ANDREW MILLER: We will only fix WA’s healthcare system when politicians actually listen to front-line workers

“If the little grey cells are not exercised, they grow the rust,” said Hercule Poirot. Agatha Christie’s Belgian detective was an illeist, who proclaimed himself the best detective in the world. Having smart phones and ChatGPT 5.0 should make us the best-informed humans in history, yet here we are trying to convince some that vaccinations work, that public hospitals need urgent attention, and the deaths of innocents - especially children - should be avoided. Nothing has changed in the struggle between the good and evil aspects of human nature, but the volume has been turned up to eleven by technology. Social media reveals occasional flashes of gold among its fast-flowing sewage, but it takes determination to find value. The competition for our commoditised attention is overwhelming. President Donald Trump provides daily masterclasses in “flooding the zone,” where our finite capacity to sift signal from noise is intentionally distracted, invoking cognitive dissonance for those who follow. The Epstein files are so yesterday. The opportunities to dissemble on every topic, including healthcare, abound. When Premier Roger Cook frequently repeats lines like “world class health system”, “code yellow is normal”, and “Google says hospitals over east are bad”, the aim is to talk over the statements of respected authorities like senior emergency physician Dr Peter Allely. The doctor, who should know, says Emergency Departments are pushed beyond simple ramping into disaster management, and that unnecessary bad outcomes, like preventable deaths, will only rise unless capacity is increased. As the world screams at itself, we need to seek out critical reasoning and a fair outcome for all people. Another doctor always worth listening to is Henry Marsh, medical role model, British neurosurgeon and author. His strategy for the management of ego, an important and elusive problem in the high-stakes world of alpha medicine, may usefully be applied more widely - including to politics. He notes that one needs a great deal of self-confidence and some healthy detachment to operate with skill every day, while knowing that some patients will have bad outcomes. Just as importantly, he says ego and aloofness must be kept in check through objective feedback from colleagues. Recently, a high-profile Sydney surgeon, Munjed Al Muderis lost his defamation case against a media outlet, and the reasoning was instructive. Judge Wendy Abraham said, “there is a darker side to his practice, not that his practice is mostly or invariably flawed,” and that the surgeon gave the “very strong impression” while giving self-serving evidence that his opinions were “unchallengeable”. How can someone like Henry Marsh maintain functional humility, when it appears others cannot? This applies equally to politicians, and all of us. Marsh says that despite accolades and stereotypes, a brain surgeon is not inherently special, they have just acquired some rare skills, like any specialist artisan. He says that what we think, see and do, and who we are, is all just electrochemistry. In the 1930s, scientists mapped the brain into eloquent and silent areas. The former being those which would cause obvious symptoms such as paralysis or aphasia if damaged by surgery, trauma or disease. The latter areas, like frontal lobes, had no obvious vital functions. Nowadays we recognise that the effects of damaging these “silent” parts of the brain can change our personality and judgement. Diseases like dementia or chronic traumatic encephalopathy might steal a person away before our eyes, even though they still walk and talk. To act — to do the best for our patients, families and society — we need ego. That ego must be tempered with truth, which is best coming from others, because it’s hard to be objective — even for an illeist. As Poirot said, “The truth, however ugly in itself, is always curious and beautiful to seekers after it.” Unlike the staggering, punch-drunk USA, there is still cause for hope in our relatively benign polity. However, we will only turn healthcare around when politicians respectfully listen to front-line workers, and humbly accept the truth.