Doctors in rural areas

of Downunder face challenges that other general practitioners do not. They often have to work alone. They need some anaesthetic and obstetric skills their city colleagues are not expected to have. They need surgical skills and much more.
It is little wonder they are in short supply out there.
When I was born my parents lived in a small rural town north of the city. It was big enough to have a small hospital and I and two of my three siblings were born there. After I arrived my maternal grandmother came to "help" my mother for a short time. When my siblings were born my paternal grandmother came to care for me and then my brother and me until my mother was permitted to come home with Middle Cat. In those far off times women were expected to remain in hospital at least a week after birth. In rural areas it also meant that women did not go home to an isolated farm  immediately after a birth. That was probably no bad thing.
It's different now. It is unlikely that a hospital bed would even be available. Any doctor would be agitating to get a healthy woman home because the bed would be needed for other purposes. The growth in rural services simply hasn't kept pace with the need.
And other things have changed too.
When we moved to the tiny place where my parents had the two teacher school my mother was just returning to teaching full time. She was required by law to undergo a medical examination so we all went to the nearest doctor. That was a one hundred and twenty kilometre round trip. 
My mother had made an appointment - or so she thought. She had rung and spoken to someone who said, "doc's out. I'll leave a message. If it's not convenient he'll get back to you." That was the way things were done. 
When we arrived he was there - doing something to the plumbing outside. He heaved himself out of the trench looked at my mother and said something like, "You better come in. Can't do it out here."
We later heard tales about this man. We met the man whose life he had saved doing what was effectively open heart surgery under the light of car headlights and lanterns on the side of the road. We heard about the time he was stopped by the police for speeding on his way back from the city. His response was apparently "Get out of my b......way. I've got a patient dying back home and I'll go as fast as I need to save him." (This was reported not by him but by his passenger - somebody he had taken to the city for urgent treatment.) The police let him go. 
There were other stories too. He made no secret  of the fact he had no time for my mother's Christian Science beliefs. He could be rude and was often abrasive. He was a man who was under stress although we children would not have understood that. 
Now the same town is twice the size and they can't get a doctor to stay. They have tried offering free accommodation. They have offered more staff and equipment for the tiny hospital. Doctors don't want to go. The pay isn't good for the hours and responsibility involved. The insurance for potential litigation is too high. A fly in fly out doctor once a week earns $2000 a day - when they can get one. 
All sorts of things have changed. Yes, a doctor can get back up help via computer and video link if the system is working but they need skills that can take  years to acquire - and they have the costs that go with it. Medicine is much more complex and demanding. There is a great deal more paper work. There are far more rules and regulations about what can and cannot be done.
The doctor back then dealt with mental health issues in his own way.  He prescribed things other than pills to help his patients. He would "drop a word" to the priest or the minister or the football coach that someone needed a bit of extra time or help. Breach of confidence? Perhaps or perhaps not - but people were getting support they needed. Now it could not be done.
Perhaps that is one reason why it is so difficult to get doctors in the bush now. But, if you know anyone who wants to take on the responsibility, then let them know please. There are vacancies in the bush.

A flat battery

is not something anyone wants. 
There are more batteries around these days. My cheap watch has one. The watch cost me about $5 from Woolies. It is cheaper to buy a new watch than replace the battery. (I have a better watch which you actually wind but it was a present from the Senior Cat and is reserved for "going out".)
There are batteries in things like that now, things we would not once have ever thought of as having a battery - unless you are under 21. There are batteries in the Senior Cat's bedroom clock and in his hearing aids. (He hates changing the batteries in those - another excuse not to wear them.) I remember the batteries for the hearing aids worn by the children in the nursery school. They wore them in a pouch on the front of their clothing. I remember having to finger spell things to my friend J.... because the batteries had failed on hers and her choice use of Anglo-Saxon words to describe their failure. 
There are batteries in this and that and something else. Some of them are rechargeable and some are not. (The battery which opens the bin Middle Cat gave us for Christmas is not rechargeable. I may just forget to replace it when the time comes. It is still irritating me.)
A friend of ours wanted to put a small electric motor on my trike. I presume that would have meant a battery as well. It doesn't matter I told him "no, I need the exercise" and, for me, it was just another thing to go wrong.
And that is a bit the way I feel about electric vehicles right now. I know there is a push to get more of them on the road, that they are seen as clean and green and far less polluting but...
The current Leader of the Opposition - soon to be Prime Minister if the polls are to be believed - reckons half of all vehicles on the road by 2030 will be electric under his government. He also reckons it only takes eight to ten minutes to recharge the batteries.
He's wrong, seriously wrong, on both counts. The cost of electric vehicles still puts them out of reach of most people. Less than 5% of cars on Downunder roads are electric. The take up rate is going to have to far exceed anything that has so far happened in the car industry. What is more Tesla is struggling to produce their cheaper version.
One of the problems is that it takes at least half an hour to partially charge the batteries. It isn't like pouring petrol into the tank. It isn't something that can be done on the road if you happen to run out of fuel. It takes some hours, generally overnight, to recharge the batteries.
I have no doubt that these things will improve. Prices will fall as the vehicles become more common. There will be improvements in technology which will allow a much faster recharge. Perhaps we will have the roof of the car covered in solar panels? Mind you that will only work if the sun is shining.
All these things remind me of a toy the Senior Cat made for one of Middle Cat's nephews by marriage. He was not quite three at the time and the Senior Cat had made him a little maypole like toy with four cars on it. You could take the people out of the cars. You could twirl the ropes around and then get them to swing back. J.... was having great fun with it but he was also puzzled. He kept picking it up and looking underneath it. 
We realised then that he was a battery-age child. He was looking for the battery. 
J... is an adult now and still has the toy. He's saving it for his own children. "They will be really puzzled."
Yes, perhaps they will be for a while - but I hope it fascinates them.
Their children will probably stare fascinated at a diesel engine and wonder how people ever used them. 

"No, I am not going to volunteer"

I said this to the person who had just asked me to volunteer to do something.
    "But Cat..."
    "I am not volunteering."
I am one of those who, when volunteers are called for, meekly put their paws up - or feel wretchedly guilty for not doing so but  yesterday's request was not one of those times. I
It made me think about volunteering yet again. It is something I think about quite often. I think about it when I go into the local charity shop because the volunteers in there are almost all very elderly. Several of them are 90 or more. They spend a day there once a week. It's hard work. They are getting tired.
I saw P.... there yesterday. 
    "Hello dear.... did B.... call you in?"
I nod and slip through to the back room to find B...  The person wanting help hasn't arrived. That happens. We are used to it. I wander off to look at the books and see if there is anything there the Senior Cat might want to read. The boy wanting help does arrive. There is no apology for being late. He doesn't want to be there. He's nervous and ready to fight any hint of being told what to do. He says defiantly,
     " I suppose you think I'm stupid too. Everyone thinks I'm stupid."
     "No, you got yourself here. That makes you smart in my book."
He can't read. He can't tell the time. He has no family and he is in danger of being kicked out of his group housing because he keeps getting into fights. So far he has somehow managed not to be in serious trouble with the law. I've been told all that by his case worker who is trying to keep him out of trouble.
But I seem to have given him the right answer. He wriggles. I ask a few questions about what he likes.  Unlike most boys in his situation he does not like football. He likes animals. He'd like to have a dog but isn't allowed to have one. No, he wouldn't like to have a dog he would actually like to have a lot of dogs. If he could have a job he would like it to be outside and it wouldn't matter what the weather was like. He hates school. They make fun of him there so he keeps being suspended when he hits back. 
We go on. His answers are largely monosyllabic unless he is talking about dogs he has met and seen. He thinks guide dogs and assistance dogs are "cool" and other working dogs  are too. Has he ever talked to anyone about this? He shrugs. I take that as a "no" so I say, "How would you feel about volunteering at....."
I mention an animal shelter I know might take him on.
     "Nah, they wouldn't want me."
     "Well actually they might. I know they are looking for someone who can help do the mucky stuff but who might want to help with..."
I get no further.
      "You serious?"
I nod.
He slouches further down in the chair and swears under his breath.
He's thinking about it. I say nothing.
     "Can I go have a look?"
     "Sure. One of the men is going over a bit later. You could go with him if you like...just have a look."
     "You got it all planned then?"
     "No....entirely up to you."
     "Think about it," he mutters not quite ready to give in easily.
He went. He might stick it out. 
I have no doubt he is not stupid. He is profoundly dyslexic but he can apparently understand "canine" and "feline" and various other animal languages. The manager of the shelter left me a message telling me that the animals had responded to him immediately - in ways they don't often do with other volunteers. Did I want to volunteer there as well?
No  - but they need him. I hope he realises he needs them too.

I had a "letter to the editor"

published in the paper the day before yesterday. Yesterday someone responded and criticised me for what I had said. You have to expect that when your write letters for publication like that.
The problem is that the writer had completely missed the point of what I was saying.
It is of course difficult to argue your case in a very limited number of words. The state newspaper likes short letters. They suggest that around 150 words is good but they will go higher - to around 350 if they think the topic is worthy of attention. Occasionally there will be a letter longer than that. Brevity though is the name of the game. Writing letters to the editor is quite unlike writing most letters. They are rather like writing letters to politicians and persons of importance. Yes, I have had more than a little experience of that.
So, this letter to the editor was about the Opposition Leader's pronouncement that, under his watch, 50%  of all vehicles on the road would be electric by 2030. They won't be of course. Downunder is too vast for that. People travel too far. People are not going to be prepared to wait even just thirty minutes to recharge the battery when they can "fill up" and leave in five. 
At the present time electric vehicles are much more expensive. I assume that the cost will drop as more people buy them. That should also bring manufacturing costs down. I have nothing against electric vehicles. They probably are the way of the future - in urban areas.
But, realistically, they have a long way to go in rural areas. The cost of the number of strategically placed charging stations which would be needed (and the maintenance of them) would be astronomical. Yes, you could have a charging station on the farm but will the combine harvester last all day? Now all the farmer has to do is take the fuel to the harvester and go on working. 
And of course there will be an increased demand for electricity - far more than what is currently estimated to be provided from renewable sources.
Is all this impossible? If I can think it then presumably it can happen.
But my letter suggested something else. It suggested that if we are actually going to meet any of the set targets then we need to change the way we live. 
I know when I go to do the weekly supermarket shop this morning I will pass cars parked on the road near the railway station. These will be people who did not get a park in the station car park. At least they will have used the train for part of their journey to work. They will have been passed by hundreds and thousands more people who will sit alone in the car they use to travel to work. That car will then sit in a carpark all day. At night the driver will once again, and alone, do the return journey. 
The cost is high but they look on it as more "convenient" than public transport. I know people who live within fifty metres of a bus that would take them almost past their workplace but they choose to drive to work.
That is one of the things that needs to change if we want to combat the problems associated not just with climate change but higher density living. We simply can't afford to allow people who have the capacity to use other means of transport to go about alone in steel  cages. 
And this isn't just for reasons associated with the environment. Our current love affair with the car has had a negative impact on our mental and physical health. Add to that the increased automation of the workplace, the capacity for some people to do increasing amounts of work from home, the increased time spent staring at screens for entertainment and more and we are growing more isolated from each other. 
Of course cars are sometimes essential. They are also essential for some people, particularly those who would otherwise find it difficult to move about.  We need to be aware though and not be led to believe that a shift to electric cars is the answer, or even part of the answer, to a problem which needs to be rethought and which will involve other changes to the way in which we live. 
Or have I got this all wrong?

The Budget is out

and contains no good news for me or the Senior Cat. This is because he gets "government superannuation". It sounds good but in actual fact some people on superannuation would be better off on the pension.
The Senior Cat is fortunate in the sense that it is the "old" scheme. When he started teaching it was a "pound for a pound" - that is, he if he put a pound into the superannuation fund then the government put a pound in as well. It sounds generous and in many ways it was.  When you retired the scheme paid you back - for as long as you lived. 
The Senior Cat has done rather well out of it I suppose because he is now 96. There are very few people left on the "old" superannuation scheme. It didn't take the government too long to discover that they could not afford to keep this generosity up. 
But was it really so generous? For the Senior Cat it wasn't  in the sense that he spent almost his entire teaching career  in rural areas. He was forced to rent government provided  housing while people in the city had mortgages and were paying off their own homes. The housing provided was - shall we say - interesting. The houses were either fibro-asbestos or weatherboard. The first one was probably very good for the time in which it was built. There were eight of them built  in two rows of four each...for the teachers and the electricity and water supply people. Those houses are still being used over sixty  years later. By now they look "tired" to say the least. I can remember ours quite clearly. There were other houses, one built on land which had not been cleared properly. There were trees struggling to grow under the house - the snakes loved living there. The house had not been built according to plan either. My sisters and I slept on the floor all the while we there because  they could not get the beds into the bedroom. (Someone suggested bunk beds but my mother was having none of that.) My parents had two single beds in another room - they slept toe-to-toe and only one of them could get dressed at once. It was a "new build"  but the "Public Buildings Department" condemned it after we had lived in it for two  years. Still, the Senior Cat had to pay rent.
And there was another one of those fibro-asbestos places where they had to take out a window and put the furniture through that way because it too had not been built to plan.
My parents were retired before they had their own home - the one the Senior Cat and I now live in. He doesn't want to move from it and we children will do everything we can to keep him here.
I thought of all this as I glanced through the budget material in this morning's paper. We are due an election in May and all the signs point to a change of government. The incoming government will slash the Senior Cat's "pay" even further - just at the point when he needs it. He can't do the maintenance he once did and neither can I. We will manage but the likely incoming Prime Minister who has twice married into money and is extremely well off himself keeps saying that those with superannuation can afford to pay more - all of course but himself. When he retires he will retire under  his old scheme as well - even more generous than the one the Senior Cat once had. 
If it wasn't going to be that way he might think differently.

The lunch box police

are at it again. 
A small boy I am acquainted with came home from school in tears because he had - wait for it - a chocolate biscuit in his lunch box. He also had cheese, carrot, and celery sticks, several cherry tomatoes and some home-made seed and nut biscuits (crackers to my US readers). There was a banana too - but that didn't fit in the lunch box.
His teacher told him - in front of his class mates - that he could not have the chocolate biscuit. It was "unhealthy food". She took it from him and told him he could have it back after school.
His mother, who is very careful about what children eat, is furious. The biscuit was a reward for having spent a considerable time genuinely helping an elderly neighbour clear up some leaves and other detritus.
T's school has gone overboard on what can be consumed at school. The school canteen only sells "healthy options". The result has been that the canteen is now used less than it was. Older children are apparently becoming adept at hiding their "less healthy options" from their teachers but T.... is too young for that - and he shouldn't have to do it any way.
I know we have an obesity problem but taking a chocolate biscuit from a child is going too far, much too far. T... has not liked school much so far and now he doesn't want to go at all. When I saw his mother she was about to go and speak to the teacher. She had given herself the weekend to "cool down" but I could see she was still fuming. 
    "Let me know how you get on," I told her knowing that she would need someone to talk to.
She called me later and was, if anything, even angrier.
    "She told me that the children had agreed they wouldn't have anything unhealthy in their lunch boxes. She said T.... broke the rules and she had no choice but to take it away and let the other children know. That's absolute rubbish. I don't mind them knowing about healthy options but five year old children can't control what is put in their lunch boxes!"
I agree.  
I asked her how he had been at school that day. He had not wanted to go and the teacher aide in the classroom (there's a severely intellectually disabled child in the class) told his mother that he had been very quiet and that he had been subjected to some remarks about food at lunch time. The remarks weren't unkind but they still upset him.
She left me an email a little while ago. T.... doesn't want to go to school at all today. He's apparently crying that his teacher doesn't like him. He doesn't want to take any lunch to school. 
All this over one small chocolate biscuit. 
T.... is a nice child, a particularly nice child. He likes to help other people. He is well on the way to being able to read. His parents have strictly limited his screen time and he plays some wonderful creative games. He is the only child and, although they would have liked another, there won't be any more. Until now he hasn't been a problem at all. 
His father will be back from an interstate conference today and I hope they can sort the problem out.
But, there shouldn't be a problem. Even if T....had gone to school with nothing more than a jam sandwich - something the teacher would no doubt consider "unhealthy" - he should not have been humiliated in front of his class mates.
I wonder if the teacher will ever realise how much harm she has done?

Fear of climate change

is being used to try and win the upcoming Downunder federal election.
It will probably succeed. One of the latest "policies" is that there should be 50% electric cars on the road by 2030 - presumably powered by electricity produced by renewable energy sources.
That appeared in the paper this morning - along with a story about residents in the mid-North of this state being concerned about the potential appearance of wind turbines on the horizon. 
I foresee problems ahead.
I have never owned a car. I don't know how to drive. I avoid using other people's cars unless I must. There are  people who tell me, "But Cat we would give you a ride."
Yes, I know they would. There are times when I would like to accept that ride. Occasionally, very occasionally, I do. I will accept a ride if it is too far for me to pedal, if it is night time, if they are also taking the Senior Cat, or I am doing something for them. When it is too hot, pouring with rain or windy or both, then  I might consider it  if I know I can repay them in some way. Other than that I will pedal thank you. 
It isn't that I want to pedal - although I know the exercise is good for me - it is because I am well aware that there are people who have got themselves into the situation of taking someone somewhere on a regular basis and then been expected to go on doing it long after it has proven convenient to do so. If I do accept  a ride then I expect to fit in with the person giving me the ride. It is my responsibility to be ready when they want to pick me up and to be ready when they want to leave the venue. 
And perhaps it needs to be more like that with other people. Perhaps they need to think of public transport like that. Public transport isn't there for them to come and go as they choose. You have to fit life around public transport. If people thought like that then there would be far fewer cars on the road. We might reach that 50% target of electric cars too. We won't the way people view cars now. 
If there was more demand for public transport then it would become more frequent. It would be more convenient. It might run more often and at times when more people wanted to use it. 
Instead of thinking like that, instead of getting vehicles off the road, the almost-certainly-incoming-government is using fear of climate change to introduce a policy which will have a negligible effect - if any - on the earth's atmosphere. 
It sounds good but it isn't the answer to the problems we are facing. We need to use cars less. We need to use public transport more. We need enough people to use it that it does actually get cars off the road.  When we do that then there might be other advantages too.