Category: AUKUS

Modest Expectations – Flying in the Faroe Islands

Together, Omar Abudayyeh, 33, and Jonathan Gootenberg, 32, have probed the mysteries of genomic editing and COVID detection. They co-published 10 scientific papers, helped launch two medical-diagnostic companies, and cofounded a Watertown startup, Tome Biosciences, that reengineers genes and cells to cure diseases. They also run the Abudayyeh-Gootenberg laboratory.

Gootenberg and Abudayyeh are an unusual pair, two scientists — a Jewish American and a Palestinian American — who prefer working together in a field that often draws solitary researchers and rewards individual achievement.

As depicted above, this Amoeba proteus is among a range of snails, algae and amoebas that make programmable DNA-cutting enzymes called Fanzors. Fanzors are RNA-guided enzymes that can be programmed to cut DNA at specific sites, much like the bacterial enzymes that power the widely used gene-editing system known as CRISPR. The reported research in this area comes from the team headed by Gootenberg and Abudayyeh.

I thus could not bypass the report of such a collaboration, which has this air of exceptionalism about it. The two seem to be highly regarded in cellular engineering, given they have raised enough funding to set up their eponymously named laboratory at MIT. The sunny publicity photograph of their team shows them flanking eleven researchers (four women and seven men). One of the women is wearing a hijab. The others show a variety of heritage; but why comment?

This is how research should be conducted, free from political and religious manipulation, and the depressing detritus of misinformation strewn by evil men. Oh, that this collaboration between Jew and Palestinian could be generalised into wider behaviour between the two peoples.

The Barnaby Grudge

The man of many self-inflicted memes

Barnaby Joyce, lying flat on his back on a Canberra street, swearing into his mobile phone, obviously pissed out of his mind – allegedly – was such unbelievable fodder for the media. The response has been predictable. Joyce is a serial roisterer; he is lazy, whether intellectually lazy beggars the question of whether he has the intellect. He collects money for doing nothing; he is completely ill-disciplined.

He is the sort of character who probably refined his skills at school, where he would have been expert in forming gangs. Where there are gangs, then there are bullies. Bullies with a smile; who have size and, in Barnaby’s case, a ruddiness and exophthalmos giving him the expression of a grinning toad, seems to some of either gender to be compelling. After all, he has a reputation of being a high-profile philanderer as well as a bar-breasting “jock”.

Joyce was once said to be the best retail politician in the country. But what did that mean? Being able to wear an Akubra without looking like a dill or effortlessly downing a schooner in a country pub? Barnaby, the engaging.

As they used to say about Bill Clinton, when you met him for 30 seconds you felt that you were the most important person on Earth. Has Barnaby emulated that?

The previous leaders of the National Party that I have met would have dismissed Joyce as a buffoon, but Joyce survived because paradoxically he had this level of “jock” charm, which none of these immediate predecessors have had.

I have not been blameless, but the only time that I emulated Barnaby’s exploit was one time when I was about 20 and stupidly lay down on a quiet piece of bitumen on the Gold Coast. Why?  Because it appeared a place of rest for this “tired and emotional” young bloke. I was fortunately rescued by a young lady who shielded me from curious police, who were inquiring about why this young man wanted to sleep on the macadam. The helpful police assisted me to my feet, suggested that a bed would be the best place to sleep it off, and spared me from the accommodation, which they could have provided.

Now Barnaby was reputedly swearing into his phone; and it would have presented a problem for any potential “good Samaritan”. After all, don’t we have the police and ambulance officers to assist such a person resting on his back in a public space, spitting invective?

Anyway, there is not much information following the photograph of the laid back Joyce. What happened? Oh, well according to unofficial authoritative connections with the National Party, Barnaby just got to his feet, dusted himself off and went into one of his favourite retail Barnaby outlets to have a hamburger and then went home, presumably to read his children a bedtime story. This last has not been confirmed.

Next day, there are reports of Littleproud and Dutton warming some lettuce leaves before meeting Joyce for a friendly chat about the dangers of the slippery surfaces of Canberra streets, not to mention plantar boxes which throw innocents from their “sovereign borders”, particularly after imbibing a mixture of prescription pharmaceuticals and alcohol, despite a warning not to do so – Joyce’s explanation for his dilemma. However, this simply highlights his irresponsibility and echoes the excuses of others for their own bad behaviour – if you are warned not to mix drugs and drink, then don’t. It’s an indictment not an excuse if you do.

Now getting serious, mate. Barnaby, take a hike. Australia has enough parasites already, even if they are good at retailing themselves.

Yet some urban parliamentarians may disagree with me. They found out that having photos of Joyce and his exploits posted around an electorate just reminded potential voters how good he is in retailing women candidates who despise his vulgarity – as a considerable proportion of urban Australia do.

Meanwhile

Feeding on the Corpse – Living the Nightmare 

A regular feeding frenzy

The entry of Morrison into the feeding frenzy over the AUKUS boondoggle has generated a thought bubble. He joins a whole group of former politicians who are clustering around the huge mound of money labelled AUKUS, which has no sensible conclusion. Spending money on potentially obsolete technology while saying they are tip-toeing along the edge of major technological advancements is meaningless. Fancy language like “pillars one” and “pillars two” just increases the arcane shroud covering the Aquatic Boondoggle.

A giant scam perpetuated by politicians who have bought us Australians sports rorts, money laundering through casinos, a gambling industry out of control, acquisition of land for the Badgerys Creek airport, handouts favouring a shady boyfriend, car park rorts, the building better regional National Party slush fund,  the PwC tax leak scandal, Dutton and offshore detention corruption within his portfolio responsibility, Morrison’s secret ministries … and it goes on and on.

The thread is that politicians, especially Ministers, can be as corrupt as they like and their retribution is placed on the equivalent of the Slow Boat to China

The actions remind me of two films.

The first is the Italian film La Grande Bouffe.

This is the story of four men who wish to gorge themselves to death, which they do in the most degenerate way. All die; the film is a disgusting exercise in gourmandising. But where the story line diverges from the Australian gourmandising on taxpayer sweetmeats is that in the film there are only three prostitutes.

Preparing to move to the Front Bench …

The second is yet to be released, but has the tentative title, The Vultures. But the images are so horrible, so depraved that a prequel called Nemesis has been released to condition the Australian nation. The spectacle of vultures alternatively preening and clawing over the carcass which was once Australia is bad enough, but the scene where the vultures are transformed into human form is particularly disturbing. Discussions are continuing, but some say, the transmogrification of the Lammergeiers to the Front Bench is just so horror-full that nobody living outside our borders could believe the debauchery through which this country has lived.

However, as part of this film in the making the Consultants, a shadowy group of vultures have been filmed stripping this aquatic Boondoggle of its monetary flesh. Most Australians will be so revolted by the blizzard of banknotes being gourmandised by this band of slavering Vultures, that they will call for it to be immediately banned.

Yuk…but unfortunately it has been bought as a training film for each member of Parliament. 

In Our Times

In Our Times is one of Hemingway’s earliest works, a series of short stories, for the want of any other words. He wrote it in around 1924 or 1925, a time when he had recently arrived in Paris and was under the thrall of Ezra Pound. His alter hero-ego, Nick Adams, appears in a large proportion of the stories, which vary from a few pages to the accepted length of short stories, in the region of 5,000 words. Before reading this book, it was helpful to know of Hemingway’s wartime experiences and his passion for bullfighting, which he consolidated into two of his best books, both written not long after “In Our Times”.  They were “The Sun also Rises” and “Farewell to Arms”. The first is structured around bullfighting in Spain and the second, his experiences of WWI in the Alps where the Italian and the Austro-Hungarian armies are locked in combat.  This Hemingway story for me is one of the greatest twentieth century novels.

Nick Adams as Johnny Yuma

The name “Nick Adams” resonated with me for another reason. Nick Adams was an actor who, in the early 60’s, featured in a western television series, The Rebel where he played Johnny Yuma, an ex-Confederate soldier now paladin. Late at night when we were doing our women’s hospital stint, we used to go across the road to the Italian trattoria and watch Johnny Yuma while having a veal parmigiana. For a group of us it became a reason to escape briefly from the stifling atmosphere we were forced to experience for ten weeks while we learnt the obstetrics trade, delivered the requisite numbers of required babies, and were rostered on the episiotomy schedule to sew up the perineal cuts. Ah, the joys of being called at 3am.

In any event, Nick Adams was a name that loomed large. He was a handsome bloke of pure Ukrainian heritage and his stage name was a contraction of his actual name. He was friendly with both Presley and James Dean. A troubled character, he died of a drug overdose in 1968. There has been some controversy over his death, but to some accident and murder seem more palatable as a cause of death than the eventual verdict of suicide. Controversy thus occurred. He was an image of his times.

What I found somewhat spooky, when I started reading In Our Times, was Hemingway’s adoption of the alias of Nick Adams. Hemingway blew his brains out in 1961.

What’s in her Name!

(The Passionate Years is a) mad, amusing, and revealing look at Paris in the twenties and at the people Caresse Crosby knew—Hemingway, F. Scott Fitzgerald, Edith Wharton, James Joyce, Picasso, Ezra Pound, T. S. Eliot, Lawrence of Arabia, and a host of others. In a single day, a visitor to the Crosby home outside of Paris might have found Salvador Dali at work in one room, Douglas Fairbanks Senior playfully swinging from the rafters, and D. H. Lawrence sunning himself by the pool. 

Caresse Crosby and her whippet, possibly named Clytoris

The edition of In Our Times that I picked up in some shop somewhere which took euros as payment was published in Paris as one the books in the Crosby Continental Editions series in 1932. It was an ambitious project by this woman who had adopted the name Caresse, (she had toyed with the name Clytoris but eventually gave that name to one of her pet whippets) when she married Harry Crosby in 1920. He was her second husband and, given their massive wealth, they lived a completely luxuriant hedonistic life, with Caresse and Harry as the centrepiece against the Bohemian backdrop in Paris as languidly described above.

She was born Mary Phelps Jacob into a well-to-do New York family. She early demonstrated her eclectic talents. For example, she invented the backless bra, when she decided to ditch the whalebone corset. The bra started off as two pink handkerchiefs stitched together, was refined and it proved very comfortable and was adopted by her friends. She sold the patent for $1500; the buyer went on to make millions.

She is even credited with having held the 220 yards record, but given that women’s athletics were hardly recognised then, why should her feat be singled out?

She was first married in 1915 to Richard Peabody, a Boston businessman, called herself Polly, had two children, and after tiring of him struck up the relationship with Crosby as noted above. As token of their love they sealed a suicide pact. Harry Crosby stuck to his side of the bargain and committed suicide in 1929 after murdering his lover at the time – not Caresse who lived on until 1978.

Among Caresse’s venture was establishing these Crosby Continental Edition books – ten of them- and yet as reported in a short biography of herself, it was a total failure.  As has been pointed out, it … may partly have been the choice of titles.   Although Hemingway, Faulkner and Saint-Exupery sound an impressive selection of authors, it was competing with Albatross, whose first ten books included titles by James Joyce, Aldous Huxley, Sinclair Lewis, Virginia Woolf, A.A. Milne and Edgar Wallace.  Caresse had been keen to launch her series with a best-seller and was delighted to get Hemingway on board, but ‘The Torrents of Spring’ is probably not his finest work.  Albatross, which later published ‘The Sun Also Rises’, then got the better deal (Tauchnitz, had earlier published ‘A Farewell to Arms’).

Overall the Crosby list contains 6 works by American authors and 4 by French writers in translation.  Was it insufficiently cosmopolitan, or even insufficiently British, to appeal to the readers of English language books in continental Europe, many of whom would have been British expatriates or tourists?

The question is totally rhetorical, but Caresse did underestimate the experience and strength of the opposition.

Albatross Books, founded in 1932 by John Holroyd-Reece, Max Christian Wegner and Kurt Enoch was a German publishing house based in Hamburg that produced the first modern mass-market paperback books.

The name was chosen because albatross is the same word in many European languages.

Based on the example of Tauchnitz, a Leipzig publishing firm that had been producing inexpensive and paper-bound English-language reprints for the continental market, Albatross set out to streamline and modernise the paperback format. Tauchnitz was established in the eighteenth century, and in 1841 started publishing English editions, including inexpensive English-language reprints of American and British authors, and then sold them in all parts of the world except the British Empire.

However, the Albatross Modern Continental Library stood out in the marketplace “with an eye for design and colour”, which included the introduction of colour-coding for different categories of books” in the form of fully saturated covers: red for crime, blue for romance, yellow for literary novels and essays, purple for biography and history, green for travel, orange for short stories, and improved typography and modern editorial policies. These modern looking volumes sold in huge numbers, and were the template for The Penguin Books, which Alan Lane started publishing in 1936. Kurt Enoch later went to work for him, after he escaped from Nazi Germany via France, as his American director.

So successful was Albatross Books that it absorbed Tauchnitz, but it was caught up in WWII and ceased publication in 1940.

By that time Crosby Editions had long gone, but fortunately I have one of the surviving copies, in moderate condition complete with its nondescript cover with the Crosby monogram.

Mouse Whisper

The Boss was President of the Student Representative Council at the University of Melbourne at a time when there were delicate negotiations to re-admit the Council back into the National Union of Australian University Students (NUAUS). He sent what he thought was a reasonable letter to his counterpart at the University of Sydney. In one sentence, he meant to use “imprudent”, but he failed to pick up the missing “r”, and the word read as “impudent”. Talk about the “War of the Missing R”. In the end, the explanation of the typo was accepted, but not before The Boss had a severe case of burning ears.

He was reminded of this when we all read in The Boston Globe of what happens when one does not pay enough attention to what in isolation would appear to be trivial. However, in context…

Lyft took investors on a brief but wild ride when it announced earnings this week. In a press release issued after the end of regular trading on Tuesday, the ride-hailing company said it expected its profit margin to increase by 5 percentage points this year, a huge jump. Investors sent the stock up by as much as 67 percent in after-hours trading, according to Bloomberg. Later, on a conference call, the company copped to making a big typo: Margins would increase by just 0.5 of a percentage point. Its shares retreated.

Lyft isn’t the only company that’s had problems with typos.

·       In 2010, JPMorgan Chase signed a trader to a contract with a salary of 24 million rand ($3.1 million), instead of 2.4 million rand. The trader sued to enforce the deal, but a judge let the bank off the hook.

·       A Maine dairy settled a case for $5 million after a judge ruled in 2018 that a misplaced comma in a state law meant that its drivers were entitled to overtime pay.

·       Last month, Boston real estate agency Gibson Sotheby’s International Realty sued the developer of the St. Regis Residences, alleging it was short changed by nearly $400,000 in commissions because of a misplaced decimal point in a contract. The developer, Jon Cronin, called the lawsuit frivolous.

It is always a case of not getting things write.

The case of the missing R

Modest Expectations – My God, not Des Clarke’s Son

There is one thing about the configuration of hotel/motel rooms. Much is made of the fact that “accessible” rooms are routinely part of a hotel’s room complement – but what does this really mean? When people think of disabled, they recognise that the signage for disability is the wheelchair. However, there is another level of disability which, on occasions, may require a wheelchair – it now tends to be described as “ambulant”, although that seems to only apply to bathroom doors.  When I need a wheelchair, I use one that can be borrowed. This is sufficient. I can manage on two sticks, even with my balance problems.

But back to those accessible rooms. Bathroom/toilet facilities need to be user friendly. Wheelchair friendly facilities must have sufficient space and most disabled facilities recognise the need to eliminate steps.  Nevertheless, many of these are not appropriately designed for the disabled who use sticks or crutches unless there are sufficient railings to assist navigating a wet floor, where sticks are liable to slip as one tries to walk on the cracks between the tiles to avoid sliding The criteria for accessible rooms definitely need to include non-slip-when-wet tiles.

What is also not factored in are the beds, which need to provide a safe place to site and reasonable ability to get out the bed. I use carer help, or else a chair located next to the bed to wrestle myself up. The mechanics are deceptively simple to assist sitting up and swinging legs over. The height of the bed should be related to the height of the person so ideally the height should be adjustable, particularly as modern beds seem designed for an accompanying ladder. The modern hospital may be the template. Hospital beds have a feature that makes them more appropriate, high-low functionality. The user can raise and lower the bed vertically, making a hospital bed ideal for people like myself, who need more assistance when getting in or out of bed.

The other issue is the inappropriateness of the chairs provided in most hotel/motel rooms – often rickety hard backed chairs or ludicrously low armchairs. Even rooms that purport to have a work desk rarely have a suitable chair on wheels. From my point of view, a decent office chair makes life much easier and I suspect for others, avoiding having to push a normal chair back and forth from a desk would be welcome.

It may be said that I am speaking from the viewpoint of a rara avis, but does anyone know? An ideal disabled room should incorporate some of the suggestions discussed above, and it would be useful to convene a working party to set the standard.

Considerations of Some Matters

Some years ago, we visited the first ghetto in the world which is located in Venice. When it was constructed to house the city’s Jews, the gates were locked at night, emphasising its quasi-prison conditions. The ghetto is far from the centre of Venice. Apart from a gaggle of Chinese tourists, the ghetto square was empty save for a Jewish family enjoying the balmy sunny day, sitting under a tree. The only jarring note was the bulletproof door to The Holocaust Museum. We did not go in. I had seen the gruesome museum in the old Gestapo headquarters in Berlin. One Holocaust Museum is enough. Pity, the Israeli government seems not to have seen it lately.

In any event we had eaten a delightful kosher lunch marred by the officious surliness of the staff. Quite obviously, non-Jews were not particularly welcome, even if we did have an inkling of the food taboos.

Reflecting on that I wonder when the world will be able to bask on the shores of the Gaza Riviera. Maybe without gates to lock the Israelis out.

The above were just a few introductory thoughts if you wish to read on.

Avraham Stern – who split from the Irgun to form the Lehi (also known as Stern Gang) in 1940 – had suggested securing support from the Third Reich.

Haaretz adds that Lehi representatives met with an official from the German Foreign Ministry in Beirut at the end of 1940.

“The establishment of the historical Jewish state on a totalitarian national basis, in an alliance relationship with the German Reich, is compatible with the preservation of German power,” the newspaper cites the Israeli document as saying. The Cradle, June 2023 (a journalist-driven American publication founded in 2021 covering “West Asia voices not heard in the world’s English-language media. That’s not the only differentiator. Not owned by any donors, and so they have no say over what is written or not.”)

Q: True or False? 

On April 19, 1943, the Warsaw ghetto uprising began after German troops and police entered the ghetto to deport its surviving inhabitants. About 700 young Jewish fighters fought the heavily armed and well-trained Germans. The ghetto fighters were able to hold out for nearly a month, but on May 16, 1943, the revolt ended. The Germans had slowly crushed the resistance. 

The SS and police captured approximately 42,000 Warsaw ghetto survivors during the uprising. They sent these people to forced labor camps and the Majdanek concentration camps. The SS and police sent another 7,000 people to the Treblinka killing center. At least 7,000 Jews died while fighting or in hiding in the ghetto. Only a few of the resistance fighters succeeded in escaping from the ghetto. – Holocaust Encyclopaedia.

Q: Tell me why the current Gaza situation is different from Warsaw?

The attendees hadn’t expected a policy shift from the meeting, according to the accounts, but felt confident that their concerns would be conveyed to Biden, to be taken into consideration in his public remarks about Palestinians. Two days later, the President made the comments questioning the accuracy of Palestinian casualties at a time when Arabic-language TV channels were showing nonstop footage of lifeless, dust-covered children being pulled from the rubble after Israeli strikes. –Washington Post

Could someone tell me why Israelis are viewed as more truthful than the Palestinians?

The Venetian Ghetto was the first ghetto instituted in 1516 by decree of the then Doge Leonardo Loredan and the Venetian Senate. It would be ironic if, by his actions in Gaza, Netanyahu emulates the Doge, albeit for a different reason, reviving the ghetto so that every Jew, whether Zionist or not, is worldwide forced to live in armed enclaves for their own protection.

When the Gunman Comes to Town

The following is from the Boston Globe response to an edited account of the mass shooting in Maine. I have spent some glorious times in Maine, although I have never been to Lewiston as far as I can remember.

Mass shootings are a rarity in Australia although I well remember the Port Arthur massacre in 1996 when 35 people were killed. I was one of the few who saw the police film of the horrific aftermath, a coloured grainy film. It was a time when I had just stepped down as President of the Australasian Faculty of Public Medicine, and my successor strongly supported our Prime Minister’s response, which inter alia resulted in banning semi-automatic and pump action shotguns, without good reason. While there were concessions to the rural lobby, there were restrictions which, despite some high-profile shootings since, have seen deaths due to firearms decrease.

Nevertheless, what is interesting about this Boston Globe article is the description of the emergency medical response, given most of the shooting victims were dead. Those injured are not as newsworthy, given the concentration on the event and the number dead. How much of the response of Maine health professionals is applicable to the Australian situation?

Dr. Sheldon Stevenson was at home hosting 10 fellow emergency physicians when the call came in Wednesday night around 7:30. Colleagues at his hospital, Central Maine Medical Center in Lewiston, were resuscitating a gunshot victim. More were on the way.

Stevenson, the hospital’s chief of emergency medicine, had been expecting this call to come one day; mass shootings had grown far too common.

With scarcely a word, the doctors stood up and decided who would stay behind and take over for the others the next morning. The rest sped the roughly 35 miles from his Portland home to the hospital.

Meanwhile, chief executive Steven G. Littleson and chief nursing officer Kris Chaisson had already fielded similar calls. There was an active shooter, and the local emergency dispatch center had activated “code triage,” alerting everyone at the medical center that a disaster was unfolding.

As the hospital braced for what would prove to be its worst disaster ever, the staff knew what they had to do, but knew little of what they might face. Ambulance crews were reporting possibly 15 to 20 victims from two shooting sites. But the gunman was at large, and there was talk of as many as five or six additional sites, possibly waves of patients streaming in all night.

Alerted by the code triage, doctors, nurses, respiratory therapists, support personnel, about 20 to 30 people in all, assembled in the ER within minutes. As word spread throughout the medical community, the emergency room filled with 100 people ready to help. Blood supplies arrived from other hospitals. Five helicopters were parked outside, ready to transport victims across the region.

The first gunshot patient arrived at 7:24 p.m. Thirteen more would stream in over the next 45 minutes — many more severely injured patients than the hospital had ever seen at once.

By the time Chaisson, the nursing chief, got to the emergency department, four shooting victims were being assessed in the trauma bays and the ER was filled with “a sea of people.”

“It was an organized chaos,” she said. “There were so many people but they knew exactly what they needed to get done … It was like a work of magic.”

Littleson, the CEO role would coordinate everything that happened next. The hospital was full Wednesday night, its 170 beds occupied, and the emergency room was already busy with the usual crush of 25 to 30 sick patients, including some who were waiting for beds. The staff would have to somehow make room for an untold number of casualties. Patients were moved into holding areas and other available spaces.

“We knew that the patients coming out of the operating room would need critical care. We had to mobilize some of our less critical care patients to other floors, to free up the ICU to take care of these patients,” Chaisson said.

Nine gunshot victims went swiftly to operating rooms — their awful wounds an urgent and obvious diagnosis. Privacy rules prevent a discussion of individual injuries, but Dr. John Alexander, the chief medical officer, named the types of surgeons who worked on them to give an idea: four trauma surgeons, four orthopedic surgeons, a vascular surgeon, a cardiothoracic surgeon, and a urologist.

Stevenson, the emergency chief, said the hospital treats gunshot wounds at least every month. But typically they are from handguns and hunting rifles, involving a single bullet wound.

The wounds he saw this time were an order of magnitude more severe, because the automatic weapon the shooter used sprays people with multiple bullets and shrapnel that rips the flesh. “They’re devastating wounds. Lots of soft tissue injuries, vascular injuries,” he said.

Because patients had been rushed to the hospital, and then into surgery, some were still unidentified two hours later. “That was a very difficult time for the families and for us as well,” he said, but eventually family members were brought inside and the patients identified.

In all, 15 gunshot casualties were taken to hospitals: 14 to Central Maine, and one to St. Mary’s Regional Medical Center, also in Lewiston.

Central Maine discharged two less severely injured patients after treatment on Wednesday night. Another patient was transferred to Maine Medical Center in Portland because the Lewiston hospital didn’t have enough operating rooms. Two died in the emergency department, and one died after surgery at Central Maine.

On Thursday, one surgical patient was discharged to home and another was transferred to Massachusetts General Hospital because of the nature of his injuries. The patients cared for at St. Mary’s and Maine Medical Center were also discharged. Late Friday two more patients were discharged from Central Maine.

That means that, of the 12 injured survivors, five remained hospitalized on Saturday — four at Central Maine (three of them in critical condition) and one in stable condition at Mass General. Staff members had prepared for such an emergency many times, in drills and exercises. Just a month earlier, they’d done a tabletop simulation involving mass casualties.

“People have assigned roles,” said Alexander, who is an emergency physician. “They understood what their roles were. They stepped into those roles and they acted accordingly. They are just incredibly heroic.”

Once it became clear there were no more gunshot patients, the challenge was convincing day-shift nurses to go home, because they would be needed the next day. They took comfort huddling with their teams, and feared leaving the hospital.

“We had to almost push them: ‘You’re still safe. … Let’s get a security escort to your car and let’s try and get you home. You’re safe at home.’”

The next day the hospital was eerily quiet. With the shelter-in-place order in effect, the hospital cancelled surgeries and the emergency room saw just 35 patients all day, compared with 120 on a typical day. By Friday, as the hospital resumed normal operation, clinicians and workers who had been stunned and shocked started processing what had happened. Counsellors were made available throughout the hospital.

“Their training and their skills take over during the event. Emotions and feelings take over afterward,” Littleson said. “The grieving process will now unfold over the next couple of weeks. In some respects, the hard part has just begun.”

Littleson, who used to work at a hospital in New Jersey not far from Manhattan, recalls preparing to receive an influx of patients on 9/11. None arrived because there were so few survivors.

He thought of that when he realized that in Wednesday’s mass shooting, the 18 dead outnumbered the 12 injured survivors.

“The tragedy of this event,” Littleson said, “is that there weren’t more patients to care for.”

I think I know what he meant, but it could have been better said.

It’s Just Dust

“When you actually successfully regulate something, so that nobody sees it anymore, your very success is the thing that causes it to emerge again. Because it’s just lost in people’s minds.” Dr Frances Kinnear 

Bernie Banton

Who remembers Bernie Banton? Do you remember David Martin? What did they have in common. They both died of asbestos-induced disease. One, Bernie Banton worked for the industry villain in asbestos – James Hardie – in the 1960s and 1970s.

David Martin

The other was a naval officer who was Governor of NSW until a couple of days before his death from mesothelioma in 1990. He had been exposed to asbestos in the ships on which he served in his long career. The navy was his life, commencing as a midshipman and rising to the rank of rear admiral.

Asbestosis was a vertically integrated disease. By this I mean from the workers in the Colonial Sugar Refinery (CSR) blue asbestos Wittenoom mine, which operated between 1943 and 1965. Here in the Hamersley Ranges, Lang Hancock started his career, in an environment where asbestos fibres are carried by wind and water everywhere, and disturbed by human activities such as walking or driving around the area. 7,000 workers and their wives and children succumbed.

This was the same story with asbestos with its cottonlike appearance, easily pulled apart or packed as insulation throughout buildings until 1984, when the dangers of the material became apparent, and the community gradually come to realise a deadly material lay in the walls of so many buildings built post-war. James Hardie was the major distributor where Banton and his two brothers worked for 20 years.

Then there were the people who worked in an asbestos-riddled environment, as the rear admiral did.

The problem is many employers, in response to public health problems, have sought to obfuscate, refuse to accept responsibility, lobby parliamentarians about loss of jobs and social catastrophe if the use of material is curtailed. Just muddy the waters, bugger the toxicity, until the community pressure through legal redress catches up with the employer’s venality. As was written a decade ago: “The banning of asbestos in 2003 was the culmination of a three-decades long process that got underway in the 1970s through the efforts of workers and their families, health professionals, and researchers” – note the absence of the employers, the big mining companies seemingly doing nothing to improve the situation.

The current furore about the silica-based material, which has become fashionable for kitchen countertops, but in the process of cutting the material to size, creates a silica-laden atmosphere. When I was entering my career as a doctor, silicosis was a major occupational health disease, contracted then by miners and quarry workers. It received so much attention and publicity as a cause of respiratory disease there was no controversy within the health profession as to this association. A major associated problem was that most of workers then were also cigarette smokers; the danger of cigarette smoking was comprehensively exposed by the work of Doll in the 1970s.

In this current scenario, where the culprit is a fashionable kitchen countertop product that is silica held together by resin, one would think that it was a no brainer to ban the product.

As the SMH editorialised this week, The (Safe Work Australia) report (recommending a ban on this stone) was handed to the governments on August 16 but not released until last Friday. Despite the delay, the Minister for Workplace Relations Tony Burke then skirted the issue of a national blanket ban saying it was not reasonable to make a final decision without the public knowing the Safe Work Australian’s recommendations. Burke said a meeting of federal and state work, health and safety ministers would be convened by year’s end to consider the next step.

Mr Burke, who have you been talking to, when the dangers of silica are so well known even before you were a boy? Your response in the media is laughable. Why the delay? Who has been in your ear?

A Fashion Plate at the White House 

At a dinner at the White House on Tuesday, Mr. Biden and first lady Jill Biden presented the Prime Minister with an antique writing desk, designed by an American company in Michigan, the White House said. The first lady gave (Jodie) Haydon a hand-crafted green enamel and diamond necklace.

The NYT covered the Albanese visit by sending its fashion editor.

In amongst all the plaudits, the visit fulfilled all the expectations outlined in my last blog. The Americans laid on the treacly flattery, and characteristically Albanese responded to his swain in the audience while talking at the dinner, by saying it will be all downhill from now on. He may be right, but not for the reason stated.

Biden treated Albanese as anybody would treat a fawning vassal. Let me indicate, as I have before, I am not a great fan of Biden, but watching him in government he gets it right most of the time. Hooded eyes, which mean it is difficult to assess his mood, a flawed man who has spent most of his life in Washington, a man who has grieved far more than most of us, Biden has a residual advantage – that “Pepsodent” smile. I would imagine that if I were in the Albanese shoes, how seductive that would be, especially if I needed a father figure.

The treatment: “Don’t be a naughty boy and play with that kid across the road without telling us. Otherwise, I’ll send you to bed without your banquet.”

Thus, Albanese is lucky – slap on the back, not on the wrist – yet. Depends now on how he navigates China. The removal of tariffs is probably more important than some hypothecated underwater war toy (if ever launched at a time when “AUKUS” has replaced “obsolete” in the Australian vocabulary.)

Albanese is lucky. I surmise this US administration cannot countenance Dutton, especially following the Morrison debacle. However, Trump would be another matter. Yes, it is Halloween this week.

Mouse Whisper

Ever heard about my Andean cousin, the leaf eared mouse. They have been called “extremophiles” Why? Well let the current issue of Science set the scene:

Few places are as inhospitable as the top of Llullaillaco, a 6700-meter volcano on the border between Chile and Argentina.Winds howl nonstop and no plants live there; daytime temperatures never get above freezing and plummet even more come nightfall. Oxygen levels are just 40% of those at sea level, too low for mammals to live there —or so biologists thought until 3 years ago when a research team captured a live leaf-eared mouse at its summit.  

That has proved not to be a fluke as climbers in the high Andes have seen the mouse scurrying across the snow searching for lichens to feed upon.

There you are!  Mice on top of the world.

Modest Expectations – Buenos Aires 1972

Defence Minister Richard Marles summed up the situation well on Wednesday by saying we live in the most strategically complex and threatening period to exist since the end of World War II – Red Alert publisher Mr Shield

Their Lordships of the Admiralty, with their hierarchy of Admirals under the First Sea Lord; the War Office with its Secretary of State and Army Council; even the later-created Air Ministry again with its Secretary of State—it was in these historic bodies that rested the real, practical control. Moreover, the responsibility of their political heads to Parliament had scarcely been altered by the emergence of the Minister of Defence.  Harold MacMillan, quoted by Arthur Tange

Approaching the lunch table I was accosted by the formidable and testy Admiral Hyman G. Rickover, creator and guardian of America’s devastatingly powerful sub-surface nuclear strike capability, and notoriously defiant of control by his nominal superior, Chief of Naval Operations Admiral Elmo R. Zumwalt. The Admiral abruptly dismissed my explanation about the need to satisfy Parliament in our democracy saying that, if we did not want the US Navy to defend Australia that was fine by him and, as a coup de grace, after listening to us he saw no reason why they should be shouting us lunch – Arthur Tange

The prudent planning of defence preparation requires genuine intellectual rigour. Instead, all that is evident in the submarine announcement is intellectual rigor mortis, and the realisation of an idea of a former prime minister who was more famous for marketing than substance. -David Livingstone – one time graduate, Australian Naval College, in SMH opinion piece 15 March 2023

Now, thanks to AUKUS, Australia’s manufacturing will be built on a foundation of defence, specifically buying and making nuclear submarines. But there is likely to be an opportunity cost in that. Given the amount of money involved there won’t be much, if any, left for anything else, such as the global energy transition, health care and agriculture – Alan Kohler New Daily 20 March 2023

Paul Keating is an old man and many of his gestures are those of an old man. His brain is still sharp; he speaks with a verbal brutality that nobody can challenge publicly because of the immensity of his achievements in nation building. This has left his successors their only pathetic defence that the world has moved on and somehow he and his views are irrelevant. It is a new world, so they say. What utter rubbish! Why take his phone calls? He’ll just slag off if we do not agree – after all, he does it in public anyway.

Wong, Marles, Albanese are saying that he is of a different age; and have become a public chorus – with a variation of the “more sorrow than in anger” theme. Wong has perfected the low affect style of the Delphic oracle. She is measured; she weathers criticism with or without abuse by corridor whispering. A perfect foreign minister of whom Talleyrand and Metternich would be proud.

Defence Minister Marles

Marles is the classic politician captured by the Defence establishment. He fits the succinct description which former British Prime Minister, Harold MacMillan, himself a former Minister of Defence, warned of the capture by the “top Brass” of the defence forces. Marles grew up in Geelong Grammar School, where his father was a teacher for many years, and even with his Left credentials there’s no way he would not have been exposed as a schoolboy to those of the same ilk as those now in command of the defence forces. He is obviously comfortable being with his own class, although there are nominal differences theoretically in his political views.

There is no doubt that like so many of his predecessors as Minister, whether Labor or Coalition, whether it be “Bomber” Beazley or Peter Dutton, he has just dutifully spouted the American and or British line.  And what of Bevan Shields’ description of the profundity of Richard Marles? Yes, I read it, but where is it?

Now for the Prime Minister. Here was the man who on the first day of the last Federal campaign did not know the simplest of facts, stumbled, simpered, tongue poked out for some reason. David Crowe, the SMH political writer, in a recent by line identified him as the “trippy” Prime Minister. “Trippy” is a slang term for a person under the influence of a hallucinogen, and sometimes the accidental trip up contains a modicum of truth.

Albanese does not seem to want to offend, and his antics in India where his obsequious dealings with the current Prime Minister Modi suggest that he does not quite get it. Modi is a dangerous figure, whose politics lie at the extreme edge of Hinduism, whose embrace of Putin is well known, but where the prospect of an alliance against the Chinese seems to have lured Albanese into an uncritical acceptance of a man whose abuse of civil rights rivals that of Xi Jinping. Such a contradiction did not go unnoticed by Keating – nor should it by us.

When Morrison unveiled AUKUS, it was thought that this was the dying lunge of a discredited government waving the flag of jingoism; that it would die with his demise. But that has not occurred. Morrison had dumped the French, who still have a substantial presence in the South Pacific, for an alliance with a nation which has Pitcairn Island as its last remaining possession in the Pacific. It no longer has any strategic place in the Pacific Ocean. British Prime Minister Sunak, in his AUKUS speech at San Diego on 13 March, referenced Barrow-in-Furness and Derby as places in Great Britain which would benefit from Australian nuclear submarine construction.

As reported, on 10 March 2023 the U.K. Prime Minister Rishi Sunak and the French President Emmanuel Macron held the two countries’ first bilateral summit in five years. They inter alia pledged to aim for a permanent European maritime presence in the Indo-Pacific, notably by coordinating deployment to the region of France’s Charles de Gaulle and the UK’s Queen Elizabeth and Prince of Wales aircraft carriers. No mention of submarines.

Two days later, Sunak met with Albanese prior to the photo-opportunity the next day. In the Australian Prime Minister’s words: “We discussed our shared commitment to bringing the Australia-UK Free Trade Agreement into effect to benefit businesses in both our countries.” Anything else?

As reported in the San Diego Union Tribune, Biden said Australian sailors will embed with the navies of both countries and study at schools specialising in nuclear-powered subs. In 2027, the U.S. and U.K. will begin placing their own submarines at Australian ports on a rotating basis. Now the USA has 275 vessels, 71 of which are submarines; Britain has a total fleet of 72 ships, 11 of which are nuclear submarines and, as the Union Tribune reported further, Australia has just under 50 ships, less than the Americans have docked in San Diego.

The paper dismisses the Collins class submarines as if they were some sort of ancient craft, an underwater galleon methinks. However, given all the aggressive talk about the defence capability of submarines, only two submarines have sunk enemy warships since WWII, which may say something about the deterrent capacity of having submarines. Nevertheless as Rex Patrick has  noted, American and British nuclear submarines have been involved in offshore bombardment of Iraq, Afghanistan and Libya.

Did the President stick round to talk to Albanese after such a momentous decision? No, he headed off to San Diego International Airport to board Marine One to fly him to a fundraiser in Rancho Santa Fe. Albanese was off to Fiji.

In simple terms, (a) the USA, by transferring its ageing nuclear submarines to us, also transfers the responsibility of nuclear waste disposal – if nothing else. The rumblings of “not in my backyard” have already started here in Australia.

(b) The British just want to flog off their nuclear submarines, thus supporting BAE ship building in Barrow-in-Furniss and the Rolls Royce nuclear expertise facilities in Derby.

(c) Australia pays a great deal of money, essentially for some very expensive toys.

What Keating did was to draw attention to the fact that the whole business seems to have been transferred from a regime known for its stunts to a new regime which had promised political sobriety. Yet nothing had changed; no real debate was entered into as the media mostly tried to smother any such discussion. The new Government was committing Australia to this enormous expenditure which frankly, on the face of it, does not make sense.

I do not follow the Keating assertion that increasing the number of Collins submarines will provide the defensive cover which his scenario projected. Nobody seems to have explored the workforce requirement, which is an important factor given that, at different periods of time, Australia has not been able to crew the Collins class submarines and apparently currently several don’t even have commanding officers. Thus, for a time, the submarines were unable to be deployed anyway. The new submarines need more crew, and while the suggestion of blended crews superficially seems reasonable, that is only if you do not accept the current Government’s banging on about “sovereignty”.

Currently the pay for an Australian submariner is about $167,000 a year, plus various other allowances, but being crew on nuclear submarines means coping with months on end beneath the waves, working six hour shifts and where night and day no longer have relevance. Blended crews mean being able to cope for long periods of having two cultures working alongside, even if they do speak the same language. There are differences that need to be addressed in sharing facilities. For instance, US naval warships are traditionally dry. It is easy to say that potential Australian submariners will be trained offshore; but what of social costs, including the attrition rate.

Then, in the world of technology advances, the prospect of unmanned submarines looms – unmanned underwater drones. The Russians evidently have that technology and it would be inconceivable that the major submarine manufacturers are not developing these as well.  Given the projected time surrounding the acquisition of Australia’s nuclear submarines, our purchases almost certainly will be dwarfed by these developments. The problem with the government propaganda is the assumption that everything else remains the same, and if they ever were, will remain on the cutting edge of technology.

David Livingstone’s opinion piece is like an antique Gatling gun deliberately mowing down the paper-thin justifications for this enormous transfer of “Australian sovereigns” from Australia to its colonial reliquary, Great Britain and the USA, whose reliability as an ally has been an article of faith adopted by both sides of Australian politics with only occasional inconvenient questioning – but certainly not by our current bunch of politicians.

The following is taken from an article published last year in an international investigative journal, Insider.

In 2005, the USS Ronald Reagan, a newly constructed $6.2 billion aircraft carrier, sank after being hit by torpedoes.

Fortunately, this did not occur in actual combat but was simulated as part of a war game pitting a carrier task force including numerous antisubmarine escorts against HSMS Gotland, a small Swedish diesel-powered submarine displacing 1,600 tons. Yet despite making multiple attacks runs on the Reagan, the Gotland was never detected.

This outcome was replicated time and time again over two years of war games, with opposing destroyers and nuclear attack submarines succumbing to the stealthy Swedish submarine.

With the Stirling engines, a Gotland-class submarine can remain undersea for up to two weeks sustaining an average speed of 6 mph — or it can expend its battery power to surge up to 23 mph. A conventional diesel engine is used for operation on the surface or while employing the snorkel.

Gotland-class submarine

The Stirling-powered Gotland runs more quietly than a nuclear-powered submarine, which must employ noise-producing coolant pumps in their reactors.

The Gotland class does possess many other features that make it adept at evading detection.

It mounts 27 electromagnets designed to counteract its magnetic signature to Magnetic Anomaly Detectors. Its hull benefits from sonar-resistant coatings, while the tower is made of radar-absorbent materials. Machinery on the interior is coated with rubber acoustic-deadening buffers to minimize detectability by sonar.

The Gotland is also exceedingly manoeuvrable thanks to the combined six manoeuvring surfaces on its X-shaped rudder and sail, allowing it to operate close to the sea floor and pull off tight turns.

The article then went on to say:

Because the stealthy boat proved the ultimate challenge to US antisubmarine ships in international exercises, the US Navy leased the Gotland and its crew for two years to conduct antisubmarine exercises. The results convinced the US Navy its undersea sensors simply were not up to dealing with the stealthy AIP boats.

However, the Gotland was merely the first of many AIP-powered submarine designs — some with twice the underwater endurance. And Sweden is by no means the only country to be fielding them.

China has two diesel submarine types using Stirling engines. Fifteen of the earlier Type 039A Yuan class have been built in four variants, with more than 20 more planned or already under construction.

Beijing also has a single Type 032 Qing-class vessel that can remain underwater for 30 days. It believed to be the largest operational diesel submarine in the world and boasts seven Vertical Launch System cells capable of firing off cruise missiles and ballistic missiles.

Diesel powered submarines are apparently particularly useful in assisting in maintaining littoral integrity if one is able to crew them. The Americans have determined to only have nuclear submarines so they can roam the world underwater – an international police force. Why else would a nation commit itself to such a program? The British want to join in if Australia will help to pay for their ailing submarine building industry– why else would the British want to use Perth as a base unless they want to join the USA in this role as a police force. Really, do we want to be part of this folly – “the final link in the chain” as Keating so bluntly put it, of nuclear submarines lurking in the Pacific Ocean.

There is another incidental fact I have learnt trying to fathom why we are committing ourselves to such enormous expenditure. The Collins class submarine was taken from a Swedish design. The Swedes have a fleet of five diesel-powered submarines, but under the auspice of Saab Kockum have committed themselves to building the new A-26 Blekinge submarine by next year, constantly advancing the technology and have ordered two more.

Finally, more than anything, Australia needs a debate on these matters – and outside the wardroom. I would like to know what we are defending and who really is the enemy, apart from the cost being committed for the next generations of Australians who will be forced to pay.

Mud by Name; but not by Taste

Continuing my occasional reminiscences of the most memorable seafood meals that I have experienced, this one concerns the giant mud crab, I thought wrongly to be solely an Australian delicacy. The crabs are caught in sheltered estuaries and mangrove areas, favouring the soft mud below low tide levels in Northern Australian waters. The flavours are distinctive; some say sweet; but like so many tastes which stick in the memory – mud crabs caught in the wild are distinctive. I first remember a large tray of these crabs on a VIP flight back in the 1970s when I first realised what I had been missing. Lobster was relegated to second place from that day on until many years later when I ate farmed mud crab fed on chicken meal. That unique taste had been lost. It was quite a disappointment.

On this night, after working in Mackay all day, we were recommended this place to eat on the outskirts of the city. Unprepossessing, the premises resembled a hut, and it was called The Hut or some such. It was 1988. As it so happened the British Lions Rugby League Team was in town and following them was a large entourage of British journalists because the whole trip was more of a jaunt than a tight schedule of Tests.

When we entered this establishment, it was somewhat basic; “homely” would have been a good epithet if the place had not been swarming with middle-aged Poms, who seemed to have done with any formal activity.  The alcoholic hubbub swirled around us, outsiders in our own country. Nevertheless, we secured a table in a corner facing the kitchen, so when the owner/chef emerged with this large mud crab, and asked whether anybody would care to have it for a meal, we responded with alacrity, such that the deal was done before the Fourth Estate had time to turn around, let alone react. Perhaps they would have enthused more over it, although there was a ripple of “got another one, guv?”

This mud crab had just been caught and dropped off at the café. I don’t know whether it was the only one, but I doubt whether I have ever seen one bigger. Even though I had actually cooked my own earlier in the decade, there was something about this mud crab feast which made it special. Unfortunately, with time, the wild crustacea and fish are increasingly a product of farming rather than being gathered from the wild. Mud crab farming is very popular in some Asian countries – Bangladesh, India, Thailand, Philippines. Mud crab is in huge demand, with equally huge prices in the international market, and thus they have mostly lost that uniqueness which we experienced one night in Mackay.

Dr Lee Gruner

Entering Bacchus Marsh

Dr Lee Gruner has just been banned from medical practice for 10 years. She is 74, and at that age, she would probably be retired or be living off the fruits of her labour, irrespective of the Medical Board’s finding. She has been punished for her actions at the Bacchus Marsh Health Service (Djerriwarrh Health) which occurred over a decade ago. It was evident to me well before that time that Dr Gruner was a smooth talker without much substance. The Medical Board’s finding about her behaviour even astounded me, although I was well aware of the dysfunctional nature of the Bacchus Marsh health service even then.

Gruner had always projected herself as an expert in quality assurance (QA), which is almost a Medusa in the number of jargon-laden interpretations to describe a very simple concept – the actual improvement of health care achieved against projected proposed improvement over a specified period. My association with managing improvement of health care first occurred with involvement in a successful “management by objectives” project in 1971-73 at the Royal Melbourne Hospital.

In 1975, the then Federal Minister of Health, Ralph Hunt, challenged the medical profession to formally assure quality in health care.  As a result, the Australian Medical Association (AMA) together with the then Australian Council on Hospital Standards (ACHS) set up the ACHS/AMA Peer Review Resource Centre and the then AMA President challenged me to take on the portfolio of quality assurance and peer review. Within a decade I found myself as President of the International Society of Quality Assurance. During this time, it gave me a wide perspective of those involved in the various “players”, both in Australia and overseas.

While there was a cohort of health professionals genuinely interested in improving the quality of health care, I found there were many flim-flam persons, hucksters and grifters who drifted around drawing flow diagrams and pie charts, writing monographs telling the clinicians what they should do, speaking in the distinctive “quality assurance creole” and holding seminars and workshops purporting to be fonts of learning. Much of this QA movement was translated into more bureaucracy, which led to the creation every three years of shelves of folders containing rules and requirements, which were neatly stacked in the administrative section of the hospitals, but to which the clinicians in general were impervious.

Effective interplay between management and clinicians is essential if true quality improvement can occur and be maintained. In addition, the quality assurance movement flourished until the central agencies started extracting “efficiency dividends” from the health sector, and the hospitals were the most vulnerable as targets for such “efficiencies”. Costs were paramount.

Dr Gruner with her gush, winning smile and line of blarney, fitted in well with this scene. She became Censor and then President of the Royal Australasian College of Medical Administrators (RACMA), being good mates with the then Chief Executive Officer. Yes, Dr Gruner constructed an impressive façade.

This façade crumbled before the findings of the Medical Board of Australia. Her behaviour, as set out in the Board’s findings, was truly appalling, given that under her medical management, neonatal management was wanting.

In 2021, Dr Surindar Parhar, who had been chief of obstetrics and women’s health between 2008 and 2015 at Bacchus Marsh Health Service, was formally reprimanded and disqualified from applying to practise medicine for 12 years after a finding of professional misconduct related to his time at the Service. But the doctor had surrendered his medical registration seven years previously, so the sanction was very much post hoc. The following is the finding, six years after he stopped practising; it happened under Dr Gruner’s watch and is equally appalling as her reprehensible neglect. (sic)

Dr Parhar was found by the Tribunal to have failed in almost every aspect of his role. The Tribunal found that he failed to conduct formal reviews in nine cases of perinatal death, and where reviews were conducted, he had failed to give sufficient clinical input and adequate processes were not used. Further, between 2009 – 2015, he failed to engage an external reviewer for cases involving foetal and neonatal deaths, failed to communicate important information and failed to supervise or assess junior practitioners who he was directly responsible for. Additionally, the Tribunal found that Dr Parhar failed to improve or maintain his own professional performance, did not keep accurate or legible clinical records, and inadequately investigated, diagnosed and managed a patient’s care.

Incidentally, the former nursing director and the maternity services manager were both banned for 10 years. Several other healthcare workers including senior midwives, junior doctors, a clinical support director and a physiotherapist were also disciplined.

Gruner now has no credibility and her neglect was allowed to continue for far too long. Nevertheless, the RACMA and the level of remuneration its Fellows attract has also gone too long without scrutiny. Some years ago, I offered to assist the College after a decade’s stint during which I was able to refine the role of Director of Medical Services (DMS) of small health services. I had a formal contract with each service at which I worked, and I had a modest base at one of the health services with shared secretarial services. From personal experience, I believe that the findings in relation to Dr Gruner’s position are sufficient reason to investigate the whole state of medical administration, where there are a number of aberrant practices, which Dr Gruner’s action highlighted. She just got caught. In Victoria there apparently is a tool to assist hospitals in appointing a DMS, and having read it, this tool is one of the theoretical “flannelling” documents that people like Gruner were adept in constructing to give the appearance of activity.

The task of a DMS is to work with and have the respect of the local doctors and visiting medical specialists; to ensure that the credentialing, scope of practice and privileging of these doctors is aligned with their knowledge and skills; to participate in the hospital management as required; and, as I showed, to extending the DMS role to being director of clinical training, as evidenced by the creation of the Murray to Mountains Intern Training Program. Removing a doctor’s privileging rights is difficult and requires a skillset not immediately obvious in medical administrator training. Moreover, the DMS must be a visible presence, not hidden away in the administrative suite of offices well away from the clinical action.

The other worrying matter shown by this Gruner episode is how long it takes for the Australian Health Practitioner Regulation Agency (AHPRA) to do anything. The Agency publicly displays its satisfaction rating, 1.6 out of 5. It is time the Chief Executive Officer, Martin Fletcher, is put under active scrutiny. An English bureaucrat imported to do a similar job he was employed to do in Great Britain, Fletcher has been in the role for 13 years, so he would know all the steps in the political foxtrot.

The current Federal Health Minister Butler had ordered a rapid review of AHPRA, which seems like a handball rather than “rapid review”.  “I am writing to the chair of the Health Ministers’ Meeting to put this issue on the agenda at our next meeting, including a rapid review of the response by jurisdictions to previous reviews.”

Martin Fletcher

I would say the AHPRA obfuscation is less “flannelling’ but rather a “whole suite of blanketing”. As such, Martin Fletcher may tuck in the last “blanket” in rejecting allegations that AHPRA had resisted government engagement and was slow to implement reforms, saying the leadership team was rolling out a “huge” program of work to improve procedures. That “blanket” sure has a lot of fluff.

Much more of this and it will be media suffocation so thick is the “blanket”. Gruner is just one of the cases to serve as a reason for a comprehensive review of AHPRA.

Time for action, and restoration of the integrity of AHPRA, shorn of excessive bureaucracy, but that is the ultimate goal, training quality staff and ensuring the agency does not have the opportunity to hide behind overly restrictive legislation – a matter for urgent Government review – and that the multiple agencies involved don’t allow cases to fall between the cracks. This will require close attention to the profile of those supposed to uphold the standards and in so doing recognise dysfunctional situations such as the one which allowed Gruner to flourish. One missive received yesterday from the current President trying to justify continuing trust in the College credentials, I’m afraid is far from enough.

Mouse Whisper

Will the Floridean Goldenlocks weather yet another Storm? Remember Shakespeare’s The Tempest?  The jester Trinculo, on hearing the Storm is coming, utters words perhaps relevant to a forthcoming New York Courtroom appearance:

Alas, the Storm is come again! My best way is to
creep under my gaberdine: there is no other
shelter hereabout. Misery acquaints a man with
strange bed-fellows. I will here shroud till the
dregs of the Storm be past.

The golden mask of Trinculo

Modest Expectations – Anno Quattuor

∞∞∞∞∞∞

There’s a difference between psyching yourself up and misrepresenting yourself, and the latter is where “fake it” has gone too far. We need a reset, and to find a way to once again prioritize and reward diligent, honest effort over faux success. Government needs to return to enforcing meaningful financial regulation; politicians and entrepreneurs who deceive their supporters need to face consequences. And we need to be less credulous and stop falling for the next shiny thing. – Helaine Olen, Washington Post

So here we are the end of my fourth year writing a blog each week.

Sometimes I feel like the Beatles’ Father MacKenzie – writing the words of a sermon that no one will hear; no one comes near; look at him working, but then it goes on to something about darning socks in the night when apparently everybody has deserted him, but he yet retains a priestly insouciance. From this chiaroscuro cell of mine, may I thank Frank Meany for his encouragement in ‘mousing’ my first one in 2019. My socks remain undarned.

Nevertheless, Ms Olen’s observation remains very pertinent to me every time I pick up my mouse. I publish one blog a week; they have grown to over 3,000 words, but it has meant I read widely, and republish with acknowledgement information I find interesting. I write a blog as now I have the time to write.  Now I have time to reflect I can leave a legacy for what it is worth. So here goes into my no. 208.

I was talking to a friend of mine who had returned from a very comfortable dinner. I mentioned to him the breakdown of the refrigerated truck bringing food, in particular meat, to our village. It is a 45 minute drive to the next towns – one was over the range; the other over more undulating territory. We were expecting friends for dinner, and my wife happened to be at the only supermarket in town to hear the news that explained the empty fridge shelves. She was able to snaffle some chicken legs, but there was not much more to be had.

The weather was unexpectedly bad for this time of the year. Low weather fronts coming through, rapidly dragging thunderstorm, rain and gusts up to 100 km/hour. At about two am, the power went off. There was a pole fire nearby. This day was cold; there was no heat. Despite the house being built as a wilderness pole house, there is no chimney. A gas fire better heats the house; you do not have to cluster around an open fire trying to keep warm. But it needs electricity to create the spark to light the gas and run the fan.

Fortunately, we have a gas stove and could cook; and with battery and candle, we survived 18 hours without electricity. Having listened to what my friend said that he feared that there would be more outages, his prediction seemed self-fulfilling. True to his prediction, next morning, another outage shut down the Sydney rail system; the day after it was the turn of two large public hospitals in Melbourne. In neither case was it thought to be due to a malignant cyberattack.

Meanwhile, the flooded Kimberley region is running out of food – not just one lorry broken down as happened to us. All the roads are now cut off; and then next day, it was the turn of Mount Isa and all the rivers that flow north of the Selwyn ranges are now in flood.

We went for 18 hours without heating, and it was very cold. But think of the deprivation that so many people across Australia have suffered alongside COVID-19. Sure, I have had a bout of long COVID, but we’ve not been flooded or burnt out – yet! Our deprivation this time was really a nothing compared what else is happening and has happened over the past few years to so many people.

Thus, our deprivation was just an irritation and perhaps a harbinger of things to come; but look at the government priorities! Nuclear submarines for God’s sake! Moreover, the sabre-rattling group assembled by the SMH was predicting a war with China in three years.

As reported in the SMH: “Former Defence Department deputy secretary Peter Jennings estimates the eight boats will eventually cost taxpayers the equivalent of 1 per cent of Australia’s gross domestic product or some $20 billion each year.

That’s roughly the combined annual revenues of Australia’s wheat and beef industries, or more than the cost of the NDIS last year. The problem is, the submarines are not expected to arrive for 15 to 20 years, which could be on the other side of a war with China.

“On the other side of a war with China.” What does that mean?

Admiral Chester W Nimitz, Fleet Admiral, United States Navy, former leading US Navy authority on submarines

As part of the agreement, the United States and Britain will rotate nuclear-powered submarines into port in Perth by 2027. One such submarine, the U.S.S. Asheville, is already there now on a port visit, before the formal schedule of rotations.

At that time, I must have dropped off to sleep because I dreamed a dream. Somebody nudges the March Hare to wake him up.  Meanwhile, the dormouse strewn with marigold flowers has arrived at the table and pipes up being asked to defend the purchase of these expensive toys, said: “This is about jobs … and Adelaide in particular will be a big beneficiary of this announcement, as well as Western Australia in particular”.  Just before being shoved into the AUKUS teapot, somebody watching asks aren’t the nuclear submarines about the defence force capability. The answer is lost in the gurgles, but the word “capacity” does get a mention before the dormouse goes down for the third time. I shake myself awake; was that a dream?

Call me the HMAUKUS Pinafore

Before contemplating further let us consider whether we have combatted our internal challenges. Our ability to cope with floods has come up short. Too much of our domestic and commercial infrastructure is built on flood plains and, with climate change heralding more extreme weather, there are large infrastructural costs awaiting Australia. Promises are easy, but nothing much seems to be done, given it is estimated that one million homes are at risk from flooding by 2030. Brisbane and the Gold Coast local government areas are the most vulnerable in numbers, but the Greater Shepparton area in Victoria has the greatest percentage of such homes (56%) with nearby Wangaratta not far behind (43%) – a total of nearly 3,000 homes. Increasingly such places are uninsurable, which leaves only we, the mug taxpayers, as the reconstruction funder.

Australia does not have the equivalent of the US Army Corps of Engineers, which, among its many functions, is flood mitigation, and although there were criticisms for the levee construction in New Orleans, there is consolidated expertise. A recent report in 2022 noted that “Seventeen years after Hurricane Katrina flooded New Orleans, the Army Corps of Engineers has completed an extensive system of floodgates, strengthened levees and other protections. The 130-mile (210-kilometre) ring is designed to hold out storm surge of about 30 feet (9 meters) around New Orleans and suburbs in three parishes.”

Even so, Nicholas Lemann, writing in The New Yorker, was not so sanguine.

After Katrina, as after Betsy, such plans were drawn up, but nobody wanted to pay for them. New Orleans had to settle for levee enhancements that fell far short of providing invulnerability to a Category 5 hurricane, and wound up returning to something not too different from its pre-Katrina state. The city is an irresistibly alluring place that does far better by its white citizens than its Black ones. Life is sweet when it isn’t tragic. Lodged somewhere in everyone’s consciousness is the knowledge that what happened in 2005 is going to happen again.

Eleven months after the Lismore floods, a Northern Rivers Reconstruction Authority has been set up and $800 million promised, but nothing much seems to have been done, which is visible to the community. Somebody might echo Lemann and say it will happen again because no government is prepared to spend the money to 100% guarantee waterproofing the current Lismore, but as with Lismore residents nobody wants to move away.

Cockatoo Island Sydney, once a ship builder, then a submarine repair yard, now an art precinct and “glamping” site

Now as the sabre-rattling group would insist Australia faces war with China. Do we wish to contemplate that? An old doctor in conversation with me years ago told of when World War I was declared, there were celebrations in the streets – he remembered hats being thrown in the air – excitement was everywhere. War was a jolly adventure in exotic places. Then, Australia was not threatened directly.

The last time Australia was directly threatened was 1942 – the population was mobilised – the dread when the postman came with news that your father, son, close relative had been killed. Food and clothing were rationed. But bombing of urban areas of Australia was restricted to Darwin and Broome – northern Australia. The Japanese onslaught was halted, they suffered mortal wounds as the War was washed north.

Volodymyr Zelensky has proved an unexpected obstacle. Given that we were fed a diet of Ukraine being corrupt, essentially a Russian satrap, and the line of least resistance was taken in relation to Crimea. Putin anticipated; NATO anticipated that Ukraine would just fall into the Russian sphere of influence.  Conventional early wisdom was that Ukraine would be partitioned with the Russians ceded the eastern fertile black plains, while the truncated Ukraine would retain Kyiv and the Polish border areas – at least pro tem.

But Zelensky had different ideas, and he inconveniently precipitated NATO leaders out of the cocktail circuit into a world bereft of Louis Vuitton and Dom Perignon. Zelensky has created the nightmare; he stood up to Putin. It was not expected that a comedian had transformed himself into a resilient warrior.

Nevertheless, the Americans always seem to have a war on the go, dragging us with them. However, none of the recent Wars have the European backdrop Ukraine has provided. So, destroying a country where the infrastructure is notably European is thus enough to put the fear of God into the Europeans. It is they which, even with the diminishing number that directly experienced the horrors of WWII, see it now being re-run in the Ukraine.

Forget the power of the people; unless they inconveniently have the power that Zelensky has. Looking around our leaders there is no-one who reminds one of this man. There seems nobody else who can lead a popular revolution.

And what of China? They assumed control of Hong Kong, breaking the terms of agreement with the United Kingdom.  There were street protests. There have been draconian measures put in place. There has been no urban warfare from those who opposed this take over. The sun still shines. The horses still race at Happy Valley and Sha Tin.

Power means control of the security forces. The street protests of the sort seen 40 years ago have been studied by those in authority and measures implemented to contain the people; these measures are increasingly perfected with more and more sophisticated brutality and repression.

The Chinese have not participated overtly in any war, apart from border skirmishes and the annexation of Tibet about 70 years ago, while in that same period the Americans have been in Korea, Vietnam, Iraq and Afghanistan – for what reward? I forgot Grenada, which the USA invaded in October 1983, a conflict which lasted four days before the Americans declared victory over a country of 113,000 people.

In fact on March 9 it was reported: that Taiwan’s Mainland Affairs Council (MAC) announced on Thursday that air routes between Taiwan and 10 Chinese cities will be reinstated on Friday, with 13 other Chinese cities selected for cross-strait charter flights. Starting on Friday, flight routes will be re-established between the Taiwanese cities of Taoyuan, Taipei and Kaohsiung, and the Chinese cities of Shenzhen, Guangzhou, Nanjing, Chongqing, Hangzhou, Fuzhou, Qingdao, Wuhan, Ningbo and Zhengzhou.

Ok … but that statement does not suggest war footing. The Americans were not part of this decision, I note.

So, what is the point of all this purchase of extraordinarily expensive toys of war? Can anybody in words of one syllable tell me how the current expenditure will help defend this country? The Taiwan response – a video of a young woman running with rifle, stumbling, with her helmet falling over her face, and then giggling. War footing? More like slippage.

Yet Taiwan has the perfect terrain for guerrilla warfare, but has anybody got the stomach for a war? What is Taiwan’s appetite for war? The Chinese would prefer a compliant Taiwan commercially strong, but avoiding a potentially destructive conflict with China. Where does Australia’s acquisition of nuclear submarines in the mid 2030s fit that scenario?

There is thus a possibility that China and Taiwan will reach an accommodation that avoids outright war. Nevertheless, some Chinese with assets are moving them to Singapore and elsewhere including Australia. Yet let us not be under any illusions that the Chinese diaspora is anti-China; some estimated that the pro-Chinese element in Australia would be about 80 per cent.

At the 2021 census, 1,390,637 Australian residents identified themselves as having Chinese ancestry, accounting for 5.5% of the total population. How is the Australian Government planning to deal with them in case of direct conflict with China. Internment? I think not. Think of the expense… but then again, those advocating building more and more sports venues, maybe they will have a secondary use. After all, the Melbourne Cricket Ground was requisitioned by the Americans and Australian defence forces between 1942 and 1945 with up to 200,000 troops using the ground facilities as barracks. Would we need it again – but now for an internment camp?

In any event, the last sentence in Helaine Olen’s opinion piece quoted at the beginning of this blog is particularly germane.

Billy Graham with a Pole

Bob Richards has recently died in Waco Texas aged 97.

Bob Richards

His would not be a familiar name today to anybody in Australia unless you, like myself, were a spectator at the Melbourne Olympic Games in 1956. He had been the Olympic champion in the pole vault in 1952 in Helsinki and had come to Melbourne in the USA team to defend his title. Pole vaulting was an unfamiliar sport in Australia, and I remember being seated close to the action. Australia had two competitors, but they had been knocked out in the preliminary round, finishing last and second last respectively.

Richards had not vaulted very well in the preliminary round, but in the final, he won with an Olympic record. As he freely acknowledged, even though he was able to surpass his Olympic record by pole vaulting over 15 feet many times, he was never able to surpass another American, Cornelius Warmerdam, a Californian who had set the World record in the early 1940s, but whose exploits were overshadowed by WWII. Warmerdam used a bamboo pole, which replaced the early solid ash poles; but by the time Richards was at his peak, the technology of the pole had moved to poles made of tubular aluminium.

Today’s top male vaulters, with refined techniques and springy fiberglass or carbon fibre poles that bow almost to U shapes, routinely soar over crossbars set above 19 feet (5.8metres). The world record is held by Armand Duplantis, an American-born Swedish athlete known as Mondo, who recently vaulted 20 feet 4-3/4 inches (6.22 metres). That height surpassed his own previous five world records, all over 20 feet (6.1 metres) and all set since 2020. From the Australian point, from the dismal performance of 1956, our standards have risen markedly.  An Australian, Steve Hooker won the Olympic pole vault at the 2008 Beijing Olympic Games.

It is the one event, where it seems that there has been no brake put on the technology; and how far will such technology take man and woman into the ether. Hooker eventually jumped a height (6.06m), which remains the fourth highest height ever attained; in the end he lost his head for heights, who wouldn’t but anyway what a career!

As it was with Richards. With his etched looks he reminded me of Billy Graham and was, to some extent, much the same evangelical as he was ordained into a Brethren when he was only 20. He was given the nickname of the “Vaulting Vicar” by some, but all I  knew was that he was a pastor for one of those evangelical Christian churches, which find the Southern American States such fertile ground. Sagebush piety, cowboy strong face enabled him to be, between 1958 and 1970, the face on the General Mills “Wheaties” packet, the  cereal known as the “Breakfast of Champions.” He became director of the Wheaties Sports Federation, founded in 1958 after President Eisenhower called for a national physical fitness campaign.

So he was, his pole vaulting seemed to be a symbol of his form of Christianity where an aluminium pole and a bar being raised set against the sky were his basic Assumption.

An Added Thought from the Vault

Women’s pole vaulting does not easily fit into the Bob Richard narrative. Currently Australia has the number two rated woman pole vaulter in the world – Nina Kennedy. Last year she won the Diamond League title with a vault of 15ft 1.5in (4.61 metres) slightly less than her best, but would Australia ever know.

The first recorded woman’s world record holder was a Ruth Spencer, an American who vaulted 4ft 9in (1.44 metres) in 1910.  The height is testimony to the change in times, when modern female athletes would high jump way higher than that. The current world pole vault record was set in 2009 by Russian Yelena Isinbayeva with a vault of 16ft 7in (5.06 metres). She held sway in the first decade of the 21st century, and with arched eyebrows, one can say that her record has not been challenged in the last thirteen years – but she was Russian.

Women’s pole vaulting attained prominence when first introduced as an event in the Sydney Olympic Games, when Tatiana Grigorieva, a Russian-born Australian, unexpectedly won the silver medal. During the 1990’s repeatedly breaking the then world record, Emma George was dominant.

Emma George

I remember for many years driving into Beechworth, her name was emblazoned on her hometown signage. But her dominance ended in tears, as the stress induced by pole vaulting caught up with her.  She vanished even before the 2000 Olympic Games with a mess of chronic injury without any comment on her mental health.

In fact, she has become the mother of three boys, seemingly happy, still greatly attracted to the outdoors as judged by her profile in the media, where she acts as a free-lance journalist – a world which I once knew as that of a stringer.

A Sense of Theatre

Col Hodges

My eye caught the following on Twitter. “Race caller Col Hodges lives in flood ravaged Forbes. After having a cold shower this morning Col hitched a ride on a fire truck to get to a boat which took him to within 50 yards of the other side where he waded in knee deep water to get to a borrowed car to travel to Bathurst {to call the races}.”

Race callers are so much part of the heritage of the country.  They all have their individual ways of learning. No University course here. Col Hodges started shooting marbles around the backyard pretending that they were racehorses. I knew one other bloke who started calling matches floating down a gutter.

When you note how many race meetings there are, it means that while the race callers in the city seem to form a kind of Establishment, there are many other meetings that need to be called. On this periphery are race callers like Col Hodges. I note that he called his first race meeting in a tiny place called Fifield, which lies between Trundle and Tullamore in the Central West of NSW with its hotel known as the Pub in the Shrub. We stopped there once just up the road from what looked like an old boarded up mill; yet as I noted in an earlier blog, there was a late model yellow Ford parked out the front and an array of expensive solar panels on the roof.

Col Hodges called a race meeting there in 1971. As he recalled “It was a picnic meeting at Fifield on Easter Saturday. It was a dirt track, there were fields of between six and 10 to describe and around 500 people were in attendance. In those days a lot of tracks didn’t have photo finish cameras. A lady in the crowd called out after a close finish that I was trying to influence the judges. I went to a lot of meetings that didn’t have photo finish cameras so that’s where I learned to be pretty diplomatic in photo finishes. If I’m sure I’ll call it but there’s that many different angles, I call at about 30-35 race tracks, and some tracks you’re right on the line but unless I’m pretty sure I’ll just say it’s between this horse and that horse. I’ll have a go if I know the angle of the track and I’m confident but I don’t like letting people down by taking a guess when I’m at a bad angle just for my own glory.”

Yet Col Hodges was the last to call a triple dead heat in Cowra in 1997, and even ventured at the time that it might be the result. This was rather adventurous given that there have only been four in the whole history of Australian horse racing since the introduction of the photo finish camera. It took the stewards 30 minutes to declare the placings.

As is said, race callers need to have a sense of theatre.

Such sadness

Last week I recalled our time in southern Malawi.  To quote local sources this past week: Heavy rains that triggered floods and mudslides have killed at least 199 people in Malawi, authorities. President Lazarus Chakwera declared a “state of disaster” in the country’s southern region and the now-ravaged commercial capital, Blantyre. Some 19,000 people in the south of the nation have been displaced, according to Malawi’s disaster management directorate.

This suggests that the Satemwa tea estate, a source of employment for many Malawians, which is only 43 kilometres South of Blantyre could not conceivably have been unaffected by Cyclone Freddy, to say nothing of the thousands of Malawian subsistence farmers whose farm plots crowded the river floodplains. Another country needing our help.

Mt Mulanje in southern Malawi in calmer times, now with floodwaters to the north and south

Mouse Whisper

He was complaining about the comment that bushfires had been reported as having decimated the ozone layer by five per cent. Five per cent is one twentieth. So, it is hardly “decimate”. Well, add this word to vocabulary to kill only five per cent – vicesimumate. In other words, we are going to be merciful – we are going to vicesimumate you lot.  Instead of two for the chop, you lot will only lose one.

∞∞∞∞∞∞

OUT NOW!

35 Poems by Jack Best

An illustrated collection of poems

Order your copy of 35 Poems now – $30 plus postage.
Email to cameo@iimetro.com.au for your copies. Any profits will go to the Ukrainian cause and Malawi relief.

Jack’s poetic side finally gets an airing in this, his first book of poems. Described in the foreword by John Bevins as:

“… a joy … indeed, hoped-for gifts beat surprises. In one of Jack’s deeply personal poems (some are jolly folly), we learn his Father urged him to read Xenophon. ‘The sweetest of all sounds’, Xenophon said, ‘is praise’. Well, this body of work — with its own sweet sounds, ‘sounds sizzling in the wires’ — gets my praise. All the more so because of Jack Best’s courage to say what he feels in a way that allows us to feel what he says”.