In today's modern, democratic way of life, one might easily be forgiven, and often is, (strictly in the politest terms) for believing that the affairs of one's bodily functions are one's own. Of course we realized long ago that our mental functions belonged to some bureaucracy or another to which we had rights of lease only, and to which certain terms of occupancy applied. But for the body, one seemed left to cope with blowing one's own nose for dinkum, squeesing one's own pimples, and farting one's own home grown fart, with fear of only an occassional retribution.

In truth, however, for a dog named Boo and Mr O. Block, the responsibility for bodily function might there end. Somehow, the conditioning for anything complicated or "deep within", is to treat it as a heritage from the gods best left untampered. Like the plumber's leaky fawcet, or the butcher's lamb chop, so the artistry and mystique of one's very substance is palmed off and spat out into the clammy, trembling hands of that guru of gurus, butcher of butchers, plumbers of plumber of plumbers, the doctor with his own powerful bureaucracy called. The Modern Medical Health System.

Have I exaggerated do you think? Have I been callous, overactive, facetious and pompous in these remarks? Well yes, I admit, a little. But the Medical Health System is a callous, overactive, facetious and pompous thing.

So where do gurus come from; what permits them this right to delve into our very substance, our bodily core, our health with such matter of fact off-handedness? And the answer. 'But we do!" "We do?"

We must regard them with overwhelming awe then, these gurus. They must be of an exceptional quality to influence our destinies so. And yet it is so much pretentious mouth-gargle.

That doctors exist is quite undeniable, but it is the manner of existence that raises some objections and it is here that the size and use of their health budget might be called into question.

A moment ago in this impertinent rave, I tendered the pertinent question of where doctors came from.

The $100,000 Man

New Zealand has four Medical Schools, one to each centre, catering for the production of 320 new doctors a year, and these at an estimated cost of $100,000 each. Considering then that each CP effectively spends in the region of $100,000 a year of the tax-payers money, and each specialist $200,000. There is a lot of money spent in the name of health. A1 so considering that New Zealand is not losing 320 doctors a year, from death, retirement or emigration, and that the shortages that do exist in some areas and fields are due to uneven deployment, rather than overall shortage, there will be a healthy surplus of 'one hundred thousand dollar doctors' to sweep office floors very shortly. The spending however doesn't stop there.

Medical empire builders as a race have an unhealthy obsession to build concrete buildings; large ones; ones that sit around for many years not being used; linked by corridors of the Russian steppe variety; that tower over and engulf, ruminate and cogwheel round these infamous "diseases", and "germs". They cost money.

The patient? What are patients? They get in the way don't they? And the doctors? Doctors are intelligent, knowledgeable people, dedicated, hard-working and sincere. They walk briskly in white coats with those varying expressions of determination, good humour, compassion, serenity, godliness, approaching orgasm, or detachment aloofness, condescension, bombasticity, belligerence or simple ignorance. People, trained to pluck from the air whichever virtue matches the occasion; professional veneer it's called. It hides those thousand insecurities remarkably well.

And lastly, the student. Yes s/he is a bright cookie; straight A entrance, leave your personality at the door. Boring? My God; Spontaniety in communication should be avoided. But why condemn, students will always be students, never much more than a reflection of the system they are in, sometimes a refraction or polarization, as modern health and disease is a reflection of the society and environment we live in.

The Benefit

So it would be nice, even profitable, if Mr O. Block actually felt healthier for this vast expenditure and manipulation, if he lived longer; if he could work more man hours, but he doesn't. A little better off than he was 100 years ago perhaps, but mainly because of other factors like cleaner conditions, fresher water, availability of certain vaccinations, none of which are essentially medical.

Unfortunately for Medicine's reputation, in almost every case of improvement in general public health, its discoveries and interventions have come after the actual improvement, the relevant contributions having been social rather than medical. So today instead of dying of tuberculosis or the infectious diseases, we are dying of the degenerative diseases, the heart and chest complications, the mental syndromes; a reflection of the society and environment.

Health, therefore, cannot simply be left to the medical profession with it's vast mechanisms and complications which revolve distances away from the essential existence of a health disorder in a certain situation, but which tries nevertheless to remove it from that situation to enable a categorization in its own terms. Health is necessarily and vitally the society's responsibility, or more particularly the individuals' within it. The biggest misconception is that doctors alone can give this health, but it is God or whoever else you believe in, which is far the more likely, and doctors with a nod and a shisk, charge the tax. The statement is of course misleading, however, as it implies some premotivation to the connivance on behalf of the doctors, where rather they are at best described as phsical pawns to some, blind alturistic mental process, which drives them to lumber onto this health something more gross than God actuall prescribed. If only Mr O. Block weren't blasted with the medical paraphernalia bit, he wouldn't be quite so blinded to his own self-curing abilities.

Where Students Fit in

For the moment, hospitals et al continue to exist, and the value of the modern medical student, by continuing in the system, might hopefully be to instil pressures from within to develop a more flexible, personal, low-key, less out of touch, less expensive and less insecure health-caring system than presently exists, and that without compromising overmuch one's personal sanity or integrity.

The presence of the medical student in Wellington I feel, has hitherto been largely ignored by the general hub-bub of people concerned with University affairs; not on any deliberate account perhaps, but more because the school's ties have tended to stay with Otago, rather than switch to Victoria. The hope is that this lack of communication might in the future be redressed, to the advantage of both parties. One of the greatest traps for Medical students as they move into, and progress through, the Medical system, is that their focus on everyday life and its events does become progressively narrowed to fit the single medical monocular, and attempts at open discussion are all too often hampered by the unfortunate tendency of those in power, not to tolerate questioning of certain age-protected attitudes; especially not from subordinates in the same field. In such questioning they take on the amazing ability to feel threatened.

In all the above remarks in no way am I seeking to be unconstructive, only to point out that in no society should a structure purporting to work in the populaces' interest, be allowed to become autonomous from the essential workings of that society. The medical system has an accountability; an accountibility to every individual for whom it strives to promote health. And as such any discussion on the workings of this system should be encouraged, not persecuted, as was the case with recent criticism, of the medical school. Only in this way will some realistic attitude develop in New Zealand, to what has for too long been an 'unquestioned' and 'awe-seeking' profession.

Squires Bacre.