5/13/2007
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I wrote the first version of "Sanctum" in July 2004. In 1987, Canberra provided eighty-three per cent of university revenue. In keeping with financial exigencies, new Commonwealth money favoured advanced education over universities, and places in the non-university higher education sector expanded rapidly. In many ways, the solitary, focused life of a biographer and freelance author seems absolutely right for Brenda Niall. In practice, funding levels rather than mission now divided Australia's various tertiary education institutions.
They were not written to a haunted self, or someone who had failed trials of antipsychotic drugs, or someone who had been hospitalized again and again under duress. They were an introduction to a man I had not properly known. I had thought of him as struggling under the constant hold of hallucinations. Finding him there during life seemed illicit; peeking into his bedroom window.
They were not written to a haunted self, or someone who had failed trials of antipsychotic drugs, or someone who had been hospitalized again and again under duress. The last dozen messages on the screen were exactly the same. Yet even though such acts can jeopardize patients, the inclination and ability of young doctors to speak up is hampered by the hierarchies in teaching hospitals. Modern medical education can be traced to a series of reforms that began in the late 19th century. Some voiced hopes of meeting one day, some had comments about other correspondents on the site, some sent good wishes on relevant holidays.
Nor, apparently, was that unseen self writing back. I had gone on the site only a day after his death, but his cyberobituary must have traveled faster. Modern medical education can be traced to a series of reforms that began in the late 19th century. On the top were the senior physicians who made rounds on the wards once or twice daily. Even when students do speak up, they may be ignored. What should a medical student do in such a situation? One possibility is to take the matter up with a more senior doctor. Students and residents are now expected to provide routine feedback positive and negative about their supervising physicians at the close of their rotation. "What our study shows," he continued, "is that interventions even without a vaccine can be effective in blocking transmission. At a 1965 seminar on the future of higher education, the first vice-chancellor of Monash, J.A.L.
Because of the stringencies of their order (the Faithful Companions of Jesus), theirs was hardly a vibrant intellectual climate, and young Brenda's reading including Graham Greene soon intimidated the author-ities. But this latest reform remains unfinished business a private sector is allowed scope to compete, but public institutions remain bound and constrained. CAEs offered higher degrees, and carried out research, though not funded for it.
Canberra would decide how many Commonwealth-supported students could be enrolled at each university and what disciplines they were to study. Dawkins wanted to expand access for students to the system, and sympathised with CAE claims for university status. Dawkins was not principally interested in nurturing diversity within the higher education system. Death stalked the Niall family: several uncles died in quick succession, all young. Finding him there after death seemed imperative. On the opposite side of the screen, there were scrolls of e-mail messages that other MySpace members had sent him: friendly, uncapitalized, hallucination-free greetings. Some voiced hopes of meeting one day, some had comments about other correspondents on the site, some sent good wishes on relevant holidays. There was a photo of him on one side of the screen, handsome and poised, with his astrological sign, educational background and a description of his ideal mate. They were not written to a haunted self, or someone who had failed trials of antipsychotic drugs, or someone who had been hospitalized again and again under duress.
The unquestionably normal person, whose photograph still looked as though it were reading its e-mail messages from the opposite side of the Web page, had already fled to find peace, or reconciliation or relief, I don't know. Next were the overworked residents, who essentially lived in the hospital while training. The student whose resident seemingly lied to the attending physician about the blood test did not speak up either.
He then reminded the student that while he had examined hundreds of such cases, the student had seen only a few. After all, in each of these examples, patients are at risk of harm, something that physicians must avoid at all costs. As the ethicist James Dwyer has written in The Hastings Center Report, "The practice of always keeping quiet is a failure of caring." But in the real world, it may be extremely difficult to go up the chain of command. Still, it will be hard to change the unfortunate perception that constructive feedback, even for a patient's benefit, is whistle-blowing. Batchelor, with just under five hundred student places allocated for 2006, is the sole survivor of pre-Dawkins days. But in the mid-1970s this was well into the future. Canberra would decide how many Commonwealth-supported students could be enrolled at each university and what disciplines they were to study. Dawkins announced that the Commonwealth would only support institutions with a minimum of 2000 full-time students. Did free education allow daughters to follow sons to university, or did this trend simply reflect school retention rates, with female rates of Year 12 completion exceeding male ones from the late 1970s?
Each soon resembled in basic organisation, courses offered and academic mission the original universities in Sydney and Melbourne. Education Minister Julie Bishop accepts the case for loosened federal controls, and has accommodated institutions seeking to rethink their mission. Finding him there after death seemed imperative.
I had thought of him as struggling under the constant hold of hallucinations. In this world, he was a Pisces, not a schizophrenic.
The last dozen messages on the screen were exactly the same. I typed his name into MySpace, feeling covert and slightly criminal. I had thought of him as struggling under the constant hold of hallucinations. Modern medical education can be traced to a series of reforms that began in the late 19th century. Next were the overworked residents, who essentially lived in the hospital while training. Wolfberg wrote in the same journal last month, for years medical students performed pelvic examinations on anesthetized women who had not given consent because senior obstetricians said it was the best way to learn internal anatomy. The student whose resident seemingly lied to the attending physician about the blood test did not speak up either.
But when he told the resident, who had seen the patient earlier and more quickly, the resident refused to re-examine the patient. Penny Henderson and her colleagues at the University of Cambridge wrote in 2005, physicians and students need to be educated about how to give feedback in professional and nonconfrontational ways. I don't know if he drank four to eight glasses of water a day.
"What our study shows," he continued, "is that interventions even without a vaccine can be effective in blocking transmission. What's much less certain is whether society is prepared to bear the costs of implementing such intrusive and costly measures for the months that would be required to manufacture a vaccine."