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Sunday Essay Munro te Whata Feature image

The Sunday EssayApril 10, 2022

The Sunday Essay: On the frontline

Sunday Essay Munro te Whata Feature image

Emma Espiner on the ceaselessness of this pandemic.

The Sunday Essay is made possible thanks to the support of Creative New Zealand

Original illustrations by Munro Te Whata

I don’t know what it’s like to be a doctor in a non-Covid world. I was in my final year of medical school in 2020 when the first wave hit and we’ve been surfing it ever since. This week a patient coughed into the face of a colleague and we didn’t even flinch behind our respirator masks and goggles. The thought of doing this ward round pre-Covid without masks makes me vomit a little in my mouth.

Anyone who works in healthcare and can hold a pen has been approached to write a frontline account of the pandemic. The frontline! What is happening on the frontline?! People expect to sit in on every major national and international event like it’s reality TV.

Three years in, we doom-scroll in our sleep, everyone has anxiety and, prior to Russia invading Ukraine, there has only been this one story looping endlessly. It feels impossible to plan ahead. Our aspirations have congealed in the face of unceasing uncertainty. Our hearts and minds are brittle from over-exposure to social media, lurching from condemnation of the confused muddle of protestors soiling parliament’s lawns, to hero worship of the improbably good-looking Ukrainians defending their homes from Putin’s megalomania.

Sometimes the television news has an update on our hospital before the communications team sends an update to my inbox announcing the latest “this is fine” angle on the pandemic. I get home from work and try to massage my N-95 ravaged face back into its normal shape and see Michael Morrah standing outside the door I just exited on the 6pm news. People send me messages saying they’re thinking of me on the frontline, and I feel like a fraud because this sucks for everyone, and we aren’t routinely thanking anyone else for their sacrifice, for just doing their job, or simply surviving while the world disintegrates around them.

Right now we’re circling the drain, held together by bonus payments, good will and a refusal to let our colleagues and patients down. What happens afterwards? When the bonus payments dry up, the nurses act on their promises to resign and move to Australia, when the allied healthcare staff remember they withdrew their strike and worked harder, for scant additional recognition, and they resign too? Whoever remains standing after all that will be faced with a mountain of catch-up work.

While undoubtedly an acute and significant threat, Covid has done nothing more than expose the threadbare korowai of our health system for what it really is: neglected infrastructure that wasn’t coping anyway.

Late in 2020, at a Māori doctors’ hui, Dr Rawiri Jansen spoke with a group of us in Tāmaki Makaurau. He warned us that it wasn’t over, that another outbreak was imminent. I remember the urgency conveyed by him and other Māori clinicians, warning of the invisible menace looming post-Covid from the lag in elective operations, cancer screening, childhood immunisations, even seemingly tangential problems like the ability to get driver’s licences that stop people, especially people on low incomes, accessing the necessities of life and work opportunities. They talked themselves hoarse on the inevitable inequity of the Covid-19 vaccination rollout for Māori if steps weren’t urgently taken to target the programme to our people. They said this to us in the meeting room at Turuki Healthcare in Māngere and went on to say it repeatedly in other meeting rooms, in the media, to anyone who would listen.

Our Māori doctors’ prescience and future-focus at that hui sticks like a RAT in my throat. Because, despite our depression, fatigue and boredom, we need to think about the future. There is a dark side to every heart-warming story of colleagues stepping up and taking on extra shifts, helping out where they can, papering over omicron-sized cracks in our services and donating to vaccination initiatives for rural Māori communities. The pending fallout relates to the complete lack of redundancy in our health system. It would be foolish to perceive the current issues as relating only to the pandemic, to consider them temporary and imminently reversible. At the end of omicron, there will be an entire health system to staff, and only exhausted, stretched employees to call upon. There will be inequities which weren’t fixed by delayed care, but entrenched and worsened. Who will have the energy to attend to this?

In this context we are also being reminded that healthcare doesn’t exist in a vacuum. Both major political parties are pivoting to respond to the truism that every election is fought on the battleground of the economy. The 2023 general election shimmers on the horizon, backlit by poll results promising an edgy contest in which nobody will be able to take anything for granted. In recent weeks Labour and National have, in tandem, swung to talking about the cost of living, inflation, petrol and benefits instead of rapid antigen tests, the team of five million and the minutiae of the global vaccine supply chain. The predictions of a recession are creeping across the economic-punditry landscape, nudging the high-level political narrative from Covid to post-Covid even when we’re still in the throes of the thing.

I contacted our rostering administrator last week, told her I was exhausted and asked to cover a different set of shifts over the weekend. She said I was needed on nights, and she couldn’t give me any extra days off, but that she’d reduce one of my 14-hour shifts the following week to an eight-hour shift. I was pathetically grateful for the reprieve. We are watching the decline of operations, clinic appointments and procedures due to staffing shortages, participating in the rationalisation of care, and we know that the delayed care doesn’t disappear, but joins a growing landfill to be dealt with later, by us. “Can the human body feel preemptively tired?” I type into Google while waiting in line for a coffee.

“The Build Back Better Plan is Dead” announced Forbes magazine in March. They were talking about Joe Biden’s disaster recovery plan for America, which dissuaded me from using the line here. Instead I think we simply have to see the post-Covid response as non-negotiable, in the same way that we saw the Covid response as such. The opportunity to learn from the mistakes made during the pandemic is too significant to ignore, particularly when it comes to equity. For years, Māori health experts have tried to explain the consequences of the inequitable provision of healthcare – in the broadest sense of the term – without having a shared understanding with the team of five million. It was easy for people to not know what was happening for Māori, and from a state of ignorance it is only a short walk to indifference. Now we have a common experience and, with the benefit of wall-to-wall, second-by-second real-time coverage of the pandemic, eyes with which to see the effects of our health inequities.

Māori death rates are higher than Pākehā, our people have gotten sicker. The vaccine rates lagged as central bureaucrats scrambled to get resources to the Māori health providers doing the heavy lifting with bugger all support in the early days, our younger age profile and higher comorbidity rates were brushed off as unimportant; the results of these decisions are laid bare in the grim accounting currently underway. You can overlay this stencil of inequity cut from the gaps in our health system onto almost any other health issue experienced by Māori historically and find the same patterns and outcomes. You will also find clinicians and researchers screaming their evidence and outrage at the injustice into the void down the generations. Surely this will be the last time our experts go unheeded.

The promise of the Māori Health Authority is simply that courageous decision-making will happen. That such decision making is evidence-based and just is without question; we have collectively proven this beyond even the most pointy-headed of critiques. There is no credibility in calls for “more evidence” on equity. The highly optimistic idea that getting rid of the DHBs will solve everything (or anything) means far less to me in looking forward, than the opportunity we have with our best advocates in position at their own table at the Māori Health Authority.

They will not go unopposed. To some extent this is helpful – we’re none of us immune from making mistakes and thoughtful scrutiny should always be welcome. Less helpful is the proximity of the general election; we have already seen the Act Party leading out a proposed referendum on co-governance between Māori and the Crown, claiming unity through erasure of difference like countless others before them. They will not be alone in characterising equity as oppression and there are, sadly, always votes in it.

In the hospital where I work, we have looked after those hardest hit by Covid, an unwelcome trophy that has everything to do with the inequities we’ve been ignoring for decades in housing, employment, the food environment and the provision of health care. Looking ahead to next year we could do worse than look at our options through the lens of health and equity; even to those for whom economic concerns are paramount, surely they can recognise productivity tends to struggle without a healthy population, and dead people can’t buy your products.

Dr Espiner writes in a personal capacity and does not speak on behalf of any district health board or hospital.


Love The Sunday Essay series? Be sure to check out The Sunday Essay postcard set over in The Spinoff shop. The set includes 10 original illustrations from the series with insight from the artists. 

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Sunday Essay Jerry Ceri Giddens Feature image

The Sunday EssayApril 3, 2022

The Sunday Essay: Jerry

Sunday Essay Jerry Ceri Giddens Feature image

Ashleigh Young writes about a cat she loves deeply and knows not at all.

The Sunday Essay is made possible thanks to the support of Creative New Zealand

Original illustrations by Ceri Giddens

Jerry is getting that look. It’s the look of Death thinking about him. Not thinking deeply, yet – just contemplating, taking the measure of him. He’s 13 or so now, and is bonier about the back, saggier in the belly. He sleeps more, dribbles more, makes a racket when eating. As he has grown older he has also begun to live with more drama. To enter the house, he bursts through the cat door like someone punching a hole in the wall, and announces himself with an unholy scream. If it has been raining and he has, unbelievably, got wet, the screaming will get weird and wrong, like someone using an instrument in a way it shouldn’t be used, and it escalates until he is answered. Ageing has deepened Jerry’s conviction that the world exists for him alone, and that if something has not gone well for him, someone else must pay. In this way he is like a terrible sort of person who knows they will be forgiven again and again.

Is it ever interesting when someone talks about their cat? Or is it like when people tell you their dreams? I think if you live with a cat who you love, you can’t find any other cat truly interesting. I’ve read essays about people’s cats, and those essays were good, but I never cared about those cats, even when the writing had that special pathos, the “cat essay” pathos, the feeling of a late afternoon in autumn, or of the end of the school holidays – the knowledge that soon it will be over. The cat essay is already an elegy. The problem is, after eight years together, I only care about Jerry. I only care about his life, his eventual death.

I see him everywhere. He is a pile of sheets waiting to be washed. A garden sack full of weeds. A flash of brightness when the sun angles a certain way over the driveway. White sneakers through the pebbled glass of the front door. I think all of these ghosts of Jerry are my brain trying and failing, over and over, to possess him, to keep him. He cannot be possessed. On his first trip to Wellington from the Waikanae SPCA, where he’d been living after being dropped off as a flea-ridden stray, he began to savagely tear apart the box he was in, his tiny head erupting from the cardboard as we sped down the motorway.

Sometimes I ask Jerry, “What are you doing?” Or, in the morning, “What are you going to do today?” It’s a stupid question, because Jerry exists outside of doing. There he is, asleep in the garden like a puffball fungus. Or he’s attacking the wood basket with a sudden passing fury. Jerry is nearly always apparently doing nothing, and the few things he does do also result in nothing. Sometimes when he’s doing something that seems especially meaningless, like going in and out of the vacuum cleaner cupboard repeatedly, I imagine I see a flicker of human-like lostness in his eyes, a realisation that he doesn’t know what the hell he is doing. But that’s human projection. I once saw him staring at a lemon on a tree and when I came back an hour later he was still staring at the lemon. If Jerry is doing anything, it is at a level we can never know.

The concept of “nothing”, too, is different for Jerry. The blank page, the edge of the universe, unproductivity – personally I fear these things, but each day, in his sleeping, his staring, his goings back and forth over the same ground, Jerry embraces nothing, reveals its richnesses and eternal tiny variations. That’s one of the reasons he is a comfort. When I hug him I seem to touch freedom itself, in this being no bigger than a mid-sized watering can, who doesn’t fear nothing. I guess the one exception is when he wants something: food. Then he becomes very focused on the horror of nothing. He cannot accept that the present moment, the huge, all-encompassing now, could receive his cries and not give him everything he wants.

There was a cat who came to live with my family when we lived in Te Kūiti. He was friendly in the way of wanting to please us. We already had a cat and a dog, so we chased him away, but he kept coming back, his tail quivering suggestively, so we let him stay and called him Wilbur. One day a woman and her two boys came up the driveway in their car. “That’s Widget,” they said. “Widget, Widget.” They lived just down the hill from us, and the mother said ever since she had become pregnant again, Widget had been flighty. They took him with them, but the next day he was back. The family tried once more, but eventually let him go. So he became Wilbur for good. Wilbur flew with my dad in a Cessna to the South Island when he and my mum moved. Would Wilbur have stayed with his first family, if he had known that he would live out his last years in Blenheim? My mother had the letter W carved into a river stone to put over his grave. W for both of his lives – the ones that we knew about.

Who was Jerry before? Who were his people and who did he run away from, or who left him behind? Not knowing who somebody was before you loved them is almost unbearable – if only we could have met at the beginning, you think, then I would know everything. I once heard him meowing forlornly in his sleep, and woke him up. “Were you having a bad dream?” I asked. Probably he’d just been dreaming that he was trying to tear open a bag of biscuits, but I liked to imagine deeper complexities, some moment in his past that he was reliving, some formative heartbreak, a family driving away. But, obviously, even when a cat is in your life you still only ever know a little about them. I once saw an Instagram story of Jerry shrieking with wild delight as he ran along a fence towards someone. Another time, as he followed me down the street, a young couple said to him, “Hey Jeff.” At one flat, my landlord told me he’d opened his wardrobe to find Jerry sleeping on a pile of clothes in there. I saw, then, that in his way of owning everything and everyone, Jerry has a sort of landlord energy. But he also has renter energy, dog energy, poet energy, bus driver energy. He is many frames per second. The only way I can really conceive of his death is to imagine that he will continue to flicker rapidly through worlds. He will have worm energy, bird energy, tree energy, northerly wind energy.

I read somewhere that cats think humans are just bigger cats. Maybe Jerry does think we’re all the same. When he dangles his arms over the garden wall like an old man at the RSA, or sits in a washing basket as if about to set sail, he sometimes looks into my eyes as if he thinks I know what he’s saying, as if I’m sharing in the delight of whatever it is. There’s an aspect of this that is heartbreaking: he thinks we know each other, and I know we’ll never know each other.

But then, it’s probably not that complicated to know somebody. With all the talk of whether cats can ever love us, we overthink it. We overthink love. Outside, some distance from the house, Jerry will throw himself to the ground to roll around on dirt and stones and leaves, making Marge Simpson-ish sounds as if annoyed I’m not doing the same. It’s like I need to be shown how great it is out here, how incredible that we’re here at the same time today, with all of these things – endless dirt and stones and leaves for the taking, a dog going past to be puffed up at. I think then all he’s saying is, Look at this. Look at everything. You need to see how good it is. Then he gets up and wanders off.

We’ve been celebrating our shaggy, slithering, slobbering pets all week on The Spinoff. Click here for more Pet Week content.


Love The Sunday Essay series? Be sure to check out The Sunday Essay postcard set over in The Spinoff shop. The set includes 10 original illustrations from the series with insight from the artists. 

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