Thursday, December 14, 2017

Closing out 2017 with a Few Thoughts

[Sorry, no pictures as the latest Microsoft Update wiped them out. 
So far their solution tells you that you shouldn't have done it in the first place.]

My First and Last Thought - Gratitude

I guess "Gratitude" is a feeling more than a thought or even an attitude.    I just know that is what I feel as I remember my Guyana time this year.    I wish I had a more complicated or sophisticated remembrance... I really do have many others:

Frustration - that I can never seem to accomplish as much as I want or thought that I could do in September;

Amazement - with the energy, drive, persistence, creativity [including all their unique excuses]  of "my" beginning nursing students;

Double Admiration -  for my colleagues on the nursing faculty.   I get lots of  thanks for coming so far... I do like the recognition... AND I am humbled in the presence of my "teammates"  who are really in the starting lineup everyday - Elsie, Candy, Roberta, Tracy and Yolanda.   [There are part-timers whom I admire and would name if I thought I could name them all.]

Pride  At first, I was congratulating myself for  being "Mercy's Executive Volunteer" now for over 16 years... And then the truth hit me!  By myself, I'd never have lasted.  I have never gone alone though I have stayed there alone.

My wife, Anne, has traveled with me ever time - though she has mostly found ways to avoid the mosquitos, the heat and the humidity.   Her traveling is done on another continent by enduring my neurotic needs for adventure and meaning and an almost total denial of my aging,  when it would be her choice for me to be beside her.   And she does it with love.

My larger family with our children and their children and well, not yet any children's children.   They miss me when they aren't doing their own lives - that is how it should be.   They do support my adventures, especially distracting Anne with their activities and achievements.     And they do it with love.

My friends and supporters,  who offer me encouragement with their words and donations [of course].  It is not the cash... it is what it means and I see that meaning every day I am in Guyana. I see:
  • tiled floors in the classrooms
  • classrooms that were raised a foot to stop the flooding rains from stopping classes,  
  • movable desks and chairs for both classrooms to accommodate small learning groups, not mentioning more comfortable on their butts.
  • retracting, solid room divider to have a partition between the classes,
  • and every student with a tablet to do their homework, research and yes, social media.
These and many others sights are  the meaning of your support.  As well, there is so much unseen.  Some of you give me money directly.  I call it my "beer fund".   However, there are so many more pressing needs - helping to pay someone's rent, transportation,  meals, debts - I don't even have enough left over for good night's drinking.  And they do it with love.

My fellow North American volunteers, those who have come down to work with me on PBL, I have undying admiration.  I started adding an interesting comment to every name; however, I realized that they are still alive! So: Tony Carr, Dennis LeBlanc, Sylvia Wilvert, Emily Flynn, Charlie Malcolmson and Cathery Lee, Andrew Alan, Beverly Clark, Marysia Donnelly and like the blanket statement in confession, "for these and all my other sins volunteers I have forgotten...  And they do it with love.

My Guyanese volunteers like, Derry Harry, Sandra LaRose, Ricky Chan who were faithful small group tutors.  This year we had more need for volunteers and some old students, now professional RN's signed up, and came in on their days off, for facilitating small groups all term - Vikram Suklal, Ginelle Williams, Tiffany Scott, Jon Daly, Mowava Rodwell, Lovey Lamont and even Ariel Williams.   There were others for previous years who we conscripted... who know who you are better than this old man's memory.   And they do it with love.

My Guyanese friends who support me in so many ways and are more like family.   My brother of a different mother, Bhiro Harry, who from the time he picked me up at the airport to the time he left me off there... he offers me physical - well, he likes beer , emotional and spiritual kindnesses.   My son-like friend, Taju Olaleye and his family Allison, Tommy and Althea - now a nursing student.  He is my importer - tablets, books, printers... all arrive quickly and safe.   He was also the Maitre'd for many of my visitors and friends at The Princess.     And then there is my personal banker, Michael Ram. I can give him a cheque, and instead of waiting for the 30-60 day wait to clear a foreign check,
 it is in my ATM account right away.   This is an enormous gift as anyone who knows my financial skills will attest.   As well, he lets me borrow an Lutheran Church in Guyana cell phone.  And they do it with love.

[Wow, this is getting longer than my planned introduction.]

My 2017 class of nursing students.   They are the reason that I come down every year.   I love to see how they struggle with new ideas and learn what they mean for their living.    They are certainly not saints, yet they are inspiring for me and I want to offer them my best because they are truly "grateful" for what I do, even if I am a little sarcastic or their exam marks are less than they expected...   And they do it with love.

Finally,  I am thankful to Everyone!  Yes, a little over the top and still true.   Almost all the staff at Mercy go out of their way to answer all my requests; this especially includes Maintenance, Dietary, Laundry, Information Technology and Administration, especially Debbie Ramsey and Helen Browman.    My "old" students greet me warmly coming and going to work, in the hallways, on the street...  I do feel that I belong there by each kindness. And they do it with love.

Basta! Enough!  I have left out great and important stuff, especially in the area of Psychiatry and mental health.   Okay so I lied again.  I want to write about my involvement with psychiatry there with Tony Carr, Peter Kuhnert and Shrenik Parekh.  I guess if I write it in January 20128, then this post will be my last for 2017!


Before I left, I asked several overlooked departments if they could tell me one thing that I could give to them that would improve their working lives at Mercy.     Of course, I was hoping that your would assist me in doing this.  So if you can, consider providing these and you can share my feeling of gratitude.

Housekeeping  - They needed a big fan for their office  in order to keep their new computer from overheating.   To show that I try and walk the talk... Anne and I brought them the fan.

Laundry - Must be the year of the fan as Laundry wanted a fan too, but more powerful.    Believe me it is the hottest place in the whole hospital.   I know that the fan costs @ $100. Cdn

Dietary -  They must be the most Guyanese as I am still waiting for their request.

Maintenance -    "Keith, I said one!"      He must think you are really going to be grateful.    He wrote, "Please see list below of tools needed for the Maintenance Department."

1.Power analyzer ( Department would able to do our own power analysis in house )
2.Heavy Duty  trolley ( moving heavy items around hospital .
3. Ampere Multi-Tester 
4. Combination driver set 1/2" and 3/8"
5.Temperature Gun ( ascertain the correct temperature of Air Conditioning units)
6. Carpentry chisel set 
7. precision screw driver set 
8. Solid joint , box joint and special pliers set
9. Random orbit sanders Screw driver bit set 
10. Combination Hex key set
11. Bolt Cutter
12. Rigid drain gun-kit ( Clearing of block sinks and drain )
13. Torx screw driver set 
14. Dewalt pistol grip drill 120 v  60 Hz 
15.18 volt cordless impact driver with driver set 
16. Dewalt  screw bits sets 
17. Electrical insulated screw driver set 
18. Manifold testing device for refrigeration 
19. Heavy duty sander 

I and they will appreciate what you can give.   Every little thing makes a big difference there.

Till next year.  Thanks for reading with me this year.  John

Sunday, October 29, 2017

Tony - The Master Doth Return

FYI: John has given over his blog to a colleague...  If you can only read his words they are in the next post below....   

Day 1:  Out of the plane into the early morning sun and blinding heat - forgot how hot the nights are here.  Nice man holding sign "Tony Carr" - ME!! - dodge the clamouring taxi-drivers and let him drive through the crazy traffic, windows open to enjoy the gestalt.  And it all comes back to me!  The roads, the stores, this is where we explored, this is where the special parts store is, this village is where .....  Wonderful coming-home feeling.

Where to, sir?  Oh dear, decisions.  Well, I need cool trousers (shorts are ridiculed here), and money, and milk.  But I need to see the accommodation to know what else.  And I'd better find out about tomorrow's work schedule?  Dwayne kindly decides, drives me to buy trousers ($6,000) and milk, and takes me to the Public Hospital.  

Bhiro (the chief, indeed the only permanent psychiatrist in Georgetown) arrives, fixes everything, Dwayne drives me to "Project Dawn" ... and now everything changes.  I walk through guarded locked gates into a different world.  Neat, painted and tiled corridors, beautiful hardwood floor in HUGE living-room, electronic keys, all clean and shiny and functioning.  Can this be Guyana?

L. (my star pupil from Skype sessions) drives me reluctantly to Taju's ("a very dangerous area, Dr. Carr, please be careful").  Ecstatic welcome from the Nigerian prince, then another from Rev John.  Sit in pitch dark on roadside patio, with a patron's car blasting unbelievably hi-fi reggae from the open doors, eat, relax, laugh - like I've never been away.
Taju, Tony and "Free Ice Cream" Nathoya
Day 2:  Lizzie's at the gate.  She lives locally, so drives me all along the busy coast road to the city centre twice a day.  Traffic is terrifying - like those pictures of Hong Kong  ...  plus occasional cows.

The hospital.  Young guy shackled to his bed, semi-conscious, b.i.b. police last night crazy on crack and pot.  Stares when roused, but mute.  L. shrugs - order more Haldol, move on.  Taller older  guy, off meds and crazy, talks to us - first guy laughs to hear his story.  Try to bargain a bit with him.  

A woman, 6' tall model, straight out of magazine, spotless hair/face/clothes/figure, lying casually on stomach looking resentfully at us ... shackled to the bed!  Replies sulkily to questions.  What?  B.i.b. police from juvenile jail?  She's a young teen who had a tantrum.  Maybe this is normal?  At least we took the shackle off.

A middle-aged aunt frantic cos the teenage nephew won't take his meds and then has psychotic outbursts:  she brings him every few months, we stuff him full of injection, and they go home happily until it gets bad again.  Agitated mother brings young man who abuses crack, goes crazy, gets sick, stops crack, gets better, over and over again.  What can we do?

A young man with his family.  He flies out in the work-crew on a Monday to the "interior" (jungle) for a couple of months (gold mining), chats to his girl daily by phone, returns for a week back home.  But last week he suddenly went very strange, ran amok, and was put on the next plane home.  Rational at interview but very odd, disinhibited, no memory of the crisis.  Sounds acutely medical.  Explain to  family this may be serious, bring him back if he gets any sicker.

The boss appears and buys us lunch!  Have worked up good appetite for beef curry and rice.  Then off to the gynae ward across the road.  Nice warm breeze blowing through the glassless windows, along with very loud street noises.  Very pleasant old lady who had a tumour removed 2 days ago - dementia/confusion - we discuss the need for another SW home visit, because husband is 80, no kids nearby, what might be in her fridge?

Home at 4pm.  Peep onto sunny patio but young woman glares back at me, so hide in my room.  Hey - Shanti (my previous piano pupil) has invited me to her daughter's birthday party - tonight!  Hastily buy store gift token as present, arrive just in time for huge family-and-church birthday feast.  Meet all the old friends from church 6 years ago, warmly welcomed.  Good food and endless pop.  Then a ride home from Tabitha (worship-leader), because my digs are right close to the church - aren't I blessed?

The gate-man here was a bodyguard for the first Prime Minister, after independence in 1966 - went to Russia with him.  (That was the genius who tore up the railroad to sell the iron to China.)  And my boss was the 2nd PM's bodyguard.  Security is tough here.

Went to Mercy Hospital to lecture, and got WARM welcome from an unexpected familiar face.  She was one of our students years ago -- now she's running the nursing school!  Did first talk, then used a glamorous student as model for the CNS, but the students were a bit quiet.

I've borrowed Taju's bike!  I keep it in Rev John's apartment - he carries it down the stairs for puny me - AND I located Winton, nice man in Maintenance from years back, and oiled it - even adjusted the saddle (what a relief.)  Borrowed shorts from John (one can't teach in shorts here) and pedalled down the sea-wall and around the park.  Huge jets of milk-chocolate seawater splashing up from the waves, great fun.

Working with the psych residents continues to be amazing.  Yesterday we saw a mass-hysteria girl -- an outbreak of "seeing spirits" at a girl's boarding-school.  And a tiny 12-year-old boy functioning exactly like a 6-year-old, mentally and physically.  And a schoolboy who was suicidal because the family are plotting to kill him.  And a mother so desperate about her immature, angry, druggie, now-pregnant teenage daughter that she got the local police to BRING her to the clinic.

Now a hectic day.  Got ride with Lizz to Mercy, got the bike from John, pedalled to the Public Hospital in rush-hour traffic!  (I walked all the dangerous bits!)  Locked the bike to the fence, saw patients with Lizz, quick lunch (popcorn and Pepsi again), leapt on bike back to Mercy, taught nursing students, got another Pepsi from canteen, biked back to Public, saw patient, taught the residents, biked back to Mercy, out to nosh with John, taxi home AND got him to stop so I could buy Crisp Rice, home by 8pm!  I'm getting good value out of my time here.

I played truant today to keep Rev John company.  Walked across town in blinding sunshine to Mercy ... er ... is that drops of rain!??  Almost my first ever in Guyana, I thought happily, crossing the road carefully - and suddenly it's Hollywood rain, catastrophic.  I'm in shirtsleeves and sandals.  So I shelter in a doorway, eventually get through to John, and kind nurse comes to rescue soggy me in her car.  Phew.

Bus driver is Rodney, drives steadily for 3 hours.  Beautiful scenery along the coast road, south almost to Suriname, lush green forest with LOTS of little villages with curious names - "La Raisonnable", "Quaker Hall", "Die Kinderer", "Just in Time", etc. - every few kilometres.  John explains these were originally sugar-cane plantations worked by slaves, and whimsically named by the owners.

 The bin ("Guyana National Psychiatric Hospital") looks like a Canadian pioneer village replica.  Started in 1850, and almost unchanged.  A smallish scrubby field with a dozen ancient buildings scattered around, some derelict, and a few peasants ambling oddly about.  Relaxed, quiet, dirty, hot.  The original hospital building is still there, huge, white-painted, wooden.

Have to badger John's students to talk to the patients.  (Come on!  How old is she?  Where from?  How long here?  Wants to go home?  Gets any visitors?)  Some get into the swing.  The rest show an interesting cultural divide:  the Indian students go mute, staring motionless in small groups.  The black students chat and giggle endlessly, ignoring the patients. 

Some of the patients recognize John from previous visits.  Turns out many patients have been here for around a decade - one or two recognized me.  Another was adamant she was going home "this week - Nurse promised me - I hope she doesn't change her mind again!"  All patients are discharged home if humanly possible.  The ones left here are "unstable", or the family refuses to have them back.  So it's mainly an old-people's-home.

On the way back we stop to show the girls the "Jumbie Tree".  Plantations liked to import a huge cottonwood tree for good luck.  (They live for 200 years or so.)  Legend has it that one of the slaves who dug the hole for this tree was buried with it as fertilizer (alive or dead, the story varies), and that if you feel the tree's enormous roots you can still feel his pulse.  It is known as "the jumbie tree" (i.e. zombie).  When the big coast road ("the Public Road", the main artery) was paved, the workers refused to cut down this tree!  So the road divides around it, traffic hurtling past.  Even now half our students refuse to go near it - in 2017.

Sunday in my quiet digs.  Tabitha calls re church: she has no car, so I will need a taxi.  Then calls back - the church is sending a bus to the Native Hostel up my road, she asked if the bus could collect me as well - and the bus driver is Rodney!  "I know Dr. Carr, of course I'll pick him up".  Church shows video of the founder's widow in India, a good message.  Get invited to lunch with Shanti, who plonks me into the senior Sunday-School class and leaves!  Managed to keep them awake and talking for the half-hour.

After lunch on her patio in a nice breeze (very tasty grey rice goo) she asks if I like playing games, and proceeds to beat me in 5 consecutive games of checkers ("draughts")!  Then I tell Shanti my favourite game is bridge - and she proceeds to learn it, fast!  Get a ride home with another church-member - they wouldn't let me walk the last 200m in a nice sunset - too dangerous!

On way to work see old man on bicycle carrying FOUR car tires, holding the top one down with his chin.  Do teaching session with residents, walk back to Mercy, John's not there, but his flat is full of nursing students studying with computers and discussing!  Take another bike ride along the sea wall, nice breeze to cool me.  Home.  Shanti calls, sends taxi, feeds me, piano lesson for daughter, taxi back -- a fun life!

Go out one day for supper with John and the eccentric chemistry Prof.  Nibble hot fried cassava wedges - yummm.  Almost get run over, my first time ever, outside the sports bar:  I will never again cross the road with two people (they suddenly ran opposite ways). 

Clinic (every morning) is always fun. Man comes home to visit mother from long spell abroad, with a LOT of money. Man becomes catatonic within days, and money disappears. Father flies in to rescue him, brings him to us, unable to speak, moves very slowly. Mother says oh, a cousin put cocaine in his porridge.  Medicine Dept won't come, has no time for nutters. Neurologist is "away".  A visiting psychiatrist comes up with a trick - Ativan abreaction - bingo, he talks! ..... and is psychotic, reason unknown.)

Marvel at the names here - they gave up "Christian" names before we did.  John's student nurses are (in order) Alica, Aqueeia, Asante, Ashana, Ayala, ... do you really want the rest?  

At the hospital a magnificent example of leadership skill.  The chief walks in with a crying lady staggering along, literally supported by her husband.  He interviews her very capably for 5 minutes ... then gets up, motions me to take his chair, says happily "All yours!", and leaves.  Now THAT'S delegation.

Down to the sports bar with John to see Chelsea play Crystal Palace. Great game, won by the Crystal Palace goalie! We watched accompanied by the best juke-box I've ever heard. Teeth-rattling bass, from a stack of speakers the size of a big wardrobe, playing 60's rock. I could live here.

A fun Sunday. Played hooky from church - Taju drove me across the Demerara river (a mile wide) to see his "farm". He's bought a 40' x 800' plot on a new road through a derelict sugar plantation (was worked by slaves - you can still see the deep-trodden gangways they carried the cane along). The land is crazy expensive. For him it's like having a cottage.

Perhaps the strangest patient.  He needed money for crack, so went to brother's house, but only the kids are at home. So he tries to take the 2-year-old's gold ear-rings off. She screams. So he throws her through the window, goes out, rips off the ear-rings, leaves her face-down in a puddle, covers her with a board, and goes home. That's a psychopath.

We arrange to take all 6 residents to the Grand Coastal hotel for a farewell poolside supper.  It caters to Americans, is very cautious about Guyanese people, and I have to charm each level of management in succession - yet they themselves are all local!  Our residents too are unexpectedly ambivalent - "you want us to swim?" Maybe we've got it wrong?  But I think they enjoyed it.  Guyana is truly an amazing experience!


Sunday, October 22, 2017

Last post from Guyana - In the Air Next Saturday

500 Years of Martin and a Lutheran Celebration
Coincidence:  Wayne Keddy
sent me this that very day.

I had to get up early at 4am to get to Ebenezer Lutheran Church New Amsterdam... I am usually up by 5 .....  So I set the alarm. Got up to take a leak and then check the clock; it read 4:01 - good timing.  I shut the alarm off, made coffee, read some, turned the computer on... and it said 1:15am.   I had not clicked the small travel watch back from Alarm Set Time .....   I went back to sleep till the real alarm at 4.

The Evangelical Lutheran Church in Guyana started on the east coast of Guyana in the area known as Berbice.   Now New Amsterdam is the capital with the headquarters of the ELCG and the National Psychiatric Hospital.  (I think that this is pure coincidence.)    So my friend and colleague, Peter  Kuhnert, left at 6 ..... to get there by 9 ..... and we got there by 8!  No traffic at all...

Shaneika at 12  - me at old
Shaneika at One

Shaneika's Baptism
I found a nice concrete bench to lie down on and have a nap.   I was awakened by lots of voices who were probably wondering who the homeless guy was...  As I got my bearings a woman asked me if I was Pastor John.   She then said, "Do you recognize this young girl?"   I didn't have a clue; maybe if I could have figured out who the first person was .....   A tall thin 12 year old girl came over, "I am Shaneika."   "Wow!  You are changed!" ..... a less than brilliant comment as she was a baby 12 years ago.   She has her baptismal picture on her bedroom wall.  

Meeting Shaneika was a joy, and to be greeted so warmly by her family was a definite highlight of the trip.    In a rash moment, I told the present pastor at Mt Zion Sand Hills, that next year I'd love to cover for her and preach up river there.   I do hope that Rev. Gloria will have forgotten that by next year for all our sakes.    Gloria made me a stole that was multicoloured and made from rags they tear up to make floor mats; it is my favourite stole.

The actual service was well attended and a rousing affair ..... at least for Lutherans.   There were persons from every congregation, including Sand Hills, which I think is the farthest from New Amsterdam.  They started in the dark, coming down the Demerara... I didn't dare complain to them that I had had to leave at 6.

The service was a true Guyanese blend of Guyanese hand clapping, Pentecostal songs, Caribbean Folk Mass and some Old Lutheran favorites,  They sang, "A Mighty Fortress is Our God".   And it must have been a sign, as it was sung at Maryknoll when we seminarians were invested in the order in 1967.  It was played with trumpets and organ -  a really rousing memory.  Back then, in our RC seminary, they changed the verse that mentioned the "Papist foe"..... and we did not sing that verse this week. either!
I might be hard to recognize with hair.
 There were so many memories that it even made the three hour service go quickly.   Everyone was dressed in red and was quite impressive.  The service started with a traditional march around the town, as a witness and to raise awareness of Lutherans.   I am not sure how much positive awareness we generated, but the (already impatient) drivers added to the celebration with their horns as they waited for us!   There were also  many friends who greeted me from all my previous trips to Guyana; I was impressed to be remembered so well.

I'll post a collage of the event; it will give you a feel for the celebration ..... and a celebration it truly was, with a good lunch, lots of greetings and at the end a Martin Luther Quiz with different teams.  I was disqualified from participating, perhaps because they were afraid I'd dominate the competition (!) so I was the timekeeper.    To let you see my Lutheran history skills:  one question was, "When did ML translate the Hebrew Bible into German?"  And I wondered to myself, "He did?"

National Psychiatric Hospital - Bearing Gifts
Pastor Rose and Peter
 Over the years, when the nursing students and I visit the hospital, I take lots of pictures of everything.  I am usually very careful of what I post online.  Most years, I have copies printed of all the patients that I have photographed and send them back by post from Canada.  I don't think they have ever gotten to any patient.   So this year, I had them printed here and planned to distribute them personally after the service. 

This worked out really well as there were two nurses interested in Mental Health in Guyana who were keen to visit the NPH.  We arranged to meet them there at 3:30 after the service.   Well, neither one showed up - ugh.  But Peter and I had met a local pastor Rev. Rose who was also a local health council representative and a frequent visitor to the hospital.  We had much to share and he was to be a great contact in improving mental health there.

While we were walking around the hospital and I was giving out pictures, a senior nurse there ran out to Peter and greeted him warmly.  He wanted to tell him how much he and other staff had valued his presentation last year on Restraints and "Code Whites".   He expressed a wish that they continue to do more workshops on his next visit. 

And there was a patient who remembered (from a few years ago) Peter and a chunky bald-headed guy (Ram) who distributed some clothing  to the men there.     And I met lots of patients who remembered me from years before.

When I handed out the pictures, the people were really amazed and grateful to see themselves.  The staff had said that they would just tear them up, but that was okay by me; I wanted to give them the pictures directly.  And while we were there no pictures were harmed in the process.   In fact. two interesting things happened:
  • First, as it was a little confusing with everyone crowding around , I laid the pictures out on a table or held them up one at a time.   Each picture was identified as "That's me!"  (There were a few patients who claimed that every picture was them, but their friends convinced them otherwise.)   They told me whether that person was in another section of the hospital or  had been discharged.   I realized that this really was a community that seemed to care about each other in a way I had not appreciated before.  They and I continue to become more human to each other.
  • Second, many people were mad at me!  I had not taken their picture and they wanted one now.  I do try to get permission, though I doubt it meets the demands of an actual consent.  Anyhow, I ended up taking another 50 people's pictures.   (I got them printed and brother Bhiro will distribute them when he goes next time.)   There is a women's ward that now prohibits men, but they too wanted their pictures, so I took them with my camera pushed through the bars. Then a group wanted a picture with me.  I guess that is why I couldn't go in; I'm irresistible.  

 Back at Mercy Hospital:  the Ethics Trial. 

Yes Jessie got convicted of murdering her Husband Elmer again for another year. The students are true pro-lifers... There are no exceptions for any lack of quality-of-life ..... Not for Jessie who was married lovingly to Elmer for over 50 years ..... She became a cold-blooded killer.  (Can you see how hard I am trying to stay neutral?)

The Cavalry Arrived

With one day of overlap Drs. Peter and Shrenik took over the education of the psychiatric residents from Dr. Tony.   They have continued the intensity and quality of education ..... and I even got into the act during one teaching session.   I would tell you more about what they have accomplished but I am hoping that they will feel the need to write a blog for me -- I mean for you!  Stay tuned .....

The Psychiatry Brain Trust:
John, Peter. Bhiro, Shrenik and Tony...not teaching.
World Food Day - No Classes

The first year get a reprieve from classes in order to raise awareness about food, poverty and healthy eating -- and they make money for a party later.   All equally important reasons.  My biggest problem was that no one made my favourite pickled onions!

Another Teacher from Canada

Nurse Rosie  a Guyanese psychiatry nurse, from our Specialized Mental Health Unit at Grand River Hospital in Kitchener-Waterloo.  She delivered several lectures at GPHC and Mercy.  The pictures are from her talk to the Juniors.  I don't get to talk to the Juniors as they have said, "You told us everything you know last year."    She came to Guyana with her dad, Sam, as he was making his first visit back after having left 45 years ago to attend a reunion.   I hope that Rosie had some Labba and black water .....

I think this was a "deportation hearing".

Thanks for reading... I'll write a closing blog, though not next Saturday ..... as Tony told me to bug him till he does one.   I plan on having a happy last week here .....  I wish you the same.  John

Sunday, October 15, 2017

Two Field Trips - Both Disturbing and Rewarding

Scary Till You Get to Know People

Right after we arrived... using the mini bus for protection.
Last week, we traveled on our first road trip to New Amsterdam about two hours east of Georgetown.  I realize how young many of our students are as many really have never talked to people who have psychiatric problems and who they see on the street or in the newspapers ..... violent, anti-social, non-communicative.  

Although Guyana is a small country, most of the students had never been to New Amsterdam or the  Jumbie Tree (see last week's blog).   It is wonderful to see how reticent they are when they first get there and how comfortable they are when we leave in a couple of hours.   It is still going to be a hard sell to get any of them to work there after they graduate.  In fact, there are none of my previous students who have ever worked there.   

I have only one requirement.  I pair them up with one patient and I tell them that they must stay with that patient for 15 minutes no matter what. Not long, eh. Almost all of them can't do it; they get too bored, too uncomfortable, too anxious.   Of course, being the old soccer coach, I throw them back.  Why? Because I want them to get a small experience of what it is like to be there... so 15 minutes is 1% of a day and 15 minutes is what percent of a year (if my sister Maggie was here she could tell me)?  Not very much, for sure ..... and then think about being here for 10 plus years... I'll let a student share her experiences:
Does this look like one student and one patient?
My first time at the Psychiatric Hospital was on 6th October, 2017 with (student) batch 70. The day started out rainy. The journey to New Amsterdam was indeed a long drive.  As we traveled along the east-coast highway, there were many small villages with villagers looking happier than town people. 

Arriving at the gate finally, I just wanted to get off the bus and stretch while waiting for instructions.  A man was walking towards the bus; everyone was afraid, and they all hopped back quickly in the bus and some used others to cover for them if they could not make it back into the bus.  This was the best part about our visit. SN X grabbed onto me extremely tight as I was in front of her and she was scared for her life.  Honestly, I was not scared; I was excited, and because of this SN X stayed with me throughout the visit.
The big guys: backs to the wall and grouped together for protection .....
We spent about 15-20 minutes with each patient that reacted to us, and tried to convince others to talk with us.  I enjoyed the company of D from ward D and J from ward C. D  had survived an accident that damaged her right-side brain; she had been in there for 25 years.  Her daughter would visit and sometimes she was allowed to visit her relatives but later got sent back to the hospital ..... D looked physically healthy; she seemed polite and friendly. She had packed her clothes and was waiting to go home because she does not like the hospital.  She also has problems standing up for long. [Her family is not coming.]  J in ward C greeted us with a friendly smile and began to answer my questions. She told us she used to sell drugs and to my surprise J said she is only 1 year old and is the mother of nine boys and she doesn’t have any friends in the ward. J looked creepy but had a wonderful smile that reminded me to smile too.

I found out that most of the patients wanted to go home; they were non-violent ; have no visitors; are able to give us some information about themselves.  The population was mostly elderly persons who said they were between ages 1-12 [very interesting].  The layout looks very uncomfortable, with no proper sanitation, and the food looked awful.

Our visit was just before Mental Health Week which was observed under the theme “Psychological and Mental Health First Aid for All” and because of this, preparation had been done and we got to see the creative side of the patients; they had beautiful crafts, shoe bags and pot holders.

The New Amsterdam Psychiatric Hospital is a community that works with patients of all kinds of mental illness and disability. They are observed and offered medication as treatment. The environment is very welcoming to an outside but the surrounding is nasty. I never neglect people but this trip taught me to always ask questions and to be aware of people because not all mental problems mean MAD.

Our last visit was to the male admission facility. The men weren't so aggressive and the place seemed more clean and less smelly. Two of them however were in isolation. Here we met Akeem who was a previous classmate of one of my batchmates. He explained to us that he was hooked on pills and his parents just sent him in here to teach him a lesson and he's leaving soon. It was unfortunate to see how two persons from the same classroom took two completely different paths.

I realized that mental illness finds a way of touching us ,because this does not only affect the patients, but also their families.  If any of those patients was a family member of mine , It would have hurt me even more to see my family in that state of mind and place.

It was something I wasn't mentally prepared for, even made me question my choice of profession for a second , but it made me realize how important my job as Nurse is, how much society needs me, the difference I could make, the lives I could touch and influence, and just gave me an idea of what to look forward to and of what is to come!!!

The best part of the trip... Lunch at Chicken Heaven
The Dreaded Day Had Come

The Before .....
I have been taking students to see an autopsy for many years; it now has entered the realm of legend, almost paralleling the horror tales of jumbies.    The upper batches delight in scaring the newbies as soon as they arrive by telling them that one day they will have to go to the morgue, "so be prepared".   During my first class with the first year, someone will ask me, "Are we going to the morgue this year?" "Do we have to go?"  "Yes", I say.   They have been anticipating the scary unknown with increasing anxiety ..... and it was to be on Friday the 13th.  What could be better?

They all write reflections after the experience as I find it a good way for them to get hold of their thoughts and feelings by having to put them as subject-verb-object... even though their English is even worse than mine.  I have attached a few student reflections:

And on the long walk back, I buy them a pop.
On the 13th October, 2017, I was given the opportunity to witness my first post mortem at the Georgetown Public Hospital Corporation.   Although I was scared to witness the operation, I was able to contain myself minutes before entering the operating room. I would describe my experience as breathtaking and unbelievable. The amount of lifeless bodies just lying around was shocking for me. I was only expecting to see one corpse in an enclosed room.

After a brief introduction by the doctor, he then began cutting a thirty-six year old female down the middle of her body. Seeing that made me feel a little weak. My thoughts were all over the place.  I wondered about what her life was like before she died, if she was a mother, her children and even how she felt as she was dying.  It was a very sad moment for me, but due to my curiosity, I was forced to look even deeper. 

The internal organs of the human body reminded me of the organs of a chicken.The size was smaller than I expected. I was told the scent of the dead would have been unbearable, but that wasn't so.
The corpse had suffered third degree burns to the posterior part of her body. I was puzzled as to why the doctor still needed to perform the postmortem, but then after he explained, I was able to understand. 

My experience today was unforgettable and very emotional.   Although I am more knowledgeable as to how it's being done, I don't think I can witness a postmortem of a family member, or with someone I knew or had spoken to.


I imagined that a morgue would be a clean, well ventilated area, but to my surprise, the Georgetown Hospital Morgue was far from that. The first thing that I saw was a body fully exposed. I really didn’t understand why. I noticed that there were a lot of dead bodies all over the place. It made me think about my late grandfather. I started to wonder if he was like those persons. One of the workers was opening a skull, so we can get to see and feel an actual brain and while cutting, he almost stepped on the head of a body that was right at his feet..

Apart from that, getting to see the parts of the body with the naked eye was pretty cool. I actually got to feel two kidneys and differentiate between a healthy kidney and an unhealthy one. I even got to see and touch a real heart, and a real brain. Basically, getting to see all the organs that I have been learning about for years was pretty awesome, but the condition of the morgue was horrible. This is an experience that will probably affect me for life and also give me a broader understanding of what the organs in the body actually look like.

After they write their reflections we talk about it as a whole class.   Some are too emotional to speak at first and some stoic, but all have been impacted with the good opportunities to learn about human bodies, the fragility of life, the importance of relationships with family and friends.   The other universal is the upsetness with the lack of respect for the dead, as well as the crowded and dirty conditions of the facility.  

As I am fond of saying, "Many things are true."   Yes, the conditions at the morgue are not up to even Guyanese standards. And Guyana is a poor country with limited fiscal resources.   So where does one take the dollars from to improve the care of neomorts in Pathology?  From Obstetrics? Psychiatry? Emergency?   There are no easy answers to really great concerns.   

Faculty Member Roberta Binda poses with the 2017 Survivors

St Ann's Girls

I still get to see my girls at St. Ann's though I have spent a lot of my time trying to keep their old computers operating.   I used to say that you really can't screw up a computer because you aren't smart enough to do serious damage; however, that was before the little girls there got access to the machines.  They have no fear of the machines - or the matrons-- so they unplug stuff and replug it in somewhere else.   This week there was no ethernet cable and it was there last week.   Anyhow they still enjoy my cameras and so they enjoy me.

This week I was the subject of much of their discussion.   They concluded that I could use a plastic surgeon to get rid of my chin waddle and the bags underneath my eyes; a hair transplant specialist; and a good barber to get rid of nose and ear hairs... and their list went on... They were brutal.   So I quoted a Guyanese proverb: "Mannish puppy nah live fuh turn daag."

        Dr. Tony & One Big Kiss (Not Dr. Tony)

Tony hosted a swim and dinner celebration with his psychiatry residents.

 My long-suffering companion (or maybe it's me who has been long-suffering) Tony Carr will be finishing up his three week stay, mainly educating the psychiatric residents at GPHC and coming over to teach at Mercy many times, on Tuesday.   Certainly all his students will miss him terribly as he brings a unique blend of knowledge about medicine/psychiatry and enthusiasm to everyone he encounters.  He has promised to write a blog after he gets home.

/He only posed with his student  nurses - no dinner!

And the kiss... and more (but this is a wholesome blog)

This October 16th will be my wife Anne Treadwell's birthday, and it will be 15 years since I have been home for her birthday.   I can't say she has never mentioned the fact, but she has never asked, demanded or hinted that I stay home and not go to Guyana.  And it has been through the whole course of our marriage.
This was my proposal long ago
and I'd do it again today.
I get lots of credit for travelling here; however, credit also goes to Anne for supporting me in my travels.   I have been lucky and blessed in my marriage.    I do not know how to thank a partner who lets you run away and save the world for three or two months every year .....  I will just say, "Thank you, my partner and wife, Anne."

"Happy birthday my dear Annie.  Love John"