47 The Wolf
Amanda continues her exploration of Stephen Jenkinson’s sublime ‘wonderings’ while experiencing life in WA’s ‘best’ rehab public hospital. She worries about the quality and relevance of the physiotherapy and Occupational Therapy on offer and tussles with her own tendency towards being institutionalised. While feeling defeat by the huge bureaucracy devoted to disease, she finds solace in the dusty, neglected zones and the workers-with-heart who sustain humanity in the face of a system hollowed out by small-minded economic thinking.
Stephen Jenkinson asks the question: What keeps the deer healthy?
Answer: The wolf!
I am captured by this thought. Here’s how I look at it: for a deer to be wolf-fit she has to be strong, swift, alert. To know every inch of her terrain and how to work it to her advantage – and of course, to know everything there is to know about the wolf and its habits. How, when and where the wolf will hunt and what are its strengths and weaknesses in its capacity to catch the deer.
To be truly useful, this knowledge must be shared with the other deer, to spread the chance of survival. All data about wolf must be reviewed and constantly updated according to the conditions that prevail at any given time and place. Deer watch each other’s back within their community and with the help of other wolf-ready species.
The Fallacy of Safety
And the deer understands that the wolf is a fixture – not something that will be eradicated in the name of safety. And this begs the question: WHAT IF WE TOOK AWAY THE WOLF? What would change for the deer? They could, arguably, become complacent in an environment that holds no terrors. Without enemies they would breed up and start impacting their environment in damaging ways. They deer could lose access to the full strength and power of their wild and alert instincts in the face of a demonstrably safe environment. They could become fat, unhealthy, institutionalised and eat themselves out of house and home creating a world that becomes imbalanced.
Oh hang on, that sounds familiar. I could be anthropomorphising here. Turning these poor Wolf-less creatures into a bunch of first world neurotics
What is our life if we insist that safety – as defined by wolf-lessness- is the most important consideration? Well, it’s a fairly unbalanced way of looking at things considering there is no safety. The deer know that. WE, as in we humans, know that.
Even though we have banished the wolf in many areas, have freed ourselves from any need and most of our capacity to pay close attention to our environment, the concept of safety is always elusive. We still have our minds with an ability unmatched by any other species, to worry about stuff that hasn’t happened, to project fear into potential futures, and to obsess about the undigested events of the past.
And for several years now we have an invisible wolf, in the form of a plague that has been loosed upon us. This leads me to think that getting rid of the actual wolf has led to the unloosing of a more problematical monster.
Do we know in our hearts that life is not ours to command? Spending a fair amount of time in a nursing home is a way to hammer home the thought that life is a mystery carried by the breath, a spark we borrow for the lifespan of our frail human carcasses….
The Traffic Lights
Before, I used the term ‘institutionalisation’ talking about deer living in an environment cleared of enemies. This word kept popping up for me as I drove through city traffic the a few weeks ago to visit my father at the Osbourne Park Rehab Hospital. This was a journey I did every day for nearly a month from mid- November into December. It was a 40 km round trip from his flat, often through heavy traffic. My sister, fully connected to the rhythms of the city, eats miles like this. I was the suffering regionalised one.
During this time, every Wednesday for my sanity, I took another journey through the city – 12 kms down to Hilton to go to a Conscious Movement class. On one of these evenings toward 6pm I was heading south on Carrington St, a main road, and approaching South Street, a major east-west artery. I twigged there was something strange going on at the intersection, and I worked out quickly that the traffic lights weren’t working. My first reaction was mild panic. But I had no choice, I couldn’t turn around, so forged ahead, and it was the strangest of dances I had with the lanes of cars and trucks I had to negotiate.
All drivers had to suddenly pay close attention to everyone in a 180 degree negotiation. I went from robot to living-being in a heartbeat! I used my hands and facial expressions, crept forward, held back, mimed respect and sensitivity and a sort of comic apology to the drivers on my right and others on my left whose own efforts to cross I might have been foiling as I moved cautiously across the intersection. I made it safely to the other side – with a big smile on my face – mission accomplished.
It shook me out of robo-land, the land of institutionalised, controlled behaviour. For those few minutes I became fully alive and engaged rather than being moved by mechanical directives, where if I was not exactly asleep at the wheel, I was certainly on automatic. What an extraordinary feeling! It made me reflect – not for the first time - how much of my life is lived second-hand like this, running off previous experience, tuned into a machine-life that is as automatic as my faithful Subaru.
The Institutionalisation Process
I became completely aware of this living at second-hand at the hospital. Dad’s institutionalisation set in early on in his stay. And I saw it in myself and the staff, especially in the young physio and rehab team. These are all pleasant young women with squeaky, high voices who seem to have a firm handle on what age and infirmity look like and what needs to be done for it.
For example, the exercise regimes they worked out for dad who had fractured his pelvis in a few places. Here is an example of suggested exercises for Dad, written down as a guide to keep his strength up:
Lift one arm up and down 10 times, lift the other arm up and down 10 times.
I kid you not. A page of this stuff. All fun, all creativity, all potential for real life experience drained away in the flesh-and-blood insistence of the mechanics of life. At no point was there suggestion or thought of the breath, no concessions to the idea of the whole, living breathing person.
I didn’t realise how much Physiotherapy is the handmaiden of allopathic medicine. They are clearly dealing with physiology here, bones, muscles, tendon, fascia; the facts and nothing but the facts.
If They Really Cared
It brought home to me that Death and aging are seen as medical events. Rehab is a practical engagement to get patients back on their feet so they can go to the toilet and take care of their basic needs. It is an empirical and physiological undertaking. Nothing wrong with trying to get old people back on their feet again.
Osbourne Park is considered Perth’s best rehab public hospital where old people come to recover for a return to a non-hospital life. There is also a wing where women come to give birth. The place is rundown, a sadly neglected, physically tired and scruffy building. There is a new part, but this must house stroke and accident victims, possibly the demographic is of younger folk and the thinking is about efficiency and the opportunity of making money from people with more capacity to make a full recovery – when you think about it, no amount of rehab is going to make an old person a useful tax paying member of society again.
And if they really understood health and well being, wouldn’t they feed their patients nutritious and interesting food? The food was beyond woeful. According to workers who I spoke to during the time my father was a resident Osbourne Park Hospital used to be renowned for its meals up until a few years ago. It was made from scratch on the property and there was pride and care in its delivery and in the concern for the details of each patients’ particular needs. Now oversized serves of unappealing and truly inedible food comes curtesy of a caterer. At the beginning and end of life, neo-liberalism seems to have established a death grip on what used to be more human-centred health care.
Some of the staff encouraged us to bring in our own food – but as there were no fridges or microwaves it was a tough ask. The food waste was monumental. I feel for the catering staff that was – I envisage lines of depressed looking staff standing in front of row after row of microwaves. Instead of the duties of kitchen-hand and chef, involving sourcing produce, chopping, cooking, tasting and plating efforts they have been downgraded to the role of food service providers. I wonder if there is a ward in this hospital where they offer ‘rehabilitation’ services to people whose work is made meaningless overnight in the interests of economic rationalism.
How Does This Happen?
There is kindness, but so much paperwork, so much arse-covering paperwork. How did we get to this point, where everyone is not necessarily tuned in to doing anything common-sense or logical in the face of human needs in case litigation ensues?
This is not an original complaint, is it? We all know this is the way things go. How does systemic change work? Why do we put up with it?
Individually we are stuck. If you want a job you have to do what is required.
And the other is our own compliance in the face of a large and impenetrable bureacracy. My sister and I have struggled to make sense of this system – and been roundly beaten down by it. I ran sad little raids around the edges to loosen things up – but it felt like grizzling in the dark. This thing is much bigger than any individual or any of its component parts. It is the logic of colonialism and global capitalism, probably more ‘isms’ than I can think of listing. Heartlessnessism?
So: WHAT DAY IS IT BARRY?
WHEN WERE YOU BORN BARRY?
HAVE YOU OPENED YOUR BOWELS TODAY BARRY?
DO YOU KNOW WHERE YOU ARE BARRY? (Dad usually says, Here! firmly to this one) It even interests him, he of little to no memory, that in 6 weeks of living within two hospitals he has been unable to bring to conscious mind that he is living in a hospital, when asked – as he often was, as a ‘cognitive test’ by the staff – where he was. You can’t blame him, to lose more memory is a fairly sane response to living at Osbourne Park or any other, Hospital.
Xmas For Dummies
The other extremely puzzling development at Osbourne Park was the amount of kindergarten level decorations that got put up in the name of Xmas: much of it stemming from the physio/Occupational Therapy room. There were cardboard boxes with brick wallpaper stuck around them simulating chimneys; badly cut out reindeers and sadly bashed up cardboard deer heads labelled dancer, prancer etc. There were walls of cut-out stockings, the lamest of lame red and green cliches. One decoration had my sister and I really stumped. It was a series of long skinny strips of cardboard roughly painted black with cotton wool balls stuck on it and secured to the wall with strips of sticky tape. 12 days to go and they are already sagging.
I know I am picking on these people, but it was seriously weird, like being in kindy, only there are no kids. These woeful efforts were the work of adults: in their 20s and older. A friend of mine suggested that this could be what the young staff think old people like. That made some sort of sense. Perhaps staff are consciously celebrating the ‘second childhood’ here, the one their textbooks talk about that distinguishes old age?
I would suggest they need to look to their own cognitive capacities at this point, maybe show a little critical thinking about their aesthetic choices? My father has lost a fair amount of cognitive ability: but he still has eyes in his head and is capable of appreciating beauty.
My feeling? How dare they! Robots do Xmas!
Nature Redeems
A redeeming feature of this rundown place is that it is only two stories high and the whole is surrounded by remnants of bush that soften the noise of the Mitchell Freeway and trains roaring past a block or two away. There are gum trees, scruffy grasses, a zone where kookaburras, willy wagtails and other species still live and work – there is sun and wind and places to sit.
I park Dad under a tree and take his fetching little orange hospital slippers off. He immediately starts to run his soles back on forth on the grass, digs his toes in, our spirits lift with the breeze and the sun on our backs. We invented games to amuse ourselves – like throwing gumnuts at targets.
And parking is free and available and because it is a public hospital, they lend out their wheelchairs and walkers. We have been told repeatedly that the public system for all its problems, can afford to have more staff than the private hospitals. I have come to realise it could have been a lot worse.
I have come to realise that if this hospital was replaced with the glass, concrete, stainless steel skyscraper and landscaped surrounds considered necessary in the face of first world disease centres - with expensive underground parking and a foyer that looks like the Ritz - things could easily get worse in terms of the considerations of basic human understandings and needs.
What am I trying to say? Much as I deplore how rundown this hospital is; much as I weep for the lack of resources going into the birthing centre and the old people’s rehab arm. If they actually do start to put any resources into the beginning and ending of life - I fear more and more robo-life will result, with less and less chance to escape into an unstructured world where the heart, the earth and breath are nurtured.
The Café For Humans
Another wonderful aspect of this hospital is the café on the ground floor. It is run by volunteers, mainly older women, during week days. The food is good and the feel and pace of the business is refreshingly human. These women care. It gives a sense of a kinder time, a sense of how things used to be. But before I get all nostalgic about the good old days etc let me rein myself in. Women volunteering, women caring, women making sure the elderly are looked after – kinder times in Western Industrial culture meant that women looked after the vulnerable – which led to a radical devaluing of their place in a world and the rise and rise of the concept of ‘gender liberation’.
I am not going to go into the complexities of this subject – we’d be here for days – and I am currently too confused about my own relationship to volunteer versus paid work to make sense of it all. I have no answers, only questions about the inhumanity of the world that has been foisted upon us.
The Trend to Luxury
It became clearer that my father would struggle to live independently so my sister and I start looking around at local Aged Care facilities. Some of the newest look like the ritziest of hotels. Balconies and expensive views for the wealthy, manicured or fake lawn and concrete bunkers for the plants. In some of them it is an impressive and faintly chilling luxury where huge TVs murmur in empty loungerooms and spacious corridors with dove-grey carpet lead one gently …remember that Monty Python sketch? ‘lead one gently towards the rotating knives’?
Although, Queenslea, a new home for the Aged near the Claremont showground which inspired the last paragraph, is onto something. They have built next to a child-care centre, the idea being to connect the oldies with the young ones. That is a brilliant idea – but it is already mandated that you can’t go into an Aged Care facility without having had a flu shot (not Covid, I mean the common or garden type of influenza) so how are they going to persuade all those parents to inject their babies and toddlers with yet another vaccination let alone get around the health and safety people??
The flu law has single handedly killed many connections to the wider world in these facilities. Visits from school children, choirs and other volunteer and paid organisations fashioned to bring pleasure to old people stopped dead about three years ago. This was before COVID – imagine how bad it is going to get now.
My sister and I visited Wearne (now called Marine View Cottesloe). The old house that has been a home for old people at the south end of Cottesloe, Marine parade for a long time has been rebuilt. Its impressive. We were sold. We want that view for Dad. West facing balcony, very nice design, well thought out, custom built. Good balance of privacy and open, shared spaces. Double glazing so the residents won’t be disturbed by the demolition of the old building between their rooms and the beach….the whole block is being changed and made over. The ocean at least cannot be contained – but it is like Fort Knox in terms of the technowizzardry needed to get in. We are frightened that dad will be sealed off from us with the coming of the plague.
The Aged Are Coming
There is a tsunami of old people building in WA and across the Western world – I am one of them. I am worried that Aged Care facilities are going to be seen like refugee camps or prisons for the for-profit companies. In an essay by Paul Hawken called Poverty is An Extractive Industry, he talks to a retired founder of a Swiss-owned for-profit detention centre who explains that when running refugee camps, “the (quote) margins are very low,” so to maximize profit, “the (quote) key is volume.” I’ll attach the essay to this story on my website soilandhumanhealth if you feel like some grim reading.
The Royal Commission into Aged Care came and went recently and the most obvious, the most important finding might have been to pay decent wages to the people who work with the aged. As far as I know, this is one ruling that has not been instituted.
In light of my experience with my own family I feel uneasy about my own approaching aging and incapacity. PLEASE GOD Don’t let them keep me indoors, away from what is natural, away from the earth. Let bare feet and sun and bush, or at least, growing things, be a part of my diminishing days. Let me always be able to shuffle to a doorway that lets me breath non-airconditioned air, perfumed by a riot of growing plants. Let me be surrounded by kindness; not the kindness of robots, but the kindness of people operating in a system fully open to the humanity of those incapacitated by age and illness, and fully recompensed and respected for the work they do.
How Does That Relate To Team Human?
So what keeps us humans healthy? Like the deer, humans need to be fully engaged with all our senses, both physical and subtle and nested in a known environment. We need to be fully in our bodies, able to operate from both a heart space and from the intellect.
We have to recognise and understand the wolf. It’s not personal. The wolf has cubs to feed and her own appetite for life – we can’t afford to take the wolf personally.
How to resist institutional, robo-living? This is a huge undertaking, a life’s work. I didn’t even know I was behaving like a robot until I hit that broken set of traffic lights. I was briefly blasted into a space where I was forced to take responsibility for myself rather than continue on the tracks laid down for me by systems hollowed out by shallow economic goals.
And for all of our days, we need to see dying and incapacity as the crucible of the life we are given. I am learning something here. Another gift from my father.
HBF Pikes
I can’t leave this story without talking about private health insurance. Even though Dad has paid for private insurance for over 60 years, we, his daughters, failed utterly in our attempts to get him into a private hospital offering rehab services where he could have the one thing he wanted - a room to himself. It seems that a man who has kept himself healthy and out of the health system most of his long life and generally presents as a compliant, polite, and pleasant human is not welcome in the private system if signs of disorientation are detected.
The odd wobbly in the early days of pain and under the influence of heavy opioids; a degree of disorientation and fear-based reactiveness on top of his memory loss was enough for him to be blacklisted (the term used is ‘code black’) from the private hospital option. Without us fighting for him, this old man would have been lost in a vast and overloaded public health system.
In the end it comes down to people who love you.
I have a renewed respect for the concept of universal free health care.
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I found Paul Hawken’s essay on the Commune site: https://www.onecommune.com/blog/commusings-the-poverty-industry-paul-hawken
