9 November 2020

[Above photo: The garden outside my bedroom, as seen through the plastic film on the screen door.]

I find it difficult to choose a metaphor to adequately reflect the depth and gravity of our (half of the voting population) relief. One try: Our recent past has been like attempting to transfer your beloved grandmother from Stella to the float on Beach Island in a northerly blow during a minus tide. Will Stella ground hard, crushing the propeller cage? Will her engine stall on the approach, putting her onto the rocks? Will the pitching boat and the heaving float smash together, with someone’s extremity cushioning their collision? Many awful-to-consider scenarios pop to mind. Then, how to get grandma from the float to a comfy chair in front of a fireplace. The pitch of the gangway is too steep, wet, and active to ascend. Entering one of the skiffs will be a challenge, equalled by rowing across the harbor in a wild sea to land on a protected corner of the shingle.

What a nailbiter this election was! Now we work, not to convince the Base to like us but to gradually improve all of our life conditions—income, health care, education, work security—and, in this way, to encourage them to buy into order and comity for all of us, however different their social beliefs may be. There is room for all of ours, if not imposed on the Other. Feeling aggrieved is a life-path for some but most of us just want to be on the train.

A handy, if temporary, solution to feeling anxious in a situation over which you have no control is to shift your focus. After I unpacked my possessions and set up my room—The IKEA branch here is small but carries well-designed lamps and bookshelves.—, Kelly and I continued the renovation of the kitchen, which he had already started. He added a 5 story spice shelf and another shelf for pots over the stove. I should note that he has built a bookcase, a small desk, and 3 shelves solely out of wood salvaged from an old double bed, underlining his ingenuity. We painted the walls and windows white, the cabinets and screens robin’s egg blue, and the pantry door a rich, dark blue. We put in track lighting and dispensed with the three desk lamps clamped on various shelves. There was a lot of paint in random locations. It is now inviting to enter the kitchen, flip one switch, and enjoy the order, aesthetic, and functionality.

Next, I decided that I wanted a transparent door, in order to view the garden while running the a/c. Kelly mused about glass and plexiglass.  I thought about Saran wrap—Stop laughing!—and clear shower curtains. I tried Saran wrap and by the second panel was hopelessly mired in plastic wrap sticking everywhere except where it should. Kelly went on-line and found a store with rolls of heavy, clear plastic.

We took a cab, using Google maps, toward Super Hawk, near my old haunts downtown. Alas, there was no Super Hawk at the indicated location. As we wandered down Shwedagon Pagoda Road, a roll of clear plastic in a shop caught Kelly’s eye. $3 later we had our own roll of very thick, very clear plastic. Within 45 minutes of returning home we had removed the molding on the screen door, stretched the plastic over it, replaced the molding, and trimmed off the excess. The above photo displays the result. I am ecstatic! Of course, when covid restrictions lift, Kelly won’t work from home and I can settle anywhere in the large, open-plan house when I am not in clinic or at UM 1. I can now, of course, but for a private call or when conducting a class or webinar, I want a background of silence which I get in my bedroom. Now I can look out on the garden, simultaneously.

In a parallel universe, Ariane has been identifying and visiting property near her home for me. The contrast between the photos and description of a place on Zillow (Absolutely ideal!) and the reality of visiting it with a contractor (Mold, needs paint and a roof, no protection of water view from a possible new home, dark inside, etc.) is striking. I have total faith in her taste and evaluative skills. It will be hers in 10-15 years or less, anyway. She is working on a design and is lining up builders. We need to find the right spot and I’ll plunk down the money. I envision two bedrooms and bathrooms with an open living room-dining room-kitchen, a wood stove, lots of light with views, a mud room, a garage and a workshop where I can built boats and putter around. It is fun to imagine it all and me in it.

If I am breathless at our near-slip into autocracy, I am equally amazed at where I find myself in my life. I’ve always liked adventure and seem to have stumbled, with help from others, into plenty of it. This morning I was recalling the days after my lobectomy in 2008, pushing my iv pole as I shuffled around a path in the post-operative ward at Kaiser-Permanente in Santa Clara. I estimated the floor tiles to be 12” on a side and by counting them could walk up to 5 miles per day as I recovered. No one else was doing the same and I credit some of my excellent response to that determination. Again, I’m lucky to come from people who modelled pushing through rough times. Both my parents did the same. Dad lost all his money—He never expected to have to earn his living, despite having gone to medical school.— in The Crash of ’29, simultaneously with my mother giving birth to their first of five children. My mother’s severe depressions and early widowhood were followed by her Second Act as a Professor of Child and Adolescent Psychiatry and as a psychoanalyst.

I recall being at the top of the in-run of the largest ski jump I’d ever been on in 1957. It was at a race in Steamboat Springs.  Marvin Crawford, who was an acquaintance of my older brother, Roger, and who was on the US ski jumping team at the Winter Olympics in Cortina d’ Ampezzo in 1956, was advising us before we jumped. He said, “Just throw yourself up and forward, with everything you have, and it will be your best jump and the safest, as well.” After clearing the flat part at the top of the out-run, landing was pretty easy on the very steep slope. I was able to follow his advice and had a good, if rather terrifying, day. We allegedly hit 70mph at the moment of take-off.

There is grit in everyone. If we simply believe the best will come if we throw ourselves into it and persevere, and if we have the good fortune to live long enough, it can pay off. Not always, and certainly not in the way we might expect it. That is part of the fun for me, the unexpected.

1 November 2020

[Above photo: On the Zambezi in 2018. I have an idea for her supper.]

This moment in time seems as important as, say, Pearl Harbor or Hiroshima. And for the future of the world, perhaps more important as our atmosphere thickens, Mother Earth warms, species vanish, weather becomes extreme, and human life becomes unsustainable in many parts of the world. Then there is racial oppression, etc. I don’t have the stomach to list all the ills we’ve been discussing so recently. Clearly this man who fosters greed, corruption, violence, and division must go or, like the course of the coronavirus in the US, suffering will increase.

Against that cheerful backdrop, I moved into much more felicitous digs on Wednesday. It took a bit to pack and unpack, but the movers arrived at 1:30PM and left Kelly’s at 3PM, a record. All I lost were some cheap ballpoint pens and a tiny stapler which I regretted ever buying in a drawer that I “forgot” to empty. Nothing broke, even the cheap champagne flutes. I again envied the Sioux and other migratory Native Americans: a teepee, perhaps a few gourds and pots, a knife, a bow and arrows, some buffalo robes, and they’re packed and ready. No lamps. No mattresses. No elliptical trainer. No suitcases of clothing. No computer or printer.

I’m sitting on my porch, saturated in green, surrounded by birds, squirrels, butterflies, and various flowers in bloom. It is a sunny day with numerous puffy white clouds floating by like thoughts in a meditation. While the humidity is 70, there is a breeze and the temperature is a mere 88, which is lovely. What a blissful day.

We enjoyed our elegant brunch from Shwe Sabwe, the cooking academy, at Jose and Irene’s home two houses away this morning. I am managing to tame their fierce, traumatized Ollie who lets me pat him if I move slowly. We chatted, of course, about the election, simultaneously moaning how over it we all were. We’ve all voted. I’ve given more money to this election than ever before, which doesn’t add up to virtue but simply underlines what a stupid and corrupt system we have. He who raises the most money has a huge advantage. The networks reap the rewards, as well as fat cats trying to keep their tax brackets low and government regulation of industry minimal. Curiously, as Mafia Don admitted in the Spring, if all the Democrats voted there wouldn’t be a Republican elected.  All they can do is try to disenfranchise significant numbers of voters. And the poor and minorities are the easiest to pick on, since we have a precedent for it in poll taxes and they have felt the least able to fight it. Things may change this time around and, with luck, the System can be modified. Get rid of Citizens United, the Electoral College, and enable publicly-funded elections, none of it easy to do.

I am trying to establish a new role here, since my class has finished, I cannot return home and a new class won’t start as long as the virus keeps clinics closed. Part of me is ready to wrap it up and settle in Maine, but I’m not done here and my living situation has just improved significantly. Life’s choices, but enviable ones. I could buy a 30’ sailboat and cruise. I could throw myself into writing, enroll in a woodworking school, etc. I couldn’t successfully learn a musical instrument, at least not to my standards: too late, perhaps too lazy (I’m not even going to consider talent here). I cannot travel, because of the virus. However, I can continue to try to augment what I’ve already done here, which is probably the best choice for me.

Kelly plays tennis almost every day and it provides him with a social life of sorts with the tennis bunch. Since the American Club has been closed, they play at L’Opera, an Italian restaurant on Inya Lake run by 90yo Francesco and his Myanmar wife (I know neither of them.). I cannot play, because of my sore left shoulder, and in any case have not played for years. This morning before brunch while he was at play, I walked for 1 ½ hours up to Inya Lake and along it. It is green and manicured and quiet and pretty.  There are a few older people out, carrying plastic stools on which to sit as they chat and look over the lake. The few shaded concrete benches are occupied by young couples hidden from the back by an umbrella, much as I saw on the overpasses downtown. It was a brisk walk and I’m happy to discover quiet places to go near home.

I imagine that I have a lot of free time but I seem to fill it up easily. Yesterday, trying to connect my computer wirelessly to my printer, I pushed the WPS button on the router, following instructions, and erased Kelly’s network. I can sit on my porch and use Jose’s internet, as I face toward his direction. But I spent fully 2 hours messing around with the computer/printer yesterday, futilely. We’ll get the network restored on Tuesday, as Monday continues Thadingyut holiday, the festival of light or fire or the Full Moon of Thadingyut, take your choice.  It would be fun to go to Taungyi, in Shan State, where they loose a flock of paper balloons with small candles in the evening. The moon was certainly full last night. How dependent I am on the internet.

Ari is going to look at a couple of small two-story cabins, appealingly rustic, on 3 acres of land with a view of Stonington Harbor on Deer Isle. It is a different vision than I had for myself, in some ways, but very compact and appealing, with a cute town to walk in, a working harbor full of lobster boats, and a great piece of property. It’s pretty quiet in winter but Ari assures me there is a nice community. And by the time I am actually spending my winters there, I may be ready to hunker down with a few friends and read, write, look at the harbor, and put a log in the Jotul. I realized after I fainted during my presentation that it isn’t responsible of me not to have a back-up plan, in case I become ill. I do not want to burden my daughter by having no place to reside in the US outside of my summer camp on the Island. Something small, attractive, easily maintained, with acreage, and a wonderful view of a harbor seems very appealing to me.

I regularly remind myself not to hold my metaphorical breath. Will we rise to the challenge and come down on the side of healing divisions, environmental stewardship, true equal treatment and opportunity, and everyone gets a decent share of the pie? Or choose a scofflaw who fills our government with corrupt inepts, winks at his rich buddies, and refuses to accept responsibility for his failures and lies? How much clearer can the choices be? Holder vs. Shelby County (2013) tells us all we need to know about this Supreme Court, how it has become unconscionably politicized.  With the latest hypocritical appointment, I see no choice but to restore some balance to it, even as that continues a degrading precedent.

Vasovagal

25 October 2020

[Above photo:  Timber bamboo in the National Botanical Garden in Pyn Oo Lwin.]

As I was thinking about our live Q&A session for AACAP, held last Wednesday (8AM PDT, 11AM EDT, 9:30PM Myanmar time), I was considering what shirt to wear. A great Zoom advantage is that I don’t have to choose and iron a longyi or press trousers. I noticed when I was shaving in the morning that I had unruly white tufts of hair like little clouds peeking out behind my neck. How to remove them evenly? I settled on tying a strip of an old cotton t-shirt, which I have used to truss up a chicken before roasting, since I cannot find cotton string in any shop. I wash it and re-use it; it is redolent of roast chicken and garlic, an appealing combination for me since I’m acquiescing to Kelly’s plant-based diet, planning to live another 80 years. I tied it around my neck, not too tightly, and was able to seed the clouds with my beard trimmer so they fell to the ground.

On the night of the Q&A, I moved my clothing rack and propped my computer on it level with my chin. I got online, as requested, 20 minutes before the session. I’d prepared a 5 minute introduction, including a brief reprise of our recorded presentation. All the presenters “assembled” and my old friend, Jon Whalen, joined us early, so I introduced him around. The time arrived, with a small audience, and I began to speak. Suddenly I felt the earth slipping away. I’ve had a vasovagal reaction once before, 35 years ago and it floored me. I quickly dropped onto my back, knees up, holding my computer in front of my face and proceeded with my introduction. I could hear myself slurring a few words as I began but the blood soon came back into my brain and I could speak as well as ever, if recumbent. Then Dr. Paramjit Joshi, our discussant, made a few adulatory and perceptive remarks.  We took questions from the audience and it was over in a trice.

At first, I felt awful. My last hurrah at AACAP, where I’ve presented numerous times, and I passed out. Then I thought, isn’t Zoom a joy! If I’d been live in SF at the meeting, someone would have called an ambulance and I couldn’t have finished my talk or heard the others speak.  My co-chair hadn’t even realized I was on the floor, I later discovered. Again, it was “good enough”. I later received emails from several people who appreciated our pre-recorded presentation and felt a bit better.

I can’t quite sort it. I had cleverly removed the t-shirt strip tied around my neck. I wasn’t aware of feeling anxious at such a tiny appearance; I was not happy the audience was small but that happens when there are excellent competing programs at an online meeting. I had exercised vigorously for 50 minutes on my elliptical trainer an hour before and hadn’t hydrated adequately. Who knows? I admired my grit for pulling it off from the floor.

The next morning two students from my last class, plus one husband, came by my place, bringing chicken soup, milk, a pulse oximeter, and a bp cuff. Word had gotten around that the old guy had dropped and they were worried. They are so sweet and solicitous.

I feel fine now and made baba ganoush at Kelly’s for the first time in years. For some reason, the commercial varieties are dull and not worth the effort of eating them. My best is with a charcoal-roasted eggplant, including some of the charred skin which imparts a smokey flavor. This attempt was, like the Q&A session, “good enough”, having been roasted in a combo microwave/broiler. It’ll improve when we get a charcoal grill.

I am set up at Kelly’s with a desk, chair, bookshelf, and a desk lamp. My bedroom is simple, large and pleasant. I put the wardrobe in the hallway to make more room and I have a comfortable chair for reading if I want to retreat there. I’ll get two more bookshelves from IKEA. I’m excited to move in, which I’ll do this week, although I’ll be dropping two months of remaining rent. It is great to talk and laugh, to get to know someone else in the way you can in a joint living space, and to share cooking. Plus, the greenery everywhere I look is such a relief. Oh, importantly, I have a demand water heater for my shower (Push the large button that says “On” and “Off”, wonder of wonders!) after 10 months of cold showers, an overhead light in the bathroom (We replaced the broken fixture.), and the broken seal between the toilet tank and bowl seems to be self-restoring. I’ll get a bicycle soon, as there are good back streets and paths on which to bike.

This period in our history has been remarkably revelatory about human nature: our proclivity to follow a tyrant who speaks our language, Dostoevsky’s The Grand Inquisitor; our capacity to be unable or disinterested in distinguishing fact from fiction, when that operation would threaten our myths; the immense power of tribalism and what a constant and sometimes exhausting labor it is to try to overcome it in myself; and how my cultural myths—science and education are unquestionably good, equal treatment and opportunity for all—are superior to yours. We are all little ants making a huge fuss about a lot of things, our “humanness”. I applaud the fuss and certainly hope my tribe prevails on 3 November.

Despite excessive anthropomorphizing, ‘My Octopus Teacher’ is a remarkably beautiful and moving film (available on Netflix), a welcome antidote to all the manipulation and prevarication surrounding us.

Errata from last week. 1) Peter Finch has never stumbled onto a cobra in a bathroom in Zimbabwe at night. 2) The green mamba in The Poisonwood Bible was in a chicken coop.

Relevant facts not mentioned: Jessie Croizat had a green mamba in the outhouse in her village in Guinea when she was in the Peace Corps. Memory is fungible.

11 October 2020

[Above photo: More levity.]

When I am at Kelly’s on the weekends we talk with each other and socialize with Jose and Irene. Saturday I made fetuccini with putanesca sauce, garlic bread, and carrot/garlic/vinagrette salad and we hosted a poker group, adding Connor who is keeping isolated. I find the time passes without my knowing and soon it is Monday and I haven’t written my blog post.

I think I get a bit strange being isolated in my aerie. I should be talking with friends in the US on Zoom daily but I, like others here with whom I speak, don’t do it. I never have found phone contact a satisfactory substitute for an in-person relationship. The former usually leave me with a hollow feeling, like filling up on Party Mix or Pringles. 

I am leaning more and more to moving in here (Kelly’s). It is green and quiet and spacious. Kelly is great company and it is fun to exchange life lessons and swap fables. My bedroom is on the lower floor and, with the outside door open and the curtains drawn back, it is light and immersed in chlorophyll. I must fix the toilet as it needs a new gasket between the water tank and the base; each time I flush clean water from the tank gushes out onto the tiled floor and heads for the shower drain. Otherwise, it is really very appealing. I even use the room, with a comfortable chair and table next to the bed, as my studio for Zoom calls and lectures. All I am missing is my elliptical trainer, which I’ll move here soon, I think.

Hardship notes from all over: “Manila’s mayor banned the daytime use of ‘karaokes, videokes, and other sound-producing devices’ after complaints from irate parents home-schooling their children amid the pandemic.” The competing needs of adults to stay sane and let off steam vs. that of children who need to learn to read. Knowing how integral and important karaoke is in Filipino culture—-At every party I’ve attended with a contingent of Filipinos, they vanish at some point into another room and slip into karaoke.—, it seems a bit of creativity could solve the conflict. Math and social studies put to music. E=mc2 has a nice rhythm. “Spanish armada” rhymes with “advanced math is harda”?  Bataan death march is tougher.  I recall a pretty young woman with a baby in her arms singing a love ballad in an immense indoor mall in Cebu; she and the large crowd gathered around her were all sobbing. It was great!  Kids learn better with heightened affect and the French know that non-native speakers learn lingua Franca from songs. “Sur le pont, d’Avignon….”, etc.

Watch the nuclear football. This man is becoming unhinged and will soon have little to lose, since he knows he’s headed for jail and doesn’t really give a shit about anyone else. Not for us to panic, just to be extra vigilant.  

I wrote this sentence 4 days ago. My “Fake News” sources mention that there are high-level misgivings (I hope a bit stronger than that.) to Mafia Don having the nuclear option available. Given his ranting, his desperation, and his desire to distract from any focus on his job performance, creating an alternative reality, such as a “terrorist attack”, in order to give him the pretext to drop a bomb (on Iran, perhaps?) to “protect vital American interests”, is a strong possibility. Even the august, generally reserved New England Journal of Medicine has weighed in on DT’s handling of the coronavirus pandemic, saying he “took a crisis and turned it into a tragedy”.  

On a lighter note, I won about $5 Saturday night and last night won $3.5 million in fake money with our online game. I’ve gotten disciplined enough that I don’t go down the rabbit hole very often, despite Kelly’s urging—“C’mon, George. He’s just bluffing. Don’t let him get away with it.”—, Kelly having folded already. I did follow along once on Saturday, only to be met with three aces; I happily had a full house and took in a few million fake $.  It is fun to play competitive games, matching wits, cards, and luck with others.

I took a long walk yesterday while Kelly was off on the tennis courts. (I’d pick tennis up again, as the American club seems to be a fairly lively social place where you can exercise and then eat a croque monsieur and chat. My left shoulder, unfortunately, will not cooperate.) I went to a little storefront on Shwe Gon Daing selling NLD gear. The election in Myanmar is 5 days after our own and I wanted to get kitted out—to keep as memorabilia, not to wear. So I bought an assortment of face masks and t-shirts and caps for myself, Irene, Jose, and Kelly. The colors are a bright red with a yellow peacock (?) or phoenix (?) and often Daw Aung San Suu Kyi’s face in black. The National League for Democracy is primarily opposed by the USDP (the military party). I’d buy that gear for souvenirs, as well, but I’ve seen none for sale.

I am beginning to make a large shift here, encouraging my students to take over the Child and Adolescent Psychiatry webinar teaching we do for about 70 general psychiatrists every two weeks. It will be good for their learning. I’m happy to consult and be as involved as they wish me to be. But I can see the handwriting on the wall and I want my efforts here to outlast me and to continue to grow. That can only happen if they own it—and I loosen my grip.

I have been very unhappy with my Vivo phone. It was cheap ($250), has a great camera with 4 lenses, a battery that lasts 3 days, and lots of memory. But I was spending forever correcting spelling mistakes. I finally fiddled and fiddled and managed to activate the auto-correct spelling and get off of the Braille keyboard. I was an hour from buying an iPhone for $500. Now I am totally happy and didn’t do an impulse-buy.

It’s sunny, after two showers, so I’ll eat a bite and head for home.

4 October 2020

[Above photo: Just for a little topical levity.]

Words are so wonderful, agreed-upon symbols that can bring you to tears, either of laughter, relief, or sadness. Here are two more I came across this week.

“Don’t piss off old people. The older we get, the less ‘life in prison’ is a deterrent.”—having a special meaning at my age.

“Education is not the filling of a pail, but the lighting of a fire.” I fear this is not so in the great majority of settings.

I was at Kelly’s house again this weekend.  The trip there felt dicey, as we aren’t supposed to travel between townships. I risked it in a Grab, knowing he was quarantined and I have been, so I wouldn’t be compromising anyone else’s safety. I was prepared to be stopped by the police but the roads were empty and we sailed up in record time. We played Gin Rummy with Jose, Kelly, Connor, and me. Connor is a really nice young guy who worked for Kelly when the latter was Country Director for PLAN International.  He joins our online poker games Sunday evenings. Jose is very fluent with computer-speak so I brought up a thorny question I’ve never been able to answer. The main problem is, I cannot actually formulate the question so it appears that I am stoned, dissolving into laughter halfway through the sentence. Here it is: Are we being bombarded by every cellphone call in a given area code in every room we are in? Because if all the people in Myanmar, international country code +95, were able to fit into Kelly’s living room with their cell phones and friends or family rang them up from somewhere else, all the phones would go off. How do the electromagnetic waves know to go to another room, for example? Is everything actually happening all at once, everywhere, denying the concepts of time and space? I know, this does sound like a discussion late at night, fueled by good weed, in a college dorm. Well, no one can understand my concern, or query, and as they look more bewildered, thinking this oldster has had some mini-strokes and is losing it, I collapse into laughter until tears run down my face. Proud to say I didn’t wet my pants but I did have stomach cramps from laughing so hard.

The next day Kelly and I walked out his driveway, turned right and passed the now-closed Kokine Hotel, famed for hourly rates, and turned down Jose and Irene’s driveway for brunch. We ordered from Shwe Sa Bwe, a restaurant and cooking training academy that delivers during covid. The food was fabulous, with fresh veggie-fruit juice, souffle pancakes, bagels with smoked salmon, a divine passion-fruit curd to put on the croissants, Annie’s yoghurt, homemade granola, and Jose’s wonderful Café Americano. Ollie, the immense, traumatized dog which Jose and Irene love and the rest of us fear, allowed me to pet him, only growling deeply and baring his teeth once. Their house, like Kelly’s, faces the same wildlife jungle in the midst of Yangon and we sat on their beautiful deck and mused, digesting, I suppose.

My cooking is taking new and unexpected turns. Having been married for 44 years to Poki, who is half-Korean and half-Japanese and a fabulous cook, I ate deeply from both cultures. Her mother, Mineko, made the best kimchee, even though she was the Japanese half. I’ve discovered a Korean market near Kelly’s and bought a large container of kimchee. I figured if the virus gets really bad and I actually can’t go out for groceries, I can live a long time on kimchee and rice. It turns out that kimchee is great in a burrito with either melted cheese or grilled chicken. A new standby. Kelly uses peanut sauce, which he learned to create while working successively in Benin and Sierra Leone, to spice up vegetables and rice. It is basically, by his ministrations, a jar of peanut butter, a can of tomato paste, some fresh tomatoes, some onions, and water for thinner, cooked. It is good. I plan to sneak in some chopped groundnuts for texture and some chopped peppers for heat.

The great wheel of Karma turned and, lo, Mafia Don is hospitalized with covid, his doctor predictably lying about the severity. “Don’t be frightened of it. Don’t let it run your life”, says Mafia Don. OK, but first I want to talk with all your staffers who are now positive, as well as the 30-50 $250,000 a pop donors you exposed at Bedminster, concealing from them that you had already tested positive. Maybe some Secret Service folks from your glam-drivearound on Friday. Oh, and perhaps the relatives of the 207,000 who have died of it in the US alone. Why don’t we just share needles? And hankies?

As to our own covid numbers, we are at about 1000 new cases daily, largely in Yangon, and up to 444 confirmed deaths. Much of the country is so remotely rural that I doubt much testing or surveillance is occurring there. I want to come home next summer for a few months; the rub is returning to Myanmar but I think I can swing it with a quarantine at both ends.

The students had their final written, 3 hours, on Monday and a 15 minute oral on Tuesday, all by Zoom. Everyone did well enough. Some were pretty outstanding, given that it was all of Child and Adolescent Psychiatry compressed into ¼ the time of a US Fellowship, that we only had a live clinic for 2 ½ months because of the virus, and that all of my teaching and supervision as well as their reading was in English. What is clear to me is that I’ll need to set up ongoing consultation groups every week or two to build upon their foundation. Fun and easy for me to do. It was sad to say goodbye without a formal ceremony, which we’ll have when the virus subsides. [One of the women mentioned that before the course began she bought a new outfit for graduation.]

This isn’t really goodbye as we have continued connections with the weekly Parents Newsletter, the biweekly Webinar Series, and just yesterday two of the students, Nang Yu Yu and Su Su, came to my apartment with groceries and opium. The “opium”, as I labelled it, is a delicious Burmese condiment one makes and supplies to me; she’s my dealer.  I persuaded them to stay for tea and we chatted away.  A student from last year called for consultation on a case yesterday afternoon. I am not alone here.

In addition to the NYT, WaPo, New Yorker, and Science, I read free online newsletters from Heather Cox Richardson and Robert Hubbell daily. Both analyze the news and provide excellent perspective on our national scene. 4 million acres in California and still burning. For a tiny donation—-$5-10/month—I have a PBS Passport, which makes available to me an incredible library of film, including all the Ken Burns’ films, many of which I’ve missed. The Island series on Hawaii, Borneo, and Madagascar are spectacular. The Burns’ Country Music series is stunning, with gripping old footage of the roots of that genre. They are a welcome antidote to Fauda and Ozark, both soaked in blood, conflict, and betrayal.  And I am so happy to have Spotify.

I listened to Journey’s “Don’t Stop Believin’” this morning, a good theme song for the few remaining weeks.  It is played at the end of each Giants’ game in Pac Bell Park. Is it still Pac Bell Park? Has someone outbid them? A strange, commodified life we lead.

I can strongly recommend Sapiens, which I mentioned last week. Our great strength is that we can myth-make, which allows for cooperation and coordination of large numbers of people. It also allows for manipulation and persecution of large numbers of people. And the stock market. Great Religions. And so much else. But read it yourself. A giant step back from our current immersion.

27 September 2020

[Above photo: The jungly view from Kelly’s top floor, set in the middle of Yangon.]

I am back to solitude, although I’ve broken it up with 3 days at Kelly’s. I also have done lectures on Zoom, conducted Journal Club 2x this week on Zoom, watched an excellent film with my students on Zoom (“A Brilliant Young Mind”), conducted 2 hours of psychotherapy by Zoom with adolescents, provided individual psychotherapy supervision for 3 hours by Zoom, had a mandatory late night rehearsal for my AACAP Q&A session on Zoom, and led the a webinar last weekend on Zoom.

The webinar included a lecture about the basics of Cognitive Behavioral Therapy for which I wrote a mock therapy session. The students did a great job of it in Myanmar language; the non-verbal 65% was very convincing and they seemed to enjoy doing it. It was interesting to write. I’ve never created dialogue and never thought I could write a novel because of it. I procrastinated starting to put it down. Once I began, however, it flowed very easily and I ended up with 4 therapy sessions, lasting something over an hour altogether. So perhaps, just like I can easily sustain a blow to the head, I can develop character. I know, I am a character but I mean……. One never knows what you can do until doing it.

On the micro level, my kitchen is so clean that the little ants I did daily battle with gave up. I haven’t seen one for over a month. Now, however, I note that an almost microscopic variety, tiny but speedy, has come on the stage, filling the empty niche. I suppose if I achieve yet one more level of cleanliness, they’ll be replaced by another subspecies so tiny my waning vision won’t notice, which is fine with me. They can tidy up the counters at that level. Do you know that there are USDA standards for how many insect parts and rat hairs are allowed in a jar of peanut butter? One example of our uneasy relationship with the rest of the animal kingdom.

I read in the NYT that the US has a shortage of N-95 masks. I have a box—a gift to me—of M-95 masks. Of Chinese manufacture, I believe. They are masquerading as the real deal but in fact are just those pleated powder-blue jobs. Funny how even the mask manufacturers are lying, trying to trick and cheat us, even with our lives at stake. Business Ethics is clearly an oxymoron, like Military Music. And I just learned that one of my students from last year, he with diabetes and hypertension, is hospitalized with Covid-19. He’s apparently improving and not in ICU, so I expect he’ll survive it. Another student who had contact with him at work called me; she’ll be in quarantine for 4-5 days, awaiting her 2^nd or 3^rd test to be returned. She has an autistic 5yo son at home; the boy, fortunately, is very attached to his father.

News alert: The count is rising and another of my students from last year is positive, as is my professor, the head of psychiatry at University of Medicine 2, and two more members of the University of Medicine 1 Psychiatry faculty who I know. People are getting a bit scared and the streets are quite vacant. We are pretty much at 1000+ new cases per day, virtually all in Yangon. It’s a little unnerving.

The three days I’ve spent at Kelly’s this weekend have been fun. We both stumble around in the kitchen but produce good food. He’s mastered banana-walnut bread and smoothies. His diet has been entirely plant-based for the past 6 months. I did make a putanesca sauce for fettucini last night which had a couple of tiny anchovy fillets in it but they hardly count. It was a low-key celebration for Jose’s birthday. He is very quiet about his birthdays; Kelly has known him well for years but doesn’t know how old he is. We guess he’s early 50’s. We had a nice supper for him, including his wife, Irene, their rather challenging dog, Ollie, Kelly and me. Champagne toasts. Presents including a complete set of Superhero action figures and a feather duster, since Jose really likes to keep his house clean. Not exactly inspired gifts, but almost everywhere is closed.

Anyway, Kelly and I are deep into Gin Rummy, trash talking the other. He has a large house and rattles around in it. Since we get on well, he suggested I just move into the bottom floor, which has its own bathroom, patio, and separate study.  I’ve determined I want to regularly spend time with my daughter and my US friends.  I’m going to exit Myanmar for Maine and California from June through November in 2021, it would be a great help to me when my lease runs out Dec 31, 2020 just to move in here. It is really comfortable and I enjoy Kelly’s company a lot. The idea of paying $1000-$1500/month to keep an apartment here for 6 months when I am absent doesn’t sit well with me.  His rent is paid for by his job. I can pony up for food+.

I’ll have to think more about it. If I do move in and it isn’t working out or if, for example, his wife moves back from the US, I can easily get a place. But it is a lovely and open-plan house with 5 floors, fast internet, an exceptionally nice kitchen for here, and set on the edge of a jungle with a stream in the middle. A variety of birds fly in; I saw an egret landing this morning. I saw a healthy mongoose run across the back lawn a week ago and Irene found an 8 foot long, large-circumference snake skin on her back patio yesterday. Likely a Burmese python lives back there, along with other beasts. They shed when they grow so I’d guess he has enough to eat. Or she.

I have little to say about the US. It stuns me, how crudely partisan it has all become. I suppose this new Supreme will help to take us back to “the good old days”, when women and blacks and foreigners knew their place. Just say “No.” to sex and the risk of pregnancy, don’t think too much about those poor folks and their children with no health care insurance. If they just bucked up and were more responsible, they could afford it, right? ACA and the right of women to choose are current targets of Mafia Don, cynically, since he lacks beliefs other than in the acquisition of power and imposing vengeance. He just sees attacking them as a chance to boost his standing with the Base and to try to exact some revenge on Obama.

I’ve concluded that religion is many things to many people but at heart is a power move, imposing its vision of order on the world and, in most, suppressing women.  When I hear that a Muslim man can simply walk out on his wife but that she cannot divorce him, that until recently Jewish women have played a very second fiddle in Judaism, that Catholic women must be forced to have a baby, or an illegal abortion, if they get pregnant (even if it is the 6^th baby and they are 38yo), and on and on. I don’t believe that there is a god in a heaven, certainly not a benevolent one, having seen the beating and raping and starving and suffering that I’ve seen in this world. And praying to a neutral or unforgiving deity seems pretty silly to me.  Religion can provide hope, community, support, caring, and tradition, as well, but that all comes at such a price of thinking and behaving rationally.  We can just create those for each other as humans and perhaps honor equality, science, and kindness more truly.

Time to call it quits for this week. I’ve gotten myself into a foul mood or perhaps unmasked a latent one.
I’m reading Sapiens which is a fascinating look at our ascent—or descent, as he suggests—-from hunter-forager to IT monkey-addicts. It dispels some important myths, like how the rise of agriculture helped us so much. We could, it is true, live in larger groupings which has allowed for a lot. We’ve paid a steep price for Zoom, however, as many before have noted.

20 September 2020

[Above photo: Since I don’t have a flag to lower, I’ll settle for black to commemorate our, said advisedly, adored and revered RBG.  Her power of intellect and determination, coupled with impeccable honesty and humanity, could light up a city of several million, if not a nation.]

It is always painful to see a beloved leader pass. I well-recall that November day we were sent out of class at Columbia Physicians and Surgeons because JFK had been assassinated. This is a greater loss to the country, in retrospect, since she was one of very few in a position of power to try to tether this beastly monument to immorality in its cage. And she was so the opposite of him: smart, principled, thoughtful, kind, hard-working, self-sacrificing. Imagine sticking it out at 87yo with pancreatic cancer on the rampage! It staggers the mind as he whines he isn’t getting credit for all the good he has done. What an inspirational leader she has been, by example. Our country, especially the ordinary people, will miss her legal decisions even if they aren’t aware of it. Her vision was certainly of a law-abiding, harmonious, prosperous, and fair nation.

My ballot came this week and I voted, sending it back electronically within 15 minutes of discovering the email that delivered it. I imagine many of us feel the same way, “Get him out, as fast as possible, before he totally wrecks the place.” I previously had a vision of him as a drunk 5yo driving a school bus filled with children down a steep and winding road. That doesn’t capture the gravity of the situation, as ice melts in Antarctica (a predicted 10’ rise in sea level when the East Antarctic Ice Sheet goes), fires rage in California (“Sweep up the leaves; it’s simple.”), 200,000 dead of a mismanaged pandemic, and angry white militia members raiding pizza parlors seeking non-existent pedophiles in non-existent basement dungeons and locking and loading to defend Mafia Don’s election “victory”.  I’m a little overwrought, I can tell, as my pulse is climbing. It felt wonderful to vote, even if it is just once. I wish I were there to write postcards. I’ll find another way to engage helpfully when my class ends next week and I’ll have some time.

I stumbled upon a tailor in the giant Bogyoke Central Market—two floors, a rabbit warren of large and small buildings and shops. I always get lost, still. I was wandering about one day and came upon “Liberal—Leader in Fashion”, as they say on their sign and labels. Liking their politics, I selected material and had 3 shirts made.  The handful of white shirts I had bought off the rack when I first came, light, casual and comfortable as they are, look a bit bland and make my face look absolutely ghostly on Zoom. Vanity, at 80! They measured me and I paid them, to return in 10 days for the shirts. I did and tried one on; it fit  perfectly and the tailoring was wonderful. But the nice, soft, 100% cotton material had been transformed into sandpaper. The shirts looked maximally presentable but were intolerably uncomfortable on my skin. I soaked them for a couple of hours. After drying, they were the same. I then washed them all with soap in my Samsung. Better, but still. I suppose it is the “sizing”, whatever that is. Like starch, perhaps, which my mother used in my father’s shirts? $12 and they fit beautifully. If they can not add sizing, I’ll go back and buy a couple more. Because……

My students commented that I looked “very smart” in one of my new shirts. Aha!  I complained that it was almost impossible, as I have 25 longis (only 3 of which I bought). Each has a different pattern and mix of colors. I’m surely not going to purchase 25, let alone 10, new shirts. I was assured that my shirts didn’t need to match my longyis. I protested, “But your one-sets all match perfectly.” “Yes, but that is for women. With men, it doesn’t matter. Men don’t care anyway. And if they care too much, if they are too careful to match their shirts with their longyis, everyone thinks they are gay.” “In fact, a fellow trainee with me was so careful matching his shirts and longyis that we all thought he was gay. And, in fact, in a couple of years he came out.” There is no blood test for sexual preference but in Myanmar they are convinced that plumage gives it away.  Stripes and checks clashing together, a measure of masculine heterosexuality, as I always suspected!

In my former life I’d have to run the Fashion Patrol gauntlet before I left the house for work.  Poki, Nate, and Ari all are very conscious of what goes well with what, including what goes well with me. I confess, I did discover that I was a bit color blind and kept buying khakis at Nordstrom Rack in San Leandro that were greenish. For the last pair I purchased, I took them outside to the daylight and also asked a saleswoman if they were green or brown. She assured me that they were brown, so I bought them. Wrong. Definitely green, Fashion Patrol determined. My students are correct. I don’t really care, although it is nice to have your students say that you look “very smart” in your new shirt. Then I forget about it and get to work.

Kelly took me to the Gems Museum yesterday; it was closed. I want to get some gifts for my students. As an alternative, we went to the new Ikea. It is unlike the Ikea in Emeryville, I can say. It is housed in a mansion, wares displayed higgledy-piggledy or not at all. Everything jammed into two floors. It was funny to watch my own consumer lights flicker on. I buy only food here. And 3 shirts. Ikea has some pretty cool design, so I bought a dish drainer, a large serving dish, a large pot for soup or pasta, and the coolest garlic press I’ve seen to date. My apartment is filling up with even that little bit.

As of today we have 5263 confirmed cases of covid-19, mostly in Yangon and Rakhine. Deaths are up from 6 a month ago to 81 at present. We are being careful. The taxi driver who drove me to Kelly’s saw I had a mask on and stopped the cab. He tried to fix his mask, one ear loop of which was broken. Settling, he simply put the remaining functional loop over one ear and let the mask hang down by the side of his neck. He did stop and buy a new one from the next street vendor we saw.

It is a gray and rainy day, kind of like Seattle when I was a kid. I must host my bi-weekly webinar in 1 ½ hours so time for lunch.

13 September 2020

[Above photo: Professor Tin Oo and I are watching Dr. Paramjit Joshi, Past President of the American Academy of Child and Adolescent Psychiatry and a force in global mental health, discussing our presentation after it was recorded for the Annual Meeting. The computer is resting on the collected works of Selma Fraiberg, an uplifting foundation for a child psychiatry presentation. The whole operation sits on my laundry drying rack, since we were wisely advised to do the recording standing up.]

I have spent this weekend at Kelly’s home, a 5 level 3 bedroom, 3 living room affair with lovely wooden floors and windows everywhere looking out on the jungle behind the house. He set me up in a spare bedroom with its own bathroom and private deck overlooking the same greenery. My blood pressure and heart rate both dropped as I slipped into the chlorophyll, watching birds in the trees and a very healthy-appearing mongoose stroll across the lawn. It is a nice switch from Chinatown and I am welcome to use it as a weekend retreat, which I shall.

This morning we went to the American Club, a complex of tennis courts, swimming pool, poolside café, commissary, and 5 houses for Embassy personnel, all on 5+ landscaped acres on the north shore of Inya Lake. Kelly has standing tennis matches here regularly. He also buys Anchor Steam beer at the commissary. I met a number of interesting people, including Alex, an anthropologist at the University of Yangon, and her husband, Johan, the EU Ambassador to Myanmar. I also met Ashley, the Director of Irish Catholic Charities here, and her husband, David, and their two children—-Dylan and ?  (I write their names so I can refer back to this.) We were joined by Jose and Irene and had mango smoothies, lunch, and cappucinos.  It was all civilized and familiarly fun. Johan and Alex lived in Delhi for years and spent lots of time in Bhutan, with accompanying tales. Alex promises to identify the name of an anthropologist or sociologist (The Department of Sociology was disbanded by the Myanmar Military years ago.) at Yangon University. I want to better understand the sleeping-with-mother thing.

I learned on Thursday that our course will end September 30, rather than October 31. The month extension was to compensate the students for not having a vis a vis clinic until mid-June. But now that covid numbers are rising rapidly, we’ll have to close the clinic and that rationale is lost. I am sure that the Medical Superintendents of the students’ respective hospitals want them back ASAP, as hospitals are becoming overwhelmed and quarantine centers are all overflowing.

Friday night we did the recording for our AACAP presentation, 4 of us in my apartment, one in Baltimore, and one in California.  I edited my two students’ presentations carefully at their requests. I obsessed a bit about the entire affair, as I always do. Since we’d be meeting from 5-9, I made hummus, almost burning up my cheap blender, and had a crudité platter, as well as rice cakes, grapes, chicken noodles soup for 4, and coffee/tea. Only the coffee was consumed. I’ll admit, if you haven’t tried hummus, its appearance isn’t exactly magnetic. Only one of the 4 others present—Htun had brought her lovely 18yo daughter—was vegetarian. So I froze all the soup and noodles, ate most of the crudité the next day for lunch, and puzzled over it. I certainly eat their food when it is offered. Maybe since most Myanmar men don’t cook, mine was especially suspect. I know several of my students have said they don’t like European food. Hummus is Middle Eastern and the soup is Chinese/Myanmar. Maybe they were anxious. Who knows?

The recording went smoothly enough, although I am not a polished speaker. But I am real and enthusiastic and it was, as Donald Winnicott said when describing most mothers, “Good enough”.  I realize that one reason I like to write is that I can control my expression that way. When I speak, my mind goes in 7 directions at once and I want to embellish each point with an anecdote or head off into a particularly telling story. On paper I can control it. It is difficult for me to deny my mind’s desire to expand when I am speaking.

I did manage to create a PP presentation with a flow of photos interspersed with a few slides containing minimal text, triggers for my discussion. So rather than having to memorize my talk as written, I just told a story as prompted by each talking point. Then I practiced, so it was relatively smooth, and I think I got my points across. Mainly, it was to convey the fun, excitement, challenges, and beauty I’ve experienced here in order to entice others to try working in apple orchards without other pickers. Probably when I review it in mid-October I’ll find all sorts of fault with it—my demons speaking—but I said most of what I wanted to, so I’m OK for now.

One exciting spin-off is that Dr. Joshi at UC Irvine and Dr. Harris at Johns Hopkins each, independently, offered to give lectures via Zoom to my class. Since this group will end, somewhat precipitously, in 2 ½ weeks, we’ll look to next year. We could ask a number of prominent teachers of Child and Adolescent Psychiatry, and perhaps other mental health specialists, to record lectures on Zoom which could then be broadcast nationwide in Anglophone developing countries, akin to the webinar series I am now doing in Myanmar.  Since it may be difficult to have the lecturer do their own Q&A because of time zone discordance, a different Child Psychiatrist could lead a Q&A discusson in real time at the end of each lecture. These could be used, with virtually (no pun) minimal cost, anywhere and everywhere English is spoken.  I think it is a potentially powerful idea and would love to see AACAP adopt it as a global children’s mental health initiative. Zoom on!!

This is one of the thrills of working in a low-resource country: a simple idea, if enabled, can provide real value.  It can even be transformative.  Now I must remember to mask and wash and socially isolate so I can hang around long enough to see these, and some other, ideas bloom.

Joe Biden is going to have to fire a whole hell of a lot of political appointees when he is elected. The cheek of trying to suppress and alter Intelligence Reports or the CDC Morbidity and Mortality data to get Bozo re-elected!  Unsurprisingly, since sociopaths, by definition, know minimal guilt or shame.

6 September 2020

[Above photo: 80 + 2/365 yo at my favorite Shan restaurant with 5/6 of my students.]

I actually turned 80 on Tuesday. Quite a feat, although the day passed painlessly. I’ve lived as long as an elephant or one of those wise, ancient turtles. It is hard to believe since men in my family pop off early: my father at 55yo, my grandfather in his 40’s, my dear brother at 42yo. Since boys identify with their fathers to some degree, I was convinced that I’d live only his life span. George Engel, who formulated the BioPsychoSocial model of illness while at the University of Rochester, wrote an interesting (to me) paper about the same issue: imagining he’d only live as long as his father, who died early.

We had a rehearsal of the AACAP presentation Thursday morning. Professor Tin Oo and I did our Introductions by Zoom but the two students and I did our presentations live in class. The students each used PowerPoint presentations and were poised and effective. I had to correct one, later in private, when she said she wanted to work with children because “they are so cute and simple.” I suggested she say, “Because I thought they were so cute and simple.”  They are incredibly complex, in Bio, in Psycho, and in Social.

My presentation was a bit of a disaster. I was reading from a paper I’d written and simultaneously trying to show photos on a projector. I hadn’t fully thought it out and the coordination was too much for me—rubbing my stomach, patting my head, humming from the Bach B minor Mass, and dancing an Irish jig simultaneously. That is what a rehearsal is for—public humiliation. Just kidding! I’ve now figured out a system, rather intricate but simple to operate, so I’ll appear natural and relaxed as I present. I just have to practice. The AACAP on-line trainer said all actors and actresses practice their lines while walking, getting it into “muscle memory”.

It recalled my working on a presentation in med school. I was in the deserted garden courtyard adjacent to the hospital dining room. Somehow, trying to recall all I wanted to say, I found myself pacing up and down on top of a concrete bench. Little did I know that behind those reflective plate glass windows ate several classmates and my brilliant junior cardiology faculty—who I admired a lot. His father was a butcher and he drove an E-Jaguar. Once he got tenure at Columbia Medical School he had a tuxedo tailor-made and got season orchestra seats at the Metropolitan Opera. Afterwards he asked me, jokingly, if I had pebbles in my mouth—the great Greek orator, Demosthenes, apparently practiced with them.

Somehow my students got wind of my birth date. I had invited them to lunch, as I do once per month or so, at the little Shan place near University of Medicine 1. I love it as the food is consistent and very tasty and the inside is quiet and rustic, like in a village. The students brought a cake, china, and coffee in thermoses. The cake, like many here is a sponge cake with yellow frosting and grated cheese—“Grated cheese?”—on top. It is a taste jolt but an interesting one. Someone mentioned cheesecake, but it’s not the same. 9 candles, giving me an extra 10 years. And they all sang and clapped. So sweet. I figure I’m good until 116, since I bought an ostrich-skin belt in the Indian market in Durban and the proprietress said it would last 40 years.

My bathroom sink has been slow since I moved in. It has gotten slower, despite pouring hot water down it to dissolve whatever I might. Fed up, I finally called the owner, who sent his guy over in 15 minutes. 15 minutes later he handed me a mass of hair wrapped around 10 little juice-squeeze straws. What could be the purpose of putting those down, I wonder, except to dam it up?  It now flows like the Mississippi!

The Covid-19 count is rising in Myanmar, mostly in Rakhine but also in Yangon, so I have increased my caution.  I am available in my  apartment by Zoom. My students run the clinic with only two of them present at a time for social distancing. They are wearing Level 2 protection: masks, gloves, face shields, and gowns. Psychiatry is stigmatized enough already, I think.   For us to appear as hazmats could be scary for a child.  

A woman brought her 11yo son in, complaining that he wasn’t “masculine” enough. Last week we discussed a paper, and I lectured, on Gender Dysphoria, so the students felt adequately prepared to do an assessment and suggest to the mother that her son did, in fact, feel male and so was masculine enough.  We may have some work to do with the family.

Poor Mafia Don!  [Never thought I’d say that!] He’s like a sugar cube dropped into a cup of hot tea, melting and rotting away before our eyes, the entire façade, the mask dropping off. Will his hair? The Atlantic article revealing his contempt for [everyone, living or dead] has taken off like crazy.  Such a powerful projection. Joe just must remain steady, welcoming, and thoughtful. Trump has nothing to run on except stirring the pot and hoping it will confuse and polarize people. I begin to have more faith in Americans, as many who are not Dems for one reason or another are able to see through his farce.

Oh Happy Day! Remember the Edwin Hawkins singers? That was a brilliant piece of gospel.