Each of us here are required to write an ethnography (or, un investigación) about something in Cuba. The topics are diverse, ranging from the culture surrounding car ownership, to renewable energy, to race and tourism. I have chosen to study the mental health care system, both because the health care system here is fascinating to me, and because I am a psych major and am comfortable with the field’s vocabulary. Elliott told me that he thought my research, especially in the field, would have been the most difficult out of anyone’s to access. Mental hospitals, specifically, are not usually accessible to foreigners. I decided to take getting into a mental hospital as a personal challenge.
Our Cuban contact mama (nuestra madre Cubana) happened to have a psychologist friend who owed her a favor. She set up a meeting time between him and I at her house. Full of nerves, I entered her house and introduced myself. His name is Raul. I started recording our conversation and he uncovered the mystery of the Cuban mental health care system. I was surprised to find out that it’s pretty similar, at least in the office, to that of the United States. Cuban psychologists use the DSM IV, have a close relationship with the APA, and use talk therapy. Raul described to me briefly the problems that Cuba’s mental health care system experiences, which, interestingly, includes prescription drug addiction among other things. Overall our talk was fascinating and highly informative. However the best part was when he offered to take me on a tour through Cuba’s various mental health care facilities. Obviously I was (and am) thrilled.
My first official tour of Cuba’s mental health care facility took place on Tuesday afternoon of last week. I met Raul outside of Hospital Fajardo, he was accompanied by a tall woman who was the boss of the psychology clinic across the street. We walked into Raul’s office, and set our bags down. I was given a long white lab coat, I think it was one of Raul’s extras. The other psychologists only had one or no buttons done, and you could see their street clothes easily under their lab coats, making the environment feel casual but still professional. Everyone who talked to me was extremely intelligent and purposeful in their actions. We then walked back to the hospital where we were going to see a patient. Despite nobody knowing me and me being obviously foreign, I was able to walk through the hospital without receiving any strange looks.
Raul, the tall woman and I entered a large open room with two beds in it. A group of doctors was standing near the entrance. I was introduced to one woman who was not wearing a lab coat, (Every time I am introduced it’s something like this “this is Becky, she is a psychology student in her third year from the United States in Chicago. She is here in Cuba to study the country, Spanish and culture, but her focus is mental health.” So my role as a participant is extremely limited, but as an observer I have freedom to write notes and record audio), she was the boss of the ward that we were in at that moment. To our right, there was an old woman patient wearing a light blue uniform and sandals smeared with blood (the blood was mostly on her pocket, and it seemed to say 3D, which was a number written on the sheets as well. There was also blood on other parts of her shirt, and on her finger). There was a distressed woman consoling her, maybe around 35 years old, eating a hospital lunch on a tray. I assumed this was her daughter. When she sat, the doctors began asking her questions. The doctors would ask her what day or year it was (Raul did this repeatedly,) and she would respond with entirely irrelevant information. They would ask her who her daughter is (and gesture to her), and she wouldn’t remember, or say that it was her mother. The doctors gestured to her leg, saying that she has an infection and that it was making her dementia worse. They asked her how old she is, and at one point she said 45 and another she said 90, she was clearly 90.
Raul was extremely kind and patient with her. He was persistent, tolerant, and understanding of her symptoms. He treated her much like a normal person. His professionalism and gentleness was actually inspirational. His actions had a consoling effect on not only the patient, but her daughter. It reminded me why I chose psychology as a career. I need to figure out how to tell him this in Spanish and sound sincere!