Mass Shootings Archives - The Best Mouse Tap

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

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.

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 – Dead Poets Society

King Charles inherited 45,667 acres of land across England & Wales, worth around £650m, generating income of £24m pa. He didn’t pay a single penny in inheritance tax & will only pay income tax if he volunteers. On the 6th May you will pay to put a crown on his head. These stark comments were relayed on a Twitter feed and, given the opaqueness of the Royal finances in many areas, the numbers are probably as reliable as any others.

It will be interesting to note which Australians will be part of the Forelock Shuffle to Westminster Abbey. How many avowed Republicans will be following the Prime Minister who, given his dainty ambivalence, will go and try to dampen criticism by offering to have a Regal Party on his plane, a modified KC-30A Multi-Role Tanker Transport, which in itself is a modified Airbus A330 jet, which can accommodate 100 passengers.

But then, at the Queen’s Coronation in 1953, 250 seats were reserved for Australians headed by the then Prime Minister, Robert Menzies. There were 8,000 invitations issued. There was an Australian military contingent which participated in the changing of the Guard at Buckingham Palace. Two Australian warships participated in a Spithead Review of 300 ships. Notably, the commentator on British Pathe reported that the crews of British and foreign ships all cheered. Foreign? It should be noted our Australian nationality on our passports only occurred in 1949; the words “British Passport” was retained on our passports until 1967.

The coronation of Charles III provides an opportunity to dispense with all the seductive pomp at which the British are very good – it appeals to all of the Cringe in Australians, afflicted by an inferiority complex which also guides the bunyip aristocracy.

We have a High Commissioner in London – let him be Australia’s representative. That’s sufficient.

But no, no, no – maybe Albanese will still be Prime Minister when William V ascends the British throne. By that time Australia should be a republic.

But then that is Australia Dreaming.

The Flag

One of the most difficult changes in Australia would be to change the flag. My first response years ago would have been dismissive; namely “who cares?”

We are used to it, and then all our history is mixed with histrionics associated with preservation of the hoar frost for those who still yearn for the Mother Country and have never forgiven the Labor Party for doing away with Imperial Honours. The preservation of the Union Jack in the Flag would preserve the hoar on the railing post.

But I suspect most people couldn’t care less. There is not a strong sense of wrapping ourselves in the Australian flag and crying “patriotism”. Yet the process to change the Australian Flag is formidable. The current Australian flag was officially raised for the first time on 3rd September 1901 at the Royal Exhibition Buildings, Melbourne, unveiled by Australia’s first Prime Minister, Edmund Barton. The design was the product of a competition held to find a national flag for the newly federated Australian nation. The competition attracted 32,832 entries from Australia and overseas; five individuals shared the honour of submitting the winning design. Apart from a few minor differences in the magnitude and number of points on the stars these people had designed what we now know as the Australian Flag.

The Australian flag was called the Australian or Commonwealth Blue Ensign until the Flags Act of 1953 gave it the title of Australian National Flag, confirming it as the chief national symbol by law, custom and tradition. This fact was recognised in 1996 when the Governor-General, Sir William Deane, proclaimed 3 September “Australian National Flag Day”.

New Zealand in the past decade spent NZ$23m in attempting to change the flag, a matter dear to the then Prime Minister, John Keys. He persuasively said that the similarity in the Australian and New Zealand flags was one reason to change. It should be noted that Australia, New Zealand, Tuvalu, and Fiji are the only nations to retain the symbol of British colonialism. Moreover, Fiji is a republic.

Strangely, the State of Hawaii retains the Union Jack embroidered in its flag. Curiously the stripes on the Hawaiian flag are similar to those on the Russian flag. The construction of Hawaii’s flag occurred when the indigenous Hawaiian rulers were ingratiating themselves with the perceived powerful European powers in the Pacific.

In the end, changing our flag is indeed formidable, but not insurmountable. How did the Canadians do it? After all, Canada has always been the favourite place for the Royals to visit, in particular the late Queen. The Canadians eschewed a referendum. They concentrated on the emblem of the maple leaf, set up a Parliamentary Committee, and then a process that involved progressive simplification of the design to the single red leaf.

On 22 October 1964, the committee voted in favour of the single-leaf concept. Two months later the House of Commons approved the design, followed shortly after by the Senate. The Liberal Ontario politician, John Matheson, one of the flag committee’s members, is often credited with achieving consensus within the committee and helping to end the Great Flag Debate in Parliament. The lesson is: keep it simple, use a universally recognised symbol, exert leadership and take nothing for granted.

I wonder if Keys had insisted on the silver fern and an “all black” background with or without the Southern Cross – and stuck to it – would the New Zealanders not have retained their current flag.

Gough Whitlam, in an interview in 1994, insisted that arguments about servicemen and women serving under the existing Flag in all of Australia’s wars were untrue. He said he had been the last Prime Minister to have served under the flag, (he was in the air force in World War II), but that Flag had been a red, not a blue, one and at RAAF funerals the casket had been draped in the Union Jack, not the Australian flag. The current flag had not been formally adopted until the enactment of the Flags Act of 1953, and had only been used in one war, Vietnam, and then only on land. The navy and air force continued to use their own flags.

“We got this blue one because Menzies did not like red,” said Whitlam, adding that his Liberal predecessor had once used the New Zealand flag while on a visit to Canada. Trust Billy McMahon to get it wrong.

Whitlam went on to say, “We need an Australian as head of state who will be accepted by other heads of state in the world and we need a flag which is identified as Australian and accepted by all — the original Australians and those who have come here from overseas.”

Whitlam said he favoured retaining that part of the flag that was distinctively Australian — the Southern Cross.

Keys made the mistake of trying to establish a consensus, probably impossible when you need to obtain change when it is a matter of taste and to convince those who believe the flag is a sacred relic.

First, I would remove the Union Jack, and re-position the Southern Cross in the night sky. I would prefer wattle as emblematic given that the Australian colours are not dark blue, but green and gold. To me, wattle provides the gold and the blue green of the eucalyptus as the background. In spring, in the southern states, the land is a tapestry of green and gold. Why do our representatives dress in a grass green colour given that this is a country of blue mountains, which essentially are the eucalyptus colour from a distance – and a suitable colour acknowledging this green merging into the blue should not be a great challenge to mix?

Then maybe Australia should have “a jury” to determine how to match the elements and then, as with Canada, the most suitable arrangement would evolve.

I must say, I have form. When I was a senior staffer, I was asked what would be discussed at the next parliamentary party meeting, the last meeting having been consumed with discussion of the Flag. I replied I supposed it would be the Party’s policy on heraldic symbols. It was reported in the media. There were some in the Party who were not amused. It gave some insight into the importance that I, as a young man, ascribed to the Flag, to which I alluded at the start of this piece. Maybe age has modified my flippancy.

Jackals and Hyenas Abroad

“Rumore” in Italian is the word for “noise”. Recently, someone commented that I (née big Johnnie) had been kicked out of the Liberal Party. One person close to me said I should wear that as a badge of honour.

Others said to me, why bother? Still a lie is a lie and needs to be corrected. Now the political process, as with any combative arrangement, attracts the jackals and hyenas to feed on the carrion of this process. By this I refer to the detritus of innuendo and lies served up in the clubs, and board rooms of Australia amid the sly chortles wreathed in cigar smoke and the glittering whisky decanters on the pour.

I was a member of the Liberal Party for about a decade in the seventies and early eighties. In that time, I was a political staffer; organised a centrist discussion group called “Grapple” with assistance from other like-minded so-called “small L liberals”, an unfortunate moniker; was a branch president for a few years and failed in three tilts to gain pre-selection for outer Melbourne parliament seats.

When I moved to Sydney in 1979, I cut my ties with “Grapple” and joined the then Australian Institute of Political Science. The Institute received funding then from some of the big Australian companies, but the money spinner was the Summer School, where aspiring politicians, and those interested in political science could debate a particular theme over the long weekend in January. The Institute produced the Australian Quarterly.

The Institute owed its existence to members of the Sydney establishment led by Norman Cowper who, in 1932, set it up as a reaction to a growth of the Fascist New Guard led by Eric Campbell on the extreme right. On the left was Jack Lang, the NSW Premier with his defiant populism, which threatened the established order in a far different way from Campbell. Nevertheless, both were authoritarian as most extreme politicians are whether they are left or right.

In the early years of the Depression revolution was in the air. How serious in retrospect who knows, but one of the results was the Australian Institute of Political Science was formed. Cowper was shrewd in that in the construction of the Sydney-based Board he invited Labor Party members to join the Board – and thus for many years this bipartisan governance persisted. There were also Melbourne directors, who would be present at the Summer School. It was all very civilised; the only problem was that the Institute was running out of money by the time I joined.

There was enough money to celebrate the 50^th anniversary, which I organised and invited David Owen, who was one of the leaders of Social Democrats and at that time considered as a future British Prime Minister. Unlike most politicians these days, he charged nothing for his appearance fee, but we engineered a first class airfare return to London plus accommodation.

The celebration was centred around the first Cowper Oration. Norman Cowper, then 87 years old, attended. The celebration was a success, which surprised some on the Board which had become a comfortable place for mates to meet when money was not a problem. I was an outsider, a Melburnian. The Institute leaned towards the Labor party. Despite the 50^th anniversary, which was just a temporary fillip, the financial situation was increasingly dire and, not for the first time in such a situation, a Board turned to me to become the Chair and solve the resultant problem of potential insolvency.

In the mid 1980s, certainly the mood for change coincided if not clashed within the Institute. The Summer school became non-viable. Where once the Summer School was “the only game in town”, now the growth of forums, symposia, workshops and all sorts of scientific meetings were competing for the space the Institute once had to itself. Politics was becoming more partisan and trying to define the political centre became impossible with the bipartisan adoption of elements of neoliberalism, banging the drum of individual freedom and the contempt for government. In other words, there was a certain pessimism about the future of the AIPS with funds drying up.

At this time, there was a move by some of the Melbourne directors who were members of the Liberal Party headed by Richard Alston to take the Institute to Melbourne and convert it into a right wing think tank. There was no plan just an assertion to trust him while his cabal appropriated the name of the Institute. Nevertheless, the unseen hand of John Elliot, then at the height of his “Fosterisation” hubris, was probably behind funding an Alston-led organisation.

By this time I had let my Liberal Party membership lapse; but the action in resisting this move of the Institute and having the Sydney directors support me in resisting this move, did not win me any friends in the Victorian Branch of the Liberal Party of which I once was a member. Then I took the secretariat of the Institute into my office and it survived, as it does today. I was fortunate to have Gay Davidson, a senior political journalist in Canberra, as my Vice-President for much of the following decade. We retained Government funding. Australian Quarterly survived with people such as Ross Garnaut editing it for a time.

No, I was not kicked out of the Liberal Party. I left it with the minimum of fuss.

I resigned as Chair of the Australian Institute of Politics and Science (the name was changed during my stewardship to better reflect its change in function) after 18 years in 2002 and was succeeded by Rick McLean. The Institute and Australian Quarterly remain to this day.

Dauber or just Dabbler

When I was searching for a site for University of Melbourne Family Club Child Care Centre in the late 60s, I had a strange encounter when I met a Miss Dauber who was, if not the only surviving descendent of Horatio Larcher, certainly a major beneficiary of his estate. Larcher, according in his brief 1942 obituary, had been born in London in 1854, and migrated to Victoria in 1871. He built up one of the largest retail distribution businesses of milk in Melbourne. To illustrate this, by 1907 he was advertising his Farm Dairy at 45 Moor St Fitzroy. At about that time, pasteurisation was introduced, and his dairy continued to increase its output from 50 to 100 quarts daily in 1896 to 10,000 quarts a day in 1922.

Returning from the UK on a visit in 1936, Larcher had brought samples of sterilised and “homogenised” milk, very popular in England. The cream was pressed into the milk and the heat sterilised. Kept in a cool place, if the bottle was not opened, Larcher was quoted as saying the milk would last indefinitely. He brought back samples. “Such milk, which could be sold for about a penny a pint more than ordinary milk, would be invaluable in Australia for transportation over any distance.” He seemed to be describing ultra-pasteurisation.

In Victoria, the Milk Pasteurization Act 1958 specified that “no one should sell or deliver milk except milk pasteurised at licensed pasteurising premises and bottled and sealed as prescribed.” At that time, only about half the milk sold in Victoria was pasteurised. I was in Trinity College at the University of Melbourne then and we had cows grazing on the College grounds; we consumed the milk from the College cows – unpasteurised. No-one to my knowledge contracted bovine tuberculosis nor brucellosis.

Therefore, Larchers had distributed milk through major generational change when at first milk needed to be purchased almost daily from the milkman, unless the family had an ice chest or Coolgardie safe or the new-fangled refrigerator.

The Larcher method of distribution was the horse drawn cart and the horses were stabled on the Moor Street premises, where Larcher himself lived. While there is a photograph of a Larcher horse and cart outside the Southern Cross in 1966, it was not long after that when Larchers closed.

The times had now changed irrevocably. The whole method of distribution was now through the corner store or the supermarket where milk could be refrigerated. The road traffic had increased such that the horse and cart with streets covered with horse excrement was no longer the best method of retaining or distributing milk. This freed up the stables, with their extensive courtyard, in a place not too far from the University of Melbourne.

Miss Dauber was interested in the conversion of the stables into a child-minding centre, and thus I entered into negotiation and I found out I was drawn into a gossamer web. Miss Dauber was a delicate woman whose age was difficult to define by just looking at her finely lined face. She seemed somewhat detached but at the same time she affected coquettish behaviour. There was another young man competing for the property to provide the child-minding centre, but he had no overt experience; even then his strange persona concealed a dark side which ultimately led to him being “sectioned” and held securely in a mental health facility for a period.

With my then young family I visited Miss Dauber on several occasions at her extensive country property at Healesville. What I remember clearly was the magnificent cork tree. I had never seen a fully grown cork tree with its distinctive bark. Funny what you remember, but after a while I realised that, despite her elegant afternoon tea hospitality, I was being strung along, as if courting for Miss Dauber’s hand, much to her enjoyment.

In the words of a nineteenth century novel, I withdrew, thanked her with a flourish of effusiveness. and sought more successfully another premises, this one in Carlton. It was a complete break. I never knew what ultimately happened to Miss Dauber. In a later architectural history of Inner Melbourne, I note reference to a Dauber Child Minding Centre in 1971 located in the Moor Street premises.

Today, it is an undistinguished block of flats. But the Larcher chimney still exists as a remnant of its glory days.

The Melbourne University Family Club with its premises in Carlton has remained, a pioneer in early childhood development.

Mouse Whisper

Jeff Tiedrich is a 65 year old New York graphic designer known since 2000 for his acerbic blogs. He has played guitar in the band Alligator and looks uncannily like Eric Clapton.

After the recent Michigan massacre, he tweeted: Well-regulated militia opens fire on Michigan State University in East Lansing. Cheap thoughts and useless prayers now being rushed to the scene … more on this soon-to-be-forgotten-and-then-repeated story-as-it develops.

Modest Expectations – Sudan

It was a modest dilemma, but a dilemma nevertheless. We had stopped in Genoa, a small sliver of civilisation which had nearly been razed to the ground two years ago by the 2019-2020 bushfires which had burnt through the far east of Gippsland. It resembled a ghost town. The late autumn day was beautiful, and we noted that there was a new bridge over the river which flowed through the hamlet. So even though there seemed to be no one around, someone had spent money on the bridge.

We stopped in front of a very shabby building. The sign on the front of the building indicated that it was once a hotel/motel. It seemed to me to be disused; my wife disagreed. She thought there were people living there. There was no fence around the front of the motel.

However, in the front of the building was a tree loaded with lemons. There was only one windfall, and that was on the wrong side of ripe.

As we were contemplating a guy riding on a tractor rode up to the north wall of the motel, but did not stop. That was the only person we saw.

I looked at the lemons. They were many beautiful ripe yellow lemons.

I was tempted; my wife said no.

The dilemma: Would you pick lemons off the tree or not?

We were only 45 minutes by taxi from Eden. Could not see any apple tree though.

Wistful in Werriwa

My eye was caught by a small piece which said that Morrison was contemplating winning Whitlam’s old seat of Werriwa. He had descended on that electorate to start the day with a group of locals, or so it was reported. Now Werriwa is the Aboriginal name for Lake George, which mysteriously periodically fills up with water and then empties, with no river flowing in and out to explain its fluctuation. Werriwa was one of the original electorates at the time of Federation. As the population has grown, the electorate has moved closer to the southern outer suburbs of Sydney, and thus has been a stronghold of the Labor Party since 1934.

Morrison believed such a seat was winnable, as he cast himself as the Everyman battling the Political Elites. He was encouraged by a media machine that we have endured for a long time, particularly after the accession of Rudd, biased to the Coalition. Morrison was also buoyed by his surprise victory in 2019, with a major swing in Queensland. He made the assumption that he could cast himself as the champion of the working man. “Man” was the operative word. Werriwa has a woman member, and with a very “Anglo” name, Anne Stanley.

Added to that were migrant communities where you could sow the divisive wedge politics, particularly playing upon conservative religious practices. Here, sexuality and general relaxation of patriarchal family relationships, admixed with spurious declamation about religious freedoms, were perceived by Morrison and his advisers to be fertile ground for playing on prejudice to gain votes. The Liberal Party candidate was Sam Kayal, the surname Lebanese; and obviously he seems to be very friendly with the Mayor of Liverpool, who is also of Lebanese heritage, presumably Christian.

When you reviewed the first preferences in the recent Federal election, the Liberal Democrats, the One Nation Party and United Australia Party collected about 23 per cent of these. The Greens received a modest increase of just over one per cent to 6.6 per cent.

Both the major Parties in the allocation of first preferences lost ground – Labor lost eight per cent and the Liberals four per cent. After the allocation of preferences, the swing against the Labor Party had been reduced to 0.3 per cent. If the three right wing splinters had been solid for the Coalition, the seat would probably have fallen to the Liberals.

When I first read the piece about Morrison, I scoffed. Now it is food for thought; maybe it was a lockdown reaction, where each side received electoral contumely. Certainly, how the votes flow in the NSW election next year will be more interesting, because the antipathy to the enforced “lockdowns” should have faded by then.

Enter Dr Ryan

Let me say, as I have said before, that my health care has been very good, considering my co-morbidities. Yet I do not have one health professional who can provide all my ongoing care. Why? Because the world of medicine is so sub-specialised that having all the information in one place is impossible. As I have been a medical practitioner, I have navigated the system with varying degrees of success. This has meant that for probably six months my auto-immune disease was undiagnosed; but I knew when I was fibrillating and not reverting to sinus rhythm.

Take for instance, because of arthritic changes in both my cervical and lumbar spine, coupled with some symptomatology which suggested impairment of neural function, a spinal surgeon that he would operate. I found his clinical approach puzzling and consulted a colleague of mine – a neurologist – who said that, in his opinion, the operations were unnecessary. That was six years ago, and the disability caused by these changes has not progressed.

He retired but referred me to a neurologist in Sydney. The cost for the initial consultation was announced by the practice to be $800, more than three times the appropriate Medicare benefit. I would have thought that outrageous, especially so given that he would have my notes passed on by my previous neurologist who had settled for the Medicare benefit as full payment for a consultation.

Ironically, through the consultant physician professional association of which I was vice-president at the time, I had negotiated with the Commonwealth Health Department in 2006 to create the Medicare item which reflected recognition of significant complexity in consultations.

Let me say that the neurologist whom I consulted was understated, yet had an eye for detail; more importantly, he had wide clinical experience and a great modicum of common sense.

Talking of neurology, Professor Monique Ryan, a prominent paediatric neurologist has been elected to the Federal Parliament. As a member of a small sub-specialty, her natural health constituency is one of the “elitist” areas of the profession – small patient load given there are about 120 paediatric neurologists; yet, irrespective of needs, the sub-specialities keep on expanding. There is also a tendency in these small specialties for the doctors to become researchers or even more sub-specialised. In a review of the field, 250 neurological disorders have been isolated, but most are very rare diseases.

Yet reflexly the tendency continues to also train more and more, despite smaller and smaller patient load per neurologist.

As a result, they tend to “keep” their patients rather than “returning” them back to the referring doctor. The other way to expand the clinical base of the paediatric neurology sub-specialty is by moving into the mental disability field, where rehabilitation is the aim, or areas such as attention deficit disorders and autism, which have become very “popular” diagnoses.

Whenever I watch reports on these spectrum disorders, I am reminded of the successful long distance swimmer, who was concurrently being treated for chronic fatigue syndrome.

While many of my medical colleagues would bristle and dismiss my comments, it’s very difficult to get any medical sub-specialty to objectively review what has been achieved as against that which was promised over a given period – and to agree on when is “enough is enough”.

Monique Ryan may now represent the electorate of Kooyong; she also represents by her professional attainment and experience, a rather narrow tranche of the health system. That is not to decry its importance; it is a matter of the allocation of scarce resources. Now she has Parliamentary standing, her utterances will be interesting; especially as the ego lurks very close to the surface in most maiden speeches to Parliament. I will read hers with very great interest, given my own experience, and see where her priorities lie, once you strip away the comments of the generalities.

The dangers of rampant sub-specialisation in medicine and elsewhere in the health system is just one potential dysfunction which needs to be rebalanced in the health system after the COVID-19 experience, an indifferent series of Federal Ministers and the unfortunate influence of a number of public servants, some of whom should be ashamed to take their pensions let alone the consultant work they fouled up – and that is before Australia has a decent Integrity Commission to investigate whether there are shenanigans and rorts to attract any action.

If the aim is to get a more equitable spread of health professionals, then as one whose nationwide Rural Stocktake in 1999 led to the creation of the rural clinical schools and university departments of rural health among other changes and who introduced a successful intern training program and opposed lengthening the post-graduate training in the name of professional “slavery” rather than education, I have been disappointed that its success has been seemingly ignored and structures dismantled. Yet there is a crescendo of complaints about the lack of rural health professionals. I shall define the systemic pathology and suggest what has to be done in a number of my following blogs.

I just hope that the incoming Health Minister can think outside and beyond the normal temptation to just get the matter off his desk and onto the States, with resumption of the “blame game”.

The Fall of Globalisation – How inconvenient.

In the years just before COVID-19 struck, I travelled widely, and in doing so visited Finland, the Baltic countries, and the countries on the lower Danube (Romania, Bulgaria, Serbia and Hungary), the boat on which I was travelling ending up nosing into the Black Sea before turning around; also Croatia, Bosnia & Herzegovina, Montenegro; Slovenia. I had been to Russia and Poland on earlier trips. Although it did not occur to me at the time, I was able to do this under the mantle of Globalisation; in fact, as long as you flew there you could also then visit Belarus from Lithuania. Belarus, together with Russian exclave of Kaliningrad, were the only two places where entry was not automatic in these European wanderings.

All the time Russians were seething; or rather Putin was seething with his Peter the Great complex. Plotting – planning for his dystopian world is just the end product of the authoritarian narcissist who gazes at their image in the world; the Chaplinesque caricature now widely spread across the world.

In the USA, it is unbelievable that the Republican Party, which ostensibly believes in free enterprise, has been complicit through the Vandal Trump in the Putin destruction of globalisation.

Trump was not the only one. For instance, the narcissist Rumsfeld cajoled a group of politicians into a “coalition of the willing” on the grounds that Iraq would be easy pickings for the American oil industry. Others may nuance it to share the blame around and saying pillorying one person is never the reason. However, George W. Bush’s famous assessment of Putin: “I looked the man in the eye. I found him to be very straightforward and trustworthy. We had a very good dialogue. I was able to get a sense of his soul; a man deeply committed to his country and the best interests of his country.” needs no commentary.

It seems that remains the belief of that great meddler, Henry Kissinger, who was so important in Hanoi winning the Vietnam war. Kissinger turned 99 a week ago; and his wrongheadedness is still being reported.

Nevertheless, the greatest win for Putin was to have his Manchurian candidate, Donald Trump, in the White House. Thus, while America slept or was “tarbabied” in Afghanistan, Putin consolidated his power base. If Hilary Clinton had been voted in as President instead of Trump in 2016, this current situation would not have arisen. She would have kicked the All European cocktail circuit which for years has gone under the name of NATO, in the backside. At the same time, Putin was meddling with a British Isles polity befuddled by one Nigel Farage who may well have been on the Soviet payroll in order to play wazir to the aspirant sultan Boris.

After all, in a prescient speech 12 years ago, Clinton stated inter alia: …NATO Headquarters is bulging with over three hundred committees, many with overlapping responsibilities. Too often, our budgets – military and civilian – are divorced from Alliance priorities, and the most important priorities have been under-resourced for years. Our secretary general has not been invested with the power he needs to truly manage the organization. This must change – and we must agree to that change in parallel with the new Strategic Concept. A new Concept with old structures will not be transformational. In fact, it may not change much of anything at all.

But that did not happen. Hilary Clinton was a casualty at a time when the world was reaching a crescendo of dystopian behaviour.

Now, it has taken a young man, unencumbered by the cocktail circuit and with the true insight of the comedian, to stand up and fight. As he said, he does not need martini glasses, he needs the armaments to vaccinate Europe against this particularly virulent Russian variant of Monkey Pox. But old habits die hard; the clinking of glasses still resonate around the palaces of Brussels.

Old Age

“It is a giant labyrinth that you walk into, they lock the door behind you, and there is no exit,” she said. “I can’t keep doing this. I’m falling apart.”

I have been concerned with care of the aged since not long after I graduated in medicine in 1963. It is now 2022. During this time, there has been a huge change in the technology surrounding care of the aged.

Yet is this reflected in the care?

People are living longer, and hence the gap between ceasing employment and death is growing. I have joined the throng.

There is this myth that looking after old people is more about care rather than medicine. When I was in practice, I was less concerned with “fast rehabilitation”, typically treatment of the sporting injury, but more with so-called “slow rehabilitation”, the staff, including the doctors, employed all the expertise available to assures each person attains his or her highest level of capability, and then maintains it. While most are old; that is not necessarily the case.

The projected Labor Party policy is to have a registered nurse on duty 24/7 in every aged care facility, which equates to employing six registered nurses to cover the one position. This is very difficult to achieve given that government has allowed the nursing home to be separated from mainstream health care with different rules – and for aged care to be largely private. The more you diffuse the expertise of a group of professionals, especially with an absentee landlord, the more you undermine the staff morale which, in turn, leads to increased staff turnover.

When almost 20 years ago I started working as Director of Medical Services in a country hospital, to which was attached a nursing home, the first thing I did was a drug audit for each of the residents with the local pharmacist. I then asked each of the general practitioners how often they reviewed each resident’s medication charts, which most did with varying degrees of reluctance.

There was a visiting geriatrician at the time. “Visiting” was a joke. He would not visit the nursing home; insisting each patient be brought to the rooms from which he worked. Incredible. In the end I secured a mate of mine, a city geriatrician to periodically visit to not only see the nursing home residents but to also provide tutorials to the local doctors and other health professionals. The problem with any program which involves visiting staff is its sustainability.

When the policy makers – divorced from reality – say “train more staff”, it is far from a magic solution.

There are basically three ways of training staff

In dedicated training institutions,
On the job – apprenticeship style,
Importing staff trained in other countries,

coupled with:

Periodic in-service training programs.

To me, what is important is to reduce the attrition levels and minimise the spread of disease. Simple to say; hard to accomplish.

There has been a shift from people suffering stroke to those suffering dementia. The incidence of stroke has fallen because of improvement in cardiac treatment, in particular in the treatment of high blood pressure. With stroke, the hope is that the patient will improve; once improvement is stabilised, then the level of independent living ability can be assessed. The problem with dementia is to slow the rate of deterioration; but in both cases, redemption is a limited commodity.

Care of the aged as I have found out is care and competence. One of the most frustrating aspects to exercise even the basic function of getting out of a chair, which once was automatic, is having to wait for someone. The horrors of not being able to undertake normal bodily functions without soiling yourself is ever present. If many of the population are like me, impatient, then learning to wait becomes one of the challenges. This is compounded everywhere by the challenge of the furniture: once it was great to be able to sink into an armchair. Now the softness becomes a giant jellyfish from which you alone cannot escape.

When I was involved with a nursing home attached to a country hospital, the key to its success was that the manager was very competent. Competency is being able to utilise the resources allocated to achieve that no patient is neglected – falls, hygiene, bed sores, nutrition, compliance with treatment being uppermost in those items monitored continually. She had an eye on how everyone was performing, which is what is needed in developing a coherent happy team and thus reducing the turnover of staff. This is important if employment is continually being disrupted by the pandemic.

I am one who believes that in community health structures you build from the bottom, not with great fanfare spray funding from the seat of government and the assumption it will work. There are packages of care everywhere, but who is monitoring the implementation rather than just the distribution of these government initiatives, which are often encased in impressive language, but of what meaning?

One may suggest a number of ways to improve the quality of care of the aged. I believe that there are indicators which denote good care. I also believe that there should be a credentialling, definition of practice and privileging system across the whole sector. When I tried to implement this process in aged care, despite it being the norm for hospitals, the Commonwealth Department of Health protested. Gives you an idea of the appalling track record of the Commonwealth Health Department in that sector. after all, has the sector improved since the kerosene bath era when Bronwyn Bishop was the Minister at the turn of the century? I have viewed hapless Federal Ministers, but the antics of Richard Colbeck in this sector shows how little the Coalition continue to view this sector of human existence.

As a result, a bad situation has festered.

Nursing homes should not be an area where the output is conspicuous consumption, as shown in the media by the acquisition of a yellow Lamborghini because of the apparent profitability embedded in the current aged care arrangements. As can be seen in the media, or in expensive church vestments (as we saw during the first year of COVID-19 when deaths in nursing homes were rampant), the residents of these facilities, many without comprehension, are in need of care, compassion and dignity. However, then give some thought to all the marvellous medical technology which has enabled lives to be extended in this way.

I am well aware that any system which seeks to monitor behaviour in all its forms will receive resistance; however, over a long period of time I have found that it works if you have the will to make it so. I am also a believer in hands-on management, not of the individual interaction between patient and health professional, but of the system. This has enabled me to pick up when inevitably, even with the best of intention, events go “pear-shaped”.

Also accept the blame for such situation where you are ultimately responsible. Then review when this happens – and one of the results of credentialing, defining the appropriate clinical practice and then privileging is that the staff members can learn from others – both the right and the wrong – with recriminations as a last resort.

Unfortunately, most systemic failures have an individual implicated; and that is often the hardest part – to get rid of that individual or individuals. A well constituted system under the new government, where all the parties are bought together in perhaps an electorate-based arrangement, so that each elected member can follow the monitoring of aged care in their electorate – and, as I said above, credentialing, definition of clinical practice and privileging would be one way of attracting attention to an area of past government neglect.

Perhaps a Prime Minister faced with the care of the aged will find out sooner than he thinks that he may need to enter its portals. Therefore he may like to receive periodic factual reports of what is currently occurring in his electorate of Grayndler and aim to visit each over the lifetime of the Parliament. After all, across Australia 151 committees should not be too much of a burden to assure better care of the aged, providing insurance for that time which each of us will eventually reach, if we live long enough. To face being placed in a nursing home, and knowing that I will be cared for in the best way possible; not left to wallow and nobody comes.

After all, as I found out, 70 may be the new 50 years; but I assure you 80 is still 80.

I am not alone. However, even though there has been an extensive review of this area recently, who of us has been consulted? Who among us aged is the protector of that increasing group of people alongside me who are demented? You see in your contemporaries the slow decline in cognitive function, the irrational behaviour, and unless each one of them has a carer who truly cares for them and has the resilience to battle the many hurdles to getting an acceptable aged care situation, they end up on a scrap heap which, for administrative purposes, is called a nursing home.

The nursing home nightmare is when I cry out, but nobody comes.

Mouse Whisper

Serious Mouse!

Since 1982, 123 mass shootings have been carried out in the USA by male gunmen. In contrast, only three mass shootings (defined by the source as a single attack in a public place in which four or more victims were killed) have been carried out by women.