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Sunday, June 30, 2013

From gloomy shadow to bright sunshine


In my previous post I described the rather uncertain first two years of our marriage. The cause of our uneasiness was a combination of Wendy’s depression, her fear of birth defects, her doubts about her competence as a mother, and my developing conviction that despite my fondness for general practice I needed to change the direction in which my career was heading: I needed to refocus on public health sciences, especially epidemiology.
Rebecca and Helen at the beach, 1959

Rebecca with great grannie Last, 1959

Waving to a ship on Sydney Harbour,
Autumn 1960

Fortunately there were many reasons for us to be happy. Despite our troubles, despite the doubts we both experienced, we were bonding, growing closer in innumerable ways. Even when she worried about her fitness as a mother, Wendy was sustained by her sense of fun, her ability to laugh at herself, and more important, to laugh at me, to lift my spirits from dour moods to a cheerful, positive thankfulness for all the ways in which we were blessed.  

Her first pregnancy proceeded smoothly after a brief bout of morning sickness.  One lasting benefit of that morning sickness is that the smell of tobacco smoke on my breath nauseated Wendy: for the first time I had an unassailable motive to quit smoking, and after several unsuccessful attempts since the first epidemiological studies of smoking and lung cancer were published in 1951, this time my incentive to quit was more powerful than the addictive, seductive pull of nicotine. I haven’t smoked since about 7 months before Rebecca was born on December 31, 1957.

Being present during most of Wendy’s labour and for Rebecca’s birth was a powerful bonding experience. I reassured Wendy as Rebecca emerged into the world that our baby was perfectly formed, had none of the stigmata of Down’s syndrome, could cry lustily as Wendy could hear for herself, and possessed facial features of both sides of her ancestry – as did our other two children in due course. Having the father present throughout labour and childbirth was almost never even permitted in 1957, but we both insisted, and beyond doubt it did much to forge secure bonds that united all of us as a family. When we repeated the process at David’s birth 15 months later and Jonathan’s birth 4 years after that, these bonds became truly unbreakable. Wendy and I never lost that conviction of a lifelong bond that held all of us together. In the next ten years of wandering over the surface of the world from one side of it to the other, this conviction that we were an indissoluble unit was very comforting. It gave us the feeling that we were impregnable, could withstand whatever adversity life put in our way. (Of course we had occasional disputes, even very rarely a shouting/screaming argument, but like a summer thunderstorm, these always passed by rapidly, leaving no scars, physical or emotional).

Wendy’s spirits lifted when I left general practice and started my new career in public health sciences. For the first year of this I was a full time student and we lived on my savings. I could have got salaried work in one of the public health departments which would have given me leave to do the lowest level public health training after a few years of service, but I didn’t want to go in that direction: I had ambitions to become a scholar, aspirations to study and do research on some of the public health problems that were prevalent in Australian society. I was intrigued about the obvious differences in illness-related behaviour I had observed in my general practice, between “new Australians” – the post-war immigrants, refugees and displaced persons, voluntary settlers from the British Isles, the Netherlands, Germany, the Baltic states, Italy and Greece. Did these differences have a cultural or ethnic basis? There were enough immigrants from Italy in my general practice population to motivate me to learn to speak Italian so I could communicate better with them. I talked to Wendy about these ideas. She was enthusiastic, supported me whole-heartedly, encouraged me, and contributed her own ideas. I’d begun corresponding with Professor W D Borrie at the Australian National University when I was still in practice at the Western Clinic, and when he offered me a research assistant position I was attracted by the idea of going to ANU as a research worker on social demography in his department. But the salary he could provide was derisory.  I’d also begun to explore the possibility of working in the UK Medical Research Council’s Social Medicine Research Unit as a visiting scholar.  This had the advantage of advanced training in epidemiology. The visiting scholar’s modest stipend was intended for a single man without dependents; I had a wife and two small children, so we had to augment the stipend with what remained of my savings. We were poorer than church-mice during that year in London in 1961-62. Yet we were happier than we had ever been since our marriage. All the dark clouds had rolled away, Wendy demonstrated all her skills and abilities to run a household on almost nothing, we explored all the wonderful free entertainment that London had to offer, Wendy and our two toddlers Rebecca and David made the most of these during the week, I joined in at weekends, and we had a fantastic, deliriously happy time. 
Eating candy floss at Clissold Park fair

Glamour girl Rebecca outside
Buckingham Palace

Beside the Round Pond
Summer 1961

With Peter Pan in Kensington Gardens
R & D in our back garden
30 Newington Green

Rebecca beside our snowman
January 1962

On the little bridge at Bourton on the Water

Beside the Thames, looking towards Big Ben

At the end of our year in London in 1961-62 we returned to Australia on another cargo ship carrying 12 passengers, this time boarding in Rotterdam, calling at Antwerp, Marseille, Genoa, Livorno (close to Florence and Pisa), Iskanderen in Turkey, then through the Suez Canal and Red Sea, across the Indian Ocean to Fremantle and Adelaide. I spent a lot of time on that interesting voyage writing up the research I'd been doing, but abundant time remained to enjoy the voyage and the fascinating ports of call, to read to our kids and to make up a story to tell them when we'd all begun to tire of hearing yet again about Winnie the Pooh and his friends, Mole and Ratty, Toad of Toad Hall, and Charlotte, Wilbur and Fern. 
Wendy and Rebecca striding past
 the Leaning Tower of Pisa

Wendy and Rebecca in Florence,
Ponte Vecchio in background









Iskanderen, Turkey














What a pity it was, though, that our kids were too young to retain any more than hazy memories of that wonderful year and the sea voyages at each end of it!



Friday, June 28, 2013

Stormy days


After reflecting on it for many weeks, I've decided to post the following abridged excerpt from my memoirs. Some readers of this blog might derive lessons from our early experience of married life.

Looking back after our 54-year marriage (55 years as lovers) ended only with the death of my beloved Wendy, I marvel that we managed to stay together in our first two shaky years. We had to struggle through festering difficulties to achieve the confident stability and mutual love that came when we were convinced that we were meant for each other. Our first two emotionally stormy years were followed by ten years during which we moved several times across the world from one side to the other until we came to rest, permanently as it turned out, in Ottawa (we came to Ottawa naively seeing this as a stepping stone on the pathway back to Australia or New Zealand).  Those years of wandering and wondering what would become of us are a story that occupies much space in these memoirs. 
Our first home: 11 Chapman Street, Torrensville
(With my car and Helen, our dachshund bitch)

Superficially our problem was simple. We were both over 30, becoming set in our ways when we began seriously courting and had got used to living independently; we each had to adjust to living at close quarters with another person whose needs, desires, hopes and fears were different from our own. Below the surface there were layers of complexity that sometimes upset the emotional equilibrium of one or both of us, often for reasons we could not understand, let alone try to prevent. Each of us kept secret from the other some personal, private worries and fears, in my case because I felt that bringing this into the open would strain our marriage. Despite living in a different country, Wendy always remained emotionally very close to her mother and sister. There were many times when she would have loved to be able to pop in and talk intimately with either of them, and innumerable letters went back and forth across the Tasman Sea between them. I almost never saw or read Wendy’s letters to her mother and sister and infer from excerpts of theirs to her, which she showed or read to me, that she revealed her sadness to them and they encouraged her to stick with me, that our lives would get better. I had a possessive, clinging mother who, I believe, did not really want our marriage to happen, let alone succeed. Several times during our first two years of
Wendy 6 months pregnant, beside a camp fire in Flinders Ranges
married life, I had to engage in shuttle diplomacy to patch up emotional lacerations my mother inflicted on Wendy. Years later Wendy occasionally revealed other ways my mother tried to drive wedges between us. I sensed enough of my mother’s unspoken hostility to motivate me to leave Adelaide, and to lift Wendy’s spirits when my career aspirations took us further away. I had no incentive to return again to Adelaide to settle there permanently.

Early in our lives together Wendy was often tearful, insecure, and unhappy. She was uncertain about our marriage. When we had been married for more than 10 years and were happily and comfortably settled in Edinburgh, she told me that she had kept a small secret stash of money for several years, enough for her fare back to New Zealand if she found it impossible to stay married. Belatedly I recognized that she was depressed but in those days I knew so little psychiatry that I was unable to help her. I asked one of my partners who dabbled in psychiatry to see her and he prescribed mild sedatives including the currently popular drug thalidomide, which happily for our offspring, she did not take during either of her first two pregnancies.  By the time she began her third pregnancy late in 1962 the danger of thalidomide was known and it had been withdrawn from the market.  A few years later when I learned a little about how the mind works I realized that in those early months of our lives together, Wendy was suffering from depression that began during our engagement to marry if not earlier and continued intermittently during the first eighteen months or so of our married life. For a few years after this she had occasional periods of sadness that could be described as mild depression but these became rare, increasingly brief and ceased altogether in the last 25-30 years of our lives together. 
Wendy with Rebecca aged 3 months

Wendy had another emotional problem that she confessed to me when we’d been married for almost 30 years: She had not wanted to have children and was almost distraught when she realized that she was pregnant for the first time. Throughout her first pregnancy she was worried and unhappy, fearing that our baby would be born malformed or suffering from Down’s syndrome. Even when her fears proved groundless she remained unhappy and worried that she would not be a competent mother. There was no basis for her fears, apart from her mother’s critical remarks. Her mother stayed with us when we lived in Sydney, and again when we lived in Edinburgh. I found it hard to tolerate her constant criticism and her interference in our approach to bringing up our children. Her way was rigid, authoritarian, and relied on physical punishment, whereas we adopted a more relaxed, permissive method that relied on rewards for good behavior rather than punishment for bad. I’m sure her mother’s constant criticism and interference during her prolonged visits upset Wendy and I didn’t help matters much when I tried to contradict or over-rule her. 

My psychological and emotional problems were more complex. The scars on my soul from damage caused by memories of the war my parents waged against each other probably never completely healed.  I was emotionally damaged, so bonding with anybody, even with Wendy, was difficult and tentative.  I have always found it hard to express my feelings in spoken words, although I could and did write my thoughts down, for example on greeting cards, and later in dedications of my MD thesis and some of my books. But the problem of expressing my feelings in conversation remained with me throughout life. Often during Wendy’s final illness we sat side by side holding hands in silence. Her voice was failing by then because ALS was killing off the nerve endings of her speech muscles. But my ability to speak was unimpaired and my mind was flooded with loving thoughts and innumerable things I wanted to say to her. She was deaf too, so I had to speak loudly, even shout, which further inhibited me when I tried to utter the words of comfort and intimate loving thoughts that were overwhelming me.
Wendy and Rebecca, West Beach

John and Rebecca, National Park

We both revealed our bodies to each other freely and often when we were newly wed. Wendy told me years later how she felt that revealing her body would make it easier to reveal her thoughts, and this worked for her: she was able to say things and to express ideas when we were naked that she could not when fully clothed. Without consciously applying similar reasoning, I tried to do this too but I was less successful and if anything sometimes I became more reticent and inarticulate without clothes to cover me. Eventually I discovered that to communicate complex abstract ideas it was essential for me first to write them down, examine and sort them out, arrange them in logical sequence, then speak them. Early in our lives together I had not learnt this.  We never had any serious arguments, nor even quarrels, in those early days, but there was often an underlying atmosphere of tension in which at times I was uneasy about what the consequences might be if I spoke my mind or criticized any of Wendy’s words or actions, and I know she felt the same, because a few years later we talked about this. Each of us felt we were walking on eggshells. It’s as well we each had this feeling – we treated each other delicately and with respect rather than insensitively or crudely. 

When it came to supporting her at her most fragile, however, I was the opposite of helpful. I was aggressive, impatient, lacking insight or understanding of how she felt, inadequate in communicating with her on an emotional wavelength that would help her, would enable or assist her to recover from unhappiness. She healed slowly without help from me. Paradoxically we had very satisfying sex lives during this fraught period. Each of us took care to satisfy the other, so neither of us was left unsatisfied. We both enjoyed oral sex as much as conventional intercourse and found this a sure way to satisfy each other. Probably we both felt that union of our bodies would facilitate union of our minds, our souls, and I’m sure eventually it did, although now she is dead my sorrow and sadness is aggravated by regret over all that I could and should have said and done to bring my soul into greater harmony with hers in those early months of our marriage – and no doubt later in our married lives too, when we were communicating better though still imperfectly.  That will always be my greatest regret about our lives together:  I was unable to communicate adequately my thoughts, my hopes, my feelings.

Now that she is dead I am invading her privacy and reading her diaries, where repeatedly I come across remarks about my moods that she often misunderstood, mistaking silence for disapproval, and mild misgivings for anger.  Our lesson, my lesson for others from our experience, is that communication between partners is an essential component in a successful and happy marriage. We discussed this vital ingredient with happily married Hindu friends in an arranged marriage about 25 years ago. They were strangers to each other when they married. The mother of one of them – the husband – urged both to learn how to communicate with each other if they wanted their marriage to be a happy one.  They did, and were as happy as Wendy and I. What wise advice this is!

As for me, several things were going on in that early period of our marriage. I was painfully aware of the abject failure of my parents’ unhappy marriage, blamed my father for its failure, desperately wanted to avoid at all costs a similar failure of my own marriage but suffered from inability to articulate my anxiety about this cause for concern. I’d never had a male role model whose behavior I could emulate (or avoid) in my role as husband and father.

At the same time I was going through a professional crisis brought about by my growing conviction that general practice, much as I loved it, lacked intellectual challenge, the time to reflect and think, that I wanted and needed to fulfill myself professionally, and moreover, general practice was an inadequate setting for many of the ideas I was developing for research.  I loved the work and felt confident that I was increasingly competent and capable of doing most if not all that a good family doctor needs to do - except deal effectively with mental and emotional disorders. Also, I was becoming a family man with growing responsibility for a wife and child, then a wife and two children.  General practice provided financial security, stability, a comfortable home, a well defined future of increasing prosperity that would enable me to offer the children a top quality education at private schools and certainty that they would get the best possible start in life. But I was moving left ideologically, to a political perspective that meshed perfectly with Wendy's, and my sense of social justice made me uncomfortable at the thought of getting rich because my patients had the misfortune to fall ill. Also, I had an ideological bias against private fee-paying schools and the social inequality and divisiveness these fostered. I felt a different kind of anxiety and guilt when I realized that the academic and research career to which I aspired would rule out for many years if not forever any possibility of being able to offer all or even any of the wealth of a successful family doctor, to my family. There were no role models in Australia to show me what I might become. In Britain there were the beginnings of general practice as an academic discipline, in Edinburgh and in Manchester. The College of General Practitioners had been born and I became active in its South Australian branch.  I had several long discussions with Adelaide’s first professor of medicine.  He explained to me that I would need academic credibility, would need to demonstrate that I had original ideas and thoughts, could provide inspiration and intellectual leadership to others with aspirations to follow where I had led. This was very challenging when I so lacked confidence in myself that I doubted whether I would even survive in academia, let alone become a leader and an inspiration to others! 

These ideas and inchoate aspirations preoccupied me increasingly during our first two years of married life, distracted me when I should have been focusing most of my time and energy on Wendy. Towards the end of 1959 when I had resolved to leave general practice and strike out in this new direction, I talked at length and in detail with Wendy about my ideas and aspirations and she encouraged and supported me whole-heartedly. Without her backing and total support, I would never have left general practice, and none of the events and accomplishments that followed would have happened. Wendy was not entirely happy in the role of family doctor’s wife. She was fully occupied with first one then two children, but she wanted to fulfill herself in a more active caring role in the community than reassuring patients who came to the door when I wasn’t there or called for help on the phone. Her spirits lifted when I confided in her my aspirations for a more scholarly career. She took her place beside me, supported and encouraged me wholeheartedly. Without that support and encouragement none of my accomplishments would have been possible. Moreover, Wendy was at one with me ideologically, was in complete agreement with me about the inequities of our way of practicing medicine and the divisive social consequences of private fee-paying schools that prosperous Australians preferred.  Ideologically we were always perfectly matched, almost from our first conversation on that magical spring day when I picked up two hitch hikers one of whom was Wendy, and my life changed forever.

Looking back on it after well over half a century, I’m sure that our successful and happy marriage owes a great deal to our transcendent love for each other, and to the patience and tolerance we both possessed, that made us able to overlook each other’s shortcomings as well as to demonstrate our deep and sincere love and affection.  We always followed the advice handed down from mother to daughter through successive generations of my mother’s family: “Never let the sun go down on a quarrel!”  Whenever we had a disagreement, which inevitably happened from time to time (less often as the years went by) both of us always made sure to make peace with each other before we went to bed.  That snippet of traditional advice may have been the wisest, most helpful thing anyone ever said to us.

Thursday, June 20, 2013

Interrupted by bull ants


After Wendy returned to Adelaide in July 1956 our theoretical love affair became practical, hands-on, and much more fun. We did much of our courting in the picturesque Adelaide Hills.  One day, when driving in these hills we were overcome as usual by amorousness. We carried our rug to a grassy slope out of sight of the road, where we settled down to express our affection for each other in our customary way.

Before either of us had really warmed to the business at hand, Wendy suddenly screamed and leapt up, tearing frantically at her clothing. 

In our careless haste we had spread our rug on a bull-ants’ nest.  Bull-ants are fierce, fire-red creatures a centimeter or so long, equipped with sharp pincers where lesser creatures have a proboscis.

They were displeased to have their nest and its approaches obscured by our rug, and let us know about their displeasure in the only way they could.  Wendy sustained several savage bites that, she later told me, raised angry welts on parts of her body I was not yet permitted to see.

We retreated in disarray and confusion.

After that unhappy experience we always inspected the site carefully before spreading our rug – or courted in the cramped  but ant-free safety zone inside my little car. 
A bull ant ready for action
Here's a link to a You-Tube movie that gives a good idea of what these beasties are like:

http://www.youtube.com/watch?v=mDRFTcNW0go