The Last Standing Appointment

Today I deleted a standing appointment on my calendar.

Last Friday I cancelled all of my client appointments and slept in. Saturday I cancelled my chiropractic appointment, a business appointment, coffee with a friend, leaving the house only to attend my weekly 12-step meeting with fellow recovering beings. Sunday I repeated the pattern, spending much of the day reading 30 chapters of a new translation of the Dao De Jing, walking the dog, ordering a pizza, and watching the Vikings beat the Cowboys. My only human interaction Sunday was with the teenage clerk at the bowling alley pizza shop near my house. Around 10 pm I canceled my Monday appointments too. I knew today was going to be challenging.

Most Mondays are pretty light days. I see a few therapy clients via telehealth, do an hour of clinical supervision, catch up on any outstanding documentation, and I have one standing personal appointment every week. This appointment has been either on Monday or Tuesday in the early afternoon for more than five years, in fact almost six. It has shifted specific time slots a couple of times, but largely has been the most remarkably consistent recurring event in my life since January 2020.

The appointment I deleted this afternoon was with my personal therapist “T.”

No more reminders, no more alerts, no more driving to Saint Paul or logging-in to telehealth. No more trauma-informed deep shadow work and EMDR processing. No more cats and dogs sliding in-and-out of the picture during sessions. No more risque discussions of what its like to be an aging gay man in the first quarter of the 21^st century. No more exploration of my deepest darkest fears, cravings, pain, suffering, frustrations, and maladaptive patterns. No more laughs about stupid shit people do, that I do. No, not today. I knew T would not be in our scheduled session.

T was my counselor the first time I attended residential treatment at Pride Institute of America in August of 2017. I remember asking the intake coordinator if T could be my counselor. Somehow I had learned from someone about his reputation as a clinician treating gay men dealing with serious dual-diagnosis issues like mine. By the time we met at Pride. I had already decided he was going to be “the one who would help me fix myself.” When I entered his office with the nine other guys in my small group, I immediately understood the vibe. Calm, no bullshit, transparent, somewhat careful, respectful, and most of all, no subject was off-the-table.

In those early days I was sizing-up T and the small group members as much as he was assessing us. He appeared to ask intentionally-worded questions, took extensive notes, challenged irrational conceptualizations, redirected big feelings or high drama. I observed a reserved empathetic compassionate detachment from the situations each of us brought into the room. In one-to-one sessions he challenged my egoic belief frameworks, delusions of grandeur, internalized homophobia, and overall sense of lack of worthiness. His style of asking clarifying follow-ups kind of pissed me off. It felt like I was being interviewed by a very tenacious newspaper reporter. Later I would learn that my senses were clouded by unresolved personal and professional trauma surrounding this very type of in-depth inquiry.

During those first 84 days of treatment at Pride Institute, there were many helping professionals who laid their blood, sweat, and tears into treating addicts like me roaming the halls of the treatment center. Just before Thanksgiving in 2017, in the last week of my extended stay at Pride, I walked into his office and we agreed it was time for me to “graduate” treatment. I signed the discharge documents, shook his hand and thanked him for his help, hugged some fellow travelers, and got in the cab to move to an LGBTQIA+ sober house in South Minneapolis. I thought at the time it would be the last time I saw him.

By Fall of 2019 I was struggling with my recovery. I had been attending recovery meetings for two years, working a few early recovery jobs (i.e. outside my past occupation), attending gatherings at a local spiritual community to practice, meeting with a sponsor; all of the recommended things a newbie in recovery was supposed to do. I even had worked with a couple different therapists with specialties in co-occurring trauma-informed LGBTQIA+ focused practices. For some reason things weren’t totally clicking, and I was stuck.

The world had not yet really become aware of Covid-19. However, as someone who worked as a concierge for a major Chinese-owned big hospitality brand, I had. In November and December of 2019 the property, a flagship business hotel in the heart of downtown Minneapolis, had a ton of parent-company employees and contractors visiting from China, many of them getting sick while staying in our hotel. A domino effect began. The housekeepers who cleaned their rooms got sick en mass and called-out of work, and then front desk staff got sick from helping out housekeeping with turning rooms, including me.

I contracted a “severe sinus infection with bronchitis” that was not a mere sinus infection. It was something more serious, but I didn’t know what. My primary care provider, an infectious disease specialist, also didn’t know, and told me to be very careful with myself. He noted my severe illness was also an indicator that my immunity had been seriously declining for awhile, and we both knew why.

Just prior to getting sick I had begun a four-month relapse on my drug of choice. It was messy, it was chaotic, it was serious, and yet somehow I kept most of it hidden.

I kept my job. I kept my apartment. I kept my sponsor and my home group. I kept my spiritual foundation. I had very few consequences except an extreme weight loss, a seriously terrible bout of “severe sinus infection with bronchitis” and a heap of internalized shame and self-loathing for falling off the wagon. I spent my 48^th birthday flat on my back coughing up unholiness from my lungs, sweating through the sheets with fever, then shivering with chills and migraine-level debilitating headaches. It was bad.

It didn’t stop me from using for another few days afterward though. I still had one more run of chaos in me before I stopped using again, during the first week of January 2020. Within my being I knew that if I was going to live another year there would have to be a serious shift in strategy. I needed to re-evaluate everything about my recovery and my life. I needed to double-down on the parts that worked, and shift everything else that didn’t. That included getting a new therapist. So, I looked up T on PsychologyToday.com and emailed him asking if he had any openings. He called back and we set our standing appointment.

Over the past almost six years I met weekly with T either Monday or Tuesday, mid-afternoon. We started in-person, but then within eight weeks of our first intake appointment the Minnesota Covid-19 shutdown protocols were implemented. My hotel shut down. The whole world shut down. I still kept weekly appointments with T via telehealth. Eventually he introduced me to EMDR, and we did telehealth and in-person trauma-focused deep therapeutic processing work together, week-in, week-out. We only missed a handful of times since then, and only when there was a health issue, work schedule conflict, or if one of us had to travel out of state. Otherwise that appointment was happening.

Over the past five-years-and-whatever-days, a lot has changed in my life. I’ve maintained my recovery from my drug of choice. I am coming up on another birthday – 54. My immunity is mostly excellent considering I’ve lived with HIV for more than 22 years, the majority of it undetectable thanks to modern antiretroviral therapies and not using. Most notably, the trauma-informed therapy work I have done with T helped me resolve my “trauma demons.” I no longer have night terrors, flashbacks, hyper-vigilance, delusions of grandeur, or a need to be a people-pleaser. The past internalized homophobia, self-loathing, shame, and guilt is mostly gone. The self-doubt and second guessing, resistance to vulnerability, and need to prove something is much reduced, albeit never completely eradicated. The focused work I did with T to rebuild my psyche has allowed me to expand my internal process of recovery, mental health, and spiritual work; healing from within my being.

What I have rarely shared with anyone was that T was one of the first of a few trusted addiction and mental health clinicians who encouraged me to explore counseling and psychotherapy as a career path. While doing my own internal work, I eventually enrolled in grad school at University of Minnesota to earn a Masters in Professional Studies in Integrated Behavioral Health. Through this journey I began a career in co-occurring behavioral health care, first as a Chemical Dependency Technician, then as an Intake and Scheduling Coordinator for a large health care organization, then as a CD/MH intern at co-occurring treatment centers. Eventually I started practicing as a caseload-carrying Licensed Alcohol and Drug Counselor (LADC), conducting CD/MH therapy groups and individual therapy sessions with individuals struggling with substance use and mental health issues. I practiced using many of the same techniques that I had learned in my work with T.

Late last year, as I was preparing to graduate from the university, T shared that he had been struggling for some time with a couple of health concerns. He assured me he was taking care of himself, but noted that sometimes he might need to be at home for telehealth sessions. That was fine with me, as I was preparing to transition to a new job as a pre-licensed psychotherapist in a large corporate mental health services practice. We would both be busy as hell. Regardless, we still met almost every week.

Through the Spring and Summer I noticed that T looked different both in-person and on-screen, appearing at times extremely fatigued and pallid, other times with changed skin coloration. Sometimes he had to gather himself back up from nodding during sessions. I checked-in with him regularly to ensure we were both still okay. Gradually it became obvious that things were weighing him down. Our sessions were less focused and targeted. Part of this was my responsibility, as I was bringing a lot of new life and career adjustments into sessions. I started a new career, moved into a rental house with a yard for the dog, was adjusting to the pace and energy fluctuations of seeing a full caseload of clients every week, had financial struggles, and my dog was going through the “terrible twos” demanding attention constantly. T still met me where I was week-in, week-out. Occasionally we would have a session here or there that was missed or needed to be rescheduled around his doctor’s appointments or my fluctuating work schedule. That said we both made the effort to communicate, keep things going, and continue our therapeutic work together.

Over Thanksgiving week this year things changed. I won’t go into details here to protect T’s privacy, but he missed our standing appointment the following Monday. It was very unusual for him to miss without communicating first, so I called and texted him to see if everything was okay. That night when we finally connected on FaceTime, he informed me of a recent medical incident on Black Friday, noting that he had been hospitalized for three days. When we were talking it was clear something deeper was wrong, but he assured me he would complete follow-up appointments and let me know if we needed to change schedules or anything more serious. Admittedly I was pretty concerned, but I said “please take good care of yourself, okay? He promised he would.

It was our last conversation.

Last Monday he missed our standing appointment again. I attempted to reach him on the phone and email, but was unable to connect. A few hours later I was contacted by the group practice owner and informed that T had been re-hospitalized, apologizing on his behalf for missing our appointment. I asked the group practice owner to please keep me posted what is going on, admitting that I knew about a previous medical condition, noting I just wanted to know that T was ok. The practice owner said they would get back to me soon.

My internal being has always had a clairvoyance element, specifically to people close to me. It has been this way since I was a little boy. I knew when my kindergarten teacher was pregnant before she announced it to my class. I felt it when one of my best friends died in an airplane disaster. When a family member, classmate, friend, or colleague is in distress, I feel it before they tell me. When grandparents, aunts, uncles, mentors, professors pass, I always feel it as it is happening. As an adult these changes in my being have become something I have adjusted to, along with a whole set of other instinctive sixth-sense-like awarenesses. Fellow peers in recovery sometimes relapse, overdose, and die; and I have felt that too. For a long time before I got clean I attempted to cover these sensations up, dulling them with substances, distraction, and work. In my recovery I have learned to accept and work with them somewhat. I regularly meditate and connect with higher source energy to continue this growth in spiritual, metaphysical, consciousness awareness. If you have read any of my previous written work you might understand of what I am speaking in this moment.

Throughout this week I continued to see clients, but something was itching at me under the surface. I knew something had shifted. By Wednesday night it hit my beingness that T was slipping away. Silently I meditated on this feeling, sat with it, leaned into my practice, and kept doing my routine. I continued to see clients on Thursday, but by Friday morning the grief and sadness took over my body. I had extreme fatigue, deep melancholy, a full-on depression response. To be responsible, I informed my superiors I was taking a personal day and canceled client sessions, returning to sleep, just to rest with what I was experiencing.

Later that morning, the practice owner called to inform me T had passed away on Wednesday as I had felt. They offered grief and loss counseling to process this news. I thanked them and hung up the phone, breaking down in tears, wailing in grief and pain.

So here we are,12:00 PM, Monday, December 15^th, 2025, the current scheduled time of our standing appointment. I am writing, processing his passing. As I write I am literally doing the grief work he taught me, and now I teach to others – letting myself feel the grief, talking about it, allowing it to be experienced. The dog has been in-and-out multiple times to check-in on me. She’s a diligent and well-trained sensory being, laying her head on my arm while I type. My mom called me to check-in. She knows about the special bond that T and I have, understanding that besides her, he knew me better than anyone.

While we were speaking I kept getting appointment alerts from my calendar app. Afterwards, still writing, I unceremoniously deleted the standing recurring appointment entry for “Therapy with T” in my calendar. It was just too much.

I will never be able to repay the debt that I owe this being. T led me through a multi-year process of trauma therapy, discovery, and healing that truly helped me “fix myself” just like I had chosen in the beginning at Pride Institute. In the end I had not only a counselor, then therapist. I also gained a confidante and a professional colleague I respect deeply. Most importantly, in the end I had a friend whom I will miss terribly. We all should be so fortunate to have had such a helper in life. All I can do is try to pass the gift on to others.

Rest In Power “T”, thank you for your service to me and everyone you touched in your human life. See you on the other side of the veil. - SF