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I woke glum too early this morning, partly because I was so tired last night that I went to bed by 6 pm. This means I am overdoing and I am still tired today. My half day of clinic is packed, we had computer viral trouble starting two days ago, my furnace is broken at home and apparently at age 37 should have been retired around age 20. The furnace people are busy and may get to it by January. Brrrr. We are lucky enough to have both a fireplace on the main floor and baseboard electric in the basement, so we aren't THAT cold and the pipes will probably not freeze. Sigh.

Hospital access meeting yesterday afternoon, two hours, and up early before that to deal with the computers and call furnace people and see patients too... normal chaos. Hope I start catching up on sleep and can stay up until 9 pm soon. I drove to Seattle three weekends in a row, swim districts, swim state and then to pick up my son for Thanksgiving. It was very nice not to drive to Seattle last weekend. I am taking a week off during the holiday madness and clinic is nearly booked until then. I may need to track down another provider. Butterfly net and bear traps might work.

The biggest discrimination in hospital access besides poverty is mental health and/or addiction. Often dual diagnosis, big surprise. Our addiction services and mental health services for the 30,000 people in the county have been thin at best. We have one full time psychiatrist. We have two one day ones. Not enough. We have a prescribing nurse practitioner who is full time. We have one addiction program. There is currently less stigma attached to alcoholism than "drugs". In rank from stigma to more stigma I would list marijuana<alcohol<tobacco<benzodiazepines<opiate pills<meth<heroin. As one patient said, "You just can't get good cocaine at all," so I am not including it. I don't like addictive drugs. Any of them. But why are some so much more stigmatized than others? A patient is a patient is a patient, right? Addiction is an illness, right? I did wonder about that for a while, until I realized that the addict lies TO THEMSELVES about the addiction as well as everyone else. Typical alcohol speak in the hospital: "I don't need to go to AA, it was just an accident, I can quit tomorrow, I don't have a problem, I am not an alcoholic." We roll our eyes. They ALL say that. We could say the speech with them. Same for other drugs.... can't fix the addict until the addict says OH I AM AN ADDICT and tries to deal with it. Some never ever do. They die younger. Sigh.

There: I was going to say I'm less glum. Oh, but I am. I donated two three session dance classes to an organization for a fund raise, and two people bought them. So I am going to teach some six count swing dance, east coast jitterbug. That should be fun....

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