Howard is a doctor, marathon runner and author. He has written two non-fiction books, My Father’s Compass (2007) and Raft (2009). Carrots and Jaffas (2014) is his first novel. His latest novel is A Threefold Cord (Hybrid, 2107)
Tonight I went to yoga as I have done just about every week since the start of the pandemic. When I say I went to yoga, on some of the occasions this was literally true: I’d run to the studio and I’d jog back – four kilometres or so each way. Frequently, however, when the germ shut the studio, I joined the class by zoom. ‘I went’ consisted simply, of turning the lights down and moving to the Persian rug on the floor. The rug feels a bit rugged (is that the origin of the term?) but it’s tolerable. I don’t imagine the Yogis of old purchased their mats from Lulu Lemon. They probably lay themselves down on bare boards or on a rug of knotted yarn like mine.
I lay down tonight and tuned into zoom on my phone. (No, I don’t have an i-pad. I don’t suppose the ancient Yogis did either.) I felt a frisson of pleasure at the the hopeful thought that tonight’s class, conducted on the eve of freedom, would be the last of enforced separation
I paid attention to the teacher. She instructed me to attend to the breath. I breathed and I attended. I like this teacher. I feel I know her well. She teaches yoga in a variety of modes, but she and I both know Yin suits me best, with its long, slow poses, its gradual transitions. She speaks: ‘Some of you will have rushed from your day’s work to this class. You might be unready immediately for stillness, so we’ll move into stillness, we’ll arrive at the unmoving state by movement, by active movement that will slow; and as we slow we’ll have the opportunity to attend to the slowing breath.
The teacher models the pose and the class follows. I gaze at my little screen. I remove my reading glasses for a clearer view. The teacher has fair curling hair with curls at the end of curls. Her skin glows peaches against her black sweater. I enjoy the sight of her.
I adopt the pose and close my eyes. My eyes remain closed through most of the following 50 minutes or so, even as, every few minutes, I move into the next pose as instructed.
Lying thus, with the senses turned inward, only the sense of hearing, of vibration, operates within my awareness. I become aware of a rhythmic percussion, a soft, recurring ‘boom’. If it’s a sound, it’s a sound too soft to actually hear. I feel this sound: boom, boom, boom, coming to me through the floorboards, eighty booms to the minute by my rough-reckoning.
The sound, the experience bears a sense of the long-known, the familiar. Eventually my ears that have worn a stethoscope for almost sixty years, recognise the soft boom, boom, boom:It’s heartbeat that I hear. This is a puzzle that solves itself when I open my mind’s eye. The sight that I ‘see’ is of my teacher, herself reclining on a mat, on a floor. Next to her is her mic through which she gives instruction. The mic picks up vibration through her floorboards and transmits the sound of the beating of her heart. I know it’s not the sound of the beating of my own heart; mine beats at forty beats per minute. I smile a smile of remembering. I remember that heartbeat. I used to listen to the beating of my daughter’s heart through the wall of her mother’s belly. I heard her heart before her mother did. Her heart beat in the womb at 120-160 beats per minute, twice the rate (in those days), of my own. It was the first way I knew her. It cued my love of her. Yes, my yoga teacher is my daughter, she of the peachy face, she of the yellow curls. I’m allowed to enjoy looking at her.
Tonight, on the eve of freedom, I hear my child’s heart, the working of her living body agitating the molecules inside the semicircular canals of my inner ear. Her living body moves my senses and once again cues love.
Deploring has long been a favourite sport of mine.
Bankers, paedophiles, turners of blind eyes have all earned my opprobrium. I’ve deplored racists and people who speak or act violently, and in common with many others, I’ve greatly enjoyed deploring politicians. I’ve deplored climate change deniers and I’ve deplored people who criminalise asylum seekers. A good deplore always left me feeling righteous. As my wife points out I’m particularly good at seeing myself as righteous.
In recent times deploring has lost some of its gloss. It’s become like tenesmus, which is the medical term for the condition of dissatisfied defaecation. The instinct is blameless, the urge is strong, but the act feels somehow incomplete.
Hillary deplored deplorables to her cost. It turns out the deplorable are not few and they live next door or across the street, or among your friends.
Covid has seen an outbreak of deplorables and of deploration, both in epidemic proportion. Anti-vaxxers, rioters who confront police, those who piss on the Shrine and expose the many to the risk of contagion; attenders (not attendees – no-one forced them to attend) at an illicit engagement party, worshippers at a proscribed religious service likewise incur my white-hot rage.
But my rage no longer satisfies. Why? Firstly, I have to distinguish between the act which I deplore and the actor. Further, I need to recognise that the deplorables are people, and what’s more they are people in the plural. They are my fellow citizens, these hundred who congregate to pray, thesethousands who block streets and provoke police officers. I can’t help wondering who these people are and reflecting on the honest thoughts and the genuine fears that prompt many of them to act in these harmful or misguided ways.
In my work I meet plenty who declare their certainty of conspiracy (big pharma, the government, George Soros – which means – wink, wink, nudge, nudge – the Jews). Others teach me the science; this week a seventeen-year old girl told me, ‘I know Pfizer impairs female fertility. I know I want to have children but I want to be safe from Covid too.’ (I told her I too had heard that report, but only here in Lightning Ridge, where I’m presently working, had I heard it. The remainder of female humanity doesn’t know what this child knew – and now unknows.) How can I deplore her for the primal fear of childlessness? What profit is there in contradicting those convictions that are religious in their depth?
The common theme among my patients is fear. It’s honest, sincere fear, invariably magnified and feeding on itself and its cesspool of ‘information’. How can we help frightened people by name-calling?
I have no respect for those people who decline vaccination and cry Apartheid! Their thinking is sloppy and they enjoy playing the victim. Less innocent too are those who behave lawlessly. But with the exceptions of the clearly malevolent minority (I include here members of bikie gangs, violent anarchists, Nazis earnestly working towards overturning democracy and restoring Whitest Australia), no-one gets up in the morning and asks, How can I do the most harm today? What is the most foolish trending opinion I can embrace?
Rather I see people who embrace such folly as attracted to the ‘glamour’ of free thinking, the ‘heroism’ of rebellion, the ‘courage’ of free speech. They evoke in me feelings that range from compassion (in my consulting room) to outright condescension (like the people of biblical Ninivehthey know not their right hand from their left).
But we are divided. We do discriminate between the vaccine-willing and the others. We grant freedoms to some and deny them to others. I can see no other choice, but I can see no long-term future in this discrimination. There is a limit to people’s acceptance of curtailment of their liberties. The fabric of community is only as strong as our leaders’ capacity to inspire.
Where are the inspiring leaders? They do exist. At the outset of the pandemic I held great fears for the most vulnerable communities in Australia. Even more than residents in Aged Care, I feared for outback indigenous communities. People who obeyed an ancient cultural imperative to wander through ancestral lands would surely catch and succumb to the virus, as they did in early colonial times to smallpox. But this did not eventuate. The traditional leaders, elders, listened to respectful advice that was appropriately conveyed. They became convinced and they carried conviction with their people. People listened, followed and were safe.
My friend Colin begs to differ. I’m pleased to oblige:
Howard. G’day and thank you for sharing.
To “deplore” is surely the most respectful way to demonstrate that one differs from another’s point of view.
Deplore – to express or feel deep grief in regard to.
In certain quarters this word came to be reviled after it was used to register dismay at public political rallies. The rallies became places where lies, insults, routine mocking of opponents and outrageous motivation of crowds chanting “lock her up” in respect of a political opponent who 5 years later has not been charged with anything. There was no crime. This from a man who now has 16 Civil legal cases underway against him and a further 16 Criminal cases underway. A man who has instigated or influenced 60 appeals against an election result, all of the appeals dismissed, sometimes with a Judge’s comment, “don’t waste the court’s time, there is no evidence”.
History teaches us such “leadership” emboldens ill informed and bigoted people to behave inhumanely. Seeing ill informed led astray, firstly to chant insults and later to attack the seat of Government leaves me weary, bewildered, numbstruck and sighing with grief. Politicising a virus is a masterstroke of machiavellianism.
If we see a small child randomly pull blooms off flowers, or hurt a small brother, or for good measure swing the cat about by its tail and then tell lies, we rightly deplore it. And try to correct it. If in the process “our rage no longer satisfies” maybe it’s because we think our voice no longer counts and have given way to misinformation or that no one is listening. There are voices the misguided listen to. They are not by any stretch “reflecting on honest thoughts”. Rather they reflect on dishonesty of a spectacular nature. If these thoughts and actions are “religious in their depth” this is called heresy, not that I’d suggest burning at the stake. But failure to act in a firm manner gives leeway for deplorable behavior such as pissing on a shrine.
Relying on people getting the correct message via the frightful spectacle of seeing grandma, a friend, neighbour or workmate suffocate to death with covid is not enough. Mandating compliance saves any argument(s).
No jab, no footy.
No jab, no coffee.
No jab, no Bali.
No jab, no work.
Doing so doesn’t mean “we grant freedoms to some and deny to others”. It’s not unlike the freedom to drive a car once learned and tested. And when that’s achieved other layers are added, such as wear a seat belt, don’t speed, and for heaven’s sake get off your phone while driving at 60kph and if you’re 15m aloft fixing the tiles put up a safety harness. Please. For a variety of reasons, one being it’s cheaper for society to do that than pay for a lifetime of care for a paralysed worker. This is not “discrimination” but boundaries for the greater good.
The following post may distress some readers. Before reading, please ensure you have any supports you might need.
This hurts the most.
If only, if only…
It happens and it hurts and the hurt can’t be helped; it can’t be talked away; it can’t be redeemed.
And when you lose the next one in this way, it finds you again unprepared, defenceless, bewildered.
When I count those lost to me by their own hand, I find the tally low: three, three in over fifty years. These three, and two more who tried and who fell, falling, astonished into my outstretched arms.
The wound is not to my pride. The wound goes deeper. Petty pride stings at slights, but this is not slight. This one trusted me, that one looked to me, they stood before me in their naked grief and I tried to clothe them in my regard: You matter. Your life has value. Your unique being has meaning.
I have been talking, I discover, to those who are beyond hearing. My words vibrate and pass, and unclothed and alone, the three take their leave.
The first died for beauty. Believing herself dysphorically to be disfigured, she could not see the beauty all others could see in the photos her despairing husband took and showed her. Beauty cannot keep her lustrous eyes. She takes her leave, she takes her life. Her husband cannot take my calls.
The second died for lovelessness. Born a late child into a family already too full of children, born whole into a constellation deformed by the severe deformity of an elder brother, this one was never deemed to have needs. He called out for notice: Mum, I’ll be good! Mum, I topped the class! Dad, I was best and fairest! Mum, Dad they made me School Captain! Mum… Dad…
They never noticed. All their time, all their energy they spent on the other one, the one who couldn’t run, who would never read. Mum and Dad had no love to waste. The unloved one made himself lovable. I never met a more winning man. I noticed him, I regarded him. He won me. But mine was not the love he lacked.
Being lovable, being good, being the one who’d always try the hardest, he tried all I suggested; he took the medication, and the next medication. He accepted the referral to a psychiatrist, he engaged with the therapist, he accepted admission to hospital. He convinced the specialist he was recovering. He left hospital and he kept his appointment with me. He spoke to me in warm appreciation. He took his leave and, leaving me in false assurance, he took his life.
Twenty years pass and still I shake my head in bewilderment. So vital his being, so warm his blood, so much greater than both, his pain.
Of the last I write least. Two years on it remains too raw. Another who died for beauty. Ugly only in her own eyes, ‘unworthy’ of the lavished love of her parents. Unable to bear the hope with which I’d inoculate her, she separated herself from me in her final months. She died by her own hand. She died alone.
My feelings are not of guilt. Not being family to any of the three, I feel none of the woundof kin, none of that stab of accusation or anger. I cared for all three. They took from their scant stores of trust and they invested in me. I tried my best. It was not enough. We all lost.
“I’m serious, Raph. I see it as a moral test. If I fail it, I’ll realise it’s over: I’ll know I lack the moral strength.”
“What are you talking about, Dad?”
“Simply this. I’m confident my legs are strong enough. It’s my spirit that’s in question: do I have the drive or the staying power or…the spiritual reserve? My fear is I’ll tire and decide to walk, and if do I weaken and walk, I’ll know my marathon ambitions to be vain. Finished.”
“Walking a marathon is nothing to be ashamed of, Dad. Especially at your age.”
”Well, shame might be an over-reaction. But willpower has been my private point of pride. I wouldn’t feel proud if I walked, simply for a failure of will.”
Like every Australian boy I always wanted to shine at sport but, being timid and lacking drive, I didn’t. I absorbed sporting ideals, however. Inspired by Pheidipides I honoured endeavour; with de Coubertain, I decided the important thing was not to win but to try my best. Translated to distance running, this meant not to give up. If I could persist I would win self-honour. Through fifty-five previous marathons I’d gained sufficient self-honour to try a fifty-sixth, on this occasion in Traralgon. But an aged man is a paltry thing and I’m an alert witness to my own decay. This Sunday’s marathon could take me as long as six hours.
(My doubts in mid-2021 arise following twenty months of lying fallow. Covid cancelled all four of the marathons I’d planned to run in 2020. I’m out of practice, trained presently to run no further than 20 kilometres.)
Over the following days the conversation with Raph plays again and again in my mind. Today, in Traralgon, my legs ask their question of will. My Rwandan yoga teacher, Philbert Kayumba, happens to be tall, slim, fit, a gifted distance runner. Phil accompanies me to Traralgon as my support person. Traralgon, I tell him, was the site of my catastrophic first marathon,as well as my fastest marathon.
Today events conspire to help me. The good people who organise the event provide a special Early Start for the elderly and the unlikely. The weather forecast is for 1 degree Celsius. The Bureau adds, it will feel like minus1. In the event, the temperature starts at 8.7, rising to a windless 14 degrees at the finish. Gloved and cosy inside my six layers of shirting, I dance up and down skittishly at the Early Start. Phil instructs me to stretch, a religious ritual among runners that has always found me a disrespectful agnostic. Obedient today I do stretch. Colin, a friend of almost lunatic devotion, who has driven three hours through fog to photograph me at this early start, falls about laughing at the sight. He snaps his old marathon comrade actually stretching.
A short young man of rotund build joins me at the line. Luke, meet Pheidipides! Luke’s fist bumps my gloved hand. Good to meet you, Fylopidees! I regard my new comrade. At five foot tall and three feet deep, Luke looks like a serious rival for last place. He tells me his target time is six hours.
The Early Starter arrives late. Ready Gents? Go! The Starter clicks his phone and we go.
Four hours and 46 minutes later, I stop. This is the Finish but it will not be the end. The daunting corollary of gaining self honour today is the prospect of doing it all again in the future.
In the course of those hours and in the passage of those forty-two thousand and 188 steps, Phil drives to meeting points and provides me with drinks, carbohydrates and caffeine, all in calibrated quantities. He keeps up a relentless commentary upon my strength, my greatness. Bystanders cheer and Phil declares, He’s a machine.
During long intervals of running alone I enjoy the feel of the benign surface of this new route. The organisers have improved the long-famed event by routing runners along the Gippsland Rail Trail. The surface of soil topped lightly with gravel is ideal. The earth yields briefly beneath my foot before releasing it with a spring. Or that’s how it feels. Viewing Phil’s video of my old man’s shuffle alters all notion of springing.
Whatever the truth of my running form, Traralgon has provided the kindest surface I’ve encountered in fifty-six marathons, a runner’s benison.
On this foggy morning, Traralgon blesses the route with a shifting curtain, visible but impalpable, of filmy white mist; by turns the mist conceals then reveals the deep green of foliage and the bright green of pastures on either side. I run through a dim tunnel of quiet and peacefulness, faintly mysterious, with intermittent patches of brilliance ahead wheresunshine breaks through. The sights bring to mind the dark tunnels towards bright light described by people who think they have died and who ‘come back.’
Here memories of the lost arise to meet me. I think of Manny Karageorgiou, my friend, officially declared Legend of the Melbourne Marathon, one of only eight to have run every one of the first 41 Melbournes. I ran the fortieth of these at Manny’s side, knowing he was achieving the wildly improbable, Manny having literally emerged from his hospital bed to run. That was a day of glory. I shared the run with my friend, rejoicing at intervalswhen he’d be surrounded by his adoring family, all of them aware that their cherished Manny was doomed. Later that day I joined Manny’s circle of old friends and extended family at his home, where we ate and drank outside and rejoiced.
The agony of their love stays with me.
When Manny set out to run his forty-second Melbourne, he fell early. His nephew and I gathered him, bloodied, to his feet and he shuffled on. Minutes later, when his wife Dmitra sighted him, she gasped, took his arm and led him from the road.
When Manny died the Melbourne Marathon died for me. I never ran Melbourne again.
Phil’s video shows my starting form to be ponderous and stiff, with my neck bent absurdly forward, and my marionette body engaged in endless chase of that pendant head. Yet I know myself to running hard. So ‘fast’ am I, I realise I’m running with calculated imprudence. I’m following my plan to attack the first half of the marathon, to run at a rate I can’t sustain.As I haven’t run further than twenty kilometres in training, there is no pace I will sustain. So I set out at my recently improved training rate of six-and-a half minutes per kilometer.
For the initial ten kilometres I run alone with my thoughts. Phil appears before me on the track, radiating: I’m amazing, I’m looking strong, my form is impressive. In addition to these loving lies, Phil plies me with iced coffee and Black Forest chocolate. To drink without choking I must stop running. As soon as I put my drink down, Phil commands me: Keep moving, Howard. Don’t let your hips seize up. The respite is delicious, the resumption tolerable. Farewell, Phil, see you around 21ks.
Fast footfalls follow me, overtaking me swiftly. A tall male figure floats past, his strides smooth and strong. He’s the leading runner and he looks like a winner. A minute later runners Two and Three overtake me. They too look good. Admiration overtakes envy; such speed, such power and grace! Over the next quarter of the race, I have the opportunity to admire fifty or more runners faster than I. With every passing, runners exchange greetings, acknowledgement and encouragement. None of this is perfunctory. The respect is authentic. A runner knows the truth embodied in every passing comrade.
Keeping up this speed is getting harder. I negotiate with my legs, I put the hard wordon them: No excuses. I know you can do this. My legs plug resentfully on. Happily, every encounter interrupts such conversation. Volunteers cry out my praises. You can do this, they cry, as if they’d overheard my inward address to tiring legs.
Ahead on the track a tall figure waves to me. It’s Phil, meeting me somewhat before we arranged, around 18 kilometers. We’ll run together to the turn at 24 km and then back some distance. By then we’ll have reached 28 kms. Once there, with two-thirds of the distance behind me I’ll feel confident of finishing. It is at this stage that Phil tricks me. He leads me to the half-way and well past it without my realising. Never knowing I’ve reached that landmark, I forget to slow, and, thus deceived, I float on Phil’s oceanof goodwill without self-pity or ruminative arithmetic.
More chocolate, a draught of Coke, a peeled mandarine and Phil is off, leaving me in the company of a tall young woman whom I’ll call Louisa, who’s running her second marathon. Louisa shares my mandarine and keeps my mind distracted,telling me of her mother, who fights her recurrent breast cancer and her rheumatoid arthritis. We’ve gone plant-based and we’ve chucked away all the auto-inflammatories. Mum did a seven-day water retreat and now you wouldn’t know her for the woman she was. No pain, no drugs. Happy.
Louisa appears to be Mum’s sole support. Mum appears to be Louisa’s project. Dad’s back on the farm in Horsham, Louisa’s the carer child. I hear about the five failed IVF cycles. I gave up teachingand became a personal trainer. Did the study and got the qualification. All my work happens in early morning and in the evening. In between I have time for Mum. And this marathon stuff, that’s my outlet. No, there’s no partner. One day, when the stars align, we’ll find each other…I guess.
Arriving at the final drinks station I seize a cup of water and the opportunity for a breather. A voice announces, This is Pheidipides Goldenberg, everyone! Hello Pheidipides. It’s me, Barry Higgins! Huge grins, flesh shakes flesh. You’re going to write about this aren’t you? I nod. I always write my marathon and in Traralgon I send the Traralgon Harriers, who organise the event, a copy for their newsletter. Barry Higgins is the soul of this marathon, having run it more times than any other and having written a fine history of its first fifty years.
A bunch of marginally faster runners overtakes Louisa and me and edges ahead, stealing Louisa away. Left now to my own thoughts, I encounter Temptation. You’re feeling pretty weary, aren’t you?Wouldn’t those legs of yours enjoy a break? A little walk couldn’t hurt, could it?
The voices make sense. But this whole enterprise defies sense. A marathon runner is a grownup child at play. It makes no sense to run where you might walk. But watch the child at play, see how she gambols like the lamb in spring, like a newborn foal. We grownup runners defy sense, defy the years. Our legs remember the joy, the delight, of speed, and our brains, registering effort, imagine the body to be speeding.
My legs have posed their question. Will now responds in the negative. Dreadfully tired, I know I’ll not yield. I run on, tearful now, and joyous. I’ve passed my test. The sun shines, the mist has risen. I’ve removed layers of clothing as I’ve warmed, handing the sodden garments, one by one, to Phil, who bears them away. He reappears now, a beacon. He’ll run me home.
I run, awash with feelings of love and thankfulness for strength, for friendship, for the volunteers, for liberty, for this window in the pandemic, and for health. Especially for health. During the past week a message comes to me from Leni, Manny Karageorgiou’s daughter, telling me of the little boy born to her, whom she named Manoli in remembrance of Manny. Manoli is now aged three. He has been diagnosed with neuroblastoma, a rare and wicked malignancy of childhood. Manoli’scancer is Stage IV. In footage of Manoli, I see him gamboling for the simple joy of movement. His head is smooth, innocent of hair. When I report all this to my wife, my voice fails me. How is it I am so blessed while others must suffer?
The world smiles upon me as the distance to the Finish shrinks beneath my feet. Phil at my side, in my ear, sings his song of faith. You’re nearly there. Only two kilometres now. You’ve done a mighty thing. You’ve inspired me. I’ll run it myself next year. Keep going, Howard, keep it up. You’re running so strongly. We reach the final turn from the rail trail to the bitumen. Minutes later we come upon vehicles parked at the roadside. The Finish is just a few hundred metres ahead, at the top of a little hill. A hill! Read hell, not hill. Phil’s voice whispers a final blessing: I’ll leave you here, Howard. Only thirty metres, now. The crowd loves you.Go!
I go. The crowd does indeed care. They cheer as if I, Pheidipides Goldenberg, were their own. These people – runners long-finished, wearing their medallions, runners’ support persons, volunteers, organisers – these people have one voice that cries, together with Pheidipides of old, ‘Rejoice my brethren, ours is the victory!’
Footnotes: 1.Watch Phil’s video. I watched it and learned to respect my own absurdity.
For my first twenty years in general practice, I worked in partnership with a famous man who happened also to be a great man. I’d heard of him before we met. His name was Donald Cordner, famed as the sole doctor ever to win a Brownlow Medal in Australian football. I learned you win the Brownlow for being the fairest and best player. Those two adjectives epitomise the man.
Donald happened to be, in his time, the tallest player in the League. Together with that height he was broad in proportion. On my first morning with him, Donald performed a tonsillectomy on a child of eight. Disdaining a trolley, he hoisted the patient in his arms and carried her to the Operating Theatre before surgery, then carried her back to the ward afterward. Donald personified two valuable characteristics in a doctor – the personal touch and broad shoulders.
At about five feet and seven inches I could only look up to this very tall man. My initial awe gave way quickly to admiration, for I saw in Donald a quality I’d seen at close quarters through the previous twenty-six years as the son of another GP. That quality was the courage to feel the pain of another, to share it willingly, to shoulder it and to carry on with calm.
I saw Dad and Donald as they brought life into the world and as, inevitably, they walked closely with others to their final exit. They did this kindly and bravely. Every birth builds us, every death diminishes us. John Donne was right:
Therefore send not to know
For whom the bell tolls,
It tolls for thee.
Seated in close consultation with a young mother one morning in the village of Diamond Creek, I was interrupted by the insistent ringing of the telephone: Would I come urgently to the Treatment Room?
For the next thirty minutes Donald and I worked frantically to revive a six-month old baby who hadn’t cried that morning. Her anxious mother found her child inert, unresponsive, not breathing. We tried all we knew but the baby would not breathe. All through this time the mother stood at our side, fully, dreadfully aware. Through it all, the baby felt warm to my touch. That warmth was to haunt me.
I returned to my patient and took up our earlier conversation: Jen, how did you feel when he spoke to you…
My patient cut across me: Howard, you’ve just been attending to something terrible in the other room. You can’t just walk back in here and carry on as if nothing has happened. You have to give yourself some time.
Jen (not her real name) was right. Nobody had ever suggested a doctor too might need care.
Over the following twenty years the bereaved mother brought her surviving children to Donald and me. We shared our unbearable, unspoken knowledge.
Another young mother, Julie, became my patient around that time. Over the next decade I delivered her babies and looked after her children. I tried to help her when she became depressed following her final childbirth, and again when she came to me for help through her divorce. Julie was a dynamo whose many ailments frequently led to surgery, and few of her numerous operations went smoothly.
Julie saw in me capacities that I could not recognise. When she brought a problem to me she did so with inordinate trust in my powers. Howard would know. That trust must have generated the power she imagined. She demanded I become a better doctor, and her faith or some species of love brought that doctor into being.
When I left Diamond Creek she followed me to the city, travelling an hour each way to see me for her many incurable conditions. When Julie moved to a more distant country town the trip to see her trusted doctor took two hours each way. Her ailments were many and her visits not few. She’d seek my counsel in her wilful mother’s decline. She shared the joy of new grandchildren. Her bones began to crumble and she looked to me for guidance about the medication that should strengthen bone, but weren’t there cases where the jaw would abruptly crack?
When aged about sixty, Julie developed intractable abdominal pain. Specialists failed to find the cause and I struggled to relieve her pain. Through all of this Julie looked to me with that unwavering trust.
Belatedly we found the small malignancy that was the cause of Julie’s pain. Cure by surgery was not possible. Supported by her brave husband, Julie endured the full ordeal of chemotherapy. To the end Julie chased a cure: she would not give up her precious life. To the end she trusted her old doctor. I was humbled by her faith.
Over fifty-one years I’ve seen death undo so many. Not all deaths were tragic, some were a release. Inevitably, though, some die in cruel suffering. I remember Robbie (not his name), a tender soul, a deeply spiritual man who’d survived a harsh childhood, and who emerged with a love that overflowed. Robbie and I shared a love of literature. He’d hunt out books he knew I’d enjoy and gift them to me, inscribing every volume with a message full of feeling. To this day I’ll pick up an old postcard, a cherished book suffering neglect, and instantly, Robbie’s handwriting, the curved lettering, bring him back; his love visible in ink.
One day I rode with Robbie as he drove his teenage kids to school. He kissed his daughter as she left the car, then he kissed his blushing son. As I followed, rather than allow me to feel neglected, Robbie kissed me too.
Robbie worked in Student Services at a university, later as a chaplain in ICU at a major hospital. He would see forty percent of his patients die.
Robbie knew his own heart would eventually fail. Numerous surgeons had opened his heart and repaired or replaced valves, not all successfully. Robbie’s cardiologist assured him his passing would be smoothed: he would not suffer. This GP reinforced this advice. Robbie and his devoted wife trusted our words.
When his time came, Robbie exited life in a prolonged and desperate struggle for breath. He died at home with his wife at his side. Years later Robbie’s widow – herself my beloved friend – continues to suffer grief born of betrayal.
In the end that must come, all we doctors can offer our patients is our warm skin and our broad shoulders.
It is late in the third year of medical school that we watch a screening of a live birth. Until this point in my life, film was always smaller than life, an image, a series of images, fictive or documentary, but extracted, never fully real or fully human, let alone monumental. But this was a video of the eruption of life. I might have been witnessing the Big Bang so enormous was this, the advent of a human.
I remember feeling electrified, thrilled, struck and struck again by a cascade of philosophic thoughts, intense joy, a sense of being a guiltless voyeur upon the utterly intimate that was utterly universal. I was witness, by invitation, to creation. I remember too, my naive amazement that a woman would allow a camera (that shockingly lacked any sense of modesty) to show her fully naked self in this way. I looked around with a wild surmise. But my friends, more worldly, more mature? – showed no shock.
It is only a year or so later that I will deliver a baby. Between the videotape and that event, my father decides I’m ready to go to Labour Ward with him. This entails walking out the back door of our house, past the rhubarb growing in the back garden, to the side gate that opens onto the lane. Dad would hasten across the lane with me at his heels. Through a second gate and we are in the grounds of the Oakleigh Community Hospital. Here Dad frequently invites me along, to watch as he performs surgery, administers General Anaesthetics, treats heart attack and pneumonia and fracture. Dad’s patients welcome me: Dad is their idol, his son would be a godling. Today my presence will demand inordinate trust on the part of a woman of her doctor. What I will share is a series of events, of unmediated sensory experiences – the rich colour of placenta and the same colour in a woman’s face, the odour of amniotic liquor, the sounds and lack of sound, of wordless breathtaking, grunting, pushing, the sight of a calm and immensely calming doctor, his movements graceful as ballet, his stillness, his attention, his kindness and his firmness – and the huge feelings of a new mother, the joy reflected on the faces of nurses, and my own sensations, intense and too many, crammed into climactic moments, and I unable yet to unpack them and describe them calmly. For now I know only awe and thankfulness.
Perhaps a year later, I stand at the side of a young woman through hours that become a full day, during which she approaches a bridge in her life. Today I’ll cross a bridge of my own. Surrounded by calming midwives, veterans in this arena, I watch as the woman pushes. The woman pushes hard, pushes long, gasps, pushes again. Her face reddens deeply, now a beetroot, now a plum. I peer hard: is that hair? Is that scalp we’re seeing? I move into place to catch a baby.
The Delivery Room encloses the birthing mother, a couple of midwives and a nervous medical student. This room, this world comprises all animal humanity as a life spills free into air. Our air, cold upon wet skin, evokes a gasp, a cry. The cry tells a young woman she has crossed the bridge. The student gropes, grabs a slippery cord, which yet dances and writhes. He applies a clamp which slips and falls to the floor. The baby cries, the mother cries; I suppose I’m tearless, but I know I have crossed too. This is one meaning that I catch instantly.
Six weeks later I travel, as directed, to a Victorian terrace house situated next to a rail crossing in Brunswick. In the house a new mother and her young husband live with their baby. The idea of the visit is for a student to learn the consequence of those climactic events six weeks earlier; that consequence is the fact of parenthood. The mother welcomes me, the stranger who crossed with her, the intimate male who usurped the father. That father welcomes me, thanks me! It occurs to none of us three that he should have been there in my stead. A bond exists, forged in the sweat and blood and urine and shit of birth giving, in the gasping and the heaving of giving birth, in the shock and the cry of being born, in the spreading flood of love for a human child.
I never visit the family again. I would not recognise the mother today. Yet every time I drive past the terrace – which happens to stand on my preferred route to the airport – whenever I pass, I remember, through all the decades that follow. I remember that day, I feel that bond.
The birth leaves me changed. I feel called.
For the first thirty years of my working life I deliver babies. It never stales. Nothing else in a life in Medicine will rock me with that astonished joy as I witness the advent of a human. When suburban GP Obstetrics eventually dies, a part of my own life is extinguished.
The Dean encourages us students to wander the wards, to seek out patients and talk with them. I approach the bedside of a thirty-year old woman lying in her bed in the Medical Ward. I’m not hunting a diagnosis; the nurse has already given me the answer – breast cancer. Cancer! All I know of the disease is it’s a killer. Here before me lies a person of my generation who is going to die. The knowledge fills me with horror. Does she know her diagnosis? Does she realise she will not live long? How do I talk with her? I turn to sneak away, but she’s seen my approach and heaving herself to sit.
Good afternoon. I’m a student doctor. Would you mind talking with me for a while? Or would you prefer me to come back another time…?
No, doctor, we can talk.
My name is Howard.
The woman returns my smile of greeting with a weak smile of her own.
What brought you to the hospital, Anastasia?
My breast. The woman points to the right side of her chest. Before two weeks I see the skin looks different, sort of rough, like an orange.
At first I put moisturiser. But when I have pain I see my doctor. He sends me here. But soon is worse.
No, the skin is break, then is bleeding, now smells bad.
A pause. My thought is all too clear: roughened skin is evidence of something growing within, tethered to the surface by fibres. The skin breaks down and bleeds
as the tumour grows. Any bad smell would indicate bacterial action on tissue that has died. You stink before you die! You live in self-disgust.
Anastasia, I cannot smell anything bad.
I put perfume, after shower, many times in day. I want smell nice when my little girl come after creche. Now I pregnant but I don’t see this baby. Is cancer, I dying. Anastasia points to her belly, which I had not noticed until now, is quite rounded. Anastasia does not look wasted, the contrary. She has plump cheeks, her hair is black and lustrous, her eyes shine. A closer look and I see her eyes shine with tears.
Perhaps, the doctors are wrong, perhaps the diagnosis is mistaken. Anastasia looks too well. But no, beneath the scent that Anastasia has applied liberally I catch a whiff of rotting.
My mind rebels. Anastasia, they can do operations for cancer…
I stop. Anastasia doesn’t look at me. Face down, upper body shaking, she weeps quietly. She shakes her head: Is too fast, is too late.
Anastasia, you’re upset. I’m sorry I disturbed you. I’ll leave you now and let you rest.
I rise to leave as the woman weeps.
I can’t bear it. I add, I don’t think you will die. The doctors will make you better.
I leave the young woman with her knowledge and my lies.
I know the meaning but I cannot say it.
I leave her alone.
I retreat and I forsake her and I deprive her of moments when she might have sat quietly with another and shared meaning.
On the day of our encounter, that idea never enters my mind.
But fifty-four years later I feel disgusted with myself.
We’ve rushed here today, to the Operating Theatre. During this Rotation we are to follow the surgeons wherever their work takes them. A couple of weeks ago the young surgeon whispered: Don’t rush home this evening, Howard. Something’s going to happen, something historic. I didn’t rush home and history did happen – Australia’s first heart transplantation. A few of us stood outside Theatre and waited. Somehow it didn’t feel anticlimactic to miss the experience, to stand adjacent as history happened. We sensed the meaning.
This afternoon the call came: Emergency surgery in Theatre. Come now! The boy on the table was riding his bike home from school when he was hit. He wasn’t too bad at first but then his blood pressure fell, and his heart started to race. His skin colour turned to parchment and his belly began to swell. His trolley bursts into Theatre and the Surgeon’s Apprentice begins to cut into the distended belly without waiting for anaesthesia: the boy had been deeply unconscious since he arrived in the ambulance. The Chief arrives, flings on gown and gloves, no time to wash, takes over the operation. A mild man of about sixty, wise, he’s not reflective now as he slashes the belly widely open and a tide of blood pours over both surgeons, onto the floor. Suction! Artery forceps! Artery forceps! Artery forceps! Frantic action above the table, quick mopping at the feet of the surgeons, lest they slip and fall. The tide of blood does not abate. No speech, nothing heard apart from fast movement of limbs as they grope and suck and search slippery viscera for the bleeder. Artery forceps grab suspect bleeding sources but the flood does not slow. The blood they are transfusing is insufficient. More blood! A second transfusion starts. The anaesthetist’s voice says, we’ve lost the heartbeat. There’s no blood pressure. The surgeon works by feel beneath the surface, groping, hoping, grasping at straws for the unseen splenic pedicle. The anaesthetist injects adrenaline, massages the heart. He looks at the boy’s pupils. They’ve dilated. He shines a light to see if the pupils will shrink by reflex. He’s searching for vitality of a brain that’s had no supply of blood – for how long? Too long. The reflex is absent. He leans over the boy’s pale face to his colleague and taps him on the arm: He’s gone. We’ve lost him.
All this took place in 1967. I don’t remember feeling stricken. Was I numb perhaps, with horror? With self-terror? I caught the event but I missed the meaning. The boy was twelve years old. His hair was fair and he was lightly freckled. Today he’d be old enough for the pension. I feel stricken now. Riding my bike – yes, a bike: the connection passes me by – riding to the shops this morning, I feel the enormity and my feet fail on the pedals.
(This is the first in a series in which this old doctor recalls and reflects and wonders.)
I should be home by now. Work at the clinic has kept me late. I tear off my mask, race down the stairs, tear across the road, chase the tram and leap aboard. It’s peak period and the tram’s pretty full. I find an aisle seat, sit down and breathe. I reach into my bag – no mask. All around me everyone wears the mask of the good citizen.
My breathing feels like an offense. I turn my back on the person at whose side I’m seated. Facing the aisle now, face turned down toward my shoes, breathing surreptitiously, I’m disturbed by a voice:
I turn to the voice, which comes from behind a mask. The voice sounds again: Why aren’t you wearing a mask?
When I tore off my mask, I ripped the hearing aids from my ears as usual. This happens: masks and aids are both secured behind my ears so the removal of the one often occasions the other. The speaking voice isn’t hard to hear however. My interlocutor is her own megaphone. Humbled, I reply, I’m afraid it’s not with me. I must have…
My reply is cut off. You have to wear a mask. It’s the law. I’ll give you a mask.
My antagonist-turned benefactor gropes in a handbag, gropes some more, shuffles contents without result. A second woman, seated facing her, opens the bag on her lap and produces a ziplock full of pristine masks.
I always carry spares. WE’RE BOTH WORKERS IN HEALTH! Take a mask.
I take a mask and fit it. Thank you, I say. Her fellow-worker-in-health resumes operations: You never answered me, WHY don’t you have your own mask?
The questioner and her mate look about 55-60 years old. Wide faces, good complexions, fair skin, hair well-groomed. All is handsome but smiles are lacking.
A tramful of now very interested passengers gazes in our direction as I lean towards the workers-in-health and speak slowly and softly, enunciating clearly but confidentially: Have you never made a mistake? Apparently not, for my sweet reason evokes not compassion but derisive snorts.
Conversation takes an abrupt turn as the women address a second malefactor. WHERE’S YOUR MASK?
The question is not directed to me, but beyond me, to one not yet seen. I crane and glimpse the smaller form of an adult male of Chinese appearance. This person declares: I DON’T HAVE TO WEAR A MASK.
YES YOU DO. IT’S THE LAW.
I DON’T HAVE TO.
The workers in health decide greater volume is required to help their quarry’s understanding:
IN THIS COUNTRY WE KEEP THE LAWS. MAYBE BACK IN INDIA YOU DON’T HAVE TO. HERE EVERYONE HAS TO WEAR A MASK!
It’s time for me to rejoin the conversation: In this country we don’t accept racism, not even among Workers in Health.
A young man strides down the aisle and joins us. He looks like he’s in his early twenties, slim, elegant in his black suit. His voice is another that needs needs no megaphone: YOU TWO ARE MISTAKEN. THE LAW DOES NOT REQUIRE EVERYONE TO WEAR A MASK. SOME PERSONS ARE EXEMPT.
Health’s blood is up. Health is not ready to yield: What’s his exemption?
Blacksuit offers further legal advice: YOU HAVE NO LEGAL RIGHT TO DEMAND THAT INFORMATION. THIS IS NOT HEALTH CARE YOU’RE PRACTISING HERE: YOU’RE JUST PRACTISING BIGOTRY.
Health falls silent. The Gang of Two turn to each other and shrug. Two stops later the mask refuser leaves us. Health loses one pitbull a few minutes later. Now alone, the remaining worker in health suddenly finds her kindle demands her attention. For the next twenty minutes she does not look up or across the aisle. When I descend she’s still silently absorbed.
Once home I open my backpack. There, with my hearing aids, is my mask.