LIVING WITH PAIN

My latest column can be read @ http://americannewsreport.com/nationalpainreport/living-with-pain-prejudice-and-mistreatment-8824038.html

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This is What “Open Carry” Has Brought Us

Check out this link for an idea of where open carry laws has brought us: http://www.dailykos.com/story/2014/06/17/1307546/-Open-Carry-incidents-at-my-place-of-employment-The-cops-got-involved?detail=email

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LIVING WITH PAIN: THE SEARCH FOR MEANING

My latest column on the search for meaning can be read @ http://americannewsreport.com/nationalpainreport/living-with-pain-the-search-for-meaning-8823972.html

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A RE-IMAGINED LORDS PRAYER FOR OUR DAY

THE ORIGINAL

 

Our father who is in heaven

Hallowed be thy name.

Thy kingdom come

Thy will be done

On earth as it is in heaven.

 

Give us this day our daily bread

And forgive us our tresspasses

As we forgive the tresspasses of other.

And lead us not into temptation

But deliver us from evil

Amen.

 

RE-IMAGINED

 

Our source of love that struggles among us

Hallowed be thy name.

Your love uplifts us all

Thy will be done

Always and everywhere especially to the wounded among of us.

 

Give us this day our daily bread

And forgive us our hate and indifference

As we forgive the same in others.

And lead us not into temptation

But deliver us from the evil of hubris.

Amen.

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Insurance Companies: A Rant

If you, like me, have struggled with a chronic, diabolical medical condition that’s robbed you of the most precious things of your life, requiring you to look for new meaning, new reasons to go on, you, like me, probably thought the medical field was in your corner.

For the most part you wouldn’t be wrong. Yes, there’s a smear of shit to wade through with doctors, medical staff, specialists and all, but the biggest hemorrhoid  in the mix are the health insurance companies.

Yes, I hear the laughter of recognition as you read that last sentence. I know, I’m not saying anything particularly new or creative when speaking of the mother fuckers who own, operate and get fabulously wealthy on the backs of people like us who have to rely on them, but let me, just for a few moments rant about the latest experience I’ve had with these nitwits, and I’m sure the crescendo of recognition and laughter will follow.

To be clear, the experience I’m going to describe has happened repeatedly to me and to others. This isn’t a one-off experience.

But first, let me put this into a familiar frame. Everyone who is in this position along with me knows the drill. You’ve gotten the prescription from your doc, taken it to your local pharmacy, dropped it off, answered all the questions and are then given a date and time to return to pick up said medicines.

After long and bitter experience you know right away that you have a 50-50 chance of getting that much-needed medicine when you return at the promised time. In other words, 50% of the time you’re fucked. The pitfalls: your doc failed to date the prescription; s/he failed to sign the script or enter his/her DEA number. Or, your told that the medicine isn’t in stock and unavailable until early next week, the reasons are legion: but the most maddening is the “Prior Authorization.” Oh, yes, the stab in the back from the insurance industry.

I was just informed by my pharmacist that a medicine I require to stay upright was denied due to the fact that my lovely insurance carrier has changed its formulary. Even though for months they approved my medicine to taken twice daily. Sometime since my last refill they have changed their policy on this particular med to the effect that they will only cover the cost at one dose daily, not two. Did they bother to notify me in a timely manner?

Is this a considered medical call based on the evidence that this med is best effective at one dose daily, instead of the two doses that, by my experience, work best for me? I’m waiting for your laughter to die down. No, no, no. It’s simply a way to put heat on my doc and me to cut back the effective dose so these ass hats can make more money than they would if I take the med twice daily.

Their possible solution?  The tried and true hoop for me and my doc to hop through? Yes, that’s right, children, the PRIOR AUTHORIZATION (PA). This dreaded phrase is the bane of existence to those of us suffering with daily, grinding pain.

PAs don’t just appear over night. No. First the pharmacy has to inform me that the insurance company wants the PA, the pharmacist informs my doc, then I call the doc’s office to make sure the request for the PA is being handled, the doc has to justify in writing why I’m taking the med twice daily. S/he sends the PA request back to the insurance company and some benighted douche bag either denies the request or approves it.

This is harassment. Why you might ask? The answer lies in the fact that I have never, not once had an application for a PA denied. I wonder if anyone has. It is simply an obstacle thrown down in our paths time and again to get us to give up and not take the drug, take it less, take a cheaper less effective med, or, most egregiously, stop taking the medicine altogether.

Hang on, there’s more. The only way you’re notified that your insurance carrier wants you to jump through this hoop is at the point of refill. Yes, there you are, if your like me and take skads of meds daily, you can’t always get your scripts refilled in advance because there are so many to track and we’ve all experienced the keepers of insurance smacking down a refill request if we are even so much as a day early. In reality there is only a small window of opportunity.

So there you are at home after calling into your pharmacy’s automatic phone refill for the meds you are out of or nearly out of when you get the automated call back from your pharmacy later that there is a delay in filling the request as the pharmacy has to contact my insurance carrier for clarification. Your heart sinks as it’s late Friday afternoon and there will be no communication on the needed refill until the following Monday. This is often a disaster.

Here, besides the reprehensible greed of insurance companies, is a small point. With all the high-tech communication at their finger tips, why can’t they install a program that tracks the users of particular meds and send out an email blast to those affected patients:  a PA is required at the very next point that the patient is low on, or out of the medicine. Why create such a cluster-fuck when we are at, or nearly or near the point of running out of the medicine? Why create such anxiety or panic among vulnerable patients?

The answer is, I’m afraid is as apparent as my salty language in this rant–moola, yes, money, always the holy grail. This is nothing more than harassment to keep us from utilizing our insurance thus filling the coffers of the managers and stock holders.

Come the revolution, with Madame DeFarge looking serenely on, the first in the tumbrels headed for the blade and basket will be the insurance executives.

May I pull the lever?

 

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Suicide Bubbles up when Depression Boils Down

Against Hanna’s will, a smile spread unevenly across her features. Gone were the dark clouds surrounding her pale eyes. Her voice was stirring, audible, and she no longer, with ivory knuckles, hugged her knees protectively against her fear, her vulnerability.

Her short hair, newly washed, ruffled under the ersatz spring breezing gently through my open windows next to her. It was after all March in Chicago and the warmth was an impostor wheedling us to lock away our coats, hats: our protection.

I shouldn’t have been afraid of her bolting again from my office for the nearest lethal instrument to end the growing disaster of her despair.

Her winter was lifting. Mine just began.

Her smile spread its inchoate terror through me and I shuddered as if a wild fire pushed by maniacal Santa Anna’s blistered a blackened swath through my heart. I Listened to Hanna’s rising hope, a hope I’d never heard from this young woman before, a hope lifting the dark lethargy strangling her for years, propelling her towards a new…what? I was afraid to know.

All I could see out there was the roiling nimbus of psychosis relentlessly stalking her, an unseen single minded stalker ready to carry her off.

Sounds dramatic, doesn’t it? Although I’ve changed identifying information, the immediacy of her stalker palpably remained, demanding and insistent, outwitting Hanna, laughing at me.

While Hanna didn’t suffer from physical pain, she did suffer the equivalent psychically and emotionally. I had been working with her twice weekly for 3 years and kept preparing myself for her ultimate suicide. I was as infected by her despair as she was. It felt like we were fighting a rear guard action until Hanna found the ignition for hope. Time ran fast and low.

As I sat with her, Hanna became agitated and the agitation grew as she refused to talk with me. After several attempts she bolted up from her chair and ran from my office out into the hall and down to the elevator where I met her. I was surprised by this as she was doing, against odds, much better. I attempted to get her to come back into my office by she met my entreaties with the silence of marble, cold and mute.

Two hours later I got a panicked call from her mother saying that Hana had swallowed the whole bottle of her anti depressants. I then helped her hospitalize her daughter.

This same scene repeated itself several times over the next year. As the year went on with Hana keeping to her schedule to with me I was convinced that she would, after all our efforts went for naught, would finally end her life. It was as if I was mourning her death even as she sat before me.

It took me months to remember an essential piece of working with people in a life or death struggle with psychotic depression. It also took me months to realize that the mourning I felt for her impending death was a reflection of the mourning Hana was experiencing for all the wasted years gobbled up by the depression. She was also mourning a death that had already ocurred in her. The early death of her sane self. The Hanna that briefly flourished before the depression darkened her world and sent her careering from one angry explosion to the next and always followed by a severe attempt on her life.

I had forgotten that many people with severe disturbances often project onto the therapist those things they don’t like thinking or feeling. It was through Hana’s behavior that I felt that her death and my mourning were close at hand. These were things Hanna couldn’t on her own feel or thing.

Her explosive rages had two origins but one trigger. The rage was the hyperattenuated anger that she felt towards the behavior of her family towards her while also representing the anger that people eventually feel as they pass through the mourning process. I was the trigger. If I wasn’t completely attuned to her, or mildly distracted by my body, she would be exquisitely aware of my temporary withdrawal and experience it like the prolong withdrawal as she saw it of her parents.

It was my job to help her figure out the sequence of events with me after the storm and suicidal behavior spent itself. It was the breaks in empathy with me and the healing of the rift with me accepting and explaining my part in the interaction. It was this very process that led to her improvement and then her extended retreat into psychosis.

What I failed to remember, and this is so important in the lives of those of us struggling with the depression and despair of pain, is that as we begin to recover from the lethargy of depression and despair, we see clearly the wreckage of our lives.

What is so lethal about this is that we genuinely begin to mourn while the snarl of the depression and despair is still very audible but now, as unlike before, we have enough energy to kill ourselves.

When someone is in the grip of a major depression, it’s difficult for them to organize themselves to actually commit the act. But when their minds just begin to clear so they can see the damage they’ve left in their wake while their energy begins to return, the actual act of suicide becomes a real possibility.

This is also a part of the process of mourning.

It’s by way of example of Hanna’s struggles that I want to make two points. First, mourning is always a part of depression and the suicidal aspect of that mourning appears often with people suffering major depression. For those in therapy for major depression, this entity that can haunt many of us. It shows itself through urgent suicidal thoughts that intrude on us any time, anywhere.

The second point is that cognitive therapy is proven to be quite helpful. But also helpful are therapists trained in psychoanalysis who know in their bones the process of projection and the power of the therapeutic relationship to bring about change.

Taken together, these two notions can go a long way to helping us recover from the unspeakable power of what Churchill named as the black dog of depression.

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My Assassin. Yours?

Dying leaves scuttle along the sidewalk in front of me as I walk along a Chicago street after dusk.

I’m following me.

The wind is up off the lake. I have on a battered trench coat with the collar pulled high under my swept back crazy hair, like Christopher Walken on a bad trip.

I step up behind me at the mouth of a dark alley and shove my .45 against my spine. My body, surprised, jumps forward but I follow and keep the barrel pressed hotly against my spine. “Turn in here,” I growl.

I say nothing when I ask me what’s going on.

Between two reeking dumpsters I shove my body face first into a grimy brick wall, place the barrel of the .45 against the base of my skull and, KGB style, squeeze the trigger.

In the cordite haze I see the gun lying in the grease next to my right hand. I back out and walk away as a cold mist weeps from the lowering clouds…

I expect readers familiar with me are saying to themselves, “I knew it, Maginn is a fruit loop lying in a puddled gutter.” You might be right, but, please, read on.

I have over the last year lost my stepfather, my dad, my cousin and am waiting for the call to tell me my delightful stepmother, who just after my father’s death is ready to follow him. My mother who just left rehab today after 6 months due to first a broken pelvis then a broken hip, has been recently diagnosed with mid stage dementia. 18 months ago my best friend who I saw several times a week died in his sleep.

It’s been one of those years.

That might make Maginn suicidal, you think. And again, you might be right. But read on.

In the last year my wife and I moved back to our home town of Chicago and as soon as we got here I fell on some unseen ice that drove all of the hardware in my spine-3 plates and 6 bolts, not to mention the battery and wires of a spinal cord stimulator plunged deeply into the surrounding swelling muscles.

It was the worst most sustained pain I’ve ever encountered, which, I’m afraid to say, is quite a statement. For months while I was in and out of the hospital trying to control the pain, I was on an enhanced dose of my usual opioid as well as morphine for breakthrough pain. Some joke, I was in breakthrough pain 24/7.

There was no way to beat the inflammation other than 4 surgeries to remove the technology and hardware. I had two surgeons perform all the surgeries in the ridiculous speed of 75 minutes. I returned home with the miracle of the horrible pain gone. Recovering from the 4 incisions was my only task.

Child’s play, I thought.

During my brief recovery the health of my elders began to plummet out of sight. Anxiety shrouded Judie and me.

Long ago when the pain was at is periodic worst, I sat around when not looking after my young son,  or while writing, I’d pause and think of ways to kill myself that wouldn’t look like the suicide it was. I wanted to make sure my small family got my insurance payout. During the day, in the middle of the night when fugitive sleep abandoned me, I wrote in my journal about the pain and my plans for destroying myself. I could tell myself no matter how bad the pain got, I always had a way out, even if by my own hand.

But I knew better, even then.

Now with the death and dying tour still extant, I’m back where I started. But now I no longer think of killing me.

No, I had something new; I had become my own stalking assassin; I wanted to murder my body and simply walk away, free and clear.

My problem, maybe yours, too, huh?

Here’s the problem with my assassin and I’ve seen it in others as well. When I begin to objectify myself like this over and over the space between the me as assassin and the me as the body my assassin wanted dead, grew. As that gap widened it’s became entirely too easy to see that body as not belonging to me.

This dreadful fantasy can grow into a delusion where the assassin loses touch with the body that is his or hers. That’s, unfortunately, when the assassin loses touch with reality and the murder seems logical. My assassin doesn’t realize he’s killing himself.

What’s happening to me with all the losses and the downturn in my health is the rise of me as my assassin. It’s a delusion. This is an entirely unconscious process that we need help in bringing to the surface to examine.

Suicide isn’t always about despair alone. It’s about holding onto the one way out when things go terribly sideways.

If you start thinking of yourself as an assassin, get help. Preferably with a therapist who knows something of Jungian therapy and symbolism, as well as being, unfortunately, familiar with pain. Cognitive therapy may also be really effective in looking at this delusion that settles on those of us in constant pain.

Still with me? Good.

Don’t let your assassin walk you, unsuspecting, into a dead-end alley.

Most of all, get help sooner than later.

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LIVING WITH PAIN: LIGHT A MATCH TO PUT OUT A FIRE

My latest column on pain and the family can be read @ http://americannewsreport.com/nationalpainreport/living-with-pain-lighting-a-match-to-put-out-a-fire-8823810.html  All comments are welcome.

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LIVING WITH PAIN: DEEPLY ENGAGING SYMPATHY

My latest column can be read @ http://americannewsreport.com/nationalpainreport/living-pain-deeply-engaging-sympathy-8823552.html

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Assassination T-Shirts Amined at Gov. Cuomo

Cheap gunsels are now hawking t-shirts in NY showing guns and ammunition surrounding lettering saying “Cuomo’s gotta go.”

The cheap “law abiding” gunsels with their t-shirts skirting the edge of a call for the assassination, murder, of the New York governor shows just how law abiding these ignorant “defenders” of the 2nd amendment they really are. They are willing only to obey laws that they determine fit their stupidly warped “interpretation” of the 2nd amendment. We must keep in mind, it’s not the ignorant gunsels promoting this warped and false interpretation, it’s the ignorant running dogs for the firearm industry, who, arm and arm with reps of the gun and ammunition producers who interpret this amendment in the most extreme way that will never, ever broach any sane law(s) that have the capacity to injure the bottom lines on their P & L statements.

This is the unsaid mantra of these idiot gunsels from manufacturers, marketers, sales people right down to the “law abiding citizens” who own so many weapons: “Fuck injuries, debilitations, life long harrowing pain and disability, medical costs, murdered adults and slaughtered children, it’s our bottom line that counts & we’re really, really self-congratulatory that we’ve been able to whip up the passions of these half-witted gunsels to do our amoral wet work for us. We are a model of corporate America upholding our constitution.”
With the passage of “stand your ground laws,” concealed and open carry laws, especially here in downtown Chicago where I’ve safely lived, I’ve never felt such danger to my life since the confrontation during the Kennedy years with the Russians over their missiles in Cuba and ours in Turkey. Nukes and now assault weapons and large capacity ammunition holder for handguns. This isn’t hyperbole, I truly now feel threatened simply taking the elevator down to the street to walk around the corner to the pharmacy.
What about our rights for the pursuit of happiness. I feel no pursuit of happiness now, just a foreboding that one knuckleheaded gunsel after the next passes me on the street or waits behind me for my coffee at Dollops Cafe. And what happens this summer in my home town when gun play reaches it’s zenith each year? Will I feel safe walking just a few blocks with my wife to Millenium Park to listen to music with my fellow unarmed fellow Chicagoans? Of course not. Nor will you, unless you are of the class of “law abiding” weapon toting asshole gunsels, manfully carrying around your phallic weapons. I guess size really does matter, huh, Wayne?
Take a poll NRA and ask if we citizens now feel safer when borderline characters are running loose in public with death dealing guns. Any predictions, Wayne, on how many of us are going to not only feel safer, but be safer?
Mark Maginn, an emphatic life-long opponent of stupidity.
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