[Above photo: Why is this woman smiling as she strides along at Mile 24 of the NY Marathon? ]

11 November 2018

As winter sets in, with crisp mornings, shortening days, brilliant sunlight, and snow flurries yesterday, I am still awaiting permission to apply for my visa to Myanmar. I can see Burma vaguely in my future. Whatever obscure reasons are hindering approval, the process is shrouded and nowhere transparent.

The weather in Yangon yesterday was: temperature 87/76 F, humidity 90%, and thundershowers. The advice is “Don’t bring a rain jacket, as it will be too humid to wear it.” Blantyre was 82/58, 27% humidity, and sunny; the rainy season hasn’t begun. Since it is at 3000 feet, it is a milder clime.   I’ll be happy to be in Myanmar, no matter the weather.

Our country breathed a sigh of relief after the elections. Not that a liberal agenda can be moved forward with the current Tweeter-in-Chief, the Supremes (So many offers of new, younger ribs for Ruth!), and the Mitch lining up his Yes-Men, but at least investigations of corruption can advance and perhaps the most egregious of His Ploys can be foiled. Now is the time for smart Dems to show their strategic chops. I’m a terrible chess player and cannot think 6 moves ahead but I know there are plenty of people out there who can.

Linda and I canvased to get out the vote on Election Day, first in Hancock County and in the afternoon in Southwest Harbor. What a contrast! Single and double-wides in the former, except for very large and fancy houses on waterfront, and lovely old salt boxes and federalists in the latter. The poverty of rural Maine is something I’ve largely encountered only while driving past it or at the Goodwill store in Ellsworth, when I am buying throwaway clothes to wear in Myanmar.  At the end of a muddy, rutted road in the woods I knocked on the door of a trailer. An elderly man wearing a gray union suit, with a large hole at the right elbow, answered. I thought, has he a shotgun in there? To my surprise, he was friendly and chatty and on the kind and benevolent side of the great divide in this election. We talked for a bit and his understanding of our current predicament was bell-clear. Next, at the end of another muddy road with many pickups parked outside and people laughing inside, was a double-wide. A 30ish woman came out and shut the door behind her, tensely saying that her mother, after whom I’d asked, wouldn’t be coming out to speak with me. She was totally wired and it was disconcerting to see her continuously flipping her dentures with her tongue in 360’s as she nervously responded to my inquiry. Having a speed party inside, I’d guess. Likely they’ve given up on the election process as a way to secure help. Next Linda went to a small house with a disabled ramp to find a 50yo amputee and her 70yo mother with their caretaker. Linda, it turns out, had delivered the caretaker’s first child.  The younger resident claimed they had applied for absentee ballots and hadn’t received them. We drove to the polling place and used the phone to discover: 1) the older woman hadn’t applied for her absentee ballot; 2) the younger woman’s ballot had been sent to the correct address—likely it got buried in the chaos of the household; and, 3) we were unable to secure  handicap transport for either of them.  They couldn’t vote.

In the afternoon we went from comfortable house to elegant home in Southwest Harbor. Linda knew a number of the residents and they all had voted. The streets were paved and, as the rain poured, we wearied of the task.  We didn’t encounter anyone who was ambivalent about voting or needed a ride, so we packed it in for the day. Overall it was a very good experience for me to be busy in a constructive-feeling way rather than just fretting about the outcome of the election, which would only become clear 24 hours later. It also was fun talking with different people, bringing a neutral agenda—just offering them encouragement and help to vote.

Time is in reverse in this note. Linda (see above photo) ran the NY Marathon, all 26.2 miles, last weekend. It was glorious for her and, if a bit exhausting for me to follow her on the subway, a fully engaging and exhilarating experience. Kind of presaging the election results, I think. I’ll do more systematic training on cheering and subway riding before her next one. I was able to see her in three spots, at mile 4, mile 18, and mile 24. She felt, and looked like she felt, terrific. There was so much cheering along the way and so many funny signs: “I’m more tired than you just from holding this sign up.” “You are running faster than a Supreme Court justice to an open bar.” “Pain is just bread in French.” And on and on. The runners could only exit Central Park, after finishing the run at Columbus Circle (59^th), at 76^th Street, and Linda then had to walk to her friend, Ruth’s, at 57^th. After celebratory photos, champagne, tapas, and cake at Ruth’s, we walked to Harold and Connie’s at 81^st and fell into bed.  I thought, well she’s got the madness out of her now. Oh, no. It was such fun she is thinking about another marquee marathon next year. “I think I’m built for long distance running.” Obviously.  Warsaw, Berlin, Paris (Do they have a marathon in the City of Light?). Reno Orsi, her Italian immigrant father, was a powerhouse who realized himself in his older daughter, not that he was moved to give her credit commensurate with her accomplishments.

I’m finishing the detailed curriculum for the course I’ll teach in Myanmar. It’s a lot of work, or at least I make it so, to assemble and teach it the first time. The second year would be simple.  In Malawi there was only a week of Child Psychiatry, for medical students, taught twice per year and I shared the teaching with others.  I suppose the unknowns in this situation make it more daunting: will I get a visa and be able to go? If so, when? How much time each week will I be given to teach? How many students will I have? Facilities don’t matter so much to me, as I can do it anywhere with a roof.

Two couples, old friends for Linda and newish for me, will come from UK for Thanksgiving, along with between 2 and 4 of Linda’s children and two grandkids. It will be such fun! Laughter, good food, fires, hikes, stories to hear and tell, watching another year pass. What a miraculous gift it is to be living, even with the progressive indignities and privations of old age.

And we took back the House! I want to see his tax returns.

[Above photo:  Kitchens I have known. Safari Camp, Liwonde National Park, Malawi]

26 October 2018

As I walked and drove around Berkeley and Oakland during my visit I was astounded at the number of obviously emotionally disturbed people appearing homeless.  They were sitting on the sidewalks on Telegraph and Durant Avenues; they were walking and panhandling on Shattuck Avenue. There was a small collection of tents right at the ‘There’ sign between Berkeley and Oakland on Adeline. And while riding the BART to the Oakland Airport I saw huge tented and tarped encampments underneath the 880 freeway. All of those people, cast off and out. One measure of the success of a society is how well they care for their most vulnerable. Didn’t DT say that once? No.

I had such a good time visiting and dining and hiking with all manner of friends in the Bay Area, including some from 50 years ago. But the urban human decay left a very bad taste in my mouth. A bitter, guilty taste.  How have I escaped such a fate, why have they not?

Seattle, where I was born and lived until 12 years old and to which I returned for my internship and a year of medicine residency, looks sparkling and prosperous. Cranes are everywhere downtown, erecting tall buildings. The weather was gloriously sunny and bright for 4 days and has been drizzly for 2. Nothing like the rainy season from November through April in Blantyre, when the skies open at any moment each day and drop buckets down, drenching everything and everyone.

My nephew, David, and his wife, Kir, and their children, Maddy and Sebastian, have all welcomed and integrated me into their family. Maddy and 4 incredibly cute and geeky high school boys brought their robot to the basement to show me last evening. They all are just bursting with ideas and talk so rapidly it is sometimes hard to decipher. The robot is amazingly complex and can lift a ball off the ground, toss it into a scoop, drive wherever, and unload it. Little motors all over.  It was such fun to hear them chatter.

I get up at 6:30 or so with the family and marvel at their dance as they inhale breakfast and get ready for school and work. David works for Valve, an incredibly successful game company, whose founder just sold the most expensive car ever, a 1962 Ferrari, for $48 million. It is pristine, all original, and was raced by several legends.  Just one of his stable. To think that computers and software didn’t even exist commercially until, what, the ‘80’s? Kir has a busy interior design business. Maddy goes to college next year. Sebastian will start high school.

The buses here are amazing—clean, quick, efficient.  In the morning I walk one block alongside Volunteer Park, jump on a waiting #10, swipe the Orca card, and sit back for a quick ride to the Washington State Convention Center downtown.

I’ve really enjoyed myself at this conference. I feel like my brain is expanding exponentially. My presentation in a panel about starting Child Psychiatry programs in low-resourced countries went well. I even sat in and held my nose through a day of psychopharmacology review. I learned useful things, to my surprise. One of the presenters, however, talked as if his patients were just objects he fed pills to and then sat back to see how they responded. Wouldn’t you know, he’s at Harvard and smart in his way so he has a bully pulpit, what Big Pharma calls “a Key Opinion Leader”.  Workshops on aggression, autism, and systems of care were amazingly interesting at points. This evening I was at a working group on problem-based learning. I facilitated problem-based learning exercises in Malawi but hadn’t realized the extent to which it has taken over medical school curricula. Of course, active learning is so much more interesting and successful, stimulating curiosity and a habit of learning that should last a lifetime. Sitting in a lecture is so passive and unengaging, generally. All said, the AACAP annual meeting was of high quality.

The first two days I was a little late for the all-day symposia I’d signed up for. The ballrooms were packed with 350-400 people and I wandered a bit each day until I found an empty seat. The first day I unwittingly sat next to a guy I’d liked and worked with in Oakland; he moved to Seattle five years ago. We had lunch at a great Syrian place he knew and he told me about his cardiac arrest 4 years ago (at 45yo, fit and running half-marathons) on a plane just before take-off to Paris. Fortunately, his wife, into whose lap he fell, is an ED physician and she did CPR and defibrillated him. He now has a stent and a pacemaker and is back running half-marathons. The following day the free seat I slipped into was next to a young psychiatrist I’d also known and liked a lot in Berkeley. He also moved to Seattle where he is structuring an interesting life with a wife and 3 kids.

I had supper with my former sister-in-law two nights ago. She is a lovely person and we talked and talked. I’ll sup with her, her husband, and their daughter with her family on Saturday. All of those relationships were disrupted by my divorce and I’m glad to restore them, if on a more limited scale.

Now I’ve walked downtown to the Pan Pacific Hotel where my friend from Berkeley, Hans, is staying. He teaches couples therapy in Seattle for 3 days several times a year and in San Francisco and Los Angeles, as well, and loves it. We’ll have supper. I feel like I now have friends throughout the world.  Maybe I always did, but I’m more aware of it now. It feels good in these times of global fear and feckless leadership.

Linda is in Boston, speaking at a conference tomorrow.  Sunday I’ll be on the 6AM flight for Portland, Maine and back in Bar Harbor by Monday.  I can’t wait to see her and the snow accumulate on the planter outside her kitchen window.