Mango Season

Linda returned from her clinical teaching in a village an hour away, having saved one woman a large and deep episiotomy and another a caesarian section by teaching the midwifery students to coach, assist, and encourage the mothers to push, by fending off the Clinical Officer who wanted to do the cutting, and by patiently modelling what she knows so well—patience with women in labor. On her way home she asked the driver to stop in the countryside where a woman was selling mangoes by the road. She bought 45 mangoes, two varieties, for less than a dollar. We are getting vitamin A toxicity, slurping these down. My idea of heaven itself!

What I have not written about are the other major themes in my life: that my divorce, after 43 years of marriage, is nearly complete and that both of my adult children don’t want to talk with me. I am not judging either my wife or my children, just noting that both events are seismic for me. I have managed to compartmentalize them some in order to proceed with my life, which is generally exciting, interesting to me, and useful to others. But they affect me, feeling a failure for a failed marriage and unhappy for the state of my relationship with my children. The four of us have shared a lot, most of my adult life, and to be deprived of each is huge for me.

In a new relationship with Linda I can see so much of myself I haven’t previously allowed. And see how difficult that must have made me to live with, because I needed to see myself as simply earnest, kind, honest, and hard-working, compliant and undemanding.  Generally those are true, but they aren’t the entire story. I’ve made no room for a direct expression of my desires. So they have come out sideways. I have certainly been concerned that I lack courage: not physically or for a cause. Just to directly express my needs, lest they anger or drive others away.

Today as we talked, Linda again challenged my myth that we were poor after my father died. Well, relative to my friends in Denver, we were. We lived in a tiny two bedroom house, mom slept in the living room on a Hide-A-Bed, and Chas and I each had a room. We rented out the basement to a couple, the Klings; he was finishing school to be a fundamentalist minister. We could hear his wife walking around the dark basement apartment, avoiding the black widow spiders we’d find occasionally, singing, “So let the sun shine in, Face it with a grin, Smilers never lose and Frowners never win.” in a tremulous voice. But, mom was a physician doing a psychiatry residency so there was a light at the end of the rather short tunnel to which the poor aren’t privileged. And we skied in the winter, hiked and camped in the summer, and never went hungry. We did eat a lot of Welsh rabbit (rarebit), creamed chipped beef on toast, cheese soufflé, and dishes to stretch a cut of meat, like ham timbales or lamb curry. Chas and I both went to Harvard and graduated from medical schools. I did work summers and all through college and medical school, but it was never odious. I’ve seen true poverty here. I guess I’ll have to bury the poverty bone.

Still, this afternoon I was wondering why I’d felt poor. Maybe impoverished is a better word. I grew up without a father and my mom, while an amazing person and very loyal, was never interested in my interior. And, mostly, I did a number on myself, with an overarching need to be perceived, my myself and others, as nice, not making waves. Mom’s 3 depressions with hospitalizations when I was 5, 6, and 7yo contributed to that. So I stunted myself in ways. And that can make one feel impoverished. And can be a terrible burden for your wife and children.

I cannot re-do the past and yet am unable to be free of regret. I wish I’d been more courageous in expressing myself, in being true to myself. I would have been a better and more understanding/inspiring father. The irony is that the only literary quote I recall from my mom was Polonius’ in Hamlet, “To thine own self be true, and it must follow as the night the day, thou canst not then be false to any man” (or woman).  As a kid I’d interpreted that as “Don’t tell lies”.  Advice is only as good as what you can allow yourself to hear.

I have my plastic waterbottle fenders and, wouldn’t you know, I haven’t been caught in the rain yet. But it is a relief to have them, a source of stress modified, if not totally relieved. There is actually a lot of stress here. People approach me for money every day, often little street children. They all look hungry and if I have some bananas I’ll share. But generally I say I am sorry but everyone wants money and I cannot give to everyone. I do give to the blind musician with his little daughter outside the GAME store. And for our guard/housekeeper’s son’s tuition/uniform/copy books/shoes, etc. Then, since my Chichewa skills are very limited, I must locate an interpreter, usually a nurse, for half of the clinic patients and all of the inpatient consultations I see. And, of course, since I have been doing child and adolescent work plus adult psychotherapy/psychoanalysis for years, the delirium, dementia, mania, acute schizophrenia, puerperal psychosis, and so on are a different population with different treatments than those to which I am accustomed. Then throw in malaria, tuberculosis, meningitis, and 10% of the population HIV positive, plus a potential raft of tropical worms and the like, and the uncertainty, and stress, rise. Plus you cannot go out at night because of the danger of getting mugged. And the guards’ boundaries are interesting; one of the young men heard the shower going yesterday and stuck his head up underneath the window to see what he might. Linda was bathing and saw a hand and then a face—he quickly withdrew and walked about his rounds. When we went out for our run she confronted him and read him out; he apologized. The biggest stressor for me is the limited resources for the poor mentally ill; few support groups, no sheltered workshops, no Alcoholics Anonymous (We may be able to improve that situation.), running out of medications often. I discovered that I can order an MRI—they have a machine and a building and a tech and a secretary—but I have to read it myself. What?!! I’m not trained to do so.

I’ve been seeing the 14yo boy I mentioned earlier whose friend’s mother attacked him with a panga knife. He’s now started having seizures from the subdural hematoma and brain injury he had so I’ve had to start him on an anticonvulsant. In the therapy session two weeks ago I realized that he didn’t just have a pronounced startle reaction; he is completely dissociated all the time unless someone engages him. I asked him to draw me a picture of the incident, which he did. All the human figures had no facial features. When he finished he cried out, jumped up, and tried to run out the door. I don’t know how this will go. I hope I can be of help to him. His mother is wonderfully patient and loving.

We ran a 5k virtual race yesterday, part of a world-wide effort to get people running. I was amazed that I ran a mile pretty easily and alternated walking and running the next two. So we are going to run regularly. Linda, having done 4 marathons and being significantly my junior (Don’t ask! I assure you she is not a child and has 5 grown children.), will undoubtedly step it up more than I want to but I haven’t run since my lung cancer in 2008 and it feels great. Moreover, we run the track at the College of Medicine Sports Complex which has a wide-open view of mountains and distance. There were two blue herons in the middle of the track yesterday when we ran. The clouds at sunset here are from a Rennaisance painting, complete with gold or silver linings, and I expect to see seraphim and cherubim descending. The natural beauty, including the greening from the rains, the birds, and the various trees in bloom, counters the scattered garbage and ubiquitous small light-blue plastic bags discarded everywhere. It is illegal to manufacture and sell them but……we call them the Malawian Blue Flowers.