Looking Back at My Time in Guyana 2018

Continuity and Change

Every year it is much the same and some differences.  Those of you who know me well know that I love "the new" more.  This preference goes back to my preference for working in ICU/Emergency rather than Chronic Care .....   So it does surprise me that I have done so much of the same thing in Guyana for over 17 years.  Maybe now that I am  "elderly" (thanks Obel!) I don't have the stamina to take on too much excitement?    Unfortunately, there may be some truth in this; I prefer to think it is because my usual experiences continue to give my living meaning.     Without my annual pilgrimage, my life would still have many blessings and meaningful relationships with family and friends; I could claim that I have a "a good life".   

And at this point, that everyday life in Canada is too selfish [self-centred] to want it as my whole identity... After all, my patron saint is Don Quixote -- and Anne had bought tickets for Man of La Mancha right after I returned.  It was wonderful, even though I have seen it more times than all my other play attendances put together.   My only frustration was not being able to stand up, sing the great songs or deliver the superb lines with the cast. 

Quixote says (it was on a poster that I had on my wall in university):

"Perhaps to be too practical is madness. 

To surrender dreams - this may be madness; 

to seek treasure where there is only trash.

Too much sanity may be madness! 

And maddest of all - to see life as it is and not as it should be!"

We are all going to be a long time dead.   I am not worried about any future existence -- I'll leave that as a surprise - or not.  My exegesis of the Bible passage (Luke somewhere: " From everyone who has been given much, much will be demanded; and from the one who has been entrusted with much, much more will be asked.") is that those who have the fortune to have been given abilities, need to give now ..... and so many in this world are asking now to share what I/we have been given.

I am doubly blest in that my family (the whole, blended, extended clan) support my madness.   I could not have run away from home for so many years without their loving sacrifices.     

The Difference of the Samenesses

School of Nursing

My main reason for going is to assist St. Joseph Mercy Hospital nursing students learn as they start their careers.    When I first lay my eyes on them as I attend their worship on their first morning, they seemed identical to classes before them.  However, as I struggle to get their names correct, they are not like others who proceeded them. (Well, except for Terri who is identical with Bailey!) And by the time I chat with them at the end of the course, I have an admiration for each of them.  They have struggled to get to nursing school and a few really struggle with me, especially the quiet ones... And I was true to my word again this year ..... no one died from my teaching!  And they all talked ..... and some even talked back.

In my individual time with each of them a large majority answered the question, "What was the best part of PBL?" this way: "We got a chance to work in small groups and listen, learn and talk to our batch-mates and get to know them."   A perfect PBL response!

When I am gone? Farewell Song by Students

I would like to take credit for this amazing response; however, I was not the lead this year.  Candy Mohan, a full time faculty member at Mercy did most of the leadership and administration.   She did a better job than I had done in the past, especially with having a continuity with tutors for the small groups.    Then, there was ms. reliable, Roberta Bindar;  she is also a full-time faculty member who ran a small group almost without fail for the whole course.   And then, our director, Elsie Asabere, who graciously filled in when we needed a tutor (like when I had pneumonia), even though she had other commitments.    

And I can't forget our volunteer nursing staff  - all were previous Mercy students though  only some worked at Mercy or other hospitals.  They arranged their schedules (changing shifts or coming in on their days off) to facilitate a small group.

 /

The students benefited from the consistency and variety of  the teachers.   And I was pretty much a supporting cast.  So this year their praise at my leaving (not for my leaving) was very uncomfortable for me.   I get singled out because I come from away ..... and am probably a little weird.   I appreciated their gifts AND I wanted them to know the real great teachers are the ones who stay and for 365 days a year give them their best efforts.   Really, without the other course faculty I couldn't afford to be weird; I would have to be normal.    

St. Ann's Girls

There had been a change in leadership at St. Ann's when I arrived, so it took me some time to find a way to contribute.    We settled on my teaching them some basketball skills and giving them some exercise.  Some of the girls are going to schools where this was to be the first year that the school would have an official girls team!  I had a good time showing them how the game was played; and, they were enjoying it.

I wanted to find a way for the practices to continue.   I remembered that my "Guyanese son", Rashleigh, could play basketball -- and during the year is usually asking me to help him out with a few bucks... So I am paying him some to run the clinics every week ..... and so far it is going great.    There are a few girls who have the potential to be very good ball players.     So Coach Rashleigh is looking for a club team that one or two of the girls could join.   

Lutheran Church Guyana

I usually do very little to assist the church there and this year I did even less.  I had brought my stole so I could attend the national Reformation Service in New Amsterdam on the last Sunday I was there.  However, pneumonia took me off my schedule and I told Davy Ram that I would not be going.  I am sure he must think that I am the worst Lutheran Pastor he has known.   In my defense, I told him my mission there was to teach and there was still much to do in my last week and I couldn't spend a whole day attending the service.  Well, Davy is a real Lutheran and he told me to get better and do what I needed to do ..... as we all live by grace .....  and he would probably still loan me the church cell phone the next time I come!

The Sameness of Difference

Psychiatric Help

I may be in need of some.  I was more involved with the Master's in Psychiatry programme and the Residents this year than ever before.    Ever since Dr. Jorge Balsiero left for the States over a year ago, the programme has lacked an administrative oversight.  As I had been involved with the development of the degree at University of Guyana, I thought perhaps I could get the programme back on a better footing.    As with almost everything in Guyana, I have been somewhat successful.    The programme is back in full compliance with the regulations and curriculum.  Dr. Bhiro Harry had done a great job doing all that was required, though documentation remains a problem.  There are one or two outstanding issues, but they are coming to completion.   Also, there are commitments of dollars for a halftime Secretary and some funding for a Director of the Residency.   

I also committed to teach every Friday at Ward Rounds and do a lecture on a required topic afterwards.   I think that I was successful in making ward rounds more interactive and educational.   As for the lecture topics, I stayed within the psychotherapy module.  My topics included:

• ·       Suicide – historical reflection, Durkheim’s classifications, trajectories, interventions, ethical responsibilities and bereavement distinctiveness;
• ·       Crisis – definition and nature, intervention counseling, techniques, therapist qualities;
• ·       Bereavement – Lindeman and Bowlby’s attachment and loss theories, grieving processes - especially mutual role behaviors, mourning vs. grieving, extended and unresolved bereavements;
• ·       Counseling with Individuals – skills - listening, leading, reflecting, confronting, interpreting, summarizing, assessment models, patient values, cultural diversities;
• ·       Marriage and Family Therapy - systems theory, counseling differences, understanding nature of relationship issues, specific therapeutic interventions, guidelines for therapy and the use of homework.
• ·       Sexuality and Sex Behaviours – myths, gender issues, including “genderbread” reflection tool, sexual development, autoerotic behaviours, different sex behaviours, including homosexuality., orgasm cycle,  anxiety and the therapist.
• ·       Session Management – understanding and development of the hour, beginning and ending tasks, joining and accommodating, resistance, therapists 3P’s - preparation, process, prediction.  

All the residents passed the exam for the module.   Great going residents!   And they even took me out for a beer before they knew the results of the exam ..... Wait --- do you think that was a bribe?

Finally - Family Medicine

I have known of the Master's Residency in Family Medicine for quite some time.  It just seemed I never got around to doing anything with them.  However, this year I needed them!  They run an excellent and organized residency and I wanted to steal whatever I could from then rather than reinvent the wheel.    In the process of being friendly, I suggested that I could do a lecture to the residents...    Well quickly they responded with several hours of requests.   I wrote some about this in a previous blog.   I mention it here as "back home" my McMaster Department is Family Medicine and they, especially the head Dr. David Price, have been great as supporting me by continuing my part-time departmental appointment.

The Final Finally

My typing fingers are tired.   Thanks for reading and for supporting me this year.  I'll tell you about plans for 2019 in the new year as is my practice...  Till then ..... John