Wednesday 27 November 2013

Suicide is painless

When someone decides to kill themselves, doubtless they feel entirely removed from the world of solutions, and the only way out is to end it all. In a way, many of those who choose to flee Ireland, engage in a suicide of sorts; to end or at least drastically change relations with home and country, is a kind of suicide. It is an act of desperation that contains within it the hope of something better. It is that same hope that sometimes gives suicide a dignity that is absent from most other acts of extreme violence.

One might then ask where is this world of solutions? There are always solutions and there is and must be a realm wherein they reside, doubtless that space is a place where the truth reigns supreme. As such, it is a place that is often, very often removed from our world, and is probably closer to a place that Plato referred to as the 'world of ideas', a realm that exists above the cave wherein (he would have us believe) we are chained and our perception of the real is confined to shadows upon the wall.

Lately I often toy with the idea of leaving for America or returning to New Zealand where I lived and worked for several years. The practice and the institution of Medicine in Ireland has a peculiar way of encouraging these thoughts. My reasons, (though not as compelling nor as painful), are within the family of reasons that the potential suicide victim considers before they make their relatively more terminal and brutal decision. Removal from the world of solutions and consequent frustration at the ground-hog day of; empty promises, of reports, reviews PR stunts and 'quick fixes'. That is the manner in which the Irish health service can simultaneously depress and oppress. Since returning from New Zealand in the past four years I have seen more suicide and self destruction amongst my colleagues than I have amongst my patients.

Upon today's horizon of possibilities the solution, those published and those planned, eventually reveal themselves to be part of the underlying pathology; the shallow and short-sighted nature of democracy, an impotent and un-enlightened leadership, our collectively blind devotion to the God of the markets,of profits and 'Growth'. Many will stop reading, or at least stop thinking at this point. The hint of a truth, an insinuation of real pathology is too painful, too close to the marrow of the the matter, particularly for those involved in and dependent upon manufacturing the usual array of inevitable and ineffectual solutions. The old adage in reference to the truth being painful, is becoming more painful than the truth itself.

Within Health and Politics the event-horizon upon which our 'solutions' are permitted to arise is a suicidal one. It is hemmed in by specific coordinates, definite boundaries that do not allow for the possibility of voices beyond the growth mantra or the delusions of Medicine's contemporary capitalist reality.

The real tragedy is not that the usual solutions are doomed to a repetition of 'four legs good but two legs better'. The real tragedy is that we lack or are deprived of the vision or the philosophy that is needed to go beyond the horizon of the markets, of profits and capitalism, to even imagine potentially effectual solutions, models for health or social governance. That is the hardest thing about living and working in Ireland; the intellectual and philosophical paralysis that defines institutions of medicine and politics alike. A paralysis that is everyday reinforced by our daily role play and by the anaesthesia of our national media, by the Shamans on RTE who sang the praises of the boom, and now weep the despair of the bust.

The intellect of the world beyond Ireland is evolving, new music and new thinkers are emerging from the chaos of modernity, whilst RTE shows us shadows on the walls and gives us the Beatles and Mr Tambourine man over and over again. One way to paralyse a people is to hypnotise them with monotone and repetition. Turn on your radio or TV eist for a while; nothing new there! You are watching the metronome of the hypnotist, back and forth the pocket-watch swings a repetition that quiets us and draws us into our stupor of acceptance.

Medicine is in crisis, politics is in crisis and not only the nature of the crisis, but the hearing about it day in and day out brings an additional layer of torture to the reality of its experience. If one is to take a cynical view of things one might say that we doctors, managers and politicians are least likely to entertain real solutions, given that our incomes are entirely dependent upon the paralysis.

Edmund Burke famously stated that evil triumphs when good men do nothing. In many respects having awareness of the cause of a pathology but choosing to support the status-quo or to do nothing, is not simply the triumph of evil, but rather is the evil itself. Personally I refuse to believe that amongst the medical profession there are only a handful of pariahs such as myself who are willing to assert or accept that it is not 'systems failures' but rather capitalism and materialism both private and institutionalised, that is the root cause of our social and medical dysfunction.

This assertion of brute materialism is safe enough as long as it is merely a shadow, yet if it is recognised as a plague that has infected almost all of the institutions of Medicine, it becomes a dangerous assertion. It is this assertion that has excludes one from the ICGP, denies one a GMS contract, bars one from RTE and terminated my own short lived writing career with one of the medical papers, (after it was compelled to offer the Health Minister an apology for my sedition.)

In 2005 I gave a presentation at Drogheda Hospital entitled "Prvate medicine is killing public patients.." Following this my supervising consultant made a call to the panel that interviewed me for a training scheme, and so I ended up going to New Zealand to train as a GP.
Ireland, particularly the medical establishment is no place for thinking or talking beyond the horizon of our contemporary delusions. Much as we are enamoured by the usual palaver of thinking outside the box, Ireland remains a box within a box within a box.

Recently I advised a patient of mine with breast cancer to 'take the weekend off'. To forget being a 'cancer patient' for two consecutive days. I prescribed: three tubs of Ben and Jerry's ice-cream, advised her not to get out of her pyjamas, to arise from bed as late as she could, to eat junk food, do no work, and lounge about the house in the self indulgent bliss of an ignorance that is increasingly common and occasionally therapeutic.

That is what those who suffer from the cancer of thought, those who retain the endangered capacity for independent analysis, need to do now and again; take a sabbatical from the repetition, from the institutionalised corruption and the same old ground hog days of solutions.

The greatest invention to have graced my garden shed in recent years is my paper briquette maker. I have a large black bin to the rear of my practice and it is the repository for newspapers and tonnes of leaflets and posters that arrive on a regular basis from my numerous nemeses; from expensive the rubbish-production department at the HSE, and the various Colleges Councils, and Quangos charged with health and governance. I add water to the black bin and after a week or two the leaflets and letters, are soft enough to be added to my briquette maker and compressed into briquettes that can ultimately be put to some use. I effect my quiet revolution as I sit by the fire and watch all of these solutions burn brightly and cast their own shadows upon the wall of my sitting room cave.

Saturday 16 November 2013

Conspiracy or fact? You decide.

Sir,—It is normal for national historians, in the narration of the history of their nation, to mention or recount, in due place, the intrusion, progress and influence of a foreign ideology or world-view. Irish national historians have done this, successively, in the cases of the arrival and impact of Christianity, the Anglo-Norman invasion, Continental Catholicism, Protestantism, the English legal system, French republicanism, British classical liberalism, Victorianism, Catholic Ultramontanism and socialism. Hence my puzzlement at the absence of any treatment, in the Irish historians’ accounts I have seen, of the principal foreign ideological penetration of Ireland in the past half-century. I mean that of American left liberalism, which, with its new set of dos, don’ts and do-as-you-likes for behaviour, thought and language, has become—with the support of Irish legislation—the Republic’s reigning ideology. The fact that since the 1960s/70s this American ideological colonisation has produced the reigning ideology of western Europe generally takes nothing from the fact that its arrival via London, and takeover in Ireland, have been a substantial part of our recent national history. Omitting an account of this from our historical narrative has been equivalent to Romanian or Hungarian historians failing (unimaginably) to recount the arrival and implementation of Russian Communist ideology in those countries from the 1940s to the late 1980s. Can anyone, beginning with our historians, explain this remarkable omission from the Irish historical narrative?—Yours etc.,

Desmond Fennell
History Ireland April 2013

Cheat On Your Taxes! its the decent thing to do.

Cheat On Your Taxes! its the decent thing to do.

When one considers the dysfunction of society and political governance in Ireland, when one opens ones mouth and begins to complain, there follows then the logical question, 'what have you done for me lately', what have you done to address the problems that cause you to weep into your pint of beer?

I file my taxes this week.  My practice made a profit of 60k last year, and out of that I am to pay some 18k in tax, 11k for last year and 90% of next years tax estimate.   All by the due date of next week. My wife is my practice manager/consultant in charge, and despite my own reluctance to declare every penny earned, she is 'straight as a dye' and would not condone the slightest thought of  "cheating", and so our honesty means that we must join the ranks of the minority who subsidise the majority and pay for the dysfunctionality of the state.

When we lived in New Zealand I did not begrudge paying my taxes because unlike ours, theirs is a nation that is relatively devoid of political corruption, and mass psychogenic delusion. Theirs is a nation with a single political vision, rather than the Irish marriage of incompatibles; like 'universal socialism' and 'pure-capitalism'.  In New Zealand we did not mind paying taxes because the state provided visible and tangible return; one could see exactly what one is working for. Clean cities, well governed municipalities, local governments that assist rather than prey upon communities for rates in every form. Indeed, one pays rates to local authorities for parks, water, garbage, and each year the local authorities send a statement of accounts to each household explaining where and how those  rates are spent.

Contrast that with the arbitrary assignation of local authority rates in Ireland, or the reality that many business struggle to afford their rates, and few if any are aware of what they are paying for. I pay the local authority 3000 euros per annum in "rates" for my office.  In addition I pay for all my utilities, additionally  I pay for my water & garbage separately, and every morning  I pick up the rubbish outside my office door. My patients pay the local authority for parking outside my office. When I opened my practice the Local authority sent me a bill of 10,000 Euro for a "contribution" to the upkeep of the pay and display parking system on the road outside my office. The pay and display system generates profits that accrue entirely to the local authority.  I refused to pay and the matter was decided by An Bord Pleanala, who had no choice but to tell the Local Authority where to go and their 10k bill was rubbished. When opening our practice we had to apply to the authority for a change of use as our building was previously a family home. We were levied at every turn by the local authority, in application fees and re application fees and planning fees. We were given hoops to jump through that many times caused us to consider selling the building and walking away.

Through the entire painful process not one human being from the council visited our premises, not one inspection of the fire codes, the accessibility... nothing. Our architect insisted that we follow every regulation and yet when works were complete and we had been bled as much as was humanely possible, we were granted our planning and the local authority moved onto its next victim.  The Priory Hall Affair was ongoing at the time. We have never had a single representative from the local authority call to see if any of the myriad of stipulations to our planning application were adhered to. Not one single visit from a single human being only bills bills bills. We were the hunted and they were the hunters.

When we lived in New Zealand we had to apply for permission to add a bathroom to the upstairs of our house. The process involved a submission of drawings an initial site inspection by the council and face to face advice and directions  on how best to proceed. We were assigned an inspector who came out to inspect the contractors work and make sure that it was up to code and that we were protected from poor workmanship and substandard practices.  The process was about protecting us, regulating the contractor and caring for the environment and the community.

 Local authorities in Ireland such as Fingal County Council, have become mini-corporations, that are laws unto themselves, they occupy multi-story office blocks such as the one that was built upon the park in Swords in North Dublin (granted permission for by itself).  They are answerable to no one set their rates arbitrarily, do not publish their accounts treat their rate payers as a unscrupulous farmer might treat his herd of milking cows, and provide almost nothing in the form of a visible return for their existence. The most significant element of Ireland's economic collapse was the housing boom and inflated market.  The majority of billions that were lost were lost via the property market.  It was the local authorities who gave the permissions for every unnecessarily constructed dwelling in Ireland, because the themselves reaped the rewards of exorbitant planning application fees.  The Blame for our economic collapse lies squarely at the feet of the professional planners who live in the ivory towers of local authorities.  Their failure to apply any element of urban planning or professionalism towards the communities they are paid to care for, is as blatant as the near half million empty housing units around the country, and the reality that many such "Ghost estates" half completed housing and apartment developments are being torn down as they have become rat infested dens of inequity.  Yet not one single urban "planner", has been called to task, has been subject to even the slightest verbal sanction. Local authorities are the corporations that have no governance, and as such their absolute power has corrupted absolutely.  The reasons are simple and obvious in that the same planners must be approached by business and politicians alike when local communities are to yield to the plans of the corporation, the real power brokers of the Irish state.  Take for example the Eirgrid project, where a cable is connected from Dublin city to the UK grid, so that Ireland can have Nuclear power the Irish way (literally via the back door).  The cable has to land on the Irish coast and be lain beneath the main-streets of several communities. Our own in Rush was one such community. The capable runs outside the door of my surgery.  The planning application for the cable was and remains as a marvellous testimony to the rubber stamping role of local authorities.  The company in their application listed an entirely different street  as the street as the site for the cable.  The made traffic calculations on the basis of this different street, and neglected to include in their report any of the health implications of the high voltage cable that sits a couple of feet below the main street.  For this kind of abuse of local communities, the 'nod' from local governments is absolutely crucial.  In the rare instance where democracy might work and local authorities are not fortunate to have a collection of obedient party members as voting Councillors, a government appointed County Manager has the power of veto and all hopes of democracy are banished to the robust regions of Irish delusion.  There is a history of venality and corruption that has yet to be written in Ireland, the liberties that central government and its corporate sponsors have had in the towns and communities throughout Ireland, speak a story that has yet to be written.  The true tragedy of that tale is that when it is committed to paper, the perpetrators, the county planners who have colluded and schemed and incompetently presided over and effectively planned the economic and ecological  and  ecological collapse of our nation, will like the counterparts in politics, have long since departed from the mess that must be addressed by our children.  One can only dream of a dictatorship that might round up the planners, politicians and bankers who have abused this state and its communities with an especial and subtle type of cruelty and an impunity that is absolute and make them accountable for their crimes, they are guilty of a greater evil than the majority who are crammed into our prisons.


In addition to a crippling  income tax, I must pay, road tax for the roads, property tax to live in my house, I must pay for my rubbish, pay for my water, and utilities, my family and I have no medical card and must pay for medical services, my children have free education that is free in name only (except maternity and child vaccines), I pay tolls to drive on new roads and pay to park outside my own front door.  The free fees at Irish Universities have returned in full and are simply called 'Student contribution charge' The registration fee at UCD is 2708 Euro before books and other costs.  In Capitalist California where taxes are a tiny fraction of their Irish equivalent and there is no such thing as a free lunch the fees to attend the prestigious University of California system are in the region of 3000 Euro. New Zealand University of Otago 2700 Euro per annum.  In Ireland free education is no more than a delusion that is shared by those who have faith in politics.  

New Zealand and American politics are defined by vision, whereas Irish politics is defined by an obsession with outward appearance and an inability to tell the difference between the two. Less politically confused nations are characterised by aspiration towards improved governance, improved services and facilities for the members of society to the betterment of society rather than the confused enrichment of the few through privilege and the enrichment of many through either corruption or social welfare.  The middle (PAYE classes) pay for both options, through a myriad of circular complex taxes. Taxes that mostly feed delusion by giving to everyone in the form of 'free' fees 'children's allowance' and taking from everyone either through multiple   taxes or through the deprivation of services. How many billions would be saved and how much efficiency would be consequenced if we were to set aside the delusion and adhere to the simple vision of either capitalism or socialism in the context of a society that becomes willing to educate itself.

New Zealand boasts a first rate public library system, modern buildings that serve as the focal point for most cities and towns, well stoked with children's story telling, teenage games rooms, newspapers.  All the trappings of a progressive society aspiring towards improved literacy and the social cohesion that arises from access to and encouragement towards literacy.., all of it is free or paid for by taxes.  In Ireland we must invent names for our taxes to perpetuate the delusion, we refer to our payments to the Troika, to bail out our private banks, these are collectively called 'water charges' and 'property taxes', new terms for new extensions to our national delusion.

Almost every small ton in New Zealand has a swimming pool that is subsidised by the state and most are accessible 7 days and 7 evenings per week for a trifling fee. A public park system that is undoubtedly the envy of the developed world with playgrounds that are equipped like private adventure parks; trampolines, massive roped climbing frames, abseiling devices, mad things that are the delight of children and the panic-attacks of parents. Paddling pools for kids, wide open tended spaces with free barbecue facilities and serviced food preparation areas (I'm still referring to the public parks).

There is no litigation to speak of in New Zealand, people don't sue councils if they slip on a Banana skin and end up with; back pain, depression, and diarrhoea for life.  There is no suing because there is a state funded no fault compensation programme (ACC), where all accidents are compensated by the state.  A simple and intelligent programme that brings an end to litigation, and a rational approach to compensation. As a consequence car insurance is not even mandatory, suing  and medico-legal litigation is relatively unknown.  A simple and enlightened effect of good governance, one that would never see the light of day in Ireland because of vested interests like medicine and law.

The New Zealand Government spends 800 million NZ dollars, (about 500 million euro), to provide a highly subsidised drugs scheme that gives affordable medicines to the entire population of 4.4 million (similar to Ireland). Ireland spends 1.5 billion euro on medicines for medical card holders, whilst the rest, the PAYE workers remain the playthings of pharmaceutical companies.

More than this there is the DOC, (the department of conservation), which manages the vast areas of conservation in New Zealand, and an impressive network of trails that traverse the land and the back of the  New Zealand Alps from north to South Island. A myriad of hiking trails are maintained by DOC, and the entire network is accessible and informed of on one easy to use website, with trails and walks for to suit all abilities and ages, practically anywhere throughout the entire country.  Many of the trails into remote regions have huts, which are small cabins, installed on the edge or at the summits of mountains, huts that have water mattresses, a stove and some matches, all tended to cared for and maintained by DOC and your taxes and realily accessible to all.  Class sizes are smaller than the Irish average, literacy and Numeracy is higher than the Irish Average, kids walk to school in their bare feet, they sit about their teacher in circles and call their teachers by their first names, education is free and there are no dodgy relations between schools and book publishers or as is the recent fad in Ireland between I-pad companies and schools. That kind open corruption would never be tolerated.  I Christchurch where we lived I never encountered a single heroin addict on the streets, and you would be hard pressed to find graffiti or even litter for that matter.

There is a certain idiocy and enlightenment that defines the Irish political Landscape, a certain inadequacy that would suggest that we are still uncomfortably shy with the notion of our independence. The shyness and lack of confidence is almost perfectly reflected in the Alter Boy who is our Taoiseach. At international summits we see him either being patted on the head by real politicians or trying to figure out if he should be in the picture, or standing at the side holding somebody's jacket. His shying away from any form of public debate or discussion, and his undisguised fear of Vincent Browne or debate in general, speak volumes of our cowed national identity, our respect for those whom we perceive as our betters.  Was this really the same nation that gave the world Burke, Grattan, De Valera,  Pearse  If romantic Ireland is with O'Leary in the Grave intellectual, self confident Ireland is on trolley in some A& E somewhere.


Yet this essay is likely to degenerate into a simple and all too familiar  begrudgery;  that the Kiwis should have a more intelligent and entirely rational form or government, a begrudgery that their streets are not peppered with an army of zombified heroin addicts, reliving the daily nightmare of an Adam and Paul existence. Begrudgery that their politicians are not the puppets of their own greed and that of special interests. However the thing to begrudge the Kiwi's is the same as the thing we should begrudge the Americans:  That these are not nations of begrudgers. We should begrudge them their lack of begrudgery.

It is this ridiculous notion in Ireland that all should be equal that causes us to resent anyone who might have more.  As though all were equal in either intellect, morality reason, The only equality that should unite us all is one of rights and access to services. And the only thing more ridiculous than 'all being equal' is the notion that happiness is related to having 'more' than others

In Ireland the state attempts to make all people equal in everything, and it is this equality that is crippling us, this equality that is born of our begrudgery.  Poverty today is almost entirely a relative phenomenon. When the Ballymun flats were pulled down and the locals 'gifted' with new apartments, these to for the most part have been lately despoiled, because it is the imagined  'poverty' rather than the real relativity that is being addressed.  If it is encountered in any real sense for the most part Irish poverty  is self imposed through ignorance, addiction, or illness. Outside of these mitigating circumstance, outside of illness or birth, poverty is non existent and yet the fear or it determines much of our politics, and consumes our taxes. There is no African underworld, no cholera, no Kwashiokor, no distended bellies etc; There is only a relativity, a mental illness, addiction, abuse and ignorance that are countered with the impotence of our national delusion.

The time has come for us to shake off this ridiculous notion of an artificial socialism, and move into an era of rational governance. Let the poor and the rich suffer, let them go to hell as the Americans do, come what may the first step towards political progress is political honesty, and Ireland today is buried beneath a haystack of lies.

There is no need for a human being to be a billionaire. there is no need for a man to have more than 10 or 20 thousand in his accounts. There is no such thing as ownership of houses, all are merely borrowed for a time. There is no need for the rich to be in receipt of welfare of children's allowance, whilst we filch unemployment benefit from teenagers. There is no need for unemployment or for unemployment benefit, if indeed we were to live within our needs. There is no need for unemployment as long as there is a single piece of rubbish on our beeches.

"I have a college degree and I shouldn't have to pick papers!" The assertion alone is the purest indication that the degree has been entirely wasted.  Give me a day to leave my practice and walk along the beaches and the coast, enjoying it with others and picking up papers, I would enjoy it more than sitting behind my desk, and more than standing in a dole queue or lying on the sofa feeling sorry for myself.

When you drive to work in the morning look at the rows of cars clogging the arteries and veins to the city, ask of yourself where the hell am I  going and where are all of these people going?  Is there any need or real purpose to most of this madness.  How many jobs have a real rather than entirely imagined purpose?  Some eighty percent of the cars on the road are carrying people to jobs that they do not wish to do, toward daily exercises that truly have no meaning beyond the markets beyond economic growth, materialism and superfluity.  Myself, I see some 20-30 patients per day and it would be a miracle if more than 2 or three were in need of medical advice or attention. The GP has become the priest and the counsellor.

Unhappiness and self delusion have become the order of the day, and we have come to be living lives that Thoreau described as those of 'quiet desperation'.

80% of the cars on the road, 80% of the antibiotics I prescribe, 90% of the tests I request ......are all returned as perfectly normal and utterly pointless.  What has happened that civilisation has moved so far away from itself from the truth of its needs?  How has the progressive stupefaction of our race remained concealed and subterranean?  Why are mothers delivering their children to strangers at crèches and then presenting to their family doctors with the same Children, out of grief and guilt. Why are their 'family doctors' rather than community physicians. Why this dependence upon medical pathology in place of truth and honesty?   Why is it that the delusion has become massive, national even international?  Why is it that access to  an unnecessary pornography of  brutal sexual violence is only two or three typed words away from adults and children alike, how id this a need and a right? How is it that the mass effects of this essential 'freedom' remain as unseen as they are entirely obvious?

The answer can only be because we are as s species becoming progressively more stupid as each day passes. A stupidity that is driven by globalisation, by materialism and by the communicative form that social media compresses and narrows each day with its 'likes' and 'dislikes'.

We live in a time where the artificial, the imagined world of the Internet of  fantasy and delusion, has become our daily bread.  Reality itself is merely an excursion a day out, a hiatus from the madness of the real, it has become something that we can take or leave, and soon it may be lost entirely.


Thursday 14 November 2013

I have never and would never become a member of the IMO, for reasons made clear in the recent past.

What is incredibly interesting is the psychological processes and moral philosophy that those who continue to invest in this morally bankrupt organisation. Personally I feel that the extent of continued loyalty and involvement with the IMO, (some 90% of members have chosen to stand by their man and continue to pay for McNieces  grotesque indulgence) is a reflection of a psychopathology that is gaining precedence throughout the medical profession, not least amongst General Practitioners.

I don't suggest that most of the GP's who maintain an involvement or association with the IMO are in anyway as devious or venal as those who were involved in the 20 million McNiece package.  I do however suspect that there is something deeper going on.  In a previous post on this forum regarding the GP "Conference" in Newbridge, one reply responded to the point that the event was being sponsored by American Health Insurance Companies, by ignoring the point, and by listing the sponsors and simply not including the American Health Insurance Company  in his list of sponsors, nor did the commentator mention that he himself was to be a presenter or chair of a portion of the conference.  I don't wish to criticise on an individual basis however what I am attempting to point to is the fact that as the initial post of this thread, clearly shows a willingness and an enthusiasm  to 'forgive and forget' that extends beyond Christian delusions and encourages others to do the same, to ignore, or not see the the faults with the IMO:  Not to be blinded by misfortune or accident, but to become wilfully blind and to do it in a spirit of togetherness.

"I saw an organization that is totally different from the organization of  2 to 3 years ago.It certainly made my mind up to stick with the IMO"

The reference to the 2-3 years ago is undoubtedly in reference to the IMO of McNiece and of Minister Reilly. Let us pose the question how many lives would 20 million euro purchase? Let us make it better and ask how many Black  lives might be purchased with 20 million Euro?  Upon what horizon does the vulgarity of the McNiece affair warrant consideration? What harm did this 20 million deal do?  Perhaps the answer on a private level is nothing, but are there other levels besides that of the personal and private preservation? No one was immediately harmed in any considerably way by the deal, and indeed the IMO would not have agreed to it if it did not believe at some stage that it could afford it. So in essence what real harm is there for an organisation to gift one of its more senior cronies, a parting gift?

This is a fundamental difficulty with the McNiece affair is.that we cannot or (more worryingly) will not see the true nature of the immorality.  There was a time in our history when mothers and fathers and school teachers and doctors refused to see immorality of an equally grotesque nature.  When Children would come from the sacristy trembling with fear, perhaps in tears, or they might come home from school having been kept back in the office of one of the Brothers for a special talking too or special attentions. I have three children and if one of them was being sexually abused by an adult, I am convinced I would know or suspect something. I am equally convinced that many many parents of the victims of Child abuse, on a certain  psychological level.. knew that something was not right with their child.  And yet they could not, or would not see the evil that was being perpetrated, perhaps because its true extent was too horrific to contemplate.  This lack of  vision was the crime the lies within the crime of Child abuse, that so few did or said anything, but continued to see the world in the same way.

In the same respect when Jews were being put into ovens, the real horror lies outside the act itself  and in the deeper and more disturbing reality that many many more, knew, and yet chose not to know.   These are the famous 'unknown knowns' of Donald Rumsfelt, things that we dont know that we know.  Regardless of the differing levels of 'evil' in each of the crimes, there is a deeper evil, a deeper corruption that we have yet to evolve beyond, and that is the capacity to perceive things as we wish to perceive them, despite the reality of the truth being far removed from our perceptions.

I make no bizarre or ridiculous assertion when I state that the IMO have  refused to open their books to an honest scrutiny.  I make no bizzare assertion when I point to the reality that it has decided against an internal audit informing members that it "cannot afford one".  These are not imaginations but realities, that Dr Wally and his audience of the willing do not wish to include upon the horizon of anti-HSE invective.  The above post suggests that we doctors should stand together (with the IMO) against the government (the imagined evil), Whilst in reality it is a well publicised fact that the Minister himself was on the very IMO committee that approved the Mcniece obscenity.

The evil here is not the IMO nor is it the HSE nor is it the Government, it is we ourselves and our capacity for self delusion, our willingness to see medicine and perhaps the world at large in the manner in which we Choose to perceive it, rather than its true and honest form.

To my mind this is the greatest of all evils, as it is the evil that permits evil to build and grow to its fantasic apogees.  Participation in the IMO is not an evil act but it does point to the fact that one chooses to see reality in a certain way, in a manner that can perhaps be described as self serving and in a certain sense pathological.

It would make no difference what so ever if the IMO were to collapse and we doctors were to have no voice and could take no united stand against the Government and the HSE, if there were no IMO and no Stand we might actually take the first step towards an honest and morally soundview of reality, without this clarity of vision that will only arrise out of catharsis, we can and will never make a stand that will have any value other than the value we hope to gain for our own selfish purposes.

There is a fundamental immorality within the McKniece affair which essentially lies at the heart of our public and private malaise, the notion that 'success' is related to material wealth.  I don't wish to point fingers however when one looks at the head of the health service observes the Ministers 16 bedroomed Laughton Manor on its 150 acre garden (google a picture for the hell of it), One is at first reminded of Tolstoy's Classic 'How Much Land Does a Man Need'. 200 years ago Ireland was governed by absentee landlords who lived in castles, on vast estates and were all bankrupt.

What has changed in our society? When was it that we signed off on the dream of our founding fathers, and became the very English lords that so many died to  liberate us from?  Pearse had a cottage in Rosmuc that speaks a deeper poetry than a thousand Laughton Manors, and yet this honest simplicity, a simplicity that is ordered about things of a supreme and sublime nature has been almost entirely displaced by our dysfunctional version of an American nightmare.

The deeper vulgarity of the McNiece affair is the notion that one man should take 20 million for himself. That one person should "need" so much in order to be impossibly happy? When we associate with and entirely unreformed and unrepentant  IMO this is the deeper vulgarity that we subscribe to. There are consultants in Ireland who make almost million per year, there are GP's who make half a million per year; all of this indulgent excess is normalised by the IMO's arrangements with McNiece.  It is not only normalised but our own involvement with the materialism that is the root and cause of most of our social pathology is mitigated and entirely relativised. What is my own excessive income of some 70k in the face of the McNiece millions? I am on the breadline it would seem.

I am not a believer in the Catholic notion of God, however what if we are to be questioned at the end of our days, what if we are to be asked, not what we gave to charity, and how many we healed.  What if we are asked to account for how much we have taken for ourselves?

Our national pathology is a moral, a philosophical pathology and we are no doctors unless we become the first to recognise the cause of our current plague, the plague of modern civilisation.  Those who have the courage to see clearly here do so with the vision of a Pearse, a Pasteur,  a Semelweis or perhaps even a Christian.