Modest Expectations – Twenty of dark chocolate

Neale Daniher

Neale Daniher is a very brave man. I admire him greatly as the epitome of all that is great about being an Australian. He fully deserves the Order of Australia recently bestowed on him; he also deserves to be invested with it as soon as practical while he can still walk.

For seven years his health has progressively deteriorated. He has motor neurone disease (MND), yet he has maintained a defiance against this progressively incurable disease.  Today, he has almost lost his ability to speak. It is a terrible disease, and I know that when I developed my own disease one of the differential diagnoses, soon discounted thankfully, was MND.

The symbol for what Daniher describes as “The Beast”, with inadvertently or not its Biblical imagery, has been the ice bucket, the ice bath, the ice pool – a plunge in order to raise funds for research.

The problem is that research into the cure for motor neurone disease is at the same level as it was when I was born. Getting nowhere substantially is not restricted to MND.  I have known researchers who have spent their lives trying to develop a malaria vaccine or find a cure for Duchenne’s muscular dystrophy – to no effect. Honourable failures – the dilemma for those seeking more money for such research. That is problem personally I have in contributing money for research into this disease – poor return on investment.

Lou Gehrig

Around the time I was born, a famous baseball player died of amyotrophic lateral sclerosis (ALS), the most common form of motor neurone disease. The disease was given his name, Lou Gehrig. He too was a brave man; a film starring Gary Cooper was made of his life. Lou Gehrig died about three years after the onset when he was only 37 years old in 1941.

Now 80 years on Neale Daniher, in his time a very gifted footballer whose playing days were foreshortened by knee injuries, is dying of the same disease. The onset of his disease was when he was 53. Over seven years survival is testimony to something innate.

Increasingly, auto-immunity is being ascribed as the culprit. Auto-immunity, the tendency of the body to destroy itself when the immune system goes rogue, is the battlefield. It is an area where the disease has been victorious up to now, particularly in the case of this disease, which causes the destruction of the nerve cells that control voluntary muscular movement.

There are a few inconclusive drugs and conservative measures which may prolong life; and as long as Neale Daniher remains optimistic, then his will to live deserves every support. After all, more than 2,000 people have the disease in Australia, and the total cost of therapeutic support per person averages out as $1m. Two are diagnosed every day; two die every day of the disease.

When there is no longer Neale Daniher around fighting against destiny, let us make sure those with this terrible disease do not die alone, paralysed, slowly suffocating. In other words, strengthen palliation, help strengthen family support but do not – I repeat – do not raise false hopes of a cure.

A muddy Saturday

This is a very simple story about a group of University students who, in 1958, won the Juniors Premiership in the Victorian Amateur Football League. It was a time when there was only one university in Victoria and therefore most of the teams that we played reflected the division between “town” and “gown”, even though the diversity of the team list reflected the normal cross-section of society. The only bond between us was a desire to play football and being under 19 we were consigned to the Juniors.

The two adult teams were the University Blacks and Blues, which were in the top grade and produced a number of players for the pinnacle, the then Victorian Football League (VFL) where you got paid. The other University team for those who just wanted a game was the University Reds.

There was a hierarchy; even as 18 year olds there were a few university students who just played VFL. which, in those days, had an Under 19 nursery as well. They were just too good to play amateur football. Many were in fact champions, not just making up the then “twenty”.

There also was the Victorian Football Association which headed a cascade of suburban and country teams where footballers who had had enough of the paltry returns from playing under the then Coulter Law in the VFL, left to play and/or coach a country team. These players would receive a generous wage and were often set up as the licensee of the local pub.

Then there were the “lily-whites” – the amateurs. In the University hierarchy, this was the place where the cohort of youngsters who were not drafted into the Blues and Blacks played. Some went straight into the top teams; some oscillated between the top teams and the Juniors.

Nevertheless, the Juniors won the Grand Final, and three members of our winning team climbed onto the roof of the University Union Building. They were said to be in a jolly state when they climbed up and affixed the Premiership flag. As one said later, they did not know how they managed to climb onto the roof given the ethanol haze that surrounded them. The flag was returned early the next week neatly folded and nothing more was said.

After that year, the team went their various ways, but one person stuck in my mind and obviously the minds of many of the others, who had known him better. He was a few years older than us and had played for the University team. He was always immaculately dressed, with his signature furled umbrella, given the grounds we played on barely afforded any shelter from the Melbourne winter. He was in direct contrast to the coach, Peter Kelliher, who was a knockabout fellow who acted, as all coaches do, with a mixture of encouragement and invective.

Ian Hamilton Munro was different. He was almost the pastoral adviser to the team – a very kind and compassionate man who was always around when you were injured, when you were having a lousy game. He was a counterpoint to the coach – one person I could always picture on the side lines – often a solitary spectator on a windswept oval.

Somebody suggested that, as we approached the 50th anniversary of the Premiership, the survivors of that year should meet annually for lunch. The first, in 2005, was deemed such a success that it was decided we would have one every year, so that has occurred every year, including 2020. This cohort, then in their youthful sixties when the lunches started are now in their eighties. Our coach, having had a stroke a decade before, was an infrequent participant from early into the lunch cycle.  The immaculate Ian Munro was a regular attender, until he fell victim to old age several years ago – and then he too was gone.

Such a small group, men now who are bonded by a football premiership gained so long ago and all accepting their mortality, has now decided to establish the immortality of their achievement and to honour their paterfamilias by donating a cup in his name for annual presentation by the Melbourne University Football Club for an annual match between the now two Melbourne University Juniors teams.

The cup is made from spun brass, silver-plated. It sits on a dark tallowwood plinth around which is collar of silver-plated nickel with enough space to engrave the annual winners for the next 80 years. It was made by the silversmiths and goldsmiths that make the solid gold Melbourne Cup each year for “that race which stops a nation” – the first Tuesday in November; these same trophy makers also create the trophies for the Australian Tennis Open; they are the last such company in existence in Australia.

Munners Cup

Ian Munro might have been embarrassed, like all good generous persons who give much, but never expect recognition. However, he would have liked the enamelled crossed furled umbrellas – one black, one blue – under his name on the trophy – the Munners Cup.

Even to us well aged, he was still always Munners – not Ian Hamilton Munro. However, that name is the cup’s pseudonym inscribed on the reverse side of the plinth. A simple story with hopefully a long nostalgic tail.

Morrison – A Description in One Word

What struck me was the stony-faced Prime Minister who had been persuaded by his Mate, Mat Cormann, to attend a West Coast Eagles match. The boos around the ground when he was introduced were universal. As part of a meet and greet in the morning, he had been persuaded by one of his consigliere, the irrepressible Mr Forrest, to partake in morning PT. It was a more typical photo-opportunity to show off his eminently “daggy” self.

He does not like to be booed. I notice that he has not turned up at any of the football matches in Victoria.

The other fact about the Prime Minister is that he is not that intelligent; yes, smart in the ways of the Molonglo swamp but not particularly well read or thoughtful. Like all people not blessed with any real sense of personal identity, he is totally versed in public relations, and therefore takes the temperature of his quarry – be it Liberal Party pre-selection or Australia before doing anything; hence he leads from the rear.

His problem, and his is not unique in this regard, is to have as the rule of thumb that you never have any Ministers and advisers more intelligent than he is.  The Prime Minister has succeeded in that endeavour, with one exception. That is the recently departed German-Belgian-West Australian, a chameleon of great skill, Mathias Cormann. There is a genus of politician who, when the master rings a bell, will argue without any shame but on cue that black is white – and too many do it persuasively, all the time knowing where the career escalator is located. Cormann has shown himself to be such an engaging man.

Morrison does not brook dissent; he just cannot take it. Part of this is explained by his reliance on a Christian belief system that does not take criticism easily. Much of the Pentecostal beliefs are couched in uncompromising, simple terms, which require no thought but a belief in a literal interpretation of the Bible. This is a Book where the ambiguities of the authors have been reduced to cartoons. His father was one such believer, and here is a person who has been coached in what some would say is a heretical belief system.

Morrison’s trip overseas has been not unexpectedly revealing. The Prime Minister of Singapore, Lee Hsien Loong, gently chided him about his aggression in relation to China; and even in the matter of mask wearing he seemed to guide our uncertain Prime Minister.

The Prime Minister has been hoping to amble the world stage but having been relegated to a landing slot at an airport distant from the G7 meeting it should have warned him at the start. There are no better people than the Poms in insulting one and then being able to smooth it over once everybody recognises that the insult was deliberate, if nuanced.  The perfect word for British diplomacy – nuance!

The daggy “Scomo” image which he believes is the basis of his rural popularity – in Queensland and New South Wales – seems not to have translated as well into International Prime Minister. Here is a guy who not only threw himself at the feet of Trump but has an old friend with connections with the dark side of the web – one of those peddling those conspiratorial beliefs, which are so much of the Trump madness.

If he were to have someone close who is visionary, with ideas that he could sample, then he may not be in his current predicament – and if he did not have an adviser called Stewart.

Biden has proved not to be the doddering front man that some of us wrongly feared, but at the centre of some hard-nosed advisers, who probably worry that Morrison is a security risk – hence the intrusion of Johnson into the Biden-Morrison meeting. It would be a problem for our relations if his words “ritual sex abuse” get wide currency in the corridors of the White House. Can Biden trust that anything he says to Morrison will not appear somewhere as an unacceptable comment?

When Howard extracted special treatment in the Kyoto Protocols for our fossil emissions, the United States owed us for our support in the Bush War Coalition of the Willing; Biden owes Morrison nothing.

In relation to the domestic scene, obviously if your Government’s handout to Big Business is essentially little more than to further enrich, then the recipients of such largesse have every reason to support the current regime. It is not an unusual situation when both sides of politics are compromised, but there is a limit which the community, however rendered compliant by the Virus, will tolerate. Australia sliding into plutocracy is not a pleasant sight.

It is also helpful for Morrison that the Murdoch newspapers’ unceasingly support him, bolstering him in a constituency of flag wavers for fossil fuels and where the environment is being progressively degraded by climate denialists.  For the moment these Murdocistas are spooking the rest of the community.

However, this strange remnant from the Trump days has found the world stage somewhat guarded. As one would have expected, he was greeted in France with all the warmth that the appalling submarine contract with the French can muster. Whatever he may think privately, Macron has been polite; it will be interesting to see if he speaks to Morrison through an interpreter – or in English.  If the first, and from afar hard to know, Macron is maintaining distance so that any communications between the two can be properly interpreted, n’est-ce pas.

Another problem for Morrison is that not all the electorates in Australia are obsessed with maintaining coal mining. There are certain electorates in Queensland and NSW where urgent steps must be taken to transfer the workforce to other industries, not to bolster coal which has to be phased out if the world is to survive beyond the end of this century.

Unfortunately, Australia has a Prime Minister who is only concerned with his re-election, and his only response to climate change and the need to reduce carbon emissions is an underlined word “technology” – as if Technology is a God like Baal to be worshipped not defined. Here a throng of happy clapping followers with arms outstretched towards this Solution and repeating over and over again, “Technology. For thine is the Answer.”

Maybe I’ll wake up and blame all this on something I ate.

Aduhelm 

“I had no sense of where to turn for help, support, or even how to express the diagnosis with family, friends or co-workers. I was lost and crept further inward. There is no single handbook one can read to prepare; each journey is different, each course of the disease takes different, meandering turns—no two are alike, the experts will tell you, an observation that is clearly numbing in so many ways.”

The drug is called Aduhelm. It has just been given the all-clear by America’s Food & Drug Administration (FDA) to be prescribed for people with early Alzheimer’s dementia. As one correspondent said, for many people Alzheimer’s disease has passed through the early stage of memory loss and is not recognised until the cognitive abilities have declined significantly.

The quote above is from Mary, the wife of a journalist, Greg O’Brien who has written On Pluto: Inside the Mind of Alzheimer’s, which follows his own decline from the early onset of the disease. Her cry is clear; and there is no wonder that those families where there is Alzheimer’s disease in their midst want a cure. No wonder that news of a drug with any prospect for improvement will generate clamour for its availability – now.

Much of the excitement generated by this drug is that it is the first since 2003 to show any promise and it has cleared a path through the FDA, not without controversy, which resulted in some members of the committee overseeing its approval resigning in protest. The method of approval has also instilled a feeling of uneasiness in this blogger.

The drug is supposed to attack amyloid-beta, the protein which appears in the nerve tangle of the Alzheimer brain. However, nobody really can say whether it is the amyloid deposits which cause the disease or whether they are waste, the result of a process which leaves this protein functionally inert in the brain. Amyloid disease is one of those differential diagnoses for unexplained disease which my generation of doctors grew to know about and recognised with its distinct histological appearance on staining.

The problem is this drug, which is defined as an amyloid-beta-directed antibody reducing the number of plaques of amyloid, is that the benefits are minimal against its downside.

This is where the drug company, Biogen, which is set to make a “motza”, begins what I call the drug company gavotte. Immaculately arrayed in elaborate steps the gavotte dancers move around in intricate steps, a spectacle of elegant circles, arms waving, legs crossing, all to produce a mannered tableau.

Even the drug company’s paid expert, in a beautifully executed twirl, said the drug “potentially prolongs patients’ independence by several months, even a few years, as demonstrated in long-term study”. She said it is a “stepping stone for our next advances” gracefully executing a series of fluttering steps.

The consumer is transported into a trance, ignoring any side-effects, asking the government to make it universally available. Biogen proposes a charge of USD4,312 per infusion “for a patient of average weight”, or USD56,000 per year.

The Institute for Clinical and Economic Review, in a somewhat bizarre statement, has said Aduhelm should cost no more than USD8,300 per year, given the “insufficient” evidence supporting its benefits in clinical trials.

Dancing the gavotte …

Biogen has defended its pricing strategy, noting that the U.S. dishes out about USD600 billion in direct and indirect costs for the disease that affects roughly six million Americans. Now that is a beautiful sideways gavotte movement by the drug company.

Biogen plans to target between one to two million patients with early onset symptoms, executives said last week. The company, generous to a fault, says it won’t raise the price over the next four years.

It should be noted that this drug can only be given as an infusion in a healthcare facility; and then there are the side effects of brain swelling and bleeding, all factors to be integrated into the patient’s health status, a patient status which is directed only one way – down.

When the gavotte is transferred to Australia, it will be greeted by a solid history of successful lobbying for drugs of questionable benefits. First, there is the special pleading, which is always highly personal as one would expect. Ron Walker, the flamboyant businessman, was an influential example of this in his quest to have an experimental drug, Keytruda included for the treatment of melanoma, of which he was a sufferer. His influence on the then Minister saw the placement of this drug on the Pharmaceutical Benefits Scheme (PBS) for his particular indication at a per patient cost of $4,500 every three weeks for two years.

He achieved his goal; he died in 2018 with the benefit of an average life expectancy increase of 12 months over the cheaper chemotherapy. Not sure about the quality of that life extension. Nevertheless, the drug can now be prescribed to other cancer patients following the largesse of the current Minister, who provides a taxpayer subsidy of $120,000 annually per patient so entitled. Has Ron Walker’s intervention been cost-effective – or just costly?

The drug companies and their shareholders have a different requirement – profit at all costs. Lobbyists hang round drug companies like flies round questionable food, as one of my less than kind associates has said, ever ready to help with selling the product whatever its effectiveness; whatever its cost to the community.

Objectivity is the casualty. Hopefully, the Aduhelm saga will not get to his level, but sometimes I wonder whether governments have lost their sense of smell.

However, the cry from the wife still echoes. Yet will her husband, the author of On Pluto: Inside the Mind of Alzheimer’s, take Aduhelm?

My mind drifts back to Neale Daniher, and the need to ensure that while we wait for a cure the palliative services are not ignored, nor the family, and most importantly, that even the person with lowest profile dies with someone holding his or her hand.

Mouse Whisper

In recognition of my friend from Dalarna, Kyrkomus, I am reminded of Carl Linnaeus, the great Swedish botanist, who sometimes got it wrong. He said that potatoes were poisonous, because he noted that the vegetable was related to deadly nightshade. However, the first woman inducted in 1748 into the Swedish Academy in Sciences, Countess Eva Ekeblad, was so recognised by showing that potatoes were essential in the manufacture of wig powder, and more importantly that cool liquor, aquavit.

Skol!

Countess Eva Ekeblad

Modest Expectations – A Range of Lemon

In 2011, shortly before he became governor of the European Central Bank, Mario Draghi warned fellow Italians that Venice in the 17th century and Amsterdam in the 18th century planted the seeds of their collapse by putting elite privilege ahead of innovation. Corporate Italy can hang on to what is left of its sheen.

To which I would also ask, do you smell the gum leaves of Canberra in that quote?

Draghi then goes on with a quote from “The Leopard”, where Prince Trancedi Falconeri says to his uncle Dom Fabrizio, “If you want things to stay as they are, things will have to change.”

This is the last paragraph from an article published in the October 24th 2020 issue of The Economist about corporate decline in Italy. The article starts with an acknowledgement of that novel by saying, “Few works of literature capture the challenges of managing [societal] decay.

If you read very slowly you might be able to detect that we too have a leopard who has learnt to change his spots at the next leap of leopards passing through the spin of his mind. 

Waiting for Bliss

Last week I came across the word “bliss” – a word little used in these pandemic times, but once linked very firmly with “ignorance”. It is an old English word, and I would ask the readers, when could you genuinely say you had experienced a state of bliss?

What is a state of bliss? The definition varies from person to person. It is not wandering round in a trance; and it is not squatting on the floor and being told to meditate. It is not a set of rosary beads nor a set of bells – some may relate bliss to one or more of the senses – sitting in front of a log fire toasting marshmallows having come in from the icy cold and relaxing in a deep armchair drinking a suitably warmed glass of wine while listening to a the Tallis Singers’ recording of the Allegri’s Miserere. To me that is a suitable caricature of the meaning of bliss. This scenario can be explained in a conscious appeal to all the senses – extreme sensuality on a forgiving cliff face.

For me, bliss has always been unexpected. I was racking my brains trying to overcome the mist of ignorance to work through how many times in my life I have experienced bliss. Twice. Both were unexpected, and one instance came after a night in the Royal Women’s hospital student quarters in Melbourne back in the summer of 1962, and the other in 2002 all’aperto in Vancouver.

In one case I had experienced; and in the other I was waiting – in expectation. In both cases there was a woman involved – one in the past tense, the other in the future.

The summer of 1962 was the year when I just become engaged and where I used to sleep illicitly in the Hospital where my fiancé was doing her obstetrics term as a student. I used to leave the hospital a tick before six am and went over the road to a friend’s flat where he had a spare bed that I could “crash” on before going off for my job. For some reason, my friend was away. He had just finished an architecture degree and maybe it was a job out of town; I don’t remember but I would occasionally run into his cheerful flatmate over Vegemite toast and cup of tea.

This particular morning the sun was streaming into the room in his rented terrace,  a comfortable bed and the record player with George Shearing playing “Folks who live on the Hill”. The album with a young woman with her black dress spread around her, demure smile, looking upwards. Drifting into sleep with this environment, this was bliss, a sense that it could never get better – the recent times provided that core requirement of optimism – the security of such optimism in the past, present and future tense which leads into that bliss, which you want to last forever.

Vancouver

The second time, I was in Vancouver sitting outside, the weather was mild and I could gaze up at the mountains hidden partially by a scarf of sea mist. I was waiting for her to arrive, and the expectation of her arrival gave me that same sense of bliss. I did not sleep or even doze off, but had a very good Coho salmon. The wine was Washington State. That I remember, and unlike my normal approach, I ate very slowly and sipped rather than gulped. The mild temperature, open air, the food, the solitude among a late afternoon drinking mob provided the setting, but overall the expectation of seeing her that sealed the bliss. She was arriving later in evening from the other side of Canada.

Both were in good times, but this very juxtaposition of these two occurrences only has meaning when I paste them with those other vignettes which constitute life, so many of which do not have the same muted delicate colours which bliss has. Bliss is thus rare – at least for myself. I hope that in my last view of human experience I will be able to be full of bliss listening to Shearing playing Kern and Hammerstein, and with that expectation of seeing Her. 

Another time; another Trek

A pool of lotuses

A few weeks ago, my blog charted our eventful course to China in the summer of 1973. The weather was foul in Beijing. There were floods and we were unable to go to the Great Wall as a result, but it was interesting times to be there, given the turbulent period China was going through at the time.  I intend reviewing notes of the visit which are in one of my numerous archive boxes. As with our difficult journey to get there, leaving Beijing was no pool of lotuses either.

Our leaving Beijing when we did, produced one of the great regrets of my life. Unlike Gough, we did not meet Mao Tse Tung, but even though the Gang of Four were then in the ascendency and he was not, Chou en-lai was still a significant figure. The then Maltese Ambassador to China and also the High Commissioner in Australia – he was a shadowy figure but he kept popping up elsewhere – said that if we stayed another day he could arrange for us to see the great man. On reflection, there may have been a discussion with Stephen Fitzgerald, the Australian Ambassador, but my lasting impression was that it was a done deal but for one thing – we were on a tight schedule and on that schedule was a meeting with the Japanese Prime Minister Tanaka. In the scheme of things at the time, the meeting with Chou En-lai could not be fitted in. As I say, I still harbour that regret, to have missed meeting with one of the greatest men of the 20th century.

There was no direct flight from Beijing to Tokyo in 1973. The route would take us in a Chinese Ilyushin, as it turned out to be, to Guangzhou and then by train to Hong Kong, where we would fly to Tokyo. That was the plan, but this trip was one of the unexpected. The fellow travellers included the Chinese women’s volleyball team. That was unexpected; to see all these 1.8 metres tall Chinese women strolling down the aisle of the plane. As I reflected, I had lived in a world of stereotypes, and these young Chinese women were not that.

Then the fun and games started. We were forced to land at the then Henchow, and we were emptied out of the planes. Initially here was no information, and efforts to find out, even trying to contact the Australian Embassy in Beijing were unfruitful. So, all we had to do was wait. The flight crew parked themselves under the wing of the plane to get out of the sun.

The airport was on the outskirts of a village, which makes me think that although they gave us a name, it was not a major hub where we landed. The facilities were rudimentary and after a fruitless endeavour to get through to Beijing, I went for a stroll down to the village. After all, there seemed to be no security, and I had reached its outskirts, when I looked back and there was a soldier carrying a rifle running down the hill. It was clear from his gesturing that I was out of bounds. Although, he was smiling and his demeanour was surprisingly sympathetic to my venture, there were rules; and he escorted me back.

Otherwise, Geoff produced a football from somewhere, so the three of us entertained the few airport staff, the volleyball team who were standing at a distance from us on the tarmac and the aircrew under the wing. There seemed to be a cone of isolation around us.  Nobody ventured near us. Not surprising when we could not speak Mandarin, and there was no Chinese minder travelling with us.

When the ball rolled over to them, it was treated as if it were a bomb. Nevertheless, these three Australians cavorting around in the sun with a strange looking ball had an audience. Geoff had been a champion schoolboy footballer, and Bill Snedden had played competitive football, as I had. Mine had been curtailed not only because of lack of skill but by my need for glasses, and the fact that contact lens technology was very primitive during my playing years. In a tussle to get the ball, Geoff showed the benefit of wide hips when he easily brushed me aside in competing for the ball. Playing on a hot airstrip losing one’s balance on such a surface reminded of the times I used to play sock football in the school’s brick quadrangle. The hands suffered as they hit the bricks.

Eventually three hot, mildly sunburnt blokes were motioned to join the plane. In retrospect, the Leader of Her Majesty’s Opposition, lost in Central China playing kick to kick on a distant tarmac, was a mildly amusing incident but today, a major political figure uncontactable in the wilds of China…well…

As we found later when we arrived in Guangzhou, the delay was due to a storm described as “monsoonal” passing through the city at that time. The air navigation instrumentation then was not equipped to enable any plane to land safely during such a storm.

Being completely “stuffed’, I have very little recollection of the city, except we were parked in a fine old hotel and the climate was subtropical. I remember the chintz curtains, looking out over lush tropical growth – the normal collection of monstera deliciosa and other undergrowth to which I could not put a name.

The next morning we were on the train to Hong Kong, and there were rice fields all along the rail line and the ubiquitous lychee trees in the middle of the fields.

Then we were across the border into Hong Kong, where we met up with Snedden’s wife, Joy, and had a relaxing time there.

I was left with the task of booking the flight to Tokyo. There were three alternatives BOAC, Alitalia and Air India. Given that forelock touching was the order of the day and there were people watching for aberrant republican behaviour, I chose BOAC. When guess what? Alitalia departed on time; BOAC was indefinitely delayed and Air India was about to leave. It was already taxiing out to take off when it was told to come back and pick up four Australians – travelling first class. Well, the revenue boost would have doubled that of the paying customers; there were only about ten others in economy, and it was the time before business class.  Also, it was a time when a country to have its own national airline was all important. Prestige before profit in those days.

We were not late for the meeting with Prime Minister Tanaka.

Backroad out of Ceduna … Where next?

Given my love of Strahan, for many years we have owned a blackwood pole house there; if it were not for the trees we would have a view of Macquarie Harbour. We once had such a view but that has now vanished in an entanglement of blackberry and tea trees. Strangely this tangle disappears down the Esplanade where there is an uninterrupted water view from the ex-mayor’s house.

I have only watched the Backroads show once, when it visited the small Victorian town of Beaufort, so much part of my family life. I thought the program strange, focussing on quirky periphery. This must make good television because the ratings are said to be high and the program receives substantial support from the ABC. It plays to a belief system of the viewers, it doesn’t shock and it gave a view of Beaufort uncluttered by any relevance. Nevertheless, those pictured obviously loved their half-hour of exposure.

At the same time a substantial film, television and book stream about the Australian bush country provides a different picture – a dark foreboding scene, deeply crime-ridden country towns, where there is always some secret which the townsfolk know but won’t tell and where a serial killer stalks the unsuspecting city-slicker. This is a country, the background to horror stories, of empty houses, banging doors, and where you only see the feet and the flashing knife.

I have had the benefit of seeing much of Australia and, looking through the schedule of past episodes of Backroads, I’ve been to most of the towns featured, not just as a tourist but to work, and that has included spending time in Aboriginal communities. Hence, for instance when I watched that extraordinary portrayal of the Aboriginal relationship in the film Samson and Delilah, it was reality, slightly “doctored” but essentially reality – it rang true, not from what I had read or had been told, but what I have seen.

 

Strahan

One of the challenges of being from “aways” is that it is important to blend in while realising that you are a “blow-in” and like all “blow-ins” you know it, they know it and, unlike the Backroads crew, when they pack away the camera, you from “aways” still have to live with the long time residents, and not be there just when the Macquarie Harbour is sparkling and the ocean is calm. The plaques around the foreshore remind of those alive how dangerous the seas are, but that was the risk of earning a living out in the Ocean.

The cinematography of Macquarie Harbour, the Southern Ocean and the accompanying rugged temperate rain forest with encircling mountains is brilliant. North barely seen are the two mountains, Heemskerk and Zeehan, the first 721 metes high, the second 684 metres. Both were seen by Abel Tasman when he sailed these two ships past the mountains in 1642. The mountains bear the names of those two ships; named by Bass and Flinders 1802 while circumnavigating Tasmania.

The Backroads episode provides this glorious perspective of the Wilderness, the Harbour, the Rivers and the Ocean. I agree, fantastic.  I have flown with a mate in his twin-engined Cessna on such a day – from Strahan over the Gordon and Franklin Rivers to the Southeast Cape and then back over the Walls of Jerusalem. Let me say there are not many days which provide the perfect uninterrupted vista without being buffeted around the sky by the powerful winds, because these are the “Roaring Forties” where the storms roll in with the greatest intensity.

“Backroads” has essentially a tourist view of Macquarie Harbour, two of the major rivers the Gordon and the Franklin, and the Southern Ocean. The King River, flowing as it does from Queenstown, being cleansed from metal pollution gets very little mention – maybe 12 years ago when the powerboat was taking people on adrenalin leaching trips up the river, it may have got a mention. But then the seaplane has gone too and the train which runs on the Abt railway gets not a mention, presumably because the engines were being overhauled. Yet that railway among others is essential to the Strahan narrative, otherwise if it were running why ignore the original lifeline after the convict settlement had gone.

Heather Ewart, the presenter, is pictured on the steel ketch “Stormbreaker”, drifting down the Gordon river; Heather Ewart on Sarah Island, a ruined convict settlement full of gore where the tourists are dropped off for a quick exposure to the horror that was; Heather Ewart as a walk-on participant in “The Ship that Was”, a long running sketch about adventurous escaped convicts, staged in a theatre setup on the wharf.

She is there interviewing a couple of young Aboriginal women from “aways” picking up shells on the beach. Mate, there are middens on the West Coast but not there where the full fury of the Ocean storms would have washed them away eons ago. Eventually, the show ends up in the woodworks, but not before we see Bob Brown, the Saviour of the West Coast wilderness and the film clips from that campaign so many years ago; the whales more recently stranded on the Ocean beach, and then for a piece of trivia, a waterskiing event to break some concocted world record for the most water skiers at any one time.  May I say I have never seen waterskiing on the Harbour as a regular activity. It is just too rough.

Picture postcard maybe; emphasis on the Wilderness, the magnificent scenery but except for a short reference to huon piners, not much about Strahan. Strahan does not exist because it is perched on a large, picturesque harbour. It was a port for the mines of Queenstown, on the other side of the West Coast Range – an isolated settlement set in the most beautiful part of Australia. People did not go there to admire the beauty; they went there to work. And the question is why – and why have they stayed?

While the background may be beautiful, the living conditions are harsh – but not the day that Heather Ewart blew in with her entourage. The opportunity missed of how a town has reconciled itself to the need to conserve when the genesis of the township was to exploit Australia. Isn’t that more the dilemma of modern Australia rather than the extent of the line of water skiers on the Harbour?

A hardy, resourceful community which has adapted – that has been my privilege of being a person from “aways” to know Strahan – to experience more than one sunset.

Somebody told me the week before Backroads was about the towns of the Dunmunkle Shire in the Wimmera. Now that is a place I know very well, particularly Minyip. Maybe I will look at what they have done with those townships.

St John’s Lutheran Church, Minyip

Special Pleading?

Let me give this person privacy. However, I have heard of a woman who was in remission from her disease of polymyalgia rheumatica and, having submitted to the AstraZeneca vaccine, promptly got an exacerbation of the disease, which has persisted.

The problem with polymyalgia rheumatica, nobody knows what causes it, whether it is a vasculitis or myopathy. What is known is that it occurs in older age groups and is associated with osteoarthritis and, in a number of cases, with another autoimmune condition, called temporal arteritis – a condition of the artery supplying the temple region. If not treated temporal arteritis can lead to blindness. This is patently a disease of a blood vessel.

Polymyalgia generally resolves by two years after diagnosis, which is complicated by the stealthy onset of the disease. Therefore, the onset is difficult to pinpoint. However, with me it burst out into a florid state of muscle pain, extreme weakness and stiffness of joints. In its untreated state one has the premonition of death, holding onto the basin in the bathroom and seeing the world disappearing from view – but trying not to let go. That is what occurred to me. After seven years the disease is chronic – I shall die with or because of the disease. The more the disease is stimulated by outside influences, the more it will shorten my life.

Treatment is cortisone, and it is in this titration of the amount of cortisone that provides symptomatic relief.  Methotrexate did nothing. Without cortisone, it is simple. I would be dead by now.

In the initial fulminant state, there is in addition to the indicators of infection, an indication that platelet function has been disturbed. In this particular case there was a marked thrombocytosis. Platelet problems are at the heart of the AstraZeneca side effects.

Being on cortisone therapy for over seven years means that adrenal function becomes compromised, well demonstrated when the replacement cortisone  was at point where it could be expected for the home grown cortisone to kick in if there was stress.  My adrenals did not kick in, and I experienced symptoms of hypoadrenalism.

Therefore, living on the edge should not be challenged by a vaccine which has its own problems, even if they are downplayed. Yes, I have had my influenza inoculation for 2021; yes I had my shingles inoculation several years ago. None provide 100 per cent protection; and indeed I have a mild reaction to the influenza inoculation; no pain at the site but a slight feeling of unwellness with upper respiratory symptomatology for several days. Symptomatically, my polymyalgia has got worse.

But then I am a doctor once a medical researcher and public health physician. The soothing words saying “do not worry” are not here crashing on a shore devoid of information. The case can be argued that it would be better to avoid the risk. However, in a country where choice is limited to who you know, well why not ask that I be given the Pfizer vaccine by my public health physician peers.

However, if my request is refused, maybe I will have to consign myself to the line of AstraZeneca injectees, with all the hollow assurances, but knowing that I am especially vulnerable to admittedly rare significant side effects.

If this insistence on AstraZeneca occurs, then I will post a daily message on social media telling everybody 24 hour by 24 hour how well I am going – and for Government “come in spinner.”

The coins are about to be tossed. The chances are of (a) no complications; (b) side-effects with the ultimate government prize of my death; or (c) putting the kip down and allowing me to have the Pfizer vaccine and of course my daily diary of how that vaccine is treating me.

Then of course I could not have the vaccine and die of that wonderful phrase “natural causes”; better than “misadventure”.

Mouse Whisper

I am entering into the world of invention. This invention threatens to take over the world, so they say. It is an American invention. It is a new type of pasta that is sweeping the trattorie of New York. There are 300 different types of pasta and yet for this new one, people have to wait for 12 weeks to get a packet of the new pasta, and then it costs USD18.00 plus postage. It is called “cascatelli” in reference to the Italian word for waterfall.

To me, the ravenous mouse, the pasta resembles a caterpillar, but this pasta is said to be able to capture ragu or vongole jetsam which may be drifting by in the sauce, flooding the pasta dish. This is the secret, opening up the tube and having pincer pasta pseudopodia able to clutch and not to let go of the tidbit onto your shirt (or in my case my mousling bib) but finding the safety of your mouth.

In Australia you can buy similar pasta, where the tube is closed, called creste di gallo – “coxscomb”. This pasta sells for about AUD$5.00.

As The Washington Post reports:

But it is the technology of opening the tube and having the right template that has the culinary world agog.

There’s no wrong sauce for this pasta. Every kind clings like Velcro.

It’s like a Venus fly trap. Anything that goes in there can’t get out.”

The pasta’s marketing materials refer to that grippy-ness as “sauceability.” Alongside “forkability” and “toothsinkability,” these goofy, made-up terms form the inventor, Dan Pashman’s trifecta of ideal pasta characteristics.

Ugh, that is sufficient mangling of the English language – bit like pasta.

 

Modest Expectations – The Size of the Universe

Is Australia an ochlocracy?

The Ancient Greek historian, Polybius drew on the traditional theory of the three constitutions: monarchy, aristocracy and democracy, which may decay into their perverted versions becoming respectively, despotism, oligarchy and “rule of violence”.

Okhlos

Okhlos is Greek for “mob”. Its potential was seen briefly in the storming of the US Capitol on January 6. It goes to show how rattled the Prime Minister continues to be when he invoked the spectre of mob rule such as that; and substitutes an irritating mantra of “the rule of law” (or does he mean lore and he has not bothered to read the evidence – but then he admits he never reads anything any time).

Morrison’s retreat behind a line of feeble excuses, backed invariably by people of privilege in the end is unsustainable. One transformation occurring in Australian culture which has probably been an important undercurrent in this societal change has been the appearance of the articulate young women who have had enough of the brutal misogyny, which hides behind the veil of Australian “mateship”.

This rise in the women voicing their experience of the underbelly of Australian social life is far from mob rule; it shows the best aspects of democracy, thriving on freedom of speech and the actions of a new leadership led by at least three young women – and presumably more of them to come.

Yet another Liberal Woman?

I watched Kate Jenkins’ underwhelming performance last Sunday morning on television. She is the Federal Sex Discrimination Commissioner, having jumped ship in 2016 from her role as the Victorian counterpart which she held for less than three years. Her successor in Victoria, Kristen Hilton, is about to finish a five years’ stint and is a female lawyer who came to the position from Legal Aid and community advocacy. Jenkins was from a different legal background and was a controversial appointment by the then Victorian Attorney-General, who happened then to be Liberal. She was appointed despite the selection committee unanimously recommending someone else, and indeed a number of the selection panel resigned in protest. After all, Jenkins had form, having worked for 20 years for Freehills, which was a law firm aligned to the employers in work disputes.

There was a change of Government in Victoria late in 2014, and despite her saying that the manner of appointment had been smoothed over, nevertheless when the opportunity arose to move back to a similar position under a Liberal government it is not surprising that she did.

It is somewhat of a dejà vu situation when, as Kate Jenkins was reported saying in 2018 after some Liberal Party MPs raised concerns about bullying inside the party, she suggested the community response would prompt conservative politicians to push for change. Her comments came at the same time one West Australian Liberal Senator, Linda Reynolds said it was time for Liberal MPs to stop talking about themselves and allow the party to deal with the bullying issue internally – the rule of lore methinks.

Now Kate Jenkins has been entrusted to look at the dysfunctionality of the Parliament House workplace, encouraging people to tell all but with no authority to name names. Initially, the Prime Minister had assigned one of his female colleagues, but after all what do you have a sex discrimination commissioner for? It seemed somewhat of an afterthought, but in the blokey culture in which the Prime Minister finds himself comfortable, it is unsurprising. After all, in this culture Kate Jenkins has to examine, the Office of Women has barely been heard. She has to report by November.

However, one suggestion that the office appointment be made by some independent body is ludicrous. Most ministerial offices have departmental liaison officers in any event. In many workplaces, one needs a police check. The problem lies in the fact that there are just too many parliamentary staff, the employing Minister needs to be confident of their loyalty and their moral compass. Cut back on staff numbers and get rid of the condottiere culture – 95 per cent of the time hanging out and five per cent ultimate brutality in the case of the Mafia. Applying that to the parliamentary office is boredom, gossiping and bullying – in varying degrees. Occasionally, they may contribute a snippet of relevance to portfolio deliberations.

As for the percentage of sexual harassment and assault admixed, that is surely the major task for Kate Jenkins. In her favour is that she seems to have been involved in sport, in particular the Carlton Football club. That probably has given her an insight into the blokey culture which, fuelled by alcohol and drugs, can become a very unpleasant scene.

However, the most obvious recommendations are that all cases of sexual harassment and assault they be immediately referred to the police and that Parliament House have a 24-hour counselling service on hand for the victim. The first harasser charged should be refused bail and have the case held over for a few months. This would be somewhat of a deterrent, as well as the name being on the public record instead of appearing nowhere but everywhere on social media – a case of “porterisation”.

Insurrection

When I was a medical student, there was only one medical school in Victoria. It was a traditional medical course, which had its roots in the Great Britain “honorary” system and Nightingale wards.

There was a vision of medical students in the mould of the 1950s series of “Doctor in the House” books, which were popular and vaguely true of a vanishing world.

We “fresher” students had a term of botany to start us in the world of human biochemistry, physiology and anatomy and then moving on to years in clinical medicine where we were introduced to our human pathology. However, that pathology included an introduction to the world of the medical hierarchy, enmeshed in a different pathology. It was a world of innate privilege. For instance, from my boys only private school about ten per cent of the students in my first year were old boys from my school; and most of those had been with me at school the previous year.  Therefore, there was an easy familiarity when we all gathered for our first term. None of the guys then from my school were more than acquaintances, as the friends that I had at school tended to be on the “arty fringe”, not on the treadmill of a year 12 two maths, physics and chemistry.

Despite having a headmaster enlightened for his time, having a factory to ensure a stream of first class honours and the academic superiority of the school, in the end, the school encouraged privilege and misogyny. After all, it was still a school where the boarders were banned from playing hockey, because it was a sport played by girls. Then there was the cruelty, both physical and mental. Until just before I entered the senior school, the prefects were allowed to cane, which some have reported did it with relish.

The masters – note male – were allowed to cane. I remember one time when I was framed as the instigator of a class riot and was caned in front of the class with a large wooden compass. This old boy had played tennis at championship level and his backhand was still a powerful weapon. Oh, such a wondrous time. And there we all were on the threshold of a career of caring and compassion.

There were few women then doing medicine, about 25 per cent at that time. One of them was a feisty blonde who as child had migrated with her parents and elder sister to Australia from Central Europe after the war. She attracted attention because she was always impeccably dressed, even down to her use of Mitsouko as a trademark, very good looking with a strong sense of morality, and willingness to engage men as equals.  This frank engagement was often misinterpreted. Because she was a fraction over 160cm, there was tendency by some to see her as a doll, unable to resist the fragrance of the male pheromones. Nothing was further from the truth. One professor, who had the reputation as a Lothario tried it on, got nowhere very quickly and punished her with a supplementary examination in his subject, which she ultimately passed. The professor wisely absented himself from this further examination.

There was the instance in one of those crowded raucous medical student parties, when a drunken male lifted her up and tried to sling her over his shoulder. Others intervened and he dropped her. In a flash she had flattened him with a fist which travelled from below knee level and he, helped by an inebriated lurch forward, copped the full intensity of the blow. She never gave any quarter; a remarkable woman (in the 1960s she was a pioneer in and passionate advocate also of early childhood education) who followed up with a successful career until she suddenly decided that she had had enough of a male-dominated world and retired. It was a pity.

The white shoe brigade

In our fifth year we had to undertake 10 weeks in the Women’s Hospital where during that period were to do twenty deliveries on our own, including two instrumental deliveries. That was one roster; the other was the episiotomy roster, where we had to go and sew up the incision made in the perineum when extracting the baby to avoid a tear. In those days it was a regular occurrence and we medical students had to do the suturing repair. It was an introduction to being on-call at night.

We were not to leave the premises without permission over the ten weeks and to compound this imprisonment, we had to wear all white – all white short coats, white shirt, white tie, white pullover, white trousers or skirt, white socks, white shoes. The one luxury we afforded ourselves when we were far enough down each list not to be immediately bothered being called was to go over the road to the Martini Bar at about eleven o’clock, have a veal parmigiana and watch a TV Western called The Rebel-Johnny Yuma.

The Professor of Obstetrics and Gynaecology was an owlish misogynist who had crawled up the pole of success by judicious naval service, membership of the Masons, a fortuitous lack of interest in the professorial post when he applied, allowing him to slide into academia without much, if any academic qualification. Then there he was, a graduate who had needed supplementary examinations to pass and was forced to undertake his first post graduate year at Tennant Creek, on the brink of a stellar career. He had a ruthless streak which, coupled with a few shrewd appointments, provided him with an aura of success. However, his most memorable utterances related to a distressed pregnant woman who came to him threatening suicide. His response – as recounted by him to us fifth year medical students – was that he showed her the window of his office and invited her to jump. The fact that she did not just proved triumphantly his insight into women. To our shame we just absorbed what he said and did nothing.

However the atmosphere, because of the activities of his lieutenants called “First assistants”, became so repressive with them singling out a Malayan Chinese student for special punishment. That was the trigger point. We students declared that enough was enough and petitioned the Professor in a written document signed by all but one of the cohort. We thought it an impressive display of solidarity, and the First Assistants were clearly rattled. Nothing happened immediately and then we felt the full force of the Professor; he isolated those he thought were the leaders and suddenly the rebellion melted away. After all, this guy could have a serious effect on careers. He enforced the punishment, “gating” the whole student cohort. This was eased as it gave the First assistants a “humane role” in releasing us from our imprisonment.

In the end a few of us, but particularly myself as I was by then Chair of The Medical Students Society, had a rough time, even though it was almost 18 months later before we faced the examiners. That is another story, but I evaded the trap – and passed, admittedly near the bottom of the year.

As to the fate of the petition, it was never seen again, except there was a second copy – signed similarly by the same set of students. I have it in my possession as an example of what he probably thought was an attempt at mob rule, but a useful document that can be added to his “in memoriam”.

After all, he was not the only disgraceful example of this disrespect for women. It was rife among obstetricians back then, but now change has occurred, especially with more female role models in the field with exemplary professional behaviour.

Then, as students, we accepted the mores, such as lining up to do an internal examination on a woman who had supposedly consented to the invasion. Some of those in my cohort, who signed the petition, became well-respected obstetricians and gynaecologists.

As for the Professor, he was knighted and acquired a trail of honorary academic degrees from all over the world, had a building named after him at one of the teaching hospitals in Melbourne and died as a revered misogynist in 1983.

IVF – Great Expectations?

The role of IVF as a ‘cure’ for infertility was crucial to the discursive construct of law as a barrier. ‘If medical advancements can help these people, it is not the role of Parliament to prevent it. Science was posited as a progressive force, aligned with nature, or perhaps with natural progress, which parliament should not impede. Paradoxically, then, law becomes both the problem and the solution as it ushers in a new era of reform.

In April 1988, my team reported to the then Commonwealth Department of Community Services and Health on the status of in vitro fertilisation (IVF). The Department prepared a summary report because some of the data we collected was confidential. The Departmental summary made the comment that the good data collected by my team “cannot be matched with good output data collected by the National Perinatal Statistics Unit (NPSU). (I use the term IVF, although ART, assisted reproductive technology, of which IVF is one, may now be more commonly used.)

To put our consultancy into perspective, the first in Australia and when 2503 pregnancies had occurred with 1851 live born infants. That was the raw statistic, and we looked at data from 1986 onwards from 15 units across Australia.

It was a time when the tabloids would pounce on any multiple pregnancy as though non-viable octuplets were in some way a blessing from God, a scenario which some members of the Roman Catholic Church applauded. It was just an instance of appalling practices, loading the woman up with fertilised eggs, on the grounds it was more likely one would be implanted.

I entered this review in a very positive frame of mind, because I knew Professor Carl Wood, who was part of the vanguard in the introduction of IVF.

The one invariable feature when we arrived at any of the units was the pictures of beaming bonny babies, so even from the early days the public relation teams were in the picture, so to speak.

Then our team confronted reality. The processes involved in IVF mean that the woman goes through a harrowing experience to conceive. Then there was the waiting period to know that the process was successful. There was some difficulty initially in finding the actual success rate. The success rate was a live baby in the basket – and multiple pregnancies counted as one. Full stop.

It was a problem in the early days and in one State where there was an “IVF cowboy” at the helm, because of his propensity to place multiple eggs into the uterus for implantation.  Of the 55 live births following IVF, 27 per cent were multiple births compared to 0.01 per cent of the total. There were 15 multiple births due to IVF of a total of 264 multiple pregnancies. Five sets were triplets born from IVF pregnancies during the time when there were only a total of 15 sets of triplets born across Australia.

The problem in assessing the “live baby in basket” against the number of IVF cycles was not made easy, because those who ran the IVF clinics were not the same team as those who delivered the women. There was thus no uniform data collection. This presented a difficulty since there were a number who might have been assessed as pregnant but who actually had a chemical pregnancy that did not progress.  This was another practice uncovered at the time – to count a rise in the hormone bHCG as a “successful IVF treatment” – a fancy bit of data manipulation since many never got beyond this stage.  In the absence of any reliable data collection, it was left to us to make the best estimate.

We noted that even at that time of our review four women had already undergone 13 treatment cycles without becoming pregnant. Considering the stress that one IVF cycle entailed, failure was a nightmarish experience – and 13 times! Added to this was a cohort of infertile men whose failure to acknowledge their own infertility created other problems. With the intracytoplasmic injection of one spermocyte into one oocyte, it always seemed to me the height of arrogance that a scientist could pick the right sperm for the right oocyte – a form of cellular eugenics. Yet in one way what could one expect. IVF was the product of veterinary medicine.

I came out of the experience of our consultancy rather differently from the person who was commissioned to undertake this review. Our reports received a mixed reception. For the most part of the succeeding 33 years, I have written nothing. Nevertheless, I have been disturbed by commercialisation of the expectations of women increasingly delaying their families – for many reasons. There is an increasing number of women in their forties seeking IVF treatment when they have certainly reached the fertility savannah if not the desert.

I was prompted to write by the following comment:

Going through IVF is the worst thing that has ever happened to me physically and emotionally. The financial costs made the whole thing far more stressful and limited how many attempts we could have. I know of people who have sold their houses and given up everything to pay for cycle after cycle to have the child they always dreamed of. What’s so infuriating, though, is that it absolutely does not have to be this expensive. This is what happens when medical care is run for private profit instead of public good.

At the time we undertook the review it was well before IVF became a hedge fund commodity like so much of health care now. One of the major reasons for the 1988 review was to understand the costs, and the report was inter alia a masterpiece in cost accounting (because of the involvement of Dr Robert Wilson).

IVF is now big business. It would be a brave politician or Department to establish an independent review as ours was. It is very difficult to work out the real success rate; it is in the interest of the industry to conflate the success rate. But the more important issue is that this is an industry that is in a position to prey on those who are so willing to give up so much for “a baby in the basket”.

The problem I have is “what is truth?” I could not believe this nonsense written by one of IVF specialists. His thesis that increasing IVF could replace falling migration levels is backed by this following burble:

Arguments based on a sense that IVF is futile for women in their 40s also hold little water these days. Twenty years ago, when I first began training in IVF, pregnancies in older women were a rarity. Yet 2017 data from Australia show that, for women aged between 40 and 44 using their own eggs, the cumulative live birth rate is well over 10% for the first cycle of IVF treatment and runs to as high as 40% by their eighth cycle of treatment.

The eighth cycle of treatment, I ask you! The cumulative live birth rate is simply, “if I keep going, what are my chances of pregnancy if I have another cycle, or another two cycles, or another three …”. Dangling a 40% success rate in front of a desperate person who is prepared to sell the house …. those who are running IVF clinics are in a position of  power -the sort of power men use to manipulate women.

Has the misogyny which once burned bright among obstetricians and gynaecology not been extinguished? Anybody making statements as airily as that suggests that it has not. Statements as that above should be tested urgently by another independent review.

I remember one piece of data that stuck in my mind. It was an early study that compared women who had undergone at least one IVF cycle and then gone back to conventional ways of procreation as those who had persisted and delivered an IVF baby. It was about the same – nine per cent.

This is another statistic that would be worth reviewing now.

Any advances on that?

Mouse Whisper

Witnesses under cross examination, however mighty their stature outside the courtroom, very soon became meek and mild and well-behaved in his hands. If they did not—if they paltered with him, or evaded his questions, or did not do justice to their testimonial responsibilities— the smell and sight of cordite smoke soon drifted into the courtroom.

I have never read a more flower-encrusted definition of bullying – in this case a description of the late Tom Hughes’ court antics.

These words are by Dyson Heydon, in a book review of Tom Hughes’ biography, in turn authored by one of those guys my mousemeister knew at school.

Attorney General Porter or his successor should not palter over the Dyson Heydon sexual harassment report in the wake of the Chief Justice’s condemnation last year of him.  Porter received a separate Departmental report on 25 February; and to all intents and purposes it is unsurprising he has done nothing since.