[Above photo: Kitchens I have known. Safari Camp, Liwonde National Park, Malawi]
26 October 2018
As I walked and drove around Berkeley and Oakland during my visit I was astounded at the number of obviously emotionally disturbed people appearing homeless. They were sitting on the sidewalks on Telegraph and Durant Avenues; they were walking and panhandling on Shattuck Avenue. There was a small collection of tents right at the ‘There’ sign between Berkeley and Oakland on Adeline. And while riding the BART to the Oakland Airport I saw huge tented and tarped encampments underneath the 880 freeway. All of those people, cast off and out. One measure of the success of a society is how well they care for their most vulnerable. Didn’t DT say that once? No.
I had such a good time visiting and dining and hiking with all manner of friends in the Bay Area, including some from 50 years ago. But the urban human decay left a very bad taste in my mouth. A bitter, guilty taste. How have I escaped such a fate, why have they not?
Seattle, where I was born and lived until 12 years old and to which I returned for my internship and a year of medicine residency, looks sparkling and prosperous. Cranes are everywhere downtown, erecting tall buildings. The weather was gloriously sunny and bright for 4 days and has been drizzly for 2. Nothing like the rainy season from November through April in Blantyre, when the skies open at any moment each day and drop buckets down, drenching everything and everyone.
My nephew, David, and his wife, Kir, and their children, Maddy and Sebastian, have all welcomed and integrated me into their family. Maddy and 4 incredibly cute and geeky high school boys brought their robot to the basement to show me last evening. They all are just bursting with ideas and talk so rapidly it is sometimes hard to decipher. The robot is amazingly complex and can lift a ball off the ground, toss it into a scoop, drive wherever, and unload it. Little motors all over. It was such fun to hear them chatter.
I get up at 6:30 or so with the family and marvel at their dance as they inhale breakfast and get ready for school and work. David works for Valve, an incredibly successful game company, whose founder just sold the most expensive car ever, a 1962 Ferrari, for $48 million. It is pristine, all original, and was raced by several legends. Just one of his stable. To think that computers and software didn’t even exist commercially until, what, the ‘80’s? Kir has a busy interior design business. Maddy goes to college next year. Sebastian will start high school.
The buses here are amazing—clean, quick, efficient. In the morning I walk one block alongside Volunteer Park, jump on a waiting #10, swipe the Orca card, and sit back for a quick ride to the Washington State Convention Center downtown.
I’ve really enjoyed myself at this conference. I feel like my brain is expanding exponentially. My presentation in a panel about starting Child Psychiatry programs in low-resourced countries went well. I even sat in and held my nose through a day of psychopharmacology review. I learned useful things, to my surprise. One of the presenters, however, talked as if his patients were just objects he fed pills to and then sat back to see how they responded. Wouldn’t you know, he’s at Harvard and smart in his way so he has a bully pulpit, what Big Pharma calls “a Key Opinion Leader”. Workshops on aggression, autism, and systems of care were amazingly interesting at points. This evening I was at a working group on problem-based learning. I facilitated problem-based learning exercises in Malawi but hadn’t realized the extent to which it has taken over medical school curricula. Of course, active learning is so much more interesting and successful, stimulating curiosity and a habit of learning that should last a lifetime. Sitting in a lecture is so passive and unengaging, generally. All said, the AACAP annual meeting was of high quality.
The first two days I was a little late for the all-day symposia I’d signed up for. The ballrooms were packed with 350-400 people and I wandered a bit each day until I found an empty seat. The first day I unwittingly sat next to a guy I’d liked and worked with in Oakland; he moved to Seattle five years ago. We had lunch at a great Syrian place he knew and he told me about his cardiac arrest 4 years ago (at 45yo, fit and running half-marathons) on a plane just before take-off to Paris. Fortunately, his wife, into whose lap he fell, is an ED physician and she did CPR and defibrillated him. He now has a stent and a pacemaker and is back running half-marathons. The following day the free seat I slipped into was next to a young psychiatrist I’d also known and liked a lot in Berkeley. He also moved to Seattle where he is structuring an interesting life with a wife and 3 kids.
I had supper with my former sister-in-law two nights ago. She is a lovely person and we talked and talked. I’ll sup with her, her husband, and their daughter with her family on Saturday. All of those relationships were disrupted by my divorce and I’m glad to restore them, if on a more limited scale.
Now I’ve walked downtown to the Pan Pacific Hotel where my friend from Berkeley, Hans, is staying. He teaches couples therapy in Seattle for 3 days several times a year and in San Francisco and Los Angeles, as well, and loves it. We’ll have supper. I feel like I now have friends throughout the world. Maybe I always did, but I’m more aware of it now. It feels good in these times of global fear and feckless leadership.
Linda is in Boston, speaking at a conference tomorrow. Sunday I’ll be on the 6AM flight for Portland, Maine and back in Bar Harbor by Monday. I can’t wait to see her and the snow accumulate on the planter outside her kitchen window.
Note: I shall post a few more times here just to make a transition. I’ll put the same post on <apsychiatristinmyanmar.com> .
A psychiatrist in Malawi 