27 October, 2010

So much to do, so little time.

There are so many things to do and I have no clues how to do it all.  That’s life in the big city.  There are hermetically sealed crates after hermetically sealed crates to get through (not my idea).  Clothes I’ll never wear ever again, books I can’t throw away, hats for display and hats for wearing, a TV from the dark ages and a monitor from the Cretaceous period.
I’d be happy to take them to a Good Sammy’s bin, but as I’m without private transport, that task is simply beyond me.  Some are easily solved: bin it.  Others not so simple, such as how do I move a 30kg TV when I can’t lift more than 10kg without my back simply collapsing under the strain.
However, I haven’t been idle.  I’ve been preparing for the arrival of my newly found American friend.  It’s meant drawing up an itinerary of activity, booking hotels, hire car, and so on.  I was hoping to book a room at Karri Valley Resort, but the last room was snapped up less than 1 day before I tried to book it, nearly 3 months out!  But that turned out to be a good thing: I found something cheaper in Margaret River, and we will travel through Pemberton to see the Karri forrests - Gloucester Tree & Diamond Tree included - on our way to Walpole’s Treetop Walk, Albany and Esperance.  Besides, Karri Valley will be full of, shudder, children being, well, annoying little children.
Christmas with the folks should be interesting: my American has never had a summer Chrissie, let alone all the delights of cold meats followed by a arvo nap then possibly a swim in the shark infested waters of the Southern Coast of Western Australia.  Not just any old sharks.  White pointers: The Great White shark.  Think Jaws.  But my mind is at ease knowing I’m more likely to die in the hire car during the trip there than be killed by a shark.
I’m quite looking forward to the journey as well as the destinations.  Plus I’m sure my guest will have the experience of a lifetime.  Something that so many of my fellow Westralians take for granted.

18 October, 2010

I have the best friends and family bar none.

Where to begin?  If you’ve read anything it has a happy ending.  Promise.
I have so many fantastic people to call friends and family and they have been very supportive during a difficult time.  However, it doesn’t end there.  So many people have helped in big and small ways to move me into my new flat, despite the worst efforts of myself and more so a certain government department who is supposed to assist people like me be independent, not co-dependent.
There are so many people to thank.  So many in fact it would be unfair to anyone to list them.  You know who you are.
So in no particular order a big thank you to Russ, Roz, Libby, Mum & Dad, Cath, Geoff, Caryn, Bruce, Ian and many, many more besides.
Thank you.
Normal service shall return shortly.

11 October, 2010

Does diagnosis help?

Sometimes I wonder about labels for the abstract and the concrete.  This may seem a surreptitious way to give the appearance of being busy.  I know better than that.  What better way to look at Mental Health week than to pry into the world of labels.
Since my early teens I struggled yet coped in some shape or form to deal with anxiety, depression and the disassociation I all simutaneously felt often without cause.  Exams made me more anxious than usual, as did the Christmas period for understandable reasons.  There was the apperition of a pattern when really none existed.  How I survived I really can't say.  It certainly wasn't mind over matter or will power: survival was by mere chance, and eventually the odds stacked against me.
1st label: acute major depression.
A box of pills and she'll be right, mate.  See you later (ie not at all).
Later that life… I was back.
2nd label Post Traumatic Stress Disorder.
And on we go. 3rd & 4th labels were Chronic Major Depression with Psychotic Features.
Right. So now you think "Uh-oh, that's all we need: a bloody psycho."   Psychosis is an unfairly loaded word.  Another will appear shortly, but for now let's deal with the 'p' word.  Psychosis merely means hallucinations and so forth are real.  That's it.  As much as I love Hitchcock films, real 'psychos' don't randomly murder people.  If really bad, a psychotic person is much, much more likely to hurt themselves rather than other people.
So this time I thought - when my thoughts were ordered - "No biggie, just another episode of depression and the auditory hallucinations (hearing voices) had the upper hand."   Yes, that was true, however the team stated from scratch.  From both my reporting and my history, some new things were discovered, resulting in a slightly different twist of diagnosis: Schizoaffective Disorder.
Okay, I'm now waving goodbye to all those who now believe I'm a whack job.  Who doesn't stigmatise schizophrenia? You don't?  I don't believe you: to my shame I still have a negative attitude to schizophrenics, and I bet I've met far more in my life than you'll ever knowingly meet.
That aside, I'm not a schizophrenic, I know all the jokes and it's an awful illness.  Look up  schizoaffective disorder by google, bing or wiki.  The point is in my case I've never had mania or hypermania, just "normal" and depressed. I have auditory hallucinations. I'm not generally paranoid. During depression I tend to be very suicidal and require hospitalisation.  Does this new diagnosis change anything?  Not really.  The only change is instead of taking a prescibed anti-psychotic when feeling overwhelmed, I take it twice daily with room to take a little more when I know I'm struggling to be coherrent or my brain is too noisy.  That's all.
The prognosis isn't too good.  For example I'm more likely to kill myself than die of natural causes, but - excuse the black humour - I can live with that.  If the current anti-psychotic loses efficacy, the alternative drugs aren't a barrel of laughs and I'm not sure I could  live with that.  But let's not cross bridges before the chickens have hatched or get splinters from fitting on the cents.
Diagnosis, like a label, does help.  Without them we don't know how to handle the contents let alone know what the contents are.  However context is just as important. 

02 October, 2010

Noisy Brain Syndrome

If, by industry, man can do good
Then he should do so
Not to prove that he can
But that he could.

There isn't a lot now that I can add to my log of "voluntary" incarceration.   Except perhaps to add what Grand Poo-Bar, Mr Hodges, had to offer today. It may not be immediately apparent how I am currently.   That's mainly due to 25 plus years of lying, good acting and a hefty dose of denial.

What was different about Thurday or Friday?  VWell, my brand new iPhone 4 was stolen.  Not having a phone was inconvenient: what was unbearable was not having Stravinsky, Shostakovich, Gershwin. Beethoven (Symphony 7.2 is sublime) or Tchaikovsky was doing my head in.  Depression is bad enough, auditory hallucinations - the three personalities inside my head but outside - are hard to handle during an episode.

Mr Hodge held my tome of mental health history and noted an antipsychotic drug wasn't as effective as it should be & that despite of many symptoms being controlled, the depth & the depression have been increasing as well the severity of hallucinations/psychosis.

Instead of calling it schizophrenia, we decided on "Noisey Brain Syndrome".  As an example of how intrusive this is for this depressive episode, it's taken 5 hours to get this far plus a fair whack of Stravinsky and Shostakovich.

I'll find out Monday all the treatment option.  Some from the outset I won't entertain, like Electro-Convulsive therapy (ECT) or Lithium.  Better Living Through Chemistry.

The biggest shock was how friends, old and new, rallied together to help me: an old iPhone 3G for basic telephony and net access, and an iPod Shuffle for music.  I can't thank them enough.

I'm not sure how ordered this entry is.  Sometime in the future when I'm better, I'll read it and know.      

29 September, 2010

No platitudes, thanks.

4am.  What better time to blog?  Well, it’s just another symptom.  The lack of sleep is due mostly to an overactive brain curiously at odds with its depression.
Let's get some definitions out of the way early;
1) Generalised Anxiety Disorder (GAD): a state in which one is overly anxious all the time, and often - but not necessarily - suffering frequent Panic Attacks,
2) Chronic Clinical Depression: a condition in which the patient suffers low mood, interest and drive. and
3) Suicidal Tendencies (ST): a particular state in which the patient can only see one solution to end their psychological pain, that being suicide, and active plans or fantasises suicide.  Ok so these may not be DMIV/V definitions, but they will do.
A person, such as myself, can suffer all 3 conditions at the same time but more usually just 1 or 2 combinations at a y one time. Treatment is brutal, to say the least.  I've been here too many times before.
Knowing there is "the other side", i.e. wellness doesn't make surviving any more pleasant.  In a way it makes it harder.  When will the next episode be?  GAD leads to depression with ST.  In my case Depression is a dominant feature.  Over the 20+ I've learned to be a damn good liar, actor & identity theif in order to function.  Most chronic sufferers recognise this and detest themselves because of it. Soon the GAD surfaces, then depression with ST.
Make of that what you want, but certainly not a life I willing choose, want, seek or wish upon others.  At this point I thank family, friends, empathises, medicos and fellow sufferers for doing what they can to help me to "the other side", back to wellness.  It is amazing how many suffer quietly, too afraid to ask for help knowing that doing so will expose the lies they have led.
And me?  Well, the anxiety that led to writing this is rapidly evaporating.  Depression has an awful habit of griping one's goolies tightly with no intention of letting go.

27 September, 2010

Hospitals are hilarious

So, after whining like a whinging bitch, I received my wish. I'm now a psychiatric patient. Things don't get much lower. It's a low as shark shit. Any lower would be six feet under.
That's it for today. Whoopee.

09 September, 2010

The Twitterati and Scruff - I mean Stuff

Funny how life never turns out as planned, and sometimes I'm happy it doesn't.

Firstly a big shout out to the Twitterati.  Without Twitter, I'm not sure where I'd be right now.  The story is simple enough; for reasons beyond my control I had less than a week to move on from the temporary stay I had.  So a plea of help resulted in a wave of retreating.  The generosity of strangers to help - not only with accommodation - but also to move my meagre belongings (one bag and a backpack) had me staggering.

So for the time being I'm in a position of not having to worry.  Well, I worry, but at least I can concentrate on the main matter of rehabilitation at Shenton Park.  There are so many more things I can do now that I couldn't do a few months ago, and I'm really enjoying gym now.  Well… mostly.  I'll never have the body of an elite athlete so it's fortunate that I don't want one.  But I am stronger, and the added benefit is less back pain.  Most of the time.

That other niggling thing, the rheumatoid arthritis, hasn't been as kind (nor has the osteoarthritis for that matter), but it's good that the body isn't falling apart.  A new lot of medications seem to be more effective and the evidence is that my hands, wrists and back aren't as painful or stiff.  A handy side effect is that my posture is better and my other bits are, how should I say this… happier?  Yes, happier is a good start.  Happier in the mornings.  Happier in the evenings.  Happier at supper time…

Good news for some: the Caretaker government is over.  After seemingly a billion weeks the Gillard Labor government persuaded enough independents to have a majority of seats in the House of Representatives.  No, the sky didn’t fall in, and it didn’t fall in when it looked like a deadlock of 74 seats to Labor, 74 to the Liberal/National/Country Liberal/Liberal National conglomerate commonly known as the Bastards Coalition, with 76 seats needed to form a majority.  (It’d like to point out to the Liberal Party leader, Tony Abbott, that the Liberals didn’t win 72 seats as he oft claims; the Coalition won 71 with 1 WA National who will sit on the cross benches.)  So now we join the fate of other nations enjoying the benefits of a minority government.  No big deal; Western Australia has had a minority government for over 2 years now, and even though it’s a Liberal/National/Independent coalition, the sky hasn’t fallen in.  Surprisingly it seems voters don’t hate Premier Colin Barnett as much as they did when he was Opposition Leader.

Of course, the other big gig going on at the moment is my Fremantle Docker's progression through the finals.  With a big injury toll this season, like Barlow's broken leg (cop that, round-ball football fans with your diving and fake injuries), making it to 5th was a big deal.  But the bookies had us as an outside chance to beat 2008 Premiers, Hawthorn.  Stuff that. We buried them from the start.  Three hours later, tough questions were being asked of the Hawks.  How could they be thrashed by such a lowly regarded sided of teenagers?

The answer's easy.  The Hawthorn Hawks aren't as good as they think they are.

Next assignment: Geelong, Friday night at the MCG.  A lot of the Freo mob flew, bused, drove and trained across the continent.  Hopefully we'll get a full house and beat the Geelong Cats again. (We beat the reigning Premiers in round 3 this year, much to the shock of sporting journos).

The other news is a new iPhone app (what? Another one?)  Yes, this app is for a select clientele.  Like me.  It's amazing to think that there are so many like minded people all over the world.  Chatted to a few, but thought "just another way to be let down."  How wrong I've been.  In fact, there is some weird thing going on.

For starters, intelligent conversation isn’t dead.  A little further down the track I find someone that I know I just click with.  We’d click better if he wasn’t in the US, and 12 hours behind.  But as Dr Carl Sagan once said “Life finds a way,” and I’m curious to find out more!

07 August, 2010

A drug induced lucid dream and other dramas

This isn’t going to be easy, and it’s not worth pretending otherwise.  It’s more stream of consciousness than a thought exercise or well thought out opinion piece on one subject.


Finally I decided to overcome my fear of a DiCaprio film.  Each character, bar Romeo in Romeo+Juliet, I saw DiCaprio and wilfully wished his character would die, and thankfully most of them did.  Christopher Nolan’s Inception would be the test, even though he probably thought the main character, Cobb, would have been filled by Heath Ledger at a guess.  I don’t know how long Nolan has been working on this film.

To my surprise, It was easier to let go of DiCaprio and see him as Cobb, a former “architect” and extractor driven by the desire to see his children.

A mysterious Japanese industrialist Saito (Ken Wantanabe) allows Cobb to assemble a team to do one last job, promising that should Cobb succeed, he’d make the charge that Cobb killed his wife Mallory (Marion Cotillard) vanish, so that Cobb can reunite with his children in the USA.  In Return Saito wants Cobb to perform an inception on his rival Fischer (Cillian Murphy), the son of the dying Maurice Fischer (Pete Postlethwaite).  Fischer is haunted by his father’s disappointment in him.  Keeping the massive business going is Fischer’s driving force to prove his father wrong.

Inception is planting a seed, a thought, in the subject’s mind without them knowing it.  By a process of drug induced sleep in which the extractor and his team share the dream with the subject, the extractor can find the information the subject has locked away in a metaphorical safe in their subconscious.  The subject creates their world, however each member of the team contributes to the dream to make it more plausible than reality, and by this process the subject unwittingly opens the safe or exposes it to the extractor.

The team consists of the architect Ariadne (Ellen Page), a graduate student of Cobb’s father-in-law and mentor (Michael Caine) whose responsibility is to create a world for Fischer, the forger (Tom Hardy) who researches Fischer’s associates - mainly his godfather and Fischer’s fellow executive Peter Browning (Tom Berenger) - to keep the inception going by adding another layer of reality to the shared dream.  Yusif, the chemist (Dileep Rao), is needed to make the right combination of sedatives to keep the team dreaming.  Finally Arthur (Joseph Gordon-Levitt) is Cobb’s associate and lookout, searching for possible ambushes and other threats inside the dream.

But there are complications in this one last job. Cobb’s deceased wife “Mal” frequently appears due to Cobb’s unwillingness to let her go from his subconscious.  She feels betrayed by Cobb after they shared a dream together, in which she believes Cobb abandoned her in Limbo, breaking their promise they would grow old together.  As a result, she’ll do almost anything to make Cobb suffer in his inceptions, even trying to sabotage them.
The only way to wake from the dream is either by being killed in the dream, or by “the kick”; the sudden unexpected sensation of falling.  It’s Yusif’s job to make the sedatives strong enough to induce sleep, but enable any member of the team to feel the kick when needed.
Additionally each team member must have a token with unique properties that only they know about; in the real world they work as expected, such as Cobb’s small spinning top which eventually slows down and stops.  In a dream, the top continues spinning forever.

The timing of the dreams must be precise, as during a dream as much as a few hours can pass in 5 minutes of real time.  This precision is required as Cobb usually uses the technique of a dream within a dream for his extraction, planting a second inception in the second dream to delve even further into the subject’s subconscious by layering the deception but further dilating time.  Arthur as the lookout uses Edith Piaf’s Non, Je Ne Regrette Rien as an auditory cue to so he can induce a kick within a dream to the others.

Fischer is constantly travelling between Sydney and Los Angeles, a 10 hour flight across the Pacific, and this provides the necessary time window needed for Cobb and his team, including Saito - insisting on being a tourist on the job - to ambush Fischer into being an unwilling subject so that Cobb can conduct industrial espionage for Saito.  But things go awry very quickly, and every member has to think fast to find a way of avoiding the very real hazard of ending up in limbo forever, unable to wake up.

Inception is reminiscent of The Matrix or Memento. What appears to be real frequently isn’t and vice versa. It’s definitely not a fluffy film one would watch casually as it requires attention to detail and an attention span greater than a few minutes.  I enjoyed Nolan’s attention to detail; for example Fischer’s private jet in Sydney is registered in Australia (its tail registration begins with VH-.)  Also the detail of Paris and other cities is first rate.  The suspension of disbelief is easy (even if for me Cobb does become DiCaprio a little too often).

The story of Cobb’s wife, Mal, as the antagonist, and defenders - the parts of a subject’s mind which try to kill the the team and thus the inception in much the same way as a bodies’ immune cells detect and kill foreign invaders - ensures there is never a dull moment.

Well, there is one dull and extraordinary boring world; Cobb and Mal’s dream when they achieve limbo and survive.  The architecture is amazingly boring, uninspiring and copy-paste repetitive.  It looks like a grey never-ending Gold Coast without a single plant of any description. (In the real world the Gold Coast is remarkably unimaginative and dull with plants.)  As an architect in the dream world, the impossible isn’t, such as the Penrose Stairs (the most famous example being by M.C. Escher) which Arthur demonstrates to Ariadne as an example of how dreams aren’t constrained by logic or physics.

Fortunately Inception isn’t as boring or as predictable as Cobb’s architecture.  Right down to the the last millisecond.  It’s not flawless and it won’t win DiCaprio an Oscar (thank god), but it’s possibly worth seeing more than once since it takes a minute to understand the difference between dream and reality; possibly most of the whole film for some.  I’ll probably watch it again even though I know I won’t get the same experience of surprise and satisfaction of knowing which depth of dream the film is in.  I found the plot remarkably easy to follow yet is it solid and interesting in its own right.  Also there are some scenes due to the CGI or fast-paced action that would be worth looking at again.  Unfortunately for me, the cinema had the sound levels all over the place, with the score often much louder than the dialogue, which was very annoying, often distracting.  I doubt there will be much debate over a coffee about what actually happened after the movie.

4 stars (just) from me.

Who is the real Meryl Dorey?

It came as no surprise to me that the self proclaimed leader of the Australian Vaccination Network (AVN), Meryl Dorey, has disappeared from view after the NSW Health Care Complaints Commission upheld a complaint that the AVN “…the AVN provides information that is inaccurate and misleading.”  Instead of providing information to parents about vaccines - the benefits and the risks - Dorey and the AVN chose to be anti-vaccination crusaders, which is fine, but one can’t be an anti-vaccination advocate while spread mistruths, lies and the distortion of facts and claim to be giving a balanced view on vaccinations to parents.

It gets worse for Dorey.  The AVN is registered as a charity with the NSW Office of Liquor and Gaming, which audited the AVN books after complaints that the AVN wasn’t acting as a charity, or properly declaring income and expenses, as well as improperly fundraising.  The AVN has just under 3 weeks to show cause as to why it should be allowed to continue to hold its charity licence.

Is that enough?  Not for me.  The AVN and Dorey have been referred to the NSW Department of Justice for possible offences.  It will be up to the NSW Director of Public Prosecutions to decide if there is a case for Dorey and the AVN to answer.  I would imagine this would include fraud, deception and possibly stealing as a servant.  Also the AVN operate all over Australia and are not confined to NSW.  This is a matter the Commonwealth Agencies such as the ACCC and the AFP should be investigating in cooperation with NSW.

If not for the continued pressure by victims of the AVN, Australian sceptics, balanced investigative journalism by the Australian Broadcasting Corporation’s Four Corners (using the BBC’s Horizon program the 7:30 Report and Lateline, and other media organisations, and a properly conducted campaign by various people, including Twitter users with the hashtag #stopAVN, the issue would never have come to light.  (Without wanting to pump up my own tires, I’ve blogged a little about the AVN before in oblique references.)

The legal and moral issues are not solely on the AVN’s shoulders.  Since way back many, many scientists and the organisations they have worked for have breached the public trust.  It’s now at a point where distrust of science is very high.  This is somewhat unfair in that it has been sham or ill-motivated scientists and pseudoscience that have brought disrepute,  not science itself.  Nonetheless, the public have turned more to woo, such as homeopathy or naturopathy.  However any prosecution of the AVN is welcome in a sceptic, scientific light, as well as a legal one, such as Alastair Hope’s Coronial Inquest into the death of Penny Dingle involving homeopathy.

It’s not the role of science to tell people how to live their lives, or in the case of medical science which course of action must be taken by the patient.  Rather, it’s there as advice for an adult audience to take on board, so that the pros and cons can be properly considered.

The difference between science and woo is simple; woo makes claims that can’t be verified and only have positive testimonies to back it up - negative testimonies are simply discarded - while science is a sceptical, logical approach, testing using the randomised double blind methodology whenever applicable and peer reviewed before being accepted for publishing by reputable journals (e.g. Nature).  Journals such as Nature or Lancet often insist on further investigations and trials before publishing, as they don’t want their reputation tarnished in any way.

So, back to Dorey.  Now that the regulators are clearly not happy with her or the AVN, why has she refused to refute the claims against her and the AVN?  Why has she stopped giving media interviews? (Self promotion has been her strength.)  Hardly the actions of someone who believes what she is doing is right and proper, I would allege.  Or perhaps her legal counsel has told her to wait to see if charges are laid against her, using her right to silence.

Despite my anti-AVN stance, I’m hoping she has been simply stupid, foolish, incompetent or a combination thereof, rather than being malicious and deliberately irresponsible.

Mad dogs and Englishmen.

It’s fair to say that when all else fails, hug your teddy.  I wrote about mental health issues, specifically depression, in my last blog, so I won’t repeat all of that here.  Instead I want to chronicle as best I can what’s been happening to me.

The short answer is it’s getting worse, despite doing everything right.  I’m exercising more; walking, gym, hydrotherapy all courtesy of Royal Perth Hospital’s LEAP at Shenton Park Campus for my ongoing rehabilitation of my spinal injuries.  I’m hoping that a fitter, leaner more active me, plus all the surrounding issues about chronic pain management, will mean more control and less medication.  In theory that should mean I should be happier.  Indeed the staff and other patients in the programme are very supportive.

Yet despite this, my mood is deteriorating rapidly.  I’m finding it harder to engage.  I’m not enjoying most things I’m doing.  Gym has become a little refuge as I can do that on my own with the physiotherapists simply looking on and only giving advice when necessary.  Using the rowing machine I can block out the world to some extent, and focus on the rhythm which can be hypnotic.

Today has been the first time in nearly a week I’ve turned on my MacBook Pro.  I’ve had so many brilliant (I hope) ideas for writing and I fear that if I begin it will consume me, as there seems to be a strong link between low mood and a desire to write a lot of material.  Perhaps it’s catharsis; writing somehow purges the darkest realms of my mind, or releases months of pent up frustrations or is simply a relief valve for my passive-aggressive habitat.  Whatever the reason, the end result is a counter intuitive burst of productivity to the detriment of my health.  There comes a time when the burst bursts, the fingers no longer type or the mind no longer creates.

If by some circumstance I become famous due to my authorship, the last thing I want is to be seen as a tortured soul or some tragic figure, brooding and dark.  Which is a problem since that becomes a voice that persuades me to submit less work than I should, or worse, not finish the umpteenth draft when I should.  The obsession with words is intoxicating.  The way they look written down, how they sound, the juxtaposition against other words. The interaction of rules and knowing exactly how to break them and when.  Knowing what’s clever and what’s pure compositionally wank.

That aside, the more tangible elements of my world are visible to anyone; the strangely teary eyes for no apparent reason, the pessimism, the seeking of comfort or solace in meaningless events, the total disregard to diet by either becoming unable to eat or gorging on fast food, unabashed anger over the insignificant contrasting with an impotence with the crucial, being unable to sleep for days on end despite a combination of exhaustion, sedatives and hypnotics, and dark thoughts that are both a comfort and alarming.  When the alarm stops the real danger begins.

Why write this publicly?  That I don’t know.  I’m not asking to be rescued, pitied, or derided for that matter.  There is some disconnect here; when I think of how I look and compare that image to what I think I see in a mirror or photo, the contrast could not be more stark, akin to believing oneself to being a thoroughbred race horse at the pinnacle of it’s career but seeing a dying elephant and knowing the dying elephant is closer to the reality.  A deep imbedded loathing of everything said, done and thought of myself.  A hatred of everything ugly and beautiful and not able to tell the difference.

Somewhere a long time ago the train derailed.  So long ago the reasons are obscured or forgotten and it matters not which.  The question becomes how to continue wading on in this waist deep rancid treacle that is my life.  A distant but powerful beacon tells me it will get better, it will, yet it is difficult to believe and harder see each time I see a glimpse of it.  These are the times I want to sleep forever.

Everything is robotic now.  I do because an alarm tells me when to get out of bed.  A timetable tells me when to catch a train.  A schedule tells me what I am to do for whichever day it is, and all the bloody days may as well be the bloody same because none have any joy about them.  Why celebrate a Friday when Monday is only a blink away, and the process begins all over again?

Depression is different for everyone.  The depth, the length, the breadth, the obstacles, the cycle and the outcomes of each episode.  Some may only experience it once (thankfully), for others they find a therapy that stabilises their life.  The possibilities don’t bear thinking about for the moment, at least they don’t for me.

Now I don’t want anyone thinking of this as a document of despair, or a hopeless confession or a cry for help.  In times past I couldn’t think straight enough to bother writing a suicide note, which was a pointless exercise anyway since my track record of suicide is woeful.  It must be since I’m writing this.  In any case I’m lucid for now, and acutely aware of the assistance available to me.

The unexpected positive is that I could not care less about any physical pain I have, as if it simply isn’t there.

04 July, 2010

Independence Day of the Mind

An honour that is given out every year is Australian of the Year.  In the past sporting heros have been given the gong more often than any other group.  But the current holder, Professor Patrick McGorry, OA, is a champion for the betterment of mental health services.  Management is one matter, but McGorry is at the coal-face; intervention where it first affects most suffers of mental health issues at the beginning - the youth.

McGorry deserved without doubt his AotY 2010, and extra weight was given to his work by being awarded the Officer of the Order of Australia - second only the Companion to the Order of Australia - in June this year (roughly equivalent to the US Presidential Medal, a British OBE, or French Officier Ordre national de la Légion d’honneur).

Yet McGorry is constantly expressing his disappointment and frustrations at the lack of government resources to combat a stigmatised health issue.

I’m not a psychologist or a psychiatrist, but I do have enough knowledge of how lacking the system is; I’ve been on all sides of the fence as a patient of “normal” health services, mental health services and a critic of how government still continue to separate mental health from other heath budgets and programs.

Despite it’s stigma, I have no issue in declaring that I have mental health issues.  On more than a few occasions I’ve been hospitalised because of my depression (once involuntary).

Now, let’s get one thing quite clear, depression isn’t a prolonged sadness.  Being sad is normal.  It happens because of events that occur in life that are unavoidable.  Death of a family member or companion, even a pet, the loss of work, for example.  Eventually sadness goes away on it’s own accord.  Depression is more insidious that that.  Sometimes it comes without any notable trigger.  Sometimes the trigger can be what would be seen by others as a happy event.  An example case of this is crying at advertisements that portray happy events to sell a product.  But whatever the cause, it’s almost impossible to pinpoint and even if it can be pinpointed it’s of little value to the sufferer in understanding why their mood is so low.

Exacerbating low mood and low self esteem are glib remarks - intentional and unintentional - by family, friends, co-workers, acquaintances and even doctors.  “Get over it,” “build a bridge,” “put it behind you,” “think positive,” “sort yourself out” are just a few insensitive remarks I’ve heard when I least needed to hear them.

A situation can also affect a depressive episode.

Possibly the least understood aspect of depressive/anxiety disorders - yes, they are part of the same problem for many sufferers - by the public, government policy makers and health professionals is when a sufferer is suffering.  That might sound silly, how can a health professional not know?  Those that suffer from more than one episode learn to become excellent actors and liars.  It’s not at easy as it sounds, and is one of a set of skills sufferers learn in order to survive, ironically when they “plan” a suicide.

This is part of the reason, if not the biggest reason, depression is stigmatised.  Suicide is seen by many for various reasons such as religious or political doctrine as a sinful, gutless or illegal choice rather than a tragedy that could have been avoided if those with faux concern had acted with compassion rather than pontificate.

Getting patients in real need hospital treatment is difficult as there are too few beds, while beds in other departments remain unfilled as part of the required spare capacity.  Hospitalised patients are usually released too early because of the pressure caused by the lack of beds, often with only a bag of medication to last a fortnight without any ongoing support.  It is little wonder those most at risk of suicide are those discharged from hospital by an inexperienced intern.  The sufferers have no support outside the hospital system; many have no family or friends willing or able to give support during recovery.  It’s akin to a patient who has undergone major surgery after a near death car accident, and released after the surgeon has closed the wounds and the anaesthetist has left the theatre.  Such a policy in “mainstream” medicine would be unthinkable, but this is exactly what happens in the same hospitals that have a mental health facility.

To make matters worse, most interns, residents, even the family doctor, aren’t particularly clued up with medications and their side effects.  And this is where I enter the story.  I didn’t know I was depressed.  Nor did I think detailed thoughts of suicide was abnormal.  My only lasting memory of events is that I wanted the pain to end and that being end would mean relief to all that knew me.  It was my General Practitioner that hospitalised me, apparently after a very heated debate with the on-duty psychiatrist and added input from a friend who happens to be a nurse.

The only bed available was in the locked ward. It’s a ward that lives up to it’s name. Patients can’t get out, usually because they are a danger to themselves or others, or because of a court ordered psychiatric assessment required before the judge hands down the sentence.  It’s bad enough being forcibly imprisoned with every shred of dignity removed, and it can’t be worse than being surrounded by staff panic buttons and psychotic - often violent - criminals; a Victorian age asylum but with clean floors and super-sedation rather than irons.  Welcome to the road to recovery.

A week later, I was given a plastic bag full of an anti-depressant and told “Good luck.”  Good luck?  I now imagine the over-worked nurses - who chain smoke to cope with the stress - having a ledger of wagers on how long it will be before the police return with a former patient.

Unfortunately the anti-depressant in vogue at the time actually caused my anxiety and depression to worsen.  Fortunately, or rather due to excellent training, my GP noticed I was getting worse, not better (I found out later that the drug had been implicated in murder-suicides in the UK and US, although I hasten to add these events are statistically insignificant compared to the amount of patients that are prescribed the drug, and therefore I won’t name it’s marketed name nor it’s pharmacological name.)  Another period of hospitalisation was required, and to be honest I don’t remember very much about that month.

Since then family, friends and my GP have been superb monitors of my depression, and I’ve learned to look out for the little things that let me know where I stand on the razor line of health; the tipping point for me, like many sufferers, is often a hair trigger and mostly beyond my direct control.  It’s not as simple as taking more medication since the half-life is between 10 and 16 days, and dependant on many factors.  However I have learned to live around some limitations, even accept that I may not be in the best position to judge.

Despite what some people may think or say, I’m not insane and nor do I feel stigmatised.  Anymore.  I say that because for many years I felt ashamed about my episodes, would even deny they exist.  But no more.  Here I am, running naked down the streets shouting “Eureka!” because there are so many people suffering needlessly, afraid of social stigmas - rightly or wrongly - and if I remain silent on the matter for much longer, I would be just as guilty as the faux concerned pontificators for doing precisely nothing remotely positive.

There is an upside to to all this.  When I’m suffering from an episode I’m strangely more productive with my creative writing.  Not only more productive, but it’s of a better quality.  I’m not an orphan nor a pioneer here.  It simply just is.  Which is how I’d like everyone to rethink depression and anxiety disorders, as well as mental health in general; don’t think of the why - or who - but rather as it just is, and that there can be a truly wonderful upside to it.  Think about it the next time you read a novel, or watch a movie, or visit a gallery of art.

Addendum 11/07/2010: The Government of Western Australia has a published a discussion paper WA Mental Health Towards 2020: Consultation Paper and I urge all residents of Western Australia or Australia to read it and make a submission.

02 July, 2010

Health reform: a good place to start is to remove homeopathy

Australia has one of the finest health care models in the world, yet it is under constant reforms and tweaks that aren’t always in the patients’ best interests.

Every citizen and resident is entitled to the very best in health care at any public hospital; a universal health care.  Complimenting the public system are the private hospitals, which cater for those who don’t need emergency surgery or care, or want a “better” standard of care, or wish to avoid being on a waiting list for non-essential or minor surgery, or even prefer to use their health insurance than use the tax-payer funded public system.

The use of the private hospital system is made more affordable by “reforms” introduced by the Howard Liberal-National government by giving a tax deduction of 30% for private health insurance.  It was one piece of many of the Howard government’s middle class welfare program.  When the Rudd Labor party swept into power (even unseating Howard, something that is almost unheard of) the middle class welfare didn’t end.  The 30% tax deduction for private health cover remained to anyone who had it.  In fact, the extra Medicare Levy imposed on the highest income earners would also be reduced to the same percentage Medicare Levy as the lowest income earners as a reward for having private health insurance.

The health insurance industry is also a strange beast.  Providers are almost exclusively Not-For-Profit Mutual Funds.  Further, their rates are capped and each year negotiate with the Federal Health Minister through the department on any increase in rates for services.  The arguments by the Funds are the same; without an increase the Funds won’t be able to provide the services resulting in a loss of membership and thus more pressure on the public health system.  The government’s position is almost always the same, claiming that most Funds are gouging their members for services they don’t need or won’t use.

This raises an interesting point.  Should these Funds be free to offer a range of products for a discerning public can pick and choose from, or should they be restricted to services that are only covered by Medicare?  (Currently dental is not covered by Medicare, but each State has a system for dental subsidy for those least able to afford dental care.  A plan exists to bring Dentistry into Medicare.)

Before the Coroner of Western Australia, Alistair Hope, is a case that raises very serious issues for the Health Fund industry.  The death of Penelope Dingle highlights the damage homeopaths can do in a self-regulated industry.  Yet it is almost impossible to be a member of a Fund without having the option of at least one “alternative medicine” in the bundle.

While Mr Hope has yet to hand down a finding, it is time for the Federal Health Department to refuse Health Funds any increase in fees until they remove any unproven medicine from their packages; naturopathy, homeopathy, in short, woo.

This isn’t the first time a Coroner has had to deal with the effects of homeopathy, but hopefully it will be the last.  As long as Health Funds package “alternative medicines” with basic cover, or even Ancillary cover, it legitimises the woo.  If any citizen or resident wants to have homeopathy or any other unproven medicine included in their insurance, then why should it be subsidised 30%?  If such treatments did work, we wouldn’t have a regular stream of Coroner’s Reports condemning the practice and practitioners, nor would we have families begging for justice.

This is a challenge for the new Gillard Government and for Health Minister Nicola Roxon in particular; stop the Health Funds from bundling woo into their packages.  The next time the Funds cry “we need to increase our premiums” the government should stand firm and suggest the Funds could save money if woo wasn’t automatically bundled with services that are legitimate, and remove the 30% refund for any service that cannot prove its efficacy.

That should save Medicare enough money to finally include dental services.

28 June, 2010

Good news, bad news.

Today was the day I meet with my neurosurgeon.  Not the one that operated on my back originally, but nonetheless a consultant and therefore good enough for me.

Knowing that the fraternity has rules I asked “Should I call you Mr?”  He smiled as the MRI and CT images loaded on his computer monitors and replied “Dave was good enough for my mother, so it’s good enough for you.”

Dave it is.

We chatted about things in general, then about the things that mattered.  He showed me the MRI, scrolling back and forth to satisfy himself the titanium had fully bonded. The plates, the screws, the 2 delicate cages that held a donor wedge of bone in place where a disc once was.  Fusion was total and couldn’t be undone.  But he wasn’t happy.  The work Emir, my original neurosurgeon, did was first class.  The problem was not of the surgery but of my body continuing to break down.  The arthritic spine was evident, almost glowing white hot on where vertebrae rubbed on vertebrae.  However we all knew that and it wasn’t a surprise.

The surprise is that the canal which the spinal cord passes through is too narrow, and becoming even more narrow.  There is no room for spinal fluid to surround the vital bundle of nerves.  It’s like having a delicate bundle of fibre optic cables being crushed in a vice from all sides.  Without intervention the sheath that protects the bundle will rupture and the core of nerves will become damaged without prospect of repair.

Fortunately the structure is stable for the moment.  It will become less stable over time, but Dave is a conservative and won’t operate unless the vertebra above my fused vertebrae become unstable.  I like his thinking; the more of the spine that is fused, the greater the pressure on the spine overall as the forces cannot be dissipated.  That’s what discs are for, to act as shock absorbers and dissipate much of the forces on the spinal column.

In one particular type of arthritis, which mainly affects young men, the vertebrae slowly fuse together until there is no movement of the spine.  Ironically this fusion makes the spine weaker, not stronger, because forces on it cannot be distributed properly.  Also the arthritis makes the bone more brittle, so fractures are far more likely to happen.  It’s been known by many names, bamboo back being one of the most common because the spinal column looks like bamboo.  These days ankylosing spondylitis (AS) is its common name.  A progressive degenerative disease related to rheumatoid arthritis (RA) - the main type of arthritis I have - and like RA, AS is a auto-immune disease.  That is, the person’s own immune system doesn’t recognise the body’s own tissue and attacks it.  In AS, the immune system attacks the fluid in the degenerating discs and the facets of the vertebra.  In RA, the immune system also attacks the bone in the synovial fluid in, for example, the fingers.  The fluid acts as lubricant and prevents bone rubbing on bone.  In my case, the poly arthritic nature of my RA affects my fingers, wrists, and my spine.  Probably my ankles too, but I don’t worry so much about them, particularly my right ankle as I can’t feel it, and my lower right leg and foot are supported by a high tech device that stops my foot from drooping and the ankle from twisting.  On flat, solid, grippy surfaces I can walk without the aid of my walking stick.  It’s an amazing feeling to be able to do that, I can’t begin to describe how much better I feel within myself to walk without aid or fear.

So, where to now?  Pain management still goes on, as does hydrotherapy and physiotherapy and, of course, consultations and prescriptions.  More importantly, Dave has referred me on to a neurologist.  The point being?  There are other issues besides walking strangely or pain.  Somewhere higher up, near or in the thoracic vertebrae, is causing a few problems.  It’s not painful, unlike my lumbar, but it needs to be looked at.  If surgery can be avoided, I don’t mind.  If not, then I know I can trust Dave to make the right decisions after another consultation.  Of course it’s great not being in a position where a decision must be made now, that my spinal column is so unstable that intervention must happen now.  I’ve been through that before, the emergency, the temporary stabilisation, the operation, and the ongoing rehabilitation.  It’s not something I would wish on anyone.

For now I’m not sure how to feel about the idea of my spine slowly crushing my spinal cord.  It’s not a surprise to me in a strange sort of way.  I’ve already started on my “bucket list.”  Today I opened a special savings account with the goal of saving enough money to travel to Beijing then travel to catch one of the Trans-Siberian trains through Novosibirsk, onto Moscow, stay a few days, then catch the Red Arrow to St Petersburg.  Why?  To do it before I can’t.

I’m not saying that being a paraplegic would stop me from doing what I want to do, but I want to be able to do it while my legs have some function left.  In some ways when my back broke, it may have been better to have lost my legs (which I did until the operation) and not have the debilitating chronic pain that I have now - a case of being able to fool most people much of the time and a few people none of the time.  Those who have met me probably think I’m a pain in the arse, or perhaps a little too jolly.  Those who know me understand that if I stopped and thought even a little about how much it hurts physically and emotionally, I would seize up like Tin Man in the rain.

There is another driving force.  Every day I’m at Royal Perth Hospital, Shenton Park Campus where rehabilitation is the focus, I see young and old who have lost limbs, who are para/quadriplegic and are rebuilding their lives.  Some are at the beginning of their journey, some are nearing the point in their lives where they are truly independent for the first time in their life.

If the prospect of death focuses the mind, then the prospect of losing independence toughens the resolve.  My resolve has never been tougher.  This is a war I cannot win, but I can, and will, win many battles along the way.

27 June, 2010

The Dashing of Babies' Heads

This is a response to http://twitter.com/heidiraff/
@Epigrammist Ezekiel 9 Explanation - Question posed by atheists on Twitter: How can the order by god in... http://tumblr.com/xt1c64w9u

Which in turn was her response to @DanVerg’s question; How can Ezekiel 9 be justified?  I embellished the question - in order to get a response as @heidiraff was constantly stalling - with a passage form Psalms.  Psalm 137:9 to be precise.  You may remember the song as sung by Boney M; By The Rivers of Babylon:
By the rivers of Babylon, there we sat down, yea, we wept, when we remembered Zion. 2 We hanged our harps upon the willows in the midst thereof. 3 For there they that carried us away captive required of us a song; and they that wasted us required of us mirth, saying, Sing us one of the songs of Zion. 4 How shall we sing the Lord’s song in a strange land? 5 If I forget thee, O Jerusalem, let my right hand forget her cunning. 6 If I do not remember thee, let my tongue cleave to the roof of my mouth; if I prefer not Jerusalem above my chief joy.7 Remember, O Lord, the children of Edom in the day of Jerusalem; who said, Rase it, rase it, even to the foundation thereof. 8 O daughter of Babylon, who art to be destroyed;  happy shall he be, that rewardeth thee as thou hast served us. 9 Happy shall he be, that taketh and dasheth thy little ones against the stones.

Ok, so Boney M didn’t sing happy shall he be that taketh and dasheth thy little ones against the stones, but it would have made for an interesting song.  Back to Psalm 137 later.

Ezekiel 9 says (in the King James Version):
1 He cried also in mine ears with a loud voice, saying, Cause them that have charge over the city to draw near, even every man with his destroying weapon in his hand. 2 And, behold, six men came from the way of the higher gate, which lieth toward the north, and every man a slaughter weapon in his hand; and one man among them was clothed with linen, with a writer’s inkhorn by his side: and they went in, and stood beside the brasen altar. 3 And the glory of the God of Israel was gone up from the cherub, whereupon he was, to the threshold of the house. And he called to the man clothed with linen, which had the writer’s inkhorn by his side; 4 And the Lord said unto him, Go through the midst of the city, through the midst of Jerusalem, and set a mark upon the foreheads of the men that sigh and that cry for all the abominations that be done in the midst thereof.  5 And to the others he said in mine hearing, Go ye after him through the city, and smite: let not your eye spare, neither have ye pity: 6 Slay utterly old and young, both maids, and little children, and women: but come not near any man upon whom is the mark; and begin at my sanctuary. Then they began at the ancient men which were before the house. 7 And he said unto them, Defile the house, and fill the courts with the slain: go ye forth. And they went forth, and slew in the city. 8 And it came to pass, while they were slaying them, and I was left, that I fell upon my face, and cried, and said, Ah Lord GOD! wilt thou destroy all the residue of Israel in thy pouring out of thy fury upon Jerusalem? 9 Then said he unto me, The iniquity of the house of Israel and Judah is exceeding great, and the land is full of blood, and the city full of perverseness: for they say, The Lord hath forsaken the earth, and the Lord seeth not. 10 And as for me also, mine eye shall not spare, neither will I have pity, but I will recompense their way upon their head. 11 And, behold, the man clothed with linen, which had the inkhorn by his side, reported the matter, saying, I have done as thou hast commanded me.

I suggest for those who aren’t familiar with bibles or concordances (those wonderful little bits of theological academia that justify anything, link any verse to any other verse, and generally attempt to confuse anyone trying to understand the bible for themselves) to grab one and have a look at the contexts in which Psalm 137 and Ezekiel are written.

@Heidiraff’s answer breaks down into 2 parts;
1. (biblical) Israel was corrupt, and
2. was in need of cleansing.  Yes, even new-borns who had no concept of “right” and “wrong”.

Ezekiel was an old school prophet; the “oh woe is Israel, oh woe is Jerusalem!” kind of guy.  This “prophecy” is no different (but I wonder if they only remembered and wrote down the prophecies that were right and those that were wrong were erased from history; certainly many prophets were denounced as false prophets).

In essence, what Ezekiel wrote (by tradition) was “God yelled at me, saying get all those that run the city, particularly priests, into the sanctuary with all their families so he can send his messengers down to destroy them.  Ok?  Thanks!  Oh, by the way, there is this angel next to me recording this event in a very efficient, bureaucratic way with pen and paper.”

@Hiediraff claims this is the same deal as Noah’s ark.  The obvious question here is that if Noah’s ark was supposed to rid the world of corruption and evil, since Noah was a righteous man, then why would it have to be done all over again?  If the story of Noah is to be believed, then we are all a result of incestuous sex from Noah’s family, which means the “flood” really wasn’t a great idea after all, even if there was archeological and geological evidence for it.  Which there isn’t.

Did god fail?  Because it’s starting to look like the god of the Israelites, Christians and Islamists is very good at getting prophets to write down a plan for humanity to marvel at before cocking up its execution.

More worryingly is that Ezekiel 9 is held up to be an example of how god looks after his chosen people by commentators like Wesley.  If we don’t turn to god and beg and plead and do everything god says without question, our innocent babies will be slaughtered by god’s henchmen, yay!

No matter who comments, or how Ezekiel 9 is interpreted, it all boils down to sin and corruption.  Ezekiel was tasked to tell all who would listen “If you don’t get your shit in one sock, then there is going to be lots of stick and no carrot.”  That’s pretty much the message of every Old Testament prophet, only they are imprecise and verbose.  Possibly due to the tea they made from that green stuff on the side of the road.

Back to Psalm 137: It’s a psalm that was, and is, used by exiled Jews (and now Christians) to remind them that although in exile, they will take back Jerusalem.  It’s also used to reassure Jews that Jerusalem is theirs for ever, no matter where they are.  Huzzah!

That, and that they’ll have a lot of fun smashing non-Jewish kids heads in with rocks.

What wonderful examples Ezekiel 9 and Psalm 137 set.  Wander slightly and your family will be slaughtered, follow the path of god and you have permission to kill newborns of your enemies.

This isn’t discipline, as @heidiraff claims.  It’s barbarianism.  For those who wonder why the extremes of Islam are brutal, this is it.  The same god, and the same reverence for the Old Testament (Torah) as Jews and Christians.  Next I’ll be told how only Christians have a moral authority because only they are the “chosen ones”.

I’m sorry; any answer that ends with the likes of @Heidiraff’s “In this case, God used other nations to discipline His children and bring them back to Himself. This was the push-me-pull-you relationship that existed until Jesus came and brought mankind back to God through His death on the cross.” is akin to saying “I don’t really know why, and it doesn’t make a lot of sense, but to me it doesn’t matter because of my personal relationship with God.”  I’d much rather the latter, honest answer than the former Jesus-makes-everything-taste-better answer drawn from the jar labeled “Stock Answers for when you don’t know the answer.”

04 June, 2010

Why Universal Health Care is Vital to Any Civilised, Compassionate Society, and how it Benefits Everyone

There's no big secret about me having rheumatoid arthritis, or a broken back.  I tweet about it, share my experiences and get some good advice from others who know about auto-immune diseases, as well as having a plethora of specialists, including a consultant rheumatologist, taking care of me.
Due to the damage in my spine, which is currently held together with titanium pins, rods, screws, a cage and will power, I also suffer chronic, intense back pain which needs it's own management plan.  Lately the symptoms of the partial paraplegia, from the significant nerve damage, have been getting worse.  More pain, less mobility and some potentially embarrassing moments in public. (Other than my risqué conversations!)
Working out what's going on isn't that straight forward.  Physiotherapy have noticed the deterioration.  A muscular-skeletal exam confirmed what my physiotherapist suspected, an expensive custom made orthotic was made to assist me to walk further than a few metres without tripping over.  Meanwhile a pathologist investigates my blood and reports back to my rheumatologist and General Practitioner (GP, just a regular doctor).  My gastroenterologist orders Doppler ultrasound, and interprets the digital video remotely from the Imaging Services Department at the hospital.  My neurosurgeon is frequently updated with digital CT scans to look for change.
That's where the “problem” lays.  The titanium that is fused into my lower spine scatters x-rays, so high resolution images near the suspect site are not possible, but there is enough change for it to be noticed.  So an MRI scan is ordered.
I don’t know if anyone knows what having an MRI is like.  I’ve become used to them, but still they aren’t pleasant for me.  The MRI scan process for me is fairly straight forward; change into “something more comfortable”, double check for any metal I might be wearing, get wedged onto a plank, then loaded like a shell into a cannon.  For the next thirty or so minutes the sounds of thumping, banging, buzzing, and harmonics of all these all but drown out any music I’m listening to through plastic tubing.  While all this is happening the electro magnets (which resonate causing the disturbing banging sounds) are so powerful, any loose metal within a few metres of the machine would be flicked through at a velocity enough to break bones or, worse, the machine.  They are so powerful that it makes me vibrate.  Indeed, I can tell when they are focusing on my lumbar region as the titanium moves with the vertebrae to cause pinching of some nerves which results in a combinations of unpleasant discomfort and sensations of having hot pokers rammed through my feet and into my spine.  Then I’m unloaded briefly, but not allowed to move, as a contrast agent is injected into my wrist.  Normally they try and find the less painful area, but it’s not always possible. The contrast agent makes my tongue feel like someone’s put a dirty teaspoon on it.  Then it’s reload and do it all over again.
Yesterday’s little outing in the tubular coffin took no less than 90 minutes.
Now I’m not saying this is, or should be, a typical experience for anyone.  It’s simply my own experience due to my unique circumstances.  Most people that have an MRI have nothing more than a little discomfort from being in a confined space for about 15 minutes.  MRI scanning is routine in an emergency hospital, such as Royal Perth Hospital, and all across Australia’s major public hospitals.
Now, here’s the fun part.  How much do you think all this testing costs?  How much did it cost me?  The MRI scan alone costs are about AU$10,000.  Cost to me? AU$0.  That’s right.  Nothing.  Same for physiotherapy, pathology, rheumatology.  Even when I had the neurosurgery to remove the spiny growths of bone, the ruptured discs, and to reconstruct and repair fractured vertebrae using expensive titanium didn’t cost me a cent.  The room with a view that I had to myself for 2 weeks during recovery cost me nothing.  The rehab, zilch.  The fitting, construction and refitting of my high-tech orthotic?  Absolutely nothing.
Every Resident and Citizen of Australia has access to free, that’s right, free medical care at a public hospital.  There are private hospitals, but the only difference between the two is that private hospitals have more expensive art in the foyer and don’t have emergency facilities.  In fact, most consultants from all disciplines, including my wonderful rheumatologist, work in both private and public hospitals.
So how can it be free, and why?  The answer is simple.  Taxation pays for it.  It even subsidises General Practitioners so that going to a doctor is cheap, and in some cases, free.  Yes, that’s right, for some people it costs nothing to see a doctor.  Going further, most prescriptions are also subsidised, to the point that once a certain number of prescriptions have been used by an individual or family, for the rest of the calendar year all listed medications are free.  Yes, free.
Every Australian is aware of this to some point.  Most wouldn’t even think about it.
Surely this is madness!  Isn’t this socialist nonsense and surely it will bankrupt the country?  Like Greece for example?
Well, no.  It’s a vital service, Universal Health Care.  For those in the Tea Party movement in the US (referred, unflattering as “teabaggers”!) who are fighting to stop the Obama administration to trend towards Universal Health Care, countries like Canada, Australia, Great Britain, France and so on are to be pilloried for having such a blatantly evil “socialist” policy.
But if they really thought about it, why don’t they complain that the police or firefighters are part of a socialist agenda?  Or government schools?  Why should doctors become wealthy at the expense of patients when the police also have arguably difficult jobs, or firefighters or teachers?  Why is it that prisoners get better health care than they could ever hope to get outside of jail?  Or members of the US armed forces and veterans?  Or indigenous Americans?  Isn’t that also an evil socialist engineering program?
The fundamental arguments against Universal Health Care start to look pretty weak in light of the evidence.  Especially since those who make the most money out of the health industry in the US are the insurance companies are the same collection of people that make the decisions on what treatment, if any, a US citizen is entitled to, or what medication they can have.  It doesn’t take much brain power to understand that these people are making decisions based on a bottom line, not in terms of health outcomes for policy holders.
At the same time, medical services and medications costs in the US are practically extortionate.  This in turn means the insurers have to charge higher premiums, which mean less people, despite the Obama Administration’s changes to stop the practice of denying policies to people with pre-existing conditions, can afford any quality medical care.  Essentially, the US is a duality; those with money and influence get the best medical care money can buy at the expense of those who work just as hard, if not harder, for far less reward.
A civilised nation would treat all citizens as equal before the law, and enable access to all services on an equal footing, be it electricity, a police force, justice through the courts if accused of a crime, or health care.  A compassionate society would treat those who, for a variety of reasons, aren’t able to fully take care of themselves or make decisions for themselves about their welfare; this is no different to how parents look after their young children or children look after their aged parents.
Using taxes to pay for these things is money well spent.  Instead of someone who becomes horribly ill and unable to work never contributing to society ever again, they are more likely to be rehabilitated where they can contribute once again.  That in itself is a powerful incentive for the patient to become well again because no one likes to be dependent on others.
I would have thought most of this is self evident or self explanatory.  Anyone with a grain of sense would know Universal Health Care isn’t about a slippery slope to some form of evil Stalinism.  At least I believe anyone with a grain of sense would know that.
Of course, if critics wish to point out how I’m some form of bleeding heart lefty socialist, then fine.  Maybe I am.  I was born in, raised in, and live in a liberal socialist democracy.  That doesn’t mean a Laissez-faire, Marxist democracy, It means a free thinking, progressive, open to new ideas, let’s give everyone a fair go democracy.  Usually it means that governments are more centralist or left of centre than governments of the USA, but nonetheless a liberal socialist democracy is a long way right of Stalinist North Korea.
Critics are welcome, if they wish to ask me any questions they like.  I can begin by stating that currently I am on a Disability Support Pension.  It’s not a lot of money, but it’s enough for most things; rent, power, and as you can see, the internet.  And independence.  Would I rather be working?  Of course, but it’s not practical nor beneficial for myself or - more importantly - an employer at this point in my life.
Would I be just as happy if I was the one paying the tax and somebody else was on a pension due to illness or injury?  Absolutely.  Been there, done that, didn’t complain.
I leave with one final question: if you’re a US citizen and a “teabagger”, how would you like to be treated if you unexpectedly became ill for a protracted period?  Would you like to worry each day about how long the insurance is going to pay and what treatment they will pay for instead of focusing on getting better?  Or would you resign yourself to becoming homeless, even imprisoned for being homeless, when every one around you pities you but says you ought to have known this is what was going to happen and paid some faceless company more money.