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