Dem Bones

Toe bone connected to the foot bone
Foot bone connected to the heel bone
Heel bone connected to the ankle bone

This old song was inspired by the book of Ezekiel in the Bible promising hope of the resurrection, but in my upbringing, the lyrics served as a reminder of the connectivity of all things.  These days, for connectivity, I would substitute – 
Covid-19 is connected to Air Pollution 
Air Pollution is connected to Climate Change
Climate Change is connected to Poverty 
Poverty is connected to Racism 
Racism is connected to Prisons 
Prisons is connected to Mental Illness… 
and around and around it goes.
What stops us from breaking this cycle?  The answers are quite complex, but at the top of the list is Corporate greed and the desire by the some of the ultra-rich to preserve the status quo at all costs.  In the past, it kind of worked too.  With guarded, gated communities, with being able to jet off to Jackson Hole to escape Covid-19, they could feel a measure of protection.  But it’s not going to work for long.  The next super-bug, may spread through the atmosphere and have more than a six foot range.  Climate change with air pollution, droughts, floods, fires and mental illness knows no borders.
Some years ago, I was fortunate to visit the South African game reserve, Londolozi.  Londolozi is a Zulu word that means “Protector of all living things.”  The Varty family who started it back in the 1920’s had three key insights – 1) Wealthy people would pay big money to come and SEE wild animals in their natural habitat, and not SHOOT them.  2) Those same wealthy people would expect a luxurious, upscale lodging and guiding experience and most important 3) The Varty’s could not have a sustainable island of luxury in the middle of a desert of poverty.  
Because of these three insights, they made four decisions – 1) Build a luxurious camp with great lodging, great cuisine, and great guides.  2) Take care of the animals. 3) Take care of the land and 4) Take care of the local population living in the region of the camp.  Educate them, give them jobs, give them health care.  Make sure they have decent housing and clean water.  I spoke to some of those local people when I was there.  I was told that it was tradition in their families to have as many children as possible.  They however were planning on having just one or two, because they wanted to be able to save up for their children’s college education.
When Nelson Mandela was finally released from prison after 27 years, one of his first stops was Londolozi, which represented for him a vision of what all South Africa could be.
It’s not just a vision for South Africa, it is a vision for the World.  We cannot protect the United States of America while the rest of the World burns up.  We cannot protect the mental health of our patients, no matter how wonderful our psychotropic medications are, no matter how skilled our psychotherapeutic techniques are, while they are being environmentally assaulted with air pollution, water pollution, pesticides, herbicides, poverty, racism, incarceration in prisons, destruction of homes by fires, floods and storms, destruction of crop land by drought and over use, and more and more super-bugs.
We are psychiatrists.  Our mission is to heal the mentally ill.  Our mission must also include our speaking for the impoverished and the underserved.  We cannot pretend that we are doing our job if we are not addressing all the other issues that are adversely impacting the people we are here to serve.  That is why we must be advocates, not just for limited areas like health insurance parity for mentally and physically ill patients, but for much larger issues that are directly going to make our patients more ill and yes, kill them. 
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Utah Psychiatric Association
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