Time Goes... that is all.. Last week ahead.

I can't believe that I have been here for over 7 weeks.  Where did my time go?  Actually, I think that I say this same thing every year.     There have been a few bumps...no internet for 5 days to start and then pneumonia knocked me out for a week...   I have been feeling better each day and now feel as good as ever.     All in all I have accomplished a few things and many people here have given me much.  So a few memories before I head North on Saturday.

National Psychiatric Hospital Visit - Annual Pilgrimage 

Thanks to a generous grant from Mental Health Without Borders we travelled to Berbice and what is still called "The Berbice Madhouse".    The trip started off late as one student thought she could leave her home at 8:00 and get to Mercy by 8:00 .....   The delay had us miss the bridge opening [for ships], so we stopped for junk food and pop. and then we visited the Jumbie Tree .....  It is a Cotton Silk Tree that was in the middle of the main road and workers refused to cut it down or else they would have bad luck till they died ..... and today it is still in the middle of the primary highway. 

There were some students too scared to leave the bus ..... not that they believed in any of the jinx-living-dead stuff, just they weren't taking any chances.   Others had to explore until one of the students cut her hand on one of the large thorns on the tree .....  I may have hammed it up a little.  I asked if she was sure it was her blood or blood of one of the Jumbies who inhabit the tree ..... or even of the slave who was buried alive as a good luck fertilizer when the tree was planted.

It was a little late when we got to the Hospital, but everything was ready for us .....   In my defense, the reason we take the trip is not for a road trip, but to get some direct experience with people who have some mental illness.   I start on the Chronic Women's Ward ..... and each student must spend a whole 15 minutes with one patient.. chat, follow, do whatever they do .....  And for almost all of them the 15 minutes is too long ..... (Too long?  Some of these patients have been there for decades .....)  I drag them back ..... and back again.   I am a little sadistic sometimes ..... There is one woman there who has some neuroleptic side effects of her medication and she just sits and rocks .....  So I got one of the anal-rational males and put him with her..   He stood while she rocked and she didn't answer him ..... so I sat him down next to her and had him mimic her rocking --and then she talked to him!

I ask my students to write a reflection on the day... One will appear on MHWB web page and one is here .....

While the Rev was pairing us up with the female residents. I grew increasingly fidgety, scared and nervous as my turn approached.  I was afraid that they would lash out verbally and physically, and due to this I kept my distance as far as possible.  I was paired with L, who was eager at first to answer my questions.  Our conversation was light-hearted which made me wonder if she had any issues at all.   I assumed too quickly; she marched out of the room for water and as she re-entered, her demeanor changed.  She was standoffish and began to hurl expletives at me.  She called me a demon and I was extremely embarrassed.

I left the room feeling puzzled and made my way to two other patients who were extremely friendly and well-educated; once more I wondered why they were placed here. Turns out their children could not bear the burden to take care of them since they started to have lots of dementia.

Our trusted local guide, T, was jolly and even took a liking to one of my batchmates.  His bouncy personality would light up any room.  He was very eager to show us the different wards, especially where he stayed.  I was astonished by the crafts that the residents made; their talents shone through their beautifully hand-painted designs.  After I got over the fear of mingling with the residents, I became comfortable enough to strike up conversations and make jokes.   I started to treat them as my equals.  T was definitely the highlight of my trip.

All in all it was a lovely trip that gave some insight into the mental health world.  It also helped me to examine some of the biases I had about “mad people”.     I also felt shame that I had looked down on those types of persons and pre-judged them before I got to know them.  I learned that not all mentally ill persons are dirty and unkempt.  They are not all uneducated and they are not all hostile or would verbally abuse you.

I have also been doing some teaching with the psychiatry programme and one benefit was that a brilliant resident accompanied us for the visit who lives in Berbice.   After the students had visited with their designated persons, Dr. Colleen Bovell spent an excellent session explaining and answering all their questions.

I do not usually post any pictures of patients who are there.   However, I want to talk about two who did give me consent to do this, 

One is this woman who wanted to show me the picture that I had given her last year.  She was so proud and grateful to have it.   I take anyone's picture who asks, and later give them a copy for them to keep.  It is a way to say thank you for putting up with my students.   She recognized me as soon as we entered and told anyone who would listen about her picture and gift.





The second woman is even more remarkable as she came up to me and wanted to know if "Dennis" was with us...

Dennis had not been here for over two years...  She was looking for him to thank him again for a paper flower that he might have made for her that she still has.    A gift that has value for her beyond any price .....    The picture is of her and student, Lily, who she was educating this year.

My Girls at St. Ann's 

I found that what the girls wanted most was to learn some basketball as now some of their schools are having organized teams for girls... Yes, I know hard it is to believe that they are just getting around to it!  So with the help of a donor or two I got ten basketballs --  and  the basket was still in good condition that Dennis and his friends had brought a few years ago.

I had started separating the really small girls who had no idea of sharing let alone teamwork, and just got them exercising and not hitting each other!   And the older girls we were learning some basketball basics. 

Aside:  I went to look at the internet for some basic drills for little weenies.  They had super-talented kids who started with dribbling two balls simultaneously behind their backs and through their legs...  This is basic??!   I guess we were doing pre-basic!   They were having a great time and I was leaving in a week .....   So this week I got my "adopted son" Rashleigh, and he agreed to continue the clinics after I left.   This week I helped him, just to show him the ropes  ..... He was a natural and the girls loved him ..... and they forgot me! 

The New Head Coach Rashleigh

It was good to see him take the lead with the clinic .....  and I will get over (maybe) the shock of being outshone.   The girls are what this was all about ..... and they will benefit all year from Rashleigh's commitment and your money!  From your donations, I am giving him a little stipend to run basketball every week.    

Finally, I found Family Medicine

I had known about the Family Medicine Residency for several years, but to tell you the truth.. I didn't have the energy to do more.   Until this year, when I needed them!  The psychiatry programme is newer and not yet as well organized.   I needed to connect with Family Medicine as they had all their paperwork in order ..... and I wanted to "steal" their forms.     I thought it would be more likely to happen if I offered to teach a class or two .....   They were very welcoming, really welcoming...   and had a huge list of things I could do ..... I ended up teaching about 6 hours in fields I am comfortable with.  Death, Grief, Bereavement, Crisis, Suicide, Interviewing Skills .....  And I did get some of their forms, which was great.

I do think that I surprised them somewhat, as they had thought that I would be a carbon copy of my friend Peter Kuhnert -- but I think they were warming up to me in the end.   I really liked them ..... at least the half or them that talked. The other half I think were preparing for a cloistered life.   I am impressed with the commitment of their local faculty and students to keep developing without even a small percentage of the resources we have in the North.   

Then there are my Psychiatry Residents

I have spent much time with these residents - almost every Friday Morning since I came.   I have attended rounds, taught some subjects that they needed and did one consultation with a patient.      They have taught me a lot in the process.   

The last few times I had criticized them (yes, me being critical!) because they have medical students at rounds who didn't do anything.   Then this week when I was there almost every patient in their overnight facility had a medical student "present the patient".  And they encouraged the students to pursue the interview with the patient --- Absolutely amazing. 100% improvement, first in rounds and then as teachers.

Then, I was supposed to give them an exam on the areas that I had covered over my 7 weeks.    It was a pretty short test - about a 30 minute one.   From experience,  I was prepared to be crushed ..... and to have the exam returned blank.   But to my thankful surprise, they had remembered well and could even apply their learning to some different situations.  And without  doubt, they all secured a successful pass. 

And a Farewell Thanks

Candy and I took our tutors out for a thank you meal.   They have done a spectacular job this year.  I am so proud to be part of this group of teachers.   I want to think my colleague and leader this year, Candy Mohan.   I am getting replaced all over the place ..... one would think that I am old!

I could never replace my readers.

Thanks for reading.

John