Avatar

Today, Rebecca took us to the movies. That's a rare experience for us. I think the last time we went to the movies it was to see Lord of the Rings. Today we saw Avatar. This is another fantasy movie, much more so, and in 3-D. There's plenty to like, even to get very enthusiastic about, in this movie. It has a strong ecological message, that all living things are interconnected and it's perilous to ignore this reality. I liked the name of the rare mineral, unobtainium, that humans space-traveled to this planet (Pandora) to extract and thereby enrich themselves.I liked the evocative name of the planet, reminding us of the legend of Pandora's box and all the troubles of the world that were let loose when the box was opened. I didn't catch their name, but I liked the tall, graceful blue-skinned humanoid inhabitants of this planet, and I liked their tails -would have really loved it if these tails had a major role in love-making as they did in a science fiction novel I read about 40-50 years ago. The screen-writers missed a wonderful opportunity there, though I suppose that may have been a step too far for the timidly prurient American censors. Some of the other living things on Pandora were beautiful and aesthetically pleasing too, and the scary nasty beasties were suitably scary without being outrageously so. The humans were mostly villainous and at least two were downright evil. It was a nice touch to have the most evil villain of all killed by two arrows through the heart, not by the human/avatar hero but by the graceful blue skinned heroine. I'm not sure I followed the symbolism or mysticism that came after that in the last few moments of the movie but overall it seemed a satisfactory ending to a generally enjoyable and worthwhile experience. Thanks, Rebecca for taking us to see it. I believe there's soon to be another 3-D movie, a new adaptation of Alice in Wonderland. Maybe next time we'll take R&R...

Life-altering decisions:1. Taking the road less traveled

Several times we have faced major signposts on the highway of our lives, when going one way or the other would make all the difference to our future lives. Deciding what was the right thing to do required long, deep thought, and it was very clear at the time how important the decision was. The first time this happened was over a lengthy period, perhaps 18 months, in 1958 and 1959. We had married in February 1957; Rebecca was born on New Year's Eve, the last day of that year, and already issues were lining up on each of two diverging paths, one compatible with a lifetime in an increasingly prosperous family practice, the other not. I had begun to discern, vaguely at first then with increasing clarity, that some time in the next few years I would have to make a major decision, whether to stay on that safe, familiar highway of general practice, or take "the road less traveled" into a different professional role. By the middle of 1958 we were established in the gracious old doctor's home at 16 Henley Beach Road, Mile End, on the western outskirts of the city of Adelaide, with my office or consulting rooms in a three-room extension in front of the house and a lovely garden with many fruit trees behind the house, in an oasis of calm amid a grimy industrial area. Rebecca was changing from a helpless baby into an active, communicating infant girl, and Wendy was pregnant again. I had become a capable family doctor; I was a junior attending physician in the outpatient department of the Adelaide Children's Hospital; and I was taking on new scholarly roles and some executive responsibilities in the newly born, rapidly growing College of General Practitioners. The senior partner in the 10-doctor group practice where I was the most junior partner was a prominent medical politician; he and I got along well, shared many values and views of life, and he had begun to mentor me as a potential follower in his footsteps. For that reason he encouraged my growing involvement in the affairs of the College of General Practitioners and began to encourage me to seek office also in the South Australian state branch of what was still in those days the British Medical Association. The other pathway that I could discern dimly at first then with increasing clarity as 1958 gave way to 1959, led towards a more scholarly career. I wasn't sure exactly what was along that road or where it would lead me and my dependent family but I knew it was more scholarly, more contemplative, and that it had something to do with public health sciences, mainly with epidemiology and medical sociology. In November 1958 when we flew to Christchurch, New Zealand, for me to meet and begin to get to know Wendy's family I was exhausted at the end of what had been a very nasty epidemic of influenza, the local manifestation of a global pandemic, in which two people in my own age group whom I knew quite well, a nurse in one of the hospitals where I delivered babies and an ambulance driver with whom I sometimes played golf, both died of overwhelming viral toxaemia. In New Zealand I fell critically ill. I had a viral pneumonia, was in an oxygen tent with a detergent mist intended to loosen tenacious mucus secretions that were choking the life out of me. For a few days I, and the attending physician, thought it was distinctly possible that I might die. I recovered slowly, and during my long convalescence I thought deeply about the future. I knew I did not want to spend the rest of my life getting rich from other people's misfortunes. At the monthly meeting with our accountant that came soon after the end of the influenza epidemic, I had been disgusted by the atmosphere of rejoicing that prevailed among my partners. As they clapped and cheered the numbers the accountant was reporting, I saw in my mind's eye the sad face of the mother of that young ambulance driver who had died. That very morning she had insisted on paying me for several fruitless visits I had made to see him, first at home then in hospital as he sank into irreversible coma and died. That was a moment of truth for me. After that I was increasingly at odds with some of my partners, particularly the two nearest my own age who were most blatantly practising medicine in order to get as rich as possible. My thoughts about a future career began to turn towards preventive medicine and public health. I began to reflect on aspects that I could study in detail while remaining in general practice and earning enough to support my family. When I tentatively floated this idea in a conversation with the most sympathetic of my partners, his extremely negative, even hostile reaction convinced me that such a desirable future was out of the question. I discussed other options with the professor of medicine at the Adelaide medical school. Sometimes openings appear for research associates in academic clinical departments but academic medicine was in its infancy in Adelaide in the late 1950s, and there was no scope for a move in that direction. After further reflection, I decided on a reckless gamble. I left the comfort and security of the group practice, took back the money I had invested to join the partnership, used it to live on for a year in Sydney while I studied for the DPH at the School of Public Health at the University of Sydney. That was the only place in Australia that offered any kind of academic study of public health sciences in those days. Despite the fact that the School of Public Health was not an intellectually very stimulating place in 1960, it was a mind-blowing year for me. I may have learnt more in that year than I did in all six years of the medical course that had ended 10 years earlier. At the end of 1960, I secured a traveling fellowship that paid a stipend intended for a single man without dependents, and embarked for London and a year in the MRC Social Medicine Research Unit. The reckless gamble was beginning to succeed and my new career in public health sciences was starting.

chances, odds, luck and all that

As an epidemiologist I'm supposed to know about rates, risks, probabilities, all the mathematical methods and statistical tricks we use to work out how likely people are to get cancer or heart disease - or as it was with us, how likely it was that we would meet, be attracted to each other, get together, stay together, and make it work as well as we seem to have done for so many years.


For many years we kept a low profile when the conversation turned to how various couples we know had first met. The way we met wasn't something to be ashamed about, or so embarrassingly flakey as as to be something unmentionable, or we were diffident to talk about; but it was really flukey, so much a matter of chance we wanted to keep it private, hold on to our secret. We began to mention it quietly to close friends when we'd been married about 35 years and began to think it might last. Then I went public, sent the story to Shelagh Rogers, host of a CBC classical music radio program, and she read it on air on our fortieth wedding anniversary, played the piece of music I had requested -and awarded me a prize for the best story.

The facts are simple enough: Janet Wendelken and her friend Louise Zuhrer were exploring Australia as hitch-hikers. On Sunday August 7, 1955, they were heading out of Adelaide on their way to Mount Gambier in the South-East of the state. I was off duty in the medical practice where I was the junior doctor and was on my way to play golf. We met because I was the driver who stopped to pick up that particular pair of hitchhikers. Picking up hitchhikers wasn't in itself unusual or flakey in those days. The custom was induced, made customary, by wartime shortages when everybody helped everybody else; and it lingered on for several years after the war was over so it was commonplace to offer people lifts. Two flukes made it possible for this particular hitch-hike to happen.The first fluke was that they were on the wrong road for their intended destination, couldn't possibly get where they wanted to go, on that road. The second fluke was that i was on that road at all, let alone on it at the same time as they were. I was between half an hour and one hour late for my golf game that Sunday morning, because I'd stopped at a hospital where I had delivered a baby in the small hours of that morning. Everything had gone OK at the delivery but the mother had bled a bit more than usual and the baby's crying hadn't sounded quite right; so being conscientious, I had stopped in to look them both over a few hours later. So I was late. I was also a few miles off my usual way to the golf course, which was down the Anzac Highway to Glenelg then along Brighton road all the way to the turnoff to the Marino Golf Club. That day I had to head west on Cross Road, turn left at the main South Road, then later planned to cut across to Marino just south of Seacliff. For them to get where they intended to go, the corner where I intended to turn west was the last place I could drop them so they could head in the other direction, towards the road they had to be on to reach the South-East. But a few minutes conversation with the curly-headed girl who had such a lovely smile attracted me to her as I'd never felt attracted to anyone before. So instead of dropping them at the corner where we would be heading in opposite directions and out of each other's lives forever, I suggested that they abandon their plan to head for Mount Gambier that day, and let me show them the dairy farming, grape growing country south of Adelaide, take them on to the south coast, bring them back to Adelaide, then next day they could set off on the right road to the south-east.

That's what we did on that early spring day in August 1955, and what I've thought about often ever since is how much chance entered into it: the odds against meeting a lifetime partner this way must be vanishingly small. We were unbelievably lucky! Over the next 10-15 years, luck more than chance favored us - but I'll talk about that some other time.

flat learning curve

This blog business is hard to master when my learning curve isn't just flat, it's sloping downwards. So let's find out if I know how to insert pictures into a blog: YES! Here is a very old photo of the home I lived in from 1939 to 1951; I was 13 when we moved into this house and 24 when I left for England; my mother had moved to another suburb near the centre of Adelaide when I got back to Australia in 1954 so my family home was no more. The Norfolk Island pines behind the garage were full-grown, probably about 12 meters tall, beautiful symmetrical trees. We had a lawn tennis court and a large fruit and vegetable garden that I am nostalgic for all these years later.

After the second world war ended in August 1945, life began to lighten up, slowly at first with wartime petrol rationing and other restrictions for a while, but by about 1947-48 things were getting back to normal. I was at university, approaching the end of the medical course in 1948 and finally graduating after six years' hard grind, in November 1949. We got the tennis court in operation in the summer of 1946-47 and for the next 3 years we played tennis most weekends from just before Christmas, when the exams were safely behind us, until about May when autumn began to shade over into winter.

In those years I was about the age that my grandchildren are now. I don't remember feeling that I had the world at my feet and I didn't have any idea what was in my future: to some extent life as a student was programmed and I passively accepted what was doled out to me - lectures, clinical tutorials to learn how to find out what was wrong with people and how to treat it; then a series of hospital posts in a year-long rotating internship. Those posts spanned the age spectrum from infancy to old age, they included two months each in a very busy emergency department, general surgery, internal medicine, and a mish-mash of other mostly useful experiences, but leaving important gaps, for instance no obstetrics/gynecology, no mental disorders except the occasional wierdo who turned up in the emergency department. There's much more I could say about those youthful experiences and the hopes, dreams, apprehension, uncertainties of life then. But that's enough already for now. More later, maybe.

Day 2

Today I will describe a typical day in our lives nowadays.

I have several new chores that weren't part of my life until a few months ago, a mixture of care giving, hunter-gathering provisions, and housework like making beds, washing dishes, preparing part or all of the meals. I make a good gourmet salad, roast a chicken with tasty stuffing, but I have a lot more to learn about cooking. Generous neighbours, our kids, and Meals on Wheels mean that I don't have as much meal-preparation as I anticipated; and I'm grateful for this. Janet Wendy insists on doing some of these chores herself, despite my nagging at her to conserve her energy for the highest priority things she wants to do; but she is slowly adjusting to letting me do more of the chores without feeling guilty about not doing them herself. We have a cleaning lady once a week for the heavy laundry and vacuuming, and have talked about but haven't yet got Molly Maids to come up from time to time to give the place a good sprucing-up. I wash our 'smalls' once a week in the light washing machine in our apartment, and drape most of them over the Ikea drying rack rather than putting them in the dryer, which I reserve for a few selected items.

My day begins after I'm up and dressed with the first of four daily uses of a resuscitation bag to inflate Wendy's lungs to the maximum. Her weakened chest muscles can't suck enough air in to inflate her lungs fully, and without this daily regimen she could suffer segmental lung collapse and greatly increased risk of pneumonia. I repeat this process before lunch, before our evening meal, and last thing before bed, when I also put in eye drops that help to keep glaucoma at bay. After that first morning blow-up, I accompany her to the swimming pool in our basement and stay with her while she has a short swim ( side-to-side across the pool now, instead of laps up and down as she did when she was fit); sadly, I can't get into the pool with her at present because my eczema has flared up, as it usually does in the dry winter air, and the chemically treated pool water plays havoc with it.

We are discovering what an impressive range of community support services Ottawa provides. The social safety net is tax-supported, so much of what we receive is paid for by our taxes. We have regular home visits by a nurse-clinician, a physiotherapist, an occupational therapist, occasional visits from a representative of the ALS Society who advises us on various items of equipment to make life easier. Once a month or thereabouts we are visited by a palliative care physician, a warmly compassionate woman who was one of my students years ago; she is wise and reassuring, reminding us that this is a gentle, easy way to leave this life: ALS is painless, it doesn't impair the mind, and just causes increasing tiredness, so Wendy sleeps a lot. One day she will simply go to sleep and not wake up. It would be a horrible disease if it struck when she was young or when she was middle-aged; but in the mid-80s or thereabouts, when there are so many really unpleasant ways to die, this strikes both of us as preferable. She has a very handy 4-wheel walker, although she doesn't always remember to use it; a device called a bed-helper that makes it easier to get in and out of bed and to turn over, and among other things, a useful rotating cushion on her seat in the car so she can swing her legs around more easily when she gets in and out of the car.

Of course her muscle weakness is progressively getting more profound. The disease first affected her neck muscles and her hands, and both have become progressively weaker so her chin has sunk to her chest and she can't do some of the simple things that she used to do without even thinking about them. I rather often have to do up buttons - which makes a change from undoing them, as I tried and sometimes succeeded in doing 54-55 years ago when we were courting. She has some strategically placed bits of velcro on her winter coat, and several other adaptations to make life easier. Most important, she is in good spirits most of the time. She does get a bit weepy sometimes; she has always been inclined to cry easily, but her weepiness now is actually a feature of ALS, according to the neurologist who diagnosed it. She still gets about a good deal on her feet, but her leg muscles are beginning to get a little weaker. We both hope she stays mobile for a long while, although she speaks wistfully about terrorizing the neighbourhood from her electric wheelchair. I hope it will e a long time, if ever, before she needs this, because if and when her legs stop working, her horizons will shrink considerably.

So we go on, one day at a time, relishing each as best we can.

Monday, February 22, 2010

Day 1: Feb 22 2010

This was my very first post, which got lost when I first posted it. Now, mysteriously, it's come back, out of sequence. It was my first attempt to record some of the events in the lives of Janet Wendy Last and myself. We began our married lives in Adelaide, South Australia early in 1957, having met about 18 months earlier in circumstances I have described publicly twice, first in a CBC Radio broadcast on our 40th wedding anniversary in 1997, then in a little speech at our 50th wedding anniversary banquet. Later I inserted one of those anecdotes in this blog. We have moved about quite a lot in our married lives, though not as much as many immigrant Canadians. I will insert from time to time a few pictures of us at various stages in our lives. Here on the left is a photo of us at Cochem Castle on the Moselle River in Germany, on our  European holiday in 2007. That turned out to be our last European holiday, indeed our last holiday.

Posted by Last's words at 8:10 AM 1 comments