last's words

John Last writes: Haphazard memories.

(Adapted from my contribution in the commemorative Festschrift book)

Thank you all for all the kind and wonderful things you’ve said about me.

And special thanks, Mariella Peca, Jen Collins and others, for all your hard work organizing this celebration and assembling this anthology to commemorate it.

I’ve been described as a ‘living legend’ and as a ‘towering figure’ (this, obviously, by people who’d never seen me in the flesh). My daughter Rebecca used politically correct language to describe me as ‘vertically challenged.’

Having survived 90 years, I’m not, and never was, superstitious. But I have had a very lucky life, no doubt about it. I chose a fortunate birth cohort, the babies born in 1926. It’s the birth cohort of Fidel Castro, Marilyn Monroe, Hugh Hefner of Playboy, and our lady sovereign Queen Elizabeth. Oh, and Winnie-the-Pooh came into this world in 1926.

Childhood before the 1939-45 world war was a time of innocence. I explored the beaches and rock pools where the hills came down to the sea near Adelaide, and rode my bike through the orchards and vineyards behind the coast, in a bountiful land where the climate and weather were nearly perfect. When the war came, cousins a few years older than I put on uniforms and disappeared. One never returned. His widow, a pretty young woman and her baby daughter, moved in with my uncle’s family. Wartime austerity was petrol rationing and gas producers, large bags of combustible gas on car roofs.

In the 1940s my brother Peter and I lived with our mother in a bungalow in the seaside Adelaide suburb of Glenelg. This was a 25-30 minute tram ride from the city centre, and a 5 minute bike ride from a wide, sandy beach where we could swim in warm, calm sea from October to April. Our family was broken: our father, a country doctor who later became a surgeon and anatomist, walked out of his marriage to our mother when I was about 6 and Peter about 3. Our mother was left to raise two boys on her own. Peter and I and many others agree that she did a superb job, equipping us with social graces, work ethic, and values that took us far in life.

Scholarships and bursaries paid for a first class education at St Peter’s College, an excellent boy’s school, and paid in full for tuition at the University of Adelaide where I started the medical course in 1944, at the age of 17. I intended to take leave from the medical course and join the army when I turned 18, but it was clear by then that the 1939-45 world war was winding down so it was unnecessary for me to join the armed forces and help to defend Australia.

There was a lawn in front of our home that was screened with chain link fencing after the war ended, and became a lawn tennis court. Here on Sundays my medical student friends, reinforced with several nurses, enjoyed tennis parties every weekend. Some of my happiest memories are of those tennis parties and of the celebrations we held as we passed milestones – the formidable examinations and practical tests of clinical skills in medicine, surgery, obstetrics and gynecology, etc. Birthday and engagement parties as the tennis players paired off in a process of assortative mating, punctuated an otherwise placid social life.

I graduated from medical school in 1949, and spent 1950 as an intern at the Royal Adelaide Hospital. At that stage and age I did not feel ready to settle down, so like many other young Australian doctors, I headed for the UK where I spent three years getting experience, mainly in internal and emergency medicine, in National Health Service hospitals in and on the outskirts of London. In 1952, I took the excellent postgraduate course mounted by the Royal College of Physicians of Edinburgh, and lived in the lovely city of Edinburgh for several months; but I flunked the exams at the end of the course, partly because I chose a very difficult specialty, cardiology, partly because my heart really wasn’t in it. I was more interested in broadening my cultural horizons and exploring Britain and Europe in back-packing holidays. I went to Paris in the spring of 1952 and fell in love with the City of Light. It was the first of many visits to Paris.

In 1954 I returned to Australia, traveling as a ship’s surgeon on a freighter carrying 12 passengers. We sailed from Tilbury Docks to Tenerife in the Canary Islands, then nonstop down the west coast of Africa, around the Cape of Good Hope and across the Southern Ocean in the ‘Roaring Forties,’ to landfall off Kangaroo Island, South Australia – four weeks without a port. I look back on that sea voyage as one of the highlights of my life, a magnificent experience in every way. I love the sea in all its moods, saw all of them on that long voyage, and loved every minute of it. One way I'm lucky is that I don't get sea sick.

I joined the Western Clinic, a large suburban group medical practice in the western suburbs of Adelaide. I greatly enjoyed family doctoring, was judged by my colleagues to be competent and capable. I was an active member of the nascent College of General Practitioners and began to tiptoe tentatively into research in the context of general practice. As much by accident as design, I began to study epidemiology. I found it an exhilarating and exciting career path.

On Sunday September 25 1955, on my way to play golf, I picked up two young women hitch hikers, nurses who’d just finished a year at Princess Margaret Rose children’s hospital in Perth, one from Zurich, Switzerland, one from Christchurch, NZ. I was instantly attracted to the New Zealander: 5-10 minutes after we met I made a suggestion that changed our lives. They were on the wrong road for their intended destination; I should have dropped them at the next cross road. Instead I abandoned my planned golf game, suggested that they change their plans, to let me show them some of the beautiful dairy farming and wine growing country south of Adelaide. By the end of that magical day, after long conversations with the Kiwi called Jan Wendelken, also known as Wendy, I knew she was the maid for me.

Jan Wendelken and John Last
planning a better world, Yankalilla, S Aust, 1955.09.25

Our courtship began with 125 letters, mostly 8, 10, 12 handwritten pages, between October 1955 and May 1956, two or more letters a week, back and forth across the Tasman Sea between Adelaide and Christchurch. We never ran short of things to say. Then she phoned me – a big deal, a huge deal in 1956, an international phone call – and we agreed that she’d come back to Adelaide, nurse at the Children’s Hospital, while we conducted a more conventional 20^th century courtship.

Wendelken-Last Correspondence 1955-56 (125 letters, mostly 8-10 handwritten pages)

Signing the marriage registry, St Peter’s College chapel, 1957.02.14

We married on Saint Valentine’s Day 1957 and had 55 wonderfully happy married years of writing, research work, adventurous travel and multiple intercontinental migrations – we lived long enough to put down roots in Adelaide, Sydney, London, Burlington, Vermont, Edinburgh, Scotland, and Ottawa. Later there were sabbaticals: we lived in New York City for a year in 1978-79, and for several months in Canberra and Sydney in 1986. There was much other travel, holidays in Europe, trips back to Oz and NZ to visit our families, and working travel for me in Colombia, Indonesia, Sri Lanka, India, Thailand, Saudi Arabia, Kuwait, Lebanon, Pakistan, China and Japan as well as many places in UK and Europe. Also, of course, much travel in Canada and the USA. At times I virtually commuted back and forth across the Atlantic, to Geneva, Stockholm, London, and Paris.

Our early travels were by sea on freighters carrying 12 passengers – by far the best way to travel long distances across the world. From 1965 onward, we nearly always flew, enduring all the discomforts and petty anxieties of air travel.

We found enough spare time to produce 3 children, all of whom have interesting, worthwhile lives.

David, Jonathan and Rebecca
On deck, mid-Pacific,
January 1964

Jonathan, Rebecca, David
Burlington, Vermont,
January 1965

Wendy inspired me, breathed life into all my professional endeavors, encouraged my scholarly activities, all our travels. When our kids were grown up, she usually came with me on these travels, enriching them with her astute observations.

In 1960 I left the Western Clinic and our little family, Wendy and I and two toddlers, Rebecca and David, lived on my savings while I did the DPH, then had a most exciting year as a postgraduate scholar in the Medical Research Council’s Social Medicine Research Unit, based in those days at the London Hospital Medical College in Whitechapel, in the East End of London. My mentor was Professor J N (‘Jerry’) Morris. It was without doubt the most mind-expanding year of my life. I met and networked with the movers and shakers of public health sciences in the English-speaking world and beyond, absorbed ideas from them, occasionally contributed ideas of my own.

Alas, most of those wonderful women and men of public health science who were my friends, collaborators and colleagues, have preceded me into the great field study in the sky – have fallen off their perches before me. That’s one of the penalties one pays for a long life: it could lead to a lonely old age if I hadn’t cultivated friendships with younger colleagues. (I’ve often said that I’ve kept my youthful enthusiasm by constant reinfection from younger colleagues).

At the end of my year in the MRC Social Medicine Research Unit, we went back to Sydney and I joined the staff of the School of Public Health and Tropical Medicine at the University of Sydney. Intellectual life there was stultifying but I was lucky: before long I was saved from stagnation by an invitation from Kerr White, to join his research team at the University of Vermont. This was another mind-expanding year. I met and got to know most of the leaders of epidemiology and public health sciences in the USA. But we were culturally at odds with some aspects of the American way of life. Kerr White invited me to accompany him when he moved from Burlington, Vermont to Johns Hopkins School of Hygiene and Public Health in Baltimore, Maryland. Fortunately I’d had another invitation, to become a top-scale senior lecturer at the University of Edinburgh. It took barely a microsecond to choose between Baltimore and Edinburgh.

We had five very happy, and for me, very fruitful years in Edinburgh. I landed on my feet, becoming principal investigator in several inter-related research studies for the Royal Commission on Medical Education. Soon distinguished visitors were coming to the Usher Institute of Public Health, not to visit the professor and director, but to visit me. I also began to get attractive invitations to leave Edinburgh, to relocate to other prestigious universities elsewhere in the UK or in the USA.

When I applied for two posts in Australia and was passed over in favour of well-connected local men, I began to take the US invitations more seriously.

The climax came in the summer of 1969. I was invited to take a cross-appointment between the Harvard Medical School and the Harvard School of Public Health. Harvard is probably the best medical school in the world. Obviously I had to look this over very carefully. I flew across the Atlantic once again and after several days of rigorous interviews, was offered and provisionally accepted this position.

There were some obvious snags. The position was soft-funded, not tenure-track, and politically fraught – and academic politics can be vicious. Housing in Boston and Cambridge was beyond our reach: we’d have to live in a distant suburb and I’d face a very long commute, 2 hours or more at the beginning and end of every working day. And neither Wendy nor I were enthusiastic about living again in the USA, where we felt out of sync with prevailing values. I’d had another invitation, from the man who headed the department of preventive medicine at the University of Ottawa. This was a nonentity of a university, but my friend Wendell McLeod, former dean of the University of Saskatchewan, who was executive director of the Association of Canadian Medical Colleges, urged me to consider it: it’s got nowhere else to go but up, he said. You can do a lot to lift it up. This turned out to be a prophetic statement.

I flew from Boston to Ottawa on a hot and steamy summer afternoon. I’d been booked into the lovely old but dilapidated Bytown Inn, on the corner of O'Connor and Slater streets, long since demolished and replaced with a characterless modern high rise hotel. I walked up to Parliament Hill, then around the Canal until I came to the Glebe -- very close to where I live now. It was nearly dusk by then. Parents sat on their front steps, sipping wine, while their kids played street hockey. The University of Ottawa was just across the Canal. I had an epiphany: this was the place! This would be a much better place to raise our kids than some far distant outer suburb of Boston or Cambridge!

So we came to Ottawa. It was a most happy choice. Half a century later I look back with a sense of accomplishment, of successful educational innovation and experiments in which students eagerly participated. Ably aided by capable staff, notably Anne Amberg, a social worker, I integrated hospital-oriented clinical experience and a community-based focus on support networks, acquainting students with the work of the social agencies in Ottawa and Eastern Ontario. I encouraged selected students to take a ‘gap’ year to travel and work in developing countries. I was appointed Canadian representative on the NIH Epidemiology Study Section, invited to become editor in chief of the massive American textbook of public health and preventive medicine, editor of a Dictionary of Epidemiology, and wrote or edited several other successful books as well as the Canadian Journal of Public Health.

With my two dictionaries, at APHA, 2007

Five editions of Public Health and Preventive Medicine
("Maxcy-Rosenau-Last") and other books I've written or edited

I consulted often for the World Health Organization in developing countries and at WHO HQ in Geneva. Looking back on it all, I feel satisfied with a worthwhile life, saddened only by my beloved Wendy’s death in 2010. But it was after 55 magical years; and I console myself with the thought that by letting her go first, I behaved as a gentleman should. I feel great pride when I reflect on her accomplishments. She could dash off a poem or a short story in an hour or two, she painted some lovely pictures that decorate our walls; and her selfless altruism and service to others led to her

Wendy receiving Caring Canadian Award
from her excellency Adrienne Clarkson,
Governor General of Canada, 2003

richly deserved Governor General’s Caring Canadian Award.

Along with family and friends I applauded enthusiastically that day. I’m sad that she wasn’t there to applaud at the investiture in 2012 when I was appointed an Officer in the Order of Canada.