Native issues among topics

MEETINGS * RENCONTRES
Native issues among topics
as psychiatrists meet
Dorothy Trainor
A Canadian psychiatrist says quent narcissistic rages and physithe permissiveness and cal abuse against bystanders.
noninterference native
In another session, psycholomen practised with their wives gist Ellen Bouchard Ryan, PhD,
and children amazed Canada's argued that women over age 65
early settlers, who were apt to beat face a communication predicatheir own children into submis- ment when they deal with health
siveness and obedience.
care professionals. She said that a
Speaking during the Canadi- health professional dealing with
an Psychiatric Association's an older female patient may have
(CPA) recent annual meeting in already made inferences that are
Toronto, Dr. Clare Brant, a spe- age-biased and stereotypical.
"Repeated experiences with
cialist in native studies from
Shannonville, Ont., said native el- negative expectations, age-biased
ders contend that family violence interpretations of their conduct,
first made inroads into native and constraining behaviour by
communities after native boys professionals exacerbate the diffiwere sent to boarding schools, culties faced by older women",
where they encountered physical she said.
Ryan, who directs gerontologand sexual abuse, and when they
went to fight in Canada's wars ical studies in the Department of
and learned methods of intimida- Psychiatry at McMaster University, said examples of negative extion during their training.
"Presently, family violence is pectations include considering
a major concern on Indian re- symptoms as an untreatable part
serves across North America", of old age, or considering assertive
said Brant. "A major factor is the behaviour as aggressive behavinative male's loss of status and our. Constraining behaviour on
self-esteem by inroads of poverty, the part of the physician might
powerlessness and anomie. This include the use of oversimplified
has resulted in a struggle for speech, or the failure to listen
power with native women that is closely to what a patient is saying.
often settled by blows and kicks." "If what it means to- be old is to
Brant said the humiliated na- be treated in a patronizing way,
tive male's fragile superego needs we professionals unconsciously asto defend itself against even trivi- sign to older women an identity
al challenges, and this causes fre- that is vulnerable and dependent", she said.
Ryan said health care profeswho behave this way are
sionals
Dorothy Trainor is a freelance writer living
not keeping up with the times
in Dorval, PQ.
because, she claimed, most
women older than 65 are enterprising and coping effectively with
challenges. "Further, in the 1960s,
60 to 65 years was old. Now 80 to
85 years is old. There will soon be
200 000 centenarians in North
America. Women particularly are
living much longer and the postretirement period for them involves 20 to 25 more years of
life."
Professionals' assumptions
about what "being old" means
have improved, she said, but stereotypes still abound. Ryan said
these may contain kernels of truth
"but many irascible old people
were irascible when they were
young. Many old people with low
competence were never competent. We may be making the
wrong attributions about why this
old patient is so persnickety.
Don't accept the first negative
impression that this conduct is
occurring simply because the patient is old".
Barbara Sherwin, PhD, a McGill University psychologist, said
social, cultural and intrapsychic
factors may affect the way women
experience menopause. "Some of
the findings in the sociocultural
and psychological literature provide a basis for identifying women
at risk for disturbances in functioning during the perimenopausal years. For example, women of
higher socioeconomic status who
work professionally outside the
CAN MED ASSOC J 1990; 143 (10)
1105
home have fewer physical and
psychological symptoms around
the time of menopause compared
with women of lower socioeconomic status who are not employed outside the home", Sherwin said.
"Together with other evidence, these findings suggest that
a diversity of roles, and thus
sources of satisfaction, may help
to protect women from the possible negative influences of life
changes during the menopausal
years."
In the closing hours of the
meeting two psychogeriatric symposia were sponsored by the
Royal College of Physicians and
Surgeons of Canada. Organized by
the CPA's Geriatric Psychiatry
Section and the Canadian Geriat-
ric Society, their aim was to bring
geriatricians and psychiatrists together.
The new CPA president is Dr.
Werner Pankratz, former head of
the Department of Psychiatry at
Lions Gate Hospital, North Vancouver. He replaces Dr. Donald
MacRae, head of the Department
of Psychiatry at Pasqua Hospital
in Regina.m
The Royal College annual meeting:
Pomp, circumstance and a large crowd
Douglas Waugh, MD
M ore than 3800 delegates
registered for this year's
annual joint meeting of
the Royal College of Physicians
and Surgeons of Canada and the
Canadian Society for Clinical Investigation (CSCI), making it the
largest medical gathering ever
held in Canada. The September
meeting in Toronto brought together some 30 national specialty
associations, including the Canadian Paediatric Society and Cana-
dian Psychiatric Association.
The formal opening ceremony was marked by pomp and circumstance that included a viceregal salute and fanfare to honour
Governor General Ramon Hnatyshyn. The Royal College president, Dr. Donald Wilson, later
presented him for admission to
honorary fellowship in the college.
His investiture was followed
by the Royal College Lecture,
"Psychiatry in the 1990s: Probing
the Brain and the Mind", by Dr.
Nancy Andreasen, director of the
Mental Health Clinical Research
Centre at the University of Iowa.
She reminded her audience that
most of our information about
cerebral function has come
Douglas Waugh, former executive director
of the Association of Canadian Medical
Colleges, is a freelance writer living in
Ottawa.
1106
CAN MED ASSOC J 1990; 143
(10)
Medical science in the '60s and '70s: `6It
was a good time to remember"
One of the themes of this year's
Royal College meeting was the
history of medicine, which was
covered in four paper sessions,
four special lectures and a poster symposium. In addition, Dr,
Ramsay Gunton. in his G. Malcolm Brown Lecture, offered a
review entitled "Academic
Medicine in Canada 1960-a Good Time to) Re1980
member"
In this fine presentation
Gunton reviewed the social and
political factors that caused an
explosion of academic medicine in the 1960s after a period
of torpor. The 1 960s were a
time of rapid economic growth
and of a sudden political
awareness of the needs of the
health care system. The introduction of medicare and creation of the Health Resources
Fund made possible a rapid
expansion of medical school
enrolment, the creation of clinical teaching units and the support of numerous geographic
full-time clinical teachers and
scientists.
Al] tlhis occurred in the
1960s and during the first half
of th. 1 970s, and in academic
circles it was quickly accepted
as the norm. However, as tns
rate of growth in the countrny
gross national product began
decline in the 1970s and Lit
other priorities came to occup)
the political agenda, suppof-l
for clinical science dwindled
But. "even as a one-time phi.'
nomenonr .said Gunton,
tablished a tnewer and be-t;-I
base for the provision of sc e ri
tific health care in our countvtSt
It was a good time to remern
ber"
Whether bx accident or do.
sign. Gunton's review ofthf
lush period served as a neal.
counterpoint to Dr. Marn-- ;)
Fritzler's Canadian Societv _-B!
Clinical Investigation (C-SCf-i
presidentia Iaddress, which
fered an lxamination f h
present state of medical rrtsearch in Canada.
Fritzler sees a regrettabica.
if understandable. trend to
ward centrifugal fragmentation
among the groups that constitute the CSCI, which he attrmbutes to increasing financial
austerity. This makes it urgent
for CSCI to play a leadership role n bringing together