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The School Bus

Middle of August... mid 1990s... Gray sky... a slow gust of wind carrying a cloud of leaves... they rise and dance and run away...

He looked up again and saw a flight of birds cutting the sky. He did not want to go. He did not want to stay. It was just past 7 A.M. He shifted his feet, looking up and down the road waiting for the vessel that would bring him down the street and towards the new place of learning.

See, he had wanted to go to the local school. Just a mile away. It wasn't up to him. He remembered what had happened at the place before. He remembered just how dark it had become. He had played with fire before. The anger was catching up. As a child, he didn't think it could be so complicated. That was supposed to come later. There was a lot to prove. 

Fire was a release. Oh he liked to see it burn. The light brought him comfort. The warmth was so soothing. Sometimes, he would get with friends and they would steal some liquor. Never really thought to drink it. But boy did it burn. He liked to go down by the little creek in the woods... see what he could burn.

He heard the beast coming. The diesel engine roared and the loud whine of the brakes cried out when the beast would turn. Shuddered to a stop right there with a hydraulic burst as the doors came open, engine rattling away.

The old place of learning had many memories. It had stood down on that state road, back behind the fast food and right across from the old mall. They had renamed it after integration. In the scramble to rearrange the education system, a black high school had been rechristened and converted to a middle school. It had stood down in Nickeltown. Off state highway 291. Pleasantburg Drive. 

The city had been built around that river. All those years ago, back before the Revolution, it had been born as a summer retreat for the folks up from the port of Charleston. You see, South Carolina started in a union with North Carolina, both states named after one of the King Charles. Charleston was founded as Charles Town, the first major city and remains to this day the largest (by most measures). It gets rather hot, and the settlers were prone to sickness from the swampy water and the storms. So they picked up, traveled Northwest, across the midlands (where at that time there was mostly swampy lands, forests and some fields), straight up into the foothills. There, in the Cherokee hunting grounds they found that river. Not a particularly large one. They took to building some mills. A main street. They build this street called Church Street. Deadended into a Church. Eventually some carriage factories and some more mills. The cotton from the lower parts of the state could be made into textiles, and the city boomed on that industry eventually. But initially the mills were mostly for grinding grain. By the 1990s it was the 3rd largest city in the state and had served as state capital for about a month when the Union burned Columbia. Charleston had ceased being the state capital long ago. 

They had called it Pleasantburg. Hence the road name. Where the new name came from was... well, see it had been a resort of bits, and very forested and natural. Very Green. Then roundabout the Revolution, the Swamp Fox did the country justice, so they decided that he was the inspiration, though they dropped the extra e and put up a statue right on Main. The textile mills disappeared in the 70s. Downtown was boarded up. It became dangerous. So they decided they needed a change. The economy diversified, and downtown was remade. In the 90s it became safe and popular. 

So Nickeltown had a school. Right near the old city dump, which closed sometime in the 70s. It had a concrete courtyard in the front. The High School had featured a Swimming pool, which had been left to nature and become a green pond. But he could remember that concrete courtyard oh so well. Not the safest place in the world. The bomb threats, people throwing things at others, the fights, gang type behavior. He had been compelled to defend himself physically a time or two. By the time he left, he had been gone in his mind so far away that it's amazing anything came out at all. 

That was when he met the hospital. Seemed a safe place at the time. They said he had the depression. They say he couldn't think so clear. Yet by the time he left that school he was thinking of the end. The darkness of the mind was powerful, and he was in the grip. Took to writing dark things.

Under the overpass and by the river... past the water treatment plant and up that hill... Across the state road... Past Augusta... by the furniture store and down into the neighborhood by the interstate... then the last turn taking it up that hill by the woods, turning right into the big lot. 

Interesting place. walking from that lot into the school, if you turned to the right and went into those woods, you could find a grave or two. The school seemed like a fortress. So he built himself up strong to survive. 

Public Service Announcement

Thank you for tuning into DarknessUntilDawn...


I'd like to give a message from our usual Sponsors... the CDC, SCDHEC, ETC...


Do not try this at home. After reading this message, click on "Personal Thoughts", "Medical", "Musical Diagnoses" and read the problem list. I literally took it right off a discharge summary. 

If you are a patient, think about how carefully you take your medication, and how sick you want to be...

If you have the power to prescribe... think about how sick you want your patients to be. Keep in mind those DEA numbers on your pads. They are there for a reason.

If you are a health care professional... Keep HIPPA in mind when you work. Keep your patients' well-being in mind. Don't screw around with other professionals. Maintain independence.

I've been thinking about South Carolina a lot. How it was. How it's changing. This is why I'd like people to tune into Poetry and "Carolina Drugs". Because I don't want South Carolina to be that way. I want a clean and calm state. One in which drug use is just something that is not actually real. Where pills are hard to find. Where it is just a story. This should be a place where sirens are uncommon. A place with trees and sunshine. The Palmetto state.

Show Time

I've been thinking about Monday. Gotta hot date. This one's a looker, folks. Oh he likes my sense of humor. What should I talk about? So much on my mind... he learned my name pretty fast. We're going to a nice place. It's bright and well kept. I bet they love analogies. He likes it when I talk legal. It turns him on. He knows all my friends. I bet they are good with names. First names, last names, code names. We can play spy movie! Or clue!

It was Doctor So and so with the xanax! It was professor XYZ with the roaming eyes! Oh dating is so much fun. This one has good nails. Physically fit. We can talk psychology!

Extinction! Reflection! Validation! Annnnnd I feel so aliiiiiiiiiiiiiiiiiiiiiive! Word play! And it feels so goooood!

Orange you glad you met me? I peel better these days. I've learned so much. Tell me about your father? 

I like my coffee with vanilla. We'll talk about the future. building bridges.

Yep, the talkers got me all set. To talk with someone else. 


On a side note, I've been thinking about the community and my concerns about boundaries. I'm very much hoping that anyone that has any sense who has worked with me professionally as a healthcare practitioner, particularly those with the power to prescribe, is taking their vacation days and rethinking their life a little. Maybe I shouldn't have worked with XYZ? Maybe I should have followed this law or that law? Maybe I should take an ethics refresher. Maybe I don't want DEA attention anymore. Maybe when this guy got flagged for Social Determinates of Health, maybe I popped up on one of those radars. Maybe I should think about retirement. Enjoying life. Maybe ECT is risky. Maybe rTMS should be used with caution. There's so many maybes. Hopefully before the governor talks to me. You know, before people start making threats of legal action. Before 600 pages of documents are secured from this hospital, before another hospital gets too much attention, before that hospital stops taking my patients, before people are buying guns... There's so much to think about... Maybe I shouldn't threaten people for holding others accountable? Maybe if someone is related to me, I shouldn't try to fuck with their healthcare? oh so many maybes... Maybe I should think for a while... Maybe my family needs me... Maybe having my name in the paper, my picture on a wall, or ridiculous amounts of money is bad. Maybe promoting prescription drugs, especially off label, is the wrong kind of attention... Yes, perhaps I should go home and rethink my life... shut my trap now and then... maybe people don't always need to know what I think? maybe it stirs up resentment, rather than jealousy. Maybe I like keeping my job and I should do it properly, within boundaries, and shut the fuck up? Naw... well... let's think about that... There's always church... but then, my uncle was a priest and that didn't work out so well. There's plenty of churches around...



Dangers of Psychiatry

Mental health requires a gentle touch. Some people should not work in mental health. some people do not understand boundaries. They think they are Gods. Then people get hurt.

Talking too much is a one way. Scribing too freely is a surefire way. Both at the same time? Recipe for disaster.
This is why some practitioners hate me right now. this is why they can't wait to shut me up. Because they know that I know their mistakes. I am their mistakes.
And the results? A mychart a mile long. Word salad. 
It was a long time ago. They were all partners. There weren't proper boundaries. There were some good intentions. But when the abusers know the providers and the providers know each other and the medication and diagnoses start flying too freely... by the time you're shipped off to McClean, it's a little late. by the time of the first coma, it's a little late.
Birds of a feather... the victims together...
Birds of a feather... psychiatrists together...
Birds of a feather... abusers together...
Birds of a feather... I've known many people. plenty of good ones.
Building a map of a mind takes humility. Not the Psychiatrists specialty. They need to cut down their egos a bit. Take their pictures off tv. take their photos off walls. Take their names out of the papers.
Go ahead, blame the patients. Go ahead, blame the social workers, Go ahead, blame the counselors. Blame side effects. Blame everyone but yourselves. Don't take vacations. Don't rotate out. Don't respect HIPPA. become partners and become too close. Refuse to retire. Go ahead. Take the insurance money, pass the pills and the blame around.
The PA is not one of you. So sorry. Now kindly go fuck yourselves. Yall need to retire. I'm counting the days. You can count the words. 

Am I afraid? Yes. Do I know how to fix it? no. Do I want to protect the community if no one else? Yes.

Guilty conscience... I know things, ya see... I just don't know how it works out. But I'm finding out. One day at a time. This is the mind you built. Maybe you just like yourselves too much.