Chiang Mai

[Above photo: After making eye contact, I told her a joke and am awaiting her response. Note my unsought military-style haircut. Thankfully, it is growing in.]

13 October 2019

I am about to leave the elegant Empress Hotel in this city for another, half the price and smack in the center of Old Town, which is a more interesting place to be. There are numerous old temples and modern coffee shops surrounded by an ancient wall [in places] and a moat.

I came to Chiang Mai with my two students, Drs. Nan Tin Moe Khine and Nwe Oo Mon, for the biennial ASCAPAP (Asian Society for Child and Adolescent Psychiatry and Allied Professionals) meeting. It was wonderful and reminded me of many AACAP (American Academy of Child and Adolescent Psychiatry) annual meetings I’ve attended.  I met terrific people from S. Korea, Thailand, Singapore, India, Nepal, Taiwan, and Australia, especially. It was great fun to be amongst such colleagues. However, instead of 5000 child psychiatrists, it had 300 attendees total, including behavioral pediatricians, early childhood interventionists, psychologists, social workers, and occupational therapists, as well as child psychiatrists.

Consequently, it was much more intimate, interesting, and convivial, despite my many good friends and acquaintances in AACAP. The pharmaceutical industry presence in the meetings was much less prominent here. And the meeting had the wonderful spirit of a multidisciplinary team working together to develop quality child and adolescent mental health services, all learning from each other, rather than the guild organization into which AACAP has devolved. Orthopsychiatry was an analogous multidisciplinary organization in the US with its own excellent journal but it has passed on.

I met a Dutch child psychiatrist who has been coming here 2 weeks a year for 15 years and has trained numerous paraprofessionals in the basics of children’s mental health.  It’s her vacation time and rejuvenates her much more than sitting on a lovely beach somewhere sipping pina colladas, I suspect.

One of my students, Dr. Nwe Oo Mon, gave a 20’ talk about our course. She was subsequently asked to be the representative from Myanmar on the ASCAPAP Executive Committee. She wisely suggested that the President send a letter requesting the same to Professor Tin Oo. “I’m just here on my own. I cannot join without permission.” Formality and hierarchy are important to remember here if you want to be effective. I am a bit of an iconoclast, so I am not always maximally effective. Myanmar is now a member of ASCAPAP, which is the regional professional organization for child mental health in Asia. It includes all of SE Asia, plus India, China, Taiwan, Japan, S. Korea, and the Philippines. Australia and New Zealand formally became members at this meeting, as well. Our little enterprise grows.

Yesterday I signed up for a tour of the Maerim Elephant Sanctuary. I have never joined a tour from a hotel before and I hesitated but it turned out wonderfully. I met a young couple from UK travelling for a year, eventually heading to Australia to do bar tending or farm work. If you want to stay in Australia as a tourist for more than a year, you must do farm work, they are that short of labor.  Solar farm work is hard but pays very well. Banana farms are awful—very hard labor in heat plus lots of venomous snakes. Avocados are a better bet.  Then I met an older couple from Waterloo, outside of Toronto. They travel a lot, it seems, and we enjoyed each other. And there was a group of 30ish friends from Mexico City; two were pals from kindergarten, and all knew each other for 13 years.

We were told amazing facts about elephants. The males hang out alone in the jungle until they smell the pheromones, leaked out of a gland near her eye, of a female in heat.  The bulls can detect the scent from 20km away and they come trotting, eager to interrupt their solitude. The interruption is brief, however, as intercourse takes between 15 and 30 seconds.  So don’t feel too bad, guys. Of course, they ejaculate 1-2 liters of semen! Gestation is 2 years and newborns weigh 200 pounds. Psilocybin mushrooms grow happily here on elephant dung and are illegal to possess, use, or sell. The guide showed us a few.

We all learned to approach and pat elephants, while shouting, “Ja!”. “Ja” means “Hello” or “Welcome” in Thai. You shout because elephant hearing isn’t so good in the high frequency range of human speech. We fed them copious amounts of bananas and squash, shoving some directly into their massive mouths. Asian elephants are smaller than their African cousins but they still weigh 3-4 tons. These had all been rescued from logging or riding operations.  After hiking to the nearby banana plantation, we cut down some trees for food—they like the leaves and the inside of the trunks. They delicately dissect the tasty heart of banana tree stems from the more fibrous outer layers with their trunk and jaws.

After making our own yummy Thai noodle soup, we walked to a large muddy pond. The elephants lay down in the muddy, soupy water and we did, too. Then we scrubbed them—and ourselves—with the mud. We were assured the mud was only 40% elephant dung and the liquid only 60% elephant urine. We kept our lips zipped. I recalled that turkey vultures in California shit down their legs, which is excellent antibacterial protection for them.  Maybe, at last, my athlete’s foot from using communal showers after playing squash and rowing in college will go away.

Finally, we rinsed off and got in a lovely swimming pool with a cold beer and relaxed until it was time to return. I am sold, especially as a solo traveler, on signing up for these tours. They may vary in quality but they support the local economy and provide me with a little social life on the road.

I don’t know how Paul Theroux, Bruce Chatwin, and other travel writers go it alone for so much of the time. I fancy myself as being OK alone but I notice that I always want to talk to and hear from others if they are there. I am more social than I imagine, I guess, which gives me some pause about winters in rural Maine. Still, it probably will be good, and interesting, for me to get to know myself well without the company of others. I can always break up the solitude with visits to friends.

NEWS BRIEFS: -My trip to the refugee camps in Rakhine State is on hold, as permission from the government is not forthcoming.

-I was formally approved by Fulbright for a 3 month extension to launch the next group of Child Psychiatry trainees, so if they can start in January, I’ll be able to help them until April.

-The noose tightens as the web of intrigue, shady characters, misdeeds, and canaries grows.