Tuesday, April 04, 2006

journaler's notes 4.04.2006 23:00

the hum of the environmental systems echo the patient's. there was a note under his pillow. he says his mother "is substantially at risk" because she cannot make her own positive decisions on outstanding obligations and no one else is authorized or willing to make them.

i can't attest to this. hopefully someone will find both of them tomorrow.

journaler's notes 4.04.2006 17:40

the patient got very still. he rang for a nurse. after a few minutes discussion, she brought in the on-call therapist. the therapist couldn't speak to the possible side effects of the medications, referring the patient back to the doctor. the patient did make the point that having an external point of reference, one he was responsible to, was essential for his health. the therapist did reach
the patient when they talked of "each doing their share."

still troubled and shaking, the patient went to take a shower, i began to record my notes. when i looked up he was gone. not in the shower or the room.

journaler's notes 4.04.2006 11:58

the patient awoke and did normal chores. his breakfast was yogurt, granola bars, bananna and tea. his mother had left all her dishes in the sink. she takes them from the dishwasher and resuese them rather than run the dishwasher, he puts them back in.

he goes to wake her up and explain that he'll be leaving later this afternoon for errands. she mentions that her social sercurity check should be in, but is confused about some changes to it. and that there is his rent check that should be cashed or deposited and could he do that for her. he responds that he could if she'd tell him what she wanted done. she says that she also wants to start doing something about setting up the tree farm on her property and talks about how that will be done. he helps clarify the terms and conditions he heard. she asks how much they were offering. he responds that they were offering 50% but she was to pay 50% of the labor for reseeding. she remarks that she was only doing that for him. he says that there is no will. she says don't start that.

this is the cause of all arguments: he will strive to be 100% accurate and when confronted with that, she will see it as a wall and become defensive. his comments could be more appropriate, but he does not know how. with what he terms "cognative dyslexia", he is forced to act out his response scripts and then sort through the aftermath.

in this case he retreats upstairs. he knows that any proceeds from the harvesting of trees would go directly to his mother's continued care. since she has no will anything left would by law go to he and his non responsive brother.

he has little resources to respond to this situation. he has neither the resources, authority nor health to appropriately respond to this situation. he sees these as walls rather than cahllenges and, with the insistence of the medications, begins to shut down. it takes an enormous act of will to stop that cycle.

he sleeps for an hour.

he realized that his only choice is to act true to himself by being truthful, being accurate. he wonders if that is the sin of pride. his mother calls him. she says that she will call the lawyer, he responds that the lawyer won't be available for another month. she wants to know how he knows.

later she calls him again. this time she announces that she had swept the kitchen and had he brought the mop to the kitchen. he asked why. she ended up telling him that he needed to act like a son and mop the kitchen. he responded that when she signed a rent agreement she requested he act like a gentleman and that he was currently doing chores, he would mop afterwards. she fussed that he should be ashamed. she said that her vacuum cleaner wouldn't work, that there was a string caught in it. he replied that he wanted to explain something to her and that she should sit down. he opened up to her that yes, he did want to be accurate, that drove him. but he wasn't seeking to be "right", he wasn't seeking to be "boss." she had to argue with him. he told her that she had no right to treat him that way. she responded that she was going to talk to his caregiver. he said that was fine but the next visit would be the last time they would go together under just his coverage, she would have to get her own caregiver.

this appears to fit his analogy of two ships passing perilously close in the night frantically signalling. barring third party intervention, both must save themselves. as the patient has found, there is no third party. why is that ? there are mediators and arbitrators, but they have to be sought and given permission to decide. why is there no one who seeks out these problems to give relief ?