Modest Expectations – Biblical Trivia

The Orange Toddler she calls him. She, our American friend, agrees that the vaccine should be tested, but the chosen vaccine should first be provided to the Great Leader. He has spruiked it – he must be made invincible. To mark the occasion in the Oval Office he must be surrounded by adoring people wearing white coats, but definitely without masks, unless made by his beloved daughter. There will be commemorative syringes for all.

That will give the American people confidence; he to bare his arm for America; the test as no other test has been seen by anybody; and then to cap it off, perhaps a couple of days, maybe a week later, who knows – the flock of white coats will be reassembled while COVID-19 is directly injected into the OT. Then he will turn, give the syringe with the Presidential seal to an adoring fan, saying that there has not been anybody ever, perhaps with the exception of Jesus Christ himself, who has done so much for America, to make it great.

No, you’re dreaming. That won’t happen because he says he has a deformity of his body, which precludes injection – too much Ancient Orange.

Maybe Sarah Cooper will be a suitable surrogate.

Hunted? Not quite

How predictable, the sanctimonious Hunt, the Minister for Health egged on by the Prime Minister, trying to blame Premier Andrews for the ills of Victoria, including the failed nursing home system. Nevertheless, a small history lesson is probably useful to dispel some of  the information about Daniel Andrews.

The problem with Victoria is that for years now it has not had a Department of Health but a “Department of Social Reform”, reflecting a social service bias at the expense of public health. Health is hospitals – full stop. That was the conventional wisdom.

The Heads of the Department have traditionally not been medically qualified. The structure of the Health Department was separated into Health, Hospitals and Mental Health, then unified for a time under a doctor, Gad Trevaks, when he chaired the then Health Commission.

That was the last time, and the real source of the decline in public health was due to Premier Kennett and his agent John Paterson, who effectively destroyed any remnant of public health considerations in the State. At the same time regulations have been loosened and, as one insider has said, food regulation and the lack of public health surveillance of food safety will be another problem that Premier Andrews will have to confront at some time.

Thus public health was in a woeful state even before the minions in the Victorian Treasury insisted on so-called “efficiency gains”, which is just a way of reducing public funding.

Then there was the case of a former chief health officer who was largely invisible during the time of his appointment and nobody seemed to care. Raina McIntyre, an outspoken epidemiologist, has commented wryly: “… such a minimalist system can get by during the good times but will be exposed in the pandemic”.

As Andrews has emphasised, this is an area where political point scoring is pernicious. It is more laughable than pernicious to hear the NSW Premier saying that she has a public health department, which “was second to none”, when the Chief Health Officer, Dr Kerry Chant, who is responsible for public health, was lucky to keep her job after the Ruby Princess and Newmarch House debacles.

After all, she has been in the job for 12 years, and was an inheritor, as were her public health colleagues, of the work done by Dr Sue Morey when she was Chief Health Officer. Dr Morey not only supervised the introduction of the contact tracing system but also enabled the public health medical officers to be recognised as medical specialists. As a result, in relationship to Victoria the public health doctors in NSW are far better remunerated. Many of those NSW public health doctors were trained by Dr Morey, who had gained formal public health training, resulting in a Master of Public Health from the Harvard School of Public Health in 1980. She set in place the public health system that is now being described as the Australian “gold standard”; it did not appear overnight. It is after all only a tool and it demands competence in its usage.

Strangled by a Thread of Cotton

Birdlife in the marshes

To me the Macquarie Marshes have always been one of the important bellwethers as to the health of the Murray Darling region. I have read much about them, but until this week had never visited. The marshes are located on the Macquarie River and lie some two hundred kilometres north-west of Dubbo, between Warren and Carinda.

To put them into context, the Marshes are an extensive wetland system covering more than 150,000 hectares, and the nature reserve covers 18,500 hectares of it. It is recognised as a Wetland of International Importance (but not by the NSW government). Most of the Marshes are in fact on private land.

The Marshes are arbitrarily subdivided into the northern and southern segment. There is more water in the latter. Importantly at present there is water in the marshes and there is abundant bird life. Black and white magpie geese swoop low as coots, ducks and a swan glide across one of the many lakes. The signs of the Marshes having periodically dried up are evident in the dead reeds where fires have wrought irreparable damage when there was no water. Across the water cormorants perch on the dead trunk, silent witnesses to the dying marshes.

Yet another sign of the degradation of the Marshes is the yellow rape mustard weed growing wild throughout the marsh areas that still are more or less dry.

The ultimate sustainability of these Marshes, even now after heavy rains have returned water there, is dictated by the cotton industry. The huge broad acres of black soil being prepared for planting near Warren attest to the nature of the enemy.

Originally it was the building of the Burrendong and Windamere Dams in the 1960s and 1880s respectively, which had diverted the wetland water to irrigation, and in so doing challenged the future of the Marshes.

That sets the picture for this almost lost resource.

We stop where the water is running across the track – 100 metres wide and from the flood post at a level of about 0.4 metres. A large 4WD lurching into a hole and then struggling out only to sink again in the running water before blundering through set the tone for the crossing. We did not attempt to cross, but had lunch at the edge of the stream. Another 4WD stopped on the other side had released a bunch of kids who set out their beach towels on the track and took advantage of a swimming opportunity.

A couple of ATVs containing a number of boisterous teenagers went by, charging into the water. They knew where to go, they clung to the right side next to the fence line. There were no holes on that side – no problems – across and gone with all round waves to those of us left behind. “Local kids”, the weathered face who appeared at the car window said.

He was a seasoned farmer who had stopped with his family, and came across to see who “these foreigners” were. He ran shorthorn Hereford cattle on a property north of Carinda – a place where he said the best cotton in the world could be grown. He was on an afternoon drive with his daughter who had brought visitors from Norway to see the Marshes.

However, the problem is that Warren always took the bulk of the water, and thus Carinda – 140kms further north – hardly received enough water to sow a crop – maybe once in ten years, despite its capacity to produce premium cotton.

His attitude is a microcosm of the problem of Murray Darling River planning. Nobody agrees. It is a free for all, with each person, each municipality, having no consideration for the people of the catchment as a whole. Why should they? Their role model – their various governments seem hell bent on fracturing the Federation. Why not add compromising the nation’s water to a deteriorating concern for country?

The Pub in the Scrub

It is but a speck on the map between Condobolin and Tullamore. Here there is a typical two-storied, corrugated iron roofed country hotel, with a bright orange tiled façade. It luxuriates in the soubriquet of The Pub in the Scrub. Its name, which also is the name of this hamlet, is Fifield. The hamlet is empty, apart from a murder of crows having a convention in the main street and a ute parked against the kerb in front of the pub.

Near the geographic centre of NSW, Fifield is surrounded by blazing yellow broad acres of canola. It was once the site for alluvial exploration for platinum and there is a sign nearby pointing to a place called Platina.

Fifield’s car graveyards

However, Fifield is a graveyard for car bodies. They are everywhere. There is an old barn, unusually with a chimney but now ramshackle, despite the incongruous new solar panels on the roof. Acres of car bodies behind the building are spread on the other side of the main road, the whole extent of which is hidden by trees. The fact there was a newish bright yellow Ford in front of the barn seems to confirm that the building was occupied.

The oval was covered in cape weed; there was once a tennis court, now overgrown, but with its net still in place and the rusted gate still visible. A disused wooden church on the corner with a handwritten sign which says “St Dymphna”, who can identified as the Lily of Ireland, the patron saint of mental illness.

However, on the road as you enter town there is a bright black and yellow sign exhorting the passing motorist not to dump rubbish – or else. Unless of course, it’s your car.

Ah, the wonderful irony of Australia.

Yuranigh

When I used to walk close to my old home among the trees which dotted the sloping land that had been preserved around the Melbourne Cricket Ground, I would come across a canoe tree where, before whitefella settlement, the Wurrundjeri people had carved a canoe from the bark.

Canoe trees were probably more common than have been found, but civilisation has a way of destroying heritage. Maybe many trees so used for canoes, shields, coolamons and other artefacts just did not survive. After all, before the whitefella came with his tree-felling prowess, there would have been open forest where the city now stands. Not surprisingly the river red gum with its stout trunk was a favourite source of bark. Bark was plentiful. Bark was the only resource they had for their canoes as there is no evidence that the dugout canoe of their Northern Australian brothers ever percolated south.

Yet the bark canoe was obviously important given the number of rivers and watercourses that flowed around and through the land which whitefellas labelled Melbourne. It is surprising so many of the trees survived so close to the centre of Melbourne

Aboriginal carved tree trunk

This reflection on tree carving was at the forefront of my mind when we visited the grave of Yuranigh. His grave lies a few kilometres east of Molong, a central west NSW town just off the highway to Orange.

The directions are well marked, the track is stony clay, there is a gate and a cattle grid, and then a short drive where old gnarled yellow box gums hold sway over a weed infested paddock. This is where Yuranigh is buried. Little is known about this Wiradjeri man except that he accompanied Thomas Mitchell to the Gulf of Carpentaria on one of Mitchell’s explorations.

Mitchell thought so much of this man that when Yuranigh died when still a young man, Mitchell paid for his grave and a marble headstone commemorating Yuranigh. It is apparently recognised as the one site in Australia where European and Aboriginal burial traditions coincide.

Around the area where Yuranigh is buried are carved trees, sinuous dendroglyphs etched into the heart of the trees – complex cuts given the tools that would have been used. The most prominent one of these is a stump protected from the weather, an extraordinary example of Wiradjeri art. It had lain for years on the ground, before being raised and now supported in a concrete base

There is another tree close by where the artwork can be viewed through a slit in the tree – the carving lying within the tree. There are four trees that define the corners of the gravesite, but some have defiantly repaired themselves and in so doing smothered the artwork.

We were alone at the site. Despite the complexity of what we were witnessing – an intertwined image where we could see original Wiradjeri work in all its complexity but only guessing as to meaning not only of the carving but also its placement in relation to Yuranigh’s burial place, I realise I know so very little.

Yuranigh grave site

Yes, I understand Mitchell’s tribute. That’s how we whitefellas celebrate dying in a world of grey – the compromise between white and black in our monuments and headstones. But the trees are not confected – they are real. In blackfella eyes Yuranigh obviously was a great Aboriginal man; the carvings denote respect. Otherwise who would take such care? “Sorry business” is such an important part of Aboriginal life.

John is not the Name

When I go to a bank or any other place where the interaction is usually with a younger generation, far younger than my “silent generation”, I find being addressed by my Christian name jarring to say the least. I quickly correct them on most occasions.

After all we have a surname for a reason, whether derived by being the “son of “, colour (white, black, brown), profession (fletcher, butcher, smith), location (London, Birmingham, Kent).

I come from a generation when every male at least addressed each other by “surname”. However, within the family and friends circle, we were called by our Christian names.

I find calling elderly people by their first name, as if they are children, unsettling. I would object to a stray carer that I have never seen before, calling me by first name. Using “John” jars just because they have seen that on some of my documentation, because those who know me call me “Jack”. Address me by my surname please.

Having thus aggressively put my point of view, my cousin told me a salutary story about his uncle. His uncle Jack went to get a job on the wharves.

He was asked his name.

“Jack,” his uncle replied.

“Look, feller, on these wharves we deal in surnames. What’s your surname?”

“Honey.”

“Well, Jack, it is …!” came the immediate reply.

One against me.

Mudgee Mud

It is about 40 years since we were in Mudgee. We came to the inaugural Mudgee Wine Festival. It was a spur of the moment decision. I asked her. She said yes. Now years later, the trip was not so romantic; you know, she said as we were driving there, “We came here in 1980. Have you been to Mudgee since?” I had travelled widely around this part of NSW and for a time I often visited Dubbo, spent time at Bathurst, found some delightful antiques at Molong and had been to Glen Davis on more than one occasion – but Mudgee?

Forty years ago, Mudgee wines were dismissed with the label “Mudgee Mud.” Give something a bad name and I doubt whether even after exposure of the wine at the Festival was sufficient for me to ever buy some. It was still very indifferent wine.

Ulan coal mine

The dinner was an uproarious affair, as one of the guys who was a geologist had mapped the coal deposits around Ulan and was making or had made a financial bonanza out of his assiduous tracking of the coal deposits around those areas. At the time of the dinner he had secured the lease over the tail of the deposit. Forty years ago, coal as they said was king, and who had heard of climate change effects!

At the end of the night, we blokes had all got along so well, and there was so much bonhomie, that everybody was shickered. Out in the car park all the blokes got into the driver’s seats and the wives, who were by and large sober, were consigned to the passenger seats. There was one exception – the young lady whom I eventually was to marry years later – insisted on driving. Just as well.

The next morning I awoke, nursing a damaged head. We had stayed down the road at Kandos, famous for its limestone quarrying. Mudgee had been booked out. As we were leaving the motel owner noted that I was a doctor.

“Oh”, she cooed, “ We would love to have a young white doctor here in Kandos.”

Different times then, different times.

Mouse whisper

On the menu at the Italian restaurant in Griffith, it was stated that one could dine “al fresco”. Sounds authentic – just as the names of any the pastas or “il cotoletta Milanese” were authentic italiano.

The term al fresco is unknown in Italy. If you want to dine outside (fuori) or in the open (all’aperto”), you will be directed to that leafy courtyard.

Thus, il cameriere will scratch il sua testa if you say “al fresco”. He may misunderstand and instead bring you acqua fresca – cold water.

all’aperto!

Modest Expectations – Vince Gair

What I wrote about Biden in May holds in my view, but but for one thing…

The most disturbing vision of Biden is his rear view – essentially that of an old doddering man. Then turn him around and there is that ever-engaging smile – as if he has a giant axon inside his skull that is connected to all the facial muscles, which make him smile on cue when somebody rings the metaphorical bell. 

Biden is a plagiarist, discovery of which aborted his 1988 Presidential campaign. Plagiarism is a mixture of deceit and intellectual laziness – or underlying dumbness. This flaw resurfaced in certain dealings last year.

… Nevertheless, one positive sign that he is a good man is how he has handled grief and he has much to grieve about in his life.

America is in a mess; no matter when the change is made there is a White House reduced to the political nursery of the Baby Trump, and there will need to be someone very focused to clear out the rattles, the dolls, the bucket and spade, and other geegaws fondled and thrown around in the past four years.

I fear Biden just doesn’t have the ability – no fire, only embers. My earlier comments about him have not changed, and my support for Bloomberg would still hold had it not been for this entry of Obama into the frame.

Kamala Harris

He is still a fake, but fortunately Kamala Harris is authentic. I had not been paying enough attention to this very smart lawyer from California because I thought Biden would choose from the talented pool of Democratic women from the Midwestern States, even given that he was colour conscious. The residual influence of the Clintons would have been tested; the accident-prone Susan Rice in the forefront of Hilary’s list.

However, the Obama imago prevailed.

Biden is not adventurous and at 78 he has the habits of a lifetime printed in his electrical circuits. Prejudices such as showed in relation to Anita Hill bubble below the surface, despite all the meae culpae he has given. I never trust a plagiarist – it shows a level  of dishonesty, subterranean it may be.

However, that pales before Trump, a person whose inability to tell the truth is well documented.

When Trump immediately attacked Kamala Harris and called her “nasty” (how pathetic can you be), he starts on the eligibility nonsense that he tried to perpetuate with Barack Obama. He is now repeating the same with Kamala Harris. In so doing, he emphasises the essential similarity between the two. One is the son of a Kenyan and white American union; the other the daughter of a Jamaican and Indian union. Coincidentally both unions broke up soon after the children were born and both had an absent father.

Trump would have preferred the traditional Tobacco Road Afro-American upon which it is easier to spew racial division and hatred.

He has a pathological antipathy to Barack. He cannot stand being mocked, his inferior intellect put to the test, his demonstrable cowardice – all in all, a vicious, corrupt guttersnipe. To put it in simple terms, he cannot bully either Harris or Obama – unlike Biden whom he has shown that he can.

There are two reasons that could be conjectured as to why Biden delayed his choice. One is that he is a natural ditherer (not a good sign in a President with so much to rectify) and the second is that he simply did not want Ms Harris. One may suspect that she is the Obama surrogate. That is not to denigrate her, but it will not be too much trouble for her to “clean up” Pence – and then unleashed she will so clearly become the President-in-waiting.

Two Vice-Presidential reactions when the President became “infirm” are relevant contrasts.

Eisenhower was 67 when he had a stroke in 1957; Woodrow Wilson was 63 when he too had a stroke in 1919. Eisenhower had nearly three years to go; Wilson the best part of two years. Richard Nixon, whom Eisenhower had foisted on him and whom really did not like much, became more prominent directly in policy decisions after 1957.

Trump is 74 and has been rushed to Walter Reed Hospital at least once; Biden is 78. Both probably are testimony to the availability of health care now in modern America, for the affluent at least, particularly in the treatment of cardiac disease and high blood pressure.

Thomas Marshall, Wilson’s Vice-President and who somewhat eerily had been the 27th Governor of Indiana (the current Vice-President Pence was the 50th), followed a different path. Again, although as with Nixon he served two terms, Marshall was disliked by Wilson and particularly by Wilson’s wife so that he was blocked from much of the day-to-day management. However, Marshall was very much his own man with seemingly a misplaced sense of noblesse oblige in refusing to take over as acting President because he feared the precedent that this action would have created.

In other words, even at an age when infirmity can strike suddenly, Biden can be tolerated because (a) Trump is so bad, probably more senile and (b) Biden has a strong deputy. However even the sight of the indecisive Biden face to face with Trump still fills me with trepidation, whereas Harris I suspect could eat Trump for breakfast and still ask for more waffles.

Is Australia prepared for the next Pandemic?

The above is the title of a paper published in April 2017 that had, as one of its authors, Brendan Murphy, whose address was given as Office of Health Protection, Australian Department of Health, Canberra.

It was published in the MJA under Perspectives and begins with the statement “infectious diseases continue to threaten global health security, despite decades of advances in hygiene, vaccination and antimicrobial therapies”. How very true!

It was a paper, which has a table of four Committees with very long names, and because they are labelled current NHMRC Centres of Excellence the assumption is that they are just that. The problem is that much of health research is encased in the gossamer of self-congratulation.

Angels dancing on a pinhead?

Much of medical research is somewhat like exquisite Chinese ceramics in the seventeenth century, refining the tools of the past to render more and complicated dexterity, but not advancing the human condition – defining how many angels you can fit on a pinhead – wonderful feats but of what utilitarian value?

The Murphy paper does not explicitly mention three people who have provided Australia with a buffer in the battle against infectious diseases.

The first was the emphasis by Michael Wooldridge, when he was Minister of Health, on raising the vaccination rates of Australia in the face of criminal behaviour by the anti-vaxxer brigade. Wooldridge had a strong base being close to Prime Minister Howard and being a member of the Expenditure Review Committee. Wooldridge retired and since then Federal Ministers for Health excluding Hunt have been an indifferent bunch in relation to their influence and interest (although at times Abbott showed he was across the portfolio).

The second was Dr Brian McNamee who, on assuming the role of CEO of the Commonwealth Serum Laboratories (CSL) in 1990, turned it from being a “basket case” into a world leader in the development of vaccines and blood product. As a bonus CSL is now very profitable. In so doing, McNamee cultivated Australia’s research capacity. He had a keen eye for the very best.

The third is Lindsay Grayson, whose crusade for people to wash their hands has provided a springboard for the community campaign to wash their hands. Men in particular are grubs and Grayson, first in hospitals then elsewhere, demonstrated how important hand washing is in minimising cross infection. His work has resulted in modification of health professional contact with patients.

On the flip side, governments had believed infectious disease hospitals were a thing of the past, and while HIV inpatients gave some of them a prolonged life, these hospitals dedicated to what was believed to be a relic of a past age were progressively closed down.

Fairfield Hospital

As I have written elsewhere I remember in the 1950s being admitted to Fairfield Hospital in Melbourne for a week for an unspecified infection, and as was the wont of the senior doctor at the time I was prescribed chloramphenicol, which was shown to have disastrous side effects. I was in isolation – quarantined – in a dedicated infectious diseases hospital, and did not escape being dosed with chloramphenicol. Nevertheless, I was well treated by a trained staff and still alive.

The New Zealand Chief Medical Officer has used the word “bespoke” in relation to quarantine facilities, especially tailored for the individual circumstance. Fairfield Hospital was just that, until it was closed by the then Premier Kennett in 1996 as a cost cutting measure, a familiar tune when it comes to public health expenditure.

The dilemma for Government now – as part of the grand exit strategy – is whether to invest in the construction of quarantine facilities. Those opposed, generally identified as central agencies, may argue there are quarantine facilities available, which were convenient when the early evacuations from China were occurring, but Christmas Island and Darwin are not the most convenient. Far more troubling for these bureaucrats is the prospect of a vaccine at a time when there is substantial hype about its prospect of success.

There are two points to keep in mind: the vaccine is far from a done deal, and there are plenty of other viruses at a time when the Climate is changing and when technology has conditioned the mood of the population to care only about Self, surrounded by Instagram or Facebook or Twitter or Tik Tok or Facetime or IsolationXbox.

However, investment in facilities now may be the price that needs to be paid to reassure Australians that our status of being a country with a low COVID-19 infection rate is preserved. It may be that the price to be paid from coming from a place of high infectivity to Australia means automatic isolation.

The paper by Murphy and his co-authors sets outs a number of Committees. Despite all the apparent impressive panoply of intellectual input set out in the paper, Australia was woefully underprepared when the Virus struck and was fortunate that our distance from the source of the original infection provided a buffer. Perhaps in hindsight, what was done there is the template for quarantine facilities to be established.

For Murphy the pamphlet of 2017 becomes the reality of 2020.

Australia just cannot be placed in permanent lockdown on the whim of some set of politicians. There is a need for a finer sieve than group punishment. If there is a lesson from this Victorian debacle it is that nobody should be allowed to visit a nursing home (or a prison) for 40 days or least a significant period after returning from abroad and not developing signs of infectious disease, then so be it. That is an obvious restriction to be put on the table, but there will be others.

The development of quarantine facilities to house the infected or those potentially infected should be near airports, and the further the airport is away from a high concentration of the people the better. There are those who wish for a vaccine, but given that viruses are coming in waves – and until this Virus struck, Australia has dodged the metaphorical bullet.

To get this whole response right is not just a case of consulting laboratory scientists whose ruminations have been effectively ignored by the community until the Virus struck. I have always taken issue with the Fabian approach of pamphleteering for change. As has been clearly demonstrated by Murphy et al in their paper, until the pandemic struck, there was no impact of these matters on the politicians. Now of course the airwaves are full of these same scientists unleashed, some able to communicate well, others not. They remain background noise while those in charge of containing the pandemic continue to work on in a social Darwinian bubble shedding the useless people whilst retaining the useful.

Wartime does not have the luxury of maintaining the idiots, just because they look good in suits. In other words, even though the cacophony of those who love show-boating remains, it is refreshing to see the “survivors”, who an observer thought from the start were competent and see some that you thought were initially incompetent improving. Hence Australia is still one of the best places to live in this Time of the Virus, even with the mistakes.

The danger is that some of the Premiers who have closed borders are caught in a competition to see who can close the longest. Closing borders becomes a mindless and sadly cruel obsession.

Now setting up, in the words of the New Zealander, a bespoke set of quarantine facilities may require less money being tossed to the other politicians-needs-a-legacy projects. I am sure the War Memorial renovations could be put on hold; and the sports stadia.

An evening looking down from the loggia

Just imagine in the Second World War John Curtin advocating for Parliament House to be transformed into the Palace of Versailles. To suggest that is so ridiculous, but Australia is in a similar crisis. The above point is to make everybody think of what is more important than the long-term health of the country – a football stadium for the inheritors of Versailles looking down from their exclusive loggia quaffing champagne and eating truffled lobster – or quarantine facilities where all the components of public health and infectious disease can be concentrated. I say again, this Virus will not be the last the infectious assault. 

The solution I propose is unashamedly simple in conception but difficult in the details of implementation. I know that; unlike the following, which is barely intelligible but it is not the only vapid advice which has been published: And we might do well to remember that the wisest and most effective course of action will more often be forged in the contest of ideas than distilled from unilateral decisions untested by scrutiny and tempered by no real debate.

However, one must not get angry, rather listen to that wise local florist who noted: “when my ability to smell the rose and the eucalypt return, so will I then contemplate the frivolous.” 

Once upon a time in Lithuania

In an earlier blog, I have written in some detail about our visit to the Baltic countries. However, a few comments may be relevant now that the hidden country of Belarus has emerged from behind its curtain. What is surprising is that when we drove from Estonia to Latvia and then to Lithuania we noted that there were no mountain ranges or marshes between the three countries – just nondescript borders. Yet, there are three distinct cultures, three distinct countries. All have struggled to maintain their independence, but with the breakdown of the old Soviet Union they all achieved their independence.

In 1989, to celebrate the independence from Russia on the 50th anniversary of the Molotov-Ribbentrop Pact, the people of those three countries formed a human chain stretching across all three countries from the Tikk Herman, a mediaeval Estonian fort in Tallinn, to the square in front of the Lithuanian cathedral in Vilnius.

In Vilnius, we were told that we would no longer need a visa to go to Belarus. Vilnius is close to the border and it was only a couple of hours drive to Minsk if it were not for the stringent border controls, which reflected that Belarus had never moved from its Soviet past. That was correct, we did not need a visa, but only if you flew into Minsk. It did not apply to land borders.

Belarus was once a client state of the Soviet Union and a founder member in 1945 of the United Nations as Byelorussia. Nobody talked about it and because it was translated as “White Russia” it was confused with the white Russians of the 1917 Revolution – those who opposed the Communist red Russians. So anybody who encountered the name shrugged their shoulders, “too complicated; little relevance” and turned to other matters. For Australia, there were very few migrants from there fleeing Soviet domination, unlike the Baltic Countries.

Protests in Belorussia

To most people Belarus (once Byelorussia) has meant nothing – a small landlocked nation of peat and farmlands, iron works and overflow Soviet manufacturing. To those who knew little, it was just a part of the Soviet Union, carved off, given a name, just to be another convenient rubber stamp, to provide another vote in the UN – to jump when the Soviets said so.

The Republic was not retained when the Soviet split up, and it was given its independence. However for Belarus, unlike their neighbours, this did not bring democracy.

So there was little surprise when a burly young former collective farm manager named Alexander Lukashenko seized power in 1994 and then, over time, consolidated his power over the population of nine million. While Yeltsin was there and in the early years of Putin, Lukashenko wanted to have his country re-absorbed into the new Russia, with himself as the Vice-President; that dream faded as Putin consolidated his personal power.

However, Byelorussia has its own language and while most people speak Russian, the country has certain differences. It is Slavic, but it has more than a pinch of Balt. It was an area, once Lithuanian as part of its empire with fortified towns. The Swedish army has tramped across it, as had the Poles. The people suffered greatly under the Soviet Union and in an article in the February 2000 Harper’s Magazine the author, who had decided to visit the Kurapaty Forest just North of Minsk, said:

“Shadows throughout the grove resolve themselves into crosses; the farther in you look the more crosses you see. Here lie the bodies of tens of thousands of Belarusians (estimates run from 30,000 to 900,000) who were executed by the Soviet authorities.” In the psyche of the Belarus people, this Soviet brutality has not been forgotten.

In 2000 Lukashenko, who had some pretensions to being an ice hockey player, was only 35 and had the support of the elderly and rural communities. His approach to government was well-defined as during that year (2000) four opposition leaders had simply disappeared.

But now in 2020 the population seems to have had enough. There is always a tipping point and Putin, if he invades, would be well aware of the cost of not only fighting but also garrisoning a hostile country, especially one where the President-in-exile is lodged in Lithuania. Furthermore, much of the countryside in the South and East has been contaminated by the Chernobyl nuclear power plant accident. Radioactive caesium is lodged in the soil.

Then there is the Russian exclave of Kaliningrad Oblast for Putin to think long and hard about if he moves on Belarus.

Kaliningrad

Kaliningrad, named after one of Stalin’s cronies, was formerly Konigsberg, the capital of Prussia. The oblast, the size of Northern Ireland, was annexed in the aftermath of World War II as a base at Baltiysk for the Russian navy, being its only ice-free port. The area is also essential for Russia’s ability to intercept and interfere with Allied communication networks – Russia’s spoiler.

Putin could move fast and send troops in to rescue Lukashenko, reckoning that his influence over Trump would stymie any Allied response involving Kaliningrad Oblast which, despite being heavily fortified, could be a risky proposition.

Currently Russia is separated from its exclave by both Belarus and Lithuania. An invasion of Belarus, unimpeded by Trump, could tempt Putin to demand a corridor across Lithuania in much the same way that Hitler demanded a corridor across Poland to the then Baltic free-port of Danzig, one of the precipitants for World War II in 1939. Lithuania is a member of the EU, and yet…there is this Manchurian candidate factor redux.

Fanciful? Better to call it out?

However, drawing breath and not wanting to wander into a nightmare more fitting of a video game, in which I am no expert; equally I am no expert in how to destroy the world to save a despot or two.

Mouse Whisper

Geraldine Ferraro was Walter Mondale’s Vice-Presidential choice in 1984. At the time, there were many ugly rumours about the Democratic New York congresswoman relating to unpaid taxes and family links to organised crime. After all, she was of Italian extraction and from Queens at a time when the Godfather series had stereotyped Italian America – guilt by association is a favourite ploy of the media.

She decided to confront the media and answer each and every question for as long as it took – by 80 minutes she had exhausted the media and when she had finished, according to a report in the Washington Post, many of the cameramen filming applauded her.

As the Washington Post recalled this week:

There was just one critic left to deal with — the conservative columnist George Will. He had sent her roses as a sort of apology, writing in a card that, “Has anyone told you that you are cute when you’re mad?”

Ferraro called Will to thank him for the roses… But there was something she needed to say. 

“Vice-Presidents aren’t cute,” Ferraro told him. And then she hung up.

Modest Expectations – Christmas at Bethany

One of the books I dipped into when I was younger was Oblomov, an 1859 novel by Ivan Goncharov. However, I found the concept of a rich, self-indulgent slob not getting out of bed such an anathema to me that I threw the book aside.

Oblomov

Some years later I again ran across this excerpt from the novel; it is the one which is most often quoted: 

“When you don’t know what you’re living for, you don’t care how you live from one day to the next. You’re happy the day has passed and the night has come, and in your sleep you bury the tedious question of what you lived for that day and what you’re going to live for tomorrow.”

As a doctor, I became aware of the Oblomov syndrome. Oblomov’s syndrome has been formally defined as a mental disorder characterised by low cognitive function, low emotional response, flat affect, or “emotional apathy” and a generally ambivalent approach to life or when reacting to people, events, thoughts, or feelings.

A more personal comment from some character in search of identity labeled himself as a typical “Oblomov” – a weak-willed neurotic who is apathetic, lazy and parasitic, unable to work”, with those characteristics culminating in self-loathing.

The recurring metaphor is a “refusal to get out of bed”. The metaphor may be extended to remaining in pyjamas for the whole day, except for making allowance for personal hygiene. It can become a way of life as Hugh Hefner clearly and very publicly showed, but I believe this outward Oblomovian indulgence covered serious neuro-pathology in the case with Hefner.

During the last months when the country has been in various levels of “lock-down”, I found myself constantly wanting to go back to bed and remain in my pyjamas. That is my reaction, but I wonder how many others, especially those without support – and here my hypothesis says that it is a male condition and not for poor people – have been faced with this situation. However, in nursing homes does it become a less voluntary condition?

The key to combating this condition is to get out of bed, have a shower, get dressed and have breakfast. Gluttony was an obvious refuge for Oblomov so I conjure up and then dismiss the picture of myself sitting in pyjamas consuming a breakfast of thick French toast dripping with butter and maple syrup, with a side dish of bacon and a gallon of orange juice laced with champagne. This context is definitely Oblomov.

Modern technology has provided excuses for staying in bed. Television, iPhones, ubiquitous apps, the introduction of Zoom, somebody to fetch and carry – paradoxically all have made one more Oblomovian. The latter day Oblomov emotes: “Why stir out of my room? Why go outside? Why travel anywhere? Why exercise?” A torrent of questions poured forth until COVID-19 imprisoned us.

As one writer has said: “Throughout many hours Oblomov tries to overcome his passivity but without result. This part of the book is deeply disturbing. After many sad events, over a couple of years, Oblomov dies of cerebral hemorrhage.”

After all, in the book Oblomov stays in bed until page 131; sometimes I have wondered what page I am on.

In the final chapter, Andrei Schtoltz, Oblomov’s friend is talking:

“He came to rack and ruin—though for no apparent reason.” As he spoke Schtoltz sighed heavily. Then he added: “His intellect was equal to that of his fellow’s, his soul was as clear and as bright as glass, his disposition was kindly, and he was a gentleman to the core. Yet he—he fell.”

“Wherefore? What was the cause?”

“The cause?” re-echoed Schtoltz. “The cause was—the disease of Oblomovka.”

“The disease of Oblomovka?” queried the literary gentleman in some perplexity. “What is that?”

“Some day I will tell you. For the moment leave me to my thoughts and memories. Hereafter you shall write them down, for they might prove of value to some one.”

Is the blog after all only a symptom of modern Oblomovism – or is it therapy?

Hijacking the Narrative

John Kitzhaber

Governor John Kitzhaber is a longstanding friend of mine and a former three-term Democratic Governor of Oregon. An emergency physician by training, he was responsible for the Oregon Health Plan. He has kindly allowed me to reproduce his recent blog – which I do in part.

Portland, Oregon

… The arrival in Portland of Federal agents on the pretext of protecting Federal property – in this case the federal building which has, in fact, been defaced and damaged in recent weeks. The damage to federal property, while perpetrated by only a small subset of the protesters, provided the Trump Administration with the opening it needed to direct Acting Secretary Wolf to deploy Federal agents to Oregon, citing the Homeland Security Act as the legal justification for this action. 

A provision in this Act gives the secretary the power to deputize other Federal agents to assist the Federal Protective Service in protecting federal property, such as the courthouse in Portland. Those agents can carry firearms, and arrest, without a warrant, those they perceive as committing a crime. This action, not surprisingly, has heightened tension and increased violent confrontations in the streets. In the process, the protest movement’s emphasis on racism and injustice has been effectively replaced by a manufactured narrative of “law and order”—playing directly into the hands of the President’s re-election strategy. 

To further complicate matters, millions of Americans and tens of thousands of Oregonians will most likely lose Federal support payments next week because of inaction by Senate Republicans to extend unemployment benefits before the current support lapses. Adding to the current environment of protest and frustration, the potentially dark social consequences of panic, blame and desperation that haunt those who cannot meet their most basic needs of food and shelter and see no hope for tomorrow creates an unstable and increasingly dangerous situation. This has been made even more dangerous by increasing inflammatory rhetoric from all quarters. 

What kind of plan could help de-escalate the situation before it spirals out of control? If the protests in our state since the murder of Mr Floyd are about social justice—about putting an end to police brutality and increasing accountability and transparency in law enforcement; about ending institutional racism and addressing the inequities that exist in our state and our nation—then what we are doing right now is not working. The peaceful protest movement in Portland has been drawn into a reactive position, a defensive position, and is at risk of losing the true narrative and putting in jeopardy the very goals for which it has been so courageously fighting.

What kind of strategy can reclaim the justice narrative that holds the moral high ground, and connect the energy of the protest to tangible and measurable actions that can redress the legitimate and long-standing grievances from which that energy flows?

Possible steps in that direction could be:

1. Leaders of the peaceful protest movement—Black leaders in Portland, religious leaders, and those who love courageous but peaceful advocacy for change—call for a short moratorium on the protests for five to seven days and urge their followers and those who seek only to exercise their right to peacefully protest, not to congregate in downtown Portland during this time. This is not a call to end the protests, which must continue. It is an intentional tactical decision to separate, for a time, peaceful protesters from those who seek violence and anarchy and from increasingly provocative and confrontational actions by federal agents. This moratorium would pause the momentum of escalating violence, and stop playing into the hands of those who want to mask the racism and inequality in America with an authoritarian narrative about law and order.

2. During this moratorium, call for a summit that would include Black leaders, protest leaders committed to peaceful change, business and labor leaders, Oregon’s governor, Portland’s mayor, members of the city council, legislative leaders of both parties, the attorney general, and the U.S. attorney for the District of Oregon. Given that the summit will necessarily be virtual, former President Obama might be invited to moderate. Considering the importance of this issue, and the amount of national coverage Portland has received over the past few weeks, the president would be likely to accept. This summit would seek two goals. 

First, develop an action plan for short and long-term steps and commitments to address, in intangible and measurable ways, the issues of transparency and accountability in law enforcement, and the conditions of injustice that have marred our state and our nation for far too long. Second, develop a strategy for how to resume the protests at the end of the moratorium in a way that will (a) keep the narrative focused on the conditions of injustice we are seeking to address and the actions, outcomes, and commitments developed in the summit; and (b) minimize, to the greatest extent possible, the likelihood that peaceful protests will be hijacked again by those who seek violence and anarchy.

  1. Also during the moratorium, secure a wide perimeter around the Federal buildings, perhaps deploying the Oregon National Guard for this purpose, to make it very clear that the state of Oregon is capable of and intends to protect federal property—just as it intends to protect state property and private property—thus eliminating the only legal justification the Department of Homeland Security has for sending these agents to our state in the first place. Not only would this perimeter protect Federal property, but it would also create a buffer, once the moratorium has ended, to protect peaceful protesters from violent and provocative actions taken by federal authorities—a task that should not be left solely to the courage of the “Wall of Moms”. 

The course we are now following puts control of the narrative into the hands of those who seek to further divide our state and our nation. We should not facilitate that, we should not allow it, we must take steps to prevent it. It is important not to lose sight of the fact that the focus of the protest is not on the legitimacy of laws that protect public buildings and private property from vandalism and damage. The protest is and should remain, focused on racism, injustice, and inequality. We cannot allow that focus and that narrative to be co-opted by either a handful of violent protesters in Oregon or by a national strategy that seeks to fuel and exploit violence and confrontation for political gain. 

The protests of the past two months are set against the backdrop of perhaps the most challenging set of problems in our state’s history: high unemployment, a daunting budget deficit, and a public health crisis. We are only six weeks away from when Oregon public schools have traditionally opened and the uncertainly about how that will be managed has put huge additional stress on parents, children, teachers, and other school employees. The ongoing, but necessary steps to bring COVID 19 under control, including the closure of many businesses and childcare centers, has added another layer of stress and uncertainty.

At this point in time, the combined leadership of Oregon’s public, private and civic sectors—and the energy, talent, and creativity of each and every Oregonian—must be engaged, with single-minded determination, to hold our state and our communities together. Now is the time to develop and implement a five-year strategy to create the kind of change rooted in social justice that we have been unwilling or unable to make in the past; a strategy to put Oregon back on its feet and lead us—all of us—through to a brighter time. By taking back the narrative, as well as the tone and focus of the important protests going on in Portland, protest leaders can help ensure that social justice, equity, and opportunity are built into the foundation of that strategy.

Somewhere in America, during this difficult time, a state needs to demonstrate that we can weather this storm without losing our sense of community, without losing our commitment to one another, and to emerge stronger and more unified than when we began. Let’s make that state Oregon.

Since this posting, Kitzhaber has followed up. Shortly after I posted it the State negotiated a removal of the Federal agents and the Oregon State Police took over.  There was a significant easing of tensions until a few days ago but there has been violence the last two nights, not at the Federal courthouse but at the headquarters of the Portland Police Association”…

The outbreak we had to have

Some may argue, to put it in the words of the Maestro, the Victorian outbreak of the Virus is the Outbreak Australia needed to have.

NSW had been the State where incompetence and carelessness were well on display but from June, Victoria has assumed the mantle and usurped that crown well and truly.

How the Premier handles the crisis could be the template for handling any pandemic – or not. He has a dreadful set of Ministers, the product of union factionalism. His public service, which has been stripped of most of its talent, is not much help. There are exceptions such the Chief Health Officer Brett Sutton and his deputy Allen Cheng.

Otherwise, the amount of intellectual integrity underpinning the Victorian approach has been woeful, and Andrews has moved, essentially groping in a policy blackness, on how best to move against a nasty hidden foe. The stress he is absorbing, particular given how weak his Health Minister is, has been extraordinary.

The lesson from the breakdown in the hotel quarantine should be clear – unvarnished or even if “coated”. This “stuff up” is just an example of giving work to your mates rather than assuring experience, trustworthiness, competence and responsibility in the contractors.

Australia is in danger of becoming a country of sunburnt baksheesh and wide brown paper bags. The sense of entitlement in some quarters of this country has grown under the guise of neoliberal narcissism – and its mantra is “only mugs work.”

The disaster is concentrated in the private nursing homes. Brendan Murphy has generally done a good job, but still remains somebody with a “tin ear”, talking about “reputational damage” that the proprietors of nursing homes have suffered, which frankly is irrelevant. There he was, presenting to a Senate Committee while the pages of the newspapers showed the owners of one or more of the affected nursing homes flaunting their yellow lamborghinis and bronzed buffness.

The problem is that the Commonwealth Government has shirked its responsibility. It has yielded to the shibboleth of “business knows best, Government should get out of people’s lives” and hence allowing self-regulation to be overseen by a group of bureaucrats waving warm lettuce leaves.

The training of the lowest level of health carers in the nursing homes is the benchmark level for adequacy and knowledge of health care. The simplest element of this knowledge and care is hygiene and hence infection control – theirs and those for whom they are caring, whether they be labelled patients, clients, customers, residents – or just people. Let us not descend to calling them “mum and pops” or “kiddies”.

However, it is not only the “lowest” levels of health carers that do not wash their hands. There are many surveys that show doctors and medical students do not routinely wash their hands – and to a lesser degree, even nurses. It would be interesting to know if the increased availability of hand sanitisers in the community may have changed habits and if there is any objective evidence that shows this is so.

The Commonwealth Government should at least be obtaining draft recommendations from its Royal Commissioners now, because the Victorian misadventure is a case study in progress and enables the Government to see what works. The Victorian misadventure is just such a fertile ground.  The Commissioners are realising that that one does not often have the opportunity to see what works or does not work “in real time”. Bugger the ivory tower – this is better than any self-serving submission. The Victorian situation is a case study in progress!

Andrews is in survival mode. However, he is all Victoria has. The predictable antics and hectoring for the sake of point scoring by a woeful set of politicians is more than unhelpful. Yet the Coates report is likely to be ugly. Already, the media watering can is nurturing the rumours.

If this next six weeks doesn’t work and with the numbers of infected people in Victoria being driven down, Andrews may be gone, subject to a Pallas coup.

Nursing home owners’ conference?

And what of the other States? What are they doing preventatively to rein in the operators of the private nursing home industry – to put a cap on the purchase of yellow Lamborghinis. Or are they behaving like “normal” governments – alternatively piously self-satisfied, sitting on their hands or putting “it on the long finger” until the community pressure becomes too great, all the while wishing the problem of the aged just disappears. Imminent elections as will be occurring in a number of states colour every policy decision.

One little measure, Commissioners Briggs and Pagono, presumably your Report will contain the amount of money the nursing home owners and shareholders contribute to the various political parties. No, of course not, not in the Terms of Reference.

All my problems come at once 

My son was on the same flight from America as Dr Higgins, in the Precovidassic era when the political dinosaurs stalked the World.

That week on March 8, CNN reported that there were more than 550 cases of the “novel coronavirus” in the USA. According to CNN at that time “around the globe, the novel coronavirus has killed more than 3,800 people and infected more than 108,000, the majority in Mainland China.”

Both men had independently acquired the then novel virus in the USA or on the flight. My son was actually No. 13 in Victoria. He went off to Box Hill Hospital when he felt mildly ill but had to battle the staff to get tested; eventually he prevailed. Despite being a journalist, he resisted publicising his plight, and went home, self isolated, tested positive and then stayed with his family in isolation for two weeks. No fuss.

Dr Higgins received more publicity, possibly because he has a famous daughter. As with my son, he had a minor upper respiratory infection and was tested. He however went back to work pending disclosure the test results for this “novel virus”. He also tested positive. Minister Mikakos weighed in and gave Dr Higgins a totally unreasonable “spray”, especially as he did not transmit the Virus! True to form, did she apologise? No, the lady was not for civilised responding.

However now Mikakos is on limited release, such has been her effect on containing the COVID-19 spread. That she is tweeting in the middle of the night is bit of a worry. I am afraid she gets no sympathy from me.

I suspect she and a number of other Ministers will resign.

She cannot be blamed for destroying the Health Department’s corporate memory and limiting the medical input in favour of advice that condemns “the medical model” (whatever that is) and fuels an environment where nobody with medical expertise would want to work. That’s the history of the Victorian Department of Health over the past decade. However, the attitude started many years before, with John Paterson and his contempt for the medical profession.

However, reviewing the Kennett legacy is not part of the current review. Kennett promoted gambling, including poker machines, as a significant contributor to the Victorian Government’s coffers. I am old enough to remember some of his disparaging comments about old people. There is no review of the spread of organised gambling and the harvest being reaped by overseas betting agencies, often at the expense of the elderly.

Although I used to like to punt and especially loved watching Winx, I question why racing has been given an exemption. City and country racing persists in Victoria and the industry seems to move seamlessly between Stages 3 and 4 Lockdowns. As one Victorian put it, “Would be a great feeling when your business is going down the toilet to turn the TV on and watch the essential horsies go around”.

However, an erudite friend of mine said: “what else is there to watch on afternoon television”. It should be noted that racing in Victoria, whether dog or horse is in the Ministerial portfolio of one Martin Pakula, who also has direct oversight of Disasters and Catastrophes.

However, the whole question of preference for sport pandering to the jocks, the whole reliance of government on gambling revenue at a time when, paradoxically, the same crowd that own the horses are often those who are wanting taxation cuts – presumably to buy more horses.

Overlaying this jock anti-intellectual climate is the cosy relationship between government and big unions (Victoria), big business (Federal) and big accounting/consulting firms (New South Wales). Queensland, with its long history of political corruption being an irritant, will have its day of reckoning as well.

The day of reckoning for the smaller States will be in the lifting of the State of Lockdown. This will be a test of shared responsibility in the face of inflammatory media that uses words like “carnage, deadliest, surge, tsunami” – any word that evokes anxiety in the community. Victoria has “stuffed up” because of a number of people, whose metaphorical heads should soon be gracing Spring Street gutters.

It is unfortunate that it is election time in various States so there is a propensity to blindly apply border restrictions, which flies in the face of Australia being a nation. Has anybody given a thought to Australia being balkanised, with Tasmania the Montenegro and the Northern Territory Kosovo?

Been there, chaps! As we headed towards the Albanian border a couple of years ago, the driver turned to me and said: “Have you got a gun?”

Having heightened the level of anxiety to a feverish level for political reasons, what will be the nationally agreed acceptable Virus levels to allow all borders to re-open, and moreover New Zealand? Elimination – that is, insisting on zero cases before opening borders is political nonsense, even in the face of there being no vaccine. Restlessness in the community increasingly will only require a minor incident before the restlessness and restrictions spills out onto the streets with the targets, the perceived virus spreaders.

Thus, agreement over what level of infection constitutes “suppression” is a priority. Once that is agreed then appropriate resources can be assigned so that Australia (and hopefully New Zealand) has one system of public health to maintain that suppression across Australia and New Zealand.

Once this relationship is tested at a government level then expansion of the initiative can be offered to other South Pacific countries. It is important in opening up trading and tourist links. As a former President of the Australasian (Australian and New Zealand) Faculty of Public Health Medicine, who advocated closer links with Pacific nations over 20 year ago working with the then Minister for Development Cooperation and Pacific Island Affairs Gordon Bilney, I feel reasonably assured of my credentials to offer this suggestion.

As the historian Humphrey McQueen has written: “In 1915 an external menace had driven Australians together; by 1919, an internal danger revealed yet again how easy it was for Australians to stand apart. If national unity involved loyalty to the Commonwealth as an administrative machine, the Pandemic showed how little of it there was.”

McQueen is somewhat harsh on Australia since New Zealand suffered more because of the laxness of its quarantine arrangements compared to those mandated by each of the Australian States. However, the pandemic varied widely. Tasmania did not have one recorded case. Yet one major consequence was the establishment of the Department of Health in 1922 and the assumption by the Commonwealth of the quarantine power, which had lain fallow in the Constitution.

In 1936, the National Health & Medical Research Council was set up so the Chief Medical Officer had a public health forum. Early on they were faced with the 1937 polio epidemic. “The prevalence of the disease in Victoria caused concern in other States, particularly New South Wales and South Australia. Up to twenty crossings into NSW were patrolled by police. Special police were stationed at railway stations, aerodromes, bridges over the Murray River and at the wharves in Sydney to control the possibility of the infection being spread from Victoria to New South Wales. Vehicles were stopped and checked.” 

Sound familiar?

Mouse Whisper

I have always wonderd why they use the word “shrewd” to define the astute mouse, rather than just say moused mouse. I have always thought of these vagabonds sleeping or digging tunnels under hedges as our country cousins. Apparently not, even though they are characterised as “shrewd”. I find that us mice are closer to the Porcupine family than to the Shrews.

Just as well I have made that point. Some shrews have salivary poison which they inject when they bite unsuspecting prey. Thus the derivation of “shrew” can be reflected in the Swedish, Danish and Icelandic words for “cut”.

While it is a shrewdness of apes, it is a caravan of shrews. As they tunnel, shrews navigate like bats: they emit ultrasonic clicks that reflect back to their ears to create an aural picture of the surroundings up to about a metre away. So the nursery rhyme caravan of three blind mice may be in fact “shrews” – talk about giving a mouse a bad name. We mice would never run up a clock in that way.

Modest Expectations – It’s Time

Two weeks ago, it was horror stories coming from Victoria about people being locked up in tower public housing blocks, and I expressed a concern as to whether locking people up in tower blocks should not be accompanied by a warning about the risk of fires and how this would be managed if the buildings were to go into lockdown. In fact a number of residents were evacuated to hotel quarantine.

It seems that threat has abated in the public mind in the face of the rising horror stories of the private nursing homes and the circumstances whereby the residents are caught up in the rising tide of community transmission.

This involved families, staff and “persons unknown” unwittingly spreading the virus to a group of our elderly population incarcerated in a system where financial profit is paramount and the operational arrangements seem far from being able to combat a pandemic. However the problem, while systemic, is not only rampant in certain postcodes and not in others but also completely contained within the private sector.

The Premier, Daniel Andrews, tries to be measured, never raising his voice and refusing to apportion blame to any sector of the population when it is probably plain to himself when reviewing the data that certain sections of the population are more susceptible to “amoral familism”, which I have mention previously. That one of the biggest outbreaks is in an aged care facility linked to the Greek Orthodox community has not elicited as yet any finger pointing in the community is testimony to his control of the situation.

The problem with “amoral familism”, which is not limited to a Greek village upbringing, is that it promotes the mindless protection of the family unit above all – the State can go hang. It is the product of an upbringing where the education levels are low and unfortunately the society in which many of the people have grown up is male-dominated and authoritarian, and often where sanctions are not enforced by the gentle remonstrations of the reasonable man, as Andrews is. Ignorance of English does not help.

Therefore, when it seems nobody is watching this group, even when COVID-19 positive, it is unsurprising if these people do not heed warnings. If I were isolated in a foreign village with no knowledge of the language, could or would I heed any warning?

Hence not having the language would be an excuse if the individual were an isolate. However, it would be rare for this to occur. Spokespersons for particular communities bob up all the time. Instead of ensuring that these potential “purveyors of death” are quarantined, these spokespersons seem just to offer a variety of excuses; they did not understand, they did know that what they were doing was criminal and the excuses flow on and on.

Andrews has a difficult job, because if he names the miscreants then he runs the problem of stigmatising whole communities for the sins of the few. Andrews also knows that these “hotspots” are in his electoral bailiwick, but given that many of the Labor parliamentarians in these electorates have migrant backgrounds, you would think that the Premier should not have to bear the full load. Some of the political actions are somewhat like those gossamer Green parliamentarians posturing in front of the locked-down housing towers, full of sound and fury, as is common with Greens, signifying nothing.

So it is easier to implement rules that disadvantage the Victorian community, moving to the second-highest category of restrictions – Stage 4. Unlike America, most Victorians know more about the Virus than they did in March when it first came to notice and are thus better able to run relatively normal lives, while appreciating the need for social distancing, hand washing and now masks. Most people have shown that they are prepared to work within increasing limits – as shown by the imposition of masks, which has been almost universally accepted.

The percentage of self-serving exhibitionists and just plain “wackos” seem to be mercifully small, but having identified themselves they could form a nucleus of inmates of the quarantine facilities that I have advocated should be constructed where those who are invited in serve a true “quarantine” period – that is, 40 days and nights. They would be joined by those deliberately flouting the government directives. After all, each of those COVID-19 positive individuals roaming the streets in a wilful manner is a “potential murderer”. Harsh words, but think about the logic. Who actually killed grandpa and grandma in the nursing home?

The other problem with Victoria is that it has always lagged behind NSW in its investment in public health, particularly in contact tracing. Victoria has been known to have under-resourced public health training for years.

That advance goes back to the work of Dr Sue Morey who, under the Head of the NSW Department of Health the late Bernie Amos, set up a comprehensive program in the late 80’s and early 90’s. Many of the current senior cohort of the NSW public heath physicians, as does the State of NSW, benefited from the program Morey established and owes her a very great debt.

The inability to find out the source of all the cases occurring in Melbourne also relies on people telling the truth and not incriminating themselves for whatever reason. Having said that, the present inquiry presumably is expected to reveal the chain of infection from case zero.

Those three young women flaunting and flouting through three States, refusing to co-operate, destroying their mobile phones and probably denying they are Nigerian are just extreme examples.

However, as with criminal activity the more the rest of the community is law-abiding, the more time there is for policing the extreme cases. As with vaccination, there is a reliance on having a high proportion of the community vaccinated – the vaccinated group provide a buffer for the unvaccinated.

There is also another “wee” problem that may be overlooked when the pandemic is distracting attention. The Ministerial retinue has returned from America. Like those who have flouted the pandemic in Melbourne, the government has not offered any advice on their whereabouts. However, the “cat may be out of the bag” when a so-called “consular officer” returning from overseas turned up in Maroochydore and then Toowoomba yesterday with a dose of COVID-19. Coincidence?

Apparently, “not actually a Consular officer” quibbled DFAT, but he was still carrying a diplomatic passport or the equivalent. The arrogance of holders of red and green passports knows no bounds, but at least the Queensland Premier has called this exemption out; however there is no mention of the whereabouts of the two Ministers. Again, there are exemptions for the few.

Clive Palmer – The Rose of Bulgaria or a Dangerous Furbo? 

I think that this son of Bulgaria, alleged owner of property in Sofia, and expert in its national sport of Split Squat has been wrongly characterised. Here in the damask fields of the Rose Valley of northern Bulgaria they talk of nothing else – but Clive.

He is up to all his Bulgarian tricks again. He has a case before the High Court challenging the Western Australian Government’s right to the close its borders.

His arguments are based around section 102 of the Australian Constitution, which states:

On the imposition of uniform duties of customs, trade, commerce, and intercourse among the States, whether by means of internal carriage or ocean navigation, shall be absolutely free. But notwithstanding anything in this Constitution, goods imported before the imposition of uniform duties of customs into any State, or into any Colony which, whilst the goods remain therein, becomes a State, shall, on thence passing into another State within two years after the imposition of such duties, be liable to any duty chargeable on the importation of such goods into the Commonwealth, less any duty paid in respect of the goods on their importation.

Most of the words in this section relate to the immediate transitional arrangement following the enactment of the Constitution in 1901 but the key clause has centred on what States can or cannot do about imposing barriers between themselves. Legal arguments have waged about what it all means and many lawyers have had their waistcoats filigreed in gold as a result.

The Attorney-General, Christian Porter, probably as a proper lawyer had the normal reflex. Since there is a challenge to the Constitution, therefore the Australian Government must take an interest. This is such a fundamental issue. Does State border closure present a challenge to the Federation if unilateral action is taken by a State to close the borders? Does Clive Palmer provide a challenge to the Australian Constitution?

The Federal Government was emboldened by the initial encouragement of the Prime Minister to keep supporting the Palmer initiative. There, in the background, would be the normal cheer group that thinks supporting Clive’s challenge a “jolly jape”. These are parliamentarians gathered together under the standard of a skunk-like animal with adolescent behavior rituals and bearing aloft an icon of Christopher Pyne. They can’t help irritating the Australian community from their seats of privileged opulence.

The Prime Minister has had second thoughts, hopefully not only because of the backlash in Western Australia to the Palmer challenge. It should be remembered that Palmer was born in Victoria and spent most of his formative years on the Gold Coast, where he made his first fortune in real estate. So he is not a genuine Western Australian – “he just ain’t one of them”.

If Clive wants to stir up the Sandgropers over this issue of secession, of which border closure is a subsection, then they might just take it out on the Liberal party at the next Federal election. Hence, Morrison backing away may have been because he realised that Palmer was trying to “tar baby” him.

One obvious solution is to form a pro-tem barrier away from the accepted geographical boundary. Cross-border regional arrangements are everywhere. To me, working in the Victorian border town of Cobram on the Murray River, meant that I had to cross to the NSW river town of Barooga more than once a day.

One has only to live in a border area to know that indiscriminately shutting borders is group punishment, unnecessarily unfair and at times unwittingly dangerous.

These are communities of interest, which have grown up over a century or more, where the border is just irrelevant to normal social and economic intercourse.

Therefore when this Virus is eventually contained there is work to be done in this area of “communities of interest”, so that if borders have to be closed then there is a fully developed plan that minimises the disruption and can be put into immediate effect. As has been said on more than one occasion, cross-border arrangements have diverse benefits and opportunities for managing a shared resource.

In any event should the adopted son of Bulgaria win his case in the High Court, I am sure that Western Australia could move its lockdown zone един метър inside its actual border with South Australia and Northern Territory. Clive, with your solid knowledge of Bulgarian, you would know what that means.

After all, Clive you are not the only gander in the “Gooserie”.

Hafnium (Hf)

I was browsing through an old New Scientist and came across a world map, which indicated that among a series of metals, Australia had over 50 per cent of the world’s hafnium.

According to the map legend, it was estimated that Australia had the biggest deposit of hafnium in the World. Hafnium does not occur independently in nature.

Even though predicted by Mendeleev it was not discovered until 1923 by two chemists Dirk Coster, a Dane, and George Charles de Hevesy, a Hungarian. The Dane prevailed. Hafn was the mediaeval name for Copenhagen. The Hungarian just shared the glory of having isolated this last natural occurring element.

Apparently, one of the major problems is that hafnium is tightly linked to zirconium in a ratio of 1:50, and exists in a group of three naturally occurring elements with titanium the lightest and hafnium the heaviest with an atomic number of 72. Lying between is zirconium. However, as far as can be obtained, the amount of hafnium produced is small, and until recently it was a considered a waste product, removed in the purification of zirconium. Zircons are renown as jewellery substitutes for diamonds, but zirconium has a multitude of uses, and put simply it is everywhere – its industrial use is in hardening alloys and ceramics. It is also anti-corrosive.

Recently, Hafnium has been found to have a number of amazing properties and it can be used in almost any industries where the word “advanced” is the prefix.

The special properties of Hafnium oxide have recently permitted further miniaturisation of microprocessors, enhancing processing speed while eradicating overheating problems.

Resistant to corrosion, the metal its oxide forms extreme temperatures. Consequently, hafnium is used in plasma cutting tips for welding, and is essential to the advancement of the aerospace industry. 

Added to this, hafnium carbide is one of the highest temperature resistant and hardest materials with melting point of 3,900 degrees Centigrade which potentially suitable in a nuclear thermal rocket (NTR) for faster spacecraft propulsion.

So writes the hafnium enthusiast linked to the company proposing to mine a deposit south of Dubbo when extolling the element’s virtues.

Despite its global market being about 70 tonnes annually, this enthusiast predicts the demand will double by 2025, and Australia could produce 200 tonnes a year. So far I am following the trail to Hafnium.

This is a small amount given that the Dubbo mine is proposed to be an open cut operation that will extract 19.5Mt of ore a year from a 32m-deep open cut mine.

The extracted ore is crushed and further reduced in size by grinding circuit. Sulphuric acid will be used to convert the material into sulphated ore, will be leached in water and sent for solvent extraction and precipitation, and onwards the final product.

Extraction of these elements and the associated pollution is increasingly being factored into political considerations when the mining spruikers are abroad. However, there are further chemical processes to separate the hafnium from zirconium.

The technological description states it is “a liquid–liquid extractive separation between hafnium and zirconium from thiocyanic acid medium using the mixtures of diisobutyl ketone (DIBK) and di (2-ethylhexyl) phosphoric acid (P204) as the extractant was developed.”

A metallurgist could answer the question of how much this extraction method damages the environment. 

It is almost as an afterthought, that process residues are treated before dumping them into storage facilities. The disposal of residue when there is a potentially such a big hole in the Dubbo landscape is far from a throwaway line.

Water will be taken from the Macquarie River, but the amount proposed is nowhere stated. In the description of the extraction of ore no amount of water is mentioned and the description hurries onto the marvels of the proposed mine.

OPAL’s lightwater pool

There is another problem with zirconium mining – the deposits often exist with radioactive elements – thorium and uranium. Small problem with an open cut mine only a few kilometres from a regional city! I find it interesting that there has been an experimental extraction plant at Australia’s Nuclear Science and Technology Organisation (ANSTO) since 2009. Hafnium is used in control rods in the nuclear reactor core.

Currently, China produces 75% of the world’s zirconium supply and hence hafnium. “China’s stranglehold on the supply chain of this material essential for advanced technology weakens the economic and political security of other nations”.

Metallurgy is one of the professions that, from the outside, smells of alchemy – there is a magical aspect to the extraction of these uncommon elements and their increasing relevance with advancing technology demanding these metallic elements with their special qualities. Then it is promoted to an essential component of our lives. Lithium has been one such metal.

However, the “green lobby” faces the whole “strategic development” lobby, where self sufficiency is increasingly important, and moving rare elements around the political game board are important chips in being able to game, with more strategic element chips than other nations. At present, China seems to have the greatest variety of these chips in the greatest quantity.

Australia has quantity in two particular chips – iron ore and coal. But that is a different game board. Given the amount of these being mined, then the impact on climate change is a constant.

However, too often the question from the local politicians when confronted with the prospect of a mine in their electorate is concern about how many jobs will be created. The Dubbo project bosses does not explicitly answer that question.

As far as one can gauge prices, the price of hafnium is in the region of USD6million a tonne; whereas zirconium is priced at USD10,000 a tonne.

To get a comparison, Australia produces 900 million tons of iron ore at about USD110 a tonne.

What progress has been made on the Dubbo mine project? In February 2020: Alkane noted that Export Finance Agency’s (EFA’s) financial support would be subject to finalisation of due diligence, acceptable financing structure and eligibility and credit requirements. As Australia’s export credit agency, EFA is mandated to support businesses, which are seeking to develop new export market. 

I have been one of those converted to the climate change lobby and I am particularly worried about the wasteful use of water in what, apart from Antarctica, is the driest continent.

I read about hafnium; the notion of there being the greatest percentage of the world’s supply in Australia has intrigued me. I have searched to find out what is its proper place in the Australian economy. Political leaders are often confronted with such decisions when they have little intrinsic knowledge of the subject.

The giraffes are watching …

However, if I were in a position to make a decision, I would be immediately worried by the massive water requirement and the fact that there would be an open cut mine where radioactive minerals are being mined close to a major regional city, the Western Plains Zoo and the Dubbo Observatory. However the dilemma is, as with all mineral extraction, how can the metal be purified with the least pollution. Unfortunately, when in doubt the large powers with a monopoly of the chips kick the game board over – and everybody loses.

Paraphrasing Einstein, who never said a truer word when he said the fourth world war will be fought with rocks, some of which may contain hafnium.

All Souls

All Souls, Oxford

I suppose being invited to dinner by Max Beloff with the academic Fellows at All Souls was an honour. Great Britain that year was sunny, and when that occurs the summer is always beautiful. Off to Oxford the three of us went one evening to have dinner.

Max Beloff was an eminent modern historian who, at that stage of his life, was tramping from one side of the political spectrum to the other. The young socialist Beloff, now in middle-age having marked time as a Liberal, was moving determinedly to the right at the time, when he invited us to dinner.

Beloff had been a Fellow since 1957, ensconced as he was in this group “at the pinnacle of British academic hierarchy”. He had attained this position much earlier than when he had pursued this neo-liberal journey, in the process setting up a private university and then later absorbing imperial honours that were piled on him by Thatcher.

When we arrived we were ushered into a reception room where pre-dinner drinks were served; I had the obligatory dry sherry as the clever repartee started. The problem with clever repartee is that it is essentially hierarchial; if the young man (it was not until 1979 that women were admitted as Fellows of All Souls) wanted to announce his presence in such exchanges, it seems dressing flamboyantly helps. The “look at me” mien serves as an entrée card.

I was well versed in the social rules of these establishments, having been an undergraduate in a residential College, which replicated much of its social mores from those of Oxford. Therefore, I shut up and only replied when spoken to by some Fellow who had not the slightest interest in whom I was.

However, the call to dinner came and there is nothing like a College refectory – long high table, paneled walls, high-backed mahogany chairs. Beloff welcomed us – the Boss thanked him. It was all so polite, but it was an experience – probably once in a lifetime. Although for them not; just three Australians to be humoured in exchange for a meal.

I was seated next to Michael Howard, the military historian and we chatted about his topic. My contribution when the Franco-Prussian War was mentioned was that I had inherited a full set of skeletal bones from my father. It was widely thought that many of the skeletons used by aspiring doctors pre-war had come from soldiers who had died in that War. They were highly prized for the muscle markings, which were very distinct on these bones. However, apart from that I cannot remember the other Fellows beside and across the table. The talk was just that – inconsequential chatter as the Fellows on either side of the table carefully updated themselves on one another, given that there was a young foreigner in their midst.

Dinner was traditional English fare, which was better than the College roast to which I been subject every night more than a decade earlier.

Once dinner was finished it was off to another room for fruit, nuts, digestive biscuits and the central cheese. The obligatory Stilton round had pride of place, and the port was passed. Then it was off to the terrace for coffee and brandy.

The night was absolutely still and balmy, the sky a curious lavender grey. Across the terrace was the impressive Codrington Library building, built in the early 18th century on the back of slavery and a sugar cane fortune amassed by a Christopher Codrington.

It highlights the problem of applying 21st century values to the funding of a building like that. The Christopher Wren sundial installed over the entrance is a spectacular reminder of the versatility of the man, and Wren himself was a Fellow.

Oh, so different from the environment of the All Souls College of Christopher Wren, outwardly becoming more sensitive to its survival after the radicalism of 1968 which threatened its existence, when it was sneered at as “a weekend home for port-drinking members of the London Establishment, grown fat on the rent of farms it owned since the Middle Ages”.

Had we had dinner in an Anachronism?

Then it was back to London. I still remember the golden glow drenching the car, and my thoughts drifted to the recently-released Joe Losey film “The Go-between” and I, projecting myself as the young man in search of a romantic interlude in the same rural saffron softness of the film.

I have often visited Oxford since, but never again had a brandy with the 42 Fellows outside on the terrace.

But then again I would have preferred to meet Julie Christie. 

Mouse whisper

A scrap of paper plastered against my mousehole. That is the problem about my mausmeister. He is always cutting out what he considers wise sayings and leaving them on sticky pieces of paper. When I scraped the piece off my “hole way”, it read:

There is nothing more difficult to take in hand or more perilous to conduct or more uncertain in its success than to take the lead in the introduction of a new order of things.

Very sage advice; but I was thinking of putting in a new entrance to my mousehaus to make a closer access to the pantry. I’ll have to think about it now.

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 – Siatonta

Grisons, Switzerland – where they say siatonta

Harry Cain sounds as if he should be a shamus in a Raymond Chandler novel, but he was an amusing health bureaucrat whom I met in the early 1970s in Washington. We were both characterised as “bright young men of promise” and interested in improving the health care in each country – in fact we would be in the vanguard of such improvements, so our conversation went.

When we first met it was the Nixon administration in the USA, and the Gorton-McMahon carousel in Australia, but like many smart bureaucrats he was advancing upwards through the Department of Health, Education and Welfare. We saw one another whenever I visited the United States. Harry, with his sardonic manner, was popular and knew which buttons to push. He and I got along as well as any two could when we were a Pacific Ocean apart.

I have been going through my files and I came across a news article about Harry in the Los Angles Times of 14 April 1978.

Harry Cain had an intermittent stutter and it apparently manifested itself when he had to address an audience. This day when he started to address an audience of 200 fellow federal bureaucrats, his stutter got the better of him and his boss had to read his statement:

I have totally lost my tolerance for the bureaucratic swamp through which a bureau like this must wade … old bureaucrats never die, they just grow obsolete and get transferred to another agency which can’t use their skills and can’t fire them.”

With those words he quit and it was reported that: “bemused bureaucrats came up to shake his hand (and) a woman threw her arms around him and asked, ‘what are you going to do now?’

His reply was that he was going to climb out of that swamp and dry out for a while.

To my knowledge, having dried out, he remained within the Beltway – running for a time the American Health Planning Association, getting quoted, and arguing that there was a need for a less centralised control under Obamacare –reduced government intrusiveness which he characterised as “the micro-management of Medicare. The scale and complexity of the health care industry (which) are beyond the grasp of 500 politicians sitting in Washington.”

Swamp life

But nowhere does Harry appear to say he ever wanted to drain the swamp. However, there still remains the problem of how to co-ordinate an American health care sector when there are so many interpretations and so many unresolved prejudices; unfortunately his time has passed.

Strong as Your Weakest Link

In 1666, a fire started in Fish Yard off Pudding Lane, spreading from the king’s baker’s oven. Thomas Farynor, the baker, could not contain it and off down the lane the fire sprinted. The fire spread rapidly through the pitch and thatch of the crowded buildings until it was stopped four days later by the military blowing up houses at the edge of the inferno. Very few people died directly, although many buildings, including the Guildhall and churches including the Gothic Old St Paul’s, were destroyed. Spot fires persisted for many months in London.

Pudding Lane, London

Unfortunately, a French watchmaker was hanged after a false confession to starting the fire. Thomas Farynor was one who signed the petition accusing the watchmaker of starting the fire, then rebuilt his bakery and died four years later.

In 2020, the fire was a COVID-19 virus phoenix arising from its suppression in Melbourne. The strong rumour in need of rebuttal, if untrue, is that the recent spread of the coronavirus in Victoria was started by one of the ladies who had returned from overseas and in whom being confined rankled, or so the story goes, so much so that she started imparting sexual favours to her custodians in return for “day leave” as it were. The security detail was unskilled and untrained in the ethics which are implicit in being able to distinguish not only what is legal and what is not – but also the difference between right or wrong, even if these particular individuals escape prosecution.

The endemic problem is that the security industry is rife with undertrained part-time staff. It is not a new problem. When I was a medical student, I used to ride in the back of the Mayne Nickless security van, as the third guard. I was provided with a loaded pistol although I had no training. I worked in that job part-time for years. However the lack of training is never a problem until something goes wrong, as has happened with the spread of COVID-19 from the Melbourne quarantine hotel when the security was laughable. And somebody, Mr Premier, sanctioned its use, didn’t he?

As I write, the COVID fire is still not under control in the two largest States. We await the outcome of the enquiry and wonder how close to the truth the above rumour is and how many truckloads of whitewash will be brought in to expunge the stain. Presumably the perpetrators will be deluged with some of the wash.

However, there is another potential ember attack on the horizon, the jolly ministerial pair of Payne and Reynolds are slated to fly to Washington with a retinue of braided officers and presumably the “usual suspects” which accompany such people of renown. However, as a concession, limiting the number of the flacks limits the number of potential exporters of the COVID -19 to Australia, I presume they will have a trained medical team to ensure they will all be abiding by Australian requirements. They are going into an environment where the Boss is in flagrant denial. Are all these travellers going to abide by our rules or by the lax American requirements?

I presume social contact will be constrained and I would hope that all travellers are vetted for their history of alcohol consumption. Actually I would hope that all will be on the wagon for the duration given the propensity for alcohol to reduce adherence to anti-COVID rules.

And what are they going for anyway, except for huff and puff – apart from the fact that it will make the Chinese dragon even more infuriated. As I am writing this I am also watching Midnight Oil with that political dud, Peter Garret singing US Forces at a 1985 concert on Goat Island:

US forces give the nod

It’s a setback for your country

Bombs and trenches all in rows

Bombs and threats still ask for more” … and onwards.

Easy to protest. I am surprised that the ALP is so acquiescent to the US trip. Richard Marles is its spokesperson. Richard Marles, the Geelong Grammarian who loves his toast buttered on both sides, is encouraging the jolly catch-up. Marles is not stupid and he is not endangering either himself physically or the nation by being a COVID carrier. However, it was the week when it was revealed that overseas forces in 1975 had rid themselves of a “troublesome Prime Minister”, and Marles knows that the shadowy forces mark down any Labor politician who does not bend the knee to overseas authority.

Being a boy used to the light blue trimmed blazer, he would well know the bounds of being a radical chap. He may have read about Whitlam’s sacking when he was a boy in Glamorgan knickerbockers – and somebody may tell him about a Mr Marshall Green whose successors are still abound.

The last recorded time an Australian Minister went to Washington was Peter Dutton and, as reported, his infected return elicited an almost hysterical reaction among his colleagues, who were were taken in hand and reassured by Dr Paul Kelly.

You know, small details about those who are going need to be considered in meeting these Americans. How many of the travellers are susceptible: over the age of 60, obese, suffering from cardiac or respiratory problems and having diabetes? Then there are the cigarette smokers.

Enough said. Sounds as if it’s not worth the risk, especially as Trump and his regime may be a footnote in history after November – and sanity begins to prevail again. After all, one is only as strong as the weakest link.

Peril at Buck House

Given I’m actually old enough to have participated in the prequel of the Whitlam sacking, to me it was always clear that it was a put-up job.

I must congratulate Jenny Hocking in having the fortitude to have the letters released. Strangely, Whitlam never maintained the rage, because what made him both great and yet vulnerable was his basic generosity.

This was the story of the three fops. One was Whitlam, but all his other positive characteristics overshadowed this vainness. The other two were also Sydney lawyers, one became a Senator; the other, Governor-General. They were James McClelland and John Kerr respectively. Both were very careful about their appearance – one exquisitely flamboyant and tasteful, exciting the sobriquet of “Diamond Jim” and the other embarrassingly boorish and tasteless, caricatured as an Irish squire with top hat and frock coat.

Whitlam was the son of a senior public servant. His education was a mixture of the public and the private with a taste of the early Canberra. McClelland, the son of a paperhanger and signwriter, was educated at St Patrick’s Ballarat and St Kevin’s in Melbourne, where he and B.A. Santamaria were mates. Kerr, whose father was a boilermaker who worked in the Sydney dockyards, went to Fort Street School.

All were very bright scholarship boys; all became lawyers – the second world war interrupted their careers. Whitlam and McClelland were in the RAAF. Whitlam was a navigator so he flew, whereas McClelland was a leading aircraftman and stayed on the ground. However, Kerr was the star; he was one of Alf Conlan’s bright young men – and a colonel by the end of the War. With Alf, he probably absorbed the dark arts of the double agent.

After the War they came to know one another well and, if it is to be believed, Whitlam was persuaded by McClelland to appoint Kerr as Governor-General on the retirement of Paul Hasluck. The die was cast, as Kerr’s boilermaker father may have said.

The constitutional crisis was played out, demonstrating Kerr as duplicitous egged on inter alia by Buckingham Palace. If the letters had been released earlier – say in 1999 when Turnbull was heading the push for a Republic, Australia may have been in a totally different state now. The longer the release was delayed, the more the response would be who cares? The major players, except the Queen, are all dead.

Undoubtedly the Queen knew about the coup. Her private secretary Martin Charteris was showered with imperial honours, most noticeably an escalating array of those that are reserved for personal gift from the queen. It is doubtful if a displeased sovereign would have been so bountiful.

However what I find instructive is that some years later when Charteris had retired to polish his escutcheon, the Queen was placed in a similar spot in relation to a constitutional crisis which occurred in Saint Kitts and Nevis in 1981, when the Governor, Sir Probyn Inniss, used his reserve powers to refuse assent to a bill passed by the government of Sir Kennedy Simmonds, the country’s premier. Inniss believed that the bill was unconstitutional. The situation was resolved when Queen Elizabeth II, at the request of Simmonds, terminated Inniss’s commission as governor.

The problem when retracing history is that in the end what has been done has been done. I, together with a number of other players who had roles akin to those of Rosencrantz and Guildenstern, may speculate on what could have been.

Fraser was a lousy Prime Minister and it may been argued that what Hawke wrought may have occurred six years earlier if Whitlam had belatedly brought in a new crew headed by Hayden and Keating and then had been allowed to manage economic policy until the scheduled election in 1978. But in the end Hawke did take over in 1983, and changed economic direction.

Many changes have occurred since 1975. The Melbourne establishment’s power is now vestigial and while the demise of these Whigs masquerading as Tories may have occurred, there has risen a very powerful plutocracy, with Sydney at its epicentre; but with Perth as a powerful outstation.

The reserve powers exist as long as the links to the British monarchy exist. Therefore, the Kerr situation could be used as a precedent for a repeat, if the plutocracy did not like the government. When you review the Governors-General since Kerr, one would have been confident that Cowan, Hayden, Stephens and Deane had the strength, integrity and wisdom in using the reserve powers in a way so as not to compromise the Australian democracy.

I would not have been so sure about the last lot of Governors-general, but the “reserve powers” situation should be addressed. It is a totally unacceptable situation that one unelected person is able to connive with a distant monarch, with increasingly tenuous links to Australia, to sack the elected Government – and to call that ability “reserve powers”.

What a joke!

The Australian propensity to change its Prime Ministers – seven in 13 years – equally may be a joke.  Thus it has been a basically unstable time and fortunately Australia has not been confronted with a Governor-General such as Kerr, using at whim the so-called “reserve powers”. Therefore, I would be wary of any merchant being appointed as Governor-General in the future. However, “reserve powers” remain the joker in the Canberra pack.

Codification of the reserve powers – just a jumble of words. I wouldn’t hold my breath that anything would occur, unless both political parties think clearly about what it means. Self-interest may drive the thoughtful on both sides of politics. Conservatives should wake up in a sweat about the spectre of a Jack Lang as Governor-General invoking “reserve powers”.

And the Australian Republic? I am an avowed Republican – but so what? I know what I would want. Given the social and economic instability of the current situation in this year of the Virus, the matter of a Republic seems somewhat of a sideshow. However, at such time as the Queen abdicates or dies, that will be the time for a serious thrust from the Republican forces.

In the meantime, the Republican movement should plan that the sideshow is ready to become the main event. Then the matter of any “reserve powers” may become irrelevant – or would it?

Putin and His Kosher kitchen

In 2001, Putin was still feeling his way amongst the leaders of the World. In January of that year he dined with the then President of Israel, Moshe Katsav. As reported in the NYT, the meal was kosher, “making the occasion a first for a Russian leader in a thousand years.”

Putin with his matzah bread

The food was kosher – mushroom soup, vegetable stuffed veal, roast turkey with fruits; even the caviar was from red salmon rather than from the scaled sturgeon.

As distinct from the White House which still ordered-in kosher when the Israeli leader came calling to Washington, Putin created an entire kosher kitchen that, as reported, required “among other things, an army of rabbis, all-new utensils and a blowtorch.”

A kosher blowtorch?

Yes, the blowtorch can help make a kosher crème brulee.

Putin has tried to dampen down the anti-semitism that has been a feature of Russia social policy – pogroms being the centrepiece. However, after briefly trying to implicate Jews in the 2016 anti-Hilary campaign, Putin has aligned Russian sacrifice in WW2 with the Holocaust. It is a way of emphasising the history of anti-semitism among the Slavonic people, but extracting Russia from the general contumely.

As reported during a recent January speech at the dedication of a monument to the siege of Leningrad, Putin indicated his latest thinking on the Holocaust and anti-Semitism. The Kremlin now sees the distinct and separate story of the Jewish wartime suffering as supportive of its broader campaign to improve the image of the Putinic Russia.

After all, Putin has had an easy time of it facing a divided opposition where clearly, for whatever reason, he has an ally in Trump. Putin very clearly realises that Russia can only achieve limited goals with military force. It is ironic that he seems to be using a similar tactic to that used by the USA to destroy the Soviet Union in Afghanistan. His support of Syria and the continuing military action in the Ukraine after his annexation of Crimea are targeted, and it could be argued that these could have been stopped if Trump were not his ally. However, the whole Trump association may have to wait until Trump’s finances are disclosed – if ever.

Putin, despite his spoiling tactics and his annoying misuse of cyberspace where it is inconceivable that he has any technological advantages, has looming problems. His is not a wealthy country as judged by its GDP, especially with its reliance on oil and the need to manage a vast country, made particularly vulnerable by both climate change and his own disdain for the environment – and the Virus.

It is always unwise to underestimate the Russians, as distinct from Putin. They have this habit of producing excellent strategists. This ability is manifest in their overall supremacy in chess. Russians are remembered mostly for their WW2 exploits against Germany and by their defeat of Napoleon.

Capturing Moscow has been a mirage for many invaders.

In 1709 there was the less well-known Battle of Poltava in what is now Ukraine. In a long term but initially successful campaign against Russia under a very competent leader in Charles XII, the Swedes against the Russians had the high hopes of taking Moscow.

Instead, the Swedish empire was effectively destroyed at that Battle and the Russians, under the generals of Peter the Great, not only gained Ukraine but also the Baltic states, giving Russia unimpeded access to the Baltic Sea. This access was consolidated by the concurrent construction of St Petersburg by Tsar Peter on what was swampland on the Baltic shore along the banks of the Neva River.

If you want to experience both Russian power and grandeur, St Petersburg should not be missed. As a parenthetic comment, the reconstructed Amber Room in the Summer Palace is one the wonders of the modern world.

Yet with his keen sense of history, Putin would know that Russian leaders have thrived on governing with the use of often unspeakable brutality. Putin has recently won a vote for him to govern until he is 83 years old. His desire for alliances, his disruptive tactics, his hold over Trump, the American floundering in Iraq and Afghanistan, his drive to maintain and expand access to seaports have served him well, as he has climbed the rungs of power from his unheralded anointment as Yeltsin’s successor in 1999.

Nevertheless, especially once the Virus has extracted its toll, when Trump has gone, when the Chinese have assessed his true value to them and Russia is again exhausted financially, the coming decade will certainly be a test of whether the blowtorch will only be used for the crème brulee.

Mouse Whisper

I have actually seen the newspaper cutting from The Age sometime in mid 1981 under Missing Friends, personal:

Would anyone knowing the whereabouts of GUY FAWKES please tell him we have an urgent job for him in Canberra.”

H.B. (Marlo)

Would anyone knowing the whereabouts of H.B. from Marlo…

Guy Fawkes

Modest Expectations – Maria A Nona

Just a brief acknowledgement of Prof Brendan Murphy becoming the first medically qualified head of the Commonwealth Health department since Gwynn Howells was Director-General from 1973 to 1982. Murphy has a certain quality, which can survive the neo-liberal/ Canberra mandarin doubt. You know, doctors should stick to their knitting – and not mix it with the “big boys”.

I must say I have been always sceptical of that mantra which inter alia the late John Paterson promoted – namely you could be content free and run a Health department with minimal knowledge of the portfolio. To Paterson, health was only an unadorned matter of cost accounting. 

Another view of the Endurance

There is one piece of COVID-19 information about the South American situation that does not get much coverage. The rate of infection in Uruguay is very low, currently being less than 1,000 infected, with 27 deaths.

Now Uruguay has only 3.5 million people and while the death rate on a population basis is higher than ours, the number of cases is very respectable given that it has borders with Brazil and Argentina.

In an earlier blog I have written of my experiences about Uruguay last year. It has the characteristic of a Spanish-speaking culture but one I found, as an Australian, a very comfortable one. Maybe it was because we had two fantastic guides with an appreciation of Australians.

If we look at attenuated tourist bubbles of countries that have suppressed the virus, Uruguay should not be left off the list.

Montevideo

Two matters stand out. The first is that a third of the population lives in high-rise condominia along the Montevideo waterfront. In some parts Uruguay may be sparsely settled, but it has one substantial city, Montevideo, with a crowded population that seems to have avoided the CoVid-19 occurrence of other cities with substantial high-rise populations.

The second relates to the MV Greg Mortimer, with a substantial number of Australians on board. There could have been a complete disaster without the intervention of the Uruguayan Health authorities.

The World Health Organisation had declared COVID-19 a pandemic three days before the brand new, luxury MV Greg Mortimer (which despite its illustrious name is registered in the Bahamas), with a crew of 85 and 132 passengers, set sail from Ushuaia on March 15 on a 21-day cruise following a similar route to that of the Antarctic explorer Ernest Shackleton.

During the next 13 days the virus struck, although everybody tested negative for the virus before they boarded. Progressively more and more tested positive until 81 of the crew and passengers had contracted COVID-19.

Both Argentina and the Falkland Islands would have nothing to do with them, even though the passengers had embarked in Argentina at Ushuaia. The Uruguay government allowed the ship to anchor 16 kms off shore and then sent in a medical team to assess the COVID-19 status of those on the ship

Uruguayan physicians who boarded the MS Greg Mortimer to assess the passengers and crew

This story has been told recently by a respiratory physician, who was on the ship. He highlighted how careful and ordered the Uruguayan authorities were in handling the situation. They provided a “sanitary corridor” which allowed for repatriation, where those who were sick, including one of the ship’s doctors, were taken from the ship. Eight were hospitalised and one person unfortunately died.

As described in a recent issue of the Macquarie University journal, the way the matter was handled was in stark contrast to the Ruby Princess fiasco.

To his credit our Prime Minister was very generous in thanking Uruguay, a fact that should not be forgotten in the Year of the Virus.

The Presidential position had just changed back to the Conservative coalition, with Lacalle Pau, the surf-loving scion of an old Uruguayan family winning the runoff from his Socialist rival by only 30,000 votes. The maturity of this change in government reflects well on the state of democracy in Uruguay and on the successful approach of containing the virus even with a change of government.

Remember also Uruguay has a 1,000 kms border with Brazil and while there are nine border crossings, in one instance between two of the border towns, it is virtually just a line on the ground, little if any spread of the virus has occurred across the Brazilian border.

Yet according to The Guardian, Uruguay is fourth in the world for success against the Virus with New Zealand first and Australia second.

The discipline shown in handling the Greg Mortimer is an exemplar, and explains the current success. While it is not stated when you are moving people from an unsafe environment to a sanctuary, nobody wants to be last off, and yet the Uruguayans were able to maintain the discipline and co-operation for 19 days before the last person was evacuated from the MV Greg Mortimer.

In Uruguay, the current Minister of Public Health is Dr Daniel Salinas, a medical graduate but it seems that five years is a long time as Health Minister. He has only been in the position since March this year.

Talk about a baptism of fire and he has already been “outed” for going where he should not have gone during the lock-down. The words were harsh, but for now he has kept his job. 

In the Year of the Virus

In the Year of the Virus, what is written at the beginning of the week may be superseded at the weekend by the way the virus is driving the government agenda, both the economy and social intercourse. How something so small can change the way we go about our life tests our ability to maintain order and not succumb to the chaos of the individual ignorance – whether wilful or not.

Chaos is epitomised by the image of the two old guys in a street in one of the infested suburbs culturally kissing one another on the cheeks and then when they knew they were being photographed grinned like idiots into the camera. As I pointed out last week, the active elderly are potentially great Virus spreaders, especially as the niceties of the reasons for testing seem beyond them.

Premier Andrews is very adroit in being prepared to call out the Aspen skiers as “persons of interest” who brought the Virus into Australia. “Bad people”. However, his adroitness is in not blaming but at the same time blaming his Labor-voting constituency.

Andrews recognises it is pointless to call out the peasant mentality that the Florentine Leon Alberti identified 500 years ago as “amoral familism” – an inability to think beyond the extended family. Panic buying is one symptom, and disregard of any appeal to community values is another. Hence the Andrews adroitness is the gentle appeal to particular community leaders in public; and then giving them a stronger message in private.

The message has changed abruptly about those in quarantine who refuse to be tested. It turns out that the resistance has occurred among children – or rather their parents for testing their offspring.

For adults, there is no excuse; the sanction should be unyielding. The other means are either the addition of another ten days to the quarantine period, or else use the new saliva test for children. The reasons for these changes rest with the experts’ assurance that the extra ten days are sufficient and that the saliva test has a comparable degree of sensitivity and specificity to those of the current procedures.

However, it does not change the need to have designated quarantine facilities near all the international airports. One of the successes occurred early with the efficient evacuation of people from Wuhan to Christmas Island and the Darwin Howard Springs facility.

That is one good reason to have permanent quarantine facilities, if for no other reason than to streamline the process of quarantining returning citizens and permanent residents to Australia and to provide space so people are not cooped up in hotels with untrained supervision, as instanced in this case. The short-term objective of improving the bottom-line of the hotels should give way to planning for a long term recognition that inevitably we will have another raft of diseases without vaccines, and thus need designated, properly designed facilities.

Whereas a ship used to raise the yellow flag to denote Infection, so must a community flag be raised to indicate a suppression of pandemics, for which the only defence is suppression through isolation. What does Australia want – worrying about cultural sensitivity and spurious privacy issues or protection against the disruption caused by a pandemic?

Andrews invoked Bentham’s utilitarianism in his media conference last Sunday; his government must work for the greatest good for the greatest number. Here he is so right, but the refusal of a substantial number of people to be tested will challenge how consistent his resolve is, or whether he considers them as “conscientious objectors”.

Governments have a number of precedents for such a group, but he seems to believe that locking down certain suburbs until the end of July may suffice. It is a difficult policy to police.

On the other hand, the vested interests remain. There is a serious one that will lurk well beyond the end of July.

Quoting from the Sunday Age, “questions have been raised this week over when health authorities contacted Cedar Meats about the positive cases and over the government’s decision not to initially name the abattoir, whose owner was a long-time member of the Labor Party.”  

Meat processing facilities – in my language, abattoirs – because of the working environment are perfect areas for the virus to re-gather its strength. This Cedar Meats facility owned by the Kairouz family has previously been subject to questions about its occupational health and safety, and now by definition it is a “hot spot” until proved otherwise.

However, rather than pursuing the Lebanese connection, would it not be better to set up a preventative strategy in regard to all the meat processing facilities throughout Australia? Maybe that is in process, and as a casual observer, all I can say is that it is an obvious matter to consider, given it is an international problem even threatening to compromise the food supply chain. Therefore, who is working on the uniformity of rules here that recognise the seriousness of the situation?

Quarantine facilities are not holiday camps. They are facilities to isolate for a period for the few whose freedoms are temporarily sacrificed for the greater good. The government has become expert in building such facilities for asylum seekers. Maybe with the media spotlight on them and staffed by trained health professionals rather than guards of dubious experience, there will be more humanity in the construction of quarantine facilities. The Olympic village model springs to mind, with all subject to social distancing and hand washing “between events”.

The promise of a COVID-19 vaccine

The history of vaccines, and especially one against a coronavirus would suggest that it is nonsense to expect a solution in the near future – if ever. There may never be a vaccine and therefore the world must work around suppression of the Virus.

It is somewhat like 1938 and Neville Chamberlain waving a piece of paper and talking about “peace in our time” – it could easily be any of our current political leaders substituting “vaccine” for “peace”. The world has found out that it cannot eliminate war – it devises mechanisms to try and suppress it – not very successfully as there are hot spots breaking out everywhere as countries lose respect for borders read “social distancing”; for “hand washing and sanitisers” read “defence”.

The corpus of research scientists has the same quota of flimflam chancers as the rest of the population. Labelling someone a “research scientist” is not equivalent to beatification. As a somewhat mediocre medical researcher I was fortunate to work among some brilliant medical scientists. I sympathise with Brendan Murphy and his obvious unsuitability for research. Mine was a forgiving research environment, but then I never wore a tie in the laboratory.

I learnt the hard way, but because I was in a laboratory where the technical standards were high to complement some of the best scientific thinkers of my generation I was very privileged. I learnt enough to achieve two doctorates in a time when one could do that without being consigned to the debtors’ prison for unpaid HECS fees.

However, I learnt one lesson from two distinguished scientists, Ian Clunies Ross and Frank Fenner. When the myxomatosis virus was developed to infect and kill rabbits, both these men were the first to have themselves injected with the virus to show that the virus did not harm humans.

I remember one of my experiments demanded taking arterial blood. First person for this study to have that procedure done on himself was me. As the responsible researcher, if I expected others to take part, then I should be the first volunteer. Arterial puncture is no big deal now, but it was different 50+ years ago.

These days the whole process has been made more complicated as the ethicists have moved in. These days Clunies Ross and Fenner probably would be surrounded by reams and reams of paper seeking justification for their research.

However, the principle remains the same.

As one psychologist has expressed it: “The golden rule – do unto others as you would have them do unto you, is about as basic as morality gets. It’s the bridge between empathy and sympathy, between putting yourself in someone else’s shoes and making some accommodation to them as a result.”

That simple statement does not need a synod of ethicists to ratify. After all the 1978 Belmont Report said much the same in a great many more words. Among the reasons for this Report were revelations in regard to the Tuskegee experiments. The Tuskegee Study of Untreated Syphilis in the African American Male was a clinical study conducted between 1932 and 1972 by the United States Public Health Service. The purpose of this study was to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.

Dr Cutler referred to below was complicit in a substantial way.

Naturally there are now researchers tripping over themselves in the search for a vaccine for COVID-19 as if this whole research exercise is less about research and more of a gold rush. The issue of how to fast track this process has inevitably lead to the question of challenge trials.

Descendents of the victims of the Tuskagee experiment

The nature of a challenge trial involves giving healthy subjects a prospective vaccine and, in this case, then infecting them with a coronavirus. As the Tuskagee and Guatemala experiences show, it can be totally unethical, and while these quoted may be extremes, there are many shades of grey.

An article in a recent issue of the New York Review of Books commented on a new book on Adverse Events: Race Inequality and the Testing of New Pharmaceuticals by Jill Fisher, a social scientist at UNC-Chapel Hill.  The reviewer, Carl Elliot, a Professor at the University of Minnesota, notes 38 members of the US House of Representatives have called for COVID-19 challenge studies to be put in place. Perfect – they can be among the first cohort to be challenged with the Virus but protected by The Vaccine.

Carl Elliot is concentrating his literary endeavours on whistle blowing and unethical research. He makes the point that in these often dangerous challenges, the “volunteers” come from the bottom of society: the poorest, the most easily exploitable, prisoners, people in impoverished countries like Guatemala or Alabama.

A challenge study on Guatemala poor in 1946-48 mimicked those carried out by the Nazis. These US researchers:

  • intentionally infected victims with syphilis and gonococcus without informed consent
  • failed to provide victims with treatment or compensation
  • covered up and did not publish or disclose the experiments, including the intentional infections and failure to provide treatment.

It was not until after his death that the person who led the study, John Cutler, a public health luminary, was revealed as the monster he was – but there were accomplices. After all, for every Dr Jekyll there potentially lurks a Mr Hyde.

Challenge studies may be integral to testing of particular research protocols, but the researchers should be prepared to be the first to be challenged. The organisation 1DaySooner promotes challenge trials and allows individuals to volunteer, or to be advocates for such trials. The website notes there are currently (as at 2 July 2020) 30,108 volunteers “interested in being exposed to the coronavirus to speed up vaccine development”. Volunteers implies they will not be paid or expect to be paid.

Still, if I were the lead researcher I would expect to be the first one infected. How many of the myriad researchers will volunteer to be the first one tested with their own challenge protocol if and when it gets to that point?

Let Him Sleep

In a question on notice on 28 October 1982 from Barry Jones, the then Minister for Foreign Affairs, Tony Street responded with the following. In so doing, between the two, they encapsulated much of the story of Raoul Wallenberg:

(1)       Is he (Street) able to say whether Raoul Wallenberg was First Secretary of the Swedish Embassy in Budapest from July 1944 to approximately February 1945 and was he described as the ‘hero of the holocaust’ for his work in saving Hungarian Jews during the Nazi occupation?

(2)       Is it a fact that he was last seen in Hungary in or about February 1945 when he set off for an appointment with officers of the Red Army?

(3)       Is it a fact that reports have been received in Sweden that he was being held in a Soviet prison since that time, that he was last sighted in the late 1970s and that, at the age of 70 years, he may still be alive and that he has been seen in Soviet prisons?

To which Minister Street replied in part:

… the Government is aware of reports that Mr Wallenberg is alive and that he has been seen in Soviet prisons. Sweden continues to pursue the Wallenberg case with the Soviet authorities, who so far have done no more than repeat their claim that Mr Wallenberg died in prison in 1947.

The Australian Government fully supports the efforts of Sweden to have the case re-examined by the Soviet authorities. Because the Australian Government has no direct standing in the matter, however, there has been little opportunity for us to make an effective intervention. The matter is basically the concern of the Swedish and Soviet Governments and for the time being it is felt that Sweden is best placed to press for a more satisfactory response from the Soviet authorities…

There is no doubt that Wallenberg was a very brave man. What he did for Hungarian Jews in trying to save as many as possible from the gas chambers was extraordinary. One of his strongest promoters in the Australian community is Dr Frank Vajda. Wallenberg saved him, at the age of nine, together with his mother, from the firing squad – a direct intervention. Everybody interprets miracles differently, and there is no wonder that Vajda, who later became a noted Melbourne neurologist, views Wallenberg as his personal saviour.

Kew

Wallenberg was made Australia’s first and only honorary citizen in 2013. An exhibition honoring him was shown around Australia between 2015 and 2019. In his brief time in Hungary, he saved many Jews. Some, as with Professor Vajda, came to Australia. There are around Australia many Wallenberg monuments. In Melbourne, I have always acknowledged the bust of him when driving past, if it was safe to do so, since the bust is perched near a busy intersection in Kew.

It is inconceivable that the Russians would not have known that the Wallenberg family not only enabled German industrialists to hide their assets but also ironically helped the Nazis, though their bank, to dispose of Dutch Jewish assets. The Russians tend not to differentiate; once a Wallenberg, always a target.

Whenever or whatever the Russians did to Raoul Wallenberg just highlights the corkscrew of the Russian mentality. In 1982 the possibility, however tenuous, existed that he was still alive. Now 108 years after his birth, non acceptance of his death makes his memory a pointless hagiographic conceit.

On 26 October 2016 the Swedish tax authorities (responsible for death certificates) finally pronounced Wallenberg dead and to be considered having died 31 July 1952. “Han ska anses ha dött den 31 juli 1952”, skriver Skatteverket i sitt beslut.”

Given those words, it is surprising the Swedish embassy allowed the question mark over his death to remain on the information sheet advertising the Wallenberg exhibition last year in NSW. The Swedish Government has done so. When Tony Street replied to Barry Jones’ question nearly 40 years ago, and there may have been a reason not to bring closure.

The Swedish Government has now recognised one of its national heroes has died. He should no longer exist in some limbo. To dismiss the recognition as a Swedish administrative mechanism is to not accord Wallenberg the recognition that he died in Russian custody.

Also, I know that some people who were directly saved by his intervention believe he should be revered as a giant of the spirit, but he was made our only honorary citizen of Australia in 2013. Why? He did not have the chance to accept; did the proposer, having refused to assign a date of death, seek to ask his advice on the matter?

I wonder whether being made an honorary citizen of another country would have been significant to him and whether he himself, having been described as being a diffident person, would have accepted? One of the problems is that people who often indulge themselves in the pursuit of vestments and honours just assume that the object of their esteem would agree.

There is a touch of arrogance in making such assumptions, particularly in the case of affording people nationality. And if you think about it, why “honorary”? Either you are a citizen or you are not.

Then Prime Minister Julia Gillard, in her eulogy when Wallenberg was awarded his honorary title, said: “Some of the individuals whose lives he redeemed became part of our first great transforming wave of post-war immigration; among the first to pledge themselves to their new home after Australian nationality was formalised in 1949.

Surely that was testament enough to his ongoing legacy – those who were spared and then were able to make such contributions as Frank Vajda. What does Honorary citizenship add and in 120 years of Australian Federation, why one?

I think Wallenberg was one of the greatest men of the twentieth century, even though he had such a short life. After all, he was the same age as Jesus when he disappeared.

Jesus left a spectacular legacy, one that has been transformative for our country as with others. Do we then make Christ an honorary citizen of the country? And of course we do not have a death certificate for Him either. But does anybody believe that Wallenberg rose from the dead? Allow him closure.

Mouse Whisper

Ever thought why it is mice but not hice? Well it is all because in the Saxon language hus was a neuter noun whereas mus was feminine. So in the plural it is still hus but for mus, which becomes mys to the plural (as was lus).

But it is more probable that in the future there will be “three blind mouses” before it becomes “as safe as hice”. After all, those little gadgets that are pushed around computers are mouses not mice. It just illustrates there is a tendency in all language usage towards homogeneity and simplicity.

So as my Aussie quoll friend would say, it’ll be grouse, mate – and grouse is grouse never grouses nor grice.

Or because we mouse love devouring literature, will it become a case of “eatymology”?

Modest Expectations – Paul Egan

I was reading Rupert Brooke’s Letters from America, which he wrote about his 1913 journey, but which wasn’t published until 1916 with a foreword by Henry James – apparently his last piece of writing. Brooke had died in 1915 in Greece, and is known for his romantic view of dying for one’s country.

The flag of German-occupied Samoa

The book is a set of well-written notes about Brooke’s 1913 travels which, despite the title, included a visit to Samoa, then under the German flag. Brooke is very sympathetic to the German rule saying it was better than that of British rule in Fiji. Nevertheless, a Samoan princess did not agree with this assessment. Climbing the flagpole she removed the German flag and, having torn it into pieces, danced on the remnants. Brooke does not report any retribution.

He describes Samoa as Heaven and although it was ruled for a time by a tripartite administration of Germany, United Kingdom and USA, in 1900 the western islands were ceded to Germany while the Americans kept the islands east of the 171st degree meridian. This latter information was not gleaned from Brooke’s writing, but his book did draw my attention to the fact that New Zealand invaded Samoa at the outbreak of war, rounding up the 50 or so Germans and native auxiliaries. New Zealand did not let go of its conquest until 1962. The League of Nations bequeathed it as a territory and other post-war finagling ensured the long time to independence.

Rupert Brooke’s account was certainly not first hand of the invasion but it is a wonder nobody has made a film of the story – with Sam Neil at the head of the expeditionary force wandering the Pacific before mounting the invasion. The Germans had a couple of large ships in the area but they were told by Berlin not to attack. A film would suit Neil’s wry humour.

Anyway Brooke wrote the following: “They must have landed at noon, I see. How hot they got. I know that Apia noon! Didn’t they rush to The Tivoli bar – but I forget, New Zealanders are teetotallers. So, perhaps, the Samoans gave them the coolest of all drinks, kava; and they scored. At what dances in their honour, that night! – but, again, I’m afraid the houla-houla would shock a New Zealander. I suppose they left a garrison, and went away. I can very vividly see them steaming out in the evening; and the crowd onshore would be singing them that sweetest and best-known of South Sea songs, which begins ‘Goodbye, my Flenni’ (Friend, you’d pronounce it), and goes on in Samoan, a very beautiful tongue. I hope they rule Samoa well.”

New Zealand Troops in Samoa NZ Archives*

Overlooking this invasion was Tusitala, the great bard of the South Seas, also known as Robert Louis Stevenson, who now lies atop Mount Vaea in Apia. I still shake my head at the thought of the Kiwis invading Samoa.

This is a Knife

That is the famous line uttered by Crocodile Dundee when threatened not by a white, but a big black man – dinkum white Aussie threatened by a stereotype. We whitefellas felt comfortable; great sight joke and the sub-title – a smart Aussie will always outwit the dopey Yank.

This is a knife …

Last week newly-minted young white constable faces a taller black teenager in Sydney, who is alleged to have said that he will break the constable’s jaw, “bro”. The young man in the hoodie knows his street talk! The young constable, instead of inviting the young alleged thug to have a cup of coffee to discus the immense psychological pressure the young man was experiencing, moves across, turns him around and trips him – one might think that reasonable if someone says he is going to break your jaw.

He did not: (a) draw a baton, (b) use tear gas, pepper or mace, (c) use a taser or stun grenade, or (d) shoot him.

That is the problem I have with police forces. They are clothed in ominous dark uniforms and dehumanising headgear with all the armaments of the military. Yet the police force is not meant to be a killing force. The more the toys of destruction are supplied to an increasingly poorly-adjusted police force, then working as an agent for Trumpian cancer metastasising across America, then who is going to halt their spread?

The solution to violence is not providing more weapons – the reverse should be true. A police force should be more concerned with each police officer being given the confidence to settle disputes with the minimum of violence. For instance, at this time of pandemic widespread use of agents designed to compromise the cardio-respiratory system such as the irritant sprays should be banned. The problem is that politicians wring their hands over domestic violence, send mixed messages when violence is rife in the community. Politicians yield to the slightest demand of police associations, where the megaphone is the loudest.

There is ambivalence when police are involved.

At the outset of the piece, I related the instance of a young policeman threatened with violence. He tackled the young aggressor, one on one – it was not a gang tackle. He was responding as he was trained to do in a potentially violent situation.

Contrast it with the images of multiple law enforcement officials, be they men or women, tackling the one individual. The sight sickens me. I am sure that there is almost always provocation and prisons, for example, are dehumanising violent environments. Drugs are dehumanising.

However, the wolf pack response is descent to the same primitive level. Just look at the all-white police officers at Central station last Saturday let off the leash, the officer in braid visible behind – not trying to restrain his men with their eyes full of hate. Not trying to lead! Not trying to maintain his police force in social distancing. Except for himself, the senior officer “looking good in a uniform”, as they say, is pictured generously social distancing himself from the fray – leading from behind.

Yet one episode after another of alleged police brutality tumbles through the media. I can never forget the images of Ron Levi, an unfortunate man having a psychotic episode in the surf at Bondi who was shot four times by two drug dealers who at the time happened to be members of the NSW police force. Shooting someone, even one carrying a knife, when presumably every policemen is taught how to disarm with the minimum of violence, destroys community confidence, shakes one’s confidence. No charges were laid against these men, despite this young guy being murdered in full sight.

Instead of questioning whether police are competent to have the paraphernalia of aptly named “assault weapons”, why doesn’t the debate start about when the distribution of weaponry should be curtailed?

Death in custody is like domestic violence; it has circled in earnest discussion ever since I can remember. The number of Aboriginals in custody has not reduced. Violence has been endemic in Aboriginal communities; to say it is not is to deny reality, irrespective of whether it is fuelled by alcohol or other drugs.

Yet there is an increasingly articulate group of Aboriginals – lawyers, public servants, Parliamentarians. The grievance rightly exists; obviously the solutions are not there for change despite the increasing number of these Aboriginal advocates. How many years are needed for you articulate people to effect change, not just to leave it someone else; not just to complain – blaming government is a way of doing nothing.

One of the advantages of modern society is that everything is recorded; just as that young constable’s action was. Instead of saying that he had had a bad day, the police commissioner should tell us what he would have done; probably nothing different. A bruised ego for an aggressive youth; but what does the young constable learn? Just exhorted not “to have a bad day” again?

Meanwhile the weaponry lobby rolls along, getting its inspiration from the brutal obscenity that masquerades as policing in the United States. Democracy dies when the police force, shorn of accountability, becomes the means of its destruction not its defence. The more weaponry a police force has the more it is likely that you or I will become the next Ronny Levi.

As they said when they came back from Bondi after killing Levi,

“That was a knife!” And the man with the braided cap responded: “We have just the carpet under which you can put the knife, and we won’t tell anybody. Probably need to replace the carpet – we burn them after five years. They become too stained.”

The Third Pole

I had not thought of the Tibetan Plateau as the Third Pole. Joel Berger’s book “Extreme Conservation” with its subtitle about “Life at the edges of the World”, in which he describes his extraordinary life, draws attention to the Third Pole. By and large, his experiences are in the snowbound parts of the planet in the depths of winter.

The Third Pole

The author has spent a considerable part of his working life trying to assess the state of endangered species, including the musk ox. The musk ox is an extraordinary animal able to survive the harshest of winters; it was hunted to extinction in Alaska, but revitalised by the re-introduction of animals there from Greenland.

Musk ox

There is a musk ox farm just north of Anchorage in a place called Palmer, on the way to Mount Denali. Incredible was my response when I first saw a live musk ox – sturdy and solid with a skirt of hair reaching its feet and with horns Berger describes as “piercing armaments”. Their closest relative is the wild yak that lives high in the Tibetan plateau, itself a different beast from the domesticated yak – and considerably bigger than the musk ox.

The musk ox is beautifully adapted having spiralling nasal turbinates so that freezing air has been warmed sufficiently by the time it reaches the lungs so they don’t become snap frozen. I have adopted two of the calves, which has maintained my status as a herd associate and bought a scarf made from the combed wool. It is woven into an extraordinary light fabric, called qiviut, which is remarkably warm and as long as you like a brown scarf, everyone should travel with one in a cold climate.

Wild yak – very difficult to tag

However, this interest in the musk ox is a prologue to the matter of the Tibetan plateau where the wild yak roams, admittedly in decreasing numbers. The problem is in the assessment of numbers, it is important to tag a beast – and wild yaks are very difficult to tag. This is the Berger expertise – tagging and tracking – and being heroically mad and brave.

However, that was the task facing the author where wild yaks are seen nearing 6,000 metres above the plateau. The Tibetan Plateau occupies an area of around 1,000 by 2,500 kilometres, at an average elevation of over 4,500 metres.

As Berger says, this plateau is the “water tower” of Asia. All the major rivers of south-east Asia – the Indus, the Mekong, the Brahmaputra, the Kangali, a major tributary of the Ganges, as well as the Yellow and Yangtze rivers all rise on the Tibetan plateau. Even Burma’s major Irrawaddy River is not immune from the effect of the Tibetan plateau.

Berger describes camping in the shadow of the Bukubada glacier, “a massive vault covering 170 square miles” (44,000 hectares) is vital to be preserved, monitoe. He describes other glaciers – the Yuxu and Yuzhu with the giant Muztag Ata glacier, located on the far western margin of China and east of the Pamirs Plateau, at a summit elevation of 7,546 m. So much water locked up and yet climate change has reached the plateau. Berger observes in the ice, the vegetation, the movements to higher ground of the indigenous wildlife, so many of which through indiscriminate slaughter are going the way of the bison on the North American prairie.

Belatedly the Chinese have recognised this, but as with so many authoritarian regimes they believe they can beat Nature into submission. Because we humans all live close to sea level, few give much thought to the dams being built on the Tibetan plateau. Thus this plateau, which provides Asia with much of its river water, is too precious to be left to one country with its selective concern about the World Order.

With climate warming and the glacial water storage thinning on the Plateau, water becomes scarce and this process will not be accelerated by the Chinese – given their form, who is not to say that they will divert most, if not all, of the water into their own river system. The planet despoilers are hard at it, and without any real checks and balances. The Mekong is particularly at risk, as Cambodia found out in the last dry season.

The world knows the Amazon is at risk – but so is the Tibetan Plateau. The problem with Tibet is clear.

However, in the minds of the West, Tibet is the Dalai Lama, once a hero but now increasingly shunned, soon to be a footnote in history. The successor will be appointed by a supervised Chinese process; Tibetans lose the links to their last traditional living god chosen by traditional mumbo jumbo.

What has to be avoided is to miss the importance of Tibet. Joel Berger gives us an intimate glimpse of what we will miss once the short term imperative of`progress ends up with the Tibetan Plateau a ruined wasteland deprived of wild life and water.

It’s somewhat ironic that the Chinese President, Xi Jinping, is reported to have cited the following Chinese proverb in a recent speech: “The ceaseless inflow of rivers makes the oceans deep.”

The problem is there is red ink seeping across the map of the world and it is not British.

If the world were brave enough it would face down China over the Tibetan Plateau – it should have the same status as Antarctica. Look, my grandchildren’s generation (and onwards). Witness the World at War over water, and remember your parents and grandparents should have read what Berger has written, taken heed, stopped wringing their hands over the Tibetan Plateau and acted. But don’t worry – there is not any moisture left on your hands. It all left with your ancestors.

Christ stopped on his way to Wilmington Station

Biden is a dud. His advocacy of the appointment of one, if not the biggest, dud on the Supreme Court, Clarence Thomas, shows that one dud knows another. At the Senate confirmation hearings in 1991, it was Biden who pilloried Anita Hall. She had accused Thomas of sexual harassment. Biden denied her the chance to present corroborative evidence. Then he came crawling back after 28 years after the Brett Kavanaugh disgrace, trying to apologise to Professor Hall – he received no dice.

This senator from Delaware, with his own problems in this area, has so many strikes against his name – and his gaffes are continuing although he has barely been out of his home for the past three months. Whether this means these gaffes are the first signs of mental decline, only his closest medical advisers know. If there is any indication of cognitive decline, he should just immediately withdraw, full stop.

I have mentioned that he looks old, covered up by a sunbeam smile, but even if he goes forward, he must resist a Sandra Palin, whether male or female, of the left. Palin helped do John McCain in. McCain was seemingly more astute than Biden and only a “chicken” – 71 at the time. If the Democrats nominate this aged “rooster”, they have to make sure that perception of his inherent weakness is not further compromised by a Vice-Presidential nominee who is already campaigning for the White House succession. It is not hard to do the numbers on Biden’s age.

So the Democrats nominate a younger active assertive person with the “smarts”, who only serves to accentuate Biden’s weakness. On the other side Trump needs a tough image now that people are beginning to laugh at him – now, after the stories of him huddling in the White House bunker and then walking behind his Praetorian Guard as they gassed the innocents. Sound familiar?

Trump recognises this need for “toughness” and in this context having a pliant poodle as a Vice-President gives him that air – at least to his fan base.

The wrestle for the Presidency

Trump is also well versed in the theatre of professional wrestling, where there is the Bad Guy against the Good Guy. Just simplify the rhetoric and make Biden look weak and confused. Violence. Pile into him; mock his weakness; back-slam him; put him in a headlock – a crusher hold perhaps. Let’s turn Presidential debates into “Ringside with the Wrestlers”.

Trump has little else left. He is the Bad Guy with the devoted fan base. The Biden insipidity gives him a chance.

Thus Biden may be caught between two “shouty” forces, which continually emphasise his inherent weakness.

Is the electorate going to be won over in November? Think carefully, you Democrats, don’t become real donkeys. 

Mouse Reflection

I decided the pool was deep enough to reflect a mouse whispering.

In the Feb 28 blog, my mausmeister under the heading: “The Price of Never Being Wrong”, wrote the following, which has been reproduced abridged…

The problem with epidemics is they thrive on ignorant national leaders, who have no idea of public health, suppressing inconvenient information. This increasing government secrecy is coupled with the modern version of the courtier castrati, people without ideas but with perfumed phrases whispering into the ear of national leaders who have lost the ability to apologise.

… I once wrote a small monograph entitled “The Dilemma of the Public Health Physician” in which I attempted, as I said, “to help public health physicians to work through the situation which confronts many professionals when they are in possession of information which others perceive as ‘sensitive’ or valuable in any respect.” 

… I went on to argue that all public health information should be freely available. Even over 20 years ago I wrote; “there is an increasing tendency for the political walls to be daubed with the graffiti of misinformation”.

On reflection am I just succumbing to daubing those political walls? Well, that is the point – public health expertise is being allowed not only to languish but also ignored as an inconvenience. But as many politicians have found out in the past, “wishing an inconvenience would go away” is not a solution.

Having said that it seems we are fortunate in Australia not only to have the calming influence of Brendan Murphy, but also his unheralded deputy Paul Kelly who, unlike his boss, is a public health physician. Their influence on the government where there is a high level of ignorance is, and will continue to be, important…

On the same day in February 2020, the Australia Health Protection Principal Committee (why do the Government give committees such indigestible titles) published one of its reports, an excerpt of which is printed below. This Committee is chaired by the Chief Health Officer, Brendan Murphy and has as its membership all his counterparts in the States.

… More than 60 per cent reduction in travellers and no cases detected in more than 30,000 Australians returning from mainland China since 1 February 2020. This has been assisted by travel restrictions imposed by China. In addition, a significant number of students from China have spent 14 or more days in third countries and have arrived in Australia to commence or continue their studies, again with no cases detected in this group. The only new COVID-19 detections in Australia in the last two weeks are eight cases in Australian passengers repatriated from the Diamond Princess cruise ship. There remains no evidence of community transmission in Australia, with thousands of negative tests for COVID-19 in the last week alone.

Much can happen in four months, and in the end as my mausmeister prophesised, they got it right, despite the Committee’s crystal ball being somewhat clouded at the end of February.

 

 

*By Archives New Zealand from New Zealand – New Zealand troops in Samoa, c.1914-15, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=51248178

Modest expectations – On viewing a Gun Carriage November 1963

A weeping blackness

But           

Refusal to enshroud

A memory

In a haze

         Of

What you were to do

                           Yet what would you be

                                             As man

                                                      Of seventy-two

                                             You when the flames of youth

                                                      Have died

                                             How promising can a man

                                                      Of seventy-two

                                                               Superannuated

                                             With a watch

                                                      A gold watch

                                             A great gold watch which ticks

                                             And tells that time is time

Who grieves

         For your greatness

         For your back

         Which now relieved

         Stands straight

For mourners lift

         Their candles high

For who knows you

         Who knows

The emptiness of the tomb

For who but you

         Can deride

The greatness that might have been

         For you – at seventy-two

 

John Fitzgerald Kennedy was 46 years old when he was assassinated. He would have been 103 this year.

It was my tribute, the tribute of 24 year old about to graduate as a doctor, still raw; still disbelieving that this man who could have inspired our generation was dead – assassinated. My first reaction was that it was some mad right-wing Southern racist.

Kennedy was a courageous thoughtful man inured to disability. However, there he was – distant but resonant to the young idealist. Staring down the Russians, learning from the ill-advised Bay of Pigs, and probably about to dump the Texan anachronism from the Vice-President position for someone who would face not only the massive change in American society but understand the nuances of post-colonial Asia.

How he would have handled the Vietnam conflict would have been instructive, because the cancerous growth of American exceptionalism – as culminating in this present Trumpian farce – may never have happened.

How different a time it was when Kennedy recommended appointments to the Supreme Court based on talent not ideology – both swiftly ratified. One was Abe Goldberg, the eminent jurist with his opposition to capital punishment that led to its long moratorium in America; the other was Byron White who, despite his strong Democratic party links, became the “swing” vote until his retirement in 1993. Funny how good sense and rational thought have flown away from Pennsylvania Avenue.

Strange when I re-read this poem after many years, that I picked the age of 72. Trump is 74 this week. Only time is ticking for him. 

The “Free-City State” of Hong Kong

Nowhere is that sense of selective self-righteousness more apparent than the extreme sensitivity in Beijing towards Australia’s criticism of China’s behaviour in the South China Sea. There is strong public support for the official view that China’s claim to historic territorial rights is totally justified, along with indignation that this could be even questioned.

Foreign Minister Julie Bishop’s statement about the need to respect the ruling of the International Court of Arbitration in The Hague last July as binding and final is regarded as particularly egregious.

Jennifer Hewett was travelling in China this month as a guest of the Chinese government.

I note that it is the same Jennifer Hewett who wrote that piece in October 2016 who referred last Friday in the Australian Financial Review to the people’s republic of Victoria.

This sly comment in an otherwise unremarkable piece of journalism stood out, because amid reasoned argument there was no justification for the statement.

“The people’s republic of Victoria” is just the same as a label of “Junket journalism” pinned to a journalist called Jennifer when discussing her guest experience in China at their expense.

After all, the paper she writes for has been prepared to the take Chinese Government money for China Watch – a propaganda instrument of that Government. Nevertheless, some of the articles are interesting when stripped of their cocô de touro covering.

Hong Kong is due to be returned to China in 2047. The Chinese Government has accelerated the process. The Chinese government doles out the rope so that the dissidents can protest for a time. Once the government has had time to assure itself that it has identified all the ringleaders, then it will move in, and use its overwhelming force to quell the dissent. At the same time, the ringleaders will be targeted so that unlike Mao, these dissidents cannot set up a guerrilla force.

The dissidents have done a very good job up to this point in harassment, but a guerrilla movement needs strong leadership to resist the inevitable imprisonment.

The aim now of the Chinese government is to arrest all of them with or without murdering some of them. Once imprisoned, then choose the instrument of torture.

In the face of this, the options for the dissidents are: be a political penitent; melt into the background; leave Hong Kong or fight on to an irrelevant death or remembered martyrdom. After all, Tiananmen Square provides the blueprint.

First, the Chinese Government clears the streets of the dissidents. There will be little forewarning before the invasion. Big business can pull down the shades and high up in their skyscrapers the noise of rioters being killed can be drowned by Vivaldi being piped through the system.

Horse racing can still proceed so we Australians can be reassured that nothing untoward has happened. You can still see Hong Kong on the TV racing channel.

However I shall concentrate on those images of empty streets bristling with of the People’s Armed Forces on street corners – men who do not speak the local Cantonese. It is the Hong Kong oxymoron for all those foreign journalists to digest searching for a catchy 32-second “grab”; an empty street full of men with guns and tear gas and heavy metal.

It is a small step for the legislature to meet in secret, not in accord with the agreement with the British – no negative votes now.

The transition is complete. The dissidents are somewhere in China, far from our eyes. The Hong Kong legislature now reborn becomes a sheet of red with applauding figurines

With time everybody in Hong Kong is encouraged to develop a convenient amnesia to what has gone on. The dissidents never existed. Business as usual nods in agreement. Eyes are averted not to see evidence of more People’s Armed Forces on street corners – men who do not speak the local Cantonese.

All the trappings of the legislative process agreed with the British may be maintained with Carrie Lam, but she will pass and eventually the fiction will fade away – and Hong Kong will now be “One China – One System”.

The Chinese Government seems to have a tricky decision about maintaining a Hong Kong with an open trade policy, but now under a Chinese rule of law. Given the mainland experience of an increasingly intrusive government, a Hong Kong shorn of the pretence of democracy has to reassure Europeans that the remnants of colonialism do provide a safe enclave for business. If the judicial system completely loses its independence, then business only belongs to the Chinese government and its concessional treatment of us Guizi.

Anyway, as one reliable source said, China always takes a long view and there is already a visible transition of importance from Hong Kong to Shanghai.

Given how the Chinese Government is playing Australia on a break, what is our attitude to all the potential Hong Kong refugees; and do you not think that the Chinese will test Australia out further in the Government’s nascent “White Australia” policy?

This whole business is complicated by the 350,000 Hong Kongers who have British Overseas National passports. These allow for one year’s access without the need for a visa; more ominously another 2.5 million are eligible but have let their passports lapse. Given how immigration-averse Boris’ government is, one can rest assure that the Brits will start putting pressure on both us and Canada to share the “pain”.

You know old boy, the Commonwealth and all that. Watch this space.

However, clinging to Mike and Donald may not be the best solution either. Perhaps we should adopt a modified Belt and Braces policy, making sure we do not rely totally on China – but something has to hold our trousers up. At present it is a lovely rusted ferric belt.

Maybe a more self-reliant by ourselves with a little help from who?

It is time for some lateral thinking, because the name
“China” keeps popping up as the answer.

After all, due to the strength of our public health response Australia has a comparative health advantage over those countries that have not recognised that the Virus breeds and feeds on Chaos.

Turning this public health advantage into an economic advantage is not helped if Australia prioritises frippery, turning this country into a circus fuelled by a shallow media and even shallower politicians.

As for Hong Kong, remember 100 years ago there was another city-state dependent on Great Britain for control over its foreign relations. This state lasted, until its invasion by Germany in 1939, for nearly 20 years – the Free City of Danzig.

Does anybody remember Danzig now?

In the meantime, what will Jennifer say?

Muscular Judaism

Some years ago when Magnetic Resonance Imaging (MRI) was a new modality I had been able, despite some government opposition, to facilitate its use attracting a Medicare benefit for the patient, I received a phone call from some guy who said he represented an Israeli technology firm. He was interested in selling MRI equipment, and he mentioned that his firm was interested in the low Tesla end of the MRI equipment spectrum. However, he wondered whether he could meet me when I was in Melbourne.

I agreed and was somewhat surprised by the address as it was essentially a residential suburb where I once owned a property.

Nevertheless the address where we were to meet was in North Fitzroy. As I anticipated, I arrived at a rather nondescript brick villa. One of the first things I noted was that all the windows were barred and the blinds were drawn. As I walked up to the front door, the light above the door winked at me.

I remember being ushered into a tiled floor entrance where a small flight of stairs led to an open living area, where three other men were lounging around. My hosts were all of medium height, with cropped hair, and what struck me was how supremely fit they appeared. They were all dressed in expensive casual attire but despite the seeming relaxed informality, the atmosphere in the room was far from that.

I remember being introduced, but names meant nothing and probably when I thought about it later, the names were likely manufactured. The only item in the room that sticks in my memory was a model of an El Al airliner, but the room had comfortable chairs where I was invited to sit, and offered coffee or tea. I chose coffee. It was instant. I hate instant.

The problem was that suddenly I did not know why I was here. Everybody spoke perfect yet accented English. The discussion started about the MRI technology and the fact that in this area Israel had developed a great number of interesting products. However, the discussion increasingly became general.

I felt trapped – there was an unspoken menace in the air. It was obvious that the MRI was the bait. All of them were very courteous and amiable. I really did not know what this encounter was about. I generally tend to deviate from the script and play with words in meetings. Not this morning – I have never stuck more carefully to the “script” and measured my replies than I did during that hour. I had never felt under such scrutiny – random seemingly innocuous questions kept coming in this seemingly friendly fashion from each of them. Their seating meant that I had to shift round to answer; I was not always facing in the same direction because of the way they had dispersed themselves.

I still had no idea what this was all about. They were searching me for some information, but what? At the end of our hour, they all got up and said how good it had been to meet me, and they would be touch.

When I was outside, I had this immense sense of relief.

I did not look back. I never tried to find the house again. Presumably they got what they wanted or thought that they had wasted an hour, because I never heard from them again. Laughingly, I related that I had had morning coffee with Mossad. Nobody smiled.

Some years later, I did go to Jerusalem when Yitzhak Rabin was Prime Minister. It was a time that one could jump into a taxi in Jerusalem and ten minutes later you were in Bethlehem in Palestine. I am glad I went there at that time, but I did not meet up with anyone who resembled the guys whom I had met in Melbourne. I ventured a question to the Conference Israeli organiser, who was a veteran of the Six Day War. He smiled, patted my arm and changed the subject.

Life with Brian 

When I left the Australian Medical Association one of the presents that I was given was a small olive tree in a pot. In honour of a surgeon with a strong link as I had with the Quality Assurance “industry”, I named the tree “Brian”.

The tree was potted and languished outside our office for a number of years making very slow progress.

Then when we moved into a new house, the olive tree followed in its wooden stave barrel. However, it still was stunted and had never produced an olive in five years.

Then one day, a delivery van took out the crepe myrtle tree in front of the house. Crepe myrtles are a favoured street tree in inner Sydney. The colour of their flowers are bright and various.

This incident left a hole in the footpath, the house brick wall exposed, and as the house is located on a poorly cambered corner of inner city asphalt which purports to be a road, the wall was vulnerable to a car running into it. At least the trees provided a barrier for the house.

Early one morning, a car ploughed into the wall, and left a Volkswagen car badge as a calling card. The car had reversed from the rubble and was disappearing around the corner by the time we had come down the stairs. Later “mummy” brought her son around to apologise and to offer to pay for the repair of the wall. We accepted the offer, and the wall was duly rebuilt.

Perhaps we reasoned if we planted the olive tree in the street it would provide some protection. It was a sturdy young tree. We planted the tree in the verge outside the front gate with no real expectations. However, released from the confines of the pot, it started to grow – and did it grow.

Over the next few years, it grew until one spring, there appeared the tiny yellow blossom foreshadowing an autumn olive harvest. The amount of olives varied but in a good years there were seven to ten kilograms. The first time we seriously picked olives, the recipe was just too tedious with the frequent changes in water and brine, and complicated by our being at home irregularly as we travelled around Australia and overseas.

So mostly we left others to come and pick them. Being away for considerable times even if we had intended to harvest them often we would come home and find the tree stripped bare. One year our regular taxi driver, John asked if he could harvest them. In return he presented us with a large bottle of olives, which tasted good and made us think again about our direct involvement.

Then there were a couple of lean years but during that time I had been to Cyprus and watched an aged nun in the courtyard of her retreat, splitting the olives and then placing them in brine. It seemed that with the additions of few sprigs of this and that and chunks of lemon that was it – so fiddling around changing the water was unnecessary.

Now in this year of the Virus, the harvest was bountiful. Locked down, she ventured out and returned with pails of green olives. Only the top most branches escaped because (a) she did not want to climb that high up a ladder and (b) for some reason the rake had gone missing.

However, there were more than enough and for those that are interested, the olive were split, stone retained and than placed in clean jars containing a ten per cent brine solution with white vinegar in a ratio of four to one. A couple of lemons were squeezed into each jar.

It is wise to use non-iodised salt, as olives are bitter enough without that bitterness being augmented by iodine. Put a slice of lemon on the top to keep the olives submerged and then a layer olive oil over the top to keep air out. Seal the bottle and wait. Six weeks later we opened the jar – and bingo. They were good, surprisingly – chewy but full of taste going well with the martini, described in an earlier blog.

Now, that we have entered the olive curing industry, and our olive tree is strong and healthy, as Brian too will be remembered, why not put a grove of olive trees down our street? Our local Council is supposed to be Green, and olive is only a shade of green. The local member of Parliament should be enthusiastic. Jamie Parker is a Green; he once was a purveyor of herbal remedies, one with the interesting title of horny goat weed.

Here is a chance to build on a life with Brian – he could initiate a Grove of Brians with our enthusiastic local member transformed into a Master Olivatore rather than just being remembered as a Faunus vendor, who accidently strayed into Macquarie street.

Mea Culpa

Let me admit to fallibility. Last week I was severely critical of the trial being proposed by the Walter & Eliza Hall Institute for Medical Research (WEHI) to give hydroxychloroquine to frontline health workers, I headed the piece with a quote from a recent Lancet article. It was purported to be an observational trial and its results fitted into my thesis – that the proposed WEHI COVID-19 trial would be ineffective, irrelevant and potentially dangerous.

I was influenced by one particular report of people in Manaus being treated for COVID-19 were given the drug and who died. Manaus had 2000 deaths in April from the virus and the numbers over all of Brazil have topped 30,000 despite their President advocating the use of hydroxychloroquine.

Yes – the Lancet article was neat; it played to my bias; I was blind; the Lancet! How could it be wrong? Surely the journal could not repeat the Wakefield fiasco of 1998, which launched this dangerous Wakefield on his anti-vaxing worldwide rampage.

Therefore, I am very sorry that I used the quote, but in apologizing for its use, I still believe in what I have written, rather than what I quoted. I hope the WEHI trial never takes place, and for all of my above reasons. However, I would still be curious to see the protocol and the ethics committee report of this study.

Mouse Whisper

I have always abhorred this tendency when people are are unsure of the colour to say “bluish” or “yellowish” or size “shortish”.

Therefore I applaud my relative Bmac in refusing to use the word “hamish”.

Now as BMac would know, hame is a two curved wooden padded harness, that forms a collar around the neck of a draft animal. In fact, hame is a yoke – a big yoke. This has to be taken seriously and not referred to as “hamish’’ – a bit of a yoke.

Therefore I applaud you again, BMac, for your deletion of “ish” in all your conversation; as long as you don’t advocate “f with chips” followed a “d of banana fritters.”

A hame in good use

Modest Expectations – Barry Marshall & Obey

Pauline has parked her grandstand in the News Ltd car park, where she is advocating a High Court challenge to border closure. This is a normal Pauline stunt, unsurprising given that the Queensland elections are imminent -and there is nothing like a confected confrontation magnified by that shrill tone of hers.

One concession you have to give to this lady, she plays “victim” very well. One of the ploys when I used to be an official visitor to psychiatric hospitals in New South Wales was the way the inpatients could produce someone who had been “victimised” and ask me to help “save”, usually, a “her”.

My companion visitor was a wise woman, who unlike myself had long practical experience as a psychiatric nurse. She warned me not to be “sucked in’’, but listen to the complaint and investigate. However, she said – maintain rationality –don’t be get caught up emotionally as these people are very clever, since it was a practised scenario, and they try you out.

Whenever I watch Pauline, I am reminded of this advice, since whenever she is pushed into a corner the voice becomes quavery and the tears well up.

The one hand clap, Pauline.

But back to reality.

How much is this High Court challenge going to cost, Pauline? $300,00? More? For what, Pauline? A failed challenge? Of course, the victim.

However, who is going to pay? You, Pauline? No way. I’m afraid it is going to be us mug punters, of course; the real victims.

Telehealth – Look Mother! No hands

I was brought up as a medical student to believe that the essence of being a doctor was to take a full history from the patient and then to do a full examination.

That was a message. The face-to-face consultation was the basis of consultative medicine and the skill was to make the correct diagnosis – or if unsure, to provide a set of differential diagnoses based on what you had elicited as symptoms and signs of the patient’s condition.

However over the course of my medical career technology has intruded upon the “maestro” doctor able to diagnose the patient before he or she sat down. Observation to me remains a very important element as it was to Dr Arthur Conan Doyle, who invested his sleuth, Sherlock Holmes, with the same or enhanced degree of observation he had as a doctor.

The astonishing array of technology and increasing differentiation of care has been something I have witnessed through my long career. Sometimes I have watched and sometimes I have been closely involved, for example with the introduction of Magnetic Resonance Imaging (MRI) into the private sector and its recognition by Government – not always the most tranquil moment of my career.

There has always been agitation from the medical profession for reimbursement for non-face-to-face consultations. With the corporatisation of medicine, where the bottom line is everything, this agitation has not lessened. “Money for jam”, as the old saying goes, many jars of which will inevitably be transferred offshore.

Having watched telehealth progress through phone conversations to uncertain video links through to more reliable technologies such as Zoom has meant that technology has challenged traditional ways of medicine.

My only hope is that the government, which is increasingly strapped for cash, monitors it use.

I have used telehealth as a patient, and for a person with limited mobility it has been particularly beneficial. I have found that the doctors have been more punctual, but that anyway may be because of the lower volume. Telehealth acts as a screen. For the plastic surgeon, you can send a picture of the lesion, and get an opinion over the phone and in my case, yes it looked as though it needed to be removed; then a regular check up with the rheumatologist reviewing my pathology, a critical aspect in my ongoing chronic disease. More importantly in talking to my neurologist, he listened to my history, and said yes, it was important to see me, but I should have a cervical spine MRI first.

Two of the three telehealth consultations required subsequent face-to-face consultation. My general practitioners friend said that with the modern video technology, it is possible to diagnose simple conditions, such as a strained muscle, by observation and prescribe a treatment without seeing the patient in the rooms.

My appointments to see specialists could only be undertaken by face to face consultations – removal of a lesion from the face, assessment for cataract removal, neurological examination for the particular set of signs.

As someone who developed an auto-immune disease insidiously, after my diagnosis it was apparent that I needed not only a good general practitioner but also one who would provide continuity of care.

Being a doctor myself, I am in the worst category in regard to regularly seeing a doctor. I can do all that general practitioner stuff – but of course I cannot. It is impossible to have an objective view of yourself until, as I found out one night, I knew that I was dying. Hypochondria is one thing; a sense of impending death is another.

I survived the night, and because of the pain and stiffness and overall weakness, I went back to my orthopaedic surgeon whom I had consulted a dozen years earlier for my acute painful knee.

At this time, I had no regular general practitioner although most days I was surrounded by them at work. However, the orthopaedic surgeon knew what it was, but orthopaedic surgeons treat by operation and not by drugs and so he flicked me over to his trusted rheumatologist. Now rheumatologists are gentle ruminative folk, but have long lists of patients; so waiting for up to six weeks is not uncommon for an appointment.

Miraculously I saw the doctor that afternoon. He prescribed tests and drugs, but I was not to take the drugs until the test results came back.

The starting line could not have come sooner; within 24 hours after taking the first tablets, my condition improved dramatically.

Unfortunately dramatic improvement didn’t equate to immediate cure, but that’s another story.

What is interesting however, in a story about telehealth, is how do you diagnose this sort of disease. As one of my general practitioner colleagues said to me that this is a GP diagnosis – you ask: “Can you roll over in bed?”

This was very much after the fact. I had already been diagnosed and was being treated. However, I had not noticed it before; he was right, I could not roll over in bed.

Theoretically, if the doctor had been as astute as this Scot, who had seen cases before, a telehealth diagnosis might have been made.

But then again I still would have had to see him in a face-to-face consultation. Telehealth is not a panacea and I would caution government and suggest once the COVID-19 pandemic is controlled, to review its application closely, especially the biggest users and then ask why? As I know too well, governments are reluctant to wind back largesse for fear of vested interests squawking about compromising people’s health.

Telehealth is a bonanza for the corporate health business, where throughput is everything, and health care a by-product.

Nevertheless, far more insidious is the large health conglomerates where the owners are dependent on government payments to profit, inevitably providing donations to political parties to keep the tap turned on. Donations after all have a wonderful effect of assisting politicians to roll over – not necessarily in bed.

Hey, Pellegrini, whatcha doing with that test tube?

A new study shows coronavirus patients who took hydroxychloroquine to treat COVID-19 had a higher risk of death than those who weren’t given the drug.  

The study, published Friday in the medical journal The Lancet (22 May), also found that COVID-19 patients were more likely to develop serious heart arrhythmias if treated with hydroxychloroquine, or its closely related cousin chloroquine.  

Arrhythmias can lead to a sudden cardiac death, the report said, but researchers did not associate the study’s fatalities with adverse cardiac affects. 

Even though it’s only an observational study – not the gold standard double-blind, randomized, controlled trials – experts say the enormous sample size makes it compelling.

The study comprises of 96,000 coronavirus patients from six different countries who were hospitalized between Dec. 20, 2019 and April 14, 2020. Nearly 15,000 patients were treated with hydroxychloroquine or chloroquine alone or in combination with an antibiotic.

When I heard that the Walter & Eliza Hall Institute for Medical Research (WEHI) were about to embark on a trial to enlist 2200 health workers into a trial to test the efficacy of the drug being a preventative agent against the virus, I checked the date. No, it was not April 1st.

Professor Marc Pellegrini is employed at the WEHI with one of those expansive titles, which suggest he is important. On television, his justification for the trial is that the drug kills the virus in the test tube. So, I might add, does bleach.

I wondered how this experiment has come about.

This modern day Lancelot has given his project a grandiose title – COVID-19 Shield. Here I wonder whether you need a diploma in public relations rather than a science degree in this modern world purporting to be medical research.

I have not the seen the protocol except it seems to be a randomised controlled trial; but one important report I would like to see is that of WEHI Ethics Committee on the proposed study and the reasons for approval.

In the latest bulletin of WEHI, there is a coy mention of this trial without naming the drug and the brief comment that it is being funded by the Australian Government. There does not seem to have been the award of a peer-reviewed grant as one would expect for such a potentially dangerous activity.

The problem for the Australian government is that there is pressure coming from the non-medically qualified – especially from such a medical expert as Clive Palmer.

In response to the above Lancet article, the WHO is reported to have put on hold the hydoxychloroquine arm of review. However, the report has all the hallmarks of the WHO walking away (or should I say “crabbing” away), without losing face.

But WEHI seems defiant. At least Professor Pellegrini is. May I suggest it is time you retire the Shield, Sir Lancelot.

Finally, as The Washington Post noted – as I have – who says Trump has been taking the drug. Has anybody seen him take it? This person who lies, lies and lies. Why would his statement of putative self-administration be any different? In any event, he now says that he has stopped taking the drug. Come on, Donald, which is the lie?

The time I under-dosed with Chloroquine (Plaquenil)

It was about 30 years ago and we went on a tour of Africa. Among measures to be taken were the mandatory yellow fever vaccination and a prophylactic antimalarial, then hydroxychloroquine, which was marketed under the name plaquenil.

It was a wide-ranging trip, which excluded South Africa, then in the grip of the apartheid Afrikaans. However, in many ways it was defining as it led to us, especially my wife, returning almost yearly to the continent.

We had previously been to North Africa – Morocco and Tunisia – but this was a month long roam through Southern and Eastern Africa. The trip incorporated the island of Madagascar, the French Département of La Réunion and then finally the Seychelles. 

We spent some time in Madagascar, both in the jungle near Antananarivo, the capital, and the island of Nosy Bé looking for lemurs and indris. After leaving there, we flew to Saint-Denis, the capital of La Réunion, where the intention was to climb La Fournaise, the volcano at the end of the island. The year previously we had reached the summit of Yasur, on the island of Tanna in Vanuatu. This is one of the only active volcanoes in the world where you can stand and look down into its fiery cauldron. La Fournaise presented another opportunity to do so.

Le Piton de la Fournaise, Reunion Island

However, while having a drink at the bar of the hotel on arrival, I started to feel unwell. I went to bed, and then passed out. As described to me I began to get very hot, and my temperature was apparently swiftly rising, and as my wife said I became quickly delirious. She did not know quite what to do except keeping sponging me to try and reduce my temperature. She told me that her plan was to phone a public health physician acquaintance in Paris, in the event that I needed to be admitted to hospital because, as she said, her French wasn’t up to an emergency admission. However, about one in the morning, suddenly I was a bundle of sweat. I woke up; my temperature was dropping. My pyjamas were absolutely soaked with perspiration

How could this be; I was taking the plaquenil regularly, but then I reviewed my dosage – it was below the prophylactic dose. God knows even to this day how this happened, but it was obviously my mistake. Fortunately, my wife did not succumb. So even though I felt lousy and confused, I increased the dose to therapeutic. The worst residual symptom was a terrible headache behind the eyes. I have never had one like it before or since.

That was it, except I felt lousy for over a week, but I did not have another crisis – nor have I had a recurrence since that day.

However, I always take Malarone, the current anti-malarial drug of choice whenever there is the prospect of contact with a malaria-bearing mosquito overseas.

But back to La Réunion, we did see around the island, including the Cirques, tropical remnant of extinct volcanoes but we never did climb La Fournaise.

No, I did not have a test to confirm – not malaria – confirm my anserine status.

But at least after that experience I can swear by hydroxychloroquine – for malaria!

Just a lurk

COVID-19 causes massive inflammation boosting cytokines, which increase the liver’s production of clotting factors, explains Beverley Hunt, medical director of Thrombosis UK and a practising clinician. For example, fibrinogen levels in a severely ill COVID-19 patient are 10-14 g/L, compared with 2-4 g/L normally and 5-6 g/L in a pregnant woman. “A COVID patient’s blood is enormously sticky,” she told The BMJ.

“All patients in critical care are at increased risk from clots because they are immobile, and when you are sick you have sticky blood,” says Hunt. Studies of venous thromboembolism rates among non-COVID patients in critical care show that rates of thrombosis can be as high as 28% if patients are not given any prophylaxis. Among patients given prophylaxis the rates are halved. So, we seem to be seeing significantly higher rates of thrombosis in COVID patients. 

“Thrombosis is definitely contributing to the high mortality rate from COVID,” says Hunt. “Not only can it lead to a pulmonary embolism, which can be fatal, but there are also higher rates of strokes and heart attacks.”

In this report in the British Medical Journal, a United Kingdom medical specialist is musing on COVID-19. Now at the outset one would have thought that the only experts interested (or consulted) would be emergency physicians, anaesthetists and respiratory specialists. However, this is a doctor expert in blood clotting which has arisen as a major COVID-19 complication, especially as the amount of anti-coagulant to be given seems to be unsettled. Moreover, there there are reports of late onset deep vein thrombosis. My Swedish correspondent mentioned COVID-19 toes, which appear to be a severe form of chilblains, pointing to this being the virus being an instigator of widespread disturbance in blood clotting.

What is further intriguing and indicates the widespread effect of the virus is loss of the sense of smell as an early sign. In humans, the olfactory cell location measures 9 cm2 and lies on the roof of the nasal cavity.

With the common cold when there is swelling of the nasal epithelium non-specifically, sense of smell is impaired. However there are reports that this COVID-19 virus infiltrates the sustentacular (supporting) cells which, together with olfactory cells, constitute the pseudocolumnar epithelium underpinning the nasal cilia and microvilli. Among other functions these cells have an effect on how odours are perceived by the olfactory cranial nerve.

It was interesting looking at the histology of the nasal lining, and its complexity. The olfactory nerve and its connections are one of the most neglected areas in medicine, because the sense of smell is more related to lifestyle rather than considered a major marker of disease. However, if it is indeed an early marker of COVID-19, attention should be paid to the way the nasal swab is taken to assist early detection, especially if the olfactory area of the nose is where the virus may lurk first.  This infiltration indicates how profound this virus may be in invading the body.

This virus is not going away soon and while Australia has, up until now, done an excellent job in suppression, “lurk” is probably the most concise way to describe it.

The Hungerford Games

We camped on the Queensland side of the fence, and after tea had a yarn with an old man who was minding a mixed flock of goats and sheep; and we asked him whether he thought Queensland was better than New South Wales, or the other way about. 

He scratched the back of his head, and thought awhile, and hesitated like a stranger who is going to do you a favour at some personal inconvenience. 

At last, with the bored air of a man who has gone through the same performance too often before, he stepped deliberately up to the fence and spat over it into New South Wales. After which he got leisurely through and spat back on Queensland.

Henry Lawson wrote thus about his experiences in Hungerford in 1893, when he had walked there with his swag from Bourke. The expectorating man’s name was Clancy, that familiar ‘loveable larrikin” character alienated from officialdom. Sorry, that is my ironic interpolation, and on the contrary Henry Lawson was not impressed by him.

There was no Pauline Hanson around in those days, and anyway she would not have been able to vote or stand for any of the colonial Parliaments in Australia at that time.

The Royal Flying Doctor Service (RFDS) periodically does medical clinics in Hungerford – this population speck, which straddles the border of New South Wales. This settlement is about a three hour drive along the Dowling Track from Bourke. I have always hankered to go there since I worked with the RFDS, for no other reason that it is there and like so much of western Queensland it epitomises my image of the laconic yet irreverent stoicism of the Outback.

We have years ago thought to drive there, but there had been heavy rains and the road beyond Bourke was impassable. The road is still unmade, but even though it is not the first place one would think to cross the border, my hankering is still strong. So I thought I would find out more.

The problem is that the Royal Mail Hotel is on the Queensland side of the Queensland-New South Wales border, which is defined by the wild dog fence. There is a border gate at Hungerford.

To get more intelligence on the current situation, I rang the publican at the Hotel. The news was grim. The gate is locked; the coppers have the key and even if I could he said it would inadvisable to try and climb over the gate. Anyway we would be aliens from New South Wales – waratah cockroaches invading the land of Cooktown orchid cane toads. So we could not stay at the inn.

So Premier Palazczuk, I promise I won’t make a High Court challenge if you open the Hungerford gate and allow us to stay in the pub. I’m not sure about the High Court challenge – however I believe there is a class action being mounted by a consortium of wild dogs to remove the fence between the two States. And it is only an unsubstantiated rumour that Clive Palmer is funding their challenge.

Muri Succursus

Mus Virgilis “destillat ab inguine virus”

We mouselings, as you know, pay homage to our celestial creator, Rodentia Nora. So we have knowledge of Latin – one of the greatest bard being one Mus Virgilis.

Given how much used the word “virus” is, we had a peep at its derivation.

“Virus” is a rare second declension neuter word for “poison” or “slime” and that attracted me to see if there was a plural form, “vira”. But the word has never been found in a plural form in Latin literature. Thus “viruses” is acceptable – even though the “es” suffix is generally associated with third or fifth declension Latin words.

And certainly do not say “viri”, which is Latin for “men”.