May 2021 - The Best Mouse Tap

Modest Expectation – An Apple Once in Paris

Just to put Australia’s lack of flexibility into context, where the AstraZeneca vaccine has been prioritised for vaccinating the population Moderna, as reported below, seems to be leading the pack. Where are we, Mr Morrison? Are you across what is happening, and if you have recently done a deal with Moderna has this advance been factored into the deal? AstraZeneca technology is apparently increasingly obsolete in the face of such coronavirus vaccines.

I remember a different time, when the polio vaccines first came to Australia. I was first injected with the Salk vaccine and then, when the Sabin vaccine arrived, it was able to be administered easily orally because it was a live attenuated virus; the Salk vaccine was quickly jettisoned. But then Australia avoided political furore; we relied on the medical evidence not the share portfolios of various people in influential places .

Also, Prime Minister there is one statistic which you use to justify the continued use of hotels for quarantine – your “99.99 per cent effective at protecting the community against COVID-19” mantra. However, when the air flows are mixed and internal, the problem of cross infection exists, whereas in the case of the Howard Springs facility the air flow is to the outside, with little or no chance of a compromised airflow. Thank God it is only that tiny percentage, Prime Minister. That causes enough chaos as we are now seeing in Victoria, without tempting Fate any further. This is where the use of data only shows what a catastrophic situation it would be if the effectiveness was any lower.

But let’s hear what the CEO of Moderna, based as it is in the Boston area, had to say about its advance, as reported in The Boston Globe, and draw your own conclusions.

Moderna’s chief executive on Wednesday discussed the biotech’s progress in developing a booster shot against COVID-19 variants, saying the company hopes to have authorization from the Food and Drug Administration on one of three booster strategies by the end of the summer or early fall.

Stéphane Bancel said Moderna is working on three different options for a single-dose booster shot against variants of concern: the current vaccine, a new variant-specific vaccine, and a 50/50 mix of the two.

Moderna last week shared early study results that showed its first two options — the current vaccine at half the dosage and a shot of its reworked vaccine — both appeared to raise antibody levels against variants that first emerged in South Africa and Brazil. Bancel said the company is expecting to receive data on the third booster strategy in the coming weeks.

“And then we’ll work with the FDA to get the safe and effective variant-specific booster to the American people as fast as we can,” he added.

The data showed that Moderna’s current vaccine “looks good” in protecting against variants, Bancel said, but the reworked vaccine tailored to fight off newer strains of the virus “looks stronger” against the B.1.351 variant first identified in South Africa.

Bancel said it’s “not impossible” that a booster could be ready for the fall for people who were vaccinated against COVID-19 in December 2020 or early January, especially for high-risk groups.

“When we have that data [on the third booster strategy] in the clinic, we will pick which one we’ll take for authorization,” Bancel said. “We’re hoping that toward the end of the summer or early fall, we should be able, if the data is good, to have authorization for a boost to be used in the fall to protect all of us so that we can have a good fall and a next good winter.”

Bancel also said the company is working with federal officials to test “the mixing of vaccines,” ensuring that regardless of which vaccine a person initially received, it will be safe for them to get Moderna’s booster shot.

“We shared last Wednesday news that the Moderna vaccine in the 12 to 17 years of age has 96 percent efficacy,” Bancel said. “The safety profile is like what we saw for the adults, and we’re working with the FDA to get the vaccine authorized as soon as we can.”

Moderna is continuing to study its vaccine for children 6 months to 11 years old, Bancel said, and that data is expected to take a few more months.

“We have to go very slow down in age to ensure the safety of the children,” Bancel said. “And we’re also starting at the lower dose, because given their lower weight, we might need to lower the dose for children. But for the teens, it will be the exact same dose, which will help the distribution of a vaccine.”

And also….

Under the heading “Breaking Alert”, The Boston Globe publishes the ongoing COVID-19 situation. An example is reprinted below.

The death toll from confirmed coronavirus cases in Massachusetts rose by 19 to 17,413, the Department of Public Health reported Monday. The number of confirmed cases climbed by 281, bringing the total to 657,119.

The number of coronavirus vaccinations administered rose by 25,904 to 7,168,399, state officials reported.

As the population of Massachusetts is about 6.3 million, and about 20 per cent are under 15, it means that many of the residents are being given their second injection of an mRNA vaccine.

Every day, the NYT has a comprehensive list of the data down to county level. Where can you obtain such data published daily in Australia, in relation to vaccination?

When the pandemic was rife in Australia we could follow its course every day with the ABC’s Casey Briggs, whose clear informative manner showed Mr Briggs as The Master of Mathematics; to which he could as well have added The Master of Clarity.

He could report vaccination levels in the same manner on a daily manner if the data were available.

Only criminal idiots would want to the fiddle the supply demand relationship by manipulating the data for so-called political advantage.

You may never recover

This is the only comment I shall make about the Princes. I sympathise deeply and know that probably their relationship, in whichever way it existed after their mother was killed, may one day be repaired to the extent that they do remain civil towards one another. I suspect the attitudes of their wives in this is vitally important.

A loving mother taken from teenage sons in the presence of an inadequate father – undoubtedly a good man but because of his own stunted upbringing with an inability to show compassion – is very familiar.

Genuine compassion is something one recognises when you yourself lack it. People may try and manufacture compassion, but fail because it is an inherent attribute, just like a sense of humour. Most of those who are afflicted with the combination of loss of a loving mother, the inability to ever come to terms with the wakening nightmare of your last glimpse of her, coupled with the attempts by the remaining father to fill the void and failing, who then eventually gives up, marries again and gradually become to you an irrelevance. Onwards into an adulthood for which you are ill prepared and then you have to muddle through life in a cloud of unforgiveness, episodic self-pity and destructive fury.

Occasionally, in among the circumstance of life with a variable dollop of pomp added, you may do something worthwhile. But for what? Your other life upon which the flashlight is never dimmed, wherever you try to escape, always haunts. For those for whom compassion does not pay, there is a delight in having all your trespasses laid bare, yet as those who trespass against you seek justification in hypocritical comment only, which encourages you to further trespass. A Sisyphean existence?

Alas, poor Harry, I knew him well.

Is anybody listening?

The three articles on China published last week in the AFR are almost like the last hurrah from one of the most insightful and level-headed journalists still living. Max Suich is one of those people who has lived a long and varied life; and his reflections on the current state of play in China draws upon his own views and those of a number of his contemporaries, and their apprehension about the course of current Sino-Australian relations.

This trilogy commences with reference to the world conditions when the AFR was started 70 years ago. It was not long after that I was on a cargo boat in the South China Sea in sight of one of the disputed islands of Matsu and Quemoy, tiny National Chinese outposts close to the mainland and Communist China. It was a time when the Chiang Kai-shek regime in the island of Formosa was seen as the legitimate representative of China in the United Nations. How fanciful that appears now, but then as we crossed the South China Sea, we were buzzed by American Starfighters which swooped out of the clouds and came over the ship just above mast height – twice.

Bloody hell, was it necessary to demonstrate to a small ship carrying wool and grain to Japan how powerful America was? The power equation certainly has shifted over the past decades in the Southern China Sea. American planes intimidating ships close to the Chinese shore in 2021 – I don’t think so – unless America was on war footing.

As for Australia: The conclusion is that while we dramatically changed our approach, we did not define a policy objective for the new relationship with China or a strategy to achieve it. Nor did we thoroughly review alternative options. We elevated anger about Chinese activities in Australia and latent ministerial hostility towards China, turning threadbare slogans into policy. Traditional measured, thoughtful policy-making in an area of such great importance is lost.

Thus spake Suich. He sets out his conclusion succinctly and directly on the first page of his trilogy. He then spends much of the rest justifying the conclusion, which is more a thesis. He had come to that conclusion as the anti-Chinese forces in this country were emboldened by Trump’s antics. No matter how Turnbull may want to re-write history he should share the opprobrium which Max dishes out.

We have no hedge – we are “all the way with the USA” but what if the USA is not there? How does our military, naval and air force stack up, in the face of an aggressive China? Not much, is his assessment. Australia is vulnerable especially, as he pointed out, Pine Gap would be an early target for any Sino-American conflict. Therefore, whether or not America proved to be a steadfast ally, part of any war strategy in this part of the World would be to knock out Pine Gap, inevitably leading Australia being locked into the conflict.

Max Suich has dissected the Australian government approach into three phases, “push back, call out, out in front”. The three stage approach typifies a crude approach to the reality where the right wing infiltrate in the intelligence always inflates the danger in order to maintain their relevance to government. Max quoted one still serving official – “without Trump the hawks would not have the mode to develop their own insane line that we had no choice but to divert trade flows and supply chains.”

As he goes on to write, the John Howard approach twenty years ago “we don’t have to choose” between America and China has been dumped, but echoing experienced advice there was no way that Australia, with its limited defence forces, could possibly back up its bellicose rhetoric. In fact, as Turnbull has written in his recent opus, Australia has to be careful where its warships sail in Asian waters because there is no doubt that the Chinese are watching. The Americans may have the power to extricate a ship which ventures too close, but Australia by itself does not.

Nevertheless, paranoia is fanned by the idea that the Chinese government is penetrating the Australia community and in particular the Chinese diaspora. Such investigation of this has only yielded Sam Dastyari who, despite his indiscretion, still seems to be involved in the sensitive vaccine rollout. There was all that flurry around Gladys Liu, the Coalition member for Chisholm, because of her apparent ties in China, but that seems to have dropped off the intelligence schedule and is not mentioned by Max anywhere in the article.

The Government seems not to be bothered by the experience of South Korea where, earlier in the last decade, it experienced a Chinese trade freeze. Yet for all the bravado, the articles note three forces operating currently in our dealings with China. The alienation from China has been aggravated, as he points out, by the circumstances of the COVID-19 virus first being seen in Wuhan and the subsequent lack of co-operation by the Chinese in the investigation of its genesis, where one of the major cheerleaders for the investigation has been Australia.

The first force is the feeling of being abandoned, and if one delves into the history of the ANZUS pact, it was constructed originally against the wishes of the State Department in Washington – the nightmare of “Washington not picking up the phone.” Then the rise of Xi Jin Ping, who has disturbed the comfortable trading arrangement that some Australians had built up with various Chinese businesses. The impression of a free enterprise economy able to exist under a one-party system was brought to a halt by Xi .

Max recognises that Xi’s assertiveness and his expansionary vision for China as a truly Pacific maritime power was another impetus for the rise in Australia of the intelligence community influence and their political hawks on both sides of the parliamentary aisles. Any moderating influence of DFAT is seemingly ignored and Max quotes Foreign Minister Payne going it alone on the Wuhan inspectors seeking answers on the Wuhan connection with the virus, and particularly whether the virus escaped from a laboratory there.

He doesn’t attempt to analyse Xi’s character, because being pragmatic, Max recognises Xi is what he is, and nothing will change him. However, this is not to say that defining his strengths and weaknesses is not more than a parlour game. Remember XI was a princeling forced to eat dirt – he understands how the game “Go” unravels. In this game, there is a need to understand its length. Xi does not intend losing; he has tasted the soil. As someone said to me, he doesn’t care about the niceties.

Max says that the breakdown of our government’s foreign policy development process and its supplanting by the security and intelligence services and their vociferous supported is a main driver of Australian government attitude.

I know there is a younger brigade of Australians who have repeatedly dealt with the Chinese and who believe that Obama’s soft position towards China would have been reflected in the present Biden administration. However, free of Obama, these so-called liberals have adopted a hard line almost indistinguishable from that of the Trumpers. In this narrative, Obama is the villain.

As Max said, we took more risks than we should; we could have been adroit. This is the position of “former senior officials who lament the lack, still, of policy making and disciplined public language about China, that weighs up options and employs some subtlety and seriously considers the risks of war.”

One source, Paul Dib, compares the situation to the 1930s where the risks set off by territorial confrontation were ever present, in Europe, Africa, and Asia. In the meantime, Australia then lived in bliss, ostensibly under the wing of the British Empire. Now it is the USA to continue to shield us, but the hawks are everywhere so that his conclusion of this need to follow the USA is “a bleak but realistic view…if the hawks of Washington and Beijing are not stifled, if compromise is rebuffed, war will be the consequence, a disaster for Taiwan and the combatants and a disaster for the rich and growing economies of our region.”

China is not complicated as suggested in the article – the World exists at the whim of Xi Jin Ping.

His adversaries are varied; have we ever really looked into the eyes of these hawks of ours – these eyes exhibiting uncertain bravado and fear?

These are not the fanatics which drove the agenda of the 1930s but more the muddle-headed wombats who took us into the Vietnam war. This time, the War will not be an away game.

I do not want the prospect, if I survive, of stumbling through the rubble which was once Sydney. Everybody, look carefully at Gaza and that was only an 11 day’s conflict.

Thank you, Max for encouraging me to write this critique.

A Prickly Situation

My eye was caught by an article in the NYT this week. It concerned the poaching of rare species of cacti from the Atacama Desert in Northern Chile and them being found smuggled into Italy.

The Atacama Desert is not particularly large compared to other deserts, but it is a remarkable ecological structure. There is an area where it has not rained for about 500 years; there is another part where the largest copper mine in the world is located.

As we looked out from our hotel in San Pedro de Atacama in this patch of green, the dominant view rising high from the desert was Licancabùr, the volcanic cone rising high above the desert. The volcano is very close straddling the Bolivian and Chilean border, and as you near it, sulphur is mined on its slopes. Sulphur – ah, the whiff of hell, but here the winds tend to cart the smell away.

This desert has historically been an area of dispute between Chile, Bolivia and Peru. It was called the Saltpetre War, and ostensibly it was about Bolivia retaining access to the Pacific Ocean but, as the name implies, it was a battle over the nitrite deposits used in both fertilisers and explosives. Chile won that war, which has enabled that country to exploit the mineral rich Atacama and, since discovered, also the site of substantial lithium deposits.

San Pedro de Atacama is in an altiplano pocket of the desert, the remnants of the Andes, which mean one is strolling and riding around at 2, 408 metres. The highest point we reached were the Geysers del Tatio which lie at 4,330 metres, a large cauldron of boiling water where there are signs in English and Spanish warning for you not to get too close to the edge of the multiple pools. The sudden spurts of boiling waters and steam at such an altitude are very impressive. There are no fences; you are able to freely wander. At least one tourist did step too close apparently and ended up boiled in one of the pools.

Even though we were only 14 kilometres from the Bolivian border we skipped walking up the volcano which tops 5,920 m. For comparison, Mount Kosciuszko is 2,200 m high.

This area of the Atacama altiplano is very diverse. What with the geysers, and flamingos standing in salt water at an alkaline PH of 10 and eating the crustacea out of the brine. These tiny marine life determine the flamingoes’ colour. Every desert has “bad lands” of rocks and gulches. Here Atacama has its red rock folded into buttes and jagged cliffs. They were thought to mimic valleys on the moon rather than a scenario from a Hollywood Western.

Here I found myself rooted, unable to move, halfway up one of these hills, on a goat track not one-person wide, winding itself to the peak. I have always suffered from vertigo, and stupidly I looked back and down. The cheerful chatter ceased. There is nothing more debilitating than being stuck like that, with feet in the shifting sand unable to move. Here, feminine resolve came to the forefront to uproot the fear – women on either side of me giving me their hands, encouraging me onwards.

We stop on the way in stone cottage villages where the construction of the houses would not have changed since Inca times. One of these villages called Machuca had about ten houses, was situated at 4,000 metres but still had its church perched on the hill above the houses. This is subsistence living. Guanacos can live at that high altitude and like their relatives, camels, will drink salty water, but like the vicuñas are not domesticated. The flightless rheas dot the landscape, not venturing close.

It was an enthralling landscape and the hospitality overall was great, the only blemish being locked in a poorly ventilated minibus with an English family for three hours as we went back to Antofagasta to catch the plane back to Santiago, but they probably had the same feelings towards us – a little more Albion disdain. Having sprawled across the front rows they objected to us wanting the windows being open. Not even my wife’s imitation of Shrek’s donkey colleague amused them.

But you see what is pointed out to you or what you are looking for, and in the desert, on this trip I failed to appreciate the flora. In the Atacama are some of the rarest and most intricate cacti. I suppose I should have been interested given the use of cactus wood to make the doors of the cottages.

Now there is an increasing market for those unnoticed cacti. The cacti of the Atacama are special. A year after the robbery from the Atacama happened, the NYT has reported on a cactus “heist”. This had been uncovered in Northern Italy. Most of the stolen plants, many over a hundred years old, had been taken from the Atacama.

As the NYT said in the article:

Cactuses and other succulents are hot business today. They have become the darlings of social media, promoted by indoor plant influencers for their outlandish looks and minimal care requirements. The pandemic only increased their popularity, with shops struggling to keep some species in stock.

The average hipster’s cactus collection will include only common species propagated in nurseries. But for some specialist collectors — who tend to be middle-aged or older men — the hobby is much more serious.

“A lot of what drives the interest and passion for these plants is their uniqueness and rarity.”

Of course, that is the problem. People with too much money, bored by their hedonism, looking for something different and in this instance, something requiring little maintenance. Perfect!

There is a line to be drawn between appreciation and acquisition. I have never been a xerophile, and in fact cacti watching has always been low on my attention span. Having written that, cacti can be striking. I wrote a piece one winter in Arizona called “Snow on the Saguaro”. Seeing those majestic cacti, their branches smothered in white, reflects how severe the winter was we were then traversing. While we marvelled and I wrote this, there was no passion to dig up all these cacti and transport them Los Angeles to become a prop for silver tinsel and light. A silly notion, but no more silly than digging up the cacti in the Atacama for them to be festooned on balconies of the palazzi of Milan.

One wonders how many of those who buy plants illicitly taken, really appreciate them, or do they just want to have something nobody else has.

Anyway, this story had a better end than most of these robberies. As has been reported:

844 cactuses made the return journey to Chile. Around 100 others had died, and 84 stayed in Milan for study.

Mr. Cattabriga (responsible for apprehending the shipments which had first passed through easier EU custom controls in Romania and Greece) has been making daily video calls to try to ensure the plants are being properly cared for while they are in quarantine. According to Bernardo Martínez Aguilera, head of the forest inspection department at Chile’s National Forest Corporation, the final goal “is that the majority of these individuals return to their natural environment, which they never should have left.”

Rules have been introduced among cacti lovers not to purchase the seeds for such exotica, on the grounds that if these cacti are allegedly propagated, it provides a cover for the poachers’ lack of provenance. A worldwide problem but this is a salutary tale. The answer is always the same – curbing the poor attracted by the cash, harvesting the cacti and a cohort of wealthy humans who always vote for subsidy, tax breaks and entitlement with rapacious middlemen who always vote for subsidy, tax breaks and entitlement with greasy paws.

Mouse Whisper

Is it an unnoticed cultural cringe? The Swans are a Sydney Australian Football team, which was transplanted from Melbourne where they were known as the South Melbourne Football Club. The colours are red and white which earned them the early nickname of “The Bloods’. But somehow, presumably because South Melbourne was originally a marsh from which the Albert Park Lake was carved, the idea of calling the team by the name “Swans” was floated. But the white swan, whether cob or pen, is not an Australian; it’s a Pom!

Black swans are as Australians as Vegemite. If the club wanted to call itself the Swans, it should have adopted black. I am surprised that my indigenous brothers played with colours and name which reflected colonial attitudes. Especially as there are only black swans on the Albert Park Lake.

Imagine the Sydney Swans changing to a black and red strip. What would they say at Essendon?

And don’t me started on the St George Illawarra Rugby League colours taken from the St George Cross which I believe has some relationship to an island off Europe.

Dragons – yes, they have relation to Australia – water dragons can be seen all over Sydney in nurseries.

By the way, the native animal of NSW is the platypus and the bird kookaburra, but a Major Mitchell cockatoo has all the elements of red (if actually pink) and white. But barracking for the platypi, the Kookas (or Burras or the Cockatoos) – could be very authentic like the Eels.

My preference. Come on The Majors.

Modest Expectations – Biden & Boehner

Here I am still writing a blog over two years from one I started inter alia with a eulogy of Jacinda Ardern, which caused some ruction among my acquaintances. I use the word “eulogy” because I was seen as being over complimentary. Yet in retrospect, given the revelations which have come out about the predatory behaviour embedded in the contemporary political scene, she has emerged as an exemplar of how a female political staffer can become Prime Minister – and not only become Prime Minister but also be prepared to hand over the reins to her then deputy, Winston Peters, while she had a baby.

Now the self-confidence that exuded coupled with the compassion and leadership she has shown in the face of the tragedy of volcano eruption and mass shooting have been so heartfelt. But I better not lay my comments about Jacinta Ardern on with a trowel; otherwise others may wonder aloud why I am still Mr Starry-eyes. Maybe it is because she does not wear a baseball cap – well not often. It also helps if instinctively you know how and when to smile and how and when to grieve.

A Woman in White

The question always arises – am I responding to an illusion? The quote below is elegant in the way it describes such a reaction.

In the novel’s famed opening scene, art teacher Walter Hartright is walking back to London on a desolate street around midnight “when, in one moment, every drop of blood in my body was brought to a stop by the touch of a hand laid lightly and suddenly on my shoulder from behind me.”

He turns to see “the figure of a solitary Woman, dressed from head to toe in white garments …”

“’Is that the road to London?’” she asks.

The encounter is both unexpected and cinematic. The dark deserted road, coupled with the late hour contrasts vividly with the light touch of the extraordinarily dressed woman and her mundane question.

No; the woman in question in this excerpt is not Christine Holgate coming home from a Parliamentary ordeal, but the woman who gives the name to Wilkie Collins’ 1859 novel “The Woman in White”, some say the first mystery novel. Her name, Anne Catherick, a woman dressed so by her mother, but it is a different way of looking at the one subject – a woman dressed in white. Beware what you wish for, even when wafting as a Friday AFR supplement apparition, who was once a Premier of a State of Australia. Was it is meant to create an illusion like Anne Catherick?

Order Arms!

During the Vietnam War, there was an increased requirement for doctors. My relationship with military activity ended when I left school and, among the many wonderfully mindless activities I left behind, was the cadet corps for which, despite my years of faithful service, I was never rewarded with promotion.

My friend and I bore scars of our service. On our uniform sleeves – mine with crossed flags to signal my devotion to the signal corps – and my friend’s, who was also a crack shot and had crossed rifles in recognition of his membership of the school shooting team. The school even then had a rifle range on the top of one of the buildings – long since gone.

But perhaps if my early love for the military camaraderie had not been dampened, who knows where Sousa would have taken me. At the annual cadet camp my friend and I tried to implement that camaraderie by inviting some of our fellow cadets who, unlike us were distinguished with stripes of authority, to share our gin in the methylated spirits bottle. Our invitation was met with undue hostility. We were not to know they were militant abstainers. The problem was we had no chevrons to be stripped from our sleeves, so long-term punishment was limited; and the matter was settled within the tent. I still remember being hit from behind and the rifle butt on my neck.

When it came to national service, which persisted into the late 1950s, I was excluded because of my calcanea vera which, in common parlance, translated as very flat feet. All my life, if I walked long distances or had jobs which required my standing on my feet for many hours, the spasticity and consequential pain particularly of my peroneal muscles and tendons and the small extensor muscles on the dorsum of the foot was intense. The pain was often incapacitating for a day or more, and the only antidote I found very late in life was R.M. Williams boots. Surgery was excluded very early.

My friends came back, but apart from the “Nasho” anecdotes very few continued with any association with armed forces. A number of the medical students committed themselves to the various armed services in order to pay for their tuition but also to provide 1,500 pounds tax free a year until they finished their course.

On graduation, they would be promoted to Naval lieutenant or equivalent and in return after their intern year they were expected to give four years of service. My father, who had strong links with armed service through his work in the Repatriation Department as a doctor and somebody who spent both pre-war and later during World War 11 as an officer in “the wavy navy” was keen that I join the Navy. His attention to polishing his handmade shoes I could never emulate; so that fantasy drifted away.

However, during the 1960s, with two kids and a wife also involved in post-graduate study, money was tight. I was working in the Monash Department of Medicine at the then Prince Henry’s Hospital in St Kilda Rd Melbourne, which was conveniently located next to Victoria Barracks. Out of the blue, a doctor with strong links with the medical corps whom I remember as Colonel Hogan, asked whether I would do some of morning sick parades at the Barracks. This led to more work undertaking the annual medical examination of the ranks, there and elsewhere in Victoria. Then, as the ballot came in for Vietnam recruitment, I was asked to undertake the medical examinations of the conscripts.

I had kept my opinions very much to myself, but I was personally devastated by the 1966 khaki election where the Coalition achieved a landslide as they played “jingo bells” all night. It is why I find this continual beating of the tom-toms of war even now so appalling. Apparently Vietnam has not been lesson enough, witnessing a generation of damaged men and women who emerged from that conflict and initially without the plaudits of a substantial number of their own generation, who instead protested in the streets.

Yet here was even the opportunity to examine young men who had been conscripted by the roll of a roulette wheel to fight in a foreign land for what proved to be vacuous objectives. I did not hide my distaste but nor did I volunteer my opposition on a street corner. The fact that my step-mother shared the secretary role of the Australia-China Society with Myra Roper at that time and that she and my father went to and were lionised in China several times during the course of the 1960s did not affect my job with the army.

We were a strange bunch, who used to gather several nights a week to examine each bunch of conscripts. Two doctors were teamed, one older and one younger who did not know one another beyond vicarious professional association. Nevertheless, there were times when I was rostered alone to undertake the recruit examinations. One night when alone I had about ten young blokes, all of whom failed my medical examination. My strictness on ensuring fitness to die perhaps swayed some of the decisions that evening. It was such a calamity that such a number were unfit, but it passed without comment from above. Incidentally we were asked not to say anything beyond that required to elicit symptoms, but if a significant disease was discovered then all one could say was that the potential recruit should go and see his local doctor.

The ability to detect mental illness was very limited and the illness had to be florid. This was the case when I was confronted by a restless young man walking up and down the corridor who insisted he wanted a gun so he “could kill some commies”. When I found he had an eyeball tattooed on each buttock, I regretfully failed him by writing “atypical strabismus” on his form, thus avoiding an essay on his obvious mental troubles. These examinations did not give us leeway to highlight mental health problems; I hoped that the local medical doctor, if he ever saw one, recognised that the young man had a serious problem.

At the other end of this medical cocoon was the recruit who turned up, complete with caftan, beads and sandals, a flower child in all ways. He stood defiantly with his principled stance, refusing to be examined. Fortunately, the only doctors left that evening were a few of the younger ones, who knew one another and thus were never rostered to work together. This defiance was an exceptional situation. The older doctors left us to sort out this problem.

Thus, we did have an advantage of youth in that we did not pull out the “I’m a doctor; you’ll do as I say” line. We just negotiated and as the night wore on, he knew that we would wait him out. He wanted some exposure as the “victim” being taken away, but as my fellow doctor said, “Look, we all want to go home. Just get up on the couch and let us do a quick examination”. For us, it was about the minimal set of words which should have given him the hint, if he had listened, that we were going to fail him. After some more tedious palaver, he consented to a limited examination.

We did not have to examine far – only needed a stethoscope on his chest. Listening to his heart, he had a very loud “machinery murmur”; all that trouble he had put us through. There was no way he could pass his medical examination; in fact, he needed to see a cardiac specialist. He had got his exemption.

Realising that all was not well, his attitude changed from truculence to fear – poor bugger – as he saw us discussing the finding – but all we were permitted to say was that he should go and see his local doctor as soon as possible. Even here we were not even allowed to tell him he had failed, even after such close contact. “Just don’t delay, but go home – and good luck”.

A Catalyst

Nick Coatsworth is an unusual doctor. He has an impressive career inter alia working for Medecins Sans Frontieres (MSF) from 2004 in Congo-Brazzaville, the Republic of Chad, and the Darfur region of Sudan. Before becoming President of MSF Australia in 2010-11. I have never met him, but during my professional career, I have met a couple of doctors with his easy confidence and natural charisma with the underlying skill to match. “This man ain’t no desk jockey,” as they say. However, this past week he has shown perfect political timing. The boyish grin has been replaced by the serious “defender of the Faith”.

I think he is a beacon, despite being the face that tried to flog the COVID-19 App, which was such a dud, and which I thought might have precipitated him moving out of the Department. He was truly handed the Australian “sandwich”. There are two ways such involvement can be interpreted, apart from bad judgement – of which we were all guilty of at one time or another. The first is that he genuinely believed; and/or he was the epitome of the loyal public servant.

There is such uncertainty about the government. This is a government once applauded for its suppression of the Virus. Now, its success is being assailed. Words like “hermit kingdom” and “gilded cage” are bandied about. But the polls suggest that Australians support border closure. There is another metaphor for the current situation “Switzerland in 1942” – a neutral country surrounded by ongoing war.

Australia has been inured to defending the borders. Against the “boat people”, we have an enduring policy of making asylum seekers very unwelcome and thus over more than 20 years of border closure and the construction of basic facilities offshore, in PNG or Nauru and countries like Cambodia which took money for not much of anything. However, it fuelled the flame that has never fully died of “White Australia”.

Stripping all the self-interest away, there are distinct matters that face the Government linked to the changing times –

The intertwining of political and scientific speak – the prize example is “herd immunity”. Ask a politician to define it; I remember when the late Senator Button asked the then Minister for Science a question with notice along the lines of “what was the relationship between an inch and a centimetre?” The Minister could not answer. Here are the key words – “without notice” – to which I would add, “without understanding”. Senator Pattison, in his cameo appearance on Q&A this week, has shown in his responses that this lack of understanding has persisted in the plush red of the Senate.
the efficacy and uptake of the various vaccines. The Government bet on the AstraZeneca vaccine where controversy seems to have engendered the hesitancy beloved by the anti-vaxxers. Unfortunately the chance to obliterate that hesitancy by providing a choice of vaccines has not been an option. Choice is important provided there is a similar proven efficacy. As for anti-vaxxers – they are not hesitant – they are clear about their opposition.
the prevention of community spread and the fact that there has been an attitudinal and behavioural change towards hygiene – masks are one example. There is a developing phenomenon of living with the virus as vaccination rolls out; the images of Australian intensive care units and dying patients have been removed from the media screens to be replaced by images of India. Nevertheless, so long as the health services are not compromised within Australia, then the government has eased restrictions locally. After all, there are few politicians who want to be unpopular, and in many countries this loosening of the restrictions is very much ad hoc and often premature.
the construction of dedicated quarantine facilities for incoming travellers, where it seems there is no plan beyond expansion of the current Howard Springs facility in the Northern Territory.
the agitation for Australian border opening. Now the Genie is well and truly out of the bottle as the business groups are beginning not only to agitate but also, as one influential person initially showed by her disdain for the collateral damage of lives lost, to question what might be an “acceptable” level of deaths from COVID that would accompany open borders. “Death at the Australian Open” would be a title for a crime novel; or schadenfreude.

The Coatsworth message was at its heart very authoritarian. All the seers, laureate prophets, tea leaf examiners, bird augers, and hand washing experts should be sidelined, and the only collective voice should be those who have to articulate and implement the policy.

It could be a long shot, it but sounds by his oratory that Coatsworth is submitting his application, and the one image I have of him is a very thoughtful guy, but one who when he makes up his mind that’s it! He may be able to accomplish this huge Medusa head task, especially as he has a track record of leadership. Good to give him a go.

On second thoughts, maybe the application should be for Prime Minister.

The Clown at 95

In Danville, the boy spent a lot of time at the movies. Fifteen cents bought a ticket to the Palace to see westerns, Bela Lugosi’s latest or slapstick comedies with Buster Keaton, the moody pratfall master, and Laurel and Hardy. Stan Laurel, the British-born comic with the bow tie and bowler, was a particular favourite and he would practice his routines. Years later, after his own rise, he tracked down the reclusive Laurel and visited him at home. When Laurel died in 1965, he delivered his eulogy with a tearful Keaton sitting in the front row. “God bless all clowns,” he said, delivering his hero’s favourite poem, “The Clown’s Prayer.” “Who star in the world with laughter,/ Who ring the rafters with flying jest,/ Who make the world spin merry on its way.”

A year later, he did the same at Keaton’s funeral.

I could not resist putting this extract into my blog. The “he” is Dick Van Dyke, now 95 but in amazingly good fettle, an actor to whom I have never paid that much attention. His show “The Dick Van Dyke Show” with his co-star Mary Tyler Moore was always somewhere in the background wherever there was a television set in a house. The times I watched it, it was a combination of slapstick towards us, the audience; yet an underlying sexual attraction between him and Moore. Otherwise, it was just conventional American sitcom.

I knew he was very tall, and that he was always fresh-faced youthfulness disguising a man who was both an alcoholic and smoked too much. Yet, teetotal but still chewing nicotine gum, he now looks remarkably fit and ever broadly smiling, his signature.

I was fascinated by the reference to Stan Laurel, and the fact that as a relatively unknown actor he gave the eulogy to Laurel at his 1965 funeral, where another famous comic, the deadpan Buster Keaton, was sitting in the front row. Keaton died a year later and again Van Dyke was the eulogist at the funeral. Before his death, Keaton gave Van Dyke one of his most valued possessions – a set of billiard cues – which Van Dyke still possesses.

These names mean very little today, but in their day, each was huge at the box office. Comedian Stan Laurel was one part of the Laurel and Hardy duo. Stan Laurel was in fact English born, in Ulverston in Cumbria, where a statue of the two has been erected.

All very interesting along the pathway of nasturtium trivia, but what caught my eye was that there is a Clown’s Prayer which, in abridged form, is somewhat different from that quoted above, says:

As I stumble through this life, help me to create more laughter than tears, dispense more cheer than gloom, spread more cheer than despair. Never let me become so indifferent, that I will fail to see the wonders in the eyes of a child, or the twinkle in the eyes of the aged. Never let me forget that my total effort is to cheer people, make them happy, and forget momentarily, all the unpleasantness in their lives. And in my final moment, may I hear You whisper: “When you made My people smile, you made Me”.

It did not take much further research to find out that there is a Holy Trinity Church in Hackney in the London East End which is known as the Clown’s Church, because every year there is a service in February to celebrate the life of Joe Grimaldi, the first archetypical clown to use the white-face makeup and the term “Here we go again”. Since 1967, the congregation has been permitted to dress as clowns. Notwithstanding, the most recent vicar is not only a chaplain to the Queen, but she has been made the Suffragan Bishop for Dover (which means she hangs out in Canterbury Cathedral).

I have travelled a long way from Mr Van Dyke, unless he has performed at one of the Clown services – but then meandering, as I say, plucking the nasturtiums as I go is one of the features of blog writing. And I refrain from suggesting a new form of opening prayer for Parliament – but the words of the prayer belie the title the Clown. More I think of Pagliacco.

Mouse Whisper

In many places of worship my image has been carved under many a pew.

I as a mouse may be one thing, even venerated. Mice in plague proportions overrunning and destroying the world are another. Mice showed the way in demonstrating the efficacy of penicillin, and you humans have benefited mightily by our sacrifice. Ask Howard Florey who also said that humans were 500 times the size of a mouse.

You as a human may be one thing and you too may be venerated. But humans overrunning and destroying the world are another.

It is just a matter of how the plague is controlled, especially when all who are running around don’t acknowledge that they can be a plague within their world of Horizons.

Modest Expectations – Cheers Bar

The actual address of Cheers Bar was 112½A Beacon Street, Boston – in other words I have resorted to an approximation for this week’s blog.

One of my former partners, who was a very good mathematician, said that he always judged his peers by knowing whether they knew when to approximate. I have never been numerical, but I know you can vanish along the decimal value of π and end up in a different world where sanity evaporates in the pursuit of such accuracy in this relationship of circumference to diameter of a circle. Endless fun.

One of the matters that used to irritate me was when I was seeking certain data, I was told it was unavailable because 100 per cent of the data had not been collected. In other words, the data publication had been delayed by over-zealous statisticians when 95 per cent would have been adequate – if the distribution is normal then approximation of data around the mean of the distribution is mostly likely to be good enough for policy considerations.

But this wise mathematician also told me that when coming to conclusions make sure your assumptions are clear and transparent; something unfortunately becoming less and less evident in public policy. Then, your approximations could be assessed as to validity in the pursuit of making the particular decision.

The excellent Dr Paul Kelly, the Chief Health Officer, clearly outlined the government assumptions in his critique (let us not say criticism) of the government’s reasoning in invoking the provisions of the Biosecurity Act to keep Australians in India from returning. His was calm, measured, sensible advice, which the Government, now scrambling to save face, will follow. Within this prediction, it shall become clear how accurate is the approximation of 9,000 Australians in India who require repatriation.

And so it was, when the COVID-19 infected Dutton emerged in their midst, it was fortunate that Kelly was there to quell the Cabinet hysteria.

I do not know just how the Government have guessed, estimated, approximated and predicted the number of Australians who have visited our near neighbours. After all, the assumption is that each of the verbs in the previous sentences mean approximately the same thing, but with an ascending order of assuredness in their use in media releases.

With most of Asia plunged into pandemic considerations has Mr Coates, in that tattered remnant of his imperial cloak – the Olympic Games, issued an approximation of the number of athletes that will become infected during this festival. My assumption is that he will say “none”. Just an approximation after all!

The Divine Light of the Gods

One of the interesting aspects of the spread of COVID-19 in India is the reaction it has generated in those who, one way or another, are driven to comment. The threat to put Australian citizens in prison because they want to come home and escape the virus was hysterical. The fact that some of our best cricketers were caught up in this catastrophe only complicated the situation.

Now I am not one of those who believe that the Government’s immediate midnight reaction would have not been approved by a strong segment of the population. These have remained quiet while megaphones from both left and right have given Morrison a roasting, to coin a phrase. However, what has been most confronting here has been the sight of the funeral pyres night after night on television. As somebody said, it is a vision of hell.

In India, fire is a very important symbol. Yet India was associated with the flower generation where there was always some swami in some ashram somewhere in India where mostly privileged Europeans were drawn to seek “enlightenment”, and lotus flower symbolism was everywhere.

I first had the privilege of traveling the length and breadth of India when it was a secular state. Then the Nehru-Gandhi hegemony was strong.

With the ascension of the charismatic Modi, India has been converted into a Hindu state, despite the fact that India’s Muslim population is the World’s third largest, close behind two avowed Muslim nations, Indonesia and Pakistan. Hindu intolerance is confronting. I have entered a Kali temple, one of the few not prohibited to non-Hindu people. To me Kali was a black doll monster, at the centre of a dark incense-ridden foreign place where I was both fascinated and yet repelled.

Contrast that with the elephant head Ganesh, where the myth of his head being chopped off by an enraged Shiva and that of an elephant sown on to replace the human head is just one of tales which surround the religion. Yet we have a figure of Ganesh in our home. Ganesh is a symbol of good fortune; and it gives a clue as to how pervasive Indian culture becomes once you have been and seen.

The COVID-19 pandemic was never going to bypass India, because wherever you go in India there are crowds, pressing in upon one another. Modi loves the theatre of the large crowd and given that Varanasi is his electorate we are constantly confronted with the spectacle of the crowded river Ganges. When I was first exposed to this crush of humanity, it was as overwhelming as the smell of India, which never leaves you. There is an axiom which tests the strength of any union, association or whatever you call two foreigners abroad. “One watches the bags, while the other creates the space.” It always seemed to work no matter where we were in India – and crowds.

It is easy to ascribe a national identity to India, and there is no doubt the Hindu caste system has embedded in itself a sense of entitlement – at least with some. This is pronounced whenever you deal with Indians as at some stage a sense of entitlement will bob up.

Again, as an example, I remember giving a talk to a group of health professionals, predominantly doctors. There were both male and female doctors at this meeting in a town in the very South of India. My talk was given over dinner in which we ate our curry served on banana leaves. The whole atmosphere was so authentic – down to the separation of the male and female doctors onto separate tables, including my partner.

This often overbearing regard for the place of women was one of the problems I have encountered, not only in India but also with some Indian-trained doctors here. Yet Indian men have a great reverence for their parents, and one of the most obvious examples of this are reports of the number of older Indian women in wheelchairs at airports; sons are very concerned to ensure the mother does not have to walk from the plane, but they clearly show their wonderful ability to walk when greeted by family and leaping from the wheelchair to run to the family. This atavistic reverence is reflected in the number of stories of the Indian-born Australian now caught in India.

The other is the number of small children who seemingly have been lodged in India. It is very difficult to see an infant apparently helpless against the encroaching Virus and to not elicit the reaction for someone “to get them out of there”. What is the reason for this? Could it be that the couple working full-time in Australia want a safe haven for their child’s care, and grandparents are an obvious place to park the children, even if it means leaving them in India for extended periods. Up until now that practice has gone unnoticed or unsanctioned.

The Indian-born population in Australia amounts to 455,389 or 1.9 per cent of the Australian population. The affinity for the country of birth, especially when there are close relatives in India, remains strong. However, one of the prices of being a citizen is that you also accept that some of your personal risks clash with public policy considerations. However, if one knows the risk, then one must also accept the consequence if risk translates into liability for the wrong choice.

The fact is that the Australian government has not factored in the need for a more long term sustainable quarantine capacity will inevitably mean hardship will occur to those waiting to return from overseas. Just as it is trying to contain the Virus where up to 50 per cent of incoming travellers may be infected throws this policy stumble into letters writ large. Larger and more custom-made quarantine facilities, where it is an accepted fact that when coming from most places worldwide there will be an invariable 14-day hiatus during which everyone will quarantine and be tested multiple times, with designated exceptions such as New Zealand and the island dependencies of our two countries. The volume of people needing to come here will increase with an impatient tourist industry scratching at the Government’s door.

Politicians try to fill the vacuum of uncertainty with unsubstantiated optimism (remember the vacuous Trump assertions as America died), which in this case is trying to predict the future of a disease in which the vaccine remains unproven in its long term efficacy – and long term in this situation means “a year”.

Does that prediction alter when our young politicians realise that their contemporaries in both Brazil and India are dying from the mutant strains stealthily and rapidly causing them to die unpleasantly; and be under no illusions this chameleon virus can mutate at the drop of a tartan rug.

Australia has achieved an enviable record in quarantine, even though there are obvious blemishes. Parenthetically, rabbits were one example. Eradication has been so successful that rabbits are now a luxury item on the dinner table. Nowhere else in a major country except New Zealand has achieved suppression of the Covid-19 virus to the same extent we have. However, you can never relax, as shown by our pursuit of the rabbit plague. (I consider Taiwan a special situation being more an armed camp than a nation.)

But after the Indian tide, the biggest test will be to see how the Government handles the anticipated 1,000 travellers returning from the Toyko Games, without assuming that any will become COVID-19 positive while out of Australia. Now where will be the holding pen? Even if the team members don’t all return at the same time, there will be a significant number to be managed at any one time in quarantine.

An expanded permanent human quarantine capacity that is not a “make do” in willing hotels clearly is essential. This sector will require staffing. That means more staffing and where does that staffing come from? I have worked in rural health encompassing inter alia assuring workforce for many years. To achieve sustainability in the workforce in a country such as ours is very difficult, especially when the policy makers are blissfully ignorant of what works because there is no readily available corporate memory nor empirical evidence of what works – just opinion and opinionation.

Here we Go Again

I have worked in rural health policy for a considerable time and it sticks in the craw when a doctor reveals his ignorance by hailing the modest injection of a rural element into the Medicare benefit for eligible patients as if it is something new. Since there has been no rebuttal, this statement just confirms that the profession has no realisation of what has occurred in the past, what has worked and what has not.

Throwing money at medical workforce problems has never worked.

Repeatedly I have outlined the challenges that face the provision of rural health, and the problem is that the structural change I assisted in bringing in through the University Departments of Rural Heath, the Rural Clinical Schools and the Rural Intern Training Program in Victoria can easily disappear if there are no champions for its continuance. This requires advocacy, not lazy policy makers, who do not care a “tuppenny tart”, as long as they seem to be doing something, even if it is a discredited strategy. This reminds me of that New York wit, Ida Downer, who wrote “Maybe some consultant provided advice at an appropriate price in order to maintain their expensive watch vice.”

There are four challenges which should be addressed in the development of any rural health policy.

Social dislocation – by which I mean that the spouse does not want to go there or where you have to send the children away to school. The concept of a young graduate going to a rural location and staying there for his or her professional life is increasingly a myth. The sensible response to this challenge is to accept that five years is a reasonable stint in one place.

Isolation – this occurs in a variety of forms, but professional isolation is one danger, even with the myriad professional development programs including online options, coupled with the availability of registrars and other doctors employed in subsidised training schemes. The sole doctor risks burnout, and one of the aims of the programs I promoted was to reduce the possibility of professional isolation.
Community tolerance – in country towns, especially if you are the only one, you have no privacy. Therefore, there are two options – immerse yourself and your family in the life of the town or get away from the town at weekends which, in a single doctor town, leads to all sorts of antagonisms. In other words, the way the community views its medical workforce is critical for retention.
Succession planning – often the hardest, because there is a push me/pull me syndrome in many country doctors. When the media spotlight is focussed on the local doctor, then if the request is not for money it is a plea for more doctors. The doctor should be planning for succession, but how many do that? Often, when the doctor is offered a doctor to assist, then the resident doctor changes direction because the fear is of another doctor impairing the incumbent’s income, which is generally a nonsensical fear unless there is deeper pathology than just basic insecurity. The successful country practices involve succession planning so there is a gradual ageing of the workforce and a balanced practice with each doctor having the general skills to provide emergency treatment but having a special skill required in the practice, such as anaesthesia and obstetrics.

Money is always an important component and I was involved in a number of Inquiries in which the level of Medicare (and before that Medibank) patient benefits was the focus. One of the misunderstandings is that doctors’ fees are set by government; the Federal governments sets the level of the patient medical benefit and when I had direct involvement generally the benefit and actual fee charged by the doctor did not have a substantial gap. That does not hold any longer, except for general practitioners for whom different policies have been implemented, such as those that encourage bulk billing. The rural doctor, whether general practitioner or specialist, nevertheless have other sources of income to supplement the income derived from Medicare Benefits.

If I were conducting a review again of the rural workforce, flying from place to place as I did in the late 1990s, I would ask the same questions to find out what was happening in relation to those four challenges outlined above. You need to stay overnight as I did, and not fly in and fly out the same day. This overnight stay can reveal the tension and the stratagems of avoidance when the simple question of more money and more resources are not automatically accepted as incontrovertible fact.

As a person who engineered one solution to rural workforce and see it being trashed after you have “left the room”, it is very sad, but as someone once said about me, my epitaph should be “He tried!”

A Woman Scorned

I never liked her father, Vice President under Bush Junior. Not that he was unintelligent. He was, but dangerously so. I’m sure that I do not like her politics, but then Liz Cheney is a determined woman, who has a set of principles and Trump in his disregard of such principles should be challenged and defeated.

She is the sole representative from the State with the smallest population, Wyoming. It is the one State that has one representative in Congress and two in the Senate.

Wyoming is a rich State, and the inhabitants pay no State income taxes because this is fossil fuel territory – oil, gas, and coal. To see the kilometre long coal trains traversing the Wyoming prairie is a sight not easily forgotten. Cheyenne is the capital in the southern part of the State two hours from the Colorado border and one hour from Laramie, where the University of Wyoming is located. Both lie on this altoplano dry area, and travelling across the country just after the snow melts, it is easy to see how the vegetation struggles.

But six hours away in the northern part of the State is Jackson situated at the southern end of the Jackson Hole Valley. Here the scenery is some of the most spectacular, with the Tetons jaggedly thrusting their snow-capped peaks more than 4,000 metres in the cærulean sky. Jackson epitomises the tax haven for the ultra-rich, with an average annual income of the residents being US$16 million, a place with which her father was heavily identified. One commentator has encapsulated the Jackson conundrum.

This form of “gilded green philanthropy,” widens even further the ugly socio-economic divide, hollowing out the community and making it harder for workers to live nearby. Unable to find affordable housing in town, they are pushed all the way into the neighbouring state of Idaho, on the other side of the treacherous and steep 8,431-foot-high Teton Pass. These workers told many a harrowing story about just making up — and then down — to work in the dead of Wyoming winter.

Close by to the Tetons is the Yellowstone Park with his surface covering the subterranean turbulence, which manifests itself in bubbling pools and geysers spreading across and into both Idaho and Montana. Some have said this is where the destruction of continental America will occur with a massive explosion.

In the meantime, there is Liz Cheney, at the prime of her working life being repudiated on voices by her Republican colleagues yet receiving a standing ovation at the end of her speech to the Caucus yesterday. The explosion which she is engineering under Trump will come, if death or gaol do not supervene. Trump who requires a cosmetic shield to conceal his vacuity, his seditious behaviour and mental deterioration must maintain his profile for another four years. During that time, his support among his own age group will winnow with inevitable death.

Liz Cheney’s march to leadership of the Republican Party is now unconstrained by any faux-loyalty. I shudder though if Wyoming becomes the model for USA. Ironically, Trump tried, but his criminal streak and his narcissism saw him come up short.

Liz Cheney may succeed. In the short term I applaud her unyielding opposition to Trump, but I also remember she is the daughter of Dick Cheney, who was de facto President for eight long years.

Mouse Whisper

There is an entrancing book published recently called “Entangled Life”. Before anyone thinks this is one of those morbid novels about self-discovery, may I interject and say it is a very entertaining exploration of the world of the fungi. One insight into the truffle makes one realise that its smell has to compete against “the olfactory racket of the forest”. As the author, Merlin Sheldrake, writes “every visual disadvantage that truffles face -being entombed in the soil, difficult to spot once unearthed and visually unappealing once spotted – they make up with their smell”.

Elsewhere in the book, Merlin (how appropriate for a mycologist) describes one of the truffle experts as having olfactory flashbacks how powerful is the memory aroma of the top truffles. But even so he admits there is still so little known about the fungus, including Truffle Mice! Boy, can we smell!

Modest Expectations – Stumps

After another 100 days I hope the world will have the same hope in Biden that it does now after the first 100 days. Having survived the four years of President Trump with all his mimicry of Batman’s enemies, it is good to have Bruce Wayne alias Joe Biden back. Sorry, so sorry I mistook your disguise as the doddering anziano, but your treatment of Anita Hill can never be disguised or forgiven because you begat Clarence Thomas, one of the great catastrophes of modern America.

Sometimes He gets it Right

Anonymouse

It was May and then June last year that this Blog started to advocate for custom built quarantine facilities. One of the Blog’s mates thought it would be too expensive, and in any event the hotel industry had near empty facilities desperately in search of customers, so hotel quarantine was born. People returning from overseas fitted the bill for the missing customers, but viral outbreaks from these hotels have sporadically occurred. However, use of such facilities has also produced lessons – all of which can be applied to the adaptation of or construction of bespoke quarantine facilities in each State near ports of entry.

The Federal Government seems to be able to wrap its collective mind around all sorts of spending needs – defence spending seems to be a bottomless pit with an endless time frame. However, when the matter of defence is against an invisible foe, with so many tricks in its RNA, then Government seems not able to grasp the enormity of the problem and has sat on its hands for 12 months now apparently wishing it would all go away. COVID-19 will persist, with no idea when it will be conquered. At the same time, the social links between countries will be irrevocably changed.

Quarantine facilities require their own expertise and one of the various expertises needed is to ensure the rapid construction with best practice observed. That is why hard-nosed visionaries such as the Wagners in Queensland who were asked by that Government to prepare a plan, should be taken seriously; their Toowoomba airport venture should be sufficient proof as to their competence and ingenuity.

But in true Australian style, Government asks for a report. Jane Halton’s report was adequate in that she articulated the obvious – a national quarantine capacity – although it’s hard to see that recommendation, together with a collection of documentation, to be worth the alleged $118,000 it cost. The Report nevertheless provides the weasel words for the Government to ignore the positive parts of the report. For instance, the Halton pronouncement set out such a situation for the “Commonwealth Weasel”.

States and Territories should now consider their hotel quarantine operations in line with the features of good practice and make adjustments where necessary to meet these baselines. Noting issues about scalability and the specialised nature of the workforce required to implement hotel quarantine, States and Territories should also investigate establishing standing arrangements with AUSMAT in the event of the need to scale up operations quickly.

Stripping out the verbiage, of which there is plenty, the recommendation is to get a national system of quarantine, with agreed standards and scalable capacity. Too much to ask that our Federal and State Governments behave like grownups and just do this? The Federal Government’s admissions about quarantine in relation to returnees from India demonstrate the scale of the problem.

How long ago did Halton write her report?

The Inglenooks of Age

When I was a young doctor, elderly patients who presented in hospital, with apparently uninteresting symptoms and signs, besides being old, were called “old sloughs”. Now I have reached that “old slough” age, it just confirms how offensive that description was. Even then I recoiled from the dismissive way hospitals were places where these patients were admitted. Care was a secondary consideration. Therefore, old people when there was considered nothing more could be done, were left in a bed with minimal attention until they could be moved to a geriatric hospital, which was one step before the nursing home.

One case stood out when I was reviewing some of these older people in hospital. It was at a time before the specialty of geriatrics had been carved away from general medicine and general practice. In Victoria there were geriatric hospitals; later I received a more detailed insight into such care when I had to run the rehabilitation unit at one of the large teaching hospitals in Melbourne and later still spent time reviewing facilities when I was responsible for certain sectors of community aged care.

I stopped at the bed of an elderly lady who had been classified as suffering from dementia. I reviewed her charts and there, on her drug charts, was a nightly dose of Relaxa-tabs. She had been taking these for years and the order seemed not to have been changed. Naturally, with the dose prescribed, she would sleep, but I was taken aback by the quantity.

Relaxa-tabs contained bromine and so, out of curiosity, I ordered a serum bromine. When the result came back it showed her serum bromine was at toxic levels and clearly explained her apparent dementia.

The tablets were stopped at the time of the test, and once the serum level was known treatment was instituted to flush the bromine out of her system. Over the next fortnight her mental state improved to such an extent that I cannot remember whether she went home directly or had a staged return to a more normal living. The demented state cleared – I know that much.

To me it was a salutary lesson in labels, especially now I am of that age. Bromine in not the problem it was in the past as it has been removed from reputable pharmaceuticals. I have read that in the USA it is licensed to be added to the water supply of naval ships and oil rigs, as in addition to having sedative properties, it also allegedly dampens the male libido. I grew up, myth or not, believing that bromine was added to the tea of soldiers for such an effect.

You can have as many government inquiries into aged care as you like, but society has passed you by when you strike 80. The elderly with money can have their care softened by the cushioning effect of their money. I had an aunt who lived for her last years in a very plush nursing home, but even in that home, it was evident how many of the staff were recent immigrants, particularly from the Philippines and Nepal.

Yet neglect remains the headline for much that goes on in the aged care sector. The stories on the one hand of the Greek Orthodox Church demanding its nursing homes pay a tithe so the archbishop can have a wardrobe of fancy raiment or, on the other hand, of nursing home owners who live lavish lifestyles, complete with the signature matching yellow Lamborghinis, running nursing homes with minimum standards of care. I well remember the whole fiasco of Bronwyn Bishop’s stewardship 20 years ago when she was the Minister responsible for defending the use of kerosene baths in nursing homes Nothing much has changed, except perhaps the kerosene.

The exploitative areas of the nursing home industry should be shut down. When Governments crab away from such a drastic solution, they tacitly agree that the immensity of the problem of nursing home care requires not only more but also better trained resources in a coordinated environment and regulatory unification between the sectors – and Governments keep saying that, but effectively do nothing about solving the problem. It is ridiculous for the Commonwealth to be running the aged care sector and the States the public hospitals, when it should be the one sector.

As indicated above, I have been involved at various times of my professional career with the aged care sector, and it is a no brainer. There should be a single system, because age is a continual wave eventually crashing on the shores of death. At present, the method of distribution of health care is via aged care packages, depending on the funding source floating on the top of the wave. Quality is incidental.

There is a philosophy with certain government sources of shovelling out the cash – job done – but what about quality and outcome? To some bureaucrats that requires actual work, collection of data and, given the reigning politicians suppress as much information as possible, they may argue what is the point?

Political announcements are all about input and the immeasurable glorious future where the recipients of such input are chewing lotus leaves – or their gums. Who needs data, especially when this is the third or fourth time the same announcement of government largesse has been made? To make the point, sometimes irony is the best way to highlight the problem, especially when the government itself is the very epitome of irony when it says, “We are taking the matter very seriously.”

The other public problem is the lack of an articulate advocate for reform on behalf of aged care residents. If you look at the vast array of those who appear on the media, there are none who regularly appear when the topic moves onto the way to actually improve the lot of the aged. The last woman of consequence to appear regularly on a panel show and make an impact by clearly showing that age was not automatically the gateway to dementia was Margaret Scott, the Tasmanian poet, who was a regular guest on Good News Week in the 1990s.

It is mainly a variety of social workers and health professionals who are some way away from being aged, often well skilled in the vocabulary of “shock and horror show”, but stopping short of doing anything.

There is the vaudeville act that the ABC has twice arranged by mixing the very old with the very young. This concept was aired first on the BBC and, given the COVID-19 pandemic, the ABC have been venturing into perilous territory, but it is assumed everybody involved has been “dry cleaned”. The concept is very interesting, but not just as sporadic entertainment. After all, grandparents looking after their grandchildren has been around for a long time, just ask the Indigenous community. I am just not aware of any program which seriously looks at the benefit of those arrangements long term and whether a program such as the ABC is airing is demonstrating anything sustainable or generalisable.

There is also that myth about 70 being the new 50. However, it is illusionary. The general improvement in the welfare of the community has improved. Too many in the years after the “new 50” start to die in a manner not befitting of a reborn generation 20 years younger.

The problem with age is invalidism and the daily humiliations that accompany it. I am reminded of the words of a young woman with motor neurone disease who said she most feared the time she could not wipe her bottom – to her this represented a turning point. Don’t just be appalled about the frail and elderly dealing with such daily humiliations. Demand that every politician spend a week or two in community service looking after the aged and contemplating their own probable destination before they can pontificate about the problems of aged care. Although perhaps their pensions will be such that their choices will be much easier in the future.

The Drums are beating

This past weekend, Essential Quality came fourth in the Kentucky Derby at Churchill Downs. Louisville is the city in the middle of this blue grass country and Bourbon distilleries.

As the NYT has reported, pre-race talk among the racing fraternity was all about what Sheikh Mohammed’ al-Maktoum’s money has accomplished, and the fact that the same group completely ignored the international human rights scandal over the Sheikh’s role in the disappearance of Sheikha Latifa, one of his daughters.

But others are speaking up. A group of human rights lawyers and students at the University of Louisville filed a complaint with the Kentucky Horse Racing Commission, asking it to bar Sheikh Mohammed and thus Essential Quality from the Derby.

“The Horse Racing Commission must also use its authority to end his involvement in Kentucky horse racing, at least until Princess Latifa is free of captivity,” the complaint document insisted. The Kentucky Racing Commission went for the long blue grass; after all, the pervasive influence of the UAE ruler who pays the wages of a large segment of the racing industry not only in Kentucky but also across the world. In Australia where the racing industry has a disproportionate influence, one can only cringe when one hears our equine commentators falling over themselves to address “His Highness”.

Two weeks ago a panel of United Nations human rights experts, including members of a panel that deal with forced disappearances and violence against women, asked Dubai for proof that Sheikha Latifa was still alive and called for her immediate release.

“Evidence of life and assurances regarding her well-being are urgently required,” the U.N. analysts said. In recent years, videos have of Sheikha Latifa, saying she was imprisoned in a Dubai palace and afraid for her life. In a 2018 video she said, “her father only cares about himself and his ego.” In an ominous premonition, “I’m making this video because it could be the last video I make,” she said. She was last seen at a meal hosted by her father that the former Irish President and erstwhile defender of human rights, Mrs Mary Robinson attended. She later said she had been tricked into attending. Yet her excuses sounded lame in a report of the matter in the Irish Examiner when, in her attempt to rationalise the woman’s dire situation, she was reported to have said Sheika Latifa was said to have a bipolar disorder. I would say it was the least of the Sheika’s worries.

As widely reported, Sheikha Latifa hasn’t been seen in public since an attempt to escape in March 2018, when her Finnish personal trainer and a former French soldier joined forces to smuggle the Sheika aboard a boat, which was later boarded by armed Emirati commandos in Indian waters. Sheikha Latifa and her personal trainer, Tiina Jauhiainen, were captured at gunpoint, sedated and returned to Dubai, with Ms Jauhiainen released after a fortnight. No mention is made of the French soldier’s fate.

This is not the first time Sheikh Mohammed’s treatment of female family members generated outrage. Last year in Britain a judge found that he had abducted another daughter, Shamsa, off the streets of Cambridge in the UK in 2000, flew her by helicopter to France and then returned her to Dubai.

In addition, his youngest wife, Princess Haya, Mrs Robinson’s mate, has also left Dubai fearing for her life after she was subjected to a campaign of intimidation and harassment.

But then the Sheikh has 30 children from six wives. Given the attention being shown to women’s right in Australia, who will be the first to issue an invitation for Princess Latifa to visit Australia – if she hasn’t been killed already by Godolphin Blue.

Tasmania – the place where it counts

Each of five electorates are called divisions. Each division has approximately the same number of electors. Voting for the House of Assembly is by a form of proportional representation using the single transferable vote (STV), known as the Hare-Clark electoral system. By having multiple members for each division, the voting intentions of the electors are more closely represented in the House of Assembly.

Since 1998, the quota for election in each division, after distribution of preferences, has been 16.7% (one-sixth). Under the preferential proportional voting system in place, the lowest-polling candidates are eliminated, and their votes distributed as preferences to the remaining candidates. If a candidate achieves a quota, their surplus votes are redistributed as preferences.

I was once elected to office by a similar system.

In this election Premier Gutwein in his Bass division nearly achieved three quotas. That is the way to do it, because once you reach the required number of votes, the surplus cascades to your fellow party members. If the level of this popularity for Gutwein had been translated across the other four division, he would have won in a landslide.

That is not how Tasmania works. Like Gaul, Tasmania is divided into three parts. Hobart in the south, Launceston in the north, and a conglomerate of towns on the north-west and west coast.

Hobart spreads westwards along the Derwent is a different constituency to Bass. Divided into Clark, where the Liberals struggled to gain a second seat and Franklin, where the Liberal and Labor Party gained two seats and Greens one, the electoral picture is far different in the other three constituencies of Lyons, Braddon and the Gutwein fortress of Bass.

Launceston, the overwhelming population centre of Bass, in fact is a much smaller electorate in geographical terms than the other two northern electorates. Yet it does include Flinders Island, where the Islanders are the closest living remnant of an Aboriginal race despite some residual controversy, where its purity left with the death of Truganini in 1878.

Devonport is the largest town in the north-west electorate of Braddon, but this electorate has a number of settlements ranging along the coast (plus King Island) and then extending down the Murchison Highway to the “mineral shield” settlements of Rosebery, Zeehan and Queenstown and the fishing and tourist settlement of Strahan lying as it does on Macquarie Harbour, the third largest in Australia, larger than Sydney Harbour.

Within Braddon are some of most extraordinary examples of untouched temperate rain forests, despite the efforts of successive Governments to destroy it in the name of jobs. Here, in one the most magnificent wilderness areas, despite a strong working class population the electorate is strongly Liberal – the heartland of Morrison populism. The Greens are the foe. Yet the south-west is the State’s unique flora and fauna Treasury.

Lyons, also a Liberal State electorally, is an amoeboid electorate which spreads its pseudopods from the east coast through the Midlands into Sheffield, a trendy watering hole just 22 kilometres south of Devonport which lies within Braddon on the north coast. Federally it has a Labor party member but in this State election it voted for the Liberal Party, a crossover trend which occurs in Tasmania; as does the number of Independent members of both State and Federal Parliament, which is not difficult to understand given how strong private politics are in Tasmania.

Last Saturday was the first time I had been in Tasmania when the State election had been held. The gracious concession speech of the Labor leader and the gruff laconic acceptance speech of the Premier contrasted with the predictable loquacity of the Greens leader given a post-election microphone. She unfortunately provided a strident tirade, and before turning her off, I had thought politics at the top here was refreshingly different. Not so.

For a population of about 550,000 with one in four of the population living in Hobart, it has 57 Federal and State politicians; and between 200 and 300 local councillors in the 29 municipalities (it was 79 when I first visited Tasmania).

Tasmania is grossly over-governed. Under the Australian constitution it is guaranteed five seats in the House of Representatives; and as with the US Senate each State has the same number, apart from the ACT and the Northern Territory.

Comparing Wyoming with a population slightly larger than Tasmania’s, it sends only one elected representative to Congress (out of 535). By contrast, Tasmania sends five elected members to the House of Representatives (out of 151).

Therefore, Federal Government policy towards Tasmania has traditionally been to fill the begging bowl and a tree not chopped down or a river not dammed or native species not exterminated have dogged policy considerations to the detriment of the State. It is private politics in its purest form. Take the health system: if Hobart gets A, Launceston and Burnie will want A too. It is the root cause of so much of Tasmanian problems – the inability to live with one another.

I was just perusing The Advocate, the paper of the north west. The number of football teams in the area is extraordinary, and as I have written elsewhere the antagonism between towns is often reflected on the football field and the closer the towns are to one another, the greater the antagonism and failure to work together. Thus, in terms of rationalising resources, this part of the State presents a problem in getting agreement to any public policy.

My contribution to this private politics, since I am a ratepayer, is the following ; first the gorse along the Zeehan-Strahan road needs to be eradicated before it consumes Tasmania, just as Queensland was threatened by the prickly pear infestation before the introduction of cactoblastis beetle. The other problem with gorse is that below its impenetrable prickly greenery it stores all its dead wood which can act as a fire accelerant.

Peruvian goat herders have been used in the USA to oversee goats which eat noxious weeds. Paradoxically if you do burn the gorse, then four to five years’ worth of goats feeding on it will eliminate gorse. Andean Peruvians are said to be the most reliable goat herders; apart from which, having a goat herd in the area will provide an industry and something for tourism. However, don’t let the goats become feral otherwise it’s another cane toad.

Secondly is to upgrade the Strahan airport to a level where it can receive planes as big as a 737. The latter is unlikely in the short term even thought it could be used for tourism in the south-west and would certainly open up the tourist market, especially with a rental car franchise. The longer term consideration is with climate change – inevitably the forests will dry out, and therefore there is a need on the west coast of Tasmania for the airstrip to be upgraded so water tankers can land instead of being based in Launceston or Hobart. For those with short memories, no one seriously believed the rainforest of the south coast of New South Wales could burn the way it did.

Then thirdly, more a suggestion than a demand, there is another industry which I find it strange that the Liberal Government has not promoted and that is dedicated quarantine facilities. I would not advocate Sarah Island in Macquarie Harbour, once a prison, but a properly constructed quarantine facility in Tasmania is certainly closer to Australia than Christmas Island.

But then the success of private politics depends on how determined and how committed one is for the long game. I wonder how well this is translated into the future administration of Tasmania.

Mouse Whisper

An unguarded comment?

As one of his colleagues recently remembered:

“30 years ago today, the wonderful C… H… died. Fabulous economist & mentor with unlimited time to talk. Friday drinks in his office often included Pichon Lalande, Lynch Bages & Chateau Talbot as he mulled over the next additions to his cellar. Great man; greatly missed.”

Different time – wrong look. Yet the connoisseur of lotus cuisine continues to be the role model for the current Canberra Elite.