understanding is fun

the chestnut of how the fall of man consequently led to adverse effects for the human race ipso facto physical and mental disorders is old hat. however in our clinical work - using this as an explanation doesn't suffice. engel talked about holistic practice ie. taking the biological, psychological, and social perspectives on board in our formulations of patient problems - some argue that its a little too broad and non-specific for people's tastes - but it seems to cover the major issues for patients. albeit with broad brush strokes.

what's missing is of course spirituality AND even more important culture (*gasp! what is he saying?! "heathen!"). Interestingly your religious leanings seems to say a lot about your own personality - pathological or not.

when confronted with a clinical problem we have to consider context - you'd be a little bit foolish to conclude that pontine meningiomas are demonic and perhaps curable only by exorcism (Manning 2008, personal correspondence!) also i'd be foolish to say that the sequelae of having to cope with it doesn't involve faith.

hearing 'voices' as in auditory hallucinations may very well have a biological substrate however the meaning attributed to them will invariably be influenced by one's cultural leanings and spiritual beliefs. us so called "christian psychiatrists" get a bit of a bad rep. we are the proverbial soft targets for both ultra conservatives and our medical counterparts. so you can imagine it gets kinda lonely where we are.

people with schizophrenia are the poorest of the poor, and perceived to be the weakest of the weak - not only are they generally in worse states of physical health, they seem to have higher rates of suicide too, and are more likely to be financially destitute. a veritable mission field - the work is great and the workers are so so few ... or working for pharma.

it is true that psychiatrists were involved in a number of significant abuses including the so called 'logical conclusion' of the eugenics movement during the nazi regimen - misguided by erronous neo-darwinian and neo-mendelian theories. also let us not forget the old soviet union - when once again misguided psychiatrists were more agents of the state than doctors. often 'labelling' political dissenters as insane. however psychiatrists like phillipe pinel in the 1800's and guys like benjamin rush were radical enough to speak against the archaic beliefs of pre-enlightenment christians. remember salem? so called 'witches' suffering from mental illnesses were treated with burnings. a quick fix no doubt.

we like to blame each other for all that is wrong in the world - really we ought to be taking a good hard look at ourselves.

men of taste

photo courtesy of hannah (cheers!)

although i don't remember this particular photo being shot, i don't even remember us ever being this cool! perhaps the hair extensions were a little retarded.
its been over 3 years since galmi and still the memory of it remains hot in my mind. seeing this photo has that strange effect of inducing odd euphoric-melancholic feelings in my gut (its not the shirts...they're pretty gnarly eh?) . i just doubt that our presence there had any lasting impact on that land - rather its changed me more than i thought. the vastness of africa simply absorbed my ego like an m and m in a boiling vat of bolognaise. while there i thought i was doing some good. changing things with what little i had to give. the converse is true. africa has left its mark on me.

instead of invigoration or inspiration, a feeling of sadness has crept in - have i lost that zeal and enthusiasm that us physicians-in-training started with? i don't think i can blame the work load or the gruelling process of further specialist training - have i grown a brain too proud for self examination? is it better to criticise or accept without judgement? they say that ignorance is bliss. more than ever am i beginning to realise how apt that aphorism might be. debating the validity of mission work (and everything else) leaves me with a little sour taste. yes, i know that it is essential in particular situations - however i am also only beginning to learn how to suspend this function for the better experience of fun and humour. only now am i starting to realise that one can have both. i thought i had given up on returning there to galmi - now i wonder if going back would be a good thing?