Wednesday, February 11, 2009

Can someone explain this one to me?

For the past two-and-a-half years, one of my jobs has been in a psychiatric hospital. Now, I promised myself years ago that I would not set foot in one of those places again, but...I needed a job, and they were hiring. In general, I love my work there: I meet with psychology graduate students (they are doing the actual work with patients) to discuss how best to provide therapy to patients, to brainstorm how to help people, and to teach students specific therapy technique. And what troubled me in the past wasn't the patients--people are people, and I typically enjoy the interactions--but the system, which gives people powerful meds and sends them back out without really teaching them how to cope with their illness, without the supports many mentally ill people need.

In the 20+ years, the system hasn't gotten any better, unfortunately. And that is fodder for another post.

But what really, really gets me is the smoking. And not even the patients' smoking; they are bored and wanting to belong and smoking is the only way they get to go outdoors (obviously not for the fresh air, though). Most of the places they have spent their time have been smoky (ever been to an AA meeting or Partial Hospital Program?). Many of these folks are so damaged by life that they almost seem to have no choice over what they do or what happens to them.

But it's the employees' smoking that just presses every button I have (you work in mental health and you can't come up with a better way to cope?). Actually, it's any smoker I have to deal with in public. I was in Target the other day and I had to sprint out of several aisles because other customers reeked of cigarette smoke and I was becoming nauseated and unable to breathe. I resent having to roll up my car windows on a nice day because some driver near me is hanging their cig out of their car window. Honey, if you don't want to breathe that stuff, what makes you think I do? (I'm tempted to get a bottle of room fragrance and spritz it in their direction.)

My tolerance for smoking has just plummeted as I've gotten older. I know part of it is my allergies; my sense of smell is more acute and my eyes water more easily than in the past. I fully admit a large part of it is having a child who is a cancer survivor; it just angers me that my innocent child who did nothing willfully wrong, who was raised in an environment that was as healthy as I could make it, had to suffer...and yet some adult purposefully puts carcinogens in his or her body and then sues because they get cancer? Who held a gun to the person's head and forced them to light up? Who shoved the smokes into their mouth, threatened them with harm if they didn't inhale?

As a behavioral scientist, I learned that behavior is purposeful. And I think of the other substances that humans "use and abuse" which are not vital to life. I can understand alcohol use...there are some health benefits to wine in moderation; in excess, alcohol disinhibits behavior, so that anxious people feel confident, depressed people feel social (or sleepy, which is also an escape). Maybe not the best strategy, but an attempt to self-treat one's uncomfortable emotions. I don't condone the use of street drugs, but for many people they serve to escape the emotional pain of abuse or loss or depression; again, not the best approach, but I can see the purpose. Caffeine? Mixed research on the health benefits, but in general enhances cognitive performance. Again, purposeful.

But putting burning sticks in your mouth (especially logical during Philly summers, when the temps top 90F, with humidity to match), with the result that you smell like a mildewed basement and you increase your risk of diseases?

If someone told you that smoking would make your penis or your boobs fall off, would you still do it? (It's called peripheral vascular disease and breast cancer, and the risk of both increases with smoking). If someone told you that you are being manipulated and ripped off by the tobacco companies, that they have deliberately added chemicals that increase the addictiveness of cigs, would you still smoke? (They do; it causes consumers to freebase nicotine.)

Someone PLEASE explain the purpose of smoking. Because I just don't get it. What does smoking DO? How does it help? And why aren't you smokers angry enough to stop?

Wednesday, February 4, 2009

Playing with Food

Perimenopause has its challenges, the most annoying being unpredictable sleep. Some nights I'm out before head contacts pillow; other times my brain is in hyperdrive. It's not worry; I gave that up YEARS ago. It's like a delayed caffeine surge...simply an 18 hour delay(!).

So my sleepytime trick is to give my brain something to do--on purpose--so it will be so busy thinking about whatever task I assigned it that it won't have time to churn on the flotsam and jetsam of my day or my to-do list. For the longest time, in the morbid and perverse fashion common to folks who work in healthcare (the same twisted motive that drives healthcare workers to rush home after a harrowing shift in the ED so they can catch the latest Tivo'd episode of "House" or "Grey's Anatomy", the very one that impels them to tell the most tasteless jokes during 11 to 7) my brain's little job was to name all the oncologists I have ever met. This was quite effective--I have encountered at least 40, and would usually be unconscious around #17 or so--and when that became mundane, there was always the option to alphabetize them. Or to list them in order of appearance. For best effect, I could visualize them leaping over stacks of charts.

Heck, if you can have sheep scaling a fence as a sleep-inducer, you can have MDs vaulting HIPAA-compliant documentation.

After months--years?--of this, though, I needed a change. Alphabetizing the states, naming all the capitals, reciting the entries in my personal address They lost their effectiveness rapidly. I needed something with creativity, purpose, and absolutely no stress.

Help came in the form of an all-natural, nitrate- and nitrite-free spiral-sliced half ham. Actually, a quarter ham; we had eaten the first half in early January, and since variety is the spice of the dining table, the rest went in the freezer for another day. Which happened to be this past weekend. Spiral sliced is handy for sandwiches, of which #1 son, aged 16, partakes daily, but even he can only eat so much. So now the challenge: what do I do with the rest?

Voila: recipe fantasies as sleep aid.

Night #1: Lentil soup, made with ham broth (also stocked in the freezer), carrots, celery, diced ham. Yummy. (I had the rest for dinner tonight. Definitely a do-again). It was nice to try something other than the tomato-based version.

Night #2: Potato soup. For those of you who are afraid of leftovers--wait a minute, how come all of you live in my house?! Diced celery, ham, and potatoes, caramelized in the pan, simmered in chicken broth, and then finished with sour cream and dill. I was scolded by #2 son for failing to obtain chives. Note to self: buy herbs on the cheap at local greengrocer and stash in freezer.

Tonight? I'm not sure. I'm toying with making a paella--the perfect excuse to morph leftovers into something unrecognizable by the leftover-phobic--but we have to see what visions pop into my head as I settle for the night.

And let's see if it hits the dinner table tomorrow evening.

Yawn. Good-night.