First page of my novel

I finally have started my novel on my career as a therapist.  I will post exercpts from time to time and hope you will critique it.  I will try to be as honest as possible without giving away any client privledged information.  I also will shed light on various diagnosis, failed treatments, modalities.  I hope to have me grow as a person and learn as I write.  Many people go into this field wanting to save the world.  They have no clue.  The textbooks do not tell you about assessments in the hood, walking the park to engage the homeless, going into homes to look after children,  watching people detox,  doing therapy in a soup kitchen and jail.  It is a journey for me and for my clients. I also apologize to my first clients that I learned with and hope they got better anyway.

And don’t get me started on insurance billing.  They don’t touch that.

Hospital discharges and pain management

I have been getting a rash of people wanting to get off of pain medications and are being kicked out of pain management.  They try to get into a suboxone clinic and have to wait or don’t qualify.  They are shaking with nausea and pain in my office.  I am helpless.  I can’t prescribe anything.  I remember my days in the detox and tell them: drink plenty of water, take B 12 supplements, rest a lot, massage, baths, and tums.  Eat non fried food.  Go to NA. I tell them to check their blood pressure and if they think they might have a seizure to go to the ER.  One client who had been shaking for two days and couldn’t eat went to the ER.  She was given one Ativan and sent home.  No monitoring.  She went to her PCP and was given 5 days of nausea pills and 4 days of blood pressure pills.  Everyone can’t afford a 14000 program.  Her insurance would pay for treatment but not the detox.  She has kids at home and can’t leave them. She only wants medical detox where she can stay at home. She doesn’t want methadone.  She missed an appointment Monday.  I wonder if the weekend was too much and she relapsed.  Maybe she is safe in the hospital.  Since she won’t answer the phone and I leave messages, I don’t know. I try not to go into the world of overdose.  I don’t know anyone else to call.  I hope the children are okay.  I worked in a detox and watched people seize from alcohol, throw up for two days for drugs, have sweats for a week from pills, sleep for two days from crack.  That was with medication.  The war on drugs is being fought in the wrong place.