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?


Pardon me?



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


Pardon me?


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.




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.


Unnatural Medicine

The young woman who sat before me said she was overwhelmed. Earlier that day she had visited a woman doctor for her Pap test and to discuss contraception. The young woman (whom I have known since the evening of her birth) sat and listened to the cascade of information and advice that flowed over her. She felt she was drowning; ‘My head swam. I thought I might faint or vomit. It was too much for me.’


The young woman is no dimwit. A graduate in Neuroscience and Philosophy she handles ideas that make my head swim. Her doctor is a thorough and thoroughly modern practitioner. She explained the actions of oestrogens and progestogens. She detailed the various routes of administration. She canvassed the respective durations of action of the different preparations.


Let us give the young woman a name. She can be Lucy.


Lucy explained why it was now critically important that she not conceive. For pressing medical reasons pregnancy could be disastrous. Her past use of barrier contraception would no longer do. Hormonal means were required. I asked, ‘Lucy, what is it you don’t understand about the Pill or the progesterone IUD or the progesterone implant?’

‘I understand them alright’, she said, ‘I just don’t want them. None of them. They’re all unnatural.’


I asked Lucy to elaborate. ‘Those hormones, they all do things to you. They affect your organs. I don’t want that. I’ve never liked that.’


Lucy is quite correct. They all do things to you. Whether it’s a device impregnated with progesterone that is inserted into the uterus – with or without a general anaesthetic (another unnatural chemical) – or a tablet that contains both oestrogen and progesterone, or a small progesterone-impregnated rod sewn under the skin of the upper arm, all will prevent pregnancy by violating Lucy’s natural biology. It was these assaults that alarmed Lucy. She felt she’d be a traitor to her own health if she embraced any of those measures. Her audience with the doctor struck at her ideology, her beliefs.


I sat and listened. I know how Lucy feels. Like most of my patients I am drawn to the natural remedy. Whether it is a hot lemon drink for a sore throat or a hot salty water soak for an infected finger, I have always prescribed these for my children, knowing I have no skerrick of scientific data attesting to their value. They just feel good. And right. And natural. My children have long mocked me for my atavism. And nowadays I see them treating their own children with the same nostrums.


Science has no truck with ideology. Science is an unsympathetic bastard. And profoundly unsentimental. The science of pharmacology defines a drug as any substance that alters a biological system. In other words, in our retreat from such unnatural substances as drugs, we resort to our hot lemon drinks and our hot salty soaks. And we feel better. But pharmacology’s corollary declares: any chemical which alters a biological system is a drug. If my inflamed finger feels better, if my sore throat improves, the salt or the lemon is a drug. Or a placebo.


I love placebos. Over the many years they’ve relieved lots of my symptoms. But, as I explained to a forlorn Lucy, placebos don’t prevent pregnancy. Against an incoming tide of one hundred and fifty million sperm cells, the placebo cannot prevent penetration of her waiting egg.


I tried to comfort Lucy. ‘There can be no natural contraception. Nature wants your every egg to be fertilised. Only the highly unnatural (but physiologically innocent) condom or the highly unnatural act of withdrawal or the offensive intrusion of hormones will prevent conception. Those or celibacy.’


Lucy took this in. She had no enthusiasm for celibacy. I added my opinion that withdrawal and cyclic celibacy were the two parents of most of the babies ever born.


Lucy left me, taking with her a prescription for the Pill. She will violate her biology that would otherwise have seen her conceive at fifteen and again – following two years of lactation – at eighteen, and again and again every three years or so until menopause and subsequent senescence and early death.


Of course everything I do in my work is unnatural. I intervene when hypertension or diabetes or elevated cholesterol would otherwise hasten the onset of heart disease. I order x-rays which expose the body to cancer-causing radiation. My surgical colleagues introduce stents. My psychiatrist friends alter brain chemistry with their medications, as they struggle to control the demons in our minds of schizophrenia and bipolar disorder. Sometimes they save lives. Most unnatural. All of it, most unnatural.


There are two Laws I have learned.


FIRST LAW: There is no such thing as natural medicine.


SECOND LAW: There are no cures. Medical science always fails. We all die.