CHAPTER 1
MY MEDICAL BACKGROUND
I GRADUATED FROM AMITE High School in 1966, received a bachelor of science degree in zoology from Southeastern Louisiana College in Hammond, Louisiana, and then received my M.D. degree in three short years from Louisiana State University School of Medicine in New Orleans. I subsequently completed a one-year "rotating O" internship at Earl K. Long Memorial Hospital in Baton Rouge, where I moonlighted very frequently in the extremely busy emergency room there and then worked for many years in emergency rooms all over the State of Louisiana as a contract physician on weekends. Of course, during my education at L.S.U. Medical School, I was fortunate in being able to receive my training at the busiest and largest public health hospital in the state — Big Charity. Between these two state-owned facilities, I received an unbelievable experience and acquired a tremendous amount of education and training. In January of 1974, I entered private practice as a solo physician in Amite, Louisiana, but my stay there only lasted one year, as I chose to relocate to Hammond, fifteen miles away, due to a multitude of factors, including general dissatisfaction and extensive overworking. While in Amite, I worked almost every weekend at the Hood Memorial Hospital emergency room, along with providing prenatal care to several dozen pregnant ladies. In fact, I delivered my first private practice baby at this hospital and then subsequently delivered twelve more healthy newborns in their newly-opened maternity unit.
When I first entered private practice, I provided medical care to ten to fifteen nursing home patients, but upon being appointed coroner later on, I decided to terminate this service due to my demanding schedule. I always had a somewhat busy hospital practice, as I generally kept between eight to ten inpatients. Over the years, for varying periods, I served on the staff of Hood Memorial Hospital in Amite, Seventh Ward General Hospital in Hammond (later becoming North Oaks Medical Center), and St. Helena Hospital in Greensburg, Louisiana, a small rural hospital located 16-17 miles northwest of Amite. My practice consisted of seeing patients of all ages and encompassed pediatrics, whereby I would perform well-baby checkups and provide routine immunizations, and geriatrics. I even practiced obstetrics for a three-to four-year period during my thirty years of medicine, as I delivered well over 350 babies at our local hospital in Hammond. I was extremely fortunate in having a knack for being able to keep an abundance of patients, which I attributed to my great personality, ability to relate well to other people, and my overt passion and understanding towards less-fortunate individuals.
After my move to Hammond, I contracted with several state agencies — the local mental health clinic, substance-abuse clinic, and public health clinic, working in both the family planning and S.T.D. sections. My two jobs at the public health clinic arose from an unexpected resignation of the doctor and the inability of the state to find someone willing to immediately step in. I was asked to join the staff of the mental health clinic because of my past experience of having worked with several psychiatrists in our area through my deputy coroner and coroner positions. My work at this psychiatric center included performing physical examinations on substance-dependent individuals, counseling, and rendering other services to mental patients, such as providing instructions regarding medication adjustments and dosages. I was also contracted with the Child Protection Agency in both our parish and our neighboring parish, Livingston, where my duties included performing physical examinations on potentially battered or neglected children and providing professional consultation, particularly at their informal monthly meetings. I continued my association with these state agencies for a very long time until my forced retirement due to an acute cerebrovascular accident (stroke) that resulted in a significant memory loss.
Fourteen years during my family practice was spent serving as coroner of our midsized rural parish of Tanigipahoa, which was located midway between New Orleans and Baton Rouge. I probably enjoyed this position more than anything else, since along with it came enormous prestige. At that time, the coroner's office only consisted of one person, that being the coroner himself, unless he was fortunate enough to have other physicians interested in assisting, for which I never was. Briefly, there are several important functions of the coroner's office. The first one, and most important, involves his responsibility in handling deaths due to anything other than natural causes, including suicides, homicides, all types of accidents, deaths from infectious processes, deaths resulting from drug abuse or toxins, stillborns, abortions, and premature infant deaths. And, because our parish at that time didn't have any type of official coroner's office or morgue, the over 1,500 autopsies that I personally performed took place at funeral homes, since the funeral directors graciously donated their establishments.
The second function pertains to the coroner's participation in dealing with mental patients and substance-abuse individuals, as he can order an immediate or emergency evaluation of any individual suspected of having an emotional, psychiatric, or drug problem. And after the individual is taken into custody by the police department, the coroner has the option of either evaluating the person himself or referring him or her to another facility where there would be a social worker, psychologist, or psychiatrist. I chose to evaluate most of these individuals myself, since I felt that I would have first-hand knowledge and thus be in a better position to determine whatever future steps, if any, needed to be taken. And again, because of not having a regular coroner's office, my office was utilized for this purpose.
There is another function that a coroner in a larger parish is sometimes allocated which involves his serving as jail physician, as this obviously pertains to his providing medical treatment to the inmates. Although our parish never did empower this position to the coroner, I was asked by both the sheriff and Hammond police chief to provide medical services to the inmates in their jails, which I readily accepted for many years. As you can imagine, my practice became extremely demanding with the addition of these extra obligations. I worked out a schedule whereby I would routinely visit the city jail at around 6:00 p.m. on Monday, Wednesday, and Friday evenings after seeing all of my private patients, and arrive at the parish jail in Amite at 4:30 a.m. on Tuesday, Thursday, and Saturday mornings, hopefully finishing in time to be back at my office for 8:00 a.m. I would also be on call for any jail emergencies, along with always having to be available for my other coroner responsibilities, my two public health clinic jobs, my mental health clinic position, and my two contracts with the child protection agency. And, on top of this, I managed to have a very busy medical practice, consisting of both appointment and walk-in patients, along with constantly being on call at the hospital for any emergencies involving my patients.
CHAPTER 2
UNDERSTANDING BIPOLAR ILLNESS
My Double-Edged Sword
IN ORDER FOR my young readers to be able to fully understand my writing techniques and demeanor, including how I formed my avid opinions, I feel compelled to explain my inherent diagnosis of bipolar disorder and relate how it affected my life both advantageously and detrimentally. I was not considered a gifted child, nor did I possess any above average mental capability, so I had to depend on some other means to be able to obtain my goal in life, which had always been to become a medical doctor. On the positive standpoint, my bipolar disease undoubtedly assisted me throughout my educational path, since my ability to overachieve and outperform was obviously a result of this syndrome. It is a known fact that bipolar individuals tend to have a higher I.Q. and possess a canting ability to succeed in any endeavor that he or she pursues. In reality, I can attest to the fact that this syndrome gave me the all-important attribute of motivation, so I used it to my advantage. In my situation, without my innate desire to study more intensely, obviously resulting from this affliction, I never would have been able to complete my education successfully. There is absolutely no doubt in my mind that my ability to concentrate and focus on something for long periods of time was also derived from this disorder.
On the other hand, I strongly feel that by detailing some of the untoward consequences that I incurred from its presence, this would hopefully place my audience in a better position to envision as to how it seriously impacted my life and molded my opinions on obesity and other hazards. Under normal circumstances, any physician could easily encounter a personal or social problem, considering that it is such a high profile profession that carries a demanding schedule. And, certainly, I was no exception. To start with, doctors are faced with difficult challenges in treating their patients, as they are constantly placed in a position of having to make difficult decisions at crucial times. Secondly, they are subjected to social issues, including family problems, due to their busy schedules and, thus, lack of quality time with their spouses and children. Then, the physician always has easy accessibility to narcotics and sedatives, creating a tempting environment, especially during the many times that he or she feels stressed out or emotionally drained. My overworking attitude and obsessive compulsiveness gradually led me into a medical disaster in the early 1970's after just several years of practicing medicine. In 1974, I started self-administering both oral and injectable Demerol, a schedule II narcotic, and Stadol, a schedule III controlled substance, and this addiction would totally engulf me during a six months downhill escapade. And at that time, it was obvious that the many years of my manifesting symptoms compatible with bipolar disease — hyperactivity, depression, inferiority, and despair — attributed to my eventually being diagnosed with this disorder, which culminated in a total collapse or so-called "crash" — this drug-abuse nightmare. However, due to my readily acceptance of having this disease and willingness to face reality, along with my strong willpower to continue, I soon returned to my practice. But, truthfully, it was only through my wife's extreme understanding and patience that I managed to get through this ordeal. Any person diagnosed with bipolar disorder who, unfortunately, experiences some type of severe emotional downfall, must develop the drive to continue to succeed, along with having someone in the family who can be depended on and who is willing to bend over backwards and offer mental support, including participating in counseling sessions. In my case, my wife graciously and relentlessly served as my eternal source of strength and nurtured me throughout this period of strife, and for that I will be forever grateful. So you can see that I was far from being perfect.
As you can imagine, my price tag for having bipolar illness and suffering from its consequences, including my escapade with drug abuse, resulted in quite a bit of undue stress during my practice, as I was forced to deal with the Louisiana State Board Of Medical Examiners. Basically, this state agency sets down standards for the practice of medicine and decides when to discipline doctors. During my ordeal, my medical license was suspended for three months, after which I was reinstated and continued to practice medicine. However, due to a combination of factors, most of them brought on by myself, this same board proceeded to harass me throughout my entire medical practice, resulting in a lifetime of agony. You know that anytime a person has to hire a team of lawyers, it will be both expensive and nerve-racking. Fortunately, with the exception of this three months sanction, my very competent legal counsel managed to keep me from sustaining any other serious consequences, but the amount of stress resulting from this over the years added up. A very favorable decision was eventually handed down from the Federal Courts which represented an inclusive judicial ruling against the State Medical Board, and this verdict kept this agency from harassing me during the last five years of my practice, but in terms of the emotional impact, it really came too late. Stress, as I will discuss later, can cause an enormous number of problems, of which weight gain can be one of the consequences. There was no doubt in my mind that constantly staying tensed-up was a very important factor in the development of my massive obesity, as I kept a horrendous appetite during most of my lifetime. There is absolutely no doubt whatsoever that this enormous weight, along with my high blood pressure (hypertension). was responsible for my eventually having a stroke, which I will explain later.
On the other hand, my uncontrollable hyperactivity (always being overly energetic) and constant feelings of depression and despair, apparently related to my bipolar illness, also played a part in my incredible appetite. Basically, I subconsciously used both the stress factors and my annoying symptoms as excuses to keep overeating. To a bipolar individual, nothing is ever "in the middle"; everything must be "extreme". So when I finally decided to create my diet program, there was no way that moderation would work in my case. In other words, my "all-or-none" attitude typical of this syndrome served as a driving force in the creation of my diet plan, since it seemed to feed my desire to shed pounds and further support my impetus to keep my weight down. I possibly even used my compulsive tendencies (unable to control) to create somewhat of an anorexia (no appetite for food), since there is no doubt that I had developed a definite fear of my gaining some of the weight back, and my obsession (overconcern) with exercises may be the other part of it. This would be the other half of my double-edged sword. However, as long as a person does not become undernourished or severely underweight as the result of a diet/exercise program, that should be perfectly acceptable in every respect.
Several of my siblings were upset over my deliberate but honest disclosure of my bipolar illness, as complete secrecy always seems to be the only acceptable option. But, in the long run, hiding a problem is the worst thing that a young person can do. As I will explain soon, disclosing any type of nervous disorder or emotional problem is of utmost importance so that treatment can be instituted earlier in order to hopefully prevent further consequences. Considering how extremely prevalent emotional symptoms are in children and teenagers and the vast number of young people all over the world affected with Bipolar disorder, there should never be any shame over seeking professional help or asking other family members to be more tolerant. I can state with absolute certainty that I lived through and observed the consequences of having an emotional problem first-hand.
During my practice, I observed that the overwhelming majority of my patients with a nervous disorder, especially anxiety (nervousness) or depression, appeared to be filled with shame and disgrace over their having it, but I tried to impress upon them the importance of being honest and open-minded instead of remorseful. I encouraged them to accept their illness, thus making them more amenable to treatment (cooperative, responsive) and prognosis much brighter. Unfortunately, once a person is diagnosed with any type of emotional disorder, there is no such thing as total eradication (disappearance of the disease), but the person, as in my case, can not only continue to do incredibly well, but as I just stated, possibly use it to his or her advantage. Sometimes, acceptance of a mental problem alone can be sufficient enough to ward off any potential consequences. I can absolutely state that a significant percentage of my patients didn't even require medications on a permanent basis, since awareness in itself seemed to be enough.
