Tuesday, 25 October 2016

Retirement III Post Retirement-blues



It is now 10 months since I fully retired, the end of December 2015. It was not a big shock to my life, my system, as I had a few years previously reduced my time at work to four days a week, and for the last 2 1/4 years, I was half-time. However, as much as I enjoyed my work and the people I worked with, during those last few months I have to admit that I was really looking forward to being done with it. As a fellow church-member said to me 10 days ago, there comes a time when you have had enough of it.

For me, for reasons I believe I have written about before, the sentiments expressed in the paragraph above present a bit of a problem. Not enough to make me really blue. I am really enjoying my retirement. Sometimes I think I am one of the most fortunate people on earth, and I am compared to many. However, if one believes one has been called to this occupation by the Lord one serves, can one really quit it? Can one really think that one is happy to be done with it?

On the other hand, there are many other things I believe The Spirit is calling me towards these days, some of which were, some would say passions, of mine in the past. Now I can devote more time and energy to them. I refer to things like my concern for First Nations, homelessness and affordable housing, peace, justice, especially in places like Palestine-Israel. No one can deny that these are still all good causes in which one can continue to serve The Lord.

One issue that I am sure many struggle with when they first retire is the question of whether they will return to their profession. This option was certain in my mind, knowing the need around the world, and thinking that I might be able to help in some less privileged place than here at home in Canada. However, so far, nothing much has materialized in those directions, as I may have shared before. Most recently though, I have been accepted as a volunteer community advisor for the Vancouver Coastal Health Community Engagement Advisory Network. In fact, tomorrow, I am meeting with a local/Richmond leader of this initiative in the area of mental health, to see if I have a role there, particularly given my background.

When I first retired, one of the things that I did was clear my bookshelves of a number of books related to my career. I gave them to my colleagues in one of the offices where I had worked. Hopefully they can get something out of them. I also gave my physician colleagues and others some particular files of materials I had collected, such as on antidepressants and antipsychotics.

Of course, another benefit of retirement was not having to pay all those dues, license fees and insurance. I no longer get all of that medical -related reading, e.g. journals etc., in my mail. However, old habits die hard. I still struggle with wanting to read and keep up with some of that, thinking that I can still do something about some of those areas. Perhaps I can. I can certainly lobby organizations, agencies and even our government about health-related issues, particularly mental, and I do some of that.

However, although I had thought right from the outset that I really had no plans to return to work, I think I decided over the last week that this is going to be even more definite. Therefore, I cleared my bookshelves out of more books. I will share these with both teams that I worked if they accept them. There were also some of the more practical self-help nature that I am offering to our church library. This is in part because individuals from the community who have been coming to our community meal have been asking for resources such as these.

I will also honestly admit that another nagging thought that I sometimes have which again could lead to real blues if I want to let it, is my success or effectiveness as a physician/psychiatrist. I sometimes ask myself, was I not effective enough? Did I not show enough skill? Did I not make a good enough impression? Is that why no one has jumped at the chance to accept my offer of services, even voluntary? I'm sure others have those questions as well.


However, I can reassure you that I am really nowhere near becoming blue let alone depressed. When every day is like one’s work weekends, without leftover ‘work’ to finish etc., what’s not to enjoy? Thankfully, I still have the health and ability to enjoy life, and financially I am alright too, thanks to years of saving. There's is another bit of advice to my physician colleagues or trainees, if you have read this. I continue to heartily recommend our M.D. Financial Services for their excellent financial planning and handling of mutual funds and RRSPs for no cost except what you already pay in your Canadian Medical Association membership dues. We are indeed fortunate. It is thanks to their help that my wife and I are in the position where in today. God is good.

Wednesday, 19 October 2016

Writing on Child Development - To Continue... or Not?

This blog was begun in part to function as a means of passing on some of the knowledge and wisdom that I hope I have gained, along with talking about my experience, as a physician come child psychiatrist. It was in response to what I could call a certain degree of failure of an initiative on the part of the University of British Columbia Faculty of Medicine Department of Psychiatry's attempt to get a Mentorship Program going for Psychiatry Residents. Meeting in person in the groups of graduates and residents as organized over a couple of years just did not seem to be happening. Therefore, I reasoned that I could try to pass on the same kinds of advice, if I could say that, through a blog as I would have meeting these individuals in person.  I tried to pass on this blog/website to some of those residents, but again, it appears that this met with quite limited success, at least so far.

When I began writing it in February 2015, I was contemplating retirement. I had reduced my work week to 4 work days for a couple of years. I had stated my intention to retire at the end of June 2013 but circumstances related to lack of replacement led to my coming back half-time from late September 2013 until full retirement at the end of December 2015.

Since beginning this blog, I also began to use it as a tool to put forth some of my writings related to child development and parenting. For several years towards the end of my career, I had taken a quite regular part in a journal club run by our Infant, Child and Youth Mental Health Division of Richmond Mental Health And Addictions Services, which is itself an arm of Vancouver Coastal Health Authority. Some time ago, we had gone through the second volume of a ground-breaking and quite influential series of three books written by Allan Schore, a researcher and clinician, Affect Regulation and Disorders of the Self. I was so taken by what he wrote about, along with much of the other material about child development and recent understanding of it and how that relates to therapy, treatment, that we were reviewing,  I felt I wanted to summarize this information in a book of my own creation. In particular, I wanted to "translate" this material in what I was learning for the benefit of laypeople, such as the parents and mothers we serve. It could also be of benefit to other clinicians, particularly non medical, working in the field.  Anyone who has read Schore's volumes will understand that this is no easy task.

Part of the reason I took this last initiative on was because I thought I could apply what I had learned for the benefit of programs and initiatives in our community that worked with young mothers and parents. I volunteered with Union Gospel Mission, took their orientation and was quite interested in a program of young mothers they run, as well as the general adolescent program. However, the leader of the first program was hard to make contact with and that direction generally seem to dissolve. Our own church runs a community meal twice a month and it was evident that some of the parents attending their might have been able to benefit from some input in regards to the difficulties they had spoken of two some of our church members. However, even that did not seem to get off the ground despite some of my efforts. Thirdly, when I had what I could call an exit interview with  the new Program Director in Richmond prior to my retirement, she mentioned another group of young mothers in the community that sounded as though it were another possibility for myself to volunteer with. However, again, my attempts to make contact with the individuals actually in charge of the program again never got anywhere.

All of this led to a certain lack of interest, understandably, in following through with working on this book. It certainly seemed as if there would be no ready-made audience to benefit from it. Some on-line checking revealed that there are other books written along this vein under the common heading nowadays of things like Parenting and Child Development for Dummies. Again, that led me to question what I might add to this literature that would be different enough to be worthwhile pursuing. All of that led to my not continuing with writing in this area for a few months, as I mentioned in a blog entry from August. However, since then I have tried to discipline myself to continue working on this project. Indeed, I even went to the length of purchasing volumes one and three of Schore's books and have begun to work my way through volume 1 and distill its material for my purposes.

As I reflect on this process, part of me thinks I am doing this because I have been used to working in this area and I'm not yet totally psychologically giving it up. Part of me was stimulated enough by this material to feel that I wanted to share it with a wider audience. So, at present,  I will continue to work on it. Earlier on, I had placed sections of it as entries in my blog. However, the manner in which I am working at it at present does not readily lend itself to that.  I am taking material from my readings and placing it into what I consider appropriate chapters in the outline I have developed for this book, so I am not really coming up with discrete portions that can be parcelled out as blog entries at this time. So, at this time all I can say is I'm not sure how soon more of it will "see the light of day" on my blog.

Part of the reason also for putting it on my blog in this way was that I hoped I would get feedback from it that would help me develop the book. However, the seemingly limited response to my blog certainly did not fulfill those expectations, at least so far. At this point though, I will persist in writing and see if I can figure out when I have sections that can be shared, hopefully for the benefit of others, and also for those interested in the field to give me suggestions for pursuing this further. I am not sure I have ever posted my outline, but I will follow with it, which might make my direction more clear and hopefully attract some interest. This is by no means final, but simply a work-in-progress.

Chapter                                               Title                                                                             Page

I.               So, You Are Going to/You Want to Have A Child/Baby?
a.     Unplanned
b.     Planned - natural, artificial and adopted
c.     Parent and family setting – couple, single, extended

II.              What are You Bringing to This Child?
a.     Your genes – heredity and more
b.     Your childhood – normal, traumatic
c.     Your parents and their parenting
d.     Your dreams

III.            What is Your Child Bringing to You?
a.     His/Her genes
b.     The result of the pregnancy experience
c.     Inborn readiness – neurological circuits, instincts

IV.            The Ups And Downs of Pregnancy - Your Experience
a.     Your health – physical and emotional
b.     Getting ready for baby – pre-natal care, classes
c.     Your expectations
d.     The family setting – alone or accompanied
e.     Other factors
    
V.             Surprises at Birth
a.     Circumstances – normal, pre- or post-mature, hospital or home, induced,
traumatic, surgical
b.     Aftermath – normal nursery, intensive care
c.     The family setting – alone or accompanied
      
VI.            The first days
a.     Bonding
b.     Caring for baby
c.     Nursing or formula
d.     The family setting
e.     To circumcise or not
       
VII.          The first 2 months
a.     Feeding, cleaning up and sleeping

VIII.         Three to Six months
a.     Interaction, increase in movement
b.     Managing choking and performing CPR
c.     The beginnings of temperament
      
IX.            Seven to Nine Months
a.     Getting moving – crawling to walking
      
X.              Ten to Twelve Months
a.     First words
      
XI.            Thirteen to Eighteen months

XII.           Nineteen to Twenty-four months
a.     Development of counter-will
      
XIII.         Year Three
      
XIV.         Year Four
a.     Sunny days may be here
      
XV.          Year Five
a.     School readiness and preparation


References