One More Week and I am Ready - to Go!

          Next Saturday at this time I'll be jetting home via Toronto and I am looking forward to it.   It does seem that my three months here is just about the right length: I have told the students everything that I know; chicken has become a four letter word; and my patience - while improving with age - has pretty much evaporated.  The cafeteria opens at 8:00 or so the sign says... at 8:55 this morning there was still no sign of life!  ... despite the choruses of  "Just now, Father."  The noises of construction generators, cement mixers, electric saws, trucks, fade into the background noises - until they stop, and then you realize the pleasure it is when you no longer bang your head against the wall.    I know that Tony and I will run to the finish this week, making the most of our remaining time -- and if I were leaving this week, I'd probably have had these feelings last week!

          I thought that you might be interested in how the students reflected on their morgue visits.  This is pretty typical :

 

          We have started our last PBL problem, "Sabrena", which we finish on our last teaching morning, Thursday.  I think that I have convinced Tony that we do not have to include that day's exam in their final marks set for that afternoon. [Say a prayer that his neurosis doesn't get the best of him and me!]

          Tuesday morning, we had guests from the National Commission on Disability come to do a presentation on the recent act and its implications for everyone in Guyana; they also offered very practical advice on how to deal with people with various disabilities.  [I had mentioned about not waving to my one-armed brother when he is water skiing.]  I had prepared the usual certificate for our guest presenters and had listed their presentation as "Increasing Sensitivity to the Needs of the Handicapped"..... an insensitive faux pas...  I was going to just rip up the certificate, but they took it ..... and I promised to say disabled the next time.  

          The act is in some ways paradigmatic of Guyana.    It is an excellent and progressive piece of legislation with almost no chance of ever being implemented .....  For example, when the "kokers" [See Endnote: Now I feel like a professor.] didn't close one morning, I had to wade through 6-8" of water on my way to class --  all wheelchairs would have needed pontoons!   Oh well, the intent is excellent.  And all the speakers were excellent; the students learned much.

         That afternoon, we did our OSCE [Oral Structured Clinical Exam]  They worked in groups of 4 and had 5 new problems at five different stations with ten minutes to discuss each problem, including feedback from the examiners.  We had three faculty who enjoyed the experience -- so who knows, maybe they will try PBL.....  I can dream!  The student teams did very well and received good grades at all stations.  One staff examiner thought that they should really know more if they were going to be RNs, but she changed her mind when she found out they had begun their education less than three months ago.   They have done very well.

          I was preaching last Sunday for the Annual Harvest Home Services at Epiphany and King of Glory churches.  I was supposed to do Ascension Church as well, but that one got cancelled.  [I guess they had a better offer.]   I had a good time and talked about "gratitude" at Epiphany and I did a Reverse Offering.  I passed around the offering plate and everyone took a quote about gratitude - no money and no sweets!  Hey, at least I liked it .....

         Then Kampta and I walked over to the bus in the West Ruimveld Market [Pics in the slide show.]  It is a very advanced Drive-Though Super-Market!   When we got to the West Bank there was no one at the church.  It seems that the government party was having a big rally with speeches and free stuff and entertainment and free transportation at the same time as MY service.   Well, Harvest Home got postponed for a few weeks and I got to talk to the remnant!  

 Yes, that is a floor mop, but to be fair Aunt Glory did clean the altar before the floors.

          I did a talk about how the Guyanese and the Israelites had similar histories.  The first lots of Indentured Indians came to Belle Vue where King of Glory is located.  It was also one of the worst plantations for Indians.  One official wrote in the same year they arrived:

"The spectacle," he writes, "presented to the observer, in the sick-house was heart-rending! The house itself was wretchedly filthy, the persons and the clothes of the patients were filthy also; the poor sufferers had no mats nor mattresses to lie on; a dirty blanket was laid under them and their clothes wrapped together formed a kind of a pillow.

In one room where there were raised boards for the accommodation of seven persons only, eleven were confined -- four of them lying on the floor. The squalid wretchedness of their appearance, their emaciated forms, and their intense sufferings from disease and sores, were enough to make the heart bleed! In the second room were found a worse class of patients. The scene in this chamber beggars description; out of the five confined there, two were dead, and one of the remaining three cannot long survive; should the others ultimately recover, it will be by a miracle -- their bones appeared ready to protrude through their skins! (these three died shortly after.) When the magistrate inquired by signs of the miserable creature who appeared to be near death, what food he was allowed -- he pulled out some hard brown biscuit from under his head, and exhibited it!"

          In the liturgy that day, we were celebrating the land that the Lord had given, and rejoicing in it.  The human spirit has amazing resiliency!   And those adults in worship would have known family who were indentured there! 

With the political rally happening at the same time, I did wonder about the similarities between religion and politics:  both seduce believers with promises for the future that one never lives to see!   At least with religion, they tell you that!

          I did a lot of Genealogy look-ups in earlier years, but this year I got one request from a big donor to Guyana Christian Charities, so I had to suck up and go do some research.   It is a good thing I knew at least that they were Catholics from Georgetown because it is impossible to get any research done at the Registry Office.  It is even worse than a few years ago!  I did find one link that I was looking for and that helped them find the grandmother's half brother in England... who is still alive.   I love happy endings -- and before I get any more requests ..... I quit!  I am leaving on a high note.

          Another high note is that we had a "boys' night out" - except that Marysia came along!  Women constantly boggle my mind.  Tony and I had tried to take Marysia and Claudette out to dinner to say thank you for all that they had done in the PBL programme.  They both told us that no thanks were necessary and they didn't need to go out to dinner.  Marysia's husband Ian had wanted to go out drinking with me, so I got him invited when Bhiro and a Cuban Cardiologist were going out on Thursday.   I told Marysia to invite Ian -- and she couldn't believe that SHE wasn't invited.   Now this was the same woman who earlier didn't want to go out at all !   So we invited Marysia in order to preserve Ian's marriage -- or at least some of the matrimonial benefits.  Lara, the cardiologist, made my night:   he knew Ché Guevara,  my hero from university days!   

          And when I tried to pay (as Bhiro had picked up the tab the last time) he said something like, "It is my honour to recognize you who came here as volunteers to help Guyana."  I was very touched.  And it was probably a good thing as a few of the crowd drank a lot of some 25 year old rum.   I still got a warm welcome from Faustina who had my Parbo opened before we sat down.  [Yes, another sign it is time to go -- she might yield to temptation next time.] 

        Tony couldn't make the Mens' Night because he was getting revived.  The church that he attends was/is having a series of Revival Services and he wanted to help the choir and the keyboardist, a piano student of his.     I did go to the opening night of the Revival as it is Tabitha's church and she is always most welcoming to me each year.    Their founder, Joshua Daniels, is 80 plus and still going strong.   However, his understanding of Christianity is much closer to Tony's than mine.   [It actually may be closer to almost everyone's view of Christianity than mine.]

          And now it is close to lunchtime!  Thanks for reading ..... and remember, there are more pictures in the slideshow above.   This is probably the last blog from Guyana; I'll do a final one after I am home.
Endnote:  On the advice of my editor.   Kokers are dams that control the flow of water into the city from the back dams/rivers and then on to the ocean.   The ocean ones are open at low tide; however, it opened at high tide and since the coast is below high tide levels.... flooding!   And in most places this is still done by hand!

  

And the Big News is...

A first for my time in Guyana:  never in my nine visits has so significant an event happened in Guyanese history .....  Are you ready?  Drum roll, please.

Guyana Golden Jaguars beat Trinidad and Tobago 2-1 to proceed in the group play for the 2014 World Cup in Brazil!



And we were there on the pitch...well almost.



Denzil, one of our nursing students, served as our host for the game. 

Last night, we were at the National Stadium to see Guyana beat its arch-rival Trinidad, to go through to the next round of the2014 World Cup for the first time in its history.   We were picked up and driven to the match by one of our more enterprising older students - Denzil Hernandez.   He used his taxi-driving skills to get us to the game on time and on the only road ..... it could rival the Long Island Expressway or the Q.E.W. from Toronto at rush hour - except that some of the road is just dirt.   He had arranged for our tickets and was going to get us our official yellow Jaguar shirt, but the scalpers had put up the price to $2,000 Gy [$10 Cdn] and he was not paying that much for a shirt .....  I thought about our NHL jerseys! 

The National Stadium was built for World Cricket a few years ago ..... and we entered through lots of security and pat-downs as they were looking for guns.   Once we were inside, Denzil led us to the field entrance with a short piece of BS about who the two old white guys were... and I guess we were now medics as we sat with the ambulance.

Looking the part.

I love watching soccer from ground level as one gets a sense of the speed and power of the young players...  It reminded me of my youth -- although actually I was never a very good  soccer player, even in my memory!   Guyana played a good attacking game and TandT was content to sit with four at the back until they went 2 down in the last part of the match... and then the referee gave them  a mercy call outside the box so that they scored in extra time.   I have mellowed some and was not coaching as the referee gave 90% of the 50-50 challenges to TandT -- I just noted it as an observation .....   Of course, old coaches never really die ..... and I had my very helpful opinions, though no one asked me for them.   We ran into other students and people we know, though Denzil was clearly "the man" as he seemed to know everyone!  

The parking lot had cars parked bumper to bumper, six deep .....  it was unlike the parking at the Polo Grounds in Wellington, Florida, where my sister lives .....   And just for good measure, Denzil's brother and his wife were there, so we fought through traffic going the wrong way to drop them off, and then back through gridlock going the right way.   We were back before midnight, dropped at our gate by our chauffeur.    A great night ..... I have always liked winning better than losing!

And speaking of winning:  Tony designed a test for the PBL sessions that we did in Anatomy and Physiology, on "the knee" (remember the blackboard diagrams?).  We gave it to our first year students and to the second year students who had the traditional pedagogy ..... AND .....  I think the results will really interest you ..... when we publish, eh?   Or, God forbid, you might have to read Tony's blog to see if he leaks the results.

This was another week over-packed with responsibilities, both in the classroom and in our social life. We had to "steal" a few extra classes to get all our PBL pages completed so we can get home to our special, loving, gracious, talented, beautiful, supportive, etc., wives on the 26th of November.   The students are seeing us very often -- I hope that familiarity doesn't breed contempt.   So far they are playing well with us and seem engaged in all our efforts.

Friday saw us all meet at the Public Hospital Morgue, the Rite of Passage for all First Year Mercy nurses -- at least since I have been there:  the visit to the autopsy lab of Dr. Nehaul Singh, the chief and only pathologist in Guyana.   (On the first day of classes the students ask, "Are you taking us to the morgue?" sometimes even before they know our names .....)   As in all other years, this year there is a range of students from petrified to curious...  There were some who had their gloves on as soon as they got there and some who found it all a little much ..... including one student who was trying for an Academy Award in the Drama category .....

This year there was a Guyanese pathology resident who spent a lot of time with the students showing them all the internal organs and cross sections.  Almost all the students participated as he suggested -- after the organ had been removed from the body.   He was a most excellent teacher, and I said a short prayer that he will consider staying in Guyana when he is credentialed.  There have been others before for whom I had said the same prayer, but the salary dollars overseas seem to them more like heaven than just another country.  I know if had asked him he would have said, " I need to feed my family."  And thus spake Qoheleth!

We returned to the classroom without any fatalities and spent the next two hours in an engaging discussion of life, death, body, respect, smells, suicide, lack of resources, amazement at the "insides" of real bodies, fervent promises to study anatomy harder -- and to get back on diets so as not to have all that fat showing when they hit the morgue tables.   It is truly a rite of passage as they will not be the same again -- hopefully!  

The organs that they explored in detail were those of a young woman about their age who had killed herself by ingesting poison.  The poison of choice was farm insecticide -- and you don't want to know what that does to a body.    The despair of the woman got hidden in the science talk, but all the class knew it was there.    I suggested that she had given them gifts... the chance to see the wisdom of the body, the reflections on the meanings of living and dying, what is precious in life, and why they are not going to have tomato soup ever again!  I said that if they can remember some or any of it, then as another old preacher once said (actually he said it so many times everyone lost track) then her life will not have been entirely in vain.  She has been our teacher in death in a way she could not accomplish with her life.   It was also Remembrance Day .....  I hope the students will remember her, as I remember Jim Bishop, Boston City Morgue, 1968.

Walking back from the morgue... and stopping for a pop at Paul's - a tradition.

Reflecting on life and death and nursing

We also had an "ethics trial" in which Dr. Tony was the Honourable Judge.   The students reflect on a case of assisted death and on whether they understood the actions and whether they might ever do the same ..... and how the ethical principles that I have been beating into their heads might apply - autonomy, justice, etc.   Then I assign roles -- such as the wife who kills her husband -- and we even bring her husband back from the grave, as well as a defence attorney and prosecutor, so that every student gets a character.  We even had Jesus appear before the court!   (He could only talk in scriptural quotes.) 

I get the most satisfaction out of having the people most violently opposed to the killing be the wife or the defence attorney .....  stretching their minds, eh?   They were very imaginative and dramatic, if not very reflective ethically -- well, you can't have everything.   The jury ruled that she was innocent because she wasn't in her right mind.   The decision reflects the ambivalence of society in general to "mercy killings" and the 'mercy killers"... It doesn't seem "all wrong" nor does it seem "all right"!

This was a week with a death theme. It was not only the morgue, but in our paper problem young Rajah is dying from an astrocytoma, and we had also visited the funeral home.   Mr. Claude Merriman described the roles that funeral homes play in the practical side of dying as well as the psycho-social supports provided to grieving families.    The students were disappointed there were no bodies in the cooler, but they did get more than enough the next day at the morgue.

One similarity with northern funeral homes is that you have to walk by the expensive caskets first before you can find the cheap ones.

We took one of my young girlfriends, Johanna, out to a fashion show.  I had promised to buy her a burger, but thought that she'd like the show better.   Now she has a lot to ask her parents to put in her stocking for Christmas.   Tony and I  were more preoccupied with the models -- and of course how much they reminded us of our wives .....

I forget whom she looked like more .....

Johanna with a runway seat.

 And to continue our full social life we were invited to join Tabitha and Sekhar as they had invited a dozen or so persons from their home state in India, Andhra Pradesh.  They had prepared traditional Indian foods so the new people wouldn't feel so homesick.    (The food was very good, but we need to work on our Telugu language skills ..... )  All the guests except us had come to work in the Information Technology  areas.

Almost like Pubnico -- the women were all huddled on their own.

And since my butt is telling me that I have typed long enough, just a final word about the girls' pictures from St. Ann's.   I have come to grips with the truth that they love my camera more than me .....  usually they take a couple of hundred pictures each time I am there; however, this time they took more than Aldric at a concert (Pubnico reference) -- some 400 plus!  I have trimmed them down to a dozen or so.

Tessa [left], a Mercy Grad and a St. Ann's Grad.  She was in my class longer ago than either of us could remember.  She was visiting her sister, Marissa, who was feeling under the weather.

Finally ....... Did I mention that GUYANA WON?
Thanks for coming this far...  John.

Rains-Runs-Reflections-Repentence-Remedies

Do you remember the picture of Tony huggingly hoisting Ms Williams in the air?  (I understand that his wife still remembers... and I can't repost it- something about false representation.)  Well, he damaged his shoulder and was in considerable pain.   He has his arm in a sling and this has drawn much sympathy from all his admiring young women - until I tell them that it happened in a rum shop brawl when he fell off the wagon!   (I love it when people believe me.)   There may be a moral here for all old guys:  It is either "The gods answer wives' prayers quickly" or "One should act one's age".  I think that the former is a better moral truth, as it is impossible to believe that we "old men" could act our age.

This was my excellent sling that was later criticized as, "What idiot made that?"

As for me... I did have a case of the "Georgetown Stomach" that came and went over a few days.  I self-medicated by popping a few Immodium a few hours before I needed to go farther than ten metres from my namesake.   [No picture included here either.]  And yes, I know it's not the best treatment, but it worked.  Now, I am not sure this offers any moral lesson as my indiscretions tend to be along  the lines of Jimmy Carter's  -- though come to think of it, those did lose him the White House.   Do you ever wonder why it is easier to see moral connections in others' actions than our own?    Another kindness of the Creator.

Our friend, Deacon Kampta Karran, who is famous for his creative ways to get favours out of us for the Lutheran Church here in Guyana, asked if he could present to our students.   He wanted to know if we were interested in having them explore "Bush Medicine" and its relationship with "Western Medicine".   Sure; and besides, any presentation by someone else is one less for us.   Kampta is Guyanese and he related to each of the students in a way that Tony and I will never match no matter how many more years we return.   He demonstrated his Oxford training and his breadth of knowledge of the subject.  The students loved it and him.  And now I know something about  na-jaar,haz-lee, suk-an-tee, na-ra, hook, chat-kay, gan-daz.   Almost all the students knew most of the diseases and remedies he named.  This medicine is alive and practiced.

Kampta "curing" Stanton of something

Now rain is not a news item here (nor for that matter in Pubnico either), but you have to remember that I now live on a construction site and because of the climate changes here the seasonal rains now come much earlier and more unpredictably.  The construction team has lengthened their 7am to 5pm six-day schedule to a 7am to 10pm one in order to get the building completed enough to work indoors so the rains don't interfere with the construction.   Tony and I admire their commitment and can cope with two gas powered concrete mixers serenading below our windows from 9 to 4, but starting on Sunday at 7am stretched our powers of appreciation.  I told the foreman that I had read lots of Guyanese history and even the slaves got Sunday off!  He assured me that the workers did get an overtime differential though he refused my request for similar payment to Tony and me.

 The rains have reduced our pathway to a pond of various depths from 2 to 6 inches.  We do have a pair of boots between us - mine.  However, Tony is more sensitive to germs, bacteria of all kinds, positive and negative, fungi, worms etc., so he got the boots and I walked barefooted.   Tony assured me that "if" I got to the kin-dom, I would get a bigger reward.    And he does let me wear the boots when I go get our supper for both of us on account of his shoulder.

I have been reflecting on our PBL experience this year and I can't help but feel extremely blest in almost every aspect of the programme.    When I first heard that Mercy had accepted 24 students (the final number came out to be 20) I could not figure out how Tony and I would get the small groups managed without killing ourselves.   And then by one of those coincidences that go by many names - fate, grace, luck - a nurse from McMaster, Marysia Donnelly, was to be here with her husband, Ian, who was a VSO/CUSO volunteer -- she was just an accompanying wife and got hold of us wondering if we had anything useful for her to do -- and did we ever!  She has been a tutor with us faithfully and skillfully since the beginning - and it looks as if she may make it to the end!

Marysia Donnelly received the Best Tutor Who is a Nurse award.

 And some of you may remember a doctor that I had met last year who was wanting me to lead a Catholic Youth Leaders session on sexuality -- until she heard me voice some slightly unorthodox views.   This doctor was also the first Dean at the new Medical School at University of Guyana, and had implemented PBL there after training at Maastricht University.  Claudette Harry also had a work history that took her all over the Caribbean.  On a whim, I emailed her and asked if she wanted to give us a hand; she has responded by giving us her whole self.   She has been a tutor all semester; this is a job she has added to an already full schedule.  Now I wouldn't call her an "old woman" as that has the wrong connotations, but she has retired more times than you can count on one hand.   And she doesn't even take naps like me ..... Amazing.

Claudette Harry stares in disbelief at a student answer.

Now these two would be blessing enough, but the individual netbooks and the additional computer cafe have been such a wondrous contribution that a comparison between last year and this year is almost impossible.  It is also impossible to name all the donors -- nor would many want to be identified -- but your generosity has made a huge impact.  All of you who contributed should have received a thank you letter from one of the students.   If you haven't received one, I hope it's the knowledge that we are grateful that counts -- and I have brow-beaten them all about sending them.   We will blame it on the post offices.

All of the computers are still in the possession of the students; some have needed some repair and a spare part. We may have one that the company is willing to replace though we would need to send it back to Hong Kong ..... So the company will let us try to fix it here without voiding the warranty -- nice.  And then if we can't, we'll send it back.

 

The students have taken to the netbooks like ducks to water... well there are a few Luddites who are moving slowly.   However, most do their research on their netbook and maybe half have net access at home or at a hotspot.  The upper classes use the cafe ones and never cease to remind me that I did not give them a netbook, but their death threats on my life have lessened.    And don't worry, I do not plan to come back begging for next year's first year students ..... I hope to be able to secure a grant from a foundation as we can now demonstrate effectiveness!  So if you know of such a granting agency, let me know.   And thanks for making this year possible.

The students have become skilled searchers and able to differentiate between good information and the wackos.  (Their increased efficiency also allows them more time on Facebook as an added bonus for them.)   They have started sharing information with each other from their research via email distribution lists, have used their netbooks in the small groups to show diagrams such as anatomy to illustrate their learning, and submit evidence to us when they feel that they did not get full marks for an exam answer and we are wrong.  By the way, we are never wrong; however, we reward their assertiveness -- and acknowledge that occasionally maybe they gave a slightly better answer.

Jomol demonstrates the intricacies of a knee joint.

I could go on, but I am getting Butt Fatigue... a sure sign that this blog is long enough.   We have had some disappointments but they are small compared to the good things.   And it is a good thing if you have read all this... Thanks, John.

I am sure you can identify with this unnamed student.