It is a real honor, oh, first of all, I'm Eugenio Roth from Miami, I'm the recipient of the past Bolivar Award, and it's a real honor. Please save your applauses for the next recipient. It's a real honor to introduce Dr. Bernardo Eng, a distinguished fellow of the American Psychiatric Association. Dr. Eng completed psychiatric training at Texas Tech and later completed a psychosomatic fellowship at the University of California in San Diego. Currently, he is the director of the Sun Valley Behavioral Medical Center and also director of the Sun Valley Research Center east of San Diego. He's the author of more than 127 scientific publications, and he has the very unique characteristic that he is past president of the American Society for Hispanic Psychiatry and also a past president of the Mexican Psychiatric Association, demonstrating his transnational influence and work. Very appropriately, he is also past chair of the APA's Council for International Psychiatry. I have a theory of what makes Dr. Eng such an outstanding individual, and I think that it has to do with his ancestry. Dr. Eng is a Mexican Norteño. The Norteños from the people of the north of Mexico are known to be passionate, energetic, motivated, strong-willed, and courageous. In addition to that, Dr. Eng's other family roots emanate from the thousands of years of wisdom, serenity, creativity, and contemplation of the country of China. So this blending of these qualities and his positive energy and enormous accomplishments on behalf of Latino psychiatry make him a very deserving winner of this year's Bolivar Award. Please welcome Dr. Eng. All right. We're not that many, but we make noise. I like that. Eugenio, thank you very much. You can also see the wisdom of Eugenio, because he didn't know he was going to be the one presenting me until about three days ago. And that was only because, again, since it's Wednesday, usually the president of the Hispanic Caucus does this, the presentation. But I learned that he was not going to be around. So we ran into each other on Saturday, and he says, you know what, none of us is going to be around. I said, well, that's a problem, because usually one of you guys comes and says, who can you think that could do it? And very kindly, Eugenio, prior to our traveling here, emailed me and said, Bernardo, I want to make sure I'm going to be at your lecture. So when is it scheduled for? And first thing is that it was going to be on Saturday, and then it turns out that it was changed to today. And I was really concerned, because most people are not around by Wednesday anymore. And he said, I'll be there. So on that, I told Hector Colon from the Hispanic Caucus, look for Eugenio Roth. And thank you very much, Eugenio, for being here, and your very, very kind words. You're a very skilled man, and your words really touched me. Thank you. And, yes. And with that, I really want to thank all of you for being here, most of it my Mexican colleagues and friends, but especially Maria. Thank you. I know you live here, but I guess that doesn't do it. You're a very busy woman, so thank you for being here. And Renato, I don't know. He was wondering if he was going to be here or not. I don't know if you changed your flight, or it was just scheduled for later. So thank you all for being here. And I was telling Nancy that it's hard to think about 90 minutes. I haven't had that much time to speak in a long time. So I don't think I was able to put so many slides together. So I guess in the last part of the presentation, we can turn this into a conversation for those who may still be here. All right. So this is my agenda, the border migration and training. And I'm a migrant, and I'm a son of migrants. My children are migrants, and my girlfriend is a migrant. So I'm surrounded by migrants. Second point is going to be settling into rural landscape. It was not planned. It was sort of an accident, and I'll tell you about it. But it was a very happy accident. A lot of things came with that, including being professionally very lonely for years because I was the only psychiatrist there. I'll tell you more about it in a moment. But I guess like the saying in English goes, right, if you get lemons, make lemonade. And that sort of opened the opportunity to create services in this underserved area where I'm still at and which remains underserved despite all the effort, but also opened the opportunity to start attending meetings like this. And eventually, through the trust of some very important people in my life, I ended up being in the global landscape, and that's the story I want to share with you right now. Okay. So I'm going to start with this quote that one must find time to stop and thank people who make a difference in our lives. And what a better use of one hour and a half, right? So if I miss anybody, I apologize in advance, but I'll be talking about a lot of people that are very important to me. So the border. I'm a border guy. This is the border, and something that people who don't live there don't realize is that there's a border area, okay? Adriana, who's my friend and colleague from Mexicali, too, she was born, well, she grew up there. I don't remember where you were born. But you've lived that part, right, where this border area has so many things in common that it doesn't matter where you're from, you know, on the American side or the Mexican side, when you go further into either one of the countries, you actually feel like a tourist. It doesn't matter where you're at. And then if you go to Mexico as a Mexican out of this border zone, and they start making comments, for example, anti-American comments, you feel bad because you're so close to your American neighbors, and the other way around. I've had the same feeling when I talk to my friends from the American side, now I am one of those, but that when they come further north into the United States, and they hear that they speak bad about Mexicans, they feel bad as well, because it's a very close interaction. And this is a picture from President Reagan and De La Madrid in 1993, there was an agreement called La Paz Agreement, where they defined this border zone, which is like 65 miles up north or 100 kilometers south, because there were some environmental problems. Among those, right at our area, there is a river called the Colorado River that goes south and transformed a desert into an agricultural place. And then the river, by its nature, goes back to the United States. It's so funny. But after going through all the fields, now it's contaminated, so it was issues about how to treat the water before it came back into the United States. But historically, the main cities are El Paso and Ciudad Juarez, and then on the Gulf of Mexico is Brownsville and Matamoros. And then the busiest border in the world, Tijuana-San Diego, and then my border, Mexicali and Calexico. Okay, some information about the border. There are 372 million travelers per year, 150 million cars cross every year, with annual cargo trucks are 12 million. Every time you hear the news about closing the border, there are a lot of business people that don't like that, because business goes to those borders every day. The goods that moved are about over $600 billion. And these are the states, four states in the United States and six states in Mexico, California, Arizona, New Mexico, Texas. And that's how I consider myself a border guy, right? So borderline is a geographic thing, all right? I'm a borderline psychiatrist, because this is where I've been most of my life. I trained in El Paso, like Eugenio said, and then in San Diego, two of the border states. And then I was born in Baja California, which is one of the Mexican states, and studied medicine in Nuevo Leon, which is another border state. So this has been my life, a border guy. Some more information about it, and it's very small print here. So there are almost 3,000 kilometers of border, one million daily border crossings. And let me—there is some interesting data here, that if the 10 U.S. and Mexican states along the shared boundary combined to form their own country, it would constitute into the third largest economy in the world. That's how much power and how much goods are in that border. So okay, migration. As Eugenio accurately described, my mother was from the state of Chihuahua, another border state, and my father was from Hong Kong. And fast and he brought them together into this city, Mexicali, and that's where I was born. Mexicali is hardly known, but I'm very proud of being from there. It's a capital city, but in that state, Baja California, Tijuana takes most of the attention. You know, it's larger, has a stronger economy, there's more tourism over there, but Mexicali, I love it. I'm very lucky to be back there after having gone to training. I'll tell you how I got back there in a moment. But as I was telling you, it's a desert that, thanks to the Colorado River, it became an agricultural town that was the strongest source of income in the early 20th century. But it also has a port in the Gulf of California. The main—one of the main activities there is to fish shrimp, and shrimp is great. When you go to that little town, you go to breakfast and you get a shrimp omelet, and when you go to lunch, you get a shrimp and some shrimp tacos, and when you go to dinner, you get shrimp in like a red sauce or something. And this is—these big letters, those who have traveled to Mexico, every city has the same thing with their letters and colors. And the other picture on your lower left side is to show you the building, the tallest building in the city, which is the only building that tall. The rest is a flat town. If you have two stories houses, it's a lot. And that's it. So it's a very young city. This is an image of the early 20th century as you were crossing the border. Can you believe that's the way it was? Just a little cabin there, or a little booth, and people would just cross, and it said Mexico if you were going south, and it would say United States if you were going north. Nothing to what's going on right now, nothing like all these inspectors and all these walls six, eight meters tall, and in Mexicali, there was a very special place, and that's why my father got there, the Chinatown, or Chineska in Spanish, is one of the oldest Chinatowns in Mexico. There are some older, only because the states are older, but this probably is the strongest and most represented Chinatown in Mexico, so much that when you ask what is the typical meal of Mexicali, it's Chinese food. So anybody who's going from other parts of the country to Mexicali, they go to try Chinese food because that's so much in the heart of how the city was born. If you ever go there, let me know. I'll take you on a tour because there is this legend, well, it's not a legend, it did happen. It's so hot that there was an underground city for immigrants that were undocumented, and they would be hidden there. Nobody would know. They would come out, just work in the stores and the restaurants, and go back in until there was a fire in those underground houses, and a lot of people died, and it became evident they were keeping undocumented people there. That story, but that's one of the origins of the Chineska, and there's a tour now where you can actually walk through the underground constructions. Okay, well, this is my family when I was a child, right? That's me down there. Let me see if this works. Okay, and that's my sister. She became a... Oh, I should add that my parents got married when they were like 19 or 20 years old, right? They met, and in less than a year, they got married. I guess that's the way it was. My father spoke more English. Well, he spoke Cantonese, but he spoke more English than Spanish. My mother only spoke Spanish, and it's funny when I used to ask them, how did you tell that you liked each other? That's the only word my mom learned in Chinese, apparently, but this is my dad. This is my mom here. This is my youngest sister. She's a geriatrician now. My mom only went to school until seventh or eighth grade because she was part of that culture where women don't go to school, and my dad, whose father died in Hong Kong when he was like 15, 16, was sent to America because he was supposed to become rich in America and send money to the rest of the family that had left behind with my father's death, and well, that's another story because they lost contact. It's amazing how the internet and mobile phones now can keep you communicated, but at that time, they lost communication, and they didn't run into each other until 40 years later, but in the meantime, my father tried to go back to school. He actually, he presented the exams with the Secretaria de Educacion in Mexico. He got grade school out of the way, junior high school out of the way, high school out of the way, and then he was so busy that he couldn't go to college, but they did insist that we went to school and finished and got a university degree so much that it used to bother me, right? It was such a pressure, but I couldn't thank him more for that. If it wasn't for that, I wouldn't be here right now, so this is all of us with my mom, and then there's a story here with my grandmother. This was my grandmother, and this was her babysitter who was a neighbor, right? She was only like three years older than us, but she would take care of us whenever my parents had to go out somewhere, and this is my brother. So what's the story here? When my mother was born in Chihuahua, she was the 13th child of my biological grandmother who died after, you know, in the postpartum. She developed postpartum depression and died, and her godmother took her to raise her, okay, and that was really my godmother here, my grandmother. It was my mother's godmother. Well, this grandmother, the one that I grew up with, had five children, only one girl, and the girl had died. She would have been older than my mom, but she had died of chikalosis, and when the opportunity came to her doorstep, you know, one of my mom's older brothers said, you know, our mom died. I'm going to take care of all my siblings, but I cannot take care of this baby. She's just too young. I cannot do it, and you're the godmother, and she says, of course, and she took her in and raised my mom, and later on, this grandmother had one of her sons die. And left this guy here orphaned, so that would have been like my mom's nephew, and I grew up seeing him as my brother all the time, so we're three biological siblings with my brother, cousin, sort of adopted mom's nephew, and that's how we grew up. Okay. Day of the Mexican Revolution. So this is going to tell you how much your parents influences you, right, or at least in my case. So the revolution ended in Mexico in 1922, and since then, every year on November 20th, there is a parade, which rather than being a military parade has become a school parade now, right? So all schools go out and march and usually it's like those in sixth grade or seventh grade. Somehow, I don't know how I ended up, but in 1970, I was only five years old and they dressed me as a doctor. Can you believe that? Nobody asked me. They just said, okay, you go with the rest of the kids and you're gonna be dressed as a doctor. So there was a legend also that my biological grandmother, the one that died when my mother was a baby, that she was a healer, all right? And my adoptive grandparents kept insisting that one of us had to be a doctor and would have inherited those natural skills that my grandmother had. So we all became doctors somehow, one dentist and one geriatrician. We still haven't figured out who inherited those skills, but we all tried it anyway. So these were my schools in Mexicali. So this was my grade school, this was my secundaria, and this was my high school. All those schools are still there. Actually, these are current pictures. The schools have changed a lot, but anyway, they're still there. And it's very funny because Nancy and I live really nearby my secundaria, and when she first moved to live in Mexicali, I would tell her, okay, this was a classroom, and this is where I got kicked out, and this is where we go ditch. Now, I was a very good student, but we were a rowdy group. Okay, so Mexicali it is, and then I'm 16 years old, and I go to Nuevo Leon, and I spent seven years there. Great years. I consider Monterrey my second home. A lot of good things happened there. This is the front of the Facultad de Medicina in Nuevo Leon. This is how I looked back then, and I want to bring your attention to this professor, Jorge Mascareñas. He was one of my professors there, the main one, the one that got my interest into psychiatry. And we're in the 1980s, right? This program is very psychoanalytically oriented, so whoever was not in psychoanalysis was like almost like a traitor in those years, and he said that, so we were in a class and said, you know, currently there are those who are organicists and functional psychiatrists, and those of us who are both, and I said, oh right, so you can be both. That's okay, because I had this thing about how are you gonna split this? Do you really have to choose between one and the other? And then I went back to Mexicali, because at that point, what is customary in Mexico is that if you want to go to a specialty, you need to take this national exam called ENART, and you can only, but in my time, you could only take it once a year. It's still that way, right? You take it once a year. So I had to decide, either I wait, because I was already taking the exams to come to the United States, right? But I'm gonna, I may lose a year, but then if I take it and pass it, and I also, well anyway, at that time there were very difficult decisions for me, so I decided to go to Mexicali, because there used to be a hospital over there, a psychiatric hospital without psychiatrists, and I said, you know, I can work there in the meantime, and I went to, it's called, now it's called the Instituto de Psiquiatria del Estado, which is the psychiatric institute, or the state psychiatric institute. It used to be called the Mental Health Institute when, in the 80s, and I met this guy who couldn't make it to New York this time, but I really had him close in my career. He took me in and said, no, we have a residency program now, you know, we have residents, you cannot just come in and, you know, I said, can I just come in and hear the classes and see patients? He said, okay, we'll do something about it, and he allowed me to come in, and it sounded funny at that time. I was volunteering at a psychiatric hospital. It sounds okay now, but back then, believe me, it is, you know, why would I go to a psychiatric hospital to volunteer? But, besides all the learning and seeing patients over there and learnings from him, we did a research that became my first paper ever in a psychiatric journal, and this was about the extra propoxyphen addiction. It was a pandemic back then. It was called Darbon. That was the brand name, and people were passing out and they were dying back then. Pretty amazing. Anyway, then I hear that I did pass the exams, and here, El Paso, here I come. There are very important people there that helped me and showed me, you know, what was psychiatry like in the United States, and not only that, represented by Hispanic people, okay? So, you may recognize this guy because he has been in the Hispanic caucus forever, Oscar, and then this guy in black, I put it there because he was a very important gentleman. His name was Frank Schuster, and this tells you how old he was. I couldn't find a picture of him on Google, okay? That's how old he was. He died many years ago, but very important thing. I did another paper there, and him and James Wilcox were my supervisors, and I was a PGY2, and this became my second paper that really changed my life academically because to one of his, one of the two, Wilcox told me to enter this competition. I didn't know what it was, but as you're gonna hear, when I trust the person who encouraged me to do something, I do it. So, I went ahead, and I won the Resident National Award from the National Medical Association, which I didn't even know that existed. So, I learned at that time that the AMA is the long, the older association, but the African-American physicians have this NMA, and that was very important because this is Chester Pierce, the founder of the psychiatric section of the NMA, but for those who don't know, he was the first African-American psychiatrist who was a professor at Harvard, okay? And it turns out that one of his students was the one, the person in charge of the consultation liaison program at UCSD, which is where I wanted to go, right? So, there we go, to San Diego, and two years over there, this is the medical center where I trained, and it turns out that I go to work under the student of Chester Pierce, and this is Joel Dimmesdale. He, he's a psychosomatic psychiatrist. He was one of the people that introduced the idea that those with some personality traits are more likely to have heart attacks, like the hostility and the type A personality. He's the one that mentioned it. So, thanks to Chester Pierce's letter, I made it into one of the top ten universities in the country, and then I met another guy that I never thought I would meet, and I had been reading about, because he defended international graduates so much and so strongly, and I get there, and he becomes my supervisor, Rodrigo Munoz, who was the first president, Latino president of the American Psychiatric Association. So, I was in good hands, and of course, UCSD is very productive, and I got two papers there. One of them was this, Ethnic Differences in Analgesic Consumption for Postoperative Pain, and it became, the two papers became chapters in a book of anthropology and medicine, so I said, oh my god, this is good. I like the idea of doing academic psychiatry, and Joel told me that I had the research bug in me, but then something happened, okay? So, that was the idea. I was gonna stay there, become a professor, but then I moved to this place during the PG-5, it's called Imperial County, and I believe that the bug came with me. So, how did that start? When we finished the fourth year, one of my classmates had been working on weekends in Imperial County, and he was leaving, and he knew that I was staying for one more year at UCSD, told me, Bernardo, I got the perfect job for you. So, I went to Imperial County, and oh my god, I stayed. This is the, this is the scenery of Imperial County, right? Crops, agriculture. Now, we have prisons, and Walmart, and other things, but the main job for years was being, working in the fields. It's a lechuguero, that's kind of friendly, but then could be pejorative name of the people that work there, and this became my patience right away, okay? So, the mix in that county compared to the rest of California is 87% Hispanic, compared to 40% in the whole state. So, it's a minority-majority county, and it's very interesting because they divided in, you know, white Hispanics, Hispanics, and mixed, multiracial Hispanics. So, I was sharing with someone the other day that some, I have this very, I also see children, because there are no child psychiatrists, so I see them. I also see the older people, because there is no geriatric psychiatrist, and they look like really Anglo, right? Okay, what's your name? Michael Herrera, okay, because the dad is Mexican, right, and the mother that brings them in is really Anglo. She doesn't even speak Spanish, or the other way around, right? Someone with last name Smith, and the mom turns out to be Mexican, and they look very Hispanic, right? So, there's a lot of mix over there, and I called this slide Building into Burnout. So, I get there in 1990, well, from 93 to 94, I did the moonlighting. I realized that it's a good opportunity, not only to start my practice, but also to help an area that's underserved. So, I arrived there in the summer of 94, and I start an outpatient office, and in two weeks, I had a three month waiting list, which I would have never imagined, and I said, okay, but I'm a liaison psychiatrist, so, of course, I'm gonna go do consults to general hospitals, 90, 100 beds, small hospitals, but they were like 25, 30 miles apart. So, at the end of an outpatient day, then I would drive, or I would drive early at 7 a.m. to see the consults. I loved it, and then they said, Dr. Ang, would you be willing to see, we have a nursing skill facility, would you come see them? Of course, and there were two, so I started dividing my days, right? One day a month at one nursing facility, the other nursing facility the next day, and then they call me from the dialysis units. Of course, I know how to see patients with renal failure, and there were four units, and there was, it was Wednesdays and Thursdays to go there, and then a lot facility, and then a day center. Actually, this one, I opened that one. I'll tell you more in a moment, and there it was. This is a aerial picture of El Centro. This is the only mall that we have, okay? We have Macy's, and Penny's, and a movie theater, and this is me back then, and I was really running like crazy, okay? I was the only psychiatrist from 1994 to 2005. I was spending 60 hours or more seeing patients. I was on call every day and every night. It was funny because I would go and see Joel Dimmesdale periodically, and he tells me, Bernardo, what do you do when you want to have a drink? And I said, oh, that's right, I haven't. I need to work on that. There was, but one of the things, very hard, you know, vacation was very hard, but I would pay for someone, locum tenens or something, you know, a week, or I would still be on call, but one of the hardest things, there was no one else to discuss cases with. That made me very lonely. I was lucky that in Mexicali, there are like 40 psychiatrists, including Adriana, and now Juan, and then Manuel, the one I told you that I had met before, and that was my own, those were my only opportunities, but the other problem is that anywhere I went, if I went to the bank, or if I went to JCPenney, or if I went to a restaurant, someone there had been my patient. The waiter, the teller, it was, so it did start to get awkward, but nonetheless, I kept on writing papers, okay. For example, I remember sending this survey to my colleagues who were referring patients to me by fax, and they answered it, and they sent it back to me, and I was able to put together a paper about how the rural non-psychiatric physicians were treating depression, and then we started reporting cases. There was one, everybody knows now that olanzapine, especially in the older patients, can cause edema. We know that, but I was one of the first ones that presented that. It was like 60 cases, and then I treated a patient with topiramate for hyperphagia, and then when we get an MRI scan, it turns out he had a tumor in the hypothalamus, so, but he improved, and that was the reason we got the, so the bug stayed there. All right, so, solitude is the profoundest fact of the human condition. Man is the only being who knows he is alone. So, despite how busy I was, I remember contacting Joel, and I said, look, I need your help, I need to do some, and then he said, okay, this is gonna mean more work, but maybe you're gonna like it. So, he was still the chief of the consultation liaison service that was done usually by the fellows, but an attending would come in on Monday, another one would come on Wednesdays, another one would come on Fridays to make rounds with the fellows. So, he gave me the opportunity as a voluntary faculty to come in and make rounds with the fellows at the CL service in this hospital, and that was very useful for me, I mean, to be challenged with cases, and the last thing published, you know how, you know, PG-4s and PG-5s can be, they're reading the last thing, and I would come in with all these patients in my mind that I was seeing, so it was a good thing, and it become a, it became a productive era. This is Dan Sewell, he was a professor in geropsychiatry at UCSD. We published a series of cases, five cases of agitation in dementia patients that responded to lamotrigine, and then we wrote this great paper with Hago Pachisco, he was a professor at UCSD as well, and it was a conceptual paper about the bipolar type 6, and I was the lead author, I cannot believe, the guy was, was very kind, and with Mark Fry, we reported a case, and this was with Camacho, I'll be talking about him in a moment, because a lot of you knew him, and he also had the research bug in him. In this case, we got Mark Fry, thanks to him, running the case by Mark Fry in a meeting like this, and he says, that's a very interesting case, bipolar depression with comorbid methamphetamine abuse, it was very interesting, so we got it published, and it was an honor, really, to be able to publish with these big guys. Back to Joel Dimmesdale, he was the lead on DSM-IV for somatic symptoms disorders, and he asked me, you know what, I need some information in a rural town, would you do this? I said, of course, if you ask me, I'll do it, and we got another paper, and then something else happened, which was unexpected and amazing. I was married at the time, and we were an infertile couple, and these three guys came to my life. They're all adopted, they're all from different biological mothers, and this is Bernardo, the oldest one, yeah, I couldn't think of any other name, right? I still apologize to him, because I couldn't name him anything else, but Bernardo, and then he even tells me, dad, at least you would have given me a middle name. No, you have to be Bernardo, like me, like we do in Mexico, right? And this is Adolfo, he's the second one, and this is my girl, Frida, Frida Maria. We had more things, by then we gave her a middle name, and they were adopted in Mexicali, and at that time, adoption in Mexico was very slow, very hard, so that had me living in Mexicali, this is, this is the wall, right? In Mexicali, and crossing the border every day to work in Imperial County, okay? So, you get an idea, this city has about a million people, and this one hardly, you know, about 180 people, the whole municipio, or the whole county. And, well, if it wasn't enough, I start practicing in Mexicali too, right? I don't know, ready to go burned out. So, I started an office because, well, there was a need, right? And I opened the first nursing skill facility in Mexicali at that time, this was 2005, and it was intended to have like 16 beds, we could only fill it as much like 10, 12 beds. I'm very lucky that Nancy also does geriatric care, so since she moved to Mexicali, she's been running it, and now it's a 50-bed facility, thank you, but now she runs it, not me. But in all these years, and in psychiatry, it's hard to talk about your patients, right? Because you're not supposed to give names and stuff, but I put this picture like this because I've been there 30 years this year. And the other day, a couple bring a child, seven years old, with ADHD, and says, Dr. Ng, okay, so I'm evaluating, I'm starting to ask the typical question, and the father says, Dr. Ng, you don't remember me? And I said, okay, I don't, and the guy is like in his late 30s, right? I was your patient, that's why I'm bringing you my son, he has the same thing I do. Oh, okay, so that's gonna make this very easy, right? Yes, yes, yes, so we start laughing. I said, oh my god, I said, I'm getting old, you were my patient, and now you have a son, and I was like, oh, Dr. Ng, you forgot, you treated my father, too. So I thought about it for a minute, and I'm very confident that I've treated thousands of patients in that county by now. But nothing is built on stone. All is built on sand, but we must build as if the sand were stone. Okay, so you cannot be seeing patients yourself all the time, so it was time to create services. So I got there in 1994. In 1998, I created this medical center, Sun Valley Behavioral Medical Center, Outpatient Services. And it was so funny. I was married at the time, and my ex-wife told me, Bernardo, why do you name yourself medical director? I said, because I'm the director. But you're the only one in that office. Well, but I knew that we were going to grow. And then we founded Alegría, which is a day center, where now we have 100 participants there every day. It's funded by the state. And then Nuevo Atardecer, that's the nursing skill facility in Mexicali. Then we built Sun Valley Plaza that was with Camacho also. Camacho came after 10 years of me being there, also by the recommendation of Joel Demsdale. And I'll be speaking more about him, but he's no longer my partner because he died. He died by suicide in 2018. Very painful death. I think a great loss for psychiatry, not only in the U.S., but in all the Americas. And I'm sure he would be here right now. And then we opened together a clinical trial site. It's called Sun Valley Research Center. And we were so happy with the Sun Valley brand. I remember we were going to open Sun Valley Behavioral in San Diego. Not only, I mean, we were going to go to San Diego. We never did that. And the latest project is MCMP, the Mexican Consortium on Neuropsychopharmacology. These two ladies here have been my partners in that. Thank you very much. I'll tell you more about a great experience. But also, we had projects that didn't take off ground. Like Sun Valley Research Mexico. We tried to open a clinical site, a clinical trial site in Mexico. After two years, it didn't fly. Under the recommendation of Munoz, when Facebook was the only platform, we tried to create this daily clinical psychiatry. It was going to be a platform. It was too much for us. We couldn't do it. And then Medisave. We're going to do, Nancy and I, we're going to do an app in Spanish where people were going to go in there, look for the medication. It was going to tell them what pharmacy it was going to be at. We could never do it. But it was a good idea. If you guys think about it, it could still be a good idea. Okay. So, this is Camacho and I with Dimmsdale. And under his guidance, they said, you know what? You have very good data. Why don't you start presenting? And we went to APA, to the Mexican Psychiatric Association, to the Geropsychiatric Association, Psychosomatic Society, ASHP. We started presenting, sending, you know, proposals and abstracts everywhere. And the funniest thing is that we would get accepted, right? We didn't expect it. And, but we, so we dedicated part of our time besides seeing patients to writing and putting data together. And even though that meant work, it helped in a lot of ways. It started helping with the burnout. It helped us see more about what we were doing with our patients. We actually improved some of our processes and of our protocols. Okay. So, how does, did that go to the global scape? Global landscape. So, one day, Manuel Alvear calls me. He was the founder of the Mexicali College of Psychiatrists. And he told me, Bernardo, I need you to come to this meeting. And I said, what's happening? Well, our president is quitting. So, we need to have an extraordinary meeting because we need to find who, you know, what to do. And I said, well, there's a president-elect, you know, what is there to do? Well, just come to the meeting. And I said, okay. So, there I go. I didn't go that frequently because I was very busy. And we go. And so, the president-elect steps up to her job. And she says, okay, so, I'm welcoming you. Something happened to our president. He's not here today, but he's not going to long, he's no longer going to be able to do this job. So, I'm taking over the college. But we need to vote for a new president-elect. I said, oh, that's cool. Well, who ends up winning the election that night? Bernardo. And I said, oh, wow. I hadn't thought about this. But, yeah, when I come in, this is the picture when we were taking oath for a new job. And Adriana became my president-elect during that year. And it was a challenge. The college was pretty neglected. It had no money. And we had to take it back, build it back from the ground. This was our first event in 2014. And we said, you know, psychiatry for everybody. We invited teachers. We invited nurses. We invited psychologists to attend. We had like a three-day event. So, it's been 10 years trying to do this. And at the same time, we kept on sending papers, right? And this was the first time we presented in the World Psychiatric Association. There is Camachito again. And this is Danny Jimenez. He with shorter hair than now. He just became the president of the American Society of Hispanic Psychiatry. Second PhD in the history of ASHP. There we were in Madrid. And here I am presenting with Ruby Castilla. Also, president of ASHP, immediate president, what? She was president when I was immediate past president. And at the same time, I was going to APME. And there's Yolanda. Thank you for all the work you've helped me with. She helped me when I was president of ASHP. She presented in, I think it was New York, right? When you presented, in fact, many years ago. And this was in Guadalajara, was one of the Mexican congresses. And then, why not? We went to Apal that same year. That's where I met this woman here. And at the same time, I was secretary and treasurer of ASHP. This was my president, Mauricio Toen, which, by the way, is the second Mexican to have the Simon Bolivar Award. I'm the third. I'm very honored to be following him. You for sure know this guy, too, Manuel Sanchez de Carmona. He's an icon in Mexico. He's been the president of ISBD, and he's still the leader of ISBD in Mexico. This was in Toronto, right, Toronto APA meeting, Toronto APA meeting in 2015. And I also wrote a chapter with Mauricio, very kind. He invited me to write with him. And this was the second year of my presidency in the College of Mexicali. And at that time, one of the draws was, because I was active at the national level, that we had past presidents from the Mexican Psychiatric Association come to Mexicali, right? And this was Marco Lopez and Juan Luis Vasquez. I'm sorry. Thank you. And this is Carlos from Mexicali. Well, he's from Mazatlán, really, Carlos Burrola. And this is Antonio Magana. We were naming that meeting after him. He's one of the longest active psychiatrists in Mexicali. And then in 2015, we wrote this paper. I like to show it, not only because he was with Dilip Jesti, past president of APA, but we were testing telepsychiatry to do neuropsychological tests because there are no neuropsychologists in the rural area. And we proved that it worked, that the results were very similar because the same patient would be tested in person and would be tested again through telepsych. But we didn't know that five years later, everybody was going to be using that. At that time, we were trying to convince people to use the methodology. And next year, I became vice president of the Mexican Psychiatric Association. So for those that don't know, the Mexican Psychiatric Association divides the country in five regions. So you become like a regional vice president. So I was for my region. And at that time, I was very keen on Tarantino. I really like that picture. I just want to show it. I was in Monterrey presenting. The other day, we were talking. That's when we met. And again, I wrote a—so I became—I developed this habit that anything I could, I would write and publish it, okay? This is in a humanities journal. And I wrote about how the movies from Tarantino can help you understand violence and antisocial behavior and things like that. AASHP has given me the opportunity to meet these big people, Roberto Luis Fernandez, who's also a past president of AASHP, and Javier Escobar, and Sergio Villaseñor. He's been the president of the World Association on Social Psychiatry. He's from Guadalajara, Mexicano. And then, something—after that, Congress in Nepal, a very important thing happened in my life. And it was that this lady here became president of APA, and she says, Bernardo, I need to talk to you. So we're on the phone, and I said, yes, Maria, what do you need? You know, I'm thinking of making a change here. Now that I'll be president, I have the prerogative of naming, you know, some positions. And there's this position called—there's this council called the Council of International Psychiatry. And, you know, usually has been chaired by past presidents of the APA. But I want to put a twist to it. And I said, sure, how can I help you? Well, I want you to be the chair. And I said, what? And again, I said, if you think I can do it, I'll do it. And thank you again, Maria, because it really changed my journey to global psychiatry. It was very challenging to be with people, experts in global mental health. The council receives people from other places in the world in every meeting. They talk to us. We came out with a curriculum during my—actually, I was also very fortunate that the following presidents, two more— I stayed a total of six years. She named me for two years, but I stayed two more cycles because the other presidents decided to keep me there. And so we created a curriculum for residency programs that wanted to have a section in global mental health. It came out of our council. We also created the International Poster Presentation Program, where international presenters would come in and would be greeted by American psychiatrists. Well, very cool, very cool. So this one was one of the first presidential receptions. And I say one of the first that I would go in because on this one, I did get invited to go in. The other ones, I had just crashed them. And, you know, you get to take pictures here with professors like Renato and the rising stars that are here. Thank you. He's a Columbia graduate, right? Columbia University graduate. Yes. Okay. So the other thing that Maria did that year was to widen the research colloquium for junior investigators, which had been happening for many, many years. To have international researchers, okay? So the idea was that any program around the world could send a resident or researcher, as long as they paid their way, you know. So there were some rules to it. But one of the best things at that time was that I met these two people, Diana Clark from APA and Charles Nemeroff, that means no introduction. But I do have to say that last year, he was the one, we coincided in Mexico City for a program. And we're talking, you know, what I had been doing. And then she said, Bernardo, have you received the Simone Bolivar Award? And I said, no, come on, Charlie. I mean, you should get it. And I said, okay. It doesn't work that way. It says, I'll nominate you. So he is the one that nominated me first. And then the word spread out, it got around. And I don't know how many letters came on. I feel very fortunate because usually there is a line of people in every award. And this was the first time I got nominated and I got it. So I have to thank him for that. And of course, if you look at the website right now on the research colloquium for junior psychiatrists investigators, our pictures are still there. I don't know if you knew that, Maria, but we're still there as international contributors. And well, so we keep promoting that researchers come to that, you know, sign up and come to the colloquium. These are pictures from the work at the Council of International Psychiatry. I want to mention Michelle Riva, who was the chair right before I became chair. She taught me a lot. Oh, my God. Nancy will remember 20 people. I would get so stressed out having to run a meeting with all, you know, when you realize that everybody there is more skilled, more trained, more experienced than you. It's very tough to run those meetings. But he taught me a lot. Griff from the University of Washington, a scholar. I mean, he's top in global mental health. Sam Apaku from, well, he is in Tennessee, but he's from Africa. And Elliot Sorrell, he's a real politician. I mean, the guy knows all the rules on how to run meetings and how to make things happen, how to raise money. And he was very patient with me, too, and helpful. And then I want to show I like showing pictures of powerful women. And here's Maria with Helen Herman and Anita Everett. At that time, there were I think you were incoming president and Helen was outgoing president. And the reason I say this is because Helen, I started working with her because I was still I was already president of the Mexican Psychiatric Association in her last year. And she named me honorary member of WPA because of the work with her. I'll tell you more in a moment. This is Enrique Chavez. He's the past president of Mexican Psychiatric Association. I'm very thankful to him, too, because while I was vice president, he says, Bernardo, what do you think about having this bi-national meeting where we can do, you know, both in Mexico and the U.S.? And we tried it and it worked. It was Tijuana, San Diego. One day was in Tijuana. The other day, we all got on across the border, got on a bus, and UCSD received us to do the rest of the meeting. It was unforgettable. We haven't had another one since then. But very, very cool. This was on another term. It is in the Council of International Psychiatry now with Neda. She kept me there at the council. And I'm still a member of the council, not the chair anymore. And you can see here Juan Gallego. He's the outgoing president of ASHP. I don't know if he's still here. Oh, there you are. I invited him. I was able to invite a couple of people there. Oh, Vincenzo Di Nicola from Canada. Very, very, oh, Annette Pike, right? Summer Gat, Soul Levin. And because of that, I became a member of this program, which is of implementation. It was very cool talking about migration and the border that got me to travel several cities in the United States. And this was, okay, so 2019, here we are. Before starting an ASHP meeting, it was funny because Saul was walking by. I didn't know him that well, but I stopped him and I said, Dr. Levin, would you come and take a picture with us? And I think it was in their mind already that they had to get closer to the Hispanic society. And since then, a lot of good things have happened. Last year, Juan presented in the presidential symposium this year again. So things have happened. And in the meantime, I was president-elect of the Mexican Psychiatric Association. And we got this agreement between UCSD and Hospital San Juan de Dios. We, you know, people from San Diego came to Guadalajara, visited, signed an agreement where a resident from San Diego would come to Guadalajara for a month or two. And then a resident from Guadalajara would come to San Diego. And we began that. The pandemic hit, so we're talking about renewing it. But in 2020, I became president of the Mexican Psychiatric Association. First time that a person from a northern state would be president in that society. And only the third one, not from Mexico City. And here, this was the executive committee. Jacqueline, who already was president of the Mexican Psychiatric Association. Alejandro, who is the current president of the Mexican Psychiatric Association. And David Saucedo, who is the president-elect. Oh, my God, we had a good executive board. Well, we can run after the other. And this has been through elections, okay. So we're very excited. That was our first national council meeting. We were planning for a great two years. And then, as I said, two months later, the pandemic hit. And we rapidly had to move from all the plans we had to the first virtual congress in the history of the country. And we were this close to setting a Guinness World Record. We contacted the Guinness, the office of the Guinness Record. And we needed to, apparently, the record that they had was 1,400. And if we had 1,500 people connected at the same time during the meeting, I think it had to be like one hour or two hours, we would get the world record. We were at 1,460-something people connected. That was our best number in the whole congress. But still, it's a record in my heart. During that time, Mexico is a member of ACRA. I'll tell you what it is in a moment. Those were the meetings. It was Afzal Javed was the president at that time, Pakistani, UK psychiatrist. These countries are the members, Argentina, Australia, Canada, China, France, Germany, Italy, India, Japan, Korea, Mexico, New Zealand, Russia, UK, and the USA. So I was in those meetings because I was president of Mexico. And then I was able to brokerage or help in brokeraging a donation from APA to four countries. At that time, personal protection equipment was donated by APA. It was very nice to be part of that process. Then came the first world side congress under Afzal Javed that was going to be in person, had to be virtual. And this is another very cool experience working in something that's called Medical Student Working Group. I'm going to show you a video. Oh, perfect. I need your help here. No, I couldn't. Oh, I did it. Okay. So, oops. Okay. So, the video that I'm going to show you is part of the work that I did with the WPA Medical Student Working Group. Afzal had in his mind what can we do for medical students to be interested in psychiatry early on, okay? Hi, everybody. Welcome to Why Psychiatry. I'm Dr. Bernardo Eng, member of the Medical Student Work Group for WPA. For our president, Dr. Osel Jebat. It has been one of his priorities to promote psychiatry among medical students around the world. Dr. Javed, please tell us why this is so important to WPA. Welcome and greetings from World Psychiatric Association. This is Dr. Rafizal Javed, President WPA. We are proud of this initiative for promoting psychiatry among medical students. WPA considers this as a high priority area in our current triennium action plan. We hope this work will prove beneficial in terms of mental health and having an emphasis on preserving, supporting, and helping to fight mental health problems. So this video, I'll show you only pieces of it, but these are medical students and residents talking about why psychiatry is important, along with the members of the group, okay? More people with an emotional or mental health problem all over the world are seen by non-psychiatric physicians than psychiatrists. So, for example, this is a resident from Belarus. Having to investigate people's life stories, being immersed in them for at least some time makes you a wiser and more... Now we go with Professor Azim, the chair of our working group from Tunisia in Africa. Psychiatry is really important because mental health is a big part of our lives. If the mind is not doing well, the body will be the same. So as doctors, we tend to forget that we're not treating a disease, we're treating a human being who can have mental issues. It goes from simple stress of the concentration... Okay, enough of that. I just wanted to give you an idea of what we did, and it was during pandemic time still, but it was very cool work. So let me see where I'm at. All right. And also during the pandemic, we had the opportunity to meet this lady. Mexico was one of the most hit countries on their health personnel, and there was a lot of burnout. And we decided to leave memory of that with a documentary that I'll show you certain pieces of it. It's cool, yeah, that's cool. The idea of this documentary is for society to know how difficult it has been for our doctors, our nurses, our social workers, and the rest of the staff that has worked, that has been there in the front line, in the battlefront with our sick people. I apologize for those that don't understand Spanish, but there's going to be a section in English. The medical sector, the health sector, has experienced this pandemic in a different way than the rest of society. The emotional wear and tear has been tremendous. And apart from finding out about some sectors of our population that unfortunately still don't have an awareness that they need to take care of themselves, the number of patients continues to grow. Burnout is a syndrome that is a response to chronic job stressors in the workplace. So it's a combination really, a triumvirate of the exhaustion of stress, a negative response to the job and the people in it, and a negative response to oneself. When you get all three of those going, that's what we talk about as burnout. Nuestro personal médico merece el apoyo más que nunca. Okay, I'm going to leave it there and let you know that we're going to feature this in the World Congress of Psychiatry, okay? And hopefully we can get it open to the public later this year. Okay, so 2021 came. The pandemic was not over yet, so we had the first hybrid Congress. Everybody would show up with a mask. We were getting tested on day one and day three. We made it. The Secretary of Health, the Minister of Health in the state allowed us to only have 500 people in person. And we had like another 1,000 or so online. So it was a very successful Congress. And here is Jacqueline and I were passing over the baton where she took over as president. And then the activity kept on going. February next year, there we were with Absal Javed. These are the representatives of all Latin America for the World Psychiatric Association. Rodrigo, that I saw somewhere in the back. Yes. Telma, who has been a great, great ambassador of Latin American psychiatry to the world. And Santiago Levin, who is now the incoming president of APAL. So again, I had the chance to publish something with President Javed. And this is in the World Psychiatric Journal. Very, very cool. But in the meantime, keep doing activities in Imperial County. This was a career day for community college students to think about going into the health field. All of us there are either psychiatric nurses, nurse practitioners, therapists, and I'm the only psychiatrist. This was in 2022, our meeting, ASHP meeting. Same thing with the, there are the three presidents now, right? Absal Javed, the past president, the current president, and the president-elect of WPA. And this is another very cool picture. Why? Because Adriana was my president-elect when I was president of the Colegio de Mexicali. Rui was my president-elect when I was the president of the American Society of Hispanic Psychiatry. And Jacqueline was my president-elect when I was president of the, I love that picture. The same year, I became a lifetime fellow, distinguished lifetime fellow of the APA. Here we're talking about clinical trials. This is, this is San Badly Plaza. We're talking about a clinical trial. We're inviting the local psychiatrists to refer patients to us. This was on Jacqueline's Congress. She invited me to give a talk on a topic that I'm crazy about, which is sedentarism and how to defeat it. This was last year's ASHP with upcoming researchers. This is with Norman Sartorius. This was the international reception last year in San Francisco with Becca. She was the outgoing president and so Levin also. And this is, this continues to be, this is the medical student work group this year. APA named me mental health equity champion for my work at Imperial County. This was in Vienna, right? We're presenting about migration. This was the announcement that we're going to have the next Congress in Mexico. So don't miss it. This is APA president and WPA president. And you know, the thing when you, it's very cool because going global doesn't mean you're not going to be doing things locally, right? This is a 5K that we do locally to raise funds for CASA, which is an institution for children in the foster home system. We raise money for them. We did very good this year, $17,000. And speaking about global, this is about the best, the greatest achievements that I see in my history. This was an APA organized meeting that happened in a cruise just in February, okay? And the people that you see sitting there, check this out. Canadian Psychiatric Association. Spaniard Society in Dual Diagnosis. World Association on Dual Diagnosis. World Psychiatric Association. American Psychiatric Association. Association of Psychiatrists of Latin America. American Society of Hispanic Psychiatry. And WARMI for the Promotion of Women's Mental Health. They all sat down at the same table and signed an agreement, the Agreement of the Americas, okay? That's going to be public, made public later this year. We're in the last touches because of some legalities. So they're correcting the last letter. But this is the first time that in a meeting, Anglo-America and Latin America sat down to agree on something. Being the witness of that has been very cool. And this is our last event, the Mexican Consortium of Neuropsychopharmacology, which was our first congress in Acapulco just a week ago. We're very excited, looking forward to more and more. This is, again, I think, Thelma, we've been seeing each other on Zoom so often in the last 12 months. She's in the Organizing Committee for the World Congress. I am in the Scientific Committee for the World Congress. Working with Dr. Wasserman has been such a delight and such a great experience. And this is the last picture. Dr. Arnau already put him on his ex-account. Yesterday, we had this meeting with all the leadership of the American Psychiatric Association, the World Psychiatric Association, and for the first time, the Mexican Psychiatric Association, because we're having the World Congress November 14th through the 17th in Mexico City. Yes, you can still submit your abstracts, okay? All right, we're almost finishing here. Life's most persistent and urgent question is, what are you doing for others? I've been very lucky for the last two years. I've had international graduates and medical students come and rotate to Sand Valley Behavioral, and they've done very well. Arnau Laslanian from Monterrey, Mexico. He came in 2022, and he's a PGY-1 at Texas Tech now in El Paso, Texas. Alejandro Lam from Puebla. He's really from Sonora, but he's a graduate from Puebla. He came in 2022, and in 2024, he just got accepted for psychiatry residency at Cleveland, Ohio. Maria Alejandra Cañas from Medellin, Colombia. She got accepted to pediatric residency in Greenville, North Carolina. Melanie Rasenstein, medical student from the Borough College of Osteopathic Medicine in Las Cruces, got accepted to surgery residency. She said that she wanted to get the last taste of psychiatry before going into surgery, and she went to my clinic. Victor Samperio from Baja, California, from Mexicali. He got accepted to internal medicine. Andres Safioti from Universidad Nahua, Mexico City, got accepted to University of Miami, and Liliana Gonzalez from Bogota got accepted to Charlotte, North Carolina. So it's very cool that without being an academic center, fully clinical, people that come there find a place in American medical graduate. So, last words. Don't speak unless you can improve the silence. And I want to have a picture of Eugenio here. Eugenio, we've known each other for many years, and in 2018, I mentioned his name before I became president to come talk to Mexico. He went to Puebla, and everybody loved him. In fact, since then, he got invited in 2019, 2020, 2021. He's a regular now. We love him so much that last year he became an honorary member of the Mexican Psychiatric Association under Jacqueline's tenure. Which, by the way, very good decision, Jacqueline. Very good. And when he finished his presentation in Mexico, he finished with the same slide that he finished in the U.S., but in Spanish, right? He said, La psiquiatria nunca debería renunciar a la psicoterapia. So, you were on X. I didn't want to put your picture that I had of you. I wanted to put the picture that you went on Twitter right away by our colleague Carlos Arnau. And the message, I want to complement that message, okay, Eugenio? So, I want to tell you before I leave today, psychiatry should never give up on medicine, okay? Because I think that psychiatry is the most human of medical specialties, but the more medical of mental health professions. So, we have the task, the responsibility of keep the two going on. I want to only think of only article on science today, okay? Metabolic profile and long-term risk of depression, anxiety, and stress-related disorders. Very clear. This is on the Sweden health system. The more inflamed, the higher glucose, the higher lipids, the higher likelihood to meet criteria for anxiety, depression, or stress disorders, okay? So, this is the prevalence of obesity and severe obesity on U.S. children from 1999 to 2016. The blue bar are Hispanic or Latinos as compared to other ethnicities. Guys, it keeps growing, and it's not that different in Latin America, okay? 46% overweight, 28% obesity type 1, 11% obesity type 2, and 4% obesity type 3. It's a serious problem. And let me do my very daring proposal, clinical proposal, okay? We're very familiar with the metabolic syndrome, right? And we're very familiar with the fact that the major disorders, while they may have some predisposition to metabolic disorders, they also can develop that from the medications we prescribe. Also because they tend to be sedentary. But, this is what I'm... Please allow me, okay? This is my lecture, so... The concept of psychometabolic disorders, okay, in fact, a colleague in Mexico and I are talking about writing a paper on this concept. Why? Because before medications, those that develop metabolic symptoms, especially that gain weight rapidly. Rapidly. Because you have people who are overweight, who are metabolically healthy, that's not. The people who develop overweight or obesity rapidly, that may predispose them to develop psychiatric symptoms, okay? So, I have MDD here touching on both boxes, right? Because I think that these disorders, we should call them metabolic depression or metabolic anxiety, compared to melancholic depression or a typical depression. I think that that requires a different approach. What I mean with psychiatry, don't give up on medicine, is because I think the psychiatrists today has to do vital signs, be able to do physical exams in this office, to talk to their patients about diet, about physical exercise, order and read lab work. Let's not forget how to do that and be very familiar about how to prescribe omega-3 fatty acids, metformins and even statins, okay? I think that's what we need, especially with the Latino population. We are the voice of our Latino Hispanic patients. So, in finishing, I want to show you this picture because I'm a psychosomatic psychiatrist. This is from the, next to the Black History Museum in Washington. Nancy took that picture and said, I'm going to use it one day and I think this was it. So, grace is gratuitous and it is a gift. So, I think this is my team in Sand Valley Behavioral. I want to mention that more than half of them are high school graduates. There is no school, so we train them and groom them to be able to work with psychiatric patients. These are my children. They're all adults now. I showed them to you at the beginning. Two of them became psychologists, the other one became a biologist. My girl is going to become a therapist. Of course, I couldn't thank you enough. Nancy, this is a photo from last night with the New York skyline behind us. These last 10 years have been great and you've been my partner in crime. I'm going to close with a quote from my good friend and professor, moments like this re-establish hope in humanity. Thank you. Thank you very much for being here. Thank you. Thank you. I said that one hour and a half seemed too long to speak and then we're almost out of time. So, I guess we have a few minutes if someone wants to come to the microphone and say something. I just am really thankful that you're here. It's a Wednesday and gosh, it's great. Bernardo, congratulations. Really, you are a person that inspires. Thank you for your support when I was a president of the Mexican Psychiatry Association. To support, nosotros también nos cuidamos. Yes. We attend medical doctors or medical professionals that attend patients with COVID. Really, I am very, very happy to be your friend. Really, I'm very happy that you represent Mexico and that you help everybody. You help young people. You help your colleagues. You help your friends. Really, you are like a mother for us. Thank you very much. Thank you. Thank you for the wonderful talk. I came here originally thinking, are we going to be talking about a personality disorder? Borderline psychiatry. It's another borderline we're talking about. One area that you haven't touched upon and I'd like you to consider is that for some of us, like myself, that are retiring and we still want to be active in our role as promoting psychiatry and contributing to the psychiatric field, but no longer want to do the nine-to-five job. Maybe there should be some sort of association or invitation for the retirees because I'm looking forward to that, to be able to retire and continue working. You don't know who you're talking to, Esteban. You may regret it. I look forward to it. Thank you. Okay. Thank you. Thank you for your comment. Now, talking about like the young people here, I have to say first congratulations for the work, like more than deserved. I also like obtained your mentorship and you helped me as well some years ago and I really appreciate that. Also, like I'm very curious to know more about the two worlds that you have and how you bind them. That's so inspirational. And for many of us that, you know, are here in the U.S. but also have some ties, you know, in Latin America, what word of advice do you have for us, you know, for early career psychiatrists and trainees? You know, it's very funny that you say that because there's so many things that we have in common and some that we don't. And sometimes, Nancy lets me or helps me adapt, right? Because sometimes if I'm coming from like an American meeting to a Mexican meeting, like schedules, right? We're all different and I'm usually on time and everybody's coming later. And if I come here, sometimes I'm the one who's late. So there are very details on that, that it's a constant work. That's all I can tell you. You don't cease to get it wrong many times. So that's what I can tell you. Bernardo, I want to say that I really, I am really your fan. I'm your fan because perhaps you have heard about it's easy to, it's hard to build, but it is easy to destroy. But it is even harder to rebuild. In 2020, you received an association with bankruptcy, actually in bankruptcy, and two months, three months later, we have a pandemic. And you rebuilded it. This is fantastic. I don't know how did you did it, but you did it. With your help. With our help, but with your leadership. Thank you. And now we have a rebuilded society because of you. I am very proud of you to call me your colleague, but even more your friend. Thank you very much. Thank you very much, Alejandro. Thank you very much. Thank you. I'm Catherine Moore. I'm from San Diego County. And I have to say, I don't know that we've ever met. I don't remember. But what I do remember is both, I've been active in the medical and the psychiatric societies. And people say, well, yes, there is a psychiatrist out in, you know, Imperial Valley, and Dr. Ng, but he's just so busy. And so now I have some insight into, exactly. In fact, I'm almost exhausted. I can't imagine being able to sustain all the things that you are describing. You must have an amazing amount of energy and I'm sure support. It seems like you have a wonderful group of people around here who support you. But I just want to say I'm very impressed and to kind of always had this knowledge that you were there. And it's very nice to see kind of in the flesh and all the things you've done. I had one question. I talked about your history. So what little experience I've had in Mexico, the physicians that train in the schools have a couple of years that they pay back to the state. Is, I didn't, I was looking for that in your history. I know you were condensing. But was that a part of your history? Yes, yeah. Well, we, that happens right after you graduate from medical school. And it is one year. There's one year that we call internship, which is a rotation through the different services. And then after that you go abroad, like into the rural area or impoverished areas. Yeah. And that happened in Monterrey for me right before I moved back to Mexicali. So yeah. Thank you. Thank you for asking. Yeah. Teresa Miskeman, thank you for coming. President-elect of the American Psychiatric Association. Thank you. Gracias, gracias. Teresa Miskeman, Rivera. More of a comment than anything, Bernardo, I think that over the years, not only your energy, but your generosity has always been with me. I think that you opened the doors for me to actually become more connected with the Latin American psychiatry. We did that session, and now I'm going to go to Mexico, yay. Yes. So I'll see you guys in November. And I love that picture of the APA and everybody else, right? So how is it that we can get connected? So I guess I do have a question. As the incoming president-elect, what else can I do? I know you've talked to me a lot about some of the things, but what else can I do? What else can I then promote? La psiquiatria en no solamente Estados Unidos, sino en Latinoamérica. Y gracias. Thank you. Thank you for coming, really. I will be briefing you on the agreement that we made, so we can start from there. Juan Gallego from ASHP and from New York. Thank you, Bernardo. Many words, but I just want to be very brief. I'm your groupie. I'm not your fan. I'm your groupie. I think you're being a rock star, and I'm very familiar with what you're doing now. For me, what I found really striking was your early stages, you know, how you are so committed to the rural communities. And despite being so busy, you were able to handle all that. So I'm very impressed by that. It's very easy when people go from local to global to forget about the local. And you remain sort of passionate and you still help local communities. So I think that, for me, is a massive achievement and commitment to the people who need it the most. Yep. Thank you, Juan. Thank you. By the way, I posted we're meeting at 4 tonight. Take the address. There's a QR code. There's going to be mariachi in the tradition of the Simon Bolivar awardees. Sorry, Adriana. Go ahead. Okay. I'm not so good with this. Thanks, because I'm so emotional. But I want to speak about we met a long time ago. Many years ago. We live in the same place. And I just want to say everybody in Mexicali and Mexico, we're all so proud of you because you did a lot of things that maybe you can't even think about it. So you give us a lot of hope about a lot of different things in life and plans. And I admire a lot of things about you. But one of the most things is that you're always happy and with these positive thoughts about what is going to happen. And I thank you for being my friend and for all that example for everybody. Thank you, Adriana. Thank you for being my friend. Thank you.

Dr. Bernardo Eng

Hispanic psychiatry

Texas Tech

University of California San Diego

Sun Valley Behavioral Center

American Society for Hispanic Psychiatry

Mexican Psychiatric Association

psychiatric services

border regions

psychosomatic perspectives

cultural psychiatry

Bolivar Award

global mental health