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Cry from the heart

The Brazil Project

Ron Elisha
MJA 2004; 181 (11/12): 669-670

How can we restore some semblance of sanity to a world spinning out of control?

Some years ago now, Terry Gilliam (of Monty Python fame) produced something of a screen gem, enigmatically entitled Brazil. It was set in some indeterminate period in the near future, at which we now seem to have arrived.

The world of Brazil was a world out of control — a world in which the infrastructure of daily living had become so complex that it required the intervention of a quasi-supernatural being when things went wrong in the lives of its inhabitants.

Played (brilliantly) by Robert de Niro, this being descends (like Superman) from nowhere to rip open the offending section of wall — behind which there pulsates an incredibly complex, almost organic, mass of wires, tubes and other assorted technological viscera — “fix” the problem and then disappear once more.

While immensely grateful, the mortals whom he has thus aided are none the wiser as to how he has effected this minor miracle, which leaves them very much at his mercy the next time the system fouls up. This threat is never far off, as the more complex things are the more often they go wrong.

It would be possible to run a society with such a quasi-supernatural saviour at hand, assuming, of course, that some terrible mishap does not befall your hero.

The gamut of potential mishaps must be extensive: kryptonite, alien forces, death rays, evil geniuses, or even the appearance of a Bizarro-quasi-supernatural being.

But, in Brazil, hero de Niro did not succumb to any of these. He succumbed to paper.

Yes, you heard me: paper.

One day, he is walking along a road when a wind springs up. A piece of paper blows up against his leg, then blows away. Then a second, then a third — before a veritable barrage. Some of these papers are whisked away, while others adhere to his flailing limbs as he struggles to free himself.

Soon he is trapped, struggling to breathe in this swirling, smothering maelstrom.

But the onslaught of the paper is relentless, torrential, unforgiving.

Soon, his struggles falter, and he drops to his knees. We sense that he has lost the battle. His struggling figure wanes, the paper begins to disperse, and soon there’s nothing left where de Niro once stood. He has been utterly subsumed — drowned and obliterated — by paper.

Any of this sound familiar to you? It should. Simply substitute “computerisation” for “complex infrastructure” and “red tape” for “paper”.

But what is red tape? Red tape consists of the requirements of a complex bureaucracy.

How is it manifest? As documentation.

Why is it seen as necessary? In order to prove that we are doing what we say we are doing.

But to whom are we demonstrating this proof? Ultimately, to a bunch of lawyers, whether they are the hired guns of a litigious patient or the hired “suits” of a government department.

Our society is drowning. It is on the verge of being utterly subsumed by the complexity of its own systems.

Anyone who doesn’t realise this is ready for a wake-up call. This is that call!

Litigation was originally put in place to protect the rights of the individual, but it now oppresses the very people it was sent to protect!

Every day around the world, billions of ordinary citizens — from doctors to nurses to accountants to engineers to shopkeepers to craftsmen to fishermen to you-name-it — spend a substantial part of every hour devoting themselves to the documentation of their job as opposed to its execution.

And with every year that passes, the level of documentation becomes more exacting, more oppressive, more intrusive, less conducive to the effective management of the job and, perhaps most damaging of all, insidiously undermining of trust.

Everybody out there is hurting.

A patient of mine who runs a small woodwork workshop for children (in which no child has ever been injured) told me that he now finds himself paying out $15 000 a year in insurance to an insurer he had to hunt for interstate.

A well-known fishing identity from Sorrento, near Melbourne, speaking on a local radio station, said that he spends half his working day on dry land filling out government forms.

Another of my patients, a family accountant, has to drop all of her loyal, regular, small clients because the documentation requirements of even the simplest transaction have placed the cost of her accounting services out of reach of these people — the very people for whom she set up her business in the first place.

On a macro scale, in my opinion, the productivity of modern society has been virtually halved by the requirements of documentation (while the consumption of paper has sextupled).

The situation is no longer sustainable. As a society, we can no longer afford the luxury of mistrust.

Yes, it’s nice to have the right to sue, but the other side of that coin is that each of us must expend half of our working lives in efforts to prevent others from suing us. Ironically, the exponential rise in documentation that was supposed to protect us from such litigation has failed miserably. We are being sued more than ever before.

At a recent risk management seminar I learnt that the United States experience of capping damages is that it doesn’t work and that lawyers simply launched more actions so as to bring their total income back to what it was before the capping.

We need to create legal systems that virtually exclude lawyers entirely (eg, the New Zealand system of compensation for medical mishap), and we need to limit their numbers quite sharply — as it seems to me that each lawyer will fill the litigious airspace available to him or her.

And, we need to become aware of the price we pay for each so-called “right” we claim. Moreover, we need to trust one another more.

The world is spinning out of control, and nobody is yelling: “Stop!”

“The Brazil Project” is about doing just that.

It is about bringing these issues into the public eye in a balanced fashion, without compartmentalising them to the point of meaninglessness.

It is about calling a moratorium on worthless documentation — ie, any documentation that is not essential to the actual running of a particular enterprise.

It is about loosening the stranglehold of lawyers, whom we ourselves have aided and abetted with our actions.

It is about recognising that there is another way of conducting our society — a way based on trust rather than adversarial acquisitiveness.

My intention is to make The Brazil Project a functioning reality — not an institution bound by meetings and minutes and mission statements, but a loose association of like-minded individuals whose aim it is to restore to the world some semblance of sanity.

This will take time, effort, energy, faith, determination and, yes, some money. As a 70-hour-per-week medico, I can’t do it alone (although success in this venture would probably render me a 35-hour-per-week medico!).

If you are interested in joining me in this endeavour, please contact me.

I do not pretend to have all the answers, nor am I entirely certain of the way to proceed, but there has to be a better way, and I believe the first step in achieving a better way is a cry of protest. The more voices that join in this cry, the better it will be heard.

(Received 17 Sep 2004, accepted 22 Oct 2004)

992 Glen Huntly Road, South Caulfield, VIC.

Ron Elisha, MB BS, General Practitioner.

Correspondence: Dr Ron Elisha, 992 Glen Huntly Road, South Caulfield, VIC 3162. relishaATbigpond.net.au

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©The Medical Journal of Australia 2004 www.mja.com.au ISSN: 0025-729X

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