Friday, May 3, 2013

Helping Ugandan orphans - Watoto Fundraising Gala

If you live in Melbourne the following fundraising event may be of interest to you. It was brought to my attention by a good friend and colleague who is involved with the initiative.


Thursday, April 4, 2013

When the doctor becomes a patient - reflections on a constrained public health system.

Sometimes when you have a health issue it can take a long time to tease out exactly what is responsible for your presenting symptoms. In my own case this applies to the debilitating post-viral fatigue that I developed after a trek in Nepal in late 2011.

The jury is still out, but I have already been assessed by three departments of one of our major teaching hospitals, including Infectious Diseases, Haematology and Neurology.

Many of my appointments have involved the customary long wait in the Outpatients Department along with a herd of other people. I think at worst this has been about three hours. On this occasion one saintly staff member started bringing around cups of water to the waiting crowd.

We are lucky to have a fine public hospital system in Australia that gives people access to the specialist care that they could not otherwise afford, but it is a pity that there does not seem to be any antidote to either the lengthy delay in scheduling of appointments or the crowded and slow-moving waiting rooms. Despite these trying circumstances, people are generally still very resigned, patient and polite and remain grateful for the attention they receive. We are conditioned to accept that it "is what it is" in terms of waiting for healthcare, whether it is at the GP or in the Emergency Department or Outpatients.

However, I digress. For my neurological symptoms I was fortunate to see an experienced consultant whom I knew of by reputation. In addition to blood tests I was scheduled for a Neurophysiology nerve conduction study and two MRI scans (brain and lumbar spine). There was a little bit of a wait on the day of the nerve conduction study and I was a little concerned whether I would get back to my car within the two-hour parking limit but fortunately I got back with about five minutes to spare. The study itself was an interesting experience. I had used a nerve stimulator on other people during anaesthetics training and had tried a TENS machine on myself, so initially it was quite similar to this, with electrodes being attached to my skin and conduction being measured with electrical stimulation, both before and after "exercise". As my muscles were getting fatigued with exertion, I had assumed this aspect would involve at least moderate exertion of a reasonable duration, but this was a faulty assumption. This component involved only a small number of repetitions of almost minimal movement e.g., opening and closing your thumb. The second aspect involved the insertion of fine needles under the skin, identifying pairs of nerves and measuring conduction. This caused a little bit of bleeding in my forehead so pressure had to be applied to prevent a haematoma and bruising. I was quite surprised that this area was exquisitely tender for about ten days afterwards.

My first MRI (brain) was in the public section of the hospital. Once again I did not have to wait too long to be called through. After changing into a hospital gown there was a little bit more of a wait before one of the nurses inserted an IV cannula in my arm (for administration of contrast) and went through the safety checklist. The cannula took two attempts but we had a nice conversation, and I was asked several times if I was warm enough. I was given some headphones to listen to music during the MRI scan (rather loud and bombastic classical music unfortunately) and was again asked several times during the scan if everything was OK. There were lots of loud noises, clicks, whirring and even some vibrating from the scanner, but time passed quickly enough. I can see why some people might feel claustrophobic in the small narrow tunnel, but I just closed my eyes and tried to assume as meditative a state as possible, and all was fine.

The second MRI (lumbar spine) was in the private section of the same hospital one evening. This time it was a long wait for the scan and in the holding bay before the scan, but the staff was attentive and caring. I had a 7pm appointment and left at 9pm.

My outpatients appointment was on 22 March, but the day before the second MRI I received an unexpected letter advising me of an appointment for a third MRI on 9th April. I queried this at my second appointment, and was advised that there had in fact been three MRIs requested (brain, lumbar spine and cervical spine), but this had only just been realized so a third scan had been booked. I was concerned that this booking took place after my outpatients appointment (for which I had already been waiting several months) had been scheduled. In the end I was just told “sorry, we can’t make it any earlier”. I then contacted Outpatients, and asked for an early appointment after my third MRI scan. It was a case of “sorry, the earliest is 10th May”. A few weeks later I received a letter advising me (without explanation) that the appointment had been moved to the 25th of May, which was two months after my previous appointment.

I will now be having the review of my blood tests and investigations six months after my initial appointment with the neurologist. It will then be over eighteen months since I first attended the hospital seeking a diagnosis for my post-viral fatigue.

I have gone through this process to date the same as any other person, without any special favours due to my vocation. This first-hand view of a compartmentalized and overstretched system is not reassuring in terms of the health care of the average person without the benefit of medical training to assuage their fears. On an individual level, everyone is doing their job and doing it well (with the exception of failing to book a third scan around the same time as the other two) and as is so often the case it is perhaps systemic issues that need to be addressed. Surely we can do better. It would be interesting to know how often logisticians and systems analysts have been included in review teams focusing on how to make our health services function more efficiently.

Lilyhammer - What a cracker!

This is a new must-see TV series showing on SBS on Saturday nights. It is the improbable story of Frank "The Fixer" Tagliani, a New York gangster who turns Crown witness and goes into witness protection in Lillehammer, Norway after falling in love with the place during the 1994 Winter Olympics. As Giovanni "Johnny" Henriksen he lives in a humble abode next door to the Chief of Police and drives an electric car. He is often seen out and about wearing headphones in an effort to learn Norwegian.

Right from his arrival in Norway we start to see why he is called "The Fixer". He rights wrongs perpetrated by youths on the train and already makes some useful alliances. Proving himself to be a gangster with a heart of gold, he saves a wandering sheep, takes a posse out to kill a marauding wolf which later killed the aforesaid sheep (despite the group being warned off by the Chief of Police) and explores "cultural differences" with the local public servant in the employment agency, using some naughty photos found in a local cabin as persuasion to do a favour for the mother of the boy who lost his sheep and to help him get a bar licence (previously "too complicated").

He seems quite keen on Sigrid, the single mother, in a gentlemanly sort of way, so it will be interesting to see where this leads.

The language effortlessly shifts from English to Norwegian and back again (sub-titles are supplied) and this is really no impediment to understanding. For the most part, the Norwegian is clearly spoken and it is possible to pick up a reasonable amount of the meaning if you have an everyday knowledge of the language. There is a little bit of low-level swearing in both languages but not enough to be offensive.

Having lived in Norway and experienced the scenery, climate and culture it is just hilarious at times to see Johnny challenging the law-abiding status quo and appealing to the rebel within. He gets things done in a way that looks after "the little people" and protects the disenfranchised and vulnerable.

Steven Van Zandt is perfect as the gangster, reprising a similar role that he played in the Sopranos, and he is also a writer, producer and music consultant for the series (also being a long-time Bruce Springsteen band member). The Norwegian cast members are very believable as ordinary small-town citizens.

It has been a very promising start and well worth continued viewing. There were two very good reviews of the series in "The Age" recently, including a feature article in the "Green Guide". Both gave it a good rating.

Electricity saving tips!

If you don't use your wall oven (whether electric or gas) on a daily basis, then consider turning the power off at the wall (or the switchboard as applicable) when it is not in use. Turing off this redundant wall clock appears to have made a noticeable difference to the power bill for the last quarter. 

Turn off your microwave and any other appliances with a digital display when not in use. Also consider turning off your digital alarm clock and door bell during the day when you are not at home. 

Replace any power boards which have a standby light which is on even when none of the power points are being used. 

Being known as "Doctor Gadget" I also have a range of solar charging gizmos which can be used for charging your mobile phone and other small appliances. However, the only problem with this is that it is quite difficult to get them fully charged unless direct sunlight is falling on them regularly, so this isn't a regular option unless you have somewhere suitable and safe to leave them during the day. It is also something more likely to be successful during the summer months. However, even if it is only the occasional charge it will still be a small contribution to reducing your power bill.

Migraine Attack - How are the mighty fallen!

After successfully enduring the rigors of standing and singing for the four major Easter services on Holy Thursday, Good Friday x 2, Easter Vigil and Easter Sunday, I was laid low on Easter Monday with a massive migraine. I felt a few 'niggles' of a headache before going to bed tired on Sunday evening, but took some simple analgesia and thought nothing more of it. The migraine crept upon me in the early hours of Monday morning, and I tried all the usual simple remedies - a hot pack to the neck, simple analgesia, anti-emetics and caffeine, but to no avail. The waves of nausea sweeping over me became more and more insistent, and in the end I had no choice but to succumb. I was amazed at the amount of liquid that issued forth, and had to conclude that the migraine had brought on a case of gastric stasis and that everything I had drunk during the morning had gone no further than my stomach. As usual, I felt much better after vomiting and was able eventually to go on and retain an anti-emetic and a prescribed migraine tablet (usually kept as a "last resort" due to the cost per tablet). Although I was now feeling a bit better, I was quite listless. I had no energy to do anything, could not read due to blurry central vision and kept wanting to doze off whilst watching an otherwise interesting documentary on the "Curiosity" Mars Rover. In the end I just continued resting in bed. Fortunately I was able to eat a light evening meal and went to bed early, sleeping for over nine hours. In the morning the headache was thankfully virtually gone, with just residual muscle stiffness and soreness remaining. As I was still somewhat bereft of energy it was lucky that there is a break from teaching this week and I can just work at home.

Migraines run in the family, so I was perhaps doomed from the start, but I still remember the first migraine I ever had at age 13 - I woke up in the middle of the night and felt as if someone was digging an ice-pick into the side of my head. Sometimes I get auras (kaleidoscopic geometric patterns moving across my visual field in an expanding crescent shape) or blurry central vision with or without a headache, and sometimes I don't. Whatever the story, it is always enervating and leaves you feeling guilty about lost time.

It is worth noting that the Skins compression garments certainly helped me to stand up for lengthy periods and reduced the stiffness in my legs but I wonder if the top section, although helpful for my back, was counter-productive for my neck and shoulders and in retrospect it was perhaps a mistake to keep wearing it overnight.

Veni sancti spiritus!

On Sunday 31 March I was as usual part of the choir at St Francis' Church, Lonsdale Street, Melbourne for the Easter Sunday 11:00 mass and we were standing in the back of the sanctuary behind the altar and the celebrant. While the celebrant was reading the Gospel one of the servers was standing to the left of the lecturn, waving the thurible back and forth, with a steady cloud of incense rising upwards. Something unusual caught my eye as a perfect ring of white smoke also emanated from the thurible. With a thick rim, it quickly became more square than round and then as it passed the celebrant and the right hand side of the lecturn it formed into a perfectly symmetrical dove, complete with wings, head and beak, and then slowly dissipated as it passed towards the front row of pews on the right hand side of the church with two shiny wing edges remaining visible until it was gone.

In Christian faith the dove is the symbol of the Holy Spirit, the third member of the Holy Trinity, and I felt as if I had seen the Holy Spirit that morning. Somewhat prophetically, the following sermon was about keeping your faith, even in times of doubt. With all the trials and tribulations in life set in a rationalistic (and some might even say atheistic) age keeping faith can be a daily struggle when your soul is sorrowful and burdened. I want to believe but I would be lying to say that there are no doubts. However, seeing that white smoky dove in that precise place at that precise moment on Easter Sunday brought some tears to the eyes of a weary soul and it was if for those few seconds the Holy Spirit made it plain that it walks amongst us and that we can dare to keep faith in hope and the message of the resurrection story.

Blackout - Life but not as we know it!

A week ago I had one of those wonderful retrospective experiences that reminds you just how dependent we are on technology.

Following the uplifting experience of singing at the Holy Thursday evening service, I returned homw looking forward to a hot meal and catching up on a few interesting shows on TV that I don't normally get to see on Thursday night due to choir practice.

The first sign that something was wrong was that the security light outside the front door did not go on. Already I was wondering if the power was off. Opening the front door confirmed this. No electricity and the main circuit breaker was still on. However, some of the adjacent properties appeared to have normal lighting and the street lights were on, so what was happening?

Like Boy Scouts, Ski Patrollers always aim to be well prepared, so with the aid of a trusty solar-powered torch candles and matches were rapidly located and lit.

However, things were looking a little grim. With no power, there was no telephone, no kettle, no stove and an overriding imperative to keep the refrigerator shut!

The good old mobile telephone saved the day as a means of contacting the power company, who promised to dispatch a truck.

Waiting was frustrating. It was too dark to read or to do any household tasks, no radio or music to listen to and dinner was definitely on hold.

It was fascinating to reflect that this was how our forebears lived until the advent of electrical power. I guess they didn't know any other way of living, and I suppose that we could adapt to it if we had to, but it certainly underlined how much we take our everyday tech nological aids for granted.

When you visit any outdoor activity and camping store, it is equally amazing just how many devices and pieces of equipment there are to help bring along the luxuries of home. Good old-fashioned simple camping with a gas stove, torch and mosquito net seems to have gone the way of the dinosaur!

Fortunately the repair truck arrived sooner rather than later, and it turned out that just a couple of wires on one of the power poles in the street had shorted out, only affecting a small number of properties. Soon all was back to normal, with power, light and hot food.

It only occurred to me later that it was not only our forebears who lived in a world bereft of power and conveniences - many people in the developing world are still in this situation. It is easy to forget how lucky we are that we happened to be born into a progressive Western society. It is the only life that we know, but we also know that we do not wish to live as they do, and in our hearts we understand why others might aspire to come here and live as we do.

This should persuade us all to be humanitarians, to do unto others as we would have done unto us. We might not be able to solve the problems of the developing world, but we can all do what we can to improve the quality of life for the other people who share the fragile spaceship Planet Earth. It doesn't cost anything to be nice and to "pay it forward".

Wednesday, February 27, 2013

Movie Review - The Last Stand

"The Age" reviewer gave this movie three stars and said it was the only genuinely funny movie that Arnold Schwarzenegger had ever made, so that was good enough to give it a go.

Although a fan of the movies that Arnie made as part of the Terminator franchise, I haven't seen many of his other movies. This one marks his return to the silver screen following his term as "The Gubernator" (Governor of California).

This film is a action adventure in the tradition of the "Spaghetti Western", but it isn't afraid to laugh at itself and pay homage to the "bigger than Ben Hur" tradition of Hollywood blockbusters where good takes on evil. In this example small town values of honesty, integrity and caring for each other come up against an amoral drug lord with seemingly limitless resources. The "little people" manage to do what the FBI is unable to do.

Schwarzenegger plays a middle-aged small town sheriff who left an illustrious career in LA behind him after losing a lot of colleagues in a shoot-out. He is kind, patient, dedicated, thorough and professional, and provides a good role model for his two young deputies (male and female) and his Hispanic senior deputy.

After the drug lord masterminds an improbable escape from custody, he drives south from Las Vegas in a hotted up car with a traitorous female FBI agent as a "hostage". There are some pretty crazy road trip and car chase scenes in which law enforcement comes off a distinct second-best. However, things change when the roadshow arrives in Somerton County. Although the young male deputy who was dreaming of a more exciting future sadly perishes, others are drafted, including an eccentric local who conveniently owns a firearms museum. After a firefight in the main street and an even crazier car chase in a corn field, in a scene reminiscent of "High Noon" Arnie and the drug lord meet on a newly constructed bridge that he needs to cross in order to escape into Mexico. Fisticuffs follow but Arnie prevails and brings the handcuffed fugitive back into town and hands him over to the Feds.

There are some nice touches which could be interpreted as tributes to Arnie's past career as a cyborg - he twice pulls a nasty sharp object out of his leg and keeps going and on the bridge, in response to the ever-escalating offer of a bribe, says "my honour is not for sale". He is also willing to acknowledge the impact of advancing years.

All key members of the supporting cast put in a solid performance. The bad guys all seem slightly unhinged, the Feds are predictable, and the small town heroes look out for each other and come across as genuine. There is plenty of humour along the way and despite the odds (and resources) being well and truly stacked against them, the viewer is willing the good guys to win.

This is an enjoyable and entertaining movie (but definitely not one for the squeamish). Schwarzenegger puts in a fine performance as someone who cares and is willing to fight for what he believes in. He shows a certain humanity and vulnerability, and perhaps his experiences in politics and the unravelling of his personal life have made him a better man with a greater ability to connect with "the little people". Perhaps there will be more good work to come.

Movie Reviews - "Life of Pi" (3D) and "How to Train your Dragon"

Life of Pi (3D)

I was initially reluctant to go and see this movie directed by Ang Lee ("Who wants to watch two hours of a tiger in a boat?") but went along as friends were keen. Particularly in 3D, the cinematography is stunning, as are the special effects (including a very realistic and progressively emaciated Bengal Tiger). Apparently filmed in a wave tank in Taiwan, the water ranged from being whipped up into a fearful storm strong enough to sink a cargo ship through glassy still reflecting the sky and the stars to clear and luminescent at night. As well as the tiger, a zebra, hyena and orangutan end up on the boat, and we see fish, sharks, dolphins, jelly fish and a massive whale in the water. Some scenes dissolve into the kind of fantasy that you would expect to see with hallucinations.

Filmed in India, Taiwan and Montreal, the film maps the journey of Pi as a child and then a teenager in India and his family's fateful trip (with their zoo animals) to a new life in Canada. The cargo ship strikes 'the perfect storm' above the Mariana Trench and sinks. Pi ends up in a lifeboat and drifts across the Pacific for over 270 days until he washes up on a beach in Mexico.

At times it is a deeply spiritual journey, with the young Pi exploring three religions simultaneously - his birthright Hindu, Christianity and Islam. At two pivotal points in the story, Pi sees God in the storm, and in the second entreats the tiger to do the same. The young man who plays the shipwrecked Pi does an outstanding job in a very challenging (and wet) role.

Until almost the end of the movie, I was viewing it as a bit of an improbable fantasy, but one for which I had enabled my "willing suspension of disbelief".

I found the conclusion to the movie quite jarring. Japanese investigators come to interview Pi, the only survivor of the sinking of the cargo ship, whilst he is recovering in hospital in Mexico. They consider his story about the tiger and other animals and the carnivorous island complete with Meerkats in the middle of the Pacific quite improbable and ask him for the true story. He then tells a far more brutish tale, of being in the lifeboat with a gentle Buddhist and his mother and the evil cook (a gorgeous cameo by Gerard Depardieu). The Buddist dies and then his mother is murdered by the cook and Pi then kills the cook. The author listening to Pi's story in Montreal says "so the zebra was your mother, the orangutan was the Buddist, the cook was the hyena and you were the tiger?". Perhaps it was the Director's (and novelist's intention), but I was left wondering which version of the story to believe. Pi asks the author which story he prefers, and of course he says the one with the tiger.

After this point (and afterwards) for me the visual wonder of the movie became clouded by questions. Was the floating island of mangroves with Meerkats and aquifers which were fresh water by day and acidic at night, killing the fish within, really carnivorous, consuming the last human inhabitant, or was it merely a hallucination? Do bananas float (yes, experimentally verified!) and could the orangutan have arrived at the lifeboat on a raft of bananas? Was the zebra who swam out under the water when Pi opened a door between compartments to try to save his family while the ship was sinking really a zebra or was this an avatar for Pi's mother? If this was so, why would he agree with the author that his mother was the orangutan? How did the four animals get out of their cages on the cargo decks to end up in the lifeboat? If it was a fake story, why did Pi get teary at the mention that the tiger, Richard Parker, did not turn around for a lingering last glance before disappearing into the Mexican jungle? If there was a tiger in the jungle, surely this would have come to the attention of the media at some point? If there was really no tiger on the lifeboat, did Pi actually construct a little raft to keep himself at some distance from the boat and then lose all his supplies due to environmental disturbances? What about the consequences of exposure and malnutrition? (Apart from matted hair and a few ribs showing he looked remarkably well after nine months at sea.) How did he end up in Canada? Was the Indian girl he married the one he left behind in India as a teenager?

If all these seeds of doubt had not been sown, I would have found the movie much more enjoyable. I did not feel that this self-destructive denouement added anything to the storyline and indeed detracted from all the good work that had gone before. Perhaps it is meant to be a sort of morality play contrasting survival against all the odds with the darkness that lurks within, where the protagonist must reflect on that age-old question, "what is truth?".

The music score is wonderful, weaving in elements of Indian musical traditions. The 3D presentation enhanced the lavish cinematography, but I am sure it would still have been very presentable in 2D. I did find it a bit tiresome wearing the glasses for that length of time and it was disappointing that there was only one Hoyts cinema in the whole of Melbourne showing the 2D version. (There is a $3 premium for 3D films and an extra $1 for the 3D glasses if you do not have them already.)

How to Train your Dragon 

This charming feel-good animated movie was just as enjoyable on a second viewing.

The basic premise involves a fearsome tribe of Vikings at war with dragons, the chief's nerdy son Hiccup who befriends an injured Night Fury dragon (and turns out to be somewhat of a 'dragon whisperer'), his friends including the fiesty Astrid, and a terrifying massive prehistoric dragon who is holding all the other dragons in thrall and forcing them to steal food from the Vikings in order to feed him. The youngsters and the dragons save the day, the large dragon is defeated and from thenceforth the Vikings and the dragons live happily ever after.

I haven't yet seen the two sequels that have been made, but look forward to doing so.

Wednesday, February 13, 2013

Movie Review - Lincoln

Directed by Steven Spielberg, this is an outstanding historical docu-drama with an outstanding cast and attention to detail. It comes highly recommended. It is also a story about how sometimes humanity can learn unpalatable lessons and right wrongs, even in a hesitant stepwise fashion. At that time there was uproar in Congress at even the mention that one day negroes and women might want to be given the right to vote!

Daniel Day Lewis is superb as America's most iconic President, and is ably supported by Sally Field as his wife Mary (Molly) and Tommy Lee Jones as Republican Thaddeus Stephens, a passionate supporter of the proposed Constitutional Amendment to end slavery. Lincoln's tall, stooped and gangly appearance, gait and fragile health make you wonder whether he was beset by Marfan's Syndrome.

There is an intensity of emotion and regard in the relationship between Lincoln and Molly, who is clearly depressed and low on self-esteem following the death of one of their sons. Despite the limited understanding of mental health issues at the time, after one fiery exchange regarding her preoccupation with her grief, Lincoln is compassionate and kind and acknowledges his own deep feelings of loss. Molly also gives an impressive speech "dressing down" Thaddeus Stephens at a reception at the White House following this emotional exchange. At the end of the film it is revealed that the love of Stephen's life is his negro housekeeper, and he takes the ratified Amendment home to show her.

The apparent authenticity of the settings, costumes and battlefield scenes is impressive. Many meetings are held in dark smoky rooms, and there is almost a feeling of historical imprint through the drab washed-out interior colours. John Williams has written a splendid film score, and the other music used (classical and otherwise) is entirely appropriate.

The political machinations are highly reminiscent of "The West Wing". Lincoln must find a way both to ensure passage of the Amendment and end the highly destructive and costly Civil War. He enlists the help of various trusty lieutenants, including a smokin' and drinkin' charistmatic James Spader. They use patronage effectively to buy votes amongst the Democrats (ironic that at this point in American history they were the conservatives) and closer to the vote Lincoln himself makes various house calls to try to persuade a number of Democrat congressmen to vote 'aye'.

Lincoln comes across as humble, thoughtful but passionate and a masterful persuader. He loves to tell allegorical stories in a laconic fashion, and reveals something of his humble beginnings and a difficult childhood with a harsh father. He is also a clever lawyer and gives a marvellous speech explaining the exigencies and uncertainties of proclamations affecting legal rights made in war time. Various newspaper reviewers have remarked on his speech to a couple of his young colleagues just before he sends a telegraph transmission to delay the arrival of the Confederate peace envoys in Washington until after the vote has taken place. In this he refers to a logical proposition of Euclid which says in essence that things that are equal are equal to each other, and this two thousand year old wisdom can equally be applied to human beings.

It is a tragedy that Lincoln was assassinated in just the first year of his second term, having gained both passage of the Amendment and the end of the Civil War. I loved the historical touch that the doctor who declares "the President is no more" uses an old-fashioned Pinard stethoscope to listen for his absent heartbeat (these days generally only used (rarely in Australia) to listen for foetal heartbeats).

It also struck me that, in the context of the current American debate about reforming gun laws, it is a lesson still unlearned that so many of its inspirational leaders have been cut down in their prime by a gun: Lincoln, John and Robert Kennedy, Martin Luther King ... As Spanish philosopher George Santayana famously said, "Those who cannot remember the past are condemned to repeat it".

Debating passage of the Amendment caused Lincoln and those in Congress to examine their consciences and look at the ethics of right and wrong, and even in our time it is a powerful allegorical tale to remind us that there are still many wrongs to be righted and many injustices in the world where we can still do better. Even if you are not particularly interested in American history, it is what it has to say about humanity as a whole that makes it compelling viewing. Without vision and the passion to militate for change things which are equal would still not be regarded as equal to each other.

Sunday, February 10, 2013

A Visit to Cairns – Part 1 – Getting There and Back.

In the midst of a busy period I took time out last December to visit relatives in Cairns in far north Queensland, travelling from Melbourne's (mainly) temperate climes to the hot and humid tropics.

It worked fairly well catching a suburban train to Southern Cross station and then taking the Sky Bus to Tullamarine Airport (approximately 20 minutes). My only criticism would be that the driver could have made an announcement at each stop at the airport as to which terminals and airlines were being covered rather than just one general announcement as we were approaching the airport.

I am not a fan of Jetstar (having had several previous adverse experiences) and was travelling with them again for cost and convenience reasons only. However, I am pleased to report that on this occasion it was an uneventful check-in and journey, with merely a few minutes' delay in departure and subsequent arrival to contend with.

The flight back to Melbourne was uneventful (well, until the kicking and screaming child in the seat behind me started up). Jetstar were efficient and even started boarding before the advertised time! I went to present some ID at the bag-drop desk together with my boarding pass and was told that this wasn't needed, which surprised me! At Cairns Airport there is no departure lounge past the gate, so everyone waits in a large hub area prior to boarding the flight. The short-term car parking costs $4.50 for even a short time, which also surprised me. I was lucky in a way seat-wise - I booked an aisle seat but I was one of the last people to board the 'plane, and someone (possibly an overseas visitor from Asia) was sitting in my seat but the row behind was vacant. So, rather asking the person to move, I loitered around for a short time to see if anyone would come to sit in that row. As no-one else came I hopped in and had the whole row to myself, and it was nice to have the window seat and not be 'hemmed in' by other people. There was a rather lovely view over the ocean and parts of the Great Barrier Reef (punctuated only by a few fluffy white clouds) until we crossed back over the coastline and headed south-west.

Getting home involved the Skybus back to the city and then catching a suburban train home. This worked fairly well, but it was after 8pm by the time I got back to the city it took a little longer to get a train home. Overall not too bad and certainly a lot cheaper than a taxi or leaving the car in the long-term car park!

A Visit to Cairns – Part 2 – An encounter with a four year-old Energiser Bunny!

The young lady of the house (who is nearly five) kept me busy at every available opportunity, including decorating the Christmas tree and building Lego skyscrapers (which was actually rather fun). I don't think the teddy bears who are my regular travelling companions "knew what had hit them" and they were pretty glad each night when the little one had gone to bed! She has more toys, CDs, DVDs and books than I think I saw in my entire childhood.

I ended up spending a lot of time playing with fluffy toys (pretty well representative of a small zoo) and building things (probably my favourite sort of active toy). As well as the Lego castle I built a Magnetix spaceship and a Migoga Marble Run (perhaps faintly reminiscent of the 'Mousetrap' of old), which required a little bit of grey matter input to ensure everything flowed in the right direction.

The youngster dismissed Buzz Lightyear as a "boy's toy" so I tried to explain to her that toys should not be characterised in this way - it was rather that different people liked to play with different sorts of toys. It was very commendable that a Swedish toy store has recently started advertising toys in a gender-neutral way. We were also playing 'birthday party' with Geoffrey the Giraffe, who started demanding that all party attendees should bring him a "good present". So, I tried to explain that we should not demand or expect gifts and that not everyone was in a situation to be a giver or recipient of gifts and that the company of friends was a gift in itself. Whether any of it will stick, who knows, but it was worth a try!

The young one also does beginners' gymnastics, and from watching one class the group of small children were extremely variable in terms of being able to follow the teacher's instructions, particularly in terms of holding a pose, and copying the teacher's actions exactly was more the exception than the rule. Apparently she did not have her normal level of confidence and the next day said that sometimes your confidence goes to sleep for a while! It is somewhat alarming to me to find out that they are shortly holding "assessments" for children so young, and already starting to create expectations that winning or getting medals is more important than doing it for fun (and this goes with unavoidable performance anxiety). I recently heard that funding will be reduced for sports that do not win medals at the Olympics and World Championships, and this seems at odds with the Federal Government's stated position that sport is about participation and not winning and of encouraging involvement in sport at a 'grass-roots' level. This is especially important as a public health measure with the current epidemic of obesity in both adults and children. Only a tiny percentage of people who get involved with sport will win or become an elite performer, and we as a community should not be fostering a "winner takes all" mindset if we want people to have a healthy attitude to participation.

After I had been in Cairns for a week another relative arrived and I joked about her being the "fresh meat" as far as the young girl was concerned. However, as she has seen a lot more of the youngster and she often gives her presents, so it was quickly apparent what the 'pecking order' was! However, when the little one did not want to play with me anymore as she would much rather play with the new visitor, it was a surprisingly emotional experience, which I did not expect. It brought back memories of being bullied and left out at school and people telling me to go away as they did not want to play with me, and the needy people I have encountered in adulthood who latch on to you as the best thing that has come into their life for a long time and almost suck the life out of you with the intensity of their apparent desire to be good friends, and then suddenly someone or something else that can be exploited comes along and they are gone - leaving you wondering what happened and wounded that you took the risk of opening yourself up and making an emotional investment in the relationship. Perhaps the most poignant example of this was during medical school when we were away on rotation and another mature age student who had lost her father to heart disease the previous year monopolised my time and took me away from the people I was fond of in my own study group. During the next 'away' rotation our study group was split up, and tragically the person I was closest to in the group was killed in a car accident on the way back to Melbourne. I felt especially sad that the time I would have spent with him was taken by someone else who it turned out was just using me and quickly moved on to some other sympathetic soul when the rotation was over.

After my visit if I was honest I would have to say that I find the concept of the child who has everything as a result of rampant consumerism quite troubling. There was an excellent article in “The Age” on 18 December 2012 reflecting on the “buy, buy, buy” mentality leading up to Christmas - "Buying useless gifts again? Try giving an experience instead." I really couldn't have said this better myself. I think next year I will go back to my earlier practice of choosing a "gift" for family members from the Royal Flying Doctor Service Christmas Catalogue and sending them a card telling them what I have donated towards in their name. You can contribute towards splendidly useful gifts such as a Heart Start defibrillator, aeroplane nose wheels, dental packages, snake bite kits, neonatal incubators and ambulance stretchers. There are also more traditional Christmas necessities available such as cards, Christmas puddings, diaries and calendars if a more physical gift is required. See www.flyingdoctor.org.au. I am proud to support their work, and if I ever had a dream job as a doctor to aspire to, it would be working with the RFDS! Of course there are many other worthwhile causes (e.g., Oxfam, offering support for people in developing countries) which have a similar donation program at Christmas.

A Visit to Cairns – Part 3 - Local Entertainment

On a Sunday afternoon my host and I were invited to an NBL (basketball) game at the 'clamshell' Cairns Entertainment Centre between the Cairns Taipans and the Woollongong Hawks (apparently the competition leaders). We had free tickets in the corporate area two rows from the front courtesy of his partner's health profession contacts. The Taipans won (76 to 66) and although the on-court action was fast and desperate, I was graphically reminded of why I stopped going to the basketball many years ago due to all the American 'hoopla' - loud music, cheerleaders and partisan antics. It was easy to see how it would be difficult to win an 'away game' in such a regional location with an almost totally one-sided crowd. There was one aspect that particularly troubled me - the Taipan's mascot (replete with a plastic Taipan head) kept marching up and down the sidelines with a double-barrelled shotgun, and at one stage "shooting" at a young boy dressed in a hawk costume. This was hardly very 'politically correct', and even though I assume it was a dummy gun, it nevertheless made me uneasy having it waved around with such gay abandon. Perhaps a case of "only in far North Queensland ..."!

A Visit to Cairns – Part 4 - The Weather Forecast: Hot and Humid …

Since I first arrived it was generally hot and humid (not below 23-26 degrees Celsius at night) and in the mid-30s during the day. Not my idea of fun! It is interesting that although genetically siblings are almost identical and our genetic history is exclusively northern-European, two of us have managed to adapt to living in the tropics, which is something I never managed to do, even when I lived in Townsville between the ages of around 8 and 17. I was always sick with some sort of tropical ailment! Melbourne's more temperate climes suit me well and I have had no difficulties managing the Scandinavian winter during my multiple visits there. Perhaps this is an example of 'epigenetics' at work - it is certainly an exciting new area of scientific endeavour.

Since it seems to be consistently hot in Queensland, particularly in the tropics, it is somewhat amusing to hear Queenslanders complaining about the heat and a 'heatwave' when the temperature is "only" in the 30s (Celsius). In Victoria it is not unusual to get high to extreme temperatures in summer, but it is more often a 'dry heat', rather than the humid heat which is the norm in Queensland. I still remember the stifling and smoky 46 degrees of "Black Saturday" in February 2009 when firestorms tore through Victoria leaving death and destruction in their wake.

A Visit to Cairns – Part 5 - Reflections on the Frailty of Ageing

Phew! Hot, humid and busy ... After an elderly relative arrived I was conscripted for both child-minding and caring duties. No wonder my host found this difficult when he had to do both for an extended period over winter. After a few more days another relative came up for a few days, so even though I was back home for Christmas it was nice to have the whole family together in one place, which hasn't happened for a few years.

I remember as a young child that my father's single aunt was in a nursing home with advanced dementia and did not even recognise her own family members. This made a vivid impression on me. This was the same great-aunt that I also remember some time earlier saying to me how impressed she was with my achievements and that she was sure that I would "amount to something". It is always much more gut-wrenchingly awful to experience the slide into dementia of a loved one at first hand, and this is what one elderly relative has been going through over the past few years. Once a vibrant, intelligent, witty, capable and resourceful woman (including making beautiful ballet costumes) who raised three children as a single parent, she is now frail and extremely forgetful and has had several serious falls. In some respects she is fortunate still to be alive as she has suffered both a fractured neck of femur and a fractured pelvis due to osteoporotic bones. It is incredibly sad as well as being challenging to care for her and keep her from harm, and when you have friends with parents of a similar age who are still in very good shape mentally and physically you cannot help but think about what she could have been like.

A Visit to Cairns – Part 6 - Intrepid Tropical Explorers

One Saturday a family group went on a day trip north in a Toyota Land Cruiser. Our first destination was the Daintree, a massive rainforest area which is a World Heritage Area. We crossed the Daintree River on a barge (which is the only way to do it at $26 per car return) and then drove on to Cow's Bay, a small crescent-shaped beach. There were warning signs about crocodiles and marine stingers, so it was definitely a case of walking a middle line between the water's edge and the vegetation when walking along the beach and keeping a keen look-out. We saved the swimming for Port Douglas, our second destination. There is a net-enclosed swimming area which is patrolled by lifesavers. The water was surprisingly warm and the water was not too deep for adults to walk out whilst enjoying a bit of fun with the generally gentle waves. My host advised not getting too close to the netting in case there were stinger tendrils trailing through the holes. Apparently the small and potentially fatal Ikuranjandi jellyfish can get through the holes, but these are checked for before opening the sea pool in the mornings.

As it was going to be a long car trip, our host decided to buy a portable DVD player for his daughter to keep her distracted a lot of the time. I was sitting next to her in the back as our elderly relative was sitting in the front. I would have to describe this machine as an instrument of torture - even the most hardened terrorist would have trouble with an unremitting and rapidly changing diet of high pitched children's cartoons. The young girl (who must surely have much better hearing than me) kept wanting to turn the sound up even though I who was further away could hear it perfectly well. These stylised cartoon voices are annoying in any language when one is forced to listen to them for an extended period - I felt exactly the same thing with children's cartoons in Norway!

A Visit to Cairns – Part 7 - Tales from the Twilight Zone!

A long time ago one of my relatives made an investment in a timeshare scheme, and as a result is able to stay in holiday apartment complexes for a certain number of days each year, and often shares these with family members. On this occasion, she was staying at a nearby complex as the guest space in the house was exhausted. I had been sleeping on an air mattress in the young girl’s play room, but the main issue with this was the inadequate window coverings, which meant that I was woken early each morning by the bright light and often could not get back to sleep. Several nights I was also woken up in the early hours by a sliver of moonlight crossing my face due to the placement of the blinds. Both the fan and the air-conditioner were loud (seems to be unavoidable in the tropics!) but as there was a bit of a cross-breeze from windows on two sides of the room I did not always need to turn them on. If the breeze got a bit brisk the blinds started flapping against the window, which would wake you up with a start. Thinking laterally, this could be minimised by interposing some soft toys on the window sill to act as a buffer! One amusing thing was that the when weight was applied, the air mattress would tend to attach to the tiled floor like the vacuum effect of suction cups. These would gradually let go with a popping sort of noise. The first time this happened I sat up startled, wondering who or what had got into the room!

As my relative had only been able to get a three-bedroom apartment, I thought I would probably get a better night's sleep there. This turned out to be somewhat of a 'comedy of errors'. The blackout curtains were largely ineffective against the stairwell lights immediately outside the windows and the bright car park below. The air-conditioner sounded like a jet engine, and when I turned it off and opened the windows there was a machinery shed on the other side of the car park that also sounded like a jet engine! As a result I was having trouble falling asleep, and of course in this situation your mind becomes over-active and you start thinking about problems, such as the expensive court case I am engaged in to recoup a lot of money that I am owed and which is a very challenging stressor in my life. This really becomes a form of night terrors which takes a while to resolve. It was also a clinical and uncomforting environment compared to the play room with all the smiling cute fluffy toys. Eventually with the help of an eyeshade and earplugs I did get off to sleep, but these become uncomfortable after a while and I woke up early again with the bright light. It was not difficult to decide that I was better off on the air mattress despite the moon and the early morning light!

A Visit to Cairns – Part 8 - Man does not live by bread alone!

At the end of our visit to Port Douglas we had an early dinner at the Zinc Restaurant. This has been reviewed in a separate blog posting [http://aurorae-australis-borealis.blogspot.com.au/2012/12/some-precious-metal-at-zinc-port.html].

I cooked a couple of times whilst I was in Cairns. One night I made a batch of chilli con carne (without the chilli and with some Moroccan spices instead) [My standard recipe appears here: http://themadscientistcooks.blogspot.com.au/2010/06/mad-scientists-chocolate-chilli-con.html]. The leftovers were used as a base for a nachos another night, which was a great way to use it up. Like a lot of spicy dishes, the flavour does improve with standing overnight. Another night I rustled individual serves of Beef Wellington served with vegetables when my brother brought a couple of chunks of eye fillet out of the freezer. This was very well received, and here is a link to the recipe [http://themadscientistcooks.blogspot.com.au/2013/02/the-mad-scientists-brilliant-beef.html]

On the final night we were all together in Cairns we went out to dinner at Pesci's Seafood and Mediterranean Restaurant, which is part of the Pier complex on the waterfront near the city centre. This has been reviewed in a separate blog posting [http://aurorae-australis-borealis.blogspot.com.au/2012/12/awesome-paella-at-pescis-restaurant.html].

A Visit to Cairns – Part 9 - “Danger, Will Robinson, Danger!”

The first few days I was in Cairns I woke up with a headache that would kill a dinosaur, but at least that was more or less settling by the time I had been there for a week! I had some swims in the small saline outdoor pool (seems to be 'de rigeur' there) and went for a walk one day along a nearby walking track. This was quite interesting, as a number of different environments have been planted or have grown up along the track. There should be a creek running alongside, but it is very dry and there was no sign of water. At the end there was a lovely lagoon with the ubiquitous native ducks and some gorgeous pink water-lillies. On the way back I was almost hit on the head by a falling mango! It was a pity that it had split on impact - otherwise I would have taken it home. Another interesting thing was two houses (some distance apart) entirely painted purple on the exterior! There are no actual footpaths in this area but apparently it is OK to walk on the nature strips. This reminded me of my visit to Atlanta, Georgia in 2004, when I was forced to walk on the road for my daily constitutional as all the nearby houses had fences down to the edge of the road. This seemed an echo of the American obsession with the car as a mode of transport.

Somewhat ironically, my host had Dengue fever earlier in the year and his house was in the Cairns 'hot spot' for Dengue at the time of my visit. There are signs in the street warning people that they are entering a "Dengue Zone"! I just had to hope that none of the mosquito bites I suffered were from dengue mosquitoes. As apparently the incubation period is 3-14 days, I expected to know soon enough (and fortunately escaped the Dengue but ended up with a bout of Influenza instead!).

Friday, February 8, 2013

Calling all introverts ...

"The Sunday Age" - 30 December 2012

It is nice to see that the term 'introvert' is increasingly being used less as a pejorative term and recognised more as an equally valid part of the spectrum of 'being human'. It was also good to see in this article a recognition that people are allowed to have different and equally valid learning styles rather than the 'one size fits all' extrovert model.

Someone who was close to me at the time once said (intended as a meaningful insult) that I was "the most introverted person" he had "ever met", and there have been plenty of other occasions where a cautious, thoughtful and reflective approach to learning and new people and situations has been regarded as defective and demonstrative of a form of mental deficiency. This is never good for the self-confidence and self-belief of an introvert and demonstrates the difficulty of making a good first impression and winning friends and influencing people in a world where extroversion is prized.

As mentioned in this article, I am familiar with the concept of 'stepping outside yourself' to deliver what the world requires, and equally familiar with the necessity of having 'quiet time' to recharge and rejuvenate. I always find it wryly amusing how some people abhor spending time alone, whereas to me a shot of time 'home alone' can be just blissful, and I do my best thinking when I can quietly focus on the task at hand.

Considering that (according to a 'Psychology Today' article – “Revenge of the Introvert” http://www.psychologytoday.com/articles/201008/revenge-the-introvert) introverts are the quiet 50% of the population, credible sources such as this that encourage introverts to be proud of who they are rather than being apologetic are to be encouraged!