Sunday, July 22, 2007

Australia’s Indigenous Women Explorers

It’s one of those stories that has been told in bits and pieces but those who’ve had a whiff have followed its trail like a hunter chasin’ a ‘roo.

There’s the official story of colonization on South Australia and Western Australia and then there’s this other story. Rebe Taylor tells the story of Kangaroo Island in her masterful local history “Unearthed: The Aboriginal Tasmanians of Kangaroo Island”. Sarah Hay created a fictional version of the sealer gangs on Middle Island near Esperance in W.A. in her award winning book “Skins”.

Julie Gough got in touch with me a few years ago because she was tracing the path of her ancestor, Woertomenyer from Tasmania. Her story and the other stories told and untold is of the diaspora of indigenous Tasmanian women in the early part of the 19th Century.

“It was a fact of Tasmanian Aboriginal culture that the men seldom learnt to swim: when they needed to cross a body of water, they were often ferried on rafts by the women, who were proficient swimmers. The Aboriginal men were therefore of limited use as labourers to the sealers, but the women proved to be invaluable” Terry Crowley, “Tasmanian Aboriginal Culture”, in Language and Culture of Aboriginal Australia, eds. Michael Walsh & Colin Yallop, Aboriginal Studies Press, Canberra, 1993 p. 58

As Rebe Taylor points out, the idea of sealers as wild men who abducted these women was at least partially a 19th Century invention and only part of the truth.

Indeed, it’s a fact of Australia’s colonial history that Tasmanian indigenous women were present with their sealer men at the first settlements of South Australia and Western Australia, at Kangaroo Island and King George’s Sound respectively. Woertomenyer who was present at King George’s Sound in 1826 eventually travelled on to Mauritius, Sydney and back to Tasmania. Other’s like Towser and Eliza Gamble settled near Albany and have descendants in wadjila and Noongar communities.

Julie Gough will be in Albany on August 24th where she will join others for an informal discussion and conversation, “Sealing days in Southern Seas: Aboriginal and non-Aboriginal Stories and History of those waters”. Location: Albany Public Library, time: 10.00 am.

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Dodging the bullet - part 2

I’m a bad patient – being an ex-nurse, that’s regarded as a truism – but I’m also impatient, not a patient that I’d like to nurse. I was reassured by a kindly nurse after 11 hours of surgery that everybody loses it after a few days, simply from the lack of sleep. I still had to apologize to a couple of nurses because I arced up at them – such is the interpersonal cost of anger(as my counsellor and friend would say).

But I think sometimes it’s worth being a bad patient because there’s a lot of bad medicine around out there and as a patient you are on the bottom of the heap. Being hospitalised is the medical equivalent of being certified, you have no rights except those that you can assert for yourself. That assertion inevitably involves you treading the fine line between aggression and tears, between resignation and anger. For me, it involved a lot of praying to get through the pain and discomfort and to manage the emotional turmoil of helplessness – besides which the Bible was the only book available, and you could read it in disconnected passages – why not the Koran, the Dhamma sutra, the tao te ching? Never mind, the Bible is at least as worthy of attention as any other great religious text and there is considerable comfort for the helpless to be drawn from it’s message of love and faith. A prayer or a mantra is something that the mind can cling on to when the seconds seem long.

Then there are finally those moments of grace when you look out the window and realize that you have survived and that the world is shining and beautiful. The sigh of relief and the prayer of thanks when the surgeon comes to you after a week and says that the microscopy has confirmed that, ‘we got all of it’.

There is nothing that can prepare you for the shock of major surgery and the physical cost of recovery. Even 6 weeks later I am still weakened and tired – the process of recovery is a gradual thing clawing back a bit of strength day by day and some days losing out to sleeplessness or complications.

Speaking of complications, one should avoid Friday discharges from big city hospitals especially if you are going to fly off to a country town as I did. It seems that there is an inevitable cost of iatrogenic disorders that accompanies surgery, something that was feared in the 19th Century and earlier times, but which it’s my experience has not changed today. I have learnt the hard way to assume responsibility for my own care because leaving it up to doctors or nurses simply leads to bungles and troubles.

Arriving home on a Friday, I stayed with friends that night and broke out in a massive sweat that night. By Saturday night I had borrowed a thermometer and confirmed that I had a temperature of 38.1. So after speaking to the surgical ward in Perth I took myself to the local Casualty department to try and get admitted. Bad move. I got sent home with a couple of flucloxacillin tablets, ‘come back in the morning’, this despite the fact that I had a discharge summary that was less than 48 hours old. So I come back in the morning, after another sleepless night. Bad move. The doctor on call, is not my GP, but one known to have a terrible reputation. Fortunately the nurse in Causalty is one of these true heroines of nursing. She’d seen me the night before but had been on triage and was ‘pissed off’ that I’d been sent home. Nevertheless, with a combination of guile and skill, she got a cannula in my arm and a dose of IV antibiotics and persuaded me and the (bad) GP that I should wait until Monday to get admitted under my own GP. ‘hospitals full’, she said. There was a remarkable number of empty beds when I finally got admitted on that Monday! But I’m eternally grateful for the white lie, I saw the GP in question deal dreadfully with a young man in the bed next to me during the following week.

So I sat outside my GP’s office on Monday morning – ‘give me the hard core antibiotics or I will kill you’ – I’d had 3 sleepless nights by then. Well he did, and while he was at it he wrote me up for some hard core analgesia (oxycodone) without asking whether I was in any pain. It was an instruction from the surgeon in Perth. Pack drill.

3 days later I partially dislocated(subluxed) my shoulder trying to turn over in bed having been frozen in position as I nursed my precious cannula (that nobody wanted to replace with a proper line) and doped to the eyeballs it was remarkably easy to do. I felt the snap and some discomfort but the next morning my mind was distracted from this by the fact that the cannula had finally tissued. These days they allow nurses 2 goes before calling a doctor to insert an IV line. Of course they don’t have specialized nurses in country hospitals who do this all the time. It’s a skill that only comes with practice and it’s the patient who gets to experience their sporadic practice. This is called improving patient care.

The next day after having dealt with my constipation caused by the combination of iron and oxycodone. ‘Yes I can administer my own suppositories’. I decided to refuse the oxycodone –‘We thought that was brave Bob’ – she said 2 hours later as my back went into spasm. It took me 24 hours to work out that I’d had enough oxycodone for my body to think it was a habit. The GP (not my GP, just one from the group practice) had decided that I could go home on oral antibiotics. I had decided that I was going to ‘cold turkey’ off the oxycodone. So I went to my friends place and threw myself into some intense rounds of Chi Kung – the first that I’d been able to do in 3 weeks – took aspirin and fought the demons through the next couple of nights.

I recalled my time back in 1974 when I had helped establish We Help Ourselves(WHOS) in Canberra. I was never partial to heroin but as a social activist I had witnessed the death from an overdose of a great poet, Michael Dransfield. WHOS was astarted by ex-addicts prior to the widespread use of methadone. It had two rules - cold turkey is the only way to go and if at first you don't succeed you're doing about average. I made the mistake taking some panadeine on my first night and after whipsawing into convulsions I recalled those two rules to my friends and my mum the next morning who were still putting me up and putting up with me . I wanted nothing more than to return to my own house with it's trees, bandicoots, birds and Ebony, my rat-hunting cat.

And God provides. I finally got into my own home, which had been cleaned and renovated by my friends who had come together over the previous weeks to support me. I was overwhelmed. One of my Noongar friend’s had found a black beanie, with yellow and red bands and it was lying next to my computer as I walked in the door. It has hardly left my head since then – the strength of the Land is with me. I settled down to endure a week of painful sleep management with a painful shoulder that I had no diagnosis for.

Ah but “ Can’t do that, computer says no”, we can give you plenty of drugs but anything that involves real people and real help is another matter. The surgery had left me with no teeth and one side of my face paralysed and I was unable to eat properly or speak without spitting. It took 3 weeks of asking before I got to see a speech therapist and I couldn’t get a physio referral at all and ended up paying a private physio to diagnose and treat my shoulder. Hard if you’re living on a pension and have no car.

I’ve had great support from friends and family and from a few heroic nurses who really care and who are better at working the system than me (and I've been sustained by my daily Chi Kung regimen). But I wonder how people who don’t have my knowledge and my network survive.

I’m about to go to Perth for 6 weeks of chemotherapy and radiotherapy and I discovered yesterday that they hadn’t removed all my teeth as I was told. I’d been dealing with a recurrence of candida (thrush) in my mouth which should have stopped once I finished taking antibiotics. So I was having a good look and I find a dead, infected molar in my remaining upper jaw. So when I go back to Perth tomorrow I expect I’ll still be a bad patient demanding it’s removal before they start and screw up their precious timetable and I expect the computer will say no. But I intend to live and survive so I’m damned if I’ll be a good patient and lie down and die. Not just yet, anyway.

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Monday, July 16, 2007

Dodging the bullet – part 1

“Well, is it stage 2 or 3?” I asked, trying to sound knowledgeable. He looked at me gravely, “It’s stage 4, it’s into the bone you can see here.” he said pointing to the Cat Scan of my jaw that we were looking at.

“So what are the odds?”

“60% survival in 5 years” he said. It was not good news, but he didn’t beat around the bush and he offered a means of beating the odds.

“ I’ve seen head and neck surgery back in the late 70’s and it wasn’t a pretty sight” I was pretty dubious. In those days a flap from your shoulder was grafted in place of the missing jaw and you sat in ICU for weeks. Not a pretty sight and survival was not good.

“Things have progressed since then. We take a free flesh graft from your arm or leg and micrograft a vein and artery into the blood supply of your face. Survival rate from surgery is about 95%“

Well, that sounds a bit better I thought and the quiet professionalism and honesty of this ENT surgeon was making an impression. I could work with this man I thought. Up until now, I’d only had a diagnosis that had made me contemplate the most painless way to shuffle off my perch. Here was a lifeline.

“You’ll need radiotherapy afterwards. It’s best if we take out your teeth as they’ll be affected by the radiation” Well my teeth were rotten anyway and it was my persistence at pursuing the lack of healing following the removal of a wisdom tooth that meant that we had got it early.

“Your lucky in that respect.” It had only spread into my lymph glands in the last month or so and since I’d moved across the demarcation line from dentistry to medicine things had been moving fast.

“We’ll get dentures for you in 12 months time” Something to look forward too.

So I went home for two weeks and threw myself into an intensive program of Chi Kung and prayer. For the last 5 years I’d been coming to terms with the manic depression that had ruled my life. Up until I had sought counselling I had ridden the ups and downs through of political activism interspersed with black periods of despair softened by alcohol and marijuana. I’d given up cigarettes 20 years ago and gave up alcohol as part of my personal deal to seek counselling and I had been ‘quitting’ dope, having longer and longer dry periods during my counselling. So that by the beginning of this year I had enrolled in university and I was set upon reinventing myself. I had learnt to control my agitation by self medicating with Valproate after going through the retinue of antidepressants.

But nothings ever easy and postponing my exams to have surgery seemed like the least of my problems and deciding to never touch dope again was the easiest of decisions. There is something about the threat of imminent death that sharpens the mind wonderfully. I threw myself into finishing off my essays and coursework. I managed to get into a recording studio for 2 hours and record 19 original songs before I lost my teeth and worse. I’d had numerous goes over the years and always given up because I couldn’t stay in tune or stumbled over a beat. This time I didn’t care it was just get them down it’s now or never.

copyright British Museum of Natural History

In the last few days before I left for Perth, I managed to get up an exhibition of a selection of never seen paintings from 1840. They’re 65 water colours done by Robert Neil of fish and snakes caught with the assistance of half a dozen Noongar men. Each drawing had the Noongar name for the fish, as well as the Latin name, and where he knew it the sealer’s name and the settler’s name. 4 different languages came together. It had taken me several years to track them down and get them photographed in the British Museum. There full publication is a project for a cancer survivor.

I was as ready as anybody could be to dodge the bullet.

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