9/11

Twenty years ago today I lived in Malmö sharing a house with some friends. A house where I had lived since I got back to Sweden from my dwelling in London the year prior. During the past weeks I had stayed in the living room though, sleeping on the sofa, as someone else had taken my old room. The reason was that I was moving out, having bought tickets to Montreal in Canada where I was going to stay with a friend for a few weeks. Then I would go WWOOFing outside Lachute. I did not have much money saved but had planned a trip during autumn and winter, and had gotten cheap tickets for the Greyhound bus across the continent to British Columbia. From there I would be heading south to San Francisco some weeks later, and then back through the United States to Quebec from December 5 to 8. My lighthearted and vague intention was to stay with friends and friends of friends as I traveled around. Spirit of youth. 

As I was packing and preparing I had the radio on and I heard about the first plane flying into the North Tower of the World Trade Center in New York. I turned on the shared television and watched from the sofa/my bed as the second plane hit the South Tower. The rest of the afternoon and evening cohabitants and friends came in to the living room and watched the scenes unfold. Thousands of immediate deaths and many more to follow, and – for better or worse – another nail in the coffin for a western world that naively believed in some sort of hastened expansion of advancement for mankind. It also made obvious a very violent threat to the open society that we had become accustomed to and had taken for granted.

 

It was first the next day or the day after that I again started thinking about my impending travels and how close Montreal and New York are to each other. Would I be able to use my plane tickets, would it be safe to journey throughout North America and would I make it back? It was not only the Twin Towers that had collapsed on 9/11, the entire commercial air industry seemed stalled. As Swissair was not yet grounded my youthful enthusiasm and confidence triumphed and off I went.

In 2021 we have discarded the lofty idea of a liberal empire. Instead we live in an almost dialectical opposite (as per Engels) agenda of low self-esteem and irrational psyches in the academic and public debate: Claiming that the studies of our own western history is racist (our cultural history has not achieved anything worthy), that genderfluidity should be the norm (fabulous for building the strong inner structure of a child). Emotional and incoherent response from a privileged upper middle class is the top dog and defines political correctness (who needs science and contemplation when we have disruption), escapism is a human right (a stable foundation and taking responsibility is unfashionable). Und so weiter. Identity politics runs amok and seemingly outlying deconstructive theories win entry. Ideology which actually generates the intolerance and division of humans it declares it is opposing. Grownups have escaped.

Although in the immediate aftermath of the attack, it ended up being an awesome trip with several lifetime experiences. Pretty much as I imagined and hoped for. Initially in Montreal and then making CSA-baskets for La Ferme Biologique de Bullion, followed by couchsurfing across the continent and back again. I made great friends whom I still have in my life and my innocent conception of how most people are nice and helpful if you meet them in person was confirmed.

The global balance of power will not accept a vacuum. Another superpower already bids for the role as world hegemon by looking at the expansion over all continents. It is unlikely that this alternative will hold similar values to us when it comes to the groundwork of society building that we have achieved: Division of power, human rights and so forth. Consequently it is obvious who must be our strongest ally in this game. I believe that the bubble of an open society with free speech and rule of law will prevail in our part of the world. We are resting on the shoulders of giants and with this foundation, reason will eventually win. Even so we have now learned the hard way that it is not something we have achieved and thus manage for free. Peace comes with a cost. We not only need to protect our outer borders with force but also continually fight for common sense against deranged ideologies within. We need to constantly defend ourselves against the people who hate us, our way of living and the cultural history that makes the open society possible, and that is precisely what we will.

End of being micromanaged

Some time ago, I made the biggest financial investment hitherto in my life. Much more than the double of what I have paid for my house. It is a bold move, but I believe that it is the correct one. Apparently the bank and accountancy concur. Starting October 1st this year, I will run my own neurology practice. I hope that I will be able to provide good consultations and the necessary continuity for the patients left out of the secondary sector, and as a silver lining I hope to be able to get back a good quality of life. I am turning forty this year and I am a father of three, and irregular shifts including seventeen-hours long night turns without rest combined with weekend work is not that tempting anymore. I am intent on becoming my own leader again, get some freedom back and run a good proprietorship serving the patients stricken by neurological manifestations.

Twenty years ago this autumn, just after 9/11, while I was crossing Canada and the United States back and forth in a Greyhound bus, I made the decision to actually go ahead and attempt getting into Medical School. I recall the meditative disposition I was in and even which book I was reading as the landscape and days shifted outside. When back in Lund I wrapped up my Philosophy and Cognitive Science studies as I worked evenings driving a forklift. I started out my medical studies in Umeå and finished them off in Odense, and the rest is history. With a few detours, the Department of Neurology at Odense University Hospital has been my home base. For the past twelve years, it is where I have returned to, and I am aware of all the internal anecdotes of the unit, which in itself could become an amusing narrative.

Albeit a great place, the situation for neurology in the Funen and archipelago region is not. Those who know me have heard me many a time muttering over how a department can keep taking on more tasks despite not having more staff and having fewer hospital beds, which is a process that has been ongoing for the entire time I have been there. Neurology has moved so much the past decade. Partly, which is very time-consuming, in the cerebrovascular field with new treatment and intervention possibilities for acute stroke patients. In fact we are now in a similar situation to the one cardiologists were in back in the 1980s when PCI was introduced for the coronary arteries. Back then however, a national plan was laid out, creating realistic infrastructure for handling this - not so much these days. Overall these news are good though, patients from all over the Region of Southern Denmark are flown into Odense to get acute treatment for a brain clot that would otherwise have rendered them paretic and without a language, or worse.

On Funen we only have one neurology department, one department! Twenty years ago, at least six departments on Funen handled patients with apoplexy. Back then, nothing acute could be done - it was prophylactic treatment and neurorehabilitation. Heavy patients to be frank, but a shared burden. This new paradigm regards stroke patients, but what about the other patients, the part of neurology that is not cerebrovascular? Neurology is also striding forward in other areas, e.g. with novel treatment options for MS and other neuroimmunological diseases, giving these patients a much better working life than before.

With high specialization and more treatment offers for the acute, what happens to all the non-emergency patients? What happens to general neurology? Exactly what you may think: People with Parkinson's and other movement disorders, epilepsy, neuropathy, etc., need to wait in line. There is no stability for them. And much less so on Funen, as they need to compete not only with the mentioned acute cerebrovascular patients but also with the ones receiving second opinion from the peripheral hospitals in the region. That is right, Funen does have one department of neurology, but it is also the university hospital for the entire Region of Southern Denmark. As a consequence, the pressure on the attending neurologist increases, as the Funen GPs (rightly) need assistance with their patients, and the waiting list for the outpatient clinic increases because of a bigger demand on the acute side. 

Has this been said many times, year after year? Have many good colleagues left because of an untenable situation? Has the constant centralization come with anything but additional layers of disruptive greasepaint created by an ever-increasing bureaucratic burden? Is this news? 

The answers are Yes, Yes and No, No. 

As the spiral keeps going in the wrong direction and I by no means believe that the public leaders or middle management are fitted with the right tools to fix these things, I could go bitter and cling on to the position I have achieved. Accept disillusionment and stay a zombie until I retire, learning to love being constantly micromanaged by bureaucrats. I would rather not, though. No more ill-fitting scrubs for me.

Over and out.

August 13th, 2020

 
Astrid Alexandra Forsberg