Journal articles: 'State University of New York at Buffalo. School of Medicine' – Grafiati (2024)

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Thirty randomly selected pre-treatment postero-anterior cranial radiographs of adolescent patients attending the orthodontic department, School of Dental Medicine, State University of New York at Buffalo comprised the sample in this study. The aims of this study were (1) to compare the depths of the right, and the left, mandibular antegonial notches, and (2) to determine whether the morphology of the antegonial notches bears a statistical relationship to some other transverse metrical characters of the face. The frontal cranial radiographs of thirty patients were digitized to determine the linear, and surface area, measurements of the right, and the left, antegonial notches as well as some transverse dimensions of the faces. An analysis of variance showed that no statistically significant difference existed between the measurements made by the two examiners, who digitized the radiographs.The data were analyzed by means of the Student's t- test. The results showed that there were statistically significant differences (P<0.05) between the measurements of the right, and the left, mandibular antegonial notches. The data also showed that there were highly statistically significant differences between the corresponding bilateral facial dimensions (P<0.001). The results of this study suggest that facial symmetry, as measured on a frontal skull radiograph, is associated with the respective depths of the right, and the left, mandibular antegonial notches.

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Charlie van der Horst, an emeritus professor at the University of North Carolina and a friend of Pathogens and Immunity, disappeared from sight on Friday, June 14 during a marathon swim in the Hudson River. His death was confirmed. Few who knew him would call him Charles as formality was not his strong-suit. Charlie was born in Holland to a Dutch father and a Polish Holocaust survivor mother. His family moved to the Buffalo, New York area and sent Charlie to school at Andover. He attended Duke University where he captained the varsity swim team in 1973-74. He remained a powerful swimmer, competing often in national Masters’ competitions. He received his MD degree from Harvard in 1979 and trained in medicine at Montefiore Medical Center and Infectious Diseases at the University of North Carolina. He was an expert in the management of fungal diseases and when the AIDS epidemic began, he knew he had to commit his career to AIDS research and care. He led a highly successful AIDS Clinical Trials Unit at the University of North Carolina and was a respected leader in this national consortium who gained international recognition and respect for his work. More than most anyone else I know, Charlie was driven to fight for justice, anywhere, any time. At the 2000 IAS meeting in Durban, South Africa he recognized that the greater AIDS need was in the developing world and he redirected his entire career towards the development of research and care programs in Africa. When Ebola hit West Africa, Charlie rushed to Liberia to help. In the U.S., Charlie was on the front lines urging his state legislature to deal fairly with all North Carolinians, working hard to fight for equity in health care. He was beloved by so many, respected for his talents, admired for his decency. He was, as my grandmother would have said—a mentsch—and more. Our world is lucky to have had him and is diminished by his loss.

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This article discusses innovations and evolution in the optics industry. Local firms teamed with Monroe Community College to hold events that introduced high school students to optics . Paul Ballentine, who analyzes technology opportunities as deputy director of University of Rochester’s Center for Emerging and Innovative Sciences, sees plenty of upside. Light-based systems are continuing to grow, but Rochester’s optics community will have to reinvent itself to thrive. The Rochester Regional Photonics Cluster has morphed into New York Photonics, with additional clusters in Buffalo, central New York, Albany, and Long Island. It now represents hundreds of optics and photonics companies throughout the state. Paul Conrow, who was teaching physical sciences at Rochester’s East High School, is now recruiting 10th graders and showing them Rochester’s optics industry. Conrow presented the idea to the district superintendent, who had been principal in the only school in America with a student eyeglass program. He introduced Conrow to teachers at a sister high school where members of the cluster were helping to plan a precision optics program.

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This study investigated the effect of meditation on music performance anxiety. Participants were 19 students between the ages of 18 and 41 yrs, who were recruited from the Manhattan School of Music, Mannes College of Music, Yale University School of Music, and State University of New York at Purchase. The experimental group received a series of eight meditation classes, and the control group received no meditation training. After the 8-week training period, all performed in a concert. Pretests and post-tests of music performance anxiety were given and post-tests of state anxiety and of performance concentration. Performance anxiety decreased among participants in the meditation group, in contrast to participants in the control group, whose performance anxiety did not decrease. Differences in regard to post-test state anxiety and performance concentration were not significant. An additional benefit of meditation was a reported increase in relaxation pleasure even in the period immediately before the performance. Results indicate that meditation may be a useful tool for aiding performers to combat performance anxiety.

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For contemporary music in America and Europe, the 1970s were a time in which the old order was changing, giving place to a new avant-garde. In Germany, the Darmstädter Ferienkurse für Neue Musik was stagnating under the inept leadership of Ernst Thomas, savaged by the press and ridden with inner squabbling and politics. For 25 years a bastion of musical innovation and experimentation, Darmstadt now seemed little more than ‘the crumbling edifice of the avant-garde's chief fortress’. The focus was shifting to Paris, where, in 1977, IRCAM opened beneath the Centre Georges Pompidou. Led by Pierre Boulez and staffed by Luciano Berio, Vinko Globokar, Max Mathews, and Jean-Claude Risset, its stated mission was to reunite science and music and create new modes of performance. Across the Channel, the composers of the New Complexity (Brian Ferneyhough, James Dillon, Richard Barrett, and Chris Dench) were also redefining performance practice, focusing not on technology but on notation and its implications for virtuosity. And in America, different schools of musical thought were colliding in the streets and the academy. Leonard Bernstein delivered the Charles Eliot Norton lectures at Harvard, then presented his ‘unanswered question’ to the American public, on television, in 1976. And uptown and downtown were ensconced, with Milton Babbitt and Morton Feldman appointed to the faculties at the Juilliard School and the State University of New York at Buffalo, respectively. On both sides of the Atlantic, seminal artistic statements were being made, heralding the unruly adolescence of a new and disparate avant-garde no longer directly connected to the Second World War.

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SummaryThis study describes Finnish university students' knowledge and attitudes towards HIV and AIDS, hom*osexuality and sexual risk behaviour. Finnish-speaking students were randomly selected from all registered students at two universities in Finland (N=9715, n=950). The data were collected by using a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire on sexual risk behaviour developed by Held and Chng. The total response rate was 35% (n=333). The data were analysed using quantitative statistical methods. Normally distributed data were analysed by t-test and one-way ANOVA, with Bonferroni corrections. Non-normally distributed data were analysed using the Mann-Whitney U-test and Kruskal-Wallis test, followed by a post-hoc test. The majority of students were familiar with HIV and AIDS, including its mode of transmission. However, there were still some misconceptions concerning HIV and AIDS. The oldest students and women had a more positive attitude towards people living with HIV and AIDS (PLWHA). Of patients with HIV or AIDS, intravenous drug users were perceived most negatively. Male students had more hom*ophobic attitudes. Students who reported that religion had an important role in their lives had significantly stricter attitudes towards sexual risk behaviour. Students' knowledge correlated positively with general attitudes towards HIV and AIDS. Knowledge about HIV and AIDS will lead to more positive attitudes towards HIV and AIDS as a disease, towards those infected as well as hom*osexual people. There is a need to focus on preventive health care and sexual health promotion by educating young people and changing their attitudes towards sexual risk behaviour.

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Mary Oliver is an American poet who has been so much fascinated by the natural world since her childhood. Natural world occupies a very large space in her poetry, if not her entire poetic work. She was born in Ohio 1935, and she spent her childhood there surrounded by Nature. She graduated from high school and went to Vassar college and Ohio State University, yet she could not get a degree. She moved to New York where she met the sister of Edna St. Vincent Millay, the famous American poet and playwright. She got a closer look to Edna’s works by organizing her papers for almost seven years. As for career, she held the position at Bennington College by being the Catherine Osgood Foster Chair for Distinguished Teaching. Later on she settled in Provincetown, Massachusetts for almost forty years inspired by the natural scenes there which are conveyed in her collections.

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Eric Barnard was a protein biochemist who played a leading role in the delineation of the molecular components of neuromuscular transmission and the emergence of molecular neuroscience as a scientific discipline. He began his career at King's College London, moving to the State University of Buffalo, New York, in 1965 before returning to Imperial College, London, in 1975. In 1985 he became the Director of the Medical Research Council (MRC) Molecular Neurobiology Unit in Cambridge. Upon retirement from the MRC, he moved to the Royal Free Hospital in London where he continued as Director of Molecular Neurobiology, but in 1998 returned to the University of Cambridge (Department of Pharmacology) as Emeritus Professor. In 2014, at the age of 86, he finally retired from active research. Although Eric was elected FRS for his early pioneering work on the protein chemistry of enzymes and the nicotinic acetylcholine receptor, his seminal contribution, initiated during his time at Imperial, was the application of molecular biological methods to the study of many neurotransmitter receptors. With Ricardo Miledi FRS (and later David Brown FRS and colleagues), he developed the Xenopus oocyte system for the expression of receptors from total tissue mRNA. His was the first group to clone a neurotransmitter receptor subunit cDNA, the nicotinic acetylcholine receptor α subunit of Torpedo marmorata . This was followed by purification and subsequent cloning of inhibitory γ-aminobutyric acid (GABA) A receptor subunit cDNAs. This achievement, driven by Eric and aided by his collaborator Peter Seeburg, led to the discovery of the ligand-gated ion channel superfamily, the discovery of neurotransmitter receptor heterogeneity, and the development of concepts of receptor families and superfamilies. His pioneering work was pivotal for the foundation of modern central nervous system drug discovery.

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Viral coinfection in the oral cavity associated to HIV infection was evaluated in 180 children from birth to 13 years of age of both sexes. The oral examinations were performed at the Pediatric AIDS Outpatient Clinic, São Lucas Hospital and Clinic Hospital, both in Porto Alegre, Brazil and at the School of Dental Medicine, University Hospital Center, State University of New York at Stony Brook, USA. The aim of this study was to identify the presence of viral infections in the oral cavity. PCR technique was used to determine opportunistic viral infections caused by CMV, EBV, and HSV in mucosal swabs. A high frequency of viral infection was detected in the oral cavity of HIV-infected children determined by the PCR technique. HIV-infected children with viruses had a favorable CD4+T lymphocyte count and unfavorable viral load.

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Journal of Plant Studies wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal are greatly appreciated.Journal of Plant Studies is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to jps@ccsenet.org.Reviewers for Volume 6, Number 1Adriana F. Sestras, University of Agricultural Sciences and Veterinary Medicine, RomaniaAna Simonovic, Institute for Biological Research "Sinisa Stankovic", SerbiaArthur T. O. Melo, College of Life Sciences and Agriculture, University of New Hampshire, United StatesBing Wang, Iowa State University, United StatesChrystian Iezid Maia e Almeida Feres, Tocantins Federal University, BrazilHoma Mahmoodzadeh, Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, IranKinga Kostrakiewicz-Gieralt, Institute of Botany, Jagiellonian University, PolandKirandeep Kaur Mani, California seed and Plant Labs, Pleasant Grove, CA, United States of AmericaMalgorzata Pietrowska-Borek, Poznan University of Life Sciences, PolandMartina Pollastrini, University of Florence, ItalyMassimo Zacchini, National Research Council of Italy (CNR), ItalyMelekber Sulusoglu, Arslanbey Vocational School Kocaeli University, TurkeyMontaser Fawzy Abdel-Monaim, Plant Pathology Res. Instatute, Agric. Res. Center, EgyptPanagiotis Madesis, Institiute of Applied Biosciences (CE.R.T.H.)/INAB, GreecePeter R. Greene, BGKT Consulting Ltd. Huntington, New York 11743, United StatesRosana Noemi Malpassi, Universidad Nacional de Rio Cuarto, ArgentinaSaid Laarabi, University Mohammed V/Ministry of National Education, MoroccoSlawomir Borek, Adam Mickiewicz University, PolandSuheb Mohammed, University of Virginia, United StatesVikas Mishra, Paher University, IndiaXiaomin Wu, Loyola University Chicago, United StatesYa-Yi Huang, Institution of Plant and Microbial Biology, Academia Sinica, Taiwan

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Calcium is an essential element for just about all cellular processes, and yet abnormally high levels of cellular calcium can cause cell death. The processes that control cellular levels of this metal ion are thus of critical importance to both normal and pathophysiological conditions. Essential in the regulation of intracellular calcium levels are the calcium channels associated with cell membranes, for instance, with the plasma and sarcoplasmic reticulum membranes of muscle cells. In recent years, there has been a tremendous increase in our knowledge of the structure and function of these channels. However, we also now realize that the term "calcium channels" is used to refer to a rather heterogeneous population of entities. In some instances, notably receptor-operated calcium channels, we have only indirect evidence for their existence, whereas with the voltage-dependent channels, considerable information is now available on their comparative physiology, pharmacology, and biochemistry. The main objective of the Symposium presented in Calgary during the 1989 CFBS meeting was to bring together experts in the area of the calcium channels associated with both smooth and striated muscle function so that they could present the current state of knowledge in this area.Dr. David Triggle, from the State University of New York in Buffalo, reviewed the importance of calcium and calcium channels in cellular function and highlighted the pharmacology of calcium channel antagonists particularly with respect to their effects on the L-type calcium channels associated with smooth muscle. Dr. Sidney Fleischer from Vanderbilt University, Nashville, Tennessee, focused on his work associated with the isolation and characterization of the calcium release channel – ryanodine receptor of the sarcoplasmic reticulum from striated muscle. Dr. Fleischer has referred interested readers to his recent review in the 1989 issue of the Annual Reviews of Biophysics and Biophysical Chemistry (18: 333–364). Dr. Balwant Tuana from the University of Ottawa presented an update complemented by original data from his laboratory in the Department of Pharmacology on the current state of knowledge of the structure of the L-type calcium channel associated with both skeletal and cardiac muscle. The last two speakers, Dr. Wayne Giles and Dr. Hamid Akbarali, both from the Department of Medical Physiology at the University of Calgary, completed the program by presenting a review of data concerning the electrical physiological properties of calcium-activated channels in cardiac and smooth muscle. Their manuscript highlights their recent studies, with co-workers in Calgary, of the properties of calcium-activated potassium currents from the human cystic artery.The organizers of this symposium, hosted by the Pharmacological Society of Canada, gratefully acknowledge the financial support of the Alberta Heart and Stroke Foundation, Alberta Heritage Foundation for Medical Research, Canadian Heart and Stroke Foundation, Canadian Federation of Biological Societies, Charles River Laboratories (Canada Ltd.), SynPhar Laboratories Inc., Fisher Scientific Ltd., Novopharm Ltd., and Mandel Scientific Co. Ltd. The artistic contribution from Sylvia Ficken of Medical Audiovisual Services in the Faculty of Medicine at Memorial University of Newfoundland, who drew the symposium logo reproduced on the title page, is also gratefully acknowledged.

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Jules M Rothstein, clinician, researcher, educator, author, and speaker, entered into the field of physical therapy in 1975 following graduation from the Department of Physical Therapy at New York University. He completed his Master of Arts Degree in Kinesiology in 1979 and his Doctor of Philosophy in Physical Therapy in 1983, also at New York University. During his training, he worked as Staff Physical Therapist at Peninsula Hospital Center in Queens, as Research Fellow with the Arthritis Foundation, and in private practice in Cedarhurst, New York. From 1977 to 1980, Dr Rothstein was Adjunct Instructor in the Department of Physical Therapy at New York University. From 1980 to 1983, he was Instructor and Coordinator of Clinical Research and Training Programs at Washington University School of Medicine, and from 1984 to 1990, he was Associate Professor at the Medical College of Virginia. A tenured professor at the University of Illinois at Chicago since 1990, Dr Rothstein also served as Head of the Department of Physical Therapy at the University of Illinois at Chicago and as Chief of Physical Therapy Services at the University of Illinois Hospital in Chicago until 1999. During that period, the department obtained more than $6 million in research funding and received APTA's 1997 Minority Initiative Award for consistently recruiting and maintaining ethnic and racial diversity among its students. He continues to serve as Professor in the Department of Physical Therapy and remains active in all areas of physical therapy, practice, research, and service. Dr Rothstein's expertise in measurement and research design has been used by many professionals—across disciplines—in the allied health community. He is in great demand as an invited guest speaker, having given professional presentations and keynote speeches on the topic of rehabilitation sciences at numerous national and international forums, including Sweden, Denmark, Iceland, Japan, and Saudi Arabia. He has also served as a consultant and visiting professor in South Africa, the Netherlands, and Poland. Dr Rothstein has made extensive contributions to the physical therapy profession's body of knowledge, including the publication of more than 60 refereed articles and abstracts. In 1985, he edited the text Measurement in Physical Therapy. He chaired the APTA Task Force on Standards for Measurement in Physical Therapy that produced the first APTA Standards for Tests and Measurements in Physical Therapy Practice in 1993. As part of that task force, he co-authored the Primer on Measurement: An Introductory Guide to Measurements Issues. Since 1989, Dr Rothstein has served as Editor of Physical Therapy and has been appointed to that position for three 5-year terms by the APTA Board of Directors. Dr Rothstein is a Catherine Worthingham Fellow of the American Physical Therapy Association. He is the recipient of numerous awards, including the Golden Pen Award, the Outstanding Service Award for Research, the Outstanding Service Award for Continuing Education, and the Outstanding Therapist Award in the State of Illinois. [Rothstein JM. Thirty-Second Mary McMillan Lecture: Journeys beyond the horizon. Phys Ther. 2001;81:1817–1829.]

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AbstractObjectivesThe aim of this study was to describe an educational method teaching Disaster Medicine to American Emergency Medicine (EM) physicians and to evaluate knowledge attainment using this method.MethodsThis was an observational study using a pre-test and a post-test. A full-scale disaster exercise (FSE) was conducted at a large academic center with two hospitals in Brooklyn, New York (USA). Eighty-two EM residents (physicians in training, post medical school) participated in the study. Inclusion criteria for study participation was all EM residents training at the State University of New York (SUNY) Downstate at the time of the study. There were no exclusion criteria. The exercise was a disaster drill designed as “Olympic Games.” Participants in the exercise took a pre-test and a post-test. The primary outcome of the study was the mean difference between pre-test and post-test scores of the study participants using independent sample t-tests. Secondary outcomes of the study were percent of critical actions met by the residents and the hospitals as measured by direct observation of trained study personnel during the exercise.ResultsMean resident post-test scores were higher than pre-test scores to a degree that was statistically significant (62% versus 53%; P =.002). The residents’ performances ranged from 48% to 63% of objectives met. The hospitals’ performances met 50% to 100% of their objectives.ConclusionThe use of an Olympic Games format was an effective model for disaster education for physicians. The model allowed for evaluation of performance and protocols of participants and hospital systems, respectively, and may be used objectively to evaluate for areas of improvement. The Disaster Olympics drill was found to improve emergency preparedness knowledge in the population studied and may constitute a novel and efficacious methodology in disaster training.DanielP, GistR, GrockA, KohlhoffS, RoblinP, ArquillaB. Disaster Olympics: a model for resident education. Prehosp Disaster Med. 2016;31(3):237–241.

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In 1918 into a peasant family, was born A. A. Shalimov, who, after finishing school and technical school he enrolled in the Kuban medical Institute (1936-1941), he worked as a doctor in hospitals near Krasnodar, in Chita oblast (1941), in the cities of Bryansk and the eagle; chief surgeon of the Orel region (1949). In 1951, A. A. Shalimov returned to Bryansk, he defended his dissertation and received the title of Honored doctor of the RSFSR. Later A. A. Shalimov moved to Kharkov, he defended his doctoral dissertation (1957) and was appointed head of the Department of thoracic surgery and anesthesiology of the Ukrainian Institute of advanced training of physicians (1959), Director of the Kharkiv Institute of General and urgent surgery (1965), head of the Department of thoracoabdominal surgery of the Kiev Institute of improvement of doctors, as head of the surgical Department, the Director of Kiev research Institute of Hematology and blood transfusion (1970) and Kyiv Sri of clinical and experimental surgery (1971), chief surgeon of the Ministry of health of Ukraine (1980). A. Shalimov was elected a corresponding member of the Academy of Sciences of Ukraine (1969), academician of the National Academy of Sciences of Ukraine (1978). A. A. Shalimova awarded the title Hero of Socialist Labor of the USSR (1982), Hero of Ukraine with the order of Powers (2005). Alexander Shalimov 870 author of scientific papers, including 35 monographs, 112 inventions, he has trained 50 doctors and nearly 100 candidates of medical Sciences. A. A. Shalimov was awarded two orders of Lenin and red banner of Labor, order of the October Revolution, the order of the Ukrainian State (2005) and "For merits" of three degrees, medals and orders and medals of foreign States. Oleksandr Shalimov was a member of the Board of the Association of surgeons im. N. And. Pirogov, the International Association of surgeons, the all-Union scientific society of surgeons, gastroenterologists and cardiologists, Chairman of the Ukrainian Republican scientific society of surgeons, full member of the new York Academy of Sciences, editor-in-chief of the journal "Clinical surgery", Deputy of the Supreme Soviet of the Ukrainian SSR 8-10 convocations. The international chamber of the American biographical Institute, he was elected "Man of the year – 1997", awarded diploma of the International biographical centre of Cambridge University for achievements in medicine of the twentieth century. Died Alexander Shalimov February 28, 2006.

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Abstract Abstract 151 The platelet integrin αIIbβ3 mediates platelet aggregation by binding the adhesive plasma proteins fibrinogen and von Willebrand factor. We previously reported that co-crystallizing the αIIbβ3 headpiece with either of the two ligand mimetic drugs eptifibatide or tirofiban, or with a fibrinogen γ-chain peptide, results in the αIIbβ3 headpiece adopting an open conformation characterized by a swing-out motion of the β3 hybrid domain. In addition, all of the compounds bound both to the αIIb and β3 subunits, with the β3 contact mediated in part by coordinating the MIDAS metal ion. We recently reported on RUC-1, a novel αIIbβ3-specific small molecular antagonist that we predicted from molecular docking and biochemical data bound exclusively to αIIb. We have now determined the crystal structure of the αIIbβ3 headpiece in the absence of ligand and after soaking in RUC-1, and correlated the findings with advanced molecular dynamics simulations and functional studies of mutant receptors to define the mechanism of RUC-1 binding. The crystal structure shows that the αaIIbβ3 headpiece in the absence of RUC-1 or other ligand adopts a closed conformation with minimal β3 swing-out, similar to what we found in the full-length ectodomain of the bent receptor in the absence of ligand. Strikingly, RUC-1 only binds to the pocket formed by the αIIb β-propeller domain and has no contact with MIDAS metal ion or other sites in the β3 I domain. Standard molecular dynamics studies revealed a very similar binding pocket for RUC-1, which reflects the lowest energy binding state as assessed by metadynamics simulations. Both the crystal structure and the metadynamics studies identified αIIb Y190 and αIIb D232 as important for RUC-1 binding. RUC-1 is a much less potent inhibitor of mouse and rat αIIbβ3 than human αIIbβ; both mouse and rat have αIIb Y190F substitutions, and in addition, rat αIIb has a D232H substitution. A recombinant cell line expressing Y190F αIIbβ3 demonstrated an ∼80% reduction in RUC-1 affinity as judged by a 6-fold increase in IC50 for inhibiting fibrinogen binding and one expressing D232H αIIb β3 had more than a 95% decrease in affinity for RUC-1. To test whether RUC-1's exclusive binding to the αIIb subunit was associated with a reduced ability to induce a conformational change in αIIbβ3, we performed gel filtration and dynamic light scattering studies. In sharp contrast to the effects of eptifibatide and tirofiban, RUC-1 did not induce αIIbβ3 to adopt a less compact conformation in either system. These data suggest that ligand engagement of the β3 I domain, in particular coordinating the MIDAS metal ion and stabilizing the β1-α1 loop movement toward the MIDAS, is a likely trigger for β3 undergoing its swing-out motion. These data have potential therapeutic implications because they raise the possibility of inhibiting αIIbβ3 with an αIIb-specific antagonist that does not initiate the conformational changes in β3 that have been hypothesized to underlie the development of two major toxicities of αIIbβ3 antagonists, thrombocytopenia and paradoxical activation of the receptor. Disclosures: Filizola: Mount Sinai School of Medicine: Employment, Patents & Royalties. Coller:Rockefeller University: Employment, Patents & Royalties; Research Foundation of the State University of New York: Patents & Royalties; Centocor: Patents & Royalties; Accumetrics: Consultancy, Patents & Royalties.

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The objective of this paper was to compare 3 bovine AI protocols, evaluating the cost of each treatment and the pregnancy rates obtained, to demonstrate the importance of routine utilization of estrus synchronization techniques. The experiment was conducted in the Farm School of Cachoeiras de Macacu of the Federal Fluminense University, in the state of Rio de Janeiro, during the period from 2006 to 2007 (August to June). One hundred sixteen crossbred female Holstein-Zebu dairy cows in cycle, with body condition between 2.5 to 4 (on a scale from 1 to 5), were selected and divided randomly in 3 groups (G). Animals in G1 [n = 60; 21 heifers (H), 13 primiparous (P), and 26 multiparous (M)], with palpable corpus luteum, received 25 mg of prostaglandin F2 intravulvar, and AI was done 12 h after estrus detection. For animals in G2 (n = 30; 11 H, 6 P, and 13 M) an intravagin*l progesterone device (CIDR®, Pfizer Animal Health, New York, NY, USA) was inserted and 2 mg of estradiol benzoate (EB) was administered i.m. on Day 0. On Day 8 the device was removed and 25 mg of prostaglandin was administered i.m. on Day 9, 2 mg of EB was administered, and 30 h later, timed AI of all animals was performed. For G3 (n = 26; 9 H, 5 P, and 12 M), the protocol used was similar to that for G2, except that on Day 8 400 IU of eCG was administered (in addition to the removal of the device) and on Day 9 the dose of EB was reduced to 1 mg and timed AI was done 27 h later. AI was done with sem*n from 2 sires with proven fertility, by the same technician. The pregnancy diagnoses were done on Day 45 by palpation per rectum and transrectal ultrasonography. The cost-benefit relation was calculated according to the cost of pharmaceuticals multiplied by the number of animals in each experimental group divided by the number of pregnancies obtained in each one, without considering the manual labor costs in all the groups and considering 3 uses of the CIDR. The statistical analyses were done using chi-square test. The pregnancy rate obtained in G2 (60%, 18/30) was superior to that in G1 (30%, 18/60) (P < 0.05), demonstrating the efficiency of the treatment that utilized progesterone. G3 (53.85%, 14/26) was similar (P > 0.05) to G2, despite the fact that the eCG was added in this group. In reference to cost-benefit, considering only the pharmaceuticals costs and the value for pregnancy obtained in each group, the costs found, respectively, were G1 U$7.02 and U$23.66; G2 U$28.57 and U$47.59; and G3 U$47.96 and U$89.05. The lowest cost in the estrus synchronization was based on the use of prostaglandins alone; the use of progesterone increased the synchronization cost, but also increased the pregnancy rate and eliminated the need for estrus observation. The addition of eCG in cows that are cycling does not necessarily demand a increase in pregnancy rate. Failure in estrus detection, using prostaglandin alone, increased the interval from calving, causing a daily loss in milk production, which justified the investment in protocols of estrus and ovulation synchronization, contributing to increase the reproductive efficiency of a dairy cow herd.

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I was born and raised in the old mining town of Barrio DAS (Don Andres Soriano), Lutopan, Toledo City where Atlas Consolidated Mining and Development Corp. (ACMDC) is situated. Dad started his practice in the company’s hospital as an EENT specialist in the early 60’s and was the ‘go to’ EENT Doc not only of nearby towns or cities (including Cebu City) but also the surrounding provinces in the early 70’s. In my elementary years, he was Assistant Director of ACMDC Hospital (we lived just behind in company housing, only a 3-minute walk). I grew interested in what my dad did, sometimes staying in his clinic an hour or so after school, amazed at how efficiently he handled his patients who always felt so satisfied seeing him. At the end of the day, there was always ‘buyot’ (basket) of vegetables, live chickens, freshwater crabs, crayfish, catfish or tilapia. I wondered if he went marketing earlier, but knew he was too busy for that (and mom did that) until I noticed endless lines of patients outside and remembered when he would say: “Being a doctor here - you’ll never go hungry!” I later realized they were PFs (professional fees) of his patients. As a company doctor, Dad received a fixed salary, free housing, utilities, gasoline, schooling for kids and a company car. It was the perfect life! The company even sponsored his further training in Johns-Hopkins, Baltimore, USA. A family man, he loved us so much and was a bit of a joker too, especially at mealtimes. Dad’s daily routine was from 8 am – 5 pm and changed into his tennis, pelota, or badminton outfit. He was the athlete, winning trophies and medals in local sports matches. Dad wanted me to go to the University of the Philippines (UP) High School in the city. I thought a change of environment would be interesting, but I would miss my friends. Anyway, I complied and there I started to understand that my dad was not just an EENT practicing in the Mines but was teaching in Cebu Institute of Medicine and Cebu Doctors College of Medicine (CDCM) and was a consultant in most of the hospitals in Cebu City. And still he went back up to the mountains, back to Lutopan, our mining town where our home was. The old ACMDC hospital was replaced with a new state-of-the-art hospital now named ACMDC Medical Center, complete with Burn Unit, Trauma center and an observation deck in the OR for teaching interns from CDCM. Dad enjoyed teaching them. Most of them are consultants today who are so fond of my dad that they always send their regards when they see me. My dad loved making model airplanes, vehicles, etc. and I realized I had that skill when I was 8 years old and I made my first airplane model. He used to build them out of Balsa wood which is so skillful. I can’t be half the man he was but I realized this hobby enhanced his surgical skills. My dad was so diplomatic and just said to get an engineering course before you become a pilot (most of dads brothers are engineers). I actually gave engineering a go, but after 1 ½ years I realized I was not cut out for it. I actually loved Biology and anything dealing with life and with all the exposure to my dad’s clinic and hospital activities … med school it was! At this point, my dad was already President of the ORL Central Visayas Chapter and was head of ENT Products and Hearing Center. As a graduate of the UP College of Medicine who finished Otorhinolaryngology residency with an additional year in Ophthalmology as one of the last EENTs to finish in UP PGH in the late 50’s, he hinted that if I finished my medical schooling in CDCM that I consider Otorhinolaryngology as a residency program and that UP-PGH would be a good training center. I ended up inheriting the ORL practice of my dad mostly, who taught me some of Ophthalmology outpatient procedures. Dad showed me clinical and surgical techniques in ENT management especially how to deal with patients beyond being a doctor! You don’t learn this in books but from experience. I learned a lot from my dad. Just so lucky I guess! He actually designed and made his own ENT Treatment Unit, which I’m still using to this day (with some modifications of my own). And he created a certain electrically powered ‘eye magnet’ with the help of my cousin (who’s an engineer now in Chicago) which can attract metallic foreign bodies from within the eyeball to the surface so they can easily be picked out – it really works! Dad loved to travel in his younger years especially abroad for conventions or just simply leisure or vacations, most of the time with my mom. But as he was getting older, travels became uncomfortable. His last travel with me was in 2012 for the AAO-HNS Convention in Washington DC. It was a great time as we then proceeded to a US Navy Airshow in nearby Virginia after the convention, meeting up with my brother who is retired from the USN. Then we took the train to New York and stayed with my sister who is a PICU nurse in NY Presbyterian. Then off to Missouri and Ohio visiting the National Museum of the US Air Force, the largest military aircraft museum in the world. For years, Dad had been battling with heredofamilial-hypercholesterolemia problem which took its toll on his liver and made him weak and tired but still he practiced and continued teaching and sharing his knowledge until he retired at the age of 80. By then, my wife and I would take him and my mom out on weekends, he loved to be driven around and eat in different places. I really witnessed and have seen how he suffered from his illness in his final years. But he never showed it or complained, never even wanted to use a cane! He didn’t want to be a burden to anyone. What most affected me was that my dad passed and I wasn’t even there. I had helped call for a physician to rush to the house and had oxygen cylinders to be brought for him as his end stage liver cirrhosis was causing cardio-pulmonary complications (non-COVID). Amidst all this I was the one admitted for 14 days because of COVID-19 pneumonia. My dad passed away peacefully at home as I was being discharged from the hospital. He was 88. I never reached him just to say good bye and cried when I reached home still dyspneic recovering from the viral pneumonia. I realized from my loved ones who told me that dad didn’t want me to stress out taking care of him, as I’ve been doing ever since, but instead to rest and recuperate myself. I cried again with that thought. In my view, he was not only a great Physician and Surgeon but also the greatest Dad. He lived a full life and touched so many lives with his treatments, charity services and teaching new physicians. It’s seeing, remembering and carrying on what he showed and taught us that really makes us miss him. I really love and miss my dad and with a smile on my face, I see he’s also happy to be with his brothers and sisters who passed on ahead. And that he’s rested. He is a man content, I remember he always said this, ‘ As long as I have a roof over my head and a bed to rest my back, I’m okay!”

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OBJECTIVES/SPECIFIC AIMS: Translational researchers often require the use of informatics methods in their work. Lack of an understanding of key informatics principles and methods limits the abilities of translational researchers to successfully implement Findable, Accessible, Interoperable, Reusable (FAIR) principles in grant proposal submissions and performed studies. In this study we describe our work in addressing this limitation in the workforce by developing a competency-based, modular course in informatics to meet the needs of diverse translational researchers. METHODS/STUDY POPULATION: We established a Translational Research Informatics Education Collaborative (TRIEC) consisting of faculty at the University of Utah (UU) with different primary expertise in informatics methods, and working in different tiers of the translational spectrum. The TRIEC, in collaboration with the Foundation of Workforce Development of the Utah Center for Clinical and Translational Science (CCTS), gathered informatics needs of early investigators by consolidating requests for informatics services, assistance provided in grant writing, and consultations. We then reviewed existing courses and literature for informatics courses that focused on clinical and translational researchers [3–9]. Using the structure and content of the identified courses, we developed an initial draft of a syllabus for a Translational Research Informatics (TRI) course which included key informatics topics to be covered and learning activities, and iteratively refined it through discussions. The course was approved by the UU Department of Biomedical Informatics, UU Graduate School and the CCTS. RESULTS/ANTICIPATED RESULTS: The TRI course introduces informatics PhD students, clinicians, and public health practitioners who have a demonstrated interest in research, to fundamental principles and tools of informatics. At the completion of the course, students will be able to describe and identify informatics tools and methods relevant to translational research and demonstrate inter-professional collaboration in the development of a research proposal addressing a relevant translational science question that utilizes the state-of-the-art in informatics. TRI covers a diverse set of informatics content presented as modules: genomics and bioinformatics, electronic health records, exposomics, microbiomics, molecular methods, data integration and fusion, metadata management, semantics, software architectures, mobile computing, sensors, recruitment, community engagement, secure computing environments, data mining, machine learning, deep learning, artificial intelligence and data science, open source informatics tools and platforms, research reproducibility, and uncertainty quantification. The teaching methods for TRI include (1) modular didactic learning consisting of presentations and readings and face-to-face discussions of the content, (2) student presentations of informatics literature relevant to their final project, and (3) a final project consisting of the development, critique and chalk talk and formal presentations of informatics methods and/or aims of an National Institutes of Health style K or R grant proposal. For (3), the student presents their translational research proposal concept at the beginning of the course, and works with members of the TRIEC with corresponding expertise. The final course grade is a combination of the final project, paper presentations and class participation. We offered TRI to a first cohort of students in the Fall semester of 2018. DISCUSSION/SIGNIFICANCE OF IMPACT: Translational research informatics is a sub-domain of biomedical informatics that applies and develops informatics theory and methods for translational research. TRI covers a diverse set of informatics topics that are applicable across the translational spectrum. It covers both didactic material and hands-on experience in using the material in grant proposals and research studies. TRI’s course content, teaching methodology and learning activities enable students to initially learn factual informatics knowledge and skills for translational research correspond to the ‘Remember, Understand, and Apply’ levels of the Bloom’s taxonomy [10]. The final project provides opportunity for applying these informatics concepts corresponding to the ‘Analyze, Evaluate, and Create’ levels of the Bloom’s taxonomy [10]. This inter-professional, competency-based, modular course will develop an informatics-enabled workforce trained in using state-of-the-art informatics solutions, increasing the effectiveness of translational science and precision medicine, and promoting FAIR principles in research data management and processes. Future work includes opening the course to all Clinical and Translational Science Award hubs and publishing the course material as a reference book. While student evaluations for the first cohort will be available end of the semester, true evaluation of TRI will be the number of trainees taking the course and successful grant proposal submissions. References: 1. Wilkinson MD, Dumontier M, et al. The FAIR Guiding Principles for scientific data management and stewardship. Sci Data. 2016 Mar 15. 2. National Center for Advancing Translational Sciences. Translational Science Spectrum. National Center for Advancing Translational Sciences. 2015 [cited 2018 Nov 15]. Available from: https://ncats.nih.gov/translation/spectrum 3. Hu H, Mural RJ, Liebman MN. Biomedical Informatics in Translational Research. 1 edition. Boston: Artech House; 2008. 264 p. 4. Payne PRO, Embi PJ, Niland J. Foundational biomedical informatics research in the clinical and translational science era: a call to action. J Am Med Inform Assoc JAMIA. 2010;17(6):615–6. 5. Payne PRO, Embi PJ, editors. Translational Informatics: Realizing the Promise of Knowledge-Driven Healthcare. Softcover reprint of the original 1st ed. 2015 edition. Springer; 2016. 196 p. 6. Richesson R, Andrews J, editors. Clinical Research Informatics. 2nd ed. Springer International Publishing; 2019. (Health Informatics). 7. Robertson D, MD GHW, editors. Clinical and Translational Science: Principles of Human Research. 2 edition. Amsterdam: Academic Press; 2017. 808 p. 8. Shen B, Tang H, Jiang X, editors. Translational Biomedical Informatics: A Precision Medicine Perspective. Softcover reprint of the original 1st ed. 2016 edition. S.l.: Springer; 2018. 340 p. 9. Valenta AL, Meagher EA, Tachinardi U, Starren J. Core informatics competencies for clinical and translational scientists: what do our customers and collaborators need to know? J Am Med Inform Assoc. 2016 Jul 1;23(4):835–9. 10. Anderson LW, Krathwohl DR, Airasian PW, Cruikshank KA, Mayer RE, Pintrich PR, Raths J, Wittrock MC. A Taxonomy for Learning, Teaching, and Assessing: A Revision of Bloom’s Taxonomy of Educational Objectives, Abridged Edition. 1 edition. New York: Pearson; 2000.

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Abstract This article studies a faculty exchange from the medical school at the University of Buffalo (later the State University of New York, University at Buffalo) to the medical school in Asunción, Paraguay in the 1950s and 1960s. The arrival of U.S.-trained medical professionals spurred a new pedagogical program designed to improve medical education by reducing the number of students enrolled, making the curriculum more scientifically oriented, and demanding the professionalization of its future doctors. Moreover, the program was strategically designed to depoliticize the medical school in Asunción at the height of the Cold War. Using oral interviews of Paraguayans who participated in the reforms, government records, and documents produced by U.S. medical professionals, the article tracks how the program was started and under what conditions it operated, and concludes that both the United States and Paraguayan medical professionals considered the program a success—it improved the quality of Paraguayan medical professionals and, at least temporarily, neutralized the political leanings of the medical school.

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ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Journal of Cell Science, helping early-career researchers promote themselves alongside their papers. Joseph A. Brazzo III is first author on ‘ Mechanosensitive expression of lamellipodin promotes intracellular stiffness, cyclin expression and cell proliferation’, published in JCS. Joseph is an MD–PhD student in the lab of Yongho Bae at the Jacobs School of Medicine and Biomedical Sciences, State University of New York University at Buffalo, NY, USA, investigating how extracellular matrix stiffness affects cell functions and behaviors, and dissecting the cellular pathways and molecular mechanisms that mediate mechanotransduction in health and disease.

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<p>La Academia Panameña de Medicina y Cirugía, se siente honrada, en resaltar la figura de uno de sus miembros distinguidos, el Académico Titular José Manuel Fábrega Sosa, MD, FACS, FSSO, APMC. Este distinguido cirujano, panameño, hizo sus estudios profesionales en la Universidad de Notre Dame, Notre Dame, Indiana donde se graduó con honores siendo miembro de la Sociedad de honor AlphaEpsilonDelta. Continuó sus estudios de medicina en la George Washington University School of Medicine, Washington, DC., donde obtuvo el grado de Medicina, graduándose también con honores siendo nombrado en la Sociedad de Honor de Medicina de los Estados Unidos, AlphaOmegaAlpha. Hizo su residencia en cirugía en el New York Hospital Cornell Medical Center y en Oncología Quirúrgica en el Memorial Sloan Kettering Cancer Center de Nueva York. Ha sido Certificado y Recertificado por el American Board of Surgery. Fellow y ExGobernador del American College of Surgeons y Ex Presidente del Capítulo de Panamá del American College of Surgeons. Además de Fellow de la Society of Surgical Oncology. A nivel local, entre otros es Ex Presidente de la Academia Panameña de Medicina y Cirugía. Y Profesor Extraordinario de Cirugía, de la Facultad de Medicina, de la Universidad de Panamá. Presidente y miembro fundador de la Asociación Panameña de Cirugía Oncológica (APCO). Aparte de tener licencia en la República de Panamá, tiene licencia del estado de California y de Washington DC en los Estados Unidos. Recientemente, ha sido merecedor a un reconocimiento, reservado para pocos cirujanos destacados, en el mundo, ser reconocido como Honorary Fellow del American College of Surgeons (Colegio Americano de Cirujanos), luego de 43 años de brindar sus conocimientos para el cuidado y bienestar de sus pacientes. Cabe destacar que al presente Solo hay 487 cirujanos en el mundo entero que han recibido tal distinción. El Colegio Americano de Cirujanos otorga este honor cada año, a cuatro o cinco candidatos que han prestado servicios humanitarios, especialmente en el campo de la ciencia médica. Es el tercer panameño en recibir este reconocimiento; el primero en ser distinguido fue el doctor Augusto S. Boyd, en 1923; luego el neurólogo Antonio González Revilla, en 1973. La universidad de Cornell, de donde egresó, lo declaró exalumno meritorio y es el único egresado en recibir esa distinción. En Panamá; la Asamblea Nacional lo reconoció como ciudadano ejemplar y meritorio y el presidente de la república lo condecoró con la Orden Manuel Amador Guerrero en el “Grado de Gran Cruz”. Honrar, honra, y la Academia Panameña de Medicina y Cirugía, y La Revista Médica de Panamá, se enorgullecen de presentar a este ilustre panameño y latinoamericano.</p><p>ABSTRACT</p><p>The Panamanian Academy of Medicine and Surgery is honored to highlight the figure of one of its distinguished members, the Tenured Academician José Manuel Fábrega Sosa, MD, FACS, FSSO, APMC. This distinguished Panamanian surgeon did his professional studies at the University of Notre Dame, Notre Dame, Indiana where he graduated with honors as a member of the AlphaEpsilonDelta Honor Society. He continued his medical studies at the George Washington University School of Medicine, Washington, DC., Where he obtained a degree in Medicine, also graduating with honors and being named in the American Honor Society of Medicine, AlphaOmegaAlpha. He did his residency in surgery at New York Hospital Cornell Medical Center and in Surgical Oncology at Memorial Sloan Kettering Cancer Center in New York. He has been Certified and Recertified by the American Board of Surgery. Fellow and Former Governor of the American College of Surgeons and Former President of the Panama Chapter of the American College of Surgeons. In addition to Fellow of the Society of Surgical Oncology. At the local level, among others, he is Former President of the Panamanian Academy of Medicine and Surgery. And Extraordinary Professor of Surgery, Faculty of Medicine, University of Panama.</p><p>President and founding member of the Panamanian Association of Oncological Surgery (APCO). Apart from being licensed in the Republic of Panama, it is licensed by the state of California and Washington DC in the United States. Recently, he has been worthy of a recognition, reserved for few outstanding surgeons, in the world, being recognized as Honorary Fellow of the American College of Surgeons (American College of Surgeons), after 43 years of providing his knowledge for the care and well-being of your patients. It should be noted that there are currently only 487 surgeons worldwide who have received such a distinction. The American College of Surgeons awards this honor each year to four or five candidates who have provided humanitarian services, especially in the field of medical science. He is the third Panamanian to receive this recognition; the first to be distinguished was Dr. Augusto S. Boyd, in 1923, then the neurologist Antonio González Revilla, in 1973. Cornell University, where he graduated, declared him a meritorious alumnus and is the only graduate to receive that distinction. In Panama, the National Assembly recognized him as an exemplary and meritorious citizen and the President of the Republic decorated him with the Manuel Amador Guerrero Order in the “Grand Cross Degree”. Honor, honor, and the Panamanian Academy of Medicine and Surgery, and La Revista Médica de Panama, are proud to present this illustrious Panamanian and Latin American.</p>

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“Live free or die!” (New Hampshire State motto) Should individuals be free to make lifestyle decisions (such as what, when and how much to eat and how much physical activity to take), without undue interference from the state, even when their decisions may lead to negative consequences (obesity, heart disease, diabetes)? The UN Declaration of Human Rights enshrines the belief that “All human beings are born free and equal in dignity and rights”. The philosophy of Libertarianism (Locke) proposes that rights can be negative (e.g. the freedom to be free from outside interference) as well as positive (e.g. the right to certain benefits supplied by others). Robert Nozick, a proponent of Libertarianism, has argued that we have the right to make informed decisions about our lives without unnecessary interference. This entitlement requires that we exercise our rights only as far as they do not infringe the rights of others. The popular notion of the “Nanny State” (often used derogatively) is discussed, and the metaphor is extended to draw on the Super Nanny phenomenon, a reality television series that has been shown in numerous countries including the UK, the US, and Australia. It is argued in this paper that social marketing, when done well, can help create a “Super Nanny State” (implying positive connotations). In the “Nanny State” people are told what to do; in the “Super Nanny State” people are empowered to make healthier decisions. Social marketing applies commercial marketing principles to “sell” ideas (rather than goods or services) with the aim of improving the welfare of individuals and/or society. Where the common good may not be easily discerned, Donovan and Henley recommended using the UN Declaration of Human Rights as the baseline reference point. Social marketing is frequently used to persuade individuals to make healthier lifestyle decisions such as “eat less [saturated] fat”, “eat two fruits and five veg a day”, “find thirty minutes of physical activity a day”. Recent medical gains in immunisation, sanitation and treating infectious diseases mean that the health of a population can now be more improved by influencing lifestyle decisions than by treating illness (Rothschild). Social marketing activities worldwide are directed at influencing lifestyle decisions to prevent or minimise lifestyle diseases. “Globesity” is the new epidemic (Kline). Approximately one billion people globally are overweight or obese (compared to 850 million who are underweight); most worryingly, about 10% of children worldwide are now overweight or obese with rising incidence of type 2 diabetes in this population (Yach, Stuckler, and Brownwell). “Nanny state” is a term people often use derogatively to refer to government intervention (see Henley and Jackson). Knag (405) made a distinction between old-style, authoritarian “paternalism”, which chastised the individual using laws and sanctions, and a newer “maternalism” or “nanny state” which smothers the individual with “education and therapy (or rather, propaganda and regulation)”. Knag’s use of the term “Nanny State” still has pejorative connotations. In the “Nanny State”, governments are seen as using the tool of social marketing to tell people what they should and shouldn’t do, as if they were children being supervised by a nanny. At the extreme, people may be afraid that social marketing could be used by the State as a way to control the thoughts of the vulnerable, a view expressed some years ago by participants in a survey of attitudes towards social marketing (Laczniak, Lusch, and Murphy). More recently, the debate is more likely to focus on why social marketing often appears to be ineffective, rather than frighteningly effective (Hastings, Stead, and Macintosh). Another concern is the high level of fear being generated by much of the social marketing effort (Hastings and MacFadyen; Henley). It is as if nanny thinks she must scream at her children all the time to warn them that they will die if they don’t listen to her. However, by extension, I am suggesting that the “Super Nanny State” metaphor could have positive associations, with an authoritative (rather than authoritarian) parenting figure, one who explains appropriate sanctions (laws and regulations) but who is also capable of informing, inspiring and empowering. Still, the Libertarian ethical viewpoint would question whether governments, through social marketers, have the right to try to influence people’s lifestyle decisions such as what and how much to eat, how much to exercise, etc. In the rise of the “Nanny State”, Holt argued that governments are extending the range of their regulatory powers, restricting free markets and intruding into areas of personal responsibility, all under the guise of acting for the public’s good. A number of arguments, discussed below, can be proposed to justify interference by the State in the lifestyle decisions of individuals. The Economic Argument One argument that is often quoted to justify interference by the State is that the economic costs of allowing unsafe/unhealthy behaviours have to be borne by the community. It has been estimated in the US that medical costs relating to diabetes (which is associated directly with obesity) increased from $44 billion to $92 billion in five years (Yach, et al). The economic argument can be useful for persuading governments to invest in prevention but is not sufficient as a fundamental justification for interference. If we say that we want people to eat more healthily because their health costs will be burdensome to the community, we imply that we would not ask them to do so if their health costs were not burdensome, even if they were dying prematurely as a result. The studies relating to the economic costs of obesity have not been as extensive as those relating to the economic costs of tobacco (Yach, et al), where some have argued that prematurely dying of smoking-related diseases is less costly to the State than the costs incurred in living to old age (Barendregt, et al). This conclusion has been disputed (Rasmussen et al), but even if true, would not provide sufficient justification to cease tobacco control efforts. Similarly, I think people would expect social marketing efforts relating to nutrition and physical activity to continue even if an economic analysis showed that people dying prematurely from obesity-related illnesses were costing the State less overall in health care costs than people living an additional twenty years. The Consumer Protection Argument Some degree of interference by the State is desirable and often necessary because people are not entirely self-reliant in every circ*mstance (Mead). The social determinants of health (Marmot and Wilkinson) are sufficiently well-understood to justify government regulation to reduce inequalities in housing, education, access to health services, etc. Implicit in the criticism that the “Nanny State” treats people like children is the assumption that children are treated without dignity and respect. The positive parent or “Super Nanny” treats children with respect but recognises their vulnerability in unfamiliar or dangerous contexts. A survey of opinion in the UK in 2004 by the King’s Fund, an independent think tank, found that the public generally supported government initiatives to encourage healthier school meals; ensure cheaper fruit and vegetables; pass laws to limit salt, fat and sugar in foods; stop advertising junk foods for children and regulate for nutrition labels on food (UK public wants a “Nanny State”). The UK’s recently established National Social Marketing Centre has made recommendations for social marketing strategies to improve public health and Prime Minister Tony Blair has responded by making public health, especially the growing obesity problem, a central issue for government initiatives, offering a “helping hand” approach (Triggle). The Better Alternative Argument Wikler considered the case for more punitive government intervention in the obesity debate by weighing the pros and cons of an interesting strategy: the introduction of a “fat tax” that would require citizens to be weighed and, if found to be overweight, require them to pay a surcharge. He concluded that this level of state interference would not be justified because there are other ways to appeal to the risk-taker’s autonomy, through education and therapeutic efforts. Governments can use social marketing as one of these better alternatives to punitive sanctions. The Level Playing Field Argument Social marketers argue that many lifestyle behaviours are not entirely voluntary (O’Connell and Price). For example, it is argued that an individual’s choices about eating fast food, consuming sweetened soft drinks, and living sedentary lives have already been partially determined by commercial efforts. Thus, they argue that social marketing efforts are intended to level the playing field – educate, inform, and restore true personal autonomy to people, enabling them to make rational choices (Smith). For example, Kline’s media education program in Canada, with a component of “media risk reduction”, successfully educated young consumers (elementary school children) with strategies for “tuning out” by asking them to come up with a plan for what they would do if they “turned off TV, video games and PCs for a whole week?” (p. 249). The “tune out challenge” resulted in a reduction of media exposure (80%) displaced into active leisure pursuits. A critical aspect of this intervention was the contract drawn up in advance, with the children setting their own goals and strategies (Kline). In this view, the state is justified in trying to level the playing field, by using social marketing to offer information as well as alternative, healthier choices that can be freely accepted or rejected (Rothschild). Conclusion A real concern is that when people are treated like children, they become like children, retaining their desires and appetites but abdicating responsibility for their individual choices to the state (Knag). Some smokers, for example, declare that they will continue to smoke until the government bans smoking (Brown). Governments and social marketers have a responsibility to fund/design campaigns so that the audience views the message as informative rather than proscriptive. Joffe and Mindell (967) advocated the notion of a “canny state” with “less reliance on telling people what to do and more emphasis on making healthy choices easier”. Finally, one of the central tenets of marketing is the concept of “exchange” – the marketer must identify the benefits to be gained from buying a product. In social marketing terms, interference in an individual’s right to act freely can be effective and justified when the benefits are clearly identifiable and credible. Rothschild described marketing’s role as providing a middle point between libertarianism and paternalism, offering free choice and incentives to behave in ways that benefit the common good. Rather than shaking a finger at the individual (along the lines of earlier “Don’t Do Drugs” campaigns), the “Super Nanny” state, via social marketing, can inform and engage individuals in ways that make healthier choices more appealing and the individual feel more empowered to choose them. References Barendregt, J.J., L. Bonneux, O.J. van der Maas. “The Health Care Costs of Smoking.” New England Journal of Medicine 337.15 (1997): 1052-7. Brown, D. Depressed Men: Angry Women: Non-Stereotypical Gender Responses to Anti-Smoking Messages in Older Smokers. Unpublished Masters dissertation, Edith Cowan University, Perth, Western Australia, 2001. Donovan, R., and N. Henley. Social Marketing: Principles and Practice. Melbourne: IP Communications, 2003. Joffe, M., and J. Mindell. “A Tentative Step towards Healthy Public Policy.” Journal of Epidemiology and Community Health 58 (2004): 966-8. Hastings, G.B., and L. MacFadyen. “The Limitations of Fear Messages.” Tobacco Control 11 (2002): 73-5. Hastings, G.B., M. Stead, and A.M. Macintosh. “Rethinking Drugs Prevention: Radical Thoughts from Social Marketing.” Health Education Journal 61.4 (2002): 347-64. Henley, N. “You Will Die! Mass Media Invocations of Existential Dread.” M/C Journal 5.1 (2002). 1 May 2006 http://journal.media-culture.org.au/0203/youwilldie.php>. Henley, N., and J. Jackson. “Is It ‘Too Bloody Late’? Older People’s Response to the National Physical Activity Guidelines.” Journal of Research for Consumers 10 (2006). 7 Aug. 2006 <http://www.jrconsumers.com/_data/page/3180/ NPAGs_paper_consumer_version_may_06.pdf>. Holt, T. The Rise of the Nanny State: How Consumer Advocates Try to Run Our Lives. US: Capital Research Centre, 1995. Kline, S. “Countering Children’s Sedentary Lifestyles: An Evaluative Study of a Media-Risk Education Approach.” Childhood 12.2 (2005): 239-58. Knag, S. “The Almighty, Impotent State: Or, the Crisis of Authority.” Independent Review 1.3 (1997): 397-413. Laczniak, G.R., R.F. Lusch, and P. Murphy. “Social Marketing: Its Ethical Dimensions.” Journal of Marketing 43 (Spring 1979): 29-36. Locke, J. An Essay Concerning Human Understanding. Ed. J.W. Yolton. London: J.M. Dent & Sons, 1690/1961. Marmot, M.G., and R.G. Wilkinson, R.G., eds. Social Determinants of Health. Oxford: Oxford University Press, 1999. Mead, L. “Telling the Poor What to Do.” Public Interest 6 Jan. 1998. 1 May 2006 <http://www.polisci.wisc.edu/~soss/Courses/PA974/Readings/week%208/Mead_1998.pdf>. National Social Marketing Centre. It’s Our Health! Realising the Potential of Effective Social Marketing. Summary Report. 7 Aug. 2006 http://www.nsms.org.uk/images/CoreFiles/NCCSUMMARYItsOurHealthJune2006.pdf>. Nozick, R. Anarchy, State and Utopia. New York: Basic Books, 1974. O’Connell, J.K., and J.H. Price. “Ethical Theories for Promoting Health through Behavioral Change.” Journal of School Health 53.8 (1983): 476-9. Rasmussen, S.R., E. Prescott, T.I.A. Sorensen, and J. Sogaard. “The Total Lifetime Costs of Smoking”. European Journal of Public Health 14 (2004): 95-100. Rothschild, M. “Carrots, Sticks, and Promises: A Conceptual Framework for the Management of Public Health and Social Issue Behaviors.” Journal of Marketing 63.4 (1999): 24-37. Smith, A. “Setting a Strategy for Health.” British Medical Journal 304.6823 (8 Feb. 1992): 376-9. Triggle, N. “From Nanny State to a Helping Hand”. BBC News 25 July 2006. 9 Aug. 2006 http://news.bbc.co.uk/1/hi/health/5214276.stm>. “UK Public Wants a ‘Nanny State’”. BBC News 28 June 2004. 9 Aug. 2006 http://news.bbc.co.uk/1/hi/health/3839447.stm>. United Nations, Office of the High Commissioner of Human Rights. Universal Declaration of Human Rights. 18 Sep. 2001 http://www.unhchr.ch/udhr/lang/eng.htm>. Wikler, D. “Persuasion and Coercion for Health: Ethical Issues in Government Efforts to Change Life-Styles.” Millbank Memorial Fund Quarterly, Health and Society 56.3 (1978): 303-38. Yach, D., D. Stuckler, and K.D. Brownwell. “Epidemiological and Economic Consequences of the Global Epidemics of Obesity and Diabetes.” Nature Medicine 12.1 (2006): 62-6. Citation reference for this article MLA Style Henley, Nadine. "Free to Be Obese in a ‘Super Nanny State’?." M/C Journal 9.4 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0609/6-henley.php>. APA Style Henley, N. (Sep. 2006) "Free to Be Obese in a ‘Super Nanny State’?," M/C Journal, 9(4). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0609/6-henley.php>.

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RECIPIENTS of The Endocrine Society’s Laureate Awards are selected annually by the Awards Committee. The Laureate Awards are presented to endocrinologists, members or nonmembers, from anywhere in the world. Each recipient is presented with an award certificate and is honored at the Society’s annual Awards Dinner in June. Nominations may be submitted by Society members only. A complete listing of all past awardees is available on the Society’s web site, www.endo-society.org. Nominations must be submitted by early April on the appropriate nomination form. The nomination form may be obtained by visiting the Society web site or by contacting The Endocrine Society. Fred Conrad Koch Award In 1957 a substantial legacy was bequeathed to the Society by the late Elizabeth Koch for the purpose of establishing the Fred Conrad Koch Memorial Fund in memory of her late husband, Distinguished Service Professor of Physiological Chemistry at the University of Chicago, and pioneer in the isolation of the androgens. This is the highest honor of the Society and is presented with the Koch Medal of The Endocrine Society, as well as a $25,000 honorarium. The award is given annually for exceptional contributions to endocrinology. The recipients of this award for the past ten years were: Ronald M. Evans and Michael G. Rosenfeld, 1999; C. Ronald Kahn, 2000; Robert J. Lefkowitz, 2001; Jan-Åke Gustafsson, 2002; Maria I. New, 2003; Patricia K. Donahoe, 2004; William F. Crowley, Jr., 2005; Gerald M. Reaven, 2006; John D. Baxter, 2007; and P. Reed Larsen, 2008. Ernst Oppenheimer Memorial Award The Ernst Oppenheimer Memorial Award was first presented by The Endocrine Society in 1944 and is the premier award to a young investigator in recognition of meritorious accomplishments in the field of basic or clinical endocrinology. The recipient must not have reached age 45 by July 1 of the year in which the award is presented. The award includes a $3,000 honorarium. The recipients of this award for the past five years were: Ursula B. Kaiser, 2004; Steven A. Kliewer, 2005; Charis Eng, 2006; Rohit N. Kulkarni, 2007; and Joel K. Elmquist and Randy J. Seeley, 2008. Robert H. Williams Distinguished Leadership Award The Robert H. Williams Distinguished Leadership Award was established by Dr. Robert H. Williams in 1970. The award is presented annually in recognition of outstanding leadership in endocrinology as exemplified by the recipient’s contributions and those of his/her trainees and associates to teaching, research, and administration. Distinguished leadership in endocrinology and metabolism may be manifest in a variety of ways and activities (international, national, and local). This award includes a $5,000 honorarium. The recipients of this award for the past five years were: David M. de Kretser, 2004; Gordon H. Williams, 2005; Richard J. Santen, 2006; Lewis E. Braverman, 2007; and Ron G. Rosenfeld, 2008. Edwin B. Astwood Award Lecture The Edwin B. Astwood Award Lecture is awarded for outstanding research in endocrinology. The recipient presents a plenary lecture at the annual meeting to honor the late Dr. Edwin B. Astwood of Boston. The award includes a $2,000 honorarium. The recipients of this award for the past five years were: Paolo Sassone-Corsi, 2004; Willa A. Hsueh, 2005; Mitchell A. Lazar, 2006; Lawrence C. Chan, 2007; and John A. Cidlowski, 2008. Clinical Investigator Award Lecture The Clinical Investigator Award Lecture is presented to an internationally recognized clinical investigator who has made major contributions to clinical research related to the pathogenesis, pathophysiology, and therapy of endocrine disease. The recipient presents a plenary lecture at the annual meeting and receives a $3,500 honorarium. The recipients of this award for the past five years were: Shlomo Melmed, 2004; Paul M. Stewart, 2005; Walter L. Miller, 2006; Stephen O’Rahilly, 2007; and John C. Marshall, 2008. Gerald D. Aurbach Award Lecture This award was first presented in 1993 in honor of the late Dr. Gerald D. Aurbach, who served as president of The Endocrine Society from 1989–1990. This award is presented for outstanding contributions to research in endocrinology. Dr. Aurbach received his B.A. and M.D. from the University of Virginia. After his training in endocrinology at Tufts University School of Medicine, he joined the Public Health Service and the National Institutes of Health in 1959 and had served as chief of the Metabolic Disease Branch, National Institute of Diabetes, Digestive and Kidney Diseases since 1973. He was the first to isolate PTH and played a key role in discovering the hormone’s biochemical mechanism of action in bone disease and calcium metabolism. The recipient presents a plenary lecture at the annual meeting and receives an honorarium of $1,000. The recipients of this award for the past five years were: David J. Mangelsdorf, 2004; David R. Clemmons, 2005; Paul A. Kelly, 2006; Eve Van Cauter, 2007; and Andrew F. Stewart, 2008. Sidney H. Ingbar Distinguished Service Award The Sidney H. Ingbar Distinguished Service Award is named in honor of the 65th President of The Endocrine Society and presented in recognition of distinguished service in the field of endocrinology. The award includes a $2,000 honorarium. The recipients of this award for the past five years were: Margaret A. Shupnik, 2004; P. Michael Conn, 2005; Robert D. Utiger, 2006; Robert A. Vigersky, 2007; and Lisa H. Fish, 2008. Roy O. Greep Award Lecture This award was first presented in 1999 in memory of Dr. Roy O. Greep, President of The Endocrine Society in 1965–1966, Editor-in-Chief of Endocrinology, and President of the Laurentian Hormone Conference. He retired in 1974 as director emeritus of the Laboratory of Human Reproductive Biology at Harvard’s Medical School and as the John Rock Professor Emeritus of Population Studies at Harvard’s School of Public Health. Dr. Greep received international recognition as a pioneer in the field of endocrinology, receiving the Society’s highest honor, the Fred Conrad Koch Award, in 1971. Dr. Greep will be remembered by his colleagues as a remarkable investigator, a loyal friend, and a patient and devoted teacher. The recipient of this award presents a plenary lecture at the annual meeting and receives a $1,000 honorarium. The recipients of this award for the past five years were: Phyllis M. Wise, 2004; Evan R. Simpson, 2005; Benita S. Katzenellenbogen and John Katzenellenbogen, 2006; Sally A. Camper, 2007; and Nancy Lynn Weigel, 2008. Distinguished Educator Award This award was established by the Society in 1998 to recognize exceptional achievement of educators in the field of endocrinology and metabolism. The award includes an honorarium of $3,000. The recipients of this award for the past five years were: E. Brad Thompson, 2004; Ernest L. Mazzaferri, 2005; Gilbert H. Daniels, 2006; Kenneth L. Becker, 2007; and Ronald S. Swerdloff, 2008. Distinguished Physician Award The Distinguished Physician Award was established by the Society in 1998 to honor physicians who have made outstanding contributions to the practice of endocrinology. The award includes an honorarium of $3,000. The recipients of this award for the past five years were: Edward S. Horton, 2004; Robert M. Carey, 2005; Glenn D. Braunstein, 2006; Bernardo L. Wajchenberg, 2007; and F. John Service, 2008. Richard E. Weitzman Memorial Award This award was established in 1982 to honor outstanding research achievements in the field of endocrinology and metabolism by a young investigator. The award was established in memory of the late Dr. Richard E. Weitzman. Born in 1943, Dr. Weitzman was educated at Cornell University and the State University of New York Upstate Medical Center (Syracuse). He received training in endocrinology at the University of Virginia and the Harbor-UCLA School of Medicine, rising to the rank of Associate Professor, and began a productive career studying neurohypophyseal hormone and cardiovascular-endocrine physiology. In honor of Dr. Weitzman, an anonymous donor has provided funds for an annual award of $1,000 to be given to an exceptionally promising young investigator who has not reached the age of 40 before July 1 of the year in which the award is presented. The award is based on the contributions and achievements of the nominee’s independent scholarship performed after completion of training and shall be based on the entire body of these contributions, rather than a single work. The recipients of this award for the past five years were: Tso-Pang Yao, 2004; Peter Tontonoz, 2005; Fabio Broglio, 2006; W. Lee Kraus, 2007; and Tannishtha Reya, 2008. The Endocrine Society and Pfizer, Inc. International Award for Excellence in Published Clinical Research in The Journal of Clinical Endocrinology & Metabolism In 1998, “The Endocrine Society and Pfizer, Inc. International Award for Excellence in Published Clinical Research in The Journal of Clinical Endocrinology & Metabolism (JCE&M)” was established to encourage, recognize, and reward excellence in clinical research published in JCE&M. There are no restrictions with respect to professional affiliation or geographic location. Each year, a jury selects the four best clinical research papers published in JCE&M in a volume year. Each finalist paper receives a $10,000 award. In addition to the monetary prize, the award includes coach airline travel, meeting registration, hotel for one night, and one day’s per diem for one author on each paper to attend the Society’s annual meeting in June. The announcement of the winners is made in April each year with the awards presented at The Endocrine Society annual meeting in June. Papers accepted for publication but not yet published are not eligible until the year that they are actually published.

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Abstract:

Introduction Discourses of queer youth suicide regularly represent non-heterosexual young men as vulnerable and as victims who are inherently without strategies for coping with adversity (qv. Rasmussen; Marshall; Driver 3). Alternatively, queer youth are sometimes marked as fundamentally resilient, as avid users of tools of resilience and community such as the internet (Smith & Gray 74; Wexler et al. 566; Hillier & Harrison; Bryson & McIntosh). In the latter approach, protective factors are typically presented as specific to queer youth (e.g., Russell 10), therefore also minoritising and essentialising resilience. Both approaches ignore the diversity of queer young lives and the capacity for a subject to be both vulnerable and resilient—concepts which need to be unpacked if we are to further our understanding of minority lives. Significantly, both approaches also ignore the fact that growing up occurs in a series of transitions, cultural encounters and circ*mstantial changes. Queer (LGBT) youth are neither all victims and vulnerable, nor are they all self-reliant and resilient. Recent research has indicated that non-heterosexual youth continue to have a higher rate of suicide and self-harm (Cover, Queer Youth Suicide), although this is by no means indicative that vast numbers of LGBTI require support, intervention or preventative measures throughout all aspects of the transition into adult life. This article has two objectives, both of which are best addressed together in order to come at an understanding as how best to frame approaches to queer youth suicide as an ongoing social concern. Firstly, to ask what human, psychological and subjective ‘resilience’ might be said to mean in the context of public discourses of queer youth suicidality, and secondly to ask what a concept of ‘resilience’ does for queer youth identity in terms of relationality. Neither objective, of course, can be met alone in a short article—the purpose here is to open thinking on the topic in ways that question normative assumptions about the conditions of queer youth in the context of liveable lives and the positioning of resilience as reliant on normative accounts of identity. The article begins with a brief overview of the different uses of resilience in the context of broad social representations of queer youth. It goes on to discuss the It Gets Better video site which aimed to produce resilience among predominantly bullied queer youth by ‘imparting hope’. Some remarks on the relationship between identity, sexuality, sociality and resilience will conclude. Resilience and the Queer Youth Subject Developed by Crawford Holling in the 1970s, the concept of resilience was used to describe the capacity of a system to “absorb change and disturbance and still maintain the same relationships between populations or state variables” (Holling 14). In terms of ecology and the physical sciences, the notion of resilience operates within an assumption that future events will not be known but will be unexpected, thereby requiring a capacity to accommodate those events whatever form they take (21). When later used in the psychological sciences, the term resilience likewise assumes disruption and uncertainty in lived experience, requiring a resilient subject to be capable in both learning and adaptation. In the context of queer youth, resilience, then, can be applied to mean an adaptation to new situations which exacerbate vulnerability to suicidality for those who are positioned to seek escape from intolerable emotional pain or the perception of life as unliveable (Cover, Queer Youth Suicide 10, 148). Resilience in this use presumes that, for example, bullying has a detrimental causal relationship with suicidality when it newly occurs if the subject does not have the capacity to adapt and incorporate it into everyday life. Bullying, however, is generally related to suicide only by virtue of its ongoingness rather than it being a sudden shift in social relations. Striking about much of the discourse of resilience in the psychological sciences is that the concept of resilience presumes a unitary subject who is a subject prior to relationality and sociality (e.g. Leipold & Greve; Singh et al.; Smith & Gray). Resilience is thus seen as a capacity to cope with adversity as if adversity arises prior to the subject rather than being a form of relationality that conditions the subject. In that context, the queer youth subject is understood in essentialist terms, whereby sexual subjectivity is represented simultaneously as both a norm and abnormal, and is a factor of subjectivity that is understood to pre-exist sociality. That is, the queer youth subject is queer before relationality with others, thereby before the kinds of relationalities that might demand resilience. An alternative is to understand queer youth not as vulnerable because they are queer, but as subjects constituted in the (inequitably distributed) precarity of corporeal life in sociality, and thereby already formed in (inequitably distributed) resilience to the sorts of shifts, changes and adversities that shift one from an experience of vulnerability to an experience of a life that is unliveable (Butler, Precarious Life; Frames of War). Approaching queer youth suicide from a perspective not of risk but through the simultaneous fostering and critique of resilience opens the possibility of providing solutions that aid younger persons to resist suicidality as a flight from intolerable pain without articulating the self as inviolable and thereby losing the ethical value of the recognition of vulnerability. The question, then, is whether such critique can be found in sites of resilience discourse in relation to queer youth. Queer Youth and It Gets Better The video blogging site It Gets Better (http://www.itgetsbetter.org) was begun by columnist Dan Savage in response to a spate of reported queer student suicides in September/October 2010 in the United States. The site hosts more than a thousand video contributions, many from queer adults who seek to provide hope for younger persons by showing that queer adulthood is markedly different from the experiences of harassment, bullying, loneliness or surveillance experienced by queer youth in school and family environments. This is among the first widely-available communicative media form to address directly queer youth on issues related to suicide, and the first to draw on lived experiences as a means by which to provide resources for queer youth resilience. The fact that these experiences are related through video-logs (vlogs) provides the texts with a greater sense of authenticity and a framework which often addresses youth directly on the topic of suicidality (Cover, Queer Youth Suicide). Savage’s intention was to produce resilience in queer youth by imparting ‘hope for young people facing harassment’ and to create ‘a personal way for supporters everywhere to tell LGBT youth that … it does indeed get better’ (http://www.itgetsbetter.org/pages/about-it-gets-better-project/). Hope, in this context, is represented as the core attribute of queer youth resilience. The tag-line of the site is: Many LGBT youth can’t picture what their lives might be like as openly gay adults. They can’t imagine a future for themselves. So let’s show them what our lives are like, let’s show them what the future may hold in store for them (http://www.itgetsbetter.org/). Hope for the future is frequently presented as hope for an end to school days. In the primary video of the site, Dan Savage’s partner Terry describes his school experiences: My school was pretty miserable … I was picked on mercilessly in school. People were really cruel to me. I was bullied a lot. Beat up, thrown against walls and lockers and windows; stuffed into bathroom stalls. . . . Honestly, things got better the day I left highschool. I didn’t see the bullies every day, I didn’t see the people who harassed me every day, I didn’t have to see the school administrators who would do nothing about it every day. Life instantly got better (http://www.itgetsbetter.org/pages/about-it-gets-better-project/) Such comments present a picture of school life in which the institutional norms of secondary schools that depend so heavily on surveillance, discriminative norms, economies of secrecy and disclosure permit bullying and ostracisation to flourish and become, then, the site of hopelessness in what to many appears at the time as a period of never-ending permanency. Indeed, teen-aged life has often been figured in geographic terms as a kind of hopeless banishment from the realities that are yet to come: Eve Sedgwick referred to that period as ‘that long Babylonian exile known as queer childhood’ (4). The emphatic focus on the institutional environment of highschool rather than family, rural towns, closetedness, religious discourse or feelings of isolation is remarkably important in changing the contemporary way in which the social situation of queer youth suicide has been depicted. The discourse of the It Gets Better project and contributions makes ‘school’ its object—a site that demands resilience of its queer students as the remedy to the detrimental effects of bullying. Here, however, resilience is not depicted as adaptability but the strength to tolerate and, effectively, ‘wait out’, a bullying environment. The focus on bullying that frames the dialogue on queer youth suicide and youth resilience in the It Gets Better videos is the product of a mid-2000s shift in focus to the effects of bullying on LGBT youth in place of critiques of heterosexism, sexual identity, coming out and physical violence (Fodero), regularly depicting bullying as directly causal of suicide (Kim & Leventhal 151; Espelage & Swearer 157; Hegna & Wichstrøm 35). Bullying, in these representations, is articulated as that which is, on the one hand, preventable through punitive institutional policies and, on the other, as an ineradicable fact of living through school years. It is, in the latter depiction, that experience for which younger LGBT persons must manage their own resistance. In depicting school as the site of anti-queer bullying, the It Gets Better project represents queer youth as losing hope of escape from the intolerable pain of bullying in its persistence and repetition. However, the site’s purpose is to show that escape from the school environment to what is regularly depicted as a neoliberal, white and affluent representation of queer adulthood, founded on conservative coupledom (Cover, “Object(ives) of Desire”), careers, urban living, and relative wealth—depictions somewhat different from the reality of diverse queer lives. The shift from the school-bullying in queer youth to the liberal stability of queer adulthood is figured in the It Gets Better discourse as not only possible but as that which should be anticipated. It is in that anticipation that resilience is articulated in a way which calls upon queer youth to manage their own resiliency by having or performing hopefulness. Representing hope as the performative element in queer youth resilience has precedence as a suicide prevention strategy. Hopelessness is a key factor in much of the contemporary academic discussion of suicide risk in general and is often used as a predictor for recognising suicidal behaviour (Battin 13), although it is also particularly associated with suicidality and queer teenagers. Hopelessness is usually understood as despair or desperateness, the lack of expectation of a situation or goal one desires or feels one should desire. For Holden and colleagues, hopelessness is counter to social desirability, which is understood as the capacity to describe oneself in terms by which society judges a person as legitimate or desirable (Holden, Mendonca & Serin 500). Psychological and psychiatric measurement techniques frequently rely on Aaron T. Beck’s Hopelessness Scale, which utilises a twenty-question true/false survey designed to measure feelings about the future, expectation and self-motivation in adults over the age of seventeen years as a predictor of suicidal behaviour. Beck and colleagues attempted to provide an objective measurement for hopelessness rather than leave it treated as a diffuse and vague state of feeling in patients with depression. The tool asks a series of questions, most about the future, presenting a score on whether or not the answers given were true or false. Questions include: ‘I might as well give up because I can’t make things better for myself’; ‘I can’t imagine what my life would be like in ten years’; ‘My future seems dark to me’; and ‘All I can see ahead of me is unpleasantness rather than pleasantness’. Responding true to these indicates hopelessness. Responding false to some of the following also indicates hopelessness: ‘I can look forward to more good times than bad times’; and ‘When things are going badly, I am helped by knowing they can’t stay that way forever’ (Beck). While these questions and the scale are not used uncritically, the relationship between the discursive construction through the questions of what constitutes hopelessness and the aims of the It Gets Better videos are notably comparable. The objective, then, of the videos is to provide evidence and, perhaps, instil hope that would allow such questions to be answered differently, particularly to be able to give a true response to the last question above. Hallway Allies liaison support group, which operates across university campuses and high schools to prevent bullying, stated in this representative way in the introduction to their video contribution: ‘Remember to keep your head up, highschool doesn’t last forever’ (http://www.itgetsbetter.org/video /entry/5wwozgwyruy/). Or, as Rebecca in the introductory statement of another video contribution put it: You may be feeling like this pain will last forever, like you have no control, it’s dark, oppressive and feels like there is no end. I know – I get it. but I promise … hang in there and you’ll find it … Wait – you’ll see – it gets better! (http://www.itgetsbetter.org/video/entry/wxymqzw3oqy/). As can be seen, such video examples respond to a discourse of hopelessness aligned with the framework exemplified by Beck’s scale, prompting queer youth audiences of these videos to imagine a future for themselves, to understand hope in temporal terms of future wellbeing, and to know that the future does not necessarily hold the same kinds of unpleasantness as experienced in the everyday high school environment. Sexual Identity, Resilience and the Normative Lifecycle In the It Gets Better framework, resilience is produced in the knowledge of a queer life that is linear and patterned through stages in relation to institutional forms of belonging (and non-belonging). That is, a queer life is represented as one which undergoes the hardship of being bullied in school, of leaving that institutional environment for a queer adulthood that is built on a myth of safety, pleasure, success and a distinctive break from the environment of the past (as if the psyche or the self is re-produced anew in a phase of a queer lifecycle). Working within a queer theoretical and cultural understanding of identity, sexual subjectivity can be understood as constituted in social and cultural formations. Overturning the previously-held liberal notion of power as the power which represses sex and sexualities, Foucault’s History of Sexuality provided queer theory with an argument in which power, as deployed through discourse and discursive formations, produces the coherent sexual subject. This occurs historically and only in specific periods. In Foucault’s analysis, hom*osexual identities become conceivable in the Nineteenth Century as a result of specific juridical, medical and criminal discourses (85). From a Foucauldian perspective, there is no subject driven by an inner psyche or a pre-determined desire (as in psychoanalysis). Instead, such subjectivity occurs in and through the power/knowledge network of discourse as it writes or scripts the subject into subjectivity. Canonical queer theorist Judith Butler has been central in extending Foucault’s analysis in ways which are pragmatic for understanding queer youth in the context of growing up and transitioning into adulthood. Her theory of performativity has usefully complexified the ways in which we can understand sexual identity and allowed us to overcome the core assumption in much queer youth research that heterosexual and hom*osexual identities are natural, mutually-exclusive and innate; instead, allowing us to focus on how the process of subject formation for youth is implicated in the tensions and pressures of a range of cultural, social, organisational and communicative encounters and engagements. Butler projects the most useful post-structuralist discussion of subjectivity by suggesting that the subject is constituted by repetitive performances in terms of the structure of signification that produces retroactively the illusion of an inner subjective core (Butler, Gender Trouble 143). Queer identity becomes a normative ideal rather than a descriptive feature of experience, and is the resultant effect of regimentary discursive practices (16, 18). The non-heterosexual subject, then, is performatively constituted by the very ‘expressions’ that are formed as recognisable identity performances in the context, here, of a set of lifecycle expectations built through a vulnerable queer childhood, being bullied, attaining hope, leaving school and fruition in queer adulthood. Resilience, in the It Gets Better discourse, then, is seen to be produced in understanding the stages of a normative queer life. An issue emerges for how queer youth suicide is understood within this particular formation that posits non-heterosexuality as the problematic source of suicidality emerges in the assumption that the vulnerability to suicidal behaviours for queer youth is the result singularly of sexuality, rather than looking to the fact that sexuality is one facet of identity – an important and sometimes fraught one for adolescents in general – located within a complex of other formations of identity and selfhood. This is part of what Diana Fuss has identified as the “synecdochical tendency to see only one part of a subject’s identity (usually the most visible part) and to make that part stand for the whole” (116). This ignores the opportunity to think through the conditions of queer youth in terms of the interaction between different facets of identity (such as gender and ethnicity, but also personal experience), different contexts in which identity is performed and different institutional settings that vary in response and valuation of non-normative aspects of subjectivity, thereby allowing a vulnerability not to be an attribute of being a queer youth, but to be understood as produced across a nuanced and complex array of factors. While the very concept of resilience invokes both an individualisation of the subject and a disciplinary regime of pastoral care (Foucault, Abnormal), queer youth in the It Gets Better discourse of hope are depicted multiply as: Inherently vulnerable and lacking resilience as a result of an essentialist notion of sexual orientation.Constituted in a relationality within a schooling environment that is conditioned by bullying as the primary expression of diverse socialityFinding resilience only through a self-managed and self-articulated expression of ‘hope’ that is to be produced in the knowledge that there is an ‘escape’ from a school environment. What the discourse of that which we might refer to as “resilient hopefulness” does is represent queer youth reductively as inherently non-resilient. It ignores the multiple expressions of sexual identity, the capacity to respond to suicidality through a critique of normative sexual subjectivity, and the capabilities of queer youth to develop meaningful relationships across all sexual possibilities that are, themselves, forms of resilience or at least mitigations of vulnerability. At the same time, “resilient hopefulness” is produced within a context in which a normative sociality of bullying culture is expressed as timeless and unchangeable (rather than historical and institutional), thereby requiring queer younger persons to undertake the task of managing vulnerability, risk, resilience and identity as an individualised responsibility outside of communities of care. Whether the presentation of a normative lifecycle is genuinely a preventative measure for queer youth suicidality is that which suicidologists and practitioners must test, although one might argue at this stage that resilience is better produced through a broader appeal to social diversity rather than the regimentation of a queer life that must ‘wait in hope’ for a liveability that may never come. References Battin, Margaret Pabst. Ethical Issues in Suicide. Englewood Cliffs, N.J.: Prentice-Hall, 1995. Beck, Aaron T., Arlene Weissman, Larry Trexler, and David Lester. “The Measurement of Pessimism: The Hopelessness Scale” Journal of Consulting and Clinical Psychology, 42.6 (1974): 861–865. Bryson, Mary K., and Lori B. MacIntosh. “Can We Play ‘Fun Gay’?: Disjuncture and Difference, and the Precarious Mobilities of Millennial Queer Youth Narratives.” International Journal of Qualitative Studies in Education 23.1 (2010): 101-124. Butler, Judith. Gender Trouble: Feminism and the Subversion of Identity. London & New York: Routledge, 1990. Butler, Judith. Precarious Life. London: Verso, 2004. Butler, Judith. Frames of War: When Is Life Grievable? London and New York: Verso, 2009. Cover, Rob. “Object(ives) of Desire: Romantic Coupledom versus Promiscuity, Subjectivity and Sexual Identity.”Continuum: Journal of Media & Cultural Studies 24.2 (2010): 251-263. Cover, Rob. Queer Youth Suicide, Culture and Identity: Unliveable Lives? London: Ashgate, 2012. Driver, Susan. “Introducing Queer Youth Cultures.” Queer Youth Cultures. Ed. Susan Driver. Albany, NY: SUNY Press (2008). 1-18. Espelage, Dorothy L., and Susan M. Swearer. “Addressing Research Gaps in the Intersection between hom*ophobia and Bullying.” School Psychology Review 37.2 (2008): 155–159. Fodero, Lisa. “Teen Violinist Dies after Student Internet Lark.” The Age, 1 Oct. 2010. 1 Oct. 2010 ‹http://www.theage.com.au/world/>. Foucault, Michel. The History of Sexuality: An Introduction. Trans. Robert Hurley. London: Penguin, 1990. Foucault, Michel. Abnormal: Lectures at the Collège de France, 1974–1975. Eds. Valerio Marchetti and Antonella Salmoni. Trans. Graham Burchell. New York: Picador, 2004. Fuss, Diana. Essentially Speaking: Feminism, Nature & Difference. New York and London: Routledge, 1989. Hegna, Kristinn, and Lars Wichstrøm. “Suicide Attempts among Norwegian Gay, Lesbian and Bisexual Youths: General and Specific Risk Factors.” Acta Sociologica 50.1 (2007): 21–37. Hillier, Lynne, and Lyn Harrison. “Building Realities Less Limited than Their Own: Young People Practising Same-Sex Attraction on the Internet.” Sexualities 10.1 (2007): 82-100. Holden, Ronald R., James C. Mendonca and Ralph C. Serin. “Suicide, Hopelessness, and social desirability: A Test of an Interactive Model.” Journal of Consulting and Clinical Psychology 57.4 (1989): 500–504. Holling, C. S. “Resilience and Stabity of Ecological Systems.” Annual Review of Ecology and Systematics 4 (1973): 1-23. Kim, Young Shin, and Bennett Leventhal. “Bullying and Suicide. A Review.” International Journal of Adolescent Medical Health 20.2 (2008): 133–154. Leipold, Bernhard, and Werner Greve. “Resilience: A Conceptual Bridge between Coping and Development.” European Psychologist 14.1 (2009): 40-50. Marshall, Daniel. “Popular Culture, the ‘Victim’ Trope and Queer Youth Analytics.” International Journal of Qualitative Studies in Education 23.1 (2010): 65-86. Rasmussen, Mary Lou. Becoming Subjects: Sexualities and Secondary Schooling. New York: Routledge, 2006. Russell, Stephen T. “Beyond Risk: Resilience in the Lives of Sexual Minority Youth.” Journal of Gay & Lesbian Issues in Education 2.3 (2005): 5-18. Sedgwick, Eve Kosofsky. “Queer Performativity: Henry James’s The Art of the Novel.” GLQ 1.1 (1993): 1–14. Singh, Anneliese A., Danica G. Hays, and Larel S. Watson. “Strength in the Face of Adversity: Resilience Strategies of Transgender Individuals.” Journal of Counseling & Development 89.1 (2011): 20-27. Smith, Mark. S., and Susan W. Gray. “The Courage to Challenge: A New Measure of Hardiness in LGBT Adults.” Journal of Gay & Lesbian Social Services 21.1 (2009): 73-89. Wexler, Lisa Marin, Gloria DiFluvio, and Tracey K. Burke. “Resilience and Marginalized Youth: Making a Case for Personal and Collective Meaning-Making as Part of Resilience Research in Public Health.” Social Science & Medicine 69.4 (2009): 565-570.

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“Human beings are not born once and for all on the day their mothers give birth to them [...] life obliges them over and over again to give birth to themselves.” (Garcia Marquez 165) Introduction The refugee experience is, at heart, one of rebirth. Just as becoming a new, distinctive being—biological birth—necessarily involves the physical separation of mother and infant, so becoming a refugee entails separation from a "mother country." This mother country may or may not be a recognised nation state; the point is that the refugee transitions from physical connectedness to separation, from insider to outsider, from endemic to alien. Like babies, refugees may have little control over the timing and conditions of their expulsion. Successful resettlement requires not one rebirth but multiple rebirths—resettlement is a lifelong process (Layton)—which in turn require hope, imagination, and energy. In rebirthing themselves over and over again, people who have fled or been forced from their homelands become both mother and child. They do not go through this rebirthing alone. A range of agencies and individuals may be there to assist, including immigration officials, settlement services, schools and teachers, employment agencies and employers, English as a Second Language (ESL) resources and instructors, health-care providers, counsellors, diasporic networks, neighbours, church groups, and other community organisations. The nature, intensity, and duration of these “midwives’” interventions—and when they occur and in what combinations—vary hugely from place to place and from person to person, but there is clear evidence that post-migration experiences have a significant impact on settlement outcomes (Fozdar and Hartley). This paper draws on qualitative research I did in 2012 in a regional town in New South Wales to illuminate some of the ways in which settlement aides ease, or impede, refugees’ rebirth as fully recognised and participating Australians. I begin by considering what it means to be resilient before tracing some of the dimensions of the resettlement process. In doing so, I draw on data from interviews and focus groups with former refugees, service providers, and other residents of the town I shall call Easthaven. First, though, a word about Easthaven. As is the case in many rural and regional parts of Australia, Easthaven’s population is strongly dominated by Anglo Celtic and Saxon ancestries: 2011 Census data show that more than 80 per cent of residents were born in Australia (compared with a national figure of 69.8 per cent) and about 90 per cent speak only English at home (76.8 per cent). Almost twice as many people identify as Aboriginal or Torres Strait Islander as the national figure of 2.5 per cent (Australian Bureau of Statistics). For several years Easthaven has been an official “Refugee Welcome Zone”, welcoming hundreds of refugees from diverse countries in Africa and the Middle East as well as from Myanmar. This reflects the Department of Immigration and Citizenship’s drive to settle a fifth of Australia’s 13,750 humanitarian entrants a year directly in regional areas. In Easthaven’s schools—which is where I focused my research—almost all of the ESL students are from refugee backgrounds. Defining Resilience Much of the research on human resilience is grounded in psychology, with a capacity to “bounce back” from adverse experiences cited in many definitions of resilience (e.g. American Psychological Association). Bouncing back implies a relatively quick process, and a return to a state or form similar to that which existed before the encounter with adversity. Yet resilience often requires sustained effort and significant changes in identity. As Jerome Rugaruza, a former UNHCR refugee, says of his journey from the Democratic Republic of Congo to Australia: All the steps begin in the burning village: you run with nothing to eat, no clothes. You just go. Then you get to the refugee camp […] You have a little bread and you thank god you are safe. Then after a few years in the camp, you think about a future for your children. You arrive in Australia and then you learn a new language, you learn to drive. There are so many steps and not everyone can do it. (Milsom) Not everyone can do it, but a large majority do. Research by Graeme Hugo, for example, shows that although humanitarian settlers in Australia face substantial barriers to employment and initially have much higher unemployment rates than other immigrants, for most nationality groups this difference has disappeared by the second generation: “This is consistent with the sacrifice (or investment) of the first generation and the efforts extended to attain higher levels of education and English proficiency, thereby reducing the barriers over time.” (Hugo 35). Ingrid Poulson writes that “resilience is not just about bouncing. Bouncing […] is only a reaction. Resilience is about rising—you rise above it, you rise to the occasion, you rise to the challenge. Rising is an active choice” (47; my emphasis) I see resilience as involving mental and physical grit, coupled with creativity, aspiration and, crucially, agency. Dimensions of Resettlement To return to the story of 41-year-old Jerome Rugaruza, as related in a recent newspaper article: He [Mr Rugaruza] describes the experience of being a newly arrived refugee as being like that of a newborn baby. “You need special care; you have to learn to speak [English], eat the different food, create relationships, connections”. (Milsom) This is a key dimension of resettlement: the adult becomes like an infant again, shifting from someone who knows how things work and how to get by to someone who is likely to be, for a while, dependent on others for even the most basic things—communication, food, shelter, clothing, and social contact. The “special care” that most refugee arrivals need initially (and sometimes for a long time) often results in their being seen as deficient—in knowledge, skills, dispositions, and capacities as well as material goods (Keddie; Uptin, Wright and Harwood). As Fozdar and Hartley note: “The tendency to use a deficit model in refugee resettlement devalues people and reinforces the view of the mainstream population that refugees are a liability” (27). Yet unlike newborns, humanitarian settlers come to their new countries with rich social networks and extensive histories of experience and learning—resources that are in fact vital to their rebirth. Sisay (all names are pseudonyms), a year 11 student of Ethiopian heritage who was born in Kenya, told me with feeling: I had a life back in Africa [her emphasis]. It was good. Well, I would go back there if there’s no problems, which—is a fact. And I came here for a better life—yeah, I have a better life, there’s good health care, free school, and good environment and all that. But what’s that without friends? A fellow student, Celine, who came to Australia five years ago from Burundi via Uganda, told me in a focus group: Some teachers are really good but I think some other teachers could be a little bit more encouraging and understanding of what we’ve gone through, because [they] just look at you like “You’re year 11 now, you should know this” […] It’s really discouraging when [the teachers say] in front of the class, “Oh, you shouldn’t do this subject because you haven’t done this this this this” […] It’s like they’re on purpose to tell you “you don’t have what it takes; just give up and do something else.” As Uptin, Wright and Harwood note, “schools not only have the power to position who is included in schooling (in culture and pedagogy) but also have the power to determine whether there is room and appreciation for diversity” (126). Both Sisay and Celine were disheartened by the fact they felt some of their teachers, and many of their peers, had little interest in or understanding of their lives before they came to Australia. The teachers’ low expectations of refugee-background students (Keddie, Uptin, Wright and Harwood) contrasted with the students’ and their families’ high expectations of themselves (Brown, Miller and Mitchell; Harris and Marlowe). When I asked Sisay about her post-school ambitions, she said: “I have a good idea of my future […] write a documentary. And I’m working on it.” Celine’s response was: “I know I’m gonna do medicine, be a doctor.” A third girl, Lily, who came to Australia from Myanmar three years ago, told me she wanted to be an accountant and had studied accounting at the local TAFE last year. Joseph, a father of three who resettled from South Sudan seven years ago, stressed how important getting a job was to successful settlement: [But] you have to get a certificate first to get a job. Even the job of cleaning—when I came here I was told that somebody has to go to have training in cleaning, to use the different chemicals to clean the ground and all that. But that is just sweeping and cleaning with water—you don’t need the [higher-level] skills. Simple jobs like this, we are not able to get them. In regional Australia, employment opportunities tend to be limited (Fozdar and Hartley); the unemployment rate in Easthaven is twice the national average. Opportunities to study are also more limited than in urban centres, and would-be students are not always eligible for financial assistance to gain or upgrade qualifications. Even when people do have appropriate qualifications, work experience, and language proficiency, the colour of their skin may still mean they miss out on a job. Tilbury and Colic-Peisker have documented the various ways in which employers deflect responsibility for racial discrimination, including the “common” strategy (658) of arguing that while the employer or organisation is not prejudiced, they have to discriminate because of their clients’ needs or expectations. I heard this strategy deployed in an interview with a local businesswoman, Catriona: We were advertising for a new technician. And one of the African refugees came to us and he’d had a lot of IT experience. And this is awful, but we felt we couldn't give him the job, because we send our technicians into people's houses, and we knew that if a black African guy rocked up at someone’s house to try and fix their computer, they would not always be welcomed in all—look, it would not be something that [Easthaven] was ready for yet. Colic-Peisker and Tilbury (Refugees and Employment) note that while Australia has strict anti-discrimination legislation, this legislation may be of little use to the people who, because of the way they look and sound (skin colour, dress, accent), are most likely to face prejudice and discrimination. The researchers found that perceived discrimination in the labour market affected humanitarian settlers’ sense of satisfaction with their new lives far more than, for example, racist remarks, which were generally shrugged off; the students I interviewed spoke of racism as “expected,” but “quite rare.” Most of the people Colic-Peisker and Tilbury surveyed reported finding Australians “friendly and accepting” (33). Even if there is no active discrimination on the basis of skin colour in employment, education, or housing, or overt racism in social situations, visible difference can still affect a person’s sense of belonging, as Joseph recounts: I think of myself as Australian, but my colour doesn’t [laughs] […] Unfortunately many, many Australians are expecting that Australia is a country of Europeans … There is no need for somebody to ask “Where do you come from?” and “Do you find Australia here safe?” and “Do you enjoy it?” Those kind of questions doesn’t encourage that we are together. This highlights another dimension of resettlement: the journey from feeling “at home” to feeling “foreign” to, eventually, feeling at home again in the host country (Colic-Peisker and Tilbury, Refugees and Employment). In the case of visibly different settlers, however, this last stage may never be completed. Whether the questions asked of Joseph are well intentioned or not, their effect may be the same: they position him as a “forever foreigner” (Park). A further dimension of resettlement—one already touched on—is the degree to which humanitarian settlers actively manage their “rebirth,” and are allowed and encouraged to do so. A key factor will be their mastery of English, and Easthaven’s ESL teachers are thus pivotal in the resettlement process. There is little doubt that many of these teachers have gone to great lengths to help this cohort of students, not only in terms of language acquisition but also social inclusion. However, in some cases what is initially supportive can, with time, begin to undermine refugees’ maturity into independent citizens. Sharon, an ESL teacher at one of the schools, told me how she and her colleagues would give their refugee-background students lifts to social events: But then maybe three years down the track they have a car and their dad can drive, but they still won’t take them […] We arrive to pick them up and they’re not ready, or there’s five fantastic cars in the driveway, and you pick up the student and they say “My dad’s car’s much bigger and better than yours” [laughs]. So there’s an expectation that we’ll do stuff for them, but we’ve created that [my emphasis]. Other support services may have more complex interests in keeping refugee settlers dependent. The more clients an agency has, the more services it provides, and the longer clients stay on its books, the more lucrative the contract for the agency. Thus financial and employment imperatives promote competition rather than collaboration between service providers (Fozdar and Hartley; Sidhu and Taylor) and may encourage assumptions about what sorts of services different individuals and groups want and need. Colic-Peisker and Tilbury (“‘Active’ and ‘Passive’ Resettlement”) have developed a typology of resettlement styles—“achievers,” “consumers,” “endurers,” and “victims”—but stress that a person’s style, while influenced by personality and pre-migration factors, is also shaped by the institutions and individuals they come into contact with: “The structure of settlement and welfare services may produce a victim mentality, leaving members of refugee communities inert and unable to see themselves as agents of change” (76). The prevailing narrative of “the traumatised refugee” is a key aspect of this dynamic (Colic-Peisker and Tilbury, “‘Active’ and ‘Passive’ Resettlement”; Fozdar and Hartley; Keddie). Service providers may make assumptions about what humanitarian settlers have gone through before arriving in Australia, how they have been affected by their experiences, and what must be done to “fix” them. Norah, a long-time caseworker, told me: I think you get some [providers] who go, “How could you have gone through something like that and not suffered? There must be—you must have to talk about this stuff” […] Where some [refugees] just come with the [attitude] “We’re all born into a situation; that was my situation, but I’m here now and now my focus is this.” She cited failure to consider cultural sensitivities around mental illness and to recognise that stress and anxiety during early resettlement are normal (Tilbury) as other problems in the sector: [Newly arrived refugees] go through the “happy to be here” [phase] and now “hang on, I’ve thumped to the bottom and I’m missing my own foods and smells and cultures and experiences”. I think sometimes we’re just too quick to try and slot people into a box. One factor that appears to be vital in fostering and sustaining resilience is social connection. Norah said her clients were “very good on the mobile phone” and had links “everywhere,” including to family and friends in their countries of birth, transition countries, and other parts of Australia. A 2011 report for DIAC, Settlement Outcomes of New Arrivals, found that humanitarian entrants to Australia were significantly more likely to be members of cultural and/or religious groups than other categories of immigrants (Australian Survey Research). I found many examples of efforts to build both bonding and bridging capital (Putnam) in Easthaven, and I offer two examples below. Several people told me about a dinner-dance that had been held a few weeks before one of my visits. The event was organised by an African women’s group, which had been formed—with funding assistance—several years before. The dinner-dance was advertised in the local newspaper and attracted strong interest from a broad cross-section of Easthaveners. To Debbie, a counsellor, the response signified a “real turnaround” in community relations and was a big boon to the women’s sense of belonging. Erica, a teacher, told me about a cultural exchange day she had organised between her bush school—where almost all of the children are Anglo Australian—and ESL students from one of the town schools: At the start of the day, my kids were looking at [the refugee-background students] and they were scared, they were saying to me, "I feel scared." And we shoved them all into this tiny little room […] and they had no choice but to sit practically on top of each other. And by the end of the day, they were hugging each other and braiding their hair and jumping and playing together. Like Uptin, Wright and Harwood, I found that the refugee-background students placed great importance on the social aspects of school. Sisay, the girl I introduced earlier in this paper, said: “It’s just all about friendship and someone to be there for you […] We try to be friends with them [the non-refugee students] sometimes but sometimes it just seems they don’t want it.” Conclusion A 2012 report on refugee settlement services in NSW concludes that the state “is not meeting its responsibility to humanitarian entrants as well as it could” (Audit Office of New South Wales 2); moreover, humanitarian settlers in NSW are doing less well on indicators such as housing and health than humanitarian settlers in other states (3). Evaluating the effectiveness of formal refugee-centred programs was not part of my research and is beyond the scope of this paper. Rather, I have sought to reveal some of the ways in which the attitudes, assumptions, and everyday practices of service providers and members of the broader community impact on refugees' settlement experience. What I heard repeatedly in the interviews I conducted was that it was emotional and practical support (Matthews; Tilbury), and being asked as well as told (about their hopes, needs, desires), that helped Easthaven’s refugee settlers bear themselves into fulfilling new lives. References Audit Office of New South Wales. Settling Humanitarian Entrants in New South Wales—Executive Summary. May 2012. 15 Aug. 2013 ‹http://www.audit.nsw.gov.au/ArticleDocuments/245/02_Humanitarian_Entrants_2012_Executive_Summary.pdf.aspx?Embed=Y>. Australian Bureau of Statistics. 2011 Census QuickStats. Mar. 2013. 11 Aug. 2013 ‹http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/0>. Australian Survey Research. Settlement Outcomes of New Arrivals—Report of Findings. Apr. 2011. 15 Aug. 2013 ‹http://www.immi.gov.au/media/publications/research/_pdf/settlement-outcomes-new-arrivals.pdf>. Brown, Jill, Jenny Miller, and Jane Mitchell. “Interrupted Schooling and the Acquisition of Literacy: Experiences of Sudanese Refugees in Victorian Secondary Schools.” Australian Journal of Language and Literacy 29.2 (2006): 150-62. Colic-Peisker, Val, and Farida Tilbury. “‘Active’ and ‘Passive’ Resettlement: The Influence of Supporting Services and Refugees’ Own Resources on Resettlement Style.” International Migration 41.5 (2004): 61-91. ———. Refugees and Employment: The Effect of Visible Difference on Discrimination—Final Report. Perth: Centre for Social and Community Research, Murdoch University, 2007. Fozdar, Farida, and Lisa Hartley. “Refugee Resettlement in Australia: What We Know and Need To Know.” Refugee Survey Quarterly 4 Jun. 2013. 12 Aug. 2013 ‹http://rsq.oxfordjournals.org/search?fulltext=fozdar&submit=yes&x=0&y=0>. Garcia Marquez, Gabriel. Love in the Time of Cholera. London: Penguin Books, 1989. Harris, Vandra, and Jay Marlowe. “Hard Yards and High Hopes: The Educational Challenges of African Refugee University Students in Australia.” International Journal of Teaching and Learning in Higher Education 23.2 (2011): 186-96. Hugo, Graeme. A Significant Contribution: The Economic, Social and Civic Contributions of First and Second Generation Humanitarian Entrants—Summary of Findings. Canberra: Department of Immigration and Citizenship, 2011. Keddie, Amanda. “Pursuing Justice for Refugee Students: Addressing Issues of Cultural (Mis)recognition.” International Journal of Inclusive Education 16.12 (2012): 1295-1310. Layton, Robyn. "Building Capacity to Ensure the Inclusion of Vulnerable Groups." Creating Our Future conference, Adelaide, 28 Jul. 2012. Milsom, Rosemarie. “From Hard Luck Life to the Lucky Country.” Sydney Morning Herald 20 Jun. 2013. 12 Aug. 2013 ‹http://www.smh.com.au/national/from-hard-luck-life-to-the-lucky-country-20130619-2oixl.html>. Park, Gilbert C. “’Are We Real Americans?’: Cultural Production of Forever Foreigners at a Diversity Event.” Education and Urban Society 43.4 (2011): 451-67. Poulson, Ingrid. Rise. Sydney: Pan Macmillan Australia, 2008. Putnam, Robert D. Bowling Alone: The Collapse and Revival of American Community. New York: Simon & Schuster, 2000. Sidhu, Ravinder K., and Sandra Taylor. “The Trials and Tribulations of Partnerships in Refugee Settlement Services in Australia.” Journal of Education Policy 24.6 (2009): 655-72. Tilbury, Farida. “‘I Feel I Am a Bird without Wings’: Discourses of Sadness and Loss among East Africans in Western Australia.” Identities: Global Studies in Culture and Power 14.4 (2007): 433-58. ———, and Val Colic-Peisker. “Deflecting Responsibility in Employer Talk about Race Discrimination.” Discourse & Society 17.5 (2006): 651-76. Uptin, Jonnell, Jan Wright, and Valerie Harwood. “It Felt Like I Was a Black Dot on White Paper: Examining Young Former Refugees’ Experience of Entering Australian High Schools.” The Australian Educational Researcher 40.1 (2013): 125-37.

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Introduction Most developed countries, including Australia, have a strong focus on national, state and local strategies for emergency management and response in the face of disasters and crises. This framework can include coping with catastrophic dislocation, service disruption, injury or loss of life in the face of natural disasters such as major fires, floods, earthquakes or other large-impact natural events, as well as dealing with similar catastrophes resulting from human actions such as bombs, biological agents, cyber-attacks targeting essential services such as communications networks, or other crises affecting large populations. Emergency management frameworks for crisis and disaster response are distinguished by their focus on the domestic context for such events; that is, how to manage and assist the ways in which civilian populations, who are for the most part inexperienced and untrained in dealing with crises and disasters, are able to respond and behave in such situations so as to minimise the impacts of a catastrophic event. Even in countries like Australia that demonstrate a strong public commitment to cultural pluralism and social cohesion, ethno-cultural diversity can be seen as a risk or threat to national security and values at times of political, natural, economic and/or social tensions and crises. Australian government policymakers have recently focused, with increasing intensity, on “community resilience” as a key element in countering extremism and enhancing emergency preparedness and response. In some sense, this is the result of a tacit acknowledgement by government agencies that there are limits to what they can do for domestic communities should such a catastrophic event occur, and accordingly, the focus in recent times has shifted to how governments can best help people to help themselves in such situations, a key element of the contemporary “resilience” approach. Yet despite the robustly multicultural nature of Australian society, explicit engagement with Australia’s cultural diversity flickers only fleetingly on this agenda, which continues to pursue approaches to community resilience in the absence of understandings about how these terms and formations may themselves need to be diversified to maximise engagement by all citizens in a multicultural polity. There have been some recent efforts in Australia to move in this direction, for example the Australian Emergency Management Institute (AEMI)’s recent suite of projects with culturally and linguistically diverse (CALD) communities (2006-2010) and the current Australia-New Zealand Counter-Terrorism Committee-supported project on “Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism” (Grossman and Tahiri), which I discuss in a longer forthcoming version of this essay (Grossman). Yet the understanding of ethno-cultural identity and difference that underlies much policy thinking on resilience remains problematic for the way in which it invests in a view of the cultural dimensions of community resilience as relic rather than resource – valorising the preservation of and respect for cultural norms and traditions, but silent on what different ethno-cultural communities might contribute toward expanded definitions of both “community” and “resilience” by virtue of the transformative potential and existing cultural capital they bring with them into new national and also translocal settings. For example, a primary conclusion of the joint program between AEMI and the Australian Multicultural Commission is that CALD communities are largely “vulnerable” in the context of disasters and emergency management and need to be better integrated into majority-culture models of theorising and embedding community resilience. This focus on stronger national integration and the “vulnerability” of culturally diverse ethno-cultural communities in the Australian context echoes the work of scholars beyond Australia such as McGhee, Mouritsen (Reflections, Citizenship) and Joppke. They argue that the “civic turn” in debates around resurgent contemporary nationalism and multicultural immigration policies privileges civic integration over genuine two-way multiculturalism. This approach sidesteps the transculturational (Ortiz; Welsch; Mignolo; Bennesaieh; Robins; Stein) aspects of contemporary social identities and exchange by paying lip-service to cultural diversity while affirming a neo-liberal construct of civic values and principles as a universalising goal of Western democratic states within a global market economy. It also suggests a superficial tribute to cultural diversity that does not embed diversity comprehensively at the levels of either conceptualising or resourcing different elements of Australian transcultural communities within the generalised framework of “community resilience.” And by emphasising cultural difference as vulnerability rather than as resource or asset, it fails to acknowledge the varieties of resilience capital that many culturally diverse individuals and communities may bring with them when they resettle in new environments, by ignoring the question of what “resilience” actually means to those from culturally diverse communities. In so doing, it also avoids the critical task of incorporating intercultural definitional diversity around the concepts of both “community” and “resilience” used to promote social cohesion and the capacity to recover from disasters and crises. How we might do differently in thinking about the broader challenges for multiculturalism itself as a resilient transnational concept and practice? The Concept of Resilience The meanings of resilience vary by disciplinary perspective. While there is no universally accepted definition of the concept, it is widely acknowledged that resilience refers to the capacity of an individual to do well in spite of exposure to acute trauma or sustained adversity (Liebenberg 219). Originating in the Latin word resilio, meaning ‘to jump back’, there is general consensus that resilience pertains to an individual’s, community’s or system’s ability to adapt to and ‘bounce back’ from a disruptive event (Mohaupt 63, Longstaff et al. 3). Over the past decade there has been a dramatic rise in interest in the clinical, community and family sciences concerning resilience to a broad range of adversities (Weine 62). While debate continues over which discipline can be credited with first employing resilience as a concept, Mohaupt argues that most of the literature on resilience cites social psychology and psychiatry as the origin for the concept beginning in the mid-20th century. The pioneer researchers of what became known as resilience research studied the impact on children living in dysfunctional families. For example, the findings of work by Garmezy, Werner and Smith and Rutter showed that about one third of children in these studies were coping very well despite considerable adversities and traumas. In asking what it was that prevented the children in their research from being negatively influenced by their home environments, such research provided the basis for future research on resilience. Such work was also ground-breaking for identifying the so-called ‘protective factors’ or resources that individuals can operationalise when dealing with adversity. In essence, protective factors are those conditions in the individual that protect them from the risk of dysfunction and enable recovery from trauma. They mitigate the effects of stressors or risk factors, that is, those conditions that predispose one to harm (Hajek 15). Protective factors include the inborn traits or qualities within an individual, those defining an individual’s environment, and also the interaction between the two. Together, these factors give people the strength, skills and motivation to cope in difficult situations and re-establish (a version of) ‘normal’ life (Gunnestad). Identifying protective factors is important in terms of understanding the particular resources a given sociocultural group has at its disposal, but it is also vital to consider the interconnections between various protective mechanisms, how they might influence each other, and to what degree. An individual, for instance, might display resilience or adaptive functioning in a particular domain (e.g. emotional functioning) but experience significant deficits in another (e.g. academic achievement) (Hunter 2). It is also essential to scrutinise how the interaction between protective factors and risk factors creates patterns of resilience. Finally, a comprehensive understanding of the interrelated nature of protective mechanisms and risk factors is imperative for designing effective interventions and tailored preventive strategies (Weine 65). In short, contemporary thinking about resilience suggests it is neither entirely personal nor strictly social, but an interactive and iterative combination of the two. It is a quality of the environment as much as the individual. For Ungar, resilience is the complex entanglements between “individuals and their social ecologies [that] will determine the degree of positive outcomes experienced” (3). Thinking about resilience as context-dependent is important because research that is too trait-based or actor-centred risks ignoring any structural or institutional forces. A more ecological interpretation of resilience, one that takes into a person’s context and environment into account, is vital in order to avoid blaming the victim for any hardships they face, or relieving state and institutional structures from their responsibilities in addressing social adversity, which can “emphasise self-help in line with a neo-conservative agenda instead of stimulating state responsibility” (Mohaupt 67). Nevertheless, Ungar posits that a coherent definition of resilience has yet to be developed that adequately ‘captures the dual focus of the individual and the individual’s social ecology and how the two must both be accounted for when determining the criteria for judging outcomes and discerning processes associated with resilience’ (7). Recent resilience research has consequently prompted a shift away from vulnerability towards protective processes — a shift that highlights the sustained capabilities of individuals and communities under threat or at risk. Locating ‘Culture’ in the Literature on Resilience However, an understanding of the role of culture has remained elusive or marginalised within this trend; there has been comparatively little sustained investigation into the applicability of resilience constructs to non-western cultures, or how the resources available for survival might differ from those accessible to western populations (Ungar 4). As such, a growing body of researchers is calling for more rigorous inquiry into culturally determined outcomes that might be associated with resilience in non-western or multicultural cultures and contexts, for example where Indigenous and minority immigrant communities live side by side with their ‘mainstream’ neighbours in western settings (Ungar 2). ‘Cultural resilience’ considers the role that cultural background plays in determining the ability of individuals and communities to be resilient in the face of adversity. For Clauss-Ehlers, the term describes the degree to which the strengths of one’s culture promote the development of coping (198). Culturally-focused resilience suggests that people can manage and overcome stress and trauma based not on individual characteristics alone, but also from the support of broader sociocultural factors (culture, cultural values, language, customs, norms) (Clauss-Ehlers 324). The innate cultural strengths of a culture may or may not differ from the strengths of other cultures; the emphasis here is not so much comparatively inter-cultural as intensively intra-cultural (VanBreda 215). A culturally focused resilience model thus involves “a dynamic, interactive process in which the individual negotiates stress through a combination of character traits, cultural background, cultural values, and facilitating factors in the sociocultural environment” (Clauss-Ehlers 199). In understanding ways of ‘coping and hoping, surviving and thriving’, it is thus crucial to consider how culturally and linguistically diverse minorities navigate the cultural understandings and assumptions of both their countries of origin and those of their current domicile (Ungar 12). Gunnestad claims that people who master the rules and norms of their new culture without abandoning their own language, values and social support are more resilient than those who tenaciously maintain their own culture at the expense of adjusting to their new environment. They are also more resilient than those who forego their own culture and assimilate with the host society (14). Accordingly, if the combination of both valuing one’s culture as well as learning about the culture of the new system produces greater resilience and adaptive capacities, serious problems can arise when a majority tries to acculturate a minority to the mainstream by taking away or not recognising important parts of the minority culture. In terms of resilience, if cultural factors are denied or diminished in accounting for and strengthening resilience – in other words, if people are stripped of what they possess by way of resilience built through cultural knowledge, disposition and networks – they do in fact become vulnerable, because ‘they do not automatically gain those cultural strengths that the majority has acquired over generations’ (Gunnestad 14). Mobilising ‘Culture’ in Australian Approaches to Community Resilience The realpolitik of how concepts of resilience and culture are mobilised is highly relevant here. As noted above, when ethnocultural difference is positioned as a risk or a threat to national identity, security and values, this is precisely the moment when vigorously, even aggressively, nationalised definitions of ‘community’ and ‘identity’ that minoritise or disavow cultural diversities come to the fore in public discourse. The Australian evocation of nationalism and national identity, particularly in the way it has framed policy discussion on managing national responses to disasters and threats, has arguably been more muted than some of the European hysteria witnessed recently around cultural diversity and national life. Yet we still struggle with the idea that newcomers to Australia might fall on the surplus rather than the deficit side of the ledger when it comes to identifying and harnessing resilience capital. A brief example of this trend is explored here. From 2006 to 2010, the Australian Emergency Management Institute embarked on an ambitious government-funded four-year program devoted to strengthening community resilience in relation to disasters with specific reference to engaging CALD communities across Australia. The program, Inclusive Emergency Management with CALD Communities, was part of a wider Australian National Action Plan to Build Social Cohesion, Harmony and Security in the wake of the London terrorist bombings in July 2005. Involving CALD community organisations as well as various emergency and disaster management agencies, the program ran various workshops and agency-community partnership pilots, developed national school education resources, and commissioned an evaluation of the program’s effectiveness (Farrow et al.). While my critique here is certainly not aimed at emergency management or disaster response agencies and personnel themselves – dedicated professionals who often achieve remarkable results in emergency and disaster response under extraordinarily difficult circ*mstances – it is nevertheless important to highlight how the assumptions underlying elements of AEMI’s experience and outcomes reflect the persistent ways in which ethnocultural diversity is rendered as a problem to be surmounted or a liability to be redressed, rather than as an asset to be built upon or a resource to be valued and mobilised. AEMI’s explicit effort to engage with CALD communities in building overall community resilience was important in its tacit acknowledgement that emergency and disaster services were (and often remain) under-resourced and under-prepared in dealing with the complexities of cultural diversity in emergency situations. Despite these good intentions, however, while the program produced some positive outcomes and contributed to crucial relationship building between CALD communities and emergency services within various jurisdictions, it also continued to frame the challenge of working with cultural diversity as a problem of increased vulnerability during disasters for recently arrived and refugee background CALD individuals and communities. This highlights a common feature in community resilience-building initiatives, which is to focus on those who are already ‘robust’ versus those who are ‘vulnerable’ in relation to resilience indicators, and whose needs may require different or additional resources in order to be met. At one level, this is a pragmatic resourcing issue: national agencies understandably want to put their people, energy and dollars where they are most needed in pursuit of a steady-state unified national response at times of crisis. Nor should it be argued that at least some CALD groups, particularly those from new arrival and refugee communities, are not vulnerable in at least some of the ways and for some of the reasons suggested in the program evaluation. However, the consistent focus on CALD communities as ‘vulnerable’ and ‘in need’ is problematic, as well as partial. It casts members of these communities as structurally and inherently less able and less resilient in the context of disasters and emergencies: in some sense, as those who, already ‘victims’ of chronic social deficits such as low English proficiency, social isolation and a mysterious unidentified set of ‘cultural factors’, can become doubly victimised in acute crisis and disaster scenarios. In what is by now a familiar trope, the description of CALD communities as ‘vulnerable’ precludes asking questions about what they do have, what they do know, and what they do or can contribute to how we respond to disaster and emergency events in our communities. A more profound problem in this sphere revolves around working out how best to engage CALD communities and individuals within existing approaches to disaster and emergency preparedness and response. This reflects a fundamental but unavoidable limitation of disaster preparedness models: they are innately spatially and geographically bounded, and consequently understand ‘communities’ in these terms, rather than expanding definitions of ‘community’ to include the dimensions of community-as-social-relations. While some good engagement outcomes were achieved locally around cross-cultural knowledge for emergency services workers, the AEMI program fell short of asking some of the harder questions about how emergency and disaster service scaffolding and resilience-building approaches might themselves need to change or transform, using a cross-cutting model of ‘communities’ as both geographic places and multicultural spaces (Bartowiak-Théron and Crehan) in order to be more effective in national scenarios in which cultural diversity should be taken for granted. Toward Acknowledgement of Resilience Capital Most significantly, the AEMI program did not produce any recognition of the ways in which CALD communities already possess resilience capital, or consider how this might be drawn on in formulating stronger community initiatives around disaster and threats preparedness for the future. Of course, not all individuals within such communities, nor all communities across varying circ*mstances, will demonstrate resilience, and we need to be careful of either overgeneralising or romanticising the kinds and degrees of ‘resilience capital’ that may exist within them. Nevertheless, at least some have developed ways of withstanding crises and adapting to new conditions of living. This is particularly so in connection with individual and group behaviours around resource sharing, care-giving and social responsibility under adverse circ*mstances (Grossman and Tahiri) – all of which are directly relevant to emergency and disaster response. While some of these resilient behaviours may have been nurtured or enhanced by particular experiences and environments, they can, as the discussion of recent literature above suggests, also be rooted more deeply in cultural norms, habits and beliefs. Whatever their origins, for culturally diverse societies to achieve genuine resilience in the face of both natural and human-made disasters, it is critical to call on the ‘social memory’ (Folke et al.) of communities faced with responding to emergencies and crises. Such wellsprings of social memory ‘come from the diversity of individuals and institutions that draw on reservoirs of practices, knowledge, values, and worldviews and is crucial for preparing the system for change, building resilience, and for coping with surprise’ (Adger et al.). Consequently, if we accept the challenge of mapping an approach to cultural diversity as resource rather than relic into our thinking around strengthening community resilience, there are significant gains to be made. For a whole range of reasons, no diversity-sensitive model or measure of resilience should invest in static understandings of ethnicities and cultures; all around the world, ethnocultural identities and communities are in a constant and sometimes accelerated state of dynamism, reconfiguration and flux. But to ignore the resilience capital and potential protective factors that ethnocultural diversity can offer to the strengthening of community resilience more broadly is to miss important opportunities that can help suture the existing disconnects between proactive approaches to intercultural connectedness and social inclusion on the one hand, and reactive approaches to threats, national security and disaster response on the other, undermining the effort to advance effectively on either front. This means that dominant social institutions and structures must be willing to contemplate their own transformation as the result of transcultural engagement, rather than merely insisting, as is often the case, that ‘other’ cultures and communities conform to existing hegemonic paradigms of being and of living. In many ways, this is the most critical step of all. A resilience model and strategy that questions its own culturally informed yet taken-for-granted assumptions and premises, goes out into communities to test and refine these, and returns to redesign its approach based on the new knowledge it acquires, would reflect genuine progress toward an effective transculturational approach to community resilience in culturally diverse contexts.References Adger, W. Neil, Terry P. Hughes, Carl Folke, Stephen R. Carpenter and Johan Rockström. “Social-Ecological Resilience to Coastal Disasters.” Science 309.5737 (2005): 1036-1039. ‹http://www.sciencemag.org/content/309/5737/1036.full> Bartowiak-Théron, Isabelle, and Anna Corbo Crehan. “The Changing Nature of Communities: Implications for Police and Community Policing.” Community Policing in Australia: Australian Institute of Criminology (AIC) Reports, Research and Policy Series 111 (2010): 8-15. Benessaieh, Afef. “Multiculturalism, Interculturality, Transculturality.” Ed. A. Benessaieh. Transcultural Americas/Ameriques Transculturelles. Ottawa: U of Ottawa Press/Les Presses de l’Unversite d’Ottawa, 2010. 11-38. Clauss-Ehlers, Caroline S. “Sociocultural Factors, Resilience and Coping: Support for a Culturally Sensitive Measure of Resilience.” Journal of Applied Developmental Psychology 29 (2008): 197-212. Clauss-Ehlers, Caroline S. “Cultural Resilience.” Encyclopedia of Cross-Cultural School Psychology. Ed. C. S. Clauss-Ehlers. New York: Springer, 2010. 324-326. Farrow, David, Anthea Rutter and Rosalind Hurworth. Evaluation of the Inclusive Emergency Management with Culturally and Linguistically Diverse (CALD) Communities Program. Parkville, Vic.: Centre for Program Evaluation, U of Melbourne, July 2009. ‹http://www.ag.gov.au/www/emaweb/rwpattach.nsf/VAP/(9A5D88DBA63D32A661E6369859739356)~Final+Evaluation+Report+-+July+2009.pdf/$file/Final+Evaluation+Report+-+July+2009.pdf>.Folke, Carl, Thomas Hahn, Per Olsson, and Jon Norberg. “Adaptive Governance of Social-Ecological Systems.” Annual Review of Environment and Resources 30 (2005): 441-73. ‹http://arjournals.annualreviews.org/doi/pdf/10.1146/annurev.energy.30.050504.144511>. Garmezy, Norman. “The Study of Competence in Children at Risk for Severe Psychopathology.” The Child in His Family: Children at Psychiatric Risk. Vol. 3. Eds. E. J. Anthony and C. Koupernick. New York: Wiley, 1974. 77-97. Grossman, Michele. “Resilient Multiculturalism? Diversifying Australian Approaches to Community Resilience and Cultural Difference”. Global Perspectives on Multiculturalism in the 21st Century. Eds. B. E. de B’beri and F. Mansouri. London: Routledge, 2014. Grossman, Michele, and Hussein Tahiri. Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism. Canberra: Australia-New Zealand Counter-Terrorism Committee, forthcoming 2014. Grossman, Michele. “Cultural Resilience and Strengthening Communities”. Safeguarding Australia Summit, Canberra. 23 Sep. 2010. ‹http://www.safeguardingaustraliasummit.org.au/uploader/resources/Michele_Grossman.pdf>. Gunnestad, Arve. “Resilience in a Cross-Cultural Perspective: How Resilience Is Generated in Different Cultures.” Journal of Intercultural Communication 11 (2006). ‹http://www.immi.se/intercultural/nr11/gunnestad.htm>. Hajek, Lisa J. “Belonging and Resilience: A Phenomenological Study.” Unpublished Master of Science thesis, U of Wisconsin-Stout. Menomonie, Wisconsin, 2003. Hunter, Cathryn. “Is Resilience Still a Useful Concept When Working with Children and Young People?” Child Family Community Australia (CFA) Paper 2. Melbourne: Australian Institute of Family Studies, 2012.Joppke, Christian. "Beyond National Models: Civic Integration Policies for Immigrants in Western Europe". West European Politics 30.1 (2007): 1-22. Liebenberg, Linda, Michael Ungar, and Fons van de Vijver. “Validation of the Child and Youth Resilience Measure-28 (CYRM-28) among Canadian Youth.” Research on Social Work Practice 22.2 (2012): 219-226. Longstaff, Patricia H., Nicholas J. Armstrong, Keli Perrin, Whitney May Parker, and Matthew A. Hidek. “Building Resilient Communities: A Preliminary Framework for Assessment.” Homeland Security Affairs 6.3 (2010): 1-23. ‹http://www.hsaj.org/?fullarticle=6.3.6>. McGhee, Derek. The End of Multiculturalism? Terrorism, Integration and Human Rights. Maidenhead: Open U P, 2008.Mignolo, Walter. Local Histories/Global Designs: Coloniality, Subaltern Knowledges, and Border Thinking. Princeton: Princeton U P, 2000. Mohaupt, Sarah. “Review Article: Resilience and Social Exclusion.” Social Policy and Society 8 (2009): 63-71.Mouritsen, Per. "The Culture of Citizenship: A Reflection on Civic Integration in Europe." Ed. R. Zapata-Barrero. Citizenship Policies in the Age of Diversity: Europe at the Crossroad." Barcelona: CIDOB Foundation, 2009: 23-35. Mouritsen, Per. “Political Responses to Cultural Conflict: Reflections on the Ambiguities of the Civic Turn.” Ed. P. Mouritsen and K.E. Jørgensen. Constituting Communities. Political Solutions to Cultural Conflict, London: Palgrave, 2008. 1-30. Ortiz, Fernando. Cuban Counterpoint: Tobacco and Sugar. Trans. Harriet de Onís. Intr. Fernando Coronil and Bronislaw Malinowski. Durham, NC: Duke U P, 1995 [1940]. Robins, Kevin. The Challenge of Transcultural Diversities: Final Report on the Transversal Study on Cultural Policy and Cultural Diversity. Culture and Cultural Heritage Department. Strasbourg: Council of European Publishing, 2006. Rutter, Michael. “Protective Factors in Children’s Responses to Stress and Disadvantage.” Annals of the Academy of Medicine, Singapore 8 (1979): 324-38. Stein, Mark. “The Location of Transculture.” Transcultural English Studies: Fictions, Theories, Realities. Eds. F. Schulze-Engler and S. Helff. Cross/Cultures 102/ANSEL Papers 12. Amsterdam and New York: Rodopi, 2009. 251-266. Ungar, Michael. “Resilience across Cultures.” British Journal of Social Work 38.2 (2008): 218-235. First published online 2006: 1-18. In-text references refer to the online Advance Access edition ‹http://bjsw.oxfordjournals.org/content/early/2006/10/18/bjsw.bcl343.full.pdf>. VanBreda, Adrian DuPlessis. Resilience Theory: A Literature Review. Erasmuskloof: South African Military Health Service, Military Psychological Institute, Social Work Research & Development, 2001. Weine, Stevan. “Building Resilience to Violent Extremism in Muslim Diaspora Communities in the United States.” Dynamics of Asymmetric Conflict 5.1 (2012): 60-73. Welsch, Wolfgang. “Transculturality: The Puzzling Form of Cultures Today.” Spaces of Culture: City, Nation World. Eds. M. Featherstone and S. Lash. London: Sage, 1999. 194-213. Werner, Emmy E., and Ruth S. Smith. Vulnerable But Invincible: A Longitudinal Study of\ Resilience and Youth. New York: McGraw Hill, 1982. NotesThe concept of ‘resilience capital’ I offer here is in line with one strand of contemporary theorising around resilience – that of resilience as social or socio-ecological capital – but moves beyond the idea of enhancing general social connectedness and community cohesion by emphasising the ways in which culturally diverse communities may already be robustly networked and resourceful within micro-communal settings, with new resources and knowledge both to draw on and to offer other communities or the ‘national community’ at large. In effect, ‘resilience capital’ speaks to the importance of finding ‘the communities within the community’ (Bartowiak-Théron and Crehan 11) and recognising their capacity to contribute to broad-scale resilience and recovery.I am indebted for the discussion of the literature on resilience here to Dr Peta Stephenson, Centre for Cultural Diversity and Wellbeing, Victoria University, who is working on a related project (M. Grossman and H. Tahiri, Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism, forthcoming 2014).

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“I’m fat–and it’s okay! It doesn’t mean I’m stupid, or ugly, or lazy, or selfish. I’m fat!” so proclaims Joy Nash in her YouTube video, A Fat Rant. “Fat! It’s three little letters–what are you afraid of?!” This is the question I pose to my class on day one of Fat Studies. Sadly, many college students do fear fat, and negative attitudes toward fat people are quite prevalent in this population (Ambwani et al. 366). As I teach it, Fat Studies is cross-listed between Psychology and Gender Studies. However, most students who enrol have majors in Psychology or other behavioural health science fields in which weight bias is particularly pronounced (Watkins and Concepcion 159). Upon finding stronger bias among third- versus first-year Physical Education students, O’Brien, Hunter, and Banks (308) speculated that the weight-centric curriculum that typifies this field actively engenders anti-fat attitudes. Based on their exploration of textbook content, McHugh and Kasardo (621) contend that Psychology too is complicit in propagating weight bias by espousing weight-centric messages throughout the curriculum. Such messages include the concepts that higher body weight invariably leads to poor health, weight control is simply a matter of individual choice, and dieting is an effective means of losing weight and improving health (Tylka et al.). These weight-centric tenets are, however, highly contested. For instance, there exists a body of research so vast that it has its own name, the “obesity paradox” literature. This literature (McAuley and Blair 773) entails studies that show that “obese” persons with chronic disease have relatively better survival rates and that a substantial portion of “overweight” and “obese” individuals have levels of metabolic health similar to or better than “normal” weight individuals (e.g., Flegal et al. 71). Finally, the “obesity paradox” literature includes studies showing that cardiovascular fitness is a far better predictor of mortality than weight. In other words, individuals may be both fit and fat, or conversely, unfit and thin (Barry et al. 382). In addition, Tylka et al. review literature attesting to the complex causes of weight status that extend beyond individual behaviour, ranging from genetic predispositions to sociocultural factors beyond personal control. Lastly, reviews of research on dieting interventions show that these are overwhelmingly ineffective in producing lasting weight loss or actual improvements in health and may in fact lead to disordered eating and other unanticipated adverse consequences (e.g., Bacon and Aphramor; Mann et al. 220; Salas e79; Tylka et al.).The newfound, interdisciplinary field of scholarship known as Fat Studies aims to debunk weight-centric misconceptions by elucidating findings that counter these mainstream suppositions. Health At Every Size® (HAES), a weight-neutral approach to holistic well-being, is an important facet of Fat Studies. The HAES paradigm advocates intuitive eating and pleasurable physical activity for health rather than restrictive dieting and regimented exercise for weight loss. HAES further encourages body acceptance of self and others regardless of size. Empirical evidence shows that HAES-based interventions improve physical and psychological health without harmful side-effects or high dropout rates associated with weight loss interventions (Bacon and Aphramor; Clifford et al. “Impact of Non-Diet Approaches” 143). HAES, like the broader field of Fat Studies, seeks to eradicate weight-based discrimination, positioning weight bias as a social justice issue that intersects with oppression based on other areas of difference such as gender, race, and social class. Much like Queer Studies, Fat Studies seeks to reclaim the word, fat, thus stripping it of its pejorative connotations. As Nash asserts in her video, “Fat is a descriptive physical characteristic. It’s not an insult, or an obscenity, or a death sentence!” As an academic discipline, Fat Studies is expanding its visibility and reach. The Fat Studies Reader, the primary source of reading for my course, provides a comprehensive overview of the field (Rothblum and Solovay 1). This interdisciplinary anthology addresses fat history and activism, fat as social inequality, fat in healthcare, and fat in popular culture. Ward (937) reviews this and other recently-released fat-friendly texts. The field features its own journal, Fat Studies: An Interdisciplinary Journal of Body Weight and Society, which publishes original research, overview articles, and reviews of assorted media. Both the Popular Culture Association and National Women’s Studies Association have special interest groups devoted to Fat Studies, and the American Psychological Association’s Division on the Psychology of Women has recently formed a task force on sizism (Bergen and Carrizales 22). Furthermore, Fat Studies conferences have been held in Australia and New Zealand, and the third annual Weight Stigma Conference will occur in Iceland, September 2015. Although the latter conference is not necessarily limited to those who align themselves with Fat Studies, keynote speakers include Ragen Chastain, a well-known member of the fat acceptance movement largely via her blog, Dances with Fat. The theme of this year’s conference, “Institutionalised Weightism: How to Challenge Oppressive Systems,” is consistent with Fat Studies precepts:This year’s theme focuses on the larger social hierarchies that favour thinness and reject fatness within western culture and how these systems have dictated the framing of fatness within the media, medicine, academia and our own identities. What can be done to oppose systemised oppression? What can be learned from the fight for social justice and equality within other arenas? Can research and activism be united to challenge prevailing ideas about fat bodies?Concomitantly, Fat Studies courses have begun to appear on college campuses. Watkins, Farrell, and Doyle-Hugmeyer (180) identified and described four Fat Studies and two HAES courses that were being taught in the U.S. and abroad as of 2012. Since then, a Fat Studies course has been taught online at West Virginia University and another will soon be offered at Washington State University. Additionally, a new HAES class has been taught at Saint Mary’s College of California during the last two academic years. Cameron (“Toward a Fat Pedagogy” 28) describes ways in which nearly 30 instructors from five different countries have incorporated fat studies pedagogy into university courses across an array of academic areas. This growing trend is manifested in The Fat Pedagogy Reader (Russell and Cameron) due out later this year. In this article, I describe content and pedagogical strategies that I use in my Fat Studies course. I then share students’ qualitative reactions, drawing upon excerpts from written assignments. During the term reported here, the class was comprised of 17 undergraduate and 5 graduate students. Undergraduate majors included 47% in Psychology, 24% in Women Studies, 24% in various other College of Liberal Arts fields, and 6% in the College of Public Health. Graduate majors included 40% in the College of Public Health and 60% in the College of Education. Following submission of final grades, students provided consent via email allowing written responses on assignments to be anonymously incorporated into research reports. Assignments drawn upon for this report include weekly reading reactions to specific journal articles in which students were to summarise the main points, identify and discuss a specific quote or passage that stood out to them, and consider and discuss applicability of the information in the article. This report also utilises responses to a final assignment in which students were to articulate take-home lessons from the course.Despite the catalogue description, many students enter Fat Studies with a misunderstanding of what the course entails. Some admitted that they thought the course was about reducing obesity and the presumed health risks associated with this alleged pathological condition (Watkins). Others understood, but were somewhat dubious, at least at the outset, “Before I began this class, I admit that I was skeptical of what Fat Studies meant.” Another student experienced “a severe cognitive dissonance” between the Fat Studies curriculum and that of a previous behavioural health class:My professor spent the entire quarter spouting off statistics, such as the next generation of children will be the first generation to have a lower life expectancy than their parents and the ever increasing obesity rates that are putting such a tax on our health care system, and I took her words to heart. I was scared for myself and for the populations I would soon be working with. I was worried that I was destined to a chronic disease and bothered that my BMI was two points above ‘normal.’ I believed everything my professor alluded to on the danger of obesity because it was things I had heard in the media and was led to believe all my life.Yet another related, “At first, I will be honest, it was hard for me to accept a lot of this information, but throughout the term every class changed my mind about my view of fat people.” A few students have voiced even greater initial resistance. During a past term, one student lamented that the material represented an attack on her intended behavioural health profession. Cameron (“Learning to Teach Everybody”) describes comparable reactions among students in her Critical Obesity course taught within a behavioural health science unit. Ward (937) attests that, even in Gender Studies, fat is the topic that creates the most controversy. Similarly, she describes students’ immense discomfort when asked to entertain perspectives that challenge deeply engrained ideas inculcated by our culture’s “obesity epidemic.” Discomfort, however, is not necessarily antithetical to learning. In prompting students to unlearn “the biomedically-informed truth of obesity, namely that fat people are unfit, unhealthy, and in need of ‘saving’ through expert interventions,” Moola at al. recommend equipping them with an “ethics of discomfort” (217). No easy task, “It requires courage to ask our students to forgo the security of prescriptive health messaging in favour of confusion and uncertainty” (221). I encourage students to entertain conflicting perspectives by assigning empirically-based articles emanating from peer-reviewed journals in their own disciplines that challenge mainstream discourses on obesity (e.g., Aphramor; Bombak e60; Tomiyama, Ahlstrom, and Mann 861). Students whose training is steeped in the scientific method seem to appreciate having quantitative data at their disposal to convince themselves–and their peers and professors–that widely held weight-centric beliefs and practices may not be valid. One student remarked, “Since I have taken this course, I feel like I am prepared to discuss the fallacy of the weight-health relationship,” citing specific articles that would aid in the effort. Likewise, Cameron’s (“Learning to Teach Everybody”) students reported a need to read research reports in order to begin questioning long-held beliefs.In addition, I assign readings that provide students with the opportunity to hear the voices of fat people themselves, a cornerstone of Fat Studies. Besides chapters in The Fat Studies Reader authored by scholars and activists who identify as fat, I assign qualitative articles (e.g., Lewis et al.) and narrative reports (e.g., Pause 42) in which fat people describe their experiences with weight and weight bias. Additionally, I provide positive images of fat people via films and websites (Clifford et al. HAES®; Watkins; Watkins and Doyle-Hugmeyer 177) in order to counteract the preponderance of negative, dehumanising portrayals in popular media (e.g., Ata and Thompson 41). In response, a student stated:One of the biggest things I took away from this term was the confidence I found in fat women through films and stories. They had more confidence than I have seen in any tiny girl and owned the body they were given.I introduce “normal” weight allies as well, most especially Linda Bacon whose treatise on thin privilege tends to set the stage for viewing weight bias as a form of oppression (Bacon). One student observed, “It was a relief to be able to read and talk about weight oppression in a classroom setting for once.” Another appreciated that “The class did a great job at analysing fat as oppression and not like a secondhand oppression as I have seen in my past classes.” Typically, fat students were already aware of weight-based privilege and oppression, often painfully so. Thinner students, however, were often astonished by this concept, several describing Bacon’s article as “eye-opening.” In reaction, many vowed to act as allies:This class has really opened my eyes and prepared me to be an ally to fat people. It will be difficult for some time while I try to get others to understand my point of view on fat people but I believe once there are enough allies, people’s minds will really start changing and it will benefit everyone for the better.Pedagogically, I choose to share my own experiences as they relate to course content and encourage students, at least in their written assignments, to do the same. Other instructors refrain from this practice for fear of reinforcing traditional discourses or eliciting detrimental reactions from students (Watkins, Farrell, and Doyle-Hugmeyer 191). Nevertheless, this tack seems to work well in my course, with many students opting to disclose their relevant circ*mstances during classroom discussions: Throughout the term I very much valued and appreciated when classmates would share their experiences. I love listening and hearing to others experiences and I think that is a great way to understand the material and learn from one another.It really helped to read different articles and hear classmates discuss and share stories that I was able to relate to. The idea of hearing people talk about issues that I thought I was the only one who dealt with was so refreshing and enlightening.The structure of this class allowed me to learn how this information is applicable to my life and made it deeper than just memorising information.Thus far, across three terms, no student has described iatrogenic effects from this process. In fact, most attribute positive transformations to the class. These include enhanced body acceptance of self and others: This class decreased my fat phobia towards others and gave me a better understanding about the intersectionality of one’s weight. For example, I now feel that I no longer view my family in a fat phobic way and I also feel responsible for educating my brother and helping him develop a strong self-esteem regardless of his size.I never thought this class would change my life, almost save my life. Through studies shown in class and real life people following their dreams, it made my mind completely change about how I view my body and myself.I can only hope that in the future, I will be more forgiving, tolerant, and above all accepting of myself, much less others. Regardless of a person’s shape and size, we are all beautiful, and while I’m just beginning to understand this, it can only get better from here.Students also reported becoming more savvy consumers of weight-centric media messages as well as realigning their eating and exercise behaviour in accordance with HAES: I find myself disgusted at the television now, especially with the amount of diet ads, fitness club ads, and exercise equipment ads all aimed at making a ‘better you.’ I now know that I would never be better off with a SlimFast shake, P90X, or a Total Gym. I would be better off eating when I’m hungry, working out because it is fun, and still eating Thin Mints when I want to. Prior to this class, I would work out rigorously, running seven miles a day. Now I realise why at times I dreaded to work out, it was simply a mathematical system to burn the energy that I had acquired earlier in the day. Instead what I realise I should do is something I enjoy, that way I will never get tired of whatever I am doing. While I do enjoy running, other activities would bring more joy while engaging in a healthy lifestyle like hiking or mountain biking.I will never go on another diet. I will stop choosing exercises I don’t love to do. I will not weigh myself every single day hoping for the number on the scale to change.A reduction in self-weighing was perhaps the most frequent behaviour change that students expressed. This is particularly valuable in that frequent self-weighing is associated with disordered eating and unhealthy weight control behaviours (Neumark-Sztainer et al. 811):I have realised that the number on the scale is simply a number on the scale. That number does not define who you are. I have stopped weighing myself every morning. I put the scale in the storage closet so I don’t have to look at it. I even encouraged my roommate to stop weighing herself too. What has been most beneficial for me to take away from this class is the notion that the number on the scale has so much less to do with fitness levels than most people understand. Coming from a numbers obsessed person like myself, this class has actually gotten me to leave the scales behind. I used to weigh myself every single day and my self-confidence reflected whether I was up or down in weight from the day before. It seems so silly to me now. From this class, I take away a new outlook on body diversity. I will evaluate who I am for what I do and not represent myself with a number. I’m going to have my cake this time, and actually eat it too!Finally, students described ways in which they might carry the concepts from Fat Studies into their future professions: I want to go to law school. This model is something I will work toward in the fight for social justice.As a teacher and teacher of teachers, I plan to incorporate discussions on size diversity and how this should be addressed within the field of adapted physical education.I do not know how I would have gone forward if I had never taken this class. I probably would have continued to use weight loss as an effective measure of success for both nutrition and physical activity interventions. I will never be able to think about the obesity prevention movement in the same way.Since I am working toward being a clinical psychologist, I don’t want to have a client who is pursuing weight loss and then blindly believe that they need to lose weight. I’d rather be of the mindset that every person is unique, and that there are other markers of health at every size.Jones and Hughes-Decatur (59) call for increased scholarship illustrating and evaluating critical body pedagogies so that teachers might provide students with tools to critique dominant discourses, helping them forge healthy relationships with their own bodies in the process. As such, this paper describes elements of a Fat Studies class that other instructors may choose to adopt. It additionally presents qualitative data suggesting that students came to think about fat and fat people in new and divergent ways. Qualitative responses also suggest that students developed better body image and more adaptive eating and exercise behaviours throughout the term. Although no students have yet described lasting adverse effects from the class, one stated that she would have preferred less of a focus on health and more of a focus on issues such as fat fashion. Indeed, some Fat Studies scholars (e.g., Lee) advocate separating discussions of weight bias from discussions of health status to avoid stigmatising fat people who do experience health problems. While concerns about fostering healthism within the fat acceptance movement are valid, as a behavioural health professional with an audience of students training in these fields, I have chosen to devote three weeks of our ten week term to this subject matter. Depending on their academic background, others who teach Fat Studies may choose to emphasise different aspects such as media representations or historical connotations of fat.Nevertheless, the preponderance of positive comments evidenced throughout students’ assignments may certainly be a function of social desirability. Although I explicitly invite critique, and in fact assign readings (e.g., Welsh 33) and present media that question HAES and Fat Studies concepts, students may still feel obliged to articulate acceptance of and transformations consistent with the principles of these movements. As a more objective assessment of student outcomes, I am currently conducting a quantitative evaluation, in which I remain blind to students’ identities, of this year’s Fat Studies course compared to other upper division/graduate Psychology courses, examining potential changes in weight bias, body image and dieting behaviour, adherence to appearance-related media messages, and obligatory exercise behaviour. I postulate results akin to those of Humphrey, Clifford, and Neyman Morris (143) who found reductions in weight bias, improved body image, and improved eating behaviour among college students as a function of their HAES course. As Fat Studies pedagogy proliferates, instructors are called upon to share their teaching strategies, document the effects, and communicate these results within and outside of academic spheres.ReferencesAmbwani, Suman, Katherine M. Thomas, Christopher J. Hopwood, Sara A. Moss, and Carlos M. Grilo. “Obesity Stigmatization as the Status Quo: Structural Considerations and Prevalence among Young Adults in the U.S.” Eating Behaviors 15.3 (2014): 366-370. Aphramor, Lucy. “Validity of Claims Made in Weight Management Research: A Narrative Review of Dietetic Articles.” Nutrition Journal 9 (2010): n. pag. 15 May 2015 ‹http://www.nutritionj.com/content/9/1/30›.Ata, Rheanna M., and J. Kevin Thompson. “Weight Bias in the Media: A Review of Recent Research.” Obesity Facts 3.1 (2010): 41-46.Bacon, Linda. “Reflections on Fat Acceptance: Lessons Learned from Thin Privilege.” 2009. 23 Apr. 2015 ‹http://www.lindabacon.org/Bacon_ThinPrivilege080109.pdf›.Bacon, Linda, and Lucy Aphramor. “Weight Science: Evaluating the Evidence for a Paradigm Shift.” Nutrition Journal 10 (2011). 23 Apr. 2015 ‹http://www.nutritionj.com/content/10/1/9›.Barry, Vaughn W., Meghan Baruth, Michael W. Beets, J. Larry Durstine, Jihong Liu, and Steven N. Blair. “Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis.” Progress in Cardiovascular Diseases 56.4 (2014): 382-390.Bergen, Martha, and Sonia Carrizales. “New Task Force Focused on Size.” The Feminist Psychologist 42.1 (2015): 22.Bombak, Andrea. “Obesity, Health at Every Size, and Public Health Policy.” American Journal of Public Health 104.2 (2014): e60-e67.Cameron, Erin. “Learning to Teach Everybody: Exploring the Emergence of an ‘Obesity” Pedagogy’.” The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. Eds. Erin Cameron and Connie Russell. New York: Peter Lang Publishing, in press.Cameron, Erin. “Toward a Fat Pedagogy: A Study of Pedagogical Approaches Aimed at Challenging Obesity Discourses in Post-Secondary Education.” Fat Studies 4.1 (2015): 28-45.Chastain, Ragen. Dances with Fat. 15 May 2015 ‹https://danceswithfat.wordpress.com/blog/›.Clifford, Dawn, Amy Ozier, Joanna Bundros, Jeffrey Moore, Anna Kreiser, and Michele Neyman Morris. “Impact of Non-Diet Approaches on Attitudes, Behaviors, and Health Outcomes: A Systematic Review.” Journal of Nutrition Education and Behavior 47.2 (2015): 143-155.Clifford, Dawn, Patti Lou Watkins, and Rebecca Y. Concepcion. “HAES® University: Bringing a Weight Neutral Message to Campus.” Association for Size Diversity and Health, 2015. 23 Apr. 2015 ‹https://www.sizediversityandhealth.org/content.asp?id=258›.Fat Studies: An Interdisciplinary Journal of Body Weight and Society. 23 Apr. 2015 ‹http://www.tandfonline.com/toc/ufts20/current#.VShpqdhFDBC›.Flegal, Katherine M., Brian K. Kit, Heather Orpana, and Barry L. Graubard. “Association of All-Cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-Analysis.” Journal of the American Medical Association 309.1 (2013): 71-82.Humphrey, Lauren, Dawn Clifford, and Michelle Neyman Morris. “Health At Every Size College Course Reduces Dieting Behaviors and Improves Intuitive Eating, Body Esteem, and Anti-Fat Attitudes.” Journal of Nutrition Education and Behavior, in press.Jones, Stephanie, and Hilary Hughes-Decatur. “Speaking of Bodies in Justice-Oriented Feminist Teacher Education.” Journal of Teacher Education 63.1 (2012): 51-61.Lee, Jenny. Embodying Stereotypes: Memoir, Fat and Health. Fat Studies: Reflective Intersections, July 2012, Wellington, NZ. Unpublished conference paper.Lewis, Sophie, Samantha L. Thomas, Jim Hyde, David Castle, R. Warwick Blood, and Paul A. Komesaroff. “’I Don't Eat a Hamburger and Large Chips Every Day!’ A Qualitative Study of the Impact of Public Health Messages about Obesity on Obese Adults.” BMC Public Health 10.309 (2010). 23 Apr 2015 ‹http://www.biomedcentral.com/1471-2458/10/309›.Mann, Traci, A. Janet Tomiyama, Erika Westling, Ann-Marie Lew, Barbara Samuels, and Jason Chatman. “Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer.” American Psychologist 62.3 (2007): 220-233.McAuley, Paul A., and Steven N. Blair. “Obesity Paradoxes.” Journal of Sports Sciences 29.8 (2011): 773-782. McHugh, Maureen C., and Ashley E. Kasardo. “Anti-Fat Prejudice: The Role of Psychology in Explication, Education and Eradication.” Sex Roles 66.9-10 (2012): 617-627.Moola, Fiona J., Moss E. Norman, LeAnne Petherick, and Shaelyn Strachan. “Teaching across the Lines of Fault in Psychology and Sociology: Health, Obesity and Physical Activity in the Canadian Context.” Sociology of Sport Journal 31.2 (2014): 202-227.Nash, Joy. “A Fat Rant.” YouTube, 17 Mar. 2007. 23 Apr. 2015 ‹https://www.youtube.com/watch?v=yUTJQIBI1oA›.Neumark-Sztainer, Dianne, Patricia van den Berg, Peter J. Hannan, and Mary Story. “Self-Weighing in Adolescents: Helpful or Harmful? Longitudinal Associations with Body Weight Changes and Disordered Eating.” Journal of Adolescent Health 39.6 (2006): 811–818.O’Brien, K.S., J.A. Hunter, and M. Banks. “Implicit Anti-Fat Bias in Physical Educators: Physical Attributes, Ideology, and Socialization.” International Journal of Obesity 31.2 (2007): 308-314.Pause, Cat. “Live to Tell: Coming Out as Fat.” Somatechnics 2.1 (2012): 42-56.Rothblum, Esther, and Sondra Solovay, eds. The Fat Studies Reader. New York: New York University Press, 2009.Russell, Connie, and Erin Cameron, eds. The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. New York: Peter Lang Publishing, in press. Salas, Ximena Ramos. “The Ineffectiveness and Unintended Consequences of the Public Health War on Obesity.” Canadian Journal of Public Health 106.2 (2015): e79-e81. Tomiyama, A. Janet, Britt Ahlstrom, and Traci Mann. “Long-Term Effects of Dieting: Is Weight Loss Related to Health?” Social and Personality Psychology Compass 7.12 (2013): 861-877.Tylka, Tracy L., Rachel A. Annunziato, Deb Burgard, Sigrun Daníelsdóttir, Ellen Shuman, Chad Davis, and Rachel M. Calogero. “The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss.” Journal of Obesity (2014). 23 Apr. 2015 ‹http://www.hindawi.com/journals/jobe/2014/983495/›.Ward, Anna E. “The Future of Fat.” American Quarterly 65.4 (2013): 937-947.Watkins, Patti Lou. “Inclusion of Fat Studies in a Difference, Power, and Discrimination Curriculum.” The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. Eds. Erin Cameron and Connie Russell. New York: Peter Lang Publishing, in press. Watkins, Patti Lou, and Rebecca Y. Concepcion. “Teaching HAES to Health Care Students and Professionals.” Wellness Not Weight: Motivational Interviewing and a Non-Diet Approach. Ed. Ellen Glovsky. San Diego: Cognella Academic Publishing, 2014: 159-169. Watkins, Patti Lou, and Andrea Doyle-Hugmeyer. “Teaching about Eating Disorders from a Fat Studies Perspective. Transformations 23.2 (2013): 147-158. Watkins, Patti Lou, Amy E. Farrell, and Andrea Doyle Hugmeyer. “Teaching Fat Studies: From Conception to Reception. Fat Studies 1.2 (2012): 180-194. Welsh, Taila L. “Healthism and the Bodies of Women: Pleasure and Discipline in the War against Obesity.” Journal of Feminist Scholarship 1 (2011): 33-48. Weight Stigma Conference. 23 Apr. 2015 ‹http://stigmaconference.com/›.

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Aunty Mary Graham, Kombu-merri elder and philosopher, writes, “you are not alone in the world.” We have a responsibility to each other, as well as to the land, and violence is the refusal of this relationship that binds us (Rose). Similarly, Emmanuel Levinas, a French-Lithuanian Jewish teacher and philosopher who lived through the Holocaust, writes that, “my freedom does not have the last word; I am not alone” (Levinas, Totality 101). For both writers, the recognition that one is not alone in the world creates an imperative to act ethically. For non-Indigenous educators working in the Indigenous Studies space—as arguably all school teachers are, given the Australian Curriculum—their relationship with Indigenous Australia creates an imperative to consider ethics and responsibility in their work. In this article, I use Emmanuel Levinas’s thinking and writing on epistemological violence and ethics as a first philosophy to consider how pre-service teachers engage with the ethical responsibilities inherent in teaching and learning Indigenous Studies.To begin, I will introduce Emmanuel Levinas and his writing on violence, followed by outlining the ways that Indigenous perspectives are incorporated into the Australian Curriculum. I will finish by sharing some of the reflective writing undertaken by pre-service teachers in a compulsory Indigenous education subject at an Australian university. These data show pre-service teachers’ responses to being called into responsibility and relationality, as well as some of the complexities in avoiding what I term here epistemological violence, a grasping of the other by trying to make the other infinitely knowable. The data present a problematic paradox—when pre-service teachers write about their future praxis, they necessarily defer responsibility to the future. This deferral constructs an image of the future which transcends the present, without requiring change in the here and now.Of note, some of this writing speaks to the violence enacted upon Indigenous peoples through the colonisation of Australia. I have tried to write respectfully about these topics. Yet the violence continues, in part via the traumatic nature of such accounts. As a non-Indigenous educator and researcher, I also acknowledge that such histories of violence have predominantly benefited people like myself and that the Countries on which this article was written (Countries of the sovereign Bindal and Wulgurukaba peoples) have never been ceded.Emmanuel Levinas: Ethics as First PhilosophyEmmanuel Levinas was a French-Lithuanian Jewish teacher and philosopher for whom surviving the Holocaust—where most of his family perished—fundamentally changed his philosophy. Following World War II, Levinas critiqued Heidegger’s philosophy, writing that freedom—an unencumbered being in the world—could no longer be considered the first condition of being human (Levinas, Existence). Instead, the presence of others in the world—an intersubjectivity between oneself and another—means that we are always already responsible for the others we encounter. Seeing the other’s face calls us to be accountable for our own actions, to responsibility. If we do not respect that the other is different to one’s self, and instead try to understand them through our own frames of reference, we commit the epistemological violence of reducing the other to the same (Levinas, Totality 46), bringing their infinity into our own totality.The history of Indigenous and non-Indigenous relations both in Australia and globally has been marked by attempts to bring Indigenous peoples into non-Indigenous orders of knowledge (Nakata, “Cultural Interface”). The word “Aboriginal”, derived from the Latin “of the original”, refers to both Indigenous peoples’ position as original inhabitants of lands, but also to the anthropological idea that Indigenous peoples were early and unevolved prototypes of human beings (Peterson). This early idea of what it means to be Indigenous is linked to the now well-known histories of ontological violence. Aboriginal reserves were set up as places for Aboriginal people to perish, a consequence not just of colonisation, but of the perception that Indigenous people were unfit to exist in a modern society. Whilst such racist ideologies linger today, most discourses have morphed in how they grasp Indigenous people into a non-Indigenous totality. In a context where government-funded special measures are used to assist disadvantaged groups, categories such as the Indigenous/non-Indigenous binary can become violent. The Closing the Gap campaign, for example, is based on this categorical binary, where “sickness=Indigenous” and “whiteness=health”. This creates a “moral imperative upon Indigenous Australians to transform themselves” (Pholi et al. 10), to become the dominant category, to be brought into the totality.Levinas’s philosophical writings provide a way to think through the ethical challenges of a predominantly non-Indigenous teaching workforce being tasked to not just approach the teaching of Indigenous students with more care than previous generations, but to also embed Indigenous perspectives and knowledges into their teaching work. Levinas’s warning of a “disinterested acquisition of knowledge” (Reader 78), seemingly unrestrained by memory or relationships, is useful in two ways. First, for pre-service teachers learning about Indigenous education, Levinas’s work provides a reminder of the ethical responsibilities that all members of a community have to each other. However, this responsibility cannot be predicated on unwittingly approaching Indigenous topics through Western knowledge lenses. Instead, Levinas’s work also reminds us about the ethics of knowledge production which shape how others—in this case Indigenous peoples—come to be known; teachers and pre-service teachers must engage with the politics of knowledge that shape how Indigenous peoples come to be known in educational settings.You Are Not Alone in the World: Indigenous Perspectives in the Australian CurriculumIn 2010, the Australian Curriculum was launched by the Australian Curriculum, Assessment and Reporting Authority (ACARA) with the goal of unifying state-driven curricula into a common approach. Developed from the 2008 Melbourne Declaration on Educational Goals for Young Australians (Ministerial Council for Education, Early Childhood Development and Youth Affairs [MCEECDYA]), the Curriculum has occupied a prominent position in the Australian educational policy space. As well as preparing a future workforce, contemporary Australian education is essentially aspirational, “governed by the promise of something better” (Harrison et al. 234), with the Australian Curriculum appearing to promise the same: there is a concerted effort to ensure that all Australians have access to equitable and excellent educational opportunities, and that all students are represented within the Curriculum. Part of this aspiration included the development of three Cross-Curriculum Priorities (CCPs), focus areas that “give students the tools and language to engage with and better understand their world at a range of levels” (ACARA, “Cross-Curriculum Priorities” para. 1). The first of these CCPs is Aboriginal and Torres Strait Islander Histories and Cultures and is organised into three key concepts: connection to Country/Place; diversity of Aboriginal and Torres Strait Islander cultures; and diversity of Aboriginal and Torres Strait Islanders societies. In the curriculum more broadly, content descriptions govern what is taught across subject areas from Prep to Year 10. Content elaborations—possible approaches to teaching the standards—detail ways that Aboriginal and Torres Strait Islander Histories and Cultures can be incorporated. For example, Year 7 Science students learn that “predictable phenomena on Earth, including seasons and eclipses, are caused by the relative positions of the sun, Earth and the moon”. This can be taught by “researching knowledges held by Aboriginal and Torres Strait Islander Peoples regarding the phases of the moon and the connection between the lunar cycle and ocean tides” (ACARA, “Science” ACSSU115). This curriculum priority mandates that teachers and learners across Australia engage in representations of Indigenous peoples through teaching and learning activities. However, questions about what constitutes the most appropriate activities, when and where they are incorporated into schooling, and how to best support educators to do this work must continue to be asked.As Indigenous knowledges and perspectives are brought into the classroom where this curriculum is played out, they are shaped by the discourses of the space (Nakata, “Cultural Interface”): what is normalised in a classroom, the teachers’ and students’ prior understandings, and the curriculum and assessment expectations of teaching and learning. Nakata refers to this space as the cultural interface, the contested space between Indigenous and Western knowledge systems where disciplinary discourses, practices and histories translate what is known about Indigenous peoples. This creates complexities and anxieties for teachers tasked with this role (Nakata, “Pathways”). Yet to ignore the presence of Indigenous histories, lifeworlds, and experiences would be to act as if non-Indigenous Australia was alone in the world. The curriculum, as a socio-political document, is full of representations of people. As such, care must be given to how teachers are prepared to engage in the complex process of negotiating these representations.The Classroom as a Location of PossibilityThe introduction of the Australian Curriculum has been accompanied by the Australian Professional Standards for Teachers (APST) which govern the requirements for graduating teachers. Two particular standards—1.4 and 2.4—refer to the teaching of Indigenous students and histories, cultures and language. Many initial teacher education programs in Australian universities have responded to the curriculum requirements and the APSTs by developing a specific subject dedicated to Indigenous education. It is difficult to ascertain the success of this work. Many in-service teachers suggest that more knowledge about Indigenous cultures is required to meet the APST, risking an essentialised view of the Indigenous learner (Moodie and Patrick). Further, there is little empirical research on what improves Indigenous students’ educational outcomes, with the research instead focusing on engaging Indigenous students (Burgess et al.). Similarly, there is yet to be a broadscale research program exploring how teacher educators can best educate pre-service teachers to improve educational outcomes for Indigenous students. Instead, much of the research focuses on engaging (predominantly non-Indigenous) becoming-teachers through a variety of theoretical and pedagogical approaches (Moreton-Robinson et al.) A handful of researchers (e.g. Moodie; Nakata et al.; Page) are considering how to use curriculum design to structure tertiary level Indigenous Studies programs—for pre-service teachers and more generally—to best prepare students to work within complex uncertainties.Levinas’s philosophy reminds us that we need to push beyond thinking about the engagement of Indigenous peoples within the curriculum to the relationship between educator-researchers and their students. Further, Levinas prompts us to question how we can research in this space in a way that is more than just about “disinterested acquisition of knowledge” (Reader 78), instead utilising critical analysis to consider a praxis which ultimately benefits Indigenous students, families and communities. The encounter with Levinas’s writing challenges us to consider how teacher educators can engage with pre-service teachers in a way that does not suggest that they are inherently racist. Rather, we must teach pre-service teachers to not impress the same type of epistemological violence onto Indigenous students, knowledges and cultures. Such questions prompt an engagement with teaching/research which is respectful of the responsibilities to all involved. As hooks reminds us, education can be a practice of freedom: classrooms are locations of possibilities where students can think critically and question taken-for-granted assumptions about the world. To engage with praxis is to consider teaching not just as a practice, but as a theoretically and justice-driven approach. It is with this backdrop that I move now to consider some of the writings of non-Indigenous pre-service teachers.The Research ProjectThe data presented here is from a recent research project exploring pre-service teachers’ experiences of a compulsory Indigenous education subject as part of a four-year initial teacher education degree in an Australian metropolitan university (see McDowall). The subject prepares pre-service teachers to both embed the Aboriginal and Torres Strait Islander Histories and Cultures CCP in their praxis and to teach Indigenous students. This second element engages both an understanding of Indigenous students as inhabiting an intercultural space with particular tensions (Nakata, “Pathways”), and the social-political-historical discourses that impact Indigenous students’ experiences. This includes the history of Indigenous education, the social construction of race, and a critical awareness of deficit approaches to working with Indigenous students. The subject was designed to promote a critical engagement with Indigenous education, to give pre-service teachers theoretical tools to make sense of both how Indigenous students and Indigenous content are positioned in classrooms and develop pedagogical frameworks to enable future teaching work. Pre-service teachers wrote weekly reflective learning journals as an assessment task (weighted at 30% of their total grade). In the final weeks of semester, I asked students in the final weeks of semester for permission to use their journals for a research project, to which 93 students consented.Reading the students’ reflective writing presents a particular ethical paradox, one intricately linked with the act of knowing. Throughout the semester, a desire to gain more knowledge about Indigenous peoples and cultures shifted to a desire to be present as teacher(s) in the Indigenous education landscape. Yet for pre-service teachers with no classroom of their own, this being present is always deferred to the future, mitigating the need for action in the present. This change in the pre-service teachers’ writing demonstrates that the relationship between violence and responsibility is exceedingly complex within the intersection of Indigenous and teacher education. These themes are explored in the following sections.Epistemological ViolenceOne of the shifts which occurred throughout the semester was a subtle difference in the types of knowledges students sought. In the first few weeks of the subject, many of the pre-service teachers wrote of a strong desire to know about Indigenous people and culture as a way of becoming a better educator. Their expectations were around wanting to address their “limited understandings”, wanting to “heighten”, “develop”, and “broaden” “understanding” and “knowledge”; to know “more about them, their culture”. At the end, knowing and understanding is presented in a different type of way. For some students, the knowledge they now want is about their own histories and culture: “as a teacher I need the bravery to acknowledge what happened in the past”, wrote one student in her final entry.For other students, the idea of knowing was shaped by not-knowing. Moving away from a desire to know, and thereby possess, the students wrote about the need to know no longer being present: “I owe my current sense of confidence to that Nakata article. The education system can’t expect all teachers to know exactly how to embed Indigenous pedagogy into their classrooms, can they?” writes one student in her final entry, following on to say, “the main strategy I got from the readings … still stands true: ‘We don’t know everything’ and I will not act like I do”. Another writes, “I am not an expert and I am now aware of the multitude of resources available, particularly the community”.For the students to claim knowledge of Indigenous peoples would be to enact epistemological violence, denying the alterity—difference—of the other and drawing them into our totalities. In the final weeks of the semester, some students wrote that they would use hands-on, outdoor activities in order to enact a culturally responsive pedagogy. Such a claim shows the tenacity of Western knowledge about Indigenous students. In this case, the students’ sentiment can be traced back to Aboriginal Learning Styles (Harris), the idea that Aboriginal students inherently learn via informal hands-on (as opposed to abstract) group approaches. The type of difference promoted in Aboriginal learning styles is biological, suggesting that on account of their Indigeneity, Aboriginal students inherently learn differently. Through its biological function, this difference essentialises Indigenous learners across the nation, claiming a sameness. But perhaps even more violently, it denies the presence of an Indigenous knowledge system in the place where the research took place. Such an Indigenous knowledge system begins from the land, from Country, and entails a rich set of understandings around how knowledge is produced, shared, learnt and, enacted through place and people-based knowledge practices (Verran). Aboriginal learning styles reduces richness to a more graspable concept: informal learning. To summarise, students’ early claims to knowledge shifted to an understanding that it is okay to ‘not know’—to recognise that as beginning teachers, they are entering a complex field and must continue learning. This change is complicated by the tenacity of knowledge claims which define Indigenous students into a Western order of knowledge. Such claims continue to present themselves in the students writing. Nonetheless, as students progressed through the semester and engaged with some of the difficult knowledges and understandings presented, a new form of knowing emerged. Ethical ResponsibilitiesAs pre-service teachers learned about the complex cultural interface of classrooms, they began to reconsider their own claims to be able to ‘know’ Indigenous students and cultures. This is not to say that pre-service teachers do not feel responsibility for Indigenous students: in many journals, pre-service teachers’ wanted-ness in the classroom—their understanding of their importance of presence as teachers—is evident. To write for themselves a need to be present demonstrates responsibility. This took place as students imagined future praxis. With words woven together from several journals, the students’ final entries indicate a wanting-to-be-present-as-becoming-ethical-teachers: I willremember forever, reactionsshocked, sad, guilty. A difference isI don’t feel guilt.I feelI’m not alone.I feelmore aware ofhow I teachhow my opinionscan affect people. I guesswe are the oneswho must makethe change. I feelsomewhat relieved bywhat today’s lecturer said.“If you’re willingto step outfrom behind fencesto engage meaningfullywith Indigenous communitiesit will not be difficult.” I believethe 8-ways frameworkthe unit of workprovide authentic experiencesare perfect avenuesshape pedagogical practicesI believemy job isto embrace remembrancemake this happenmake sure it stays. I willtake away frameworkssupport Indigenous studentsalongside Indigenous teacherslearn from themconsult with communityimprove my teaching. In these students’ words is an assumed responsibility to incorporate Indigenous knowledges and perspectives into their work as teachers. To wish representations of Indigenous peoples and knowledges present in the classroom is one way in which the becoming-teachers are making themselves present. Even a student who had written that she still didn’t feel completely equipped with pedagogical tools still felt “motivated” to introduce “political issues into Australia’s current system”.Not all students wrote of such presence. One student wrote of feeling left “disappointed”, “out of pocket”, “judged” – that the subject had “just ‘ticked the box’” (a phrase used by a second student as well). Another student wrote a short reflection that scratched the surface of the Apology¹, noting that “sorry is something so easy to say”. It is the mixture of these responses which reminds us as researchers and educators that it is easy to write a sense of presence as a projection into the future into an assessment task for a university subject. Time is another other, and the future can never be grasped, can never truly be known (Levinas, Reader). It is always what is coming, for we can only ever experience the present. These final entries by the students claim a future that they cannot know. This is not to suggest that the words written—the I wills and I believes which roll so quickly off the pen—are not meaningful or meant. Rather, responsibility is deferred to the future. This is not just a responsibility for their future teaching. Deferral to the future can also be a way to ease one’s self of the burden of feeling bad about the social injustices which students observe. As Rose (17) writes,The vision of a future which will transcend the past, a future in which current contradictions and current suffering will be left behind enables us to understand ourselves in an imaginary state of future achievement … enables us to turn our backs on current social facts of pain, damage, destruction and despair which exist in the present, but which we will only acknowledge as our past.The pre-service teachers’ reflective writing presents us with a paradox. As they shift away from the epistemological violence of claiming to know Indigenous others from outside positions, another type of violence manifests: claiming a future which can transcend the past just as they defer responsibility within the present. The deferral is in itself an act of violence. What types, then, of presence—a sense of responsibility—can students-as-becoming-professionals demonstrate?ConclusionRose’s words ask us as researchers and educators to consider what it might mean to “do” ethical practice in the “here and now”. When teachers claim that more knowledge about Indigenous peoples will lead to better practice, they negate the epistemological violence of bringing Indigeneity into a Western order of knowledge. Yet even as pre-service teachers’ frameworks shift toward a sense of responsibility for working with Indigenous students, families, and communities—a sense of presence—they are caught in a necessary but problematic moment of deferral to future praxis. A future orientation enables the deflection of responsibility, focusing on what the pre-service teachers might do in the future when they have their own classrooms, but turning their backs on a lack of action in the present. Such a complexity reveals the paradox of assessing learnings for both researchers and university educators. Pre-service teachers—visitors in placement classrooms and students in universities—are always writing and projecting skill towards the future. As educators, we continually ask for students to demonstrate how they will change their future work in a time yet to come. Yet when pre-service teachers undertake placements, their agency to enact difference as becoming-teachers is limited by the totality of the current school programs in which they find themselves. A reflective learning journal, as assessment directed at projecting their future work as teachers, does not enable or ask for a change in the here and now. We must continue to engage in such complexities in considering the potential of epistemological violence as both researchers and educators. Engaging with philosophy is one way to think about what we do (Kameniar et al.) in Indigenous education, a complex field underpinned by violent historical legacies and decades of discursive policy and one where the majority of the workforce is non-Indigenous and working with ideas outside of their own experiences of being. To remember that we are not alone in the world is to stay present with this complexity.ReferencesAustralian Curriculum and Assessment Reporting Authority. “Cross-Curriculum Priorities.” Australian Curriculum. Australian Curriculum and Assessment Reporting Authority, n.d. 23 Apr. 2020 <https://www.australiancurriculum.edu.au/f-10-curriculum/cross-curriculum-priorities/­>.———. “Science.” Australian Curriculum. 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Teaching to Transgress: Education as the Practice of Freedom. New York: Routledge, 1994.Kameniar, Barbara, Sally Windsor, and Sue Sifa. “Teaching Beginning Teachers to ‘Think What We Are Doing’ in Indigenous Education.” The Australian Journal of Indigenous Education 43.2 (2014): 113-120.Levinas, Emmanuel. Existence and Existents. Trans. Alphonso Lingis. Pittsburgh, PA: Duquesne UP, 1947/1978.———. Totality and Infinity. Trans. Alphonso Lingis. Pittsburgh, PA: Duquesne UP, 1969.———. The Levinas Reader. Ed. Sean Hand. Oxford: Basil Blackwell, 1989.McDowall, Ailie. “Following Writing Around: Encountering Ethical Responsibilities in Pre-Service Teachers’ Reflective Journals in Indigenous Education.” PhD dissertation. Brisbane: University of Queensland, 2018.Ministerial Council for Education, Early Childhood Development and Youth Affairs. Melbourne Declaration on Educational Goals for Young Australians. Ministerial Council for Education, Early Childhood Development and Youth Affairs, 2008. <http://www.curriculum.edu.au/verve/_resources/National_Declaration_on_the_Educational_Goals_for_Young_Australians.pdf>.Moodie, Nikki. “Learning about Knowledge: Threshold Concepts for Indigenous Studies in Education.” Australian Educational Researcher 46.5 (2019): 735-749.Moodie, Nikki, and Rachel Patrick. “Settler Grammars and the Australian Professional Standards for Teachers.” Asia-Pacific Journal of Teacher Education 45.5 (2017): 439-454.Moreton-Robinson, Aileen, David Singh, Jessica Kolopenuk, and Adam Robinson. Learning the Lessons? Pre-service Teacher Preparation for Teaching Aboriginal and Torres Strait Islander Students. Queensland University of Technology Indigenous Studies Research Network, 2012. <https://www.aitsl.edu.au/docs/default-source/default-document-library/learning-the-lessons-pre-service-teacher-preparation-for-teaching-aboriginal-and-torres-strait-islander-studentsfb0e8891b1e86477b58fff00006709da.pdf?sfvrsn=bbe6ec3c_0>.Nakata, Martin. “The Cultural Interface.” The Australian Journal of Indigenous Education 36.S1 (2007): 7-14.———. “Pathways for Indigenous Education in the Australian Curriculum Framework.” The Australian Journal of Indigenous Education 40 (2011): 1-8.Nakata, Martin, Victoria Nakata, Sarah Keech, and Reuben Bolt. “Decolonial Goals and Pedagogies for Indigenous Studies.” Decolonization: Indigeneity, Education & Society 1.1 (2012): 120-140.Page, Susan. “Exploring New Conceptualisations of Old Problems: Researching and Reorienting Teaching in Indigenous Studies to Transform Student Learning.” The Australian Journal of Indigenous Education 32.1 (2014): 21–30.Peterson, Nicolas. “‘Studying Man and Man’s Nature’: The History of the Institutionalisation of Aboriginal Anthropology.” Australian Aboriginal Studies 2 (1990): 3-19.Pholi, Kerryn, Dan Black, and Craig Richards. “Is ‘Close the Gap’ a Useful Approach to Improving the Health and Wellbeing of Indigenous Australians?” Australian Review of Public Affairs 9.2 (2009): 1-13.Rose, Deborah B. Reports from a Wild Country: Ethics of Decolonisation. Sydney: U of New South Wales P, 2004.Verran, Helen. “Knowledge Systems of Aboriginal Australians: Questions and Answers Arising in a Databasing Project.” Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures. Ed. Helaine Selin. New York: Springer, 2008. 1171-1177.Note1. The Apology refers to a motion moved in the Federal Parliament by the 2008 Prime Minister. The motion, seconded by the Leader of the Opposition, was an official apology to members of the Stolen Generations, Indigenous peoples who had been removed from their families by the state. A bill to establish a compensation fund as reparations was not passed (Burns).

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IntroductionThis article addresses the experience of designing and conducting life-writing workshops for a group of clients with severe mental illness; the aim of this pilot study was to begin to determine whether such writing about the self can aid in individual ‘recovery’, as that term is understood by contemporary health professionals. A considerable amount has been written about the potential of creative writing in mental health therapy; the authors of this article provide a brief summary of that literature, then of the concept of ‘recovery’ in a psychology and arts therapy context. There follows a first-hand account by one of the authors of being an arts therapy workshop facilitator in the role of a creative practitioner. This occurred in consultation with, and monitored by, experienced mental health professionals. Life-Writing as ‘Therapeutic’ Life-story or life-writing can be understood in this context as involving more than disclosure or oral expression of a subject’s ‘story’ as in psycho-therapy – life-story is understood as a written, structured narrative. In 2001, Wright and Chung published a review of the literature in which they claimed that writing therapy had been “restimulated by the development of narrative approaches” (278). Pennebaker argues that “catharsis or the venting of emotions” without “cognitive processing” has little therapeutic value and people need to “build a coherent narrative that explains some past experience” in order to benefit from writing” (Pennebaker, Telling Stories 10–11). It is claimed in the Clinical Psychology Review that life-writing has the therapeutic benefits of, for example, “striking physical health and behaviour change” (Esterling et al. 84). The reasons are still unclear, but it is possible that the cognitive and linguistic processing of problematic life-events through narrative writing may help the subject assimilate such problems (Alschuler 113–17). As Pennebaker and Seagal argue in the Journal of Clinical Psychology, the life-writing processallows one to organise and remember events in a coherent fashion while integrating thoughts and feelings ... This gives individuals a sense of predictability and control over their lives. Once an experience has structure and meaning, it would follow that the emotional effects of that experience are more manageable. (1243)It would seem reasonable to suggest that life-writing which constructs a positive recovery narrative can have a positive therapeutic effect, providing a sense of agency, connectedness and creativity, in a similar, integrating manner. Humans typically see their lives as stories. Paul Eakin stresses the link between narrative and identity in both this internal life-story and in outwardly constructed autobiography:narrative is not merely a literary form but a mode of phenomenological and cognitive self-experience, while self – the self of autobiographical discourse - does not necessarily precede its constitution in narrative. (Making Selves 100)So both a self-in-time and a socially viable identity may depend on such narrative. The term ‘dysnarrativia’ has been coined to describe the documented inability to construct self-narrative by those suffering amnesia, autism, severe child abuse or brain damage. The lack of ability to achieve narrative construction seems to be correlated with identity disorders (Eakin, Fictions in Autobiography 124). (For an overview of the current literature on creative and life-writing as therapy see Murphy & Neilsen). What is of particular relevance to university creative writing practitioners/teachers is that there is evidence, for example from Harvard psychiatrist Judith Herman and creative writing academic Vicki Linder, that life-narratives are more therapeutically effective if guided to be written according to fundamental ‘effective writing’ aesthetic conventions – such as having a regard to coherent structure in the narrative, the avoidance of cliché, practising the ‘demonstrate don’t state’ dictum, and writing in one’s own voice, for example. Defining ‘Recovery’There remains debate as to the meaning of recovery in the context of mental health service delivery, but there is agreement that recovery entails significantly more than symptom remission or functional improvement (Liberman & Kopelowicz). In a National Consensus Statement, the Substance Abuse and Mental Health Services Administration (SAMHSA) unit of the US Department of Health and Human Services in 2005 described recovery (in general terms) as being achieved by the enabling of a person with a mental illness to live meaningfully in a chosen community, while also attempting to realize individual potential. ‘Recovery’ as a central concept behind rehabilitation can be understood both as objective recovery – that is, in terms of noting a reduction in objective indicators of illness and disability (such as rates of hospital usage or unemployment) and a greater degree of social functioning – and also as subjective recovery. Subjective recovery can be ascertained by listening closely to what clients themselves have said about their own experiences. It has been pointed out (King, Lloyd & Meehan 2) that there is not always a correspondence between objective indicators of recovery and the subjective, lived experience of recovery. The experience of mental illness is not just one of symptoms and disability but equally importantly one of major challenge to sense of self. Equally, recovery from mental illness is experienced not just in terms of symptoms and disability but also as a recovery of sense of self … Recovery of sense of self and recovery with respect to symptoms and disability may not correspond. (King, Lloyd & Meehan; see also Davidson & Strauss)Symptoms of disability can persist, but a person can have a much stronger sense of self or empowerment – that is still recovery. Illness dislocates the sense of self as part of a community and of a self with skills and abilities. Restoring this sense of empowerment is an aim of arts therapy. To put it another way, recovery is a complex process by which a client with a mental illness develops a sense of identity and agency as a citizen, as distinct from identification with illness and disability and passivity as a ‘patient’. The creative arts have gone well beyond being seen as a diversion for the mentally ill. In a comprehensive UK study of creative arts projects for clients with mental illness, Helen Spandler et al. discovered strong evidence that participation in creative activity promoted a sense of purpose and meaning, and assisted in “rediscovering or rebuilding an identity within and beyond that of someone with mental health difficulties” (795). Recovery is aided by people being motivated to achieve self-confidence through mastery and competence; by learning and achieving goals. Clearly this is where arts therapy could be expected or hoped to be effective. The aim of the pilot study was not to measure ‘creativity’, but whether involvement in what is commonly understood as a creative process (life-writing) can have flow-on benefits in terms of the illness of the workshop participant. The psychologists involved, though more familiar with visual arts therapy (reasonably well-established in Australia – in 2006, the ANZAT began publishing the Australian and New Zealand Journal of Art Therapy), thought creative writing could also be valuable. Preparation for and Delivery of the Workshops I was acutely aware that I had no formal training in delivering a program to clients with mental health illness. I was counselled during several meetings with experienced psychologists and a social worker that the participants in the three workshops over two weeks would largely be people who had degrees of difficulty in living independently, and could well have perceptual problems, could misjudge signals from outside and inside the group, and be on medication that could affect their degree of engagement. Some clients could have impaired concentration and cognition, and a deficit in volition. Participants needed to be free to leave and rejoin the workshops during the afternoon sessions. Attendance might well fall as the workshops progressed. Full ethical clearance was attained though the University of Queensland medical faculty (after detailed description of the content and conduct of the proposed workshops) and consent forms prepared for participants. My original workshop ‘kit’ to be distributed to participants underwent some significant changes as I was counselled and prepared for the workshops. The major adjustment to my usual choice of material and approach was made in view of the advice that recounting traumatic events can have a negative effect on some patients – at least in the short term. For the sake of both the individuals and the group as a whole this was to be avoided. I changed my initial emphasis on encouraging participants to recount their traumatic experiences in a cathartic way (as suggested by the narrative psychology literature), to encouraging them to recount positive narratives from their lives – narratives of ‘recovery’ – as I explain in more detail below. I was also counselled that clients with mental health problems might dwell on retelling their story – their case history – rather than reflecting upon it or using their creative and imaginative ability to shape a life-story that was not a catalogue of their medical history. Some participants did demonstrate a desire to retell their medical history or narrative – including a recurring theme of the difficulty in gaining continuity with one trusted medical professional. I gently guided these participants back to fashioning a different and more creative narrative, with elements of scene creation, description and so on, by my first listening intently to and acknowledging their medical narrative for a few minutes and then suggesting we try to move beyond that. This simple strategy was largely successful; several participants commented explicitly that they were tired of having to retell their medical history to each new health professional they encountered in the hospital system, for example. My principal uncertainty was whether I should conduct the workshops at the same level of complexity that I had in the past with groups of university students or community groups. While in both of those cohorts there will often be some participants with mental health issues, for the most part this possibility does not affect the level or kind of content of material discussed in workshops. However, within this pilot group all had been diagnosed with moderate to severe mental illness, mostly schizophrenia, but also bipolar disorder and acute depression and anxiety disorders. The fact that my credentials were only as a published writer and teacher of creative writing, not as a health professional, was also a strong concern to me. But the clients readily accepted me as someone who knew the difficulty of writing well and getting published. I stressed to them that my primary aim was to teach effective creative writing as an end in itself. That it might be beneficial in health terms was secondary. It was a health professional who introduced me and briefly outlined the research aims of the workshop – including some attempt to measure qualitatively any possible benefits. It was my impression that the participants did not have a diminished sense of my usefulness because I was not a health professional. Their focus was on having the opportunity to practice creative writing and/or participate in a creative group activity. As mentioned above, I had prepared a workshop ‘kit’ for the participants of 15 pages. It contained the usual guidelines for effective writing – extracts from professional writers’ published work (including an extract from my own published work – a matter of equity, since they were allowing me to read their work), and a number of writing exercises (using description, concrete and abstract words, narrative point of view, writing in scenes, show don’t tell). The kit contained extracts from memoirs by Hugh Lunn and Bill Bryson, as well as a descriptive passage from Charles Dickens. An extract from Inga Clendinnen’s 2006 account in Agamemnon’s Kiss: selected essays of her positive interaction with fellow cancer patients (a narrative with the underlying theme of recovery) was also valuable for the participants. I stressed to the group that this material was very similar to that used with beginning writers among university students. I described the importance of life-writing as follows: Life-writing is simply telling a story from your life and perhaps musing or commenting on it at the same time. When you write a short account of something chosen from your life, you are making a pattern, using your memory, using your powers of description – you are being creative. You are being a story-teller. And story-telling is one very important thing that makes us humans different from all other animals – and it is a way in which we find a lot of meaning in our lives.My central advice in the kit was: “Just try to be as honest as you can – and to remember as well as you can … being honest and direct is both the best and the easiest way to write memoir”. The only major difference between my approach with these clients and that with a university class was in the selection of possible topics offered. In keeping with the advice of the psychologists who were experts in the theory of ‘recovery’, the topics were predominantly positive, though one or two topics gave the opportunity to recount and/or explore a negative experience if the participant wanted to do so: A time when I was able to help another personA time when I realised what really mattered in lifeA time when I overcame a major difficultyA time when I felt part of a group or teamA time when I knew what I wanted to do with my lifeA time when someone recognised a talent or quality of mineA time I did something that I was proud of A time when I learned something important to meA memorable time when I lived in a certain house or suburbA story that begins: “Looking back, I now understand that …”The group expressed satisfaction with these topics, though they had the usual writing students’ difficulty in choosing the one that best suited them. In the first two workshops we worked our way through the kit; in the third workshop, two weeks later, each participant read their own work to the group and received feedback from their peers and me. The feedback was encouraged to be positive and constructive, and the group spontaneously adopted a positive reinforcement approach, applauding each piece of writing. Workshop DynamicsThe venue for the workshops was a suburban house in the Logan area of Brisbane used as a drop-in centre for those with mental illness, and the majority of the participants would be familiar with it. It had a large, breezy deck on which a round-table configuration of seating was arranged. This veranda-type setting was sheltered enough to enable all to be heard easily and formal enough to emphasise a learning event was taking place; but it was also open enough to encourage a relaxed atmosphere. The week before the first workshop I visited the house to have lunch with a number of the participants. This gave me a sense of some of the participants’ personalities and degree of engagement, the way they related to each other, and in turn enabled them to begin to have some familiarity with me and ask questions. As a novice at working with this kind of client, I found this experience extremely valuable, especially as it suggested that a relatively high degree of communication and cognition would be possible, and it reduced the anxiety I had about pitching the workshops at an appropriate level. In the course of the first workshop, the most initially sceptical workshop participant ended up being the most engaged contributor. A highly intelligent woman, she felt it would be too upsetting to write about negative events, but ultimately wrote a very effective piece about the empowerment she gained from caring for a stray cat and locating the owner. Her narrative also expressed her realisation that the pet was partly a replacement for spending time with her son, who lived interstate. Another strong participant previously had written a book-length narrative of her years of misdiagnoses and trauma in the hospital system before coming under the care of her present health professionals. The participant who had the least literacy skills was accepted by the group as an equal and after a while contributed enthusiastically. Though he refused to sign the consent form at the outset, he asked to do so at the close of the first afternoon. The workshop was comprised of clients from two health provider organisations; at first the two groups tended to speak with those they already knew (as in any such situation in the broader community), but by the third workshop a sense of larger group identity was being manifested in their comments, as they spoke of what ‘the group’ would like in the future – such as their work being published in some form. It was clear that, as in a university setting, part of the beneficial effect of the workshops came from group and face to face interaction. It would be more difficult to have this dimension of benefit achieved via a web-based version of the workshops, though a chat room scenario would presumably go some way towards establishing a group feeling. Web-based delivery would certainly suit participants who lacked mobility or who lived in the regions. Clearly the Internet is a vital social networking tool, and an Internet-based version of the workshops could well be attempted in the future. My own previous experience of community digital storytelling workshops (Neilsen, Digital Storytelling as Life-writing) suggests that a high degree of technical proficiency can not be expected across such a cohort; but with adequate technical support, a program (the usual short, self-written script, recorded voice-over and still images scanned from the participants’ photo albums, etc) could make digital storytelling a further dimension of therapeutic life-writing for clients with mental illness. One of the most useful teaching techniques in a class room setting is the judicious use of humour – to create a sense of sharing a perspective, and simply to make material more entertaining. I tested the waters at the outset by referring to the mental health worker sitting in the background, and declaring (with some comic exaggeration) my concern that if I didn’t run the workshop well he would report adversely on me. There was general laughter and this expression of my vulnerability seemed to defuse anxiety on the part of some participants. As the workshop progressed I found I could use both humorous extracts of life-writing and ad hoc comic comments (never at the expense of a participant) as freely as in a university class. Participants made some droll comments in the overall context of encouraging one another in their contributions, both oral and written. Only one participant exhibited some temporary distress during one of the workshops. I was allowing another participant the freedom to digress from the main topic and the participant beside me displayed agitation and sharply demanded we get back to the point. I apologised and acknowledged I had not stayed as focused as I should and returned to the topic. I suspect I had a fortunate first experience of such arts therapy workshops – and that this was largely due to the voluntary nature of the study and that most of the participants brought a prior positive experience of the workshop scenario, and prior interest in creative writing, to the workshops. Outcomes A significantly positive outcome was that only one of the nine participants missed a session (through ill-health) and none left during workshops. The workshops tended to proceed longer than the three hours allotted on each occasion. Post-workshop interviews were conducted by a psychologist with the participants. Detailed data is not available yet – but there was a clear indication by almost all participants that they felt the workshops were beneficial and that they would like to participate in further workshops. All but one agreed to have their life-writing included in a newsletter produced by one of the sponsors of the workshops. The positive reception of the workshops by the participants has encouraged planning to be undertaken for a wide-ranging longitudinal study by means of a significant number of workshops in both life-writing and visual arts in more than one city, conducted by a team of health professionals and creative practitioners – this time with sophisticated measurement instruments to gauge the effectiveness of art therapy in aiding ‘recovery’. Small as the workshop group was, the pilot study seems to validate previous research in the UK and US as we have summarised above. The indications are that significant elements of recovery (in particular, feelings of enhanced agency and creativity), can be achieved by life-writing workshops that are guided by creative practitioners; and that it is the process of narrative construction within life-writing that engages with or enhances a sense of self and identity. NoteWe are indebted, in making the summary of the concept of ‘recovery’ in health science terms, to work in progress by the following research team: Robert King, Tom O'Brien and Claire Edwards (School of Medicine, University of Queensland), Margot Schofield and Patricia Fenner (School of Public Health, Latrobe University). We are also grateful for the generous assistance of both this group and Seiji Humphries from the Richmond Queensland Fellowship, in providing preparation for the workshops. ReferencesAlschuler, Mari. “Lifestories – Biography and Autobiography as Healing Tools for Adults with Mental Illness.” Journal of Poetry Therapy 11.2 (1997): 113–17.Davidson, Larry and John Strauss. “Sense of Self in Recovery from Severe Mental Illness.” British Journal of Medical Psychology 65 (1992): 31–45.Eakin, Paul. Fictions in Autobiography: Studies of the Art of Self-Invention. Princeton: Princeton UP, 1985.———. How Our Lives Become Stories: Making Selves. Ithaca: Cornell UP, 1999.Esterling, B.A., L. L’Abate., E.J. Murray, and J.W. Pennebaker. “Empirical Foundations for Writing in Prevention and Psychotherapy: Mental and Physical Health Outcomes.” Clinical Psychology Review 19.1 (1999): 79–96.Herman, Judith. Trauma and Recovery: The Aftermath of Violence - from Domestic Abuse to Political Terror. New York: Basic Books, 1992.King, Robert, Chris Lloyd, and Tom Meehan. Handbook of Psychosocial Rehabilitation. Oxford: Blackwell Publishing, 2007.Liberman, Robert, and Alex Kopelowicz. “Recovery from Schizophrenia: A Criterion-Based Definition.” In Ralph, R., and P. Corrigan (eds). Recovery in Mental Illness: Broadening Our Understanding of Wellness. Washington, DC: APA, 2005.Linder, Vicki. “The Tale of two Bethanies: Trauma in the Creative Writing Classroom.” New Writing: The International Journal for the Practice and Theory of Creative Writing 1.1 (2004): 6–14Murphy, Ffion, and Philip Neilsen. “Recuperating Writers – and Writing: The Potential of Writing Therapy.” TEXT 12.1 (Apr. 2008). ‹http://www.textjournal.com.au/april08/murphy_neilsen.htm›.Neilsen, Philip. “Digital Storytelling as Life-Writing: Self-Construction, Therapeutic Effect, Textual Analysis Leading to an Enabling ‘Aesthetic’ for the Community Voice.” ‹http://www.speculation2005.qut.edu.au/papers/Neilsen.pdf›.Pennebaker, James W., and Janel D. Seagal. “Forming a Story: The Health Benefits of Narrative.” Journal of Clinical Psychology, 55.10 (1999): 1243–54.Pennebaker, James W. “Telling Stories: The Health Benefits of Narrative.” Literature and Medicine 19.1 (2000): 3–18.Spandler, H., J. Secker, L. Kent, S. Hacking, and J. Shenton. “Catching Life: The Contribution of Arts Initiatives to ‘Recovery’ Approaches in Mental Health.” Journal of Psychiatric and Mental Health Nursing 14.8 (2007): 791–799.Wright, Jeannie, and Man Cheung Chung. “Mastery or Mystery? Therapeutic Writing: A Review of the Literature.” British Journal of Guidance and Counselling, 29.3 (2001): 277–91.

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Abstract:

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. Follow-up correspondence. 12 May 2016.Jenkins, Wendy. “Tales from the Backlist: A Fortunate Life Turns 30.” Fremantle Press, 14 April 2011. <https://www.fremantlepress.com.au/c/bookclubs/574-tales-from-the-backlist-a-fortunate-life-turns-30>.Keesing, Nancy. ‘An Enduring Classic.’ Australian Book Review (May 1981). FACP Press Clippings. Fremantle. n. pag.King, Noel. “‘I Can’t Go On … I’ll Go On’: Interview with Ray Coffey, Fremantle Arts Centre Press, 22 Dec. 2004; 24 May 2006.” Westerly 51 (2006): 31–54.Larsson, Marina. “A Disenfranchised Grief: Post War Death and Memorialisation in Australia after the First World War.” Australian Historical Studies 40.1 (2009): 79–95.Lindstrom, Richard. “The Australian Experience of Psychological Casualties in War: 1915-1939.” PhD dissertation. Victoria University, Feb. 1997.Loughran, Tracey. “Shell Shock, Trauma, and the First World War: The Making of a Diagnosis and its Histories.” Journal of the History of Medical and Allied Sciences 67.1 (2012): 99–119.Lucas, Anne. “Curator’s Notes.” A Fortunate Life. Australian Screen. <http://aso.gov.au/titles/tv/a-fortunate-life/notes/>.McLeod, Steve. “My Fortunate Life with Grandad.” Western Magazine Dec. (1983): 8.Munro, Craig. Under Cover: Adventures in the Art of Editing. Brunswick: Scribe, 2015.Murphy, Ffion, and Richard Nile. “The Naked Anzac: Exposure and Concealment in A.B. Facey’s A Fortunate Life.” Southerly 75.3 (2015): 219–37.———. “Wounded Storyteller: Revisiting Albert Facey’s Fortunate Life.” Westerly 60.2 (2015): 87–100.“NBC Book Awards.” Australian Book Review Oct. (1981): 1–4.PBL. Prospectus: A Fortunate Life, the Extraordinary Life of an Ordinary Bloke. 1–8.Repatriation Records. Albert Facey. 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/>.

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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.