Nightmare

I have been in a nightmare mood all day. Going to Ecuador is about leaving everything and I did not realize that was so difficult. Saying goodbye over and over again is increasingly painful, I am not sure I can get through the day, and then I do and look forward to the same the next day and the next. Except that I am leaving again tomorrow for San Francisco for the American Psychiatric Association meeting to get as many hours of educational credits so as not to lose my license to practice medicine while I am away. I was looking forward to the trip because I will see my sisters and friends and of course some 20,000 or more psychiatrists, but perhaps because I have not adjusted to the time, I am struggling to fire up some enthusiasm.

It is curious that I received an email from someone I knew in Salt Lake City, who is involved with a campaign against the Scientologists, who always have quite a presence at the APA and put alot of money and energy into disparaging psychiatry and offering an alternative. Francois tries to counter the Scientolgists power and influence, trying to reveal the negative aspects of the cult. He wrote to me because he wants psychiatrists involved in the fight against scientologists. What a surprise to receive an email from him. I actually went to Cancun one year with Francois, his son Julian, and my daughter Tara when she was three years old, so it was shortly after I moved from Southern California to Salt Lake City. I remember getting very ill there with Montezuma's revenge, and perhaps Francois did too. Somehow we went off our separate ways and I had not heard from him until I received the email last week. I will try to look for him in the group of protestors outside the convention centre. I have ignored the Scientologists all these years and not thought much of their influence; I will have to learn more from Francois about why he is so involved in exposing them; certainly there is something personal in his campaign.

I am not sure how focussed I will be at the meeting. I have signed up for interesting courses, which I feel obliged to attend, but I find myself distracted during meetings, always choosing a lecture which is packed and overflowing and impossible to hear. There are 'industry supported symposia' which are very popular because drug companies provide free food; it is bizarre to watch the scores of psychiatrists who push through the lines to get their free dinner. Sometimes, one has to line up hours in advance to get a table and I never want to get to the talk that early so invariably I get there when there is no food left or when there is no syllabus either. I would rather have the syllabus, but then when I get home, I pile them up in my office and never look at them again. It may be that the pharmaceutical companies are no longer allowed to offer free anything. December 31 of last year was the last day they were not prohibited from giving away free pens and gifts. It seems that many psychiatrists were working for pharmaceutical companies and not behaving very ethically and the APA has decided not to accept free (nothing is ever free) 'gifts'. I believe this is the first APA ever which is not "industry supported". It has been questionable ethically anyway. It will be interesting to see the changes. There is an exhibit area where usually most of the psychiatrists walk through all the exhibitors' booths picking up whatever they can get without paying; sometimes useful gifts such as signed copies of new book, but more often only free pens with the pharmaceutical company label, or other tasteless article that seems great for a moment because it is given away , but later is just burdensome to carry back home in one's suitcase. I resolve each time I go to the APA not to get too excited about the 'free' gifts. More often than not I come home with articles and journals that I forget to read until I clean out my office and discover that they are outdated and useless. Now I am questioning what in fact I get out of the APA; usually it is CME's, which are hours of educational credits necessary to maintain one's license. I have remind myself of that. After a couple of days of missing all the good lectures and dosing off in the ones I find as alternatives, I guiltily decide to do something different. I cannot complain about being in San Francisco, which is a wonderful city to explore.

Karen is visiting my sister Monica, which will pull me away from the meeting I am sure. I will have to remember that I am there to get these CME's! 

I will miss Maya who will be playing two roles in Cinderella Sunday. She has spent hours and hours preparing and rehearsing for this event, and then will be onstage perhaps a minute or two. I will receive a DVD of her performance, but it will not be the same as being there. I will miss it and am feeling horribly guilty. I did not plan this very well.