Sunday, November 28, 2010

This is late, I must be getting Guyanese...

Problem Based Leaving

I am [was is now the right word!] in the midst of packing – or rather the packing in in the midst of me!   I threw out tons of old papers and somehow, I think that I have one more box to leave…if or when I come back.  Anyhow, it seemed that every lousy piece of paper had a memory attached to it and almost all enjoyable… but it has slowed me down some.


Tony and I finished our last PBL class with the First Year students in style on Wednesday:  Ms. Helen Browman, CEO at Mercy and Dr. Claudette Harry observed and participated with the students.    At the end of the session, they were supporters of our attempts to re-introduce it.   So on the last class of the last paper page, Tony and I got some support.  It sure was a long time coming… and it did provide some energy to even think that it might survive.

[And who is Harry?  Well, she was the first Dean of the Medical School at University of Guyana in the ‘70’s and she had developed a whole curriculum of PBL for the medical students.  However, after she went to PAHO, the PBL approach disappeared.   Tony and I actually took them both out to dinner to learn from her experience and maybe how she might have done it differently.]

Thursday was a day to hand out the grades and chat with each of the students individually about their performance and grade.   They all to a “T” said that they could/should have worked harder, as if that provided some sort of absolution or talisman against the negative comment of the teachers.    We had very few negative comments and none that don’t usually make the top ten lists of every teacher’s feedback.  We have been impressed with the students – participation, enthusiasm and work rate.

It is at the end, when I know more clearly why I come here.  It is to see how much the students have learned and how much they have grown up.   I think that I have always gotten off on helping others grow into themselves.  

Our final session, after the marks were handed in, was a general evaluation of the programme and its specifics.   Their responses were positive and all welcomed the chance to work rather than listen to a "talking head" read from a text.  And as usual, after there were no more assignments, they said that the homework wasn’t that tough and could have been more difficult.   When I was a novice, I had this cognitive dissonance as all throughout the year they complained about homework and now…  As an old guy, I believe their non-confession is a ploy to have us really, really stick it to the next group of first year students!    I usually tell them that their comments were really helpful as Tony and I were going to be teaching them again in their second year.


We were also surprised as they hosted a farewell party and tribute to us over the lunch hour.  We sang some songs and there were a few speeches about our wonderfulness.  As well, we received a lovely plaque with a thanks and a picture of themselves on it.  I did feel that we made a difference in their lives and nursing career.

Lots of Goodbyes
Every week one of the girls takes a picture of this one on the wall at St. Ann's
 I visited Sister Beatrice for my last time this trip - and maybe ever.  She has developed pneumonia and was somewhat dehydrated, so they brought her into Mercy Hospital.   I knew this because as I was going upstairs to visit her at the convent an older Sister came rushing towards me, walker and all, to tell me that she was where I had just left!   Anyhow, we did chat and I told her of all the people that I knew who were praying for her and that I was grateful for having known her and goodbye.

That day I also thought that I was saying goodbye to my girls at St. Ann’s.  I am still not sure whether they will miss my camera or me more.   I have come to know many of them over the years.   Lucy proudly told me that she was now halfway through her dog first aid book and there is nothing on red-eye in dogs.   Keep reading I told her.   They do all come to see me and ask – “Can I borrow the camera?”  “I didn’t have it last week.”  “I’m next, right?”   I have just learned to sit loose and the only time I look for my camera is when I am ready to leave.   And almost all the pictures of the girls are ones they have taken by themselves.   I now have to go through them and select two of each of them and get them printed and shipped back to them from Canada.   Some of the older girls have 50-60 pictures and always want me to print all of them!   Some new ones are in the slide show at top .....
Mary Peter - one of my favourite girls at St. Ann's
It is good to be part of their growing.  Two will go on to the University of Guyana… Amazing!  And others have been apprenticing in a trade and learning how to manage a job…  I am optimistic about most of their futures. 

Good Bye Again…

I was invited to the 475th Anniversary of the Ursuline Sisters and how could one refuse an invitation like that --  besides, "my girls" were going to be dancing during the Mass… and could I take some pictures?     And Sylvia wanted to take Tony and me out to dinner and she was going to the Mass.  [Tony was giving his last piano lesson.]   The Ursuline Order was dedicated to taking care of girls and women, so priests did all the talking about the good work of the Sisters by quoting from bishops… and no one saw the unfortunate irony.  Maybe by their 500th anniversay a woman might get to reflect on her life as an Ursuline?




Most of the St. Ann’s Girls were corralled up in the balcony; however, the dancing girls were downstairs. During the offering they waltzed down the aisle; they were excellent - disciplined, co-ordinated and seemingly enjoying the whole dance.  One might have mistaken them for perfect angels.   Whoever taught them had a lot of patience, and talent too.    They were even given a warm round of applause.    They were all so glad to see me as they had their best dresses on.  As well, they asked if they could borrow my camera!

Goodbye Sylvia 

Sylvia is the Scarborough Fathers volunteer who is down for three years – ugh.  So she will probably still be here if and when we get back.   For some reason Tony and I seemed to have adopted her… and I was secretly trying to convert her to Lutheranism.. . as she heard me preach several times and then just last Sunday went up river to Mt. Zion at Sand Hills.    It is in an isolated part of the west bank and accessible by boat.  I call it the jungle though the people there say, “Pastor, dis nah no jungle.”   Sunday was Harvest Home and after a longish service they had a meal for everyone; and then we had to wait for the torrential rain to slow down to normal rain before we left in an overloaded speedboat with no jackets.   And then after dropping off a half dozen people in the church van, we got a flat tire at night on the Timheri Road.   Dick coast it to underneath a street lamp and after a few anxious minutes discovered the jack in an unusual place.  It was a good thing that Dick had done it before ..…  
Everyone pitched in.. I got the spare loosened from a coat-hanger improvised holder; Sylvia held the nuts and bolts ..… and we were back on the road ..… somewhat later than expected but safe.

Goodbye Dick – kind of…


I forgot to mention that Dick was not feeling well and had no voice really at the 9AM service at Calvary and by the time he was done at Sand Hill, he was beat… See the evidence.   And the flat was almost the last straw… He has way too much patience for the “last” straw.     He dropped us at his home as he just wanted to crash… and Sylvia and I would get a taxi.  I did sneak in a good bye; he isn’t real keen on goodbyes… but it will be against the odds that our paths will cross in the future.   So it was a true goodbye to my Pastor friend.



Good Bye to the Rest…

It was like the children’s book, Goodnight MoonGood bye all the Sisters of Mercy – Judith, Noel, Kenneth, Catherine…  And Good bye St. Ann’s Brenda, Barbara, Mary Peter…  Good bye all my graduates –Yolanda, Bhola, Taju, Ashiana, Annessia, Sabrena, and many more…  Good Bye staff at Mercy – Helen, Juanita, Laurelle, Jenny, Claudia and all the others…  Good Bye all those who have enriched my life these last three months Good Bye   Guyana!

Hello Anne and all my family – Sue, Emily, The Iz, Sara, Rod, Shilo, Christine, Evan, Jennifer, Kristin, Mike, Sydney, John Aaron, Amber, Sienna and Aidan..

Hello all my friends.   Hope to see you all soon… or more likely a closer email!

I thought that I would have had a much more reflective ending to this year.  However, I am just thinking of getting out and home.  Maybe I’ll try and write one later…   Yes, I know it says that I send them only when I am in Guyana, but what preacher would be worth his salt if he always did what he said?  

I am now in Florida...

So… “Help, Save, Comfort and Defend us O God.”  Till we meet again… John

Friday, November 19, 2010

My... Travels with Charlie

Charlie Malcolmson, an old colleague from McMaster and a Paediatric Intensivist, arrived last Saturday on schedule; however, his wife Cathy, also from McMaster and a Nurse Practitioner, was unable to come at the last minute because of some pressing family matters.  I had already put on my Tour Guide hat.  So after Charlie arrived at Mercy and had a little nap (he had come in on the red-eye from Toronto), Tony put him in a cab to get to my place.   We then walked around “my” Bourda Market and saw and heard and smelled all the sights and sounds and tastes.
 

Another colleague from Mac was here, Brian Cameron, who is a paediatric surgeon.  Unfortunately for me, Charlie had lost Brian’s phone number.  [I think he was relying on Cathy to have all the details…]  So while he was napping, I detectived  [my editor will love the word]  his number by going to the paediatric surgery department, where I had a great chat with a former student who just that day had come back from having a baby and had never heard of Brian.  I did discover that he was working with two docs – one a Persaud; not very helpful as there are more Persauds here than d’Entremonts in Pubnico!   I ended up in the Director of Nursing’s office where by a circuitous process I obtained Brian’s “new” phone number.  [The phone with the number he had given Charlie had been “uplifted”.]   Well, Brian was teaching a Trauma Team Training Programme just outside Georgetown… and said we should visit.  So visit we did.  






The team [8 or so ITs and docs] from McMaster and Emory University – long story about the connection to each other and the Lilendaal building – had set up a computer simulation with a manikin that was more life-like than me some mornings.   It moaned, breathed with a chest up and down, could have any cardiac rhythm possible, femoral pulse, etc…  This simulation was set up as a person hit by a car and with various injuries ..… The manikin allowed for a realistic insertion of a chest tube and air sounds, etc.   Here I was in a village outside of Georgetown and witnessing the most up-to-date equipment in the world!  

In my usual priestly way, I tried to make them all feel really guilty for not doing anything like these computer simulations for the nursing programme.    Well, they did have nurses on their teams; and in fact, Yolanda was in my first class at Mercy!   I was proud – I am sure she remembered no medical ethics, psychology or sociology, but she was still in the country, contributing ..… Great!

After several hours with Brian, I took Charlie to Celina’s Resort  to see the beautiful brown ocean and mud beach before the sun went down.    It is funny how old friends yak....  it was like at the end of a day – or night – in ICU at McMaster ..… easy and comfortable and wide ranging without too much “good old days” bull.   I had made the mistake of inviting Brian to dinner – not that having Brian was a mistake, but by the time he arrived, with the whole team, and they actually got dinner served, Charlie was occasionally “cat-napping”.



Then the next day, Sunday, was even tougher… Charli came to hear me preach – twice – in two different churches.  Now that is a friend.   The second church was King of Glory across the Demerara and the floating bridge.   I had bartered my sermon there for a wonderful meal cooked by Dolly and Kampta, and had arranged a Sugar Factory tour.    The three Karran’s – Kampta, Dolly and their daughter, Kavita – are the backbone of the small country church [They are probably the ankle and tail bones as well.]  Dolly’s food was excellent, and the tour too ...…



We arrived at the Sugar Factory at Wales and the Production Manager, Vincent George [a Good Lutheran], greeted us with more information than anyone could absorb about sugar production -- all before the tour started -- because it is so noisy in the plant no-one can hear!
Pictures can be found at: Sugar Factory At Wales Pictures

The factory takes the raw cane and makes a sugar that mostly [the A grade product] gets sent to Britain and refined there.  Everything is reused:  the cane parts are dried and used to power the plant and the steam is captured and used for energy.   It is very efficient, though there is really not much market for cane and without a heavy subsidy, the plant would have to close.  As in all of Guyana, this reflects a daily reality:  there is talk of it closing everyday… and yet, it is still going in season 24 hours a day, 7 days a week…   And if it did close, what do cane cutters and factory workers do ...... when most have been doing it since they left school early….....? 

Then we had dinner at Taju’s [non-existent to Canadian Immigration]  restaurant and ice cream parlour… and the day was over.

Monday [and Tuesday and Thursday] we introduced Charlie to the students and our version of Problem Based Learning.  In true McMaster style, he watched on Monday and led on Tuesday… ..  After all those years, he was a natural – and kinder than  Tony or I would have been ..…  The students loved him.  One experience that Charlie may have forgotten but the students won’t:   he was facilitating a small group when he didn’t know something, so he went and looked up the answer in a book, came back and shared what he had found.  Great modelling.  

I keep promising to do a totally serious PBL one day… and still it hasn’t come… “Just now” in the Guyanese parlance for “Don’t hold your breath.”




Wednesday was another holiday, so I “borrowed” the orphan girls’ bus and driver, and our class and Charlie and Tony headed east to New Amsterdam and the National Psychiatric Hospital.  The excuse was for Charlie to see some of the country and take pictures and for the students to interact with patients.   It was a good visit at the hospital -- and thanks go to Bhiro Harry, a psychiatrist at the Public Hospital for getting all the permissions.  For several hours we toured all the buildings and chatted with all the patients… It took a little “wall-peeling” with the students when we started, but after a while they got the hang and were chatting like Tony and me.
More Pictures at:   New Amsterdam Psychiatric Hospital
On the way home, we stopped and got everyone some ice cream at Taju’s… and I stocked up with some Chow Mein for Charlie and me, as I was just going to email and rest in the evening.   After I got home, my “friend” Default was not online, so couldn’t scam his wireless…  I called Tony to have him send a note to my wife just saying I had no net…..
I think the day at the “asylum” had worn off on him…  He sent Anne an email that in short stated that I was being held involuntarily at the Psychiatric Hospital.. but don’t worry, I’d probably get released in a day or so…   Now not the best attempt at humour, but no one ever accused Tony of being a comic.  What was even worse was he didn’t read any return emails…  Anne had written him back asking if it was for real… and when he didn’t answer got really worried for me [ah nice, eh?] and called a few people including the CEO Helen here, who was off-duty on the holiday.   Well, I still had no internet so decided to go into Mercy and have our Chow Mein together with Charlie and use his internet…  As soon as I got there I saw an email from Anne and was reading… “Call the High Commissioner…” when the doorbell rang.  I went down and answered it and there was the nursing supervisor, and two nurses who seemed surprised to see me!   It took some time for us to understand each other.  Helen had sent them to find Tony because Helen had already called the CEO at the Public Hospital and a few other people to get me “released.”  [Helen had no trouble believing that my “tentative” nature got me in trouble…]  
We went into Tony’s flat where he was doing class preparation, oblivious to the commotion and turmoil he had created .  He was surprised as well!  And still wondering why a spouse would get upset at her husband being held in a psychiatric facility in a foreign country… [Anne, too, apparently believed that my “personality” lent itself to confinement.]  
After apologizing to everyone on the planet – excluding Tony – and promising Helen [who said that this was one of the worst years in her life with the fire, car accident, and now a kidnapped volunteer] a good dinner, etc… Charlie let me use his cell phone and I talked with Anne who was glad (understatement) to know I was safe and that she would not have to go ahead with booking her flight to Guyana .…    It is not easy being the family of an “adventurer” and (much like coaching) it is more stressful than playing the game – or being in a foreign country.   I am distressed that Anne had to go through all that worry, and/ but warmed and comforted that she would come to “rescue” me.   What a wife!

Thursday we worked Charlie again ….. He met two of the Paediatricians here Mootoo and Jabour.  Jabour did his paediatric training in Alberta, and they struck up a conversation about the new post graduate programme in paediatrics at University of Guyana and linkages with McMaster.    Then, for our Thursday clinical case with the Seniors, I found a child who had been admitted with suspected Leptospirosis that was really a kidney problem.   So Charlie led the rounds ..…  And he was no longer wondering IF there was anything that he could do here ..…  He left on Friday morning with more than enough reasons why he and Cathy should return ..... for many years to come ..… Hopefully.  If he remembers and has time, he will add some words of his own to the blog.   

Company sure is exciting and exhausting.  And I am relaxing without water… It has just decided not to work, so stay down-wind till I can shower ......  



Unclassified Items

I think that the cow face (low down) appeals to me the most.   I already know that I do not like calf’s hoof… 

About half of the students needed a chest X-ray and sputum tests after their routine tests were quite responsive.   They are worried, with reason:  if they have active TB, they will have to leave and then repeat the whole year.  Ugh.  Imagine having Tony and me twice!

Ambulance response time is a little slower in the community of Berbice!


Thanks for reading and may all your nightmares be over quickly and happily, John

Friday, November 12, 2010

Losing: ....Sleep, Mangoes, Doc Daniel and Parent’s Dreams

Losing Sleep over Mangoes

No, I have not suddenly desired mangoes over chips…  This is the story:  At the back of the Calvary Lutheran Church property and directly outside the back bedroom window is a majestic 3 story mango tree just sitting there quietly; it is hardly noticeable – until those little fruits ripen… and then the dogs go crazy – barking for hours at a time two or three times a night for the last three nights.   Do my dogs like mangoes?  No… Let me finish the story.   They go into barking fits because a thief sneaks [?] onto the grounds and climbs the mango tree and fills his sack with mangoes… and then he leaves.

It did take me a few times to figure out what was happening… but after the second time I saw him with a very heavy-looking sack over his shoulder nonchalantly walking towards the street and the market which is open 24 hours to sell his new cash crop.  [And my dogs barking ferociously still!]   I yelled at him and he kept going as if he knew what was good for him.   Ah sleep… not.  He returned at 4ish to the same cacophony of dogs throughout the neighbourhood, led by my two guard dogs.  I promised Anne not to do anything “too” stupid… So I just chatted with him from my window about intelligence, relationship with his mother, and other street niceties… and he left… and now time to get up.
The local wisdom was that he wouldn't come back two nights in a row.   Other local wisdom is: stand on your roof and throw bricks at him.  Okay plan; but couldn’t figure out how to get on my roof… and it may have violated my passivist sensibilities and the “too” stupid promise.   Well, he did come back around midnight… ..  So I shot him – several times!
I told him he was now on candid camera and I was going to send his picture to the newspapers as a “tief” who steals from a church.  He really did get out of the tree in a hurry and with an empty sack.   When I looked at my proof of theft… I had wonderful pictures of the flash highlighting my screens.  
Now I was really mad and had to have him to return -- not so much to get justice as that I just couldn’t believe I made such a rookie mistake with my camera.   Wishes do come true…  He returned later that night and I got him.   The dogs were trying to climb the tree and I told him... “Keep the g-d mangoes.. If you come back I am going to break both knee caps.   He left with the mangoes… and I went to sleep till morning…  And I had a picture!


To his credit, he clung to the tree like a squirrel.  And mangoes grow at the outsides of the branches…  It would be something interesting to watch – if it weren’t in the middle of the night.
The next night at about 11 the dogs go crazy… Ugh!   So true to my word I grab a large stick and head out to the tree.  And, oh yeah, the new live-in caretaker is now with me, and he has a bigger stick ..…  I figured this decreased my action to “reasonably” stupid and I could just watch as Michael pounded him, so I could still be a pacifist.

Well, he got over the back fence before either of us could reach his knees.   We sure showed him that time!!   And I did answer one ongoing question: “Do your dogs bite?”  The answer now is clear.  The thief says, “No.”  I guess the dogs are pacifists, too.   And buying mangoes at my supermarket will never be the same again.

Doctor Daniel does not go to Dinner – Again but, “Pierre” Appears

Doc Daniel is a gracious doctor here to whom I have referred many times.  He must be the official greeter for every volunteer and doctor from India.  He is the leader of a missionary church here as well as being a doctor at Mercy.   He invites all the volunteers to dinner at least once during our stay, at his home or a restaurant… and I have never had him agree to come out as my/our guest.  This last Monday, he agreed!  We planned to meet at 6 and go to the Windjammer and let Sylvia have another free meal. [We don’t want her wasting away to nothing.] 
As I was leaving, Tony called to say Doc is sick and can’t come.. we were going to cancel it all, but we remembered how excited poor, hungry Sylvia was, so we decided to go anyhow…
I get there early [what else is new?] and as I am sitting there with a beer I was chatting with a Guyanese heavy weight boxer… and then a guy comes dragging himself in and I say, “You look tired.  Canadian?”  He nods and we shake hands… Now my story begins.
I get him a beer [He’s Canadian, eh?]    And he starts on his tale ..…  Briefly:   he is married [for the second time to a Guyanese woman] to an Amerindian woman and they live in region 1 on the far west of Guyana in a village called Maruka.     His wife was pregnant and dutifully attended al her prenatal clinics in the country.   And everything was fine… until she started to have contractions.   The rural midwife attended and after her waters broke and for the next 32 hours she had contractions and pain… 
The baby was trying to be born breech.   This was not noticed by the midwife ......   After many hours of this, “Pierre” got his wife in a speedboat [can you imagine the smooth ride?] down river to the town of Charity and a local hospital where they did notice the breech, so sent them by ambulance another hour or so down the road to Suddie and the regional hospital there.  Here, as “Pierre” describes it, they had wonderful care from the doctors and nurses and the baby was delivered by C-Section.  He said that the doctor was caring, skilled, etc… and spoke only Cuban Spanish, so several of his Cuban colleagues did a joint English translation. 
All this eventually led to the parents being told that their baby had fluid sacs in her head and at the lower part of her spine and they were going to have to go to Georgetown Public Hospital for treatment.   So off they went by ambulance, speedboat, ambulance ..... to the city…    They spent a week or so at GPH and no one came to see the baby or offer a solution, so up they went and got the baby to Davis Memorial, a private Seven Day Adventist Hospital in the city.   Here they did meet a surgeon who said that he was to operate on the baby the next day..    This was the morning of the day I met "Pierre" … and the surgeon had not showed up all day…..
 
No wonder he looked tired; I couldn’t even imagine what the mom was looking like.  Their baby has Spina Bifida of the most serious kind.   I tried to do my best therapeutic grunting routine and not say anything as he was just talking about sacs…  Just then Tony arrives… and I introduce him to “Pierre” who briefly describes his journey and problems with the baby… and I could see that Tony is preparing to deliver his three hour clinical presentation on SB, complete with drawings he was planning to make on the hotel’s napkins.   Whoaaaa… and like a good spouse, I gave him the “eyes of death” [and for those of you not married, it conveys:  "you do what I think you are going to do, you won’t see the sun rise!"]   So he adopted the therapeutic grunt technique as well… A similar process was repeated with Sylvia.
 
We did offer our condolences and moral support for him and his wife… and then a couple from Canada also joined us… He was a sixties exile from Guyana who married a Canadian girl… and (small world!) knew Elizabeth Abdool [I haven’t told her yet, as this is a test to see if Elizabeth reads the blog] who is the President of Guyana Christian Charities in Canada. 
On Wednesday, a Senior Student Nurse tells me that Mercy Hospital has just admitted a baby who has SB…  Yup, Mercy had the necessary requirements to perform the surgery and follow-up, so “Pierre’s” baby and wife were here.   And I thought they would make good patients for our new clinical rounds.
They agreed – and so did the surgeon with the usual “who has the bigger ......” requirements, just to show who is really in charge. 

At 2 pm [Guyana time] the seniors interviewed “Pierre” and his wife [don’t really have to give her a fake name too, do I?   I think if you really want to know their real names you can see Tony’s blog.]   It was a sad time and the parents were articulate and had learned so much in a few weeks – and really will have so much more to learn in the years to come.   And Tony got to do his modified three hour lecture.    And the students answered some of the patients' questions at the end and thanked them for their effort to help them learn about their child and about a real life family and their journey.  When I asked the parents what they were both worried about, they were in agreement:  What were they going to do with their child [a special needs child] in a small remote village in the mountains of Guyana?   Seems like a fair question!    

Some things about “Stuff”

  • Sister Beatrice Fernandes, who has not been well the whole time I have been here, wants everyone to know that she takes strength from all your prayers.   Actually, when I visited her this week, she was on the verandah “catching some breeze.”
This statue is at an entrance to the convent.  I have always liked it.  am not sure why because it is really no nun that I ever knew growing up... no yardstick in her hand!

Two colleagues and friends from McMaster, Charlie Malcolmson and his wife Cathy Lee will be joining Tony and me for a week on an “exploratory” visit to see if there is something for them to do if they come back again sometime.   Cathy is a Nurse Practitioner and Charlie is a Paediatrician from McMaster.  We have arranged a schedule for them.. and in true Guyanese fashion have put it in pencil!   It will be good to have them here.

The Black Board picture in the slide show is how the seniors saw my personality profile… Not bad for an old guy…  Tony was upset because he didn’t get a TEN in the “cool” factor!


I do try and keep in correspondence with everyone who writes me… but sometimes it takes me awhile.  And with company coming and the surge in worry about getting everything accomplished in our remaining two weeks… I’ll probably not get around to responses this week -- but I really do value your comments…

At Calvary Church, they actually want me back preaching this Sunday.   The last time I talked about slavery and my limited mind has not left the topic.  I will talk about freedom.  Now to do this I changed a reading… a liturgical mortal sin.  [However, I am not worried as it won’t be my first liturgical sin.]  My mind has played with a Chinese proverb,

“I dreamed a thousand new paths.
I woke and walked my old one.”

May you all be seekers of freedom and may some of your paths be unknown.
                                                                                                                                             John

Saturday, November 6, 2010

Justice, Confidentiality and an "Iota" of Just[ice] is not Enough

Tony and I have two hours on Tuesday when we aren’t doing pbl.  This Tuesday, Tony gave out our exam! … And I gave them Pineapple Turnovers – or Pine Tarts. [And Tony can’t figure out why they like me better.]   There are now 10 students from the original 13; I say that I have a surprise for them…  I randomly hand out 5 "pines" and then return to begin my comments on Justice…  I don’t get very far before the student grumbling is too much to ignore… none who had the pine tarts were complaining.   [And maybe that is the essence of human justice – those “with stuff” think that it is fine; those “without stuff” are quick to claim violations of fairness.]  
I ask them why they are upset…. “Not Fair”, they cry…  “What isn’t fair?  Can’t I do what I want with my money?”   [Liberty ah yes,  best argued by those who have the “stuff”.]  

How could I make it more fair?…   Maybe you should get a pine because you deserve it?”… 

So I gave out a short test and whoever gets the right answer gets the tarts.  …..  Only four right answers.  I retrieved the five pines from the first group [Actually, there were threats of violence to my person as I took back the tarts as none of the original recipients got the answer] and gave them to the four correct answers – one got two.  They did not like Merit any better… as it, too, was quite random… "What about attendance?"  “I have the highest class average.”    So bemoaned the pine-less students.
How could I make it more fair?”… 
I really need a pine, Rev. John.”  “Me too!” went the chorus.  “Great, and how do we determine need?”  There are two really thin students … so I gathered up the five from the merit-ers and split the tarts 3 and 2 between them.  A Need-based system was not to their liking either.   “I am hungrier than they are.”  Okay.  “So who is going to eat their pine right now and who will save it for later?”   Five said that they would eat it now… So the pines moved to the five hungry.   And the refrain was similar… “They just had lunch; they are hogs, not hungry.”
How could I make it more fair?”… 
Look at me.  I am fit and eat only what I should.”   Okay… “So we shall exclude those who abuse food.”  So I picked out 4 of the class who are on the heavy side… and the two thin ones… and one is diabetic…  and two can’t stay awake in class- so obviously are abusing something. So the five pines moved to the most virtuous. “Hey it is not my fault I am diabetic.”  “It is not my fault I fall asleep; I have to travel an hour to get here and that is after I look after my chores.”  “And Miss Good person never does her own homework, she copies mine.”  [All is fair in love, war and pines.  So much for Personal Responsibility.] 
How could I make it more fair?”… 
We are all your students… You must treat us equally.”   Okay.  “As you have all five pines, are you willing to share with your batchmate equals?”   She was not obviously thrilled with this solution … and in the resiliency of the human spirit announced, “Well, if I keep two; you can split the other three in thirds and everyone can have an equal share.”  [If you have the “stuff” Equality means something different than if you don’t.]
I got through the major concepts of justice including Retribution and Utilitarianism.   I ended with, of course, giving them all a pine tart.  And then the diabetic and a few of the others said that they didn’t like or couldn’t have a pine tart and what was I going to substitute…   [Yes, I know that a pine is not the healthiest, but it is hard to see a carrot as a reward for anything.]
Next, I had them pair up and gave them one extra pine tart between them.  They had to decide whom they would give it to …and a justice reason… Now the chorus was “Rev John, it is unfair for you to make us work so hard for one pine!”   In the end, 4 pines were given on the basis of perceived need.- beggar on street, housekeeper, porter, and Dr. Tony… and one on a sameness principle… school secretary.
All in all, a good hour… and like most students before them, they will remember the “pines” and have no recall of the why, just that they were good.  Plus, I gave Sister Catherine my tart, as she was one of those fired last week.


Confidentiality – Yes and No

It will come as no surprise to anyone who knows me that Neurology is not one of my strong suits… and when I do try I usually mess it up.   Naturally, it can happen the other way round, too.  Tony took on Ethics this week…   As you remember, we had a student who had to leave because she was diagnosed with active TB.  Tony and I have tried to support her get good care and fairly soon.   A doctor at Mercy agreed to see her and CEO Helen agreed that the hospital would pick up her bills here… Students don’t usually get assisted till they are in second year…  Anyhow, on examination, she was found to be pregnant as well.   This was a surprise!   She was distraught as she was on a pill and already had a child … and … and…  Well, on Wednesday evening Tony and I made a visit to her home with her mom and siblings and daughter; and she was coping better. 

The day before, when the doc had told her she was pregnant, the doctor got her permission to tell Tony and me about her pregnancy.   On Thursday this student came to our class to say hello and... good bye to her batchmates.    Now Tony jumped on the chance to demonstrate his ethical prowess with a great example of how Dr. Devi had gotten the student’s permission to share the fact that she not only had TB, but was pregnant.    Now this would have been an excellent example of how to maintain confidentiality in real life –except for the fact that she had not told her batchmates that she was pregnant .......    In true Doctor form, he quickly indicated that while she hadn’t told them, she really wanted to share it… and “many things are true” again…  [And nerves are those thingys that make you nervous.]    Her batchmates did support her and encouraged her to return to nursing next year…



Some Things of Note

  • ·         Reformation Sunday
 
This was the Premier Performance by the Calvary Lutheran Church Melody Makers.


The King of Glory - Reformation Crowd? Chris Klafs is in there somewhere.

Tony chaired a distinguished panel:  Pastor Young, Chris Clafs – the Florida Synod representative to Guyana, Errol Ramdhany, a local scholar and myself.  We waxed on [and waxed off] wisely beneath the shade of a Silk Cotton Tree to an audience of all ages about how the Reformation has impacted the present.   One thing which I didn’t share at the time was that with all the freedom of information that the Reformation brought, most of what I said came from a Unitarian Universalist source – a sermon that Anne delivered to a UU Congregation in Canada.  This must fit under the rubric of “priesthood of all”!


  • ·         “The Little Apple of Death” 




Also beneath the Silk Cotton Tree [there are no Jumbies in this one, I think], there was a beautiful and bright red tomato-ish fruit… Very lovely and just at a height where even the smallest child can appreciate it.   However… Mancinella, as it is known in Florida, contain strong toxins in all its parts. It will secrete a white milky substance during rainfall.  Allegedly, standing beneath the tree during rain may cause blistering of the skin from mere contact with this liquid.  Burning the tree may cause blindness if the smoke reaches the eyes.  The fruit can also be fatal if eaten. Many trees carry a warning sign, while others are marked with a red "X" on the trunk to indicate danger.  [http://en.wikipedia.org/wiki/Manchineel]    This is not exactly what you’d like your kids to be playing with most days!


·         A Friendly Canadian and Barely Clothed Women

Our newly found friend, Ian MacKay, a consultant who is down here to help upgrade a local hotel and restaurant, Grand Costal, invited us and any stragglers over for a swim and to be his guests for dinner.  So we invited Sylvia, a Scarboro volunteer.  She walked over to the internet-deprived Mercy Volunteers and got them to come as well.   

We had a wonderful time and will return this Friday with our First Year Class for their outing with snacks.   If I get this out after we have swum, [or swimmed, swummed, had swum, went swimming or…] I’ll add the pics to the blog’s top slideshow.   And don’t worry, I won’t get too excited with all those beautiful young women; I’ll fantasize about their grandmothers!
Of note also was that we picked up another Consultant, who had previously been in Iraq for several years and had just been in Guyana for a few weeks.   When we asked him what he thought of Guyana, he said, “I think that I may return to Iraq as it is better there.”    He didn’t seem to be kidding… Ugh!    Update:  He has chosen to work in Afghanistan..   [Are you kidding me?  Double Ugh.]

  • ·         Diwali
Friday was the Hindu festival of lights. Diwali means a row or cluster of lights which symbolizes Light over Darkness, Knowledge over Ignorance, Good over Evil and Love over Hate.  How can you be against that, eh?
Diwali falls on the lunar month of Kartik meaning the month of October or November on the darkest night of the Hindu lunar year.   This is an occasion for the young and the old, men and women, rich and poor - for everyone irrespective of their religious and economic background who seeks light, knowledge and love.    The festival is celebrated throughout the world to ward off the darkness and welcome the light into our lives.  As William Shakespeare said,  “See ye that light yonder?  So shines a good deed in a naughty world”.  This festival is also celebrated as the beginning of New Year, and the blessings of Lakshmi, the celestial consort of Lord Vishnu, are invoked with prayers.   Lakshmi is a wonderful manifestation of the Brahman as she is considered the intermediary for beauty and wealth!  Nice combination, sort of a Virgin Mary, Martha Stewart and Beyoncé. 

  • ·         Free Ice Cream Equals No Canadian VISA


After Tony and I made our home visit to our student, we had to stop at Taju’s for dinner and a few beers [for John] and ice cream, as we were made Honorary Life Members of the Free Ice Cream Club.   While I was there I remembered to ask Taju for a price on 20 gallons of ice cream that the School of Nursing is responsible for providing to the Mercy Hospital Christmas Party.   I thought that I could get a good discount.  He said, “No charge.” As it was his alma mater, he would donate it.  His only question was whether they wanted it in gallon jugs or individual cups.  You would think that makes him a good guy?
The next day he was denied a Canadian Visa to attend a week-long ice-cream marketing course at the University of Guelph because he was at risk of remaining illegally in Canada.   God save me from those faceless bureaucrats who are keeping Canada safe from hard-working entrepreneurs.    There is really no appeal, as the course starts at the beginning of December.  

I have been proud to be an immigrant to Canada as I have always thought it to be a kinder and more welcoming nation than so many others.   Today it is not true.   While I was firing off letters in my “Righteous Anger” phase, Taju wrote back, Oh Reverend John don't be upset; for every disappointment there's an iota of blessing hidden somewhere.”

 Thanks for reading and may your blessings not be hidden.   John


Saturday, October 30, 2010

Just Some Folks - Not All

 Sounds of Silence - NOT

I have long since thought that we did not have anything at our core – no central defining value, soul, centre, whatever.   We are the unique ingestion of our experiences and especially our experiences with others.   So the “who” of John is the amalgamation of all the relationships of a lifetime.   There is no “Cogito, ergo…” anything.  I am my memories, some conscious, some only felt, of all the relationships of living.  These relationships may be long and intimate, conflicted or demanding or punishing, short and/or significant.  They are all there in “who” I am today.   These internal beings share in the new experiences of my present incarnation.  How could I have been anyone if not for those who have known me and I have known?   However unique or different I am, I owe it to the people like those whose existing has bounced into mine this week in Guyana.
Rev. Richard Young
I would have a difficult time keeping a white Lutheran pastor who used to be a doctor and has been here for nine years anonymous… and there is really no need to do so.   I met Dick even before I physically met him… He had arrived as a long term missionary just before I first came in 2002.   He had a big write-up in some Lutheran rag… that told of a hodgepodge of activities in which he would be involved.   I did get to meet him that first year and every year thereafter.    And after his move into the city several years ago, we have gotten together frequently… for a few beers. [Yes, I drink them all as Dick doesn’t.]  I could not really last more than three months here because I do not have the patience nor the spirit to deal with all the disappointments of inertia, but Dick has a wonderful acceptance of people and all their failings….. He is a pastor of the people here; he has a sense of call that emboldens his work even when it is a colossal failure – in my eyes. 

Enough of the pre-canonization propaganda….. I am sad:  Dick is finishing his ministry in Guyana for all sorts of reasons at the end of December.   And, of course, this means he will not be here if/when I return.  [Ah yes, my students, as I have said, “grief is essentially selfish” – at least initially.]  He will head back to his family farm in Oregon… and I will miss him.
And he has become a part of me – as Doc Young before him.  That Doc Young was a retired police surgeon whom my mother kept busy by bringing me to his home (next door) for treatment… I have a lot of stories – here's just one: I fell through a French door full of glass and gashed my head… and he stitched it up right in his kitchen.  Now that isn’t the point of the story…  The point is that he gave me a six pack of small Cokes and told me to take one every hour! 
From their Prison Shots of 2006
 



Annessia and Nathoya

These two had been my students a few years ago and were among those 19 fired/laid off by Mercy to “save” the hospital.    Well, Tony and I had a meeting for all those folks last Sunday and 6 showed up [I have seen almost everyone else in the following days.]  It was a good meeting of sharing and support and for a moment there seemed to be more of the spirit of the Mercy Family there than elsewhere.  It is strange – well, not that strange for here.  There was very little resentment at Mercy even though almost no-one had seen it coming.   It confirmed my “script” that there is a generalized despair….. like "Nothing good ever happens here in my life and why should this be different?"   Anyhow, they exchanged phone numbers and offered ideas of how they could use their strengths to get jobs. 
I had met Annessia after she had been fired and, like the others, was not all that distressed – at least not as much as I was.  (She had just received the award for the most improved student in her batch.)   Mercy had forwarded all the names and phones to other hospitals and major employers who might be looking.   Mercy nurses are still regarded as the best in Guyana and rightfully so…  So the next time that I saw Annessia she was wearing a smart looking pants outfit with a Bhawant Singh Hospital logo…..  She had been hired at another private hospital in Georgetown and for considerably more dollars.  And Nathoya is there too… I have not seen her personally as she is very short and I may have missed her in a crowd!
They are my children here - and the reason that I have come here.  I want the best for them that they can manage.  I didn’t realize how much of myself that I had invested in them….. all of them.    They had been pre-incarnated by those McMaster family members who were also given the opportunity to "free up their futures" by those who really had none of their own…  I remembered them (and me with them) going in a blink of the eye from loyal staff to potential corporate saboteurs.  Strange -- if I had a soul it would have MUMC branded on it….. for McMaster University Medical Centre, as it was then.

Another Nursing Graduate
Last week she had asked me if she could talk to me and I said sure ….. [As Anne just wrote:” …you can say no, sorry, not today as I’m too busy.  Oh, I forgot – you have to take care of your need to be needed ...... and I’m not kidding or disparaging; I do know that’s important for your soul.”  Soul? And she calls herself a Unitarian?]   This nurse eventually caught up with me to tell me that she will be leaving Mercy Nursing  - initially to stay at home with her three kids… Her second child was born at the end of her first first year in the school of nursing.   You see, if you are pregnant in the first year you have to leave. [I have not quite figured out this reasoning, but I am pretty sure it has to do with British decorum and all that stuff.]  Well, two years later she returned to start nursing again and became one of the few "two-timers" of my students.   I shall not use her name, though those who know her already know her story…..  Her own mother had abandoned her when she was small and she is determined that her children will have the sense of a mother who cares about them – even if it will be difficult financially.   I am sure she will return to nursing, in Guyana, but now a special season is demanded in her living.   She seems to be me ......  so familiar that she has to be me.  (When I stop coming here, perhaps I’ll have money for analysis!)
 
I may have another two-timer.  A bright first year nurse who has a child and is a single parent has had a cough for some time.  I had been after her to find a doc….. well, she got into line at the Public Hospital – as she has not been in the family long enough to get care at Mercy – and would still be there, except that, not having Dick’s patience, I paid for her to get a TB test done at Mercy.  And, yes, she has active TB, so she has had to withdraw from the school, as the first year students are only allowed three days absence…   So she has been at home and is now waiting for treatment to begin; hopefully, that will be sometime soon.   And the rest of us will need to have a TB test as they are worried about the spread.   I really doubt it as you usually have to have prolonged and close contact.
 
I have at least a dozen people left… I thought his would just be a short point-form thingy.  Maybe I should have a commercial break?   Okay one or two more, and that’s it.  

A Girl from St. Ann’s
Like the nurses above her story will be no secret here… She just turned 16; the pumpkin age for all girls at St. Ann’s to leave.   I’ll call her “John[Did you know that all the newborns whom I baptised dead or alive at MUMC and whose parents didn’t want a name for them, I baptized them John. How can one go to the kin-dom without a name?]   Well this John was going to be adopted by an overseas couple who had visited her and were captivated by her personality.  In the process of applying for a visa, it was discovered that John was Hiv+.  And the family admitted that they were not strong enough to cope and the adoption was cancelled.   John has really never recovered in spirit.   Sometimes the matrons wonder why she acts out… and sometimes the smaller kids have answered “John” when visitors ask who is in charge of St. Ann’s.   Anyhow, Sr. Barbara has allowed the older girls whose hopes of ever passing an exam are minimal to work as apprentices and John is working with a veterinarian.   So I promised to buy her a book on animal husbandry at the bookstore.   We [John, John and several of her friends made the trip] actually found a book on First Aid for Dogs, complete with all the gruesome pictures of disease and accidents. 

It was a successful trip and when I got home – guess what – one of the dogs at the parsonage or had a red eye.   So I took a digital picture of my guard dog humping my leg ..… and went back to St. Ann’s and asked for a consult from Dr. John, and said that I would pay for good advice for my  dog.   She was thrilled and so was everyone else – till she realized that she would actually have to read the book!   I am still waiting for the advice and as the dog in question is still barking most of the night it seems that the disease wasn’t terminal. 

I have no idea of how and if John will survive outside the womb of St. Ann’s.   And I remember feeling the same (though I don’t have Hiv, nor am I a girl) when I left Maryknoll and Catholicism:  I didn’t know if I would survive… and if I did as what?   I do think that there were some who would have given me the same odds as this John…  I can only pray that this John will survive with the blessings I've had.

Can you handle another?  Just one more?
Gold Coast Waiter
I took Dick [see earlier, above] out for a farewell meal before his dance card gets all filled.  He wanted to go to the Chinese restaurant that was a favourite of my favourite nuns Sheila and Theresa.  I will make the waiter anonymous not only to protect his identity but also because I have already forgotten his name.  I knew him and he knew me; and, we both remembered Theresa who could not leave with extra chicken bones for her Guyanese dogs who seem immune to the warning to never give chicken bones to dogs.   And he always tried to get a little free medical advice from Sheila…  I promised to remember him to Sheila -- who will remember his name.  

The long standing restaurant was pretty much a ghost town as the new and chrome and cool New Thriving Chinese restaurant had opened across the street.   He stood, polite and courteous, unlike me in most ways, yet I saw myself in him --  in a world that had passed his style by, where customers were valued for themselves and their stories as well as their dollars… and the tip is included in the bill.   I imagine that this is how all us older people feel and whether the new will be better, I don't know – it just will be.  At least we can remember and smile.    

There are more of me here... and many of you are me, as I am you.   Thanks for joining me this week.  For better or for worse.. I would not be here without you in my spirit and in my body... John


I'll do this as a PS so I don't make a liar out of myself.

My Adopted Son, Rashleigh, The Lecturer
We were exploring a paper problem of a young Amerindian child in the interior who was thrown into prison for a crime that wasn't a crime.  The students wanted to go on a field trip - naturally, to the interior to see a jail there - and the sights too.  I had thought that we could get a tour of the local facility but apparently it was not possible for a class.  So I remembered that Rashleigh had spent a few days in the Georgetown lock-up in his youth a few years ago.  I asked him if he would come and describe his experiences there - and believe me, you don't want to know!   I was very proud of him - mature and articulate and descriptive... very descriptive.   Anyhow, I had promised if he came he would make my blog this week; as well as, I took a couple of thousand (Guyanese) off his loan ......