Modest Expectation – Andorra

The pollution index in Ha Noi as we drove around the city in an electric car last week was 5. Melbourne and Sydney were 1 and 2 respectively on that day. Only Kolkata in India was higher at level 6.

Vietnam is in a state of construction. Heritage listing does not seem to be a word much used in this city. Driving from Ha Long to Ha Noi is an example. Driving down the long esplanade along Ha Long Bay, to the left are the long sandy beaches and beach umbrellas and beyond, the Bay is littered with Nature’s limestone obelisks. On the right was a wasteland boarded up waiting for the next multi-storied building, the condominium development of which dog beachfronts all over the world, especially when the sand seems to be endless and the sun shines benignly as it does generally in October and November in northern Vietnam.

I had heard that Graham Greene had written The Quiet American in the Metropole Hotel in Ha Noi where he had a dedicated suite on the second floor. The Quiet American, which has been twice filmed, is said to have presaged the American War. I said casually some time before that I would like to stay there, but when we arrived there from Ha Long, it was very much a snapshot of Vietnam on its way to becoming yet another “Asian powerhouse”. The Bamboo Bar beside the swimming pool exemplified what life in Ha Noi in the period of French occupation may have been like. Here Graham Greene, as he wrote, would have had by his side his signature cocktail – gin, Italian sweet Vermouth and cassis – a Negroni without the Campari. For my part, I ordered one and was surprised to see it was served with raspberry sorbet which one tipped into the drink à la affogato. This accompanied my steak tartare rather than any novel in progress.

Hotel restaurants exist to recreate the theme of past privilege within a cocoon of luxury; where celebrity nudged shoulders with other colonials – and where life shone through an air of colonial insouciance  – the Bamboo Bar as one of these inglenooks.  As you move to the infinity pool through a tropical garden surrounded by the brilliantly white hotel building, it is easy to imagine this as once an oasis to get away from swirling hoi-polloi in the streets. Now, rather than colonial expats there are tourists and local citizens. Business deals are being done in this relaxed atmosphere. The French colonial rulers have long since gone.

Ha Noi inter alia is a religious jumble of pagodas, Confucian temples and Christian churches. The cathedral is grey, concrete on granite, a hint of the grisaille in appearance of its façade, with apologies to Notre Dame. Ho Chi Minh’s mausoleum is pointed out to us as we drive – a place of secular homage.

Train Street

The hotel is on the edge of the Old Quarter, with its narrow streets, the most spectacular of which is Train Street, where trains pass along within touching distance of the dwellings and the now closed cafes. In many of the promotional pictures, tourists are seen walking the railway line. No longer, after we were told a tourist was killed by a train, which effectively gave reason for access to the street to be closed to tourists. The Old Quarter is what one would expect in an Asian city, and even though the government is clearing swathes of it, it still survives with the distinctively curled tiled roofs, the plethora of shop signage designating its cheek by jowl activity, the narrowness of the façades, often three-storied, like the “Father, Son and Holy Ghost” three-tiered levels as found in English town houses. Houses and workshops are crammed together. There is Silk Street, yes complete with worms; and lantern street; specialty streets abound.

By contrast outside the Old Quarter, there are the wide boulevards, and the old colonial buildings here have been converted into government buildings – the government is in session and the National Assembly Building is an off white cube – the exterior walls are clad with vertical slats. Circles and squares – all with symbolic significance. There are 400 parliamentarians – we are stopped as two uniformed motor cyclists with sirens blaring sweep past followed by a bus carrying politicians off to lunch; no separate limousines here.

We pass the house which General Giap owned. The large property is surrounded by high walls. Through the gates we can see several jeeps. Giap died in 2013 but his family still owns the property. But I thought, what about the jeeps?

To be frank, Ha Noi was a series of glimpses, except when the time when we were parked while my wife walked around, the passing parade was of a bustling live society, and the police have a low profile as the people go about their daily life. It seems that the Vietnamese are an industrious lot, generally friendly, willing to help and if there is widespread poverty it is hidden. Shoes are said to signify the prosperity of the country. The Vietnamese are well shod.

Just before we went back to the hotel, we had the signature drink created by Nguyen Van Giang, the head chef at the Metropole Hotel, just after WWII. Our guide darted into a nondescript building, down a passage, and emerged with two egg coffees – espresso coffee with this mixture of egg yolk, condensed milk and vanilla whipped and placed on top. My wife’s response; she bought two egg coffee cups and we await the first egg coffee on home soil.

Responding to my glimpse of Vietnam, in the end I ask myself about the American War – why? why? Then I think of Ukraine, “today’s Vietnam” – and that common modern day nemesis, Lyndon Baines Putin.

“Hanoi Jane” – Burden and Stigma

One of the people who had, for a period, intruded her celebrity status on my life – although there would never have been an opportunity for our paths to cross – has been Jane Fonda. We are about the same age, and both lost our mother when we were young and, whether it had any connection, Fonda has confessed to growing up with low self-esteem. I read that her father was demanding; and I remember one of my father’s sayings was “What are you doing that for, John?”

There were three films she made early on her career which still stick in my mind. They were:

“Barefoot in the Park”



All are remembered for different reasons. The first was fantasy, but it was easy as a newly married couple, as we were, to identify with a feisty couple in the movie adapted from the long running Neil Simon Broadway play. Robert Redford was the stage male lead, and Jane Fonda was the female lead – the trials and tribulations of the newly-married couple, girl and boy in love; girl and boy divorcing; girl and boy reconciliation, and the glorious sunset. I saw this film before I had ever been to the New York. New York that Woody Allen knew so well; it is a great backdrop to comedy where interpersonal tension is being played out. There is a certain brittleness in all these comedies, and Jane Fonda character epitomised this. However, what attracted me at that time in New York was the ride through Central Park in a horse drawn carriage. It is kitsch, pure kitsch – but watching the film it seemed to be something I wanted to do with my then wife.

When we did go to New York in 1971, we stayed at The Plaza Hotel. Outside were the drivers with their horses and carriages. The area exuded the pungent smell of horse excrement and to get to the carriage one had to pick one’s way through it to get to a carriage. The allusion was gone.

Klute was a great film. We saw it in San Francisco in 1971. I always found Jane Fonda edgy, with her voice just too well articulated as if she was constantly self-conscious. In many ways, she would have been perfect to play Eliza Doolittle in Pygmalion. This edginess was absorbed into her role as a prostitute being stalked. It was at this point in the film when the serial killer was about to strike, that we got up and hurried towards to the exit. There was a murmur around as we ran up the aisle – to the effect of “what the hell are they doing leaving at the climax of the movie?”. I had looked at my watch. We had a plane to catch to Australia.  In those days, there was no security and boarding just was a matter of turning up and presenting your ticket and passport. We were travelling light as our baggage had gone missing somewhere between Frankfurt and Stockholm. In the end, we just assumed that Donald Sutherland, as the gumshoe Klute, had rescued her. The reaction to our exit was unexpected – you would think at such a point in the film nobody would have noticed us leaving, much less comment.

In between those two films was her marriage to Roger Vadim, and his attempt to turn her into another Bardot; but whereas Bardot was sensuous, Fonda was hardly a sex-kitten. Her approach was a bit like the school librarian doing porn, but by the time of Klute she had lost the “Vadim cute”, and become the anti-War activist. Both she and Joan Baez were photographed in Ha Noi. She earned the nickname “Hanoi Jane”, because of the ill-judged picture of her, wearing a helmet, behind a Vietnamese anti-aircraft gun. The activist label fitted Joan Baez more comfortably, as her protest against injustice and war always seemed to have a deeper commitment. After all, Fonda married Tom Hayden, well-known as a foremost anti-War activist, and they stayed married for 17 years from 1973, until Hayden called it quits.

The third film “Julia” was a complete tour de force. Jane Fonda here played Lillian Hellman, the American playwright. The Julia story formed part of her memoir “Pentimento”. Vanessa Redgrave played Julia, the Jewish German student in this filmed nightmare of Germany in the 1930s. Irrespective of whether it was only the product of a fertile mind, the film was so harrowing in its depiction of life in Nazi Germany that whether it was total fiction or not was irrelevant in depicting such a spectacle of horror. If there was any doubt about the quality of Fonda’s acting ability, this film dispelled it.

Jane Fonda after her marriage to Hayden ended in divorce in 1990 married Ted Turner, the founder of CNN, and I lost interest in following her career. In fact, the only times I seemed to remember – but remembered vividly – were those three films, and her antics during the “American War”. In film work, she was also in “Cat Ballou” and then in “Coming Home”, a film about the aftermath of the War; and then “On Golden Pond”, which played out a role with film and real life coinciding in the relationship between a father and his estranged daughter. Katherine Hepburn played a prominent role in the film since it needed such an actress with presence as she had. It was a tribute by Jane to her father, who died the year after the release of the film, in 1982. None of these made the same impact as the three other films I mentioned above.

Jane Fonda remains on the Vietnamese screens in the garb of the anti-War heroine who visited Vietnam and was photographed behind a weapon designed to shoot down American planes. Never mind, that the installation was there to protect Ha Noi from the destruction being wrought by American aircraft – Ha Noi was carpet bombed, certain sections of Americans who were traumatised by the War exercise their God-given right to abuse her, even spit on her face with tobacco juice. She has apologised for her Ha Noi appearance, said she was sorry…

When his and Fonda’s son married, Hayden concluded his toast to the couple and reportedly introduced Fonda by saying, “We know how Jane always becomes the part she’s playing. Hopefully, that won’t be the case in our son’s marriage!”

Maybe, that interlude when I selected Fonda films was to reinforce my view of a certain other lady. I don’t know. Funny thing to think about leaning over a writing desk reaching for my mouse in a posh hotel in Ha Noi.

Requiem for a Neo-Liberal

CNN National House USA Mid-term Exit Poll

R +13             65+

R +11             45-64

D +2               30-44

D +28             18-29

I remember lying on this lawn watching the kites leisurely drifting overhead in the thermals against a clear blue sky. Broome in July of that year was a leisurely place, when I had the opportunity to try and absorb “The Road to Serfdom”, Hayek’s classic treatise underpinning of neo-liberalism. It was a time in the late 1970s.

Hayek bangs on about freedom. “The most effective way of making people accept the validity of the values they are to serve is to persuade them that they are really the same as those which they, or at least the best among them, have always held, but which were not properly understood or recognised before.”

Hayek, all in one sentence – authoritarian, paternalistic, elitist. His book is an attack on democracy cloaked in academic jargon, I thought at the time, as I rolled over and watched the drifting birds.  He offered no structure to replace democracy. Yet it took time to show neoliberalism to be an illusion, reaching its apogee in Donald Trump.  In the meantime, be “vewy, vewy, vewy” afraid since Elmer Fudd is “vewy, vewy, vewy” likely to run for President in 2024.

But perhaps I never could distinguish between Hayek and the Beach Boys in “Serfing USA”. From this latest USA poll it seems that the younger generation, as the figures indicate, at last are replacing the “E” with a “U”.

Surfing is a more more shared  relevant experience to the younger generations than serfdom under an old man with an addiction to fifty shades of yellow.

It is about time that politics is less about Me but more about You, the community. What! Idealism building to a crest? Not a red or blue wave, just in these perilous times the wave vanquishes that authoritarian madness that we have to tolerate with people like Trump, Putin and every other ruler who attempts to assuage his deep feelings of self-loathing by transferring these dark recesses of their collective minds to the destruction of the World.


There we were on the South China Sea, and since the sea was a little rough, and balance is already a problem, I started to do some channel surfing. And there it was, unexpectedly, the 2022 Melbourne Cup being shown in real time. What other horse race would be shown on a French ship in Vietnamese waters. Not an Everest; nor a Kosciusko; not even a Wycheproof. Despite the huge amount of money which this guy V’landys seems to be able to fling on horse races for the benefit of Arab sheikhs and other deserving racing nobility, such as Lloyd Williams and the Waterhouses and their ilk. V’landys has, as far as I know, not arranged for his wonderful collection of highland flings to be shown in the South China Sea. And do not I think he would care a damn if they were ever shown – probably not.

Nevertheless, the Melbourne Cup remains still the icon borne aloft in the minds of the small men and normal sized women who are named jockeys, and the men and women who are called trainers – and of course the Innocents, the owners, people inured to throwing their money down the equine toilet, as though it were tossing three coins into the Trevi Fountain in Rome. As they sang in the eponymous song: “Make it mine”, as they wished, tossing their money away.

Democracy at Work

Excerpt from Boston Globe

After a tumultuous summer during which his company temporarily lost its liquor and entertainment licenses after fights broke out at the venue and on the Block Island Ferry, Ballard’s Beach Resort owner Steven Filippi may have lost his unopposed bid for a town council seat.

The businessman, who was on the ballot (unopposed), received just 92 votes, while more than 1,050 people wrote-in alternative candidates. The three candidates with the most votes will win the three open seats on the Block Island* Town Council, which also serves as the island’s licensing board.

*Block Island is an island in the U.S. state of Rhode Island located in Block Island Sound 14 km south of the mainland and 23 km east of Montauk Point, Long Island, New York, named after Dutch explorer Adriaen Block. Population 1410.

Mouse Whisper

I had just come back from visiting my bush relatives, the Marsh Yellows, and was nibbling on a piece of Roquefort Grand Premier Bleu, when I heard him say to nobody in particular, “Well, fancy that, born on the same day, same year as Tom Hayden, the prominent anti-war activist. Married to Jane Fonda for 17 years. You know it is a fact of life, there are two times when you are unique – the moment you are born and the moment of death. Even though it is only for a femtosecond, you are the youngest person on the planet. Now that is one for the curriculum vitae of everybody – “I once was the youngest person on the planet”.

Tom and Mouse Meister, sharing a common 1939 birthday with Betty on the cover of Life.


Modest Expectations – Song of Joy

We are sailing on Le Lapérouse, one of Ponant’s cruise ships, which is on an eight day cruise up the Vietnamese coast, commencing from Ho Chi Minh City. The weather reflects the fact that it is still the rainy season. This Ponant ship was constructed in two parts by VARD, one of the major global designers and shipbuilders of specialised vessels. Headquartered in Ålesund in Norway and with approximately 8,000 employees, VARD operates seven shipbuilding facilities, three in Norway, two in Romania, one in Brazil and one in Vietnam. VARD also develops power and automation systems, deck handling equipment, vessel accommodation, and provides design and engineering services to the global maritime industry.

The hull was constructed in the Romanian city of Tulcea, which is the major settlement on the edge of the Danube Delta, but the ship was outfitted in Norway, and the Scandinavian influence is shown in the clean lines and the light airy fittings which seem to be beech or pine. The trip between Tulcea, through the Danube Delta (predominantly Romania but including the Ukraine and Moldova) to Norway takes three weeks and it was towed by tugboat the whole way. It must be an interesting journey these days to enter the Black Sea towing a partially finished ship. Unless you have been there, you do not appreciate the Delta’s immense size, and stopping off on one the many settlements in the Delta, as I had done on a previous trip down the lower Danube, I learnt that the villagers spoke Ukrainian not Romanian. There is much cultural intermingling.

Le Lapérouse hull, under tow

The ship, as its name suggests, is determinedly French, although curiously it is registered in Mata’Utu, the largest settlement in the Wallis and Futuna Islands, a French territory north of Fiji and west of Samoa.

On the bow of the boat, flutters the Breton flag – nine alternating black and white stripes in the upper left canton of which, in serried rows, there are what look like eleven scarecrows – not the stated description impenetrable in my heraldic illiteracy. The captain of the ship is a Breton.

Before we embarked, we all had to be tested for COVID-19 in Vietnam. I might add it cost around $22 for two of us, whereas when we were tested earlier in the year prior to going to New Zealand, it cost in the region of $120 from one of those “cut-price” pharmacies. Thus, all the passengers who boarded the ship were RAT negative, but on the first day one of the crew was reported to have tested COVID positive and from then on, all the crew wore masks. There were no more positives reported.

The food is mostly French, the wine is French, the chefs are French, the waiters are mostly Filipinos or Indonesian and the sommelier comes from Djibouti. The service is superb, but still there are gangplanks to be negotiated, and tours are for those who can walk over uneven streets and for three nights, there was weather, with “pitching and rolling” in a three metre swell. Nature is there to test not cuddle one. Fortunately, the typhoon in the Philippines was tracking away, but we were still left with strong winds from the north.

Nevertheless, the two cabins for disabled passengers have been outfitted well, with quasi-timber floors, not tiles which are notoriously slippery, irrespective of the vigour of the boat movement. The cabin is spacious, and the shower space has been cleverly designed to accommodate a wheelchair, but not so large that the ambulatory disabled cannot grasp a hand rail.

The passengers are mainly French; there is a smattering of Americans, 18 Russians – and about seven Australians, including a retired nurse from Canberra, who classifies herself a seasoned Ponant traveller having been on four cruises including this one, although this one was more courtesy of an enforced COVID confinement on the previous cruise resulting in credited days on a future cruise.

The large cruise ships have emerged from a period where they were seen as villains in the spread of COVID-19 and that there was something squalid about this form of leisure – the love boat, excessive drinking, a casino and theme park on the water with variety shows, games and boorishness admixed into some forced jolliness.

Ponant is none of these. Perhaps the price deters some and these boats have much smaller numbers of passengers and promises of French chic, personalised service, no herd-driven demand to participate in onboard activities, sensible flexibility in the rules and exotic locations. To what was promised: I would say “yes” to the first four.

The problem with the places where this ship berthed is that they were working ports, and to see the historic and natural sites one had to go well away from the dock for whole day excursions. Perhaps some time in the future Vietnam will have more “cruise ship docks” given the country is looking to develop this area of tourism, together with the massive resort developments taking place along the coastline with its palm fringed beaches. Vietnam has been a preferred holiday destination for both Russians and Chinese tourists, and while the Chinese have developed their own casino resorts they are probably empty at present while China remains effectively locked down. Nevertheless, the long bus excursions from cruise boats would still remain.

Ha Long Bay

I contemplated several and paid for the Ha Long boat excursion, but in the end I suspected the boat transfers may prove too difficult and didn’t go – reports of unstable portable steps more suited to giants and small, rocking boats confirmed it was the right choice. No doubt the huge limestone rocks which dot the Ha Long Bay justify recognition by UNESCO as one of its spectacular World Heritage sites, but not if venturing to see them is more ordeal than being able to appreciate their uniqueness. Fortunately, the view from the “main channel” when you enter the Bay provides sufficient exposure.

To me the challenge was to take a cruise to compensate for several cancelled because of The Virus in 2020. In the intervening two years my level of disability has increased so choice of cabin and activities requires planning.

Among the 94 cabins there were two for the disabled. As I said above, they are so well appointed that they should serve as models for all ships setting aside space for the disabled, so different from the airlines.

However, let me be frank and it may be my own experience, but Asia does not yet do disability well. That is not to say that people do not try and be unfailingly helpful, but they are untrained and nobody in many cases has thought about access nor the needs for showers, toilets and beds to be disabled-friendly. Rooms provided with rails, nonslip floors, chairs – firm enough so that one can get up unaided – a feature that equally applies to the bed.

This is increasingly going to be a challenge to the tourist industry as the number of not only wheelchair bound, but the ambulatory disabled increase – a very fertile ground for the entrepreneur prepared to challenge this whole area of Aids to Daily Living, even on holiday.

Fraser and the Fishing Boats

Fraser was right to claim successive governments did not withstand similar pressures as he had experienced, but he sees these as pressures of hostile and xenophobic anti-refugee community sentiment: the long-term agenda of immigration officials was of greater weight in Australian politics, expressing itself as an insistence on governments and Immigration Ministers. The “mandarins at the border” did not abandon the templates they had developed, and eventually they found future governments who would progressively implement their agenda. During 2010, former Prime Minister John Howard’s Immigration Minister Philip Ruddock would boast about ‘his’ “interlocking suite of measures”.. Philip Ruddock  was referring to policies he brought to the Parliament; yet another view might argue he merely claimed for himself the proposals first tabled at Fraser’s 1979 Cabinet meetings.

(From James Smit, “Malcolm Fraser’s response to ‘commercial’ refugee voyages” p 103) 

Colourful Vietnamese fishing boats ply their trade along the coast. They are the same vessels that sailed with refugees to Australia. Seeing them, I was reminded of the first time I went to Broome. I had booked into the Mangrove Motel which was located on a sandy knoll and from my window I looked onto a forest of mangroves and beyond out to that distinctive azure sea which is the Indian Ocean. The difference between low and high tides can be much as 10 metres. Perched in the mangroves was a beached Vietnamese fishing boat. It was 1979. Over the years whenever I returned the boat was more decayed until there was only a remnant of the keel left.

Yet despite the conclusion reached in a review of Fraser’s contribution, between 1975 and 1982 when he was Prime Minister, 60,000 Vietnamese came to Australia, but only 2,000 who came were identified as “boat people” or “queue jumpers”, as Minister McPhee called them at the time. Most of the refugees came from South Vietnam, some were opponents of the incoming communist regime or had worked for the foreign forces. Those fleeing in the fishing boats still had to negotiate the Indonesian and Philippines archipelago, where they were attacked by pirates, the women raped, and all those on the boat including children murdered. Those who did reach Australia were allowed to stay and were not inhumanely towed out to sea.

The acceptance of these Vietnamese owed much to Whitlam’s ditching of the “White Australia” policy, which had underpinned much of our community attitudes, particularly to non-Europeans, since settlement in 1788.

The end of the 1970s found Vietnam still in turmoil; the concurrent rise of the Khmer Rouge and their Killing fields in Cambodia just aggravated the strife in Indochina in the aftermath of the “American War”. Arising from the criminality of the use of carpet bombing, napalm on villagers, inhumanity spread like fertilizer over the Indochinese countryside. Retribution was often brutal. Yet in Australia, with a blind eye to what was happening in the World, Government has maintained a policy of obstruction of those trying to reach their perceived safe haven, Australia, unless “they played the game”.

The use of the term “queue-jumpers” exemplified this response akin to “chaps, play the game.” Despite all, Australia has a vibrant Vietnamese population, the older generation having given way to a generation born in Australia.

Just like the election of 1966, the conservative party in Australia has been unerring in pushing the “yellow peril” button when in electoral strife. John Howard was, to me, the epitome of the curate’s egg, hard boiled.  The various exercises under his stewardship designed to prevent asylum seekers coming by boat, demonised the people smugglers, and then imprisoned those trying to escape conflict. Their crime? “Not playing the game” was added to the charge sheet.

It was an expensive solution. One source has it that in 2021 the annual cost, per person, to the Australian government of detaining and/or processing refugees and asylum seekers was estimated as follows: almost A$3.4m to hold someone offshore in Nauru or Papua New Guinea; A$362,000 to hold someone in detention in Australia. The deal struck between Cambodia and Australia to take refugees, which was brokered by Morrison, then Immigration Minister, in 2014, ended four years later after the Cambodian government had pocketed A$40m for ten asylum seekers, only one of whom stayed in Cambodia. He was last heard of in 2019 without assistance, a Muslim in a Buddhist country, no access to Cambodian citizenship and forgotten by Australia.

It is easy to tolerate inhumanity when you are shielded from its excesses. The demon is the people smuggler, and so it goes, there is something morally wrong in endeavouring to use whatever means at hand to reach Australia. However, given that Australia was up to doing questionable deals in response to getting rid of asylum seekers at great cost, it would have made more sense to locate an immigration department presence on one of the Indonesian islands and cut the middleman out. Then, perhaps the public disgrace where the Tamil family were treated so appallingly could have been avoided.

At several stages, given that we have an apartment in what was Frydenberg‘s electorate, I contemplated a hunger strike, but given my general health, it would have been futile, but then standing up for something you believe in is essentially an exercise in futility.

I always think of the IRA soldier, Bobby Sands, who died in 1981 aged 27 in the Maze prison, maybe an urban terrorist but a man who believed passionately in a cause for which he was prepared to die. After all, the litany of beatified persons, who died for their belief, forms one of the Christian Church’s traditions. Their images are cast across Christendom and they live on as labels of churches, cathedrals and basilicas.  Plus, you have a particular day in the calendar where people may worship your hallowed name.

But not Bobby Sands.  Misguided … depends on whose perspective – a person who faced his own mortality, but yet has no church in his name. I could not do what he did, with the walls of rationalisation I had constructed to reassure myself.

Anyway, the Tamil family are now happily ensconced back in Biloela, and my gesture perhaps would just have been recorded on a sheet of newspaper in the recycling bin.

Cosmetic or Not

Typically reserved for the rich and famous, cosmetic surgery was, and still is, desired by many women and men, regardless of financial constraints. In today’s world with numerous financing options available, it becomes just a matter of “what would you like to do first?” 

I grew up in an era when plastic surgeons were highly respected. The advances they had made during the World Wars in fact defined the specialty. By definition a plastic surgeon needs to be very skilful, and given the level of disfigurement of some of the war casualties, the surgeons had to be patient, knowing where they were going with each procedure – facing challenges which were then thought insurmountable. Through experience the surgeons improved the outcomes for their patients while also gradually defining the specialty.

Sir Benjamin Rank

Sir Benjamin Rank was the doyen and because of him and his team, Melbourne became respected worldwide as a centre for plastic surgery. I was fortunate in many ways to have known so many of these highly skilled surgeons; one I classified as a friend, another two were in my year of medicine, one made an outstanding contribution in determining the blood supplies to skin and underlying tissue of various parts of the body; the second combined plastic surgery with ophthalmology, a sub-specialty which, even now, is increasingly directed towards improving appearance rather than correcting deformity and extirpation of tumours.

I had a bad car accident in 1981 and among my myriad injuries was one where my chin struck the steering wheel. It had previously been shown when I had any dental work that my bone is very dense. When my chin struck the steering wheel, I sustained a cruciform lesion, suggesting my tissue between steering wheel and jaw imploded. My jaw was not fractured, so although sore, no wiring was required, but my chin was damaged far beyond just stitching up a complicated laceration. It needed plastic surgery.  The tissue which had sagged around my jaw line had to be fixed. Multiple operations and bandaging to help to hold the repaired tissue followed. Meticulous it was; now what remains is a meandering scar on my chin, hardly visible. But it is 41 years since the accident and cosmetically it has stood the test of time.

Thus, cosmetic surgery is not standalone expertise, conjured up without regard to the rules of mainstream plastic surgery. Why these so-called aesthetic surgeons, essentially general practitioners who have created their own tribe, are allowed to practice is probably due to the fact that much of the work lies outside Medicare.

The other myth that these aesthetic surgeons hide behind is that any medically qualified practitioner should be able to undertake the practice of medicine. Is that a full stop? It may have been so, even at the time I graduated, since it was assumed that as a student we were exposed to all aspects of medical practice – here was the leap of logic – and thus were competent. That mantra of see one; do one; teach one …

Prof Mark Ashton

It was a fallacy then and it is a fallacy now. It is appalling that Mark Ashton was harassed by the Health Department after he blew the whistle on the shonky practices, which passed as “cosmetic surgery”. Plastic surgery is all about outcomes. Cosmetic results – yes important, but in the hands of a competent surgeon what would you otherwise expect? At the simplest level this may be just removing a tumour from the skin. However, it is vital to remove all the tumour otherwise more surgery will be required to determine the tumour edge. A competent surgeon gets this right first time to avoid trauma to the patient and additional cost – to either the patient or the taxpayer (and this depends on the results of pathology and whether the lesion proves malignant or not). In my case once, the plastic surgeon did not get the edge, but he was quick to realise that he had not done so, and the additional operation was done efficiently with an excellent result- it has not recurred in 30 years.

I‘m very much a believer that all plastic surgery should be under one set of best practice rules. Those cosmetic surgeons who have learnt the practice involved in creating a temporary illusion that the ageing process can be combatted should abide by the same standards that I would expect from a plastic surgeon undertaking lifesaving rather than lifestyle operations. To me it is so obvious. The dark side of this area of surgery was caught on camera, where the supposed surgeons were engaging in disgusting antics, while performing liposuction. Unbelievable.

The area has been subject to multiple investigations by the media, but the prime response has been the lawyers threatening a class action. However, what of the government and organised medicine?  Most of these cosmetic cowboys join the Australia Medical Association knowing how loath it is to criticise its constituency – or rather to call for a total revamping of the regulating and disciplining agencies.

The scandal of the raid on Professor Ashton shortly after the 60 Minutes TV exposé, by Federal Government regulators, made me think of dark corridors or coffee bars where scuttlebutt is devised, and shock-horror – money can change hands.

If I were Government, I would initiate an investigation into how the raid came about, and just who was the whistleblower. Or was there one?

In the meantime, I would bring the whole practice of plastic surgery including cosmetic surgery under the one regulating body, offer the chair of such a body to Mark Ashton for five years, together with staff including a panel of qualified plastic surgeons to review the competence of all those practising and generally fix this appalling mess. If this means obtaining the Kabuki doll appearance has to be carved out in another country, so be it.

I wonder what Sir Benjamin Rank would have done; but then we live in different times. That does not mean Australia should be inflicted with a class of people – that of incompetent practitioners – in their case laughingly called cosmetic surgeons, should be able to display their incompetence and general disregard for their patients and leave it to the reputable area of the Australian health system to repair. Furthermore, those cosmetic surgeons who are providing competent, quality procedures should welcome such a move.

A good story

The following report appeared this week in the Boston Globe. Why it is a good story is evident, and I realised how little I know. But this article I’m glad I read.

Explorers Bradford Washburn and Robert Bates travelled to the remote Yukon wilderness in 1937 to climb Mount Lucania, but a month of bad weather that preceded their trip had left the Walsh Glacier, the starting point of their expedition, covered in “fathomless” slush and “cut to ribbons by dozens of new crevasses.”

The poor conditions made it impossible to get a flight off the glacier after their climb, so the men hiked more than 100 miles to safety, shedding supplies that would have been too heavy to carry. It was one of the more remarkable survival stories of the past century.

Nestled in the cache they left behind were cameras that Washburn, a renowned photographer, had planned to retrieve a year later but never did.

Instead, a seven-person expedition team recovered the cameras in August, 85 years later and more than 12 miles from where they had been left. The team of explorers announced their discovery last week.

Washburn, who died in 2007, would become one of the world’s top mountaineers, in addition to his work as one of its foremost cartographers. In Boston, he would be known as the man who built the Museum of Science into one of the premier institutions in New England.

The explorers found a portion of one of Washburn’s aerial shutter cameras, a Fairchild F-8. They also recovered two motion-picture cameras with the film loaded, a DeVry “Lunchbox” camera model, and a Bell & Howell Eyemo 71, as well as mountaineering equipment.

Conservators at Parks Canada, which oversees national parks in Canada, are treating the cameras to see if any images can be recovered.

The idea to recover the cameras came from Griffin Post, a professional skier who had learned about the cache while reading a 2002 book about the explorers’ harrowing journey, “Escape from Lucania” by David Roberts.

Post read Washburn’s journals, enlisted the help of scientists, and this year led two expeditions to the glacier in Kluane National Park and Reserve in the northwest corner of Canada in search of the cameras.

“You do all this research, you have all this science-based reasoning, and you think it’s totally possible: We’re going to go in there and look in this certain area, and it’s going to be there,” Post said Saturday. “And then the first time you actually see the valley of the Walsh Glacier and how massive it is and how many crevasses there are, how rugged the terrain is, your heart kind of sinks and you’re kind of like, no way, there’s just so much terrain.”

To find the items, the team enlisted Dorota Medrzycka, a glaciologist who interpreted maps and historical observations of the glacier’s flow to determine where the cache might be. But she could only provide estimates, and the group spent days searching the glacier.

“It would take us the whole day to walk 10 kilometers up glacier and come back to camp,” Medrzycka said. “And going up, there was quite a bit of crevasses, so there was a lot of zigzagging to try to find spots to jump over them.”

The group could not simply return to the spot where Washburn and Bates had left the cameras, because the glacier’s flow had changed the landscape.

Glaciers move at a constant speed from one year to the next, but not the Walsh Glacier, Medrzycka said. Unlike most, it is a surging glacier, which means that every few decades it moves more quickly for a period of a year or two.

In a normal year, the Walsh Glacier typically flows less than 1 meter per day. During the surge, it moves more than 10 meters, or about 32 feet, per day. Since the 1930s, there have been two surges.

Toward the end of the team’s weeklong trip in August, Medrzycka noticed two anomalies in the pattern of the ice, which she guessed had been caused by the surges, and was able to calculate a new estimate about where the items might be.

The revised estimate ended up sending the team to the items the next day.

“Knowing that the educated guess I made actually paid off and was right, it’s a very incredible feeling,” Medrzycka said.

Her findings also provided a new data point about the glacier that will be helpful for researchers.

“We can now better understand the change in the dynamics on Walsh Glacier and potentially be able to better predict how this specific glacier might change in the future,” Medrzycka said.

Whether the surging was tied to climate change was unclear, she said.

Climbers Bradford Washburn (right) and Robert N.H. Bates near the summit of Mount Lucania around July 1937. Until their summiting, Lucania had been the highest unscaled peak in North America.

“This irregular flow, that means that they are not behaving like other glaciers in the region,” Medrzycka said. “It’s difficult to say how much of what happens on Walsh Glacier is related to anything climatic or if it’s just internal behaviour.

The team was backed by Teton Gravity Research, a company that creates media showcasing extreme sports and plans to release a film about the item recovery.

Post said that though it seemed unlikely, he was cautiously optimistic that researchers would be able to recover images from the cameras.

“It was so unlikely to find the cache in the first place after 85 years,” he said. “Yes, it’s unlikely that some of that film is salvageable — but maybe it is.”

Mouse Whisper

The Italians have a phrase “come un ghiro” as in “ho dormito come un ghiro” – I slept like a dormouse, meaning I slept well, which is not surprising given that our dormouse cousins spend up to six months in hibernation. Like the T-Model Ford which could be any colour as long as it was black, dormice are any colour as long as it is Hazel; unless they are of the edible dormouse variety which was a delicacy favoured by the Romans and still persists as a delicacy among the countryfolk of Croatia and Slovenia, where their fat little bodies cooked are supposed to rival squirrel in their greasiness.

Oh, and you can tell a dormouse from a rat because the dormouse has a furry tail whereas the rat has a scaly tail. Just thought you’d like to know, if you’re looking to put one in your teapot to cook and mistaking cousin rat for one of them … just joking.

The dormouse’s head may have been in the teapot, but John Tenniel ensured the furry tail remained visible.

Modest Expectations – Swansea

Saigon River

For the next two weeks, we are cruising the waters of Vietnam. Commencing in Ho Chi Minh City, we have just pulled out into the Saigon River as I write this continually changing blog. It is Tuesday just after seven am, four hours behind Sydney time, on a day when the Treasurer will empty his pot of gold or whatever over the Australian people. Past cranes, moored tramp steamers, the container barges, the tugboats, house boats and small craft, it is raining and for a working port, it is strangely silent.   Clumps of water hyacinth, a skerrick of Mother Nature, defiantly float down the heavily industrialised river. We await the delivery of our breakfast. It is four hours to the sea.

Once Miss Saigon Now Don’t Miss Ho Chi Minh City

We landed in Ho Chi Minh City, which we all once knew as Saigon. Here in a city of about 10 million people, most seem to live on motor bikes and scooters. This is the inescapable impression one gets of this city as you drive from the airport. Gone are the days of wandering the city. My images are those of a man encased in a vehicle being driven hither and thither. The city I knew as Saigon shows little signs of what they call “The American War”. Our guide drives us past the War Remnants Museum where, we were told, the detritus of the War abandoned by the Americans as they retreated from Vietnam in 1975 is on show. To the people it is there to serve as a reminder; and it is in a distinct space away from the Military Museum, where the success of the Vietnamese people is remembered. Its forecourt is littered with planes, helicopters and tanks, mostly Russian. We did not go in.

My experience of the Vietnam War was examining those young men whose birthdays came up in the lottery, drafted if classified as medically fit. These young men were 19 years old; and now these ageing veterans are beset by the demons of having experienced war in a land that they hardly knew for a cause disgracefully misrepresented by the politicians of the time. I well remember the Federal election of 1966 when Harold Holt won in a landslide victory, interpreted then as a ringing endorsement of the War.

Võ Nguyên Giáp

Unlike the Second World War, where Australia was threatened briefly with invasion, this was a War concocted by a few men, some of whom should have known better. It then descended into an obsession, a delusion, and the young people rebelled. After all, it was a war for the Americans to save face “by soundly defeating a third world country with third world socialist ideals with third rate communists like Ho Chi Minh and Võ Nguyên Giáp”. How so very wrong were these assumptions. Lyndon Johnson found that out when he poured over 500,000 troops into battle with over 58,000 casualties. Australia, his “all-the-way” fellow traveller, committed 60,000 army, naval and air force personnel for 521 deaths and over 3,000 wounded.

For what? I am no longer the young doctor who examined conscripts, but someone being driven around a bustling metropolis. We stop at the Presidential Palace where a North Vietnamese tank crashed through the gates on 30 April 1975 effectively ending the War.  Now the grounds are a place for families to walk around, children to play, and there is only one small reminder when a uniformed man officiously challenged my wife while she was photographing, but did not prevent her from doing so, once reassured she was not trying to evade payment for entry into the grounds by crashing the gate. He nevertheless made her stand behind a mythical white line he had drawn with his finger.

Being a young doctor in the 1960s, the money for recruit examination came in handy as I was living on a meagre post-graduate scholarship and had a family. It gave me a perspective on the young men who had been called up. Only once was I confronted by a young man in beard and the uniform of the Woodstock set. He refused to be examined; I and a young fellow doctor whom I knew well were left as the night went on trying to induce him to be examined. A bloody martyr. Save us the histrionics, I thought at the time.

There was no way we were going to pass him, but we stupidly thought we could save him from being arrested if he would consent to be examined. We watched and he watched back. Eventually, the other young doctor calmly explained that eventually we could just leave him and then what may happen would be beyond our control; we were not infringing on his rights any more than any other doctor except that we could not explicitly say anything to him about what we found. While he was in this room he was totally under our control; we just had a job to do – and the word repeated  several times struck a chord.

It did not take us long to find a reason for failure to pass his medical examination. He had the loudest machinery murmur that either of us had ever heard, indicative of a septal defect in the heart.  The only further requirement for us then was to ascertain whether he was symptomatic, which he wasn’t. As this was going on, the defiant demeanour had given way to the fearful request asking if anything was wrong. We could only respond to by saying he should go and see his local doctor as soon as possible. He did not have a local doctor – “only the sick had doctors” – we shrugged and told him to get dressed and find a doctor anyway; that was all.

Given the buggery he had caused, which just meant we got home about eleven in the evening, we had a wry laugh about it. Reflecting on that episode now from a distance in time, it was just an example of bureaucratic anomie we had to tolerate to get and maintain our employment; and rationalise that there were three groups of  examining doctors – one looking to fail and one with the zeal to pass them. The third group who were those encased in their pure objectivity. Of course, you knew in which group my friend and I lay.

All these memories came back as we were driven around this city, where the French influence is still evident in the wide boulevards lined with tall resin trees. The Notre Dame Cathedral Basilica is encased in scaffolding and is temporarily closed. Yet you see it is derivative from the Paris Cathedral of the same name, except that the Saigon version is built of Toulouse bricks, which have retained their bright red colour even after so many years. The French were here in Indochina from 1858 until 1954 when its army was crushed at the Battle of Dien Bien Phu, a defeat which should have alerted the Americans to the robust strategic combativeness of the North Vietnamese – and their courage.

Bánh Mì to go

Today is near the end of the rainy season, and while the hotel is ablaze with Singapore orchids and hydrangeas, the streets are beige and grey, there was frangipani in leaf but yet to flower. Shop fronts cluster – cafés, a motor bicycle repair shop, bánh mì outlets, craft shops. Then we drive into the street lined by the likes of Hermes, the flash Takashimaya and all the other suspects for the wealthy shopper.

We stayed at the Hyatt, an excellent hotel where the standard of Vietnamese cuisine raises the bar for their cousins in Australia. As I gaze around this spacious hotel with its people, obligingly going out their way to cater for me, I thought, how pointless the aptly renamed American War was. Unfortunately, there are those in power who cover their eyes and create memorials to those who so unnecessarily died or were so crippled not only physically but emotionally that they are the legacy for a fruitless war. Yet the raided bluster still goes on, even if the aim is the destruction of a War Memorial rather than Vietnam.

Medicare Lost

There are a number of elements in the Australian Health system which are both misunderstood and misrepresented. The 1946 Referendum granted the Federal Government the power of providing a financial benefit for medical, dental, pharmaceutical and hospital services. The benefit goes to the patient; it is not a fee charged by practitioner or institution. It is the amount of funding to be paid as a “benefit” to the patient for a particular item of medical service. A dental scheme has never been enacted.

In 1974, optometrists gained limited access to benefits on the grounds that they were deemed “medical”. It was a propitious time for that profession because of the number at that time who were members of parliament. It helps. The consequence of this generosity was the potential for this to cascade to every health professional being able to be deemed “medical”.

That has yet to happen, even though it is every central agency’s nightmare, given that Medicare is one of few expenditure line items not to be capped, although from afar, it is evident that capping is being undertaken by subterfuge. This generates its own problems for patients as the gaps between medical benefit and actual fee charged inevitably widens.

Finally, doctors are free to charge what they believe fair and reasonable. The Federal Government has no control over prices and incomes, last tested by the Referendum result at the end of 1973. The States do have the ability to fix prices, but in this day and age that would be politically suicidal – even if a Government tried to isolate one group of professionals.

When Medibank and Medicare were being brought into being, both Bill Hayden and Neil Blewett, as Ministers of the Crown were very knowledgeable and spoke the language of “health” fluently. So did Michael Wooldridge on the Coalition side later. All three were effective. From the commencement of my graduation in medicine at the end of 1963 to the present, there have been 22 Australian Health Ministers. Bill Hayden in fact was never Minister of Health, but as the Minister responsible for the introduction of Medibank, he may as well have been. Most of the others are in the same basket as is the current incumbent, Mark Butler. They neither speak “Health” nor know much about it. Thus, they are very susceptible to those influencers, whether these are in fact knowledgeable or not. Health has its fair share of the evangelical, the biased, the bigoted and the just plain stupid. Imagine you are standing in a marketplace where everybody is speaking a different language that you barely understand, but you are the newly appointed consul from Rome and everyone is speaking Arsacid Pahlavi.

All three mentioned above had very good bureaucratic backup; people knowledgeable and able to speak “Health.”  The problem is that a Head of the Department over a 12 years’ reign who does not really understand her portfolio, save as being very good at keeping her Minister on side irrespective of party has been accompanied by the decline in the quality of health policy. This modus operandi essentially ensures that nothing of importance gets done; especially if you use the ruse of shuffling everybody every few months which is a recipe for destroying the corporate memory.

There are a number of bureaucrats who believe that bureaucratic management can be content free.  The late John Paterson clearly believed this, but he was not alone. This theory does not work in health. Having been around longer than most in health policy and politics, I remember well the axiom that it takes 18 years for any reform to be sustained; and that is what has been lacking. John Deeble and Dick Scotton were working on the reform of medical financing from the mid 1960s, with important input into the influential Nimmo Inquiry in 1969. The culmination of their work was the passage of the Medicare legislation in 1983. That sounds about the expected time, and the scheme was successful. But over time, with the loss of these two especially, when dysfunctions in the ongoing implementation emerge, remedies are not found.

Corporate memory is shown to be in short supply. Since Medicare from the start provided the right balance between government funder, health provider and patient, it nevertheless was susceptible to gaming. First there were the State governments who, once the Federal Government allowed them access to Medicare payments, privatised a substantial amount of their services or, in the case of Victoria, just diverted health payments to other parts of the State budget. So, the first impediments were rogue State governments compounded by a weak Federal response.

The second element in maintaining stability which was very important were the periodic Inquiries into the Fees Schedule between the AMA and Government, the last being in 1984. The value of these Inquiries was that they made both sides produce data, however imperfect, instead of opinion. As such, these data could be examined objectively and a negotiated position agreed. After these Inquiries finished, which were essentially exercises in cost accounting, the consultancy which Robert Wilson and I were involved in looked at in depth into several of these exercises, quasi-inquiries between government and specific segments of the medical profession. There is no doubt that the Fees Inquiries were not conducted with the level of complexity now required in costing medical services and practice arrangements.

However, it is fair to say that costing radiation oncology practice in the 1980s approached this level of complexity. There were a number of lessons which still can be learned from this exercise. The first was that when the professional relativities were being developed, most of the radiation oncologists were employed in the public sector. Hence the only reference point to Medicare benefits was the salary they earned from the particular State-run facility.

The technical staff were salaried – the radiographers, the scientists and all the others essential for treatment. Capital expenditures by States was on machines – when funds were available new equipment would be purchased – with no thought given to amortising the cost of these facilities. At the same time technology was improving with development of linear accelerators, the most commonly used treatment machines, and there were calls for such machines to be funded.

Essentially then we had to construct a cost effective model, taking into account all of the above three elements for private radiation oncology practice, which we did in association with the Federal Department of Health, involving delineation of the professional, technical and capital components. Along the way, we determined that three linear accelerators were the most efficient deployment of facilities. There were subsequently a number of Inquiries into Radiation Oncology trying to disprove our findings. Eventually politics triumphed – single treatment machine facilities were installed with all the staffing problems that entailed and the Federal government allowed the States to have access to the capital component despite the costings being based on private facilities. This decision has bedevilled the health system ever since; not only States privatising but also “double-dipping”.

The other change has been the extensive corporatisation of medical practice with both Australian and in recent years international finance company owners, and since the sustainability of the business model is profit not patient outcome, then the gaming of Medicare items becomes an essential component underpinning such a model. Nothing has been done to change this effect on Medicare. As a consequence further Medicare funding is repatriated overseas.

Finally, there are the doctors themselves. Even among the medical profession before corporatisation, some had already embarked on determining the best methodology to game the system. Medical practice loses its credibility if the objectives are all financial. With seemingly endless differentiation of the specialties and the chopping and changing of item descriptors, the number of items expand and their descriptors have expanded. With volume comes complexity, and therefore some doctors have been known to employ people specifically to work out the optimal profitability by manipulating the value of various items of service, whilst maintaining the broad lines which the Health Department has established, such as for general practitioners the 80/20 rules (seeing more than 80 patients for 20 or more billing days a year) and more recently a similar rule for consultant physicians and paediatricians in relation to telehealth.

Extravagant lifestyle becomes one driver to charge well beyond the benefit. If there were regular Inquiries, it could focus everybody’s need to have an affordable health system. If the proceduralists have good results, then the patient is inclined to accept the cost. I suspect that is why some ophthalmologists are able to charge exorbitant fees – cataract removal and lens implant gives back eyesight, in skilled hands it is swift, with little fear of complication. Moreover, we only have two eyes so there is a limit on the number able to be done on the one person! Personal willingness to pay a premium has always been an important vector. For most ophthalmologists, attention to the items of service remains an important vector for profitable gaming if one believes the recent claim that injection for macular degeneration is being overused; and here there may be more than two bites at the cherry. This illustrates how narrow is the walkway between gaming and outright fraud.

Item descriptors are the basis of relativity, the different value of one specialty against the another. The relativities were set in the early 1970s when each of the then specialties was asked to value its professional expertise, but over time, changes in medical practice should have been factored into medical practice and altered these relativities. The benefit when conceived was set based on the professional component. It assumed the cost of the technical component would be paid by the hospital or facility where the operation takes place, which led in the 1980s to recognition of stand-alone day surgery centres. The problem of capital expenditure in terms of prostheses has never been satisfactorily sorted out, and if it is not absorbed into a global benefit for a particular item of service, it will continue in a limbo state of chaos.

Now that the Government intends to place consulting firms on a strict diet, the Department should beef up its expertise in medical knowledge and cost accounting by constructing a long term Medicare Branch directly responsible to the Minister, based on the model Robert Wilson and I conceived which was successful and transparent until the content-free big consulting firms took over.

The areas to be examined should expect the AMA to develop a similar expertise and be less concerned with vapid reactive media releases. However, it also needs to be recognised that with greater complexity in medicine one organisation can no longer claim expertise across the entire medical spectrum and therefore this process inevitably involves the assistance of specialist organisations.

Then the effects of the following can be objectively examined

(a)      gaming, and when gaming becomes fraud

(b)      corporatisation

(c)      States accessing Medicare

(d)      the structure of items and their descriptors to incorporate the three components

(e)      the future of relativities

(f)       the re-institution of regular Health Department – AMA Inquiries

I have also not included so-called aesthetic surgery – lifestyle masquerading as health. It requires a separate line item.

As an addendum, some may say that the recent MBS Review carried out some of these tasks and, with its latest hand-picked committee, it will deal with the relevant issues. However, I don’t see all the above issues on its agenda. The MBS Review was a massive undertaking that had many critics, especially in relation to the perception of hand-picked participants and pre-conceived outcomes.

The recent media attention on a PhD about the use of Medicare items and perceptions of overuse adds another dimension. I have yet to read the 400 or so pages of the thesis, but there is clearly disagreement about what conclusions were actually reached and their accuracy; the mainstream media, as always, does its bit of headline grabbing without too much concern for the nuance. Unhelpful when the rot is widespread and entrenched.

The Throwback

Just a thought about the antics of Vladimir Putin when I heard that many of the young educated, the basis of a middle class which Russia has always found difficult to maintain, have left the country. They are those who have the funds to do it, and in a country which is essentially socially corrupt, “who you know” is paramount to achieving one’s goal.

The fool Yeltsin, who facilitated the transition of Russia to a kleptocracy enabled a large number of the financially adept without any apparent morality to carve Russian resources up into fabulously wealthy satraps. Putin’s rise from being an obscure KGB agent showed the value of contacts, in fact becoming a form of padrone, and then realising the fallibility and foibles of Yeltsin, he nestled like a cuckoo, not making himself a large target in order to be underestimated by potential rivals as he threw them out of the nest.

Putin was a shrewd, intelligent man, who yet has always carried a mystical belief in Mother Russia. Whether Putin was religious or not, he recognised that in post-Communist Russia, the Russian Orthodox Church could be an ally. After all, while the Church looms large within the framework of Orthodoxy, Moscow is not numbered among the original five Patriarchies.

Feelings of inferiority drive most political behaviour and Putin is no different. The Russian Soviet Empire in which he was born had been stripped of its Asian states and most of its European hegemony. The disdain of the freed Baltic states would have infuriated him. Khrushchev, having ceded Crimea to the Ukrainian Soviet in a fit of pique, meant Crimea also need to be recovered in this post-Soviet world.

Putin still had influence in two satellite European countries – Belarus and Ukraine. Elsewhere in the Caucasus and in its former Asian empire, it has been able to ensure that what Russia determines, these states will obey, and he showed what happens with disobedience when he defeated any Georgian aspirations in 2008 and carved pieces off the country to reinforce the point.

Putin repeated the process in Ukraine by occupying the Russian speaking border areas and carrying out a bloodless annexation of Crimea, in so doing humiliating Ukraine, sending elements of the Ukrainian navy based in Sebastopol packing, as Russia assumed control of the Black Sea naval base.

Now it is a different Ukraine, Putin’s corrupt Ukrainian marionettes having been banished by a young man – Zelensky, a true knight errant. And Ukraine has significant resources and a population of over 44 million people (cf Georgia 10 million).

Putin came to office over 30 years ago with all the novelty of youth unknown; now at 70 and over 30 years later, he exists in his braggadocio shell, which threatens and threatens. The problem is that his oligarch mates have not devised the business model for a nuclear war outcome by which they can loot without having to worry about radioactive caviar and vodka laced with just a tincture of polonium. After all, the latter has been favoured Putin method of eliminating his individual adversaries.

Toilets all at Sea 

Fallingwater, Bear Run, Pennsylvania

I recall the anecdote about Frank Lloyd Wright who once said to his son-in-law, Winston Peters; “Wes, sit down will you. You are ruining the scale of my architecture.” Frank Lloyd Wright was a small man, and Wes had been helping in the construction of this extraordinary house, Fallingwater, built over a creek. Whenever anybody mentions Wright’s name, Fallingwater is the first of his many buildings that people associate with him.  Fallingwater is located at Bear Run near Pittsburgh in Pennsylvania.

Wes Peters, with Frank Lloyd Wright

I remember shaking Winston Peters’ hand, when we were serendipitously at Taliesin West in Scottsdale, Arizona at the same time as he was. Given that Wright built homes from the perspective of his short stature, with many of the low ceilings his houses could be described as “snug”. Winston Peters was lean and rangy. I was struck by his quiet manner and in the “old money” he was nearly six foot five inches tall. Wright was feisty. Peters was not, and he would have done what he was told and sat down.

The reason that I thought of that exchange is that it is probably best not to have airlines run by the vertically challenged. I have not travelled by air for some time, but my level of disability is gradually increasing, the price of increasing age. However, in the airplane toilets, you cannot swing a leprechaun – and manoeuvring in such a confined space, where I suspect that the partial pressure of oxygen is much compromised, I have great difficulty using a facility the size of a small wardrobe. The senior airline executives may find cleaning their backsides in an airline toilet a breeze. I do not.  For the disabled of normal size in such a confined space, especially with doors that may open out on a very narrow passage space trying to orient oneself when using canes or crutches is a learned art. This problem has been aired recently in an international travel magazine by a wheelchair bound person who now, when about to travel on a plane, prepares by eating and drinking little in the 24 hours before the flight. Probably resembles the preparation regimen before a colonoscopy.

The danger of deprivation is dehydration, since the plane’s atmosphere desiccates the traveller, and therefore depriving oneself of fluids prior to flying is not very desirable. I just use a container discreetly, and my carer empties it. You must be able to adjust yourself and take your time; and have a very understanding carer.

There are rules about toilets depending on whether the plane has a single or double aisle; and all planes with a seating capacity of over 60 passengers are required to have a toilet. In these smaller planes, the level of difficulty is compounded; and I have been in some embarrassing positions in a Dash-8, where there is no water to wash your hands, and when the door is open, it blocks access to the cockpit and the toilet itself is constructed for a midget – and a small one at that.

Smaller and smaller

I have been on long flights in small planes without toilets and have coped. Nevertheless, the convention of providing any receptacle requires knowing what it is like trying to empty your bladder when the plane is caught in even light turbulence. I am sure I am not the only one to have difficulties; but it is a topic which, like many in the shadows of disability, is not discussed very much – a taboo particularly in the board rooms of small people.

Mouse Whisper

A twitter more about men than mice.

A brilliant Merrie England twittertwist:

My son has lived through five chancellors, four home secretaries, three prime ministers and two monarchs. He’s four months old.

And as Larry the Cat would say, it’s just another new lodger at No. 10 …