Welcome back to the Thought Broadcast, the trainee-led podcast from Australasian psychiatry. My name is Ed Miller, and today we're interviewing Mark Lawrence. Mark likes to refer to himself as an average Joe Māori boy from Glenfield, a school dropout that somehow got through. A student of life that loves sports, teaching, and learning new stuff, a father of four young adult children, married for 28 years, a retired triathlete and rugby head coach who loves exploring new places, travel and outdoors. And also a closet nerve with big thighs. And welcome to the podcast, uh Mark. It's really good to have you.

Yeah, Curi, thanks uh for inviting me, I really appreciate it.

I know you've got some other titles as well that I thought you might like to talk about.

Connections rather than anything else. So I fuck up a generically linked um to uh Nati Manchester, England on my dad's side from Withingshore, uh, but on the Maori side I fuckapapa to uh the Northland region, Hokianga. Um so I have tribal connections with Terarawa, Toopodi, and further north with uh Napui. And mainly connect to the west side of uh Northland, which is really where I connect to because that's the main area that I've been. Genuine adult psychiatrist that works in a public health care system in Tauronga, uh New Zealand, being the recipient of the Henry Rungomo Bennett Memorial Scholarship, who was the first Māori psychiatrist and who comes from Tiarawa. And I was lucky enough to receive the Pirika Taonga in 2022 in Orfata Mara in Urotru, which is in the in the memory of our first co-matur, uh Arma Piraca. I hold an academic position uh both at the University of Auckland teaching fifth years and training interns, but also have a connection with Ataga Medical School through the uh local school in Wellington. Most of my research areas um are mainly within the area of Māori mental health, uh, equity, and uh I I also sit on the college board, but also on the uh doctors uh union board as well, which we're currently going through protest and strike action at the moment. And so been involved with the college for a number of years actually. In 2012, I was the chair for Tekonia, which is the Māori advisory to the college, and I did that until 2015, then I took over the New Zealand National Office chair, which we also call Tutiakakuroa, and then from there um then went uh on onto the board. And yeah, and it's been a wonderful journey, and today was really wanting to extend the conversation about some of the challenges uh early life growing up and some of the the challenges that we're able to then work through things I didn't really understand until I was a younger adult. So I will be talking about issues to do with racism and and how that affects, but making sure we we put into context that racism isn't exclusive to one group, but in states that often, well in states that have been colonized by different states, there seems to be a pattern uh which is similar to uh in here in Altero and Australia and our Aboriginal and Torres Strait Islander. Brothers and sisters have similar experiences, and I think we're at a stage in our development that it's it's okay to have some open conversation about the the challenges in this space. So some of the things I might say might give people some unpleasant emotions, and if I talk about things like colonisation, what I'm referring to is I'm really referring to processes in our history that led to some of the systems within both education, criminal justice, and of course health, which I'm more very much interested in, in how things have those systems often uh don't work particularly well for First Nations people. So it was it was really just to talk about some of that personal experience so people can maybe help relate to it. Uh, but also I think the important things is to then how do we find solutions to improving the situation because all you trainees out there are one day going to be fellows who are gonna be in positions of influence and power and then trying to create some knowledge, some conversations about how do you navigate this challenging space. That's really the main co-pop and drive for having this conversation. I really appreciate the opportunity to speak.

And so just to put this conversation in broader context for our listeners, so you gave a really personal lived experience account of your experiences of racism kind of growing up and also through sort of high school and medical school at the RAND and TP Congress in Perth. And so then I kind of met you afterwards and wondered if you'd like to come on this platform and just kind of give a similar talk through kind of this podcast. And so that's where this came from. So look over to you and really, really keen to hear your story again.

Yeah, okay. I can't remember exactly what I said. Uh I haven't seen the recording. Uh uh personally, I I don't like looking at myself. No one well, actually, probably the only person that likes looking at myself is uh everyone probably knows how how I feel with American politics, but look, I think the most important thing growing up is one of the challenges when you have a as a a European father and a Maori mother, some of the things I didn't actually realise had happened growing up. So for example, m my father, if he would apply for rental properties, they wouldn't give rental properties if it was with a Maori family. It didn't matter if they were in in those days they often refer to people like me as half caste because you are fifty percent Maori and fifty percent English if you fractionate one's entity as a person. And of course, in the New Zealand context, if you've been here long enough, the long are the days that we talk about fractionation of oneself, and that whole concept of fractionation is an offensive term for for many Maori or for actually for anyone. It's like you can't fractionate your maleness or your femaleness or your non-binariness, you know, you are what you are, but you can't necessarily say one's greater than the other. And of course, when you fractionate people, you then can separate and then decide who qualifies for something and who doesn't. And in the Māori world, we would just say if you have fuck a papa, it doesn't matter how many generations back, you have fuck a papa, you are Maori, and that's it. There's no other qualification you need.

Sorry, Mark, I was just wondering that term fuck a papa, that might not be a term that particularly people from Australia or possibly the broader kind of Australia.

Oh sure, yeah, I can yeah. So papa just means to put in layers. Fuck her, it's WH is not the fucker in in English. It just actions the whatever the verb is. So what it means is to put in layers, which then l then actually means one's genealogy or connection to one's past. So it's it's one's heretry really back to the you know multiple lines. Uh so Vakapapa is just your your family tree. And so growing up, I mean one of all things growing up, I didn't know I was Maori, I didn't know I was Pakia, I just knew I was Mark Lawrence from Born in Wellington, but grew up in you know Glenfield. And then I didn't really notice that there is any difference, and of course, these things that were happening in our family system that dad would wouldn't often talk about, you know, you find out later on and some of the challenges uh that you had. And then I don't know if I said I was one of six and I'm the oldest male, and then I've got two older sisters, two younger brothers and one younger sister. All of us had had had similar experience within the educational system. And it was interesting, I I was speaking to my older sister, and I I said, Oh, just remind me what happened when you were in in four form. So four form would have been included.

If if she was age fourteen, that's probably year nine.

Yeah, so she was year nine, and she said uh it's okay for me to share the story because I don't want to just talk about my experience, I want to talk about the other experiences within the family system. And back in those days, there were you know, we didn't have computers, so you could do typing. And she talked to me about typing class, she just asked the typing teacher if she could help her with the shift key to do capitals uh on the typewriter, and because she couldn't quite work it out. And then the female teacher then yelled at her and said, Typical Māori, you're useless. And then, of course, my sister at that time wouldn't tolerate that, that was just not acceptable to her. So she told me that she punched her, and I said, I'm only going to share that you pushed her, oh it's too late. And she then got dragged down to the principal's office and expelled instantly. And of course, she went home, dad, who is Pakia, white European, then found out what had happened, and then the next day the principal, realizing that her father was right, had a totally different attitude towards him about what had happened, explained what had happened, the teacher then came into the class and said, Yes, that's exactly what I said, and then the teacher was then uh fired because you know she had no had no really argument. And that was like one of many situations that had happened, and then I I think I had shared with you that out of the six of our siblings that had g gone to the you know school system, all of us were asked to leave school by fifth form, including myself. And that was because we were often put in a in a box of oh well, these uh underachievers that need to leave.

And then sounds like that was sort of like almost an expectation.

There was yeah, it was an expectation. And if you look at the whole generation my siblings are, in my view, a lot brighter than I am, I would say, in a lot of ways, and for me I was just stupid enough just to keep going back because I sort of had an attitude of not really having any barriers, but I didn't realise the system wasn't really supportive of my development. And I guess if I I didn't have any athletic ability, I probably wouldn't have lasted, and that sort of kept me there in in a sense. So in my story when I was asked to leave, you know, I thought it w well Marswell because I respected the teachers and they knew what they were doing. I did share that I'd done um fifth form two and a half times and then eventually got university entrance. And in a sense, at that particular time too, I I was actually also fortunate because within our educational system at that time, Maori as a as a topic was only being introduced as a topic you could do. So that was some of the first contact that I have with particularly with Maori language uh and connection to the Maori world. There was always connection back home, but I I had little knowledge of process on how things were done. I definitely had didn't have the the the language schools that I have now within that space that I could really understand. And then I was fortuitous enough to be a you know a talented sports person that then led me to you know go to Otaga University and a degree in physical education because I wanted a physique teacher. And at that time, you know, the first to go to university in my family, it was just like it was it was unknown. And I must say, even though you know Otaga University is down the bottom of the South Island in New Zealand, it was a really good environment to learn. But then even there there were there were some some challenges once again often to do with rental properties. But like I said, my name didn't discriminate against me, so I definitely got to have a look.

But until that I remember you were telling me the story, so if you had a m sort of a Māori sounding last name, I think you were saying you're much less likely actually be approved for a rental property.

You won't even give it a look in. And see, that was even back in in the eighties and nineties, but it still exists even in my city that I live in, Totonga, with my daughter's experience with her friends who had graduated from Otaga and got employment at Totonga Hospital, they couldn't get access to rental policies until they changed their name to English names. And that's, you know, 2022. Sort of like, you know, we're not some things really haven't changed. And well looking at at trying to address equity and particularly in health becomes a political football, and you'll know yourself, Ed, you're you you know different parties that have different perspectives. And it's really interesting how they change the narrative and the wording, how they describe things that give an impression of privilege to to one group, and we you know we need to be basing our healthcare decisions based on need, although the need that has arisen through our historical injustices have really led to some of the challenges, and it's unfortunate that political parties are seeking votes, they will use this as a really good argument to get votes. Yeah, it's it's really interesting to watch. But if you take a step back and you think, well, well, what are the issues? The issues are more about in in my view, about justice and truth and fairness and understanding context. And if if political parties were more neutral in the way that they describe these things, and even in with the voice to parliament in Australia, I think things would move in a a more positive direction. Because if you look at the yes campaign in Australia, and I'll I'll talk about this because it's interesting, that the yes campaign people say, if you don't know, educate yourself to be informed and then make a choice. If you have a look, the yes campaign, because I've looked at it, they don't say if you don't know, vote yes. They say if you don't know, learn what you need to know and then make an informed decision about what you're going to do. Uh but if you look at the no campaign and those that are voting no, they say, well, if you don't know, just vote no, which is not democratic. I find that sort of quite a challenging narrative to follow. But what I also find really fascinating about that is if you think of the Australian population as uh about 26 million, 26 million plus, uh Aboriginal and tour Strait Islanders represent 3.2% of the population. So if you think about that, you've got about what's that's about 800,000 people. Not all of those are gonna be uh old enough to vote, so there's got that's that number's gonna go down. So even if you've got every single Aboriginal tour islander person to vote, and not every Aboriginal tour islander is gonna vote yes, but there'll be some that will abstain, because I think it's not not gonna make a difference. There'll be some that may even share the similar views of the Dom culture and that and well that's their perspective, but it's not their vote that really counts. It's the non-Aboriginal and Torres Strait Islander vote that determines the outcome in the same way in the nineteen sixty-seven referendum when they they asked that well they had to have two amendments of the constitution. The one was uh I think section one two seven, which talked about um that they wouldn't count Aboriginal Tourist Islander people as humans or or people that were part of the fauna and flora. And so they had to remove that section one uh two seven so they could be counted, which I think okay, that's that's good. They've been in in this place for sixty-five thousand years or more and we're gonna determine if they are going to because they didn't vote, because they they weren't considered human, because they weren't able to so then you've got the dominant culture vote determining their outcome, so that's one. And then of course the second vote they had to consider was I can't remember the section, but what all it was is it's called the race law to create laws specifically for Abhishna or Tourisha Islander group. Now I find that retrospectively looking at that as the most racist amendment in in any act, because theoretically, if you then count them as part of the population, why do you then have to make another amendment to make specific laws about just one group? And I think clearly that law was there to have still some power and control constitutionally to be then make decisions about that particular group. Because theoretically, once you decide under section 127 to remove that they can't be counted, that they can be counted, by definition they become part of Australia, whether the Aboriginal to Australia or they've come from elsewhere. So I I just find that fascinating that they had to create a separate law just specifically for that group. And then if you come to 2023 and you look at the voice to parliament and you get the no campaign, who then say this is racist, they have no self-reflection on their own constitution and also the constitutional changes that, in my view, looking from outside, were clearly to create laws for only one group of the population, which was clearly a racist law. Well, amendment to the constitution that would then allow the creation of other laws to then have special laws for one group. The other interesting thing that I've I found out with with this and and I looked at the different constitutional well remits or referendum uh that have been had over Australia since the 1901 constitution. So it'd been 44 applications for referendum. Do you know how many referendum have passed? Any idea? You might not know.

I think two or three, something like that.

Eight. So eight out of forty-four. So it's around about eighteen percent. The last referendum that went to to the Australian citizenship was in 1999, uh, whether it should become a republic, and I think it met the threshold around 45%, so it didn't make the threshold. So the other thing is with the referendum too, you have to have a double majority. What does that mean? Double majority means that you have to get at least uh four of the six states that say yes, and it must be greater than 50%, and then the overall total collectively has to be greater than 50%. You know, that's going to be a a big ask. And as you know, the 1967 referendum did pass with a clear majority of I think it was about 90% or more, but that wasn't a really a yes-no campaign. That was more about do you think Aboriginal Torres Strait Islander people should be counted as human beings? Well, geez, I'm glad they they they voted yes. And of course, they also voted that that they support the position of having uh specific laws for that particular group. And then once again, if you reflect on, well, who's making the decision? It's not Aboriginal Torres Strait Islander people, it was all the citizens of Australia in 1967 who were citizens that were voting on these issues that deciding for another group. So when you think of power and and influence, where you see the power, there's no power within the Aboriginal Torres Islander group in terms of the position that they were then in any position to be able to vote on this matter, and that the power lay within the constitutional systems that were established as part of colonization. And you've got to remember, any place that needs to be colonized by another group, they need to create a narrative that supports the the position. I'm sorry I'm talking about this in in some detail, but I think it's really relevant both to our nation nationhoods, that people have to r reflect that the systems that have been established don't often support the First Nations people. And yes, New Zealand has Hefakaphutanga, which was our declaration of independence, and and did establish us as a sovereign state, and this happened before the Tri. Most authorities would say that Hefakaputanga, although it was mainly with northern Maori tribes, that allowed us to be considered a sovereign state, which was accepted by King William at the time. And then in 1840, the Tritia Waitangi was established. Now the reason that's really, really important is there were concerns at that time with immigration of some naughty Europeans coming here causing a muck. And Maori wanted to say, hey, let's establish some governorship, a governor so w you you can manage your people, but can you just please leave us? We want to be independent and still do what we do, but we want you to set up your governorship to manage these naughty people that were coming in. Some were naughty, some weren't. Before the the establishment of a colonial government uh and the power structures, uh Tirito Waitangi was our first immigration policy because you really couldn't come here without respecting the terms of that agreement. Because it allowed you to come but not at the expense of us, and it came with certain obligations. The challenge in our history is the interpretation of various aspects of the articles, which is probably beyond this discussion. But the fact if you look at the Tiriti, it doesn't talk about Maori, it doesn't talk about race. What it talks about is in simple terms, hey, come here, let's be nice to each other, let's get on and progress together. That was it. There was n nothing more simplistic than that, but our history uh shows that it hasn't really worked that way. So this pretty heavy discussion about a a couple of important issues that that I'm interested in. I wonder if I should just focus on some of the medical school and and and some of the journey that I had through there.

Thank you for everything that you've said because it's obviously something which is still real, you know, and still happening in terms of th that intrinsic power sort of differential. And I was sort of paralleling that in my mind with power differentials within medical school as an institution as well. Yeah, so over to you. I know you've got experiences of that as well.

Before I finished my degree, I I just woke up one day and said, I'm gonna do medicine. And I initially thought because I was really really involved in sports and I thought, oh, I could be an orthopedic surgeon, I could be a sports. At that time uh sports medicine wasn't actually a specialty, but in the area of of health anyhow. And then so I I had to do pick up chemistry. So I hadn't done chemistry, and I got through a postgraduate pathway based on my Māori Fakapapa. So it was a and then to be fair, you know, the the educational system didn't treat me particularly well and didn't really have much faith in me. And so without that pathway, and I think I got a b like a B plus average. I think you need to get a A plus these days in a postgraduate degree. It's changed. Oh I wouldn't even get in now 'cause the standards gone up. But I can remember in in third year and started my clinical uh attachments and then there were lots of people in my class that were really anti the fact that I sort of got through a back door And that I I didn't deserve to be there. And that was really upsetting. And I can I can remember talking to a good close friend of mine and saying, Hey, look, I just don't want to do this anymore, it's too much. And I said, I wanna wanna leave and said, Oh, well, why? And I said, Oh, I just find it really hard and they said, Oh, do you want to see a psychologist? And I said, Yeah, yeah, I said I'll see psychologists to talk through it. So I did. So I saw a psychologist and he was great. I mean, he was so straight up with me that just loved it. And then he got to the core of the issue and goes, Why do you want to go? And I said, I keep getting, you know, hard timed by the these other students that that feel I don't deserve to be here. He he called my bluff and said, Well, well, just leave then. Go. Why did you want to do medicine? And I said, Well, well, I wanted to help my people. And I said, Well, you're gonna listen to this guy and not follow your dreams. And he said, Well, what's it what do other people think? Like what and he goes, What do you mean? You know, your family, your you know, they're really happy I'm doing this, you know, first one to go to university, you may be the first doctor in your family. And I said, Is is that important? I said, Yeah, it is. And I was responding in my uh lack of probably a personal maturity, that I was responding to the the negativity and being sucked into the to the narrative that and in some ways I I sort of half believed it. In some ways, I was given this opportunity, but then when I take a step back and go, well, hey dude, you weren't given the same opportunities to succeed, and this is why we have this, and then once I sort of got my head around that, I wasn't gonna then internalize that sort of guilt for me. And like now as a a more senior member of the medical profession and the some of the important changes and progress that we've made within our own college, you know, I'm so glad that I'll participated in that in some way and progress things in a better place. So glad that I I saw that psychologist who really made me think about and you know that power of word and the power of just reflection and that power of of really understanding why you do things. Yeah, so that was quite transformative uh for me.

It sounds like that psychologist made a massive influence on your life, particularly in that moment.

Yeah, it wasn't one session. I mean you got to get to get to know me first, and then when we got down to the core issues, yeah, it was interesting. I thought, oh yeah, you're right. Yeah, you're letting that person control her your future. What do you want? And then it was just yeah, you're right. You know, but at that particular time I was particularly vulnerable. And to be fair, at that particular time too, because we're talking early 90s, within the medical profession too, in the other specialties, there was quite an an undercurrent of giving these people uh that they d didn't deserve to be there. When you have these changes, it takes a a cultural shift uh for others to to actually process that. I mean I can I can reflect on that as an adult now and a senior doctor, but I can imagine that there would have been some that also that they would have been not particularly supportive of that.

I was just wondering within psychiatry as an institution or a practice today, what are the things which are racist about what we do today, contemporarily, without potentially even noticing? I'd be really keen to hear your perspectives on that.

When I finished medical school and then was able to get a job up in Todong where I can currently live, I've I've been there since I graduated in the mid-90s, other than having one year away in Waikato, which is about an hour and a half away from our coastal uh city where I live, my aspirations in terms of specialties, you know, changed quite a lot. Like I said, I was quite keen on doing something within the sports sector, I was quite keen on orthopedics, I was very keen on sports medicine, but even at that time, if you want to do sports medicine, you have to go to Australian College of Sports Medicine. And I realised that I've only got really one good well, I've got two eyes, but they don't really function particularly well together, and so I don't have good depth perception when it came to the surgical site. So I knew early on, because I I spent a lot of time in in theatre, I wasn't going to be a good surgeon, I'm not gonna be. And then I thought, well, I really like pediatrics, so so I did a diploma in pediatrics, and then when it came to kids dying, and then unfortunately they do, I just found that just one of the toughest things to have to go through and then t tell a family, and and it so I thought, oh, I'll do child and essence psychiatry. And then Prof. Wherry was working and doing locums in the area, and you know, he was an iconic person back in the day, and so I spent a lot of time with Prof. I have huge respect for him. He was a bit old school, to be fair, but I learned it a lot. And then there was just the opportunity with another colleague, Donna Clark, and I, who were both working there, and that particular time our Ministry of Health at the time were we were looking for more psychiatrists, so they had then made available some postgraduate scholarships to help increase the workforce. And so Don Don and I uh had applied for the Henry Dogomo Bennett Scholarship. And then you've got to remember back in those days too, we had student loans. I had a I had like a over a hundred thousand dollar student loan, two kids, we were poor, didn't have much. I mean, we had the basic and and so the scholarship allowed the opportunity to get some technology, get your first computer, and all those sort of things that you just didn't have access to, attend uh conference. So that was the major incentive. And then to be fair, during the journey, like I I took a scenic uh tour through the examinations, you know, it took me eight years to get through fellowship, and I had four kids during that that too, and I struggled through the exams to be fair, and you know, got there in the end, but getting fellowship, I guess, in a sense, wasn't the end yet. Well, it's good it's great to get fellowship, but it just doesn't stop, you know. Like, but if you think that's it, you know, like I'm a fellow, woohoo, I can just cruise now, no way man, you're always learning, you're always developing, you just be really open and know that it learning is just a life journey in in this space. And sometimes you have good days, sometimes you don't, sometimes you have good engagement, sometimes you don't. But there's no harm in trying to do your best in in that space. Now I forgot what the question was. What was the original question? I've probably gone off track.

No, not at all. I think you've partly answered it. It was around what other sort of present potentially institutional forms of racism, or not even necessarily institutional, but forms of racism that we might encounter within the psychiatric practice currently.

Yeah, I mean I guess the interesting thing is about the assumptions that we make about certain things and situations, and it it's really important that we don't go down particular narrative where we make shortcuts about uh assumptions of things because of limited uh experience and contact, particularly with First Nations people. Remember, we're seeing a very narrow cohort of our population. You might think it's not narrow because but it is, in essence, in our communities, it's it's actually a small part of real you know life. You may not always see the most successful people in our communities because of their illness processes that impact on their functioning. So I just try to be really broad and try not to make too many assumptions about things until we have the facts. And a classic case was you know a case that I had seen where it was a Maori family where the mother who was in a different region insisted that she be present for the interview of this particular person, and I didn't have any issue with that other than getting consent from the Tangata Fai order. See, so even our languages turn. So Tangata Fai order means Tangata person order finding uh wellness. So, yeah, we can have consumer, yeah, we can have patience, but our our Maori term for someone looking for seeking how we would call Tangata Fai order. So someone who is seeking wellness rather than a deficit model that's someone that's sick, and then we have to then so it's it's a slight subtle change in language and understanding. Both of her are trying to achieve the same thing, it's just that we just have a label that has a different origin and a different way of interpreting it, which is less, in my view, pejorative. And so this this woman came and she quite very angry family member, and and she just wanted to be there as part of the interview to ensure that their loved one was being heard, that it felt safe for them, and it was really quite confronting from the beginning, and I and I just really didn't understand why anyhow. But then after about 20 minutes, the family member said, Oh, thanks so much, I'm gonna go now. And we're only halfway through the interview. And then I found out later on, I was just checking up on the that she was okay with that. And then you find out that within their family system that a previous other family member, well, sorry, it was one of their uh the other child had access mental health services in another region and they sent him away and then then he killed himself. And this was like a decade or decade and a half ago. And you then reflect and go, Oh, okay, you know, this is a family member who's really angry and not trusting the system because they had already let them down with the other family member, and I only could just my understanding was in the way I could formulate it, ensuring that their loved one doesn't get rejected or is getting the right help that they felt they needed, and without knowing that it really explained the the situation because you could disinterpret that if you didn't explore and understand it, you go, Oh, well, that's an angry family, but why are they so angry, you know? But anger's just an emotional state to how one is feeling at the time, unless you understand the the context, the the the story behind it. I think that's the special thing about psychiatry. We do have that capacity to really treat the person. If you treat the person, you'll always win. And that's what I I love about psychiatry, that it gives me the time to be able to treat them as a whole person and not just a collective bunch of symptoms that that then lead to a you know diagnostic label. I mean the more I I become and the more ambiguous things become between things. I can remember when I first finished my fellowship in exams and I'd learnt all the guidelines, I was really up to play with all the different terminology and phenomenology and could really articulate myself within some of that space really well, it becomes more ambiguous the the longer you spend in in this space. And that at the end of the day, the most important thing is that capacity to engage in that person and trying to find out what they actually want or or need, if they've got the capacity to be able to, you know, I say to some of the students that I teach, I said if you don't know what's going on, ask them because they might have an idea. And if the idea seems reasonable, then you can consider it. If it doesn't, then you you know obviously you don't. Most people when they go to seek help somewhere, they've got some sort of idea that there's something other than I guess when you're having to see some of the because of compulsion where there's you know capacity issues, but let's just assume that people have capacity and can make reasonable decisions about their situation. Most of us go somewhere because we've got some idea, geez, it could be this or it could be that. And then I say, if you don't know, well say you don't know, but you can still, you know, say, well, this is what I've heard, these are domains of concern, and if you if you need more time, well, you just you know get more time. There's some cases that I I've still trying to find really hard to find the the core issues. It doesn't happen that often, but when it does, it's okay not to know. It's better to do that than actually think you know what it is, but you're not quite sure because you want to convince someone you think you know what you're doing. And of course, when you say these things, you you've got to give some justification for why you don't know. You can't just say I don't know because I'm not listening to you, uh don't know because it actually doesn't quite meet this particular criteria in these domains. You know, our dioxide labels aren't the arbitrary cutoffs in terms of time frames, particularly DSM5, if they're a system that you know that aligns with a private sector model where you can apply for funding based on on labels. And if you look at the number of diagnoses over the from the various DSM4, uh the evolution of the from from the DSM4 TR and five, they've all gone up. They've created more diagnostic labels. But that fits a managed care system in the American healthcare system rather than being necessarily s scientific. And yes, we do we do need diagnostic labels that help us to at least focus on where we need to focus our domains uh and and our areas of treatment, but they're they're they're quite arbitrary.

I'm trying to think, you know, there's something about being real with somebody else and seeing, you know, the part of us that that we share in common rather than the labelling, the diagnosis, the differences, trying to be sort of on all interactions to just find the similarity, even though that's often so difficult, you know, given the complexities of so many of the problems and systems that we all exist in and have inherited from the past as well.

And people know if they're genuine. You you know if someone listens to you, you know if they can give you time. And you might be busy in that, but it doesn't take too much just to just to slow down a wee bit and and be present in that particular moment with someone. So I I I look for knowledge in in all spaces and time, and one of my favourite quotes is by Master Ugwe in Kung Fu Panda, and he's giving Kung Fu Panda Poe some advice, and I'll just read it because I think it's well I think it's cool. Quit, don't quit. Noodles, don't noodles. You are too concerned with what was and what will be. There is a saying, yesterday is history, tomorrow is a mystery, but today is a gift. That's why they call it the present. And I think sometimes we don't focus on present and at this point in time where we are right now, and the things that are in front of us that are really important. And I think my main advice that I give to people is just be in the present with whatever you're doing at that particular time, particularly if it's a tongue to fai order, and they will know that. Kung Fu Panda, Poe, yeah, take that advice, and I'll say to you uh students out there, just do your best, learn from your mistakes because you'll make heaps, and just be aware of the challenge it would be for particularly indigenous doctors working in the space, because we get overburdened with a lot of the roles in this space, and that that to address racism in in its entirety, it's not for Aboriginal Torres or Maori people to fix, it's for everyone. We're all part. Like indigenous people, First Nations people want to be part of the solution, but we need all you out there to be part of that on the journey and to be our voices when we're not there, because if we improve the system, we're going to improve it for everyone. Hey, so Ed, thank you so much. I hope it made some sense. It's been great to catch up.

Thanks very much for your time, Mark. We appreciate it so that concludes our discussion with Mark Lawrence. Thank you very much to our producers, David Beale and Nishna Kuma, Shady Dave for our intro music, Sidonia Printers for our artwork, and of course Australasian psychiatry for the opportunity to record this podcast.