Sore Shoulder

28 June 2020

[Above photo: One of my students, Dr. Su Myat Yadanar, on the beach at Dawei, taking a break from her clinic last weekend.]

There is so much good news here. The webinar we did for >500 physicians across Myanmar was such a success that I’ve volunteered myself and my students to do a series of 13 more. We’ll use the same format—a lecture-discussion followed by two detailed case presentations. Not surprisingly, one of the cases presented then, who had a near-miraculous turnaround of very aggressive and disturbing behaviors, reverted to his old ways the day after the presentation. But my intrepid student (see photo above) has continued to work with him and the family and he is doing well again. Success in this work is rarely a straight line, especially with intellectually disabled patients whose un-learning may be as impaired as their learning.

A follow-up on the 11yo boy who is cared for by his elderly grandfather and three elderly, spinster great-aunts. After his brief hospital stay and twice per week visits to clinic, he is sleeping at regular hours and only had a single, brief, daytime aggressive outburst when his great-aunt scolded him for something. The adults have been taking him outside to a park daily. He looks happier. He is mutable, I think; I fear the adults are much less so. The primary great aunt repeats that all she wants is a pill for his aggressive behavior and a pill to make him go to sleep at night. Whew!

Professor Tin Oo sent me an email from Nay Pyi Taw, the capitol, where he had just met with the Union Minister of Health and Sports. The latter agreed to build a child and adolescent psychiatry training center and clinic facility, presumably on the grounds of Yankin Children Hospital where we now hold our clinic. This is thrilling to me. If they will also fund a professorship in Child and Adolescent Psychiatry at University of Medicine 1, which the Rector mentioned to me, I’ll feel I have really gotten something going here.

Our Facebook page, Caring For Our Children, is off to a stumbling start. Never having done this sort of thing on Facebook before—I really don’t know how to navigate it well.—-I should have been much more clear about my idea and plan. One of my students suggested that we start again, with a different title. The student who has been administering it has used it like a regular Facebook page—-a self-advertisement with photos, etc. I want a simple informative newsletter, in Myanmar and English, with weekly entries and, eventually, a Q&A appendage. No photos, no advertisements for ourselves or our services. We’ll start again, after thinking it out together more carefully.

The pharma marketing CEO did follow-up with a lunch invitation. I asked that all my students could be included, which he seemed happy about. We had the best Thai meal yesterday, with lots of laughter. I was so full I came home and promptly fell asleep on the couch for 2+ hours. The soft-shell crab and the sautéed razor clams were outstanding, as was the chicken curry in coconut milk and the baked fish with ginger and lemon grass. Dish after dish. The CEO, whose name I don’t even know, was a friendly Indian from a small village outside of Lucknow. A handsome devil, he’s surrounded himself with a couple of lovely women assistants. The piece de resistance of the meal was frozen durian in coconut cream. Heaven!

My left shoulder was a bit painful in early April when I  lifted weights, small 5# dumbbells. My routine was 50 repeats of 9 different exercises, added to 45 minutes on the elliptical trainer. I stopped doing the exercises which caused pain and, finally, all exercise of my upper body but the pain has increased. For the past 3 weeks I cannot sleep well, every position hurts my shoulder. I often must nap in the afternoon, as a result. I cannot take non-steroidal anti-inflammatory medication, since I whacked my kidneys with chemotherapy 10 years ago and NSAIDs don’t agree with them. I’ll see a doc next week but it is definitely irritating, physically and emotionally. I had a frozen right shoulder some years ago as a result of doing competitive yoga (I, of course, was the only one in the class competing!). That was a terrifying experience. I couldn’t move my upper arm at all, could hardly sleep, etc. Two steroid injections later and I was fine and it hasn’t returned. It felt like a paralysis or an amputation, however; I couldn’t button my own shirts, let alone put them on or remove them. This shall pass, I am sure, but probably needs a little medical care.

It is awful to see the testing numbers rising in the US again, even as I feel a certain shadenfreude—“You deserve it, dummies.”—that it is hitting Texas and Florida especially hard, given their governors’ arrogant, dismissive stances. As if we can get the economy going without careful attention to the virus. But my niece lives in Austin and is at risk if she were to contract the disease, which helps me contain my splenic joy.

Why is scientific opinion so reviled by so many? Is it that, no matter how hard I wish for something to be otherwise, science always is right?  Is it that those guys who stayed in school and got advanced degrees actually do know more than me about some important things that affect me? Scientific opinion generally emanates from universities and government agencies with a mantle of authority, which infuriates people, like DT, who want their opinion to best all others. It’s a kind of group narcissism. “The world works the way I feel it does.”, critical thinking be damned. Many preachers, people with a direct phone line to God, feel it is their imperative to tell their flocks how the world is. Science, including evolution, can interfere with their power.  Often their power derives, in part at least, from opposing a rational viewpoint, which resonates with their flocks. I note that I am talking about his base.

It is chastening to reflect on how tidied-up my sense of history is. In 1862 The Great Emancipator, stated, “If I could save the union without freeing any slaves I would do it; and if I could save it by freeing all the slaves I would do it; and if I could save it by freeing some and leaving others alone I would also do that.” Sigh.  I had no idea. Just as was Freud, we are (mostly) all creatures of our time and place, imperfect.