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

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!

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.