When in Chad, I took notes and walked around with a Camera. My mission was, in my mind, to help with the immediate concerns/suffering, to document, and to learn about a larger world with my feet in it. Advocacy became more prominent than I would have expected. In some way, the writing and documentation probably also served an anxiety-mitigating function… intellectualization takes you out of the moment, a bit. But that was a fair trade-off.
Having returned, though, I have this aversion to taking pictures. I can be in them, I can want to preserve moments in time, but I don’t carry a camera (one was in my pocket for six months) and have a slight pang of guilt for this. I wonder what my new Chadian friends will think if they saw photos of me in Canada. This is foolish on many levels, but the object of this thread is not to be rational and prudent, but to be descriptive. A photo seems to me a wish to preserve, and I have nothing to add. My giddy and smiling nephew and niece are rather well photo-documented already… I just play with them and field questions about mud, carrots, monsters and stuff… I like that.
Casual cruelty. There is a concept in psychiatry called “over-kill” or “casual cruelty.” When a guy gets in a “fair fight” in the bar or wherever, and he hits his opponent who then falls over, he stands back. The fight is done. If the guy continues to kick and punch and inflict damage, pain and suffering, then this is deemed aggravated assault, and it can happen for a few reasons. I’m not really going to get into it, but the desire to see others in pain is bloody well endemic in our society. TV shows such as The Sopranos, Criminal Minds and Dexter, all runaway hits, reflect this desire in us to be exposed to this cruelty. I say experience not in the sense that anyone wants to carry it out. Not at all. But to my knowledge (and I’ll admit that I’ve not done any research into this, but I’m guessing that there are more than a few PhD theses written on this very topic), Tony Soprano is the “good guy”, albeit a complex character. I don’t know when I have ever been cajoled by television into wanting to character identify with a psychopath (again, made more complex in that he is a pro-social one; Tony stands up for Italian culture, family values, community safety, etc). Dexter is a more striking example. He only goes after baddies, but the gore, the sadistic drive, and the absence of empathy are there in great part. Criminal Minds trip over themselves to depict evil in a more provocative and disturbing form each week.
It is too much. I used to watch them, and now I choose not to. In one sense, the duty to withstand negativity, psychologically challenging emotions, and disgust, are necessary for a psychiatrist. Our duty, as is the duty of many other professionals or philosophers alike, is to see the world for what it is, and pay attention to appearances when the mind wants to look away or self-protect. In some fields this is called “negative capability,” but I think that I am using this term in the Bionian sense (As in Wilfred Bion). I used to think that I had a high negative capability, but it turns out that the exposure to so much suffering in Chad has worn this out. My buffer is still thin.
I watch the television, an escape for me that lives on, and while I used to revel in the psychological twistedness of the characters, and their undoing, now I find it banal at best, and usually aversive. Sure, there are bad people, and they don’t care about others, and some of them are truly callous and perverse. But the majority of suffering in this world is due to neglect and indifference. Chad’s government doesn’t give a fuck about their people. They just don’t. They would kick every NGO out of the country if it weren’t for the risk of losing aid money and IMF and other assistance. This is a country that wanted to tax MSF for the medicine brought into the country that was being dispensed FOR FREE. Right now, to me, the face of evil is the face of the man behind the desk that made that decision.
Six Feet Under, now that is a good show.
I’ve been back for over a month now, and the fatigue has mostly lifted, I’m getting back to being skinny rather than mildly alarmingly rakish, and the humour is starting to come back without me pretending. I seek out fun, rather than trying to be a part of it for mainly the sake of distraction. I think a lot about healing. The pragmatics of healing psychological distress. I think about closeness and caring, and the vulnerabilities that this engenders. I am thinking about connection-making and breaking. The ties that bind and the ties that keep us from moving on.