This morning I tagged along with Giancarlo Distefano (a nurse at NYCH) and one his buddies named Dave. Dave works down the treet from the Fitzroy clinic at something called the St. Mary Outreach program. He organizes activities and outings for different groups, and today he and Giancarlo organized an outing to the Youyangs for 6 "socially isolated" men who frequent the local community health care centers. Basically, we piled in a van, drove about an hour out of Melbourne to the Youyangs, hiked up it, made some lunch, and headed back to Melbourne.

The six guys were from all over the world. Two came from Egypt, one from Samoa, one from Malta, and two were local Australians. A couple were relatively social, but most of them were withdrawn.

One of the men from Clifton Hills wasn't exactly withdrawn, but he would often repeat the same things over the span of a couple of minutes. He also said odd things, including that he refused to shop at Safeway because he didn't understand it. He also said that he never drove, especially not on freeways, because people "drive like hell" and "burn rubber" (Interestingly, he didn't mind our own driving on the freeway because he thought Dave was a good driver). He said he couldn't drive because he couldn't understand the "principles" behind it. That's interesting because he also says he went to electronics school on scholarship when he was 19. He says his mother died then, which seems to have been when he started to have psychiatric troubles. Even so, he did seem to have some insight into his condition. He said things like "I'm not dangerous" as if perceiving that some might think he was.

One of the men from Egypt was the most social of all. Turns out he's been to China to teach English and to learn about herbal medicine. He lit up when I asked him to teach me some Arabic. He went into a thing about the many words that are the same in English and Arabic (he says bug, de/cipher, logarithm are examples). Also, 'talib f'tb' means 'I'm a medical student'. An interesting thing happened as he, I, and the Maltan climbed the mountain. We had been climbing for a while and had almost reached the top. Probably 5 minutes away from the top, there was a bench overlooking the landscape. Behind the bench, it was plain as day that the trail kept going up. But he insisted and insisted (even invoked 'logic') that this bench was at the top. I was happy not to argue about it, but the Maltan was more vocal about saying that we hadn't reached the top. But there was some mental block in the Egyptian that wouldn't let him accept the fact that we hadn't reached the top (an example of his 'logic': "why would there be a bench anywhere but at the top of the mountain? it doesn't make sense").

The Samoan was a fisherman and was very proud of his country. He said that American Samoa was actually more beautiful than Samoa. But he also told a strange tale of how he came to Australia. He had previously lived in New Zealand with his wife. But after the first week there, he said that his wife got too possessive - wouldn't let him go out with his buddies. So the guy talked to his boss and got transferred pronto to Australia. I'm not even sure he said goodbye to his wife.

In the afternoon I shadowed Dr. Jacka at Fitzroy. The most memorable patient was a girl who we saw, and actually we saw her mom (with the girl in the room) first. The mom then left the room and Dr. Jacka interviewed the girl. She'd been getting into a lot of trouble with her temper lately, picking fights with random people. It wasn't until about 10 minutes into the interview tho that she mentioned that she had been raped, and that all of her outbursts had followed after that. Dr. Jacka, who usually has a certain irreverance in the way he approaches patients, kind of snapped into a different mode at this point. His first question was who the girl had spoken to about the rape. She said she had spoken to the police, but they were no help - that it would be her word against his. She had not spoken to her mom about it. Dr. Jacka popped online to google and looked up a number for a group he said she should call up and talk with (I forget exactly what kind of group it was). She was reluctant, and Dr. Jacka kind of went back to his playful irreverance and pulled the "I'm the doctor, and I'm telling you this is what you have to do." card. His argument was that he didn't care whichever method she might use to cope with it, but that with her recent outbursts it was clear that whatever she was doing to cope wasn't working. And while she was doing things now she couldn't have imagined doing one year before (like getting into fights), she could very well be doing even worse things in a year's time that seemed unthinkable now. It was all quite effective I think.