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Wednesday, August 19, 2009

something's gotta give

There is nothing like returning to a place that remains unchanged to find the ways in which you yourself have altered.
- Nelson Mandela

i had the pleasure of being shadowed at my job last week. it is not my favorite experience. a stranger following you, listening to your dialogues, and offering feedback and criticism to you as part of their job. we are grant-funded however, and the manager of the grant has their responsibilities, just as i have mine. and you never know what you have to learn.

it turned out to be a very pleasant experience. our clinic was cancelled that day as the attending was persuaded to have labor induced and gave birth to twins. so the person responsible for shadowing and i had lunch and talked about the program, and then she sat in on 3 individual sessions i had scheduled for that afternoon.

there is a movement underfoot in our state to examine and reshape the idea of substance abuse treatment and referral in the medical setting. i actually believe it's probably long overdue. the indulgences and over-indulgences of tobacco, drugs, and alcohol do have health implications and they tend to be serious. they also tend to be costly.

tomorrow i will be attending a conference put on by the grant program which is really a brainstorming session. they are expecting 150 persons and have some relevant speakers. i have been asked to join some others and moderate discussions at my table and to report to the larger group. i am fortunate enough to be bringing the HIV perspective to the conversation. and i shouldn't have to tell you how intrinsically linked HIV and substance use/abuse are.

our state traditionally has been ranked 48th in spending for substance treatment. this is not a fact that i am boasting about. it is merely a reading of the importance this issue has in Colorado. so in the sbirt screening process, referral to appropriate treatment modalities is paramount. but i fear they are limited, hard to find, and challenging to discern the appropriate fit. my hope is that tomorrow's dialogue will signal some change in this attitude and create some momentum that collaboration and systemic change needs to happen.

i mean, if we don't believe someone getting clean and sober is important, or that moderation is actually a virtue and saves lives, how likely is any individual to believe it either?

today's sound choice is the highly underated royal crown revue with "something's gotta give" - yes that's a rat pack remake... i certainly had my days of being a rockabilly/swing afficianado... i even learned how to do the lindy hop..


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