The Miner


 

He’s a tall man, slim. He wears clothing of dark gray. When he gives his surname, I nominatecorrectly his country of origin in Northern Europe. It’s only after we’ve parted that it occurs to me his name translates to Big Son. He might well descendfrom a line of big sons.

Even though he’s past retirement age, I ask him what he does for a living. Out here the farmers and the miners never quite give it up. I’m a miner, he says – a shrug, a wry smile. The lure of the big find is too strong for some to stop.

– Where do you live?

– Out along the Seven Mile. I’ll take you and show you if you like. You can see the diggings.

– OK, I have your address. I’ll drive out.

– You can’t. You’ll get lost.

This rings true. The town is peopled by those who don’t wish to be found, persons escaping the Lawor vendetta or drug dealers or the tax man or the former spouse, or a life of persecution in the old country. Nobody really knows the population. The town boasts fifty-four ethnic groups. As you drive into town a sign welcomes the visitor. A little further on a sign reads: “POPULATION ?”

The 2016 census lists 2016 persons, a neat match, probably too neat. No one really knows. It’s though a further 3000-odd are hidden away in the hills, where they live in disused trams or railway carriages, huts and caves. In the past, the local Police designated a discrete patch of earth behind the shopping strip where scamps and scally wags were allowed to park when they came into town for supplies. Certain back roads were allotted to these folk. The Police would ask no questions so long as the miners did not bring themselves to their attention.

Big Son instructs me to meet him outside the front of the clinic after I finish work: you can follow me out along the Seven Mile. At 5.00 precisely I step out into bright sunshine where Big Son looks at my white hire car and says, Get into my vehicle. Yours is too pretty to take out bush. I jump in to a large, hard-working 4-wheel drive and we drive out of town.

The further we drive the thicker the marks of the digger. Low structures of tin and timber alternate with mullock heaps of pale stone and earth and random bit of rusted machinery. We’ve left the bitumen behind us, dirt tracks branch off and wind off in all directions into thin scrub. I’ve lost my bearings. My companion keeps up a commentary: that claim there belongs to a friend…over here you can see cabins…the people over on the right run a really good tourist operation.

Before I came to this country I moved to Roma – I had a girlfriend there, the usual story, you know – in Roma I set up a photographic studio.

Photography was my trade. 

The narrating voice has taken on a note of pride.

I didn’t speak the language, but I taught myself by watching videos in Italian. I succeeded as a linguist but I struggled in my photography business. No network.

I visited Australia – curiosity, you know?  Back in Roma I applied for a visa to settle in Australia. It was for adventure. I came out here and started to dig. I married once, had a couple of daughters. The marriage ended. Married again, my wife is an artist, an art teacher. We fostered a little child. He was murdered. My wife went mad. I sold up, sold all this – by now we’re at his claim and we’ve pulled up – I had to sell and take her to the city for treatment…

The young bloke who lived over the hill there, a loner, a misfit, killed the little one. He lived there, a recluse, a neighbour. No one knew anything about him until he committed murder. Of a child.

CARRIAGE HOME

My wife got better and we came back. I got a new claim just by my old one. This is it. ‘This’ is a patch of elevated stony ground with holes in it. Disparate bits of metalwork rise above the surface and disappear below. I peer down a hole walled by a cylinder of galvanised iron. The hole is a mine, about one and a half metres in diameter. My host says, it goes down eighteen metres. I consider the dark and the deep. Obviously you don’t suffer claustrophobia…

I do, to a degree. I think anyone with imagination must.

Spiral staircase for a mine

Bright blue steel steps disappear into the depth of another circular hole. Big Son says, a friend invented that spiral staircase. The friend sells them to diggers and small miners across the country. This machine here he points to a steel contraption – I built. I invented it and patented it. I’ve sold a few of them, but most diggers can’t afford $18,000…

The digging machine invention

The machine that my host devised is a complicated structure of thick steel, encasing steel cables, an electric motor and meters with dials and numbers. It stands, grey, substantial and sophisticated on the primal earth. There’s not a speck of rust. It’s a machine for digging a mine. I gaze at the device in awe. Inventor and invention alike stand solid and impressive, gunmetal grey, erect in the unforgiving sun.

Who trained you in engineering?

No one. I always liked machines, devices, gadgets. I pulled things apart, curious you know?

What does a digger do who can’t afford a mechanical digger? Pick and shovel?

Yes. If they can’t scavenge bits of old machinery. Maybe fix it up, get it working.

I consider pick and shovel work in the digital age. Out here summer temperatures reach fifty in the shade and stay there for days. But I do know why a digger might stick at it. On the way out of town Big Son pointed out a jewellery showroom: Very honest people there, prices very reasonable. They’ve got a gem there that I dug up, very valuable. They paid ten thousand for it. They’ll sell it for forty thousand, but they might have to hold it for years.

Another person, obese, not old, walking on a stick, hobbled and rolled picturesquely into the clinic this morning. Both her florid gait and her words told a story that stretched the truth in support of her quest for a medical certificate for welfare benefits.

We moved onto other subjects. 

What’s your work – when you’re able to do it?

I’m a miner, she said. I’ve got forty thousand worth of raw gems in this bag. 

In this town that outlandish statement might just be simple truth.

Here, gemstone is currency that doesn’t leave records. Bankers, accountants, the taxman need not know.

My tall host looks around his claim. He says, There’s always theft. You can’t make your property safe from thieves.

I ask, Do people arm themselves?

Some do, they have guns… shootings aren’t rare out here.

This here is my blower – Big Son points to a large hollow, elevated structure of steel and rust, that rises above the claim, shaped like one of those concrete mixers you see on trucks at building sites. This towers above us. It does something with mullock that I don’t really understand, but it sounds like winnowing. My host tries to explain: You see that motor there? I found it in a derelict street sweeper. It’s a three-cylinder diesel. I adapted it. It’s noisy. The miner turns a switch. A battery turns the motor over, it fires then clamour, brutal and immediate, drowns conversation. The thick steel platform vibrates beneath our feet. 

Come this way, into the house. Twenty metres from the claim, just down a small slope and hidden from sight at the claim, stands an elegant modern building of steel and timber. Yes, this too was designed and built by my host. It stands on leasehold land. The house lease is separate from the mine lease: You get a home lease for twenty-five years. You renew it every twenty-five years.

We pause at the threshold. Big son points: these stones everywhere, that’s gemstone waste, that’s potch. My host leans a long way down and picks up a pebble. Here take this, a little souvenir. I look at the little grey pebble. Its centre glows with blue and green fire.

Inside, all is dark. A woman of middle age materialises and speaks in a florid French accent.

We stand in the dark room until electric light reveals walls hung with artworks in oils that startle with their mute emotional power. The artist steps from the shadow and speaks with shy pride about the paintings.

– You see that brown shading? Do you know what I use for pigment? 

I regard the glowing brown and shake my head.

– Coffee. Nescafe. I’ve tried other instant coffee. Nescafe gives that fire in the brown.

We come to a bathroom whose walls are a menagerie of megafauna: emu, koala, kangaroo, in their greys and browns move across bright panels of white and lime. My hostess explains: We sit on the toilet and instead of blank walls, we gaze at animals, bounding across the walls, alive.

We pass a small portrait, the only watercolour. The painter passes it by. Big Son pauses. We regard a bright portrait of a little boy with a face full of life andwild, straw-coloured hair. He radiates light. Big Son says quietly, this is our little one.

Deploring


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.

 

It’s deplorable.

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.

What Does it All Mean? – V The Final Act

‘TRIGGER WARNING’

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.

What Does it all Mean? – IV

Warm Skin and Broad Shoulders

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.

Julie died.

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.

What Does it All Mean – III

Crossing a Bridge

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.

What does it all mean? – 2

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.

Thank you.

My name is Howard.

I Anastasia.

Hello Anastasia.

The woman returns my smile of greeting with a weak smile of her own.

I sit.

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.

The pain?

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.

What does it all mean? Part 1

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.)

The MRI

Two Sundays ago I underwent magnetic resonance scanning of my prostate. I was feeling well, I just had old man waterworks, nothing out of the ordinary. But there was a rise in the prostate antigen. MRI is an ominous sign: generally when a doctor orders an MRI she’s looking for a cancer.

My GP said, I don’t think this is cancer.

My specialist said, It’s probably benign.’

My medical self thought, I don’t think this patient has cancer.

So far, so unconvincing. When the appointments person said, There’ll be no charge. Medicare covers this scan… I really misgave.

Medicare means the Government. Governments are not sentimental, not famously charitable, excepting when it comes to cancer. When it comes to cancer the Government says, No charge, Howard. On the house, old fellow. Sorry for your news.

Cancer evokes awe. When someone says, So and So has cancer, we say, Oh.

Silence follows, we experience awe. True awe, not the cheapened article as in awesome Uber ride. This is the real thing: we stand, hushed; we feel a chill, we’re in the shadow of the absolute.

***

I turned up at the hospital which was a place of silence. I gave my name, I gave my phone number, I gave my excuses for being there. The man looked at me suspiciously and asked for my Driver’s License. He held it in a gloved hand as far away from his face as his short arms allowed. He photographed the document, grunted and returned it to me. The man sanitised me and allowed me to enter. I walked the empty corridors, climbed abandoned flights of stairs, got lost, retraced my steps and tried again. In the bowels of the building I found MRI. The young woman behind the perspex screen read through the lengthy pre-admission affidavit I’d completed. She read my thirty-three responses to questions: full name, date of birth, did I have dentures, did I have implants, were my hips natural, how about my knees, had I ever had an MRI before, why was I having this examination, how was my health, did I have coronary stents, ureteric stents, urethral stents, was I wearing hearing aids, did I believe in God, did God believe in me, did I have a next of kin, whom did I want notified in case of emergency, had my name changed in the last ten years, and had there been any change in my date of birth. The young woman ticked all my responses. All satisfactory, all correct. Then she noted the date of my document: ten days earlier. Sorry, Howard, I’ll have to ask you to fill out this questionnaire once again. It’s ten days old. We can’t accept it over a week. I filled out the form: same questions, same answers.

A nurse, gowned, masked, gloved, came and claimed me. What’s your full name? Date of birth? By nowI knew the answers by heart. I told him. Here, he said, passing me a small plastic tube, this is your micro-enema. The prostate is radiologically remote, hard to visualise. We can’t have any waste matter obscuring the view. 

Waste matter? Perish the thought.

The nurse, probably male, probably forty, but who knows? – led the way. He indicated a door. Here’s your bathroom. Go in there and insert the tube.  I entered and looked around. I saw no bath. I sat down above a porcelain bowl. There were only two openings for the tube. I chose the back one and inserted the tube, a novel sensation. I awaited the arrival and departure of waste. Nothing happened. I emerged and the nurse claimed me again. He lay me down, inserted an IV into an arm vein, asked my full name, and what was my date of birth.He recorded the responses and took me into the MRI chamber. I clambered into a mechanical vault whose walls were of mausoleum white. I lay down on a narrow board. A machine propelled me and the narrow board backwards into the mausoleum. Nurse placed earphones over my ears. What music do you like? I answered and he (My name’s Brian) turned a dial to ABC Classic FM. Some musicians performed some fretful baroque sounds which were free of melody. The nurse placed a gadget in my right palm: Press this button if you need to get out urgently. I’m going to inject contrast. What’s your full name and date of birth? He recorded my responses. Okay, we’ll get under way now. You’ll be in there for 40 minutes or so.

I said, there’s something I ought to tell you.

What’s that?

I haven’t discharged any waste.

Oh!

Now the board slid me feet-first out of the tomb. Back in the bathroom I sat down again. I did my honest best. My output was modest. I returned to the MRI chamber, purged and waste-free. Earphones back on, I heard mechanical sounds of the end of the world, mercifully drowning the Baroque. I napped. Brian tapped me on the shoulder, told me I was free to go. Contact your doctor tomorrow for the report.

***

I called the next day. I said I was the referring doctor – which was not entirely untrue. I gave my full name as referring doctor. I gave my full name and date of birth as patient. I waited. I don’t think the radiologist will have reported the scan yet, said the pleasant young lady. I’ll just check… Yes, I do have a report. Howard Jonathan Goldenberg?

Yes.

Born January 8, 1946?

Yes.

Normal scan. No sign of malignancy.

Once, on a cold day in Melbourne

Someone called the Clinic the other day and left this message: ‘Alexa Rosa wanted to speak to the doctor who treated her mother a long time ago. And she wanted to buy your book.’ Did I know an Alexa Rosa? I thought somehow I should. A scene came back to me: a cold winter’s day in Melbourne, a young family in a front room, a sick mother, her worried husband, their adult daughter.

If this truly was my Alexa, then her story was strong and bright in my recall. I could never forget it. It was the winter of 1971. I had a new marriage, a new licence
to practise medicine outside of the hospital and a brother about to marry
in the United Kingdom. In order to raise the fares to the wedding I moonlighted as a radio locum. A radio locum installed a two-way
radio in his car and travelled, like a taxi driver, to wherever the job
called. On this occasion the call came to the Migrant Hostel in Kororoit Creek Road Altona. My bride, an able map reader, sat at my side and navigated.


Kororoit Creek Road in Atona was a long drive from everywhere else. When we arrived and parked in a vast car park, Annette (the bride) repeated the Controller’s directions, “Building 19, apartment 5.” I stepped outside.
Here, at Melbourne’s western edge, you could see the setting sun
disappearing beneath the horizon and the world darkening.

I didn’t feel happy leaving Annette there in the dark. I looked beyond the carpark toward the distant buildings. Would Annette be any safer in that lowering mass? Annette said, “I’ll be alright here. Just go.” Troubled, I went. How would I find building Nineteen where someone needed a doctor, someone who was suffering from something, possibly something serious? Having now reached the first of the buildings I could see my search was hopeless. The buildings were all great bulky cuboids of concrete. All were unli. And the dark was cold. I wandered and looked for numbers. No number nineteen anywhere, no five. I knocked on a door to enquire. The door opened, I asked, Can you direct me to Flat Five? A hand flew to the heart. The head shook: I not English. I sorry.

I felt sorry too. I turned dully away. Of course no English, everyone here newly arrived, everyone indoors, appalled, like me, by the cold. Movement in the shadow on
my left. I hailed the shadow: Excuse me, do you speak English? The head
shook no, while the face smiled a wide yes. The shadow, a young man,
beckoned, and signed me to follow. I followed. He moved swiftly along cement paths, in and out between buildings, along corridors, until abruptly he stopped in his tracks, pointing and nodding furiously. The shadow knocked on a door, turning to me, smiling. Pointing towards the door, the shadow said, English! The door opened and a voice spoke: Good evening. How can I help you?
Did you send for a doctor?
No.
Is this Apartment Five?
No. This is seven.
Is this Building Nineteen?
No but I’ll take you to Number Five..

This was someone not lost in language nor in space. Feeling found, I followed. A building or two or three later, my guide stopped and knocked on a door. I noted a large numeral 5 next to the doorway and felt almost
hopeful. The door opened and a pretty young woman appeared. Behind her stood a man, older than she; behind him a couple of small children, curious and fearful, clutched at the man’s legs and peeked. The young woman saw my
medical bag. She told me her name and said, Come in Doctor. Thank you for coming. My mother is sick.

Mother lay on a couch. She did not look well. Her daughter explained: We arrived just today from Spain. During the flight Mother started to cough and it was hard for her to breathe. Now she has a fever. We didn’t know how to call a doctor. Thank you for coming.

I examined the lady. I thought I heard altered breathing sounds in one
lung. I bent and listened hard. The air struggled into one side of the chest, it rattled and squeaked.This was bronchopneumonia. Ordinarily a hospital matter, this called for X-RAY, possibly intravenous treatment as an inpatient. How would this lady get to hospital? Would Medicare cover a new arrival? Would the ambulance take her? Was there another way?

I straightened and addressed the  man through his adult daughter. Mother is sick. She has an infection in her chest. She needs strong antibiotic medicine, she might need to go into  hospital. If you wish I can start some treatment here, now. And with luck she will improve quickly.

The daughter translated for her father. The two spoke with the mother, the three nodded. They had decided. The daughter spoke. Thank you doctor, yes, we would like you to treat her. Thank you doctor…we don’t want hospital.  I fished out some  penicillin – no, mother is not allergic – and gave the lady a hefty dose by injection. I wrote out a prescription for oral penicillin to commence the next day. 

Leaving detailed instructions for a range of eventualities I prepared to take my troubled leave. I wished the lady well, I wished the whole family good health in Australia. The daughter reached for a purse. How much do we pay you, Doctor? I did not want payment. A doctor who deserted his sick patient didn’t deserve payment. I said something like, There is no charge. To myself I said, You have paid me, you’ve paid off my guilt. The young woman protested, No Doctor, we must pay you. We don’t know who sent you. How did you know we needed you? I didn’t know. Once again I wished them well and I left, my ears burning with blessings I could not accept.

Back in the car, I found Annette unharmed. I said, I couldn’t find my patient. And I told her the story.

***

It might have been six months later when I was called to the Delivery Suite for the birth of a baby. Birth was not expected for some weeks. Labour was well advanced when they called me and birth was imminent. I needed the mother to help. ‘Push, hard, push! The mother didn’t speak English. A masked figure at her side coached her, translating my words: Big, long push. Push….The mother pushed, her face turning deep red, the veins standing out on her forehead. Stop pushing now! Don’t push! Breathe, breathe…The mother breathed and with each breath the head advanced. The mother breathed her baby into this life, accompanied by fluids, red and clear and mucoid, and followed by the placenta and cries from the baby and crying from the mother. I counted fingers and toes and other parts and placed the baby on the mother’s chest and wished the new family joy. I pulled off my mask and thanked the person whose interpreting had made the birth smoother. I extended a hand, My name’s Howard. We have met, she said, removing her mask. I am Alexa.

***

Alexa explained she had come to visit her friend, now a new mother, in her ward. Abruptly, labour started and accelerated. The hospital discovered there was no-one to interpret for a Spanish speaker so Alexa volunteered. We chatted. She told me her own mother was well, recovery had gone smoothly. She, Alexa, was working as a wardsperson in this hospital. She told me she hoped to study nursing.

I said, I don’t know if you realised I had been called by an entirely different person on the day you arrived from Spain. I never found that person. I never discovered how I fund your Mum. I know, said Alexa. God sent you.

A few weeks later my father told me a new family had started seeing him as their local doctor. They’re from Spain, he said. They tell me you treated the mother for pneumonia.

***

Forty-nine years passed. Locked down, I’m doing Telehealth from home. A message arrived for me, asking me to contact an Alexa whom I had know years before. I rang the number. Alexa speaking, said a voice. The voice sounded Aussie. I told Alexa who I was. She asked, Do you remember us? If you arrived from Spain in 1971, then yes I do. How could I forget? We did. It was 1971. I guess you were about nineteen then. Exactly. So you’re sixty-eight now? Yes. And I did do nursing. I’m still nursing. We talked for a while. Mum is still alive. She’s ninety-three now. Dad only died last year. Do you remember what you said when you left us that night? What did I say? You said, I wish you health and happiness in this country. You blessed us and your words came true. I reminded Alexa of her words to me in the Delivery suite. You said, ‘God sent you.’ That’s right. God did send you. It’s the only explanation. That was the night I became a believer. I found God in the Hostel.

***

In the few days that have passed since Alexa opened the closed door on half a century, I’ve felt excitement and perturbation. I’m excited that Alexa and I will ‘meet’ again, that I’ll ‘see’ my pneumonia patient again, spry and vital; that I’ll meet the children and their father, that I’ll learn their stories. At the same time, some different, powerful feeling operates and unsettles me. It’s the thought of the power of a word, the reverberation of a small act. Alexa sees the hand of the Divine. Does that make me somehow an instrument in a plan? I cannot begin to recognise anything so lofty. I dismiss any idea of some special mission I might have; I find that sort of belief a burden, an embarrassment; it makes me want to run away.

But I’ve been moved to tears thinking how a simple act might lodge in memory, might germinate as a seed, might influence a life; that somehow, quite without intent or thought or awareness, a simple act could take root, help, lift, encourage, perhaps inspire. That thought brings with it a glow, the sense I have done as I know my father did before me – many times – some act of unwitting goodness that lived on afterwards. I’ve felt overcome with a feeling of blessing, perhaps of being a small link in a long chain that might continue on, in lives undreamed…

Mercedes, aged 92 years
Alexa and son

The Hero

My father was a doctor. In his small town where we lived he was adored. As a boy I saw Dad as a hero, standing against illness, repairing broken bodies, relieving suffering. One morning a grownup came to the front door, his hand wrapped in a bloody towel. His horse had bit his hand. I looked up and I saw the blood dripping. I called Dad, who took the man into the Surgery and closed the door. After a while the man walked out, his hand in a spotless white bandage. Dad had repaired him. Dad, the hero.
Fourteen years later I entered the Oratory Competition at my city school. I spoke about doctors and I called them ‘society’s noblest sons.’ My father read my speech and said, ‘Darling, I’m afraid that’s not true. Doctors aren’t so noble.’
I had been reading ‘The Story of San Michele’, the memoir of a Swedish doctor who worked in fin de siecle France. A cholera outbreak in Naples saw the young doctor leave the safety of Paris to work among the Naples poor. In the plague hospital the doctor worked alongside a nurse. The nurse was young, beautiful, a nun. With death all about them, the two young people felt the call of their vital flesh. I read the old doctor’s account, modest, intense and arousing. I saw the two walking with eyes open, day after day, into the valley of death. How could I not see them as heroes? I did not alter those words. My speech convinced the judges and I won the contest.
Today the plague rages about us. At the outset, before contagion struck down the many, the principal of my clinic offered to release from duty any clinician who feared catching the virus. I felt shocked. We had worked through AIDS, when any pinprick might mean death. (I did in fact suffer a needlestick injury at the hands of one of my infected patients.) We had worked though the Swine Flu and through SARS. That was our job, our calling. How could I leave and sit it out at home?
Today I sit at home. I have closed the door, closed myself and my wife in, closed the world out. I feel like Noah might have, as, closed in his Ark, he saw the waters rise upon those locked out.
Meanwhile my younger colleagues work on. They all have spouses, aged parents, small children, whom they might infect. With eyes open they work on.
Friends and relatives send me emails, congratulating me, thanking me, for taking good care of myself. My children thank me. Each letter, every approbation for my prudent (read, ‘cowardly’) retreat heaps burning coals upon my head. Praise appals when you know it to be false. No hero, I know heroes when I see them. If in these days of plague, you consult a doctor, if you are treated by a nurse, you will know them too.