The Only Culprits – in response to Glenn Tucker

Today the Jamaica Gleaner published a commentary piece from Glenn Tucker (educator and sociologist) about the “real culprits” behind child sex abuse. In the article, Mr. Tucker displays the same line of reasoning that allows rape culture to be so prevalent in our society – that of blaming anyone other than the perpetrator of the crime.

Mr. Tucker takes the point of view that our alternative Caribbean family structures are the main reason child sex abuse is taking place. He blames single mothers, absentee fathers, the revolving door of stepfathers – everyone except the actual person who should be blamed: the perpetrator.

I can’t argue that the way people raise their children leaves much to be desired. But as much grouse as I have with most parents in this country, there is no way I can condone blaming mothers and step-fathers for the actions of grown-ass men and women who prey on minors. Parents can do more to protect their children, certainly. But the argument that the blame lies entirely with the victim/victim’s parents is wholly reductive.

The entire tone of the piece is condescending and self-righteous, with Mr. Tucker seemingly placing himself above the “dalliances” of the hoi polloi – even so far as extricating himself from the responsibility of reporting suspected cases of abuse.

I know a mother who dolls up her daughter in nice short, sexy little dresses twice each week and sends her off to pastor for ‘driving lessons’. Four years later, when she became my friend at age 16 (do the math), she still did not know the difference between the stick and the ignition. This one is not likely to reach the courts, however, because she tells me gleefully that Pastor is “really, really good”.

Every citizen has a moral and ethical (and in some cases legal) responsibility to report cases like these, regardless of the child’s current age or the attitude of her parent. Failure to report abuse or suspected abuse is equally as heinous as committing the crime yourself.

The only thing necessary for the triumph of evil is for good men to do nothing
-Edmund Burke

Then Mr. Tucker attacks the hard-working investigators of these alleged cases; an attack, which as a primary care physician, I take very personally. No agency or institution is completely infallible, but we have to believe that the overall thrust of organisations like CISOCA and the CDA is in a positive direction.

His sentiments completely devalue the efforts of governmental and non-governmental agencies alike. And he fails to consider the roadblocks of financial and human resource limitations, the constraints of our justice system and the inherent rape culture/informer fi dead culture. He, the indifferent observer, is content to blame the people actively trying to deliver justice instead of the people who are perpetrating the crimes.

But it’s the final paragraph that sends chills down my spine, when Mr. Tucker includes himself in the group of “dirty old men”, referencing I presume the population of mature men of power eliciting sexual favours from minors in return for financial assistance.

Because of the extent of family disorganisation in this country, it is us dirty old men who are keeping the bodies and souls of these ‘victims’ together, making them graduate from school. And university, in some cases.
Jamaica Gleaner February 6, 2017 (emphasis mine)

The meaning is ambiguous but the paragraph lends itself to a much more sinister interpretation. And I don’t think Mr. Tucker is the only university graduate who feels this way. If these are the opinions of the people teaching our children and leading our communities, it’s going to be a lot harder to fix our culture than I thought.

Gender. Sex. Silence. Survival.

All across the globe, gender revolutions are happening. And it’s not just in National Geographic’s January 2017 Gender Revolution issue. From the Women’s March in Washington D.C. (and others like it around the world) to the #saytheirname movement in Jamaica and the wider Caribbean, the concept of gender and sexual autonomy have become the prescient buzzwords of the new year.

So many changes are taking place in the landscape of gender – now we’re talking about it openly, for one. Compare the evolution of gender into terms like ‘non-binary’, against the potential backpedaling of the US government away from reproductive autonomy. What a time to be alive.

Of course, negative reactions are to be expected. When Loop JA posted their article on Trina, a Jamaican trans woman featured in the National Geographic issue, almost every comment disparaged the young woman – calling her ‘it’, saying she should have died in one of the many attacks on her life. And somehow in the same breath, being angry that she ‘chose’ to portray Jamaica as way more violently homophobic than it actually is.

It’s true that not all Jamaican gays/trans-folks/bisexuals experience life the same way. Jaevion Nelson (long time human rights activist) points out that by focusing on the most brutal stories we forget about the voices who are not so downtrodden, but equally important. There is no one way to be gay/trans/non-binary and Nat Geo should have considered that in their piece, instead of perpetuating the horror crusade that has become de rigueur in discussions about Jamaican homophobia.

This is not to say that there aren’t things about Jamaica that are downright horrifying. Take the recent travesty involving a Moravian pastor caught in a “compromising position” with a 15 year old girl. (Which is being handled terribly by the media, might I add).

The Moravian church has a lot to answer for, but the culture of silence isn’t only perpetuated by church-goers and elders. The silencing of young girls is so entrenched in our society that it seems impossible to break.

The silence of mothers should not be passed to their daughters. Daughters do not need to inherit the silence of their mothers.
–Ijeoma Umebinyo

Organisations like We Change JA and the Women’s Resource and Outreach Centre (along with dozens of human rights activists) are writing letters and editorials that demand an end to the secrecy. The #saytheirnames movement is growing.

But human rights movements always gather momentum really well only to fizzle out as the public loses interest. Right now everyone is interested in what WROC and the activists have to say but in another nine days those groups will be behind the scenes again, unobtrusively working to change the way our society thinks.

What great catalyst will it take to shake Jamaicans out of their indifference? When will one million women march together for gender equality, sexual autonomy, reproductive rights? Is it to be a slow, inevitable downward spiral, despite the desperate efforts of an enlightened few?

Will we wake up in time to save ourselves?

To the Fifteen y/o Girl (and all the others like her)

Dear heart,

I don’t know why this happened to you. Why the people who were supposed to protect you failed to do so. I don’t know why you had to be the one whose case made such a public splash. Why your darkest, most painful moments became a matter of great national debate. Why your life was suddenly split open.

I don’t know how you are coping, reeling from all of this. How you will recover. How far the other side of that bridge must appear. How alone you must feel.

But you are not alone. You. Are. Not. Alone.

And It. Was. Not. Your. Fault.

And You. Are. More. Than. This.

Right now it may feel like you will never be anything more than a victim, or a bad girl, or the centre of a horrible horrible story. But you will be. You are more than that and you will continue to be so much more.

It will take time. Healing takes time. And courage. And faith – in yourself, dear heart. It might seem so impossible now but there will come a time when you forget to think about this chapter in your life. When the pain hurts a little less. When you start to love yourself again.

You cannot yet understand how the strands of your life will recover from this hopeless tangle. But we must ask you to trust that you are strong enough and brave enough to survive this. If only because you have to.

There are hands and hearts waiting to help you. All you’ve got to do is ask.

Waiting by the Library One Freezing Morning

The pressed kiss of my buttocks
against the cold concrete is mediated by
the thin cloth of my jeans
This bench is a parasite
Across its placenta of 96% cotton and 4% spandex
it steals every molecule of heat
from my begrudging ass

In games of waiting I am a sore loser
with muscles aching and contorted from
spasms of shivering
teased out by every cold breeze
each of them lovers – must be
to garner such
instantaneous, overwhelming reactions

The wind caresses my face with ice
kisses the tip of my nose with frostbite
attempts other intimate contact
I would like to defer

There is nowhere to run,
only the cold confines
of this damn stone bench
pressed up against my backside
like some
unsolicited dance partner

I cannot wait
for this waiting
to be done.

Evolutions

The evolution of an illness is similar to the evolution a story.

My colds always start with sniffles and a tickle at the back of my throat. Except instead of a tickle it’s more like a yard fowl decided to gently graze for scraps on my soft palate. Naturally I get a sore throat.

The next day I have serious sinus issues. My nose is Niagara Falls – the rushing water and the dam all at once. I take cold medicine, which wins the battle but not the war. My upper respiratory tract infection starts to trickle downstream.

Because I don’t cut my nose off, all that Niagara falls goodness gets washed down into my bronchi and smaller airways. Two days later I’m coughing up a lung – that yellow stuff, so you know it’s infected.

Shortness of breath and chest pain go hand in hand with the hacking, reminding me this isn’t some simple flu and that I probably have a pneumonia (for the umpteenth time). This goes on for a week or so before I try to get help. When I give in to the less-than-kind remarks about my unhealthy appearance (thank you, work colleagues) it’s antibiotics and sick leave that doesn’t involve actually resting.

Despite myself I get better, though it takes the better part of two weeks. My body rediscovers its equilibrium, but the cycle is always poised to start again.

Like my cough started with some virion, stories start with an idea. A suggestion that replicates and multiplies into something significant. That grows from its point of origin towards some inexorable, organic destiny. Stories run their course despite us, whether they are stopped prematurely or reach a natural conclusion. And the writer rests, but the cycle is always ready to start again.

The Unfortunate Business of Death

Breaking bad news at one in the morning
Is not part of the prescribed medical school curricula
Real life has no point score for empathy
Patience
Directness
But conversations twist as they need
And break when they must into tears
Screams
Silence
Five minutes.
(Is an exam, not the ending of a life)

Chasing Creativity

The muse of inspiration is a very elusive fellow. The mole in Whack-A-Mole comes to mind, or that crafty Bugs escaping poor Elmer Fudd. Maybe it senses my subconscious’s mixed feelings towards creativity (like, why did I choose such violent analogies?) but whatever the reason inspiration is certainly not sleeping in my bed at nights.

Of course, if being inspired isn’t part your day job, it’s much harder to clear the cobwebs from your boxed up dusty mind at whatever odd times you can snatch to first be inspired then find the time and will and consistency to write or paint or choreograph. If you’re not in a state of continuous and conscious open-mindedness (as, for example, in my day job where being closed off happens whether you want it to or not) your task is that much harder.

My problem isn’t getting inspired though. I frequently think of topics I’d like to talk about at length, or story ideas to get on paper (someday) but at the exact moment of inspirational breakthrough I am nowhere near pen or paper or laptop. I’m in a taxi, or about to head out to work, or in the middle of seeing a patient and my brain goes ‘We’ll just file it away for later’ and it goes the way of the Dodo.

(I cannot be the only person whose brain does this).

The obvious solutions are to jot down a quick line on my phone so I can remember at least what I was so inspired about. Or to walk around with a voice recorder (or, again, use the one on my phone. Ha.). But, that quick line on my phone often fails to capture the essence, the vivre, of my brief excitement. The line goes dead and hangs limply in black pixels, mocking me with its wasted potential. Repeat ad nauseam.

Perhaps the real solution is to quit my day job and roam the streets, laptop or notepad in hand, digging for inspiration like a coal miner: grubby, starving and desperately grateful for the light of the sun.

It’s a Good Morning

Last night I did yoga for the first time.

I’ve been talking about it for years – of course the closest I’ve ever come was attempting a two hour instructional video and giving up after the first five minutes. But last night under the stars in the instructor’s backyard with a light summer breeze brushing against my straining muscles, crickets and muted traffic playing background music I pushed myself to keep up and finish what I’d started. It paid off. I woke up this morning feeling refreshed in a way I haven’t felt for a long, long time.

The only sad thing is that Montego Bay doesn’t have many opportunities like this. For a city that is jam-packed with tourists and expatriates our culture is ridiculously under-globalized. And once these opportunities spring up they’re usually available to only an elite group of people (uptowners). The Western end of the island is struggling to keep up with the East, even though Kingston is the only city on that end that’s spearheading development.

Still, I am grateful for the expansion of alternative hobbies and activities in my hometown. Dance classes are becoming more popular, cafes are patronized more often (and by people who aren’t tourists). Now there is yoga (there has probably been yoga for a while). And while these opportunities wax and wane in response to public support and financial solvency, I hope there will be a gradual evolution of fun (and healthy!) things to do in the second city.

We can be more than just our beaches (but we do have awesome beaches).

Day in the Life of a Paediatric Intern

This post originally titled, Waving the White Flag. (It’s Kleenex).

Where to start with Paediatrics? The current headlining scandal? The mind-numbing, soul-crushing duties? The prickly staff? The demanding work days? How about all of it, all at once, the way it is in real life. Nothing about this rotation happens in an orderly fashion. One time our senior registrar scolded us for not completing discharge summaries on time, saying “they are just as much a priority as dealing with procedures for patients on the ward and from clinic and giving medications”. If it’s one thing Paeds has taught me, it’s that everything can be a priority, all at the same time.

But all this non-stop action has succeeded in murdering my already feeble immune system so that I am now sick. With the flu. Probably. Or tuberculosis. Probably (not). If you know anything about me, it should be that I do not handle illness well. I handle it like a boy, really. Which is probably sexist to say but we all know it’s true. Boys are complete babies when they get sick. And so am I. I curl up in the foetal position and demand soup in a voice that sounds like death colded over*. I am utterly useless at anything involving physical, mental or emotional energy and I sometimes fantasise about using telekinesis instead of getting up to retrieve my phone from the counter five feet away.

Going to work today was entirely out of the question, so I used my leftover energy to feel guilty about calling in sick. I know what a Paediatric work day is like. I also know that I have duty tomorrow and I had to make the decision to take today off so that I could have some reserve of energy with which to survive that 36 hour beat.

This is what a Paediatric work day is like for me:

Starts at 8AM (unlike Surgery which would start at 6:30-7 because the earlier you arrive, the earlier you leave. On paeds you leave late no matter what). At 8AM you see patients on the ward until ward rounds start at about 9:30.

Ward rounds end at about 11AM when you start the day’s procedures which include taking blood, collecting urine samples and sending patients for investigations (like xrays etc). This is for patients admitted on the ward, as well as patients here for the day for a review or patients sent up from clinic.

All intravenous medications are administered by the interns, on a strict schedule. Medication also has to be ordered daily from the pharmacy because they don’t send up more than one day’s supply. This means writing up several charts and getting your senior house officers (SHOs) to sign them because your signatures carry no weight.

Then there is other paperwork like writing discharge summaries and prescriptions for the patients leaving. And there is following up of lab results, mostly cultures from microbiology, that require one of you to go into the lab for about an hour to write down results from the 3-4 books that serve as records.

All this takes you until well into the afternoon and suddenly it’s 3PM and you haven’t stopped for lunch. You just gave the 2PM medication but you can’t eat yet because this baby needs an intravenous access (a ‘drip’) and another baby just got admitted from Accident and Emergency (A&E) needing blood and urine cultures.

There are three of you working but it doesn’t seem like enough. The SHOs will ask “Are you the only one doing procedures? Where’s Dr. So-and-So?” and you will calmly explain that Dr. So-and-So is giving medication while Dr. What’s-Her-Face is in A&E seeing referrals and there’s no one left to help you and they will press their lips together and give you a look which you’re pretty sure does NOT mean “That sounds rough, I’ll help you” and instead means “Well. You’re just gonna have to get your shit together” and you move on with your day. Breathe and move forward should be the mantra of Paediatrics.

After you finish procedures, following up the regular lab results for the samples you took off in the day can take you beyond 4PM because some result always comes back abnormal and needs to be acted on. I don’t like to leave that kind of work on the duty intern because duties are rough enough without adding work that’s carried over from in the day. So I never end up leaving before 6PM and usually leave around 8PM.

I’m not going to get into my eating habits because my aunt reads this blog and would probably have a conniption but suffice to say I would not turn down the offer of a live in chef. Or maid. Or professional masseuse. Or all three in one so I’d only have one monthly fee. Am I setting the bar too high?

Fuck it. The bar was high before I even got here. This whole time I’ve been trying to brush it with my fingers, on tiptoe, stretching furiously toward some untouchable standard. Today I got to rest my aching body/mind/soul for a teensy bit. Tomorrow it’s back to the rack.

Flecti non frangi.

_______________________________________________

(*Because death warmed over sounds a little too pleasant. Like Death already got soup and a blankie and now he’s pleased as punch. Although I have been told that my sick voice sounds very sultry so maybe my voice actually is warmed over).

All of Only Halfway There

What’s the hardest thing you’ve ever had to do? Physically, emotionally or mentally. Have you ever stretched yourself to the absolute limit?

What did you find? Did you break, or just bend? Did they crush you?

I bet you survived. Humans are like that. Determined as cockroaches.

My Paediatric experience will be unlike any of my batch-mates. We manned the special care nursery at a time of national crisis – babies were dying, health ministers were being impeached, the public was furious. We interns, the most junior staff, were the bulk of the paediatric department. To say we were screwed was an understatement. Every odd was stacked against us.

And yet.

We survived. Not just survived, thrived.

Of course, the first six weeks were the worst hell imaginable. I cried at work. Twice. I pushed IV medication and the lab staff and myself. I lost weight, I was anxious all the time. We all had chronic fatigue.

Then slowly and painfully, like a lizard shedding its skin (does that hurt? I feel like it should hurt), we metamorphosed, Kafka-style. Almost overnight we hardened, gained competence. The odds were still stacked, but we got better at playing them. The workload lightened. For doctors who were molded by an overpopulated nursery (thirty babies our first few weeks), taking care of eight newborns (plus or minus three) was child’s play. I moved from the desperate panic of ‘How will I survive this?!’ to the weary surprise of ‘I must have been stronger than I thought’.

Like all things do, my three months on Paediatric Medicine passed. January 4 I stumbled into the staff meeting bleary eyed and battle-worn but ready to take on whatever staff assignment they threw at me. Internal medicine was my new playing field. Game face, on.