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Wednesday, November 23, 2011

All in a Day's Work

I've been thinking a lot about my job lately. Mostly because I really and truly am getting much closer to walking away from it. After all, I technically retired almost four months ago. I've been working a couple of days a week on contract since August first to try to provide a bit of continuity until the county can find a replacement. But it is time to go. I feel it in my bones.

There's an old saying, "It's not what you know, but who you know." That's pretty important in county mental health with it's confusing welter of rules and regulations. There are a couple of attorneys I converse with from time to time. Their knowledge base is a godsend. And there are other mental health directors who've been friends for years. (More than twenty for some.) I appreciate knowing people I can call to discuss things with. Those linkages will leave when I do, unfortunately. And it will take a long time to build new ones for whomever comes next.

Those linkages are critical because there's always another agency trying to push mental health to do something about the crazy person cluttering up the streets or someone else's waiting room or the local market. The mentally ill tend to make people nervous. When something makes us nervous, we want it to go away. Since local mental health staff have the magic bullet that can get someone sent for a three-day involuntary stay at a psychiatric hospital, there's a lot of pressure. And many conversations that go something like this:
"Why can't you do something about that person?"
"Because they don't meet criteria?"
"Well, why don't they?"
"Because it's not against the law to be  crazy . . ."

Nope. It's not against the law to be weird, or psychotic or delusional. We can only hospitalize folk involuntarily if they are an imminent risk of danger to self or others because of a mental illness. Not because they're drunk or an addict or a public nuisance or haven't had a bath in awhile. There is one other category: grave disability. This means someone is incapable of meeting their basic needs for food, clothing or shelter because of a mental disorder. We don't really see a whole lot of that. What we do see is people who are too drunk or addicted to take care of themselves, but the code sections don't apply to them.

And so it goes. In the past two days, I've untangled a few thorny legal issues, continued to work on a perennial problem with transport for mental patients, attended a politically charged meeting, provided support and consultation for clinical staff, pulled together an agenda and attachments for next week's Quality Improvement (a Medicaid requirement) meeting, and finessed the final stages of getting opening windows in our office suite--something I've been working on for a couple of years.

There are things I will miss when I go. Years ago a friend of mine who ran the Health and Human Services Departments in first Shasta, then Placer counties, told me he loved being in the thick of things when bullets were flying. I know it's metaphorical, since no one shoots at you these days with anything but words and documents, but I like that, too. I will miss solving the day-to-day problems at my workplace, which is probably why I'm still there.

On the other hand, so long as I'm hanging onto one personna, it means I don't really have the time I'd like to let the writerly side of myself blossom fully. There's something the Dalai Lama once said about some doors having to close fully before other ones can open. Makes sense.

As Thanksgiving draws closer, I am grateful for my long friendships in the mental health field. And ever so humbly grateful to have been able to provide support for a disenfranchised population that has little in the way of a voice.

We are all human beings. Black, white, brown, rich, poor, straight, gay, mentally ill or sane. John Donne said: "Each man's death diminishes me, for I am involved in all mankind. Therefore never ask to know for whom the bell tolls. It tolls for thee."

It is never just about you, or about me. But about all of us. That's why I'm still at county mental health. Because it's a place where I can give something back. The challenge for me will be finding another way to do that after I leave.

Thursday, November 17, 2011

Zen Musings

Fall is fading. Winter will be here soon. Mornings I can feel her frosty breath tickling the back of my neck. It's a time for finishing things as another year draws to a close. And a time for new beginnings. 2011 was a pivotal year in many ways. Makes me curious what 2012 holds in store.

In spite of a heavy winter that was late to leave the Sierras, I got to take both planned eight-day backpack trips in the Sierra. Plus a few shorter ones. I suppose if I meandered down to Lake Isabella, I could still go backpacking, at least until winter gets here in earnest.

Mammoth Mountain opened last week with at least a few runs. The beta is that coverage isn't bad. So, skiing is an option once again. That's the wonder of the Eastern Sierra. It truly is nature's unparalleled playground. Shortly after I moved here, the woman who was the county Social Services Director told me I'd come to Mammoth Lakes for a reason and to never lose my sense of awe. Marilyn would be proud of me, since I never have. It's a rare day that goes by that I'm not grateful to live here, snow, hundred mile an hour winds and all.

Gratitude aside, I have to admit I'd kill for a Trader Joe's or a Whole Foods close by. I truly get tired of the one grocery store in town. Sometimes I have to gird myself to go in there. And after the tourists converge on Mammoth Mountain, shopping on weekends simply isn't an option. Lines extend down the aisles and it can take half an hour to go through a checkout stand. So, I find myself shopping at odd hours: like ten P.M. on a week night. Or even later than that. It's amazing. The later I shop, the drunker the other supermarket patrons look. Since I'm in charge of the county's Alcohol and Drug Program in addition to Mental Health, I try to keep a very low profile during these noctural shopping expeditions.

One of the challenges of being a therapist in an uber small town is running into clients outside of the office. Despite my very best efforts, someone usually tries to flag me down to talk no matter where I find myself. And so it goes. I suppose I should feel flattered. And I do have to admit, I'd feel much worse if they ran like hell when they saw me!

Back to winter and reflections on the year that's rapidly passing. There are so many things I'd like to get done this winter. Like cleaning out the desk drawers in my study. And making some sort of sense out of my husband's electronic shop. (Good luck with that one. Haven't told him about that project just yet!) Who knows? Maybe there will even be the wherewithal to clean out my closets. It's a closely guarded secret,  but I still have clothes from thirty years ago. Maybe even forty. They all still fit and occasionally I'll pull something out and let it see the light of day again.

I'm looking forward to a good writing year. The last book in my Transformation Series will be published. And I hope to have a good start at the next series. Maybe a few more short stories will show up, too. In fact, there's one I'm working on right now that needs an ending. It will come to me. They always seem to in unusual ways.

It's cozy in my house tonight. Fire is buring cheerily in the woodstove. Wolves are curled up in three separate corners. Tomorrow is a free day for me. Wonder how I'll use it?

Tuesday, November 1, 2011

Where Did October Go??

Just got back from a small climbing trip to the hinterlands of Nevada and, let me tell you, I don’t think there’s any state—including Alaska—that has quite the back-end-of-the-world feel Nevada does. You can drive for hours on paved roads and only see one or two other cars. It’s truly like the world ended and no one told you.

Interestingly, the back roads winding up fetching little canyons were chock full of hunters. Maybe that’s why there was no one on the macadam. As a climber, hordes of hunters make me a bit nervous. My husband remembers growing up in the forties and fifties in rural Montana. Every hunting season, there were hunters killed by “friendly fire”. So, I wear lots of bright colors and tie bandanas around the dogs’ necks. Sometimes I sing. Good thing there's no one to hear since I've never been able to carry a tune!

We managed to climb a couple of remote peaks; three to be precise. But two were twin peaks, so they really only count as one since I didn’t have to conquer a whole bunch more vertical to stand on top of something.

I realized as we pulled back into California yesterday that it was Halloween and ski season was only about twelve days away. Of course, Mammoth Mountain doesn’t have much in the way of snow. But I’ll bet they’re making it. It’s been cold enough at night. And, flurries are forecast for Thursday. Today, however, the sun is bright and the sky is the incredible blue that it only seems to get in the Eastern Sierra. I’ll enjoy an extended fall for as long as I can. When winter comes at eight thousand feet, it stays for a very long time.

Just before we left for Nevada, our central heat quit. And, because this is the Eastern Sierra and service isn’t easy to come by, it took several days before the one Carrier-certified guy in the region had time for us. We couldn’t have left town without the ability to set the thermostat to something low, but above freezing. If we had, we’d have risked frozen pipes. In any event, seems a hardy chipmunk had crawled up onto our roof. He was the curious sort because he managed to fall twenty-five feet down the exhaust pipe of our propane furnace to the ground floor where he blocked the air egress. Because the furnace is smarter than the chipmunk, it knew better than to start up. The good news is it only took the repair guy half an hour and we were good to go.

Even though we have heat again, I’m still sad to see an all-too-short summer fade into winter. It didn’t get warm here until early July. On a more positive note, I got in way more backpacking than I thought I would given the amount of snow blocking high passes in the Sierra. And, who knows? Perhaps this will be a low snow winter. We’re due after two winters with incredibly heavy snowfall. It still hasn’t sunk in that I’m partially retired and can go skiing during the week when the mountain looks about as empty as Nevada’s back roads. I’m sure that reality will come home to roost sometime in December. Assuming we get some snow that is. I've racked up many a ski early season on subterranean rocks.

Think I’ll circle back to psychological topics beginning with next week. We’ve had a rash of very unhappy folk through our clinic doors here of late. So, maybe I’ll blog about expectations and learning to value what we have instead of always wanting something different. If there are topics any of you are interested in, let me know. I can be fairly eclectic so long as the area has something to do with how people view/process their worlds.