In the olden days I was an expert at inserting photos. Times have changed. I'm still learning the New Ways. All three of these are photos relating to this post. First is the front of CeCan, second is a hallway, to the right of which is the waiting area for people receiving injections and chemo, third is a view from the drive looking downhill and away in the distance to Cofre de Perote. Everywhere we look, we see mountains.
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My husband is at the moment a patient at CeCan, Centro Estatal de Cancerología, here in Xalapa. It is on the side of the hill called Macuiltepetl which rises above the city and is mostly covered in forest. He started at a fancy clinic in Puebla which was pretty and well furnished and had glitzy publicity and was private and very expensive. A friend convinced him to meet with the hematologist at CeCan. She sat with him and me and our friend in a small office (someone else's) for over an hour and explained his illness and who she was and the services at CeCan, so he switched.
CeCan is a full service cancer center. They don't turn anyone away. To use it, you have to receive Seguro Popular which everyone here who is a permanent resident of Mexico and does not have other Mexican insurance is eligible for. It is part of the government's ongoing effort to provide universal health care.
So Jim applied for and received Seguro Popular and then went for certification of his illness and THEN enrolled at CeCan. I guess we brought some prejudices with us. Or I did. I wondered if it would be a raggedy, ratty, dirty overcrowded place like some of the places I took clients on Medicaid to years ago in the USA.
It isn't, by any stretch of the imagination. It is clean, attractive, and relatively cheerful and busy with staff as well as patients. And staff AND patients are kind, helpful and truly,I don't know the right word, but friendly and warm. I think a real cultural difference that I've experienced is that as opposed to USAers, Mexicans here are comfortable with strangers, at ease speaking to them, and not afraid of standing or sitting close to each other. It means a lot of warm contacts. CeCan is a large institution with several connected buildings and lots of hallways and turns which are different on different floors. It goes without saying that beginners at navigation there get lost. So you ask where something is, and people don't just tell you, they take you: both staff and patients do. Waiting on lines, people chat and laugh with each other. One woman received bad news on a line we were also on. She turned and her eyes filled with tears. I am learning to be a bit Mexican. Without thinking, I reached over and put my hand on her back. She put her head briefly on my shoulder and then lifted it and smiled at me before heading out. Old people are routinely offered chairs, including (groan) me. (Recently a woman said how young my HUSBAND looked! What can I say?)
For a long time I have wondered (as have far greater minds than mine) if it is at all possible to figure out the underlying factors that drive people to hold onto seriously destructive beliefs in the face of all reason. In our black-and-white culture, we tend to paint people who don't agree with us all one color. It's hard to be subtle. As I have watched the ripping apart of Gaza, I have seen no evidence of the policy to spare civilians Benjamin Netanyahu claims exists. Instead, it appears that the Israel Defense Forces he commands are bent on absolute destruction. I wonder how Netanyahu who I am sure sees himself doing good could appear to have twisted himself into someone so evil. Who is this man who stirs the pot of hatred in his country so successfully? And why does he do it? Why does he feel righteous (not to say self-righteous) following his policy of enormous overkill in Gaza? Is it possible to figure out how we justify horrible actions to ourselves, all of us? And why, with all our knowledge, haven't we come to terms with our own proclivity for violence in response to perceived attacks, for hatred of people we don't know. Why haven't we developed a way to soften this hatred.
I happened upon a review by Vivian Gornick of a book called "Becoming Freud" by Adam Phillips. I bought the book for my Kindle, and I will refer to it throughout this piece. I am not a "Freudian", whatever that means, but I think he opened up ways to look at people from unexpected angles. Freud's discoveries give us an opportunity to take a different approach to Netanyahu.
In her review, Gornick says:
"It was through attention to the unconscious that he [Freud] made his major discoveries, the most important being that from birth to death we are, every last one of us, divided against ourselves. We both want to grow up and don’t want to grow up; hunger for sexual pleasure, dread sexual pleasure; hate our own aggressions — our anger, our cruelty, our humiliations — yet these are derived from the grievances we are least willing to part with. The hope of achieving an integrated self is a vain one as we are equally divided about our own suffering; we do in fact love it and want — nay, intend — never to relinquish it."
Somewhere I saw an illlustration of the human psyche in which our consciousness, our supposedly sensible, aware part, was riding a giant bull or some similar animal, barely under control. The bull was our unconscious, unruly portion of ourselves, much bigger and stronger.
There is no definitive explanation of the conscious and the unconscious, nothing even close as far as I'm concerned. But we tend to recognize that we have been exposed to so much, have woven so much out of what we´ve been exposed to, that we can't possibly be conscious of it all, pull it into our decision-making or our creative efforts, even when it would be useful to do so. And if Freud is right, we don't even want to know all the unconscious stuff we harbor: it would go against who we think we are and what we want to be. We tend, all of us, to justify our own hideous actions to ourselves and others. Very few of us happily accept ourselves as evil creatures who enjoy doing evil things.
Sigmund Freud (1856-1939) and Nathan Mileikowsky (1879-1935), Benjamin Netanyahu's grandfather, shared pretty large pieces of cultural heritage (so did my dad's parents for that matter). But they responed to their heritage in very different ways. Netanyahu's father and grandfather became revisionist Zionists who were deeply committed to getting as much of the British Mandate of Palestine as they possibly could to turn into the country Israel. Their efforts were bloody. Freud's background was not so political.
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Adam Phillips says,"The Jews of central and eastern Europe in the 19th century lived mostly in small communities as minority groups in what were often tolerant but hostile cultures.They were hemmed in by restrictions and prejudices, but were not perceived as a threat to the states in which they lived....They had access only to the resources of their tightly knit communities, and they lived, like all immigrants with, and under, a great deal of suspicion. The continuity of their lives resided in their family traditions, which were religious in origin, their inherited ways of life in a diaspora that had become their culture....The consolations of locality were always provisional....
"....The stories of the poorer Jews in central Europe in the ineteenth century tend to be generic...due to the lack and limits of ...documentation. (Freud's parents and grandparents would mpt jave beem omterested om tjeor ñoves tje wau [Sigmund Freud] taught us to be. For these people, success was survival....[T]here fate was to be always potentially nomadic because they had no political or civic status, living always on sufferance in foreign states.
Orthodox judaism itself was declining in the nineteenth century "...due to the pressures of modernization. The haskalah--the Jewish Enlightenment...--was eroding the old scholarly-rabbinical tradition in favour of a more rational, skeptical humanism, radically suspicious of dogma and traditional forms of authority and encouraging more politically active forms of assimilation."
This was a period in which "European boundaries were shifting in Europe and the status of Jews was unclear. Whether or not they were a race or a people...they were resident aliens wherever they lived...As both the enemies and inventors of Christianity the Jews were doubly disadvantaged...they were by definition a dissenting group....
Although Freud ended up with an education in Enlightenment values, there had been "Generations of politically marginalized Jews in his family, people for whom political participation was unthinkable."
Freud and other Jews of his generation believed they had found a culture in which they had "a place and a voice" in Vienna.
Phillips goes on, " The allure of a taken for granted liberalism, however wishful it seems ...[in]hindsight...must have seemed irresistible to the Viennese Jews of Freud's generation...[which] wanted to free themselves from...a 'history of the Jewish people...long limited to a religious narrative of persecutions and martyrdoms. Esther Benbassa writes this 'story of suffering stood in for History in the proper sense of the term' as a way of preserving the fragile unity of the community in diaspora.'
This "story of suffering" still is dominant in the lives of Jews, secular or religious, who participate in Jewish culture. For some (many?) it merges with the notion of Jewish specialness, of Jews as "chosen people." Before the end of World War II, these beliefs offered, sometimes, means to survive and to maintain some integrity in their identities. Of course the genocide they suffered under Hitler gave it new life. Today, I think, especially in light of the great social and economic changes wrought in the second half of the twentieth century,Jewish communities themselves have changed. For some Jews, the mythology of their past has become malignant.
Netanyahu, the Zionist, is one of these Jews I think. Freud was not. Freud's father had renounced orthodox Judaism. He was apparently a failing wool merchant and because of this, the family moved first to Leipzig and then to Vienna, at the time a particularly vibrant and liberal city. The family stayed there. Many, many Jews who couldn't sustain themselves in "local shtetl communities" were migrating to eastern and central European cities.
Jews wanted their kids to gain respectability by hopefully taking up a profession, "preferably medicine or the law." Freud was consciously drawn to Enlightenment values, and himself said his father "allowed me to grow up in complete ignorance of eveything that concerned Judaism". Yet Freud's endeavors seem shadowed by his family's Jewish immigrant past.
Some cogent points on the value of antidepressants by Maura Kelly in the Atlantic, some cogent points on the value of antidepressants.
"[G]ood therapy is often very expensive--far more expensive than most people can afford, particularly because so many health insurance plans provide little or no coverage for it--whereas less-than-excellent therapy can contribute to a sense that one's problems are intractable, that things will never change. (I speak from experience.) Perhaps it's also worth noting that if developing a fitness habit were easy for the average person, then the obesity epidemic wouldn't be the most serious and costly health problem facing our country right now. And many seriously depressed people have a difficult time getting out of bed, to say nothing of going for a thirty-minute jog--though for some of us, like myself, our mental illness happens to come with a degree of obsessive-compulsiveness that often manifests itself at the gym."
And quoting Daniel Carlat, former author of The Carlat Psychiatry Blog and anything but a pill pusher:
Carlat, an associate clinical professor of psychiatry at Tufts University School of Medicine, wrote in to agree that "psychiatrists often overdiagnose disorders of questionable scientific validity, they have become overly fixated on medication solutions to life's problems, and many have accepted a steady flow of drug industry money, creating so many conflicts of interest that it is impossible to know who we can trust." But he also noted that "missing from her review is an unequivocal if perplexing truth about psychiatric drugs--on the whole, they work." (Carlat, let us remember, had no axe to grind; Angell had written favorably about his book.)
(HT to Andrew Sullivan)..
Of course it's important to realize--VERY important--that if you're a bit down you shouldn't simply go to your family practitioner for ten minutes and accept a prescription for antidepressants with no real examination of your symptoms.
Also check out one of Andrews Quote for the Day items here.
Mexico Bob For all of you with curiosity about Mexico this is a great blog by a guy married to a Mexican in Irapuato. Really, this kind of stuff is what people up north should be reading.
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