is caused by haloperidol
and we wonder
why wanderers
are told to contain
toxins in multitudes
strain
load-bearing
bones
of snapped
earths

we
cannot
hold the center
because there are 3 axes
and any frames of reverence
are references to the
404 types of unfreedom
each more cursed than the last

to know
to be
to
dobedoobedoo

thats comedic
for tragedy is only a farce
history & science only
unherstoric facts
slavery only the servitude invented to keep capital flowing
we
are not WD40
or cancer
but the bones of the air
the tides of the earth
and the oceans true spiral
is sand and mirth

Chew them up and spit them out.
Focus now. Now talk.
Nope — can’t speak the words aloud.
My mouth is filled with caulk.
Visions of words play out in my head
But I can’t get them to play nice.
Instead things have to be left unsaid.
Or I will pay the price.
Can’t risk it. Can’t say it.
It’s wriggling out of control
Can’t chance it. Can’t do it.
Can't say anything at all.

“Chew it up, and spit it out.
Spit it out. Spit it out.
Chew it up, and spit it out.
Spit it out Already!”

Spasms before they leave your lips
You’re ******* the words up
You apologize again for it.
An overflowing cup.
****** distortion. Mental exhaustion
Teeth clamped down tight.
Depression sets in, the fear sinking in
You  try with all your might.
Chewing on yourself again,
Embarrassment creeps in.
It’s not about if it will happen,
The question is “when?”

“Chew it up, and spit it out.
Spit it out. Spit it out.
Chew it up, and spit it out.
Spit it out Already!”

The muscles are darting,
oh no it’s starting,
Your hands begin to shake.
Your tongue slides left,
Your neck bends right.
How much more of this can I take?
You want to run
You want to hide
But there’s nowhere to go.
You can’t run away from it,
Your face you have to show.
You try to stay as still as you can
So no one else can see,
You just want to cut out your tongue
But speech is a necessity.

“Chew it up, and spit it out.
The song must be sung.”
Can’t chew it up, or spit it out
This disorders got my tongue.

In the beginning it was subtle,
And thus went unobserved.
He’d be reading a good article
And he started missing words.

Of course he was intelligent
And his mind filled each Lacuna,
But I wonder, could we have saved him
Had we only noticed sooner?

Eventually whole paragraphs
began to escape his grasp.
A mental fog enveloped him,
He’d forget what he’d read last.

Every day he tried to work
Was like the day before.
Until he had to admit
He couldn’t do it anymore.

A subtle dyskinesia
Like a seaquake in the brain
Left the poor man terrified
Of things left unexplained.

Perhaps it was a mercy
when dementia settled in,
I hope he lacked awareness
of the Hell he’d entered in.

When his vital signs began to fail
I found I could not cry.
The one I loved had vanished
Long before the day he died.

Clozapine is an FDA-approved atypical antipsychotic medication for treatment-resistant schizophrenia. Clozapine is not the first-line drug of choice due to its range of adverse effects, making compliance an issue for many patients. However, clozapine also has some advantages, including lowering the risk of suicide and tardive dyskinesia and fewer relapses. Regarding suicide risk, clozapine has been demonstrated to reduce suicidal behavior even in non-treatment-resistant schizophrenia and patients with schizoaffective disorder. This activity reviews the mechanism of action, adverse event profile, toxicity, dosing, pharmacodynamics, and monitoring of clozapine pertinent for members of the interprofessional team where this agent is indicated.