[Above photo: With my long-time friend, Stephen Arkin, in front of his favorite won ton dive in the Sunset District of San Francisco. 55 years after we first met, I finally realize how much taller he is than I.]

10 February 2020

Although I have a “Multiple Entry Visa” for Myanmar which is good for 6 months, my “Stay Permit” must be renewed after every 70 days. Curious. And the cost is considerable, considering that soon I’ll be working full-time for the government (University of Medicine 1) for free. In fact, it is cheaper to fly to Thailand and back than to pay for a Stay Extension; on your return to Myanmar with a valid multiple entry visa, you get a FREE Stay Permit extension. Since this is my last week before classes start full-time, I am taking 5 days to visit Sukhothai, the ancient capitol of Thailand, replete with wonderful monuments. My friend, Kate, suggested it after a moving visit there herself some years ago. Tonight I’m staying at an old house with four rental rooms (each with a balcony and en suite bathroom) in a very quiet spot in the middle of Chiang Mai. It is run by a lovely, attentive couple and the whole place has an appealing aesthetic, replete with greenery and calm. You go through a small locked gate from the street and walk down a long, narrow corridor lined by bamboo and many healthy plants.  I’ll taxi to the bus station in the morning to catch the 10:15AM for Sukhothai where I’ll stay for a few days.

This evening I wandered through tiny lanes with frangipani trees and bougainvillea in bloom, stumbled on a sweet vegetarian restaurant and made up for not eating lunch. Then I wandered back and, somehow, found the home where I am staying. I’m going to buy a huge vase and bonzai a frangipani tree on my deck. The fragrance is so incredible and the trees look so wonderfully weird.

Aillen was going to meet me here but she was informed that she’d be on a 14 day quarantine when she returned to Macau. Then, more recently, they closed all the casinos and shut down the airport so no flights are going in or out. It would have been much more fun for me travelling with her.

The last week was eventful. I joined Professor Tin Oo at the University of Medicine 1 Library where he and 2 other senior psychiatrists were conducting oral exams for the applicants for my training program. They have completed a written exam already. Happily, there are 5 who will be in the group, not 4 as was proposed, and they are all women. I knew one and met two others who seem terrific. One has left her husband and two children, 5 and 3yo, all of whom she adores, in Magwe and will return each weekend to visit them and run her private clinic. Another will return to Dawei each weekend, a 13 hour bus ride each way, to run her clinic. They work for, and highly value, their education, these docs. And two more psychiatrists, both men, from the Defense Academy have applied and are awaiting Ministry approval. So I may have 7!  Little by little the core of child-trained professionals grows here.

Speaking of which, I began to train the UNICEF-funded group in Interpersonal Psychotherapy for Adolescents on Saturday and Sunday this week. The class ran 9-4:30 each day with a brief break for lunch. There are 7 women and we are looking to add an 8^th participant. One is a psychiatrist, one a GP with a Masters in Psychology, two psychology graduate students, and three others with interest and experience in counselling. They are at very different levels of training, experience, and English proficiency so it will take some flexibility to  bring them all along. The irony is that in this country of great need, it is not easy to find a clinical site in which to do brief (6-12 weeks) therapy. The government programs, including the juvenile detention facilities—euphemistically known as “Training Schools”—all require Ministry approval, which may take forever. The bureaucratic constipation here greatly retards progress.  It’s not as if a better decision is made when a request sits motionless on the corner of your desk for 3 months.

The training group, as with all groups in my experience, was a bit flat the first day, and much better the second. Since I am doing it in my apartment, complete with PowerPoint projector and screen, white board and markers, and a large thermos full of lepay yei jan (green tea), everyone is relaxing a bit faster than normal. Most wore fancy clothing the first day and jeans on Sunday. I shall wear my Shan shorts and a tee shirt, thus avoiding the ironing demanded if wearing a longyi and white shirt.  When lunch came, the leader of the program found a little Shan restaurant a quarter of a block up my street where we can eat for a pittance and the food is fine. I’d walked past it many times but had not peered into the darkness of the entrance to see what it looked like inside. It’s good to have another handy, inexpensive, tasty go-to spot when I don’t feel like cooking. Interestingly, the two young Masters in Psychology students are lively and very engaged, asking questions and revealing themselves openly. I say interestingly because the psychology program at University of Yangon has no psychotherapy training or trainers. They’ll lead the way for the group, I think.

After class Saturday I went to a Burns Night party. The birthday of Rabbie Burns, the de facto poet laureate of Scotland (“Red, Red Rose”, “To A Mouse”, “To A Louse”, etc.), is celebrated wherever there are Scots. We went to two fabulous Burns Nights in Malawi, complete with kilts, sporin, dirks, pipers, highland dancing, and a lot of Scotch whiskey. Plus toasting the haggis and some roasts—of men by a woman and of women by a man. Such drunken fun!

This party was at the home of my friends, Jose and Irene. She is a Scot and loves to sing Scot and Celtic songs, as I described in an earlier post. She has a bell-clear voice, perfect for the job. In addition to singing Scot songs, there was a piper whose drones kept sticking (to the hilarity of all), a young Burmese man who could play truly amazing acoustic and electric guitar, and two women who sing from the American jazz songbook (one is British, one is Dutch). Kelly and I roasted dozens of different kinds of sausages and beer and wine flowed freely. One man, Peter, gave a terrific brief history of the honoree, including his lecherous proclivity. The man delighted in sex, having something like 14 children with at least 4 different women. When he couldn’t sleep with the woman he was courting, he’d sleep with her chamber maid. Given that there was no birth control, excepting abstinence, 14 may not actually be as astounding an indicator of his libidinal appetite as it would seem today.  Perhaps it says more about his lack of responsibility.

I had to leave at 10:30PM, since I was tired from teaching all day and had to do the same the next morning. I wrote a brief thank you to my hosts when I got home and sent it off on WhatsApp, going to their many invitees. In it I mentioned I was sorry I had to “fuck out early”. Now, if you look at a qwerty keyboard, f and d are immediate neighbors, especially on a bitty iPhone. When I discovered it in the morning the two responses were, “A typo, I think.” And “Homage to Burns, I’m sure.” Good laughs were had.

And good laughs were needed this week, given the disgusting mess the Pres. and his cronies are making of our government and country. If the GOP weren’t so spineless, they could contain him quite easily, even without removing him from office. They certainly managed to thwart the majority of Barack’s good deeds, and he is intelligent (like a human, not like a reptile). We must get out the vote and then he’ll go.

[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.

[Above photo: Early evening boat traffic on the Yangon River from my deck.]

26 January 2020

It is 9:30AM and we’ve already been treated to an episode of drum banging and cymbal clanging. The decorations at the intersection of Sint Oh Tan and Maha Bandula for the Chinese Lunar New Year celebrations are over the top. A 75’ long dragon. A long row of elevated (up to 10 feet) pedestals for acrobatics and dancing. There are pop-up shops and displays all over Maha Bandula, lanterns hung for blocks, loud loudspeakers, stalls with delicious-but-deadly looking brown and white gelatinous cakes, and on and on. I leave for Mandalay this afternoon to teach the nursing faculty for 3 days so I’ll have some respite from the noise and crowds. What a time for a corona virus to emerge! Would drinking Corona have any prophylactic value? I like to think so.

I am excited about the 3 day course, an Introduction to Child and Adolescent Mental Health, I’ll teach at the University of Mandalay. I have no idea how much of any of it will stick but at least they get a taste of it and I can do a follow-up course for them in the Fall after my major teaching responsibilities have concluded. My graduated students there can, as well. I was pushing to get the grand monthly salary of $200 that the government gives to each doctor but realize that then it may make it harder for me to come and go as I wish.  I want 3 months a year in the US, mostly on Beach Island.

Three of us—two physicians from Metanoia Mental Health and I—met with two UNICEF workers to review the grant and teaching project we’re starting. The entire focus is to teach 8 of them psychotherapy. Am I excited! And they are smart, highly motivated people. Of course, the head, at 38yo, looks about 25, making me realize that I am old enough so everyone under 60 looks fresh out of college. Where have the years gone?

They certainly have gone to my belly which isn’t huge but also isn’t toned. I dislike that old man protuberant belly look and, yes, I’ll continue my sit-ups although they are the most hateful part of my little exercise routine. Harold started us with the Canadian Air Force exercises when we were in medical school; we’d do them each morning  to the Beatles “A Hard Day’s Night”, which was lively enough to get the juices flowing even without any pushups. I must now use weights to tone my muscles and cannot do pushups. I can do them fairly easily, but I’ve injured my shoulders with them in the past so it’s no pushups for me. I recall thinking at the time how silly Jack Palance looked at the Oscars when he dropped to the floor at 72yo and did one-armed pushups. Now I sort of understand his desire to showcase his personal attempts to defy aging.

I went to Yangon Mental Health Hospital on Wednesday for their CME. It was very good—high quality, especially presentations by the three senior residents summarizing the current literature on Dual Relationships, the Adverse Childhood Events studies, and the use of ECT for treatment-refractory PTSD, respectively. There was a nice lunch provided by—you guessed it—-United Pharma, “Serving Your Healthcare Needs”. Their presentation was almost an hour long. I especially liked Cholinerv, “A CNS Stimulant/Neuroprotective Agent” helping “Memory, Focus, and Brain Health”. Also, “LiverCare” a “Liver Health Supplement with Siliphos” having “The Power of Two” (containing both Silybin and Phosphatidylcholine plus Multivitamins and Zinc) whose motto is “Love Your Liver, Live Longer”. I wonder if their science is as good as their graphics. No, I don’t.  At home I am very critical of paid presentations, knowing that the gift of a Risperdal-imprinted pen alone can make you prescribe it more often than other 2^nd gen antipsychotics. But here, with salaries at $200/month they get a free lunch and several hours of quality CME. I cannot be that critical of the psychiatrists. I just always include undue influence by the drug companies in my presentations.

The highlight of the week was a tour of the Military Services Medical Academy by Professor Nyan Win Kyaw, the Chief of Psychiatry. Two younger faculty picked me up and took me out for a breakfast of mohinga on our way. The facility is massive, much larger than the University of Medicine 1, with very up-to-date classrooms, library, skills labs, etc. They have an entire building dedicated to gross anatomy dissection, 4 students per body. The massive sign in front announces “To Be A Good Soldier And An Efficient Doctor” in gilt letters. I don’t think efficiency is the first quality I’d seek in my personal physician.  Across the street is the parade grounds and hostels where the “Cadets” live. Knowing how the Tatmadaw (army) has been used in the past, I went with apprehension but I think that, generally, you can best effect change close up. After all, the soldiers are humans, most have families with children, and all are under a lot of stress, which impairs parenting. Soldiers, even more than physicians, are moved about the country like chess pieces which causes considerable developmental disruption here, as it does in the US. “Military brats”.  I offered to do some lectures for the medical students during their psychiatry rotations. Part of the attraction was that Dr. Nyan Win Kyaw is such a smart, kind, energetic guy that I was drawn to helping him, however I might.

An exception to the above approach to effecting change would be with a sociopathic narcissist. If they aren’t my patient, ignoring them and protecting myself from them is likely the best approach, since change is not going to happen and why reward their bad behavior with attention. The recent ad attacking Susan Collins is smart, I think. I heard it described as “vicious, which I don’t think at all. Honest and direct, I think. Watching her sell out the people of Maine, pandering to Trump Republicans while saying she is “concerned” is gag-worthy. She voted against Equal Pay for women, for god’s sake! And for Brett Kavanaugh, after an endless amount of hand-wringing. Hand-wringing is supposed to signal deep moral deliberation, I guess, but she employs it often enough that it is clearly a combination of political calculation and window-dressing. She’ll lose the next election and will lose it with shame for having supported this liar 90% of the time. There will be a lot of GOP bloodletting; we used to think it was a treatment for ailments but it only makes a mess and weakens a person.

I now will go out and buy some hand sanitizer. I generally avoid it, as it isn’t good for the water supply but since I’ll be travelling on a plane in 6 hours and since there is a big Chinese presence in Mandalay, I’ll be careful. I worry about Aillen, working in a hotel in Macau. Nearby Hong Kong is now reporting cases.

[Above photo: I bought this painting within a month of arriving. I like its evocation of the ruined glory of ancient Bagan seen through the painter’s vision, distorted by the grid/fence of tyranny, and the gradual emergence of people into a world of color.

19 January 2020

I am very pleased with my new apartment. It feels a bit silly to be so absorbed by it but it is my home and shall be for the foreseeable future. It is light and airy and spacious. The single mosquito that visited me every other night for the first 10 days may still live in my bedroom but I erected my mosquito net and now sleep without fear of getting dengue or chikungunya.

In preparation for my first cocktail party I wanted to get snacks and make a signature drink. I had a bottle of champagne so thought of Old Cubanos. I last made them15 years ago when Poki asked her new boss over for supper at the house she was renting in Santa Cruz. The drinks were a hit and Rama was tossing them down at a rate that alarmed us.

Now I needed rum, limes, mint, simple syrup, and a cocktail shaker and shot glass. The ingredients were easy to find, although I made a mint tea infused simple syrup, in lieu of having enough mint to crush. I did have enough mint for a garnish. I looked for a shaker and a shot glass everywhere to no avail. Then I thought I should try on Lanmidaw Street, which has restaurant supplies. Bingo, a shaker and a shot glass.

I’d been making ice for days so that was set. The limes are so tiny that I had to squeeze 35 of them to get enough juice. All ingredients, and glasses, chilled in the fridge.  I bought flowers and arranged them in 2 vases. Now for the snacks.

I found a variety of chips and nuts and cheese and crackers. I splurged and bought egg yolk coated, fried salted fish skins, expensive but intriguing. They were the surprise smash hit. And fresh strawberries and grapes. Then fried, spicy sticky rice cakes, also addictive.

The long and the short is that 8 of us sat on my deck over the river in the evening glow, listened to the murmur of river traffic, ate like locusts, drank like fish, and chatted until 11:30 PM. We had planned to go to Green Gallery for Thai but never left the balcony.  The party was a great success and the Old Cubanos, if labor intensive, were welcomed. Kelly drank 3 and left sober as a preacher.

I had my teeth cleaned, an important event in anyone’s life. I went to Evergreen Dentistry—-Green teeth? Unclear on concept.—which is a terrific group of dentists led by a Burmese whose father practices in California. This man apprenticed with his father, took the dental licensing exam here and passed, and has started the go-to dental care clinic in Myanmar. Never went to dental school. One of the Brits described cracking a tooth. She went in for care and the female dentist measured her for a (?) crown and said it would take some time. “Two or three weeks?” “30 minutes.” She watched it being built on their 3-D printer. It fits perfectly.

My last tooth cleaning was in Malawi, at a place the Peace Corps uses in Lilongwe. The dentist was rough and did a poor job. My standards are high, as my go-to-gal in Berkeley was Natalie who was smart as a whip, careful, and obsessive, just what you want in a dental hygienist. When I had a cleaning in Bar Harbor before leaving for Malawi, the dentist said I had bone resorption beneath my front incisors and should have implants right away or my teeth might fall out unexpectedly.  3 ½ years later, all are holding fast. I think business might have been slow.

I was able to connect with a webinar at the San Francisco Center for Psychoanalysis on “The Erotic Field in Adolescent Treatment”. The paper and discussion were both excellent, addressing the lack of literature on the subject and the anxious retreat of therapists in the face of adolescent sexuality. A lost therapeutic opportunity.  The audience questions, as often happens at SFCP, were of variable quality, often serving more as a grandstand for the questioner than to advance the discussion.  There previously was a lot of neurotic posing and preening at the Scientific Meetings, I recall. The audio and video signals were perfect, however, and if the timing works out, it is a cheap, easy, and quality source of learning for me in the future.

I was running errands on Wednesday, getting my weekly allowable from the Embassy ($3000/week in order to accumulate $18,000 for the year’s rent in advance), collecting a box of books I sent through the  “diplomatic pouch”, picking up my exquisitely-tailored suit and shirt from Sein Shwe ($170 for the suit!), and finding a bamboo or palm-leaf mat to put under my coffee table.

As I was walking on the street a few days earlier, a scruffy guy approached me and struck up a conversation. He suggested I might find said desired mat in the main market. Then he asked if I liked men. Not sexually; I like women. Oh, I’m not gay, he said. I just like men sometimes. I’m not sure what signal I was emitting to attract him but my subsequent signal was pretty clear. Not infrequently I am asked, if walking alone to my apartment at 10 or 11PM, if I want a “girlie massage”. My only interest in their inquiry would be their story: what brought them to pimp and what story of struggle, poverty, and defeat has brought the girls to sell themselves?  As to the sex, it seems devoid of meaning and repugnant. Or perhaps the meaning is too clear and troubling.

At any rate, on Wednesday I turned toward Zay Bo Gyoke, the enormous, old clothing, textile, and jewelry market in the center of downtown. I was also trying to find more paintings by the guy, Ko Thet, who did mine (above), as I admire his unconscious.  I was led around for awhile and eventually was taken to a basket shop. When I explained what I wanted, the enterprising woman send her son off. He came back shortly with a 7’x6’ split bamboo mat, finished with a cloth border. It was perfect, if used and right off the floor of someone else’s shop. Suits me and I’m sure I paid too much but it completes the room.

On Thursday I had lunch with Professor Tin Oo and the newly graduated psychiatry residents at the Golden Inya, a modest (but excellent food) spot on Inya Lake. Tables were set outside, in the shadow of the Yangon Canoe, Kayak, and Rowing Club boat shed, facing the lake. It was very pleasant, although no one made a speech, which I found curious.  “We did that at the graduation ceremony.” There were many of the requisite group photos.

After lunch, Professor Tin Oo and I met with the Rector of University of Medicine 1, Rector Professor Zaw Wai Soe.  He wanted to chat with me a bit, to understand my intentions. He let on that he wanted, eventually, to establish a professorship in Child and Adolescent Psychiatry. I wonder now if he wanted an endowment for that. Perhaps he just wanted to confirm his intent of supporting our work. He seems like a man with vision and who is a benevolent but canny strategist. He suggested that I should meet the Ministers of Health and Sport and of Education and that he would facilitate the meeting. When I bemoaned my lack of Burmese, he laughed. “Now is not the age to be learning a new language.”

Staying in a place for a while, not just a year or two, is the only way to effect lasting change, I’m convinced. If you invest, others will invest in you. My decision to remain is further reinforced.

On with the hijinks at home. Where is Dr. Joseph-Ignace Guillotin when we need him? Perhaps we should use a rack or a breaking wheel? I’m almost ready for our own Reign of Terror, starting with the mouthy guy from Ohio, the deceitful ranking Republican on the House Ethics Committee, tyrannical Addison Mitchell McConnell, and moving upward. I want to put our VP in a room full of naked, sex-starved nubiles and watch his circuits light up and smoke while “Mother” looks on disapprovingly from a large flat panel screen.  Then DT could be given a massive Still Face experiment, where no one responds to him in any way, not even punitively. It all goes to show that we neglect a significant portion of our population at our own peril—and theirs, of course—, since they will be vulnerable to demagoguery. While we, the elite, degrade ourselves by developing cruel fantasies.

[Above photo: A late afternoon view of the busy Yangon River from my balcony.]

12 January 2020

Talk about impulsive. When I extended my apartment lease from December 31 to March 31, my landlord mentioned that he had two additional penthouses for rent on the same street but in the Lower Block and closer to the Yangon River.

When I returned from the US, I asked to see the spaces if they were bigger than my current apartment. I had arrived to feel that I was living on a sailboat—tiny, precise, a place for everything but with no breathing room.  One of the apartments had already been rented but I saw the other and two days later, yesterday, I moved in. It costs a bit more than my prior apartment but has a living room that is 4x as large, a big kitchen with a dining table fitting easily into it, and three full bathrooms instead of two. Plus, and it is a big plus, I am close to the river, assuring myself a good cool breeze and great views of the river traffic.  

We first went through the place and the landlord asked if I wanted any additional furniture.  I made a list and he took us to a huge furniture mart where we strolled around and I picked out what I wanted. He suggested I get a desk and a desk chair, which I had forgotten. I paid for a file cabinet because I want one and shall donate it to the Child Psychiatry Clinic when I no longer need it.  I chose a couple of large, rattan lounge chairs and asked him to remove 4 awfully banal paintings and a carpet with a modern, ugly design of black and white blobs.

The owner was very helpful, calling three of his men and bringing a truck to help me move. I was well-packed and we carried a mountain of stuff down in the lift in short order, loaded it on the truck, drove 1 long block, unloaded it, and took it up the elevator to my new place. The amount of work, except for driving, was the same if we’d moved down the block or to a different country. The new apartment has good vibes and I feel considerably less cramped.

One of my first steps unpacking was to drop an oil-slick jar of spicy black bean sauce on the floor, shattering glass shards over a large area. I cursed myself, kept my head, and wore flipflops as I swept, wiped, and scrubbed up the oily, orange/black mess. No glass in my feet, happily. I’ll have to replace the sauce, as I love it with chicken and green peppers, prawns with scallions, or any vegetarian dish.

I’ve sorted stuff, put books on shelves, clothes in a wardrobe, and hung a couple of pictures, so it feels like a home. I even went to a grocery store for olive oil and other staples.

I’ll have the British women over for cocktails this Friday—one of them, Sinead, leaves in 10 days, having completed her work and her 6 month project. Her mother is HK Chinese so she has family in UK, Hong Kong, and all over Australia. When she leaves, she’ll travel and dive in the Philippines, New Zealand, and Australia/Tasmania. I think there must be some family $ there. Oh, to be her age (30+) with all of life before her and an adventuresome spirit. That, of course, isn’t enough to guarantee happiness or success or anything but the idea of that freedom is romantically appealing.

Sinead contacted me yesterday afternoon and we went to a wonderful restaurant with fresh noodles and fresh dumplings, all homemade. We then hopped across the street and met Faye. All three of us went to see a film at the Japanese film festival. It was a strangely touching film about a man with muscular dystrophy who is initially a tyrant, treating his volunteer caregivers as vassels. He gradually evolves, as do they, in a realistic manner and becomes a sympathetic character. “Supposed” to die at 20yo, he lived a quite full life until 42yo, by force of will and the recruitment of volunteers to keep him vital and out of the hospital. The Japanese sensibility was on full display and it certainly differed from mine in many ways: guilt and shame kept the volunteers in line for a long time, until they came to love the patient’s spirit.

Aillen and I are scheming to get her over here for a long weekend—except that I am working every Sunday and several Saturdays. Yikes, what have I gotten myself into?!

One great advantage of my place is that the living room is ample to easily accommodate the 8 students in the class I’ll teach on weekends over the next 4 months. That will save the organization (Metanoia) having to hire a room; the one they were getting at a good price is fully an hour away with good traffic. This way, I can save all that time and cab fare—and everyone will take off their shoes on entering, so there will be minimal mess.

Today I walked to Lanmadaw Street where I had previously bought some plastic chairs for our clinic. Sure enough, even though it was Sunday and the shop was closed, they sold me 8 chairs at a discount. I whipped them over my head and walked off, trying to avoid snagging low power lines, shop signs, and sidewalk umbrellas with the legs. I ran into all three but people smiled at me and were helpful.  Seeing this old white guy doing manual labor, like them, seemed to cheer them and a girl from the little street restaurant in front of my building opened the door and held it for me. I’ll have to try the restaurant soon, as the food looks delicious and there is actually an indoor part of the restaurant, which means they have running water. The sidewalk in front of my building is always packed with happy-looking customers sitting on tiny plastic stools at tiny plastic tables. I have a good feeling about this move.

I served Chinese moon cakes and coffee this morning to the psychiatrist who will be in my weekend class. She is terrific, having left government employ because the work was “boring”, basically 10-15 minute medication visits for chronically mentally ill patients. She has taken several courses on EMDR in Thailand and is intrigued to learn more about, and to practice, psychotherapy. We talked about wide-ranging topics and I suggested she and her business partner look into getting NGO status. They then could attract grant money for interesting projects and could do psychotherapy on the side, as they gradually build up a paying clientele. She’ll talk with Ohnma about it.

One thing we discussed was the need and practicality of developing counselling and triage skills in Health Assistants, who provide a lot of primary care in remote villages. This is a dream of mine, to develop the Child and Adolescent Mental Health infrastructure with some child and adolescent psychiatrists and many, many more lessor-trained practitioners who can adequately address 90+% of the problems, referring the rest.

It is exciting and confirms my desire to be here. I worry a bit, as the public and private sectors have some rivalry and I don’t want my ideas to die a political death. A practical death—-That there simply isn’t the government will to fully develop a child and adolescent mental health network—would be easier to swallow, somehow.

I’m going to cash it in for now. Thankfully, the Iranians have more sense than the American in charge. It’s difficult to say who is more fanatical.

[Above photo: The Macau MGM Casino in foreground with the Grand Lisboa Casino to the right. Photo taken on our harbor cruise.]

5 January 2020

I can recall thinking of 2020 off in the distance, so far that I imagined it was beyond my reach. Here I am, feeling 18yo again at times, and girding my loins for a 5 month teaching sprint. I’ve gotten myself into a busy spot, I think, running my 7 ½ month Child and Adolescent Psychiatry course again, as well as teaching and supervising leaders of a local NGO who have just gotten a UNICEF grant. Plus I’ll teach  assorted short courses, starting with the Mandalay University of Nursing Mental Health Faculty. Oh, well. Might as well do it, if I am going to do it. I’m also a great believer in sublimation, Freud’s term for turning sexual desire into productive (not reproductive) activity.

Aillen and I enjoyed walking around Macau, going into several of the numerous old Portuguese Catholic churches, the restored theatre, and a great little noodle shop with a very surly hostess. We took a tour boat for a cruise up, down and all around the island, getting new perspectives on the massive and fabulous hotels (see above for a sample). And we went up the Macau Tower, the longest bungee jump in the world at 233 meters. We were on the floor below the flight deck and watched a couple of daring fools leap off and plummet past us; my attempts to catch them on the fly with my camera were futile.  We had supper in an elegant but not expensive Japanese restaurant; one tasty item was robata foie gras. Tired, we re-tired but at the stroke of 12 the fireworks started. We couldn’t see them from our room but could see crowds in front of our hotel “ooing” and “aahing” so we rushed downstairs just in time for the finale, which was pretty good, it being China. I wonder if Iran and the US can just have dueling fireworks displays; the loser either lifts the sanctions or dismantles their hydrogen bomb program. Norway can judge.

We seem to be in an escalating spiral with The Donald, and it is frightening to think of He-of-the-serious-bone-spurs at the helm. I’d rather it be John F. Kennedy or, actually, anyone. Millard Filmore. SpongeBob. His impulsive, inadequate self has stirred up a hornets’ nest and Americans and many others will die because of it. Think back on how well it actually was working with Iran under Obama. Yes, there were Hezbollah and Hamas and other bad regional proxies but I think we may now see things seriously deteriorate in the Middle East. Who thought they could deteriorate? But they can. All in the name of diversion from his Senate Impeachment trial. The good senator from Tennessee is such an evil SOB and all the spineless minions that kowtow to him are nearly as bad, enabling him as they do. Memo to self: Write yet another letter to Susan Collins.

It was a relatively short hop to Bangkok and another to Yangon. As a good omen, I was met in the Arrival Hall by a taxi driver offering me a 10,000 Kyat ride, as opposed to the standard 12,000 kyat at the front entrance. Of course, we had to hike a kilometer through obscure airport halls to a distant parking lot but it was good to walk after being cooped up.  Arriving at my apartment, the lock on the inner door stuck and I couldn’t make it work. So, I called the landlord and as we were chatting, lo and behold, I got it open. Bring out the umbrella and the sprinkle stops.

My apartment was filthy. I like to think it is dust that accumulated while I have been gone but I’m not so sure. That theory wouldn’t explain the condition of my pillowcase, for example. Anyway, 1 ½ days later, all is washed, dried, folded, put away, dusted, and swept. My bathroom is spotless, as is the kitchen. I’ll do the guest bathroom when awaiting a visitor, under the general proposition that things do get dirty when sitting idle. At least that’s a more encouraging idea than that the pig-sty condition of my apartment was due to my prior sloth. I did make a very tasty sautéed garlic chicken with chili black bean sauce and fresh asparagus for lunch, so I’m not a total bum!

The weather is super and it is cool enough that I can sleep with the window open and no A/C. I had meals with two friends—-brunch and supper—-yesterday and caught up with them. Today I’m hanging out on my own and may watch a film tonight. I plan to look around for a somewhat larger place, although I really just want more wall area on which to hang paintings, a large outdoor table with two more outdoor chairs, another book shelf, and a large toaster oven. My location is perfect for my work and I certainly don’t want to try to travel each day in this traffic. My route to Children’s Hospital is up Pyay Road in a direction opposed to most morning traffic, so it is a snap.

I feel so sad for the GI’s that our Dear Leader-of-the-bone-spurs is going to use as cannon fodder, let alone all the innocent and not-so-innocent civilians who will find themselves in harm’s way. I fear a conflagration. We are again acting, true to form, as the Great Satan.

[Above photo: The Parisian Hotel and Casino, Macau]

1 January 2020

The year has come to a rapid close.  I suspect it can get much worse on the US political stage in 2020. I  appreciate our attempts to mark time; I think it slows down its passage. Otherwise we’d be crying in a crib one moment and struggling to recall the name of our favorite film—or person—the next. It is scary to see my peers really slowing down, becoming more sedentary, more preoccupied with bodily ailments, and struggling with recall.  My experience highlights the advantage of living in an extended family: as you gradually lose it, you can identify with, and lean on, the younger, energetic ones who haven’t.

I had a wonderful sail on the Bay in Lagniappe with Neil and a Rotary friend of his, Peter. The wind was light and fickle but it was still fun and refreshing to be on the water again. Neil is masterful in the skills and aesthetic of boat maintenance and improvement, so the boat gleams. I still cannot convince him to go south with me, catch the trades, and glide to Hawaii. With planning and the right season, the risk would be minimal and the fun of being out of sight and reach of land for 10 days, self-contained, would be special. The beat close-hauled on the trip back might be a grind, a steeply-tipped cabin sole for the same amount of time. But a worthy adventure.

Marie and I had a good walk and better talk. She is one of the most resilient people I know. She loves Zydeco dancing and has found partners over the years with a similar inclination. They travel to Louisiana, go on Zydeco cruises, and generally take fun while staying fit. I saw her daughter, Simone, and met the three darling granddaughters, 8, 6, and 2yo. Little kids are so incredibly cute.

I went with Marie, her friend from middle school in Salinas, and her guy, Murray, to a wonderful Christmas concert at the Jazz and Justice Church. Of course, I fell in love with the preacher, who was simply gorgeous. The music, by both black and white artists, was out of this world. An 11 time Grammy nominee, three amazing black women vocalists, a rock-solid house band, and the amazing Chris Cain. The latter is a white guy who looks like a schlub but is a magician on guitar and vocals—with eyes closed I would have guessed BB King was in the house. Anyway, it reminded me what a repository of brilliance and talent Oakland is.

Then I had coffee with Kimally.  We caught up and relived many moments from the Seneca Oak Grove program. It was a locked residential program for 22 of the most violent, traumatized kids in the state. It was pretty scary at times, although neither of us was ever injured. It was great training, as working in a good system with the very disturbed can be, but a sobering lesson in how early and repeated trauma is branded into the brain so fiercely. Some of the kids are now doing much better, even well. I recall taking one hugely muscular, relatively conscience-free boy to the Emergency Department because he had cut himself with broken glass. It was a trip, trying to keep him from listening to gangsta rap in the car and setting up a date with the woman in the adjacent room. He’d previously, at 12 yo, shot his mother in the arm when she was beating him with a shoe. He used to “protect” his aunt while she was on the track. At Oak Grove he attacked one of our staff with a scalpel and we sent him to juvenile hall. He’d also beaten a number of staff and probably seduced one of our nurses. After juvenile hall, he was living in a rooming house and murdered another kid, for which he is still in prison. What a time that was. Kimally looks great and is such a sweetie, raising her sister’s teenage daughter. The latter is bound for Spellman College next year.

I hiked with my hiking group 3x and had a meal with my friend, Martha, and her daughter, Laura, and husband, Nick. On Christmas Day I spent the evening with them, again, having a wonderful meal of brisket in marinara sauce over pappardelle.  Both Martha and Laura/Nick have remodeled their respective homes so beautifully.

Supper with Tu, Marisita, Hans, and Patricia was wonderful and filled with memories. Jon Whalen and I met several times, having  supper once. His grandson has just been released from the hospital after a long stay for treatment of H. Influenza meningitis. He’s making a swift recovery, as you’d expect from a 3month old. Jon and I saw and heard Charlie Musselwhite (He, also, is an Ancient.) at The Freight and Salvage. He must be our age but still has his chops and has wisely surrounded himself with a young, vibrant band.

I went to Ed and Robin’s for their traditional latka party on Christmas Day. David Harris, a famous draft resistor who went to prison for 2 years and later married Joan Baez, was there, now married to Ed’s niece. He currently has very serious illness but his mind remains sharp.  After prison he became  a journalist and, later,  a writer of books on social causes. He knew my college roommate and friend, Peter Barnes, with whom I’d shared lunch the day before in San Anselmo. Such small circles we run in.

I had supper at Mary’s new apartment and the next day walked around the Lafayette Reservoir with her. She is also a model of resilience and thoughtfulness for me, having lost her husband and moved out of their home within a year +.  She seems such a solid source of kindness and good judgment.

I also spent the night in Santa Rosa, visiting with John Croizat and his partner, Linda. John is a fabulous singer-songwriter and you can hear some of his work on his YouTube site at John Roy Zat Croizat. If you have access to a child or grandchild under 6, or if you just want to see a great music video, watch “I like trucks”.

I stayed most of my California visit with Ellen Bloch, whom I’ve known since I was in med school and rooming with her brother. She lives in a gorgeous 100+ year old home in a park-like setting in the middle of Berkeley. You must cross a bridge in her yard over a year-round stream to get to her front door. We mostly had the house to ourselves and shared a number of breakfasts and suppers. Her eldest, Ben, came to stay for a few days with his partner. Ben is an accomplished landscape painter whose work you can see at benblock.com. Ellen was very generous and gracious with my using her home as an Air BnB, minus the nightly fee.

Now I am in Macau, visiting a friend, Aillen. She, also, is a tower of relilience, given the slings and arrows of her fate. We laugh a lot. The place is like Vegas on steroids. The Portuguese were given permission by the Chinese to establish a trading post on the island in 1557 and there are numerous quaint homes and old churches in various districts. The Portuguese left in 1999, ceding control back to China so this is a 20^th anniversary celebration. I’m staying in the middle of Macau, but we went to Cotai, a newer casino area, last night. It was over the top, with massive, gaudy buildings, endless casino areas inside, and colored lighting everyw,here. A scale-model of the Eiffel Tower and the Arc de Triomphe are in front of the Parisian (see above). So many of the casino games are electronic that is seems pretty silly to put your money into them. You don’t even have the illusion of control, of pulling a lever to make the lemons, oranges, etc. line up.  I don’t know how to play craps or roulette and I’m sure if I sat at a Blackjack or Hold-em table I’d lose my buy-in immediately. No gambling for me.

I’ll be off to Yangon in 2 days and shall resume writing this regularly from there. I haven’t exercised myself about DT in days and I’m pretty certain it hasn’t affected any outcomes in the courts or in Congress. All in all, an excellent vacation, even if I had to miss seeing several very good, and old, friends.

[Above photo: Berkeley and San Francisco from the top of Claremont Canyon Conservancy.]

1.1.2020

I am, as above, safely in Macau, heading for Yangon in 2 days. Forgive my failure to write my blog posts but they shall resume shortly.