Sewn Lips

The “Guardian” reports on a detailed litany of sub-standard medical care at Christmas Island.

I read the piece with interest and with some recognition: I had worked there earlier, before the present ‘off-shore processing’ (the hasty export of the unwanted) was instituted. Initially I kept silent. Then I wrote the following, which is the introductory chapter to a suite of stories which will appear in 2015 in my next book of non-fiction, “Burned Man.”

“Sewn Lips

A few years back I signed up to work for a short time as a doctor caring for Asylum Seekers detained on Christmas Island. I went with every impure intent. Indignant over my country’s conduct towards refugees, I headed to the island determined to observe, to record and to betray: I would witness wrongdoing and I would expose it.

But I signed a Confidentiality Agreement: now my lips were sewn. So I would have to resort to allegory, to obliquity, to any literary device to tell unforbidden truths while avoiding forbidden fact. And of course I had every right to report on my own state of mind.

In the event the Administration thwarted my plan: I saw no wrongdoing, detected no bruises, smelled nothing: nothing to report. Stolid unimaginative warders ran a barely decent prison. Good nurses, skilled young medical colleagues, experienced mental health nurses were on hand to attend to generally healthy, universally miserable patients.

Keeping the system honest from the outside, the Red Cross visited and the Australian Newspaper snooped.

And we servants of the nation did everything by the book. We followed all the rules and Conventions. We – the system now incorporated me – we kept Australia’s nose clean. Assiduously, conscientiously, courteously, with perfectly consistent meanness, we kept our clients (they weren’t patients, my true client was the Government) we kept them healthy, we kept them confused, we provoked them by systematic delay.

We drove them mad.

Australia’s impeccable gulag calibrated its practices to equality with the countries of origin. We managed to be just as cruel without raising a bruise.

Meanwhile, doctors were drinking every night. One guard took his own life, another attempted suicide. One mental health worker was dismissed for ‘fraternising’. In fact, she visited her 18-year old client who had been held incommunicado for 36 hours in a psychiatric ‘facility’ (lovely facile word, drained empty, morally bleached) in Perth. She understood her authority ended once she delivered her patient to the Psychiatric Hospital, but his need and her care did not.

I returned to Australia proper and resumed my life. Back now with family, a free person, a citizen, surrounded by comforting supports, I found I had brought the island with me. Contaminated, implicated by national service in unkindness policy, I was troubled by dreams. Night after night, in darkness and unable to speak, I saw myself doing things I had not actually done.

In those dreams I did Australia’s work. I lived the nightmare we perfected.”

The Guardian article by Oliver Laughland: http://www.theguardian.com/world/2014/may/27/doctors-litany-of-medical-neglect-of-asylum-seekers-still-largely-ignored?CMP=soc_568

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Virgin from Christmas Island to the Mainland

A man walks into my consulting room with a bouncing limp. He is tall and upright. He bows slightly and shakes my hand. The familiar courtesies.

I greet him: Salaam Aleikhum.

He responds: Aleikhum Salaam.

We exchange names. His name is Ahmed. He says: “My foot is painful. Please excuse me. I am afraid I must remove my shoe.”

His problem is visible through an opening in his sandal: the left great toe is infected. The flesh of the nail bed is hot and red, a crescent of swollen skin surrounding a sunken island of nail. The skin is shiny, stretched to bursting. A promising eyelet of pus peeps from beneath a corner of the cuticle.

The infected nail bed is about to burst in a flow of laudable pus. The pus will stink, Ahmed will feel better and so will I. Finally, a patient telling me a straightforward story. Finally a patient I can cure.

I treat the infection, dress the toe and ask Ahmed to return tomorrow to renew his dressing.

“I cannot come tomorrow.” His manner is politely regretful. “I will leave here tonight.” He speaks softly, practicality competing with swelling happiness: “I have my visa.”

Ahmed’s smile is a field of waving daffodils.

As it happens I will fly out tonight too. After three weeks of seeing patients here, Ahmed is the only one I meet to win a visa. The remainder reside in trailer parks of hope and despair.

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The Mosque Turns Fifty

By far the most elegant structure on Christmas Island is the mosque. I come across it while running, shortly before sunset on a Sunday afternoon. It is time for me to recite Mincha, the afternoon service. I descend to the shore and gaze out to sea. Empty for now of smugglers and pursuers, the sea is a wide place of peace.

While reciting the silent devotion I can hear the unmistakeable sung sound of the call to prayer. There in front of me is the sapphire sea; behind me the towering slope; and in my ears the voice of the muezzin: I might be in Haifa.

I find myself musing on that word, muezzin. How homophonous with the Hebrew ma’azin, ‘to make hear’, to announce.

I complete my prayer. It shall be on that day, that the Lord shall be one, and His name one.

I jog over to the mosque. Its gold minaret rises from creamy walls to catch the setting sun. The green slope beyond darkens toward blackness. A great quiet falls upon the world. I walk towards the mosque’s open door and count shoes at the threshold: there are ten. How many is a quorum, I wonder?

Outside, on the grass, a plaque of stainless steel bearing the Australian coat of arms announces the assistance of the Federal Government of Australia in the construction of the mosque. I read the date: fifty years ago. The plaque is fixed to a mount by iron bolts that have rusted. The emu and the kangaroo gaze at each other across a widening stain of brown that flows down across the plaque.

My imagination begins to work. I’ve seen no-one on the island wearing Islamic dress. I have seen the slender, sinuous forms of young Malay women jogging in skimpy western tops. How many Muslims live on the island? How many of them live their faith? How does a remnant faith survive here, cut off from the root in Malaysia and Singapore?

Over the following week, some answers filter to me. It turns out that this coming Wednesday the community will mark the mosque’s fiftieth birthday. The federal Department of Immigration and Citizenship is paying for the airfares of a couple of clerics from the Islamic community in Perth. All citizens of Malay descent are invited, numerous non-Malay dignitaries are invited. Hundreds will attend this by-invitation only event. Remarkably enough, Doctor Howard Goldenberg has not been invited.

On Wednesday morning I approach the boss of the Health Team: “Have you heard about the mosque’s fiftieth birthday party this morning?”

She has.

“I think a member of the Health Team ought to attend. As a token of respect. An invitation should be obtained for one of us to go. I am willing to attend – to represent Health.”

The boss is silent. She gazes stonily at me, her face saying, “Get real, Howard. It’s a work morning. Go and do your work.”

The Islamic community marks its milestone without the presence of the stickybeak from Health. I wonder whether I might have inflated the importance of Islam in the lives of the islanders. Within the men’s compound there is a second mosque, little patronized by the detained persons. Grotesquely, the chaplain for all these Muslims is a Greek Orthodox priest.

I go to my work and I meet a man in distress. He suffers shame in simply describing his plight. I cannot control my bladder, Doctor. I wet myself, like my small baby son. I cannot pray when I am defiled, I cannot go into the mosque; I have to shower five times every day. Continue reading

The Slashed and the Hanged

After three days on Christmas Island I take night call. The phone rings at 0045. It’s Henry the Team Leader, Henry the unflappable, Henry who smiles at every reverse, at all bad news.

Henry has the oblong face and slab-shaped skull of the adult who was once a very premature infant. His crooked smiles and wry look – ‘it could be worse’ – sit well on the slopes of that narrow face. Tonight, however, his voice is direct: no smile is audible: “Security is bringing five men in to the clinic who’ve slashed themselves and another man who tried to hang himself.”

“I’m on my way.”

The drive along half known, unmade, unlit roads  takes longer than it should, as I make a number of wrong turns. There is a moon, bright against the island’s dark sky. A black cloud bisects the moon transversely, sitting across its upper half. The black is very black, the white brilliantly silvery. I have never seen a southern hemisphere of moon like this.

When I arrive in the clinic, all cubicles are full. There are the five men who have cut themselves, and not one, but two, who’ve tried to hang.

I don’t know where to look first. I don’t want to look at all.

In the nearest cubicle a man lies flat on his back, his throat livid in the glare of the examination light. He does not move.

I speak, asking his name.

No word, no movement.  Continue reading

Hungering, Christmas Island

Something is wrong, something is upside down. The hunger striker and I stare at each other from opposite sides of a scaffold that neither of us constructed.

I follow the protocols, which are wise and worthy. But it is all wrong, everything is upside down.

My job is to work to improve or protect health. I have to find a way, to create a language that the patient and I will share; to locate and level the place where we will meet.

This contract is not spelled out nor ever inked; elsewhere there is no need. The patient is here, I am here, we can get down to work.

But when I attend the hunger striker all of this is inverted and twisted out of shape. The person whom I attend is not a patient: the person gives no sign, has no wish for my attention.

The non-patient never called me; I am a part of the system that he imposed upon first; now the system imposes me upon him.

The non-patient and I have opposite wishes: mine is to protect life and vital organs, his to destroy them.

The generality of patients whom I see here in the Detention Centre come to see me on my own territory; I mean the clinic. But the starver is weakened, usually lying in his room in the Compound which is located behind high, stout electrified fencing. The nurse and I walk along long corridors without natural light. Serial serious doors unlock to admit us and lock again behind us. We emerge into sunlight in an expansive open area, surrounded by discrete bedrooms for two persons.

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