Drowsy Sunday

[Above photo: From my balcony the Year of the Rat celebrations on Sint Oh Tan Lan, Yangon. Notice the yellow dragon. A perfect petri dish for 2019-nCoV!]

2 February 2020

It is so pleasant to awaken whenever, lie there for as long as I like in a dreamy state, and then arise as my mind organizes itself to head in a particular direction. However, starting next Sunday I’ll have a class here from 9-5 every Sunday, excepting two in April (Thingyan Water Festival Holiday), until the end of May. In my eagerness to combat loneliness, spread the word, and to work with UNICEF I signed up to train 8 in psychotherapy on Sundays. Happily, I anticipate it will be a fun and lively training and it is something I feel very comfortable doing.  The 4 people I know who have already signed up for it are terrific.

I’m putting together a presentation for the annual meeting of the American Academy of Child and Adolescent Psychiatry which happens to be in San Francisco in October 2020. It is fun to think about last year’s course and how to make this year’s better. And I’ll get to see my friends in the Bay Area, as well.

The 3 day training of 33 faculty at the University of Nursing Mandalay went well. The nurses are so appreciative of a physician who treats them as an equal.   Doctor-nurse relationships have paralleled man-woman relationships for too long. Different but complimentary skill sets doesn’t mean superior-inferior but it has gotten expressed that way. I recall in Malawi asking one of my Peace Corps cohort, a distinguished researcher/clinician, why he didn’t include the nursing staff on medical rounds each morning. It hadn’t occurred to him, although the nurses had much more information about the condition of the patients and the patients’ families than did the doctors or medical students he was teaching.

Some of the younger nursing faculty were really on the money, understanding what I was saying and asking interesting questions. Some were pretty quiet and some seemed to not understand it very well. Of course, only a handful were Mental Health faculty. But they all were very appreciative and want me back with more in the Fall. The Head of the University of Nursing, Professor Nyi Nyi Htay, was a smart, engaging guy with a PhD and strong research interests. The whole enterprise is underfunded, of course, and it is a life-long dream for them to go to a single conference abroad. The entire health care establishment feels like an engine whose fuel supply is so restricted it cannot develop more than 20% of its potential torque.

Along those lines, there are a lot of Masters and PhD theses lining the shelves of the libraries. They cannot afford the fees to have them published in open-source journals (like PLOS) and no one can afford the subscription fees to the other journals (Lancet, BMJ, JAACAP, JAMA, etc.). Lots of careful thinking and hard work may get them a degree but their contribution to the corpus of knowledge is orphaned, gathering dust. I spoke with Harold about how I might set up an on-line repository, since PLOS was his baby, and he had some good ideas.

[Jesus! I just got a Skype call from a pretty woman with a lot of cleavage called “Nice Priscilla”. Freaky. Time to run a thorough scan of my computer, I think.]

I’ll talk with the Powers-That-Be about developing a simple system to scan and put online all of the research that is moldering away. It must make the students feel dispirited about their work, knowing it isn’t going to be shared.

In Mandalay I stayed at the Royal Naung Yoe Hotel; it was a modest place but clean and quiet with an extensive breakfast spread. Curiously, on different booking sites the price of a room varied from $15-55/night. My room was tiny, much like being on a sailboat; everything needed was there but in a very restricted space. The shower, like most here, had an immense shiny nozzle and plenty of warm water; it ran onto the tiled, tilted floor and out the other end into a hole in the wall. I think it must have been into a pipe and the joint wasn’t cosmetically complete. Still, I imagined rats and kept the bathroom door shut. My sleep was disturbed by the episodic and frantic howling of groups of street dogs nearby.

I had forgotten it was winter with cool evenings in Mandalay and didn’t bring a sweater or fleece. From the minute I arrived at the airport in Yangon I began to freeze. On the plane surrounded by people sneezing and snuffling, with visions of corona virus in my head, I continued to shiver. So when my hotel room was warm, if a bit stuffy, I was happy. The last night, however, I wanted fresh air and opened the window; within a minute a mosquito was buzzing in my ear. I slapped her (only the females bite us) hard and arose with resignation for the presumably futile exercise of trying to find, and kill, a tiny insect in a room with shadows, drapes, furniture, and a 12 foot ceiling. Wonder of wonders, on my pillow was a dark creature; indeed, the same mosquito who had tortured me. Back to sleep.

My students from last year’s course took me to supper and we laughed a lot. They are so thoughtful; I shall stay a few extra days on my next trip so I can see them and their workplaces. They have started a Child Psychiatry Clinic at Mandalay Children’s Hospital! I am so proud of them.

The senior faculty of nursing were kind and generous, arranging for my transportation each day and taking me to a splendid supper on the last night. There were formal opening and closing ceremonies for the course, officiated by two junior faculty members, with the giving of certificates of attendance, photos, speeches, and gifts.  They don’t have many extra-mural trainers and they seemed very pleased, as was I.

I returned to Yangon the next day, fatigued.  However, when Kelly and Jose asked me to join them at Byblos for pizza and pool, I couldn’t refuse. We had laughs, as my pool was awful.  I’m not sure what has happened; I used to be pretty good (50 years ago).  My vision is wanting and my eye hand coordination seems less than ideal now. Am I ageing?

I noticed I am not walking distance regularly and am feeling out of shape. So I purchased a magnetic  elliptical cross-trainer (very well made, good electronics, attractive) for $230 (delivered, assembled) in a local sporting goods store. I’m starting at 5 km and low tension and I’ll work up. I break a sweat so I think it is good. Between weights (450 reps), floor exercises (deep knee bends with weights, 3+ minute planks, sit-ups), and the machine I’ll be fit in no time. Recent studies demonstrate marked increased elasticity of arteries in anyone at any age who trains for and runs a marathon. I’m all for arterial elasticity.

As to DT, get out the vote and work for your candidate and, eventually, the Democratic nominee. What curs these duffers be! And how in the devil can George and Kellyanne occupy the same bed?  A freak pairing, like a lion and a lemur or those stressed elephants in ?India who were trying to mount rhinos.