The pregnant man: race, difference and subjectivity in Alan Paton’s Kalahari writing

In South African imaginative writing and scholarly research, there is currently an extensive and wide-ranging interest in the ‘Bushman’, either as a tragic figure of colonial history, as a contested site of misrepresentation, or even as an exemplary model of environmental consciousness. Writing and research about ‘Bushmen’ has not only become pervasive in the academy, but also a site of controversy and theoretical contestation. It is in this context that this paper investigates the meaning and significance of ‘Bushmen’ for Alan Paton, one of South Africa’s most well-known writers. Paton’s writing is not usually associated with ‘Bushman’ studies, yet this article shows that the ‘Bushman’ became a highly charged and ambivalent figure in his imagination. Paton’s problematic ideas are contextualised more carefully by looking at the broader context of South African letters. The article initially analyses Paton’s representation of ‘Bushmen’ in his Lost City of the Kalahari travel narrative (1956, published in 2005. Pietermaritzburg: KZN Press), and also discusses unpublished archival photographs. A study of the figure of the ‘Bushman’ throughout the entire corpus of his writing, ranging from early journalism to late autobiography, allows us to trace the shift of his views, enabling us to reflect not only on Paton’s thinking about racial otherness, but also gauge the extent to which his encounter with the Kalahari Bushmen destabilised his sense of self, finally also preventing the publication of the travelogueDepartment of HE and Training approved lis

Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: A stepped-wedge cluster randomised trial

Background: Neoadjuvant chemoradiotherapy (nCRT) plus surgery is a standard treatment for locally advanced oesophageal cancer. With this treatment, 29% of patients have a pathologically complete response in the resection specimen. This provides the rationale for investigating an active surveillance approach. The aim of this study is to assess the (cost-)effectiveness of active surveillance vs. standard oesophagectomy after nCRT for oesophageal cancer. Methods: This is a phase-III multi-centre, stepped-wedge cluster randomised controlled trial. A total of 300 patients with clinically complete response (cCR, i.e. no local or disseminated disease proven by histology) after nCRT will be randomised to show non-inferiority of active surveillance to standard oesophagectomy (non-inferiority margin 15%, intra-correlation coefficient 0.02, power 80%, 2-sided α 0.05, 12% drop-out). Patients will undergo a first clinical response evaluation (CRE-I) 4-6 weeks after nCRT, consisting of endoscopy with bite-on-bite biopsies of the primary tumour site and other suspected lesions. Clinically complete responders will undergo a second CRE (CRE-II), 6-8 weeks after CRE-I. CRE-II will include 18F-FDG-PET-CT, followed by endoscopy with bite-on-bite biopsies and ultra-endosonography plus fine needle aspiration of suspected lymph nodes and/or PET- positive lesions. Patients with cCR at CRE-II will be assigned to oesophagectomy (first phase) or active surveillance (second phase of the study). The duration of the first phase is determined randomly over the 12 centres, i.e., stepped-wedge cluster design. Patients in the active surveillance arm will undergo diagnostic evaluations similar to CRE-II at 6/9/12/16/20/24/30/36/48 and 60 months after nCRT. In this arm, oesophagectomy will be offered only to patients in whom locoregional regrowth is highly suspected or proven, without distant dissemination. The main study parameter is overall survival; secondary endpoints include percentage of patients who do not undergo surgery, quality of life, clinical irresectability (cT4b) rate, radical resection rate, postoperative complications, progression-free survival, distant dissemination rate, and cost-effectiveness. We hypothesise that active surveillance leads to non-inferior survival, improved quality of life and a reduction in costs, compared to standard oesophagectomy. Discussion: If active surveillance and surgery as needed after nCRT leads to non-inferior survival compared to standard oesophagectomy, this organ-sparing approach can be implemented as a standard of care

Yet being someone other /

Olivier, Fani