Diagnosis Day Quotes

I was once asked if I had any ideas for a really scary reality TV show. I have one reality show that would really make your hair stand on end: "C-Students from Yale." George W. Bush has gathered around him upper-crust C-students who know no history or geography, plus not-so-closeted white supremacists, aka Christians, and plus, most frighteningly, psychopathic personalities, or PPs, the medical term for smart, personable people who have no consciences. To say somebody is a PP is to make a perfectly respectable diagnosis, like saying he or she has appendicitis or athlete's foot . . . PPs are presentable, they know full well the suffering their actions may cause others, but they do not care. They cannot care because they are nuts. They have a screw loose! . . . So many of these heartless PPs now hold big jobs in our federal government, as though they were leaders instead of sick. They have taken charge of communications and the schools, so we might as well be Poland under occupation. They might have felt that taking our country into an endless war was simply something decisive to do. What has allowed so many PPs to rise so high in corporations, and now in government, is that they are so decisive. They are going to do something every fuckin' day and they are not afraid. Unlike normal people, they are never filled with doubts, for the simple reasons that they don't give a fuck what happens next. Simply can't. Do this! Do that! Mobilize the reserves! Privatize the public schools! Attack Iraq! Cut health care! Tap everybody's telephone! Cut taxes on the rich! Build a trillion-dollar missile shield! Fuck habeas corpus and the Sierra Club and In These Times, and kiss my ass! There is a tragic flaw in our precious Constitution, and I don't know what can be done to fix it. This is it: Only nut cases want to be president.

The greatest barrier I have met is the almost total absence from the minds of my audience of any sense of sin... The early Christian preachers could assume in their hearers, whether Jews, Metuentes, or Pagans, a sense of guilt. (That this was common among Pagans is shown by the fact that both Epicureanism and the mystery religions both claimed, though in different ways, to assuage it.) Thus the Christian message was in those days unmistakably the Evangelium, the Good News. It promised healing to those who knew they were sick. We have to convince our hearers of the unwelcome diagnosis before we can expect them to welcome the news of the remedy. The ancient man approached God (or even the gods) as the accused person approaches his judge. For the modern man, the roles are quite reversed. He is the judge: God is in the dock. He is quite a kindly judge; if God should have a reasonable defense for being the god who permits war, poverty, and disease, he is ready to listen to it. The trial may even end in God’s acquittal. But the important thing is that man is on the bench and God is in the dock.

One day I would like to make up my own DSM-111 with a list of “disorders” I have seen in my practice. For example, I would want to include the diagnosis “psychological modernism,” an uncritical acceptance of the values of the modern world. It includes blind faith in technology, inordinate attachment to material gadgets and conveniences, uncritical acceptance of the march of scientific progress, devotion to the electronic media, and a life-style dictated by advertising.

We have all heard such stories of expert intuition: the chess master who walks past a street game and announces “White mates in three” without stopping, or the physician who makes a complex diagnosis after a single glance at a patient. Expert intuition strikes us as magical, but it is not. Indeed, each of us performs feats of intuitive expertise many times each day. Most of us are pitch-perfect in detecting anger in the first word of a telephone call, recognize as we enter a room that we were the subject of the conversation, and quickly react to subtle signs that the driver of the car in the next lane is dangerous. Our everyday intuitive abilities are no less marvelous than the striking insights of an experienced firefighter or physician—only more common. The psychology of accurate intuition involves no magic. Perhaps the best short statement of it is by the great Herbert Simon, who studied chess masters and showed that after thousands of hours of practice they come to see the pieces on the board differently from the rest of us. You can feel Simon’s impatience with the mythologizing of expert intuition when he writes: “The situation has provided a cue; this cue has given the expert access to information stored in memory, and the information provides the answer. Intuition is nothing more and nothing less than recognition.

The common thread from all those stories was that talking helped, and listening, and time. One day I would find my own place. I couldn't run there, though, because it didn't exist yet; I had to build it myself, out of forgiveness, truth, and terrifying gestures of friendship.

In the spring of 2009, I was the 217th person ever to be diagnosed with anti-NMDA-receptor autoimmune encephalitis. Just a year later, that figure had doubled. Now the number is in the thousands. Yet Dr. Bailey, considered one of the best neurologists in the country, had never heard of it. When we live in a time when the rate of misdiagnoses has shown no improvement since the 1930s, the lesson here is that it’s important to always get a second opinion. While he may be an excellent doctor in many respects, Dr. Bailey is also, in some ways, a perfect example of what is wrong with medicine. I was just a number to him (and if he saw thirty-five patients a day, as he told me, that means I was one of a very large number). He is a by-product of a defective system that forces neurologists to spend five minutes with X number of patients a day to maintain their bottom line. It’s a bad system. Dr. Bailey is not the exception to the rule. He is the rule.

The fact is, Donald’s pathologies are so complex and his behaviors so often inexplicable that coming up with an accurate and comprehensive diagnosis would require a full battery of psychological and neuropsychological tests that he’ll never sit for. At this point, we can’t evaluate his day-to-day functioning because he is, in the West Wing, essentially institutionalized. Donald has been institutionalized for most of his adult life, so there is no way to know how he would thrive, or even survive, on his own in the real world.

If your faith is based on lack of affliction, it’s on the brink of extinction and is only a frightening diagnosis or a shattering phone call away from collapse. Token faith will not survive suffering. Nor should it.

Every patient who was prescribed the drug stood a chance of soon needing it every day. These people were willing to pay cash. They never missed an appointment. If diagnosis wasn’t your concern, a clinic was a low-overhead operation: a rented building, a few waiting rooms, some office staff. And bouncers. These clinics did require bouncers.

Everything is boring, boredom is the other epidemic which is making Europe ripe for decline. Boredom is the end product of each and every civilization. It is the arteriosclerosis of the great thinking peoples. The moment always arrives where even God, whether he’s called Zeus, Zebaoth or Zoroaster, has finished creating the universe and asks: “What’s the point of it, actually?” He yawns and chucks it aside. Mankind does the same with civilization. Boredom is the condition of a people which no longer believes but all the same is doing just fine. Boredom is when every clock in the country is predestined to be correct. When the same naive flowers blossom again in the month of March. When every day the deaths of good family fathers are announced in the papers. When a war breaks out in the Balkans. When poems go on about the stars. Boredom is a symptom of aging. Boredom is the diagnosis that talent and virtue are slowly being spent. Boredom is the life-long determination to a form of being which has worn itself out.

To give the devil its due, ours is the best Age men ever lived in; we are all more comfortable and virtuous than we ever were; we have many new accomplishments, advertisements in green pastures, telephones in bedrooms, more newspapers than we want to read, and extremely punctilious diagnosis of maladies. A doctor examined a young lady the other day, and among his notes were there: ‘Not afraid of small rooms, ghosts, or thunderstorms – not made drunk by hearing Wagner; brown hair, artistic hands; had a craving for chocolate in 1918.

The diagnosis of the human plight is then not simply that humans have broken God’s moral law, offending and insulting the Creator, whose image they bear—though that is true as well. This lawbreaking is a symptom of a much more serious disease. Morality is important, but it isn’t the whole story. Called to responsibility and authority within and over the creation, humans have turned their vocation upside down, giving worship and allegiance to forces and powers within creation itself. The name for this is idolatry. The result is slavery and finally death.

I’d thought for so long that I would become a schizophrenic, and if I was a schizophrenic, that’s all I would ever be. But a person doesn’t become their diagnosis. Your mom isn’t breast cancer, you don’t become cancer. You live with cancer. So often, we think of a person living with mental illness as their mental illness, and that’s unfair. A person is never their diagnosis, not even my mom. Delilah showed me that. She lives—and has lived—a full life. She has a husband. They travel. She’s a photographer, an artist. She tells the funniest knock-knock jokes I’ve ever heard. She takes her meds every day, but still has hallucinations from time to time. She is not schizophrenic. She lives with schizophrenia.

EDS is a scary and challenging diagnosis, but the consequences of not knowing are far greater than that of a correct diagnosis. EDS symptoms can range from the very mild to the extremely severe. One thing is certain, though: If I had received a diagnosis back when my symptoms were mild, I would be living a very different life now. Every single day, in my struggle to actualize the person I still can be, I cannot help but mourn the person I could have been.

But no matter how carefully we schedule our days, master our emotions, and try to wring our best life now from our better selves, we cannot solve the problem of finitude. We will always want more. We need more. We are carrying the weight of caregiving and addiction, chronic pain and uncertain diagnosis, struggling teenagers and kids with learning disabilities, mental illness and abusive relationships.

Notice the things you do which give you energy and stimulate you in a positive way. Choose to spend time on these every day.

I remember a woman, the mother of a child with Down syndrome, had come to talk to us about the manner in which the doctors and geneticists had discussed her daughter’s postnatal diagnosis with her, which ranged from heartless to clueless. But then, she said, on the day she and her baby were being discharged, the attending resident had come to say goodbye to them. “Enjoy her,” he had said to this woman. Enjoy her: No one had ever told her that she might delight in her baby, that her baby might be a source not of troubles but of pleasure.

Before the baby, before the diagnosis, before the pandemic. Before. Before when I was earnest and clever and ignorant, I thought, life is a series of choices. I curated my own life until, one day, I couldn't. I had accepted the burden of limitless choices only to find out I had few to make.

Janna knew - Rikki knew — and I knew, too — that becoming Dr Cameron West wouldn't make me feel a damn bit better about myself than I did about being Citizen West. Citizen West, Citizen Kane, Sugar Ray Robinson, Robinson Crusoe, Robinson miso, miso soup, black bean soup, black sticky soup, black sticky me. Yeah. Inside I was still a fetid and festering corpse covered in sticky blackness, still mired in putrid shame and scorching self-hatred. I could write an 86-page essay comparing the features of Borderline Personality Disorder with those of Dissociative Identity Disorder, but I barely knew what day it was, or even what month, never knew where the car was parked when Dusty would come out of the grocery store, couldn't look in the mirror for fear of what—or whom—I'd see. ~ Dr Cameron West describes living with DID whilst studying to be a psychologist.

just begged the question: If it took so long for one of the best hospitals in the world to get to this step, how many other people were going untreated, diagnosed with a mental illness or condemned to a life in a nursing home or a psychiatric ward? CHAPTER 30 RHUBARB By my twenty-fifth day in the hospital, two days after the biopsy, with a preliminary diagnosis in sight, my doctors thought it was a good time to officially assess my cognitive skills to record a baseline.

It is safe to assume that, no matter how it appears, the attempt probably did not come out of the blue. Look for clues. Some possibilities include a family history of mental illness, a history of abuse, unusual or stressful family dynamics, prior diagnosis or evidence of a psychiatric disorder and/or bizarre behavior long before or in the days or weeks immediately preceding the crisis. Part of your job is to be a detective, assembling the pieces in the puzzle that is depression.

My other client, whom I will call Teresa, thought Lorraine had MPD and hoped I could help her. Almost no one recognized this condition in those days. Lorraine was forty years old and had been in and out of psychiatric hospitals since she was thirteen. She had had various diagnoses, mainly severe depression, and she had made quite a few serious suicide attempts before I even met her. She had been given many courses of electric shock therapy, which would confuse her so much that she could not get together a coherent suicide plan for quite a while. Lorraine’s psychiatrist was initially opposed to my seeing her, as her friend Teresa had been stigmatized with the "borderline personality disorder" diagnosis when in hospital, so was seen as a bad influence on her. But after Lorraine spent a couple of months in hospital calling herself Susie and acting consistently like a child, he was humble enough to acknowledge that perhaps he could learn some new things, and someone else’s help might be a good idea.

When Larry Sherman designed the Kansas City gun experiment, he was well aware of this problem. “You wouldn’t tell doctors to go out and start cutting people up to see if they’ve got bad gallbladders,” Sherman says. “You need to do lots of diagnosis first before you do any kind of dangerous procedure. And stop-and-search is a dangerous procedure. It can generate hostility to the police.” To Sherman, medicine’s Hippocratic oath—“First, do no harm”—applies equally to law enforcement. “I’ve just bought myself a marble bust of Hippocrates to try to emphasize every day when I look at it that we’ve got to minimize the harm of policing,” he went on. “We have to appreciate that everything police do, in some ways, intrudes on somebody’s liberty. And so it’s not just about putting the police in the hot spots. It’s also about having a sweet spot of just enough intrusion on liberty and not an inch—not an iota—more.

As a special branch of general philosophy, pathogenesis had never been explored. In my opinion it had never been approached in a strictly scientific fashion--that is to say, objectively, amorally, intellectually. All those who have written on the subject are filled with prejudice. Before searching out and examining the mechanism of causes of disease, they treat of 'disease as such', condemn it as an exceptional and harmful condition, and start out by detailing the thousand and one ways of combating it, disturbing it, destroying it; they define health, for this purpose, as a 'normal' condition that is absolute and immutable. Diseases ARE. We do not make or unmake them at will. We are not their masters. They make us, they form us. They may even have created us. They belong to this state of activity which we call life. They may be its main activity. They are one of the many manifestations of universal matter. They may be the principal manifestation of that matter which we will never be able to study except through the phenomena of relationships and analogies. Diseases are a transitory, intermediary, future state of health. It may be that they are health itself. Coming to a diagnosis is, in a way, casting a physiological horoscope. What convention calls health is, after all, no more than this or that passing aspect of a morbid condition, frozen into an abstraction, a special case already experienced, recognized, defined, finite, extracted and generalized for everybody's use. Just as a word only finds its way into the Dictionary Of The French Academy when it is well worn stripped of the freshness of its popular origin or of the elegance of its poetic value, often more than fifty years after its creation (the last edition of the learned Dictionary is dated 1878), just as the definition given preserves a word, embalms it in its decrepitude, but in a pose which is noble, hypocritical and arbitrary--a pose it never assumed in the days of its vogue, while it was still topical, living and meaningful--so it is that health, recognized as a public Good, is only the sad mimic of some illness which has grown unfashionable, ridiculous and static, a solemnly doddering phenomenon which manages somehow to stand on its feet between the helping hands of its admirers, smiling at them with its false teeth. A commonplace, a physiological cliche, it is a dead thing. And it may be that health is death itself. Epidemics, and even more diseases of the will or collective neuroses, mark off the different epochs of human evolution, just as tellurian cataclysms mark the history of our planet.

A small step forward . . .every . . single . . .day. The sun is coming up and I am wondering, 'What wondrous thing shall I witness today?

And the concept of an extraordinary means of preserving life, or a risky, optional treatment that doctors don't recommend, is one I studied in graduate school and fascinates me to this day. It's the idea that the patient ultimately controls their own fate, and that is the greatest freedom you can have within a system that sees patients as their diagnosis rather than as people

Because now mental health disorders have gone “mainstream”. And for all the good it’s brought people like me who have been given therapy and stuff, there’s a lot of bad it’s brought too. Because now people use the phrase OCD to describe minor personality quirks. “Oooh, I like my pens in a line, I’m so OCD.” NO YOU’RE FUCKING NOT. “Oh my God, I was so nervous about that presentation, I literally had a panic attack.” NO YOU FUCKING DIDN’T. “I’m so hormonal today. I just feel totally bipolar.” SHUT UP, YOU IGNORANT BUMFACE. Told you I got angry. These words – words like OCD and bipolar – are not words to use lightly. And yet now they’re everywhere. There are TV programmes that actually pun on them. People smile and use them, proud of themselves for learning them, like they should get a sticker or something. Not realizing that if those words are said to you by a medical health professional, as a diagnosis of something you’ll probably have for ever, they’re words you don’t appreciate being misused every single day by someone who likes to keep their house quite clean. People actually die of bipolar, you know? They jump in front of trains and tip down bottles of paracetamol and leave letters behind to their devastated families because their bullying brains just won’t let them be for five minutes and they can’t bear to live with that any more. People also die of cancer. You don’t hear people going around saying: “Oh my God, my headache is so, like, tumoury today.” Yet it’s apparently okay to make light of the language of people’s internal hell

He has so little energy in his body that he can only walk to the bathroom on the other side of the hallway twice a day. After a few meters he is worn out, much worse than after the marathons he used to run. He was a triathlete, he earned a brown belt in judo, became Dutch champion in hockey, until he contracted pneumonia in 2005 and never recovered. Ever since, he has a headache, vertigo, and insomnia, but worst of all the fatigue: after minimal effort his muscles would lose all their strength and take days to recover. Only after a few years did he get a diagnosis: Chronic Fatigue Syndrome (CFS).

To put the words / labels / diagnosis bluntly, in my own wording / description form: -'Narcolepsy with Cataplexy' is, becoming considered, an 'Auto-Immune Disease' which directly effects the Brain and the Neurological, Central Nervous and Immune Systems; aswell as involving also, the Endocrine System...- 'Narcolepsy' is the inability to get 'restorative sleep' which results in the inability to maintain wakefulness, throughout days and/or nights; so one with it does not sleep well, nor has energy, often. 'Cataplexy' is a symptom of Narcolepsy and is 'a minimal to complete, temporary muscle paralysis,

Doctor?” said Jan. “What doctor? I called him this morning and got his secretary on the line. I asked for a flu prescription and was told I could come pick it up tomorrow morning between eight and nine. If you’ve got a particularly bad case of flu, the doctor himself comes to the phone and says, ‘Stick out your tongue and say “Aah.” Oh, I can hear it, your throat’s infected. I’ll write out a prescription and you can bring it to the pharmacy. Good day.’ And that’s that. Easy job he’s got, diagnosis by phone. But I shouldn’t blame the doctors. After all, a person has only two hands, and these days there’re too many patients and too few doctors.

Quincy laughed. "If I were Elizabeth I shouldn't thank either of you for that comforting diagnosis. Would it do any good to open Aunt Sarai's grave and drive a stake through her? If you believe in as much sorcery as that, you must regret the days of witch-burners, Carew." Carew said quietly, "No. Witch-burners were barbarous blunderers. If I wanted to suppress a dangerous letter, could I do it by burning the envelope and leaving the letter loose? The witch would come back unchanged; I should merely have postponed the danger until another time and place. And have further handicapped myself to meet it, by depriving the witch, by violent death, of the years allotted her, or him, for evolution." Joseph said with dry humor, "She might not have used them for that, Carew. At least not for your idea of it." Carew shrugged. "That would be her responsibility, not mine. And, in any case, she would be that many years nearer the time of her inevitable change." This time Joseph did not answer, only smiled.

This concept upends the way most people think about their subjective experience of life. We tend to place a lot of emphasis on our circumstances, assuming that what happens to us (or fails to happen) determines how we feel. From this perspective, the small-scale details of how you spend your day aren’t that important, because what matters are the large-scale outcomes, such as whether or not you get a promotion or move to that nicer apartment. According to Gallagher, decades of research contradict this understanding. Our brains instead construct our worldview based on what we pay attention to. If you focus on a cancer diagnosis, you and your life become unhappy and dark, but if you focus instead on an evening martini, you and your life become more pleasant—even though the circumstances in both scenarios are the same. As Gallagher summarizes: “Who you are, what you think, feel, and do, what you love—is the sum of what you focus on.

Ideally, work is consecrated. It is something that happens within the present moment . . . Ideally, work is just another beautiful form of joining the cosmic sparkle. But this is an ideal. . . . I worked as a psychiatrist in public institutions . . . for nearly 20 years. During the last 12 of those years, I was consciously trying to be mindful of love, to practice the presence of God. It was the most frustrating thing I ever tried to do. . . . as soon as I entered the ward everything changed. I was immediately kidnapped. I was gone: away from the present, away from any sense of love or its source, away from even appreciating my own being. . . Looking back, it seems clear that I went into my sense of responsibility for the diagnosis and care of the patients. . . . And there was so much paperwork! Most days I would remain forgetful until my work was done and I was driving home. Then I would remember, and such sadness would fill me. Where had I been? How could I have allowed myself to be so captured? I can remember driving home one day after I had spent a long time feeling helpless with a very disturbed patient. I actually slapped myself in the face when I realized I could have been praying for her and praying for myself instead of just worrying about what to do. I tried everything . . . and still it did not “work”. . . . It stopped only when I left the psychiatric institutions and started working full-time with Shalem. . . . I go into this detail because what I am saying does not apply only to psychiatric institutions. It applies, to some extent, to almost every institution we have. It applies to education and social work, to government and business, and to religious institutions as well. People are stuck in all these places, and they can neither get out of them nor find a loving quality of presence within them. Love demands defenselessness, and in many if not most of our workplaces that is just too high a price.

But no matter how carefully we schedule our days, master our emotions, and try to wring our best life now from our better selves, we cannot solve the problem of finitude. We will always want more. We need more. We are carrying the weight of caregiving and addiction, chronic pain and uncertain diagnosis, struggling teenagers and kids with learning disabilities, mental illness and abusive relationships. A grandmother has been sheltering without a visitor for months, and a friend's business closed its doors. Doctors, nurses, and frontline workers are acting as levees, feeling each surge of the disease crash against them. My former students, now serving as pastors and chaplains, are in hospitals giving last rites in hazmat suits. They volunteer to be the last person to hold his hand. To smooth her hair. The truth if the pandemic is the truth of all suffering: that it is unjustly distributed. Who bears the brunt? The homeless and the prisoners. The elderly and the children. The sick and the uninsured. Immigrants and people needing social services. People of color and LGBTQ people. The burdens of ordinary evils— descriminations, brutality, predatory lending, illegal evictions, and medical exploitation— roll back on the vulnerable like a heavy stone. All of us struggle against the constraints places on our bodies, our commitments, our ambitions, and our resources, even as we're saddled with inflated expectations of invincibility. This is the strange cruelty of suffering in America, its insistence that everything is still possible.

Within this narrative, creation itself is understood as a kind of Temple, a heaven-and-earth duality, where humans function as the “image-bearers” in the cosmic Temple, part of earth yet reflecting the life and love of heaven. This is how creation was designed to function and flourish: under the stewardship of the image-bearers. Humans are called not just to keep certain moral standards in the present and to enjoy God’s presence here and hereafter, but to celebrate, worship, procreate, and take responsibility within the rich, vivid developing life of creation. According to Genesis, that is what humans were made for. The diagnosis of the human plight is then not simply that humans have broken God’s moral law, offending and insulting the Creator, whose image they bear—though that is true as well. This lawbreaking is a symptom of a much more serious disease. Morality is important, but it isn’t the whole story. Called to responsibility and authority within and over the creation, humans have turned their vocation upside down, giving worship and allegiance to forces and powers within creation itself. The name for this is idolatry. The result is slavery and finally death. It isn’t just that humans do wrong things and so incur punishment. This is one element of the larger problem, which isn’t so much about a punishment that might seem almost arbitrary, perhaps even draconian; it is, rather, about direct consequences. When we worship and serve forces within the creation (the creation for which we were supposed to be responsible!), we hand over our power to other forces only too happy to usurp our position. We humans have thus, by abrogating our own vocation, handed our power and authority to nondivine and nonhuman forces, which have then run rampant, spoiling human lives, ravaging the beautiful creation, and doing their best to turn God’s world into a hell (and hence into a place from which people might want to escape). As I indicated earlier, some of these “forces” are familiar (money, sex, power). Some are less familiar in the popular mind, not least the sense of a dark, accusing “power” standing behind all the rest. Called

Simply put, within AS, there is a wide range of function. In truth, many AS people will never receive a diagnosis. They will continue to live with other labels or no label at all. At their best, they will be the eccentrics who wow us with their unusual habits and stream-of-consciousness creativity, the inventors who give us wonderfully unique gadgets that whiz and whirl and make our life surprisingly more manageable, the geniuses who discover new mathematical equations, the great musicians and writers and artists who enliven our lives. At their most neutral, they will be the loners who never now quite how to greet us, the aloof who aren't sure they want to greet us, the collectors who know everyone at the flea market by name and date of birth, the non-conformists who cover their cars in bumper stickers, a few of the professors everyone has in college. At their most noticeable, they will be the lost souls who invade our personal space, the regulars at every diner who carry on complete conversations with the group ten tables away, the people who sound suspiciously like robots, the characters who insist they wear the same socks and eat the same breakfast day in and day out, the people who never quite find their way but never quite lose it either.

Once I had found the courage to tell Rebecca about the children in my head, it wasn't so hard in the coming months to tell Roberta. On the train from Huddersfield one day in May I made a roll call of the usual suspects: Baby Alice; Alice 2, who was two years old and liked to suck sticky lollipops; Billy; Samuel; Shirley; Kato; and the enigmatic Eliza. There was boy I would grow particularly fond of named limbo, who was ten, but like Eliza he was still forming. There were others without names or specific behaviour traits. I didn't want to confuse the issue with this crowd of 'others' and just counted off the major players with their names, ages and personalities, which Roberta scribbled down on a pad. Then she looked slightly embarrassed. 'You know, I've met Billy on a few occasions, and Samuel once too,' she said. 'You're joking.' I felt betrayed. 'Why didn't you tell me?' 'I wanted it to come from you, Alice, when you were ready.' For some reason I pulled up my sleeves and showed he my arms. 'That's Kato,' I said, 'or Shirley.' She looked a bit pale as she studied the scars. I had feeling she didn't know what to say. The problem with counsellors is that they are trained to listen, not to give advice or diagnosis. We sat there with my arms extended over the void between us like evidence in court, then I pushed down my sleeves again. 'I'm so sorry, Alice,' she said finally and I shrugged. 'It's not your fault, is it?' Now she shrugged, and we were quiet once more.

As the pumping engines for the circulatory system, ventricles must have a particular ovoid, lemonlike shape for strong, swift ejection of blood. If the end of the left ventricle balloons out, as it does in takotsubo hearts, the firm, healthy contractions are reduced to inefficient spasms—floppy and unpredictable. But what’s remarkable about takotsubo is what causes the bulge. Seeing a loved one die. Being left at the altar or losing your life savings with a bad roll of the dice. Intense, painful emotions in the brain can set off alarming, life-threatening physical changes in the heart. This new diagnosis was proof of the powerful connection between heart and mind. Takotsubo cardiomyopathy confirmed a relationship many doctors had considered more metaphoric than diagnostic. As a clinical cardiologist, I needed to know how to recognize and treat takotsubo cardiomyopathy. But years before pursuing cardiology, I had completed a residency in psychiatry at the UCLA Neuropsychiatric Institute. Having also trained as a psychiatrist, I was captivated by this syndrome, which lay at the intersection of my two professional passions. That background put me in a unique position that day at the zoo. I reflexively placed the human phenomenon side by side with the animal one. Emotional trigger … surge of stress hormones … failing heart muscle … possible death. An unexpected “aha!” suddenly hit me. Takotsubo in humans and the heart effects of capture myopathy in animals were almost certainly related—perhaps even the same syndrome with different names.

Let me put the contrast in a single concrete example. The physician who finds time to give personal attention to his patients and listens to them. carefully probing inner conditions that may be more significant than any laboratory reports, has become a rarity. Where the power complex is dominant, a visit to a physician is paced, not to fit the patient's needs, but mainly to perform the succession of physical tests upon which the diagnosis will be based. Yet if there were a sufficient number of competent physicians on hand whose inner resources were as available as their laboratory aids, a more subtle diagnosis might be possible, and the patient's subjective response might in many cases effectively supplement the treatment. Thoreau expressed this to perfection when he observed in his 'Journal' that "the really efficient laborer will be found not to crowd his day with work, but will saunter to his task surrounded by a wide halo of ease and leisure." Without this slowing of the tempo of all activities the positive advantages of plenitude could not be sufficiently enjoyed; for the congestion of time is as threatening to the good life as the congestion of space or people, and produces stresses and tensions that equally undermine human relations. The inner stability that such a slowdown brings about is essential to the highest uses of the mind, through opening up that second life which one lives in reflection and contemplation and self-scrutiny. The means to escape from the "noisy crowing up of things and whatsoever wars on the divine" was one of the vital offerings of the classic religions: hence their emphasis was not on technological productivity but on personal poise. The old slogan of New York subway guards in handling a crush of passengers applies with even greater force to the tempo of megatechnic society: "What's your hurry...Watch your step!

Dr. Noyes. He came, made the examination, and actually showed the widow the diseased aortic valve which had been the material, the “illusory,” cause of death. But now Mrs. Eddy rallied her forces. The doctor’s diagnosis, though confirmed by autopsy, had been wrong. Asa had not died of heart disease, but had been killed by “metaphysical arsenic,” by “mental poison.” Her enemies and his had slain him by telepathic influence. To console herself for her failure to avert the death, and to counteract the effect it might have on the weak-kneed, she gave an interview to a representative of the Post of Boston, and it appeared in that paper two days after the death. Here are some significant extracts: “My husband’s death was caused by malicious mesmerism... I know it was poison that killed him, but not material poison, but mesmeric poison... After a certain amount of mesmeric poison has been administered, it cannot be averted. No power of mind can resist it.

The case of a patient with dissociative identity disorder follows: Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis. Cindy had been well until 3 years before admission, when she developed depression, "voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen. Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life. Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged. At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters.

It is often asserted that education is breaking down because of overspecialisation. But this is only a partial and misleading diagnosis. Specialisation is not in itself a faulty principle of education. What would be the alternative - an amateurish smattering of all major subjects? Or a lengthy studium generale in which men are forced to spend their time sniffing at subjects which they do not wish to pursue, while they are being kept away from what they want to learn? This cannot be the right answer, since it can only lead to the type of intellectual man, whom Cardinal Newman castigated -'an intellectual man, as the world now conceives of him. ,..one who is full of "views" on all subjects of philosophy, on all matters of the day'. Such 'viewiness' is a sign of ignorance rather than knowledge. 'Shall I teach you the meaning of knowledge?' said Confucius. 'When you know a thing to recognise that you know it, and when you do not, to know that you do not know - that is knowledge.' What is at fault is not specialisation, but the lack of depth with which the subjects are usually presented, and the absence of meta- physical awareness. The sciences are being taught without any awareness of the presuppositions of science, of the meaning and significance of scientific laws, and of the place occupied by the natural sciences within the whole cosmos of human thought. The result is that the presuppositions of science are normally mistaken for its findings. Economics is being taught without any awareness of the view of human nature that underlies present-day economic theory. In fact, many economists are themselves unaware of the fact that such a view is implicit in their teaching and that nearly all their theories would have to change if that view changed. How could there be a rational teaching of politics without pressing all questions back to their metaphysical roots? Political thinking must necessarily become confused and end in 'double-talk' if there is a continued refusal to admit the serious study of the meta- physical and ethical problems involved. The confusion is already so great that it is legitimate to doubt the educational value of studying many of the so-called humanistic subjects. I say 'so- called' because a subject that does not make explicit its view of human nature can hardly be called humanistic. All

How about when you feel as if you are at a treacherous crossing, facing an area of life that hasn’t even been on the map until recently. Suddenly there it is, right in front of you. And so the time and space in between while you first get over the shock of it, and you have to figure out WHAT must be done feels excruciating. It’s a nightmare you can’t awaken from. You might remember this time as a kind of personal D-day, as in damage, devastation, destruction, damnation, desolation – maybe a difficult divorce, or even diagnosis of some formidable disease. These are the days of our lives that whole, beautiful chapters of life go up in flames. And all you can do is watch them burn. Until you feel as though you are left only with the ashes of it all. It is at this moment you long for the rescue and relief that only time can provide. It is in this place, you must remember that in just 365 days – you're at least partially healed self will be vastly changed, likely for the better. Perhaps not too unlike a caterpillar’s unimaginable metamorphosis. Better. Stronger. Wiser. Tougher. Kinder. More fragile, more firm, all at the same time as more free. You will have gotten through the worst of it – somehow. And then it will all be different. Life will be different. You will be different. It might or might not ever make sense, but it will be more bearable than it seems when you are first thrown, with no warning, into the kilns of life with the heat stoked up – or when you get wrapped up, inexplicably, through no choice of your own, in a dark, painfully constricting space. Go ahead, remind yourself as someone did earlier, who was trying miserably to console you. It will eventually make you a better, stronger person. How’d they say it? More beautiful on the inside… It really will, though. That’s the kicker. Even if, in the hours of your agony, you would have preferred to be less beautiful, wise, strong, or experienced than apparently life, fate, your merciless ex, or a ruthless, biological, or natural enemy that has attacked silently, and invisibly - has in mind for you. As will that which your God feels you are capable of enduring, while you, in your pitiful anguish, are yet dubious of your own ability to even endure, not alone overcome. I assure you now, you will have joy and beauty, where there was once only ashes. In time. Perhaps even more than before. It’s so hard to imagine and believe it when it’s still fresh, and so, so painful. When it hurts too much to even stand, or think, or feel anything. When you are in the grip of fear, and you remember the old familiar foe, or finally understand, firsthand, in your bones, what that actually means.

I’m the living dead. I feel no connection to any other human. I have no friends and I don’t really care much about my family any longer. I feel no love for them. I can feel no joy. I’m incapable of feeling physical pleasure. There’s nothing to ever look forward to as a result. I don’t miss anyone or anything. I eat because I feel hunger pangs, but no food tastes like anything I like. I wear a mask when I’m with other people but it’s been slipping lately. I can’t find the energy to hide the heavy weight of survival and its effect on me. I’m exhausted all the time from the effort of just making it through the day. This depression has made a mockery of my memory. It’s in tatters. I have no good memories to sustain me. My past is gone. My present is horrid. My future looks like more of the same. In a way, I’m a man without time. Certainly, there’s no meaning in my life. What meaning can there be without even a millisecond of joy? Ah, scratch that. Let’s even put aside joy and shoot for lower. How about a moment of being content? Nope. Not a chance. I see other people, normal people, who can enjoy themselves. I hear people laughing at something on TV. It makes me cock my head and wonder what that’s like. I’m sure at sometime in my past, I had to have had a wonderful belly laugh. I must have laughed so hard once or twice that my face hurt. Those memories are gone though. Now, the whole concept of “funny” is dead. I stopped going to movies a long time ago. Sitting in a theater crowded with people, every one of them having a better time than you, is incredibly damaging. I wasn’t able to focus for that long anyway. Probably for the best. Sometimes I fear the thought of being normal again. I think I wouldn’t know how to act. How would I handle being able to feel? Gosh it would be nice to feel again. Anything but this terrible, suffocating pain. The sorrow and the misery is so visceral, I find myself clenching my jaw. It physically hurts me. Then I realize that it’s silly to worry about that. You see, in spite of all the meds, the ketamine infusions and other treatments, I’m not getting better. I’m getting worse. I was diagnosed 7 years ago but I’m sure I was suffering for longer. Of course, I can’t remember that, but depression is something that crept up on me. It’s silent and oppressive. I don’t even remember what made me think about going to see someone. But I did and it was a pretty clear diagnosis. So, now what? I keep waking up every morning unfortunately. I don’t fear death any more. That’s for sure. I’ve made some money for the couple of decades I’ve been working and put it away in retirement accounts. I think about how if I was dead that others I once cared for would get that money. Maybe it could at least help them. I don’t know that I’ll ever need it. Even if I don’t end it myself, depression takes a toll on the body. My life expectancy is estimated to be 14 years lower as a result according to the NIH. It won’t be fast enough though. I’m just an empty biological machine that doesn’t know that my soul is gone. My humanity is no more

CONFESSIONS OF A CLING-ON If a man is walking in a forest and makes a statement, but there is no woman around to hear it, is he still wrong? Or if a woman is walking in the forest and asks for something, and there is no man around to hear her, is she still needy? These Zen koans capture some of the frustrations people have with the opposite gender. And where is the dividing line between someone simply having a need, and someone being a needy person? Is it written in heaven somewhere what is too much need, too little need and just right amount of need for the “normal person?” Ask pop radio psychologists Dr. Laura, or Sally Jessie Rafael, or any number of experts who claim to know for sure, and you’ll get some very different answers. And isn’t it fun to see the new sophisticated ways our advanced culture is developing to make each other wrong? You better keep up with the latest technical terminology or you will be at the mercy of those who do. Whoever has read the latest most recent self-help book has the clear advantage. Example: Man: “Get real, would you! Your Venusian codependency has got you trapped in your learned helpless victim act, and indulging in your empowerment phobia again.” Woman: “When you call me codependent, I feel (notice the political correctness of the feeling word) that you are simply projecting your own disowned, unintegrated, emotionally unavailable Martian counterdependency to protect your inner ADD two year old from ever having to grow up. So there!” Speaking of diagnosis, remember the codependent. Worrying about codependency was like a virus that everyone had from about 1988 to 1994. Here’s a prayer to commemorate the codependent: The Codependent’s Prayer by Kelly Bryson Our Authority, which art in others, self-abandonment be thy name. Codependency comes when others’ will is done, At home, as it is in the workplace. give us this day our daily crumbs of love. And give us a sense of indebtedness, As we try to get others to feel indebted to us. And lead us not into freedom, but deliver us from awareness. For thine is the slavery and the weakness and the dependency, For ever and ever. Amen.

Even though there was not a shadow of doubt that my boy was an Aspie, we never pushed to get a formal diagnosis. He already had an IEP in place, so I figured, why bother? As long as he was getting the help, the modifications and the tools he needed to succeed, I didn’t care about the diagnosis. Then Jay entered 3rd grade, and well, that way of thinking changed. That year the other children started to notice Jay’s quirky behaviors and uncontrollable emotional outbursts. But even more importantly, Jay was starting to notice. He was not sleeping at night, his anxiety level was at an all-time high and his self-confidence was dangerously low. One day, in the middle of a meltdown, my boy blurted out, “I feel like I am a square peg trying to fit into a round hole, and no matter how hard I try to make myself fit, I can’t do it. Why am I like this, Mommy?” My heart broke for my son. Not believing was no longer an option. We took him to be officially diagnosed.

About two weeks later, on September 10, 2005, O’Kelly died of a pulmonary embolism. What O’Kelly realized, in the shadow of his final days, was the extraordinary power of a moment. He wrote: I experienced more Perfect Moments and Perfect Days in two weeks than I had in the last five years, or than I probably would have in the next five years, had my life continued the way it was going before my diagnosis. Look at your own calendar. Do you see Perfect Days ahead? Or could they be hidden and you have to find a way to unlock them? If I told you to aim to create 30 Perfect Days, could you? How long would it take? Thirty days? Six months? Ten years? Never? I felt like I was living a week in a day, a month in a week, a year in a month. Now, take a second look at the beginning of O’Kelly’s memoir, especially those final two words: “I was blessed. I was told I had three months to live.” That opportunity to live was why he felt blessed. Shouldn’t we share his zeal for moments that matter? We may have more time to live than he did, but should that be a reason to put them off? This is the great trap of life: One day rolls into the next, and a year goes by, and we still haven’t had that conversation we always meant to have. Still haven’t created that peak moment for our students. Still haven’t seen the northern lights. We walk a flatland that could have been a mountain range. It’s not easy to snap out of this tendency. It took a terminal illness for Gene O’Kelly to do it. What would it take to motivate you to create a Perfect Moment?

Most of the trip was a blur, but on the last day, I sat down for breakfast with several of the roommates, including Jeff King, who had been diagnosed years earlier with multiple sclerosis. Dave and I had discussed Jeff’s illness many times with each other, but that morning I realized that I had never actually spoken with Jeff about it. Hello, Elephant. “Jeff,” I said, “how are you? I mean, really, how are you? How are you feeling? Are you scared?” Jeff looked up in surprise and paused for a long few moments. With tears in his eyes, he said, “Thank you. Thank you for asking.” And then he talked. He talked about his diagnosis and how he hated that he had to stop practicing medicine. How his continued deterioration was hard on his children. How he was worried about his future. How relieved he felt being able to talk about it with me and the others at the table that morning. When breakfast was over, he hugged me tight. In

Despite the best efforts of many physicians, Mary died in Vancouver Hospital eight years after her diagnosis, succumbing to the complications of scleroderma. To the end she retained her gentle smile, though her heart was weak and her breathing laboured. Every once in a while she would ask me to schedule long private visits, even in hospital during her final days. She just wanted to chat, about matters serious or trivial. “You are the only one who ever listened to me,” she once said. I have wondered at times how Mary’s life might have turned out if someone had been there to hear, see and understand her when she was a small child — abused, frightened, feeling responsible for her little sisters. Perhaps had someone been there consistently and dependably, she could have learned to value herself, to express her feelings, to assert her anger when people invaded her boundaries physically or emotionally. Had that been her fate, would she still be alive?

Sorrow and grief become constant companions as we experience losses both big and small. Dementia has been called “the long goodbye” for a reason. Anticipatory grief is also a part of the caregiver’s journey. We know how the story ends from the day we hear a dementia diagnosis. We try not to dwell on our loved one’s demise, but that reality bubbles just below the surface of our everyday lives.

Who are we, the people who have ADHD? We are the problem kid who drives his parents crazy by being totally disorganized, unable to follow through on anything, incapable of cleaning up a room, or washing dishes, or performing just about any assigned task; the one who is forever interrupting, making excuses for work not done, and generally functioning far below potential in most areas. We are the kid who gets daily lectures on how we’re squandering our talent, wasting the golden opportunity that our innate ability gives us to do well, and failing to make good use of all that our parents have provided. We are also sometimes the talented executive who keeps falling short due to missed deadlines, forgotten obligations, social faux pas, and blown opportunities. Too often we are the addicts, the misfits, the unemployed, and the criminals who are just one diagnosis and treatment plan away from turning it all around. We are the people Marlon Brando spoke for in the classic 1954 film On the Waterfront when he said, “I coulda been a contender.” So many of us coulda been contenders, and shoulda been for sure. But then, we can also make good. Can we ever! We are the seemingly tuned-out meeting participant who comes out of nowhere to provide the fresh idea that saves the day. Frequently, we are the “underachieving” child whose talent blooms with the right kind of help and finds incredible success after a checkered educational record. We are the contenders and the winners. We are also imaginative and dynamic teachers, preachers, circus clowns, and stand-up comics, Navy SEALs or Army Rangers, inventors, tinkerers, and trend setters. Among us there are self-made millionaires and billionaires; Pulitzer and Nobel prize winners; Academy, Tony, Emmy, and Grammy award winners; topflight trial attorneys, brain surgeons, traders on the commodities exchange, and investment bankers. And we are often entrepreneurs. We are entrepreneurs ourselves, and the great majority of the adult patients we see for ADHD are or aspire to be entrepreneurs too. The owner and operator of an entrepreneurial support company called Strategic Coach, a man named Dan Sullivan (who also has ADHD!), estimates that at least 50 percent of his clients have ADHD as well.

The diagnosis had taken sleep away from me, too, that day in the doctor’s office. Together with my girlfriend and my future.

The situational diagnosis conversation. In this conversation, you seek to understand how your new boss sees the STARS portfolio you have inherited. Are there elements of start-up, turnaround, accelerated growth, realignment, and sustaining success? How did the organization reach this point? What factors—both soft and hard—make this situation a challenge? What resources within the organization can you draw on?

I sat on my patio watching the wispy clouds until the sky turned a soft shade of magenta and the sun dropped below the horizon. Over those hours, my mind let go of the day, which provided space for an unexpected message to be heard. ​The message was:  Embrace the journey. Embrace all of it, even the good and bad. You may not have chosen this journey, but it is, and forever will be, yours. I sat in silence a little longer, taking in the revelation. ​It's true. I didn’t choose cancer; cancer chose me. As much as I was desperate to skip past the chemo, surgery, radiation, and everything else that comes with a diagnosis, I needed to experience the lessons that would unfold along the way. I had to embrace it all to become a better version of myself. It was time to “embrace the journey” instead of resisting it.  ​I didn’t know if I could, but I’d try.

Negotiate time lines for diagnosis and action planning. Don’t let yourself get caught up immediately in firefighting or be pressured to make calls before you’re ready. Buy yourself some time, even if it’s only a few weeks, to diagnose the new organization and come up with an action plan.

Awareness. A critical mass of people is aware of the need for change. Diagnosis. You know what needs to be changed and why. Vision. You have a compelling vision and a solid strategy. Plan. You have the expertise to put together a detailed plan. Support. You have sufficiently powerful alliances to support implementation.

gaining acceptance, and there’s a difference between using the internet as a way to develop a sense of fluency and competence, and retreating into it because we feel we have no other choice. Thomas tells me that as he’s come to understand his own Autism and work on unmasking, he’s gotten better at noticing how he feels and figuring out how to care for himself. For many years, particularly before his diagnosis, he would just push his emotions and desires away. “This week I noticed my energy replenishment was at a standstill,” he says. “I couldn’t focus on data work, which is normally one of my passions. I journaled about it a bit and realized my girlfriend has been home more than usual lately. I love her, but being around her all day was overstimulating me.

A placebo cure is almost always temporary, and we are looking for permanent resolution of the pain. Therefore, we would not be satisfied with a placebo cure. This is all too common. People are administered a large variety of physical treatments, feel better for a few days, and then need another treatment. (And, of course, they never overcome their fear of physical activity.) One of the reasons I know the TMS program does not induce a placebo reaction is the fact that almost all patients have permanent resolution of symptoms. A second reason is that the placebo effect is based on blind faith; patients know little or nothing about the disorder they have and the rationale for treatment. They simply trust the treating practitioner. The educational program employed in the treatment of TMS is the very opposite. I teach patients literally all I know about the disorder; they are encouraged to ask questions, and they are warned that they must find the diagnosis logical and consistent. Their recovery depends on information, on awareness. They are active participants in the recovery process. This is anything but a placebo process. Perhaps the most compelling argument that what we do is not a placebo is the fact that on numerous occasions since the publication of the book Mind Over Back Pain, the predecessor of this one, people have reported complete and permanent resolution of pain simply by reading the book. There is no personality influence here, no bedside manner; just plain, solid information. And we have learned that that's what it takes to banish TMS. (page 109)

I was amazed at how expensive economists thought doctors were. They instituted many economic maneuvers—de-skilling medicine onto nurses and physician assistants; computerizing medical decision-making; substituting algorithms for thinking—because they assumed that doctors were such expensive commodities. And yet doctors were not expensive, at least, not the doctors I knew. We cost no more than the nurses, the middle managers, and the information technicians, alas. Adding up all the time I spent with Mrs. Muller, the cost of her accurate diagnosis was about the same as one MRI scan, wholesale. Economists did the same thing with the other remedies of premodern medicine—good food, quiet surroundings, and the little things—treating them as expensive luxuries and cutting them out of their calculations. At Laguna Honda, for instance, while most patients were on fifteen or even twenty daily medications, many of which they didn’t need, the budget for a patient’s daily meals had been pared down to seven dollars, which could supply only the basics. I began to wonder: Had economists ever applied their standard of evidence-based medicine to their own economic assumptions? Under what conditions, with which patients and which diseases was it cost-effective to trade good food, clean surroundings, and doctor time for medications, tests, and procedures? Especially ones that patients didn’t need? Although Mrs. Muller was an impressive example of Laguna Honda’s Slow Medicine, she wasn’t the only one. Almost every patient I admitted had incorrect or outmoded diagnoses and was taking medications for them, too. Medications that required regular blood tests; caused side effects that necessitated still more medications; and put the patient at risk for adverse reactions. Typically my patients came in taking fifteen to twenty-five medications, of which they ended up needing, usually, only six or seven. And medications, even the cheapest, were expensive. Adding in the cost of side effects, lab tests, adverse reactions, and the time pharmacists, doctors, and nurses needed to prepare, order, and administer them, each medication cost something like six or seven dollars a day. So Laguna Honda’s Slow Medicine, to the extent that it led to discontinuing ten or twelve unnecessary medications, was more efficient than efficient health care by at least seventy dollars per day. I

Note: The first incident happened after the arrest by the Netherlands police in May 1980. I suffered from that, which destroyed my career, future, health, and life. I tried and tried to investigate that, but the police didn't even register the first information report (FIR). It stayed, refusing since 1980 until now, which creates suspicious questions about what the reasons are for not filing the case. It mirrors whether the Netherlands government victimised me or whether the hired ones of the international intelligence agencies have been a hindrance or the criminal groups. - The second incident happened in the shape of uncurable cancer; it was a deliberate mistake and ignorance of the Netherlands Urologists, who did not follow even the primary medical borderlines for the checkup during one year from 2016 to 2017. After the diagnosis, they are hiding the reality, and they still do not take it seriously. I still hope that the Netherlands' neutral and free media will awaken to help me investigate the incident. It will save millions of lives around the world. In God's name, take it seriously to protect me and others. I feel suspicious elements around me. I cry and pray day and night for God's protection since I do not exclude the Qadeyanis witches and magicians, who keep doing black magic continuously that the West does not understand. My Real Story In A Poem *** I never thought I would suffer from cancer The metastatic prostate gland I still cannot decide that It is natural or human-made Since everything is possible In the medical-criminal world How it happened in Western society; Civilized urologists ignored it deliberately From 2016 to 2017 Telling that nothing was wrong Whereas I was suffering from Bleeding, burning, and pain During urinating I begged urologists for a wide-scale checkup With MRI scans and other new technologies But urologists stayed rejecting; Whereas I was paying insurance for that Consequently, at the beginning of 2017 The diagnosis became a time bomb that I had metastatic prostate gland cancer, Which was not curable, They listed me on the death list, Treating for longer life expectancy However, they do tell not the truth And stay suspicious It confuses me and creates grave fear Since then I am bearing terrible side effects Factually, I became victimized twice By criminals, Intelligence Agencies And underground-mafias Which I am unable to trace alone In this regard, I approached Western Media, Ministries, police, courts, Euro Union Unfortunately, none of those responded Even my motherland media cruelly ignored It seems as if I am in the grip of the demon And The Prisoner Of The Hague Everyone has left me alone in pain, Stress, fear, depression Even my children don't care And realize my tears Where resides sympathy, empathy, And humanity? I feel death before death It is a silent cruelty Ah, where should I ask and beg For justice, help, and investigation That civilized world should know An innocent is under victimization I believe God will help and protect And someone from somewhere Appear to hold my hands To eliminate all criminals and demons My cancer will be curable With a longer life expectancy, in some ways Amen, O' merciful God amen.

aside from the real-life obstacles Henry might face in the health-care system, the main reason is people live fulfilled lives every day without an explanation for why they feel different. It doesn’t make anyone, their wants, or their needs less valid to not have a medical diagnosis.

What we believe about our health has a powerful effect on our immune system. If our approach to a diagnosis, a treatment plan, or a diet is driven by fear, we miss out on the benefits of our loving inner wisdom.

After his terminal diagnosis, Phin dropped out of society. He left his job, because it was meaningless to work when you’ve been given a death sentence. He left his fiancée, because he wanted to spare her the torture of watching him die. Since he had no hope for the future, he began to live day by day. Sort of like a dog. That’s not a negative comparison. Dogs live in the moment. They don’t think. They don’t dwell on the future. They exist to meet their base needs. Eating. Sleeping. Breeding. Surviving. No worries. No regrets. Minimize effort, maximize pleasure.

It happened in Chicago in 1886. On the first of May, strikes paralyzed cities across the country. The Philadelphia Tribune offered a diagnosis: 'The labor element has been bitten by a kind of universal tarantula - it has gone dancing mad.' Dancing mad were the workers who fought for the eight-hour day and for the right to form unions ... On every May first, the entire world remembers them. With the passing of time, constitutions, laws, and international accords have proved them right. But some of the most powerful corporations have yet to find out. They outlaw unions and keep track of the workday with those melting clocks painted by Salvador Dali.

In Nam the psychiatric patients go back to duty. One hundred percent of the combat exhaustion, 90 percent of the character-behavior disorders, 98 percent of the alcoholic and drug problems, 56 percent of the psychosis, 85 percent of the psychoneurosis, 90 percent of the acute situation reaction—they all go back with an operation diagnosis on their record of acute situation reaction. No ominous-sounding names to disturb the patients or their units. It works. The men are not lost to the fight, and the terrifying stupidity of war is not allowed to go on crippling forever. At least, that’s the official belief. But there is no medical or psychiatric follow-up on the boys after they’ve returned to duty. No one knows if they are the ones who die in the very next fire fight, who miss the wire stretched out across the tract, or gun down unarmed civilians. Apparently, the Army doesn’t seem to want to find out.

January 18th, the forty-seventh anniversary of the founding of the German Empire, brought melancholy reflections for all Germans. The Bolshevist-hued Socialists were impotently raging in defeat; the bourgeoisie lamented past glories; the Majority Socialists were under a crossfire from both sides. The Conservative Kreuz-Zeitung wrote: "January 18th: What feelings are awakened on this day under prevailing conditions! In other times we celebrated today the Empire's glory, its resurrection from impotence and dissension to unity and strength. We believed its existence and power assured for centuries. And today? After less than half a century the old misery has come upon us and has cast us down lower than ever. This time, too, Germany could be conquered only because it was disunited. In the last analysis it was from the Social-Democratic poison of Internationalism and negation of state that the Empire became infected and defenseless. How painfully wrong were those who, in smiling optimism, ever made light of all warnings against the Social-Democratic danger. It will be our real danger in the future also. If we do not overcome the Social-Democratic spirit among our people we cannot recover our health." The Kreuz-Zeitung's diagnosis was correct, but it had required a national post-mortem to establish it.

The team’s diagnosis of a problem this morning centers on Sergio. The entire group has just spent time discussing Sergio’s most recent review. On any given day, all employees are getting and giving feedback from multiple sources about how they’re doing their jobs. Nothing in a formal review comes as a surprise. But it’s also expected that individual reviews will be discussed with the entire team and with total candor. Niko

I left the practice of law when it became clear that my autistic son needed an advocate. The collective chaos of managing three children, a fourth pregnancy, two nannies, a housekeeper, and a demanding career finally overwhelmed me. My husband and I considered hiring someone to manage our autistic son’s education and therapies, but I simply couldn’t delegate his care. I needed firsthand knowledge of his diagnosis and how to treat it. Leaving professional life was hard. I walked away from friends, a schedule, a salary, and social stature. I plunged into full-time parenting, something at which I was not proficient—something that still perplexes me! However, remaining in the workforce would have been harder. I made a free choice, fully apprised of the risk I took, and I have never looked back. Philosopher Ayn Rand believed there is no such thing as sacrifice. Rather, there are only rational decisions that bring us closer to our ultimate goals. In other words, the choices we make are irrefutable evidence of what we value. Even generous acts reflect a set of values. Living in accordance with those values gratifies us, hence our gain outweighs our loss. In a world of scarcity and competing demands, Rand’s view has a certain hard-nosed rationality. We give up something we want for something we want more. We each have a single life, made up of finite seconds that tick inexorably away. How we choose to spend each day both expresses our values and carries us closer to our ultimate goals, even if we have never articulated precisely what those values and goals are. I was fortunate that my decision to come home had a positive, even miraculous, outcome for my son. Others make similar decisions without such obvious payback. I still have professional aspirations, and I’m pursuing them wholeheartedly, but I will not return to the practice of law. My time at home focused my values and helped me understand what I want to do with my remaining days, months, and years.

Opening the ten-day event, Hayek diagnosed the problem of the new liberals: a lack of alternatives to the existing (Keynesian) order. There was no ‘consistent philosophy of the opposition groups’ and no ‘real programme’ for change.24 As a result of this diagnosis, Hayek defined the central goal of the MPS as changing elite opinion in order to establish the parameters within which public opinion could then be formed. Contrary to a common assumption, capitalists did not initially see neoliberalism as being in their interests. A major task of the MPS was therefore to educate capitalists as to why they should become neoliberals.25

Respiratory Nursing   Chronic Obstructive Pulmonary Disease Diagnosis: Ineffective Breathing Pattern related to airflow restriction Desired Outcome: Following intervention, the patient's breathing pattern improves, as evidenced by absence of dyspnea and oxygen saturation >94%, pH >7.35, and PaCO2 <60 mm Hg. Assessments and Interventions Rationales Assess respiratory rate and depth q6h. Restlessness, dyspnea, tachypnea, use of accessory muscles of respiration are signs of respiratory distress, which should be reported. Auscultate breath sounds q6h. A decrease in breath sounds or an increase in wheezes is a sign of respiratory failure. Administer bronchodilator therapy with albuterol metered dose inhalers 2-4 puffs every 4 to 6 hours as needed. Albuterol increase expiratory volume by decreasing airway smooth muscle constriction. Administer ipratropium (Atrovent) 80 mcg, three times per day. Formoterol (Foradil) 12 mcg every 12 hours. Or administer tiotropium (Spiriva) 1 capsule (18 mcg) inhaled once daily by HandiHaler device Inhaled anticholinergics

Jesus made this diagnosis a long time ago when talking about temptation. “The spirit” — notice the language again — “is willing, but the flesh [the body] is weak.” This is very true and largely ignored and forgotten in our day. Habits eat willpower for breakfast. So there is the will, there is the mind, and there is the body. They are working badly, sometimes in ways that are kind of humorous to us, but often in ways that are horrible and unspeakably tragic.

The situational diagnosis conversation. In this conversation, you seek to understand how your new boss sees the STARS portfolio you have inherited. Are there elements of start-up, turnaround, accelerated growth, realignment, and sustaining success? How did the organization reach this point? What factors—both soft and hard—make this situation a challenge? What resources within the organization can you draw on? Your view may differ from your boss’s, but it is essential to grasp how she sees the situation. The expectations conversation. Your goal in this conversation is to understand and negotiate expectations. What does your new boss need you to do in the short term and in the medium term? What will constitute success? Critically, how will your performance be measured? When? You might conclude that your boss’s expectations are unrealistic and that you need to work to reset them. Also, as part of your broader campaign to secure early wins, discussed in the next chapter, keep in mind that it’s better to underpromise and overdeliver. The resource conversation. This conversation is essentially a negotiation for critical resources. What do you need to be successful? What do you need your boss to do? The resources need not be limited to funding or personnel. In a realignment, for example, you may need help from your boss to persuade the organization to confront the need for change. Key here is to focus your boss on the benefits and costs of what you can accomplish with different amounts of resources. The style conversation. This conversation is about how you and your new boss can best interact on an ongoing basis. What forms of communication does he prefer, and for what? Face-to-face? Voice, electronic? How often? What kinds of decisions does he want to be consulted on, and when can you make the call on your own? How do your styles differ, and what are the implications for the ways you should interact? The personal development conversation. Once you’re a few months into your new role, you can begin to discuss how you’re doing and what your developmental priorities should be. Where are you doing well? In what areas do you need to improve or do things differently? Are there projects or special assignments you could undertake (without sacrificing focus)? In practice, your

A medical student is sent for training at a clinic specializing in sexual disorders. The head of the clinic takes the student on a tour. In the first room they enter, there’s a patient masturbating. “What’s his diagnosis?” the student asks. “He has a severe case of Semen Buildup Disorder. If he doesn’t ejaculate multiple times a day, he becomes disoriented and nauseated.” In the second room they find a patient with his pants down around his ankles, receiving oral sex from a beautiful nurse. “What about his diagnosis?” the student asks. “Same condition. He just has better health insurance.

... each day provided some tiny step forward, some steps so small you would miss them if you weren't looking. I'm always looking- eager to witness that next miracle.

Dearest April, When I met you, I immediately felt like the sun rose and set in your eyes. I went to bed thinking about you at night, and I woke up with you on my mind in the morning. We had some really good times, didn’t we? I relished the long walks we took. I looked forward to seeing you at night and sleeping with you in my arms. Then I got the diagnosis. I found out that I was sick, and when I needed you to be there for me, you fucked my best friend. You weren’t there to hold my hand through chemo. You weren’t there to help me get to and from doctors’ appointments. You weren’t there when I was so sick I couldn’t hold my head up. You were with him. You were under him and on top of him and with him instead of me. I asked my brothers to give you this letter in the event of my death, so if you’re reading this, I’m gone. I’ve lived out my days, and even though you’ve moved on, I need to tell you how I feel. A good man might want to ease your conscience. A good man might want to give you some peace. But good wasn’t important to you. I fucking hate you. I hate that you’re breathing. I hate that you’re alive. I hate that you’re able to laugh and that you’re going to go on and procreate and make more sorry-ass human beings just like yourself. I hope that your heart leaped when you got this letter. Final words of love from me. Hahahahahaha! I am dead, so I can say whatever I want. And what I want to say is: I fucking hate you. I hope you get exactly what you deserve in life. With the utmost hatred and disdain, Matthew Reed PS – I still hate you.

In the story, Ivan Ilyich is forty-five years old, a midlevel Saint Petersburg magistrate whose life revolves mostly around petty concerns of social status. One day, he falls off a stepladder and develops a pain in his side. Instead of abating, the pain gets worse, and he becomes unable to work. Formerly an “intelligent, polished, lively and agreeable man,” he grows depressed and enfeebled. Friends and colleagues avoid him. His wife calls in a series of ever more expensive doctors. None of them can agree on a diagnosis, and the remedies they give him accomplish nothing. For Ilyich, it is all torture, and he simmers and rages at his situation. “What tormented Ivan Ilyich most,” Tolstoy writes, “was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and he only need keep quiet and undergo a treatment and then something very good would result.” Ivan Ilyich has flashes of hope that maybe things will turn around, but as he grows weaker and more emaciated he knows what is happening. He lives in mounting anguish and fear of death. But death is not a subject that his doctors, friends, or family can countenance. That is what causes him his most profound pain. “No one pitied him as he wished to be pitied,” writes Tolstoy. “At certain moments after prolonged suffering he wished most of all (though he would have been ashamed to confess it) for someone to pity him as a sick child is pitied. He longed to be petted and comforted. He knew he was an important functionary, that he had a beard turning grey, and that therefore what he longed for was impossible, but still he longed for it.” As we medical students saw it, the failure of those around Ivan Ilyich to offer comfort or to acknowledge what is happening to him was a failure of character and culture. The late-nineteenth-century Russia of Tolstoy’s story seemed harsh and almost primitive to us. Just as we believed that modern medicine could probably have cured Ivan Ilyich of whatever disease he had, so too we took for granted that honesty and kindness were basic responsibilities of a modern doctor. We were confident that in such a situation we would act compassionately. What worried us was knowledge. While we knew how to sympathize, we weren’t at all certain we would know how to properly diagnose and treat. We paid our medical tuition to learn about the inner process of the body, the intricate mechanisms of its pathologies, and the vast trove of discoveries and technologies that have accumulated to stop them. We didn’t imagine we needed to think about much else. So we put Ivan Ilyich out of our heads. Yet within a few years, when I came to experience surgical training and practice, I encountered patients forced to confront the realities of decline and mortality, and it did not take long to realize how unready I was to help them. *   *   *

Student behavior had been a challenge, Walmsley told me. One girl sometimes got up from her seat to dance across the classroom. A boy with a special-ed diagnosis could answer problems on paper but had trouble speaking up in front of his classmates. On a quiz, he wrote Walmsley a note: “Teacher, you think I’m stupid, but I’m not.” On the wall was a chart showing a ladder, each level representing one behavioral demerit. Step 1 is a warning. At Step 3, a child is sent to the “icebox,” an isolated chair at the back of the classroom. By Step 5, a parent is notified, and the child is removed from the classroom. Each student’s name was written on a wooden clothespin, and as he or she accrued demerits, the pin moved up the ladder. Like Arpino with her kindergarteners, Walmsley spent an extraordinary amount of time policing how his fourth graders sat. Were their eyes “tracking” the teacher? Were pencils resting in the pencil groove of the desk? He didn’t hesitate to give demerits for small infractions. “Remember how I was talking about chocolate milk? How milk and chocolate are our products?” he asked the students, referencing the previous day’s multiplication lesson. When a boy named Anthony answered, “Yes!” he earned a demerit for speaking out of turn. By the end of the period, Anthony’s clothespin had moved up the ladder, and Anthony was sitting in the icebox, scowling.

In most popular Christianity, “heaven” (and “fellowship with God” in the present) is the goal, and “sin” (bad behavior, deserving punishment) is the problem. A Platonized goal and a moralizing diagnosis—and together they lead, as I have been suggesting, to a paganized “solution” in which an angry divinity is pacified by human sacrifice.

This concept upends the way most people think about their subjective experience of life. We tend to place a lot of emphasis on our circumstances, assuming that what happens to us (or fails to happen) determines how we feel. From this perspective, the small-scale details of how you spend your day aren’t that important, because what matters are the large-scale outcomes, such as whether or not you get a promotion or move to that nicer apartment. According to Gallagher, decades of research contradict this understanding. Our brains instead construct our worldview based on what we pay attention to. If you focus on a cancer diagnosis, you and your life become unhappy and dark, but if you focus instead on an evening martini, you and your life become more pleasant—even though the circumstances in both scenarios are the same. As Gallagher summarizes: “Who you are, what you think, feel, and do, what you love—is the sum of what you focus on.

I liked Finland for its absence of overt rage or street crime. This wasn’t the United States, this wasn’t Spain. It was calm here, and moody, a gorgeous, elegant place with slightly off-kilter serotonin levels. A depressed country: this was an easy diagnosis to make, given the suicide statistics, which Scandinavia sometimes tries to deny, just the way Cornell University tries to allay the fears of incoming students’ parents about the famous Ithaca gorge, which, like a harvest ritual each fall, claims the life of a few more hopeless freshmen. Don’t worry, the college brochure should say. Though some students do in fact leap to their deaths, most prefer keg parties and studying. All of Scandinavia was alluring, with its ice fishing and snowcaps, but everyone knew about the legend of ingrained unhappiness among Finns, Norwegians, and Swedes: their drinking, their mournful, baying songs, their muffled darkness smack in the middle of the day.

I knew Gigi would understand. My life started here, in Thailand. In a small commune run by women, for women. They say it takes a village to raise a child and that’s what I had. A whole village of like-minded women who looked out for one another and their offspring. Until the next adventure beckoned on the balmy breeze, and with babes strapped to their chests they followed their hearts and kept roaming. The communes are long since gone. Those beautiful barefoot women with a baby on a breast are now elsewhere. They were ahead of their time with their wildness, their sense of adventure … ‘Now Mom’s only battle is beating cancer. But she’s got her apothecary for that, and she’s winning. Every day she gets that little bit stronger.’ A year ago, she gave me the news of her diagnosis. Mom told me not to cut my travels short and rush home. It was under control. While Mom might be the best healer there is, she doesn’t like being the coddled patient. Still, she’s my everything, so rush home I did. I stayed for a few weeks and saw with my very own eyes that she was getting

Few I have met have actually had a ‘last year.’ Most had only a ‘last’ month or two, a few weeks or days, or a few seconds. To have a whole year to examine one’s life consciously in the context of approaching death is almost unique in the human experience. And it gives a person the power to heal that which remains unloved and unloving. But why wait for a terminal diagnosis before opening to the potential grace and wonder of this living moment. No one can afford to put this work off any longer, because almost no one knows the day on which the last year begins.

Maybe what I needed, finally, was to wake up to that voice inside of me, and acknowledge, finally and fully, what it was trying to tell me: ONE DAY YOU ARE GOING TO DIE. It is the simplest truth of them all, and yet it is the one we fight the hardest. We push it away. We procrastinate. Death is something that happens to other people, or else to us in a future so distant it's the same thing as "never." We prioritize all the things that matter the least at the expense of those that matter most. People wait entire lifetimes to see the Great Wall of China until they are too sick to travel, and save the bottle of Veuve Clicquot till they can't drink anymore. We wait till tomorrow to make that important phone call, until Friday to wear the purple lipstick, or for the summer to start working on the clubhouse for the kids. Before we know it, we have an illness, then a diagnosis, then we are knocking at death's door. Life is now. It's right here. This is it. The past is just a series of memories coded in the hippocampus. Tomorrow, forever a day away, is a myth and an illusion of our brain's insistence on linear time. This moment is the only one that exists. In the very next moment, you could also be gone, a memory in someone else's hippocampus.

a cancer diagnosis alters the way you frame everything.

So, I ordered that 2nd diagnosis for another ridiculously high amount of money and unfortunately it turned out that the first diagnosis was correct. It became a brutal fact, written as if it were hammered in stone that the tumor was indeed a malignant liver tumor. And yet, I will never forget how and with a never-felt-before, deep intensity Blissy looked at me when the vet let me alone with the information that I should put her down. To me, Blissy seemed to be able to look right into my heart and right into my soul saying something like: PLEASE, PLEASE PLEASE do not give up on me yet.

What Yvonne manages to do, in the days after Brian’s diagnosis and in the days after Brian’s death, is to locate herself exactly where all the guide-to-grief people say she should be. At home, by herself, with her daughters or with friends, she lets herself be a mother awash in grief. We have one brief phone call in which she weeps to me that she just wanted more of him, and I feel so much the same way that instead of comforting her, as I intended, I just weep with her and then we mumble our goodbyes into our wet phones. With us, and then later with me, she doesn’t center her grief. She’s careful not to cry first or loudest and she rarely refers to her own loss. She is, as Brian says, a fucking class act.

Even on the bad days, in the hard moments, in the pain, the crisis, or disappointment, the diagnosis, the grief over all the ways life is less than what it could or should be, even then, I think of AA’s wonderful line: “Accepting hardship as the pathway to peace; taking, as [Jesus] did, this sinful world as it is, not as I would have it.”6

Data sources All these components give you feedback and insight into how best to configure your campaigns, although the data sources are often spread around in different places and sometimes difficult to find and interpret. Campaign types Search & Partner Dynamic Search Display Network Remarketing & Dynamic Remarketing Google Shopping for eCommerce Google Merchant Center Data feeds Google Shopping Campaigns Device selection PC / Tablets Mobiles & Smartphones Location Targets & Exclusions Country Metro State City Custom and Radius Daily Budgets Manual CPC Enhanced CPC Flexible Bidding strategies Conversion Optimizer (CPA) Return on Ad Spend (ROAS) Conversion Tracking Setup and configuration Transaction-Specific Conversion Tracking Offline Conversion import Phone call tracking - website call conversions Conversion Rates Conversion Costs Conversion Values Ad Groups Default Bids Keyword Themes Ads Ad Messaging & Demographics Creative Text & Formatting Images* Display Ad Builder* Ad Preview and Diagnosis Account, Campaign and Ad Group Ad Extensions Sitelinks Locations Calls Reviews Apps Callouts Ad Rotation & Frequency Capping Rotate Optimise for Clicks Optimise for Conversions Keywords Bids Broad Modified Broad Phrase Exact Destination urls Keyword Diagnosis User Search Queries Keyword Opportunities Negative Keywords & Match Types Shared Library Shared Budgets* Automated Rules Flexible Bid Strategies Audiences & Exclusions* Campaign Negative Keywords Display Campaign Placement Exclusions* NEW! Business Data and Ad Customizers Advanced Delivery Methods Standard Accelerated Impression Share Lost IS (Budget) Lost IS (Rank) Search Funnels Assisted Impressions & Clicks Assisted Conversions Segmentation Analysis Device performance Network performance Top vs Other position performance Dimension Analysis Days & Times Shopping Geographic User Locations & Distance Search Terms Automatic Placements* Call Details (Call Extensions) Tools Change history Keyword Planner* Display Planner* Opportunities* Scheduling & Day Parting Automated Rules Competitor Ad Auction Insights Reporting* AdWords Campaign Experiments* Browser Languages* *indicates an item not covered in this version of the book

The situational diagnosis conversation. In this conversation, you seek to understand how your new boss sees the STARS portfolio you have inherited. Are there elements of start-up, turnaround, accelerated growth, realignment, and sustaining success?

My mother's whole life changed in an instant because of her choices, and her diagnosis made me a lot more thoughtful about what I did from day to day. Knowing my life was a miracle, I didn't want to do anything to jeopardize it. Here's the thing, though: Your life is a miracle too.

Eager. I like that, Manny." "Good morning to you too, Sleeping Beauty. Or should that be good afternoon?" "It's still morning, though I feel like I've slept away the day." "You must've needed it." "Is that your medical opinion?" "No. I'm off duty." Just hearing his deep voice had Harper snuggling back under the covers, wishing he was next to her. "Pity. Because I'm not feeling so good, and I was hoping you made house calls." "What's wrong?" "A distinct case of I-miss-you-itis." "Damn it, if I wasn't halfway along this Craters of the Moon geothermal hike, I'd be there in a flash." He muttered a curse. "I know. I can give you a more accurate diagnosis over the phone if you do one thing." Smiling, she said, "What?" "Tell me what you're wearing." Her thighs clenched as her smile extended into a grin. "My, my, Doctor, I didn't think this was one of those calls." "You're in bed. You're missing me. What did you expect?" "A little decorum." "Yeah, sure." "You're right. I want to torture you a little." "A lot, considering I'm now envisaging you cute and sleep rumpled." "What are you wearing?" "Why?" he asked. "Because I'm assuming there are families on that hike, and too much envisaging may lead to more than one tent pole in that national park." He laughed so loudly she had to hold the cell away from her ear. "You really are something else," he said. "And for the record? I miss you too." "So I'll meet you in the foyer at four for our picnic?" "Yeah. I found the perfect spot." "Secluded?" "Babe, you're killing me." "Not yet, but maybe this will help." She lowered her voice. "I'm wearing nothing and I'm thinking of you." She hung up on his garbled cry, grinning madly.

After her diagnosis, she was determined to keep working, but that only lasted about six months before she had to admit she wasn’t able to do her job anymore. Even with the symptoms coming and going, there was no way to know when she would have a bad day, and she couldn’t stand to have to call in so often on such short notice. She was devastated when she had to quit, and she’s never quite bounced back emotionally.

As you’ll read in Chapter 11, when colic was first described in the 1950s it was the hot new thing. And throughout the latter twentieth century whenever a baby cried, she was diagnosed with colic. It was a constellation of symptoms positioned as a diagnosis that had no clear treatment. For better or worse, colic was the label that kept pediatricians free and clear from fixing the problem. There was no fix. Fast-forward to the early twenty-first century. Reflux is the new colic. Unfortunately, some of my colleagues have fallen into the habit of labeling every inexplicably fussy baby with reflux. What’s worse, some act on the impulse and prescribe medications when they’re not indicated. Some of this is a function of a new label. Part of this may be a consequence of doctors seeing more and more babies in the same eight-hour clinic day. A label and the promise of a pill have a certain appeal when facing a desperate, tired mom in a six-minute follow-up visit. So proceed with caution if your doctor hears crying, sees a dirty burp cloth, and immediately wants to start medication. Remember that you are your baby’s lead advocate. Take the time to consider all that we’ve talked about over the past few pages before assuming medication is the only and best solution.

His love, Rita, had died in her late forties, only a few years after they had lost Alistair to the mental health system. From Rita’s diagnosis to her departure, it was only a matter of weeks. Yet here was this lovely man telling me he had lived a good life. Through tears, I asked how he saw it that way. ‘I have known love, and that love has not lessened for one day in all of these years,’ he said.

It is so easy to overlook the wonder of life until something threatens to snatch it from us. How willingly we sacrifice the days of our lives to trivial distractions-silly computer games, unnecessary errands, useless worry. We get caught up in our own petty concerns and miss the beauty unfolding right in front of us. Rushing headlong into the next thing, we fail to appreciate the blessing of the only thing we can really claim as our own, the present moment. We toss a few balls in the air and start juggling, as fast as we can- all in the effort to do a little more, to exert a bit more control, to feel more secure or more worthy or more accomplished. But there is nothing quite like a critical diagnosis, with its ticket to the world of hospital rooms and treatment plans, to bring all the balls crashing back to earth. Suddenly, when life hangs in the balance, we wish we could have this lost moments back, wish we could live them differently, with more love, more attention, more patience. With more gratitude for all we blindly took for granted. Pg27

When we are faced with a frightening diagnosis, we are also given the chance to change the way we think about our lives. It offers a precious chance to surrender in faith to the divine and to live with gratitude for the gift of time.

For the United States of America, remote in a hemisphere whose isolation the war had forever destroyed, World War II was mainly an expedition, a crusade of sorts to set to rights a world gone wrong. Many Americans equated the world's troubles with Hitler, Tojo, Mussolini - or some "ism" - and honestly expected that when the symptoms of the sickness were treated, a better day would surely dawn. Government propaganda, and even business advertising, continually bolstered this hope. It was an attitude among all parties, typically American, and in the light of American history and ethos, inevitable.

In the absence of certainty, medical science remains unsure what story to tell. Too often it turns away from patients rather than listening to the long and chaotic stories we tell, narratives that start and stop and double back, searching for meaning in the or house rash that broke out that day or the car accident that triggered pain of the death after which nothing was the same. Indeed, one reason that people who may or may not have Lyme disease cling to the diagnosis of chronic Lyme as a name for their medically unexplained symptoms is that the impersonal nature of modern medicine has no better explanations, at least not on the level of storytelling. When we suffer, we want recognition. Where science is silent, narrative creeps in.

But, in my opinion, the most horrifying part of Anna’s experience isn’t what happens to her physically, but how the people around her react: how her doctors dismiss and ignore her, expecting her to suffer through her pain for the good of her baby without any concern for whether her body can handle it; how her husband assumes she’s either making up or exaggerating her symptoms. I’m afraid I didn’t have to exaggerate these reactions at all. They’re all too real. The tendency to assume that women can’t be trusted to accurately convey their symptoms comes from the historical diagnosis of “hysteria,” which was once thought to be a medical condition said to only affect women. Doctors were taught that women were inherently liars, unreliable, or hysterical hypochondriacs. In some cases, they were even believed to be possessed. And these beliefs have persisted, even after the diagnosis of hysteria was proven to be nonsense. To this day doctors prescribe less pain medication to women than they do to men, they take longer to diagnose us with illness, and they’re more likely to send us home in the middle of a medical emergency like a heart attack. Unfortunately, all these prejudices disproportionately affect women of color. If you’re ever curious about why the maternal mortality rate in the United States is so high—particularly among Black women—these are good places to start. Doctors don’t understand our bodies, they don’t believe us about our symptoms, and they ignore us when we try to tell them we’re in pain.

If you take one thing from this book let it be this: even the dying are alive. If you're a reader with a life limiting diagnosis: I see you. Grieving your body is continuous, sometimes the pain is intolerable, it is never an act of cowardice to talk about your life. You can't control the reactions of others, only what you do with it. Both the physical and mental aspects of our lives are intolerable some days, and that is okay. Ask for help, someone is there to listen. You are not a burden.