Ian Webster, AO

Physician and Emeritus Professor of Public Health and Community Medicine, UNSW
November 2014
Each issue we ask someone from the alcohol and other drug sector to share a little about their work and life.

This weekend I will... spend Saturday writing letters to medical practitioners about patients attending the Nowra Drug and Alcohol Service and the Shoalhaven District Hospital. I hope to have time to start a woodcut and apply the final coats of paint to two tables I’ve repaired. Then to watch ABC TV and catch up with The Guardian, New England Journal of Medicine and Midnight’s Children by Salman Rushdie. And then make certain the garden is watered as the days are hot.

I wish I'd never… I don’t think there is anything I wish I had never done because everything has added up to life’s experience – its ups and downs. There are a myriad of things I wish I had done and now can’t. I would have liked to pursue physics and astronomy and then had time to study art and literature in greater depth, but being driven by the day-to-day demands of medicine has meant that much has to be set aside.

I'd originally planned to work... as a physicist or scientist of some kind, but ended up doing medicine. I grew up in a country town where the significant people were not physicists, scientists or politicians, but farmers, practical people, the Bush Nursing Hospital staff and the general practitioners. Our local doctor gave me a difficult book to read, Aequanimitas by Sir William Osler; I learnt later that Osler was the ‘father’ of modern clinical medicine. The book’s frontispiece had a quote from Thomas Carlyle: “Don’t look to the far dim distant future but do that which is clearly at hand.” And that, in essence, is how my work and life has been shaped ever since.

The qualities I most value in my colleagues are... honesty, hard work, preparedness to share the load and to value the opinions of others. Most of all I value those who have some humility in the face of the complex and important tasks of helping others; I am thinking especially of mental health, addiction and homelessness. There is no room for hubris when dealing with human predicaments. As a university student my friends and I were seized by the idea that we had to identify with those who were most marginal and disadvantaged.

I'll never forget... the personalities I have met on ‘skid row’ – lives so different from our own. I can never forget – the infant who was brain-damaged because there was a breakdown in communication between doctors; the coughing child and the flickering TV in the blacked-out Sheffield tenement; my grandmother’s stories; and the adventures my wife and small sons had as we set off for Whyalla, South Australia and then by ship for England to an unknown and uncertain future. Good decisions they turned out to be.

If I had more time, I'd... catch up on literature, spend more time drawing and painting and researching some of the issues which have intrigued me – social aspects of health and the nature of the problems of pain, the mind and addiction.

I'm most scared of... mob behaviour; to see the way large groups and small groups turn upon others with anger and hatred distresses me. Violence is just beneath the surface and so easily stirred up. We see it in racial conflict, war and politics; even in the behaviour of football crowds. I most admire those who stand against the mob; I most admire those who stand beside the vulnerable.

For my next holiday... we plan to visit to Japan, a country I know very little about. I am looking forward to seeing Japanese culture and traditions especially the woodcut prints and art.

I can't get enough... time to do so many things: to explore the issues of addiction, pain, suicide and mental health and day-to-day medicine. And then time to use my hands - in woodwork, art - and time to read.

I'm really terrible at... saying no. I like to do things and to be involved and should allow more time to ponder and think. However, there is a sense of immediacy and urgency when you deal with people who are suffering. Ted Noffs, the pastor at the Wayside Chapel, in the 70s, had painted on the walls of the Little Theatre his version of a statement from antiquity: "If not you, who? If not now, when? If not here, where?" That has served as my motto.

Career wise, I’m most proud of... starting or being there at the start of some of today’s well established entities; most importantly I am proud of the people I have supported who are now doing so well. I was there at the start of the National Campaign Against Drugs, the National Drug Strategy, the setting up of the National Drug and Alcohol Research Centre (NDARC) and FARE (Foundation for Alcohol Research and Education) and other non-governmental organisations and government advisory groups. Two highlights were the NSW Drug Summit in 1999 and the NSW Alcohol Abuse Summit in 2003 – two great democratic events. And, beyond alcohol and drugs – community medicine, homeless clinics, health screening and more. A great adventure.

My big hope for the drug and alcohol sector is... firstly, that it will cease to be marginalised and its front-line staff will be recognised for the selfless people that they are. Dr Neal Blewett, when Commonwealth Minister for Health, said that some of the most admirable people he met in his role as Minister came from drug and alcohol services. From a medical/health perspective I hope the problems experienced by people who use alcohol and drugs will be seen as central to the task of health care just as managing diabetes or coronary heart disease is today. And in public policy I hope society and its governments will progressively adopt sensible policies based on the fundamental principle of harm minimisation and not the bias of wishful ideology.

The sector's biggest challenge going forward... will be two intersecting ideologies, firstly, that addiction is a failure of the will and a deliberate choice and, secondly, that addiction is the reason people are poor. I fear these ideas will be used by neoliberal governments against poor mothers, families and others to deny families and individuals the welfare support to which they are entitled. It is already happening in the US and is an ever present risk in Australia. I hope that justice - social and institutional - will win the day.