themselves as men of science fighting disease and not as healers with a little knowledge helping nature to get a sick man well. - Sir Auckland Geddes

this photo has been added to the lobby of pavillion a at denver health and was unveiled in a small ceremony today. the photographer john fielder was present and talked a little about his work, his relatioship to work, nature, and his relationship to that. his perspective abouut nature and healing is that they are connected. nature is the major healing force. it's a beautiful perspective. i certainly can vouch for both the miracle of medical science and the completely transforming majesty of a good night's sleep.
just as powerful might be his donated image. filters on the camera allow for the sun to be captured in this fashion. my impression of the photo is a very spiritual and very hopeful one. and i'm happy i'll see it now and again as i meander through my workday.

you can see more of john's work at his site

this is one of my old school faves... allison limerick with "this mortal coil" doing a 1991 cover version of "nature's way" originally by a band named "spirit"

Tuesday, November 9, 2010

dog days are over

image credit.. hans bellmar via dennis cooper

Run fast for your mother, run fast for your father
Run for your children, for your sisters and brothers
leave all your love and your longing behind
You cant carry it with you if you want to survive
The dog days are over
The dog days are done
Can you hear the horses?
Because here they come....

i haven't had much experience in identifying real courage. i certainly don't think i have had the opportunity to display any (at least on purpose). it started out cattywampus and spiraled from there for me. i have always considered myself a misfit and assumed that i would never be the right fit for much of anything.

i have forgotten the zest with which i left home in my teens to live life on purpose and say "yes" to pleasure. to be so sure that anything or any unknown  had to be better than the agony and frustration i was feeling then.  i was convinced that i was being courageous by stepping outside the box. the truth though, in hindsight, was that i was running from myself. i didn't have the courage to stay and work things through right where i was at.

this particular drama has played itself out repeatedly these last few years. i slip into a situation(either literally or in my own mind) where i feel that i can't tolerate the bullshit any longer and i do what i always do. i run. i calculate a new move, sometimes forward, sometimes not, and bolt. like a cat with all those lives, i have managed to land with some balance. and all this time, i have done this ritualistic, history repeating itself, ceremonial dance, without even realizing that i had been like a tiny character in a music box, just replicating the same movements to the same tune by rote.

as this new layer of truth has revealed itself, i become disenchanted about my ability to determine my own motivation. am i in the throes of some old trauma? am i afraid of conflict? do i fear rejection enough to reject myself first? do i feel more comfortable running than i do settled? these are the questions and judgements that run through my mind like a cat in a cage. why am i always sure that i am in the wrong when i first consider an encounter?

i don't have the answers to these persistent queries today. i don't think i am close to knowing all the way around the truth. and i don't think i have to know. what does come increasingly clearer to me is the painstaking forgiveness i need to breathe. breathe in and breathe out. tonglen as the buddhists named it. inhaling in the essence of letting go of judgement of myself and conversely exhaling the wonder and simplicity of acceptance of the world i live in.

this breathing exercise i have adopted is not automatic or second nature at all. it is almost against my nature actually. it requires work. it takes effort. it calls for being awake.

Monday, November 8, 2010

silence for the ring of fire

Indonesia volcano 2010 update. The volcano eruption of Mount Merapi in Indonesia is one of the natural disasters to hit Indonesia in recent weeks. Actually, Mount Merapi erupted twice killing several people and leaving many others displaced. There have been 38 deaths attributed to the eruptions, compared to tens of thousands of displaced people.
Continued eruptions have made it so that some international flights are canceled, and many shelters for evacuees have reached capacity. Many people prefer to sit around and watch news reports on the volcano, as aid work has been delayed due to the continued eruptions.
The volcano is expected to continue burping gas and ashes for weeks, which could lengthen the time that refugees must stay in shelters. People are growing restless and bored, and devastated people have heard that their homes have been destroyed.
After Mount Merapi’s eruption, experts noted an uptick in other volcanic activity in some of the 21 volcanos around the region known as “the Ring of fire.”

World by Aiden Kyle
Indonesia Volcano 2010 Update
November 2nd, 2010 reposted from CNM News Network

Saturday, November 6, 2010

how to save a life

Step one you say we need to talk
He walks you say sit down it's just a talk
He smiles politely back at you
You stare politely right on through
Some sort of window to your right
As he goes left and you stay right
Between the lines of fear and blame
And you begin to wonder why you came

Strength Over Speed Colorado

our team has been piecing together some ideas for a newer direction for the hiv positive patients who are (or are struggling with) dealing with substance abuse issues and healthcare adherence lapses. there are several factors which are closely related to many of these individuals challenges.  trauma, stigma, depression, aging, sexual dysfunction, isolation, self-esteem, mental health are the first of many to come to mind.

most of the patients i see live below the poverty level. some by design, but most reside in this strata because this is all they know. insurance is not an issue as it is not a choice. luckily in colorado, there is a state program which is designed to give access to healthcare to every coloradan. so much of the basic and intricate healthcare issues and hiv care issues can be met. but honestly, many of these individuals don't care about healthcare or hiv care. the avoidance of these as well as avoiding as many of their feelings beyond numb creates a perfect environment for drug and alcohol use to morph into abuse almost invisibly- at least to them. it's quite a different story to the world around them as out of balance seems quite evident.

one thing that seems to be a reality in our city is that  a sense of community and camaraderie in the world of alcohol and drugs exists and beckons. the bars- especially gay bars are community oriented and geared towards fun while you use. music, emcees, shows, drag shows, comedy, dancing, are all at our fingertips as we begin to cement our relationship with drugs and alcohol. the concept of fun is interlaced with use and as we all know it does feel good to get high. it's moderation which becomes the issue, or maybe the lack of it.

so when people are conceptualizing themselves changing their use, or stopping their use, the idea of fun and festivity becomes a major factor. "life will be dull without the party" accompanies a belief that there will never be joy in their lives again if they stop using. seems pretty reasonable to me. felt that way myself actually. and if you think about it, the image of sobriety pales with regard to fun-loving. as a matter of fact, even though i believe that being sober has brought an unbelievable sense of calm and peace to my life, i don't even think my using friends think of me as being very much fun. conversely, i would imagine they see me as a buzz kill.

anyway, we are trying to put together a visual and approachable set of peers who have gone through the changes involved in giving up drug use and drinking and have become conduits of joy. i know that i am much happier than i was before 9/29/04, and if you sit an chat with me for a while, i think you'll believe it and feel it, and i know it is true of many, many others too! this is the subliminal message we want to disseminate. i am currently looking to seattle's strength over speed  for some inspiration. that grassroots effort has been in development for a few years and i believe they have affected lives. they mix together men who have stopped using meth with men who are actively using- some of those reformed are involved with 12-step and some are not. this encounter, no doubt, allows people weighing their options to see that life can easily continue successfully without the armor of substance protecting us.

the next offering is a workbook-driven curriculum for meth users that is evidence-based and hails from the Matrix Institute of CA. i worked with a version of it previously when i helped develop a program called  the "mile high meth project" for another agency. the matrix has its strengths and weaknesses, but the structure works well and it is designed to engage user's right brain in order to address the left. coming down off meth creates so much emotionality, that any process that can grab their attention is worth its weight in gold. this is not specifically for gay men. this is much more universal. this is also not poz-only. it's not as if people discriminate when they are actively using, and i am trusting that same acceptance tendency can bring educational opportunities as well as personal growth and self-acceptance.

this layer will hopefully work as we extend our efforts here beyond gay men. in colorado, poz persons who are not gay men struggle with isolation and stigma even more intensely. there is a small sense if community among these subsets, but it is not cohesive. at least not at our workplace. thus far, we have started a drop in group for the gay poz patients and it seems to be making an imprint. this week heralds its 1-year anniversary, and i believe we have had almost 100 persons through our doors. and our substance treatment numbers for that population have quadrupled with the onset of this effort. and the work continues.

of course, what we are working towards includes helping people find their way to healthcare adherence and retention. the science has been available for some time to keep this virus manageable and undetectable. the costly and debilitating problems that unaddressed hiv infection brings can be greatly minimized by adherence. honestly, i have seen about 15 persons pass this year and most of them would be categorized in the aforementioned. i know that what i am working towards is how to save a life.

keep your fingers crossed... oh... and, can you see my heart smile?

of course the fray are from colorado turf. their stunning debut album seemed to almost usher in the latest indie music boon that we are now in the midst. i heard an interview with lead singer isaac as he talked about visiting a mountainside drug and alcohol recovery camp for youth and was inspired to write these lyrics. appropriate.... local...... lovely..

Friday, November 5, 2010

haven't got time for the pain...

“I slept and dreamt that life was joy. I awoke and saw that life was service. I acted and behold, service was joy.”...Rabindranath Tagore
i spent the morning reading texts from a friend who is angry. not at me per se, but at life. he has struggled with his art, his work, and his finances for the last several years. my belief is that it is taking quite a toll.

he has always had a tendency to be critial of others and sharp witted with his criticisms. but this once very entertaining leaning of his seems to have shifted into toxic territory. members of his inner circle have left the building and are staying as far away as they can. getting close somehow gets them under his silver-tongued knife and who wants to live like that?

not surprisingly, he messaged me with diatribe that was intended to surprise and stir up doo doo about them and with me. and on a small scale, it worked, but i didn't want to give rise to that energy. some of what he said was no doubt true, but certainly not all of it, and his intentions didn't merit respect.

but i've known him for 30 years or so. i care about him and have made a few attempts to share my new direction with him, and he listens although i am not sure he hears. i know he is hurt by this seemingly endless struggle, by the loss of his nearest and dearest, by the insistence of his family that he let go of some of his dreams, and this hurt has become a virus that has taken hold of his heart.

i am sad. i rebuffed his shit-stirring attempts and highlighted the posture of assuming the best, making room for good in life, choosing peace. but i don't know if i'm heard. i don't know if i can help. i know i don't have to to judge or set free. i can try to understand and hold a light. i can remember that i have loved him and understand he may need it now more than ever.

carly simon.. 1994... grand central station.... i haven't got time for the pain..

Thursday, November 4, 2010

borderline cover

Something in the way you love me won't let me be
I don't want to be your prisoner so baby won't you set me free
as i listened to my healthcare provider tell me yesterday that i am approaching borderline high blood-pressure, i found my stomach tightening slightly. silently i am aware that i have gained more weight than i am okay with. i have been so busy with all the things i do that i keep convincing myself i am too tired and will be okay. conversely, i have been overeating candy that is out for public consumption in the back office, have rekindled my love affair with vanilla lattes and croissants in the morning and stepped up my in front of the tv time evenings after work. his words were not a surprise to me at all.
i don't have what is considered high blood pressure today, but unless i change my patterns and behaviors, i most likely will. this is most definitely like moving through life on a spiral. i know this road, or a road just like it, and what happens where the rubber meets this road? can i reflect the same show of good sense that is discussed by me on a gallimaufry of occasions? if i claim to want optimum physical and mental health, can i choose behaviors that reflect that desire. can i let go of behaviors that do not fit?

the eating problem is real. just as real is the sedentary lifestyle and lack of physical exercise. the cardio that has worked for me for such a long time has fallen short of my needs this last year. but truthfully, i have been too lax to replace it. but as in all indulgences, there is an emotional component to all this. as i toss the m&m's voraciously and repeatedly onto my tongue, i am most definitely soothing some sort of discomfort.

this must be a nike moment in my life... just do it.. sounds so simple.... doesn't it?

couldn't resist posting the jody watley version of this song.. it really connects with me..

Tuesday, November 2, 2010

inside my head

had another stellar meal at parallel 17 last night. the lemongrass prawns were lovely, but the starter and the finish were the two standout acts in this show. we had the tuna tacos in the beginning. crispy little shells filled (and overflowing) with cubes of deliciously marinated ahi sashimi which were nestled into bed of avocado mouse and then topped with a baby dollop of wasabi creme fraiche.  and the desserts were ba-na-nas (well figuratively). deep dish dark chocolate mousse, coconut milk panna cotta, and a pear and ginger tart with sweet brown butter. the owner came to our table this visit and made everything seem much more hometown. the company, however, is what is most memorable about the meal. i have known my friend for about 6 years now, and our relationship has changed by miles yet somehow remained very much the same.

today i am leaving early to go vote. there are so many things unsavory about several of the choice on the ballot that i have to make sure i have my say. i haven't come to terms with what our village and our state will look like if my choices are not validated by my neighbors. sometimes finding faith looks like a very long road.

the topic of relationships and dating keep coming up. i am not currently engaged in either. as a matter of fact, i would say i'm almost thoroughly conflicted. i detest the pressure by others to be seen in a couple to really be "seen", all the while feeling the cultural pressure from inside pushing outward. i sometimes think that i need to be with someone to be complete somehow. it's a little bit queer how all this works. 

i am still haunted by the images of richard hawkins (posted above) at the AIC show in Chicago last week. haven't put it all together yet as to just why, but i know that some of the images impacted me on a core level. i was creeped out and drawn in at the same time. as the experience continues to distill, perhaps more will be revealed. certainly i know that other aspects of my life work that way. in the meantime, i will just continue to swim through infatuation with the voice of this man. the iconographic images may have opened a new vein of wealth waiting to be mined.
i came across this vid with the illustrious pet shop boys and thought it somehow fitting for this post 

Monday, November 1, 2010

still life

image: richard hawkins dragonfly
There are things that we never want to let go of, people we never want to leave behind. But keep in mind that letting go isn’t the end of the world, it’s the beginning of a new life.
i just arrived back home yesterday. it has been a whirlwind visit full of emotion and repositioning of conclusion and assumption. it seems odd that so much of my grownup ideas about friendships and fun are based on the first 12 years of such i got while i lived in chicago. somehow, after moving there, i was able to pull myself up out of a dark pit of confusion and conflict to find some grounding and build a life. but as life happens, everything fell apart and i walked right into a sinkhole.

revisiting people that shared that world has been heartening at the least. i have seen how my contemporaries have been able to buoy themselves and find balance in their own lives. and i may have opinions about their some of their means and their results, but that is only opinion. it doesn't change the fact that indeed they have found a level.

perhaps the greatest thing this mirroring did for me was to give me a reason to exhale. and somehow, i feel i can put some baggage i have been lugging around away for awhile. maybe forever. i think i always felt like i needed to measure up and do much better, maybe even make someone proud. or be proud myself.

so  now i am reminded that the dreams i have been holding have actually passed on and new dreams have replaced them. i am still the same person, just homogenized. or maybe distilled. or simply reduced.  letting go, reconstructing and re framing my perception, and making room for new things is the order of the day.

vacation- check
conference- check
next stop- holidays

the image above is named "dragonfly" by richard hawkins and is part of the third mind tour currently at the art institute chicago. this was a show i completely loved.

and more anberlin. here's an acoustic version of breaking..