Shifting Points of View: Things that Matter, and Fight Like a Girl

Emma Johnson attended these sessions at WORD Christchurch’s Shifting Points of View season on behalf of Booksellers NZ. All books mentioned are listed at the bottom of the page, and available from booksellers nationwide.

To the victor, history. To the dominant culture, the narrative. Under the dense coverage of those tales, others remain hidden. In the Shifting Points of View series, which WORD Christchurch is presenting as part of the Christchurch Arts Festival, other perspectives are brought to the fore for us to consider. The centre of the story moves – a centrifugal force of discussion spins us around to look outwards, to see things differently, to consider others, to empathise. Or even to act.

Set within the context of this age of efficiencies and disconnection, two very different sessions called for us to move beyond the insular to more connection – in the Galler session, as a means to change our modern healthcare system and in the Ford session, to counter both the furious eddies of misogyny online and perhaps the more pernicious ‘everyday’ sexism.

Things that Matter: Dave Galler and Glenn Colquhoun in discussion
GallerColqhoun-photoFine words, ‘nuggets’ of experience, and two medicine men came together on Saturday 2 September in an eloquent affirmation of humanity at the sold-out ‘Things That Matter’ session. Dave Galler, an intensive care specialist at Middlemore Hospital, wrote the book after which the session took its name, which sets out to demystify healthcare and encourage patients to play a greater role in decision-making. Here in conversation with Glen Colquhoun, a poet and GP, he called for a rethink of the modern healthcare system by widening the frame of reference.

Asked to consider how his growing up in Jewish culture in New Zealand informed his medicine, Dave was cautious in seeking cause for effect. His mother, an Auschwitz survivor, married his father in Israel, and they immigrated in the 1950s – leaving behind something that they wanted to forget, which pushed their children into assimilation; the celebration of Jewish culture was to come later. He traces his belief in medicine’s need for kindness to his parents’ profound warmth, in spite of their experiences. The Jewish traditions of scholarship, healthy debate and the expectation that your view will be challenged are apparent in his role as a natural advocate for change.

Recognising the interconnectedness of social systems and myriad factors that come together to express themselves in illness in Aotearoa, both Glen and Dave advocated for a holistic perspective and a need to look beyond the nexus of doctor and patient – both as a means to better identify the health system’s failings and to ensure its improvement. Glen put the questions on the table: ‘Is it the role of doctors to be political? Where does the duty of care extend to?’ As a GP, he sees the social causes of disease every day. Dave pointed to North American first nations people, and to Māori, as having the broader perspective that could vastly improve modern health care – one that is inclusive of spiritual wellbeing, of whanau, and of community. And having a purpose.

Our focus on technology and the body leads us to overlook other elements that are fundamental to our wellbeing. And this can be critical. ‘Those that recover in intensive care – whether they recover is determined by many things, but is heavily weighted in who they are.’ He also illuminated the broader costs of a healthcare system with a singular focus – those of lost opportunity and potential for many in deprivation, ‘the environmental equivalent would be our rivers’. He gave an example of a 19-year-old patient who had contracted pneumonia early on in life due to bad housing, who arrived at the ICU with an illness that would have given most people nothing more than a runny nose. Here he was on death’s door (thankfully he recovered). He was on oxygen at home – his life restricted, because of a bad start in life.

So, what do we need to do? Glen and Dave were in agreement. Start by moving beyond the ‘efficiencies’ of 35-patient rounds at the hospital and ten-minute doctor visits. Start rewarding kindness and empathy, because fundamentally medicine is about people. Create a system that rewards these values, that allows doctors to build up a body of knowledge and a broader awareness of community and family situations – these could save time later on. At the very least we need an honest sizing up of the need, and an acknowledgment that we do not have the resources to meet this.

Dave also called for a sense of purpose, because it gives you a way ‘to marshal your resources’, and then align policies across seemingly competing interests – ‘so that they do not cancel each other out’. His call to action was unequivocal: ‘We’ve got to demand this. If you wait for the government to solve your problems, you’ll be waiting a long time.’

In health, it is ‘values, empathy and kindness’ that we need more of. Connecting the parts to make a better functioning whole; shining the light on the bigger picture.

Clementine Ford: Fight Like a Girl

clem-photobook.pngBut sometimes shining the light on the smaller parts of a system is just as important. The formidable and funny Clementine Ford, journalist and feminist writer, called for this as a means to make visible seemingly innocuous systemic sexism, and as a means to undermine it.

Her book Fight Like A Girl looks to address the imbalance of power between the sexes, by taking power, because asking nicely won’t affect the system. And as in any power dynamic, the imbalance is benefiting one group – so men need to give up some of theirs. Her critiques, arguments and journalism have been dismissed (to put it kindly) by ‘men’s rights activists’ as ‘degrading to men’.

But this is exactly the crux of her point – this preoccupation with how men feel about feminism needs to go; they have been hogging the light for too long. In her second sold-out session at SPOV, she used ‘Hate Male’ – the deluge of abusive messages she has received over the years –  to ground her talk on the need to place women firmly at the centre of the feminist story. Unapologetic and unwavering, Clementine calls for us all to stop relating the discourse to men: there is no need to reward them for engaging in the dialogue, as it should not be about them.

The Hate Male collection aptly illustrated her point that women’s increasing agency is being met with a wave of vitriol in some places, most often by men who feel their worldview is threatened. Hardened, reactive stances emanate from behind the safety of their screens. The messages Clementine has received reveal that the current of misogyny runs thick and that there is a profound disconnect in this online world; but it also gives an opportunity to galvanize, for feminists to connect and to respond to these men with humour ‘by taking the rug out from under them’ in a very public forum. Clementine used humour extensively and extremely effectively to turn the tables on the abuse, draining it of its power.

cleminactionMany of these ‘men’s rights activists’ abuse her for getting upset about words – the old ‘Can’t you take a joke?’ is often lobbied in her direction. Yet, as she astutely points out, their words come in response to her words, ‘So who is really the oversensitive one?’

What is in a word then? The use of certain words aligns those who use them with a power structure and a rape culture, and other words empower others to stand up and call it out. Clementine calls for society to stop excusing behaviour and insults – the minimising tactics were seen here with the ‘boys will be boys’ approach to the Roast Busters. When the narrative makes such instances seem small or insignificant, it forms part of the cultural scaffolding that has made this okay, in service to patriarchy and rape culture (where those of privilege are not punished when it could impact their future potential).

It all starts on the small scale, an incremental chipping away at the power structure. Clementine furnished the audience with tips to combat this subtle, systemic sexism, which can be much harder to challenge than the ‘big ticket items’. When faced with a sexist joke, ask someone to repeat it several times or to explain why it’s funny. This shifts the spotlight onto them, and the onus to justify it.

Both sessions opened up new perspectives and possibilities to act. Both called for us to look beyond ourselves. Too often there is a tendency to place the self at the centre in the insular modern experience. But people like Clementine Ford, Dave Galler and Glen Colquhoun breathe life into the promise of empathy.

Attended and Reviewed by Emma Johnson on behalf of Booksellers NZ.

Things That Matter
by David Galler
Published by Allen & Unwin
ISBN 9781877505645

Late Love: A BWB Text
by Glenn Colquhoun
Published by BWB
ISBN 9780947492892

Fight Like a Girl
by Clementine Ford
Published by Allen & Unwin
ISBN 9781760292362

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DWRF 2017: Word Balm, with Glenn Colquhoun, David Galler and Sue Wootton

Available in bookshops nationwide.
pp_glenn_colquhounDWRFIt was a mild autumnal night as a nearly sold-out crowd of 100 or so ventured out to listen to three expert witnesses talk about ‘what literature can do for Medicine’. Glenn Colquhoun (right), David Galler and Sue Wootton all have experience in the worlds of medicine and words, and they were a thoughtful expert panel in consideration of this topic.

The three authors read from their work, with Colquhoun and Wootton sharing exquisite poetry that bridges what seems to be the divide between medicine and the arts, perhaps specifically the art of being human.  The final line of Colquhoun’s shared poem, written for a teenage client of his medical clinic, expressed with tenderness the remodeling or deconstruction that is perhaps needed when we think about illness and ill-health: ‘learn to love the broken bits’.

pp_sue_woottonSue Wootton’s poem ‘Wild’ was a reminder of what is at the heart of our human being: Measure my wild. /Down to my last leaf,/my furled, my desiccated. This deciduousness,/this bloom …’ The sharing of this poem followed a discussion of the clinical nature (sometimes thankfully, sometimes awfully) of medicine and the medical tests and interventions that come from living in a bio-technological era.

pp_david-galler_3_origA lot of the discussion was centred around how to gain/regain human connection in the medical world.  At one stage this dialogue considered the role of touch in the professions, and how touch can be more than just the corporeal laying on of hands, although that, too, was discussed as sometimes fitting. Galler (left) shared his experience of having a serious accident, and the recognition from the staff upon being admitted to hospital. They wanted to talk; he needed the morphine.  To Galler, the sharing of this anecdote expressed the subtle and artistic evaluations medical practitioners need to make in the moments, and how crucial and important these are to a patient’s sense of humanity. The ‘touch’ here could be in assessing with compassion what is most needed in the moment.

Glenn Colquhoun’s metaphor further exploring this, in which he compared his role as doctor with that of a surfer catching waves, was perfect; if you wait too long or take off too soon, you miss the wave.  This, he said, is like the art of listening that occurs in the relationship with a patient; you need to feel out when it is time to talk and time to listen; when it’s time to move forward and to move back.  Here, the ‘touch’ is in the words, or their absence.

I left the discussion wishing, as Colquhoun also mentioned, that the medical world was not so separate from the human, everyday one we exist in. If, as he says, the ‘white walls and white sheets’ could be or become more integrated with our lived experience, perhaps it wouldn’t be such a scary and sometimes isolating place to inhabit, as we all inevitably do, either as patient or family member.

Event attended and reviewed by Lara Liesbeth on behalf of Booksellers NZ

Word Balm – An event at Dunedin Writers and Readers Festival 2017
Featuring Glenn Colquhoun, Sue Wootton and David Gellar 

Programme for the DWRF, running from 9 – 14 May

AWF15: Atul Gawande interviewed by David Galler

‘Thou shalt not kill; but needst not strive
Officiously to keep alive…’

pp_atul_gawande

Arthur Hugh Clough had it poetically straight in the early 19th century, but with modern medicine we now sometimes expect miracles at the end of a scalpel or the syringe injection of a new drug.

But surgeon and medical writer Atul Gawande questions if we are asking patients the right questions to discover what outcomes they wish for; his own father when faced with problems said a good quality of life would be being able to sit around the dining table, eating and conversing with friends.

Gawande thinks it is important that the right questions are asked about end of life care, he told a packed three tier audience in the ASB Theatre in discussion with ICU specialist David Galler.

An important anecdote: when one group of prospective knee replacement candidates had discussion with their doctors only about the medical procedure, most chose to go ahead. But when a similar group were given the same information and were also asked about the outcomes they wanted from surgery, fewer opted to go ahead.

A highlight was the tale of a zoo let loose in the residential nursing home. Plants and pets are part of most homes, so it was argued why not in residential care? Great plan, but having a large number of parakeets delivered before cages were constructed caused temporary chaos. However long term results saw happier, more engaged residents taking dogs for walks, cuddling cats and feeding the birds… as well as becoming more active, more engaged and needing dramatically fewer medications.

Gawande writes incredibly well – as a medical columnist for the New Yorker his apprenticeship under a tough editor the many rewrites he was asked to make, see his literary skills matching medical ones.

A postscript discussion by the two doctors talked about the surgical theatre check list system initiated at the Boston hospital where Gawande works which is now used internationally in many hospitals,including Middlemore, where Galler is based.

Reviewed by Jillian Ewart