January 17, 2021
Well, yesterday was eventful! We hiked to Maunawili fro Waimanalo ~5 miles. I was at maximum heart rate so some of the inclines were difficult. Post hike I used Iwatch ECG and got back readings of atrial fibrillation twice measured. After a nap normal sinus rhythm. My recovery pulse a minute after from pulses over 140 was good.
Last evening Rebecca talked with Pohai Nani caregiver who was very concerned that Lotte was yelling help me! We facetimed with her. She did stop but her frail body lying in the bed, gaunt because she's was not eating told us that she was near death. These past few weeks Rebecca has been attempting to talk directly with Lotte's doctor but messages to him had gone unanswered. We discussed the institutional Pohai Nani issues that objectify Lotte so she becomes a problem yeller to them. She did have periodic facetime services with the COVID lockdown and regular session before with her psychiatrist who was very thoughtful and attentive to her care. Unfortunately, her medical care was much more institutionalized concerning us. For the past few months Rebecca has received calls from the staff that Lotte is not eating, she is refusing medicines, she is complaining of pain and yelling help! The staff had a urine sample come back with bacteria so her psychiatrist not her medical doctor wondered if she had a urinary tract infection and then her medical doctor prescribed an antibiotic. Unfortunately she spit out the pills and then again Rebeca was informed but her medical doctor was unaware. Unfortunately Rebecca was not allowed to come into the facility except for rare occasions for "compassionate" visits. She had to stay 6 ft. away and wear a mask. Lotte could not recognize her. Comfort with touching was not allowed. Her doctor far removed from contact with her relies on staff to communicate with him, so if no communication to him but to Rebecca this denies him important information. Unfortunately, the institution has it set up that the staff are directed to provide certain prescribed services which precludes human interaction and does not allow them to try human comfort approaches to client discomfort. I'm describing how a total institution dehumanizes and objectifies their charges.
Finally Rebecca did talk with Lotte's doctor who then responded with prescribing morphine which Rebecca and I both thought was appropriate at this last stage of her life. After some more telephone calling making sure she got the medications in a liquid form we went off to Kaneohe Longs retrieved the medication and arrived at Pohai Nani to find the police and ambulance there. She had passed away. Rebecca knows Lotte for over a decade. She had lived at Pohai Nani for almost ten years. After the death of Rebecca's husband in hospice care at their condominium Lotte became Rebecca's concern since she was showing great emotional instability and dementia. Rebecca reached out to relatives but they showed little interest in involvement. Lotte had financial assets. Her late husband's son helped Rebecca problem solve the finances. She had good support from financial people and others and she continued to be the power of attorney and principal advocate for Lotte. Rebecca would go to Pohai Nani and take Lotte out for her favorite chinese food of shrimp and honey walnuts or to Zippy's for an ice cream sundae. We went to concerts in churches for choirs, musicals in Honolulu, etc. Sometimes we had picnics. Though moderately confused she recognized me and was pleasant with a nice smile. Then the pandemic came, she was isolated at Pohai Nani and all this wonderful contact stopped.
Life continues. So Olivia contracted COVID-19 and died. Jeannie, also Rebecca's close friend passed the same day. Lotte just passed. Our neighbor is looking more befuddled and his wife now has been sick, taken to hospital, and seems confused to some so we are aware to assist them. We are concerned about our good friend who just was released from the hospital with respiratory problems. We are aware of the danger of the pandemics since we heard about a child of friends who died from COVID. Another friend will have open heart surgery for Aortic Valve replacement.
Rebecca and I do hike twice per week. My health is changing so I'm attempting to be active but not put myself in danger. I have a good cardiologist who I am in active contact with so my heart rate and ECG monitoring on my new Iwatch (thank you Daniel) gets posted to him if I'm concerned. I am mortal so this blog is an avenue for my living through our pandemic while, hopefully not succumbing to the social isolation and conspiracy syndromes that I sometimes write about.
Today I became aware of anger and resentment expressed by an important person in my life. I don't have to wonder if there is a history of this sort of resentment in the past. I could recall a few instances in which thankfully we were able to talk and have a better understanding of each other. I am open to doing the same now but if my refusal to give certain confidential information causes this kerfuffle I currently am at a loss.
My original intention today was to write about John Mack M.D. a brilliant and charismatic teacher of mine when I was doing my psychiatric training at Harvard's Massachusetts Mental Health Center. A psychoanalyst in adult and child psychiatry, interested in substance induced mental health changes, he won a Pulitzer for writing about Lawrence of Arabia. He then became interested in analyzing people who reported experiences of being abducted by aliens. He wrote two books concerning his research and his opinions grew very controversial. He wrote that their experiences should not be just characterized as delusional but understood as actual experiences which had changed the individual sometimes in positive ways. Unfortunately, Harvard had a committee investigate these research publications. He continued to teach and hold tenure but his reputation was somewhat tarnished. Are there Alien abductors who are communicating through these abductions with the rest of us? Well, the controversy with his conclusions have resulted in some other hypothesis for this alien abduction "syndrome". Some researchers have shown that in folklore there is tales of spirits and entities communicating with the chosen recipient while asleep or immobilized in bed. The phases of REM sleep include hallucinations (Dreams), haptic touching sensations, and sleep paralysis. All phenomenon that could explain the unusual experiences of some of those reporting abduction experiences. In any case when I was in training at the Massachusetts Mental Health Center we learned about countertransference. The analyst developing certain strong feelings and attitudes toward their patient. Some suggested Mack developed this. In the anthropology literature likewise similar problems have arisen as criticism of some of the research of anthropologists who have identified very closely with their subjects "gone native". So I'm back to Qanon thinking that the reports about some of these believers may include a gradual interest and then devotion to only reading and writing about their now delusional interests in these conspiracy postings. Like Mack they now believe without considering the strong possibility that they are chasing a fantasy.
https://en.m.wikipedia.org/
https://www.thelancet.com/
https://www.psychiatrictimes.
https://www.nytimes.com/2021/
https://www.nytimes.com/2021/
Some time ago I read research article about video games and online game that used combat, killing, war, and cat and mouse chasing as media for our youth. The question was chicken or egg, a result of our savage nature or as causes for our aggressive acts in the public. I recall reading also about addiction since I was now the chairperson for The Physician Health Committee and most of our interventions, monitoring and advocating was for physicians and dentists who were addicted. Addicts do very strange things associated with their addiction which causes their practice to be in jeopardy. Then I recall also learning about addictions that are behavioral such as pornography viewing. The dopamine receptors and the pleasure circuits in the brain were suspect to be involved with repeated exposures to pornography resulting in permanent brain changes. Addictive behaviors are born through pleasure systems being triggered by these target interests leading to compulsive viewing. I was aware early on in my career that behavioral conditioning was real. Then research in fetishes showed me that a fetish can be induced behaviorally taking a life of its own. For example, some years ago researchers exposed men to women in high heels on a screen while they masturbated. Low and behold! years later other researchers contacted many of these men who reported having this fetish as part of their sexual experiences. So we are creatures of habit and addiction. If you view Qanaon and then restrict your information and viewing to only these sites you could be reinforcing your pleasure systems with being triggered by these obsessive interests.
Well. Today was harder but writing has some release and maybe this causes my pleasure sensors to light up so am I in control and am I writing or ...?
In any case, I'll share a new species of Homo sapiens with you. "Homo sapien Hikis Octageraius discovered in the mountains of Hawaii. Here are four males photographed lounging in their favorite habitat" (Rebecca).
Leonard
Love the photo...evocative of a movie I saw a long time ago... “Grandpas in the Mist”...
ReplyDeleteVery sorry to hear of Lotte’s institutionalized “care” and of her death.