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Thursday, October 29, 2015

Haiku on Beg/ Enter/ Chill/ Refresh


Moon begs attention
Night light shining through window
Stops lunatic dream

Begging bowl empty
Old man sits on the sidewalk
Dreaming recipes

You say I must work
I beg to differ my friend
Battery leaking


Enter a contract
Eyes, mind and heart wide open
It will never break

Enter the Dragon
Bruce Lee beating the bastards
Favourite movie

You invite me in
Hesitantly I enter
Accepting my fate


A chill in the room
Frost palpable reception
Wearing the wrong tie

Cold bacon sandwich
Cliff top north easterly chill
Early morning start

Roaring hearth fire
Snug of an old English pub
Warm beer and chilled wine


Morning ritual
Brush out yesterday's decay
Refresh your mindfeel

Brush teeth together
Refresh your relationship
Share the minty taste

Change your view of life
Clean all the windows at home
Refresh your outlook

Tuesday, October 27, 2015

Making of a Child Psychiatrist (29): Interlude & Prelude (2)

My parents introduced us to some new friends, Kiah Bastian and his partner Jan who were close in age to us, but had become part of the Martin extended family. Kiah was a sewing machine mechanic, and had done some work for Eve, and his lighthearted fun-loving nature had intrigued everyone. He was keen on barbecues, so at weekends we trooped off to the beach, or to national Park, or some sand dunes for slightly underdone chops and snags. We were confused by the weather. So it had been sort of the beginning of summer in England when we left, and we had sort of expected Australia to be hot. But it was winter, and of course down by the beach with a slightly chilly wind, and Jan and I would both be shivering. This was not just jet lag, but seemed to be an unexplained feature of us. The good thing was that Jan could always be warmed up by a cuddle. We did actually bond well with Kiah and Jan, and when we returned many years later were able to take up the friendship again.
Eve had a secret life. In England she had been to art classes in Margate, and with Ted often away and Andrea at Cabra College during the day, Eve took herself off to the Adelaide School of Art, which she attended for the three years of Ted’s posting. She was happy and productive, and we have some paintings of Brownhill Creek and other places around Adelaide, as well as portraits and sculptures (in the Barbara Hepworth style, begun shortly after her return to England). I had not realised that my mother was an artist. I knew she was a very competent if self-effacing dressmaker, and had watched while she made multiple costumes for church shows, under pressure and using odd materials like crepe paper. But to get this new perspective was profoundly important to me, and made sense of how and why she ‘got the picture’ so quickly in discussions.
The Royal Australian Air Force decided to have an annual ball during our time in Adelaide, and Jan and I had been invited to accompany Ted and Eve. Sadly Andrea, then only 11, was unable to accompany us. Remembering the joyous experiences of our ballroom dancing days we were excited. Jan had a long dress with a matching jacket; I suspect that Eve may have worked the sewing machine into some late nights to make Jan shine even more than usual. The style in the 60s was for the ladies to wear long gloves; so these were purchased. I did not own a dinner jacket, and had given up black shoes after leaving school. So one Saturday we were driven into the city and went to David Jones on Rundle Street where I gained my first ever shawl collar penguin suit and an evening shirt and a black bow tie. All very smart, and we have photos to prove it. It was a great evening, and we danced and danced on the floor covered in sawdust (as was the style of those days). We also enjoyed the obligatory meat pies with sauce (one of the quaint realities of Australian high culture).
As much as possible we travelled at weekends when Ted was free to drive us. We did the wineries in the Barossa, though truthfully I can only remember Seppelt’s and Kaiser Stuhl; perhaps the tastings were too much for us.
On one occasion we drove up to Woomera; nearly 500kms in fairly warm conditions. The poor Gordini struggled, and air conditioning didn’t exist so we had to open the windows – which of course then made talking problematic over the noise. Both Jan and I have strong memories of the red dust to the sides of the roads, the vistas stretching for ever, especially north of Port Augusta and, amazingly the occasional tree at a rest stop absolutely covered in noisy budgerigars. We had never seen anything like this, and were blown away. Admittedly as a youngster of 9, we had owned a budgie which was friendly and would sit on your shoulders, nibble your ears and leave small round messages. Eve, with time on her hands during the day had taught it to play football with a glass marble; endless amusement for us all at the kitchen table. But a flock of hundreds of them in variegated colours in their natural environment was a beautiful and overwhelming experience.
I had expected to see rockets. That was what my father was working on for 15JSTU; radar guidance systems for ‘black knight’ first launched in the late 1950s, and also ‘blue streak’. But we were civilians with ‘no clearance’, even though Ted was the OC (Officer Commanding). So, we dined in the mess, slept in Nissan huts (with no air conditioning, of course), and the following day completed the return journey. Ah well, it was a nice family outing, and I could fantasise about what went on, even if Eve, Jan and Andy just wanted a shower.
Ted was in love with his car, being the first new one he had ever owned (of the 2 up to that date). In fact at the end of his tour he took up the option of having the car transported back to the UK, where he continued to use it for some years. But Jan and I were 19, and had begun to have driving lessons from her father Reg, and his brother Laurie who had been a driving instructor. So eventually, Ted gave in and allowed me to do some driving on long trips – preferably when there was no other traffic, and wide enough roads. That is until the fateful day I ran over a snake. Or at least we thought I had run over a snake on the road, and there was gentle hysteria about needing to investigate and remove it if at all possible. So Ted asked me to pull in to the side of this long country road. I did, and managed to find the only bit of grass which was hiding a piece of wood with a large nail sticking out. Well, I had not seen it. I am sure nobody else had either. But there we were, on a road with little or no traffic, and a rather limp nearside front tyre. Ted was not amused, and his ever present frown deepened and darkened. We got out and, in a rather tense atmosphere, I got my first lesson in how to change a tyre. I had damaged Ted’s pride and joy; I never did get to drive it again. I had fulfilled my destiny and proved that I was missing 4% somewhere. That tense atmosphere never quite eased for the last couple of weeks before we had to leave Adelaide.
Jan had been quietly working away at the University of Adelaide in the Biochemistry Department, under a Doctor Keech. It was a mixed experience for her in many ways. She loved the atmosphere, the sense of working with others in a scientific endeavour. She was obviously on a steep learning curve, but was usually (of course) asked to do the routine and mundane jobs. Jan, being Jan, did not mind because it was all building her experience towards her future, and adding the practical side of things to her first year of theoretical biochemistry at Bedford College. The downside of the experience was that the said doctor, in that way of slightly older men, particularly men in authority, was pressing his feelings onto Jan, and had made several advances that Jan found very uncomfortable. I am not sure how she managed. She certainly did not tell me for a long time. This was good at one level. I would have killed him.

Making of a Child Psychiatrist (28): Interlude & Prelude (1)

I seem to have had a lifetime connection to Australia.
My paternal grandfather Clifton William (known as Pop) had been born in Preston in Lancashire, with a sometime violent father (William Henry) who had been an organist at St. John’s Church and styled himself as a ‘Professor of Music’. His wife (Emily née Crook) inherited her money from an industrious unmarried aunt who owned a small confectionery business decorating cakes and had purchased terraced houses for investment. Pop went to a posh boy’s school in Crosby, Merseyside (Merchant Taylor’s, founded in 1620). This may have been a bit of a joke, given that that WH’s father was a travelling merchant of cloth made in Lancashire. Anyway, consistent with the times, Pop was beaten at school and home - often given as the reason his parenting style was somewhat ignorant, rigid and occasionally violent.
Pop left school at 14, joined a lawyer’s as an office boy, moved to work at Lever Brothers, and in 1917 joined the Royal Flying Corp which later amalgamated with the RNAS to become the Royal Air Force. He was demobbed in 1919, by which time he had gained his pilot’s wings and later, very much the creator-innovator, created his own civilian flying school in Brighton that seems to have been quite successful. This led him to write a book (‘Martin’s Air Navigation’, 1937) for which my artistic father drew all the diagrams. The book was adopted by the Air Ministry in 1939.
Nan (Alice Beatrice née Reynolds, who had herself been a nurse with the Women’s Auxiliary Army Corp in the first world war) and Pop, ever restless, migrated to South Africa in 1949 to run a small hotel, taking the two youngest children (of 7). Two years later they migrated to Sydney, Australia, where Pop made a career as an estate agent.
So, in my childhood I had two treasured possessions. The first was a tiny replica Zulu shield with an attached spear (now sadly lost), for which I had little history or background. The second was a large format but somewhat thin glossy yellow hard back book ‘The Aboriginal Story’ (Ruth C. Williams) which had line drawings of the original owners of Australia in everyday action and family life, as well as drawings of the unique animals that live here. I was intrigued by this book, and have treasured it since the age of about 8. I still own it, and (reverently handled) it has remained in fairly good condition.
So, not only did we have my parents living in Adelaide in 1963, my grandparents lived in Sydney, as did my aunt Sheila. The youngest son Mike lived with his family in Newcastle, NSW. In addition, over time various other members of the family had migrated. While two of my father’s brothers had migrated to the United States (Ray and Tony), John migrated to Melbourne, and Douglas (an adopted brother who was my godfather) migrated to Sydney, as did Joan and her husband Harry. We had hopes of catching up with everyone during our trip.
Once in Sydney we drove out to Merrylands and stayed for a brief happy reunion with Nan and Pop, before packing the five of us into my father’s powder blue Renault Gordini for the drive across to Adelaide. That sounds easy except the Gordini was somewhat tiny, and Martins somewhat large. The other bit that sounds easy is the drive which we had to take in stages given it was nearly 1400 Kms on the Sturt Highway. My father had every faith in his car – well placed as it stands. You never think of these things as a young person, but that must have been a major adventure for both my parents and my sister Andrea (just turned 12), none of whom at that time would have driven anywhere near that distance in England, although Ted and Eve had previously had a driving holiday through France, Austria and Germany with some neighbours of ours, the Winslows.
Jan and I were overwhelmed by the blue haze scenery of the Blue Mountains, and by the sheer distance to be covered. We had a memorable overnight stay at Wagga Wagga in a motel (our first time), and next morning I was challenged to a classic ‘rite of passage’ Australian motel breakfast with the lot including bacon, sausages, steak and eggs. Jan was more sensible, of course. We headed out to the Hay Plain (full of not very much for hour after hour). We talked and talked catching up on family news from both sides of the globe, but long stretches were mesmerizing and there was lots of sleepy dozing and silence. We took reasonable meal breaks and loo stops given Ted was doing all the driving, my mother still not very confidant, and Jan and my driving ability an unknown quantity. From Mildura we cut down through the wine-growing Barossa Valley (to be visited several times later) to Elizabeth (at that time newish satellite ‘city’ to the north of Adelaide towards Gawler). From this direction you get little sense of the layout of Adelaide which is actually a spectacular 1 kilometre square surrounded by gardens and parkland, and designed by Colonel William Light whose statue north east of the city we were later taken to see (Light’s Vision). The city at that stage had a population of only 23,000 souls in a state that had only just past the million mark with Jan’s and my arrival. You get a better view of the city, and how it is placed in the plain stretching to the sea, from Mount Lofty a place we were to visit several times.
My parents should have been living in Officer’s quarters at Edinburgh Field RAAF Base, but this was never to happen for some reason. So they had taken up residence in half a sandstone villa in Clifton Street, Hawthorn, one of the suburbs about 5 Kms from the city centre. The house was owned by an older couple who befriended Ted and Eve, and were much later to lend us an elderly car for a time when we later emigrated. Jan shared with Andy, and I slept in a bed on a covered veranda close to nature.
The first day of work came as a shock, despite a few days to get over jet lag. The Waite Institute was a rambling set of buildings only a short distance from home, and was set in an arboretum of almost every native Australian tree that existed. Jim Silsbury was delightfully relaxed man with a great sense of humour, but also a serious scientist in a senior position; his focus was on developing a grass that would be drought resistant. My job in those first few days was to measure and record the length by width of lucerne samples taken from various properties in the south east of South Australia. Boring and tedious, but apparently important; and someone had to do it. I was quick, focussed and worked hard. At tea and lunch breaks I began to get to know members of the staff – a wide range of people from differing backgrounds who all seemed to share that relaxed, laconic sense of fun I was later to realise was very much a feature of Australian blokes.
In one of the conversations, Jim learned that I played bridge. He must have tucked the information away, because several weeks later his regular partner was unavailable, and he asked if I would like to sit in. We used a simple Acol system with some small refinements, and won the evening. I ended up playing several more times, enjoying very much playing ‘with the boss’, but also the intellectual chatter and repartee that was all part of each evening.
Later in our stay, Jim asked if I would like to go on a field trip down to Tantanoola near Mount Gambier; four blokes in a four wheel drive for four and half hours down through Murray Bridge to the lower end of the Coorong and nearly to Mount Gambier. Spectacular scenery; funny conversations, and we stayed overnight in a pub. The next day was up early and outdoors examining and collecting soil samples and what looked to me like weeds from several different properties. I just did what I was told; which was good because I had no idea what I was doing… I did know that I might be up for some more measuring back in the lab.

More later…

Monday, October 26, 2015

Transverse Myelitis and Chest Pain

I have been reflecting on the issue of chest pain since being in contact with a number of Transverse Myelitis support groups.
I have a chronic recurrent pain in my chest. It has been there for 6 years since my TM began. It starts at about level T7 in my thoracic spine, and travels down at an angle to the right, in between two ribs, and round to the front of my chest where (peculiarly) I have a patch of numbness where the ribs join the sternum. The numbness is there all the time. The pain comes and goes. When it is there, it is stinging, seems to be more at the end of a breath or at the beginning of a breath, and seems to affect some of the muscles of my chest, which from time to time go into spasm. It can be just niggling, irritating. At other times it it is sharp, insistent, and takes my breath away. At these times, it makes my eyes water. It seems to be worse some mornings, particularly if I have had a busy day the day before. It seems to be worse after driving a long distance, as if holding my arm up affects the nerves or the spine. It seems to be worse after I have done some gardening or after something else a bit physical. I have recently been doing some easy Karate arm movements - punches and blocks - and that can bring the pain on for a couple of hours although it seems to settle down then for a couple of days. I have noticed recently that it is much worse when I am tense for whatever reason. So after two days of work in town, I am tired, thoughtful and tense - and the pain requires action.
Pain is funny, even if it is not funny. We all describe our pains in different ways - which makes it difficult for doctors to make sense of (particularly the tired or grumpy ones). We all have different beliefs about pain. We all have different tolerances to pain. Mostly I put up with my chest pain as an old friend. I am still alive. I can still work. If I have pain it is telling me I need to take a break. Sometimes I need to take paracetamol, but to this point have not needed to take anything more than that. I guess I have reasonably high tolerance. Some of that may have come from 22 years of training in Karate.
One belief, is that we do not feel pain at the point of the pain, but rather we perceive the pain in our minds. Theoretically this should give us the power to ignore pain. That would be stupid if we were accidentally cutting ourselves or burning ourselves. But sometimes it is useful. Women who feel pain during childbirth often do not feel it at the moment of birth or in the moments after birth when they have the joy of a new baby. Mostly they can forget the pain if they intend to get pregnant again.
There is an odd phenomenon linked to exercise. If I do some exercise for 20 minutes or so (on my indoor bike), the pain will often go away for a time. The exercise does not have to be extreme (although sometimes Karate was (in the past when I could do it, and that was when I really noticed the phenomenon). Exercise provokes endorphins in the brain - the morphine-like substances that naturally occur after exercise, stress, joy, or meditation.
I learned meditation about 35 years ago, and practice mindfulness and meditation in a variety of ways. Meditation helps my pain. The strange thing is that if you focus directly on the pain you sort of cannot find it. It slips between your mental grasp. When you begin to think about something else, pain slips slyly in from the side. If you practice the focus over time, you get better at not feeling pain when it is there.
Acupuncture and Acupressure have helped my pain. There are two or three tender spots along the pathway I described, and apparently these are acupuncture points. Have a needle put in for an hour, and the pain can go away for days. Putting pressure directly onto the spots (Shiatsu) and holding it there for  about 5 minutes, or even rubbing the spots, can make a difference. Seriously...
I have recently given in (after 6 years) and bought a TENS machine for home use. This is Transcutaneous Electrical Nerve Stimulation. Two pads are stuck to the skin - usually one over the pain, and one over the origin of the pain close to the spine (i.e. the nerve root). The machine is portable, and goes into pocket. It has a couple of dials which can change the character of the stimulation and also the intensity. Over 30 minutes you may have to increase intensity to increase 'the buzz'. I only use it every couple of weeks, but pain relief can be up to two days in my case. Oh, it pays to read the instructions carefully, and also get initial advice from a physiotherapist on how to use your TENS. If it does not seem to be helping, go back and discuss placement and settings again.
Now, I know there are people who have really severe pain, or who cannot tolerate pain at any time. They end up taking lots of mild medications, and when those don't work, they end up taking more 'effective' painkillers, and when those don't work, they end up taking narcotics which may do the job for a time, but are costly and addictive. My belief would be that even those in serious and chronic pain can gain something from exercise. My belief would be that even those in serious and chronic pain can gain something from regular and practiced meditation - initially under the eye of a specialist trainer. My belief would be that even those in serious and chronic pain can gain something from acupuncture or learning to do self-administered acupressure.

Do something for yourself. Take charge of just a bit of your recovery. Please give it a go. It may help you, it may not. I hope it does.
'Taking Charge: a journey of recovery'

Sunday, October 25, 2015

Haiku on Collapse/ Rise/ Star/ Get


A long tiring day
Thinking, creating, writing
Collapse into dreams

Lacking maintenance
Bridges we built between us
Collapse in a heap

Orwell's dystopian view
Cultural collapse


Go on, keep at it
You can tease me all you like
You won't get a rise

What is a pay rise
When you are a volunteer
Working just for love

They climbed the slight rise
Chasing rays of setting sun
And were left breathless


In floodlight he saw
In moonlight he followed her
In starlight they kissed

Inscribed on paper
Stories lived in the real world
Written in the stars

Stars from a distance
Cool twinkling lights to envy
Burning up inside


Right, that is it. right?
Gotta get outa this place
Last thing ever do

Get rich really quick
Become a politician
Repent at leisure

The widow's young get
Became a widow maker
Genetic's will out

Monday, October 19, 2015

Making of a Child Psychiatrist (27): Med School (5)

I used to try to get to see Jan as often as possible. When we could not meet, we spoke on the phone although it was sometimes difficult to get access to the phone at Halliday Hall given the numbers of students needing access.
Jan was living in Swiss Cottage in a rented flat with her older sister Wendy who had a secretarial job in London. It was a lengthy journey on the underground from Clapham South to Charing Cross on the Northern Line, changing to the Bakerloo line to Swiss Cottage. A short walk and I was there. The flat was small but had 2 bedrooms a kitchen and a lounge, and while I was very keen to spend time in the bedroom it was just not possible – so we sat in the lounge room. Wendy is a somewhat reserved person, with little in the way of conversation, so we would sit on the couch or the floor and discuss our progress at Uni with uncommon propriety, while Wendy sat and stared into space. There was no television of course, though we could play music at a reasonable level. We had to keep a steady supply of shilling pieces as the weather cooled towards Christmas, and the gas metered heater seemed to have a voracious appetite.
At the end of an evening I would troop back to the underground and sit in uncomfortable reflective isolation, often gnashing my teeth that I could not get physically close to Jan with her sister sitting guard. The sap was definitely rising.
We did get out sometimes, going to the Tate or National Galleries, and may have gone to the cinema, though I have no memory of what we saw.
On one memorable occasion in, the two of us went out to dinner to celebrate Jan’s birthday. I had come across an advertisement somewhere for a restaurant called the ‘Tun O Port’, which advertised a free glass of port after your meal. In the way of all medical students, this deal seemed very hard to pass up. The restaurant was small and intimate, and we shared a main course of beautifully cooked and presented Chateaubriand, along with a bottle of Medoc. We took our time, enjoying each other’s company and the meal, but by the time we had finished the dessert, we were slightly ‘Brahms and Liszt’ to use the Cockney expression. We could not refuse the port, of course. We lingered over coffee, but eventually Jan had to go home, and did not want to miss the last underground; so we parted, and she went north and I went south. We both had study to be completed during Sunday before returning to College.
I am always aghast at my naiveté. I was not to hear the full story till many years later. Jan had caught the underground, but somewhere along the line had lost her ticket (or perhaps had forgotten to purchase one). Apparently she felt ill for most of the journey, and when she got to the exit gate must have looked very green and unwell. Despite her lack of ticket the ticket collector, recognising her state and the possible consequences, ushered her quickly through. Jan was ill for most of Sunday. On reflection, this is not a surprise. At 5 feet 2 inches, and only a petite 7 stone, Jan did not have the capacity for half a bottle of Medoc and then a port – even over a reasonably lengthy meal. Why it took me such a long time to learn that she could not manage too much alcohol, and that certain wines could provoke a migraine, I just don’t know. I suppose the classic medical student story was that if the girlfriend was a bit drunk, then conquest was easier. But at our age and stage and circumstance, conquest was never going to be a possibility. I eventually learned a special lesson in the long path to loving this special woman.
Christmas is always a special time, and luckily Reg and Bob had invited me to stay with them in Westgate (given I had nowhere else to go). I had organised a job with Margate Post Office to earn a bit of extra cash toward our planned Australia trip (if it happened). So I slept in the ground floor number 15 bedroom at the Kingsmead Court hotel on the sea front, while the rest of the family stayed at their house (‘SeaWhiff’) on Ethelred Road. Each evening, dear Bobby would make me a bacon sandwich and a thermos of coffee for my breakfast the next morning, as well as a sandwich for lunch. I would walk down the silent dark winter world of St. Mildred’s Road to the sea front, let myself into the empty hotel, and snuggle up in the blankets until the 5am alarm the next morning. Then fortified by the ‘buttie’, I would cycle several miles into Margate to the post office sorting office, collect my full bag of post and the post office ‘treadlie’ and cycle round my route until I had correctly delivered all the missives.
Back at the sorting office I learned how to sort the incoming post into all the labelled alcoves in preparation for the next day. I joined the banter of the regular workers, and made a number of special friends very quickly. However, on the third day I was taken aside quietly by one of them who told me I needed to slow down. If I worked too quickly, then somebody might end up surplus to requirements; I got the implied threat very quickly and slowed down.
Christmas ended up with the family driving up to Farnham to stay with Bobbie’s sister Sally and her family. Her husband Jack was a builder, doing very well; so much so that he owned a couple of racehorses. The house was very large, and had a stable and a couple of paddocks out the back with horses. Jan had had riding lessons as a young girl, but my horse riding had been limited to the donkeys on the beach. So it was a new experience to actually get up close and personal with an ex racehorse.
Jack was a very sociable and inclusive man with an ebullient nature. So the routine after dinner was for the men to retire to the study, and drink whisky and smoke cigars; much to my surprise, I was included. Both my parents had smoked, and I had taken it up as a student, so I relished the opportunity to experience the habits of the wealthy, fully imagining that one day, as a doctor, I would naturally be included in their company.
Shortly after our return to our respective colleges, we heard from the IUAC that our applications to spend the summer of 1963 in Australia had been successful. So a level of excitement recurrently threatened to derail the several months of study necessary to complete first year Uni. We had to plan jobs for the three months in Adelaide. Jan received a favourable reply from the Professor at the University of Adelaide Department of Biochemistry. I had been recommended to apply to the Waite Agricultural Institute a short distance into the foothills up the road from where my parents were living and would host us. Eventually I had a positive response from a Dr. Jim Silsbury, a senior researcher at the Waite. The job would be nothing to do with medicine, but everything to do with science and practical work.

Excited, and with passports and travel details organised, we settled back down to study, and the routine of our first year of University. The dream of exploring Australia was an immense reward dangling at the end of a string of lectures, practicals, tutorials, study and ultimately some trial examinations