Friday, 19 October 2012

Ulysses or lithium?

A slightly later start for a more leisurely day: leisurely breakfast with Yousuf and an interesting conversation about the ways in which the anti-medical regime, in place at Winterbourne (and subsequently the Complex Needs Service) in Berkshire since 2002, has undermined and ended the careers of several senior medics there, and destroyed the culture of excellence for  training junior doctors. Determined not to be that latest victim, I am very unsure about what I need to do next.

Onto “Cultural Psychiatry, Empowerment and Best Practices in Europe” which was mostly rather dry and about the sizes and needs of people of different cultures - until the final presentation by Professor J Achotegui from Madrid. He told of the terrible desperation economic migrants felt, and the often fatal lengths to which they went, to land on the Spanish coast. There were severe psychiatric consequences of the displacement, alienation and rootlessness – as well as rejection, worthlessness and helplessness they subsequently experienced (not unlike life for doctors at Winterbourne since 2002!). In a crescendo of emotion, he described how their mental conditions, a sane response to an insane situation, were not well-captured by any current psychiatric diagnosis. With the help of Homerian poetry, anthropological reflections , a little economic analysis and a public education campaign, he had coined the term ‘Ulysses Syndrome’. Not everybody in the audience took to the cut of his jib, but nobody could deny him his fervour and passion for humanitarian responses to international civic bureaucracy.

From Spain to Germany – and one of the plenary lectures, on mapping care pathways, by Heinrich Helne. After a vaguely interesting preamble about principles and examples from Italy, Japan and USA he got thoroughly dug-in to the intricacies of the German system. Losing the will to stay awake, a walk in the fresh air through the ancient streets of the Old Town was called for. I caught up with Kath, Andrea, Emma and Olivia and we ambled from our hotel to the astronomical clock – arriving a few minutes after it had struck noon. With five ringside seats available in the pavement cafĂ© next to the Old Town Hall, there was little choice but to sit down and enjoy the rare luxury of a lunchtime beer - while waiting for the disciples, Jesus, lust, sloth, greed and death to appear or jiggle for the one o’clock show.

We then ascended the tower in the tardis lift to see the two o’clock show from aloft, next to the lone trumpeter. Most impressive – as was the walk across Charles Bridge ominously watched by the  looming statues.

Back to the congress centre for the committee meeting of the Education Section – which I had recently been coopted onto. What were they on about, I wondered – and I simply had the intention to find that out, and whether any of them were friendly to psychotherapy and experiential training. Very friendly and welcoming, we heard of a couple of international surveys, proposals to have new psychiatrist educational seminars at future meetings, NY Cornell’s outpost in Doha (Qatar), and our free use of a Harvard project manager.

The extremely affable chair, Bulent Coksun from Turkey, took us over to dinner at the nearby Holiday Inn – but was profuse in his apologies for having to attend a form dinner elsewhere himself. The remains of us had a fairly raucous time being rude about each other’s countries and customs, and our own. Suffice to say that one dinner guest had to be restrained and told to be more compliant with his Lithium!

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