Статті в журналах з теми "Knee Wounds and injuries Australia"

The management of extremity injuries above the knee has been well described, but the evaluation and treatment guidelines for penetrating injuries below the popliteal crease has received less attention. A 6-year retrospective review of 100 patients who sustained isolated below-knee gunshot wounds. Patients with proximal extremity, torso, or head wounds were excluded from review so that we could focus on principles of managing below-knee wounds. All patients were evaluated with complete physical examination, ankle-brachial index, and plain X-rays. One patient presented with hemodynamic instability. Twenty-four patients underwent arteriography based on physical examination, an ankle-brachial index less than 0.9, or both. Twenty-two vascular injuries were identified in 19 patients, and an additional injury was found in a patient who went directly to surgery for pulsatile bleeding. Six of these 22 vascular injuries required treatment for bleeding or arteriovenous fistula. Treatment was by embolization in 5 and surgical ligation in 1. Thirteen patients had compartment syndromes. Thirty-five patients had fractures, and ten (29%) of these had an associated vascular injury. Four patients had peroneal nerve injuries, and three of these had long term disability. No limb loss or death occurred. We conclude that patients with low-velocity below-knee gunshot wounds sustain fractures, vascular injuries, compartment syndromes, and nerve injuries, in decreasing order of frequency. Arteriography and embolization may be useful to control bleeding; vascular reconstruction was unnecessary in our experience, and limb loss did not occur.

Background: Treatment of lower limb injuries pose a great challenge. Debridement is the key to success in the management of major limb injuries followed by soft-tissue coverage in the form of suturing, skin grafts, or flaps. Our aim is to study the management of various below knee soft tissue injuries.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Subjects were recruited from patients presenting in Emergency/Surgery OPD, HIMS, Dehradun with a primary diagnosis of below knee soft tissue injuries. A total of 64 patients were included in the study.Results: Primary closure was done in 6 wounds and coverage in rest, with maximum in the form of split skin graft. Abrasion wounds were managed without any surgical intervention. Reconstructive surgery was performed two or more times in 39.06% patients. Local complications were seen in 23.43% of patients and general complications AKI and Tetanus in 2patients.68.75% of patients with local complications were observed to have contaminated wound status at the time of presentation. The average duration of hospital stays ranged between 3 to 56 days. Majority of the patients were discharged within 1 to 3 weeks with mean duration of hospital stay being 17.82±10.95 days.Conclusions: Proper debridement, early coverage of wounds and prompt identification and management of complications is the key to success in the management of lower limb trauma.

In 1998, the Canadian historian and politician Michael Ignatieff wrote: “All nations depend on forgetting: on forging myths of unity and identity that allow a society to forget its founding crimes, its hidden injuries and divisions, its unhealed wounds.” Ironically, Ignatieff's home country has belied his assertion. Canada has engaged in collective remembering of one of its hidden injuries—the Indian residential schools—through a Truth and Reconciliation Commission (TRC) from 2009 to 2015. Australia, too, has reckoned since the 1990s with its own unhealed wounds—the separation of Aboriginal and Torres Strait Islander children from their families, or, in common parlance, the “Stolen Generations.”

Gunshot wounds of the elbow joint are the third most common after knee and shoulder injuries. Features of the anatomical and functional structure of the elbow joint, the close location of the vascular and nervous formations, favorable conditions for the development of infection determine the severity of gunshot wounds and cause the complexity of its treatment. Objective. To evaluate the frequency and nature of the elbow joint gunshot wounds in the structure of the general combat injuries, as well as to determine the volume of medical care and direction of treatment of such injuries in the conditions of the regional hospital as a stage of care. Methods. A retrospective study included 1 809 patients (96.0 % of men, mean age (33.7 ± 0.2) years). Firearms limb injuries were detected in 1 013 (56.0 %) of all victims, of which the elbow joint — 25 (2.47 %). Mines and explosives injuries were in 22 (88 %) of the patients, bullet — in 3 (12 %). Results. Tactics of treatment of elbow joint gunshot wounds depended on the severity of the condition of the victims and the nature of concomitant traumatic injuries. In the structure of combat injury of the elbow joint the majority was combined (52 %) and multiple (40 %) injuries and was accompanied by gunshot fractures in 60 %. In patients who were in severe state, applied the tactics of Damage control in two stages. At the first stage the fractures were fixed with plaster splints or external fixation devices (EF), the wounds were not subjected to full surgical debridment (SD), but only washed with antiseptics and the visible foreign bodies were removed. In patients with soft tissue injuries wounds the primary SD was performed according to general principles, injured nerves were not restored. In the second stage, after patient is stabilized, the repeated SD of the wound was performed. After their uncomplicated healing the EF was removed and the method of fixation was changed to internal osteosyntesis. Conclusions. It is recommended to perform stabilization of intra-articular gunshot fractures of the elbow joint with EF and after uncomplicated wound healing go to the internal osteosynthesis. Key words. Elbow joint, gunshot wounds, treatment.

Introduction:The Misericord, or stabbing pike, was a frequently used battlefield implement in medieval times. The misericord was used by battlefield clerics to relieve the suffering of irreparably wounded soldiers. Its cultural parallels include the Roman gladius, the Japanese wakazashi, and the eponymous Liston knife used in pre-Victorian era surgery in England.Methods:This demonstration will analyze modern misericord injuries in the light of the current epidemic of long knife (or zombie knife) attacks in London and the domestic terrorist threat in Australia.Discussion:A review of this weapon is pertinent to the projected low-technology, low-impact, and deep-penetrating wounds expected in urban terrorism in Australia and other cities globally. The talk will emphasize field discussion, demonstration, and disarming techniques against modern misericord-type weapons.

Decompressive fasciotomy for preservation of lower extremity function and salvage is an essential technique in trauma. The wounds that result from the standard two incision four-compartment leg fasciotomy are often accompanied by a wide soft tissue opening that in the face of true compartment syndrome are often impossible to close in a delayed primary fashion. We describe a technique using a device that allows for dissipation of the workload across the wound margin allowing for successful delayed primary closure. Consecutive patients who presented to the 28th Combat Support Hospital in Baghdad, Iraq with a diagnosis of compartment syndrome of the leg, impending compartment syndrome of the leg, or compartment syndrome of the leg recently treated with fasciotomies were followed. All patients underwent placement of the Canica dynamic wound closure device (Canica, Almonte, ON, Canada). Eleven consecutive patients treated at a combat support hospital in support of Operation Iraqi Freedom underwent four-compartment fasciotomies for penetrating injuries. There were five patients that underwent a vascular repair [three superficial femoral artery (SFA) injuries and two below knee popliteal artery injuries] and six patients that had orthopedic injuries (three comminuted tibial fractures, two fibula fractures, and one closed pilon fracture). Patients returned to the operating room within 24 hours for washout and wound inspection. Mean initial wound size was 8.1 cm; mean postplacement size was 2.7 cm; average time to closure was 2.6 days. All patients were able to undergo primary wound closure of the medial incision and placement of the Canica device over the lateral incision. Ten of the 11 patients (91%) could be closed in delayed primary fashion after application of the device. In our series of patients with penetrating wartime injuries and compartment syndrome of the leg we have found the use of this dynamic wound closure device to be extremely successful and expedient.

ABSTRACT Objective: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. Methods: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico(r) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases. Results: We evaluated 10 patients who used Pico(r) in our service. All patients had a favorable outcome according to established criteria. No complications were identified regarding the use of the NPWT device. The mean follow-up of the patients after the use of the device was 10.5 months. Conclusion: The NPWT can be safely used in wound infections and complications following TKA with promising results. Long-term randomized prospective studies should be conducted to prove its effectiveness. Level of Evidence IV, Case Series.

OBJECTIVE: To evaluate the ability of a novel topical antimicrobial gel containing cetrimide, bacitracin, and polymyxin B sulfate to prevent infections of minor wounds. DESIGN: A clinical trial compared the test preparation with placebo and a povidone iodine antiseptic cream. SETTING: Five primary schools in Sydney, Australia, participated in the study over a 6-week spring/summer school term. SUBJECTS: Children aged 5–12 years with parental consent were eligible for study participation. Accidental injuries occurring at school were treated in a standardized manner by nurses at each site. OUTCOME MEASURES: Wounds were evaluated by the medical practitioner after 3 days of topical treatment. The clinical outcome was classified as resolution or suspected infection. If a clinical infection was suspected, the injury was swabbed for microbiologic evaluation. Growth of a dominant microorganism was classified as a microbiologic infection. RESULTS: Of the 177 injuries treated, there were nine clinical infections. A comparison of these showed a significant difference among treatment groups (p < 0.05). This difference was associated with the test preparation and placebo; the test preparation reduced the incidence of clinical infection from 12.5% to 1.6% (p < 0.05; 95% CI, 0.011 to 0.207). A comparison of microbiologic infections showed no significant differences among treatment groups (p > 0.05). CONCLUSIONS: The novel gel preparation containing cetrimide, bacitracin, and polymyxin B sulfate showed therapeutic action and reduced the incidence of clinical infections in minor accidental wounds. It may be a suitable product for first aid prophylaxis.

Background: In the recent era of trauma majority of people suffer from lower limb injuries, which cause functional disabilities and psychosocial consequences. Lower limb injury specially below knee generally involves young and productive people so it is the prime responsibility of the society to prevent such incidents. Our aim is to study clinical profile of various below knee soft tissue injuries to develop better prediction models for defining the most important target for prevention and to reduce morbidities and disabilities.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Subjects were recruited from patients presenting in Emergency/Surgery OPD, HIMS, Dehradun with a primary diagnosis of below knee soft tissue injuries. A total of 64 patients were included in the study.Results: Maximum number of patients were in the age group of 20-40 years (46.88%), and were predominantly males (84.38%). The commonest mode of injury was RTA (75%) primarily involving 2 wheelers (72.91%). Most patients (42.18%) had late presentation to the hospital i.e. after 72 hours of injury which was found to be associated with contamination of wound in 66.6% of patients.Conclusions: The study emphasizes the need for preventive strategies and protection mechanisms for lower limb injuries. Late presenting contaminated wounds leads to higher complication rates hence there is need for efficient ambulance services for ensuring timely intervention.

In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports. It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education.

Simultaneous dislocation of three joints the hip knee and ankle joint in an ipsilateral limb is a very rare pattern of injury and only a single case has been reported in the literature, but it is associated with acetabulum fracture. A 34-year-old male had met with a road traffic accident involving left lower limb. Radiographic examination revealed (i) Posterior dislocation of the hip joint without any fracture (ii) Posterior dislocation of the knee joint(iii)Open fracture dislocation of the ankle joint with medial malleolus fracture tibial pilon fracture. The patient underwent an immediate closed reduction of the hip joint by Allis method. Simultaneous reduction of the knee and ankle joint was done and appropriate splintage gave. Open wounds were well debrided and trans-articular fixator was placed over knee and ankle joint. At a second stage, the medial malleolus fracture and tibia pilon fracture were fixed. MRI scan was done which revealed an anterior cruciate ligament injury of the knee. At 6-month follow-up, the patient was ambulating with full weight-bearing on both lower extremities without any assistive devices. There always lies a high risk of hemodynamic instability and other serious and life-threatening injuries due to the high velocity of trauma involved in such cases. The outcome of ipsilateral hip knee and ankle dislocation can vary widely depending on the circumstances and other associated injuries.

Four children who incurred perianal injuries as a result of a sexual assault were followed on a longitudinal basis to document the anatomical changes that ensued. The subjects, whose ages ranged from 4 to 8 years, were followed from 1 week to 14 months. They were examined in both supine and prone knee-chest positions and a 35-mm camera mounted on a colposcope was used to record their injuries. At the time of the initial examination, there were a variety of findings including erythema of the tissues, edema of the skin folds, localized venous engorgement, dilation of the external anal sphincter, and lacerations of different depths. Superficial lacerations reepithelized within 1 to 11 days. The second-degree wounds in two of the children were healed by the 1- and 5-week return visits, leaving narrow bands of scar tissue. In the two subjects who were followed the longest, signs of both a second-degree laceration and a surgically repaired third-degree injury had virtually disappeared by 12 to 14 months after the assaults. The wounds in one subject, infected with a herpes simplex type 2 virus, remained erythematous for a longer period of time than did similar injuries in the other children. A skin tag created by the avulsion of the tissues in one subject persisted, although it became less obvious as it retracted into the redundant folds of the perianal tissues over time.

New Zealand fur seals Arctocephalus forsteri are the most abundant of the 4 otariid (eared seal) species distributed across Australasia. Analyses of stomach contents, scats and regurgitates suggest a diet dominated by bony fish and squid, with cartilaginous species (e.g. sharks and rays) either absent or underrepresented because of a lack of preservable hard parts. Here we report on a subadult specimen from south-eastern Australia, which was found ashore emaciated and with numerous puncture wounds across its lips, cheeks, throat and the inside of its oral cavity. Fish spines embedded in the carcass revealed that these injuries were inflicted by chimaeras and myliobatiform rays (stingrays and relatives), which matches reports on the diet of A. forsteri from New Zealand, but not South Australia. Shaking and tearing of prey at the surface may help to avoid ingestion of the venomous spines, perhaps contributing to their absence from scats and regurgitates. Nevertheless, the number and severity of the facial stab wounds, some of which led to local necrosis, likely affected the animal’s ability to feed, and may account for its death. Despite their detrimental effects, fish spine-related injuries are difficult to spot, and may be a common, albeit cryptic, type of trauma. We therefore recommend that stranded seals be systematically examined for this potentially life-threatening pathology.

This study aimed to establish whether post-mortem injury patterns can assist in distinguishing drivers from front seat passengers among victims of motor vehicle collisions without regard to collision type, vehicle type or if safety equipment had been used. Injuries sustained by 206 drivers and 91 front seat passengers were catalogued from post-mortem reports. Injuries were coded for the body region, depth and location of the injury. Statistical analysis was used to detect injuries capable of discriminating between driver and passenger. Drivers were more likely to sustain the following injuries: brain injury; fractures to the right femur, right posterior ribs, base of skull, right humerus and right shoulder; and superficial wounds at the right lateral and posterior thigh, right face, right and left anterior knee, right anterior shoulder, lateral right arm and forearm and left anterior thigh. Front passengers were more vulnerable to splenic injury; fractures to the left posterior and anterior ribs, left shoulder and left femur; and superficial wounds at the left anterior shoulder region and left lateral neck. Linear discriminant analysis generated a model for predicting seating position based on the presence of injury to certain regions of the body; the overall predictive accuracy of the model was 69.3%. It was found that driver and front passenger fatalities receive different injury patterns from motor vehicle collisions, regardless of collision type. A larger study is required to improve the predictive accuracy of this model and to ascertain its value to forensic medicine.

Introduction:Patients affected by spina bifida (SB) can present varying degrees of paralysis, limited mobility, impaired sensation, orthopedic problems and bowel, bladder, and renal impairments. Skin wounds are reported as one of the primary diagnosis associated with hospitalizations in SB affected patients. In young patients, pressure injuries can occur more frequently at the lower limb. A multidisciplinary approach and a proper surgical technique are mandatory to obtain favorable long-term outcomes, in terms of adequate coverage and risk of recurrence. Case Presentation:A Caucasian male 21-year-old wheelchair-bound patient with history of SB was admitted to our department with stage four pressure injury on the medial aspect of knee joint and osteomyelitis. After antibiotic therapy wound preparation and debridement, we covered the pressure sore with a pedicled fasciocutaneous flap harvested from the medial compartment of the thigh. In the distal part, we splitted the fascia from the flap and used it to reconstruct the exposed knee joint. We did not report any complications and no recurrence was observed at 1-year follow-up examination. Conclusion:In this reported case, the multidisciplinary approach and the surgical technique allowed us to cover the soft-tissue defect around knee joint, reducing morbidity, surgical time, and cost with good long-term outcomes. Keywords:Spina bifida, pressure injuries, fasciocutaneous flap.

Abstract Missile injuries of the sciatic nerve are frequently encountered in modern violent conflicts. Gunshot and fragment wounds may cause large nerve defects, for which management is challenging. The great size of the sciatic nerve, in both diameter and length, explains the poor results of nerve repair using autografts or allografts. To address this issue, we used a simple technique consisting of a direct suture of the sciatic nerve combined with knee flexion for 6 weeks. Despite a published series showing that this procedure gives better results than sciatic nerve grafting, it remains unknown or underutilized. The purpose of this cases study is to highlight the efficiency of direct sciatic nerve coaptation with knee flexed through three cases with missile injuries at various levels. At the follow-up of two years, all patients were pain free with a protective sensory in the sole and M3+ or M4 gastrocnemius muscles, regardless of the injury level. Recovery was also satisfying in the fibular portion, except for the very proximal lesion. No significant knee stiffness was noticed, including in a case suffering from an associated distal femur fracture. Key points to enhance functional recovery are early nerve repair (as soon as definitive bone fixation and stable soft-tissue coverage are achieved) and careful patient selection.

Skin cancer from 775 patients in the savannah showed a preponderance of squamous cell carcinoma (SCC) of the leg related to neglected, poorly managed and chronic ulcers or scars from burns or injuries. SCC of the head and neck had no predisposing factor. Malignant melanoma overwhelmingly affected the feet, dermatofibrosarcoma affected the trunk and Kaposi sarcoma affected the limbs. Basal cell carcinoma (BCC) comprised only 2% of all skin cancers. The 18 albino patients had a higher frequency of both SCC and BCC mostly on the head and neck. Excisional surgery was generally effective, the wounds being closed primarily or by means of flaps and skin grafts. However, 98 patients required amputation below the knee for tibial involvement by SCC. The prognosis and health care costs of skin cancer will only be improved if burns and injuries are adequately treated.

Objective: To demonstrate the safety and efficacy of downward stripping of the long saphenous vein. Design: Retrospective study in a series of patients treated surgically by the author. Setting: Department of Surgery, Nepean Hospital, Sydney, Australia. Patients: Patients presenting with clinical signs and symptoms of varicose veins attributable to sapheno-femoral incompetence. Interventions: Patients underwent flush sapheno-femoral ligation with stripping of the long saphenous vein using a downward stripping of the long saphenous vein between the groin and knee. Main outcome measures: Cosmetic appearance of the limb and presence or absence of neurological disturbance suggestive of injury to the saphenous nerve. Results: Satisfactory healing of all wounds was found. Good aesthetic results and no neurological complication was encountered. Conclusion: Groin to knee downward stripping of the long saphenous vein provides a safe and effective method for managing varices of the long saphenous vein.

Purpose: to determine the causes of injuries in sports and the factors that cause them. Material and methods: study of special literature and generalization of experience of preparation of sportsmen in various kinds of sports. Analysis of factors influencing sports injuries in order to develop measures for their prevention. Results: There are a large number of injuries that can be received during sports. In our article we will consider some of them. Trauma is a lesion of the surface of the body or internal organs, which arose under the influence of external factors, as a result of which one or another organ has lost the ability to perform its function. Depending on the nature of the injured tissue, there are skin (strokes, wounds), subcutaneous (ligament ruptures, bone fractures, etc.) and abdominal (hemorrhage, chest injuries, joints) injuries. Injuries are divided into direct and indirect, depending on the point of application of force. They can be single (eg, transverse femoral fracture), multiple (multiple rib fracture), combined (pelvic fracture with rupture of the bladder) and combined (hip fracture and frostbite, etc.). Injuries are open with a violation of integrity and closed, when the replacement of tissues and organs occurs with intact skin and mucous membranes. According to the level of severity of injuries are divided into mild, moderate and severe. Injuries to the extremities are most often observed in the localization of injuries in athletes, among them injuries of the joints, especially the knee and ankle, predominate. Upper limb injuries (70.0% of all injuries) are more common during gymnastics. Most sports are characterized by injuries of the lower extremities, such as athletics and skiing (66,0 %). Head and face injuries are typical for boxers (65,0 %), fingers - for basketball players and volleyball players (80,0 %), elbow joint for tennis players (70,0 %), knee joint - for football players (48,0 %). etc. Among sports injuries, as a rule, a high percentage of injuries of medium severity. Conclusion: analysis of the causes of injuries in sports, allows us to conclude that injuries in sports can be prevented. A coach in a certain sport plays a crucial role in injury prevention. Its activities should take place in close contact with medical staff. It is the physician's responsibility to systematically record all injuries. Not only severe injuries, but also moderate injuries must be carefully studied, the causes of their occurrence must be identified and the necessary measures to eliminate them must be developed.

Gunshot wounds (GSW) are becoming increasingly prevalent in urban settings. GSW to the trunk mandate full trauma activation and immediate surgeon response because of the high likelihood of operative intervention. Extremity GSW proximal to the knee/elbow also require full trauma activation based on American College of Surgeons Committee on trauma standards. However, whether isolated extremity GSW require frequent operative intervention is unclear. We evaluated GSW at our Level I trauma center from January 2012 to December 2016. Demographic data and injury patterns were abstracted from the trauma registry and charts. The number of GSW increased yearly but the age, gender, Injury Severity Score and injury pattern did not change (P = ns, not shown). There were 504 GSW that included an extremity and 194 (38%) involved multiple body regions. There were 310 GSW (62%) isolated to an extremity and 176 were proximal to the elbow/knee. If proximal GSW had an Emergency Department systolic blood pressure <90 mm Hg, 53 per cent underwent vascular repair, 12 per cent had soft tissue repair, and 29 per cent required no operation. If proximal GSW had an Emergency Department blood pressure >90 mm Hg, 57 per cent underwent orthopedic repair, 22 per cent required no surgery, and only 13 per cent required vascular repair (P < 0.01). In the absence of other criteria for full trauma activation such as shock, the need for the immediate presence of a general surgeon to perform emergency surgery for a GSW isolated to the extremity is low.

The rate of aerobic dance injuries has been high for two decades. To determine the types of lower-extremity injuries to aerobic instructors, a questionnaire was sent to 18 fitness centers in the Sydney, Australia, metropolitan area requesting information on the number and types of injuries, frequency of activity levels, footwear worn, and treatments sought. The reported rate of injury was 77%. The leg was the most common site of injury, reported by 52.9% of respondents, followed by the foot and ankle (32.8%), and the knee (20%). These figures are comparable to previous studies. Further investigation is warranted into causes and preventive measures, and information on the kinetics and kinematics of the lower extremity may increase understanding of the incidence of lower-extremity injuries to aerobic instructors and participants. (J Am Podiatr Med Assoc 91(10): 528-532, 2001)

Introduction: Posterior cruciate ligament is the primary stabilizer of the knee. Among the potential complications in arthroscopic repair of this ligament, there are vascular lesions, due to laceration, thrombosis and injury of the intima of the popliteal artery. We used one case to show the vascular complications that may arise in arthroscopic repair of the posterior cruciate ligament, how to handle it and the results. Methods: One patient, 33 years old, with a history of traffic accident. In a physical exam the patient shows pain and swelling of the knee, positive posterior drawer test and positive Godfrey test. X-rays on the knee show posterior tibial translation and MRI a complete fibers rupture at the middle third of the posterior cruciate ligament. An arthroscopic repair surgery was scheduled three weeks after trauma, with PCL reconstruction using simple band technique.After surgical intervention, hemostatic cuff was released, no peripheral pulse, paleness and coldness of the member was confirmed. An arteriography was carried out, which confirmed absences of distal vascular filling in the popliteal artery. An urgent referral was carried out with Vascular Surgery Services, who had been informed of the surgery previously (a notification that is part of our routine for this kind of interventions). Arteriorrhaphy and venorrhaphy of the popliteal arteries was fulfilled 12 hours later, with a leg fasciotomy. Daily monitoring was performed, and after 72 hours, muscle necrosis is seen with wound drainage, analysis shows presence of gram-negative bacilli, Proteus Mirabilis-Pseudomonas spp and the lab results showed leukocytes: 8.700/ml, ESR: 58, CRP: 48. A new surgery is performed with complete resection of the anterior external compartment of the leg, and a system of continuous cleansing is applied with physiological saline solution and boric acid for 14 days until drainage is eliminated. Vancomycin and ceftazidime EV was indicated for 14 days and, after a good evolution of the wounds, patient is discharged from hospital with Sulfamethoxazole/trimethoprim 160mg/800mg to be taken orally for 14 days. Results: After treatment with oral antibiotic is completed, wounds progress positively. Foot in equinus position, has positive distal pulses with distal sensibility. Use of a thermoforming brace is indicated for movement. Vascular Surgery Services are currently following patient’s evolution. An ankle arthrodesis surgery is evaluated for the future. Conclusion: Combined injuries that result in a posterior tibial translation over 15 mm and, those that come along with injuries in the anterior cruciate ligament or posterior lateral structures of the knee, should be repaired through surgery. Vascular lesion caused by laceration, thrombosis or injury of the intima of the popliteal artery, mainly during perforation and preparation of tibial tunnel, is a serious lesion. Although these vascular lesions during arthroscopy are complications relatively rare, a potential risk should be considered, with consequences that could be fatal for the extremity and for patient’s life when bleeding is involved. In those cases, urgent treatment is imperative, that is the reason we believe it is safe to coordinate with Vascular Surgery Services before the surgery is carried out.

BackgroundThe grade cricket competition, also known as premier cricket, supplies players to the state and national teams in Australia. The players involved are generally high-performing amateur (subelite) club cricketers. However, to date, there is no study on the injury epidemiology of Australian grade cricket.AimTo conduct injury surveillance across all teams playing Sydney Grade Cricket (SGC) competition during the 2015–2016 season.MethodsA cohort study was conducted to track injuries in 408 male cricketers in 20 teams playing SGC competition. Players were tracked through the MyCricket website’s scorebook every week. Cricket New South Wales physiotherapists were alerted if there were changes to the playing XI from the last game. If any changes were made due to injury, then an injury incident was registered.ResultsDuring the course of the season, a total of 86 injuries were registered from 65 players, resulting in a loss of 385 weeks of play. The overall injury incidence rate was 35.54 injuries/10 000 playing hours with an average weekly injury prevalence of 4.06%. Lower back injuries (20%) were the most common injuries followed by foot (14%), hand (13.75%), knee (7.5%) and calf (7.5%). Linear regression analysis showed that the likelihood of injury increased as the mean age of the teams increased (R=0.5, p<0.05).ConclusionThe injury rate in SGC is lower than that reported at elite level. However, the high rate of lower back injuries (20%) highlights an area of concern in this cohort. High workloads or inadequate physical conditioning may contribute to such injuries. This study sets the foundation for understanding injury epidemiology in grade cricket and examines the links between injury and performance, these results may assist coaches and administrators to develop and implement cricket-specific injury prevention programmes.

Background/aimAnterior cruciate ligament (ACL) injury is a common and devastating sporting injury. With or without ACL reconstruction, the risk of knee osteoarthritis (OA) and permanent disability later in life is markedly increased. While neuromuscular training programmes can prevent 50–80% of ACL injuries, no national implementation strategies exist in Australia. The aim of this study was to compare the ability of four alternative national universal ACL injury prevention programme implementation strategies to reduce future medical costs secondary to ACL injury.MethodsA Markov economic decision model was constructed to estimate the value in lifetime future medical costs prevented by implementing a national ACL prevention programme among four hypothetical cohorts: high-risk sport participants (HR) aged 12–25 years; HR 18–25 years; HR 12–17 years; all youths (ALL) 12–17 years.ResultsOf the four programmes examined, the HR 12–25 programme provided the greatest value, averting US$693 of direct healthcare costs per person per lifetime or US$221 870 880 in total. Without training, 9.4% of this cohort will rupture their ACL and 16.8% will develop knee OA. Training prevents 3764 lifetime ACL ruptures per 100 000 individuals, a 40% reduction in ACL injuries. 842 lifetime cases of OA per 100 000 individuals and 584 TKRs per 100 000 are subsequently averted. Numbers needed to treat ranged from 27 for the HR 12–25 to 190 for the ALL 12–17.ConclusionsThe HR 12–25 programme was the most effective implementation strategy. Estimation of the break-even cost of health expenditure savings will enable optimal future programme design, implementation and expenditure.

Basketball is one of the most played games in the world with a huge amount of fan following and has a great number of basketballers. Sometimes players get severe lower body wounds such as ankle sprains, shortage of breath, head, teeth, hand, and fingers. Female players have a higher risk of knee injuries than male players. These are health issues that players face while playing basketball. Sports organizations spend millions to train fresh basketball players or for the development of the previous basketball players. The internet of things (IoT) made everyday things readable, controllable and recognizable through the internet and the wireless sensor networks. It is simply the network of interconnected devices that are embedded with sensors, software, and connectivity modules.Nowadays, with this growing technology it is possible to protect the life of players in the game as well as in training sessions, if we detect the problems early in players and appropriate actions will be taken to reduce adverse health effects which can be very dangerous. In this paper, we will propose an architecturefor basketball based on the internet of things (IoT). The main goal behind this approach is to introduce a healthcare system based upon sensors, actuators, devices and telecommunication technologies to communicating real-time stats.

Background: Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. Purpose: To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Study Design: Systematic review. Methods: Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Results: Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. Conclusion: A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes of administration, and treatment regimens, which prohibits making any definitive conclusions. Currently, the clinical use of placenta is limited to only commercial placental tissue allografts, as there are no placenta-derived biological drugs approved for the treatment of orthopaedic sports medicine conditions in the United States. However, this review shows that the application of placental cells or tissue allografts appears to be safe and has potential to improve outcomes for orthopaedic sports medicine indications.

Studies on species that attain very large body sizes provide a powerful opportunity to clarify the ecological correlates and consequences of body size, but logistical obstacles mean that most ‘giant’ species have attracted little field-based research. The Australian scrub python, Morelia kinghorni (= M. amethistina in earlier literature), is the largest Australian snake. Our three-year field study in the Tully River Gorge of tropical north-eastern Australia provides the first detailed ecological data on this species. Snakes aggregate in the gorge during the dry season for reproductive activities (combat, courtship and mating), and these aggregations consist primarily of large adult males. Wet-season samples from a nearby road contained more females, and more juvenile animals. Body temperatures of diurnally active pythons averaged 25.2°C, and were highly correlated with air and substrate temperatures. Larger snakes were cooler than smaller conspecifics, perhaps reflecting their slower heating rates. Recapture of marked individuals suggests that pythons of both sexes and all body sizes maintain fixed home ranges, as the distance from initial capture did not increase through time; most animals were recaptured <100 m from their initial capture point, but some dispersed at least 1.5 km. Adult male pythons spanned a massive range in body sizes (1.3–3.76 m in snout–vent length, 0.30–11 kg in mass), and larger males were more likely to engage in combat, exhibit combat-related injuries (bite wounds) and obtain matings. Presumably reflecting the reproductive advantage of larger body size, males attained much larger maximum sizes than did females within our study population.

Severe knee injuries are common in alpine skiing and the hamstring muscles are known to counteract the anterior tibial displacement that typically accompanies major injury mechanisms. This study aimed to assess the Maximal Eccentric Hamstring Strength (MEHS) of youth competitive alpine skiers during Nordic Hamstring Exercise (NHE) in terms of dependence of sex, age and biological maturation. A total of 246 7- to 15-year-old skiers were tested with respect to their MEHS using an NHE-based measurement device (Vald Performance, Newstead, Australia). Significantly greater absolute MEHS was observed in skiers of the under 15 years (U15) category compared to skiers under 10 years old (U10) (227.9 ± 61.1 N vs. 142.6 ± 28.9 N; p < 0.001), also when grouped by sex. Absolute MEHS was revealed to be lower in U15 females compared to males (213.5 ± 49.0 N vs. 241.9 ± 68.4 N; p = 0.001); in U10 skiers there was no sex difference. For all age groups and sexes, absolute MEHS values were significantly correlated with age and biological maturation (p < 0.001). However, when normalized to body weight such associations disappeared, which is why this is strongly recommended when testing around their growth spurt. Overall, this study established sport-specific normative reference data that may be of interest to researchers and sport practitioners alike.

Abstract Introduction Although stress ulcer disease related to burn injury was noted previously, it was the report of a series of 10 cases by Curling which lent the name to the finding. Occurrence of the disease has been attributed to the stress factors of hemodynamic instability with resultant decrease in defense factors of the gastroduodenal epithelium noted as patients began to survive massive burns. At one time, the incidence was reported as high as 23% of hospitalized burn patients. However, with advances in supportive care and antacid therapy, some have wondered if Curlings ulcers may have become extinct. Methods We report the case of a 21-year-old male admitted after MVC with 53% TBSA burn (32% full-thickness) and multiple blunt trauma injuries. Early in his course he underwent splenectomy, small bowel resection, right hemicolectomy, and ORIF of an unstable lumbar fracture, and below-knee amputation. He underwent staged excision and grafting of burn wounds and had been autografted with exception of about 11%TBSA of the left lower extremity (wound controlled with allograft). On hospital day 38, the patient was noted to have melanotic colostomy output with a concomitant drop in hemoglobin level from 7.6 g/dl to 3.5 g/dl. Results The gastroenterology service was consulted, and they performed upper endoscopy on hospital day 39. A large amount of clotted blood was seen in the stomach, but the source of bleeding was not visualized. Subsequent endoscopy the following day showed an erosion of gastric mucosa in the gastric fundus consistent with ulcer, on which two clips were placed. The patient’s stool was tested for H. pylori antigen and the test was negative. The patient continued on a proton pump inhibitor, non-steroidal anti-inflammatory drugs were held, and his hemoglobin stabilized and melanotic ostomy output resolved. Conclusions Antacid therapy, H2-blockers, and proton pump inhibitors have historically been used in cases of large burns. However, in the care of other critically ill patients the association of this therapy with ventilator associated pneumonias has lead to new scrutiny. In addition, a renewed emphasis on multimodal pain management may be introducing a bias towards an increase in so-called aggressive factors, namely NSAIDS administered over longer periods. Advances in critical care of burn patients have made Curling’s ulcers rare, but not extinct.

Talus fracture are extremely rare in children. The talus is predominantly made up of cartilage with higher elastic resistance than adult bone thus the pediatric talus bone can sustain higher forces before fractures. The prevalence for paediatric trauma in talus fracture is estimated to be five times rarer than for adult trauma . The most common mechanism of injury in talus fractures is axial loading of the talus against the anterior tibia with the foot in dorsiflexion. The talar neck is the most common fracture site, followed by the talar body. Report: A 9-year-old boy was brought to emergency department following a fall from bicycle after his right foot caught in back wheel. He was unable to weightbear on his right foot and his anterior ankle region was swollen, with no open wounds or abrasions. Radiographs of right ankle revealed a fracture at neck of right talus (Hawkins type II ) then proceed with CT scan to characterize the fracture pattern and extent of injury. His fracture was fixed with two headless cannulated screws size 4.0 under I/I guidance. The patient was advised non-weight bearing with below knee cast for 6 weeks. After 2 months the patient was pain free and had resumed all his activities. X-ray after 1 year showed a consolidation of the fracture without evidence of avascular necrosis. The Hawkins classification can be used to describe the different types of fractures of the talar neck and to predict the risk of avascular necrosis. These injuries can be difficult to diagnose with plain radiograph, and further assessment with CT scan or MRI may be necessary. Undisplaced fracture can be managed non-operatively with cast immobilization and displaced fracture can be treated with either closed or open reduction. Complications are still likely to be encountered in the course of talus fractures treatment considering the precarious blood supply to the bone as well as complex ankle and subtalar articulations. According to Smith et al study with 29 subjects , displaced pediatric talus fractures and those associated with high-energy trauma resulted in more complications ; avascular necrosis (7%), arthrosis (17%),delayed union (3%),neuropraxia (7%) and the need for further surgery (10%). [Figure: see text][Figure: see text] Conclusion: Talar fractures in the pediatric age group are very rare. A minimal or undisplaced fracture of talus is less likely to undergo avascular necrosis than a displaced fracture but even with optimal treatment, avascular necrosis may still occur. It is of prime significance that these fractures should be diagnosed well in time to avert complications. Therefore an appropriate length of follow-up is required. References: Vivek D , Jairam DJ , Paediatric Talus Fracture :Volume 5 Issue 8, International Journal of Science and Research August 2016 PG 1040-1041

The purpose of the study was to improve the functional results of treatment of patients with closed fractures of long bones of the extremities with polytrauma. Materials and methods. The results of treatment of 95 patients with fractures of long bones of the extremities with polytrauma were analyzed. Among them there were 70 (73.9%) men and 25 (26.1%) women. The victims had one or more closed fractured of the long bones of the limbs. Persons of young and able-bodied age from 31 to 50 years old prevailed – 47 (48.9%) patients. Results and discussion. Active restorative treatment was started on the second and third days after the operation at the beginning of passive movements in the joints then, as the postoperative wound healed, on the sixth and seventh days, it was active. Depending on the nature of the fractures various implants were used, in most cases, low-contract ones, which in a particular case allow achieving maximum anatomical reposition and achieving stable fixation of fragments, which provides the possibility of an early start in the development of the joint. In the immediate postoperative period in 11 patients with open fracture type B3, superficial suppuration of the soft tissues around the pins was noted, which was easily dealt with using a device for injecting drugs into the infected pin channel. Four patients with granulating wounds of the lower leg underwent autodermoplasty with a free skin graft, all 100% were healed. Phlebothrombosis developed in three patients with hip fractures: they underwent an urgent operation by angiosurgeons – vessel plexization. Long term results of treatment in terms of 8 months to 5 years were studied in 76 patients. Treatment outcomes were assessed with some criteria (union, neuro vascular disorder, varus or valgus, rotation, shortening of the limb, movement in the knee and hip joint, pain, walking hanging activity). Four patients developed chronic osteomyelitis, they underwent seguestrectomy with sub segment recovery. Delayed consolidation was noted in six patients with complex fractures (type C). Two patients developed a defect in the bones of the lower leg up to 5 sm, they subsequently underwent lengthening of the segment. Post-traumatic contracture was noted in four patients. Three patients had persistent leg edema, chronic post-traumatic thrombophletitis, equinus deformity of the feet, significant chromate – the result was rated as “poor”. According to the results of ratings as “excellent”, “good”, “satisfactory” and “poor”, quantitative designations were assigned as 5, 4, 3, 2 points, respectively. In the 76 patients studied, the long-term results were assessed as follows: in 24 (31.6%) patients the result was regarded as excellent (5 points), in 37 (48.7%) patients it was good (4 points), in 12 (15.8%) %) – satisfactory (3 points), in 3 (3.4%) – poor (2 points). Conclusion. As a result of the use of low-contact on-bone plates in the osteosynthesis of complex comminuted fractures of long bones, with combined injuries, 90.3% gave excellent and good functional results. With a combined chest injury, intramedullary osteosynthesis with a pin with reaming is contraindicated, due to the risk of developing fat embolism. In these patients, it is necessary to operate with bone plates

In this study the evolutionary development of orthopedics (management of diseases of bones and joints), which commenced in early Mesopotamia and Egypt, is followed through Classical times.The Greek infl uence probably commenced in the 6thcentury BC with Democedes of Croton who cured the Persian king’s dislocated ankle. The Corpus Hippocraticum laid the foundation of orthopedic practice in antiquity. Although knowledge of anatomy was limited, its four books on orthopedics (The Nature of Bones, Mochlicon, On Fractures, On Joints) count amongst the outstanding contributions of Hippocratic writers. In systematic manner the general recognition and management of fractures and dislocations are covered, followed by the handling of individual lesions. Hippocrates differentiated between closed and open fractures (with overlaying skin wounds). Closed fractures were reduced to as normal a position as possible – manually where possible, but with large bones and in the presence of formidable muscle mass, mechanical traction was often employed (e.g. the Hippocratic bench and the bizarre succusion ladder for spinal deformities). There is no mention of the use of analgetic drugs. After application of cerate (mixture of olive oil, soda and pitch) to the skin, the fracture was immobilized by a combination of plasters and compresses (often fi rmed up with gum-mixtures) – but never very fi rmly. On the 3rd, 6/7th, 9thand 12th days the bandaging was removed, the lesion inspected and if considered necessary, re-aligned, A variety of splints were then applied. Strict bed rest was enforced, as well as a light diet (no wine or meat for 10 days). It was believed that fractures of the feet, clavicle, ribs and jaw healed after 20 days, of the forearm after 30 days, and fractures of the upper arm and leg after 40 days. Open fractures were considered very serious injuries, and reduced very carefully. Protruding bone fragments were removed (sawn off if necessary) and the wound was covered with black cerate, compresses and light bandages. Pressure and heavy splints were thought to induce infection and gangrene and thus avoided. Dislocations were reduced as soon and as effectively as possible, before muscle spasm set in. As with fractures manual reduction was, where necessary, complemented by mechanical traction. After extensive washing of the joint area with warm water, cerate was applied to the wound and specialised bandaging (even splints) ensured immobilization. Open dislocations like open fractures were considered very serious and reduction was not attempted. Again all pressure bandaging was avoided. A non-functional joint was commonly the end result. The management of 18 specifi c fractures is described in detail. Jaw fractures were fi xed by the binding of contiguous teeth. Fractures of the spinal column clearly presented a major problem. Although knowledge of spinal anatomy was surprisingly good, the diagnosis of fractures was very difficult and its association with spinal curvatures presented almost insurmountable problems of management. It was recognized that rib fractures could cause serious damage to the lung and pleura. Complex problems caused by arm fractures involving the elbow or shoulder joints, and combined radius and ulna fractures, are addressed. Femur fractures presented major problems and permanent leg deformity was very common. Open femur fractures were extremely serious and Hippocrates even stated that a physician who could ethically avoid becoming involved in treating such an injury, should do so. Fractures of femur necks were not recognised. The Hippocratic work, Wounds of the head, dealing with fractures of the skull, is not covered in this study.Management of the major joints are individually described. Seven different techniques of reducing a dislocated shoulder joint are mentioned The original description of the management of the dislocation of the wrist and hand is lost. Proper reduction of hip-dislocation was essential to avoid muscle atrophy and life-long limping, and was achieved by intricate mechanical suspension. Strangely enough, lateral dislocation of the knee was a common occurrence and not seen as a serious problem. Congenital club feet were effectively treated by prolonged fi xation in the correct position by way of tight bandaging with compresses stiffened in glue-mixtures.There is abundant skeletal evidence of osteo-arthritis in Neolithic man, but no clear description of it in the Corpus Hippocraticum. Gout is repeatedly mentioned in the Corpus but without detailed descriptions of the disease. In the Roman era authors like Heliodorus, Antyllus and Celsus in particular, wrote authoritatively on orthopedic subjects, Osteo-archaeological evidence is that fractures were treated expertly in the Roman army. Conditions consistent with degenerative osteoarthritis and true gout (as podagra and chiragra) were described by Celsus and Aretaeus of Cappadocia. Soranus, Rufus of Ephesus and Galen also wrote on orthopedic subjects. We will today differ from many statements made in the Corpus Hippocraticum, but it is clear that the orthopedic basis laid by those documents was not seriously challenged for 1 000 years.

Abstract Background Netball is estimated to be played by more than 20 million people worldwide, but there is evidence of high injury incidence. A thorough understanding of the types and rates of netball injuries is essential for effective injury management and prevention strategies to be developed and implemented. This systematic review summarises the published findings with respect to injury types, participant characteristics and any identified risk factors for netball injuries. Methods A librarian-assisted computer search of seven scientific databases was conducted for studies reporting on netball injuries. Inclusion criteria were studies published in English, in peer-reviewed journals, which reported data on injuries and variables (e.g. age and competition level) that have been proposed as possibly associated with netball injury risk. Results Forty-six studies (43.5% prospective, 37% hospital/insurance records, 19.5% retrospective) from 45 articles were included after screening. The majority of studies (74%) were conducted in Australia or New Zealand. There was little consistency in the definition of ‘injury’. Elite or sub-elite level players were included in 69% of studies where the level of competition was reported. The duration of injury surveillance was generally related to the format of competition from which data were collected. Self-report questionnaires were used in 48% of studies and only 26% of studies used qualified health professionals to collect data courtside. Injuries to the ankle and knee were the most common (in 19 studies) although the incidence varied considerably across the studies (ankle 13–84% and knee 8–50% of injuries). Prevention of ankle and knee injuries should be a priority. Children sustained more upper limb injuries (e.g. fractures) compared with adults who sustained more lower limb injuries (e.g. ankle and knee sprains/strains). A large number of potential risk factors for injury in netball have been investigated in small numbers of studies. The main circumstances of injury are landings, collisions and falls. Conclusion Further studies should be directed towards recreational netball, reporting on injury incidence in players by age and utilising high-quality, standardised methods and criteria. Specific injury diagnosis and a better understanding of the circumstances and mechanisms of injury would provide more meaningful data for developing prevention strategies.

Abstract Background The Australian wine industry is a valuable part of the wider Australian economy worth approximately A$45 billion annually and employs 163,790 people either full time or part time. Australian agricultural industries are amongst the nation’s most dangerous workplaces with joint, ligament, muscle and tendon injuries being commonplace along with wounds, lacerations and musculoskeletal diseases. It is therefore important to try and minimise the risk of injuries to workers. The aims of this study were to (1) identify whether lower limb problems occur in the Australian wine industry and (2) identify the types of safety footwear worn. Methods Participants were recruited from the Australian wine industry. The study was a cross-sectional anonymous survey of 82 questions with n = 207 respondents. Questions related to job role performed, types of lower limb problems experienced, level of pain, restriction of activities, types of footwear worn, general health and physical health. Results The main working roles were winery (73.4%), vineyard (52.2%), laboratory (39.6%), cellar door (32.4%) and office (8.2%), with 63.3% of participants working in more than one role. Lower back pain was the most commonly reported problem at 56% followed by foot pain (36.7%), knee pain (24.6%), leg pain (21.3%), ankle pain (17.9%), hip pain (15.5%), toe pain (13%) and heel pain (11.1%). The most popular footwear used by participants were elastic sided safety boots, followed by high cut lace up safety boots with side zip. Overall, although the pain experienced was moderate, it did not impact the workers ability to perform their duties and the majority self-reported as being in very good general and physical health. Conclusion To date no data have been published on the types of lower limb problems or the types of safety footwear worn in the Australian wine industry. This study is the first to demonstrate that elastic sided safety boots were the most popular amongst respondents and that lower limb problems occur with workers. Therefore, further research into the safety footwear used in the Australian wine industry is needed to better support workers health while working in their varied roles and conditions.

“Pedestrian struck by train” represents one of the highest magnitude blunt force traumas. Despite the severity of injuries, these patients can have good outcomes. A 25-year-old male presented after being struck by a train. He had several injuries, including extensive complex pelvic fractures, right external iliac artery and vein laceration, and right femur and tibia fracture. He was taken to the operating room for damage control surgery and attempted revascularization of the right lower extremity. The extremity became ischemic and required above knee amputation followed by hip disarticulation and hemipelvectomy. His pelvic wounds were treated with negative pressure wound therapy and gradually closed. He was eventually discharged to a rehab facility for continued recovery. This case highlights the interventions that allowed a young man who was struck by a train to survive. He improved significantly since undergoing hemipelvectomy, indicating that severe pelvic injuries from high energy trauma may necessitate hemipelvectomy.

Introduction This study identifies injuries that arise at a public event in an environment where multiple industries, service providers and patrons are present simultaneously. Methods A prospective survey method was used to collect data relating to injuries occurring at the event. The event was the Royal Adelaide Show, a 9-day agricultural and horticultural show hosted in a capital city in Australia during 2002. All patients who presented to St John Volunteers for treatment were the population for this study with the sample population being people who sustained an injury at the event. Results Crowd attendance over the nine days was 622,234. A total of 1028 patients presented for treatment with 265 (26%) being the result of injury. It was observed that minor wounds were the most common injury treated (18%), followed closely by lacerations (17%). The majority of injuries occurring at the event were minor in nature. There were 42 persons injured while working at the event. Of these, 9 (21%) required transfer to hospital by ambulance. Conclusion At the event studied, there were a number of injuries occurring that required treatment/management. On average, there was one worker transported to hospital by ambulance each day of the event. There may be a role for more formalised injury surveillance at mass gathering events to assess and monitor injury trends to both patrons and workers in this dynamic setting.

Abstract Background To identify prognostic factors determining final visual outcome following open globe injuries. Methods Retrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities. Results A total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p < 0.001), globe rupture (p < 0.001), retinal detachment (p < 0.001), Zone III wounds (p < 0.001), hyphema (p = 0.003), lens expulsion (p = 0.003) and vitreous hemorrhage (p < 0.001). Multivariate analysis demonstrated presenting visual acuity (p < 0.001), globe rupture (p = 0.013) and retinal detachment (p = 0.011) as being statistically significant for predicting poor visual outcomes. The presence of lid laceration (p = 0.197) and uveal prolapse (p = 0.667) were not significantly associated with the final visual acuity. Conclusions Poor presenting visual acuity, globe rupture and retinal detachment are the most important prognostic factors determining final visual acuity following open globe injury.

Introduction: Tissue engineered reconstruction is a minimally invasive approach for healing major complex wounds successfully. It combines accurate, conservative debridement with a specially adapted suction method, platelet-rich plasma (PRP) injections, and biomaterial application to salvage injured tissues and grows new soft tissues over wounds. Case Report: A healthy young man in his early 30s presented to our emergency department with complex knee-thigh injuries following a high-velocity automobile accident. Degloved anterolateral thigh, severe thigh muscle injuries, and ruptured extensor patellar mechanism were observed. Accurate conservative (as opposed to radical) debridement and PRP injections salvaged the injured muscles and tendons. Specially carved reticulated foam wrapped around the injured ischemic muscles, followed by low negative, short intermittent, cyclical suction therapy. Wound exploration 4 days apart revealed progressive improvements with considerable vascularization of the injured soft tissues within 2 weeks. Thereafter, meticulous reconstruction of the salvaged muscles and tendons restored anatomical congruity. An absorbable synthetic biomaterial covered the sizeable open wound with vast areas of exposed tendons. Five weeks later, exuberant granulating tissue ingrowth within the biomaterial filled up the tissue defect. A split-skin graft covered the remaining raw areas, which “took” completely. Early rehabilitation enabled the patient to return to active work, play contact sports, and perform strenuous activities effortlessly. Conclusion: Minimally invasive tissue engineered reconstruction is a novel approach using a series of simple minimally invasive procedures. It lessens the duration of surgery and anesthesia, maximizes soft-tissue salvage, lowers morbidity, minimizes hospitalization, saves costs, and improves the patient’s quality of life significantly. Keywords: Mangled extremity, Limb salvage, Financial, Trauma, Modified negative pres

Introduction: Severe open injuries of limbs, especially of the femur and tibia when associated with vascular injuries, present major challenges in management. The decision to amputate or salvage can often be a difficult one even for experienced surgeons. Mangled lower extremity results due to high-energy trauma, especially due to motor vehicle accidents, and is defined as injury to three of the four systems in the extremity that is soft tissues, bone, vascular, and nerve. Open fractures are classified by Gustilo and Anderson’s classification in which type 3B is an injury where soft-tissue loss and primary closure of the wound are not possible and type 3C is any open fracture with vascular compromise. Case Report: We report a series of six ipsilateral fractures of the femur and the tibia treated at the Department of Orthopaedics, Sri Ramachandra Medical College and Hospital, Chennai, Tamil Nadu, over a 3-year period (2014–2017). The mean age of our patients was 30 years old, and there were five men and one woman. The right side lower limb was frequently involved (five cases), and the main etiology was road traffic accidents (six cases). Articular involvement was found in six cases. Skin wounds were noticed in all cases (type III C of the Gustilo classification). Urgent wound care, fluid replacement, and antibiotic therapy were undertaken for open fractures. According to modified Fraser classification, all six cases was classified under type II-C. Mangled extremity severity score for five cases was 7 and for one case it was 8. Ganga Hospital Open Injury Severity Score was also used which was found to be in borderline range of 16 score for three cases, 15 score for two cases, and 14 score for one case. All six cases were managed with serial wound debridement + Ilizarov fixator + soft-tissue repair with involvement of orthopedic, vascular, and plastic surgery team. Limb salvage was done for all six cases after considering all the factors. Postoperatively, rehabilitative

Objective: This study examines characteristics associated with permanent residential aged care (RAC), respite RAC and transitional care (TC) placement for older individuals following an injury-related hospitalisation. Method: A retrospective analysis of individuals aged ≥65 years who had an injury-related hospitalisation and who had a linked record in RAC, TC or activities of daily living (ADL) data between 1 July 2008 and 30 June 2013 in New South Wales, Australia. Comorbidities were identified using diagnosis classifications and a 1-year lookback period. All hospital episodes of care related to the injury were linked to form a period of care. Both new and existing admissions to RAC were examined. Multinominal logistic regression was used to examine the factors associated with new admissions to permanent RAC, respite RAC and TC compared to return to the community. Results: Of 191,301 injury-related hospitalisations, 41,085 (21.5%) individuals either returned or were new admissions to permanent (87.2%) or respite (12.8%) RAC and 3,218 (1.7%) individuals were admitted to TC. There were 3,864, 4,314 and 2,630 new admissions to permanent RAC, respite RAC and TC, respectively. Of the injury hospitalisations, 70,796 (37.0%) individuals had an ADL assessment. Compared to individuals who returned to the community, individuals newly admitted to permanent RAC were four times as likely to have dementia (OR: 4.36; 95%CI 4.15-4.57), those admitted to respite RAC were twice as likely to have dementia (OR: 2.37; 95%CI 2.21-2.54) and people admitted to TC people were less likely to have dementia (OR: 0.60; 95%CI 0.53-0.68). Individuals with shoulder and upper arm injuries were twice as likely (OR: 2.31; 95%CI 1.98-2.68) and individuals with knee and lower leg injuries were one and a half times as likely (OR: 1.87; 95%CI 1.60-2.18) to be admitted to TC. Overall, individuals who were admitted to permanent or respite RAC had a higher likelihood of experiencing limitations associated with their physical, cognitive or social abilities, with individuals admitted to TC having a higher likelihood of having limitations maintaining personal hygiene and mobility compared to individuals returning to the community. Conclusion: An understanding of the profile of which older individuals are using RAC (permanent or respite) or TC services can usefully inform current and future aged care service use.

Background: Soccer is the most commonly played team sport in the world and a high-risk sport for anterior cruciate ligament (ACL) injury and subsequent ACL reconstruction (ACLR). Purpose: To assess the rate of further ACL injury in patients who have undergone ACLR with hamstring tendon autograft after soccer injuries in Australia and to determine factors associated with repeat ACL injury and return to soccer. Study Design: Case-control study; Level of evidence, 3. Methods: From a prospectively collected database, a series of 1000 consecutive ACLRs using hamstring autografts performed in soccer players were identified. Patients were surveyed at a minimum 5 years after reconstruction, including details of further ACL injuries to either knee, return to soccer or other sports, and psychological readiness per the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale. Results: Of the 862 participants reviewed, ACL graft rupture occurred in 85 (10%) and contralateral ACL rupture in 68 (8%) within 5 years after the reconstruction. The 5-year ACL graft survivorship was 94% for females and 88% for males. The survivorship of the contralateral ACL was 92% for males and 90% for females. When compared with those aged >25 years, the odds of ACL graft rupture was increased by 4 to 5 times in those aged 19 to 25 years and 3 to 7 times in those ≤18 years. Further ACL injury to the graft or contralateral knee occurred in 44% of males aged ≤18 years. Risk factors for further ACL injury were younger age at time of surgery, male sex, and return to soccer. Graft diameter did not influence ACL graft rupture rates, and 70% of patients returned to soccer after ACLR. The mean ACL-RSI score was 59, and patients who reported more fear of reinjury on this scale were less likely to have returned to soccer. Conclusion: The prevalence of ACL graft rupture (10%) and contralateral ACL rupture (8%) was near equivalent over 5 years in this large cohort of mostly recreational Australian soccer players. ACLR with hamstring autograft is a reliable procedure, allowing 70% of patients to return to soccer in this high-risk population. Risk factors for further ACL injury are progressively younger age at time of surgery, male sex, and return to soccer. Graft diameter was not a factor in ACL graft rupture, indicating that other factors, particularly age, are of primary importance.

PurposeThe purpose of this paper is to determine which factors are associated with 6,065 patient presentations with non-life-threatening urgent conditions (NLTUCs) to an after-hours general practice, an urgent care clinic (UCC) and an emergency department (ED) on Sundays in Southeast Queensland (Qld).Design/methodology/approachA retrospective, comparative and observational study was conducted involving the auditing of medical records of patients with NLTUCs consulting three medical services between 0,800 and 1,700 h, on Sundays, over a one-year period. The study was limited to 6,065 patients.FindingsThere were statistically significant differences in choice of location according to age, number of postcodes from the patient's residence, time of the day, season, patient presentations for infection and injury, non-infectious, non-injurious conditions of the circulatory, gastrointestinal and genitourinary systems, and need for imaging, pathology, plastering/back-slab application, splinting and wound closure. Older adults were more likely to be admitted to the hospital and Ed Short Stay Unit, compared with other age groups.Research limitations/implicationsBased on international models of UCC healthcare systems in United Kingdom (UK), USA and New Zealand (NZ) and the results of this study, it is recommended that UCCs in Australia have extended hours, walk-in availability, access to on-site radiology, ability to treat fractures and wounds and staffing by medical practitioners able to manage these conditions. Recommendations also include setting a national standard for UCC operation (National Urgent Care Centre Accreditation, 2018; NHS, 2020; RNZCUC, 2015) and requirements for vocational registration for medical practitioners (National Urgent Care Centre Accreditation, 2018; RNZCUC, 2015; The Royal College of Surgeons of Edinburgh, 2021a, b).Practical implicationsThis study has highlighted three key areas for future research: first, research involving general practitioners (GPs), emergency physicians, urgent care physicians, nurse practitioners, urgent care pharmacists and paramedics could help to predict the type of patients more accurately, patient presentations and associated comorbidities that might be encouraged to attend or be diverted to Urgent Care Clinics. Second, larger studies of more facilities and more patients could improve the accuracy and generalisability of the findings. Lastly, studies of public health messaging need to be undertaken to determine how best to encourage patients with NLTUCs (especially infections and injuries) to present to UCCs.Social implicationsThe Urgent Care Clinic model has existed in developed countries since 1973. The adoption of this model in Australia close to a patient's home, open extended hours and with onsite radiology could provide a community option, to ED, for NLTUCs (especially patient presentations with infections and injuries).Originality/valueThis study reviewed three types of medical facilities for the management of NLTUCs. They were an after-hours general practice, an urgent care clinic and an emergency department. This study found that the patient choice of destination depends on the ability of the service to manage their NLTUCs, patient age, type of condition, postcodes lived away from the facility, availability of testing and provision of consumables. This study also provides recommendations for the development of an urgent care healthcare system in Australia based on international models and includes requirements for extended hours, walk-in availability, radiology on-site, national standard and national requirements for vocational registration for medical professionals.

Introduction The aim of this paper is to examine whether recent catastrophic tsunamis have driven a cultural shift in the awareness of Australians to the danger associated with this natural hazard and whether the media have contributed to the emergence of “tsunami” as a new Australian catastrophe. Prior to the devastating 2004 Indian Ocean Tsunami disaster (2004 IOT), tsunamis as a type of hazard capable of generating widespread catastrophe were not well known by the general public and had barely registered within the wider scientific community. As a university based lecturer who specialises in natural disasters, I always started my public talks or student lectures with an attempt at a detailed description of what a tsunami is. With little high quality visual and media imagery to use, this was not easy. The Australian geologist Ted Bryant was right when he named his 2001 book Tsunami: The Underrated Hazard. That changed on 26 December 2004 when the third largest earthquake ever recorded occurred northwest of Sumatra, Indonesia, triggering the most catastrophic tsunami ever experienced. The 2004 IOT claimed at least 220,000 lives—probably more—injured tens of thousands, destroyed widespread coastal infrastructure and left millions homeless. Beyond the catastrophic impacts, this tsunami was conspicuous because, for the first time, such a devastating tsunami was widely captured on video and other forms of moving and still imagery. This occurred for two reasons. Firstly, the tsunami took place during daylight hours in good weather conditions—factors conducive to capturing high quality visual images. Secondly, many people—both local residents and westerners who were on beachside holidays and at the coast at multiple locations impacted by the tsunami—were able to capture images of the tsunami on their cameras, videos, and smart phones. The extensive media coverage—including horrifying television, video, and still imagery that raced around the globe in the hours and days after the tsunami, filling our television screens, homes, and lives regardless of where we lived—had a dramatic effect. This single event drove a quantum shift in the wider cultural awareness of this type of catastrophe and acted as a catalyst for improved individual and societal understanding of the nature and effects of disaster landscapes. Since this event, there have been several notable tsunamis, including the March 2011 Japan catastrophe. Once again, this event occurred during daylight hours and was widely captured by multiple forms of media. These events have resulted in a cascade of media coverage across television, radio, movie, and documentary channels, in the print media, online, and in the popular press and on social media—very little of which was available prior to 2004. Much of this has been documentary and informative in style, but there have also been numerous television dramas and movies. For example, an episode of the popular American television series CSI Miami entitled Crime Wave (Season 3, Episode 7) featured a tsunami, triggered by a volcanic eruption in the Atlantic and impacting Miami, as the backdrop to a standard crime-filled episode ("CSI," IMDb; Wikipedia). In 2010, Warner Bros Studios released the supernatural drama fantasy film Hereafter directed by Clint Eastwood. In the movie, a television journalist survives a near-death experience during the 2004 IOT in what might be the most dramatic, and probably accurate, cinematic portrayal of a tsunami ("Hereafter," IMDb; Wikipedia). Thus, these creative and entertaining forms of media, influenced by the catastrophic nature of tsunamis, are impetuses for creativity that also contribute to a transformation of cultural knowledge of catastrophe. The transformative potential of creative media, together with national and intergovernmental disaster risk reduction activity such as community education, awareness campaigns, community evacuation planning and drills, may be indirectly inferred from rapid and positive community behavioural responses. By this I mean many people in coastal communities who experience strong earthquakes are starting a process of self-evacuation, even if regional tsunami warning centres have not issued an alert or warning. For example, when people in coastal locations in Samoa felt a large earthquake on 29 September 2009, many self-evacuated to higher ground or sought information and instruction from relevant authorities because they expected a tsunami to occur. When interviewed, survivors stated that the memory of television and media coverage of the 2004 IOT acted as a catalyst for their affirmative behavioural response (Dominey-Howes and Thaman 1). Thus, individual and community cultural understandings of the nature and effects of tsunami catastrophes are incredibly important for shaping resilience and reducing vulnerability. However, this cultural shift is not playing out evenly.Are Australia and Its People at Risk from Tsunamis?Prior to the 2004 IOT, there was little discussion about, research in to, or awareness about tsunamis and Australia. Ted Bryant from the University of Wollongong had controversially proposed that Australia had been affected by tsunamis much bigger than the 2004 IOT six to eight times during the last 10,000 years and that it was only a matter of when, not if, such an event repeated itself (Bryant, "Second Edition"). Whilst his claims had received some media attention, his ideas did not achieve widespread scientific, cultural, or community acceptance. Not-with-standing this, Australia has been affected by more than 60 small tsunamis since European colonisation (Dominey-Howes 239). Indeed, the 2004 IOT and 2006 Java tsunami caused significant flooding of parts of the Northern Territory and Western Australia (Prendergast and Brown 69). However, the affected areas were sparsely populated and experienced very little in the way of damage or loss. Thus they did not cross any sort of critical threshold of “catastrophe” and failed to achieve meaningful community consciousness—they were not agents of cultural transformation.Regardless of the risk faced by Australia’s coastline, Australians travel to, and holiday in, places that experience tsunamis. In fact, 26 Australians were killed during the 2004 IOT (DFAT) and five were killed by the September 2009 South Pacific tsunami (Caldwell et al. 26). What Role Do the Media Play in Preparing for and Responding to Catastrophe?Regardless of the type of hazard/disaster/catastrophe, the key functions the media play include (but are not limited to): pre-event community education, awareness raising, and planning and preparations; during-event preparation and action, including status updates, evacuation warnings and notices, and recommendations for affirmative behaviours; and post-event responses and recovery actions to follow, including where to gain aid and support. Further, the media also play a role in providing a forum for debate and post-event analysis and reflection, as a mechanism to hold decision makers to account. From time to time, the media also provide a platform for examining who, if anyone, might be to blame for losses sustained during catastrophes and can act as a powerful conduit for driving socio-cultural, behavioural, and policy change. Many of these functions are elegantly described and a series of best practices outlined by The Caribbean Disaster Emergency Management Agency in a tsunami specific publication freely available online (CDEMA 1). What Has Been the Media Coverage in Australia about Tsunamis and Their Effects on Australians?A manifest contents analysis of media material covering tsunamis over the last decade using the framework of Cox et al. reveals that coverage falls into distinctive and repetitive forms or themes. After tsunamis, I have collected articles (more than 130 to date) published in key Australian national broadsheets (e.g., The Australian and Sydney Morning Herald) and tabloid (e.g., The Telegraph) newspapers and have watched on television and monitored on social media, such as YouTube and Facebook, the types of coverage given to tsunamis either affecting Australia, or Australians domestically and overseas. In all cases, I continued to monitor and collect these stories and accounts for a fixed period of four weeks after each event, commencing on the day of the tsunami. The themes raised in the coverage include: the nature of the event. For example, where, when, why did it occur, how big was it, and what were the effects; what emergency response and recovery actions are being undertaken by the emergency services and how these are being provided; exploration of how the event was made worse or better by poor/good planning and prior knowledge, action or inaction, confusion and misunderstanding; the attribution of blame and responsibility; the good news story—often the discovery and rescue of an “iconic victim/survivor”—usually a child days to weeks later; and follow-up reporting weeks to months later and on anniversaries. This coverage generally focuses on how things are improving and is often juxtaposed with the ongoing suffering of victims. I select the word “victims” purposefully for the media frequently prefer this over the more affirmative “survivor.”The media seldom carry reports of “behind the scenes” disaster preparatory work such as community education programs, the development and installation of warning and monitoring systems, and ongoing training and policy work by response agencies and governments since such stories tend to be less glamorous in terms of the disaster gore factor and less newsworthy (Cox et al. 469; Miles and Morse 365; Ploughman 308).With regard to Australians specifically, the manifest contents analysis reveals that coverage can be described as follows. First, it focuses on those Australians killed and injured. Such coverage provides elements of a biography of the victims, telling their stories, personalising these individuals so we build empathy for their suffering and the suffering of their families. The Australian victims are not unknown strangers—they are named and pictures of their smiling faces are printed or broadcast. Second, the media describe and catalogue the loss and ongoing suffering of the victims (survivors). Third, the media use phrases to describe Australians such as “innocent victims in the wrong place at the wrong time.” This narrative establishes the sense that these “innocents” have been somehow wronged and transgressed and that suffering should not be experienced by them. The fourth theme addresses the difficulties Australians have in accessing Consular support and in acquiring replacement passports in order to return home. It usually goes on to describe how they have difficulty in gaining access to accommodation, clothing, food, and water and any necessary medicines and the challenges associated with booking travel home and the complexities of communicating with family and friends. The last theme focuses on how Australians were often (usually?) not given relevant safety information by “responsible people” or “those in the know” in the place where they were at the time of the tsunami. This establishes a sense that Australians were left out and not considered by the relevant authorities. This narrative pays little attention to the wide scale impact upon and suffering of resident local populations who lack the capacity to escape the landscape of catastrophe.How Does Australian Media Coverage of (Tsunami) Catastrophe Compare with Elsewhere?A review of the available literature suggests media coverage of catastrophes involving domestic citizens is similar globally. For example, Olofsson (557) in an analysis of newspaper articles in Sweden about the 2004 IOT showed that the tsunami was framed as a Swedish disaster heavily focused on Sweden, Swedish victims, and Thailand, and that there was a division between “us” (Swedes) and “them” (others or non-Swedes). Olofsson (557) described two types of “us” and “them.” At the international level Sweden, i.e. “us,” was glorified and contrasted with “inferior” countries such as Thailand, “them.” Olofsson (557) concluded that mediated frames of catastrophe are influenced by stereotypes and nationalistic values.Such nationalistic approaches preface one type of suffering in catastrophe over others and delegitimises the experiences of some survivors. Thus, catastrophes are not evenly experienced. Importantly, Olofsson although not explicitly using the term, explains that the underlying reason for this construction of “them” and “us” is a form of imperialism and colonialism. Sharp refers to “historically rooted power hierarchies between countries and regions of the world” (304)—this is especially so of western news media reporting on catastrophes within and affecting “other” (non-western) countries. Sharp goes much further in relation to western representations and imaginations of the “war on terror” (arguably a global catastrophe) by explicitly noting the near universal western-centric dominance of this representation and the construction of the “west” as good and all “non-west” as not (299). Like it or not, the western media, including elements of the mainstream Australian media, adhere to this imperialistic representation. Studies of tsunami and other catastrophes drawing upon different types of media (still images, video, film, camera, and social media such as Facebook, Twitter, and the like) and from different national settings have explored the multiple functions of media. These functions include: providing information, questioning the authorities, and offering a chance for transformative learning. Further, they alleviate pain and suffering, providing new virtual communities of shared experience and hearing that facilitate resilience and recovery from catastrophe. Lastly, they contribute to a cultural transformation of catastrophe—both positive and negative (Hjorth and Kyoung-hwa "The Mourning"; "Good Grief"; McCargo and Hyon-Suk 236; Brown and Minty 9; Lau et al. 675; Morgan and de Goyet 33; Piotrowski and Armstrong 341; Sood et al. 27).Has Extensive Media Coverage Resulted in an Improved Awareness of the Catastrophic Potential of Tsunami for Australians?In playing devil’s advocate, my simple response is NO! This because I have been interviewing Australians about their perceptions and knowledge of tsunamis as a catastrophe, after events have occurred. These events have triggered alerts and warnings by the Australian Tsunami Warning System (ATWS) for selected coastal regions of Australia. Consequently, I have visited coastal suburbs and interviewed people about tsunamis generally and those events specifically. Formal interviews (surveys) and informal conversations have revolved around what people perceived about the hazard, the likely consequences, what they knew about the warning, where they got their information from, how they behaved and why, and so forth. I have undertaken this work after the 2007 Solomon Islands, 2009 New Zealand, 2009 South Pacific, the February 2010 Chile, and March 2011 Japan tsunamis. I have now spoken to more than 800 people. Detailed research results will be presented elsewhere, but of relevance here, I have discovered that, to begin with, Australians have a reasonable and shared cultural knowledge of the potential catastrophic effects that tsunamis can have. They use terms such as “devastating; death; damage; loss; frightening; economic impact; societal loss; horrific; overwhelming and catastrophic.” Secondly, when I ask Australians about their sources of information about tsunamis, they describe the television (80%); Internet (85%); radio (25%); newspaper (35%); and social media including YouTube (65%). This tells me that the media are critical to underpinning knowledge of catastrophe and are a powerful transformative medium for the acquisition of knowledge. Thirdly, when asked about where people get information about live warning messages and alerts, Australians stated the “television (95%); Internet (70%); family and friends (65%).” Fourthly and significantly, when individuals were asked what they thought being caught in a tsunami would be like, responses included “fun (50%); awesome (75%); like in a movie (40%).” Fifthly, when people were asked about what they would do (i.e., their “stated behaviour”) during a real tsunami arriving at the coast, responses included “go down to the beach to swim/surf the tsunami (40%); go to the sea to watch (85%); video the tsunami and sell to the news media people (40%).”An independent and powerful representation of the disjunct between Australians’ knowledge of the catastrophic potential of tsunamis and their “negative” behavioral response can be found in viewing live television news coverage broadcast from Sydney beaches on the morning of Sunday 28 February 2010. The Chilean tsunami had taken more than 14 hours to travel from Chile to the eastern seaboard of Australia and the ATWS had issued an accurate warning and had correctly forecast the arrival time of the tsunami (approximately 08.30 am). The television and radio media had dutifully broadcast the warning issued by the State Emergency Services. The message was simple: “Stay out of the water, evacuate the beaches and move to higher ground.” As the tsunami arrived, those news broadcasts showed volunteer State Emergency Service personnel and Surf Life Saving Australia lifeguards “begging” with literally hundreds (probably thousands up and down the eastern seaboard of Australia) of members of the public to stop swimming in the incoming tsunami and to evacuate the beaches. On that occasion, Australians were lucky and the tsunami was inconsequential. What do these responses mean? Clearly Australians recognise and can describe the consequences of a tsunami. However, they are not associating the catastrophic nature of tsunami with their own lives or experience. They are avoiding or disallowing the reality; they normalise and dramaticise the event. Thus in Australia, to date, a cultural transformation about the catastrophic nature of tsunami has not occurred for reasons that are not entirely clear but are the subject of ongoing study.The Emergence of Tsunami as a “New Australian Catastrophe”?As a natural disaster expert with nearly two decades experience, in my mind tsunami has emerged as a “new Australian catastrophe.” I believe this has occurred for a number of reasons. Firstly, the 2004 IOT was devastating and did impact northwestern Australia, raising the flag on this hitherto, unknown threat. Australia is now known to be vulnerable to the tsunami catastrophe. The media have played a critical role here. Secondly, in the 2004 IOT and other tsunamis since, Australians have died and their deaths have been widely reported in the Australian media. Thirdly, the emergence of various forms of social media has facilitated an explosion in information and material that can be consumed, digested, reimagined, and normalised by Australians hungry for the gore of catastrophe—it feeds our desire for catastrophic death and destruction. Fourthly, catastrophe has been creatively imagined and retold for a story-hungry viewing public. Whether through regular television shows easily consumed from a comfy chair at home, or whilst eating popcorn at a cinema, tsunami catastrophe is being fed to us in a way that reaffirms its naturalness. Juxtaposed against this idea though is that, despite all the graphic imagery of tsunami catastrophe, especially images of dead children in other countries, Australian media do not and culturally cannot, display images of dead Australian children. Such images are widely considered too gruesome but are well known to drive changes in cultural behaviour because of the iconic significance of the child within our society. As such, a cultural shift has not yet occurred and so the potential of catastrophe remains waiting to strike. Fifthly and significantly, given the fact that large numbers of Australians have not died during recent tsunamis means that again, the catastrophic potential of tsunamis is not yet realised and has not resulted in cultural changes to more affirmative behaviour. Lastly, Australians are probably more aware of “regular or common” catastrophes such as floods and bush fires that are normal to the Australian climate system and which are endlessly experienced individually and culturally and covered by the media in all forms. The Australian summer of 2012–13 has again been dominated by floods and fires. If this idea is accepted, the media construct a uniquely Australian imaginary of catastrophe and cultural discourse of disaster. The familiarity with these common climate catastrophes makes us “culturally blind” to the catastrophe that is tsunami.The consequences of a major tsunami affecting Australia some point in the future are likely to be of a scale not yet comprehensible. References Australian Broadcasting Corporation (ABC). "ABC Net Splash." 20 Mar. 2013 ‹http://splash.abc.net.au/media?id=31077›. Brown, Philip, and Jessica Minty. “Media Coverage and Charitable Giving after the 2004 Tsunami.” Southern Economic Journal 75 (2008): 9–25. Bryant, Edward. Tsunami: The Underrated Hazard. First Edition, Cambridge: Cambridge UP, 2001. ———. Tsunami: The Underrated Hazard. Second Edition, Sydney: Springer-Praxis, 2008. Caldwell, Anna, Natalie Gregg, Fiona Hudson, Patrick Lion, Janelle Miles, Bart Sinclair, and John Wright. “Samoa Tsunami Claims Five Aussies as Death Toll Rises.” The Courier Mail 1 Oct. 2009. 20 Mar. 2013 ‹http://www.couriermail.com.au/news/samoa-tsunami-claims-five-aussies-as-death-toll-rises/story-e6freon6-1225781357413›. CDEMA. "The Caribbean Disaster Emergency Management Agency. Tsunami SMART Media Web Site." 18 Dec. 2012. 20 Mar. 2013 ‹http://weready.org/tsunami/index.php?Itemid=40&id=40&option=com_content&view=article›. Cox, Robin, Bonita Long, and Megan Jones. “Sequestering of Suffering – Critical Discourse Analysis of Natural Disaster Media Coverage.” Journal of Health Psychology 13 (2008): 469–80. “CSI: Miami (Season 3, Episode 7).” International Movie Database (IMDb). ‹http://www.imdb.com/title/tt0534784/›. 9 Jan. 2013. "CSI: Miami (Season 3)." Wikipedia. ‹http://en.wikipedia.org/wiki/CSI:_Miami_(season_3)#Episodes›. 21 Mar. 2013. DFAT. "Department of Foreign Affairs and Trade Annual Report 2004–2005." 8 Jan. 2013 ‹http://www.dfat.gov.au/dept/annual_reports/04_05/downloads/2_Outcome2.pdf›. Dominey-Howes, Dale. “Geological and Historical Records of Australian Tsunami.” Marine Geology 239 (2007): 99–123. Dominey-Howes, Dale, and Randy Thaman. “UNESCO-IOC International Tsunami Survey Team Samoa Interim Report of Field Survey 14–21 October 2009.” No. 2. Australian Tsunami Research Centre. University of New South Wales, Sydney. "Hereafter." International Movie Database (IMDb). ‹http://www.imdb.com/title/tt1212419/›. 9 Jan. 2013."Hereafter." Wikipedia. ‹http://en.wikipedia.org/wiki/Hereafter (film)›. 21 Mar. 2013. Hjorth, Larissa, and Yonnie Kyoung-hwa. “The Mourning After: A Case Study of Social Media in the 3.11 Earthquake Disaster in Japan.” Television and News Media 12 (2011): 552–59. ———, and Yonnie Kyoung-hwa. “Good Grief: The Role of Mobile Social Media in the 3.11 Earthquake Disaster in Japan.” Digital Creativity 22 (2011): 187–99. Lau, Joseph, Mason Lau, and Jean Kim. “Impacts of Media Coverage on the Community Stress Level in Hong Kong after the Tsunami on 26 December 2004.” Journal of Epidemiology and Community Health 60 (2006): 675–82. McCargo, Duncan, and Lee Hyon-Suk. “Japan’s Political Tsunami: What’s Media Got to Do with It?” International Journal of Press-Politics 15 (2010): 236–45. Miles, Brian, and Stephanie Morse. “The Role of News Media in Natural Disaster Risk and Recovery.” Ecological Economics 63 (2007): 365–73. Morgan, Olive, and Charles de Goyet. “Dispelling Disaster Myths about Dead Bodies and Disease: The Role of Scientific Evidence and the Media.” Revista Panamericana de Salud Publica-Pan American Journal of Public Health 18 (2005): 33–6. Olofsson, Anna. “The Indian Ocean Tsunami in Swedish Newspapers: Nationalism after Catastrophe.” Disaster Prevention and Management 20 (2011): 557–69. Piotrowski, Chris, and Terry Armstrong. “Mass Media Preferences in Disaster: A Study of Hurricane Danny.” Social Behavior and Personality 26 (1998): 341–45. Ploughman, Penelope. “The American Print News Media Construction of Five Natural Disasters.” Disasters 19 (1995): 308–26. Prendergast, Amy, and Nick Brown. “Far Field Impact and Coastal Sedimentation Associated with the 2006 Java Tsunami in West Australia: Post-Tsunami Survey at Steep Point, West Australia.” Natural Hazards 60 (2012): 69–79. Sharp, Joanne. “A Subaltern Critical Geopolitics of The War on Terror: Postcolonial Security in Tanzania.” Geoforum 42 (2011): 297–305. Sood, Rahul, Stockdale, Geoffrey, and Everett Rogers. “How the News Media Operate in Natural Disasters.” Journal of Communication 37 (1987): 27–41.

Hundreds of thousands of Australian children were born in the shadow of the Great War, fathered by men who had enlisted between 1914 and 1918. Their lives could be and often were hard and unhappy, as Anzac historian Alistair Thomson observed of his father’s childhood in the 1920s and 1930s. David Thomson was son of a returned serviceman Hector Thomson who spent much of his adult life in and out of repatriation hospitals (257-259) and whose memory was subsequently expunged from Thomson family stories (299-267). These children of trauma fit within a pattern suggested by Marianne Hirsch in her influential essay “The Generation of Postmemory”. According to Hirsch, “postmemory describes the relationship of the second generation to powerful, often traumatic, experiences that preceded their births but that were nevertheless transmitted to them so deeply as to seem to constitute memories in their own right” (n.p.). This article attempts to situate George Johnston’s novel My Brother Jack (1964) within the context of postmemory narratives of violence that were complicated in Australia by the Anzac legend which occluded any too open discussion about the extent of war trauma present within community, including the children of war.“God knows what damage” the war “did to me psychologically” (48), ponders Johnston’s protagonist and alter-ego David Meredith in My Brother Jack. Published to acclaim fifty years after the outbreak of the First World War, My Brother Jack became a widely read text that seemingly spoke to the shared cultural memories of a generation which did not know battlefield violence directly but experienced its effects pervasively and vicariously in the aftermath through family life, storytelling, and the memorabilia of war. For these readers, the novel represented more than a work of fiction; it was a touchstone to and indicative of their own negotiations though often unspoken post-war trauma.Meredith, like his creator, is born in 1912. Strictly speaking, therefore, both are not part of the post-war generation. However, they are representative and therefore indicative of the post-war “hinge generation” which was expected to assume “guardianship” of the Anzac Legend, though often found the narrative logic challenging. They had been “too young for the war to have any direct effect”, and yet “every corner” of their family’s small suburban homes appear to be “impregnated with some gigantic and sombre experience that had taken place thousands of miles away” (17).According to Johnston’s biographer, Garry Kinnane, the “most teasing puzzle” of George Johnston’s “fictional version of his childhood in My Brother Jack is the monstrous impression he creates of his returned serviceman father, John George Johnston, known to everyone as ‘Pop.’ The first sixty pages are dominated by the tyrannical figure of Jack Meredith senior” (1).A large man purported to be six foot three inches (1.9 metres) in height and weighing fifteen stone (95 kilograms), the real-life Pop Johnston reputedly stood head and shoulders above the minimum requirement of five foot and six inches (1.68 metres) at the time of his enlistment for war in 1914 (Kinnane 4). In his fortieth year, Jack Johnston senior was also around twice the age of the average Australian soldier and among one in five who were married.According to Kinnane, Pop Johnston had “survived the ordeal of Gallipoli” in 1915 only to “endure three years of trench warfare in the Somme region”. While the biographer and the Johnston family may well have held this to be true, the claim is a distortion. There are a few intimations throughout My Brother Jack and its sequel Clean Straw for Nothing (1969) to suggest that George Johnston may have suspected that his father’s wartime service stories had been embellished, though the depicted wartime service of Pop Meredith remains firmly within the narrative arc of the Anzac legend. This has the effect of layering the postmemory violence experienced by David Meredith and, by implication, his creator, George Johnston. Both are expected to be keepers of a lie masquerading as inviolable truth which further brutalises them.John George (Pop) Johnston’s First World War military record reveals a different story to the accepted historical account and his fictionalisation in My Brother Jack. He enlisted two and a half months after the landing at Gallipoli on 12 July 1915 and left for overseas service on 23 November. Not quite the imposing six foot three figure of Kinnane’s biography, he was fractionally under five foot eleven (1.8 metres) and weighed thirteen stone (82.5 kilograms). Assigned to the Fifth Field Engineers on account of his experience as an electric tram fitter, he did not see frontline service at Gallipoli (NAA).Rather, according to the Company’s history, the Fifth Engineers were involved in a range of infrastructure and support work on the Western Front, including the digging and maintenance of trenches, laying duckboard, pontoons and tramlines, removing landmines, building huts, showers and latrines, repairing roads, laying drains; they built a cinema at Beaulencourt Piers for “Brigade Swimming Carnival” and baths at Malhove consisting of a large “galvanised iron building” with a “concrete floor” and “setting tanks capable of bathing 2,000 men per day” (AWM). It is likely that members of the company were also involved in burial details.Sapper Johnston was hospitalised twice during his service with influenza and saw out most of his war from October 1917 attached to the Army Cookery School (NAA). He returned to Australia on board the HMAT Kildonian Castle in May 1919 which, according to the Sydney Morning Herald, also carried the official war correspondent and creator of the Anzac legend C.E.W. Bean, national poet Banjo Paterson and “Warrant Officer C G Macartney, the famous Australian cricketer”. The Herald also listed the names of “Returned Officers” and “Decorated Men”, but not Pop Johnston who had occupied the lower decks with other returning men (“Soldiers Return”).Like many of the more than 270,000 returned soldiers, Pop Johnston apparently exhibited observable changes upon his repatriation to Australia: “he was partially deaf” which was attributed to the “constant barrage of explosions”, while “gas” was suspected to have “left him with a legacy of lung disorders”. Yet, if “anyone offered commiserations” on account of this war legacy, he was quick to “dismiss the subject with the comment that ‘there were plenty worse off’” (Kinnane 6). The assumption is that Pop’s silence is stoic; the product of unspeakable horror and perhaps a symptom of survivor guilt.An alternative interpretation, suggested by Alistair Thomson in Anzac Memories, is that the experiences of the vast majority of returned soldiers were expected to fit within the master narrative of the Anzac legend in order to be accepted and believed, and that there was no space available to speak truthfully about alternative war service. Under pressure of Anzac expectations a great many composed stories or remained selectively silent (14).Data gleaned from the official medical history suggest that as many as four out of every five returned servicemen experienced emotional or psychological disturbance related to their war service. However, the two branches of medicine represented by surgeons and physicians in the Repatriation Department—charged with attending to the welfare of returned servicemen—focused on the body rather than the mind and the emotions (Murphy and Nile).The repatriation records of returned Australian soldiers reveal that there were, indeed, plenty physically worse off than Pop Johnston on account of bodily disfigurement or because they had been somatically compromised. An estimated 30,000 returned servicemen died in the decade after the cessation of hostilities to 1928, bringing the actual number of war dead to around 100,000, while a 1927 official report tabled the medical conditions of a further 72,388 veterans: 28,305 were debilitated by gun and shrapnel wounds; 22,261 were rheumatic or had respiratory diseases; 4534 were afflicted with eye, ear, nose, or throat complaints; 9,186 had tuberculosis or heart disease; 3,204 were amputees while only; 2,970 were listed as suffering “war neurosis” (“Enlistment”).Long after the guns had fallen silent and the wounded survivors returned home, the physical effects of war continued to be apparent in homes and hospital wards around the country, while psychological and emotional trauma remained largely undiagnosed and consequently untreated. David Meredith’s attitude towards his able-bodied father is frequently dismissive and openly scathing: “dad, who had been gassed, but not seriously, near Vimy Ridge, went back to his old job at the tramway depot” (9). The narrator-son later considers:what I realise now, although I never did at the time, is that my father, too, was oppressed by intimidating factors of fear and change. By disillusion and ill-health too. As is so often the case with big, strong, athletic men, he was an extreme hypochondriac, and he had convinced himself that the severe bronchitis which plagued him could only be attributed to German gas he had swallowed at Vimy Ridge. He was too afraid to go to a doctor about it, so he lived with a constant fear that his lungs were decaying, and that he might die at any time, without warning. (42-3)During the writing of My Brother Jack, the author-son was in chronically poor health and had been recently diagnosed with the romantic malady and poet’s disease of tuberculosis (Lawler) which plagued him throughout his work on the novel. George Johnston believed (correctly as it turned out) that he was dying on account of the disease, though, he was also an alcoholic and smoker, and had been reluctant to consult a doctor. It is possible and indeed likely that he resentfully viewed his condition as being an extension of his father—vicariously expressed through the depiction of Pop Meredith who exhibits hysterical symptoms which his son finds insufferable. David Meredith remains embittered and unforgiving to the very end. Pop Meredith “lived to seventy-three having died, not of German gas, but of a heart attack” (46).Pop Meredith’s return from the war in 1919 terrifies his seven-year-old son “Davy”, who accompanies the family to the wharf to welcome home a hero. The young boy is unable to recall anything about the father he is about to meet ostensibly for the first time. Davy becomes overwhelmed by the crowds and frightened by the “interminable blaring of horns” of the troopships and the “ceaseless roar of shouting”. Dwarfed by the bodies of much larger men he becomestoo frightened to look up at the hours-long progression of dark, hard faces under wide, turned-up hats seen against bayonets and barrels that are more blue than black ... the really strong image that is preserved now is of the stiff fold and buckle of coarse khaki trousers moving to the rhythm of knees and thighs and the tight spiral curves of puttees and the thick boots hammering, hollowly off the pier planking and thunderous on the asphalt roadway.Depicted as being small for his age, Davy is overwrought “with a huge and numbing terror” (10).In the years that follow, the younger Meredith desires emotional stability but remains denied because of the war’s legacy which manifests in the form of a violent patriarch who is convinced that his son has been rendered effeminate on account of the manly absence during vital stages of development. With the return of the father to the household, Davy grows to fear and ultimately despise a man who remains as alien to him as the formerly absent soldier had been during the war:exactly when, or why, Dad introduced his system of monthly punishments I no longer remember. We always had summary punishment, of course, for offences immediately detected—a cuffing around the ears or a sash with a stick of a strap—but Dad’s new system was to punish for the offences which had escaped his attention. So on the last day of every month Jack and I would be summoned in turn to the bathroom and the door would be locked and each of us would be questioned about the sins which we had committed and which he had not found out about. This interrogation was the merest formality; whether we admitted to crimes or desperately swore our innocence it was just the same; we were punished for the offences which, he said, he knew we must have committed and had to lie about. We then had to take our shirts and singlets off and bend over the enamelled bath-tub while he thrashed us with the razor-strop. In the blind rages of these days he seemed not to care about the strength he possessed nor the injuries he inflicted; more often than not it was the metal end of the strop that was used against our backs. (48)Ironically, the ritualised brutality appears to be a desperate effort by the old man to compensate for his own emasculation in war and unresolved trauma now that the war is ended. This plays out in complicated fashion in the development of David Meredith in Clean Straw for Nothing, Johnston’s sequel to My Brother Jack.The imputation is that Pop Meredith practices violence in an attempt to reassert his failed masculinity and reinstate his status as the head of the household. Older son Jack’s beatings cease when, as a more physically able young man, he is able to threaten the aggressor with violent retaliation. This action does not spare the younger weaker Davy who remains dominated. “My beating continued, more ferociously than ever, … . They ceased only because one day my father went too far; he lambasted me so savagely that I fell unconscious into the bath-tub, and the welts across my back made by the steel end of the razor-strop had to be treated by a doctor” (53).Pop Meredith is persistently reminded that he has no corporeal signifiers of war trauma (only a cough); he is surrounded by physically disabled former soldiers who are presumed to be worse off than he on account of somatic wounding. He becomes “morose, intolerant, bitter and violently bad-tempered”, expressing particular “displeasure and resentment” toward his wife, a trained nurse, who has assumed carer responsibilities for homing the injured men: “he had altogether lost patience with her role of Florence Nightingale to the halt and the lame” (40). Their marriage is loveless: “one can only suppose that he must have been darkly and profoundly disturbed by the years-long procession through our house of Mother’s ‘waifs and strays’—those shattered former comrades-in-arms who would have been a constant and sinister reminder of the price of glory” (43); a price he had failed to adequately pay with his uncompromised body intact.Looking back, a more mature David Meredith attempts to establish order, perspective and understanding to the “mess of memory and impressions” of his war-affected childhood in an effort to wrest control back over his postmemory violation: “Jack and I must have spent a good part of our boyhood in the fixed belief that grown-up men who were complete were pretty rare beings—complete, that is, in that they had their sight or hearing or all of their limbs” (8). While the father is physically complete, his brooding presence sets the tone for the oppressively “dark experience” within the family home where all rooms are “inhabited by the jetsam that the Somme and the Marne and the salient at Ypres and the Gallipoli beaches had thrown up” (18). It is not until Davy explores the contents of the “big deep drawer at the bottom of the cedar wardrobe” in his parents’ bedroom that he begins to “sense a form in the shadow” of the “faraway experience” that had been the war. The drawer contains his father’s service revolver and ammunition, battlefield souvenirs and French postcards but, “most important of all, the full set of the Illustrated War News” (19), with photographs of battlefield carnage. These are the equivalent of Hirsch’s photographs of the Holocaust that establish in Meredith an ontology that links him more realistically to the brutalising past and source of his ongoing traumatistion (Hirsch). From these, Davy begins to discern something of his father’s torment but also good fortune at having survived, and he makes curatorial interventions not by becoming a custodian of abjection like second generation Holocaust survivors but by disposing of the printed material, leaving behind artefacts of heroism: gun, the bullets, the medals and ribbons. The implication is that he has now become complicit in the very narrative that had oppressed him since his father’s return from war.No one apparently notices or at least comments on the removal of the journals, the images of which become linked in the young boys mind to an incident outside a “dilapidated narrow-fronted photographer’s studio which had been deserted and padlocked for as long as I could remember”. A number of sun-damaged photographs are still displayed in the window. Faded to a “ghostly, deathly pallor”, and speckled with fly droppings, years earlier, they had captured young men in uniforms before embarkation for the war. An “agate-eyed” boy from Davy’s school joins in the gazing, saying nothing for a long time until the silence is broken: “all them blokes there is dead, you know” (20).After the unnamed boy departs with a nonchalant “hoo-roo”, young Davy runs “all the way home, trying not to cry”. He cannot adequately explain the reason for his sudden reaction: “I never after that looked in the window of the photographer’s studio or the second hand shop”. From that day on Davy makes a “long detour” to ensure he never passes the shops again (20-1). Having witnessed images of pre-war undamaged young men in the prime of their youth, he has come face-to-face with the consequences of war which he is unable to reconcile in terms of the survival and return of his much older father.The photographs of the young men establishes a causal connection to the physically wrecked remnants that have shaped Davy’s childhood. These are the living remains that might otherwise have been the “corpses sprawled in mud or drowned in flooded shell craters” depicted in the Illustrated News. The photograph of the young men establishes Davy’s connection to the things “propped up our hallway”, of “Bert ‘sobbing’ in the backyard and Gabby Dixon’s face at the dark end of the room”, and only reluctantly the “bronchial cough of my father going off in the dawn light to the tramways depot” (18).That is to say, Davy has begun to piece together sense from senselessness, his father’s complicity and survival—and, by association, his own implicated life and psychological wounding. He has approached the source of his father’s abjection and also his own though he continues to be unable to accept and forgive. Like his father—though at the remove—he has been damaged by the legacies of the war and is also its victim.Ravaged by tuberculosis and alcoholism, George Johnston died in 1970. According to the artist Sidney Nolan he had for years resembled the ghastly photographs of survivors of the Holocaust (Marr 278). George’s forty five year old alcoholic wife Charmian Clift predeceased him by twelve months, having committed suicide in 1969. Four years later, in 1973, George and Charmian’s twenty four year old daughter Shane also took her own life. Their son Martin drank himself to death and died of organ failure at the age of forty three in 1990. They are all “dead, you know”.ReferencesAWM. Fifth Field Company, Australian Engineers. Diaries, AWM4 Sub-class 14/24.“Enlistment Report”. Reveille, 29 Sep. 1928.Hirsch, Marianne. “The Generation of Postmemory.” Poetics Today 29.1 (Spring 2008): 103-128. <https://read.dukeupress.edu/poetics-today/article/29/1/103/20954/The-Generation-of-Postmemory>.Johnston, George. Clean Straw for Nothing. London: Collins, 1969.———. My Brother Jack. London: Collins, 1964.Kinnane, Garry. George Johnston: A Biography. Melbourne: Nelson, 1986.Lawler, Clark. Consumption and Literature: the Making of the Romantic Disease. Basingstoke: Palgrave Macmillan, 2006.Marr, David, ed. Patrick White Letters. Sydney: Random House, 1994.Murphy, Ffion, and Richard Nile. “Gallipoli’s Troubled Hearts: Fear, Nerves and Repatriation.” Studies in Western Australian History 32 (2018): 25-38.NAA. John George Johnston War Service Records. <https://recordsearch.naa.gov.au/SearchNRetrieve/Interface/ViewImage.aspx?B=1830166>.“Soldiers Return by the Kildonan Castle.” Sydney Morning Herald, 10 May 1919: 18.Thomson, Alistair. Anzac Memories: Living with the Legend. Clayton: Monash UP, 2013.

In many dairy industries, but particularly those that are pasture-based and have seasonal calving, “surplus calves,” which are mostly male, are killed at a young age because they are of low value and it is not economically viable to raise them. Such calves are either killed on farm soon after birth or sent for slaughter at an abattoir. In countries where calves are sent for slaughter the age ranges from 3-4 days (New Zealand and Australia; “bobby calves”) to 3-4 weeks (e.g., Ireland); they are not weaned. All calves are at the greatest risk of death in the 1st month of life but when combined with their low value, this makes surplus calves destined for early slaughter (i.e., &lt;1 month of age) particularly vulnerable to poor welfare while on-farm. The welfare of these calves may also be compromised during transport and transit through markets and at the abattoir. There is growing recognition that feedback to farmers of results from animal-based indicators (ABI) of welfare (including health) collected prior to and after slaughter can protect animal welfare. Hence, the risk factors for poor on-farm, in-transit and at-abattoir calf welfare combined with an ante and post mortem (AM/PM) welfare assessment scheme specific to calves &lt;1 month of age are outlined. This scheme would also provide an evidence base with which to identify farms on which such animals are more at risk of poor welfare. The following ABIs, at individual or batch level, are proposed: AM indicators include assessment of age (umbilical maturity), nutritional status (body condition, dehydration), behavioral status (general demeanor, posture, able to and stability while standing and moving, shivering, vocalizations, oral behaviors/cross-sucking, fearfulness, playing), and evidence of disease processes (locomotory ability [lameness], cleanliness/fecal soiling [scour], injuries hairless patches, swellings, wounds], dyspnoea/coughing, nasal/ocular discharge, navel swelling/discharge); PM measures include assessment of feeding adequacy (abomasal contents, milk in rumen, visceral fat reserves) and evidence of disease processes (omphalitis, GIT disorders, peritonitis, abscesses [internal and external], arthritis, septicaemia, and pneumonia). Based on similar models in other species, this information can be used in a positive feedback loop not only to protect and improve calf welfare but also to inform on-farm calf welfare management plans, support industry claims regarding animal welfare and benchmark welfare performance nationally and internationally.

Introduction The recipe is more than just a list of ingredients and the instructions on how to prepare a particular dish. Recipes also are, as Janet Floyd and Laurel Foster argue, a form of narrative that tells a myriad of stories, “of family sagas and community, of historical and cultural moments and also of personal histories and narratives of self” (Floyd and Forster 2). Among the most intimate and personal sources of recipes are manuscript cookbooks. These typically contained original handwritten recipes created by the author as well as those shared by family and friends; some recipes were copied from published cookbooks or clipped out of newspapers and magazines. However, these books are more than a mere collection of recipes and domestic instructions, they also paint a unique and vivid picture of the life of their authors. These manuscript cookbooks were a common sight in many Australian colonial kitchens, yet they are a rarely examined and rich archival source that provides a valuable insight into foodways, material culture, and the lives and social relationships of the women who created them. This article will examine the manuscript cookbook created by Phillis Clark in the Darling Downs during the 1860s. Through a close examination of Clark’s manuscript cookbook, this article will explore colonial domestic habits and the cultural context in which they were formed. It will also highlight the historical value of manuscript cookbooks as social texts that chronicle daily life, both inside and outside the kitchen, in colonial Australia. A Colonial Woman Phillis Clark was born in Tasmania in 1836. She was the daughter of Charles Seal, the pioneer of the whaling industry in that state. In 1858 she married Charles George Clark, the eldest son of a well-known Tasmanian family. Both the Seal and Clark families were at the centre of social and political life in Tasmania. In 1861, the couple moved to Talgai, twenty two kilometres north-west of Warwick in the Darling Downs region of Queensland. Here, Charles Clark established himself as a storekeeper and became a partner in the Ellinthorp Steam Flour Mills, the first successful flour mill in Queensland (Waterson 3). He also represented Warwick in the Queensland Legislative assembly between 1871 and 1873. Clark’s brother, George Clark, also settled in the area together with his wife and family. In 1868, both families set up home in adjoining properties known as East Talgai and West Talgai. This joint property, with its well manicured gardens, English trees, and fruit orchard, has been described as a small oasis “in an empty, brown and dusty summer landscape” (Waterson, Squatter 19). The Manuscript Sometime during this period Clark began to compile her very own manuscript cookbook. The front of Clark’s manuscript is dated 1866, yet there is ample evidence to suggest that she began work on this manuscript some years earlier. Clark was scrupulous in acknowledging the sources of her recipes, a habit common to many manuscript cookbook authors (Newlyn 35). She also initialled her own creations, firstly with P.S., for her maiden name Phillis Seal, and later P.S.C. for Phillis Seal Clark, her married name. By 1866 Clarke had been married for eight years so it can be assumed that she commenced her manuscript some time before 1858. A number of the recipes that appear in the manuscript appear to be credited to people living in Tasmania. Furthermore, a number of the newspaper clippings found in her manuscript can be dated to before 1866, including one for 1861. The manuscript itself is a hard bound and lined notebook, sturdy enough to withstand the rigours of daily use in the kitchen. The majority of recipes are handwritten but there are also a number of recipes clipped from newspapers interspaced within the manuscript. The handwritten recipes are in a neat copperplate style and all appear to be written in the same hand. The recipes are not found in distinct sections, although there are some small clusters of particular types of recipes, highlighting the fact that they were added to the manuscript over a period of time. At the front of the manuscript there is a detailed index noting the page number on which each recipe is to be found. The recipes themselves follow the standard conventions of the period. The Sources The sources from which Clark gathered some of the recipes in her manuscript indicate the variety of texts that were available to her. There are a number of newspaper clippings pasted in the pages of her manuscript for a range of both recipes for foods as well as the so-called domestic remedies (medicines) and receipts for household products. Amongst the food recipes there are to be found instructions in the making of cream cheese in the Irish manner and a recipe for stewed shoulder of mutton as well as two different methods for preparing kangaroo. While it is impossible to fully know what newspapers all these clippings have been taken from, at least one of them came from the Darling Downs Gazette and General Advertiser and it is likely that some of them might also have come from a number of the local Warwick papers (one which was founded by her brother-in-law George Clark) that were in publication during Clark’s residence in the area. Clark also utilised a number of published cookbooks as sources for some of the recipes in her own manuscripts. Like most Australians until the last few decades of the nineteenth century, Clark would have mainly resorted to the British cookbooks that were available. The two most commonly acknowledged cookbooks in her manuscript were Enquire Within Upon Everything and Eliza Acton’s. Enquire Within Upon Everything was an immensely popular general household guide amassing eighty-nine editions in a little over forty years in print. It contained information on a plethora of subjects (over three thousand individual entries) including such topics as etiquette, first aid, domestic hints, and recipes. It first appeared on the British market in 1856, under the editorship of Robert Kemp Philp, and became available in Australia in the same year. Booksellers in the Darling Downs advertised copies of the book for the price of three shillings and six pence. Eliza Acton, for her part, was one of Britain’s leading cookbook authors. Her books were widely available throughout the colonies with copies advertised for sale by J. Walch and Sons booksellers in Hobart (‘Advertising’ 1). Extracts from her cookbook Modern Cookery for Private Families began to appear in Australian newspapers only months after it first was published in Britain in 1845 (‘Bullion’ 4). Although Modern Cookery did not provide any recipes directly catering for Australian conditions, its simple and straightforward approach to cookery made it an invaluable resource in the colonial kitchen. Such was the popularity and reputation of Acton’s work that in the preface to Australia’s first cookbook, The English and Australian Cookery Book, the author, Tasmanian born Edward Abbott, stated that he hoped that his cook book would posses “all the advantages of Mrs. Acton’s work” (Abbott vi). The range of printed sources contained within Clark’s manuscript indicate that women in colonial households were far from isolated from the culinary trends occurring in other parts of Australia and the wider British empire. The Recipes Like many Australian women of her class and generation, Phillis Clark reproduced the predominant British food culture in her kitchen. The great majority of recipes contained in her manuscript are for typically English dishes, particularly those for sweet dishes such as biscuits, cakes, and puddings. Plum pudding, trifle, and custard pudding are all featured in her book. As well, many of the savoury dishes such as curry, roast beef, and Yorkshire pudding similarly reflect the British palate. In There is No Taste like Home: The Food of Empire, Adele Wessell argues that the maintenance of British food habits in Australia was a device to reaffirm “cultural and historical bonds and sustain a shared sense of British identity” (811). However, as in many other rural kitchens, native ingredients also found a place. Her manuscript included a number of recipes for the preparation of kangaroo and detailed instructions for the butchering of the animal. Clark’s recipe for “Jugged Hare or Kangaroo” bares a close resemblance to the one that appears in Edward Abbott’s cookbook. Clark’s father and Abbott were from the same, small social milieu in colonial Hobart and were both active in the same political causes. This raises the intriguing possibility that Phillis also knew Abbott and came into contact with some of his culinary ideas. Australians consumed all manners of native ingredients, not only as a matter of necessity but also as a matter of choice. The inclusion of freshly killed native game in Clark’s kitchen would have served to alleviate the monotony of the salted beef and mutton that were common staples during this period. The distinct Australian flavour that began to appear in manuscript cookbooks like Clark’s would later be replicated in their printed counterparts. Australian cookbooks published in the last decades of the nineteenth century demonstrate the importance of native ingredients in colonial kitchens (Singley 37). The Darling Downs region had been a popular destination for German migrants from the 1850s and Clark’s manuscript contained a number of recipes for German dishes. This included one for the traditional German Christmas cake Lebkuchen as well as for various German puddings and biscuits. Clark also included an elaborate recipe for making ham or bacon in the traditional Westphalian fashion. This was a laborious process that involved vigorously rubbing salt, sugar, and beer into the leg of ham every day for a fortnight after which it is then hung to dry for a couple of days and then smoked. Katie Hume, a fellow Darling Downs resident and a close friend of the extended Clark family described feeling like a “gute verstandige Hausfrau” (a good sensible housewife) after salting 112 pounds of pork she had purchased from a neighbour (152). While, unlike their counterparts in the Barossa valley in South Australia, the Germans who lived in the Darling Downs area did not leave a significant mark on the local culinary landscape, the inclusion of German recipes in Clark’s manuscript indicates that there was not only some cross-cultural transmission of culinary knowledge, but also some willingness to go beyond traditional British fare. Many, more mundane recipes also populate Clark’s manuscript. “Toad in a Hole”, “Mutton Pie” and “Stewed Sirloin” all merit an entry. Yet, even with such simple dishes, Clark demonstrated a keen eye for detail. This is attested by her method for the preparation of a simple dish of roasted pumpkin: “Cut into slices 1 inch thick and about 5 inches long, have ready a baking dish with boiling fat—lay the slices in it so that the fat will cover them and bake for 20 minutes (by fat I mean good dripping) Half an hour will not bake them too much. They ought to be brown” (Clark 13). Whilst Clark’s manuscript is not indicative of the foodways of all classes across Queensland society, it does provide some insight as to what was consumed at the table of a well-heeled rural household. As the wife of a prominent businessman and a local dignitary, Phillis Clark would have also undoubtedly been called upon to play the role of hostess and to entertain her husband’s commercial and political acquaintances. Her manuscript also reflects the overwhelmingly British nature of colonial Australian foodways despite the intrusion of some foreign dishes. As Anne Murcott argues, the preparation and consumption of food provides a way through which individuals can express the more abstract significance of cultural values and social systems (204). The Clark household also showed some interest in producing a broad range of products in the home. There are, for example, a number of recipes for beverages including those for non-alcoholic ginger beers and flavoured cordials. They were also far from abstemious, with recipes for wine, mead, and ale included in the manuscript. This last recipe was given to her by her brother Alfred who, according to Clark, “understands brewing and therefore I think it can be depended upon” (Clark 43). Clark also bottled her own fruit, made a wide range of jams, including grape and mock melon, as well as making her own butter, confectionery, and vinegar. The production of goods like these within the home indicates the level of self-reliance in many colonial households, particularly those finding themselves far from the convenience of shops and markets. Many culinary historians argue that there exists a significant time lag between the initial appearance and consumption of a particular dish in a society and its subsequent appearance in the pages of a cookbook. This time lag can be between forty and 150 years long (Mennell 44; Mason 23). However, manuscript cookbooks reflect the immediacy of eating practices. The very personal nature of manuscript cookbooks would suggest that the recipes included within their pages were ones that the author intended to use in her own kitchen. Moreover, from the reciprocal nature of recipe sharing that is evident from these types of cookbooks it can be concluded that the recipes in Clark’s manuscript were ones that, at least in her own social milieu, were in common usage. In her manuscript Clark clearly noted those recipes which she especially liked or otherwise found useful. Many recipes throughout the manuscript have been marked as “proved” indicating that Clark had used and tested them at some stage. A number of them have also been favourably annotated as being “delicious”, “very nice”, “the best”, and “very good”. Amongst the number of recipes for “Soda Cake” that feature in the manuscript Clarke clearly indicates that “Number 1 is the best”. However, she was not averse to commenting on recipes and altering them to suit her taste. In a recipe for “A nice light Cake”, for example, Clark noted that the addition of a “little peel and currants is an improvement” (89). This form of marginal intrusion was a common practice amongst many women and it can even be seen in the margins of many published cookbooks (Theophano 186). These annotations, according to Sandra Sherman, are not transgressive, since the manuscripts are not authored “by” anyone (Sherman 121). In fact, annotations personalise the recipe and confirm the compiler’s confidence in it (Sherman 121). Not Just Food: ‘Domestic Receipts’ As noted above, Clark’s manuscript contained more than just recipes for food and drink. Many of them are “Domestic Receipts” that reflect the complex nature of running a household in rural Australia. Some of Clark’s domestic receipts are in the form of newspaper clippings and are general instructions for the manufacture of simple household products such as a “ready to use glue” and a home-made tooth powder. Others are handwritten and copied from other domestic advice books or were given to Clark by family and friends. A recipe for manufacturing “blacking for stoves”, essential in the maintenance of cast iron stoves, was, for example, culled from Enquire Within Upon Everything. Here, with some authorial intrusion, Clark includes her own list of measured ingredients to prepare the mixture. An intriguing method for the “artificial preparation of ice” involving the use of ammonium nitrate and bicarbonate of soda was given to Clark by Mrs. McKeachie, the wife of Charles Clark’s business partner. Clark also showed an interest in beekeeping and in raising turkeys, with instructions for both these tasks included in her manuscript. The wide range of miscellaneous receipts featured in Clark’s book highlights the breadth of activities that were carried out in many homes in rural Australia. A hint of Clark’s artistic side is also in evidence, with detailed instructions on how to create delicate fern impressions on paper also included in her book. As with many other women in colonial Australia, Clark was expected to take on the role of caregiver when members of her family fell ill or were injured. Her manuscript included a number of recipes for “domestic remedies”, another common trope in books of this kind as well as in their printed counterparts. These remedies included recipes for a cough mixture composed of linseed, liquorice, and water and a liniment to treat rheumatism which was made by mixing rape seed oil and turpentine with a hefty dose of laudanum. Clark used olive oil in a number of medical recipes to treat burns and scalds. As well, treatments for diphtheria, cholera, and diarrhoea feature prominently in her manuscript. The Darling Downs had been subject to a number of outbreaks of dysentery and cholera during Clark’s residency in the area (Waterson, Squatter 71). For “a pain in the chest” Clark recommended the following: “a piece of brown paper spread with tallow and placed on the chest” (69).The inclusion of these domestic remedies and Clark’s obvious concerns for her family’s health is particularly poignant given her personal history. Her family was plagued by misfortune and illness and she lost three of her ten children in a six-year period including two within just months of each other. Clark herself would die during childbirth in 1874. Sharing and Caring The word “recipe” has its origins in the Latin recipere meaning to “receive”. In order to receive there has to be, by implication, someone doing the giving. A recipe signifies an exchange and a connection between individuals. The sharing of recipes was a common activity for many women in nineteenth century Australia. Wilhelmina Rawson, Queensland’s first published cookbook author, was keenly aware of the manner in which women shared recipes and culinary knowledge. This act of reciprocity, she argued, not only helped to ease the isolation of bush living but also allowed each individual to be “benefited by the cleverness of the whole number” (14). For many, food often has a deeply private and personal component, being prepared and consumed within the realm of the home. However, food is also a communal experience and is openly shared through rituals, feasts, the contexts in which it is bought and sold, and, most importantly, reciprocal exchange. In her manuscript, Clark acknowledged a number of different individuals as the source for the recipes she included within its pages. The convention of acknowledging the sources of recipes in manuscript cookbooks functions as a way to assert the recipe’s authority and to ensure that they are proven (Sherman 122). This act of acknowledgement also locates Clark within a social network of women who not only shared recipes but also, one can imagine, many of the vicissitudes of domestic life in a remote rural setting. In her study of women’s manuscript cookbooks, entitled Eat My Words: Reading Women’s Lives Through the Cookbooks They Wrote, Janet Theophano describes these texts as “the maps of the social and cultural life they inhabited” (13). This circulation of recipes allowed women to share their knowledge, skills, and creativity. Those who received and used these recipes not only engaged in a conversation with the writer of these recipes but also formed a connection with a broader community that allowed them to learn more about themselves and the world. Conclusion The manuscript cookbook created by Phillis Clark is a fascinating prism through which to explore domestic life in colonial Australia. The recipes contained in Clark’s manuscript reflect the eating habits of her own family and those of a particular social class in Queensland. They not only demonstrate the tenacity of British foodways in Australia but also show the degree of culinary adventurism that existed in some homes. The personal, almost autobiographical nature of manuscript cookbooks also provides an intimate view in the life of its creator. In the splattered pages of Phillis Clark’s book we can read the many travails, joys, and tragedies of her life. References Abbott, Edward. The English and Australian Cookery Book: Cookery for the Many, as Well as for the Upper Ten Thousand. London: Sampson Low, Son, and Marston, 1864. ‘Advertising’. Launceston Examiner 9 Mar. 1858: 1. ‘Boullion, The Common Soup of France’. The Sydney Morning Herald 22 Aug. 1845: 4. Clark, Phillis. “Manuscript Cookbook”. 1863 Floyd, Janet, and Laurel Forster. “The Recipe in Its Cultural Content.” The Recipe Reader: Narratives, Contexts, Traditions. Ed. Janet Floyd and Laurel Forster. Aldershot, Hants, England: Ashgate. 2003. Hume, Anna Kate. Katie Hume on the Darling Downs, a Colonial Marriage: Letters of a Colonial Lady, 1866-1871. Ed. Nancy Bonnin. Toowoomba: DDIP, 1985. Mason, Laura. Food Culture in Great Britain. Greenwood, 2004. Mennell, Stephen. All Manners of Food: Eating and Taste in England and France from the Middle Ages to the Present. Oxford, UK: B. Blackwell, 1985. Murcott, Anne. “The Cultural Significance of Food and Eating”. Proceedings of the Nutrition Society 41.02 (1982): 203–10. Newlyn, Andrea K. “Redefining ‘Rudimentary’ Narrative: Women’s Nineteenth Century Manuscript Cookbooks”. The Recipe Reader: Narratives, Contexts, Traditions. Ed. Janet Floyd and Laurel Forster. Aldershot, Hants, England: Ashgate, 2003. Rawson, Wilhelmina. Australian Enquiry Book of Household and General Information: A Practical Guide for the Cottage, Villa and Bush Home. Melbourne: Pater and Knapton, 1894. Sherman, S. “‘The Whole Art and Mystery of Cooking’: What Cookbooks Taught Readers in the Eighteenth Century”. Eighteenth-Century Life 28.1 (2004): 115–35. Singley, Blake. “‘Hardly Anything Fit for Man to Eat’: Food and Colonialism in Australia.” History Australia 9.3 (2012): 27–42. Theophano, Janet. Eat My Words: Reading Women’s Lives Through the Cookbooks They Wrote. New York, N.Y: Palgrave, 2002. Waterson, D. B. “A Darling Downs Quartet”. Queensland Heritage 1.7 (1967): 3–14. Waterson, D. B. Squatter, Selector and Storekeeper: A History of the Darling Downs, 1859-93. Sydney: Sydney UP, 1968. Wessell, Adele. “There’s No Taste Like Home: The Food of Empire”. Exploring the British World: Identity, Cultural Production, Institutions. Ed. Kate Darian-Smith and Patricia Grimshaw. Melbourne: RMIT, 2004.

When we think of disability today in the Western world, Christopher Reeve most likely comes to mind. A film star who captured people’s imagination as Superman, Reeve was already a celebrity before he took the fall that would lead to his new position in the fame game: the role of super-crip. As a person with acquired quadriplegia, Christopher Reeve has become both the epitome of disability in Western culture — the powerful cultural myth of disability as tragedy and catastrophe — and, in an intimately related way, the icon for the high-technology quest for cure. The case of Reeve is fascinating, yet critical discussion of Christopher Reeve in terms of fame, celebrity and his performance of disability is conspicuously lacking (for a rare exception see McRuer). To some extent this reflects the comparative lack of engagement of media and cultural studies with disability (Goggin). To redress this lacuna, we draw upon theories of celebrity (Dyer; Marshall; Turner, Bonner, & Marshall; Turner) to explore the production of Reeve as celebrity, as well as bringing accounts of celebrity into dialogue with critical disability studies. Reeve is a cultural icon, not just because of the economy, industrial processes, semiotics, and contemporary consumption of celebrity, outlined in Turner’s 2004 framework. Fame and celebrity are crucial systems in the construction of disability; and the circulation of Reeve-as-celebrity only makes sense if we understand the centrality of disability to culture and media. Reeve plays an enormously important (if ambiguous) function in the social relations of disability, at the heart of the discursive underpinning of the otherness of disability and the construction of normal sexed and gendered bodies (the normate) in everyday life. What is distinctive and especially powerful about this instance of fame and disability is how authenticity plays through the body of the celebrity Reeve; how his saintly numinosity is received by fans and admirers with passion, pathos, pleasure; and how this process places people with disabilities in an oppressive social system, so making them subject(s). An Accidental Star Born September 25, 1952, Christopher Reeve became famous for his roles in the 1978 movie Superman, and the subsequent three sequels (Superman II, III, IV), as well as his role in other films such as Monsignor. As well as becoming a well-known actor, Reeve gained a profile for his activism on human rights, solidarity, environmental, and other issues. In May 1995 Reeve acquired a disability in a riding accident. In the ensuing months, Reeve’s situation attracted a great deal of international attention. He spent six months in the Kessler Rehabilitation Institute in New Jersey, and there gave a high-rating interview on US television personality Barbara Walters’ 20/20 program. In 1996, Reeve appeared at the Academy Awards, was a host at the 1996 Paralympic Games, and was invited to speak at the Democratic National Convention. In the same year Reeve narrated a film about the lives of people living with disabilities (Mierendorf). In 1998 his memoir Still Me was published, followed in 2002 by another book Nothing Is Impossible. Reeve’s active fashioning of an image and ‘new life’ (to use his phrase) stands in stark contrast with most people with disabilities, who find it difficult to enter into the industry and system of celebrity, because they are most often taken to be the opposite of glamorous or important. They are objects of pity, or freaks to be stared at (Mitchell & Synder; Thomson), rather than assuming other attributes of stars. Reeve became famous for his disability, indeed very early on he was acclaimed as the pre-eminent American with disability — as in the phrase ‘President of Disability’, an appellation he attracted. Reeve was quickly positioned in the celebrity industry, not least because his example, image, and texts were avidly consumed by viewers and readers. For millions of people — as evident in the letters compiled in the 1999 book Care Packages by his wife, Dana Reeve — Christopher Reeve is a hero, renowned for his courage in doing battle with his disability and his quest for a cure. Part of the creation of Reeve as celebrity has been a conscious fashioning of his life as an instructive fable. A number of biographies have now been published (Havill; Hughes; Oleksy; Wren). Variations on a theme, these tend to the hagiographic: Christopher Reeve: Triumph over Tragedy (Alter). Those interested in Reeve’s life and work can turn also to fan websites. Most tellingly perhaps is the number of books, fables really, aimed at children, again, on a characteristic theme: Learning about Courage from the Life of Christopher Reeve (Kosek; see also Abraham; Howard). The construction, but especially the consumption, of Reeve as disabled celebrity, is consonant with powerful cultural myths and tropes of disability. In many Western cultures, disability is predominantly understood a tragedy, something that comes from the defects and lack of our bodies, whether through accidents of birth or life. Those ‘suffering’ with disability, according to this cultural myth, need to come to terms with this bitter tragedy, and show courage in heroically overcoming their lot while they bide their time for the cure that will come. The protagonist for this this script is typically the ‘brave’ person with disability; or, as this figure is colloquially known in critical disability studies and the disability movement — the super-crip. This discourse of disability exerts a strong force today, and is known as the ‘medical’ model. It interacts with a prior, but still active charity discourse of disability (Fulcher). There is a deep cultural history of disability being seen as something that needs to be dealt with by charity. In late modernity, charity is very big business indeed, and celebrities play an important role in representing the good works bestowed on people with disabilities by rich donors. Those managing celebrities often suggest that the star finds a charity to gain favourable publicity, a routine for which people with disabilities are generally the pathetic but handy extras. Charity dinners and events do not just reinforce the tragedy of disability, but they also leave unexamined the structural nature of disability, and its associated disadvantage. Those critiquing the medical and charitable discourses of disability, and the oppressive power relations of disability that it represents, point to the social and cultural shaping of disability, most famously in the British ‘social’ model of disability — but also from a range of other perspectives (Corker and Thomas). Those formulating these critiques point to the crucial function that the trope of the super-crip plays in the policing of people with disabilities in contemporary culture and society. Indeed how the figure of the super-crip is also very much bound up with the construction of the ‘normal’ body, a general economy of representation that affects everyone. Superman Flies Again The celebrity of Christopher Reeve and what it reveals for an understanding of fame and disability can be seen with great clarity in his 2002 visit to Australia. In 2002 there had been a heated national debate on the ethics of use of embryonic stem cells for research. In an analysis of three months of the print media coverage of these debates, we have suggested that disability was repeatedly, almost obsessively, invoked in these debates (‘Uniting the Nation’). Yet the dominant representation of disability here was the cultural myth of disability as tragedy, requiring cure at all cost, and that this trope was central to the way that biotechnology was constructed as requiring an urgent, united national response. Significantly, in these debates, people with disabilities were often talked about but very rarely licensed to speak. Only one person with disability was, and remains, a central figure in these Australian stem cell and biotechnology policy conversations: Christopher Reeve. As an outspoken advocate of research on embryonic stem-cells in the quest for a cure for spinal injuries, as well as other diseases, Reeve’s support was enlisted by various protagonists. The current affairs show Sixty Minutes (modelled after its American counterpart) presented Reeve in debate with Australian critics: PRESENTER: Stem cell research is leading to perhaps the greatest medical breakthroughs of all time… Imagine a world where paraplegics could walk or the blind could see … But it’s a breakthrough some passionately oppose. A breakthrough that’s caused a fierce personal debate between those like actor Christopher Reeve, who sees this technology as a miracle, and those who regard it as murder. (‘Miracle or Murder?’) Sixty Minutes starkly portrays the debate in Manichean terms: lunatics standing in the way of technological progress versus Christopher Reeve flying again tomorrow. Christopher presents the debate in utilitarian terms: CHRISTOPHER REEVE: The purpose of government, really in a free society, is to do the greatest good for the greatest number of people. And that question should always be in the forefront of legislators’ minds. (‘Miracle or Murder?’) No criticism of Reeve’s position was offered, despite the fierce debate over the implications of such utilitarian rhetoric for minorities such as people with disabilities (including himself!). Yet this utilitarian stance on disability has been elaborated by philosopher Peter Singer, and trenchantly critiqued by the international disability rights movement. Later in 2002, the Premier of New South Wales, Bob Carr, invited Reeve to visit Australia to participate in the New South Wales Spinal Cord Forum. A journalist by training, and skilled media practitioner, Carr had been the most outspoken Australian state premier urging the Federal government to permit the use of embryonic stem cells for research. Carr’s reasons were as much as industrial as benevolent, boosting the stocks of biotechnology as a clean, green, boom industry. Carr cleverly and repeated enlisted stereotypes of disability in the service of his cause. Christopher Reeve was flown into Australia on a specially modified Boeing 747, free of charge courtesy of an Australian airline, and was paid a hefty appearance fee. Not only did Reeve’s fee hugely contrast with meagre disability support pensions many Australians with disabilities live on, he was literally the only voice and image of disability given any publicity. Consuming Celebrity, Contesting Crips As our analysis of Reeve’s antipodean career suggests, if disability were a republic, and Reeve its leader, its polity would look more plutocracy than democracy; as befits modern celebrity with its constitutive tensions between the demotic and democratic (Turner). For his part, Reeve has criticised the treatment of people with disabilities, and how they are stereotyped, not least the narrow concept of the ‘normal’ in mainstream films. This is something that has directly effected his career, which has become limited to narration or certain types of television and film work. Reeve’s reprise on his culture’s notion of disability comes with his starring role in an ironic, high-tech 1998 remake of Alfred Hitchcock’s Rear Window (Bleckner), a movie that in the original featured a photojournalist injured and temporarily using a wheelchair. Reeve has also been a strong advocate, lobbyist, and force in the politics of disability. His activism, however, has been far more strongly focussed on finding a cure for people with spinal injuries — rather than seeking to redress inequality and discrimination of all people with disabilities. Yet Reeve’s success in the notoriously fickle star system that allows disability to be understood and mapped in popular culture is mostly an unexplored paradox. As we note above, the construction of Reeve as celebrity, celebrating his individual resilience and resourcefulness, and his authenticity, functions precisely to sustain the ‘truth’ and the power relations of disability. Reeve’s celebrity plays an ideological role, knitting together a set of discourses: individualism; consumerism; democratic capitalism; and the primacy of the able body (Marshall; Turner). The nature of this cultural function of Reeve’s celebrity is revealed in the largely unpublicised contests over his fame. At the same time Reeve was gaining fame with his traditional approach to disability and reinforcement of the continuing catastrophe of his life, he was attracting an infamy within certain sections of the international disability rights movement. In a 1996 US debate disability scholar David T Mitchell put it this way: ‘He’s [Reeve] the good guy — the supercrip, the Superman, and those of us who can live with who we are with our disabilities, but who cannot live with, and in fact, protest and retaliate against the oppression we confront every second of our lives are the bad guys’ (Mitchell, quoted in Brown). Many feel, like Mitchell, that Reeve’s focus on a cure ignores the unmet needs of people with disabilities for daily access to support services and for the ending of their brutal, dehumanising, daily experience as other (Goggin & Newell, Disability in Australia). In her book Make Them Go Away Mary Johnson points to the conservative forces that Christopher Reeve is associated with and the way in which these forces have been working to oppose the acceptance of disability rights. Johnson documents the way in which fame can work in a variety of ways to claw back the rights of Americans with disabilities granted in the Americans with Disabilities Act, documenting the association of Reeve and, in a different fashion, Clint Eastwood as stars who have actively worked to limit the applicability of civil rights legislation to people with disabilities. Like other successful celebrities, Reeve has been assiduous in managing his image, through the use of celebrity professionals including public relations professionals. In his Australian encounters, for example, Reeve gave a variety of media interviews to Australian journalists and yet the editor of the Australian disability rights magazine Link was unable to obtain an interview. Despite this, critiques of the super-crip celebrity function of Reeve by people with disabilities did circulate at the margins of mainstream media during his Australian visit, not least in disability media and the Internet (Leipoldt, Newell, and Corcoran, 2003). Infamous Disability Like the lives of saints, it is deeply offensive to many to criticise Christopher Reeve. So deeply engrained are the cultural myths of the catastrophe of disability and the creation of Reeve as icon that any critique runs the risk of being received as sacrilege, as one rare iconoclastic website provocatively prefigures (Maddox). In this highly charged context, we wish to acknowledge his contribution in highlighting some aspects of contemporary disability, and emphasise our desire not to play Reeve the person — rather to explore the cultural and media dimensions of fame and disability. In Christopher Reeve we find a remarkable exception as someone with disability who is celebrated in our culture. We welcome a wider debate over what is at stake in this celebrity and how Reeve’s renown differs from other disabled stars, as, for example, in Robert McRuer reflection that: ... at the beginning of the last century the most famous person with disabilities in the world, despite her participation in an ‘overcoming’ narrative, was a socialist who understood that disability disproportionately impacted workers and the power[less]; Helen Keller knew that blindness and deafness, for instance, often resulted from industrial accidents. At the beginning of this century, the most famous person with disabilities in the world is allowing his image to be used in commercials … (McRuer 230) For our part, we think Reeve’s celebrity plays an important contemporary role because it binds together a constellation of economic, political, and social institutions and discourses — namely science, biotechnology, and national competitiveness. In the second half of 2004, the stem cell debate is once again prominent in American debates as a presidential election issue. Reeve figures disability in national culture in his own country and internationally, as the case of the currency of his celebrity in Australia demonstrates. In this light, we have only just begun to register, let alone explore and debate, what is entailed for us all in the production of this disabled fame and infamy. Epilogue to “Fame and Disability” Christopher Reeve died on Sunday 10 October 2004, shortly after this article was accepted for publication. His death occasioned an outpouring of condolences, mourning, and reflection. We share that sense of loss. How Reeve will be remembered is still unfolding. The early weeks of public mourning have emphasised his celebrity as the very embodiment and exemplar of disabled identity: ‘The death of Christopher Reeve leaves embryonic-stem-cell activism without one of its star generals’ (Newsweek); ‘He Never Gave Up: What actor and activist Christopher Reeve taught scientists about the treatment of spinal-cord injury’ (Time); ‘Incredible Journey: Facing tragedy, Christopher Reeve inspired the world with hope and a lesson in courage’ (People); ‘Superman’s Legacy’ (The Express); ‘Reeve, the Real Superman’ (Hindustani Times). In his tribute New South Wales Premier Bob Carr called Reeve the ‘most impressive person I have ever met’, and lamented ‘Humankind has lost an advocate and friend’ (Carr). The figure of Reeve remains central to how disability is represented. In our culture, death is often closely entwined with disability (as in the saying ‘better dead than disabled’), something Reeve reflected upon himself often. How Reeve’s ‘global mourning’ partakes and shapes in this dense knots of associations, and how it transforms his celebrity, is something that requires further work (Ang et. al.). The political and analytical engagement with Reeve’s celebrity and mourning at this time serves to underscore our exploration of fame and disability in this article. Already there is his posthumous enlistment in the United States Presidential elections, where disability is both central and yet marginal, people with disability talked about rather than listened to. The ethics of stem cell research was an election issue before Reeve’s untimely passing, with Democratic presidential contender John Kerry sharply marking his difference on this issue with President Bush. After Reeve’s death his widow Dana joined the podium on the Kerry campaign in Columbus, Ohio, to put the case herself; for his part, Kerry compared Bush’s opposition to stem cell research as akin to favouring the candle lobby over electricity. As we write, the US polls are a week away, but the cultural representation of disability — and the intensely political role celebrity plays in it — appears even more palpably implicated in the government of society itself. References Abraham, Philip. Christopher Reeve. New York: Children’s Press, 2002. Alter, Judy. Christopher Reeve: Triumph over Tragedy. Danbury, Conn.: Franklin Watts, 2000. Ang, Ien, Ruth Barcan, Helen Grace, Elaine Lally, Justine Lloyd, and Zoe Sofoulis (eds.) Planet Diana: Cultural Studies and Global Mourning. Sydney: Research Centre in Intercommunal Studies, University of Western Sydney, Nepean, 1997. Bleckner, Jeff, dir. Rear Window. 1998. Brown, Steven E. “Super Duper? The (Unfortunate) Ascendancy of Christopher Reeve.” Mainstream: Magazine of the Able-Disabled, October 1996. Repr. 10 Aug. 2004 http://www.independentliving.org/docs3/brown96c.html>. Carr, Bob. “A Class Act of Grace and Courage.” Sydney Morning Herald. 12 Oct. 2004: 14. Corker, Mairian and Carol Thomas. “A Journey around the Social Model.” Disability/Postmodernity: Embodying Disability Theory. Ed. Mairian Corker and Tom Shakespeare. London and New York: Continuum, 2000. Donner, Richard, dir. Superman. 1978. Dyer, Richard. Heavenly Bodies: Film Stars and Society. London: BFI Macmillan, 1986. Fulcher, Gillian. Disabling Policies? London: Falmer Press, 1989. Furie, Sidney J., dir. Superman IV: The Quest for Peace. 1987. Finn, Margaret L. Christopher Reeve. Philadelphia: Chelsea House Publishers, 1997. Gilmer, Tim. “The Missionary Reeve.” New Mobility. November 2002. 13 Aug. 2004 http://www.newmobility.com/>. Goggin, Gerard. “Media Studies’ Disability.” Media International Australia 108 (Aug. 2003): 157-68. Goggin, Gerard, and Christopher Newell. Disability in Australia: Exposing a Social Apartheid. Sydney: UNSW Press, 2005. —. “Uniting the Nation?: Disability, Stem Cells, and the Australian Media.” Disability & Society 19 (2004): 47-60. Havill, Adrian. Man of Steel: The Career and Courage of Christopher Reeve. New York, N.Y.: Signet, 1996. Howard, Megan. Christopher Reeve. Minneapolis: Lerner Publications, 1999. Hughes, Libby. Christopher Reeve. Parsippany, NJ.: Dillon Press, 1998. Johnson, Mary. Make Them Go Away: Clint Eastwood, Christopher Reeve and the Case Against Disability Rights. Louisville : Advocado Press, 2003. Kosek, Jane Kelly. Learning about Courage from the Life of Christopher Reeve. 1st ed. New York : PowerKids Press, 1999. Leipoldt, Erik, Christopher Newell, and Maurice Corcoran. “Christopher Reeve and Bob Carr Dehumanise Disability — Stem Cell Research Not the Best Solution.” Online Opinion 27 Jan. 2003. http://www.onlineopinion.com.au/view.asp?article=510>. Lester, Richard (dir.) Superman II. 1980. —. Superman III. 1983. Maddox. “Christopher Reeve Is an Asshole.” 12 Aug. 2004 http://maddox.xmission.com/c.cgi?u=creeve>. Marshall, P. David. Celebrity and Power: Fame in Contemporary Culture. Minneapolis and London: U of Minnesota P, 1997. Mierendorf, Michael, dir. Without Pity: A Film about Abilities. Narr. Christopher Reeve. 1996. “Miracle or Murder?” Sixty Minutes. Channel 9, Australia. March 17, 2002. 15 June 2002 http://news.ninemsn.com.au/sixtyminutes/stories/2002_03_17/story_532.asp>. Mitchell, David, and Synder, Sharon, eds. The Body and Physical Difference. Ann Arbor, U of Michigan, 1997. McRuer, Robert. “Critical Investments: AIDS, Christopher Reeve, and Queer/Disability Studies.” Journal of Medical Humanities 23 (2002): 221-37. Oleksy, Walter G. Christopher Reeve. San Diego, CA: Lucent, 2000. Reeve, Christopher. Nothing Is Impossible: Reflections on a New Life. 1st ed. New York: Random House, 2002. —. Still Me. 1st ed. New York: Random House, 1998. Reeve, Dana, comp. Care Packages: Letters to Christopher Reeve from Strangers and Other Friends. 1st ed. New York: Random House, 1999. Reeve, Matthew (dir.) Christopher Reeve: Courageous Steps. Television documentary, 2002. Thomson, Rosemary Garland, ed. Freakery: Cultural Spectacles of the Extraordinary Body. New York: New York UP, 1996. Turner, Graeme. Understanding Celebrity. Thousands Oak, CA: Sage, 2004. Turner, Graeme, Frances Bonner, and David P Marshall. Fame Games: The Production of Celebrity in Australia. Melbourne: Cambridge UP, 2000. Wren, Laura Lee. Christopher Reeve: Hollywood’s Man of Courage. Berkeley Heights, NJ : Enslow, 1999. Younis, Steve. “Christopher Reeve Homepage.” 12 Aug. 2004 http://www.fortunecity.com/lavender/greatsleep/1023/main.html>. Citation reference for this article MLA Style Goggin, Gerard & Newell, Christopher. "Fame and Disability: Christopher Reeve, Super Crips, and Infamous Celebrity." M/C Journal 7.5 (2004). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0411/02-goggin.php>. APA Style Goggin, G. & Newell, C. (Nov. 2004) "Fame and Disability: Christopher Reeve, Super Crips, and Infamous Celebrity," M/C Journal, 7(5). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0411/02-goggin.php>.

There have been a number of Australian memoirs written by adoptees over the last twenty years—Robert Dessaix’s A Mother’s Disgrace, Suzanne Chick’s Searching for Charmian, Tom Frame’s Binding Ties:An Experience of Adoption and Reunion in Australia, for example—as well as international adoptee narratives by Betty Jean Lifton, Florence Fisher, and A. M. Homes amongst others. These works form a component of the small but growing field of adoption life writing that includes works by “all members of the adoption triad” (Hipchen and Deans 163): adoptive parents, birthparents, and adoptees. As the broad genre of memoir becomes more theorised and mapped, many sub-genres are emerging (Brien). My own adoptee story (which I am currently composing) could be a further sub-categorisation of the adoptee memoir, that of “late discovery adoptees” (Perl and Markham), those who are either told, or find out, about their adoption in adulthood. When this is part of a life story, secrets and silences are prominent, and digging into these requires using whatever resources can be found. These include cookbooks, recipes written by hand, and the scraps of paper shoved between pages. There are two cookbooks from my adoptive mother’s belongings that I have kept. One of them is titled Miss Tuxford’s Modern Cookery for the Middle Classes: Hints on Modern Gas Stove Cooking, and this was published around 1937 in England. It’s difficult to date this book exactly, as there is no date in my copy, but one of the advertisements (for Bird’s Custard, I think; the page is partly obscured by an Orange Nut Loaf recipe from a Willow baking pan that has been glued onto the page) is headed with a date range of 1837 to 1937. It has that smell of long ago that lingers strongly even now, out of the protective custody of my mother’s storage. Or should I say, out of the range of my adoptive father’s garbage dump zeal. He loved throwing things away, but these were often things that I saw as valuable, or at least of sentimental value, worth keeping for the memories they evoked. Maybe my father didn’t want to remember. My mother was brimming with memories, I discovered after her death, but she did not reveal them during her life. At least, not to me, making objects like these cookbooks precious in my reconstruction of the lives I know so little about, as well as in the grieving process (Gibson).Miss Tuxford (“Diplomée Board of Education, Gold Medallist, etc”) produced numerous editions of her book. My mother’s is now fragile, loose at the spine and browned with age. There are occasional stains showing that the bread and cakes section got the most use, with the pages for main meals of meat and vegetables relatively clean. The author divided her recipes into the main chapters of Soups (lentil, kidney, sheep’s head broth), Sauces (white, espagnol, mushroom), Fish (“It is important that all fish is fresh when cooked” (23)), Meats (roasted, boiled, stuffed; roast rabbit, boiled turkey, scotch collop), Vegetables (creamed beetroot, economical salad dressing, potatoes baked in their skins), Puddings and Sweets (suet pastry, Yorkshire pudding, chocolate tarts, ginger cream), Bread and Cakes (household bread, raspberry sandwich cake, sultana scones, peanut fancies), Icings and Fillings, Invalid Cookery (beef tea, nourishing lemonade, Virol pudding), Jams, Sweetmeats and Pickles (red currant jelly, piccalilli) and Miscellaneous Dishes including Meatless Recipes (cheese omelette, mock white fish, mock duck, mock goose, vegetarian mincemeat). At the back, Miss Tuxford includes sections on gas cooking hints, “specimen household dinners” (206), and household hints. There is then a “Table of Foods in Season” (208–10) taking the reader through the months and the various meats and vegetables available at those times. There is a useful index and finally an advertisement for an oven cleaner on the last page (which is glued to the back cover). There are food and cookery advertisements throughout the book, but my favourite is the one inside the front cover, for Hartley’s jam, featuring two photographs of a little boy. The first shows him looking serious, and slightly anxious, the second wide-eyed and smiling, eager for his jam. The text tells mothers that “there’s nothing like plenty of bread and Hartley’s for a growing boy” (inside front cover). I love the simple appeal to making your little boy happy that is contained within this tiny narrative. Did my mother and father eat this jam when they were small? By 1937, my mother was twenty-one, not yet married, living with her mother in Weston-super-Mare. She was learning secretarial skills—I have her certificate of proficiency in Pitman’s shorthand—and I think she and my father had met by then. Perhaps she thought about when she would be giving her own children Hartley’s jam, or something else prepared from Miss Tuxford’s recipes, like the Christmas puddings, shortbread, or chocolate cake. She would not have imagined that no children would arrive, that twenty-five years of marriage would pass before she held her own baby, and this would be one who was born to another woman. In the one other cookbook I have kept, there are several recipes cut out from newspapers, and a few typed or handwritten recipes hidden within the pages. This is The Main Cookery Book, in its August 1944 reprint, which was written and compiled by Marguerite K. Gompertz and the “Staff of the Main Research Kitchen”. My mother wrote her name and the date she obtained the cookbook (31 January 1945) on the first blank page. She had been married just over five years, and my father may, or may not, have still been in the Royal Air Force. I have only a sketchy knowledge of my adoptive parents. My mother was born in Newent, Gloucestershire, and my father in Bromley, Kent; they were both born during the first world war. My father served as a navigator in the Royal Air Force in the second world war in the 1940s, received head and psychological injuries and was invalided out before the war ended. He spent some time in rehabilitation, there being letters from him to my mother detailing his stay in one hospital in the 1950s. Their life seemed to become less and less secure as the years passed, more chaotic, restless, and unsettled. By the time I came into their lives, they were both nearly fifty, and moving from place to place. Perhaps this is one reason why I have no memory of my mother cooking. I cannot picture her consulting these cookbooks, or anything more modern, or even cutting out the recipes from newspapers and magazines, because I do not remember seeing her do it. She did not talk to me about cooking, we didn’t cook together, and I do not remember her teaching me anything about food or its preparation. This is a gap in my memory that is puzzling. There is evidence—the books and additional paper recipes and stains on the pages—that my mother was involved in the world of the kitchen. This suggests she handled meats, vegetables, and flours, kneaded, chopped, mashed, baked, and boiled all manners of foods. But I cannot remember her doing any of it. I think the cooking must have been a part of her life before me, when she lived in England, her home country, which she loved, and when she still had hope that children would come. It must have then been apparent that her husband was going to need support and care after the war, and I can imagine she came to realise that any dreams she had would need rearranging.What I do remember is that our meals were prepared by my father, and contained no spices, onions, or garlic because he suffered frequently from indigestion and said these ingredients made it worse. He was a big-chested man with small hips who worried he was too heavy and so put himself on diets every other week. For my father, dieting meant not eating anything, which tended to lead to binges on chocolate or cheese or whatever he could grab easily from the fridge.Meals at night followed a pattern. On Sundays we ate roast chicken with vegetables as a treat, then finished it over the next days as a cold accompaniment with salad. Other meals would feature fish fingers, mince, ham, or a cold luncheon meat with either salad or boiled vegetables. Sometimes we would have a tin of peaches in juice or ice cream, or both. No cookbooks were consulted to prepare these meals.What was my mother doing while my father cooked? She must have been in the kitchen too, probably contributing, but I don’t see her there. By the time we came back to Australia permanently in 1974, my father’s working life had come to an end, and he took over the household cookery for something to do, as well as sewing his own clothes, and repairing his own car. He once hoisted the engine out of a Morris Minor with the help of a young mechanic, a rope, and the branch of a poinciana tree. I have three rugs that he wove before I was born, and he made furniture as well. My mother also sewed, and made my school uniforms and other clothes as well as her own skirts and blouses, jackets and pants. Unfortunately, she was fond of crimplene, which came in bright primary colours and smelled of petrol, but didn’t require ironing and dried quickly on the washing line. It didn’t exactly hang on your body, but rather took it over, imposing itself with its shapelessness. The handwritten recipe for salad cream shown on the pink paper is not in my mother’s hand but my father’s. Her correction can be seen to the word “gelatine” at the bottom; she has replaced it with “c’flour” which I assume means cornflour. This recipe actually makes me a liar, because it shows my father writing about using pepper, paprika, and tumeric to make a food item, when I have already said he used no spices. When I knew him, and ate his food, he didn’t. But he had another life for forty-seven years before my birth, and these recipes with their stains and scribbles help me to begin making a picture of both his life, and my mother’s. So much of them is a complete mystery to me, but these scraps of belongings help me inch along in my thinking about them, who they were, and what they meant to me (Turkle).The Main Cookery Book has a similar structure to Miss Tuxford’s, with some variations, like the chapter titled Réchauffés, which deals with dishes using already cooked foodstuffs that only then require reheating, and a chapter on home-made wines. There are also notes at the end of the book on topics such as gas ovens and methods of cooking (boiling, steaming, simmering, and so on). What really interests me about this book are the clippings inserted by my mother, although the printed pages themselves seem relatively clean and uncooked upon. There is a recipe for pickles and chutneys torn from a newspaper, and when I look on the other side I find a context: a note about Charlie Chaplin and the House of Representatives’s Un-American Activities Committee starting its investigations into the influence of Communists on Hollywood. I wonder if my parents talked about these events, or if they went to see Charlie Chaplin’s films. My mother’s diaries from the 1940s include her references to movies—Shirley Temple in Kiss and Tell, Bing Crosby in Road to Utopia—as well as day to day activities and visits to, and from, family and friends, her sinus infections and colds, getting “shock[ed] from paraffin lamp”, food rationing. If my father kept diaries during his earlier years, nothing of them survives. I remember his determined shredding of documents after my mother’s death, and his fear of discovery, that his life’s secrets would be revealed. He did not tell me I had been adopted until I was twenty-three, and rarely spoke of it afterwards. My mother never mentioned it. I look at the recipe for lemon curd. Did my mother ever make this? Did she use margarine instead of butter? We used margarine on sandwiches, as butter was too hard to spread. Once again, I turn over this clipping to read the news, and find no date but an announcement of an exhibition of work by Marc Chagall at the Tate Gallery, the funeral of Sir Geoffrey Fison (who I discover from The Peerage website died in 1948, unmarried, a Baronet and decorated soldier), and a memorial service for Dr. Duncan Campbell Scott, the Canadian poet and prose writer, during which the Poet Laureate of the time, John Masefield, gave the address. And there was also a note about the latest wills, including that of a reverend who left an estate valued at over £50 000. My maternal adoptive grandmother, who lived in Weston-super-Mare across the road from the beach, and with whom we stayed for several months in 1974, left most of her worldly belongings to my mother and nothing to her son. He seems to have been cut out from her life after she separated from her husband, and her children’s father, sometime in the 1920s. Apparently, my uncle followed his father out to Australia, and his mother never forgave him, refusing to have anything more to do with her son for the rest of her life, not even to see her grandchildren. When I knew her in that brief period in 1974, she was already approaching eighty and showing signs of dementia. But I do remember dancing the Charleston with her in the kitchen, and her helping me bathe my ragdoll Pollyanna in a tub in the garden. The only food I remember at her stone house was afternoon tea with lots of different, exotic cakes, particularly one called Neopolitan, with swirls of red and brown through the moist sponge. My grandmother had a long narrow garden filled with flowers and a greenhouse with tomatoes; she loved that garden, and spent a lot of time nurturing it.My father and his mother-in-law were not each other’s favourite person, and this coloured my mother’s relationship with her, too. We were poor for many years, and the only reason we were able to go to England was because of the generosity of my grandmother, who paid for our airfares. I think my father searched for work while we were there, but whether he was successful or not I do not know. We returned to Australia and I went into grade four at the end of 1974, an outsider of sorts, and bemused by the syllabus, because I had moved around so much. I went to eight different primary schools and two high schools, eventually obtaining a scholarship to a private girls’ school for the last four years. My father was intent on me becoming a doctor, and so my life was largely study, which is another reason why I took little notice of what went on in the kitchen and what appeared on the dining table. I would come home from school and my parents would start meal preparation almost straight away, so we sat down to dinner at about four o’clock during the week, and I started the night’s study at five. I usually worked through until about ten, and then read a novel for a little while before sleep. Every parcel of time was accounted for, and nothing was wasted. This schedule continued throughout those four years of high school, with my father berating me if I didn’t do well at an exam, but also being proud when I did. In grades eight, nine, and ten, I studied home economics, and remember being offered a zucchini to taste because I had never seen one before. I also remember making Greek biscuits of some sort for an exam, and the sieve giving out while I was sifting a large quantity of flour. We learned to cook simple meals of meats and vegetables, and to prepare a full breakfast. We also baked cakes but, when my sponges remained flat, I realised that my strengths might lay elsewhere. This probably also contributed to my lack of interest in cooking. Domestic pursuits were not encouraged at home, although my mother did teach me to sew and knit, resulting in skewed attempts at a shirt dress and a white blouse, and a wildly coloured knitted shoulder bag that I actually liked but which embarrassed my father. There were no such lessons in cakemaking or biscuit baking or any of the recipes from Miss Tuxford. By this time, my mother bought such treats from the supermarket.This other life, this previous life of my parents, a life far away in time and place, was completely unknown to me before my mother’s death. I saw little of them after the revelation of my adoption, not because of this knowledge I then had, but because of my father’s controlling behaviour. I discovered that the rest of my adoptive family, who I hardly knew apart from my maternal grandmother, had always known. It would have been difficult, after all, for my parents to keep such a secret from them. Because of this life of constant moving, my estrangement from my family, and our lack of friends and connections with other people, there was a gap in my experience. As a child, I only knew one grandmother, and only for a relatively brief period of time. I have no grandfatherly memories, and none either of aunts and uncles, only a few fleeting images of a cousin here and there. It was difficult to form friendships as a child when we were only in a place for a limited time. We were always moving on, and left everything behind, to start again in a new suburb, state, country. Continuity and stability were not our trademarks, for reasons that are only slowly making themselves known to me: my father’s mental health problems, his difficult personality, our lack of money, the need to keep my adoption secret.What was that need? From where did it spring? My father always seemed to be a secretive person, an intensely private man, one who had things to hide, and seemed to suffer many mistakes and mishaps and misfortune. At the end, after my mother’s death, we spent two years with each other as he became frailer and moved into a nursing home. It was a truce formed out of necessity, as there was no one else to care for him, so thoroughly had he alienated his family; he had no friends, certainly not in Australia, and only the doctor and helping professionals to talk to most days. My father’s brother John had died some years before, and the whereabouts of his other sibling Gordon were unknown. I discovered that he had died three years previously. Nieces had not heard from my father for decades. My mother’s niece revealed that my mother and she had never met. There is a letter from my mother’s father in the 1960s, probably just before he died, remarking that he would like a photograph of her as they hadn’t seen each other for forty years. None of this was talked about when my mother was alive. It was as if I was somehow separate from their stories, from their history, that it was not suitable for my ears, or that once I came into their lives they wanted to make a new life altogether. At that time, all of their past was stored away. Even my very origins, my tiny past life, were unspoken, and made into a secret. The trouble with secrets, however, is that they hang around, peek out of boxes, lurk in the corners of sentences, and threaten to be revealed by the questions of puzzled strangers, or mistakenly released by knowledgeable relatives. Adoptee memoirs like mine seek to go into those hidden storage boxes and the corners and pages of sources like these seemingly innocent old cookbooks, in the quest to bring these secrets to light. Like Miss Tuxford’s cookbook, with its stains and smudges, or the Main Cookery Book with its pages full of clippings, the revelation of such secrets threaten to tell stories that contradict the official version. ReferencesBrien, Donna Lee. “Pathways into an ‘Elaborate Ecosystem’: Ways of Categorising the Food Memoir”. TEXT (October 2011). 12 Jun. 2013 ‹http://www.textjournal.com.au/oct11/brien.htm›.Chick, Suzanne. Searching for Charmian. Sydney: Picador, 1995.Dessaix, Robert. A Mother’s Disgrace. Sydney: Angus & Robertson, 1994.Fisher, Florence. The Search for Anna Fisher. New York: Arthur Fields, 1973.Frame, Tom. Binding Ties: An Experience of Adoption and Reunion in Australia. Alexandria: Hale & Iremonger, 1999.Gibson, Margaret. Objects of the Dead: Mourning and Memory in Everyday Life. Carlton, Victoria: Melbourne U P, 2008. Gompertz, Marguerite K., and the Staff of the Main Research Kitchen. The Main Cookery Book. 52nd. ed. London: R. & A. Main, 1944. Hipchen, Emily, and Jill Deans. “Introduction. Adoption Life Writing: Origins and Other Ghosts”. a/b: Auto/Biography Studies 18.2 (2003): 163–70. Special Issue on Adoption.Homes, A. M. The Mistress’s Daughter: A Memoir. London: Granta, 2007.Kiss and Tell. Dir. By Richard Wallace. Columbia Pictures, 1945.Lifton, Betty Jean. Twice Born: Memoirs of An Adopted Daughter. Middlesex, England: Penguin, 1977.Lundy, Darryl, comp. The Peerage: A Genealogical Survey of the Peerage of Britain as well as the Royal Families of Europe. 30 May 2013 ‹http://www.thepeerage.com/p40969.htm#i409684›Perl, Lynne and Shirin Markham. Why Wasn’t I Told? Making Sense of the Late Discovery of Adoption. Bondi: Post Adoption Resource Centre/Benevolent Society of NSW, 1999.Road to Utopia. Dir. By Hal Walker. Paramount, 1946.Turkle, Sherry, ed. Evocative Objects: Things We Think With. Cambridge, Massachusetts: MIT P, 2011. Tuxford, Miss H. H. Miss Tuxford’s Modern Cookery for the Middle Classes: Hints on Modern Gas Stove Cooking. London: John Heywood, c.1937.

Teichman notes in her study of illegitimacy that “the point of the legitimate/illegitimate distinction is not to cause suffering; rather, it has to do with certain widespread human aims connected with the regulation of sexual activities and of population” (4). She also writes that, until relatively recently, “the shame of being an unmarried mother was the worst possible shame a woman could suffer” (119). Hence the secrecy, silences, and lies that used to be so common around the issue of an illegitimate birth and adoption.I was adopted at birth in the mid-1960s in New Zealand because my mother was a long way from family in England and had no support. She and my father had fallen in love, and planned to marry, but it all fell apart, and my mother was left with decisions to make. It was indeed a difficult time for unwed mothers, and that issue of shame and respectability was in force. The couple who adopted me were in their late forties and had been married for twenty-five years. My adoptive father had served in World War Two in the Royal Air Force before being invalided out for health problems associated with physical and psychological injuries. He was working in the same organisation as my mother and approached her when he learned of her situation. My adoptive mother loved England as her Home all of her life, despite living in Australia permanently from 1974 until her death in 2001. I did not know of my adoption until 1988, when I was twenty-three years old. The reasons for this were at least partly to do with my adoptive parents’ fear that I would leave them to search for my birth parents. My feelings about this long-held secret are complex and mixed. My adoptive mother never once mentioned my adoption, not on the day I was told by my adoptive father, nor at any point afterwards. My adoptive father only mentioned it again in the last two years of his life, after a long estrangement from me, and it made him weep. Even in the nursing home he did not want me to tell anyone that I had been adopted. It was impossible for me to obey this request, for my sense of self and my own identity, and for the recognition of the years of pain that I had endured as his daughter. He wanted to keep so much a secret; I could not, and would not, hold anything back anymore.And so I found myself telling anyone who would listen that I was adopted, and had only found out as an adult. This did not transmogrify into actively seeking out my birth parents, at least not immediately. It took some years before I obtained my original birth certificate, and then a long while again before I searched for, and found, my birth mother. It was not until my adoptive mother died that I launched into the search, probably because I did not want to cause her pain, though I did not consciously think of it that way. I did not tell my adoptive father of the search or the discovery. This was not an easy decision, as my birth mother would have liked to see him again and thank him, but I knew that his feelings were quite different and I did not want to risk further hurt to either my birth mother or my adoptive father. My own pain endures.I also found myself writing about my family. Other late discovery adoptees, as we are known, have written of their experiences, but not many. Maureen Watson records her shock at being told by her estranged husband when she was 40 years old; Judith Lucy, the comedian, was told in her mid-twenties by her sister-in-law after a tumultuous Christmas day; the Canadian author Wayson Choy was in his late fifties when he received a mysterious phone call from a woman about seeing his “other” mother on the street.I started with fiction, making up fairy tales or science fiction scenarios, or one act plays, or poetry, or short stories. I filled notebooks with these words of confusion and anger and wonder. Eventually, I realised I needed to write about my adoptive life in fuller form, and in life story mode. The secrecy and silences that had dominated my family life needed to be written out on the page and given voice and legitimacy by me. For years I had thought my father’s mental disturbance and destructive behaviour was my fault, as he often told me it was, and I was an only child isolated from other family and other people generally. My adoptive mother seemed to take the role of the shadow in the background, only occasionally stepping forward to curb my father’s disturbing and paranoid reactions to life.The distinction between legitimacy and illegitimacy may not have been created and enforced to cause suffering, but that, of course, is what it did for many caught in its circle of grief and exclusion. For me, I did not feel the direct effect of being illegitimate at birth, because I did not “know”. (What gathered in my unconscious over the years was another thing altogether.) This was different for my birth mother, who suffered greatly during the time she was pregnant, hoping something would happen that would enable her to keep me, but finally having to give me up. She does not speak of shame, only heartache. My adoptive father, however, felt the shame of having to adopt a child; I know this because he told me in his own words at the end of his life. Although I did not know of my adoption until I was an adult, I picked up his fear of my inadequacy for many years beforehand. I realise now that he feared that I was “soiled” or “tainted”, that the behaviour of my mother would be revisited in me, and that I needed to be monitored. He read my letters, opened my diaries, controlled my phone calls, and told me he had spies watching me when I was out of his range. I read in Teichman’s work that the word “bastard”, the colloquial term for an illegitimate child or person, comes from the Old French ba(s)t meaning baggage or luggage or pack-saddle, something that could be slept on by the traveller (1). Being illegitimate could feel like carrying heavy baggage, but someone else’s, not yours. And being adopted was supposed to render you legitimate by giving you the name of a father. For me, it added even more heavy baggage. Writing is one way of casting it off, refusing it, chipping it away, reducing its power. The secrecy of my adoption can be broken open. I can shout out the silence of all those years.The first chapter of the memoir, “A Shark in the Garden”, has the title “Revelation”, and concerns the day I learned of my adoptive status. RevelationI sat on my bed, formed fists in my lap, got up again. In the mirror there was my reflection, but all I saw was fear. I sat down, thought of what I was going to say, stood again. If I didn’t force myself out through my bedroom door, all would be lost. I had rung the student quarters at the hospital, there was a room ready. I had spoken to Dr P. It was time for me to go. The words were formed in my mouth, I had only to speak them. Three days before, I had come home to find my father in a state of heightened anxiety, asking me where the hell I had been. He’d rung my friend C because I had told him, falsely, that I would be going over to her place for a fitting of the bridesmaid dresses. I lied to him because the other bridesmaid was someone he disliked intensely, and did not approve of me seeing her. I had to tell him the true identity of the other bridesmaid, which of course meant that I’d lied twice, that I’d lied for a prolonged period of time. My father accused me of abusing my mother’s good nature because she was helping me make my bridesmaid’s dress. I was not a good seamstress, whereas my mother made most of her clothes, and ours, so in reality she was the one making the dress. When you’ve lied to your parents it is difficult to maintain the high ground, or any ground at all. But I did try to tell him that if he didn’t dislike so many of my friends, I wouldn’t have to lie to him in order to shield them and have a life outside home. If I knew that he wasn’t going to blaspheme the other bridesmaid every time I said her name, then I could have been upfront. What resulted was a dark silence. I was completing a supplementary exam in obstetrics and gynaecology. Once passed, I would graduate with a Bachelor of Medicine, Bachelor of Surgery degree, and be able to work as an intern in a hospital. I hated obstetrics and gynaecology. It was about bodies like my own and their special functions, and seemed like an invasion of privacy. Women were set apart as specimens, as flawed creatures, as beings whose wombs were always going wrong, a difficult separate species. Men were the predominant teachers of wisdom about these bodies, and I found this repugnant. One obstetrician in a regional hospital asked my friend and me once if we had regular Pap smears, and if our menstrual blood contained clots. We answered him, but it was none of his business, and I wished I hadn’t. I can see him now, the small eyes, the bitchiness about other doctors, the smarminess. But somehow I had to get through it. I had to get up each morning and go into the hospital and do the ward rounds and see patients. I had to study the books. I had to pass that exam. It had become something other than just an exam to me. It was an enemy against which I must fight.My friend C was getting married on the 19th of December, and somehow I had to negotiate my father as well. He sometimes threatened to confiscate the keys to the car, so that I couldn’t use it. But he couldn’t do that now, because I had to get to the hospital, and it was too far away by public transport. Every morning I woke up and wondered what mood my father would be in, and whether it would have something to do with me. Was I the good daughter today, or the bad one? This happened every day. It was worse because of the fight over the wedding. It was a relief to close my bedroom door at night and be alone, away from him. But my mother too. I felt as if I was betraying her, by not being cooperative with my father. It would have been easier to have done everything he said, and keep the household peaceful. But the cost of doing that would have been much higher: I would have given my life over to him, and disappeared as a person.I could wake up and forget for a few seconds where I was and what had happened the day before. But then I remembered and the fear exploded in my stomach. I lived in dread of what my father would say, and in dread of his silence.That morning I woke up and instantly thought of what I had to do. After the last fight, I realised I did not want to live with such pain and fear anymore. I did not want to cause it, or to live with it, or to kill myself, or to subsume my spirit in the pathology of my father’s thinking. I wanted to live.Now I knew I had to walk into the living room and speak those words to my parents.My mother was sitting in her spot, at one end of the speckled and striped grey and brown sofa, doing a crossword. My father was in his armchair, head on his hand. I walked around the end of the sofa and stood by ‘my’ armchair next to my mother.“Mum and Dad, I need to talk with you about something.”I sat down as I said this, and looked at each of them in turn. Their faces were mildly expectant, my father’s with a dark edge.“I know we haven’t been getting on very well lately, and I think it might be best if I leave home and go to live in the students’ quarters at the hospital. I’m twenty-three now. I think it might be good for us to spend some time apart.” This sounded too brusque, but I’d said it. It was out in the atmosphere, and I could only wait. And whatever they said, I was going. I was leaving. My father kept looking at me for a moment, then straightened in his chair, and cleared his throat.“You sound as if you’ve worked this all out. Well, I have something to say. I suppose you know you were adopted.”There was an enormous movement in my head. Adopted. I suppose you know you were adopted. Age of my parents at my birth: 47 and 48. How long have you and Dad been married, Mum? Oooh, that’s a tricky one. School principal’s wife, eyes flicking from me to Mum and back again, You don’t look much like each other, do you? People referring to me as my Mum’s friend, not her daughter. I must have got that trait from you Oh no I know where you got that from. My father not wanting me to marry or have children. Not wanting me to go back to England. Moving from place to place. No contact with relatives. This all came to me in a flash of memory, a psychological click and shift that I was certain was audible outside my mind. I did not move, and I did not speak. My father continued. He was talking about my biological mother. The woman who, until a few seconds before, I had not known existed.“We were walking on the beach one day with you, and she came towards us. She didn’t look one way or another, just kept her eyes straight ahead. Didn’t acknowledge us, or you. She said not to tell you about your adoption unless you fell in with a bad lot.”I cannot remember what else my father said. At one point my mother said to me, “You aren’t going to leave before Christmas are you?”All of her hopes and desires were in that question. I was not a good daughter, and yet I knew that I was breaking her heart by leaving. And before Christmas too. Even a bad daughter is better than no daughter at all. And there nearly was no daughter at all. I suppose you know you were adopted.But did my mother understand nothing of the turmoil that lived within me? Did it really not matter to her that I was leaving, as long as I didn’t do it before Christmas? Did she understand why I was leaving, did she even want to know? Did she understand more than I knew? I did not ask any of these questions. Instead, at some point I got out of the chair and walked into my bedroom and pulled out the suitcase I had already packed the night before. I threw other things into other bags. I called for a taxi, in a voice supernaturally calm. When the taxi came, I humped the suitcase down the stairs and out of the garage and into the boot, then went back upstairs and got the other bags and humped them down as well. And while I did this, I was shouting at my father and he was shouting at me. I seem to remember seeing him out of the corner of my eye, following me down the stairs, then back up again. Following me to my bedroom door, then down the stairs to the taxi. But I don’t think he went out that far. I don’t remember what my mother was doing.The only words I remember my father saying at the end are, “You’ll end up in the gutter.”The only words I remember saying are, “At least I’ll get out of this poisonous household.”And then the taxi was at the hospital, and I was in a room, high up in a nondescript, grey and brown building. I unpacked some of my stuff, put my clothes in the narrow wardrobe, my shoes in a line on the floor, my books on the desk. I imagine I took out my toothbrush and lotions and hairbrush and put them on the bedside table. I have no idea what the weather was like, except that it wasn’t raining. The faces of the taxi driver, of the woman in reception at the students’ quarters, of anyone else I saw that day, are a blur. The room is not difficult to remember as it was a rectangular shape with a window at one end. I stood at that window and looked out onto other hospital buildings, and the figures of people walking below. That night I lay in the bed and let the waves of relief ripple over me. My parents were not there, sitting in the next room, speaking in low voices about how bad I was. I was not going to wake up and brace myself for my father’s opprobrium, or feel guilty for letting my mother down. Not right then, and not the next morning. The guilt and the self-loathing were, at that moment, banished, frozen, held-in-time. The knowledge of my adoption was also held-in-time: I couldn’t deal with it in any real way, and would not for a long time. I pushed it to the back of my mind, put it away in a compartment. I was suddenly free, and floating in the novelty of it.ReferencesChoy, Wayson. Paper Shadows: A Chinatown Childhood. Ringwood: Penguin, 2000.Lucy, Judith. The Lucy Family Alphabet. Camberwell: Penguin, 2008.Teichman, Jenny. Illegitimacy: An Examination of Bastardy. New York: Cornell University Press, 1982. Watson, Maureen. Surviving Secrets. Short-Stop Press, 2010.

In the last months of his life, 86-year-old Albert Facey became a best-selling author and revered cultural figure following the publication of his autobiography, A Fortunate Life. Released on Anzac Day 1981, it was praised for its “plain, unembellished, utterly sincere and un-self-pitying account of the privations of childhood and youth” (Semmler) and “extremely powerful description of Gallipoli” (Dutton 16). Within weeks, critic Nancy Keesing declared it an “Enduring Classic.” Within six months, it was announced as the winner of two prestigious non-fiction awards, with judges acknowledging Facey’s “extraordinary memory” and “ability to describe scenes and characters with great precision” (“NBC” 4). A Fortunate Life also transformed the fortunes of its publisher. Founded in 1976 as an independent, not-for-profit publishing house, Fremantle Arts Centre Press (FACP) might have been expected, given the Australian average, to survive for just a few years. Former managing editor Ray Coffey attributes the Press’s ongoing viability, in no small measure, to Facey’s success (King 29). Along with Wendy Jenkins, Coffey edited Facey’s manuscript through to publication; only five months after its release, with demand outstripping the capabilities, FACP licensed Penguin to take over the book’s production and distribution. Adaptations soon followed. In 1984, Kerry Packer’s PBL launched a prospectus for a mini-series, which raised a record $6.3 million (PBL 7–8). Aired in 1986 with a high-rating documentary called The Facey Phenomenon, the series became the most watched television event of the year (Lucas). Syndication of chapters to national and regional newspapers, stage and radio productions, audio- and e-books, abridged editions for young readers, and inclusion on secondary school curricula extended the range and influence of Facey’s life writing. Recently, an option was taken out for a new television series (Fraser).A hundred reprints and two million readers on from initial publication, A Fortunate Life continues to rate among the most appreciated Australian books of all time. Commenting on a reader survey in 2012, writer and critic Marieke Hardy enthused, “I really loved it [. . .] I felt like I was seeing a part of my country and my country’s history through a very human voice . . .” (First Tuesday Book Club). Registering a transformed reading, Hardy’s reference to Australian “history” is unproblematically juxtaposed with amused delight in an autobiography that invents and embellishes: not believing “half” of what Facey wrote, she insists he was foremost a yarn spinner. While the work’s status as a witness account has become less authoritative over time, it seems appreciation of the author’s imagination and literary skill has increased (Williamson). A Fortunate Life has been read more commonly as an uncomplicated, first-hand account, such that editor Wendy Jenkins felt it necessary to refute as an “utter mirage” that memoir is “transferred to the page by an act of perfect dictation.” Sidonie Smith and Julia Watson argue of life narratives that some “autobiographical claims [. . .] can be verified or discounted by recourse to documentation outside the text. But autobiographical truth is a different matter” (16). With increased access to archives, especially digitised personnel records, historians have asserted that key elements of Facey’s autobiography are incorrect or “fabricated” (Roberts), including his enlistment in 1914 and participation in the Gallipoli Landing on 25 April 1915. We have researched various sources relevant to Facey’s early years and war service, including hard-copy medical and repatriation records released in 2012, and find A Fortunate Life in a range of ways deviates from “documentation outside of the text,” revealing intriguing, layered storytelling. We agree with Smith and Watson that “autobiographical acts” are “anything but simple or transparent” (63). As “symbolic interactions in the world,” they are “culturally and historically specific” and “engaged in an argument about identity” (63). Inevitably, they are also “fractured by the play of meaning” (63). Our approach, therefore, includes textual analysis of Facey’s drafts alongside the published narrative and his medical records. We do not privilege institutional records as impartial but rather interpret them in terms of their hierarchies and organisation of knowledge. This leads us to speculate on alternative readings of A Fortunate Life as an illness narrative that variously resists and subscribes to dominant cultural plots, tropes, and attitudes. Facey set about writing in earnest in the 1970s and generated (at least) three handwritten drafts, along with a typescript based on the third draft. FACP produced its own working copy from the typescript. Our comparison of the drafts offers insights into the production of Facey’s final text and the otherwise “hidden” roles of editors as transformers and enablers (Munro 1). The notion that a working man with basic literacy could produce a highly readable book in part explains Facey’s enduring appeal. His grandson and literary executor, John Rose, observed in early interviews that Facey was a “natural storyteller” who had related details of his life at every opportunity over a period of more than six decades (McLeod). Jenkins points out that Facey belonged to a vivid oral culture within which he “told and retold stories to himself and others,” so that they eventually “rubbed down into the lines and shapes that would so memorably underpin the extended memoir that became A Fortunate Life.” A mystique was thereby established that “time” was Albert Facey’s “first editor” (Jenkins). The publisher expressly aimed to retain Facey’s voice, content, and meaning, though editing included much correcting of grammar and punctuation, eradication of internal inconsistencies and anomalies, and structural reorganisation into six sections and 68 chapters. We find across Facey’s drafts a broadly similar chronology detailing childhood abandonment, life-threatening incidents, youthful resourcefulness, physical prowess, and participation in the Gallipoli Landing. However, there are also shifts and changed details, including varying descriptions of childhood abuse at a place called Cave Rock; the introduction of (incompatible accounts of) interstate boxing tours in drafts two and three which replace shearing activities in Draft One; divergent tales of Facey as a world-standard athlete, league footballer, expert marksman, and powerful swimmer; and changing stories of enlistment and war service (see Murphy and Nile, “Wounded”; “Naked”).Jenkins edited those sections concerned with childhood and youth, while Coffey attended to Facey’s war and post-war life. Drawing on C.E.W. Bean’s official war history, Coffey introduced specificity to the draft’s otherwise vague descriptions of battle and amended errors, such as Facey’s claim to have witnessed Lord Kitchener on the beach at Gallipoli. Importantly, Coffey suggested the now famous title, “A Fortunate Life,” and encouraged the author to alter the ending. When asked to suggest a title, Facey offered “Cave Rock” (Interview)—the site of his violent abuse and humiliation as a boy. Draft One concluded with Facey’s repatriation from the war and marriage in 1916 (106); Draft Two with a brief account of continuing post-war illness and ultimate defeat: “My war injuries caught up with me again” (107). The submitted typescript concludes: “I have often thought that going to War has caused my life to be wasted” (Typescript 206). This ending differs dramatically from the redemptive vision of the published narrative: “I have lived a very good life, it has been very rich and full. I have been very fortunate and I am thrilled by it when I look back” (412).In The Wounded Storyteller, Arthur Frank argues that literary markets exist for stories of “narrative wreckage” (196) that are redeemed by reconciliation, resistance, recovery, or rehabilitation, which is precisely the shape of Facey’s published life story and a source of its popularity. Musing on his post-war experiences in A Fortunate Life, Facey focuses on his ability to transform the material world around him: “I liked the challenge of building up a place from nothing and making a success where another fellow had failed” (409). If Facey’s challenge was building up something from nothing, something he could set to work on and improve, his life-writing might reasonably be regarded as a part of this broader project and desire for transformation, so that editorial interventions helped him realise this purpose. Facey’s narrative was produced within a specific zeitgeist, which historian Joy Damousi notes was signalled by publication in 1974 of Bill Gammage’s influential, multiply-reprinted study of front-line soldiers, The Broken Years, which drew on the letters and diaries of a thousand Great War veterans, and also the release in 1981 of Peter Weir’s film Gallipoli, for which Gammage was the historical advisor. The story of Australia’s war now conceptualised fallen soldiers as “innocent victims” (Damousi 101), while survivors were left to “compose” memories consistent with their sacrifice (Thomson 237–54). Viewing Facey’s drafts reminds us that life narratives are works of imagination, that the past is not fixed and memory is created in the present. Facey’s autobiographical efforts and those of his publisher to improve the work’s intelligibility and relevance together constitute an attempt to “objectify the self—to present it as a knowable object—through a narrative that re-structures [. . .] the self as history and conclusions” (Foster 10). Yet, such histories almost invariably leave “a crucial gap” or “censored chapter.” Dennis Foster argues that conceiving of narration as confession, rather than expression, “allows us to see the pathos of the simultaneous pursuit and evasion of meaning” (10); we believe a significant lacuna in Facey’s life writing is intimated by its various transformations.In a defining episode, A Fortunate Life proposes that Facey was taken from Gallipoli on 19 August 1915 due to wounding that day from a shell blast that caused sandbags to fall on him, crush his leg, and hurt him “badly inside,” and a bullet to the shoulder (348). The typescript, however, includes an additional but narratively irreconcilable date of 28 June for the same wounding. The later date, 19 August, was settled on for publication despite the author’s compelling claim for the earlier one: “I had been blown up by a shell and some 7 or 8 sandbags had fallen on top of me, the day was the 28th of June 1915, how I remembered this date, it was the day my brother Roy had been killed by a shell burst.” He adds: “I was very ill for about six weeks after the incident but never reported it to our Battalion doctor because I was afraid he would send me away” (Typescript 205). This account accords with Facey’s first draft and his medical records but is inconsistent with other parts of the typescript that depict an uninjured Facey taking a leading role in fierce fighting throughout July and August. It appears, furthermore, that Facey was not badly wounded at any time. His war service record indicates that he was removed from Gallipoli due to “heart troubles” (Repatriation), which he also claims in his first draft. Facey’s editors did not have ready access to military files in Canberra, while medical files were not released until 2012. There existed, therefore, virtually no opportunity to corroborate the author’s version of events, while the official war history and the records of the State Library of Western Australia, which were consulted, contain no reference to Facey or his war service (Interview). As a consequence, the editors were almost entirely dependent on narrative logic and clarifications by an author whose eyesight and memory had deteriorated to such an extent he was unable to read his amended text. A Fortunate Life depicts men with “nerve sickness” who were not permitted to “stay at the Front because they would be upsetting to the others, especially those who were inclined that way themselves” (350). By cross referencing the draft manuscripts against medical records, we can now perceive that Facey was regarded as one of those nerve cases. According to Facey’s published account, his wounds “baffled” doctors in Egypt and Fremantle (353). His medical records reveal that in September 1915, while hospitalised in Egypt, his “palpitations” were diagnosed as “Tachycardia” triggered by war-induced neuroses that began on 28 June. This suggests that Facey endured seven weeks in the field in this condition, with the implication being that his debility worsened, resulting in his hospitalisation. A diagnosis of “debility,” “nerves,” and “strain” placed Facey in a medical category of “Special Invalids” (Butler 541). Major A.W. Campbell noted in the Medical Journal of Australia in 1916 that the war was creating “many cases of little understood nervous and mental affections, not only where a definite wound has been received, but in many cases where nothing of the sort appears” (323). Enlisted doctors were either physicians or surgeons and sometimes both. None had any experience of trauma on the scale of the First World War. In 1915, Campbell was one of only two Australian doctors with any pre-war experience of “mental diseases” (Lindstrom 30). On staff at the Australian Base Hospital at Heliopolis throughout the Gallipoli campaign, he claimed that at times nerve cases “almost monopolised” the wards under his charge (319). Bearing out Facey’s description, Campbell also reported that affected men “received no sympathy” and, as “carriers of psychic contagion,” were treated as a “source of danger” to themselves and others (323). Credentialed by royal colleges in London and coming under British command, Australian medical teams followed the practice of classifying men presenting “nervous or mental symptoms” as “battle casualties” only if they had also been wounded by “enemy action” (Loughran 106). By contrast, functional disability, with no accompanying physical wounds, was treated as unmanly and a “hysterical” reaction to the pressures of war. Mental debility was something to be feared in the trenches and diagnosis almost invariably invoked charges of predisposition or malingering (Tyquin 148–49). This shifted responsibility (and blame) from the war to the individual. Even as late as the 1950s, medical notes referred to Facey’s condition as being “constitutional” (Repatriation).Facey’s narrative demonstrates awareness of how harshly sufferers were treated. We believe that he defended himself against this with stories of physical injury that his doctors never fully accepted and that he may have experienced conversion disorder, where irreconcilable experience finds somatic expression. His medical diagnosis in 1915 and later life writing establish a causal link with the explosion and his partial burial on 28 June, consistent with opinion at the time that linked concussive blasts with destabilisation of the nervous system (Eager 422). Facey was also badly shaken by exposure to the violence and abjection of war, including hand-to-hand combat and retrieving for burial shattered and often decomposed bodies, and, in particular, by the death of his brother Roy, whose body was blown to pieces on 28 June. (A second brother, Joseph, was killed by multiple bayonet wounds while Facey was convalescing in Egypt.) Such experiences cast a different light on Facey’s observation of men suffering nerves on board the hospital ship: “I have seen men doze off into a light sleep and suddenly jump up shouting, ‘Here they come! Quick! Thousands of them. We’re doomed!’” (350). Facey had escaped the danger of death by explosion or bayonet but at a cost, and the war haunted him for the rest of his days. On disembarkation at Fremantle on 20 November 1915, he was admitted to hospital where he remained on and off for several months. Forty-one other sick and wounded disembarked with him (HMAT). Around one third, experiencing nerve-related illness, had been sent home for rest; while none returned to the war, some of the physically wounded did (War Service Records). During this time, Facey continued to present with “frequent attacks of palpitation and giddiness,” was often “short winded,” and had “heart trouble” (Repatriation). He was discharged from the army in June 1916 but, his drafts suggest, his war never really ended. He began a new life as a wounded Anzac. His dependent and often fractious relationship with the Repatriation Department ended only with his death 66 years later. Historian Marina Larsson persuasively argues that repatriated sick and wounded servicemen from the First World War represented a displaced presence at home. Many led liminal lives of “disenfranchised grief” (80). Stephen Garton observes a distinctive Australian use of repatriation to describe “all policies involved in returning, discharging, pensioning, assisting and training returned men and women, and continuing to assist them throughout their lives” (74). Its primary definition invokes coming home but to repatriate also implies banishment from a place that is not home, so that Facey was in this sense expelled from Gallipoli and, by extension, excluded from the myth of Anzac. Unlike his two brothers, he would not join history as one of the glorious dead; his name would appear on no roll of honour. Return home is not equivalent to restoration of his prior state and identity, for baggage from the other place perpetually weighs. Furthermore, failure to regain health and independence strains hospitality and gratitude for the soldier’s service to King and country. This might be exacerbated where there is no evident or visible injury, creating suspicion of resistance, cowardice, or malingering. Over 26 assessments between 1916 and 1958, when Facey was granted a full war pension, the Repatriation Department observed him as a “neuropathic personality” exhibiting “paroxysmal tachycardia” and “neurocirculatory asthenia.” In 1954, doctors wrote, “We consider the condition is a real handicap and hindrance to his getting employment.” They noted that after “attacks,” Facey had a “busted depressed feeling,” but continued to find “no underlying myocardial disease” (Repatriation) and no validity in Facey’s claims that he had been seriously physically wounded in the war (though A Fortunate Life suggests a happier outcome, where an independent medical panel finally locates the cause of his ongoing illness—rupture of his spleen in the war—which results in an increased war pension). Facey’s condition was, at times, a source of frustration for the doctors and, we suspect, disappointment and shame to him, though this appeared to reduce on both sides when the Repatriation Department began easing proof of disability from the 1950s (Thomson 287), and the Department of Veteran’s Affairs was created in 1976. This had the effect of shifting public and media scrutiny back onto a system that had until then deprived some “innocent victims of the compensation that was their due” (Garton 249). Such changes anticipated the introduction of Post-Traumatic Shock Disorder (PTSD) to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. Revisions to the DSM established a “genealogy of trauma” and “panic disorders” (100, 33), so that diagnoses such as “neuropathic personality” (Echterling, Field, and Stewart 192) and “soldier’s heart,” that is, disorders considered “neurotic,” were “retrospectively reinterpreted” as a form of PTSD. However, Alberti points out that, despite such developments, war-related trauma continues to be contested (80). We propose that Albert Facey spent his adult life troubled by a sense of regret and failure because of his removal from Gallipoli and that he attempted to compensate through storytelling, which included his being an original Anzac and seriously wounded in action. By writing, Facey could shore up his rectitude, work ethic, and sense of loyalty to other servicemen, which became necessary, we believe, because repatriation doctors (and probably others) had doubted him. In 1927 and again in 1933, an examining doctor concluded: “The existence of a disability depends entirely on his own unsupported statements” (Repatriation). We argue that Facey’s Gallipoli experiences transformed his life. By his own account, he enlisted for war as a physically robust and supremely athletic young man and returned nine months later to life-long anxiety and ill-health. Publication transformed him into a national sage, earning him, in his final months, the credibility, empathy, and affirmation he had long sought. Exploring different accounts of Facey, in the shape of his drafts and institutional records, gives rise to new interpretations. In this context, we believe it is time for a new edition of A Fortunate Life that recognises it as a complex testimonial narrative and theorises Facey’s deployment of national legends and motifs in relation to his “wounded storytelling” as well as to shifting cultural and medical conceptualisations and treatments of shame and trauma. ReferencesAlberti, Fay Bound. Matters of the Heart: History, Medicine, and Emotions. Oxford: Oxford UP, 2010. Butler, A.G. Official History of the Australian Medical Services 1814-1918: Vol I Gallipoli, Palestine and New Guinea. Canberra: Australian War Memorial, 1930.Campbell, A.W. “Remarks on Some Neuroses and Psychoses in War.” Medical Journal of Australia 15 April (1916): 319–23.Damousi, Joy. “Why Do We Get So Emotional about Anzac.” What’s Wrong with Anzac. Ed. Marilyn Lake and Henry Reynolds. Sydney: UNSWP, 2015. 94–109.Dutton, Geoffrey. “Fremantle Arts Centre Press Publicity.” Australian Book Review May (1981): 16.Eager, R. “War Neuroses Occurring in Cases with a Definitive History of Shell Shock.” British Medical Journal 13 Apr. 1918): 422–25.Echterling, L.G., Thomas A. Field, and Anne L. Stewart. “Evolution of PTSD in the DSM.” Future Directions in Post-Traumatic Stress Disorder: Prevention, Diagnosis, and Treatment. Ed. Marilyn P. Safir and Helene S. Wallach. New York: Springer, 2015. 189–212.Facey, A.B. A Fortunate Life. 1981. Ringwood: Penguin, 2005.———. Drafts 1–3. University of Western Australia, Special Collections.———. Transcript. University of Western Australia, Special Collections.First Tuesday Book Club. ABC Splash. 4 Dec. 2012. <http://splash.abc.net.au/home#!/media/1454096/http&>.Foster, Dennis. Confession and Complicity in Narrative. Cambridge: Cambridge UP, 1987.Frank, Arthur. The Wounded Storyteller. London: U of Chicago P, 1995.Fraser, Jane. “CEO Says.” Fremantle Press. 7 July 2015. <https://www.fremantlepress.com.au/c/news/3747-ceo-says-9>.Garton, Stephen. The Cost of War: Australians Return. Melbourne: Oxford UP, 1994.HMAT Aeneas. “Report of Passengers for the Port of Fremantle from Ports Beyond the Commonwealth.” 20 Nov. 1915. <http://recordsearch.naa.gov.au/SearchNRetrieve/Interface/ViewImage.aspx?B=9870708&S=1>.“Interview with Ray Coffey.” Personal interview. 6 May 2016. 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National Archives of Australia.Roberts, Chris. “Turkish Machine Guns at the Landing.” Wartime: Official Magazine of the Australian War Memorial 50 (2010). <https://www.awm.gov.au/wartime/50/roberts_machinegun/>.Semmler, Clement. “The Way We Were before the Good Life.” Courier Mail 10 Oct. 1981. FACP Press Clippings. Fremantle. n. pag.Smith, Sidonie, and Julia Watson. Reading Autobiography: A Guide for Interpreting Life Narratives. 2001. 2nd ed. U of Minnesota P, 2010.Thomson, Alistair. Anzac Memories: Living with the Legend. 1994. 2nd ed. Melbourne: Monash UP, 2013. Tyquin, Michael. Gallipoli, the Medical War: The Australian Army Services in the Dardanelles Campaign of 1915. Kensington: UNSWP, 1993.War Service Records. National Archives of Australia. <http://recordsearch.naa.gov.au/NameSearch/Interface/NameSearchForm.aspx>.Williamson, Geordie. “A Fortunate Life.” Copyright Agency. <http://readingaustralia.com.au/essays/a-fortunate-life/>.