I have worked with some other people to start a monthly writing group and this was one of our exercises, to write about an author whose writing you find influential. I’ll include my piece on this below:
Václav Havel: 5 October 1936 – 18 December 2011
“I should probably say first that the kind of hope I often think about (especially in situations that are particularly hopeless, such as prison) I understand above all as a state of mind, not a state of the world. Either we have hope within us or we don’t; it is a dimension of the soul, and it’s not essentially dependent on some particular observation of the world or estimate of the situation. Hope is not a prognostication. It is an orientation of the spirit, an orientation of the heart; it transcends the world that is immediately experienced, and is anchored somewhere beyond its horizons. I don’t think you can explain it as a mere derivative of something here, of some movement, or of some favorable signs in the world. I feel that its deepest roots are in the transcendental, just as the roots of human responsibility are, though of course I can’t – unlike Christians, for instance – say anything concrete about the transcendental. An individual may affirm or deny that his hope is so rooted, but this does nothing to change my conviction (which is more than just a conviction; it’s an inner experience). The most convinced materialist and atheist may have more of this genuine, transcendentally rooted inner hope (this is my view, not his) than ten metaphysicians together.
Great Barrier Island
I had some time off recently and did a three island trip over my holiday. I first kayaked to Rangitoto, as previously blogged. Then I took the slow ferry out to Great Barrier Island. It is a 4.5 hour trip on the ferry as it is a big ferry that carries over vehicles and supplies to the island. The island is very remote feeling, although it really isn’t that far from Auckland. It doesn’t have running water or electricity, the houses and bachs (short for “bachleor’s” cabins) have solar and wind power and store water in cisterns. I kept being shocked by the scale. I had read in the tourist guides and they talked about “cities” and “restaurants,” but the truth is, I drove through Tryphena twice before I realized I was actually in it. The restaurants were very informal settings and many of them felt extremely local. Since the island only has 900 year round residents, it is quite a small community.
The wildlife is incredible. I was most thrilled about the wild parrots (Kaka) flying about, eating flax flowers, squabbling and chasing each other. From the top of Hirakimata, it sounded like a jungle below as Kaka sqwacked and chased each other. There were a lot of Tui, also, and the island has a large population of Brown Teal, which are endangered elsewhere.
On the way back we saw numerous whales spouting (I was disappointed to not be able to see anything more than a spout of water, but it was still exciting). Then we had dolphins that came up to the ferry for awhile. I have noticed that the wind and sun make an incredible difference in being able to get good photographs. There was a lot of sun on the water and so not very good photos. Also, if it is too cloudy, it is hard to see very deeply in the water. Other times, with the right angle of sun and lack of clouds, I have gotten crystal clear photos of dolphins.
Kayaking to Rangitoto
One of the first things I wanted to do when we moved into our flat was to get over to Rangitoto. Every morning I look out at it and feel it beckoning. Well, it took almost a year and a half to get there, but I kayaked over this week!
The trip over was great, the 6 km. didn’t seem like too much work. Then we hiked up to the summit and that was a nice walk after being in a kayak for about an hour and a half. There is a lot of lava rock and very little soil there and it is very dry. I took a few photos and enjoyed the hike.
However, I was involved in another helicopter med-evac. One of our party developed breathing problems that continued to fluctuate over time and I talked with the tour guide, a great guy, about that it was safest to not have her kayak back and to get med-evac’ed off the island. This is the second time I have been off on a holiday trip to an island and gotten involved in a med-evac. I am starting to think I either need to do some wilderness medicine course or stop going out to the islands!
The trip back was really choppy and I was greatful for the skirts we had to cover the opening of the kayak, otherwise, we would have had a lot of water on board! I also had to swap out mid-way with another kayaker. Our guide was concerned that two of our party (we were in tandem kayaks with two people per boat) were falling behind in the wind and waves and he wanted to put a stronger paddler in that boat. He had mentioned we might do this if necessary before setting off, but I couldn’t really imagine how you would swap paddlers in the middle of the water – but here is what we did, we formed a raft of several kayaks with people holding on to the one next to them. This stabilised the kayaks. Then one person (me) climbed out of my seat and sat further back on the kayak. Then the other person climbed over and into my seat, and then I switched over to her seat. It all went smoothly, but as I was going across, a little more space opened up between the kayaks than I would have really wanted and I was closer to “sitting” in the water than I wanted to be. The paddle back was gruelling and I felt hung-over the next day from the exertion. We got a late start and the wind and waves were pretty strong.
So, I made it to Rangitoto, the crater was smaller than I thought it would be. I got to kayak. I do have to say that I was a little less enthusiastic about running out and buying a kayak after that paddle, though….but we’ll see…
My on-line video debut
My employer got together a few American psychiatrists to shoot a promotional video. The results can be found at the link:
ADHB American Psychiatrists Testimonials
I seemed a lot less wooden and stilted when we were doing the video! It was fun to do, though, and a good chance to reflect on some of the positive aspects of working in New Zealand.
After the Health of Health Professionals Conference
I had a great time at the conference and it was really energizing. I met many inspiring people from all over the world. There are a substantial number of people doing great work to support clinicians and to bring compassion back into healthcare, and they are doing it at the individual, research, and administrative levels.
Of note, Robin Youngson gave a great presentation.
Tony Fernando gave a presentation on positive psychology that had a lot of practical information about how to be more compassionate in clinical work.
Jane Lemaire, from University of Calgary presented a series of studies that her group have done on physician well-being, one of the most interesting was on the positive cognitive and relational effects of simply feeding doctors (something that often takes back seat in a busy clinical day).
Marsha Snyder gave a great presentation on the issues involved in working with patients who are doctors.
You can still see the conference programme on-line if you want get an idea of what the conference was about. I thought I understood that the conference organizers would be putting up some additional information following the conference, although that was up at the time I posted this.
View more presentations from the conference.
The next conference will be in 2013 in Queensland Australia.
The Health of Health Professionals Conference
I will be presenting at the Health of Health Professionals Conference in Auckland, on November 3rd. The topic is: “What is Good for the Patient is Good for the Doctor.”
This presentation will examine clinician burnout, Gary Schwartz’ book, The Way We Are Working Isn’t Working, recovery principles from the recovery movement, and Parker Palmer’s concept of the “new professional.”
The focus of the presentation is on the concept that the care that a clinician provides for a client is partly dependent upon the practice environment that the organization creates for the clinician to practice within. As above, so below.
Another quick post…
Mary Pat and I went up toward Warkworth yesterday. We drove around Omaha Beach and then up to Leigh, where the Goat Island Marine Reserve is located. It was a good day trip and nice to reconnect to New Zealand after we have had so much time away in Australia and the US.
Here are a few photos from yesterday’s trip…
Australia!
About two weeks ago, I went to Australia for the first time. The trip was for the World Congress for Psychotherapy. I was in Sydney the whole time and I really enjoyed seeing another major city in this region. It was a 3.5 hour flight from Auckland and is the closest city larger than Auckland. Sydney has a population of about 4.5 million (which is around the population for the whole country of New Zealand) and it is in the Australian state of New South Wales. The whole population of Australia is around 22.5 million (roughly equal to the populations of the four US states of Illinois, Wisconsin, Iowa, and Nebraska).
The Great American Dissatisfaction/Dream
On returning from a trip back to the US, I have several observations about the country and myself. I was struck by the sheer material abundance of the place and the feeling of dissatisfaction and lack in the people and myself. The solutions for this problem of dissatisfaction are generally material. Yet these material solutions do not fulfill the need or satisfy the dissatisfaction.
What is the American dream? Maybe that gives a clue to the dissatisfaction. It seems that that dream is of acquisition and/or improvement. The desire to “make things better” seems to be very American, and yet I am beginning to wonder if the impulse to make things better comes from an inability or difficulty in accepting what is. One often hears of “American ingenuity” as a source of innovation. At what point does change become a trap rather than an ongoing adaptation to the environment? I used to be perfectly happy with a razor that had two blades, but then it became harder to get refills for it, so I moved up to the new triple blade, and then it became more difficult to get refills for that, so I tried the quadruple blade, it seemed absurd, but I could no longer find refills for the triple blade. Now I just bought a quintuple blade razor and I feel manipulated by the razor blade companies.
It is instructive to look at the dissatisfaction as the flip side of the dream. This is one principle I feel that I have gained from living abroad for a year, that every culture creates itself according to its values and that the drawbacks or blind-spots of a culture are the shadow of its strengths. In this way it is not so unusual to examine strengths and weaknesses in relation to each other. The United States values efficiency, innovation, and the pursuit of happiness. These facets have made the US a very productive, powerful, and creative force in the world, but is there a point where these strengths are over-developed and we have an impersonal society in which people are processed in a quick and efficient manner (I am writing this after having just got through the check-in and security at O’Hare airport where I had to take off anything metal, take everything out of my pockets and go through a “backscatter x-ray” machine for my “safety”). We have bewildering choices for everything from razors, to toothpaste, to blue jeans, and yet are we, as a people, happy or fulfilled?
The dream is for more; the dissatisfaction is that what we have is never enough and that things could always be “better.” On my last day in the US, Borders bookstore was closing. It was very sad to step inside and see the giant signs, “EVERYTHING 40% OFF,” the long lines, and the sense of good deals to be had. We left almost immediately. To me, this felt like the end of an era. While it is true that Borders was a business and it was about acquisition, it was also a place that created a social place that people could meet, that you could check out new books and ideas. Borders wasn’t my favorite place to go for coffee, community, and new ideas, but when I lived in Champaign, I did go there fairly regularly, maybe every few weeks. It was a place to go before or after a movie to talk and browse, or a place to go and read a book, but to also be in a public space that contained the possibility for socialization if I ran into a friend.
The space shuttle also landed for the last time on my last day in the US. This also seems like an end of an era of creativity, dreams, exploration, and innovation. This collective work led to many new scientific discoveries and a common purpose and focus for the country and the world. As the movie, “In The Shadow of the Moon,” showed, it also led to a change in the way that we, as human beings, see and experience the Earth. It was a chance to have an awareness that we are all part of something larger than ourselves and that what happens to one person has the potential to affect everyone.
In the development of ideas, there is often a point where the fullness of the idea is reached and nothing much new is discovered or created (although there can be endless variations on this, like the many new psychiatric medications that are not significantly different than the medications already in use). The idea becomes sterile, the work technical and tedious, and the benefits and results more meager and less gratifying. It seems possible that the United States is at that point. Are we using our creativity, our ingenuity, and our ability to design efficient systems in such a way that the pursuit of our dreams only leads to dissatisfaction? If that is the case, the more energy we put into the pursuit of our dreams, the more unfulfilled and dissatisfied we become. We buy food that does not nourish or gratify, but it is efficiently made, conveniently packaged, and it looks good. We buy bigger and bigger TVs and home theater systems, to give us a more convenient and efficient way to watch movies in isolation from other people. We can download anything we can imagine, and yet our imaginations are unfulfilled.
I have had a couple of recent conversations with people about the Buddhist concept of “the hungry ghost.” What I can remember about these creatures is that they have tiny throats and insatiable appetites; they eat and eat, but are never satisfied or fulfilled. The restless consumption of US society does seem reminiscent of these creatures who only dream of consumption, yet they are never nourished.
Much of the efficiency of American culture seems to neglect nurturance, which is an aspect of fulfillment. For all their conspicuous consumption and discharge of the acquisitive drive, there is an emptiness, dissatisfaction, and persistent hunger in American society. Coming from abroad, the US seems filled with busy people, impatient, in a hurry, irritable, restless, self-absorbed and a little bit like locusts consuming mass quantities of goods and food in a way that is not only not fulfilling, but is also not sustainable.



































