Reverend Horton Heat and…

Sheltering from the rain where the tram meets the train it occurs to me I’m at a hub, the locus of the hurrying many. A good spot to promote your goods or your services or your gig. At my feet, on a patch of dry asphalt, a sort of yellow mound takes my eye. The mound turns out to be a pile of magazines, the strong yellow blazoned with bold script in magenta. It’s intended to catch the commuter’s eye.
 

When it comes to reading material I am my mother’s son. The printed word always lured Mum from the world of people and food and things: if it was legible Mum would leg it.

Me too. This was readable material so I read. I read CHOPPED. None the wiser I peered at the words in a smaller font. These are the words I read:

 

REVEREND HORTON HEAT

 

THE MEANIES

 

Hmmm. I guessed these were musical groups, bands, we used to call them. There was more:

 

Guantanamo Baywatch. Clever. I liked it.

 

Puta Madre Bros. Rude, naughty. I liked it.

 

Drunk Mums. Why not? 

 

The Cherry Dolls. Chris Russell’s chicken Walk. Ho hum.

 

The Pinheads. If you have that originality you aren’t one.

 

West Thebarton Brothel Party. I recalled the two occasions I went window shopping in a brothel. That was Hong Kong, not Thebarton West.

 

The Shabbab. Shepparton Airplane. There’s a ring to these.

 

La Mancha Negra. What can that mean? Probably nothing. Word stuck, word-drunk, I always want to decode the metaphor. A mistake: listen to the music.

 

The Reprobettes. Pretty literate. A snob, I am mildly surprised.

 

Flour. Hmmm.

 

Amyl and the Sniffers. Naughty again, very naughty. I am enjoying my morning’s reading. 

 

Racing on (I hear my tram approaching) – Slim Customers. King Puppy & the Carnivore. Thee Cha Chas. Was that three or thee? The eye wants to see what it wants.

 

Tape Wolves. Red Brigade. Do the members of this group know much about the Red Brigades?

 

Itchy Scabs. I love it.

 

The team pulls up as I read: Double Yad. Golly. I feel no doubt at all the namegiver intends this name. Understands the acronymic coupling of the Hebrew letter yad. Knows it to be the abbreviated form of the Ineffable Name.

 

My God!

 

 

The Wrong Doctor

 A lady older than I – all the patients seem older than I am – enters my consulting room. Tall, broad in her build, her face is oblong. If she were a horse she’d be a Clydesdale. A voice rattles and grates from the lady’s throat, the voice of a thousand cigarettes: ‘What’s your name, son?’

I tell her.

‘And you’re Frank’s locum?’

I confess I am.

‘Right. This is what I need.’ The lady pushes a scrap of paper across my desk.

I read her list: Valium, Nembudeine, Mogadon.

Diffidently I wonder aloud, ‘What conditions do you take these for?’

The lady – was her name Gloria? – it was so long ago – the lady looks at me in mild disbelief. Is the doctor a bit simple?

‘For pain of course. And nerves. And to sleep.’

I commence writing out her prescriptions. In 1970 we wrote our scripts longhand. Valium for her nerves, nembudeine, a handy concoction of narcotic and barbiturate, mogadon, another benzo.

A doctor stirs within me: ‘I should point out the risk of becoming dependent on these medications.’

‘Rubbish! You think Frank doesn’t know what he’s doing? He knows I’m not the addictive type.’

Subdued by the confidence of my neighsaying patient, I resume writing.

‘I need a smoke. Want to join me?’

The doctor within feels more secure on this ground. ‘No thanks. Smoking isn’t all that good for your health.’

‘Rubbish! A few fags can’t hurt. Frank smokes.’

‘Well, I’m not Frank’s doctor. But no-one smokes in here.’

‘Rubbish!’ The lady reaches across the desk, her broad arm brushes me as she removes the lid from a small ceramic jar, revealing a dozen or so cigarettes all standing to attention. She takes one, flips it expertly between her lips, sucking back a denture that ventured a peek at the world outside. ‘Got a light, or do I have to use Frank’s?’

 

The locum is always the wrong doctor. Gloria expected to see Frank and, doubtless, to subdue him at his point of weakness, his fondness for the occasional fag. This very young locum is composed almost entirely of weaknesses, but smoking is not one of them. He is decidedly the wrong doctor: ‘I’m afraid no-one smokes in here with me.’

‘What do you mean?’

‘I mean no-one smokes in this room while I am in it.’

Gloria gives me hard look: ‘It’s not your practice!’

‘That’s true. But you must excuse me if I step outside while you light up.’

Glowering, Gloria snatches her script and takes her leave.

 

Later, Frank chuckles: ‘Gloria always tries that out on me too. I always say no. Glad you did as well.’

 

image: envisioningtheamericandream.com

Last Coffee at the Prairie Hotel

 

It will be centuries/before many men are truly at home in this country,/and yet, there have always been some, in each generation/there have always been some who could live in the presence of silence.*

 

Have you ever visited Parachilna? Situated in the remote north end of the Flinders Ranges in the South Australian outback, this town is reckoned to have a population of six souls. The principal edifice in the town is the Prairie Hotel. If you visit this pub, as I have, repeatedly over the past two decades, you will count many more bodies than the half dozen you might expect. We come in all our different ages and stages to Parachilna and we stop at the Prairie Hotel. We come – grey nomads and graziers and gourmands – we come in our large SUV’s, our battered utes, our private planes. We arrive for the famous food, the haunting landscape, the novelty, the romance!

 

Though I myself run to the cities. I will forever/be coming back here to walk…up and away from this metropolitan century…*

 

I come for the coffee and the company. Around Christmas time, with summer blazing in the Flinders, the nomads have fled back south, tourism has withered and the hills stare back at the bleaching sun. The world lies silent, listening to its aeons. The Prairie Hotel is old, its walls of stone thick, holding the heat at bay. In this heat and desolation eccentrics and locals gather in the cool of the bar of the pub.

 

 

And some, I have known them, men with gentle broad hands,/ who would die if removed from these unpeopled places…*

 

At this time of the year Christian doctors have joined their loved ones in the moist green down south, leaving in their place a locum, old, wearing his Jewish hat. In that sense I am both eccentric and a local. 

 

Though I go to the cities, turning my back on these hills/…for the sake of belonging…/the city will never quite hold me. I will be always/coming back here…to see, on far-off ridges,/ the sky between the trees, and…to hear the echo and the silence.*

 

I mentioned the coffee. If you hate coffee most places in the Flinders Ranges will reinforce your hatred. But if you revere the sacred bean, come drink at The Prairie Hotel. There, Lachlan Fargher presides over a serious espresso machine. There I drop in year upon year, unannounced. Lachie looks up, says, ‘Hello Howard. Strong latte, extra hot?’ I nod, Lachie bends his handsome head in concentration and soon I sip that elixir that brings me on a drive of sixty-seven kilometres (each way) every lunchtime of my fortnight locum. (Excepting Shabbat. I sure as shit don’t drive on Shabbat.) Others come to drink the eponymous Fargher Lager, others to eat the famed Feral Grill, a collation of native viands, not – I regret – kosher.

 ‘To everything under the sun there is a season…’ All ends, everything passes. That’s what nostalgia is for. The North Flinders is a treasure house for the nostalgist; in Brachina Gorge, see geological striations in great walls of rock telling their mute tale of aeons unimagined; in Arkaroola, note and lament the passing of the ediacaran, whose fossils mark the first life on earth to have nerve cells organised to process sensation; and note the lonely stone walls – unroofed but still erect in their noble proportions – of dwellings abandoned by pioneers whose hearts cracked in the long droughts.

 

Add to this is my own lament. With the passing of the unlamented, lamentably polluting coal resource in Leigh Creek, the mine has closed. Soon the Clinic that served the mine will close too. In future summers the North Flinders will not summon its Jewish locum.

 

Driving south yesterday, at the conclusion of a medical estivation in Leigh Creek, I stopped at the Prairie Hotel. Lachlan Fargher looked up: ‘Hello Howard. Strong latte, extra hot?’ I looked at the Aboriginal paintings in the Dining Room that is really a gallery of fine art. I took in the old timbers, the scarlet collection tin for The Royal Flying Doctor Service. I took in Jane Fargher, Licensee, the brain and spine of a brave enterprise. I looked at Lachie, his black curls bent over his machine; at Avalon, springtime’s barperson. Tomorrow, or tomorrow’s tomorrow, the former will brew Aussie coffee in Nashville Tennessee and the latter will practise criminal law. I drank my latte, said goodbye and drove away.

 

 

 

• Fragments of ‘Noonday Axeman’, by Les Murray

 

More Unnatural Medicine 

Following my recent blog post titled ‘Unnatural Medicine’ one correspondent bothered to respond thoughtfully and at considerable length. As you will see from the passage below (excerpted from his comments) he writes insightfully and with strong feeling. I quite understand that intensity; health is both a personal and a universal concern. Further, at the head of its hierarchy and ruling our fate, standing over us, exciting our awe and our resentment, are the doctors.

 …On the other hand we see leaders in western medical practice dismiss Chinese medicine, for example, as quackery and voodoo medicine. Despite clinical trials clearly demonstrating the effectiveness of acupuncture, for example, many Scientists declare that there are no such thing as “meridians” in the human body as their existence has not been clinically demonstrated. The hypothesis is dismissed despite evidence gained from the applied testing that they do. Further, many assert that all forms of Chinese medicine, sometimes including acupuncture, should not be considered “real” medicine. (This includes senior doctors advising government and insurers.) Yet this practice has 4,000 years of accumulated clinical practice, is taught in major teaching hospitals in China and practiced daily by doctors in conjunction with “modern” western practice. Numerous clinical trials of diagnostics, treatments and herbal concoctions have been conducted, which are generally dismissed in the west, often merely because they are not available in English. When they are available, the results are howled down because there is no critical mass of such research available. Yet the Chinese pharmacopeia is yielding impressive results in western labs in the treatment of everything from common infections to malaria and cancer. Why is there such resistance to the science of Chinese medicine?
With the social and economic power of the western pharmaceutical industry we continue to see western medicine practised with an emphasis on the provision of drugs as first recourse in treatment. So pervasive is this that you have written about patients who want the prescription of a drug, any drug, rather than wanting to hear a more complex story of how to achieve health and of some doctors who support this approach. We have a culture of “science” where alternatives can often be dismissed and
where pharmaceuticals are pushed to the frontline of treating almost any and every condition. Incidentally, my father peddled Debendox – among many other drugs- to doctors in the 1960s and ’70s for the treatment of morning sickness and later associated with birth defects. It was given to me as a treatment for travel sickness. Hard science and its practice makes mistakes.
Please forgive my self indulgence in presenting my rant, Howard. I know your musings are often light-hearted and exploratory of deeper things. But I guess my point is this: there is an ideological
spectrum in medical practice, which can be said to range from “natural” to “unnatural”. There is medical practice that works with the “natural” processes of the human, which includes an understanding of diet, exercise, psychology, history, social conditions, the environment, etc all having their effects, good and bad, on human lives. In common parlance “natural” usually refers to seeing patients as people first, human beings subject to and part of nature in never-ending cycle of birth, life, death, repeat (depending on your belief). My experience of your practice puts you in this camp. Do as little harm as possible, be cautious, be curious, respect the person, do not jump to conclusions or easy answers, respect the life process. Sometimes trauma means offering treatment (or not) that may cause damage or harm. A difficult choice.
There is also practice that does not respect the human, does not give value to patient’s experience, knowledge of their body, etc. There is a dominant (moot?) practice of prescribing western pharmaceuticals first and asking questions later in the next 15-minute consultation a week later. This well-documented practice is disease focussed
and knows little of health, except as the “absence” of disease. This “unnatural” practice is characterised by a focus on the disease or condition, of which the “patient” is merely the subject. Treat the disease, not the person.
This spectrum lies at the heart of current debate and power struggles within medicine and in policy regarding human health. It has enormous implications also for all policy that focuses on the human species as somehow separate from “nature”, implicitly subject to different rules, with or without the possibility of divine intervention to protect us from
ourselves.
 
I find myself highly stimulated by my correspondent’s comments. I’m bursting with an accumulation of thoughts and feelings of my own, musings and speculations. I suppose these have gathered and grown within me over a lifetime in medicine. (It has quite literally been a lifetime: born into a household that accommodated my family and my father’s medical practice, I grew up in medicine. I was weaned on milligrams and speculums.)
 
My own feelings about western medicine and doctors are as mixed as anyone else’s. I am old enough to need the services of my doctors quite frequently, while still young enough to be doling out medical services to others. Macbeth cries, ‘Throw physic (medicine) to the dogs. I’ll none of it!’ And in a few cryptic words the Talmud declares: ‘”tuv harofim le’ge’hinnom” – the best of doctors can go to hell.’
Does medicine have an ideology? If an ideology is a system of beliefs or ideals or principles, I believe medicine does have an ideology. In the practice of that ideology I see the best of medicine, and in its abuse, the worst. That worst is the exercise of power for its own sake, a petty parochialism, a readiness to denigrate what it does not understand; and, in budget season, a hypocritical piety.(“No, no, no, Mister Treasurer , you must not cut, peg or regulate our fees – or our patients will suffer.’) The best is seen in your doctor’s service of ‘scientia cum caritas’, knowledge with loving care.
For me it is the ‘scientia’ which is the hard bit. Your good doctor is a scholar: the word means ‘teacher’, ‘master’, ‘wise one.’ That scientific doctor applies himself to the evidence. He suppresses his own human hankerings, his romantic leanings, his wishful thoughts. That doctor brings to his work a rigour, an austerity, a devotion to the pursuit of demonstrable truth. When I am sick I truly need that science; and your good doctor brings that to my bedside.
Let me give you an example. While working in the Emergency Department of Alice Springs Hospital last week I watched while five doctors worked to save a man who had been found at a remote roadside, unconscious and convulsing violently. The man was tall, strongly built, apparently athletically fit. His mountain bike was found lying near him. Unable to tell us how or what or when, his powerful body defied his absent mind as it jumped and threw itself around. I stood, quietly appalled, watching a man fifteen years my junior, disconnected from mind, at the threshold of the void.
The doctors watched him for signs. Acutely attentive to which limb moved, which did not; how his pupils reacted to a pencil beam of light; whether and how strongly he responded to voice (initially he’d stir; later he did not), and to a painful stimulus. Here was a biological organism in a near agonal state. The doctors looked up to study the lines and waves and numerals on the screen. How strong is his heartbeat, how effective his circulation? How much oxygen are his lungs delivering to the circulation and – critically – how high is the blood pressure? The readings were elevated above the norm. I misgave and pointed out the elevation to the Team Leader. ‘That’s good,’ he said. He explained that the damaged brain was much more vulnerable to low blood pressure than high. The outcome, he explained, was worse when pressures were low. ‘The outcome’: two words pregnant with knowledge, with meticulously gathered and tested and scrutinised evidence. Tough minds had obeyed tough rules in the gathering of that evidence; now smart scholars would deploy this in our immediate emergency. I witnessed dry science at the service of hot blood. 
It was imperative to control the seizures and to treat pain. Surely he had pain – he’d had a fall, presumably at speed, his skin was torn from his body, gravel and mud grimed his raw wounds – and he was vomiting forcefully on arrival. He must not be allowed to vomit lest he aspirate and block his lungs.
Next the man’s respirations must be controlled. He’d be paralysed and placed on a respirator. He’d become utterly defenceless. The very doctors who would overcame his defences must become his protectors.
To all these ends, all of them critical, all of the utmost urgency, strong drugs would be used – opiates, benzodiazepines, muscle relaxant drugs, anaesthetic agents, anti-emetics. Doses must be calculated minutely, effects monitored, dosages re-calibrated. The precise numbers of milligrams and micrograms would determine whether this man would live, would walk, would think, would speak, read, laugh or love. ‘Will this man ever get back on his bike?’ All lay in the hands of these scientific doctors.
 But how to calculate dosages? Unable to weigh a stuporose man threshing his own body, the doctors had to guesstimate. Too much opiate would lower blood pressure and endanger the damaged brain. Too much anti-convulsant would do the same. And both classes of chemicals might suppress breathing. The anaesthetic drugs must be adequate to paralyse him (to allow intubation and the use of the respirator), but again these agents can defeat their own purpose.
So the doctors injected morphine, eagle eyes upon oxygen saturation and respiratory rate and blood pressure. They injected metoclopramide to prevent vomiting that morphine so readily triggers. They deployed three different anticonvulsants, in doses nicely titrated, before they were able to control the fitting. Now came the intricate business of intubation, the act of introducing a breathing tube deep into the throat in defiance of every natural reflex and physiological objection; this procedure, a pas de deux of surpassing intensity, saw all present hold their breath in unconscious imitation of the patient, now paralysed, whose breath was held from him by chemical restraint. Now the tube was guided truly, now oxygen supply was resumed, hypoxia reversed. All breathed out.
Our patient would never know how medical science saved him. How doctors had used just enough of every hero molecule, how they had threaded that narrow path between his own injuries and the potential harm of their remedies. How every drug might poison him. And of the race of his life, the literal counting of seconds where every second counted, the quietly hectic passage of time when he arrived as quivering meat and was so soon stable. Safe!
Equally deep was the pool of knowledge that detected the cause of all – no, not head injury, not brain contusion, not spinal cord injury – a heart attack had thrown this athlete, engaged in a mountain bike race in unseasonal heat, into coma and convulsion at the threshhold of death.
So, yes, western medicine has its ideology. Last week I saw that ideology save a human person. Clearly I am in awe of that sort of intellectual discipline which is so far above and beyond my suburban skills.
By way of contrast we who practise by instinct, by intuition, must tread the shallows of organic disease, even as we grope in the deeps of human suffering. You cannot afford to indulge our speculative modes of medicine when your damaged organs call out for science.
In the earliest years of my practice I felt frustrated when patients informed me of the advice they’d received from alternative practitioners. Those healers would declare to my patient her spine was out and they’d put it back; they’d looked in her eyes and found her pancreas was sick and they’d cured her with herbs. Not with drugs, no, never with drugs. Those healers prescribed detox diets for the liver, cheerfully unaware that the liver detoxifies all. They told my patient they knew what was wrong, where I knew I did not, where no doctor could – in any scientific sense – know.
I came in time to respect the achievements of these practitioners. My patients felt better for seeing them, encouraged, confident in their recovery. I wondered how this could be and it came to me that the naturopath gave the patient the gift of an unrushed, attentive hearing. The amplitude of time, the emphasis upon natural healing, the resounding vote of confidence in the forces of the natural body helped the patient materially. I realised how intuitive, how insightful, how respectful was this practitioner. I recognised in the naturopath the healer I wished to be. But there was one difference, ineradicable: I never heard a patient quote the alternative practitioner confess ignorance or impotence. Free of the shackles of constraining science, the practitioner never said three words that I need to use every day. Those three words are: I don’t know.
I am pretty confident I have by now offended some readers. This is always a risk with the trenchant expression of strong opinion, of ideology, if you like. And it is not only western doctors who hold an ideological position. I consider it natural to humans, perhaps universal, to cherish convictions about health and its care. These convictions too encompass values, traditions, emotional needs. Mine are distinctively my own. Every distinct human will differ. Expressing my full thoughts on these subjects might offend seven billion humans.
Nevertheless I propose to write a series of short pieces which might include:
Why some doctors resist and resent alternative medicine;
‘Thou shalt not kiss thy patient’ and other absurdities.
Why I recommended acupuncture for a patient whom doctors could not help.
Why doctors prescribe medicines: Big Pharma, big mamma, bad sicknesses;
My Debendox daughter.
In writing on these matters I expect to relieve myself of strong feeling, long pent. And after all that I will scarcely have responded to my correspondent’s weighty concerns.
 
One final vignette before I let you go. In 1972 I joined a rural practice where I worked happily for almost thirty years. Around that time I met a squat jolly man and his slim jolly wife. The couple had three small daughters and I became their family doctor. They were a devout family, members of a small local congregation of a church which is possibly the most widely respected by the secular majority in this country. They wore their piety tactfully – neither crucifix nor yarmulke nor hijab declared publicly their private faith.
From time to time Mother brought the little girls, slim, elfin presences with smiles that sweetened my day. They’d sit on my knee while I discussed their condition their mum. In time they grew up and left their small home town. One of the three, whom I’ll call Sarah, returned and introduced me to her fiancé, a member of Sarah’s church. The two had decided on a career as ministers to the youth in the service of their church. Soon they would marry and take positions in a distant city interstate.
 
When I saw Sarah next seven years had passed. Her father had died of complications of orthopoedic surgery. Her face shone with grief and pride as she introduced her batch of three small children to me. Slim like Sarah, all with biblical names, they played at our feet as we spoke of their grandfather, that squat jolly man, and of his passing. Sarah and her husband petitioned the church for a posting in Melbourne to be nearer the family.
They settled in an outer suburb on the far side of town and I saw nothing of them for about three years, when Sarah turned up in my waiting room. Delighted and surprised I listened as Sarah told me of the strange and slow development of her second child, a boy. ‘Jeremiah might have autism.’ We talked. I told Sarah I was no expert in that condition. She seemed to know that already. She wasn’t after diagnosis, but counsel and for that it was to her old family doctor she turned.
Years passed. Once again I was delighted one day to discover Sarah in my waiting room. She was the final patient of my morning. By chance I had no more patients to see for the next hour and a half.
‘Hello, Sarah. What brings you here?’
‘Howard, this morning in the shower I found a lump in my left breast.’
‘Does it hurt?’
‘No.’
‘Do you have chills, a fever?’
‘No, it’s not mastitis. I weaned Benjamin a year ago.’
I examined Sarah’s left breast. Her slim body habitus made the lump easy to find. It was a hard lump, a little larger than an almond. I felt the opposite breast: normal. I probed her axillae. There, in the left armpit I felt a second lump, also hard. I tried to hide the dread I felt.
Sally looked up at me, searching my face: ‘Can you feel the lump?’
‘Yes. It’s a worry. Please get dressed and we’ll talk.’
We talked for an hour. We talked of the probable cancer, of its possible spread, of treatments, of specialists – who, where, when? Sarah asked, ‘Do think I’ll be cured, Howard?’ I did not think she would. I said the signs were worrying and I feared the worst. Sarah looked down and rummaged in her handbag for her hanky. She sat quietly, tears rolling down her cheeks. She dabbed her eyes and cried some more. The hanky was a sodden ball in her hand. She blew her nose and said, ‘I’m not frightened for myself. The children… they’re so young.’ Fresh tears followed.
At length it was time to finish. I stood up. On blind instinct, driven I suppose by hard feeling, I said, ‘Sarah, stand up.’
She did so. I stepped forward, took her in my arms and hugged her. She hugged me back, hard. I dropped my arms but she hugged on. And on. At length she released me. She took a deep breath, found a small smile and said, ‘That’s what I crossed Melbourne for, Howard.’
I never saw Sarah again. Her surgeons wrote to me from time to time. Eight years after her doctor took her in his arms and breached medical ethics, Sarah died. 

Lights off in the City of Churches

We are driving along a principal Adelaide artery. Dusk has fallen and passed. It is dark now. This main road carries a lot of traffic along its numerous parallel lanes. Unfamiliar with Adelaide and totally devoid of any sense of direction, I pay close heed to my guide, Georgie, a native of the city.

 
‘Merge left,’ commands Georgie. I obey. On my right a larger car swoops close, overtaking me. Studiously attentive to my own lane, I concentrate on the road ahead.
 
Georgie explodes. Pablo guffaws. They point: ‘Look! Look! Look over there!’ I look over there. Over there is the car that swooped by a few seconds ago. Indistinct movement from the roof of the car. Lines of cars in our many lanes slow now to take a bend and we close on the vehicle of interest. I sneak another look. There is movement: a head and torso project up through a sunroof.
 
Straightening up now, I resume driving as Pablo and Georgie shriek ever louder: ‘Look! Look!’ I do look. The moving torso has arms. The arms wave frantically. The face appears to be female. The torso is manifestly female: with every wave of her arms the waver causes her breasts to wobble wildly. I know all this because the waving woman is naked from the waist up. What is more, the waving lady seems to be performing specifically for us.
 
This is puzzling. Unfamiliar with local road culture, I wonder whether we are witnessing a species of road rage. In fact the waving and the wobbling – and quite likely the undressing – are all the opposite of road rage: road love, in fact.
 
Jumping and wobbling and waving in the cold of this winter night the woman mouths words in our direction. We cannot hear. Quite frantic now the dancing mime of The Great Northern Road redoubles her tempo. Surely we will notice her, surely we must hear.
 
The traffic lights turn red and all cars come to rest. The swooping car has swapped lanes, drawing directly alongside us so the terpsichorean gesticulator can make herself heard. She makes a winding movement with her right hand. She mouths her message. Windows slide downward in the car on our right. We lower our own. Voices are heard, a chorus from our neighbours: ‘Your lights! Turn on your lights!’
 
We turn on our lights, smile, wave and mouth our thanks. The lights turn green, the dancer disappears from the sunroof and we drive our ways.
 
 
 

On the Main Road

Friday afternoon, the eve of the sabbath. Riding home from my shift in the Emergency Department at Alice Springs Hospital I would have missed her if I’d been abiding by the law. Luckily I was riding along the footpath when I came upon her. She looked about fifty but I reckon her true age at mid-thirties. Her large face seemed inflated, her eyelids puffy, her lips swollen, her natural flabbiness accentuated by deforming scars and oedema. The face was bronze in colour. Her gaze was inward – even when I was abreast of her, when I addressed her, I was absent to her. 

In all our minutes together we were never more than ten metres distant from people passing in cars and on foot. But in our leaden ballet we would dance alone.
She was shorter than I and a good deal heavier. The weight differential would matter when I’d struggle to lift her. I was a metre from her when I first registered her human presence. A slender tree at my right shoulder obscured her from sight. Abrupt movement caught my eye, a straining, forceful jerking of her thick neck and thorax as if she sought to escape. In fact the opposite was the case. 
The woman’s hands worked to adjust a cord that looped once around the tree then twice around her neck. I saw the cord and stopped. With all in place she suddenly slumped. Don’t! Don’t do that! – these were all the words I found. I flung my bike aside and threw myself towards the woman. She grunted but did not speak. My arms about her did not arrest her fall. The cord tightened. I remembered the knife in my lunchbox. As I groped frantically in my backpack she thudded suddenly to earth at my feet.  
A white cord floated down after her. The cord was a lengthy bootlace, the sort you pull on to tighten your running shoes. That slender tie would never support ninety kilograms of self nihilation.
Lying on the earth her silent body did not move. Was she breathing? A wave of alcoholic air reaching my nostrils answered that question. Was she conscious? I spoke. No response. I shouted. No answer. I placed my right thumb into the small bony notch above her eye and pressed hard. This truly painful stimulus evoked no movement, not a flinch. On the Glasgow Coma scale I reckoned her score at eight of a possible fifteen.
As I crouched in all my clinical perplexity an Aboriginal woman appeared at my side. Gesturing in the direction from which I’d been riding she said, The hospital is just back that way. Did I smile as I thanked her? I don’t know.
My lady was alive, breathing, intoxicated, apparently unconscious. In the long seconds since slumping she had not moved. What harm had her spinal cord suffered in that violent moment when the bracing cord arrested her fall? I could not know. My phone: where was it? Fast fingers delved and delivered from my pocket. I rang triple zero. The voice asked, Police, Fire or… Ambulance! I shouted. Ninety seconds after giving location and clinical details the siren sounded behind me. The vehicle pulled up alongside my waving, jumping body. A tall woman blonde woman alighted. She would have been in her thirties – like our patient, and unlike her. I answered her questions. A friendly smile lit her face as she said, Big shock for you, I’d imagine. This time I did smile. After a shift in Alice’s Emergency Department I’d become inured to shocks. The paramedic crouched over our patient and I heard her say: Hello girlfriend! as I mounted and headed home for the peace of Shabbat.
   

Bob in Starbucks 

I’d like a soy chai latte, please.

Grande? Venti?

A shake of my ignorant head.

The young man explains.

Grande please.

Marker pen raised above paper cup: What’s your name, sir?

Howard.

Pardon me?

HOWARD.

 

Next time, a different Starbucks: what’s your name sir?

Howard.

Pardon me?

Bob.

Sure, Bob. Won’t be long.

 

Bob loiters and in truth it is not long before he is drinking the curiously tolerable blend of sugar, sugar, sugar, spices and soy.

 

My name has always been plastic.

I keep at home a newspaper cutting from ‘The Murrumbidgee Irrigator’ of early January 1946, announcing the birth of Yvonne and Myer Goldenberg’s second child: ‘Myer and Yvonne Goldenberg are delighted to welcome their second child, Adrian. Brother to Dennis.’

Friends flocked to the Leeton District Hospital to congratulate Myer and Yvonne and to commiserate with Adrian. Horrible name, they said to my parents. Do you really hate him that much?

Ben and Ethel visited, bringing their four-year old boy, Howard. Mum looked at Dad, Dad looked at Mum and Adrian became Howard.

 

I got used to Howard. The softness in Mum’s voice as she spoke the name, the pride in Dad’s, convinced me Howard was good. I used it for a long time.

 

I came to Melbourne, became an adult and learned to drink coffee. I patronised Universita Café where a short, round young waitress named Theresa asked me my name.

Howard.

Pardon?

Howard.

OK John, I’ll bring your cappuccino to your table.

She did, John drank and the coffee was excellent.

John patronised the Universita for twenty years.

One day I bumped into a man there whom I knew. (I had his baby son’s foreskin at home, but that is another story.)

Hello Zev.

Hello Howard.

We sat down.

Theresa brought our coffees. Handing me my cappuccino, she said, There you are John.

Zev said, Who’s John? This is Howard.

Theresa looked confused. Mortified actually.

I never had the heart to return to the Universita.

 

I reverted to Howard for a further score of years. And remained Howard. Until I broached the threshold of Starbucks.