Showing posts with label Psychiatry. Show all posts
Showing posts with label Psychiatry. Show all posts

Sunday, October 23, 2016

The "Last Post"... till I am back home

I still can't get that slide show working 
So click on  This Week's Pictures.

I have a Dilemma about Returning Home

This morning when I went to get an egg sandwich for breakfast... I saw to my amazement the "Donut Lady" had returned after a year's absence. Fresh, still warm, large, sugar ones.  And during my last week... Oh the Agony!


The First Year's Turn to visit the Morgue

The 2016 Survivalists of Rev John's Trip to the Morgue

After our visit being cancelled last week because there were too many medical students, we returned on Wednesday.  But when we got there -- more medical students.   When Dr. Singh arrived on his motorcycle he saw me ..... He would take care of everything.  I hoped so, as I wasn't leaving this time.   He was a man of his word and arranged to have one body brought in to an adjoining room where my students were also led.    Here the associate pathologist also a Singh ["Singh" is like "O'Connor" -  dime a dozen name] -- first name Yogeshwar [not a dime a dozen name].  I'll let one of the students tell you about the visit:

"My first experience at the morgue was terrifying.  I have always been afraid of dead bodies, not because they scare me but because of the fact that I know that I am going to die someday.  Seeing them makes me wonder about my life and when it is going to end.  This is the scary part because, I don’t want to die.  I don’t want to leave this world and my family and friends.


But being at the morgue today helped me to appreciate life a whole lot more.  It made me realize how meaningless riches and popularity and material things are.   It was difficult looking at the body just being butchered like an animal or some piece of meat.   I thought about the fact that he had a family and how they must feel knowing that he is gone, but I also felt good that they were not there to witness such a gruesome thing.  

Other than what was going on inside me. I was afraid that the smell would get to me, but it didn’t.   At one point I was afraid to look at the face of the corpse, but thankfully I had my friend to help calm me down and I started to relax and that is when I got curious and wanted to touch.  Even though I knew it was a dead body I kept looking for some sign of life.  Personally, I find it hard to understand what it means to be dead. 

Other than my personal fears, the trip to the Morgue was good.  The pathologist Dr. Yogeshwar Singh was a great teacher.  He took time to explain lots of things to us, even though I can’t remember half of it.  When the organs were being removed from the body, I somehow started to feel a pain in my heart; I thought that I would faint.   I wondered if he was feeling any pain.  Even though I am curious, I don’t think that I ever want to go back to the morgue, much less witness another autopsy.   

I must say thanks to Mercy School of Nursing for giving me such an experience.  It has taught me a lot and I plan to share it with my family and friends.  I want to help someone else to appreciate life and their loved ones a little more than they do right now."


Speaking of Scaredy Cats  Frogs and Rev

Bad Selfie with Gecko
A few weeks ago, one of those salamanders or lizard things dropped down from the ceiling on my head...  and I was just a little jumpy.    These geckos are all over and more a nuisance than anything else.   However, early this morning as I lay sleeping, I felt something walking over my ear and when I went to brush it way - it was pretty big - a frickin' frog.  Now I did scream "a little", but I think that I may have had just cause.   We both lived.  I caught the frog and put him [although I guess it could have been a her] outside.   And I live on the second floor ..... now I have "The Celebrated Jumping Frog of Mercy Hospital".  Sorry Mark Twain.

Final Exams - a Time for Massive Prayer

Singing to the End - and a new adventure.
This is the time of year that my freshman class of 2013 finish up and prepare to write their National Final RN exams... three days all together - two written and one practical.  As tradition would dictate, on the day before, the whole school assembles and wishes them well with prayers and advice.. and we send them on their way to do battle!  In some ways it is had to believe that it has been over three years since they first stepped into my classroom.

                                                              Singing every day.

Leave it there for Just Now

I heard it said that in battle, you need to leave everything and everyone where they die... However, Guyana has taken that message to heart even in times of peace. Stuff just stays where it stopped or was left. A few examples:
Storage?

Never know when you may need it.
But Officer, I only went for gas.













I may be next!
And my famous "Guyana 911" ambulance of 2010 - still there!

Great News Finally

The first classes for the Master in Medicine - Psychiatry were held.  I got the honor of teaching in their second class.   Now I hold the title of "The Absolutely Best Foreign Professor". [Remember Raj?] There have been so many people who worked hard to achieve this, especially Drs. Bhiro Harry and Jorge Balsiero... and our Canadian Mental Health Team Members... who are even more excited about participating in the future.  They are already planing their February and September trips in 2017.  Ask about how you can join them.  There are four doctors who have been helping in the Psychiatry Department at Georgetown Public Hospital for a few years and hoping that the residency would finally start... and now they will get credit for all their hard work.

I met with them in a state of the art multimedia centre at Georgetown Public Hospital... equipped by a Canadian company.  I forgot to get the benefactor's name, as I am not above groveling to get a smaller one at Mercy SoN.   It is also equipped with a phone line that kept ringing on the screen... and I couldn't figure out how to answer or stop it!

New Residents: Drs Vanetta, Elizabeth [Head Resident], Stephan, Old Fart, Meena

And before I forget...

I had a good visit with Raymond Jagessar, who is now a Full Professor in Chemistry at UG... and a "good" Lutheran.   We shared a drink [Ray's was coconut water; mine wasn't] with good memories of Pastor Dick Young who has vanished into the Oregon hinterlands.


And when I was in New Amsterdam I had a quick visit with the  Lutheran Music Academy there.  I had a lively and enthusiastic conversation with the three new volunteer music instructors, Lauren, Sandor and Kirsten.   They conduct music lessons for the surrounding community and at all different levels of ability.  The founders of the school are Eric Sayre and St Olaf's College in Minnesota - along with the support of "Good Ol' Dr Erv."  Click on their link if you are into music.

Lauren, Sandor, Kirsten the 2016-7 Music Teachers

Several weeks ago, I had the privilege of presenting Dr. Tony Carr's and my programme of Problem Based Learning to Director Tabitha Mallampati's class on teaching theories.   It also gave me the chance to reflect on the strengths and weaknesses of how the Mercy programme has been evolving.  These insights are for another time.
There were some Mercy Grads who showed up to hear me again.
And yes, Sister Barbara McLean, I did get to visit with Malinda and make sure she was eating... And I forgot my camera ..... I also forgot my camera [well, actually I did have my camera, but I forgot that I had it] when the Mercy Corps Volunteers had me over for a wonderful team-cooked meal in their nice, but wireless, wireless home...  I am sure I am forgetting stuff, but this will have to do for a few weeks while I finish here and travel to Florida to see some family and then to my Canadian home and my wonderful wife and children and grands.   Till then, thanks for reading.  John

Sunday, October 25, 2015

Down the Back Stretch

One Last Week Ahead

I use the horse racing analogy not because of any fierce speed on my part; it is the time that is racing...  "Do not go gentle onto that good plane..."   or so said the non-guitar playing Dylan.   I am running as fast as I can to complete all I set out to do, but I fear I'll have a "DNF" posted.   This is probably how I feel every year. (And if I listened to what I tell my students, I'd go back and read my old blogs to see.)   Almost none of the uncompleted stuffs are related to needing more money. I realized a long time ago that I would never ever be able to give enough even with my small focus of the nursing school and St. Ann's -- things like the outdoor playground for the girls at St. Ann's.  The new basketball backboard is up and the girls really enjoy it and we have balls... However, it is really hard to change routine.  When I was at St. Ann's Thursday afternoon, it took over 30 minutes to find the key for the locked playground.   The girls had not used it since we left on Sunday. It is not that the sisters and matrons don't want them to play; it is not thought about, as it hasn't been done before .....  changing behaviours is slow work .....   I really would hate to see it sit locked for months .....  Dennis and I will be back to St. Ann's a few more times and keep kicking the can, but even if I stayed till Christmas some stuff would still not be changed .....  The good news is that if I get back next year, I will know where to start as the same problems may still be there!

Mental Health and Psychiatry

Last week the Graduate Academic Committee of the Graduate School of University Guyana approved the offering of the degree Master in Medicine, Psychiatry.    This was the last big hurdle before there will be an official Psychiatry Residency Programme in Guyana.   There is a more formal committee for the university but they almost always accept the working committee's recommendations.   A few of my colleagues deserve the credit for pushing this through - Drs. Bhiro Harry and Jorge Balseiro who did  all the research and document preparation for several long months.   It also had the support of the Dean of Health Science, Dr. Emanuel Cummings, and the Dean of the Medical School, Dr. Madan Rambaran, all of whose experience with University Committees were essential.   I had the privilege of attending the meeting as a "Visiting Expert"... I really think I was there to just add some colour.

Guyana is still number one in the world by population for suicides ..... and as you know if you read the papers online or even my blog, the events that scream the need for better mental health in the Guyanese community are the daily occurrences of spousal abuse, violence, etc.  There is now a concrete though long term approach to treating the most difficult mental illnesses.    Four general practice doctors will begin the three-year programme in the new year.    It is uncanny how one positive development can have the power to dispel the darkness.
This is probably from Confucius.   However, is also
the saying of a group from Maryknoll that I joined in 1964.  (Dennis as well.)
As much as I love psychiatrists and think they do wonderful things, I know that the new programme is only a tiny part of improving the mental health needs of the country and the delivery of services to the sufferers from mental illness.    There are other initiatives both by government and private groups, including faith groups.









Last Sunday, I was invited by the Youth Group of Holy Rosary to talk about suicide prevention and mental health.   Mental health needs are being brought to the forefront of public discussion over the last two years.    I am optimistic there are much better times coming in these areas.

More Mental Health

The new Minister of Public Health, Dr. George Norton, liked the idea of a National Mental Health Institute -- a separate place that would be the focal point for all Mental Health Services in Guyana, much like the Caribbean Heart Institute.  Recently, they have purchased two buildings near the hospital that will house the psychiatry outpatients, provide teaching classrooms for the residents' and medical students' rotations in psychiatry, a community reference library and meeting rooms, and the main office for the Mental Health Unit of the Ministry of Public Health.

Setting for the National Mental Health Institute (in progress)
on Quamina Street.


Leslyn Holder,
the new National Mental Health Coordinator.
We have a new National Mental Health Coordinator, Leslyn Holder, who is getting organized and presenting the first ever budget for Mental Health.  A costing accountant has detailed the costs of implementing the National Mental Health Action Plan 2015-2020.

Lots more good stuff is happening, including the third trip to Guyana of the Canadian Mental Health Team whom you an find on FB at:  Transforming Guyana's Mental Health System. Old timers Peter Kuhnert and Ram Kalap will be joined by first timers Lance Morgan and Shrenik Parekh.  They are here to finalize goals for the next 3 to 5 years.

Peter last year
Ram and John last year

Your Tablets and their Stories

The generosity of those who have little amazes me again and again.   When I was getting organized to come down, I had asked Elsie Asabere, the Director of the Nursing School if she could identify all the new first year students who had a device that could access the internet.   She wrote me back that there were only ten who did not have a tablet, laptop or phone; so I bought 20 tablets with donated funds.

However, when I got here there were 15 who did not have anything and a few more whose units were not really very good.   So I said that as I had planned to give five as photography contest winners to girls at St Ann's, could they decide among themselves which 15 students would get a tablet?  I was willing to just have two photo prizes if they needed more than the 15.   When I returned there were only 15 in total who needed a tablet ..... because, they told me,  the girls at St Ann's needed them more.  More?  I was amazed at their cooperation and generosity towards others.  

Well, I have run out of time to do the photo contest ..... so I decided to see which first year students really needed a tablet right now.  I knew two second year students had had their tablets from last year give up the ghost and they had no money to get another tablet ..... but the first year were my priority, so I asked who really needed a tablet.  (Some had little phones that could access the net, but I couldn't read them even with my glasses.  So I said that I had four extra ones now (I knew someone who really needed one in second year) and we would draw lots for who got them.      The next day I brought in some blank sheets to do the draw... And the class had decided that there were only really three students who needed the tablets and I could use the other for someone who needed it more.  More?

Another first year student came to tell me that a quiet student needed the last one... So I said, Fine send her in.   She arrived at my room and told me she had a phone but the charger was broken and was waiting for some family to come at Christmas to bring her a new charger ..... and in the meantime, she would use a batchmate's on class days.    She did not need it.   And she did know of one second year student who needed it more.  More?

I do not want them to sound like Mother Theresa - or else I couldn't yell at them when they gave a stupid answer (yes, I know there are no stupid questions, but there are some incredible answers) -- imagine yelling at Mother Theresa!   However, they are gracious, kind and generous... amazingly generous.   Next year, I will get everyone a good tablet - with your help of course...  I might even roll the donations to my beer fund into it as well.   I do know what more is...

The National Flower is Becoming Endangered

The government has banned the sale and use of styrofoam at the start of 2016.  The white food boxes have littered the landscape from ocean and canals to trees.   An amazing move!  And as usual, I have been ahead of my time:  I have been having my meals here in plastic reusable containers since Maria Kidner and Jane Greiling made me, back in 2003 (and as Kristin did many years ago in Dundas). Actually, they shamed me into it and -- and then they never came back to check .....   And today I have the same ones ..... though they have gotten stained over the years so the kitchen staff always ask me, "Have you cleaned these recently?"


Dennis is getting ready to leave the day before me, but not before packing his parachute and one more pink umbrella drink at Frenzy's Bar on a Saturday Morning...   He tells me that those umbrellas are nothing to laugh at as they are big chick magnets ..... Anyhow, the "chicks" get their laugh for the day....  All kidding aside, I will miss him.






Dennis will write next week's blog and I will probably finish up the following week.. Thanks for sharing our adventure - John, Dennis and Emilee.

Sunday, September 20, 2015

The Big Surprise... [drum roll, please]

Dr. Emilee Flynn Arrives

On Monday night, Emilee arrived in Guyana.  Emilee has been trying to come to Mercy Hospital for about a decade to see and work with me.   Yet for one reason or another, could never get here.   Now she is so important, a distinguished senior paediatric resident at St. Christopher's Hospital for Children in Philadelphia, that I am really just helping her.   I have known Emilee ever since she was born.  She is the oldest child of my sister Monica and her husband John Flynn (I think he's also a doctor  ).   It has been many years since I actually have seen Emilee in person, so it has been a great time to catch up with her life and living... and get some new and embarrassing stories about my sister which I'll be able to use the next time the clan gets together.
Emilee has matured into a wonderful woman and sensitive paediatrician -- and she has been on the go ever since she arrived.   Emilee is interested in practicing medicine in some developing country after she finishes her residency this year, so is here to look at how children are cared for here and has accompanied a local paediatrician Dr. Malika Mootoo on her rounds and clinics for a couple of days.  When she returns she will team up with Dr. Rohan Jabour another long-time paediatrician here, as well as a new (to Mercy) Cuban Paediatrician Dr. Rosa.   

In the middle week she is travelling to Linden and then back to GT to lead a programme on Helping Babies Breathe -- a course in neonatal resuscitation.   

Emilee is walking around the Bourda Market.
with Dolly  Karran
who has a stall at the market
 and is an old friend of mine. 
I have gotten her out in the city walking around. Don't worry, Monica: she had me and my awesome strength to ward off any muggers.   As well, she has been helpful with the PBL course and other classes.  In fact, I was going to cancel my afternoon class and walk Emilee around the city; however, the students so wanted the chance to talk with her about her life and becoming a paediatrician that they begged me not to cancel.   I did not realize how much of an embodiment of their dreams Emilee represents; she is a symbol of the kind of person they wish to be.  Emilee gave them a chance to see themselves in the future .....  and for a few moments it was close enough for them to taste.  

Of course we went to St Ann's (see slide show at upper left); she also met my friend Dr. Bhiro Harry and attended several planning meetings at the Everest Cricket Club where she enjoyed some Banga and Shark as well as Plantain Chips.   She watched Bhiro and me imbibe a few drinks and she stuck to water.   Georgia, Bhiro's wife, invited her to their home for dinner.  She met Indira who is Bhiro's and Georgia's favourite daughter and a doctor who is pursuing further education in psychiatry to be able to help cure her father ..... and their favourite son Pravesh who is a dentist.










Emilee came to a Mental Health and Suicide Prevention meeting with the local press corps and the Minister of Public Health, Dr. Norton.  She was introduced as part of the team of technical specialists working for the Ministry!


It is good to have her here; I have been honoured by her wanting to visit me and see my life here.   I am sure she will be in more of these blog posts, but for now - enough.

My Health

I have been recovering from my cough etc., and now feel only about a decade older than I actually am .....  I went of my own accord to see Doctor Devi who lives in the flat next door and who has been checking on me every time she comes or goes.   She put me on a bag-load of pills and tonics and home-squeezed fruit juice! Now I do feel well -- and I hope this means that I won't get my usual bronchitis after I get home.

A New Ambulance for Mercy

A colleague, Chris Klaffs, who has been coming to Guyana for many years and is from the Florida Synod of the Lutheran Church has assisted her friend, Pastor Mike Mielke who lives about 30 miles from her in Florida and has the great Wilderness Lake Church.  He has friends/family at Banks Distributing -- my beer company, eh?  He loves Guyana, and several of his congregation are Guyanese.  He and his church raised money for two ambulances -- and one of them is for Mercy!  This is a great service for the hospital and its patients.  Thanks!!




Some Thoughts on Receiving Donations

Here are parts of a recent email from Dennis LeBlanc who has been down for the last two years and is planning on being here again in October.   He had a reflection on asking and giving that I want to share.


Hi Jo'c,

Yesterday you wrote "I am always humbled by donations" . . . that is a word I have always felt and used myself. I carry all sorts of baggage about asking for money, but a couple people have pushed me beyond my self-imposed limits around "fund raising" over the past few years. I can't say it's gotten any easier, but I have tried to be a little more bold and creative (the tin cup routine never worked well for me) in asking for money for causes important to me.

This is the outdoor "playground" at St Ann's we are trying to improve.
When people give, I am still truly humbled by their care, concern, generosity and support. Well, I've had a lot of practice in humility lately! Today at the nursing home, three staff people came up to me (separately) and talked about the newspaper article and how they "wanted to help out a little". One hundred and fifty dollars ($150) later, I staggered back to my desk, overwhelmed by their words and gifts. It has truly been "a wonderfully humbling day"!  The total amount raised now is $704 (that's good 'ole U S of A dollars, not Guyana dollar value)!
Thanks for reading... More next week. John
except .....  does anyone know what this is?



Friday, November 15, 2013

Dennis' Reflections on Volunteering in Guyana

Opening thoughts  . . .

As I sit here writing these opening words, surrounded by all the familiar creature comforts of our home in Massachusetts that we have spent a lifetime accumulating, the powerful awareness washes over me that the body and the psyche were not designed to make the massive transition from a third world country to our middle class US lifestyle in just 48 short hours. To go from shorts and sandals one day, to shoes, long pants, jacket, winter hat (layers and layers) the next, is a leap; to go from 90+ degrees to around 30 degrees in a few hours, is a shock to the system; to go from litter and garbage strewn on the sidewalks, grass and streets at will, and where the stench and smells of their accumulation is inescapable … to our little town where litter is gratefully hard to find and garbage finds its way to the dump; to go from pervasive poverty and pain to a place where the accumulation of wealth and the goal “of a better tomorrow” have some semblance of hope to be achieved and are not just pipe dreams and a fantasy world . . . and on and on. Sitting here, having been there, has an air of unreality to it right now. “Business as usual” isn’t working inside me. How can my system adjust to that 12 hour plane ride that separates night and day, poverty and wealth, hope and despair??!! Time will tell.

Just a little older, eh?
In some ways this trip for me has been 48 years in the making. For it was in 1965 that I first entered the Maryknoll Missionary Fathers college seminary in Illinois, planning to spend my life as a Catholic priest in the mission field. It was then and there too, that I met a kind and sassy Brooklyn boy named “Jo’c” (John O’Connor by birth, though no one called him that except the principle whom he visited often!). I am so grateful that our friendship has withstood the test of time, change and the challenges of growth and differences, and particularly grateful for how hard Jo’c worked and planned to help me have a wonderful experience teaching and exploring with him in Guyana for the past three weeks. 
From here on, a few reflections on my time in Guyana as I journaled them (through letters home) during my stay. 

                           
“Don’t Glamorize”                                                                        Oct. 23, 2013

Dear Maggie:
A few observations from a 2 1/2 hour walk I just returned from -- during "5 o'clock traffic hour" in downtown Georgetown -- amidst the thousands of people speeding around on foot and in cars, buses and cabs, I was the ONLY white guy to be found; I was also the ONLY guy in shorts to be seen; I was also the ONLY dude wearing sunglasses or a baseball hat .... to say that I "stood out in the crowd" and drew 10,000 glances, is an understatement!! Luckily I didn't get too lost, because in the dark I would have REALLY stood out! But their friendliness dispelled most fears that tended to surface because of our differences.

I have developed a new commandment that I wanted to share with you (and all) ---  "Thou shalt not glamorize me, where I am, or what I'm doing" !! I am still the same 'ole incompetent/sometimes more competent smuck that I've always been. Imperfections or abilities know no geography. 

And so whereas I appreciate the "pride in you" that you and others have expressed, I don't want it to diminish where you are and what you're doing. Life's work is tough wherever we find ourselves! 

Just had a little supper we brought up from the cafeteria and ate in the room (cold macaroni and cheese, potato salad and something green and was still moving, I think). Now I need to get ready for tomorrow's classes and it is quickly approaching my 9 p.m. bedtime. 


“Nighttime in Guyana”                                                                 Oct. 24, 2013

"Great minds think along the path", they say, Maggie. The title of your email to me last night "Good Night" happens to be what I wanted to write something about at midnight, then 1 and 2 .... then at 3, 4, 5 a.m. !

I remember when I would glibly say "Good Night" or "Sleep well" or "Have a good night's sleep" or "Don't let the bed bugs bite" (the later will need to taken up at a future date!) .... then old age set in!! With prostate and bladder issues to contend with, a "good" night would be getting awakened out of a sound sleep "only" 3 or 4 times a night. Then came Guyana!

After five nights here so far, here is my “new normal” ... getting into bed about 9 p.m. after my cold shower (remember there is only one knob in the shower... that drips about 50 drops a minute -- pretty sad that I'm now counting drips!), the sweat is pouring off me by the time my head hits the pillow. My puddle and I settle in for the marathon night. Of course I have my two salvific fans taking dead aim at me for the night -- but what first feels like a respite from the heat, suddenly is more like a billowing furnace.

Now the "wall" that divides Jo'c and me is more like a dividing wall -- with no separate ceilings. So if one of us has a light on, the reflection is seen off our common high ceiling.  We may be taking our snoring duet onto "America' Got Talent" ... whoops, except he's Canadian.

Then there the other chorus of sounds of the night ... like the trucks, cars, buses, cabs with their horns ALWAYS blaring, traveling down a busy main street RIGHT outside my window, of course. I've been teaching myself some new swear words during those sleepless hours!!!

Then there is the rain ... an anticipated welcome relief, but oh no-- it gets hotter. I was awakened by this crashing sound only to realize that the tropical rain was pounding down -- onto our TIN roof!!! The noise was deafening and I found myself longing for Jo'c to snore even louder!!

So after battling snoring, traffic, torrential rains, I think that must be it. Dozing in and out, I then hear (like in a dream) this bellowing, rhythmic chanting coming from somewhere other than my head. Of course, it's from the huge police academy right outside my window on the busy street with all that traffic. They are doing their 5 a.m. outdoor marching drills ... and making sure the whole neighborhood knows it!


“Pictures Lie”                                                                                Oct. 26, 2013

Thank you so much for remembering that today is the anniversary of my ordination, and for your 'morning note' of my sermon title on that Reformation Sunday 38 years ago, "You Are Accepted".  So thanks to you, Maggie, and many others in my life, for putting up with my multitude of imperfections, and continuing to accept me over the years.
38 years ago...
"Now I am a Psychiatrist"
Yesterday was as full, busy, and diverse a day as I've had, and trying to capture it does not seem even remotely possible. But I'll try to paint a bit of a picture with words, knowing that like pictures they are at best inadequate. They are one dimensional and "uni-sensory" and the senses of touch, smell, hearing even taste are conspicuously absent (this is huge in pictures of Guyana, where the oppressive heat and the powerful odors dominate the landscape). 

The destination was the town of Suddie on the northwest shore of the Atlantic about 2+ hours from our hospital in Georgetown. Getting up at 5 a.m., we traveled 45 min. to a couple mile long pontoon bridge that crosses the Demarara River (a very shaky ride across the river with thousands of other cars traveling their morning commute on it too). Then it was on to catch a ride to cross the Essequibo River in these very “primitive” wooden boats that would carry us through a series of islands, and over some 'testy' waters, to the unseen shores ahead. The boat drivers are fearless, and know that 'time is money', so their idea of a safe travel speed and ours were quite different. I kept reading the many painted sayings on the wall of the canopied craft (“God is the Greatest”, “Love everyone”, “Live a good life”, etc., oh yeah, and “We are not responsible for” ....), wishing I had brought my rosary beads and gone to confession  ... while constantly humming “Just a closer walk with Thee” !!! But with water spraying from every direction from our wake (I didn't dare say that word out there!), we finally arrived in what felt like a eternity (aka, 45 min. later), hugging the land, praying to all the major religions that Guyana has represented in it (throwing in a couple others for good measure), grateful to have survived . . .  and oblivious to fact that that also was the ONLY way back!!!

We then got into another crazy (a requirement to get a license here) driver’s cab, racing off at the speed of light, comforted only by the idea that we would at least now die on Terra Firma (and we think Boston is bad!!). We arrived at Suddie Public Hospital (rustic does not begin to describe it!!), to have about 75 people waiting there (from many miles away and for many hours) under a tin lean-to (remember it's over 90 degrees with humidity between 80-90) in order to talk with the 3 doctors with whom we were traveling. Some of the cases were beyond sad, and my helpless went into overdrive as I went around talking with those waiting, and trying to provide some sense of compassion and empathy -- but inside feeling totally useless. I wanted to do something concrete tangible to improve their lives this day, not be the vague, impotent therapist who spouts pious platitudes and knows that changing someone else didn't come with my diploma. ....  
At the start of the clinic, everyone got introduced.
Then I sat with Yul (a man of about 55 yrs. old, though his body looked so much older) and listened with tears in my eyes to how he had been beaten up on the street within an inch of his life about 10 years ago, suffered significant brain trauma and vision loss, has been barely employable for most jobs, trying to raise his teenage son on his own, has scars from the beating permanently visible all over his face (and probably many other unseen places) ....  Then he has the nerve to say to me, "but today is a new day, and the doctor has come for us (one time per month at best), and here I am talking to a kind man from the United States who is asking me about MY life .... man, isn't life a good thing!!!!". Shame on you, Dennis, for thinking otherwise.


The Doctor is IN
...asking me about my life. Isn't life a good thing.













It is humbling to be here where gratitude and appreciation abound, and bitterness and envy are infrequent visitors. As I have aged these past years and my athletic body feels like it is fast fading, my anger frustration response has lead me nowhere ... so I have intentionally worked to focus on a spirit of gratitude each time I get on my bike for a ride, to appreciate what I CAN do this day not on how it is slower or harder than the days before. But this is truly hard work for me -- important, but hard. Here, like with Yul, it seems to happen like we breath ... naturally, spontaneously, effortlessly. I admire that. Against these odds, I admire it all the more.

“My saddest day”                                                                     Oct. 28, 2013

Today we got up early to go down to the nursing school on the hospital compound we live and work on, to meet up with our 17 students for a "field trip". The destination was the town of New Amsterdam to visit Guyana's only psychiatric hospital for the day (known by the locals as "the Berbice Mad House"). I thought I was prepared for it, by a great deal of experience in working at Fairview Hospital in Salem, Oregon and Fernald State Hospital in Massachusetts (the oldest hospital for mental retardation mental illness in the country) in my early years, and visiting sundry others over the years. Well, sit down for this --- "I was WRONG, dead wrong"!!!

What we saw there defies description, and so I have few words coming to me right now. But I will say that what I did see made me embarrassed to be a part of the human race. That we can warehouse people in such a fashion, and hide them away so that no one knows who they are, where they are, how they are doing, is a travesty. And to bring a smile to their face or show comfort and compassion for a few moments, does little to soothe my sadness -- which is just as well, because if it were that easy, it would feel cheap.

There is saying out there somewhere about "Tears are good for your soul". If that be true, my soul is getting much attention, because I can't contain all the tears right now. So I must stop, and try to find words at a future time.




“The ‘H’ word”                                                                      Oct. 31, 2013

Today is the first year nursing student's traditional "Bake Sale" to raise money for a special celebration that they have in December. They take this very seriously and work very hard to prepare their own special dishes to sell to the hospital staff and visitors. Of course, being one of their teachers now (they call me "Rev #2"), I can't be playing any favorites, so I just HAVE to try a little of everyone's creation! I have expanded my culinary horizons here in Guyana (hopefully not my waist size too) and have often ventured outside my USA comfort zone to explore the Guyanese cuisine. I know I mentioned my new philosophy for eating, "if it's not still moving, I'll try it" ... well, that may be a little liberal even for me to say!! So far I've spent about $1,200 at the Sale (that's only $6.00 US) -- but don't have heart failure, I'll still fit in the plane, and I think I'm done ... and done-in.

But this leads me to some thoughts I have had about the Guyanese people in general and these young (18-22 ish year old) nursing students in particular.  A word came to me on that first Sunday morning that I arrived (having already visited Boston and NYC along the way) and was immediately felt from the cab driver that took me to the hospital (1 hr. drive), as he warmly greeted me and talked the whole way ... only stopping, when he pulled over to a roadside fruit stand and told the owner something in the distance -- the owner then pulling out a machete and proceeding to carve up a coconut from his stand. The driver put a straw in the hole the man had made, and then handed it to me saying, "Welcome to Guyana, my new friend. I hope your stay is a good one!" Trying to at least pay for his kindness, I quickly halted as he said, "It's a gift -- no pay for a gift here."
This is the same Sandra
who delighted in scaring Bev


The same word came to me as our cab entered the gated hospital compound, and the woman "security" (not much security really here) guard warmly welcomed me to Mercy Hospital. I have seen Sandra everyday since, and we rarely pass without a joke, quip or story of some kind. She makes me feel at home in my unfamiliar surroundings.



And then that word came bellowing my way on the very first day that I went into the nursing student's classroom at 7:45 a.m. They begin their day (always!) with "morning song". They sing and clap with such enthusiasm and sincerity through songs like "Father Abraham", "S-a-l-v-a-t-i-o-n", "Amen", and others, and with a gusto that is so palpable and contagious, that our theological differences evaporate for me, and I sense profoundly "the tie that binds"! 
My Baptist Training pays off in the hand clapping singing.
At the end all hold hands in the circle we have formed, and a spontaneous prayer for the journey of the approaching day is offered. This first day of mine, they ask me to pray.  Now this has often happened back home, and I can sometimes feel like I'm the token minister-guy who you're suppose to ask to pray -- but this first day I felt (and continue to feel this) that they are saying, "Welcome to our gathering; our home is your home!"
























Then there was the bus driver who had taken a group of us (seven Canadian and American professionals) to visit a hospital in Suddie, about  2 hours from Georgetown. After a full day there, we were hungry and talking about trying to find a restaurant. "Nonsense" replied the driver whom I had NEVER met before, and he then pulled out his cell phone and made a quick call. We ended up 30 minutes later at his Hindu family's home. They were celebrating an annual feast (Puja) where all their friends, neighbors, community members -- and evidently us!! -- were invited to drop over during the day to share in the food feast they had prepared. So seven of us foreigners arrive on their doorstep, to be treated to a medley of foods as if they were awaiting our arrival! For the next hour and a half we ate, visited, were shown their ducks, chickens, fruit trees, flower garden, etc., and left filled with so much more than

 Many other stories have blessedly come my way... but for now, back to THE word. It is the "H" word. No, not the "Hot" word that I continue to complain about on a regular basis. And no, it's not "Hell" which I now fear more than ever-- because I don't do heat well at all, and I figure eternity is just slightly longer than my three weeks here. The "H" word that has so impressed me is (drum roll....) HOSPITALITY. Now many have shown me hospitality in my life, for which I am deeply grateful. But here it was instantaneous, and has been pervasive. People are exceptionally polite and respectful, and very rare is the time when someone passes me in the hospital compound or even on the street, that there aren't words of greeting and acknowledgement. Granted this US white guy stands out in a crowd, but they do it with each other too. In a land where horrendous stories abound, and poverty and pain are pervasive, kindness and hospitality are alive and well. Irony or blessing?  You're call. I know I have made mine.


“Relief . . . No Relief”                                                                    Nov. 5, 2013

Which brings me to the realization that this is both an appropriate metaphor AND real life here. There is NO RELIEF here -- from the heat, humidity, torrential downpours ... or from poverty, pain, unemployment, corruption, garbage, congestion, noise, danger, illness ... and on. Relief is a concept very few can afford (the rich or powerful, maybe). These are not temporary problems that come and go like our seasons. They are the perpetual state of affairs, that people today have inherited from their forebears, and now whose children are also destined to have as the reality of their lives. True some will "escape"  (aka, emigrate ...  to Caribbean, the US, Canada, etc.) seeking jobs, a livable income, security; but they are the VERY few amidst the 700,000 people that inhabit this country about the size of Oregon (and about 10 times the size of Massachusetts) who have a realistic hope of "a better tomorrow". The rest are "predestined" (and I don't use that word lightly) by the shear magnitude and pervasiveness of the systemic problems that enslave them, and by the powerful and corrupting forces that hold the keys to a better tomorrow. I thought I knew what it was like to feel small and helpless in the US with our self-serving government officials and long entrenched, endemic struggles ... but Guyana trumps even the Republicans (and some of the Democrats to be "fair"!). Relief is a luxury that "does not compute" for the Guyanese.

This became viscerally and poignantly clear to me during my visit to St. John Bosco Orphanage for boys this week. It was a hot day (go figure!!), but the sky looked particularly ominous. Then the torrential rains came, driving the 40 or so boys (ranging in age from about 4 - 16, mostly on the younger side though) under the covered shelter (with no sides), which is about 30 feet x 40 and that was mostly taken up with large wooden tables. An attendant was trying to keep all the boys inside (have you ever tried to herd cats!!), but wasn't having much luck. Then the sheer force of nature came to her assistance, and blew most of the stragglers in! 
John has the "same" picture from 2002!
For the next two hours .... about 15+ of the 3 and 4 year olds fell asleep in a beautiful and pathetic line on the tables, huddled close for companionship and connection; a few older boys were hitting a cricket ball and creating their own "ball field” in the maize of people that weren't mercifully asleep. It was an accident(s) waiting to happen -- but I realized that I haven't lost all my reflexes!! -- and the others seemed sadly oblivious to the dangers, and were just running around in utter chaos.

Some action HAD to be taken -- for my sanity, if not their safety. So another volunteer (Donna Joy) and I dragged out some board games, and we valiantly tried to "herd cats" and get them "settled down" (a completely misguided concept!). I had a group of eight and the game I had was "Snakes and Ladders".
There are Rules...  There are Rules...

With no concept of taking turns, little ability to add up the numbers on the dice, to count the proper number of spaces ... let alone in a sequence that was anything but random and self-serving ... it was a MOST interesting experience. My complete and utter frustration with the game and the chaos around, was exceeded only by the smiles on their faces and the appreciation in their eyes. Few are the times when such a ratio (1 to 8) or structured playfulness, are experienced in their lives. They hunger to know that they are more than a part of a mass of others who share their plight. They thirst for a connection that affirms who they are and gets a glimpse of the unrealized potential they hold inside.






After a couple hours a bell rang, all activity abruptly stopped, and like lemmings they quickly got in a line (smallest in front to tallest in the back), and waited impatiently to go into their common "dining area" for a donated dinner of rice and curry that was given by a neighboring family. I humbly stood in the background listening to them “Say Grace” for their meager meal, and sadly realizing that this picture is repeated three times a day, seven days a week, 365 a year ... if they are lucky. I will NEVER have another Thanksgiving without great guilt AND gratitude for the fate that has shaped our differing lives.

The bus ride home was reflective, as has been the time since. The depression I feel about their fate and future is palpable, harsh and deep. And I welcome this feeling, for I have long since learned that there are some situations in which depression is not only inevitable, but normal. Too often, I find that many are quick to think of depression in diagnostically pathological terms (it's a bad thing that should be "fixed" and gotten rid of), when in fact it is the natural, human, healthy, response to certain situations. My depression is not just at the current deplorable conditions (admittedly, my “new-be, foreigner” judgment), but that they will grow up into a world which will still not welcome them, still not give them the refuge and sanctuary they deserve, still not nurture their potential and foster a sense of hopefulness and possibility. Is this really that different from what we see in parts of Greenfield, Maggie, or in those with whom you work in Boston, Emily, or others of you in your communities ... probably not. But today, here, its my time and place to take in the reality around me, and to get an up close and personal look at the lives we painfully see everywhere that there is poverty, inequality, disregard, and abuse of power. And so I write ... and hope you are still reading.

RELIEF here today? Not in the weather or in the conditions of so many of the Guyanese. In a week now, I will be home to experience relief from both the heat and my meager surroundings here. For the Bosco boys, there is no sign of relief. Relief died along time ago for most of them. This breaks my heart and burdens my soul .... and I'm grateful for both.

But I'm repeating my "therapeutic commandment" as I linger in the hard, dark places -- "There is no such thing as one feeling!" So as I peel back the layers of the "onion" of depression, I'm beginning to find sadness, hurt, anger, fear, gratitude, appreciation, wonder, curiosity, compassion, love and, of course, the “big M” word .... MYSTERY. Always more to discover.
Catching Some Breeze


Blessings to all,
Dennis  (aka, “Rev. 2”)