March on, Geraldine!

I never read Little Women by Louisa May Allcott but I remember reading Jo's Boys, which was one of the sequels or spin-offs that followed it. Now I've read March, Geraldine Brooks' Pulitzer Prize-winning novel about Mr March, the husband and father who is a shadowy figure in the background, away in the Civil War during the action of Little Women, or so I'm told. It further reinforces my admiration and respect for this interesting writer whom I can claim as a fellow-Australian even though she is now an American citizen, married to an American and living in the USA. I've thought of her as one of the most interesting contemporary writers since I read Year of Wonders, her  imaginative story of the people of Eyam, the Derbyshire village that quarantined itself in an act of extraordinary altruism during the catastrophe of the black death, and in particular, the story of Anna frith, a teen-aged girl who evolved into a healer during the period that her family, friends and others in the village were dying of the plague. I recommend this book to graduate students and residents in public health and preventive medicine because it provides insight into and understanding of the impact of a terrifying natural phenomenon that strikes down people seemingly at random without any obvious cause, presenting vividly the point of view of the victims and their kin as well as the one who tries to care for them. More recently I read People of the Book, another splendid story, this time about people who left a mark on a famous mediaeval illuminated manuscript, the Sarajevo Haggadah. Historical novels tend to be stereotyped as bodice-rippers and the like, but it's insulting to type-cast Geraldine Brooks as a historical novelist. She is a writer of sufficient stature to be described as a novelist, a Pulitzer Prize-winning novelist, forsooth.  

March describes the social and cultural scene in the United States north and south before, during and immediately after the civil war, the superficially 'civilized' southern aristocrats whose genteel way of life rested on the obscenity of slavery, the more hard scrabble existence of northerners in the early stages of industrial development, the hard lives of slaves constantly threatened with brutality and pitiless tearing apart of families.  The war itself was one of the first bouts of what john le Carre called the periodic madness that afflicts the American people. Geraldine Brooks deftly sketches enough details to reveal its horrors and the appalling mortality caused by infected war wounds: tetanus, gas gangrene and septicaemia were invariably fatal, and made this war more lethal than any before or since.  American books and movies have romanticized the civil war, glamorized the warring factions and air-brushed away the sordid details. Geraldine Brooks has confronted these head-on and in this comparatively short book, has presented the most honest picture of the American civil war that I have ever read. Her book is a superb example of historical fiction at its best, she and her book are worthy recipients of this prestigious prize.

Midnight's Children

I read Salman Rushdie’s magic realist novel Midnight’s Children when it was first published, before it achieved the fame conferred on it by winning the Booker Prize.  Now I’ve seen the movie, directed by the Indian-Canadian Deepa Mehta, with screen play by Salman Rushdie.  These two Indian expatriates have joined forces to deliver a masterpiece as impressive in its own way as the novel.  The premise of the novel was that children born at midnight on August 15, 1947, the moment when India became independent from Britain and the British Empire, possessed special magical powers, were destined for important roles as India evolved into a great power.  The movie, brilliantly directed, masterfully acted by a cast of Indian actors, is as impressive as the novel. I wanted to reread the novel, which survived the winnowing of books as we moved from one house to another.  I remember which shelf it was on in the apartment where I’ve lived for the past dozen years, remember that it had a blue cover and spine detached from the book. Perhaps I discarded it because it was so battered: I was unable to find it when I went hunting for it after seeing the movie. Frustrated by that fruitless search I bought the 25^th anniversary edition, and dipping into this I’m as impressed as I was on first reading.  It’s a brilliant novel, conveys vividly the turbulent and bloody history of India’s first quarter century of freedom from British rule. The book and the movie end before the rise to economic prominence of India in the last quarter century; and the accompanying expansion of a prosperous well-educated urban middle class. It’s a sad commentary on modern India’s lack of mature political tolerance that the movie had to be made in Sri Lanka.  

Labour

Although I'm not a fan of the royal family whose deeds and misdeeds are more likely to provoke my derision or contempt  than admiration and respect, I felt a small measure of empathy this morning when I heard on CBC news that Kate, Duchess of Cambridge, has gone into hospital in the early stages of labour, accompanied by her husband Prince William. She is a week or so overdue. They are in their early 30s - at least he is, and as they were university students together, she must be approximately the same age as he. It's all reminiscent of Wendy's experience and mine: early 30s, a week or so overdue, high summer hot weather teetering on the edge of a heat wave. I've mentioned our firstborn's birth in several previous posts. Here are a few more details. Like the royal couple, Wendy and I drove to the hospital together in the very early morning of a hot day, New Year's Eve to be exact. I stayed by her side almost constantly until our first baby was born, holding her hand, feeding her sips of water, wiping sweat from her brow, offering words of comfort. She had no severe pain until the baby's head was distending her perineum, when a few whiffs of anaesthetic clouded her consciousness enough to take the edge off; but she was wide awake a few minutes later when our baby daughter slid into this world, bellowing loudly - I remember thinking that being born must be a painful experience for the baby as well as for the mother: our baby daughter was bellowing with pain, and despite the heat of the labour room, she began to shiver with cold, until swaddled in a cosy blanket. She had been living at 37 C In the snug comfort of the womb, and the outside world was much cooler despite the summer heat of the Memorial Hospital in Adelaide. Wendy was in labour until late afternoon, 10-12 hours. At her birth our daughter had an almost uncanny resemblance to my mother and her brothers, with traces also of Wendy's father.  That helped us to decide on her name, Rebecca, after her paternal great grandmother. We had considered this name, among others, before she was born, and the family resemblance settled the matter. I can just dimly remember the little old black-clad lady for whom we named our daughter, can remember a perfume that didn't quite disguise her body odour, can remember a very hot black and white striped peppermint that she gave me, that I spat out as soon as I could. Rebecca lost that extraordinary resemblance within hours of her birth, as did her two brothers in due course. A scholarly obstetrician, Melville Kerr who was my colleague and friend at the University of Edinburgh, said it's caused by labour's effect on the baby's facial tissues and is a reliable test of paternity, but he could not explain why it's the facial appearance of ancestors on the father's side of the family that most often appear ephemerally in this way. I feel privileged to have seen it.

Bastille Day

July 14 - Jour de Bastille. I get a frisson of sentiment on Bastille Day. In 1954 when I was back-packing around Europe I planned my travels to be in Paris for the festivities. Alas, France had just suffered a great military defeat: the fortress of Dienbienphu in what was then called French Indo-China had fallen to the Vietnamese freedom fighters and the war to cling to this relic of colonialism was lost. (Unfortunately for Vietnam and for what American presidents call the Free World, the political significance of this event was misunderstood: the USA tried to prop up what they perceived as a 'domino' in the war on communism, at great cost in blood and treasure to themselves, at tenfold or greater cost to the Vietnamese). On Bastille Day 1954 the fountains in Place de la Concorde were not playing under floodlights, celebrations weren't muted but cancelled altogether, even the night clubs in Place Pigale were deserted or closed. In 1977 I flew to New York on July 13 to meet my publisher's editor at Appleton Century Croft, to sign the contract for my first stint as editor in chief of the massive reference textbook of public health and preventive medicine that is now eponymously known as Maxcy-Rosenau-Last. Bastille Day 1977 was the day of a power outage that shut down New York for over 24 hours. Appleton's had booked me into a posh suite on the top floor of the Sheraton Mid-town hotel. I had to walk up 37 floors to go to bed that night, and worse, next morning I had to walk down 37 floors in total darkness because the emergency lighting in the stairwell wasn't working. I met Rich Lampert, my editor at Appleton's, who became a good friend, but instead of the planned luxurious lunch at a posh restaurant, Rich Lampert and I had a stand-up hot dog and root beer at a street barrow on 42nd street opposite the New York Public Library. Several other Bastille Days have been memorable but those two stand out as unforgettable.

Another interview

It's a sign of advanced age, notoriety, fame; whatever. This morning I was on the receiving end of yet another interview, my fifth in the past 18 months or so, about the specialty of which I was for a few years regarded as a world leader. It is part of a series to be published in the Canadian Journal of Public Health. I warmly welcome this initiative.  I hope it continues on track and yields usable material for a series of articles that will help recruit enthusiasts to public health practice, research and teaching.

I greatly enjoyed this morning's interview. I hope the young public health specialist who interviewed me enjoyed it too, and was encouraged to continue interviewing old farts like me, finding out what attracted us to public health, what we regard as essential skills and personal attributes for a successful and productive career. He promised to send me a transcript, and perhaps I'll ask him if I may post some of it on this blog. I told him that I moved into public health ten years after I graduated, after rich experience in clinical practice and patient care; and that my motives or incentive were philosophical and ideological. Philosophical, because I'd realized that it makes more sense to find out what's causing illness and injury and take action to prevent it from happening, rather than to wait for these unfortunate events to happen and treat illness and injury one person at a time. Ideological because I'd found it unacceptable to get rich from fees I extracted from families afflicted with illnesses that sometimes had catastrophic impact on them. (I described the 'moment of truth' that led to this life-altering decision in a post on March 15, 2013).

This interview gave me a chance to speak about my own self-perceived weakest link, the essential attribute required for success as a public health worker: political savvy. I recall a CPHA meeting in Alberta at which the provincial minister of health said he was against making seat belt use and helmets for motor cyclists mandatory because his freedom loving constituents wouldn't like being told what to do. I asked him whether he thought elected officials such as he should lead or follow public opinion. I got a round of applause for the question, which obviously discomforted him (and he didn't answer it). Likewise I detest the present government ministers' constant reference to 'taxpayers' as the arbiters of all that they do. I want to ask them if the needs of newborn babies, school  age children and indigent dependent people should play any part in policy-making. Their actions and policies make it pretty clear that these groups don't count for much in this (or any other right-wing) administration. I hope this message come through loud and clear in this interview 

The age of magic

Sydney, 1960

Snack time, Sydney 1960

A powerful reason for our happiness and light hearts during our year in London in 1961-62 and for many months on both sides of it was the adorable age of our two little children. It was the age of magic when they believed the Winnie the Pooh stories, believed that Mole and Ratty and Toad of Toad Hall could really talk, believed that Fern could hear and understand the conversations between Charlotte, Wilbur and Templeton, believed there really was a Cut-and-Come-Again Pudding (they wanted Wendy to make one like it, so she did, and surreptitiously added to it as she excised portions for them after each meal time. For a time this added to their belief - which I shared - that she was superhuman). 

Feeding pigeons in Trafalgar Square, 1961

Peter Pan in Kensington Gardens
Autumn, 1961

Rebecca and David were only 15 months apart in age, almost like twins in some ways, very affectionate, standing hand in hand together in the face of adversity and all the uncertainties of those wandering years. It was the age of cute sayings, spontaneous bon mots. Like legions of other parents of youngsters at that magical age we wished we'd jotted their remarks down, but we didn't, and like those legions we soon forgot most of them. We have a good photographic record, and I'd hoped to find a few gems in Wendy's diaries, but the pickings there too are slim to non-existent. 

Early in September 1961 we took a train to Cambridge. It was foggy as we sat in a crowded carriage at Liverpool Street station, every seat taken in our 3rd class compartment. As we waited for the train to start, David broke the silence to ask the profound question that all  bright children ask sooner or later: "Mummy, where did I come from?" Wendy looked me in the eyes with an expression that spoke volumes, and told him how Daddy had planted a seed in her tummy and it had grown into a little baby - him. David gazed at Wendy with his big unblinking eyes and asked a second, practical question: "How did I get out of your tummy, Mummy?" So she told him that too, no nonsense about storks or cabbage patches, just the facts. David - and the strangers sharing our compartment - took it all in, asked no further questions. Then the train began to move and the clackety-clack of wheels on the rails drowned out further conversation. Soon the fog lifted too, and by the time we got to Cambridge the sun shone brightly down from a clear blue sky on what turned out to be the hottest day of that summer, with a temperature in the 90s.  

Two youthful activists approaching
Parliament House, Canberra, 1963 

en route Sydney - Melbourne 1963

On June 9 1963 when we were living in Sydney, Jonathan was born, adding new responsibilities to Rebecca's and David's lives. They lived on in a magical world of their own for a few months more but slowly when Jonathan's congenital heart disease became apparent and as they took on more household duties, the dynamics changed and their magical world slowly faded away. Even all these 50+ years later, I still miss it.

Beside the shark-proof rock pool,
Mosman, Sydney Harbour, Summer 1962-3

With Grannie Vera Last in our garden
98 Grasmere Road, Cremorne, Sydney 1963

Our little family, Jonathan aged 6 months
Adelaide, December 1963

On Frozen Lake Champlain
December 1964