Feeling Bad

I have been feeling bad lately.  Let me explain.

I work as a supervisor in a mental health program.   I manage other clinicians, nurses, and psychiatrist who serve people with severe mental illness.  It is a stressful job by itself and involves a lot of therapy, case management, medical follow up, consultation, traveling, etc.  It is a job that not anybody can withstand or even consider taking, because it is not a typical mental health facility.   The program is based on the PACT model (Programs of Assertive Community Treatment) and it involves intensive psychiatric and rehabilitation services , similar to what clients receive in psychiatric hospitals, but in the community.  So you can imagine the amount or work and tension that we often experience in trying to help individuals with paranoia, delusions, disorganized thinking, and poor social skills remain living in their homes.   Even though I may be describing it as a difficult job, it is very self rewarding.  We are actually helping people stay away from institutions and jails simply because of the severity of their illness.  We are helping them live normal lives like the rest of us.

But I recently started feeling really bad about my job because of the way the company sometimes treats our staff.   They are not usually paid the salary that other facilities and hospitals in the community pay their clinical staff, plus they started hiring more bachelor levels so that the  cost of hiring people would be less.  So the competition has been an uphill battle which results in a high turn over rate.

Since I started working for this PACT program in 2011, we have had two full time doctors, and recently two part times.  The two part time psychiatrists  shared the case load of a total of 101 clients.  The last two psychiatrists were working under a contract  instead of being regular employees.  But unfortunately , one of the two part time doctors decided to move out of the state for a better paying job (its usually  because of the money) and we found ourselves planning to have one part time doctor cover  while starting to recruit for another doctor to take over the other half of the caseload.   The situation became more complicated when the company advertised the position and found a candidate who was willing to work full time instead, as a regular employee.  Having a full time practitioner is what the PACT model is based on primarily and it facilitates the overall function of the program.    So needless to say, the company had to make the difficult decision to “get rid of the part time psychiatrist” so that we can officially hire the new full time practitioner (who happens to be an ARNP who can do the same type of job as a psychiatrist).   Of course, letting the remaining part time psychiatrist know was the hard pill to swallow.  Not to mention informing the clients (once again) that their psychiatrist was resigning and they were going to be seen by a different practitioner.   Our clients who all suffer from a severe and persistent mental illness, are already marked by difficult times in their lives, and change is one of the most difficult experience which can exacerbate their symptoms.

The CEO of the company is the one who negotiates with psychiatrists and makes the final decisions about which psychiatrist to hire.  My supervisor and I interviewed the new candidate and we liked her, but the CEO was the one making the decision about moving  forward with her, meaning that the part time psychiatrist who was still working with us had to go.   Part of me said we were doing the wrong thing… that we should’ve looked for a another part time psychiatrist so that we wouldn’t have to lose the one we already had.  I was informed that the CEO would then speak with the part time psychiatrist about our plans, which I was glad I did not have to do, although I wished we could have done something different so that we can keep the part time psychiatrist.  But that was not my decision to make.

To make matters worse, last week, the part time psychiatrist approached me and asked me about what the company was planning to do with her if they find a full time practitioner.  I was dumbfounded and caught off guard, not knowing what to say at the moment.  I thought that the CEO had spoken with her about his decision already,  but it turned out he had not informed her yet.  So I had to tell her the truth at that moment, I don’t believe in lying or hiding things from people, especially staff people who work with me.   But I also told her that the CEO should be speaking with her about the matter in more details soon.  So, understandably, the part time psychiatrist seemed upset and said she will just resign.

I felt as big as an ant.

Here we are, literally getting rid of a part time person, a human being with a family to feed and a career to keep, so that we can replace her with a full time person who will take her place to “serve our clients.”  The company has a budget to keep, so having one full time psychiatrist was more financially convenient.   I understand the technicality and the business part of the reason why we need to make this decision.  But the human side of the matter sucks.

So I feel bad.  I feel we made a mistake.  I wish I could have done something different and prevent having to get rid of the part time psychiatrist.  I wish the CEO would have contacted the part time psychiatrist early and offer her to stay with maybe less hours, but still stay working with us along with the full time ARNP.

But it is too late now.  She decided to suddenly resign , sooner than what the contract mandates.  I can understand her anger and frustration. I also understand the need to have a full time practitioner who also has more flexibility with traveling and visiting our clients.

So I am split in half, feeling glad that we found a full time practitioner soon;  but still feeling bad that we lost a very good psychiatrist and made her upset in the process.

At the end of the day, the ones suffering the most are our clients, who will have to face another change of providers.  And most likely run the risk of  increasing their symptoms of mental illness because of this transition they are forced to face.

It’s hard being a supervisor sometimes.

 

What we are teaching our children

No matter if you insult and sexually assault people , you can still be elected president of the US.

No matter if you intimidate others , discriminate ,and cause division , people can still vote for you and become president of the US.

No matter if you discriminate and act arrogant, and have a grandiose complex, you can still be president of the US.

No matter if you make fun of disabled people, you still can make history and become president of the US.

All you have to do is act as if money is the most important thing to be somebody and be well  respected.  

Just be arrogant, self centered, and grandiose and people will want you to be their leader.   

This country has shown to the rest of the world that what we value the most are the things we once discouraged in our homes, school, and churches . But this country has made a big turn . 

 Because this country we call “America” has chosen a bullying billionaire who exhibits all these characteristics, and has become the next president of the US. 

Don’t Criticize 

If you are going to criticize me, first I ask that you try to put yourself in my shoes and consider all the stuff that I go through. If you’re still going to express your opinion, you can then give me some constructive feedback, but do so in a respectful way. If not, then I’m not going to listen and deal with any issues you may have with me.

I will continue with my journey in whatever way I choose to,  because I refuse to be intimidated by anyone. I am not going to be manipulated by your disrespectful and empty words. I refuse to accept any responsibility for what you think about me. Keep your misery to yourself. So close your mouth and continue your way.


Have a nice life. 

Life summarized 

This existence seems to be merely an awareness based on fabricated thoughts and individualized perceptions we call “reality” that dictates most of our behaviors.  This overall existence called “life” is mostly preferred over the notion of “death” because we usually don’t want to acknowledge the inevitable end of this perceived existence.

We choose what we believe, many times without realizing it, and continue our existence as if what we believe is an ultimate truth.   We deceive ourselves with fantasies and illusions that nourish our egos and makes us feel secure and important… but it is all an attempt to distract us from our destiny: death.

We tend to want to belong to some kind of group and community , creating societies, in order to feel secured and protected (trying to recreate the experience inside the womb).   But we often fail to realize and accept the fact that we are simply deceiving ourselves.  Unconsciously afraid of facing the reality of our mortality.

And because of this profound fear, we continue our journey of biased perceptions attempting to maintain a state of awareness we call “happiness”, not realizing that it depends solely on circumstances that we choose to cherish.

This existence is slowly decaying and shutting down.  This awareness will eventually cease to be present and we will  not even know it has happened.  All we can be aware of is what is experienced at the present moment.  Right now.

Think about it.

 

 

 

Excitement in Paradise

I have been visiting another country outside of the US.  and it has been an exciting experience.  The country is the Dominican Republic , and I am truly experiencing every moment of it.   I wanted to emphasize a few details that I have been perplexed with.   My wife has warned me about a few things in  this country (which is actually her home town), particularly the lack of respect towars traffic laws. 

During my stay in the DR, I have witnessed and experienced the total disregard of rules and respect for others on the streets.  While driving on streets and avenues, various automobiles, trucks, and motorcycles run in front and around me like there is an apocalyptic emergency.  Especially the motorcycles, which travel on the opposite lane , run every stop sign, and do not stop or slow down while crossing intersections.  They run at high speed and do not seem to care about the safety of others.   People use horns to intimidate , particularly large truck drivers , and to warn others to get out of the way or to yield because they are about to pass by.   People often create additional lines of cars by trying to slowly pass others in close proximity.  


It is as if stop signs didn’t  exist, even though they can be seen everywhere. The lines on the roads are merely decorations. Traffic lights are rarely  obeyed.  Cutting people off and stopping in front while waiting at red lights is common.  Pedestrians , including children , cross the roads or stand between two lanes waiting to cross the road, while cars and motorcycles fly inches from their bodies.  It is truly a scary but exciting view.  It reminds me of an action movie.  I feel the same rush and adrenaline when I am playing a high speed  car racing video game.  Except that I am in real life. 
I started to regard stop signs as a reminder to hold my breath while  crossing  intersections (instead of actually stopping the car), and resume breathing afterwards.  People usually cross and then look , instead of vice versa.  I started hoping people will stop or slow down while I cross an intersection because if I don’t , I may not be allowed to cross myself.  It’s a survival of the fittest.  


Another interesting sight was seeing taxi drivers with cars that were literally falling apart .  Many buses did not have  a door and some cars didn’t have  license plates.   Some motorcycles and scooters had three or four people on them.  They also carry big loads of groceries.  The smell of burned gasoline is overwhelming.  


Keep in mind that the DR is a poor country and most people live in these conditions out of necessity.  So by no means am I  criticizing or judging the Dominican culture.  The food is great and people are very friendly.  There are many people who randomly came to the rescue when we had a problem with our car and needed assistance with  pushing and jumping the car’s batteries.  Others, still in their pre-teens, approached my car while at a red light and started washing my windshield.   Of course, many people expect to be paid but it is also part of their need to survive. 


Children play on the streets and a lot of elders sit on the corners watching cars go by. It is mainly a familiar and friendly environment.  But most people here drive as if they are always in a big rush and patience is rarely practiced.  When I return to the states, I will most likely be stunned by the tranquility and patience that people drive with .  But I would miss the familiarity and friendliness of the Dominican people.  

The bell 

Have you ever noticed that we become weak but wiser when we get older? Everyone’s life can be illustrated with a bell shaped line (like in statistics’ bell curve).  We all are born being weak, frail, naked, cold, and confused.  We are also dependent on others’ total care and protection.  If we are not well taken care of, we can fall and injure ourselves easily.

We are also under the same condition when we’re are close to death in our advanced age.  During our last days we are also weak, frail, naked, cold, and confused.  But during the rest of our lives, in the middle part of the bell, we learn more, develop, become stronger , more intelligent, and faster.  Our lives become more enthusiastic and adventurous.  We tend to feel more successful and busy.  This can be experienced by reaching the highest point in our professional career, buying a new house or car,  traveling around the world, having the maximum number of friends, and manifesting our artistic or  musical talents to the maximum.

  But after this high point in our lives, we start to get tired, slower, and limited. Our health begins to deteriorate, our strengths are not so great  and our goals are no longer as important. We slowly begin to deteriorate and lose interest in certain parts of our lives that we once were so obsessed with. We also begin to see loved ones deteriorate and die around us.  We may develop other interests that are less ambitious.  We start to get “older.” 

And this is when we reach the point that we once began at.  Our lowest point as far as strengths and abilities .  But at the same time , this return to our “lowest points” is also the return to our selves .  The return to our natural beings.  The return to the real nature of our existence. We are no longer fixated on our ambitions, our dreams, and our goals.  We are no longer lost in our thoughts and fantasies about what we should do and who we should become.  We simply face the stage in life where we have to accept who we really are.

 We begin to be forced to deny our egos and accept our true selves . Some of us receive this stage in life with appreciation and joy.  Others receive it with regrets and desperation. But we all receive it eventually. 

It is almost like returning to dust… 

Returning to nature.