Wednesday, April 22, 2015

Seeing things, don't call the Sangomas just yet

Seeing things or hallucinating can be a very worrying symptom for Africans because it plays well into our superstitious notions of witchcraft and ghosts. No matter how well educated you are there is an element of you that holds some of your basic African cultural beliefs dearly. Hard to fathom phenomenon like hallucinations make most of us Africans turn to these basic beliefs for possible answers and it is very understandable for us to do this. Seeing things is also worrying because it is associated with possible mental illness which is laden with stigma in many African communities or any community for that matter.

Before you call the Sangoma you need to know that many things other than witchcraft and mental illness can cause hallucinations.

It is true that mental illness can cause hallucinations however the hallucinations due to mental illness are rarely ever visual. Psychotic conditions like schizophrenia usually involve auditory hallucinations. Auditory hallucinations means that you hear voices that are not there. 

Seeing things or visual hallucinations where you see and hear well formed people, objects or animals is not a common symptom of schizophrenia. Visual hallucinations are usually a side effect of medications. They can also be due to intoxication and/or withdrawal from illicit drugs.

When you are not a user of illicit drugs and you start seeing things it's very important to think hard about any new medications or recent changes to your medications. Also think about any herbal remedies you may be using. If a doctor does not take a good history of your current medications you might end up being refered to psychiatrists and risk being put on anti-psychotics when you do not need them. Take a list of all your medications to the doctor and ask the doctor to check if any of the medications can cause hallucinations as a side effect. If you are asthmatic and recently had an asthma attack ask your doctor if they gave you medications called steroids to help open up your airways. Steroids are known to cause hallucinations in some people. Stress and lack of adequate sleep might also cause hallucinations therefore think about these issues to discuss with the doctor. Also think about new foods you have eaten recently or beverages you may have taken with possible hallucinogens.

In the unlikely case that you may be developing a mental health problem do not feel defeated. Psychiatrists can work with you to control whatever condition you are developing. Remember the brain is an organ like any other part of the body and if it is unwell we need to treat it just like we treat a cough or a broken bone. Mental health problems can be well controlled by psychiatrists so do not be ashamed to ask for help.

If you do go to the Sangoma try not to accept any remedies you have to eat or drink because these might be toxic or may cause you to see things more. 


Saturday, April 11, 2015

Africans and Anxiety

Africans are lively people who love to sing and dance or perform with no worries. This is what we are commonly led to believe. However intelligent Africans can suffer from all kinds of anxieties from perfomance anxiety to social anxiety and generalized anxiety disorder. Unfortunately the sufferers may not always get help and may go through life avoiding situations that bring out the anxieties at the cost of not performing to their full potential at home and at work.

I first realized that I suffered from severe stage fright in late primary school. I never had trouble raising my hand in class because I never thought of the classroom as a stage. I joined the debate club and was one of the enthusiastic organizers of a school wide debate tournament. On the day of the tournament I had my great points prepared and when I stood up to speak in front of the whole school my voice started shaking and I could not look up. My hand also started shaking uncontrollably and I barely made any sense. My debate team mates could not understand how someone who had great points could turn out to be such a disappointment on stage. I had similar scarring moments in secondary school. As time went on it became harder and harder to control my stage fright and I ended up touring with my school's debate team to help them with points but was asked not to debate. It was devastating. It became obvious that I could never be a lawyer, a judge, a professor or any job where my stage fright would be an issue. 

The awareness of anxiety disorders among my teachers was non-existent. In an ideal world a teacher would have refered me to an educational psychologist who would have realised I had severe performance anxiety and then refered me to a child and adolescent psychiatrist. The psychiatrist would have tried cognitive behavioral therapy to help me realise that the stage was not a threatening place. If this failed I would get pharmacological help like beta blockers to take before any performance situation.

I never got any help with my anxiety. I just avoid situations where it comes up as best I can. I have developed coping mechanisms for presentations, I practice countless times until I have no fear. In situations where I am put in a performance situation off guard I still fumble and people who do not know that I went to Stanford always dismiss me as a very unintelligent person. I know my potential so I never feel down for long about such situations. In medical school I have no anxiety when interacting with patients but practical exams can be challenging if my mind decides it is a stage set up. The amazing thing about medical school is that it helped me put a name to my struggle with public speaking and I now know where to turn for help if my fear threatens my future. I know that having an anxiety problem does not mean you are not smart, in fact many people in the U.S and the U.K get help with their anxieties and live productive lives as teachers, doctors, lawyers, judges and so on.

Teachers in African schools must be more aware of anxieties that could prevent otherwise intelligent children from flourishing. As soon as a teacher notes a child has a problem they should refer them on to educational psychologists and then a psychiatrist may get into the picture if necessary.

Tuesday, March 3, 2015

The wisdom of my darkness

I am darker because my skin has more melanin
It's not because my soul is darker or that my thoughts are more dim
Have you ever walked through the African summer sun without a hat and without enough melanin?
The wisdom of my darkness should not be a mystery to you after you do that!

Thursday, January 22, 2015

Critical Thinking pieces about real issues facing Batswana

Share with any Motswana facing any of these issues. I do not write stories often but from time to time something grabs my attention and I have to write an essay or a story about it. For free, enjoy!

1. Sending Rice

Introduction: This story looks at the lives of two realistic Batswana sisters. The wealthy one wonders whether she is doing enough to help her struggling sister. The story is relevant to Batswana struggling to balance the pursuit of success with sharing with family. Traditionally we helped our extended family members, how do we do this in the midst of the nuclear family centered way of living in modern day Botswana?

I just sent my little sister a big bag of rice. It was really an attempt to ease my guilty conscience. It is hard to enjoy my newly purchased BMW while knowing that my little sister and her brood of five children-and counting, judging by how moody she has been lately, I just know she is pregnant, again! - are going to bed on near empty stomachs.

When people who do not know anything about me see me in my avocado green BMW, they see a successful young Motswana woman who has her life together. However, people who know that Gogontle is my little sister, see a greedy woman who would rather build mansions and buy expensive cars than help her struggling sister.


I know Gogontle’s first born, Letshego, despises me. She thinks I do not do enough to help her mother. At fifteen, Letshego has a great deal on her plate. Her little brothers Morwalo, Keeme, Nkemisang and Kefeditse (the names of the last three all mean I am done having children) are a nightmare to take care of since they are very unruly. The fact that Gogontle is always in debt and struggles to buy food at the end of every month hardly does much to help Letshego sleep better at night. Letshego’s report cards show that her tough life is not conducive to learning. In a year or so she will sit for her junior certificate exams and it will be nothing short of a miracle if she passes. She needs to pass in order to advance to senior secondary school and beyond if she is to make something of herself. I fear that if she fails she will discover boys and have many children just like her mother. Gogontle was about Letshego’s age when she discovered boys and started having children.

At this point I know you have started to hate me too. Why don’t I take Letshego from her mother and put her in an environment where she can study well? Why don’t I help Gogontle or Mma Letshego, as she likes to be called, get out of debt so that she can give her children a decent life?

What I am going to say next is predictable. I have tried to help my sister. Before I got married I had few responsibilities of my own and I tried to take Letshego from Mma Letshego. Mma Letshego lives in a part of Gaborone which she can afford. It is not a decent part of Gaborone. If you are imagining a part of Gaborone with shebeens on every street and ruthless tsotsis or criminals lurking behind ill constructed one room houses, you are right. I wanted to stay with Letshego in Block 5, which is much nicer. I did manage to get Mma Letshego to give me Letshego when Letshego was in standard five. At that point Mma Letshego had three children already and Letshego was a seasoned babysitter. Her mother was reluctant to let her go because it meant Mma Letshego would have to take care of Letshego’s younger brothers by herself. Eventually she let me have Letshego. I took great care of Letshego, I paid enormous attention to her school work and I got really attached to her. Her school work improved exponentially at the better primary school in Block 5 and I realised that my little sister’s daughter is actually intelligent. I was so proud. 

                                       ***Woolworths vs Pep***
One day Mma Letshego visited her daughter at my house. She brought Letshego school shoes bought from Pep stores. I was touched that she had thought to bring her daughter something because usually she did not bring anything when she came over. She usually came over to ask for money for one thing or another so I knew this was a big deal. In her innocence, Letshego remarked that no one wears school shoes from Pep at her new school. She thanked her mom for the shoes but said she preferred wearing the Woolworths shoes that her aunty Metsi bought for her. It was like witnessing a train wreck and being powerless to stop it. I saw the moment Letshego’s words registered in her mother’s mind. The words pierced MmaLetshego’s ego like a sword and the hurt on her face was beyond concealing. My sister immediately told her daughter to leave the sitting room of my three bedroomed BHC rented house so that she could have a talk with me. She said she thought it would be best if she had her daughter back. I tried to explain that Letshego was just eleven and eleven year old children can sometimes say things they do not mean. My sister looked me in the eye and asked me why I was so dead set on making her daughter look down upon her. I said she was being ridiculous; all I have ever tried to do was to help her daughter. Within thirty minutes Mma Letshego had packed all of her daughter’s clothes and was on a taxi headed to the taxi rank to get another taxi to take her and her daughter to her home on the opposite side of Gaborone. She left the Woolworths shoes on the bed where Letshego used to sleep with a note inside the left shoe that said ‘we don’t need you and your Woolworths shoes’. Letshego was transferred back to the less than ideal primary school in her mother’s neighbourhood and her grades have been on a downward spiral ever since. 

My sister and I did not talk for months after the Pep vs Woolworths incident. I started to wonder if I had really been unintentionally making Letshego look down upon her mother. Maybe I should have left the clothes buying to Mma Letshego but wouldn’t it have looked bad if I had taken Letshego and never bought her clothes I could afford? After some months I heard through my cousins that Mma Letshego was pregnant with her fourth child, the father had bailed like all the other fathers and my only sister was on the brink of dying from hunger because she had been fired from the Chinese store where she worked for missing work a lot to go to pre-natal appointments at her local clinic. Suddenly our falling out seemed trivial. I visited her with groceries and begged her to take them. I ended up feeding her and her family until the new baby was four months old and she could leave it with a baby sitter to find work as a storekeeper in another Chinese owned store. She is qualified to do little else.

             ***Nothing small about making a small business succeed in Botswana***

It then occurred to me that if Mma Letshego furthered her education past junior secondary school she might get a better job and improve her circumstances. She had dropped out of form two to have Letshego and she had never gone back. I was ready to pay for her to go to night school during the week but she felt that a single mother of four has no time for school. The thought of working, taking care of her children and schooling just mentally exhausted her. She did however request a loan to start her own business. No one was more pleased than me that my sister was going to start a business. I started to imagine her becoming successful in her chosen business and having enough money to do fun things with me. I imagined us having lunch at a place like Gaborone Sun or going on holiday to a beach in South Africa without her feeling like we were wasting money. The truth is my sister was fun and spontaneous before she started having children and sometimes I miss the person she was before the children came. The problem with Gogontle is that she is a hopeless romantic. When she meets a man she always falls head over hills too fast. The men always promise her the world and before she knows it, she is pregnant and they have vanished.

The first business she tried was selling sweets and fat cakes in front of her local primary school. As soon as she started making a profit, three other ladies put up stalls next to her to sell exactly the same things she was selling. The students did not have enough buying power to sustain all the stalls so all the stalls went out of business in a matter of months. My sister found work in another Chinese store. Her business spirit was not extinguished yet, however. In a few months she started travelling to Johannesburg, South Africa to buy clothes in shops that were not available in Botswana yet to sell to people in Botswana for a profit. It was really hard to make a profit in this business. The people she sold clothes to often took them on credit and then refused to pay her for months. She also was involved in a few horrific accidents on her trips to Johannesburg where she narrowly escaped with her life. It was obvious to the both of us that the business was not working out for her. I bought her a taxi and hired a driver. Between the driver buying his girlfriends take away dinners every night and the frequent accidents needing costly repairs, the taxi ran at a great loss. In the end I did not blame her for selling it off. Other attempts at starting a small business met a similar fate for Mma Letshego. I was able to keep her hope alive for a little while but after some time she lost hope and resigned herself to working in Chinese shops again. Her eyes used to shine when I proposed a new business she could try but once she decided small businesses were not for her she just promised to give the business a thought without a spark in her eye.

Now I am married with my own children. My husband has siblings who could use our help just like Mma Letshego. I can’t do much for her anymore because if I help her, I have to accord the same kind of help to my husband’s siblings. By the same token he can’t do much for his siblings either. My husband and I are doing well. We just finished building a house in a plot we bought in the city and I recently bought myself a new BMW. Our success fills me with guilt because we can’t really share it with Gogontle or his siblings. If we help them we can’t have the life of our dreams and we are likely to be miserable yet having the life that we worked so hard to attain makes us feel guilty all the same. There is just no winning! When the guilt gets to me I have a bag of rice delivered to Gogontle’s house. Just rice, no tomato sauce, no mayonnaise and no meat. I send bags of rice to my husband’s struggling siblings too. The bags buy me a few guilt free moments in my nice house or my BMW, before I start to wonder if rice is all I can really do to help.

Discussion points:  
1. Are there any parts of the story that you relate to?
2. Should successful siblings help their struggling siblings?
3. To what an extent should they help?
4. If you help your siblings, should your husband help his siblings too?
5. Letshego has potential but her environment is not well for studying, do you think there should be government interventions to help children like Letshego in addition to free education.
6. Mma Letshego struggled to find a good small business. Do you think she could be successful if she tried harder or is it almost impossible for most small businesses to survive for long?




2. Men are not dogs

Introduction: When a man hits or abuses a woman in Botswana, women like to say ‘men are dogs’. Are men really like dogs? In this story a psychiatrist helps a couple heal after the man beats the wife. The story argues that men can be helped to treat their partners better through psychotherapy. Unlike dogs, men can change with medical help therefore men are not dogs. The story hopes to give Batswana women and men hope that some violence in relationships can be effectively dealt with by professionals. Violence is bad but people should not give up on love before attempting to attain expert help. It is told from the woman’s perspective and then switches to the man’s perspective.


“It is like when a dog has discovered the taste of chickens. There is nothing you can do to make it stop eating your chickens or chickens from the neighbourhood again and again. When my dog Phatshwa started eating the neighbourhood chickens in my home village I had no option but to call the veterinary people to come and put him down with a lethal injection. I really loved Phatshwa but the neighbours were ready to kill him if I didn’t because their chickens are their livelihood and all my attempts to get Phatshwa to stop eating their chickens were futile,” said the chatty young nurse as she applied antiseptic to the cuts and bruises on my left cheek.

“Please leave him Mma Mokgosi before he does this again because next time the person cleaning your wounds might be a morgue assistant and not a talkative nurse like myself. Once a man starts beating his wife it is highly likely that he will do it again and again,’ she continued.

 She was sweet and I could feel the genuine care in her voice. However, it was hard to take her seriously with her short skin tight white uniform. The last time I was in Princess Marina, which was in 1994 to give birth to my second child, nurses wore long loose dresses. Today Marina corridors are like modelling runaways. Young local male doctors who are just returning from overseas are mostly to blame for this new dress code among the young female nurses. I know some of these young nurses are competing for the attention of the male doctors. They would do anything to become the wife of a doctor. A part of me wants to tell this na├»ve chatty nurse to go and get a less revealing uniform and stop trying to get the attention of any man, doctor or no doctor. The attention of a man leads to you being rushed to the Princess Marina emergency room wearing panty hose on your head (they protect hair better than a scarf during the night) and a wrap-around cloth with African print also known as a chitenge at 1 am.

The antiseptic stings but the sting is nothing compared to the pain in my burning left cheek where Mogobe’s fist landed. It was our wedding band on his finger that cut my cheek. The irony of this does not escape me.

Mogobe hit me. My Mogobe hit me. I can keep repeating this fact but I doubt it will totally register any time soon. Fifteen years of being happily married and out of nowhere he hits me.

                                                          **********                       *********
“Will I hit her again Dr. Keagakwa?” I asked feeling uncomfortable to be in a psychiatrist’s office. All my life I have thought that only crazy people need to see psychiatrists but my general practitioner Dr. Peolwane said a psychiatrist could help me make sure I never hit my wife again.  I am sceptical but I have no choice. Mma Mokgosi called my aunts and uncles along with her own and she swore in front of all of them that if I hit her again she will divorce me. 

“She says people say that once a man has started hitting his wife it is highly likely that he will do it again and again. She wants reassurance that I won’t do it again. I promised her I would try my best not to hit her again but I don’t know if I can trust the promise myself. In fifteen years, I have never even thought of hitting her but a few weeks ago a tiny argument set off a burning rage in me that I could not control and I did the unthinkable. I lost control doctor. How do I know I will not lose control again?” I continued hoping one of Botswana’s most experienced psychiatrists would help me save my marriage. 
“Mr. Mogobe Mokgosi I can sense that you do not feel comfortable being here with me. I know that seeing a psychiatrist is not something well embraced by us Batswana. I would like to thank you for being brave enough to come and I would like to urge you to relax,” said Dr. Keagakwa. She gave me a warm reassuring smile that made me feel a bit more comfortable. I was nervous that a female psychiatrist would be very judgemental about the terrible thing that I have done to her fellow woman, my wife, but she seemed ready to help me regardless of what I have done.

“Very often when domestic violence or abuse occurs, the main focus is on helping the victim, mostly women, heal from the ordeal. Very little help is given to the perpetrators, mostly men, because many people think the perpetrators are monsters who need to be punished not helped. I am happy that you realise that you need help. If many men asked for help in time they could stand a better chance of avoiding the suffering caused by repeated acts of domestic violence,” continued Dr. Keagakwa.
“Is it possible that I am going crazy doctor? I have never lost control the way I did before. By hitting her, I risked everything, my marriage and my relationship with my children. It was a totally crazy thing to do and two weeks on, I am still wondering why a usually rational man like me did such an irrational thing,” I asked deeply nervous about what the woman with degree certificates from the top universities in the U.K fighting for wall space in her office would say.

“Judging from the extensive history that I took from you and your medical records, I can assure you that it is highly unlikely that you are losing your mind. However, you are right that what you did was a very irrational thing. Doing an irrational thing does not always mean someone is going crazy. It is true that crazy people often do irrational things but normal people can also do irrational things under some special circumstances. I am going to ask you a few questions to further elucidate my point. Would you agree with me that the brain is an organ just like a leg?” said Dr. Keagakwa.

“Yes,” I agreed.

“Sometimes a person can break a leg that was normal before, right?” said Dr. Keagakwa.

“Would you say that someone with a broken leg that can be healed is the same as a cripple with a leg that permanently cannot function unless the cripple uses some prosthetics?” asked Dr. Keagakwa. Being a lawyer, I realised she was using the socratic method to help me understand her point so I played along.

“Well, doctor the person with a broken leg that can heal is temporarily like the cripple in the sense that they cannot use their legs properly without prosthetics but having a broken leg that can heal does not make someone a cripple. Down the line the person with the broken leg will heal if they get help to heal the leg and they will no longer be like a cripple”, I said.

“Good. Do you see where I am going with this analogy?”she asked.

“Yes, I do. You are saying that something affected my brain to make me act irrationally just like something breaks a leg to temporarily cripple someone. However, my acting irrationally does not mean I am crazy, it just means I need some help to find out what caused my irrationality so that I do not act irrationally again,” I replied.

“Great. I truly appreciate that you are really paying attention. I can tell you love your wife and really want to never hurt her again. I also want to add that when people see symptoms that their leg is broken, they run to the hospital to get help yet when they act irrationally which is often a big sign that the brain is “temporarily broken”, very few run to a psychiatrist for help. As psychiatrists we are not just here for what you call crazy people, we are here for all kinds of psychological problems. With that said do you have any questions so far?” said Dr. Keagakwa.

“I understand the analogy but I still want to know if you think you can fix me. My mind was definitely temporarily malfunctioning when I hit Mrs. Mokgosi. It is just that one of the partners at our law firm , Mogobe, Seeletso and Dintwa, has been cheating clients out of their money in the name of the firm and it looks like the law suits against the firm are going to bankrupt us. I have been awfully stressed attempting to salvage the firm I worked my entire adult life to build. While my career is taking a huge hit, Mrs Mokgosi is slated to become the next CEO of Kgalagadi Breweries in a matter of weeks. I am elated for her but I keep thinking the power dynamics in our relationship are going to shift drastically when I lose the firm and she becomes a high powered CEO. Each time we argue, I keep thinking she is starting to undermine me because her career is going better than mine,” I explained. It was hard to admit that my wife’s huge success was somehow threatening to my ego but if I truly wanted help I needed to be honest.

“I will do my best to help you Mr. Mokgosi but it will take weeks of medication and psychotherapy to help you with what you are going through. Just from what you are saying I can tell you are depressed, I will start you on an eight week course of anti-depressants today. Depression can cloud judgement and lead to impulsive acts like hitting someone as in your case. It also appears that you are deeply anxious about the future. The anti-depressants will help with the anxiety but resolving your law firm issues could greatly reduce the anxiety too. Anxiety and depression are very common but many people do not know that medications exist that can reduce the severity of these conditions. You do not have to fight them on your own if they are interfering with your life. I know it seems unmanly for many African men to take pills to cope with some of life’s stressful situations but trying to handle some issues on your own leads to things like taking out the stress on those we love, which you would agree is not ideal. In our next session we can start to talk through how your work related depression and anxiety translated into domestic violence at home. We will also attempt to find ways to help you view your wife’s success in a positive light and not as an assault to your ego,” explained Dr. Keagakwa.

“Thank you for your help doctor. It sounds like I am in good hands. Will Mrs. Mokgosi be joining me for any of the psychotherapy sessions,” I asked.

“I would like to see you each separately in the beginning and then together towards the end of the talk therapy sessions,” she said.

I thought she made a lot of sense. I have been going to the sessions and taking the medication she prescribed. My firm went bankrupt and we had to close it. I am now working for someone else’s firm. I am no longer my own boss. Mrs. Mokgosi got the job as the CEO of Kgalagadi Breweries a week after my law firm folded. I bought her a huge bouquet of flowers and a bottle of expensive wine to celebrate. Thanks to Dr.Keagakwa I did not see this as a blow to my ego. Dr. Keagakwa likes to joke that men are not dogs because men can attend psychotherapy sessions and change their behaviour while dogs can’t. She says she gets an image of a dog sitting in the patient’s couch in her office when she hears people say men are dogs, which always makes her laugh. The improbability of having a talk therapy session with a dog is particularly funny to her. Her sense of humour is quirky but I don’t mind it because she probably helped me save my marriage to the woman I love with all of my heart.


Discussion points:  
1. Once a man hits a woman is the relationship doomed?
2. Do you believe that violence can be a symptom of a mental disorder that can be cured or do you think this is just an excuse?
3. Should Mma Mokgosi throw away fifteen years of marriage or work on it.
4. Can our society do more to get our men to seek psychological services before they get violent?
5. Do you think encouraging young men to get professional help for relationship problems could reduce the so called passion killings?

Sunday, July 20, 2014

Is it ok to be an African Nerd

Do African nerds have to hide their nerdiness to be accepted. If you show too much interest or knowledge about something should we encourage it.

Nerds can achieve a lot of things. If your African child loves cars a lot, should you subscribe them to a cars magazine or suggest another interest? Should you reach out to parents with children who love cars so that your child can get a chance to be part of a community that can nurture their intense passion? A love for cars can turn to a love for designing uniquely African cars if it is nurtured in the right manner.

Sometimes it seems like as Africans we value well roundedness so much that we discourage intense focus that can lead to breakthroughs. In fact too much interest in one thing often makes people wonder if you are not going crazy. 

As soon as my mother realized my love for reading she bought me a lot of books. I read all of them till they were torn and she bought more. I read so many books that by age 11, I told my parents I wanted to publish my own book. Most parents would laugh at this. My parents took me to a writers' group at the University of Botswana. I met with established writers and they were so positive and encouraging. This experience taught me not to be afraid to pursue any interest because people will think I am nerdy because the established writers were really keen to encourage my interest. I have moved on to other intense interests and my parents have never stopped being supportive. Writing, codes, theories, blogs, medicine, publications and games they keep up and never make me feel like I am too much.( I am a bit much but bless them, they never say it to my face :) )

Find out what your little siblings, son, daughter, niece or nephew is into and see how you can encourage them to pursue it. Most Nobel prize winners for science say an adult bought them a chemistry set at a young age and that encouragement sparked a lifelong focus on science. What is nerdiness if not intense focus on one or few interests.

If you are an African nerd, come out of the shadows and pursue your interest intensely to see where it may lead. You might fail but you might also succeed. I have failed pursuing some interests but you dust yourself up and re-focus.

Monday, July 7, 2014

Smart

(First blog post in a long time. Writing has always been a hobby and when the inspiration to write hits, you can't ignore it forever.)

The word of the week in tablets is ......SMART... (See photo of four bit code at my fb page, the amateur writer invents a word game, no surprises there!)

Smart is a very interesting word. We all have an idea of what it means but if you think about it, it is actually a vague word. It basically means you do well in school. Do people do well in school for the same reasons? Not really. I have met different kinds of 'smart' people.

The Hardworker - Loves working hard and passes because they put in the effort. If they do not study hard, they fail. Beginning of university may derail them if they get into a party loving group. Must maintain focus. They are my favorite kind of smart people because I think hard work is to be valued. Not every hard worker does well in school though so you do need to be able to retain the material you learned and knowing what to work hard on helps. If someone works hard and gets no results, there may be a need to get study tips or to find out if there is an underlying learning or memory problem.

The Gifted - There are many kinds of academic gifts. Some people have one while some have a combination of gifts. Hard work enhances any gift so gift or no gift, I hope you value hard work. The gifts include:

The auditory genius - Remembers most of what they hear, may pass by just going to lecture with no reading.

The conceptual genius - No need to explain hard concepts to them twice.

The photographic memory genius - basically a ticket to Harvard or thereabouts if lucky. However may struggle in math, science or law if they can't analyze what they remember well no matter how perfect they remember it.

The fast processor/thinker - Excellent at chess, card games and can calculate the bill with the tip added at restaurants fast. The most extreme I met was a humble friend at Stanford who could calculate the total for several items at the till with tax added fast enough to replace the cash register if it broke! Had MIT in his background, no surprise there. If they are in medical school the fast processor with conceptual abilities might struggle with memorizing heavy subjects like Micro and Pharmacology because these subjects require hard work and this type of smart person may be used to passing with no effort. Best suited for computer science where solving technical problems fast and handling loads of information fast are great advantages and impress bosses.

Unfortunately for me, I am the hard worker type for the most part. Definitely not a fast processor since I am terrible at chess and all fast paced card games. Do not even try to teach me. I like to think slowly, take my time, philosophize look for interesting patterns, theories, codes etc so I am more on the conceptual side. I let my fast processor friends handle the bill and tip at restaurants unless there is a calculator handy.

Medical school has been great because once I get to know people I slowly discover the gifts that got them here. Fascinating for someone interested in many aspects of human behavior.

Medical school also interestingly pushes all kinds of gifts to their limit such that hard work is required of people of all types from those with no gifts to those with many gifts. During the basic science years the amount of information is enough to overload any gift.

This is just about book smart types. There are many people who do ok in school but are smart in other areas e.g street smart, people savvy, business savvy, sports savvy etc. That's for another post.

What kind of smart are you or are you too modest to say? Fair enough.

Monday, June 27, 2011

Ten manageable conditions/diseases that might make an otherwise loving African man abuse or even kill his wife or lover

When a man abuses his partner its not just sick, he might be literally sick and in need of medical attention.

Many relationships in Africa reach a point of no return due to domestic violence and abuse. An otherwise loving man suddenly changes in behavior and becomes violent forcing the woman to flee from the relationship. In some instances the violence ends in death of one or both partners (e.g 'passion killings') .

In some cultures women are encouraged to bear the abuse in silence hoping that it will end at some point and their once charming man will spontaneously return to normal.

It recently occurred to me that violent or abusive behavior could simply be a symptom of various manageable diseases or conditions. I set out to compile a list of some common conditions that could cause even well meaning men to become violent. All these conditions are manageable.


Ten manageable conditions/diseases that might make an otherwise loving African man abuse or even kill his wife or lover


Depression
Anxiety
Diabetes
Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Personality Disorder (OCPD)
Attention Deficit Hyperactivity Disorder (ADHD)
Oppositional Defiant Disorder (ODD)
Bipolar Disorder
Schizophrenia
Low self-esteem




Once an abusive incident has occurred, acknowledge that it was a bad thing and then find a way to get the perpetrator to seek medical attention.Get the relevant medical practitioners to take an extensive history that can help them decide which of the above conditions caused the violence and then devise a suitable treatment plan. Some medical practitioners may be too lazy to help, urge the perpetrator to be very persistent until they get help.


In the minds of many Africans, African men are a symbol of staunch rationality. It is hard to fathom that they can sometimes suffer from conditions that can slightly impair their rationality. Violence and abuse are bad. However in some instances they do not mean the man is a cruel unloving person, they just mean he is a human being with a condition that sometimes affects his rationality and he needs professional help to get better.

Many of the above conditions can be managed by medication and psychotherapy.We often wrongly believe that psychotherapy is for westerners. However, given the high level of domestic abuse, many African men might need to get themselves a personal psychiatrist and/or psychologist in order to show their love to their partners. Relatives can counsel a man who is abusing his wife or lover but they are not professionals and they cannot provide medications for mental conditions that cannot be healed by psychotherapy alone like anxiety and depression.

Do not wait until it is too late to get help for the man or walk out from an otherwise perfect relationship without looking into the above conditions which are manageable.Educate yourself and your loved ones about all these conditions because the information might help you save a relationship or even a life in the future.