Saturday, December 31, 2011

Some thoughts on… Renewing Oneself

With an election year upcoming, Obama faces a tough battle. Despite passing landmark legislation (DADT) and handling tough foreign policy choices (Osama bin Laden), the economy in the US has lagged and with it his prospects for second term. The critics are cutting him little slack and even loyalists are questioning strategy. To win the campaign, the President will need to renew his image from an outsider driving hope to an insider creating opportunity.

But how do any of us really renew ourselves? Let’s look to the arts for some ideas.

The reimagining of the Broadway musical On a Clear Day You Can See Forever has an inspired premise. In the original production the tension, where a psychoanalyst by conducting hypnosis falls in love with the past life of his client, was firm but not taut. The revival with Harry Connick Jr. as the physician changes the patient’s gender to a man and heightens the inevitable love triangle. The doctor’s self-confidence is shaken professionally by falling in love with a patient, personally by questioning his attraction to a man, and spiritually by throwing out his academic knowledge in the belief of an after-life.

The first step to renewal is a crisis of confidence whether it be in oneself, our support network (family/ friends), or in the institutions surrounding us (work, state, government). The quandary provides the catalyst for change. In the case of On a Clear Day, Connick’s character must choose either to end his career or change his beliefs. While the production’s revisions are clever and the actors are terrific, there is not sufficient charm to lift the material. By the end we feel we feel pleasantly hypnotized but can’t seem to remember what was so enjoyable.

John le Carre’s novel Tinker, Tailor, Solider, Spy has a new film adaptation that wipes away the veneer of the seductive Bond stereotype to reveal the rotten underbelly of espionage. The head of British Intelligence is forced out and then killed after he suspects a mole lies at the top levels of his team. His protégé George Smiley played in silent awe by Gary Oldman is brought out of retirement to create a secret group outside of British Intelligence (“the Circus”) to find the mole. Smiley was forced out of the Circus at the same time as his boss and since his life has been interwoven with work the ousting was his crisis of confidence.

His secret to renewal though is not revenge but reflection. He persistently, methodically, unemotionally, replays the information to find the mole. Oldman is glorious as a hyper-rationale man in the midst of chaos. His face barely quivers a sentiment as he step-by-step reclaims what was taken. Especially fascinating is how the film maker portrays this period of reflection. The scenes are quiet tension with a pervasive dread that the plans will be revealed. There are no heart-pounding action scenes, or special effects dazzlery. The director films the scenes as if they are an optical illusion. Like Smiley, we observe the action through windows, glasses, or bars never participating but always a voyeur. This film is a must see for any Bond, Bourne, Mission Impossible fan. It calmly wallops them away.

In the French movie, The Artist, renewal comes not just to the protagonist but to an entire genre of film. Jean Dujardin is George Valentin, a silent-movie era hero who is brought down by the advent of talking pictures. Luckily, the hero has a supporter who watches over him through his mistakes, downfall and eventual redemption. This is not a new plot line (see Sunset Boulevard or Garbo Talks), but the revelation is that the story is told as a silent movie and the audience forgets that there is no dialogue.

Having lost his career Valentin, faces a crisis of confidence and passes through years of reflection for not choosing to move into the Talkies. His renewal occurs once he overcomes his pride and recognizes that he needs the help of others to be successful again. When one has been on top, swallowing your self-importance is not easy, but is likely the hardest step to renewal. Dujardin is charm and light in the show, and he along with the film, director and production are easily the ones to beat at the Oscars. Silent movies are on top again this year.

Obama has already encountered the first two challenges to renewal – facing a crisis of confidence and reflecting on his actions and judgments. To ascend in the polls, it is the final challenge of pride, which will be the toughest. In his case, pride comes from a belief that multi-lateral negotiations are the key to success. On the international landscape this noble intention has borne out well. In the domestic field, he will need humility to recognize that he needs to drive some agendas unilaterally, e.g. job creation. Although he does not like playing in the mud, he will need to get his hands dirty for the good of the country.

Happy ReNew Year everyone.

December 31, 2011

Sunday, October 2, 2011

Some thoughts on… Having Privilege

From the last blog, I am continuing the theme of entitlement. In the US and EU, people are protesting austerity measures, because they feel they are owed something by the government rather than taking accountability themselves. The surprising part is that the protestors are relatively affluent members of society. If this were poor people in the US dissenting austerity measures or demanding jobs, their requests surely would be ignored.

So does having economic privilege result in a feeling of entitlement? Once again rather than the arts, I am going to use my experience in Mali to inform the question.

Last Monday, Cisse, my guide, and I drove to Djenne a city about 500km from the capital Bamako – leaving at 4am and getting back around 11:30pm. Each way took about 6 hours (enough time to sleep and write these blogs).


Figure 1: Cisse on right

The trip was comfortable. The road was paved and truck drivers pulled to the side to let others pass. The scenery was surprising for sub-saharan Africa. Although much of Mali is desert, the parts around the Niger River are lush and the crops feed much of the country. The contrast of the red earth with the green landscape is striking.


Figure 2: Landscape outside of Bamako

Along the way, were numerous guard and toll stops. The guards did not hassle the drivers nor were they looking for bribes. I am sure there is corruption in Mali but it was not obvious to me. One of the most organized stops was a Cholera checkpoint where everyone was supposed to wash their hands and shoes.


Figure 3: Mandatory cholera station along the road

The Djenne Mosque is a mud structure, the largest in the world, and a UNESCO Heritage Site. It is located on the original site dating back 1000 years, but the recent structure was reconstructed a hundred years ago.


Figure 4: Djenne Mosque

The market outside of the mosque takes place every Monday, and has been occurring for centuries with people coming from Burkina Faso, Niger and Mauritania to exchange goods.


Figure 5: Marketplace on Mondays

The setting provided an opportunity to reflect on privilege and entitlement. Imagine a 2x2 grid with the dimensions of “privilege” and “no privilege” on one axis, and “entitlement” and “no entitlement” on the other. We can imagine people falling into each of the four boxes:

• No privilege – No entitlement: Almost all the parents in the hospital queue in Bamako would fall into this category.
• Privilege – Entitlement: The Greeks and Americans seem to have this in spades

The corners of the grid seem to be the uncommon categories:
• Privilege – No Entitlement: These are people who continue to work hard, earn and contribute to society, even though they have enough money to live quite happily. A few people seem to fall into this box – Warren Buffet, Mike Bloomberg, George Clooney, Bill Gates.
• No Privilege – Entitlement: I thought it would be hard to find examples of this, but I describe one below.

At various points throughout our road-trip, there were kids trying to sell things. One rather entrepreneurial boy was selling rusty tin cans recreated into cars, bicycles, and dumptrucks. They were made by his “brother” and though a fascinating toy, I was a little frightened of typhoid. After my typical “merci non”, he surprised me by asking for a “cadeau”, or present, in French. Somehow the tourist culture has led to a dependency amongst the population where they expect items like bic pens or paper as a present – for not doing anything. Giving out pens was a practice I followed in India, but I now realize this is leading to an unhealthy reliance. This was one of the few examples I have seen of No Privilege – Entitlement outside of aggressive children beggars in India which have their own story (see Slumdog Millionaire).

Heartwarmingly the Malienne culture is trying to break the habit. Waiting for the ferry to Djenne, a 2-year old boy came up to me and started engaging. He was playing with two empty Fanta cans; I poured a little bit of my juice into his can which he drank with relish; when he came back for more, his brother batted him away. I didn’t take pictures of the boy or the children at the hospital, because it seemed to intrude on privacy.


Figure 6: Ferry to Djenne (truck fell into water trying to get on ferry)

Although privilege doesn’t always imply entitlement there does seem to be a strong correlation. I don’t have a solution to the issue (by no means advocating communism), just hoping that by being more aware we can choose a better path.

October 2, 2011

Tuesday, September 27, 2011

Some thoughts on… Feeling Entitled

People in Greece are protesting the government for imposing austerity, people in the US are blaming Obama for not having passed a job program, and politicians across the US/ EU are blaming each other for the impasse. We seem to have devolved into a society that keeps asking the government or our leaders, what next they can do for us. Is it just Westerners who have this feeling of entitlement or do others as well? Instead of seeing what the Arts have to say about this, I’ll use our visit to Mali to inform the question.

On the spur of the moment, Klaus signed up 1½ weeks ago to carry out burn and facial surgeries in Bamako, Mali with an organization called ReSurge! The team of 15 surgeons, anesthesiologists, nurses and pediatricians, arrived on Saturday night for a 2 week assignment at Gabriel Toure hospital – one of two public care settings in this city of 1.2 million. Since I was in Europe anyway, I decided to join for the first few days.

Mali is amongst the 25 poorest countries in the world, and yet socially very rich. The streets are safe and people are welcoming. Like other cities, kids try to sell you phone cards or trinkets or water, but a gentle “non merci” and they don’t bother you further. There is respect for the elderly, a conscious requirement for politeness – one must say “bonjour” or give salaam before engaging in discussion, and a sense of public discipline. The oppressing heat and local culture may prevent the Northern go-getter environment, and music pervades the cultural aesthetic.

In advance of surgery over the next two week, the team on Sunday was devoted to setting-up the operating rooms and screening patients. The hospital is an open architecture African edifice with large verandas, a network of crumbling buildings, and patients waiting on hallways floors perhaps days on end to be seen. Their faces exude patience and trust rather than frenetic activity. They may be seen by a physician today, or they may not, at least they are here.

One stream of activity is the arbitrage of patients. Radio announcements to outlying villages and the city told people about the free service weeks in advance. On Sunday morning, the halls were filled with over 300 people including parents and children. The diversity of the afflictions varies from cleft palates to severe burns that have healed and left the children functionally compromised, i.e. can’t lift an arm or open their hand. The parents likely amongst the poorest in the country sometimes require two translators to get to English – there are 21 local languages and French is spoken widely. They have dressed themselves and the children in their finest clothes and shoes to see the physicians, some of them likely having waited weeks or traveled hundreds of kilometers.

The hospital is not equipped to conduct these types of operations, and so the group brought 37 boxes of anesthesia equipment, gauze, antibiotics, and other essential items. Much of the material will be left behind except the equipment which must be taken back for the next outing. At the outset, the operating room contains two beds, two trolleys and good air conditioning. By the end, the set-up is sufficient to conduct about 6-8 surgeries a day, leading to a total of perhaps 60 cases in the 2 week period.


Figure 1: Klaus and Giem (from Vietnam) having set-up operating rooms


Figure 2: Anne Marie (Netherlands) and Fran (San Francisco) with OR supplies


Figure 3: Improvising anesthesia exhaust

Although poor, this country is not Somalia. The kids are not malnourished, and the affection shown by the family to travel this far for a second chance is inspiring. The children are pure joy. They wait with open eyes and infinite patience likely not even understanding what the doctor will do.

Perhaps the most heart-rending decision is choosing who to treat given the seriousness of the condition and physical ability of the patient.
• A 3-month old with a cleft palate is turned away because she is too small – perhaps next year; sadness envelopes the parents’ face.
• A 4-year old with severe facial burns has a fever and screams for minutes at the touch of the nurses or instruments. He may be too frail to go through surgery, but the risk is taken otherwise he may lose his vision.
• A 6-year old named Aliya with a burn extending down her arm so that her wrist bone is showing, is so calm in the screening room, there is a thought she may not recover from anesthesia, the mother insists she is just very scared.

It would be impossible to treat everyone. As with any volunteer program, the point is to see and heal as many kids as possible with the limited resources of time and money.

In the US, the “Great Generation” went to war believing in the creation of a world which would be a better place for their children. Their offspring, the Baby Boomers and Gen X, twisted the challenge into believing that they deserved a better world, and needed to acquire it at any cost including leaving a worse world behind. This sense of entitlement is pervasive, to the point where there is a prospect that the next generation (those under 5 now) may be poorer than us and inherit a degraded environment.

In Mali, the children and parents in the hospital are not feeling entitled. They have endured a tough circumstance and are thankful for the assistance – they are in no way expecting or believing they deserve support. Perhaps it is privilege in the US that is driving this sense of entitlement. The next blog will be about the distinction between the two terms.


September 26, 2011