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Thursday, April 28, 2011

Here on Earth

Writing about literature and medicine some years ago, I lamented the passing of the age when good scientists wrote with such elegance and clarity that not only was it easy to understand what they were saying, it was immensely pleasurable to read their works. This is true of a handful of modern day scientific popularizers like Lewis Thomas, Peter Medawar and Carl Sagan. Here is another to add to their ranks. Tim Flannery is a paleontologist who has morphed into an ecologist. I'm reading his new book, Here on Earth; a Natural History of the Planet, with immense pleasure and frequent "Ah! Yes!" moments as one after another the complex concepts he discusses emerge on his pages in multidimensional clarity. It is most encouraging that perceptive scholars like Flannery can still be found in this era of gobbledegook and obfuscation. It is doubly so when he is able to write about the natural history of the earth with convincing optimism -- if only we can heed and adhere to the advice and suggestions he offers. This book should be required reading for all national policy makers. All who fail to heed his words should be permanently barred from holding any public office ever again.

Thursday, April 21, 2011

Stork flaps its wings, Repulsing the monkey, Riding the tiger

These colourful phrases identify moves in the graceful exercises of Tai Chi. I had my second weekly lesson today, and confirmed an impression I had at the end of last week's lesson. If there is an equivalent in voluntary muscle movement to dyslexia, I have it: I am unable to coordinate my arms and legs the way well drilled soldiers can. I have a faded recollection of being asked to resign from army cadets when I was at school 70 years ago because I had great difficulty marching in step with the others and could never swing my arms so my left leg and right arm moved in the same direction at the same time. In Tai Chi exercises I'm supposed to move an arm and the leg on the other side of my body in synchrony, and I can't ever seem to do this. As for standing on one leg, that's impossible without my cane to support me. I'll keep going, just be the least coordinated member of the group. The others, all at least 20-25 years younger than I and all absolute beginners like me, take pity, help me as much as they can. Today I got through the entire lesson without a twinge of sciatica so that's one indicator of progress: muscle tone must be better. I'll keep going, no matter that I can't stroke the parrot's tail, strum the lute or carry the tiger to the mountain.

Friday, April 15, 2011

Self-centred thoughts

As far back as I can remember I've had a keen interest in the world around me. Among my earliest memories is of living in my maternal grandparents' home in the early 1930s; it was a partly Jewish household and the conversational fragments I heard and partly understood often conveyed their anxiety about family members who seemed to be in grave danger in Europe. A few years later when I learned to read, the newspaper headlines and stories were almost all about wars in Manchuria, China, Abyssinia, Spain, and about the aggressive expansion of the Nazi regime beyond the borders of Germany. From 1939 to 1945 the news was all about episodes in the second world war. At first the news was unremittingly bad: defeats and retreats everywhere. Slowly the tide turned and our side began to win strategically important battles as well as minor skirmishes. Peace in August 1945 was uneasy, fragile and incomplete. Vicious civil war in Greece and wars of liberation from colonial masters in what had been the Dutch East Indies, French Indo-China, and sundry obscure African colonies erupted; the colonial liberation war in French Indo-China morphed into the American-led war in Vietnam. The Korean war began in 1950, and more than 60 years later the two Koreas remain sunk deep in mutual suspicion and paranoid hatred. In the Congo and elsewhere in sub-Saharan Africa, war has taken 5-10 million lives. Increasingly vicious and bloody conflicts erupted in Latin America, originally between dispossessed and landless rural subsistence farmers and wealthy landowners whom the Americans supported, again in the mistaken belief that these were wars against the supposedly evil empire of the Soviet Union, which was evil in some respects, but also riddled with corruption and incompetence, and ultimately proved unsustainable, collapsing in 1989. Living in the USA in 1964-65, Wendy and I found some aspects of the American way of life profoundly disturbing, notably the strident militarism that led to limitless expenditure on costly new weapons. I remember thinking that this bottomless pit into which the nation poured its wealth (mostly borrowed wealth) was unsustainable in the long term. The day of reckoning is nigh. It's beginning to dawn on even ideologically driven politicians that they've gone wrong somewhere, somehow. The nation owes trillions, many individual Americans have credit card debts equal to a year's wages or more. It's different in Canada, but if the USA defaults on its astronomical loans the world's monetary system will collapse and nothing will ever be the same again. And this at a time when all that wasted wealth is very urgently needed to invest in ways we must adapt to the rapidly developing global climate crisis. Food prices are rising because a series of coinciding natural catastrophes -- floods, droughts -- directly due to climate change, have reduced food reserves while demand continues to rise. Fish stocks, previously up to a quarter of human protein intake, are depleted, because over-fishing and predatory maritime fishing methods are driving many species to extinction. Safe, secure supplies of the most essential resource, fresh water, are depleted and diminishing, causing confrontations and incipient violent conflicts that are likely to be more deadly than ever. I fear that the next few decades will not be pleasant for humans, nor probably for many other life forms. Selfishly, I'm glad I'm growing old, but I'm very uneasy about the state of the world my children and grandchildren will inherit.

Saturday, April 9, 2011

Catalogues of ailments

Several lifetimes ago when I was a recently married family doctor in a group practice on the west side of the city of Adelaide, South Australia, I remember coming into the house one day from the consulting rooms that opened on the street in front of our home, and telling Wendy about a patient I had just seen. This was a very interesting woman, a retired lawyer who had spent her professional life as a parliamentary draughtsman. She was single, and every annual holiday she traveled to a new destination, spending her annual leave soaking up the 'atmosphere' - the culture and ways of life - of the people in the city or country she chose as her destination. At first she had traveled to each of the main cities in Australia, then to New Zealand, and after that, as air travel became less costly while she became more well to do, she had visited Singapore, Hong Kong, India, Fiji, Honolulu, and several cities on the west coast of North America, San Francisco, Vancouver and Los Angeles (she made these longer expeditions by sea). She told me a little about these annual expeditions; usually she stayed put in the same hotel at her destination, using it as a base from which she made day trips, visited the local museums, art galleries, etc, went to live stage performances of plays, ballet, or whatever else was on offer. By the time I met her those travels were a thing of the past, she was old, frail and sick with multiple diseases that often afflict elderly people. She had survived breast cancer and gallbladder surgery, she had varicose veins and a small varicose ulcer, and most recently, not long before she became my patient, she had fallen and broken her wrist. She had a list of her diseases and disorders, arranged in chronological order according to their date of onset, and beside each one, her estimate of severity - the extent to which it inconvenienced her, caused pain, or interfered with her comfort in other ways, the medications or appliances she used for each condition, and whether, in her judgement, the treatment was doing her any good. Altogether she listed almost 20 conditions, all neatly tabulated. She was pleased and proud when I told her I intended to adapt her system for use in my practice; I duly did so, and it was my first serious step along the road that took me from family practice to epidemiology. I've sometimes thought I should go full circle and make a list of the ailments I have now in my 85th year, but it would be a depressing sight to see; so I'll continue my ad hoc approach, telling my excellent family physician what's bothering me the most each time I see her, ask her to deal with that and forget about the other dozen or more other problems on my unwritten list.

Friday, April 8, 2011

Sunshine begins the healing process

For at least four months after Wendy died I was in deep mourning, grieving for her, suffering from a condition not much different from quite severe clinical depression. As the days got perceptibly longer and sunnier with the approach of spring, my spirits lifted, I began to recover, for the first time felt able to think positively about the future and make plans for it. So next week I start weekly classes of Tai Chi, that gentle, graceful Chinese form of exercise; in early May I will be taking part in a three-day writers' retreat, where I hope I will learn something about memoir writing, or what the author running the retreat calls 'creative non-fiction' which means inventing dialogue or conversation that approximates to what was actually said at the time. That's one way to enliven my dull and boring narrative of my life. My other main aim is to weave Wendy more tangibly into the fabric of my story, bring her back to life in the pages of my story from 1955 onward. My third impending agenda item is a visit to Karen and Pradeep Kumar in Hamilton, with a side trip to see a couple of plays at the Shaw Festival in Niagara on the Lake. Finally there are three chapters to revise in Public Health and Ecology, a lineal descendant from Public Health and Human Ecology, this time to be published by Oxford University Press; my friends Frank White and Lorann Stallones are writing or have already written the other chapters (this would be first on my priority list if I were still a workaholic as once I was, but I have a few months grace to finish this). I can't say that I face the future with optimism or great hope in my heart, but at least I feel ready to carry on for a while, sundry annoying minor ailments notwithstanding.

Friday, April 1, 2011

Memoir-writing

On the radio I heard someone talking about memoir-writing. I pricked up my ears and listened closely. Lately I've been reading the fascinating memoirs Karen Trollope Kumar has written about the years that she and her husband Pradeep lived and worked in the Garhwal Himalayas. Recently I've also reread Wendy's lovely memoir of her Depression era childhood on the outskirts of Christchurch, New Zealand - regretting yet again that we never persuaded her to carry her story on to later childhood, an abortive attempt to study nutrition and dietetics at university level, nursing training and working as a nurse in New Zealand, Scotland, private nursing in Scotland and England, and nursing in Australia. Fragments of the last part of this phase of her life are revealed in her diaries, which also record her meeting with me. Karen's memoirs and Wendy's are far more vibrant with life than my dull record. I began writing this in the early 1990s, revised, updated and expanded it about 10 years later, and now I am thinking about another attempt to breathe life into this moribund document, which reads more like a boring textbook than the story of a life that has been tremendous fun, very interesting, and once or twice has helped in a miniscule way to shape public policy. The radio talk, which I heard only partly, touched on the extent to which memoirs should include or suppress sordid and seamy truths about the writer. My memoirs contain a couple of sordid truths about myself, although I've omitted a few other episodes of which I'm deeply ashamed. What I heard of this morning's radio conversation implied that an honest memoir writer would include warts and all. I think this requires a debate, and if as I intend to, I take a course in memoir writing this fall, it's one aspect I will be eager to learn more about.