Ask Wednesday: Dr. Jean Ramses Rouchon on his life in public health (so far)

We are honored to interview Dr. Jean Ramses Rouchon, a naturalized citizen of the United States who has in the course of his varied educational and work experiences become a skilled practitioner in public health. He earned his Doctor of Medicine degree in Port-au-Prince, Haiti in 1992.

The situation

The same day I reported here "Why I decided to retire," I mailed the President of the University of North Carolina a formal, signed version of the email I'd sent him the preceding Monday (and mentioned in my "decision" report). Today I received a cordial reply in which the President thanked me for sharing my concerns and said he regretted that I'd had to go through that. He said he'd "keep a close eye on the situation."
    I was encouraged by that, and also cheered by the President's taking the opportunity to thank me for my "many years of service to our great University." He acknowledged that I had "contributed immensely to [its] operations" and said he sincerely appreciated my work.
    And I appreciated hearing it from him.
    From him, whose words I can believe.

Because I didn't wish to hear similar words spoken insincerely from one of the supervisors involved "in the situation" (which I described in the cited post), I had emailed the President on April 16, under the pretext of apologizing for not being at his staff meeting that morning, to let him know that:

The reason I'm not there (I'm writing this during the meeting) is that I could not bear the thought of having to suffer the possible utterance of my name by [either] supervisor when they reported their division's activities^*. It's the same reason that I declined their offer on Friday to host a retirement party for me on my last day.

    I had told them:

Some friends will be taking me to lunch on April 23. I don't need or want a party hosted by you. Thanks.

    Thanks, but no thanks. Not in your situation.
_______________
* A friend who attended the staff meeting told me that my name and retirement had indeed been uttered by the chief supervisor, so my absence had spared me the hearing thereof.

Beyond the rail

Renaissance Concourse
Atlanta Airport Hotel

My room was on the ninth floor. Yesterday (Friday), standing a few feet from my door, I took the photo to the right. By my estimation, the Renaissance Concourse Atlanta Airport Hotel has at least two hundred rooms whose door is about ten feet from a short railing leading to misadventure. Maybe three hundred rooms, assuming that you might not have to fall but two or three floors to kill yourself. And you can't see it well from that photo, but the balcony for each floor along the far right juts out farther than the balcony below. There's no chance on that side of grabbing a railing on your way down (obvious from the photo below).

From an elevator opposite the
spot where the photo above was taken

    Upon my arrival Thursday morning for an overnight meeting, the sight of the balconies had made me feel uneasy—the same way I'd felt walking across San Francisco's Golden Gate Bridge in 1967 or 68. I hugged the hotel balcony wall as I walked from the elevator to the far corner where it turned out Room 938 was located. (It was a good location so far as the window view was concerned.) When I returned to 938 at the end of the afternoon session, a housekeeper's cart blocked my way along the wall, so I had to get closer to the railing than I liked. I considered moving the cart, but I made myself buck up.
    Yesterday morning, preparing to go down for breakfast, I thought about calling the desk to send someone up to escort me to the elevator. The intervening hours had given me too much time to reflect on the Golden Gate Bridge Feeling—the sense that your body might suddenly try to jump over the rail and you wouldn't be able to stop it.
    It made me wonder how many suicides each year aren't really suicides in the sense of a willful act to do away with yourself, but just people's bodies acting on their own without the bodies' "owners" being able to intervene? Might be difficult to get statistics on that.
    Again, I steeled myself and went unescorted. I may have walked faster than the day before.
    But why was I having this uneasy feeling now? I'd been near high cliffs and rails quite a few times since 1967, and I had rarely had the feeling again.

When our meeting convened on Thursday afternoon, we'd all been asked to introduce ourselves and share "something interesting." Most of us already knew each other, from one or more previous annual meetings of our enterprise, but several people were new this year.
    When my turn came, I said,

In eleven days I'll no longer be who I am, so there seems to be little point in telling you who that was. But for those who don't know me yet I will say that this is my tenth annual meeting. I am, for the few days left before my retirement, the state coordinator for North Carolina.
    I've been asked one particular question so often lately, it might possibly be of interest to you how I'm dealing with the prospect of retirement.
    The most interesting thing about it to me is the strong polar-opposite feelings I have about it.
    On the one hand, I'm really glad to be leaving the organization I've worked in for fourteen years. One of the reasons is that it has already ceased to be what it was, and I very much dislike what it has become. Your organizations back home are hierarchical too. So has mine always been. But over the past few months it has become rigidly so—more top-down, more chain-of-command. The commands come down, and subservience is supposed to go back up. If you want to communicate with someone in a different part of the hierarchy, don't call them directly, but go up your chain to where the two hierarchies meet.
    Enough! I'll be relieved to escape my division's oppressive regime.
    But on the other hand, I'm already sad thinking that this is not only my tenth annual meeting—it's also my last. I'm going to miss working with all of you on our beloved tuition-savings program for college students in our states who want to pursue degrees that our own state doesn't offer. I'm going to miss each of you personally. We have become friends.
    Of course, no one likes to feel sad, so I'm trying to focus on the glad part of the situation —escaping the division I've worked in for fourteen years. I'll try to put off the sad part until later.

Well, the truth is I can't feel entirely glad about retiring from work that has given me a great deal of satisfaction. I think I'm feeling...diminished.
    It happens to many retirees. Some feel that they no longer have anything to live for, and a number of these die soon after their last day at work.
    Walking along the hotel balcony, think I feared that some hidden part of me might commandeer my body and pull or push it toward the rail....

After passing through the The Zimbabwe Exhibit at the Hartsfield-Jackson Atlanta Airport yesterday afternoon, a World Wildlife Fund poster brought back a powerful feeling I'd had the day before on the flight to Atlanta. The sound of a young child talking to its parent had provoked in me a profound sense of vulnerability. My heart went out to that child. I ached with the knowledge that it would not always be taken care of, that it was subject to wanton hurt, ill-treatment, even abandonment. How helpless are our children, how dependent on us our pets and even the livestock we raise...to slaughter. How vulnerable wild animals subject to legal hunters, to poachers, to each other.
    On the plane, I thought it was the child's vulnerability I felt. Stopped before the poster of the young elephant and its mother, I thought it was the vulnerability of the small elephant.
    I suspect now it was my own vulnerability that was trying to speak to me.

Suicide is painless

In my day job, I coordinate for North Carolina an arrangement involving all of the southeastern states by which they share "not commonly available" academic degree programs with each other's residents at in-state tuition rates.
    At least, I thought I did. For years I've quoted "not commonly available" thinking I was quoting from the regional guidelines governing all of the participating states. But yesterday I discovered that the guidelines don't even touch the topic. The arrangement actually permits participating states to share with each other any of their academic degree programs they want to share, however commonly or uncommonly available they may be. The word "common" or "uncommon" isn't even used in this context. The only regional restriction on sharing is that the states can't approve another state's degree program for their residents if they have a similar program.
    There is the proviso, though, that each state may have additional guidelines based on its own needs. And North Carolina does have an additional guideline, one that was written into the legislation that authorizes our participation in the arrangement. That is, it's the law. We may

select for participation only...programs that are likely to be unique or are not commonly available in other participating states.

    I'd always read the legislation as simply codifying for North Carolina the regional guideline affecting all of the participating states. And I'd always read the regional guidelines sure that they stated somewhere that the states could share only their "not commonly available" degree programs. But I recently became aware that another of the states doesn't consider uncommonness of availability, and I asked the state coordinator, "How can you just ignore the regional guideline?" She asked me to show her what in the guidelines I was referring to.
    I pored over their every line but couldn't find the phrase anywhere, nor any language remotely like it. It was all just in my mind.

Self-deception is so easy, at least as easy as suicide is painless, a clause from Robert Altman's 14-year-old son Mike's lyrics for the song from M*A*S*H:

Suicide is painless,
It brings on many changes,
And I can take or leave it if I please.

    Self-deception, though, isn't at all easy to take or leave. Several days of email exchanges were required to bring me to the definitive reading of the regional guidelines. Self-deception hides from us, even weaves a thick web of supporting deceptions to protect itself. That is, we hide the deception, we weave the web.
    I haven't been able to discover that I had any powerful motive for deceiving myself about "not commonly available." Somehow or other I got the idea that it was in the regional guidelines, which seemed eminently sensible. How could it be otherwise? All of the states were simply sharing their uncommon programs. That was what it was all about, that's how I'd explained the arrangement to hundreds of people.
    I must have heard dozens of clues, during email exchanges or conversations or at meetings of state coordinators, that it just wasn't so, but my woven web "protected" me from picking up on them, even enabled me to neutralize conflicting statements or simply reject them as uninformed. I understood it better than they did.

If we can do this in matters with little at stake, think how well we must be able to do it in matters of love, life, and death. We believe that we're loved when we're not (or that we're loved more or more often than we really are). We believe that someone is looking out for us when no one is. We even believe that the someone is the Best Someone There Could Be.

...Few people know that most airports have houses of worship: they tend to be white, high-ceilinged, scrubbed, and soundproof, imbued with a spirituality so general that even atheists can find refuge in them. They go unused, for the most part, except in times of emergency and terror—after a crash or when a war breaks out. They're eerie little niches but also restful and perfect for catching up on paperwork....[p. 103, Up in the Air, by Walter Kirn, 2001]

...[Owners] of dogs will have noticed that, if you provide them with food and water and shelter and affection, they will think you are god. Whereas owners of cats are compelled to realize that, if you provide them with food and water and shelter and affection, they draw the conclusion they they are god...Religion, then, partakes of equal elements of the canine and the feline. It exacts maximum servility and abjection, requiring you to regard yourself as conceived and born in sin and owing a duty to a stern creator. But in return, it places you at the center of the universe and assures you that you are the personal object of a heavenly plan. Indeed, if you make the right propitiations you may even find that death has no sting, and that an exception to the rules of physical annihilation may be made in your own case....[p. xvi, Introduction to The Portable Atheist, by Christopher Hitchens, 2007]