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.
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