Shoulder Surgery, and an Unrelated Arm

My recent shoulder surgery brought to my awareness the difference that a small change in perception can make in everyday activities such as “looking at your arm.”

I was all set to go to St. Joseph’s hospital, downtown, at 2 pm to check-in for my 4 pm surgery when I called my doctor to make sure that:
a) he had gotten over his death-rattling flu (at least that’s what it sounded like to me) and that
b) the 10 days straight we had of rain was not going to prevent the staff from begging off for the weekend (this being Friday morning) and forgetting about my surgery.

He answered his cell, still sounding a bit under the weather, but assured me that yes, the surgery was still on, and that I should actually get to the hospital at 12 noon instead, and that I should make sure not to eat anything after a “big breakfast.”

I agreed, while mentally making a note not to get there until 12:30pm, smelling a rat… in any case, getting there that early just was “not on” as there was a small matter of moving a sofa to my living room, a move that had been delayed by the same rains. Our empty living room was about to filled with a nice cream colored sofa, and it was to be done without getting rain, mud or bird droppings on any part of it. Hence, it had to be moved when the sun was shining… and Friday was the first such day.

The sofa was moved up two flights of stairs easily, (dislocated shoulder and all) and my wife and I arrived at the hospital at 1 pm.

At check-in, the polite and helpful person in Admission took us through the paperwork, including the question of what kind of room we wanted, only to find out that there actually were no rooms available. There would be one private room available when someone else checked out, but that was it. She encouraged us to go upstairs anyway. The upstairs nurse would find a place for me, she assured us, although when we overheard her asking the upstairs nurse “where yuh goin’ res’ dem den?” it did give us an opportunity to laugh out loud. She looked quite embarrassed when she woke up and realized that we were sitting right in front of her. A quick apology has us all laughing...

Upstairs, we sat in the waiting area, and promptly fell asleep, in spite of a little anxiety that I feel whenever I walk into a hospital, and recall some terrible happenings seen on some episode of ER – like the one where “the resident screwed up and the guy died,” which seems to happen every week with a different twist.

At around 3:30, just as we were getting antsy, she told us that the room was ready. I jokingly said to her “we should just go straight to the operation and forget about the room!” I was about to be very glad that she didn’t take me on.

As I walked into the room and sat on the bed, I wondered what a room in the US would look like. This one was clean, and had a television and an adjustable bed – which was what I would expect for J$5000 per day (about US$85.) The paint was a little “chippy-chippy” here and there. There was no remote for the television in sight. Toilet paper and towels were not to be found (probably appropriated by prior residents many years ago, never to be replaced.) On the other hand, there were no roaches, and not too many mosquitoes coming through the open doors and windows.

At this point, it was one of the nice, warm Jamaican afternoons that migrants from Jamaica in Toronto and New York dream about. There was a big tree outside with spreading branches, and a neighborhood sound system was just warming up for a night of “boom-boom” music as my grandmother used to say.

By now, I had had my temperature, blood pressure and weight taken. To my untrained eyes, the equipment seemed fairly modern, although I did notice them sharing the equipment between quite a few nurses.

I settled into my room, and awaited the arrival of my parents, who I began to guess were going to arrive before the surgery started – as it was now 4:30. They came just in time for my “gowning” ceremony. I knew to expect that they had some little hospital gown with my name on it, replete with wide open spaces in the back for the butt to stick out of.

Sure enough, the nurse arrived with a nice blue cap and a pink gown with flowers. “Pink?” I said in dismay. “That’s all we have left …” she said in sympathy.

My wife, mother and father had a good laugh when I came out of the bathroom, and took pictures. That was definitely the low point.

One came 5pm, 6pm, 7pm, 8pm … and the official story from the kind but uninformed nurses was that they didn’t know what time it would be, but it would definitely happen that night.

My parents left to have dinner and came back with something for my wife to eat. I, by now was raving with hunger, having had nothing from 9am that morning. I snuck a couple of peanuts into my mouth, savoring the nice roasted, salted taste. I even imagined that they helped a little.

By now, my Jamaican ingenuity had solved the problem of not having a remote for the TV. I remembered that on top of every cable box were buttons, and I was able to find these while standing on a chair and reaching to the box, above the TV and change the channels to something decent (carefully avoiding programs like ER.) Of course, there was nothing good on. And my anxiety was still ebbing and flowing at the thought of all the interesting things that had gone wrong in my television-based memory – “Oh, no … CODE BLUE…. Get the crash cart… CLEAR….. KA-THUMP…. huge body convulsion… beep….. beep…. beep.”

9pm. 10pm. 11pm. At that point I had had enough, and I yanked on my jeans and shoes and walked out in my pink “nightie” to find out what the deal was.

The nurses once again affirmed that it would definitely be tonight, and that the doctor had operated all last night until about 8am that same morning. Wow.

But not to worry, they said, let’s call and find out what time your surgery will be. One of the nurses called down to the operating room and got him on the phone. She asked him a few questions, and then asked him if he’d like to speak with me.

He did, and was quite apologetic at the long wait, but things had gotten moved around when some frozen, human tendons had come in from Miami and two people needed them put in their knees before they went bad.

By now, I was feeling a little bad that I was so impatient, when there were human tendons thawing out before they allowed some poor wretch to walk again after years of confinement to their beds. Who was I to stand in the way of their surgical miracle just because I could not wait through a few reruns and I couldn’t forget all those episodes when Dr. Carter, the erstwhile resident, was chastised for intubating when he should have been doing something else.…?

I slunk back into my room with a sheepish smile for my family and told them about the tendons. I should be going down at 12:00 midnight I said.

After I sent my parents home (they were asleep, drooling on the furniture) I settled into the single hospital bed with my wife. The nurse came in and gave us a suspicious look and asked us if we’d like another bed … like a cot in that room… a SINGLE cot for my wife. I guess the sight of me curled up half-naked beside her prompted that…

Another bed came in, my wife settled into it, and we fell asleep.

At 1:30 the phone rang, no-one was there and an orderly came in to wheel me to the operating room. I gave the wife a last longing look and lay down for the ride, half-asleep.

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We went down the hall past the nurse’s station, and into an elevator. The orderly said nothing. The nurse was watching me carefully (lest I bolt, I’m sure.)

I was rolled into the corridor outside the operating theater, so called because… I have no idea. I could feel my naked butt against the sheet. It’s a good thing I had the presence of mind to…

“Hello Mr. Wade” came a nice warm and female voice, I’m nurse (Smith was it?)” A black, plump middle-aged woman looking like everyone’s grandmother smiled at me and that sure did help the jitters. I couldn’t remember her from ER (thank God I didn’t get Abby, who is a ditz and had that bad affair with those several guys over several seasons.)

The nurse engaged me in some small talk, before another warm, but younger, female voice introduced a cute face behind glasses, surrounded by hospital scrubs. She introduced herself as my anesthesiologist. At this point I knew… it was better to be in a not so modern hospital in Jamaica among friendly, familiar voices and people, than to be on ER. Or in one of those cold American, hospital factories I’ve believed that US hospitals have become.

We did the Jamaican dance – what school did you go to, and do you know so and so. Of course, we had some friends in common, and we chatted on, until she started explaining about how in a minute “I wasn’t going to like her” when she gave me an injection in the neck to deaden my arm and shoulder.

She further went on to explain that they were probably only going to give me a local.

That sounded… interesting… as I knew they were going to drill a small hole in my clavicle. And they were going to use a piece of nylon to connect my shoulder bone to that clavicle. It sounded like a combination of watching a carpenter work, and being at the dentist.

Oh shit.

After getting one injection to get an IV in, I laid for an hour while an entire gallon of saline solution mixed with an antibiotic dripped slowly into my bloodstream. I’m not sure where it all went… I promised myself to drink more water from now on.

Then the cute-ish anesthesiologist injected my neck, directly into something sounding like the Brachial Nerve.

That hurt a bit, and then the tingling she had promised started with a huge twitch in my left arm, akin to a muscle spasm, but not quite. She stuck the needle in and while I couldn’t see what she was doing, I could feel different parts of my arm responding with some strange sensations. She asked me “where did you feel that” at each point and I told her. She said that she needed to make sure that my arm was totally dead before the doctor started the surgery, and that I would need to let her know if I could feel anything.

I promised her.

Remember the story about the guy who had his leg amputated while he was wide awake, and they thought he couldn’t feel anything, but he felt everything, but couldn’t respond because he couldn’t move his body? I think it was on ER… That was the thought I was having.

Anyways, she kept on playing this game, and a growing sensation started creeping down my arm, until my fingers stopped obeying my mental commands to move them. She remarked, in response to my request to make a fist, “Ah ketch him now!”

And then I was left for some time to my own thoughts, while they went around the back, probably to stage right of the theater, to sharpen the drill bits they were going to use, and to prepare the Ajax to clean up the big mess they were obviously about to create… and that nurse Smith would have to clean up just because you children are always making a mess around here, and you needed a good spanking, etc. etc.

I realized that this was all nonsense, of course, and decided to use some of my meditation techniques, honed from 15 or so years of on and off practice (OK, more off than on.) I tried several before realizing that these techniques, developed over thousands of years in the Far East, did not come close to being able to deal with “the time in ER when the guy came in and they operated on the wrong part of his anatomy.”

In the background, I could hear some sounds (which I, of course, strained to hear more clearly.) I could hear a doctor or nurse saying “Mrs. Brown, I need you to move your leg a little to the left.” In response I could hear a grunt… followed by a “Good… now move your other leg six inches to the right.”

For all I know, they could have been doing a manicure (at 4am in the morning.) Or childbirth… or like the time on ER when the insane guy who thought he was pregnant found out that….”Mr. Wade? It’s time for us to go in.”

My heart skipped a beat as we entered … the operating theater.

It looked like a clean, better-lit, ganja-less version of my mechanic’s garage.

I saw one of the doctors/nurses/mechanics swabbing the floor with what I swore was Ajax. Yuk. I looked around for the drill.

They swapped me over to the operating table. Me and my dead arm… that felt like a knapsack.

I looked up into what looked like a dental light.. except that there were twenty bulbs instead of two.

I lay there while they did some “critically important things” like change the music playing in the background and talk about this other guy who they had operated on the week before that I kinda looked like.

I felt like I was too close to one side of the very, very narrow table and I moved over just an inch to get better placed.

I looked around then over to my left… HEY… wasn’t that my arm dangling off the edge of the table? My dead arm?

It was eerie. I recognized the arm as mine, with the same hair and shape I recalled from quite a few baths and laps in the pool. But it was like looking at another person’s arm, not my own.

Well, not wanting to have my arm dangling untidily off the table (who knows what else it might decide to do on its own, especially with that cute-ish anesthesiologist walking around, and having responsibility for a needle in my neck.) I reached over with the good arm and picked up the dead one and laid it carefully down beside me on the table. That was close….

Finally, the doctor came in and started shaving my shoulder. At least, I think that’s what he was doing, as I could only hear some scraping sounds. I don’t think he used any shaving lotion, which probably violates some health code someplace. I thought to myself… I think that’s gonna hurt when I can move this arm of mine again.

Then came a cautionary voice. My anesthesiologist casually mentioned that she thought the blood pressure monitor was mis-calibrated, as the person before me also showed a spike in blood pressure.

Now, the little medicine I know tells me that one’s blood pressure goes up under stress.

I wonder now if my medical team was not starting to think that I was being a wuss.

My evidence of the truth of that thought was the announcement a few minutes later that were going to do the operation after putting me under a general anesthesia, or in technical terms “asleep.”

A few short words later and the next thing I knew I was waking up in my room asking my wife for something eat. I ate some soup. She claims that I ate my mother-made cheese sandwich. I still ask her what happened to it, thinking that she’ll confess to sneaking off with it.

I glimpsed my father at some point, in cycling clothes.

I slept, dozed and babbled from about 6:30 until about 12:00, and demanded to know the whereabouts of that cheese sandwich.

My arm gradually regained it’s feeling, thankfully, starting with the fingertips. I’ve never been so happy to have my arm attached to my body. I’ll never again utter the line “I’d give my left arm for that.” That is, unless it’s for something really cool.

So I was happy to see my hand’s feeling coming back and start to show my wife and mother that I could indeed move my hand again, quite proudly. That is, until the pain started in my shoulder. It was a dull, deep aching pain that would not go away, regardless of how I squirmed and shifted in the bed. I tried adjusting the bed using the electrical controls, lifting up the back and then lowering it, lifting up the feet, and then lowering them.

But nothing made a difference, so I asked my wife to run and get the nurse. She returned with yet another injection, and asked me where I would prefer to get the “jook,” in the thigh or in the butt. I asked her which one would work faster, and she said confirmed that, of course, that would be the butt.

I offered my butt for her immediate consideration – and I vigorously denied my wife’s assertion that it had anything to do with her age and/or physical beauty (I heard her muttering something about “dese young t’ings” and my alleged interest in being the centre of attention.)

Anyways, notwithstanding the trauma of the injection was well worth the pain relief and slightly euphoric effect that came quickly.

Lunch came, I changed from my surgical garb into street clothes and it was finally time to go.

24 hours later, the deed was done and my shoulder injury was corrected (I believe.)

I went home and sat down with my laptop for the next 10 hours or so, getting up only to use the bathroom.

And am I glad I have a left arm.

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Entering Politics

I just heard the news that Rosa Parks has passed away.

While she was an activist, and not a politician, it reminded me of my commitment to enter active politics. The problem is, at the moment I'm not able to create a point of entry I'm happy with.

As I mean this to be a shorter blog intended to get the mental ball rolling in a particular direction, I'll keep this short.

Rosa Parks actions turned out to be the catalyst of a tremendous sequence of historic changes -- much more than she had ever planned. Many others had "refused to sit at the back of the bus" but it was her action that unexpectedly created a snowstorm of other activity, that helped catalyse the US Civil Rights Movement.

I also want to create a snowstorm.

And I want to do so in a place that brings up almost a universal sense of revulsion among Jamaicans -- local politics. Just letting people know my intentions has been enough to bring up strong feelings of anger and hostility in some.

Beyond that anger, however, is a deeper commitment that just about every Jamaican has, which is to be lead by people whom they respect and who respect them, and want the same things that most of us all want.

It's that simple.

Sometimes.

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Kidnap Leader Captured in Trinidad

The following article appeared in the Trinidad Guardian this morning, and seems to reinforce the point I was making in the blog entry on Crime in the Caribbean. While this is good news, notice the emphasis at the end on "weeding out criminals."

In other words, there is the idea built in that in a nice garden of normal people, there is one aberrant person, and if only that person or small group of persons were to be weeded out, then things would return to the way we want them to be.

Here in Jamaica, the same logic prevails, as commentators and politicians talk over and over again about the 100 to 500 or so criminals that are creating 90% of the trouble, and if only we could "eradicate" then things would be the way we want them to be. Operation Kingfish in Jamaica, currently underway, is built on this premise.

To me, this is superficial and wishful thinking. In fact, the latest upsurge of crime in Jamaica is being blamed on the success of Operation Kingfish -- it is said that the success in arresting the drug gang leaders has led to a vacuum, into which smaller more desperate criminals have stepped in order to protect / extort / terrorize the communities they have left behind.

In other words, the conditions that created the problem have not changed, only a handful of players. Trinidadians seems to be making the same mistake we in Jamaica have made, in thinking that stopping kidnappings rests on aressting the few leaders.

I hope it works, but I suspect that it will take more than that. My earlier blog talks about the need to take personal responsibility, and I believe that that must happen to create an environment that is different from the one we currently have that breeds criminality. Here is the article from 10/24/05:

KIDNAP GANG LEADER HELD
BY DENYSE RENNE

Two men, one of whom is a former member of the Jamaat al Muslimeen, remain in police custody, after they were held during early-morning raids yesterday morning.

Investigators have described the arrest of one of them, a 39-year-old former Jamaat member, as a major breakthrough in several Central kidnappings.

Police say the man holds key information into many Central kidnappings and also the location of kidnap victims still being held.

The man was arrested at around 2 am at his Longdenville, Chaguanas, home, after a search warrant was executed.

Investigators said the man had been charged in the past for kidnappings, and had also been linked to several murders and other criminal activities.

A 36-year-old man, of Four Roads, Diego Martin, was also arrested in Enterprise in connection with several kidnappings.

Investigators said the men were among 50 people held by a contingent of police and soldiers, as they swooped down on areas in Enterprise, Longdenville and Cunupia late Saturday night into early yesterday.

The dragnet started at 10 pm on Saturday and ended at 5.50 am yesterday and came about as officers intensified their search for three Chaguanas kidnap victims. (See Page 7)

The joint effort was led by officers from the Chaguanas, Southern and Port-of-Spain CID, Organised Crime Narcotics and Firearm Bureau, Inter-Agency Task Force and the Defence Force.

The exercise was headed by Supt Rattan Singh and Lt Frank Metivier, while field operations were co-ordinated by Insp Stephen Ramsubhag, Sgt Danny Ramlogan and Cpls Terrance Williams, Terrel Figaro and Mitchell Mohan.

In all, some 200 law enforcement officers, 50 of whom were from the Defence Force, were involved in the raids.

Three men, ages 19, 21 and 23, all from Enterprise, were arrested in connection with the kidnaping of businesswoman Tessa Ramdath-Maraj, 26, who was abducted on October 18 outside her parents’ Valsayn businessplace.

A 32-year-old Seymour Village, Laventille, man was also arrested in connection with murder which took place a year ago.

Twenty-four people were also arrested on outstanding warrants, for crimes ranging from rape, robbery, possession of arms and ammunition, trafficking of cocaine and marijuana to housebreaking.

Following the exercise, 13 people were charged and will appear before a Chaguanas magistrate today.

Among them was a 42-year-old Chaguanas businessman and his 36-year-old wife, who were arrested at their Caroni Savannah, Chaguanas, home, following the execution of a search warrant.

While searching the house, officers allegedly found a .22 revolver and ten rounds of ammunition. The couple was later charged for possession of arms and ammunition.

Senior officers have hailed the exercise as a success and have vowed to continue such exercises in an attempt to weed out criminals in the Central Division.

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More Healthcare

I'm at home today, recovering from shoulder surgery (and about to jump on a plane to Barbados.)

There is all good news, fortunately.

The surgery was successful, and I am only experiencing a bit of pain now and again -- mostly due to some useful drugs that I'm taking.

While the waiting period to start the surgery was quite long (from 4pm to 4am,) my family and the staff allowed the time to pass quickly. In particular, my wife was a real sport, and I have a new found appreciation for her caring and loving nature. She has a real commitment to the welfare of others, and I feel positively stingy at times because she is so generous. Once again, I felt lucky to have her in my life, but I felt it quite powerfully yesterday as she lobbied to spend the night with me at the hospital (and was willing to sleep the night in a chair to do so.)

My parents were also real troopers, and were falling asleep in their chairs at 11:00pm when I told them to "please go home!"

The staff at St. Joseph's were... so very _human_ at each step of the way... in the best sense of the word. In my few dealings with the healthcare systems in the U.S. I never felt that way so clearly.

So... the body is sore, but the mind and soul came out stronger for the experience.

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Incidentally, that's not my shoulder in the picture above, but it gives a good idea of what my own X-ray looked like with the clavicle floating above the acromion or "shoulder bone".)



For the medically inclined, my shoulder had a Type 3 separation, shown at left. Both ligaments were severed, and replaced with artificial binding.

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More on the Sources of Crime in the Caribbean

In this blog I posted an earlier entry on the Sources of Crime in Jamaica. When working recently on a blog on first-person responsibility, I realized that I made a conceptual jump that put me very quickly, perhaps too quickly, into the realm of possible solutions.

I thought I'd try to illuminate some more of the issue in this blog.

I've travelled to work in a few countries in the Caribbean, and I read the Trinidadian or Barbadian papers daily.

In Trinidad in particular, a recent but steady rise in crime has Trinis asking themselves "what happened?" Listening to them complain is much like listening to us Jamaicans 20 years ago, and it's a little like looking at ourselves in the mirror. In a way, it's easier to think about what they should do differently because it's just easier to think about what someone else should in general. I'll use the Trini situation as a case study for the rest of us in the Caribbean.

It's interesting to hear the variety of responses from people, and the different levels of responsibility that they are willing to take.

As I mentioned before, Trinis are engaged themselves "What happened to get us to this place, and what is to be done to get us out of it?"

I happen to be writing this blog a couple of days after the fourth monthly bombing in Port of Spain (October) and two weeks after an acquaintance of mine was kidnapped and beheaded.

Here are the types of responses I've noticed.

1. The Avoiders
"Those criminals need to be strung up."
"There are only a few bad eggs, and once they are weeded out, things will return to normal."
"I'm leaving this country and the mess it's in."
"The government / politicians / police / army / church / Blacks / Indians / Creoles / Syrians /youth / drugs / deportees are to blame."

The common theme is that of a complete lack of ownership.

2. The Shared and Mythical ''We''
"We are all to blame''
"We must find something to do about this"
''The problem is within our society"
"The culture is at fault"
''We are too...(something) ................. as Trinis''

The common theme is a lack of individual responsibility

3. Personal Responsibility
"What can I do?"
"What am I missing / What am I not seeing?"
"How did I let this happen?''

This last set of questions are being asked by the very few. They are the ones that are able to look at the situation without any sense of blame, but with a full sense of ownership. They are able to engage themselves and others in an urgent and creative search for deep and empowering answers.

Outsiders
As an outsider, it's obvious to me that the current situation (with its random bombings and pre-planned kidnappings) has been caused ..... by Trini's. Something is happening (or not happening)in the following places (among others) that is producing this particular criminal phenomena:
-- families
-- churches
-- schools
-- sports
-- security forces
-- political organizations
etc.

Alternately, one may also say that something did not happen in these institutions in order to allow these things to happen.

By comparison, some things both did and did not happen in Jamaica and Barbados such that kidnappings, for example, have not happened.

Accordingly, something happened, and something did not happen, to allow murders to increase the way they have in Jamaica, which now has a murder rate that is one of the world's highest.

The interesting point here is that only those persons in the third zone -- that of personal responsibility -- will be able to create empowering avenues for action that make a difference. Only they will be able to discover the profound and poorly understood reasons why there are kidnappings and bombings.

They will also be the ones most likely to create programs that will impact society positively and turn these problems into opportunities for decisive action.

Another way of saying this is to say that they are the brave, the strong and the few who are willing to plumb the deep and dark corners of their own souls for answers. They assume that they have the power to create solutions.

The real irony here is that the assumption of "problem-solving" power carries with it a necessary flip-side. The flip-side is that it carries with it the assumption of ''problem-creating." The power of one must imply the power of the other.

Yet, we Caribbean people (among others) operate without this awareness, and give up most of our power to make a difference. The result is that we sound shrill, much like our politicians who try to solve problems by blaming others while avoiding responsibility.

No wonder our most pressing problems remain unsolved.

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Migrating to America

Now that I'm home, and really feel like I'm home for the first time in 21 years, my mind has been floating to exploring the reasons why we Jamaicans, including myself, migrate in the first place. What is it that takes us away from home, and more often than not to some place that's colder, nowhere near as pretty, socially hostile (or at least indifferent) and very, very far away from those that we love?

I think this is going to warrant a few blogs at least so I'm going to consider this blog a bit of a throwaway, or in other words a way of getting the first few thoughts out of my head and into words, in the hope that some deeper insights will follow at some point (funny how that works...)

In a poll conducted a few years ago, over 80% of Jamaicans said that they would be willing to migrate to the US if given the chance.

Well, in talking to theseJamaicans, it's clear to me that they (estimated to be some 80%+ of the country's citizens) have absolutely no clue as to what they really want. In other words, they have no idea what the USA, Canada and England have to offer and hold a seriously distorted view of the countries they aspire to live in.

This ignorance is probably not resolved for most, until after the green card has been issued, and the move has been executed. I think it takes a couple of years for the emigree to realize what they have really gotten themselves into. At that point, they join the ranks of fellow Jamaicans who continue to paint an overly rosy picture of their new home country.

What does it mean to migrate?

This is one of those moments when I wish I were a poet, because the end point of a migration and a few years of acclimatization is probably best expressed in the form of a poem or picture that evokes a feeling of the space that one finds oneself in.

From this moment forward, I'm going to focus on migrants to America, but I believe that the same principles apply to all 3 major destination countries.

Choosing to become Black, White or Fringe

After about the third or so year, a Jamaican emigree makes a subconscious choice to join one of the subgroups that people must join if they are of African descent, or at least coloured. They "become" either Black American, White Mainstream, or remain on the Fringe as an ethnic group member.

White Mainstream
The smallest subgroup is that of White Mainstream.

Jamaicans comprise a variety of races, including Black, white / European, (East) Indian, Chinese, Lebanese (Syrian,) Jewish and others. Jamaicans who are not Black normally enter the White Mainstream subgroup. So do some Black Jamaicans, as this subgroup is not defined by race as much as it is defined as mindset. Jamaicans who join the White Mainstream subgroup are often those who are generally professionals, who tend to be better educated.

These Jamaicans are marked by the White Mainstream accents that they possess, and sometimes by an unwillingness to put forward their Jamaican-ness unless directly asked (usually by another Jamaican.) Their children, depending on their complexion, become a part of White society, and quickly lose any contact they once had to Jamaica. They maintain minimum contact with other Jamaicans in the US, and do not join in the activities or clubs of other Jamaicans, as they have effectively put that world behind them.

Black American Jamaicans
As can be expected, most Jamaicans become Black American. They affect the accents, tastes, values and social/cultural habits of this subgroup, even though they might maintain their Jamaican-ness as long as they can. The majority of Black Jamaicans join this group, as it is the easiest to join, even though there are significant cultural differences between the two cultural groups.

Most Jamaicans eventually affect Black American accents, and by the following generation the link between the person and their Jamaican-ness becomes increasingly tenuous, until it eventually disappears altogether for practical purposes.

The Fringe
The Fringe Jamaican consigns himself or herself to the ethnic edges of society. They may never lose their pronounced Jamaican accent. They may never apply for US citizenship, and therefore not vote in their adopted countries. They may still bea eating ackee and and saltfish, green banana or rundown every day for breakfast.

They would surround themselves with other Jamaicans, and only become as American as they needed to, in order to get by in their jobs. Their attention would be focusedon what's happening in Jamaica, and know the latest news on politics, sports and the weather. They, of course, would be planning to be in the US only temporarily, and never feel that they "belong."

A Jamaican who migrates is faced with a choice as to which group to ally themselves with, or to join -- and join they must.

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