Clinical Notes from the Outback


Howard Goldenberg’s memoir, Raft (Hybrid Publishers, 2009), is not quite one more story in the line of Mary Ellen Jordan’s Balanda (Allen & Unwin, 2005) or Maureen Helen’s Stranger Among the Martu (ABC Books, 2008). Like those earlier books, Goldenberg details his experiences in remote Aboriginal and Torres Strait communities. Like Helen’s, his story is one of medicine, illness and health, and encounters with the unfathomable. Unlike either of them, it is not a narrative of a year spent in a strange and forbiddingly alien place. Rather, Raft is a series of vignettes that ostensibly tell us less about the author’s struggle to understand and more to document the lives of the patients he treats, even if those lives are presented in snippets.Raised in rural Leeton, NSW, Goldenberg primarily practices medicine in Melbourne. He also frequently works as a relief doctor, seconded over many years to dozens of Aboriginal communities from One Arm Point and Bidyadanga to Wilson’s Promontory and Thursday Island. His job is to fill in for the local medico who is on a fortnight’s leave home, or sometimes to fly in to provide doctor’s services for a spell in a community that isn’t fortunate to have a regular attending physician.

As such, Raft can seem a bit disjointed in the early going. The first section of the book offers briefly described incidents ranging from Broome to Halls Creek to Mutitjulu, and thence to Jabiru and Katherine. In each Goldenberg tries to sketch out the role that a doctor plays, and the cultural barriers he must overcome simply to hold a conversation, much less to diagnose a malady or offer a palliative. Succeeding chapters offer tiny case histories, glimpses into the families of afflicted people, tales of despair and, glancingly, the doctor’s own struggle to make sense of this world of pain. 

Midway through the book, during an extended meditation on life in the relatively calm lands of Galiwin’ku, Goldenberg begins to experience a glimmer of understanding, the chance of hope. Another, surreal, chapter recounts a ride in a troopie with members of a dance troupe from Wadeye making their first appearance at the Garma festival. There is suspicion, a bit of fear, some testing of courage, and ultimately, acceptance.

As Goldenberg tells more and more stories, it seems that a sense of coherence, of logic, begins to shine just over the horizon. His exposure to works of art in Balgo and on Elcho Island opens up a vein of warmth; he marvels at the beauty that painting reveals in the midst of squalor and degradation. But a real sunrise never comes.

The sense of the tragic never goes away, and a real possibility of shaping these shards of his life in the Outback is never realized. I was puzzled by the staunchly episodic feel of the book, the continental meandering that brought Goldenberg no closer to a resolution–a moral, if you will–that he could construct out of these many experiences. As I relaxed my expectations a bit, I began to appreciate the matter-of-factness of his retelling of these lives he has encountered in the course of his work. If this is not exactly a vehicle for Aboriginal people to tell their own stories, Raft at least provides something very like an objective portrait of the people he encounters. I began to respect the author for the simplicity of his reporting and to be grateful to him for his refusal to embellish.

In the acknowledgments that close the book, Goldenberg offers the briefest of explanations for this tone, noting that among his advisors in style was Helen Garner, who urged him “strenuously to publish the pieces she liked and to incinerate those sections — ‘posturing and rhetorical’ — that she did not. It is precisely that lack of an attempt at fiery moralizing that distinguishes Raft from many otherwise similar memoirs of encounters with remote Australia.

A few pages earlier, in a chapter that attempts to summarize his perspective, Goldernberg offers a brief paragraph that adumbrates Garner’s advice and offers the closest thing to a lesson learned from these many glimpses into a world “not at peace”:

I have found myself uncomfortable in many ways. I have felt helpless, and confused by my helplessness; irrelevant and occasionally absurd. I have experienced shock and moral disorientation. Numb hopelessness followed, then a phase of toxic resignation. Later came a calmer state of acceptance, which left me open to encouragement; and now I maintain a poised refusal of acceptance (p. 214).

Raft is a series of meditations. To read it is the work of a few hours, but it offers substance for a lifetime of thought. Goldenberg has come to no conclusions, and does not ask his readers to judge either. He simply presents what he has seen, and asks us not to accept it.

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