Monthly Archives: October 2015

“I was never very good at Math. I was never so bad at Math that I bought a lottery ticket.”

By Posted in Life, Opinion Tagged , , , , 2 Comments

The maxim printed above was authored by Paul Jarrett, my friend in Phoenix. This ancient Phoenician is longer in the tooth than a sabre-tooth tiger and keen as mustard in the brain department. He locates himself as somewhat to the right of Barry Goldwater, an American conservative to make today’s Tea Partiers blush pink in comparison.
 

The Jarrett advice rings painfully true, not just of lottery tickets, but of gambling generally. I have seen lives ruined by the winning of a lottery; lives lost to suicide by failure to win at the track, the casino, the local gambling shop. I have known a stockbroker, a man of conscience and long experience, his retirement ruined by the depressive illness that followed losses – not his own, his clients’ – who gambled on the Exchange. I have seen desperate ugg-booted women in curlers, seated joylessly playing poker machines at 6.00 am.

 

Here’s a farmer that hanged himself on expectation of plenty…*

 

Last week’s paper told of a poor Sydney resident, shackled to menial employment by his immigrant’s accent, learn with resentment of a neighbour’s lottery prize. The immigrant kidnapped the winner’s son for ransom. In chloroforming him he inadvertently killed him. In one act the kidnapper lost his ‘prize’ and a father lost his son. In the next act the kidnapper lost his freedom for life. 

  

Paul Jarrett and Bary Goldwater

 I am in short, that miserable, un-australian being, a wowser. Like Paul Jarrett I was never very good at Math…

 

 

*From the porter scene in Macbeth

 

 

The Delinquent Chromosome and the Marathon Runner 

By Posted in Family, friendship, Life, Love, Medical, Poetry, Running Tagged , , , , , 11 Comments

Most of us have no intercourse with our forty-six chromosomes. They perform their work honourably in intracellular obscurity and we leave them alone. Not so for my friend Manny Karageorgiou: his Chromosomes Numbers 13 and 14 have conspired to mutate. This mutiny came to light late in 2013 when he broke a rib without trying. He simply breathed or coughed or heaved a carton and the rib quietly cracked.
 

What Manny has tried to do – what he has managed to do every year for 37 years – is to run the 42.195 kilometres of the Melbourne Marathon. Manny is one of a tiny and diminishing band of brothers to achieve this feat. This, their 38th year, they number only eight.

 

When Manny’s rib cracked he consulted his doctor. In their shared innocence, patient and doctor initially believed they were dealing with a painful area in Manny’s chest, a mere nuisance, an impediment to running: and Manny had a marathon to run. The Marathon would call him. Come October Manny would obey the call and run. Always the Melbourne Marathon, always and only Melbourne. Athens too, has called Manny. Deep in his Greek heart’s core he hears that call. He feels aeonic tremors, he hears echoes across time of Pheidipides at Marathon field. Manny feels, he hears and he yearns to join the runners in Athens; but year after year that marathon clashes with Melbourne’s.

 

Manny could not run both. Melbourne held him: captive of his love for the Melbourne, of his obligation to its history, of his loyalty to his old comrades, Manny stopped his ears to Athens in October, he turned his back on the Aegean and, busted rib and all, he ran Melbourne. That was last year. For a period of time between the fracturing of the rib and that Sunday in October, my colleagues filled Manny’s body with poisons – thalidomide, dexamethasone, bortezomib – in their attempts to put down the chromosomal mutiny. The short term for that poisoning is high-dose chemotherapy. 

 

When I wrote of Manny’s marathon in 2014, runners from around the world responded in awed respect of the man who’d run thirty-seven Melbournes, and who’d prepared and run it this time with a diseased rib and a poisoned body.

 

All that was in 2014. Since then Manny has undergone autologous haemopoietic stem-cell transplantation. The chemical savagery of this procedure – doctors have to poison every blood-producing cell in his body – can cure or kill. It did not kill Manny. But the mutiny grumbles on, bones everywhere are eroded, they await their moment of innocent impact or small tumble. One crack and a marathon runner will have run his last.

 

Manny’s haemato-oncologist, a compassionate and scholarly man, forbids running. He knows too well Manny’s disease. My guess is he has never run a marathon, is innocent of the joy, has never known the intensity of that blood-filled, tear-filled passage through space and time to self-realisation. For his part, Manny knows little about his proliferating mast cells, rogue daughters of his body’s revolution; he knows less of the osteoclasts punching holes in his bones; and nothing of the dysregulation of an oncogene translocated to his perfidious chromosome 14. But Manny knows enough. He understands the doctors do not speak of cure, he accepts the unending medication, he understands the risks of running. But he takes the occasional light run.

 

I haven’t asked Manny, ‘Do you run to live?’ I sense that the occasional light run is the answer that Manny’s mind or body drives him to. When Manny asks this family doctor, ‘Do you think I can run the marathon again this year?’ – the question I hear is: ‘Am I permitted to live before I die?’ And who am I – captive of my own marathon dreaming – to deny Manny? I decide I will run Melbourne at Manny’s side.

 

   

***

 

 

Lining up at the rear of the field of seven thousand dreamers before the Start, Manny implores me for the seven thousandth time: ‘Promise you’ll leave me behind once I’m too slow for you, Howard. I don’t want you to sacrifice your time for me.’ Manny never dreams he’s honouring me. But even before the gun sounds, runners reading the rear of Manny’s shirt salute him: ‘Legend!’ – they cry – ’Thirty-five Melbourne Marathons! Amazing!’ They clap him on the back, not realising Manny’s shirt sells him short by two marathons. Manny does not correct them. The same people spill glory and goodwill onto me in my Spartan’s shirt: ‘Go Spartan!’

 

A beautiful morning for running. Beneath low cloud a light breeze cheers and cools us as we snake along boulevards and run spirals through Melbourne’s parklands. Manny’s prudent pace suits me. I search for bodily pains to fret about. Nothing: silence from the supposed stress fracture in my left foot, nothing from the torn right calf muscle that I have rested from four weeks. The opposite calf sends alarms, but these are false. Pheidipides Goldenberg has no complaints.

 

Running half a pace behind Manny I take him in, not as the indoor person I have known, but Manny as runner. His build is not classic Kenyan: Manny is constructed of old materials, a series of chunks assembled one on top of the second. Impressive that he has lugged this unpromising torso through thirty-seven marathons. Projecting below that torso are the legs which are Manny’s secret. Beautifully muscled, elegantly defined beneath skin shining with vitality and sweat, Manny’s legs look decades younger than he as they pump smoothly, rising, descending, devouring distance.

 

Approaching the thirteen kilometre mark, Manny grinds on steadily, shouting out greetings to figures who come into view and earshot, his comrades, these, fellow members of the hallowed eight. To a man they look old. And calm. The marathon is their familiar foe. It holds no terrors, no surprises for them. Not for the first time, I recall Tennyson’s Ulysses as he looks upon his comrades:

 

 

Souls that have toil’d, and wrought, and thought with me –

That ever with a frolic welcome took

The thunder and the sunshine…

You and I are old;

Old age hath yet his honour and his toil;

Death closes all; but something ere the end,

Some work of noble note, may yet be done…   

 

 

With a cry of a different temper, Manny swerves, his voice joyous. He mounts the kerb, sweeps a good-looking woman into his arms, kisses her face, her hair. She pushes him away a little, looks at him searchingly. Satisfied, she smiles: ‘You look good, darling, you look wonderful. You’re running smoothly.’ The good-looking woman is Manny’s wife Demetra. She plenishes us both with cola and kisses, promising to find us again ten kilometres down the route. Manny releases his wife, takes a step, turns back, grabs Demetra again, crying into her hair, ‘I love you, darling’, and sets off again. I look down and try to deal with a lump that has risen in my throat.

 

Heading out toward the beach now we are bathed by sun and cooled by the breeze. Aaah, blessed day. The first Kenyan, having turned and now heading homeward, glides past us on air. Shouts of wonder rise from all throats as runners and spectators alike react to this shock of the beautiful. 

 

‘That’s my street there, Howard, Number 141. Please join me and my family at any time from 3.00. Bring your wife. Please.’ I want to join Manny and his family. If I finish in time I’ll certainly be there. Until now, Manny has spoken little while I have spoken more. A quieter person, he places one foot before another, repeatedly, steadily, and runs inwardly. I ask from time to time, ‘How are you going, Manny?’ ‘Not great. Not as good as last year.’ Not feeling great but not complaining either. As we swing out along the beach road and past Café Racer, a bunch of bystanders suddenly flows onto the road in our path and Manny’s face relaxes and falls into a wide smile. Hugs, handshakes, claps on Manny’s back, kisses on Manny’s face from two toothsome young women, and Manny keeps smiling and keeps on running. The interlopers pump sunshine up Manny’s arse and run alongside him. For the best part of an hour we run with the posse and through all that time Manny is smiling.
We come to the turn and the posse whoops and cheers as Manny turns for home. Manny is brother to one, uncle to a couple, second cousin to a few more, godfather to another. The kissing females are godson’s girlfriend and her girlfriend. The brother is shorter than Manny, genial, younger, rounder and pretty fit. He stays the distance for the full hour as do godson and one of the kissers. Others, out of shape or out of condition, fade away and re-join us later. Finally, with farewells, more clasps and shakes and blessings the mob falls away. ‘See you at my place, darling!’ ‘See you after three, Manny!’ The mob loves Manny and he them. Afterwards he tells me, ‘They’re here to meet me every year. Every year at the same spot. They never fail.’ A little later Manny says, ‘Dem and I are taking the whole family to Athens next year…it won’t be at marathon time of course.’

Increasingly I relish Manny’s invitation to join him and the family. These people run to the beat of a familiar drum.

  Back on the road, unescorted by Manny’s family, I have a question: ‘Manny, are you Manuel or Emmanuel?’

‘Manuel. They call me Manny. Also Manoli.’ 

Manny, Manoli – these affectionate diminutives are the aural furnishings of a life. Cushioned at every mention of his name, the man lives his life in relation, in connection, not alone, never – so long as these names are heard – alone. Back on the road, the solid road, returning from my abstractions, back with Manny-the-person I notice him struggling wordlessly. What silent erosion within his skeleton, what deposition of para-proteins in his kidneys, what mischief in his marrow, hampers this champion? Conversely (and most striking), how remarkable the redemptive effect of the loving presence of Manny’s family!

 

 

Around the corner and into Fitzroy Street where the crowds thicken and the cheering is a roaring without end, we allow ourselves a fifty-metre walk up the ugly little hillock placed here for the torment of the tiring runner. I reckon we’ve run better than two thirds of our 42.195 kilometres. Manny bursts into joyous shouting: ‘My baby! My baby!’ Emerging from the midst of the thronging cheerers is the adoring Demetra, bearing encouragement and affection and more Coke. And a baby! – their first grandchild. Manny cradles the pink bundle, adores her like a Magus. To me Demetra passes chocolate! I’m dubious about this; I’ve never eaten chocolate in the middle of a run. Will I like it? Will it like me? Too late – it’s melting in my sweaty paw. Now it’s inside me, followed by a bottle of Coke. Supercharged with caffeine and sugar and fluid I am invincible. In Demetra’s arms, holding his pink grandbaby, Manny looks the same, but once around the corner and out of sight, he looks and feels utterly vincible.

 

 

Around the corner now and into St Kilda Road, the broad thoroughfare closed to traffic in honour of us marathoners. The sun shines, the day has warmed, everyone who is not running enjoys the balm. Runners enjoy the painful raising of knees, the heavy hurt in the thighs, the weight of weary, weary bodies that started running almost four hours ago. The 32 – kilometre sign tells us there are only ten kilometres to go. Only ten kilometres to go feels to a runner as welcome as only ten more years might sound to a prisoner serving life. The experienced runner knows the second half of a marathon starts at 32K.

 

 

We plod in the sunshine. The field has thinned as faster runners leave us behind and others – the broken, the breaking, the bleeding, those limping – fall behind us. Here to one side of us, runs Eeyore, a young woman from England. She runs smoothly ahead then stops, bends forward in apparent pain, and breaks into a slow walk, and soon she is at our side again. Eeyore replies to my clinical enquiries morosely. I encourage her, I pump sunbeams, I tell her she should be proud. I should shut up and allow her to enjoy her misery. Eeyore and Manny and Pheidipides keep company intermittently until the final few hundred metres. Just ahead and to our left runs an aged, arcuate Japanese runner. His age might be anywhere from fifty to seventy. He clings to a line, a crack visible in the road’s surface where one layer of tarmac meets its neighbour. Dourly, silently, mute to my greetings, his spine twisted into a boomerang convex to the left, Japan runs the lines. His speed is no better than ours but I bet he could run all the way to Hokkaido without stopping.

 

 

A soft sound issues from the female who runs half a pace ahead on our right. The slight sound recurs – the grunt of a person in pain? – pulls me close. No not a grunt, it’s a moaning, the woman’s lament for her suffering self, her threnody sung for self-comfort. She’s about forty, shapeless, pale, a moving emblem of tortured humanity. The moment brings me back to the Olympic Marathon (I think it was at Barcelona) where a Swiss or French runner, whose name I seem to recall was Dominique Something approached the Finish. No-one who witnessed the sight of this tall, thin woman, faltering and staggering in her final lap of the stadium will forget her in her extremity. The brutally hot day, the merciless steeps of Monjuic in the approach to the stadium, the criminal timing of the event in such heat had all but undone her. She lumbered into view, slowed, stooped, seemed to recover herself and advanced. Time and again she seemed at the point of falling. Officials were seen to move toward her, then to retreat. Appalled viewers on screen and in flesh begged wordlessly for it to end, but Dominique stumbled on. Twenty, thirty metres from the Finish she fell. Officials came to her aid and in so doing ended her chance of completing the Olympic Marathon. It is Dominique whom I hear now as this woman moans.

 

 

It is no disrespect to acknowledge that we belong to the dregs of the marathon world: among the select who run marathons, possibly the most resolute and vigorous of people, our sub-group group is the most enfeebled. And all the more honour to us who persist. On we go, pausing for drink every three kilometres, enjoying the excuse to walk twenty, thirty metres. Then up again with weary legs, up and back into the slow steady tread that our heartbeats allow us, that is all our breaths and our body salts and our fluid reserves and our moral reserves can support. We walk, we pause to walk thirty guilt-free walking paces, then on again we run, and on. Manny and I negotiate small contracts: we’ll run without stop to the top of this short rise, then we can coast down the farther side; we’ll run and not stop until we reach the next drink stop, then we’ll reward ourselves with cool fluids and a splash of water; we’ll run now and will not stop until we reach the MCG, and then…

 

 

We enter the great stadium side by side. The huge grandstands tower about and above. We insects crawl the margins below. At my left Manny says, ‘It’s magnificent, isn’t it?’ It is, it is indeed. We swing our arms, pumping our reluctant thighs into action, we raise our heads, then hoist ourselves onto our toes for the final 150 metres. Two aging men, one with an intact skeleton, the second much ravaged, swing around the bend. We pass the bent man from Japan: his face, transmogrified, is a rising sun; and Manny and I are sprinting, and sprinting we fall across the Line.

 

  

  

POSTSCRIPT: I have written elsewhere of my inadvertent double entry (and double payment) in this year’s Melbourne Marathon. I duly wore two bibs – each with its distinct number – and with them, both electronic timing chips. I had speculated that Pheidipides Goldenberg might record a finish in both last and second-last places. If you google Melbourne Marathon Results 2015 you will see how closely I anticipated the result. And you’ll find, ahead of me by one second, Manny, Manuel, Manoli Karageorgiou. 

  

I Tried to Drown

By Posted in friendship, Life Tagged , , , , , , 4 Comments

I tried to drown my enemy last night. I thought he and I might become friends. He seduced me, and I fell. I told myself he was the apple of my eye. I knew what I was doing, I saw behind that gleaming façade the black tunnel and the signs that warned me, give up hope all ye who enter here.
I dressed him in candy pink, the better to declare to him and to all who beheld us together, this is unnatural, this is absurd, we do not belong together…I made him look ridiculous the better to ridicule myself.

Early in our – what was it? – a friendship? – an affair? – he showed himself in all his treachery. Yet I could not put him to one side.

I had, I knew, sold my soul. I had no recourse to a Divinity, no-One to pray to.

I spoke to my friend, saying:

Wert thou my enemy, O thou my friend,

How wouldst thou worse, I wonder, than thou dost

Defeat, thwart me?

Lying in the bath last night, pleasuring my marathon-weary muscles, my friend called me. I reached for him with hands all slippery. My friend was in my fallible grasp, at my mercy. I dropped him into the waters, to his fate.

Some time later (I cannot say how much time had passed) in an act of mistaken morality, I hoisted him from the depths. I shook him a little, dried him perfunctorily, turned my back on him and plunged my face beneath the waters to remove the soap. I had done with my bath and I had done with my friend.

I emerged and I dried myself. Just then my i-phone rang and I knew I had failed to drown my enemy.

 

Yizkor

By Posted in Faith, Family, Life, Love Tagged , , , , , Leave a comment

 
I found the photograph I had been missing. It was found, as most of my misplaced objects are, precisely where I had placed it; in this case it was safely at the bottom of my backpack. I wanted it for remembrance. 

The photo sits in its small oval frame. It shows two small boys sitting side by side. Their cheeks have been pinked by some process of photographic enhancement common to photos from the ‘fifties. One boy sits cradling a large teddy bear. The boy’s face is a narrow oval, his expression unsmiling, alert, guarded, attentive to the photographer who is an adult in a frightening world controlled by adults. The second boy, taller, wider, rounder, has a fuller face, topped with wavy titian hair. He has the daughter of a smile on his face. His is the image I have sought, this the face of the person I wish to hold in remembrance.

 

The portrait conveys much of what I wish to hold: the elder boy is Dennis, his parents’ firstborn, my brother. His destiny is here to be read. It’s all here – firstborn, male, cherished; good-natured, close to his younger brother – and fat. In this photograph Dennis must be about four. In less than sixty years he will be dead.

 

***

 

Literally translated, the Hebrew word yizkor means ‘he will remember’. Over the recent Festival period I recited the yizkor prayer for my father, my mother, my wife’s father; and for Adrian, my consuegro; and I remembered them all tenderly. It was only when I prayed for Dennis that I cried. I cried for the protective brother I could not protect, for the always-advising brother I could not advise, for the firstborn who worshipped this usurper as a hero. 

Dennis did not ask to be born fat. He did not ask to be born first. He loved his father as his father loved him – not wisely but too well.

Immoderate in all he did Dennis loved his younger brother immoderately. I miss him, I pray for his rest as I pray for my own.

 

Walking with my Father*, after all this Time

By Posted in Books, Childhood, Faith, Family, Life, Music, My Father's Compass Tagged , , , , , 9 Comments

Most Saturdays I walk with my father. Saturday is shabbat, when I go to shule (synagogue) in the morning and walk home alone afterwards. It is this walk that I take with Dad. It works like this: services at the shule of my choice finish around noon-thirty – precisely the time my family will be gathering at home. No-one wants to risk coming between a Goldenberg and her food at meal time; too dangerous. So just a few moments before the congregation sings the concluding hymn, Adon Olam, I duck out of shule and hurry homeward.

 
When it comes to a prayer or a song a Goldenberg is not one to short-change his Maker. So, striding like my father before me, I sing that song as I walk, feeling anew the melody I sang with my father through our decades of shule-going together. In fact, Dad and I shared two different melodies to Adon Olam, one of them quite beautiful, the other even lovelier – or should I say – slower, sweeter, more expressive of longing. We loved them both, I love them still, and so I sing – first one of the two, then the second.
 
When I was a timid child I attached myself devoutly to the final lines of this song:
Into His hand, I entrust my soul
While I sleep and when I awaken;
And while ever my soul remains with me –
The Lord is with me – I will not fear.
 
But of course I did fear. First I feared the wolves and the bears that would come for me in my bedroom from the grim tales of Europe; later I felt afraid of snakes, of adults who shouted at me, of the world. I felt safe with Mum and with my dreadnought father, and – more perilously – with my risk-taking brother Dennis. I did a lot of fearing and I seized needily at the comforting closing line of Adon Olam. I’d sing it to myself when I walked alone in the dark.
 
***
 
Dad sang sweetly, his light tenor voice rising high above the circumambient baritone drone of fellow worshippers. He’d look intent as he sang, for music spoke to Dad more truly than words. Dad always claimed he didn’t like poetry, but he loved song. Music reached Dad in his secret places of abiding anxiety, it inspired him and carried his hopes, his love of life, his belief in beauty.
 
It was late in Dad’s life that he surprised me, speaking once of Adon Olam: Whenever in my life I’ve felt afraid, that last line has come to me. As a child I’d sing it to myself when I was walking alone in the dark.
 
Now a man walks home alone. Approaching threescore and ten he walks, still vigorously, as his father walked. He sings softly as he walks. Adon Olam swells in his throat. His voice slows to climb the penultimate arc of old melody, he holds that high note, then allows his voice to fall, to slide peacefully, into peace.

The man walks home alone but never alone.
 
· *’Walking with my Father’ was a chapter title in my first book, ‘My Father’s Compass’ (Hybrid, 2007). That memoir recorded my life with my father that had ended with death at a great age, a few years earlier. It was that book in which I first went public with my (possibly regressive) ancestor worship.

All this Juice and all this Joy

By Posted in Life, Running Tagged , , , , , 4 Comments

The first signs, mere hints, come creeping into our lives. Mornings aren’t so dark, the air doesn’t bite, birds sing their old early songs, bobbing figures are sighted in the streetscape. The wind turns northerly, bearing scents and pollens. Gardens burst into sudden colour, the sky seems higher, its lowering grey gives way to – to what? Can this be blue? We don’t readily trust these auguries, for this winter has frostbitten our trust in nature’s cycles. But soon it is undeniable: spring, SPRING is here!

Runners come out of hibernation; it is they whom we sight bobbing up and down on our streets, all of them preparing for the Melbourne Marathon. They bob but I bob not. My wretched, traitorous right calf locks and bites with every step, hissing at me, Pheidipides, you can forget the Marathon this October.

Meanwhile two identical envelopes arrive in the mail, both addressed to Pheidipides Goldenberg, both from the marathon people. I open the first and find my runner’s bib and the electronic chip that will time my run. A wry pleasure, these, tokens of a challenge that might yet defeat me before I start. The second envelope contains a second electronic chip and a second bib with PHEIDIPIDES printed across it with a runner’s number below. That number is not the same number as on bib Number One. What can this mean? Am I two persons? (Come to that, am I one person?) My I.T. skills being as they are I must have completed an entry form, hit ‘pay’, sent it off, forgotten I’d done it and repeated the entire process. So here I am, a runner torn, forlorn, with two identities.

This Melbourne Marathon will be – would be – my forty-eighth. Not a novelty then, but yet entirely different. Come October 18 I won’t run for myself but as a companion, a support person to a true hero, one of the very few runners to have completed every single Melbourne Marathon. I wrote of this hero last year: how, recently diagnosed with a serious condition, then treated with rays and our medical poisons, he ran and managed to grind out a finish despite his disease. To accompany this modest man will be a privilege. He responds to my self-invitation, Howard, I can’t allow you to sacrifice your marathon for mine. I’ll slow you down…

Inwardly I laughed. This man who knows fears and deeps far beyond my knowing, cannot know my capacity for running a new Personal Worst. And with two electronic chips, each secured to a running shoe, and each uniquely linked to a bib number, I will follow myself over the Line and finish both last and second last.

Of Chillis and Medicine

By Posted in Childhood, Family, Life, Medical Tagged , , , , , , 5 Comments

It was early in my medical career when I first encountered the diabolical burn of the chilli pepper.
A Greek man ferried, carried, hurried his screaming child down the driveway of our home to the side door that admitted patients to Dad’s consulting room. The child’s round cheeks were red, his eyes streamed, his left upper and lower eyelids were scarlet. The father’s distress equalled the child’s: grief and fear contended in his broken speech: Is doctor house? Too much paining! My son, he burn… Terrified – I was fourteen, and although self-apprenticed to Dad, I knew I was out of my depth – I opened the door and stammered over my retreating shoulder, Doctor will come soon, I’ll tell Mum. The man wept, rocked his child, rocked himself, his tears fell, mixing with his son’s.

Mum hurried and said kind, calming things. She fetched damp cloths and wiped the boy’s eyelids and his lips, swollen like plums. Afterwards Doctor did come, gave an injection and peace returned.
Mum explained, The boy thought the red chilli pepper was some sort of lolly. When it burned his lips he cried. Then he wiped his left eye with his chilli hand. He must have rubbed the right eye with the other.

All that happened a long time ago. I was reminded of it today as I peeled and chopped mango for a lime and mango fruit salad. I sucked a lot of mango pips, I slurped the juicy flesh from mango peelings. And my fingers and palms began to tingle. My lips tingled too. Soon tingle turned to burn. I looked at my fingers, all red and juicy and I remembered the day I prepared mango mousse for twelve. That day a dozen mangoes bled onto my lips and hands; and today my skin remembered. I had disregarded the warning at the end of the recipe to protect my skin with rubber gloves. The recipe closed with the words, both the mango and the chilli originate in Latin America. They are botanically close.
The word recipe is one a doctor uses with every prescription: the large R stands for the instruction to the compounding pharmacist, Recipe – please make up the following recipe. I did some doctoring today as well as some cooking. I claim to be a bold cook, not a good one. My family are bold eaters and candid critics of my cooking, just as they are of my healing. They will tell me after dinner what they think of my recipe.

Should Nurses and Doctors Accept Work in Australia’s Detention Centres?

By Posted in Asylum Seekers, In Detention, Life, Medical Tagged , , , , , , , 6 Comments

In 2010 I worked in an Australian detention centre for short time that felt like a long time. The experience was the worst in my fifty years in Medicine. I signed a confidentiality agreement, sewing my own lips in the process. I saw no atrocity, no wrongdoing, other than torture by impersonal and meandering bureaucracy. Yet the suffering was general; it saw inmates, guards, nurses and doctors all resorting to self-harmful acts. I saw honourable people treating the detained with skill and humanity. I saw them constrained by employers and distrusted and insulted by patients, who felt sure that we too were liars. Yet we did some good. People, whether sick in body or in spirit, were treated with kindness and respect.

For six months after I returned to the mainland I was visited by dreams in which I sat on Tribunals without name, determining the fate of nameless individuals doomed by history and by Australian laws. Captive in these dreams, I doled unequal laws to defeated supplicants. I’d awaken and ask myself, did I really do that? But, inescapably, I knew I was implicated.

My island was a paradise of procedural propriety compared to today’s islands of Nauru and Manus. Doctors and nurses have returned from these places with distressing reports. Some have argued that, knowing what is now known, it is in unethical to work in these places; that the system tortures inmates; that participating is to become complicit in torture. More moderately, all clinicians and observers who return seem to agree that incarceration harms the inmate. The first law of medical ethics being, first do no harm, is not an ethical practitioner obliged to refuse to share in that harmdoing?

A new element affecting the work of a detention clinician is the outlawing of reporting wrongs seen in that work. Offenders face the threat of two years gaol. Nice systematic irony: to protect the liberty of Australians we incarcerate boat people; to protect the integrity of the system we incarcerate truthtellers. Interestingly, the flood of job offers to work in Detention that recruiters used to send to remote doctors such as myself has dried up. Someone, somewhere must have decided Australian clinicians are unreliable.

What then must a nurse or a doctor or a psychologist or a psychiatric nurse do? If offered, may we accept this work? Even if we are forbidden to speak of what we see?

I compare the situation to working with patients in places of dangerous epidemic disease. The first such case I read of was the cholera that broke out in eighteenth century Naples, where a young Swedish doctor left his fashionable private practice in Paris to work with the afflicted. He found himself working alongside a young nurse who was both beautiful and a nun. At any moment the disease might take them. The two work steadily on, afflicted by the losses and by the erotic fever that seizes them both. The drama of the two who risk all for strangers has never left me. The doctor, Axel Munthe, wrote of this in his memoir, The Story of San Michele.

We saw just such heroism played out by Australian nurses and doctors who went to Africa recently to save people from Ebola. We saw it, and -as a nation, as individuals – we prayed for our heroes and we applauded them.

Nothing new here: nurses and doctors work with AIDS, with multi-drug-resistant TB, with Lassa Fever. It is natural to the species to measure the need before the personal risk.

The second precedent is an unhappy one; during the twentieth century doctors working under dictatorships accepted orders, accepted payment, enjoyed promotion and protection, and participated in abuses ranging from imprisoning sane dissenters in psychiatric institutions, to ‘eugenic’ murder, to torture. And being bought, they shut up about it. If clinical ethics learned anything from these abuses it was the imperative to speak out.

In the light of history I see the duty of free citizens, clear and uncomplicated. It is to go to the camps, to do such good work as might be done, and to speak out.