essay: Dark Times

Dark Times                                                                                                   18.5.2010

 

I think it may be useful to revisit the darker days of my life to date.  How did they happen?  What did they tell me?  I grew up and have lived most of my life in an era without global war or major depression, unlike my parents’ generation.  There have of course been other big threats and challenges – the nuclear war / doomsday clock scenario, and catastrophic climate change come readily to mind.  These are still threats, more insidious and less immediately life-changing than, say, the two world wars of last century.  However I’m sure every life has its dark times, and these are mine.

The first is the death of my younger brother Peter at age seventeen, when I was twenty-one.  Although springing from the same nest, Peter and I had quite different childhoods, particularly as we reached our teens.  I had much conventional success at school, Peter mucked up – perhaps in reaction – although an esteemed child psychiatrist Dr Peter Eisen was to say that Peter’s behaviour was explained by his belief that he would die young!  That ‘retrospective revelation’ was immensely sad and quite unfathomable, except in the light of Peter’s development of insulin-dependent diabetes at age nine.  After this, and the decline in his health as he resisted attempts to help him manage the problem, his behaviour deteriorated in earnest.  By early teenage he was ‘keeping bad company’, sleeping rough, stealing cars, was well known to the local police and had left school early after moving through a few prestigious ones that weren’t up to the task.  If what Eisen said was correct Peter, whose behaviour almost certainly included very youthful sexual experience, was just living a short life at speed.  The stress on the family was profound – probably reaching its zenith when Peter threatened Dad with a knife.  The successful old soldier and politician was really struggling with the biggest crisis of his own colourful life.

At some point a family decision was made that I should leave home and pursue my early medical studies as a resident of Trinity College – the rationale presumably being that home life had become too disruptive for boy wonder to continue to shine.  I was probably happy to leave an increasingly fraught situation, and excited about living at Uni; but in retrospect I feel some guilt that I could / should have done more to help Peter and the family.  I became to a degree insulated from the family woes, and left to get on with my own life in those exciting years of my own late adolescence.  The now obvious price was that I lost real contact with my brother, and suspect I only became really involved again as a somewhat more mature medical student, when Peter developed the rare disease that was to claim his life.  I didn’t really know the person who the playmate of my early childhood years had become.

After several years of poorly controlled diabetes and at times living rough, Peter developed Goodpasture’s Syndrome, a much rarer autoimmune disease that destroys the kidneys and the lungs.  Apparently it is curable with today’s medical armoury, but in 1971 there was only cortisone in increasingly dangerous doses.  Peter had a fine paediatrician – Dr John Court – and I became a part-time go-between aiding communication with Mum and Dad, as Peter spent many weeks in and out of Ward 3E at the Royal Children’s, and I was living nearby. I well remember the moment out on the balcony overlooking Royal Park when Court told me that Peter’s plight had become hopeless; it was a toss-up whether the disease or the cortisone would kill him first.  Breaking this to Mum and Dad was very painful, as was the medical decision to cease treatment.  Peter quickly went into respiratory failure and gradually stopped breathing as we waited at his bedside, and the nurse switched off the oxygen.

We traipsed home to tell my sister Kim, then aged twelve. In a decision that’s hard to condone now, she had been sent to stay for a few weeks with a friend, to shield her from Peter’s demise. I believe that Kim and Peter’s relationship had been affected by some nasty incidents and unavoidable difficulties, but this was not the right thing to have done – certainly by the dictates of modern child psychology, which were largely unknown to Mum and Dad.  I remember picking up Kim from Linda Lloyd’s house nearby.  Our parents were shattered, barely able to speak, so the task of telling Kim fell to me.  Images of all these intensely emotional moments are seared into the memory.  I remember sitting with Kim on a bench out by the swimming pool, and telling her that Peter had died, and then being silently shocked by her muted reaction.  Now it’s not so hard to understand – and children may grieve quite differently to adults. Perhaps it was a brick in the wall of Kim’s own capacity for denial – so unhelpful in the management of her own diabetes, and yet perhaps helping her to cope with resulting profound disability later in her life.

In a sad sense family history has repeated itself.  I was too young, immature and distracted with my own life to be much help to Peter.  By the time Kim’s major problems with diabetic complications were developing, we’d both long left the family nest and were living as married adults; but I have a lingering sense that I could have done more to help Kim, despite living at distant separation for much of that part of our lives. At one point, perhaps when I became aware of the ‘psychopathology of chronic illness’ as a model for Kim’s dysfunctional self-management, I tried to hook her up with a good psychiatrist.  As with other relationships with a succession of specialists, she managed to sidestep both the specialist and the problem – fundamental though it seemed to be.  These complex health / relationship issues reach a point, often before one becomes fully aware, where a satisfactory solution is no longer achievable.  Perhaps a closer, more caring sibling relationship could have achieved more.  Kim is fond of me, and I am fond of her as my only surviving sibling – blood being thicker than water – but at times I struggle with the gulf between our differing personalities, and probably my own guilt.

 

The next big, painful drama was losing a patient on the operating table when I was a twenty-eight year old isolated doctor in PNG.  I did two years as ‘Medical Superintendent’ of Kerema Base Hospital, just clear of my residency training.  In reality I was an isolated, inexperienced doc with a large clinical workload of very sick people.  The only other doctor, a similarly youthful Andy Hall, was the Provincial Health Officer; he’d arrived from Britain not long before me, and his role was more administrative.  Health care, especially obstetrics, could be full of drama and death as patients often presented late and/or in extremis.  One day an unknown tiny Kukakuka (PNG pygmy) woman presented very late in obstructed labour, the baby still alive.  She had an aged husband, and a crowd of armed warriors assembled outside our crappy little theatre as I prepared to do a Caesar, with Andy to give the anaesthetic.  The old fellow had taken much convincing, but there seemed to be little choice – no planes were available to fly her to Port Moresby.  In retrospect, following more closely the PNG obstetrics dictum ‘Forget the baby, save the mother’ might have been a better idea, but the Moresby specialist I’d radioed concurred that an emergency Caesar was necessary.

I’d nearly completed what seemed to be a successful operation – the baby was out and alive – when the mother suddenly arrested and despite our strenuous efforts couldn’t be revived.  Neither Andy nor I knew the cause of this tragedy, which made going out, covered in blood, and fronting the primitive old husband and his friends even harder.  We felt very alone and uncertain of our own safety, but they settled down after the initial shock and anger.  The old man didn’t want the baby, so relatives took it away.  The next day we carried out a post-mortem (another pretty ghastly and unexpected duty) in the hot little shed that passed for a morgue.  The poor woman had died of a huge ‘saddle’ embolus obstructing both pulmonary arteries –must have been present in pregnancy as a deep vein thrombosis, and dislodged during surgery.  I had nightmares about this dreadful episode for some years.  There were many deaths at the hospital, but none under such frightening circumstances. It’s OK, I guess, to put up one’s hand for an isolated posting when inexperienced – there was nobody else to do it at the time – but one must then accept a significant risk of medical disaster.  And perhaps it’s better to spend longer considering big decisions than leap in, responding to a sense of urgency – although even now it’s hard to know what else we could have done.

 

Generally life has been pretty good to me, and I have given something too.  But the next big ‘fail’ was the failure of my first marriage – to Prue Cleland, the mother of my children, seventeen years after the wedding.  On the face of it, and I hope not sounding too self-justificatory, this is what happened.  Establishing a rural medical practice, building our own home and bringing up three young children had its stresses – but seemed to me a happy time of life, with the usual family holidays, involvement with kid’s schools and activities.  Prue had tried various home-based careers, to which I had contributed in several ways.  Other than my daily work, and a strong interest in peace / environment movement activism, there wasn’t anything that kept me away from home.  Eve had some teenage issues and was moderately rebellious, often when I returned to ‘the haven’ after a long day.  I often responded with traditional assertion of authority; Prue was unhappy with this and more supportive of Eve.  We decided to seek counselling over this issue, and saw a young psychologist over about six months.  Gradually the emphasis in these sessions shifted to looking at the marriage.  Another issue had been control of money; I earned it and gave Prue an agreed amount each week, to which more could readily be added.  Prue would have been happier with a joint bank account, but I was uneasy about that, as I believed that Prue shopped without much regard for price.  Other than these issues, I’d believed that everything in the garden was at least OK.  Prue had spent regular time throughout the marriage travelling to Melbourne to see a psychiatrist, whom she’d been seeing long before she met me.  I knew from Prue what it was about – the difficulties of a dysfunctional upbringing; perhaps at times I struggled with this unending commitment, but I don’t think I showed that very much.

Anyway, near the end of 1994 after six months of the counselling Prue shocked me by saying that she was considering ending the marriage; I’d thought the sessions had been going quite well.  After some thought, I said to Prue that we needed to reach a decision soon, as various commitments with friends and family were anticipated in the summer holidays; I suggested that she consider things for a week and give me her decision.  In my heart I thought that I’d been a reasonable partner, or to put it more strongly: I thought that I had ‘put in’ to the relationship and couldn’t do much better.  So Prue’s decision to leave came, once again, as a shock.  My gut reaction was to accept it – if I couldn’t think how to ‘improve my performance’, and Prue didn’t think I was worth staying with, how could I feel secure that six months on the same crisis wouldn’t recur?  So despite concerns about how Eve, Tate and Lec would cope, mitigated by knowing that we’d both continue to care for them, and that they’d be better off than with parents who were unhappy together, we parted – amicably at first. It was paramount that they continue to feel loved and wanted by both parents, as indeed they were.  Not having done such a thing before, perhaps neither of us foresaw the full effect of a sense of loss of family.  I grieved this loss at once, developed some depressive symptoms and, perhaps unwisely, sought consolation in a new relationship just six weeks later.  ‘Amicable’ changed to overtly hostile. Prue had said in a brief written explanation for our friends that she found the marriage too restrictive; that she wanted the opportunity to develop on her own.  Her mother Bliss said that I was ‘too strong for Prue’, whatever that meant.  Prue also said that the romance had disappeared, that I should have taken her on some holidays without the children.

My take on these events changed a bit as I pondered what had gone wrong.  I knew that I’d believed that marriage was forever, and the loss of a sense of family proved to be very painful; though for all sorts of reasons, not least financial, I had to get on with my life.  My employment was complex, challenging and changing too at that point, in a difficult quirk of timing.  Prue’s upbringing and experience of family had been quite different to mine.  Her father had deserted not long before she was born, and was a serious serial philanderer.  Her mother was an embittered single mother of four young children, and found a (apparently) financially attractive replacement in Sydney Neath – he turned out to be a mostly disastrous stepfather, abusing Prue along the way.  With three older brothers, and a traditional and embittered mother, Prue’s place in the family and expectations of career were set low.  So of course she left home as soon as she could and ended up in some strife with men.  She worked conscientiously on all this with Dr Rose over a good many years, but I think was less committed to ‘family’, at least to the ideal, than I was.  So she was able to pull the plug rather quickly when things didn’t go as well as in the early years.  Although I’d had a fair number of relationships before marriage, most were relatively brief – none more than a year.  I see much merit now in getting to know somebody very well before committing to marriage and children.  It’s of interest that I’d not just been infatuated, but had valued marrying someone different, and indeed Prue was.  So many doctors seemed to marry nurses or other health professionals, and that seemed perverse to me – a recipe for boredom. I can see that argument from both sides more clearly now.  But would any of this have changed a decision to marry?  Who knows?

Eve, Tate and Lec were at first very upset, but seemed to accept the situation quickly.  All developed strong networks of friends, perhaps partly in reaction to loss of family.  Prue and I organized to have them living with us both for equal time each week, and that seemed to work OK, though their friends were all in Prue’s area.  Tate was the most obviously adversely affected.  Moving from primary school where he’d been doing quite well and with friends who were good students, he developed close friendships in high school with a group of boys whose academic sights were set low.  They also managed to get into regular trouble with the police, and Tate took some time to learn that there was little future in that.  He left school early and completed a landscaping apprenticeship, but after a few years found his way into an architecture degree – and to his great credit has joined his siblings as a university graduate.

 

Thankfully I’ve reached the last tale in this catalogue of woes; it’s about burning out in the job I’d aspired to, trying to juggle too many balls.  Not long after the marriage ended I was appointed acting medical director of Maroondah Hospital after the messy ‘political assassination’ of my boss.  It was quite a stressful position at a time when the Kennett Government was cutting the heart out of public health, and not at all what I wanted to do.  So after about a year, I applied for and claimed the position of forest campaign coordinator at Environment Victoria, the recently renamed state Conservation Council – it was a campaigning organization and also umbrella group for conservation groups across the state.  I was also trying to complete a Master’s degree, trying to be a good single parent for half of each week, beginning a new relationship and working a few sessions in general practice to boost the meagre NGO wage.  At the age of forty-six, I began to realize that the best reflexes would always be those gained in a first career – medicine in my case.  Trying to match it with young, skilled, energetic campaigners was a challenge, and the job itself was demanding – lots of ‘thinking on feet’ when fronting the media, and lots of conflict.  The latter was more bitter with those nominally on the same side than with the loggers.  I had to fight hard for the right to get my first campaign started – against the giant wood-chipper Amcor, and on my first day walked into another quite difficult ongoing conflict in South Gippsland.  Older conservation heads didn’t think we should take on Amcor, but I prevailed, and began a high-energy campaign already tired.  In retrospect it was probably too big a bite for a small, cash-strapped NGO, but it did lead to a new style of campaigning that was picked up by other groups.

Then there was a cranky, vindictive and at times vicious group in the Wombat Forest who were close to the loggers and hated Environment Victoria and therefore me; there’d been much dark water under that bridge before my time.  Their attacks were personal and designed to throw you off your game.  We relied heavily on volunteers, and my main helper was a longstanding vol who had saint-like status in forest conservation; in fact she was an ex-nun, single and very dedicated.  I felt that she subtly undermined me, wanted to do the more traditional type of campaigning, and could be quite manipulative.  Although the campaign against Amcor went quite well and developed several arms, there came a point, after I’d been at EV three or four years, when I started to feel that I could to nothing more that would make a difference.  I didn’t have significant depression, but it was similar; I felt that I could no longer give what I had to, and resigned from the job and the life-change I’d worked hard to achieve.  This was burn-out, a bitter pill to swallow, particularly as I’d barely believed in that concept.  In my case, I think I just had too many irons in the fire, balls in the air, whatever.  My approach to this problem, after working a few more months as a volunteer, was to go back to what I knew I could do well and without too much strain – general medical practice.  Sadly I have not yet mustered the enthusiasm to be an activist again, though I’ve followed my conservation interests in other ways.

One of these was to write and collate a history of forest campaigning in Victoria – quite a big undertaking as good records were hard to find.  It took about three years, and I made a fateful decision not to include the Wombat Forest Society among the guest contributors.  I thought the trouble they were bound to cause would derail the project, and I’d taken advice from key conservationists I respected.  The consensus was that WFS were more of a troublesome industry reform group, and as such not properly part of a history of forest campaigning.  Perhaps my antipathy for those people made me accept that argument too readily, as clearly being left out would make them very unhappy – and they were.  About eight months after publication they mounted a credible threat to sue me as publisher and two other contributors.  In the end the threat came to nothing, but caused me quite a deal of trouble, time and expense until it evaporated.  They had their ‘friend’ at Friends of the Earth deliver a scathing attack on the book.  In the end it was all just an annoyance, but perhaps I should have been more generous and included my detractors. Who can tell how it might then have turned out?  Anyway, that’s enough of ‘dark times’.

 

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