Sometimes things are not as they seem and we see, as the biblical Paul wrote, ‘through a glass darkly’. Sometimes there is more than meets the eye; it is what makes the world so interesting. Maybe it’s why we wrap gifts –or give them, for that matter. They are such stuff as dreams are made on…

I have always loved New Zealand; to me, it is a gift, and so is what I’ve recently learned about its origins. To think that Aotearoa –the land of the long white cloud- is more than the ribbon I can see today, more than the Maori seafarers could see even a thousand years ago when they first arrived, is astonishing, and not a little intriguing. An article in the Guardian (https://www.theguardian.com/world/2017/feb/17/zealandia-pieces-finally-falling-together-for-long-overlooked-continent?CMP=Share_iOSApp_Other) reports on a paper published in GSA Today -the journal of the Geological Society of America: ‘Zealandia covers nearly 5m square km, of which 94% is under water, and encompasses not only New Zealand but also New Caledonia, Norfolk Island, the Lord Howe Island group and Elizabeth and Middleton reefs. The area, about the same size as the Indian subcontinent, is believed to have broken away from Gondwana – the immense landmass that once encompassed Australia – and sank between 60m and 85m years ago.’

Of course, even with satellite-derived bathymetric data, it’s hard to appreciate. And the skeptics, largely silent in their apathy, still sit in the shadows wondering what difference knowing  this  makes. After all, it’s almost all underwater, some of it way underwater –one edge of it ‘can be placed where the oceanic abyssal plains meet the base of the continental slope, at water depths between 2500 and 4000 m below sea level.’ http://www.geosociety.org/gsatoday/archive/27/3/article/GSATG321A.1.htm Would we be any the worse, the unimpressed might argue, if this remained undetected? Would the ignorance handicap us in some way? Any way…?

In the conclusion to the paper, the authors assert that: ‘As well as being the seventh largest geological continent Zealandia is the youngest, thinnest, and most submerged. The scientific value of classifying Zealandia as a continent is much more than just an extra name on a list. That a continent can be so submerged yet unfragmented makes it a useful and thought-provoking geodynamic end member in exploring the cohesion and breakup of continental crust.’ But it seems to me that questioning the value of this discovery misses the point entirely. Misses, perhaps, the point of gifts and the wrapping in which they are concealed.

Although I am now retired, I am reminded of something that happened late in my career as a gynaecologist and which continues to intrigue me. It makes me wonder just how many other assumptions limit our vision…

Sometimes in medicine, we feel the need to step back from the fray, to attempt an objectivity denied to those whom we treat. It allows us, we explain, to adopt another, more reasoned perspective -one which is unadulterated by their pain and emotion. ‘A thought which, quarter’d, hath but one part wisdom’ as Hamlet said.

And yet, looking out from the forest of my age, I realize that sometimes people don’t want to be treated as patients, but as people. Fellow travelers. What they want is a knowledgeable friend, not a textbook to which they can turn. One has to learn to gauge the needs…

Jean was not a new patient, but her visits were erratic and unpredictable. Sometimes it was for a pap smear, but more frequently it was for what she would only characterize as an ‘infection’ –“The usual one,” she would inevitably add with an embarrassed laugh. But neither I, nor any of the other doctors she had seen were ever able to find the infection, so it had become a sort of standing challenge as to who would find it first.

Jean was a very fit woman then in her early fifties, who taught both English and drama at a nearby high school. Meticulous about her appearance, I would see her in the waiting room sitting bolt upright, shoulders back, head perched on her shoulders like it was suspended on fine wires to keep it from despoiling the immaculately dressed body below. Her hair was brown and short with each strand assigned an immoveable location lest it be chastened with the brush she kept on her lap in a little purse.

That day, however, I noticed she had added another weapon to the arsenal on her lap –a little pump action plastic bottle, the content of which she would surreptitiously spray on her hands from time to time, followed by a vigorous rubbing as if she had just applied some soothing lotion.

She smiled when she saw me and extended a just-sprayed hand in greeting. “I think I’ve solved my problem, doctor,” she said as soon as we were settled in my office. “I just wanted you to check and see if there was any difference –you know, down…” She blushed before she could finish her sentence. She immediately produced the little bottle and sprayed her hands again. “No infection,” she added, regaining her composure after the little entr’acte.

“And the little bottle?” I had to ask.

“Sanitizer,” she answered proudly. “It’s antibacterial,” she added, and dived into the purse to read the label to me. “It contains triclosan… For some reason it’s really  hard to get nowadays.” Her face suggested that puzzled her. “I mean it kills bacteria doesn’t it? And they’re the troublemakers…”

I suppressed a sigh and sat back in my chair. “It also encourages bacterial resistance, Jean. And it doesn’t seem to be any more effective at cleaning than good old soap and water.”

She blinked, but whether in surprise, or disbelief I couldn’t tell. “But…” She gathered her thoughts before continuing. “We pick up bacteria from our environment and dirty hands are how we transmit a lot of diseases. We have to keep them clean… Bacteria” –she said it as if the word itself were dirty- “Bacteria are everywhere.” She pointed to an alcohol-based hand sanitizer I kept on my desk. “And I see you don’t take any chances either. ”She relaxed in her chair as if she’d proved her point.

I allowed myself the sigh I had avoided earlier. “An interesting dichotomy, isn’t it?” She raised an eyebrow. “That we live in a world jam-packed with so many bacteria that they are virtually ubiquitous…” I continued, “…and yet so few cause us trouble.”

“But…” She leaned forward on her seat.

“But we seem to want to malign them all; we act as if they were all our enemies. And yet, our own microbiome –the bacteria living in our intestines- are absolutely essential for our health in ways we are just discovering. And apparently the number of bacteria normally living in and on a healthy human body outnumber our own cells by ten to one.” I stopped and smiled at her incredulous expression. “We –our cells- are only the tip of the iceberg.”

I suppose I thought I’d just be reminding her of something she already knew, but her eyes were saucers. “Zealandia,” she said after a moment’s reflection.

“Pardon me?” I’d never heard the word, and wondered whether she was referring to the title of some obscure novel she was teaching at school.

“Zealandia,” she repeated as if she were surprised I didn’t recognize the term. “You know, doctor, the continental landmass of which New Zealand is a part? It’s 95% underwater so you can’t see it and therefore don’t appreciate it’s importance. We usually only judge what we can see, don’t we…?” she added with a wink and a big winning smile.

We all have our blind spots.


The Goddess of Small Things

Every office needs a goddess. Every doctor needs to see one now and then to keep things in perspective. Separate the two Magisteria.

I have a goddess –not self-professed to be sure, but in a pinch, self-acknowledged. She comes to see me once a year or so, for reasons that are not at all transparent.

It began about fifteen or more years ago. It was a surprise; the referrral letter from her doctor said nothing about a goddess. It didn’t even mention her powers, as I recall. It merely said “Infection!!”  and although the writing seemed laboured, reluctant –scrawled perhaps describes it best- the exclamation marks were clear enough. In fact, they were several times the size of the writing, and burrowed deep into the page, breaking through the paper in one particularly enthusiastic area as if to justify their mission.

Judith did not come across as your average goddess at all. In fact that first time she seemed rather shy and dressed as background; I didn’t even noticed her sitting in the already crowded waiting room until she stood up when I mis-called her name. A short woman with matching short dark hair, she was wearing a dress that seemed at once plain, and at the same time almost camouflaged against the other dresses in the room. Quite a trick, really. She only stood out when she moved across the room to correct my shortening of the Judith part of her name to Judy.

She spoke, or rather commanded my attention, as soon as I closed the door. I couldn’t place her accent, but it seemed an unusual one. “I require only one thing of you, doctor, so we can dispense with the usual history taking.”

I hate it when they do that. I’m a specialist; I’m supposed to take a careful history and solve their otherwise intractable problems with the benefit of my esoteric knowledge base.

She studied my face for a reaction and, obviously satisfied with the engendered confusion, proceeded to enlighten me. “I’ve been to several specialists already, but they all seem unwilling –or perhaps unable- to help me.” I don’t know why, but I felt like a PhD candidate about to defend an assertion in his thesis. I was being examined.

“I have a recalcitrant case of Mobiluncus mulieris in my parts.”

I have to confess that I blinked involuntarily at the words. Was she a nurse? A doctor in disguise, sent by the provincial medical association to check on my competance? I had to think fast –she had just named one of the several microorganisms thought to be responsible for a rather malodorous vaginal problem. “Bacterial Vaginosis can be very difficult to treat…”

She was silent for a moment and then sat down in a chair across from my desk, a smile incipient, hiding in full view. “Very good, doctor.”

“Did I pass?”

The smile blossomed on her face like a rose opening in the morning sun; her eyes twinkled with mischief. She sat back in the chair, finally relaxed. “I had to know…”

I didn’t ask.

But from that moment, she seemed to bond –with me, with the room, with the Gestalt… And, no doubt it was my imagination, but she suddenly surfaced from the background, like a picture focussing. She shook her head like a fairy might and blinked back at me from somewhere deep inside her head. “You will be my doctor,” she said simply and then stood up.

The interview was obviously over, the threshold attained and crossed, but she stopped at the door and turned to me. “I will not come with problems I cannot solve, merely with problems I wish to discuss.” The now-famous blink again. “Is that all right?” she said, already knowing it was as she turned and left.

She would appear from time to time and tell me of her trips to places I had never heard of. Sometimes it was cloaked in the pretense of needing a pap smear, or a culture for some totally esoteric sexual disease, but we both understood that these were excuses. Dissimulations to cloak her need to connect. It was as if, when she disappeared each time through the door, she ceased to exist –much like Brigadoon –the famous musical about a town that exists for only one day every hundred years.

I told her the story of Brigadoon on a visit when she suddenly appeared in the waiting room, after not seeing her for what seemed like several years. She disappeared behind her eyes for a moment in surprise and when she surfaced again, she was a pixie. She shrugged mischievously, as if caught with a hand in the cookie jar. “I travel a lot,” she said, but not convincingly.

I realized how little I actually knew about her and when she sat down, I decided to find out more. But I suppose she could read my expression and shook her head almost imperceptively. “Magic lies not in what you can see, but in what you can’t quite make out, don’t you think?” she said innocently enough.

I smiled to conceal my embarrassment at being caught about to probe a past which, by some unwritten, unspoken understanding we had agreed should remain hidden. “My secretaries think you are a…” –I hesitated to continue, fearing she would take even the substitute word that I had decided to use the wrong way. An unintended, pejorative way. One secretary –the younger one- had actually said ‘witch’, but the other, the older worldly-wise one, a more sexually-innuendoed word.

But she merely smiled; her eyes told me she already knew what I wanted to say. “You were going to disguise their guess, weren’t you?”


“Or change it into something more… polite?” her face twinkled playfully. I have to confess I blushed at her seeming prescience. She leaned towards me over my desk. “Some have called me fey…” She thought about the word for what seemed an eternity. As if she wasn’t sure how much to disclose. “There are many words they use,” she whispered and then sat back. “Witch, enchantresss, goddess… Weird things like that, because, like you, they don’t know much about me.” She stared at me for a full minute and then at something over my head –or so it seemed. “Because I only appear long enough to influence some part of their everyday lives and then vanish, there is a touch of mystery to me, I suppose.”

The skin on her face relaxed and she suddenly seemed older. Wiser. Ancient.

She got up slowly and walked to the door. “But it’s not like that, you know. Not really…” Even from the door I could see her sigh. “No matter what they think, I don’t do very much for them.” A final blink before she turned. “I am the Goddess of small things,” she said over her shoulder as if to the wall. As if, as it turned out, I would never see her again.