Modest Expectations – Shakespeare in Love

Testudo

Our jolly duo and their retinue have been in Washington for the normal annual discussions on reintroducing the testudo as a secret weapon in the invasion of the Chinese consulate in Sydney and whether oars for the Australian quinqueremes are suitable for a long blockade of the Sino-Territorian harbour in Darwin. Their visit coincides with the national security adviser in the White House testing positive to COVID-19.

In a more serious vein, it seems a long way to go to give the Yanks a gentle slap.

The question remains as to whether a custom-made suite is being created in one of the defence establishments to test how comfortably these stalking horses can be accommodated for 14 full days after they return. Facilities so plush as to make even the Ministers blush?

By “stalking horses”, would the Commonwealth be setting up such a facility so that all the Ministers can assure us mug punters that they can freely travel overseas and say that “all measures will be taken to protect the Australian community” on their return from overseas where “fruitful and productive talks” were undertaken.

The basic cancer in this country is that the politicians and their mates are sealing themselves off from the rest of the country, so they retain all the healthy remuneration and the perks of office and beyond – irrespective of the party. A special quarantine facility would just serve to emphasise this separation. This whole situation is only going to be cured by some deep electoral cleaning, a very difficult task given the way the media’s saprophytic existence supports the status quo.

Nevertheless, it may be interesting to see if an obscure single line item appears in the coming Budget. 

Growing Old 

* Residential aged care or nursing home. I grew up with the nursing home nomenclature and feel comfortable in it describing what should be emphasis on the “nursing” rather than the “residential”.

It was a revealing article. On a day when the pandemic was raging through Victorian nursing homes*, a report appeared in the Property Section of the AFR (28 July), headed “Estia Health can’t quantify pandemic hit to earnings”. Says it all.

Estia Health is one of the largest residential aged care providers in Australia with 69 homes, 6,180 beds and more than 7,500 employees across Victoria, South Australia, New South Wales and Queensland. Its chair and board have nobody with any clinical health expertise. Gary Weiss, the Chair, Doctor of Juridical Science (JSD) from Cornell, is the very model of the modern business tycoon, “legendary corporate raider”, asset stripper, draining the demand side to maximise profit.

His responsibility portfolio also includes Ardent Leisure; so he is a very busy person. Yet he appears to have no expertise in the central issue – containing pandemic in nursing homes, given that two of the Estia homes have well over 100 COVID-19 sufferers. Doesn’t fit your business model, Dr Weiss? What are doing to improve the situation about the rest of your Empire?

For many years I was involved in the management a number of public nursing home facilities in rural Victoria as the both Director of Medical Services and also later as Director of Clinical Training. When I came into one of those positions the first thing was to undertake a review of the nursing home residents’ medications with the local pharmacist. It is one measure of a doctor’s involvement in nursing homes because one gets a sense of how often the residents receive medical attention by such a review.

There were always stories of medical practitioners, who did visit private nursing homes waving to the resident and then moving on and billing Medicare. The fact that such stories had currency was disturbing enough, but I certainly found in some areas a reluctance of doctors to visit nursing homes on a regular basis.

I was fortunate that the nursing homes I was involved in were attached to the hospital and worked under the rules of the particular health service. I was able to thus monitor and encourage the local doctors to see the residents regularly. May I also say that there are some general practitioners who are interested in geriatrics and they should be identified as future role models for their less involved colleagues. At that time there was a country health service that had completed the transition from being an acute care facility to one which concentrated on care of the elderly, and the nursing staff re-trained accordingly.

The problem was that this model needed a “champion”, but the doctor, who initiated this change was too self-effacing to promote his model widely. It was regrettably a lost opportunity.

These public nursing homes exist as a function of the health care system. It is ridiculous to maintain the fiction that they are a home in the conventional sense. Health care is superimposed on a residential environment. It should be noted that the public sector has 10 per cent of these nursing home “beds” in Victoria and yet only 0.6 per cent of the COVID-19 sufferers.

Private nursing homes and the local health care services are under different jurisdictions. There is thus a situation when a facility for the elderly, the most vulnerable people in the community, has no formal link to the local hospital. This has been the case before the advent of the Virus and the early responses to this situation showed so clearly this dysfunctional aspect of the health care system, even to the extent of a private nursing home initially refusing to cooperate.

Let us consider the “Before Virus” situation, when an individual resident needed urgent medical attention in a private nursing home, the immediate conventional response was to send them to hospital, often without informing the hospital in advance – or ever. If there is an agency aged care worker, or just a very understaffed nursing home at night, it is just a natural response for the patient to be sent off to hospital regardless.

On arrival by ambulance the resident waits, often in the ambulance, is admitted to the hospital or left in the emergency department and sent back to their “home” often without any communication between hospital and aged care facility. If admitted they are either discharged back to the home or to the mortuary.

So much for coordinated action! The lack of same has led to mutual resentment between nursing home and hospital.

However before the pandemic arose, establishing a Royal Commission to take the heat out of the sector seemed the best choice.

The Aged Care Quality and Safety Commission has been, as I said before during the Time of Newmarch, one of the most useless neo-government bodies I can remember. The Royal Commission seems to be an irrelevancy as it grinds on, with Lynelle Briggs and Tony Pagano only reporting in October; personally I have a high regard for Lynelle Briggs.

Significantly the Commonwealth now with a medically qualified Departmental Secretary, Brendan Murphy, with a broad knowledge and contacts with Victoria, his Department has been able to move relatively quickly to mobilise the hospital workforce, bolstered by AUSMAT, to fill in the deficient work force in the private nursing home sector. How different from the uncooperative, often confrontational scenario described above!

The Victorian government is developing a strategy on the run. The question remains of whether NSW should have recast their policy after Newmarch rather than having it been bogged down by one of those face-saving useless inquiries. On the other hand by early response using AUSMAT, the North-western Tasmanian infection of a number of nursing homes was nipped in the bud. That was a lesson Tasmania seems to have learnt. The essence is that the States assume responsibility for the private nursing home sector. What is happening in the other States in the wake of the above disasters – nothing? One only can presume that the private nursing home industry is fighting back, and of course seeking government support rather than asking their shareholders to assume extra financial responsibility.

The nursing homes are not generating the Virus; it is being brought in from outside. However, once it is in the nursing home, it has the sort of chaotic environment in which the Virus loves. Nursing homes thus will require extensive structural updating, and not the least in this time of the Virus, the most effective air conditioning. AUSMAT brings that order to curtail the Virus.

However, the staffing, the qualifications, the required skills, the discipline required are the critical element. I find it somewhat baffling that the AMA have called for a Royal Commission, while there ostensibly is one due to report before the end of 2020.

However, in this area where there is a lack of objective data because in reality government oversight is minimal; then the various politicians fall back on anecdote. In so doing, it only serves to emphasise the disparate quality of the private nursing home sector; one politician has a good experience and therefore it is only natural to generalise from this one case in the absence of systematic data; a second politician has a bad experience … It is another matter for the politician to use his experience to defend the whole sector.

Having had a long association with this sector, it has been clear to me that it is important the industry should be recognised as part of the health sector – and therefore management should be devolved to the States so the possibility of co-ordination can exist, particularly in times of emergency. For instance, it was almost nigh on impossible to get nursing homes accredited and staff credentialed – as occurs with hospitals, because private nursing homes exist under Commonwealth rules. Those with shoddy practices are always resistant to such oversight, and unfortunately my experience is that the Commonwealth effectively goes along with that.

The problem is the all the health services concentrate on the services for which they are directly funded; and any regional co-operation is personality dependent. If there is a lazy or incompetent manager, the system is such that it protects them, because conflicting anecdotes and personal prejudice tends to thwart the solution – competent management.

Public/private health services have tended not to work because the mix stumbles over the financial imperative. The question boils down to how much am I, or my family, willing to pay for me to be placed in a nursing home environment. For the family without contacts in the health sector, the lack of objective information is a major problem when families are faced with making a choice and thus fall back on affordability and public relation handout where every private nursing home is “an invitation to Paradise”.

The better the nursing the less the knee-jerk reflex to bundle the patient off to hospital when ill. The more a doctor visits the better the preventative measures. The presence of a competent specialist geriatrician, especially those with psycho-geriatric experience who has a regional role in not only reviewing the difficult resident but educating the local general practitioners and nursing staff, the better the care. The whole matter of medical training in geriatrics and its ongoing turf dispute with medical rehabilitation specialists is another issue, which needs resolution in the longer term. However, “turf issues” are not helpful.

The last thing that is needed when the AUSMAT bring order and control of the Virus and then leave, its immediate task completed; yet there appears to be no national plan follow up. You know the normal mantra, “we have to wait until the Royal Commission reports.”

I would accept what Murphy and his mob decide rather than wait for a Report encased in governmental aspic, even one with the redoubtable Ms Briggs.

By the way, it is unfortunate comparison of AUSMAT with the SAS, AUSMAT do not, to my knowledge, kill innocent bystanders.

To Dr Weiss and all of your fellow owners of nursing homes, nursing home care should be a different vehicle – one shorn of the primacy of the dollar, one where you realise irrespective of how wealthy you are, old age approaches.

If one of the outcomes of this pandemic is to improve overall standards, improve co-ordination with the nursing home sector, enhance mutual respect, have a regular interchange of data and engage in all the rules of good management that the text books provide, then Australia should be satisfied. I for one want to be assured that I will not die in a bed of soiled sheets, where nobody comes and death arrives as a massive relief.

Fr Don Edgar OGS

Don Edgar died last week. Don was a country boy; his parents ran the newsagency in Wangaratta at the time I entered his life. Don and I met in College. Don was a theology student and I a medical student. There was nothing memorable about our meeting, which is often the case when you run into somebody and although you may immediately have nothing in common, you have an instant mutual regard – and form a friendship.

One person we both admired was the College Chaplain, Barry Marshall.

The Reverend Dr Barry Marshall

Following Barry Marshall, Don had a lifelong association with the Oratory of the Good Shepherd, in which he was appointed Companion, which brought a set of obligations where “piety” had a real meaning.

Barry Marshall was a charismatic figure. He influenced Don immensely. Marshall grew up near Coolah, north of Dubbo. His father was a grazier. It was unsurprising that after a stint in the RAF during the war and then ordination he became a “bush brother” based in Bourke. It is a funny thing but if my friends and acquaintances were a typical cross-section of Australian professionals, then there must have been a rite of passage to pass through either Bourke or Broken Hill on their way to their future career.

Both Marshall and Edgar were committed Christians, and Trinity College at the time of Marshall’s chaplaincy had a balance of spiritual guidance and robust secular behaviour. Marshall had a twinkle in his eye and reminded me of Father Brown with his kindness, his ability to listen, to have an easy relationship with the “Jocks” and possessing disciplined firmness. There were boundaries that he would not cross, and Don inherited much of this sturdiness. It was a tragedy that Marshall prematurely died as the result of an accident in Oxford, when he still had much to fulfil.

Don’s religious discipline I suspect had its seeds in his early time from the age of 13 being a naval cadet, with an eventual career beckoning at the end of his teenage years. He was a model cadet, midshipman and at the time of his resignation to pursue his religious vocation, a sub-lieutenant. Many of his fellow naval officers were in College at the same time but studying electrical engineering. Generally, aspiring naval engineers were sent to the UK for graduate education. Electrical engineering was the exception because graduates could study under Charles Moorhouse, who was Professor at University of Melbourne and regarded internationally as the doyen of this discipline.

There was one memorable night after we had both graduated and he was a curate in a country parish near the Victorian border in the North-east in the lee of the snow-capped mountains. My then wife and I were invited to stay with him, but the weekend was one of filthy weather that only Victoria can produce, windy, sleety rain – and the drive north in a car, far from waterproof. The heater gave up early early in the trip.

It was miserable, but eventually we were able to find the vicarage. We were almost completely frozen. However when we entered, the transformation was miraculous. The building was small and hardly imposing, but inside the fire had turned the rooms into a welcoming environment; the claret was at room temperature, the soup was simple – and Don was an easy-going welcoming host.

We had arrived long after the time we hoped to get there, but the fact that Don had provided such a comfortable destination is a memory that has been indelibly imprinted ever since. Never then and since had I felt such a welcoming environment – there is an element of magic – or is that another word for a unique spiritual experience?

Such was the nature of this extraordinary man who spent many years emulating the Abbé Pierre dicta – as a worker priest in railways yards in France, where he always said he was cold-shouldered by his co-workers until they found out he was an Australian not a Pom. On his return to Australia he continued to work in the railway yards in Darwin, he got married, had four sons.

During this period he re-entered the mainstream to the extent that for a time he was the vicar in Tongala, a dairy community in northern Victoria. It was another wintry night in 1981 when I was on my way to see him and his family, when my car aquaplaned on the flooded road, and the car ended up against a post and burst in flames. Maybe, it was an intercession, which caused the miracle of my escape from the car before it caught fire and  burned. My injuries caused by the accident prevented me from moving for weeks afterwards, and I was shuttled from hospital to hospital. Don visited me in hospital, but it was another six months before I visited Tongala and met the family.

Over the years we would see one another periodically as his domestic circumstances and calling changed, but when he finally landed in the western suburbs of Melbourne working among recent arrivals, in particular the Southern Sudanese community, it was almost impossible to find out what he was achieving so self-effacing he was. He just would not talk about himself. It was only listening to the sons talking about their father at his funeral that I knew what I had missed.

We had seen him last in February when we shared a Candlemas cake. He was then hampered by bilateral carpal tunnel operations, which ironically left him not only with stigmata but also dependent, which he hated.

This year has made communication separated by borders difficult, and it was only several days before he died that his stepdaughter asked that he was moved to palliative care and he specifically had asked her to let me know. As I said, I thought he was indestructible and he would bury me, but that was not to be. When he heard an audio message I sent to him, he responded with: “Good old, Besty.”

He died two days later.

The Eucharist was held at All Saints Footscray, from where he was farewelled by ten family members and an impressive array of the Church hierarchy. There were over 200 sites watching via online streaming. Modern technology had enabled us to be involved from 900 kilometres away.

Given the simplicity of his life, I wonder what he would have said if he realised that he was being borne away to his Destination in a Rolls Royce hearse. “Good old, Besty, trust him for noticing” and I can hear that laughter as he said it. 

The Day the Mormon came calling

It was just an ordinary day in Parkville some years when looking through the window of his terrace house, he saw two young clean cut men in dark suits, white shirts, thin ties and close clipped hair walking down the street. The boys had arrived from the Ark of Mormonism, he thought. It was an affluent neighbourhood so the two Mormons took the chance of separating. They stopped in front of our hero’s house. Next moment there was a knock on the door and the young watcher answered the door. The normal response to tell them to politely to go away was replaced by another stratagem. There being only one chap was just too tempting.

The young man was invited in and seated in the front room. Before he could get a word out, our hero asked directly “Are you a Christian?” looking intensely into the eyes of the young man. “I am a Mormon,” he commenced as he fingered what was probably the Book of Mormon. The Book of Mormon occasionally joins the ubiquitous Gideon Bible in motel rooms. Once our hero had flipped through the Book with all its underlying basic dogma, which could be construed as a derivative of American values. Pity about the polygamy, white supremacy with a Palestinian tan, and so on. It was not by chance that it was a Moroni who passed the tablets or was it cactus juice to jolly old Joseph Smith. Bit of intolerance in our hero, (which can be ascribed to youth) when he burst forth with “You are heretic. You need to be saved. You need to repent. You need to embrace Anglicanism.”

This conversional diatribe continued; our hero was now out of his chair stalking around stabbing the air with his finger calling out: “Hallelulah’ let this infidel be saved.” The voice rang out. The Mormon was now on his feet backing around the room trying to get away from the intense yet beatific expression.

“Repent ye, and be saved from this work of Satan. Become an Anglican.”

At this juncture, a young woman entered the room. She looked at the chap with his back to the wall. She laughed at the sight as much as that young woman ever did.

“For God’s sake, would you stop yelling, you’ll wake the children. Let him go. You’ve had your fun.”

“Nearly had him converted when you interrupted. Fire and brimstone. Good for the soul. He just about ready to change your gear that of the Anglican – sports coat, leather elbows, college tie and cords.”

“Don’t mind my husband, you can go whenever you would like.” She had ignored her husband, moved out of the front room and opened the front door, there being little distance between the room and the front door. The terrace house was one of those with the front door is almost on the footpath.

If you have never seen a “scuttle”, then you had to see that one, eyes to the ground, clutching his Briefcase and Book, and into the arms of his partner who had come back to see what had happened.

The young woman gave her husband one of those looks and went back to the kitchen or wherever.

Never been troubled by Mormons since though. Whether the Anglican converter’s transmission matured as he aged is a moot point.

Putin Nyet

As an addendum, Sydney Russians were one of the groups that voted against Putin. A shirtfront? At least a tug on the coat tails.

Mouse Whisper 

The John Travolta of the Australian Parliament, Furbo Wilson has set up a ginger group called The Wolverines (given the colour of wolverines perhaps it should be more appropriately called the “umber” or perhaps “melena” group.)

Now for Mr Wilson, a few facts:

  • wolverines stink like skunks
  • they feed off other animals’ kill – the animal equivalent of rent-seeking.
  • wolverines are snowy relatives of the weasel

So your group of jolly jape-ridden parliamentarians could be called the Wolverine Skunk Weasels.

Beware also if the Labor Party ever set up a Grey Wolves group. Grey Wolves are the biggest killers of your WSW. Take your pick Tibetan, Eurasian, Caspian Sea or Tundra Wolves -all Grey.

We rodentia know stuff!

One of the wolverines

Modest Expectations Ate

Bob Hawke has died. A cricketer, he would have been proud of making 89. Unlike Whitlam, he had a very good first XI. Some were brilliant. He did not make the same mistakes as Whitlam. He was not divisive; as with all good captains, he gauged the strengths and weaknesses of the opposition, and that of his own side. He had at least one dictum – he exerted attitude change in his own party such that the old time union collective thinking in which he had grown up, was changed.

However, when you go against your normal working person constituency, no matter how beneficial that might be for the Australian community, paradoxically you increase the power and influence of those elements which remain emphatically opposed to your reforms and who, over time, would seek to distort or destroy those reforms.

In time others may pore over the Hawke legacy and I for one wonder what he would have done for Australia if he were of the current generation and waiting for Saturday.

A Surfeit of Coke

Talking of mortality, one option that has not been widely canvassed about the current US Presidency is that Trump may die suddenly in office. If it is true that he drinks 12 cans of Diet Coke a day, has a diet of fast food and is so obviously overweight suggests that he is a walking health disaster waiting to happen.

In his latest medical history his height is recorded as 6ft 3in, but on his medical record when was being drafted into the US Army the record says 6ft 2in. Has he grown an inch as an adult? Really? Look at his shoe heels. Already obese at his recorded 243 pounds, how does anyone know what his real weight actually is? That missing inch plunges him further into the Obese.

Of course we do not know about his health status any more than we know about his tax returns. He obfuscates from his sandpit. It is his whole strategy to create sandstorms.

However, the one thing that Trump cannot make a deal about is his physical health.   He can only hope that the drugs will deal with his atheroma, not to mention what appears to be a cancer-prone diet.

Judging by the media reports there is a chorus of learned doctors or psychologists who obviously believe he is mentally impaired despite the protestations. His bizarre behaviour is just a quirk of his personality – a legacy of his early childhood his apologists say.

Trump prefers Diet Coke, and his daily consumption of it is extreme. According to the pundits, the excess drinking is linked to mood swings and dementia. As we all know, because he tells us, he is a cohort where n=1. He may be thus unaffected and the mood swings may be due to other factors, but the world ought to know. It is reasonable to know the mental state of a person who has control of the nuclear button, and what has caused it.

Is he mad? It is a question that publically the world would not answer through its current beige array of politicians. There are those politicians who prefer the Trump flamboyance – a man of many mental colours. There is that state of Munich delusion that one can cuddle up to Trump, know this man’s mind, and get him to sign a promise to be a “good, predictable boy”. Some have tried to put a political straitjacket on him – to be his great friend and mentor – to their cost. That is his art of the Deal. It costs you, not him!

Well, his handlers could deprive him of Diet Coke and see what happened, and see if the twitter finger stops twitching and rationality prevails.

However he is well past satisfying Koch’s postulates. The Diet Coke could have replaced his blood and no longer would he be like any of us mortals …

He is the Child Trump caught up in The Rapture. The Rapture is quoted as a doctrine that at the return of Christ, all believers will be caught up, “raptured”, to meet the Lord in the air. The bodies of dead believers will be resurrected, and all believers, living and dead, will be glorified. To the believers, it is a passport to immortality. That is the Child Trump constituency, who may call him not King but at least Duke.

The problem as with Mr L Ron Hubbard, whose disappearance galvanised a whole generation of charlatans, if he dies now as a demonstrably unhealthy Old Trump, his followers may believe the Child Trump is not dead. He may become a cult for the Enraptured, setting up shrines with figurines of the dear little child with golden hair and red baseball cap along the highways of America waiting for him to come again.

However, that is probably better than that of him never accepting the American people’s verdict saying at the end of 2020 “You’re fired!”

Shoulder replacement – The Anatomy of Medical Advance

I have a worn-out body. A major road accident over 30 years ago did not help.

So I was attracted to an advertisement in a major metropolitan daily for complete shoulder replacement. The advertisement is cast in a way that suggests it is just the thing for a worn out shoulder. Out with the old; in with the new. Like repairing a car, but with a car you at least can get a written guarantee.

However, when one is embarking on a major operation, such as a shoulder replacement, it may go well. You, the patient, if it is a new procedure, may become the poster person for the operation, the one the hospital and surgeon wheels out when boasting how great you, the Result is. You are the Positive Result and are allowed to say a few words, the surgeon performs the benediction, interviewer sums up from the media handout – and the camera is turned off.

The problem is that what the advertisement lacks is setting out the complications, which are rapidly becoming the small type to protect the surgeon and which frankly most patients do not want to hear. There it is in small type at the bottom of the advertisement: “any surgical or invasive procedure carries risk. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.”

However, if you get a complication with such a complex operation as a shoulder joint replacement, you are looking down a long corridor of pain and disability.

I consulted a shoulder surgeon some time ago, because that is how specialised orthopaedics is. This bloke was very frank. Shoulder surgery was difficult; unpredictable results; the surgeon he would recommend is “very good”. However, in the end it is how much knowledge I, the patient, have in making an informed decision. I weighed the evidence up, and said I had decided against an operation on either shoulder.

Outcome is one matter for making an informed decision, especially as increasingly surgery is leaving foreign material in your body. Some is fine; some is not and when a technique is new, how do you know the likely outcome? The answer is you, the patient, do not. Trust in the integrity and skills of the operator are paramount.

But not quite! What was absent from the advertisement was the cost.

Let’s list them.

There is the cost of the hospital stay – everything down to the nametag. The cost of the surgeon – the enquiry about whether there was an assistant and why – and then the anaesthetist. That person is often forgotten in determining the cost, because he or she is the person the patient sees fleetingly.

Then there is the cost of rehabilitation. Because there is a belief that the surgery has a magical effect similar to laying on of hands, the need for rehabilitation may be underestimated. Try to take a middle course and ask, even if it means flattering your particular surgeon that “it could not possibly happen with him or her at the ready”, get a price which includes a contingency item for the costs of complications.

The solution – make it mandatory for prices to be displayed, including the guaranteed consumer floor price – that is, the Medicare benefit. This makes the shortfall starkly obvious.

Then given the notorious asymmetry of information, it is suggestive that there may be a case of brokerage – where those with knowledge negotiate for the customer, without the emotional stress of having the condition. Needless to say, there is a business model to be developed where, through brokerage, the asymmetry in health information can be corrected – as long as the process is uncontaminated, as the mortgage brokerage system recently was shown to be.

It’s Time – The Bubble rhymes with Trouble

One has the feeling that Victorians are going to go after Morrison and his crew with cricket bats. Morrison is not the right fit for Victorian voters. The hillbilly persona does not wash well in Victoria especially as he so clearly identifies himself as a New South Welshman, and the fact that Frydenburg is the only Victorian of note left standing says a great deal about the state of the Liberal party. The problem is the myth of a liberal Victorian has been blown away with the rise of the populist far right in Victorian Liberal politics, since the Kennett accession in 1990s.

The situation uncannily resembles 1972 – a NSW Prime Minister and a Victorian Treasurer. However, the Leader of the Opposition was Whitlam in 1972 – New South Welshman, secured six seats in NSW, the greatest number. His “It’s time” introduced the charismatic presidential-style campaign. Despite everything, Whitlam did not win in a landslide. In fact, Labor lost four seats in Victoria, one in South Australia and two in West Australia. However, it picked up seats in Victoria (net two), Queensland and Tasmania.

Snedden was never in any danger of losing his seat of Bruce in 1972 and Frydenburg should be in the same position. But is he? The bellwether seat is Corangamite, long a Liberal stronghold but for some time marginal with the spread of Geelong to the west counterbalanced by the shift of affluent retirees to places like Torquay and Barwon heads. If Corangamite is lost, so is Australia to the Government.

And tellingly Shorten is a Victorian.

If the Labor party wins big in Victoria, and takes seats in New South Wales and South Australia, what happens in Queensland, Northern Territory and Tasmania becomes irrelevant in the numbers game, except in perpetuating the cleavage in Australian society. This cleavage is not more starkly demonstrated than by the Green and Labor advance in the northern coastal regions of NSW. However, go across the border into the Gold Coast and one is in solid Liberal Party territory.

One has to realise that love of a member in Queensland is inversely proportional to the despisal in the “Mexican” States. Listening to a highly intelligent North Queensland academic referring to the member for Dawson as “good ol’ George” is confronting for those of equal intelligence without the privilege of being baked in the tropical sun.

However, there are several differences in the political scene now and in 1972 and that is the rise of the Independents. The Independents are fashioning themselves into a party of the Centre, freed from the constraints of the Creationists, Falangists and Rural Socialists, that coalition within the Coalition. One of the important features of this election is to see how well the Independents perform – one observation is that they seem to do well when the incumbent member is so appalling that anyone somewhere decent becomes electable.

The bellwether here is Kerryn Phelps. She profited from the clumsy dumping of Malcolm Turnbull and the fact that she had a high profile. However, the problem with her high profile is that she has a great deal of baggage and given her time as President of the AMA and the nature of her support base at that time, it would be a surprise if she has maintained that support base. Considering that her opponent has had more time to assess her, is a former DFAT charmer, is as likely to be as smooth as Dr Phelps is spiky, then she has a challenge. If she holds the seat, then again one can guarantee the swing is on against the Government.

However, the lessons for the government are undoubtedly how this country goes about climate change, how it participates in the Coalition of nations in the South Pacific, how New Zealand and ourselves become outspoken on the matter – just as I would remind the reader that 20 years ago we were outspoken about getting nuclear testing by the French out of our backyard swimming pool.

So I can predict, but I am notoriously bad at it. However, irrespective of whether Morrison or Shorten is Prime Minister after this weekend, any future government worth its reputation should realise that Australia is the joint Guardian of the South Pacific and Southern Ocean and Antarctica – and that is only the start. Trade and jobs become irrelevant if the Earth becomes uninhabitable.

And that, Mr Morrison, is not a Canberra bubble!

The Curse of Pre-polling – The Loss of the Democracy Sausage

I have voted. It was very convenient. It was easy to park the car near the hall. No waiting time. I met both the Greens and Liberal candidates – both nice guys. However as it is a safe Labor seat, you are more likely to meet Elvis Presley than the Member.

Pre-polling is so popular, since most Australians view voting on the Day as one step from having to go to the dentist. Having to run the gauntlet of those trying to shove a piece of paper into your hand and then having to queue, in the end, everybody will have exerted their preference and have voted by Election Day. In several elections’ time, if this trend continues, Election Day may become the Day that nobody came. So there you are, with the picture of politicians with a heavy countenance as they have when they are voting for an increase of their entitlements, in bilateral solemnity agreeing to now decrease the pre-polling time in the future. After all, one has to protect the “democracy sausage”.

Mouse Whisper

Heard in the Louis Vuitton emporium in Pooncarie as one stockman said to the Vuittoneur as he was looking through the range of outback portmanteaux:

“Why is it that politicians are always having Visions? Who do they expect to see? And why – if you can have a Vision of the Future – is it not acceptable to have a Hallucination of the future? Makes as much sense.”

 

Modest Expectations Too

Ron Lord

Ron Lord died at the weekend. Ron was a journalist who grew up in the days of “concrete-foot-in-the door journalism”. This was the accepted muscular journalism of the Norton and Packer era in the late 50s. I met Ron when he was the resident journalist at the Australian Medical Association. He was never the high flyer that some of his fellow journalists who moved in the upper echelons of political influence were, but he was one of the first to recognise that there was a niche in health journalism beyond the learned medical journals.

He may not have been the first but publishing and editing Healthcover, a journal devoted to health policy in the 1990s was a bellwether for journalists who have trod the same pathway since. Ron was an edgy character, loyal to his employers but with a honed critical faculty, a person who knew his limits. He had a rare shorthand ability to rival that of a Hansard reporter, which enabled him to accurately and precisely record what people said rather than just printing the media handouts. Thus his was a refreshing approach to which I was privileged to assist.

His passing is a time for appreciating Ron’s contribution to health journalism and then moving on.

Can I jump puddles alone?

I wrote this first when I was severely disabled with pain, stiffness and weakness – the result of a presumed autoimmune disease. Mr McGuire’s recent ill chosen words reminded me that some able-bodied, articulate people can demonstrate insensitivity and in turn need to be reminded – although he seems to be awash with contrition.

Four years after first writing this reflection, although my health is much better, I am still dependent but with flashes of independence and thus hope.

When you go from independence to dependence in a relatively short period, it is bad enough.

But consider the case of this man, when the change was instantaneous – the result of trauma on a rugby field – and persistent. My condition pales by comparison

This young man was determined to walk at his graduation ceremony. His was a high profile accident and the media were there in spades.

The background to the television news report was that the young man had been severely disabled – the word paraplegic was not mentioned – only his determination to walk to receive his degree and, almost incidentally mentioned in the report, he had a wife. When the picture came on the screen he rose out of his wheelchair and with his wife supporting him as though he were a statue, he tottered a few steps across the stage. No, he had not walked – his carer had borne his weight and even though she was half his size, held onto him while he made the small distance across the stage. Then the news item was over – no attention to the wife’s efforts – no watching him struggle back to the wheelchair or more probably the wheelchair moved into position to avoid the need. He had said he would walk to receive his graduation certificate. It was the gritty devotion of his wife – his carer – that enabled him to do so. Good luck – his family could only wish that he would improve; but what struck me was the essential importance of the carer and how little reference was made to her in the news item.

Likewise, had it not been for me having my wife and others to care for me I would not have been able to continue to work at that stage and full time.

I hate being in a wheelchair. Not that I am in a wheelchair that much, but when I have to move more than 100 metres it becomes very difficult without one. What is wrong with the wheelchair? Nothing. I have been surprised by the comfort the modern wheelchair affords.

However, you become a different human being in a wheelchair. Until you make it clear that being in a wheelchair does not mean that your IQ is automatically halved, you tend to be ignored or treated as a child. I remember sitting in a wheelchair and being confronted by a small boy in a stroller. We were at a similar eye level and he with the ingenuousness of a child stared at me. To which I responded “ Son, see what awaits you.” His parents laughed but I wondered whether they continue to deny the five year old the use of his legs.

The other is that you exist in a forest of legs belonging to the able-bodied. You become acutely aware of that facility to walk, which you considered as an automatic right of homo sapiens. It is compelling to watch the easy facility of movement that you have lost. It brings home the sheer complexity of the evolutionary trail watching the striding young man or woman clasping the iPhone to the ear. There is plenty of time to observe when you are waiting in a wheelchair.

This waiting time is emphasised if you happen to be one of those people who has been both impatient and fidgety. In a wheelchair, impatience is not a wise strategy. Gesturing irritably – especially with a walking stick – is counterproductive!

Likewise, you cannot act on impulse – jump up and do something. Getting to your feet is a considered exercise. In other words, it is the carers who count in such an environment. Their understanding of the level of background support required is crucial.

This was brought home to me when I decided to walk along the Seattle waterfront from the ferry terminal to my hotel. At the time the Seattle waterfront was undergoing massive reconstruction and therefore hailing a cab was difficult and I misjudged both the distance and my capacity. “The little boy” had decided to get out of his stroller. For about 50 metres with two sticks it was bearable. However, as I moved forward the uneven asphalt became jolting potholes; walking down improvised inclines, minor to the able-bodied, become challenging ski runs. I struggled, and my carer kept watch for an hour, hovering and supporting, without saying how stupid I was. This was my “puddle” moment.

The occasional person, invariably a young woman, stopped to ask whether I needed help. For an hour I moved along, away from the dusty, sulphurous fumes and clanging steel of the waterfront, onto quiet civilised pavement. The hotel was in sight, and as you do when you walk with sticks, your eyes are mostly directed towards the terrain. What made this segment better was the line of copper beeches, which I could count as I passed each one. I remember when I ran those inaptly named “fun runs” and I was getting tired, it was the next telegraph pole in the street or on the highway, which was the marker of achievement.

My carer who had been ever present suddenly asked whether she could go and get the wheelchair from the hotel since the footpath was paved and the hotel was not more than two hundred metres away. She had picked the right moment. I agreed and she disappeared as I slogged on with the vain hope that I would get there before she could bring back the wheelchair. The definition of bliss is being propelled in a wheelchair up and through the hotel foyer to the bar for a cold ale.

Caring, as I have found out, and the interaction with the person in care is something you see, but unless you are in the situation, you will never feel the importance of that interaction.

However, caring is not the exclusive preserve of some professional group or a financial benefit enshrouded in impenetrable regulation. It is a basic tenet of our society.

It is up to those disabled but articulate, to continually advocate for a better deal, not only for the disabled, but also for the carers. Neither the carer nor the person being cared for live in parallel. However, the challenge remains of how best to translate that interaction between those who have the interpersonal skills intuitively and those who need to learn the skills to improve the interaction. The internet seems to be full of exhortation as to what is best for the disabled, but there does not seem to be much room for interactive comment.

Yet 272,000 carers are under 25 years. I have grandson who was then 14 and who, without prompting, brought me a chair when I needed to sit down. He knew without any words being exchanged what was wanted, because he was paying attention to his environment rather than a piece of technology.

As against this was a young girl of similar age, head down, concentrating on her texting who pushed past me into the lift. Suddenly there was a scream of anguish as the door closed on her inattentive self. It was fortunate that it was not a railway crossing – or a puddle, which turned into a fathom-deep pond.

The allusion in the title is to the Australian author, Alan Marshall, a useful text for us all. He did learn to negotiate that fathomless puddle. Has government with this recent budget done the same thing?

Mouse Whisper

Heard in the Louis Vuitton emporium in Tibooburra: What is better, a retail politician or a wholesale disaster?