Family, Therapy

I’ve been seeing a doctor who is a family therapist. It all started around 1982 when my family and I were going through an epoch of change; it made sense to me to consult a family therapist. In the 1980’s family therapy was enjoying a vigorous infancy and Brian was one of its champions and very well-known in his field. I suspect Brian’s aura of celebrity was an attraction for me.

 

 

I saw Brian again today, as I have done at intervals ever since 1982. I continued seeing Brian long after I learned celebrity is illusory. You could say I see my doctor now for his aura of ordinariness.

 

 

The family events of the 1982 epoch were decidedly ordinary, but to me they felt momentous: a loving father and his doting daughter found themselves in conflict at bedtimes. Every single night! Tears overflowed from a deep well of love. Leapfrogging shouting matches, feelings wounded on both sides. Bewildering. The child’s parents brought her to Brian with whom she had a private consultation that lasted thirty minutes. The parents were then invited to join therapist and naughty daughter. From that day the loving father has loved and the naughty daughter has doted and they’ve never fought like that again.

 

 

 

I kept seeing Brian. He diagnosed an overdose of compliance. He suggested I cared too much for the expectations of others. He prescribed delinquency. It must have worked because my father remarked: Howard, you’ve changed. I felt troubled and liberated. At the age of thirty-six I’d entered adolescence.

 

 

 

In 1983 my father in law was diagnosed with advanced cancer. He was not old and he wasn’t ready. None of us was ready. We went, four of us, to see Brian. Brian helped us – a family foundering, a frightened cancer sufferer who would not see his grandsons’ barmitzvahs, a shocked wife, a daughter trying all she knew: how to support a father, to comfort her mother, to mother her own distressed children? And a son in law out of his depth.

 

 

 

 

How did Brian help? What did he do? What did he say? I cannot say. But he helped: through the fear, through the dying, through the disfiguring grief in all its forms. Somehow I didn’t cry. I loved my father in law, called him Dad. But when he died my eyes stayed dry. I felt myself shallow. A year later the family was doing well. I watched a TV mother spreading margarine onto white bread. I saw her TV family eating, children dancing around  the mum. The voiceover said, You ought to be congratulat-ed.  And I started to cry. So I went to see Brian.

 

 

 

Perhaps it was Brian who cured my sadness. Perhaps he helped me to know my sadness and to make room for it in my life. For a time we stopped seeing each other. I left his consulting room taking with me the gift of tears, accessible again now after a drought of three decades.

 

 

 

But before too long I was back. I was doctoring as well as I could, I was fathering and brothering, I was a son. And I was doing my best at all of these. I was husbanding too, an amateur at the job. All these jobs, so important! To fail at any of them? Unbearable thought! I needed some help for a problem I couldn’t define. In my sessions with Brian I must have received help without quite being able to name it. I heard myself say once, I measure my life in coffee spoons. It was busy-ness I was suffering from, jamming too many important things into too few frail minutes. For sixty minutes every month or two I’d breathe out. I’d hear Brian ask a question and I’d pause and think and answer slowly. Brian would hear me. I’d hear myself.

 

 

 

And so it went on. Family kept happening: this one married, that one became unwell, another distressed. Parents aged, their bodies failed, their willpower arrayed in fierce battle against any help. Grandbabies were born, astonishing joys, swamping strains, grandparents stretched to thinness. A parent died, a brother died, finally the remaining parent. Family, the furnace and theatre of my life, kept happening; so, naturally did my therapy with Brian. By now Brian knew this family, in its longitude and its latitude, in its occasional depths, in its many heights, as few outsiders could.

 

 

 

Brian never seemed to say much. He’d sit and think and nod. Silences would stretch open and I’d feel comfortable within them. When Brian spoke I’d hear an affirmation – my feelings, Brian’s words – and something more, some new molecule of extension or understanding. It was never portentous but it would sink into me and I’d leave lighter.

 

 

 

As the years became decades I began to recognise distinctive elements in my visits to Brian. Prompted by the remark of another who works in mental health, this seems more like a friendship than therapy, I conceded that partial truth. I heard too unspoken echoes of purists: what sort of family therapy is it when only one family member participates? Fair enough, but not far enough; these thoughts never outweighed the heft, the lift, of one person meeting with another, of a person encountering himself through narrative and counter-narrative; of knowing himself respected, accepted, safe to extend himself and to develop. I could see this as it had become, a friendship. I could sense the fear and the sneer of Authorities that decree that a doctor who is also a friend must be less of both. That absurdity is the zeitgeist, the fruit of the self-distrust which has become normative in all professions. Deeply I know it to be untrue of my friendship with my doctor.

 

 

 

At some stage, perhaps twenty years ago there entered a new element, love. It happened like this: Brian closed his professional rooms and began to see patients in his home.

That home is a Victorian building with a central corridor leading to private rooms. One room serves as waiting area; you enter and find it littered with books and magazines. Comfortable chairs invite a guest to sit and browse. Nothing you pick up is familiar, everything is novel or intriguing. Too soon, the appointed hour arrives and the guest who-is-the-patient enters Brian’s consulting room. Here bookshelves extend from floor to lofty ceiling. Brian appears, offers coffee, I decline, he disappears to prepare his own cuppa and leaves me to the books. I know no library to match this cornucopia. Books of poetry, books of biography, of history, of ideas, of beauty and cultures. Every author I know or have heard praised is in that room. There’s not a book here that I own or would not wish to own. I browse until Brian returns with coffee and spoils it all. I put down the book, passing some remark. Brian says, borrow it if you like, Howard. And I do.

 

 

 

A book lover meets a second book lover in a book bower every couple of months. I meet Rilke and, never understanding a word, I fall into a trance. Brian recommends fellow physician, William Carlos Williams, whom he calls a satyr.

 

A dawning realisation: I wish never stop this “therapy.” I must never cease visiting these books. What’s more I need to continue. Divorce, a stranger to my family story, breaks down walls that were built of my children’s love and faith and hope. The bricks and the timbers fall hard and heavily onto my little ones. The floor buckles beneath them. They are thrown about hard. Will they be broken? Unlike that epoch of my wife’s father’s death, now I know  my pain, I shed my tears, I ache as one aches for the pain in the heart of one’s tenderest. I act strong; I become bricks, timber, floor. How durable am I? Bricks, timbers, floors do not complain. But Brian hears all of this, he nods, he murmurs. He understands. Perhaps he says something that shifts the picture; some light gets in. At the end of the hour I get up and I leave that old room of books, thanking the therapist and riding fast to work. The puffing and the sweating help. I arrive at work feeling encouraged, a bit lighter. 

 

In the calms between the storms we speak of work, mine and Brian’s. What does it mean to labour where we must always fail? What is the call? How to answer the call? I speak of legacy. What have I received? What does it call me to do, to be, to become? What do I pass on? And how? We speak too of a shared passion. Brian and I know the one eternal truth of any great love: love means loss means grief. It is the love of the Collingwood Football Club in whose depths we know this truth.

 

I write and I publish books, articles, opinion pieces. I share many of these with Brian. I present him with a copy of each of my books, inscribing each one in thankfulness. Thankfulness for what? I think I’m giving thanks, in the final analysis, for Brian knowing me. My inscription boils down to, Thank you Brian; I feel known. Brian never congratulates me, never approves the writing. For once I’m not looking for praise or admiration or congratulation, those junk foods of a ravenous ego. It is enough that Brian knows that I write and I am serious.

 

In years past a patient would say to me, I’ll make an appointment to see you first thing next Tuesday morning.

Well, no you won’t. First thing next Tuesday I’ll be seeing my own doctor…

Why so coy? Where’s the shame in saying I’m seeing my psychiatrist?  So I start to say that and it alarms people. They search my face, hoping for a joke. So I explain. By and large people prove equal to learning that every human needs help from time to time. I’m one of those humans who gets help.

 

I reach the age of seventy years and Brian and I speak of retirement. It’s an idea that remains an idea, an abstraction. It sits over there on a shelf, within my view, but dimly, while my work burns brightly, and I continue. So, after his fashion, does Brian. For years now he’s taken no new patients, continuing with a rump of which I must be one. He won’t abandon us. Eventually he expects it must end; he’s ready but are we?

 

Three more years pass. Family keeps happening. Visits to the family therapist continue. Late in 2018 Brian and I appoint to meet again in February 2019. February arrives. Brian asks of my outback experiences and I tell him of the familiar joys, the familiar frustrations, the shocks against which time cannot shield. I speak of family, how once again I’ve been feeling the urge to dash to the rescue of this loved one or that other. We speak of that impulse which is a reflex which has become a habit. I know in my being that habits ossify. What used to work will not work forever. I used to jump to catch my little ones as they fell. Is this what I must do in this late phase, when my little ones are grown and stronger than I know? A habit becomes a pathology, I know. Brian listens, ponders, offers no directive. I’m not looking for instruction. I receive what I need, what always I’ve received from Brian, an attentive listening. I hear my voice, Brian hears it, a quietness settles around us. A seed of thought falls, to germinate and take root and grow.  We’ll talk of it at our next session, or at some session later.

 

It’s nearly time to finish. I speak of Collingwood, of how we came so near to glory, of defeat in those last moments. Brian mourns: remember it ever; speak of it never. A Brian pause, then: we reach a point when we look back and see where we’ve been… how far we’ve come… how far short we’ve fallen. What have we done, what remains to be done? What can we still do?

 

My ears, attuned still to the Collingwood near-triumph, detect an alteration in tone, a new note. It is of valediction that Brian speaks, a farewell, a long farewell to all this richness. He goes on: it is not ours to finish the work, nor are we free to desist from it. I murmur, Hillel, The Ethics of the Fathers.

 

We rise. I pull out my diary to appoint the next visit. “No, Howard. This was our final session.” So it was! I had managed to forget.  Brian escorts me to the door and waves a goodbye. He’s still standing by the doorpost as I jump on my bike. I ride to work, not hurrying, not sweating, just thinking, thinking and feeling. I’m seventy-three years of age. Brian has been my doctor for thirty-six-and-a-half of those years.

 

My Friend the Policeman

Working here in this large regional hospital in the Kimberley not a day passes without a call to the care of drunken patients.

More often than not the patient arrives in the company of a pair of police officers. More often than not the patient is abusive. Frequently she swears at her captors, often roaring at the them. The custodians stand calmly, quietly watchful, gentle, as I do my work and the patient does her worst. The police officer is here as a guardian, my guardian, the hospital’s, the patient’s. I wonder at this patience.

 

 

 

***

 

 

 

When I was very small my parents brought me to the city for the High Holydays.

Mum took me to Collins Street, a river different from those I knew in our small riverine town.

Collins Street flowed, a fast human current that would sweep up a small boy, sweep him away, never again to see his loving kin. I looked up and about, legs everywhere, legs striding fast, eddies, rips, king tides. 

I gripped Mum’s hand tighter. “Mum said, don’t be afraid, Howard. The Police will look after you. If you ever get lost find a policeman. The Police are your friends.”

 

 

Back in my hometown I knew this to be true. A man pulled my pants down in the park. A couple of days later I told my parents about the man’s strange behaviour. Mum looked at Dad and Dad looked at Mum and a few hours later Sergeant Stewart arrived at our house. 

We walked together into the park. I led him to the place and answered his questions. “Look around the park, Howard. Can you see the man?”

I couldn’t but I didn’t want to disappoint the officer. I pointed out a man dozing on his picnic rug: “That’s him”, I said. Sergeant Stewart said, ‘It’s a very serious thing to make false accusations, Howard.” I learned a new word that day. 

 

 

Another time I found a ten shilling banknote in the street. Briefly I was rich. Mum said, “‘It’s lost property, darling.”

“No it’s not Mum. It’s found.”

“You report lost property to the Police and they look for the owner.”

I walked to the top of Wade Avenue, past the courthouse and around the corner to the Police Station. Sergeant Stewart opened a book dipped a pen into an inkwell and asked, “What’s your name Howard?”

“Howard.”

“Do you have any other names, Howard?”

“Jonathan. Goldenberg”

Sergeant Stewart’s thirsty nib drank again and again at the inkwell as he recorded my address and my parents’ telephone number. “Leeton two eight, isn’t it, Howard?”

Six months passed, an age. Our telephone rang and Constable Bulley said something to Mum. Mum thanked him and hanged up. “Go to the Police Station, Howard. No-one has claimed the ten shillings.”

I went and said I’d come for the money. I signed the policemen’s book and I left, a rich man.

 

 

 

On one occasion I tested Police probity. Leeton sat in the Murrumbidgee Irrigation Area, fruit bowl for the nation. Fruitfly was the feared enemy that could wipe out the industry, it might destroy livelihoods and the local economy. You weren’t allowed to bring exotic fruits into the MIA. If you wanted bananas or pineapples you had leave the Irrigation Area and drive to Narranderra, nineteen miles distant. One Sunday we did just that and gorged on those tropical fruits. To my surprise, my law-abiding parents embarked on a criminal career and brought the surplus home.

After lunch the next day I was loitering outside our house in Wade Avenue when Sergeant Stewart strolled past. The Sergeant is my friend; I should offer him the pleasure of conversation:” Hello Sergeant.

“Hello Howard.”

“We’ve got bananas at home.”

The officer smiled.

“And a pineapple.”

“Good afternoon, Howard.”

 

 

 

***

 

 

Ten years ago I met Detective Inspector John Bailey (retired) in Albury. He spoke of his father, the police officer who, unarmed, braved an armed murderer, who shot him. Bleeding from his wounds Bailey Senior grappled with his assailant, pinning him beneath him. Bailey died, the only police officer known to have arrested his own murderer. Bailey – the son – showed me the George Cross, awarded posthumously to his father. I hefted the weighty silver medal in my palm, while the old officer looked down at me between ptotic eyelids: “It’s a great thing, a George Cross, but it’s not a substitute for a father.” The orphaned son followed his father into the force, entering in his teens, retiring a much-decorated and admired servant of the community.

 

 

 

***

 

Every night in the Kimberley police officers bring in their freight of broken and bleeding humanity. Their charges reel with the effects of alcohol, their heads, faces, limbs bloodied. Many are handcuffed. Invariably the officers tower over the injured prisoner. Sometimes the prisoner-who-is-patient shouts in a crazed manner, offering abuse to nurses and coppers alike. The officers remain calm, their manner respectful, even, I should say, kindly. Gently they lead the injured miscreant to care. I see this, time and again. I see it and I marvel.

 

 

 

 

***

 

 

 

I never became separated from Mum in Collins Street River. I never needed police succour until the day came when an arsonist set fire to my motor cars parked in the street outside my home. The policeman, Commander Kim West said, “When someone sets fire to your car they’re saying they can burn your house. They’re saying they can burn you.” The Commander asked me about my children. He gave me a significant look. He wrote some digits on the back of his card and handed it to me: “That number will get me night or day, Howard.” 

 

 

 

Twenty years have passed since the Commander gave me his card. A few months ago Kim returned from Europe where he’d visited with his wife. He buttonholed me: “We went to Auschwitz.” A shake of the massive West head: “Shocking. Shocking. When I tell people that, they say,Who’d want to go to Auschwitz?  I tell them, Everyone should go to Auschwitz!  Soon after our chat, Kim became unwell. Tests showed cancer, advanced and widespread. Very quickly he died. At the close of his funeral the minister said to the congregation: “The last prayer Kim recited was at the former concentration camp at Auschwitz. There he and his wife read the Jewish Prayer for the Dead. Rise please and read this with me: Yitgadal ve’yitkadash shmei rabah…” 

 

 

Portrait of Kim West by Dr Harry Unglik for the Archibald Prize

Paul’s Passing

An attentive reader of this blog will recognise the name Paul Jarrett. Paul was my friend. He died last week aged ninety-nine years and eleven months. We had known each other by email for ten years. By the time we met in the flesh Paul was ninety-four. We were together in the flesh but thrice, and spent but five days in each other’s company. Yet his friendship enriched me. So long as my mind knows the truth Paul Jarrett will be with me.

 

 

 

Every day Paul sent out numerous emails to his friends and family, who numbered about eighty souls. I became one of those fourscore followers. By the time we became

e-friends Paul had retired from Surgery, he’d ceased piloting aircraft, he was living alone with his memories and his collection of ragged stray cats. The TV news fed his active mind, which would turn often to past world events. He’d recall those as well as people from his private life, teachers, relatives, colleagues, friends, and most keenly of all, his deceased wife Beverley. Paul would send emails, four or five or six in number. I read them all.

 

 

 

 

I came to know a man who believed in God, who attended his Methodist church every Sunday, who voted Republican, who supported gun ownership, who disliked Obama and who loathed Hilary Clinton and who loved cats. Paul described himself as a conservative. He said, I’m to the right of Barry Goldwater and he showed me a photograph of the two, taken around the time of Goldwater’s run for the Presidency. Goldwater was far to the right of any US president of my lifetime  (with the exception of the present incumbent, whose position can only be the fruit of daily conjecture and of analysis of the tea leaves of his Twitter account). Characteristically Paul never mentioned to me that Goldwater intended to appoint him to his Cabinet as national chief of Health.

 

 

 

 

I was none of those things that Paul was, yet a friendship grew. Paul and I both entertained a veneration of our late fathers and mothers that bordered on ancestor worship, we both loved Medicine, we cherished old friendships, we preferred the burnished past to the distasteful present, and we could smile at human error and laugh at ourselves. I’d read Paul’s emails and I’d enter a different world; I learned about earlier eras, I met remarkable people, I was challenged with novel viewpoints (frequently opposed to my own), I relearned Medicine I’d long forgotten. I knew I stood in Paul’s shadow but he saw me in my own light. I’m sure I felt flattered that such a man would treat me as his equal.

 

 

 

Paul and I shared a real friendship. I’d challenge him when his politics got up my nose and, unoffended, he’d defend his position. Paul’s penultimate year was spent grieving for the America he loved. He detested the Democrat candidate and felt offended by the Republican. He knew duty would call him to cast his vote. In his distress Paul’s agony was spiritual in its intensity. He would not shirk his duty. He must serve his country. Patriotism, that quality that cynics dismiss as the refuge of the scoundrel, burned brightly in my friend and he suffered for it. 

 

 

Let me share with you some of Paul’s very many letters. 

 

 August 2, 2015

My mind returns to the days when I would, by my mood and demeanor, sour a bowl of honey.

Beverley, who was acutely attuned to my moods would pinch my cheek, give me a pixyish

smile and say, “Be Happy”!

At first this would annoy me, then I realized that she never acted like I did, so there must be some choice in presenting a foul mood.

Some of us pull an ill disposition around us like a protective blanket.

Not Bev.  She was as careful about her demeanor as she was about her appearance.

 

August 11, 2015

I am not sure where the admonition to, “Feed My Sheep” ends and Backshish begins.

Never have I seen such a drive and competition for charitable funds nor such a constant demand for our attention so that we can be hit-up.  By phone, by mail, by door to door solicitation, through the Media and other advertising.  The sheer volume makes one suspicious that such an army of petitioners can not contain only those with charity in their hearts.

And all of this attention is not devoted toward appeal for charitable donations.  The phone just rang.  It was a canned message.  It said, “How are you?  Good.  Can you hear me all right?  Good.  (I had not said a word.)  Congratulations are in order, you have just won a vacation trip with two guests, all expenses paid, all you can eat—“  At this point I hung up.  That automatic dialer will call me back tomorrow.  Hopefully my automatic answering machine will converse with their automatic dialing machine and transcription.

Saturday I received 5 pieces of regular mail, 4 of which were appeals for money and one an advertisement for a Mexican Restaurant. 

I will admit that I could be a more cheerful giver, but in addition to wanting to hang on to my money, I am beginning to question whether or not I am getting my money’s worth?

We are living in times that can only be described as “Devious”.

 

 

 

“Now the Day is over, Night is drawing nigh.  Shadows of the Evening steal across the sky”.

And what a day it was.  The temperature hit 117 in the shade, and to add to the disasters brought in by August, Beverley’s Grandmother clock jammed the chain on the weight that powers the clock itself when it ran down.  My vision is not sufficient to fix it any more.  It has happened before and I have been able to get it going again, but my vision is no longer capable of accomplishing this.  Her clock was amazingly accurate, and I enjoyed hearing it chime the hours and quarter hours, during the day and through the night.

I have eaten a frozen dinner prepared for me by Ann, and am about to settle down in front of the television and nap before time to go to bed.  This is the daily routine.

A gracious good evening to all of you.

G’nite!

 

 August 16, 2015

It promises to hit 117 again this afternoon.

The poor cats do not have refrigeration, but they have cool spots under the shacks

and have thrived in this heat for many years. Sylvester as spokesman for the Etudiants,

scolds me for not permitting them to come inside where it is cool, but this falls on deaf ears when I consider the life of Riley they lead, and the amount of fur they leave behind.

I try and keep the bed outside the Breakfast Nook moist when it comes into the shade in the afternoon, which is the only air conditioning they are going to get.

When you stop and think about it, it takes some temerity to lecture me about the weather, and Sylvester may be spending some time in attitude modification in the near future.  He has lost a lower right canine tooth (if cats can have canine teeth), but I have observed no loss of appetite.  They are eating me out of house and home.

I worry about them though when I am called to my reward (whatever that may be).

 

 

 

 

 August 29, 2015

I was thinking about some unusual surgical cases I found myself involved with without adequate training or experience.  A surprise after opening the patient.

Having no other source of help in the urgency of the moment I prayed urgently and silently.

That ordinary people can accomplish extraordinary things with God’s help, I can affirm.

 

 

 

October 11, 2015

I received a call from Bob and Dianne at the Cabin with Nikki this week-end.

Bob has the knowledge and ability to provide Satellite telephone service up there, and it works well.

They have had a lot of rain, the Pack Rat problem appears to be under control and the weather is nice with Fall in the offing.  Bob reports that the road up to the Cabin is in need of repair from rain damage, and he will be able to do that with his new tractor.  I think they return tomorrow.  There are some apples that are ripening and they will bring some for me.

Those Western Delicious yellow apples from Stark’s Nurseries are the best I have ever tasted, although late freezes make them available about once in ten years.

It is warm here, although comfortable.  We have what my Mother would call a “Buttermilk Sky”.  Little sun, a slight breeze and a great day to sit on the Patio and smoke a cigar.

It looks as if I may be around another Christmas, and I am making plans to prepare envelopes for my Family to insure their delivery.

The cats have made me a present of the head of a Roof Rat which they laid out on the Patio door mat.  I discarded it because I have no recipe for Roof Rat heads, although I appreciate the gesture.

 

 

 

Paul Jarrett has died. America has lost one of its big men, a patriot, a man of substance and integrity. Medicine has seen the passing of the last of his kind. A congregation has lost a faithful worshipper. We who were Paul’s friends have lost a wise man, a sort of prophet. Phoenix has lost an ornament. But whatever his greatness in the wide world, it was in the little corners of life where I saw Paul Jarrett’s meaning writ clear. It might be seen in his solicitude for the unpromising cats he succoured, in the empathy and in the respect he extended to those battered living things. Born into an era where males were born to rule, Paul esteemed women higher. 

 

 

 

Paul was the son who honoured his father and his mother; of two brothers Paul treasured and measured the greatness of the one, and cherished the second in his deformity. Paul was the husband who never ceased to love and to sing the praise of the wife he outlived for so many lonely years. Paul was the father proud of those stalwart sons, adoring of that dandled daughter; Paul was the grandfather who inspired grandson Benjamin to follow him into the guild and bond of medicine; Paul was the Methodist whose whole heart could celebrate his great-grandson’s bris. The measure of the man, Paul Jarrett, was the honour he paid to those he loved.  

 

 

 

More than once Paul wrote, “Great was the celebration in Heaven when Beverley arrived.” Such was the simplicity of Paul’s faith. Mine differs. But it gives me pleasure to imagine how great might be the celebration for that good and faithful man. 

Not Pittsburgh

I call and invite myself to visit with my friends David and Nancy in Pittsburgh. Nancy is a paediatrician and David a paediatric psychiatrist. Their lives in work are an inspiration to me. I get onto David. He’s welcoming and hospitable as always. ‘We’ll love to have you. What are your dates, Howard?’

‘Last week in October.’

‘That’s unfortunate’, said David, ‘I’ll be attending the meeting of the Academy of Child and Adolescent Psychiatry at that time, in Seattle. You couldn’t come to Seattle, could you?’

I can come and I do. And so I don’t go to Pittsburgh.

In Seattle, a sizeable city where the rain falls, coffee shops and bookshops abound – as in Melbourne. The coffee is good, just about good enough to compensate for the weather. Like Melbourne, Seattle is a UNESCO World City of Literature. I feel at home in Seattle’s mists and drizzle, with Seattle’s coffee and bookshops, and in the city’s richness of cultural endowment.

I attend the conference and I soak up the latest research into adolescent mental health. I see how my friend David knows everyone, how they cherish and venerate him, how the younger researchers find him inspiring. Over thirty years’ leading child psychiatry in Pittsburgh David has contributed richly to his field. Adolescents without number he saves from death by despair. A few years back I see him at his work, one-on-one with kids whose lives are blighted from the start. I see and I marvel at the pioneering work that keeps these kids alive and helps them thrive.

It turns out the Academy are honouring David, choosing him to give the Plenary Address. On occasions like this Americans enjoy pomp and formality. The Plenary is a grand event. Every delegate attends. A great hall fills. David and his fellow Illuminati – numbering perhaps one hundred – occupy tiered rows of seats facing the audience. The audience of seven hundred delegates and their friends and spouses fills the remaining rows. Oratory bursts into flower, moving with the spirit from Grandee, to Honoree, to Celebrity, to Worthy Worker. As Yeats wrote, ‘…all’s accustomed, ceremonious’.

I sit in the front, opposite my friend, myself aglow in his glory. David sits, pregnant with the words that will distill his wisdom. But before he will speak, we must hear from a Traditional Leader of the Peoples native to this area. Her name, we read, is Connie McCloud. A short, stout woman rises to her feet before us. She is not young. I notice her heavily tinted spectacles. You don’t need sunnies in Seattle; perhaps her sight is impaired. The woman does not move until a younger man with brown skin offers an arm, which she accepts, and she descends ponderously to the lectern. The President of the Academy introduces the speaker: ‘ It is an honour for me to present Connie McCloud to offer us her Blessing and her Welcome. Miss Mc Cloud has led her people, the Puyallup, for over thirty years.’  Someone adjusts the microphone to her height. Connie McCloud stands and regards us, visitors to her lands. She thrusts a fleshy arm upwards and she gives voice.

The voice is at one moment strong, freighted with pride and feeling, the next moment faltering beneath that heavy freight. The woman tells us proudly of her country, of its sacred mountain, its waters, its nourishing salmon, its deer, its skies and clouds and forests. ‘We have always been here! Despite all attempts to bring that to an end, we have always been here!’ The voice rises and the woman declares, ‘And God damn it, we are still here!’

She flings her stout arm backward and upward: ‘Our sacred mountain, which you will be told is Mount Rainier, is Tacoma. A newcomer named it for a friend of his, a magistrate named Rainier. Mister Rainier never visited these lands. He never saw our mountain.’  I’m reminded of Alice Springs, named for Alice Todd, absentee wife of the telegraph surveyor. The true name of that place is Mpartwe.

The speaker speaks of her lineage. She names her father, names his, then traces both to the brother of Great Chief Seattle. (As far away as Australia we’ve know that name for the lines attributed to him upon the imminent surrender of his lands: ‘Every part of the earth is sacred to my people. Every shining pine needle, every sandy shore, every mist in the dark woods, every meadow, every humming insect. All are holy in the memory and experience of my people.’)

At length Connie Mc Cloud says, ‘Here is my blessing. Here is my prayer for your success here in our lands. Here is my prayer that your wise people, your leaders, will find a cure for this suicide that takes away our young people.’ Oratory comes to its end as Connie Mc Cloud bursts into song. None of us non-native persons has heard song such as this. An ageing woman’s voice rises and falls, consonants and vowels sewn together into a strange fabric of slow rhythms and novel patterns, make their way into our stilled being. A sense of something solemn, something authentic and ancient and potent, penetrates us. The song rolls along, a river of sound that flows, from age to age, with steady pace, to its last syllable. We know a serious peace. I look up. David is mopping his eyes even as I do the same.

https://www.theolympian.com/news/local/article203194544.html

When at length David does speak, it is of death – of the premature loss of our young at their own hands. David is not a morose person. His rubicund features glow with ready playfulness. The life and the play reside alongside the gravitas of the protector of young lives. David’s theme this evening is ‘Saving Holden Caulfield.’  The reference is to Salinger’s The Catcher in the Rye, in which Holden Caulfield imagines himself as the catcher of children who tumble helplessly over a sheer cliff at the edge of a ryefield. David and his colleagues are the catchers below the ryefields from which our true life teenagers leap.

David begins with a light-hearted remark that I don’t catch. He twinkles and his audience relaxes. Then it’s down to business: ‘After all these years we’re seeing not a fall in teenage suicide, but a rise. After all these decades of research and treatment we’re not winning. It’s not as if we don’t know what works: research has shown us what works; we’re simply not implementing it. After these many years in the field my mind turns to retirement, to enjoying the grandchildren. But there’s that graph’ – David points to the rising line of trend on his slide – ‘and I’d like to see it point downward before I leave the field.’

David flies back to Pittsburgh, to Nancy and his children and his grandchildren. His house stands 500 yards from The Tree of Life Congregation where a family gathers on Shabbat to name their eight-day old baby boy.  A man posts on Facebook, ALL JEWS HAVE TO DIE. The man enters the congregation and the following are named among those who die:

• Joyce Fienberg, 75, of Oakland;

• Richard Gottfried, 65, of Ross;

• Rose Mallinger, 97, of Squirrel Hill;

• Jerry Rabinowitz, 66, of Edgewood;

• brothers Cecil Rosenthal, 59, of Squirrel Hill, and David Rosenthal, 54, of Squirrel Hill;

• married couple Bernice Simon, 84, of Wilkinsburg; Sylvan Simon, 86, of Wilkinsburg;

• Daniel Stein, 71, of Squirrel Hill;

• Melvin Wax, 88, of Squirrel Hill;

• and Irving Younger, 69, of Mount Washington.

Waterfall

I’ve just watched a short film which shocked me. Basically the movie captured the knifing by one human being of another. Shocking enough to see real footage of the live cutting of a human, but the knifor actually got the knifee in the eye.

I watched the youtube to prepare myself. Next week I will be the knifee. I’ve selected my knifor, a charming young woman who talks with me about books. If someone is going to poke a knife in your eye you might as well choose a good conversationalist. Because, they tell me, I’ll remain awake throughout the procedure in which she’ll remove my cataract.

Years ago I consulted a doctor about some red blood cells that had bobbed up in my urine. I felt well, I had no pain, the organ in question looked as good as ever it did. The doctor and I found ourselves in agreement: it’s probably not cancer. But we’d better take a look, he said. I agreed. The doctor then described the procedure of taking a look, a matter of tubes up my tube, a matter of lube within my tube…

Yes, but what about anaesthesia?

Don’t worry about that, said the doctor, we’ll use xylocaine jelly.

But I do worry about that. Put me out, please.

Don’t be a baby, said the doctor.

So I remained awake. Someone removed my undies. Dumpy middle-aged women wearing scrubs didn’t bother to glance, let alone admire, while the man, an awardee of the Order of Australia, travelled north through a passage that had known southbound traffic only. Electrifying.

I’ve been re-reading Philip Roth’s ‘American Pastoral’ in preparation for next week’s book chat. Next week, if I see my way clear, I’ll let you know how I go. Meanwhile if you enjoy a good vomit, google Cataract Surgery for the Layman you tube.

In Praise of a Very Small Town

Before I answered the calI I’d never heard of Trundle. When I googled it I might have giggled. A town of six hundred souls, Trundle boasts the second-widest main street in New South Wales, and its pub boasts the longest verandah in the state. I didn’t giggle. I held my mirth.

All morning I chased my tail in the big city, I caught my plane, I recited the Traveller’s Prayer and I breathed out.

It was dark when the plane dropped me at Dubbo. The bloke in the burger shop near the airport added up my bill for one bottle of iced coffee, one bottle of putative lemon. I pulled out a ten-dollar note.

Something was different: the man didn’t scan the bottles. He did his calculation in his head. Ten dollars fifty, he said. The man looked up and saw my money. Ten bucks, he said. I thanked him. You’ll know where to come next time, he said. I said I will. I meant it.

I took the shorter route to from Dubbo to Trundle. I didn’t realise the shorter route would take me by dirt roads for much of the distance. Over the two hours on those back roads I startled a few kangaroos but encountered no vehicle passing in either direction. The dark of Dubbo was darker out there in the quietness and the road signs were unlit. I took a wrong turning and got lost. I got unlost and entered Trundle. The wide main street was brightly lit. Nothing moved.

At the hospital I asked the nurse, can you direct me to my quarters? No, she said, I’ll take you. Follow me. She jumped into her car, I into mine and we drove through the dark to a house that wasn’t brick. We bought this to let to visitors, she said.  We’ve spent seven years renovating it. The nurse opened the front door and I stepped into the perfumed past. Motel deodorant swamped all olfaction. The nurse pulled a switch revealing animals that greeted me from every side. A steel sheep and a steel cow stood at either side of the front door. In the lobby a crocheted mouse in a lilac dress stood knee-high by a bedroom door. A second mouse in white stood guard at the second bedroom. A third mouse in soft pink waited by the third bedroom. Ladies’ hats hanged from hooks, trailing ribbons of many hues. A large painting of Trundle’s main thoroughfare (famed for its width) stood on the loungeroom floor. The streetscape peeped brilliantly from behind a swath of brown paper upon which someone had written, apologetically, Sorry, Not For Sale.

Flowers fashioned of bright fabrics overflowed from waterless vases in every room. In the kitchen, mugs of colourful ceramic spilled from every cupboard.

Relentless decoration everywhere. Art deco china cabinet, four kinds of chilli sauce and very white bread indeed.

Décor surrounded me, pressing in from every side. Furnishings that dated backwards in time from the year 1950 overflowed in every room. Here was the Australian rural past in glowing abundance.

Tucked behind a bedroom door, in the depths of a very large leather hatbox, sat a felt hat in sky blue. An emphatic navy ribbon decorated the hat. Above all stood a framed text, written in smart neo-gothic. Its title read, The Story Of a Hat. The story told how that hat was made by hand for a wedding at a period when no woman went to church unhatted or ungloved. It was a matter of respect. The story, unsigned, ended with the words, This hatbox belonged to my grandfather.

Two thoughts registered: This house was, not renovated but de-novated – a home to memory. You would not sneer at sincerity. And kitsch would not be the word; this was love.

In the main street shopfronts stood beneath brave signage. Two of every three shops were closed. A sign read, Trundle Talkies. Excited, I raced across the road to check the movie times. I was too late by thirty years. I read the signage above the garage. Pontiac, Plymouth – those makes that ferried my family across the state in the 1950’s – now extinct.

A card in one shop window read, closed until further notice, ill child. I saw five clothing shops. The stock seemed to be the same in all five. Three were closed, one with a notice advising, Yvonne comes Thursdays and Mondays, 11.00 to 3.00.

I went to the first of the open shops to buy undies. The child in charge was sorry, they had none. I might try the Op Shop two doors down. No undies there either, but I noted the stock in the Op Shop looked the same as in its competitors.

Two doors down was the office of the Annual Abba Festival. Thousands attend. They put on a special train from Sydney. Everyone dresses up as one Abba person or another. Great are the festivities.

I doctored in Trumble for three days. Most patients were farmers, heirs to farms worked by their families for generations. Many of these people were older than I. None complained when an emergency elsewhere in the hospital detained me. If I said, sorry to keep you waiting, they looked mystified, then assured me it didn’t matter.

I thought about this. These people worked the farm from sunup to sundown. There was always work to do. But they had time to spare for other people. They’d survived the long cycles of dearth and plenty. In the present dry – the worst in memory – people were feeding their stock by hand. They’d stopped planting crops, waiting for the rains. They knew time differently from my patients in the centre of the great city.

My principal in the practice spoke of an epidemic of depression, of farmers dying of sadness. Others would be forced from the land, to walk away from the family farm. It occurred to me to ask, where are the Aboriginal people? Not here. We’re not on a river. And there’s no community in Parkes either – no river there. But strong communities in Dubbo and Forbes. They’re on rivers.

My three days completed I rose at 2.45 am to drive to Dubbo to catch the earliest flight to the city. I drove down that wide, wide street, built for the bullock trains to do their long u-turn.

I hurried through the dark, eyes wide for suicidal kangaroos. I arrived at the airport and checked in. I checked my phone: I’d arrived on time. Chasing my tail again.

Faith and the Flu Vaccine

Some trust in God, some trust in nature, others trust in nothing and no-one.

The roots of these feelings lie deep, too deep generally for the light to penetrate.

These feelings are almost religious: they express some faith or, occasionally, a fear of all faith.

If you try to debate feelings of this nature you’ll find them impervious to argument. They are held sacred and well away from the light of enquiry.

If you believed I held a particular faith you might consider my belief absurd. But because of your good manners you’d probably keep that view of my quaint beliefs private. You’d realise argument would not budge me and, out of kindness you’d refrain from locking horns with me.

Circumcision evokes a great example of quasi-religious positions. Whenever you hear the subject discussed you’ll recognise the intensity with which a person expresses a position. Here we find conviction, not opinion. Convictions are guarded fiercely, they are immune to fresh evidence: conviction is the opposite of scientific openness of mind. I have noticed how lay people, doctors and nurses alike defend their positions on the foreskin with religious intensity. I do not argue with the foreskin zealot.

Winter has come to Australia with promise of our regular influenza epidemic. With winter comes a rise in religious sentiment on the matter of immunisation against the flu. The government preaches immunisation, we doctors echo with our own hosannahs, the trusters in nature shriek back. We all talk at each other. We find it hard to listen when our faiths collide. Doctors trust in herd immunity. On Facebook my daughter tells ‘friends’ she trusts her doctor father. One respondent trusts in nature (“I‘ve been vegan for seven years, and I’ve never had the flu during all that time.”). Another respondent trusts no-one and nothing (“ It’s a conspiracy. Big pharma in cahoots with government.”)

I looked up some facts about influenza and vaccination. I found plenty of facts but these will change few minds. (Two thousand proven influenza deaths. Lots of people become unwell in the two weeks following vaccination. Not everyone who is vaccinated with be immunised. Not a single proven death from the vaccine.)

I had been doctor for two weeks when I saw my first influenza death. The patient caught the flu late in pregnancy. She deteriorated rapidly, developed pneumonia and was soon brain-dead. Her baby was delivered by emergency caesarean section and lived. That baby never knew her mother. Mother was twenty-four years of age. That was my own age at the time.

Last week I vaccinated my children and my grandchildren against the flu. I had the vaccine myself. I offer the same vaccines to all my patients. I answer their questions, I provide information, but I don’t enter into religious disputation.