The Illusionist(s)

I have seen this type of patient only 3 times in the entire length of my practice–a certain expectant, determined-to-be-closed patient who’s unwilling to work with me either by “opening up” to the process of treatment, or by being honest about their intentions and their ability to commit to whatever is involved. When I first started I wanted the experience of working with anyone I could get–it didn’t matter, I wanted to be able to figure the case out, try every angle I could, and see if I could make something happen. But when patients don’t want to work with you, and actively work against you, the result is often painful, physically. Painful for me, as well. We’re trained to watch out for that, to keep the kind of unbiased professional distance we need to operate: there is no place for “the personal” to interfere in the process. But it always, always hurts, even though now it seems to be that much less of a shock. I now recognize the signs, get a referral list out, and tell the patient I’m no longer available, even if their actions are nasty (or in one case, just plain illegal).

I’m grateful there have only been three such patients in nine years–but each time I’ve encountered the phenomenon, I’ve focused on the feeling involved, and I’ve missed the remedy I needed to give.

I’ve been told that as practitioners, we get the patients we need to see. People we need to learn from, people who choose us to help them because they find something “in kind” with us, even if it can’t be named. The person who told me this also told me that when he started his clinic work, almost every patient he saw had schizophrenia.

I noticed that in my own list of patients, the majority of them were the type who will develop cancer, if it isn’t interrupted. They can be excessively controlling, fastidious, ordered. They are fascinated by music, and beauty (the beauty of nature in particular), and harmony. They put themselves last on the list when everyone else’s needs call to be met. They grieve (but don’t know why) and smoke (and don’t know why) and hide themselves as well as they can muster, at first by working really hard to “be nice”; then with firm resistance, and finally by lying outright. Underneath everything, though, they just don’t trust. That feeling is the engine that runs the whole show–they don’t trust the physical world around them (so it has to be cleaned up, organized, changed, beautified); they don’t trust others (and feel like others try to pull the wool over their eyes, or will abuse them in some way–often because they do); and they hide as much as they can about themselves, weaknesses they feel make them vulnerable. They don’t trust their own bodies and feel that on a very deep level, they and their health are incredibly fragile.

They’re right, of course: their health is fragile, and they are fragile. They can’t trust others because they really don’t feel they can place any trust in themselves (and they are blind to the fact that others find it difficult to trust them in return). And so they will often tell me that they will simply not tell me anything. They will refuse to answer direct questions because they don’t believe I need to know the answers (but I do!) and they’ll be set in their ideas despite whatever I can do to demonstrate that their beliefs simply don’t apply to what’s actually taking place in terms of the work we’re doing. In short, they face me with the same kind of doubt, the same kind of questioning stubbornness and tendency to fixed ideas I can have about them, and we can languish in this back and forth dynamic forcing us into its dance. It’s taken me a lot of time to figure out that “getting stuck in that dynamic” is the problem–and that if I step back and look, everything the patient does is a demonstration of all that I need to know to prescribe well.

When the third patient of this type presented herself, I thought, “What the hell am I doing wrong?” and felt completely insulted. I’d put in a lot of time, unpaid; I’d gone out of my way to see the patient via house call, since she couldn’t come to see me in my office–and because she complained of not having enough money, I never charged her mileage. I listened to her protests of an inability to afford the cost, despite knowing she came from a well off family and completed a post-graduate degree which placed her in a well-paying full-time position with the university even before she was done with her studies. I knew she’d managed to travel most of Europe, study full time, and buy her own home in Toronto long before most people her age could scrape up enough to pay rent on their own apartment–and yet I listened to what she was telling me instead of seeing what she was showing me. I spent hours trying to cajole her into answering my questions, when really I could have saved myself all that effort if I’d just let what I was seeing register.

"makes an excellent living fence"

Instead I locked everything I knew to be true about her away in the insult.

But I never stopped thinking about her case. And finally it dawned on me that if I just considered what I’d observed–the stubborn refusal and insistence on hiding herself; the persistent physical pain and its location, which hinted at grave problems with sexual relationships; the unguarded criticism she would launch at a particular man and his behaviour (again, sexual) and the unhappiness she hid regarding her current relationship; her responses to all the medications she’d been given, which actually brought her state even more clearly into focus–it was an easy case, I don’t know how I missed it. But I do know that when we take things personally and react to them that way instead of looking at what we’re being shown and what it tells us, we can become lost.

It’s taken me a while to figure out what to do next, with this case, how to initiate the way we continue on with each other after cutting off communications several months ago. After putting together my own research and taking another look at the case with a very critical, inductive eye, I repertorized only what I knew to be facts about her behaviour and symptoms. That was the easy part: the difficult part was figuring out what to do with that information.

So I took a dispensing envelope and the vial of medicine, wrote out a label, and twisted out a number of pillules to enclose in the envelope. On a plain piece of stationery, I wrote out very simple instructions for use. I wrote more, of course–a brief note on what I was sending, and why. In the end, the patient is still suffering, still dealing with pain on a daily level. I have something which might alleviate that pain once and for all–and I decided that I couldn’t withhold it, and that everything else that came to pass should be seen as the means to which this possibility could be explored. So I packed it all up in an envelope with instructions, and sent it off to my patient’s address in the city.

The choice to take or ignore the remedy is not mine, but in my note I tried to cover every angle of the decision. If she takes it and decides to go ahead with it, I’ll manage the case. If she doesn’t, and discards it, that’s good too. I don’t know if sending the remedy is selfish on my part–I want to think of it as payment for a good lesson, long past due. And hopefully well learned.

Divided, Part II

It’s just about to become Homeopathy Awareness week, internationally, so I thought I’d post this list of quick facts about Homeopathic medicine. I thought I’d post it because I know the facts are largely unknown among Homeopaths–in particular, the homeopaths who practice here in Canada. They’re basic, they’re well documented, they should be something we know our way around, but we don’t (most Canadian homeopaths aren’t aware of the political realities of our practice in the context of conventional medical hegemony anyway–and here in Canada that power structure’s in place with far more pull than it is in the UK, where these facts have been collected).

So here goes. With full credit and many thanks to Louise Mclean, LCCH MHMA, who compiled the data below (and I’ve added to it with elaborations relevant to Canadian and American practitioners).

45 QUICK FACTS ABOUT HOMEOPATHY

How Homeopathy Works

FACT 1: Hippocrates ‘The Father of Medicine’ of Ancient Greece, wrote that there were two Laws of Healing: The Law of Opposites and the Law of Similars. Homeopathy treats the patient with medicines using the Law of Similars; orthodox Medicine uses the Law of Opposites, e.g. antibiotics, anti-inflammatories, anti-convulsants, anti-hypertensives, anti-depressants, anti-psychotics.

FACT 2: Homeopathic theories are based on fixed principles of the Laws of Nature which do not change – unlike medical theories which are constantly outdated or disproved, and are therefore always changing.

FACT 3: Homeopathy is an evidence-based, empirical medicine.

FACT 4: Homeopathy is both an art and a science.

FACT 5: The Homeopathic “Provings” of medicines are a more scientific method of testing the effects of medicines on the human body than the orthodox model.

FACT 6: Homeopathic medicine awakens and stimulates the body’s own curative powers. The potentised remedy acts as a catalyst to set healing into motion.

FACT 7: Homeopathy treats the whole person. Homeopathic medicines work by communicating a current/pattern/frequency of energy via the whole human body to jump start the body’s own inherent healing mechanisms.

FACT 8: Homeopathy assists the body to heal itself, to overcome an illness which brings the patient to a higher level of health. Orthodox medicine suppresses the illness, bringing the patient to a lower level of health.

FACT 9: The homeopathic practitioner endeavours to search for and treat the cause of the dis-ease in order to heal the effect.

Homeopathic Medicines

FACT 10: Homeopathic remedies are cheap. Cheap to produce, environmentally economical (one plant can make enough medicine for billions of people, for a long time, with no destroyed rainforests or plundered cultural materia medica for the sake of patents in Homeopathy’s wake)

FACT 11: Pharmaceutical medicines are expensive. And their production can and does include all the expense and devastation cited above.

FACT 12: There are more than 4,000 homeopathic medicines.

FACT 13. Homeopathic medicines have no toxic side effects and cause no dependencies.

FACT 14: Every true homeopathic medicine is made using one substance – whether plant, mineral, animal, etc. We know the exact substance it was made from, unlike most modern drugs where we are rarely informed of the ingredients.

FACT 15: Any remedy up to 12c or 24x potency still contains molecules of the original substance in a measurable quantity; and this is known as Avogadro’s number (or, the estimated number of particles in a mole, in chemistry; approximately 6.02214×10²³).

FACT 16: Every patient is unique, therefore homeopathic medical treatment must be individualised.

FACT 17: Homeopaths treat congenital illness, tracing its origins to 6 main genetic causes: Tuberculosis, Syphilis, Gonorrhoea, Psora (scabies), Cancer, Leprosy.

FACT 18: There are hundreds of thousands of homeopathic books, available at specialist outlets, not sold in the high street.

Homeopathy on the NHS

FACT 19: There are 5 homeopathic hospitals in the UK – in London, Tunbridge Wells, Bristol, Liverpool and Glasgow. They cost the NHS under £10 million a year compared to the £100 billion for the total annual NHS budget for 2008.

FACT 20: At one of the earliest debates on the NHS Act of 1948 the Government pledged that Homeopathy would continue to be available on the NHS, as long as there were “patients wishing to receive it and doctors willing to provide it”.

FACT 21: There is a campaign by certain UK professors to oust homeopathy completely from the NHS after they wrote an NHS headed paper to all Primary Care Trusts in 2006 telling managers not to refer patients to the Homeopathic hospitals.

FACT 22: The Homeopathic hospitals are clean, with friendly, well informed staff. The patients are generally pleased with their treatment, unlike many orthodox National Health Service hospitals.

FACT 23: The chances of contracting MRSA or C. Difficile at a Homeopathic Hospital are extremely rare.

FACT 24: Unlike orthodox medicine where two thirds of all conventional hospital admissions are due to the side effects of pharmaceutical medicines, the bill for negligence claims soaring into billions, one UK leading insurance company reported only ‘a couple’ of claims against homeopaths in a ten year period.

Orthodox Medicine Opposing Homeopathy

FACT 25: In the United States in the early 1900s there were 22 homeopathic medical schools and over 100 homeopathic hospitals, 60 orphanages and old people’s homes, and 1,000+ homeopathic pharmacies. You can read all about them in Julian Winston’s book, Faces of Homeopathy

FACT 26: Members of the American Medical Association had great animosity towards homeopathy after its formation in 1847 and it was decided to purge all local medical societies of physicians who were homeopaths. To read more about this, read Harris L. Coulter’s books, Divided Legacy Volumes I to IV.

FACT 27: Big Pharma does not want the public to find out how well homeopathy works!

Scientific Studies

FACT 28: In 2005 the World Health Organisation brought out a draft report which showed Homeopathy was beneficial, causing Big Pharma to panic and the Lancet to bring out an editorial entitled ‘The End of Homeopathy’.

FACT 29: In 2005 the Lancet tried to destroy Homeopathy with a meta-analysis which only looked at 8 inconclusive trials out of 110, of which 102 were positive. This was a fraudulent analysis.

“The meta-analysis at the centre of the controversy is based on 110 placebo-controlled clinical trials of homeopathy and 110 clinical trials of allopathy (conventional medicine), which are said to be matched. These were reduced to 21 trials of homeopathy and 9 of conventional medicine of ‘higher quality’ and further reduced to 8 and 6 trials, respectively, which were ‘larger, higher quality’. The final analysis which concluded that ‘the clinical effects of
Homoeopathy are placebo effects’ was based on just the eight ‘larger, higher quality’ clinical
trials of homeopathy. The Lancet’s press release did not mention this, instead giving the
impression that the conclusions were based on all 110 trials.”

Find Peter Fisher’s rebuttal article here.
Find links to the Lancet’s original 27 August 2005 issue, with its cluster of articles condemning both homeopathy and the suppressed WHO report promoting homeopathy, here (you need a subscription and a credit card).

FACT 30: There have been many clinical trials that prove homeopathy works. In the past 24 years there have been more than 180 controlled, and 118 randomized, trials into homeopathy, which were analysed by four separate meta-analyses. In each case, the researchers concluded that the benefits of homeopathy went far beyond that which could be explained purely by the placebo effect.

That’s lovely. But I’m sick of maligning the effect of Placebo. I think we ought to study the damned placebo effect already, since it cures far more ailments than the vast amount of conventional medical treatments. There’s something to it, evidently. We should find out what it is.

FACT 31: The Bristol Homeopathic Hospital carried out a study published in November 2005 of 6500 patients receiving homeopathic treatment. There was an overall improvement in health of 70% of them.

FACT 32: Homeopathy can never be properly tested through “double blind” randomised trials because
each prescription is individualised as every patient is unique. Therefore 10 people with arthritis, for example, may all need a different homeopathic medicine.

FACT 33: Homeopathic medicines are not tested on animals.

FACT 34: Homeopathic medicines work even better on animals and babies than on adults, proving this cannot be placebo.

FACT 35: Scientists agree that if and when homeopathy is accepted by the scientific community it will turn established science on its head.

Homeopathic Practitioners

FACT 36: In the UK, Homeopathic Practitioners train for 4 years in Anatomy and Physiology, as well as Pathology and Disease, Materia Medica, Homeopathic Philosophy and study of the Homeopathic Repertory. (In Canada, the minimum training is 3 years of basic medical sciences (A & P, Pathophysiology, physical examination; training will often include things like counseling skills and holistic nutrition; the core focus is on Homeopathic medical philosophy, Materia Medica, the Homeopathic Repertory and supervised clinical training. A further two years of clinical training is typical; continuous study and training is expected of each practitioner).

FACT 37: Most homeopaths treat patients who have been referred to them by word of mouth. Most patients seek out homeopathy because conventional treatment has not benefited them or because it poses too great a risk of side effects.

FACT 38: The homeopathic community has thousands, even millions, of written case notes that demonstrate the positive benefits of their treatment. Some homeopaths have video proof of their patients before and after treatment.

FACT 39: Homeopaths charge patients an average of £50 an hour. Specialist Doctors can charge up to £200 or more. (We charge more here in Canada–on average about $120/hour; Americans tend to charge even more than Canadians. Public health insurance varies by province in Canada but in Ontario–the most populated province–conventional medical doctors charge an average of $200 per patient seen. The average visit with an MD takes 8 minutes; you do the math. Physical examinations, health statement letters, and diagnostic tests are all billed as “extra”, which increase the per-visit rate of pay if applied).

Popularity of Homeopathy

FACT 40: The popularity of homeopathy has grown in the past 30 years, its revival entirely through word of mouth and estimated to be growing at more than 20% a year the world over.

FACT 41: Hundreds of famous people throughout the past 200 years have enjoyed the benefits of Homeopathic medicine.

FACT 42: The aristocratic patronage of homeopathy in the UK extended well into the 1940s and beyond can be easily demonstrated. In the Homeopathic Medical Directories there are lists of patrons of the dispensaries and hospitals. They read like an extract from Burke’s or Debrett’s.

FACT 43: Homeopathy is practised nowadays in countries all over the world. In India (where it’s been practised without interruption for 200 years) there are 100 Homeopathic medical schools and around 250,000 homeopathic doctors.

FACT 44: In a recent Global TGI survey where people were asked whether they trust homeopathy the following percentages of people living in urban areas said yes: 62% in India, 58% Brazil, 53% Saudi Arabia, Chile 49%, United Arab Emirates 49%, France 40%, South Africa 35%, Russia 28%, Germany 27%, Argentina 25%, Hungary 25%, USA 18%, UK 15%.

FACT 45: The media as a whole has been unwilling to air a defense of the efficacy of homeopathy
and the validity of this 250-year-old profession.

Aren’t we at all curious why, especially since the media’s never reticent when given the opportunity to publish attacks against it? In writing this up, I had no trouble finding media articles in major “news” publications which parrotted the conclusions in the Lancet–all without publishing links to the original source, and all without any journalistic history of concern for complementary or alternative medicine in general. Time.com published a brief article encouraging “literate” doctors to slam homeopathy just like the Lancet did, without so much as a link or quote from the original meta-analysis, something a “literate” doctor might like to examine for him or herself. There’s something else a “literate” doctor might wonder about, given the Lancet’s very long history of publishing numerous successful studies proving homeopathy’s efficacy over the course of it’s own history (The Lancet even published the WHO’s own supportive report on Homeopathic medicine in the same issue as the cluster of anti-homeopathy articles and the damning Meta-Analysis). Why all the “buy-in” from powerful media all over the world? Why is such poor journalism suddenly the norm, along with contempt for reader intelligence and curiosity? And why were so many mainstream media “sources” (such as MSN.com, for example–which specializes on celebrity gossip and on-line advertisements) suddenly interested in summarizing anything The Lancet has to say?

It should give us some idea about the way media can work to affect what we do, no matter how successful we are as practitioners.

Divided, Part I

For over ten years now I’ve made my living in alternative medicine. It doesn’t really matter what kind of experience you collect, what kind of working relationship you build with your patients, what kind of hit-or-miss scenario you encounter along your particular journey, nor does it matter who “teaches” you anything, no one wants to tell you about or discuss one constant in our work: every couple of years, like clockwork, we alt-med practitioners find ourselves scrambling to mobilize against some well organized, well funded threat to our livelihood–a threat that can be local or national, and is now often international in scope. And every time it happens, people in our professional communities think that somehow “things will work out for the best” if we just go along with what’s happening, consider the attack to be some kind of “constructive criticism” we could use to our advantage (and then try to change what we’re doing because we think we can become “more acceptable”). Sometimes, we take the government and conventional medicine at their word for what they’re trying to do with us, if the “attack” ends up leading (coincidentally!) to some time consuming, money sucking “process” initiative.

That’s the best case scenario, one that, in my experience, has yet to end well. The worst case, the most evident reaction, includes an automatic factioning process. Various alternative medical system “regulating bodies” (societies, associations, colleges, and boards) all claim to be working “right alongside the government in a “process”–the only valid process–that will make us all “legal” (or acceptable, or legitimate…whatever it is we’re told we’re not, by everyone except our patients). “Everyone else” not in the “chosen” and involved body is just “doing the wrong thing”. Somehow, we always fail to see how it is we’re all lured off to take part in these ongoing projects that lead nowhere but effectively tear us apart. I wonder how we keep missing this, every time it happens.

It’s difficult to think we’re ever going to be united on anything any time soon when so much paper and ink are wasted in international and local one-upmanship endeavors, which quite literally show us up to be politically retarded. Easy to manipulate, we still think it’s all about what we’re supposedly doing wrong, and who we have to blame and ostracize in our communities for creating the “bad name” with which we’re all labeled. It’s like we assume the position of the powerless, every time. We are quite literally the unwitting instigators of our ongoing demise. This is never more evident than when we’re confronted with the kind of challenges we never seem prepared to face, whether they come at us from a local source, or from some huge force far outside of the confines of our own state laws.

This year’s big challenge in Canada is Bill C51–it’s full of massive restrictions regarding access to all natural substances–herbs, vitamins, medicines, and just good old real food–to which we’ve idiotically allowed Big Pharma, Big Food, and Big Medicine to control access. It will also dictate choice and behaviour, with severe repercussions to individual citizens who opt to use alternative medicines, and to practitioners alike. It opens us all up not just to these transgressive laws, but also laws made in other countries which previously did not affect our own behaviour–such as the Codex Alimentarius, which many natural health physicians believed would never apply here in Canada. Under C51, they’ll become law in Canada and we’ll be subject to those laws, without their having to undergo the parliamentary process in to become law in this country. There won’t be any recourse then, in terms of protest–elected officials will have no say in the matter, and they’re our one tiny link to power in this country.

It will mean the end of alternative medicine as we know it here–that is, it won’t be available to the public through well trained, educated, and skilled practitioners, only through conventional medical doctors (who are not required to undergo this education process in order to prescribe). To add insult, the bill is intended to be the “thin edge of the wedge”. It will be one of the first which will override any legislative sovereignty we have as a country. And that will open the door to plenty of other such bills, not necessarily ones which affect alternative medicine alone. It’s meant to be a real Trojan horse of a law, the potential for abuse is staggering.

And yes, the repercussions include seizure of property–homes, practices, files, medicines. They include incarceration, asset seizure (so it will be impossible to defend yourself, should the law be used against you), and the imposition of very heavy fines (these will be applied to manufacturers of natural products primarily–the idea is to shut them down, eliminate their access to plants, seeds, genetic materials for the manufacture of natural products; but the fines will also be levied against individual practitioners, consumers, people like parents who choose to treat their children with real food or herbs, too).

Two years ago, when Homeopaths were being suckered into yet another “self-regulation” scheme that we were never allowed to devise ourselves, I remember having one hell of an ongoing argument about the process with my own doctor, a Naturopath who trained me quite well in my own studies in classical Hahnemannian Homeopathy. But he’s an exception as a Naturopath–for his accreditation, the DHANP, he was required to study Homeopathy in school to the same basic extent that I was: five years of conventional medical sciences following a completed university degree, combined with a full three year Homeopathic medical science training course, and two years of supervised clinic work in classical homeopathic medicine. This is an American accreditation, one we don’t have in Canada at the moment–mostly because NDs here have succumbed to demands made by conventional medicine that they prove themselves to be “science based” practitioners. As a result, the “ND” designation here allows you to claim that you are a Homeopath even though you’ve never studied homeopathic medicine. When the NDs got that little plum, they were also given quite a political pedestal, which raised them far above the Homeopaths and other alternative medical practitioners below. Suddenly NDs were the authority, their patients could seek out help and receive repayment for their expenses from private insurers…while the NDs ensured that Homeopaths, Traditional Chinese Medical doctors, and others would no longer be covered under those policies. Divide and conquer, effectively implemented, part one.

Divide and conquer part two came along when the “self-regulation” process became an opportunity to destroy both NDs and HDs (homeopathic doctors) by attempting to create a regulatory “college” board which included them both. The first clue that this was to be a destructive idea was the fact that the NDs were under fewer practice restrictions, would not fulfill education and ethical standards set by Homeopathic medical societies, and finally, held a great deal more political clout in the conventional medical community than their Homeopathic counterparts, and nothing was being done to fix that inequality on this proposed college. That should have been a glaring clue we could not overlook: and yet, I remember my own doctor thought this college would be a great idea. When I protested that he wasn’t thinking about the poor training most NDs have in Homeopathy, and how so much of our future as homeopaths will be compromised because of the lack of priority that has been placed on the need for full training of homeopathic medicine as opposed to it’s opposite paradigm, conventional medicine…he pooh pooh’d my concerns as if I couldn’t understand what was going on. I insisted: I pointed out to him that the very school in which he used to teach student Naturopaths classical homeopathy, the Canadian College of Naturopathic Medicine, no longer employed a classical homeopath on its teaching staff. He no longer taught there himself, and the full extent of the school’s courses on homeopathy were now being written and taught by a pharmaceutical company selling polypharmacy patent medicines mislabeled as “homeopathic” to untrained physicians, all looking to practice lucrative homeopathy as if it were the same as conventional medicine. He agreed there was a problem there, but couldn’t seem to understand that this would put us all at a disadvantage. He couldn’t see that this pharmaceutical company, now the sole Canadian-based lab making the Homeopathic remedies Hahnemannian homeopaths use, was poised to reach into a promising new market of untrained MDs, who’d be far more inclined to use their rote prescription patent medicines under the guise of treating patients with Homeopathic medicine. After all, alternative medicine is a huge growth market right now, our patients have all tried conventional methods and those methods have failed. Over 70% of the population now uses some form of alternative medical care–that’s a big chunk of the marketplace that’s up for grabs to Pharmaceutical companies looking for even bigger profits. And that fact puts all the bona fide alternative medical physicians in a disadvantaged position.

He meant well, he was idealistic and completely bamboozled by the lure of “scientific legitimacy”, the kind conventional medicine approves of, the kind that keeps pharmaceutical companies humming. He protested that not enough Homeopaths were familiar with the basic medical sciences, even though he knows full well that those courses are handy in terms of reference, and of knowing about the conventional medical paradigm and how it differs significantly to Homeopathic medical science, which requires a completely different perspective in which to practice effectively. I argued then, and still argue, that a Homeopath had better understand Homeopathic medical perspective and method thoroughly–or stay away from the medicines and the practice of homeopathy all together–choose a modality that’s a lot easier, closer to conventional methods, instead. It would be more useful for us to know what diagnostic tests are available here, so that when our patients bring their results to us we can interpret them effectively, and act accordingly (send them out for even more tests, or use the information in our own differential diagnoses for finding the similimum). But that information’s only taught to MDs–and they’re not willing to share that knowledge. Another fact that should alert everyone concerned that the last priority in this “protective measure” is our patients’ care, that public health and consumer protection are definitely not on the agenda for these regulations.

This conflict was the greatest disappointment I’ve ever felt in my teacher, and in my doctor: to me it was mystifying that he would be willing to argue a point even if it meant we would both be compromised in the end. When I told him this, he told me not to worry, and said, “The government can never take away your right to make a living.”

I couldn’t believe such a capable and learned person could be so politically naive, so gullible. And so thoroughly unaware of our shared history as physicians in North America. They damn well can take away our right to make a living as practitioners away. They could, and they have in the past. Using very similar tactics. Successfully.

Molecular Gastronomy, Toronto Style

My friend Geoff is turning 40 next week.

(It only looks like I’m obsessing about age, but I’m not, I’m just thinking about the occasion).

When Geoff and I were students, I made Geoff an involuntary friend. The details are convoluted and odyssean, but it’s the truth. I was in a moment of crisis I don’t think I’d ever encountered before, busy constructing a plan of rebuttal and attack but really kind of clueless about what I’d have to negotiate, and Geoff was a sudden, familiar face. He happened to be around at just that moment, the first I recognized when I scanned the great room in the Steadman Lecture Halls. He seemed poised, serene, and relaxed behind a paper cup of Tim Horton’s, smoking a cigarette by his books and surrounded, as usual, by a group of really beautiful girls. Maybe he was waiting for a lecture to begin. I don’t know if that’s the case, all these years later, because in my state of complete dumbfoundedness I never thought to ask. I just remember reaching my hand out to him and pulling him along with me, as if he’d just been waiting for me to extract him from his group. Good thing I didn’t ask, now that I think back: I have a feeling we’d have passed the rest of our education in separate spheres of study and influence. Then I’d never have acquired the many gifts which came from Geoff, directly.

Here are some:

1. A tape made while Geoff was away, working in the mountains of Lake Louise at a teahouse so high in the Rockies trips to the nearest town happened only once a week. They involved lugging all of the restaurant’s garbage down to the town’s landfill, since vehicles could never make the climb. The tape included the Two Nice Girls’ “Spent My Last $10 on Birth Control and Beer” (an anthem like no other); Dick Siegel’s “Jesus, John, and Elvis” (still relevant, Mr. Obama and Ms. Clinton); and Louden Wainright’s “Don’t Leave Your Records in the Sun”, my introduction to Blue Grass music. He named the collection “Songs Like (my) Driving”, as he’d spend every trip in my car with his eyes fixed on a point under the dash whenever we went anywhere, as if they were held open with fear and those tiny braces on Malcolm McDowell’s eyelids in Clockwork Orange. “Any time you change lanes,” he’d say, “you’re asking for trouble”.

2. Divine, John Waters, and the magical, incantatory force of Cha Cha Heels they created.

(I bet Geoff and Nicky were the first to put John Waters on a syllabus in an institution of higher learning).

3. When Geoff came back from living in Prague for over a year, he showed up on our doorstep in Parkdale. Our landlord couple, who lived on the bottom floor, were not getting along well with us because I’d recently insisted on having the rooms painted and they were resisting. Geoff was early, many hours early. When we finally got home, Geoff’s luggage was outside their front door, which slid open as we came in. Geoff stood in our landlord couple’s entrance holding a glass of wine, surrounded by our suddenly besotted and very friendly landlord couple, who absolutely loved meeting Geoff and concluded that we couldn’t be so bad if we had such a friend. The landlords were amazing after that, talking with us for hours and inviting us out for coffee and dessert. When the house was successfully sold and we all packed on moving day, they ended up giving us a goodbye card stuffed with $50 dollar bills plus the interest on our rent deposit, and they cried as they wished us well. They were really great! And we’d never have known if it weren’t for Geoff.

4. Food. Geoff was always a fantastic cook, able to take almost nothing and transform it into something great. His mom tells me he’s been cooking since he was 7, when he took his first cooking class.

So it’s no surprise then that we’ll be having a birthday meal for him at Colborne Lane, an eclectic modern restaurant in the St. Lawrence Market district in Toronto, where the cuisine is influenced by Ferran Adria’s molecular gastronomy. The Chef’s done his time at El Bulli with Adria, but he’s clearly going for a kind of asian fusion molecular menu, something much more personally relevant. So it should be interesting (though I have to say, supplying these people with the chemical ingredients they use was always a little frightening, back when I was “doing my own time” at a compounding pharmacy in the city–you’d always wonder what the hell they were using some of these lab compounds for when they made those “foams”, “jellies”, “freeze-dried powders’”, and exactly how what they were doing differed from General Mills, or Monsanto). Hidden among the usual menu items (salmon, tuna, duck, chicken) in their alien incarnations, I notice this offering:

Beef tenderloin + slow & soft poached

egg + chorizo+fondant potato + smoked salt +

steak sauce jelly + Yukon gold potato puree

And realized that that’s the part that’s all Toronto: the Meat and Potatoes, adorned mostly with adjectives and few chemical reactions. Toronto’s a fantastic city for food and restaurants, and it’s big enough to keep a place like Colborne going for years, even though it’s got competition in the cuisine on the western end of the city; but you know it couldn’t be much of a repeat draw without conceding to that enduring protestant desire for steak and mashed taters.

(I’ll be sure to avoid that selection on the menu).

I haven’t a clue what wines you’d pair with such super-accentuated flavours, in their unexpected textural transformations, but I’m looking forward to finding out.

Fichi farcite con noce e cioccolato

The baking is done. Well, except for some cookies I really should whip up. And I will, as soon as I get a free moment.

I’ve been wondering how it is I’ve spent so long avoiding every possible means to get out of where I am. Oh, sure, I could have sought out ways to learn how to write, years ago, so that I could be published somewhere (anywhere) until I had some body of work to show for my efforts. I’m wondering how it is that I kept hearing the critical voices in my head, when I have other voices–encouraging ones!–coming from all angles around me as well. I wish I’d found a way to ask someone to help me to do this, instead of let myself be convinced that I’d never be able…that what I could do was irrelevant in some way, worth nothing to anyone. It’s not. I’ve been led to see how wrong that is. And I feel so angry about everything that’s brought me to this stagnant and deadly place. But mostly I feel so angry that I never believed I could do something to escape it.

Until now.

I hate resolutions. They are doomed, by nature. But the New Year is coming and this is the time to turn this around and re-imagine myself as whatever it is that lost girl wanted to become. Why is it I’ve never been to places I’ve made myself stop wanting to see? What have I put into place to paralyze me?

I feel like I’m on the verge of pulling that whole construct down. It’s such a happy possibility to contemplate over sliced finocchio as the year ends.

In anticipation, and in celebration, of all the revolutions to come, here’s my recipe for stuffed figs for Christmas:

You’ll need:

1 package of dried figs (I like to use the ones from Cosenza–since they’re from the place where this Christmas sweet originates).

1 package of fresh walnut halves or pecan halves (your choice. If you use pecan, roast them slightly first).

100 grams high cocoa content chocolate (I’m going to use one with lots of cocoa, lots of cinnamon and cardamom, and lots of chili pepper).

(chocolate chips are optional)

1. Flatten and then slice open the dried figs, cutting from the base of each fig to the fig’s “stem”. Don’t cut through that, but open the cut figs up like butterflies.

2. Place a nut half on one side of the sliced fig, and, if you like, put some chocolate chips into the dried fruit as well. Other ideas for stuffings include using real chocolate nibs that you’ve chopped up.

3. Fold the fig together again, so that the nutmeats are sandwiched inside the fig’s halves. Arrange them in one layer on a plate or tray lined with parchment paper; cover the layer with more parchment, then use a weight on top of the paper to “press” the figs flat for an hour or so.

4. Melt the chocolate in a double boiler. According to your preference, hand dip each fig in the chocolate to coat it thoroughly or in part; if you prefer that the chocolate just serves as a bitter counterpoint to the sweetness of the dried fruit, drizzle the melted chocolate over the figs until they’re coated to your preference. Place them on parchment and allow the chocolate to set.

You can vary the kind of chocolate you use: black and white chocolate swirled together looks pretty; or you can use a spiced dark chocolate (such as the one with cinnamon and chili pepper) to add extra nuances of flavour to the dried fruit and nut mixture.

A little prosecco, a late harvest wine or an icewine made from Cabernet Franc would make a perfect cold weather ending to a long, long year.

My New Year

Yesterday wasn’t as frustrating as I thought it would be, what with the long drive after the first real winter day of the season. I drove east and then north in relative peace, listening to a recorded reading from a novel, something I’ve wanted to do on long drives for ever, but could just never accomplish. The day was almost perfect–sunny, chilly, snowy; I was going to meet my brother for some coffee before driving up but he said he was going the same way; he actually changed his mind when he thought I’d be buying coffee for him, but the fact that my father was there made me rethink the whole proposition. I haven’t got a lot of reasons for wanting to be around my dad these days, especially when he’s got an audience and a reason to be defensive. The guy dislikes me: I get it. No need to belabour the point. I have more enjoyable things to do.

Dr. J was in pretty good spirits yesterday but starting to get a little annoyed and peeved over the results of the last remedy, which brought on a deep depression, tooth sensitivity, extremely long migraines, and even more weight gain despite attempts at restriction. So we hashed out a new approach and he ended up “seeing” what I’d suggested, about 3 consults ago. And so here I am with my new medical friend, above. Let’s see how things go.

It’s been an interesting ride with this doctor, since I started, and I think I may be looking for a solution that doesn’t exist sometimes. If cure is on its way, it’s going to take a while, again; and now I’m feeling like we’ve got to go really deep and it’s possible I’m a little bit frightened, because the pathology is so deeply set. But I finally got him to see the case as I have–right from the start there is evidence of bone deformity in my crazy dentition–small dental arches, large teeth, and slow, faulty, disruptive dentition. Now I know this just illustrates the severity of deficiency my ancestors suffered–I’d have to say on my father’s side, since his family has these bone deformities much more than my mother’s does. Where Dr. J. saw sycotic, I kept seeing syphilitic–in the mineral deficiency, hormonal disturbances, deep depression, and violence which is everywhere in my life. If there is bone deformity in the organism right off the bat, even if it is only initially visible just in the teeth, then the pathology is severe enough to compromise the very foundation (the skeleton) of the organism. Nothing goes deeper than that.

I’m not looking at cysts, or PCOS, or endometriosis, or even just severe anemia or hypothyroidism; I’m actually looking at something far more insidious, far more hidden, and far more progressive. I’m looking at cancer; neurological deterioration, and emotional and mental deterioration instead.

I write this to remind myself: this is the pathological process I’m interrupting.

Mirror

Just what has been so terrifying about the experience of you?
The Knowing. Facing that, about you. The way each word you choose penetrates and finds its frightened source in me. The merciless smile, the glance to ensure my pupils dilate and contract, as you speak. You are comfortable with the exposure you create, nonplussed at the flaying of skin, the mining of the open nerve. When I try to stop you, you pull me in with your tongue, details of eyes meeting, skin bared and stroked. Climax. You press your stories on me like soft lips, kissing here, brushing discreetly, here; your mouth sheathing sharp teeth undressed to bite the spots where the skin is thin.

You pull my secrets out of me with your own, whispered slowly to me like confidences. And then, when I have no choice left, you pull away.

Mortification, ailments from.

Silence, ailments from.

Delusions: Forsaken, that she is.

I will take some of the hair, the dog that bites me.
I will swallow whole flowers, filled to sheer petals with vitriol.
I will crunch my teeth together through yellow metal, arsenic, salt.

And be equal: eye level, above ground, breathing.