Reflections

“We cannot know the solutions until we first know the people … Most of us do not stay long enough or get close enough to the front line to ever be able to discover stories like this one.”

Krithika Murali MB BS, BMedSci

Clifford Bruce Osborne, known as Bruce, had an extensive and diverse medical career that included the rare achievement of Fellowships in three disciplines — general practice (1980), medical administration (1987) and psychiatry (2001). Throughout, Bruce remained committed to compassionate patient care and improved regional health services. Bruce was born on 23 February 1951 and grew up in Dandenong, Victoria. In 1975, he graduated in medicine from Monash University, ...

Hugh M Lowy

THE TREATMENT of epilepsy has undergone rapid change in the past decade. New drugs, novel treatment options and the impact of genetics are having an impact on the therapy of this common condition. This edition of Fast facts is authored by three senior and experienced clinicians. The book is easy to read, well set out, has excellent tables and images, and each chapter has a ...

Geoffrey K Herkes

Marjan Kljakovic was a general practitioner for over 30 years. He was Professor of General Practice at the Australian National University when he died on 14 August 2012, some 2 weeks after a devastating heart attack. Marjan was a man of great passion and enthusiasm for life, and, beneath an often larger-than-life outward persona, a man of great sensitivity and thoughtfulness. He brought all of these qualities to his ...

Anthony C Dowell · Karen M Flegg · Les J Toop

Robert Bohdan Mikolaj (Bob) Ravich was born on 26 August 1937 in Gdansk, Poland. He immigrated to New Zealand after World War II and later studied medicine at the University of Otago, graduating in 1962. He was a resident at Christchurch Hospital, then a senior medical registrar and senior registrar in haematology. In 1968 he took up an appointment in Australia as a senior research fellow in haematology ...

Kate M Ravich · Frances M Boyle, AM

Botanical taxonomy is a repository of medical biographical information. Such botanical memorials include the names of some indigenous orchids of Australia. By searching reference texts and journals relating to Australian botany and Australian orchidology, as well as Australian and international medical and botanical biographical texts, I identified 30 orchids indigenous to Australia whose names commemorate doctors and other medical professionals. Of these, 24 have names ...

John H Pearn MD, PhD, DSc

A Fellow of the Royal Australasian College of Physicians commemorated in TanzaniaAlexander MacKenzie (Sandy) Rankin left an indelible legacy in Tanzania. Born in Perth in 1929, he graduated from the University of Adelaide in 1952, and developed a lifelong interest in medicine in the developing world early in his career. In the main, his commitment was in Africa. Starting in 1959 as a registrar at University ...

Krishna Somers FRCP, FRCPE, FRACP

Adolf Saweri was born on 28 July 1941 in Sarmi, West Papua. He was known to most Australian medical graduates who have worked in Papua New Guinea (PNG) since the 1960s. In 1960, after completing his schooling in Kotaraja in the West Papua region (at the time, a Dutch territory, Netherlands New Guinea), he was one of seven students from the region chosen for medical training in Port ...

Ian Maddocks

David Healy was born in Melbourne on 30 September 1948. He studied at Monash University, graduating in medicine in 1973 and completing a PhD on human prolactin physiology in 1979. After commencing training in obstetrics and gynaecology at the Royal Women’s Hospital, Melbourne, David completed his training at the National Institutes of Health in the United States and the Simpson Memorial Maternity Pavilion in Edinburgh, Scotland. In 1985, ...

Luk J F Rombauts

General practice: the integrative approach. Kerryn Phelps, Craig Hassed. Sydney: Churchill Livingstone, 2011 (xxiii + 993 pp, $150.00). ISBN 9780729538046. COMPLEMENTARY MEDICINES and practices are widely available to, and used by, the Australian public. Until now, there has not been a framework to integrate this into safe, evidence-based medical practice. We needed a book of this calibre.Both authors are leaders in the field of ...

Patrizia Boetto

In a week when the presidential election was imminent, but Americans were more concerned with Hurricane Sandy and Halloween, an Australian visiting professor in New Orleans shares his observations of life and health in the United States and the ongoing recovery from Hurricane Katrina.

Charles S Guest Visiting Professor

You were only 2 months old. I met you in the children’s intensive care unit one night, almost 3 years ago. Intracranial haemorrhage, they said. What happened? We were trying to keep you alive. You were tiny in that large hospital cot, dwarfed by technology and oversized pyjamas, your bedtime lullaby the hissing of the ventilator and suction machines. We calculated fluid requirements, made your blood pressure and electrolytes look ...

Alison M Snodgrass MB BS, MRCPCH(UK) · Hong Liang Tey MB BS, MRCP(UK)

PETER DOHERTY’s ability to span the gap between the most abstract basic science and the everyday world is once again evident in this, his third popular science paperback. Put it on your Christmas gift list. It will intrigue the nerdiest high school student, stimulate the most militant environmentalist and give pleasure to anyone who has worked in the biological sciences or medicine during the past ...

Yvonne E Cossart

FOR MOST AUSTRALIAN DOCTORS, a child dying from malnutrition, malaria or tuberculosis is something you read about in textbooks, not see in your day-to-day practice. Yet for doctors like Damien Brown, a volunteer with humanitarian organisation Médecins sans Frontières (MSF), it is an all too regular reminder of the impact that conflict, weak governance, and a lack of essential services have on the health of ...

Natalie J Gray

Complex challenges call for action inside and outside the health care box. Inside the box, health workers can manage hypertension and diabetes and beat tuberculosis. But they need support from outside the box — leadership and adequate tools for their work.

Ian Maddocks MD, FRACP, FAChPM

For those who work in conditions of abundance, what should inform our practice are the memories of crying need, unmet. By failing to internalise the lessons of working in needy areas, and continuing to work in a bubble, we fail our unseen fellow man.

Ranjana Srivastava MB BS(Hons), FRACP

The clinic of the Sudan Medical Relief Project (www.sudanmedicalrelief.org) is in Old Fangak, in what is now the Republic of South Sudan. In 2010, I spent 7 weeks working there with an American medical team, before being evacuated owing to increasing violence in the area. We flew with one backpack each from Lokichoggio, on Kenya’s border, into South Sudan. Our plane was a twin-engined Cessna with an ...

Benjamin H M Hunn BMedSc(Hons)

Health workforce governance: improved access, good regulatory practice, safer patients. Stephanie D Short, Fiona McDonald, editors. Farnham, UK: Ashgate Publishing, 2012 (xix + 272 pp, $110). ISBN 9781409429210. ENSURING THAT we produce a health workforce that is well trained, “fit for purpose”, equitably distributed, and that delivers effective and safe health care is a key responsibility of all those involved in medical education, health governance and health policy making. Various health scandals have drawn the attention of the public to failures in health governance, and raised considerable doubt about the ability of the health professions (and in particular doctors) to self-regulate in a way that will protect the public. This ambitious academic text seeks to link the “three pillars” of health workforce governance: access to health services; regulation of health service providers; and patient safety and quality of care. The book is edited by experienced Australian academics with backgrounds in health economics and law, respectively, and its scholarly tone reflects this. Contributors have been deliberately selected by the editors from a wide range of disciplines, and comprise academics, regulators and health professionals from Australia, Canada and Indonesia, both well known and less well known. While the major focus of the text is Australian, some chapters describe examples drawn from the Indonesian and Canadian contexts — these would have been more useful if their relevance to health workforce governance in the Australian context had been made more explicit or, alternatively, if the whole text had a more clearly articulated global focus. Although this disciplinary variability is promoted as a strength, it does produce chapters that vary dramatically in approach and relevance. The book is divided between chapters that are a pleasure to read (and take notes from) and those that focus on describing micro-policy changes and leave the reader with a sense of frustration and many questions unanswered. While this is a book of great relevance to scholars interested in health workforce and governance and there are some outstanding chapters, the patchy quality overall and lack of a coherent narrative linking the chapters limits its relevance for a broader audience.

Sarah L Larkins

Australian cancer care is among the best provided in the world. Yet, many cancer patients choose to either forgo aspects of conventional treatment or seek unproven complementary therapies. My own recent cancer treatment prompted me to wonder whether these choices may, at least in part, be due to the failure of Western medicine to address the psychological ...

Tanya L Hall BMed, FRANZCP

In the past, most deaths took place at home. There has recently been a lot of interest in providing patients and their families with a “good death”, and research has shown that if a choice was given to terminally ill patients in the intensive care unit (ICU), they would prefer to die at home. Much ...

Vineet Sarode MB BS, MD, FCICM · John Reeves MB BS, FANZCA, FCICM · Jonathan Barrett MB BS, FRACP, FCICM · Jennifer McCambley CCRN, BEdSt, PGDipPsych

I have always known all of this, although I’m not sure how. You’ll just have to believe me, because I’m the only one who knows the whole story. My mother must have told me about her poor sister, because that all happened many years before I was conceived. But there was a lot more. My mother’s sister was young, about 35, when the doctors found she had ...

Nicholas R C Wilcken MB BS, PhD, FRACP

At birth, Moses Kharat was given a life sentence of poverty and suffering. Born a lower-caste Dalit in the rural Indian district of Buldhana, he would spend most of his childhood helping his family with hard labour, and was unlikely to ever know an education. Today, he is a medical doctor, and he reminisces about the day missionaries came to his village, providing him and others with the schooling and health care needed to break out of the cycle of poverty.

Bharat Ramakrishna BMedSci · Michelle Y Li BMedSci · Ray Wang BMedSci · Lily T Ho-Le BMedSci · James S Wei BMedSci · Henry R Jennens BMedSci

Long-term continuity of care and community engagement mean a lot to a doctor. When we pulled up in the driveway of our first rented house in Camperdown, south-west Victoria, a woman’s face appeared over the fence. “Hello”, she said, “Who are you? What are you doing here?” I explained that we were doctors and would be working in the town. “Oh, you got any family here?” ...

Ruth A Stewart MB BS, FACRRM, DRANZCOG