St Vincent’s Hospital Medical Alumni AssociationE-Newsletter summer 2013-2014

Welcome to the summer 2013-2014 newsletter of your association.

In this edition – in brief

New website for the association

Our new website was launched in October 2013……………………………………………..………………….read more

Annual General Meeting

The Annual General Meeting of the Association will be held on………………………………………… read more

The 2014 Association Annual Golf Day

The Alumni Association Annual Golf Day for 2014 will again be held......................................read more

Historical Talk and Cocktail Party

For 2014, the topic of the historical talk will be the history of................................................read more

Obituaries

Dr Gerard Little…………………………………………………………………………………………………………..…….…read more

Dr Peter J Johnston……………………………………………………………………..………………………………………read more

Book review

In this edition we publish a review of a new book by Dr Ian McDonald entitled “The crisis in contemporary medicine and the rise of the reflective physician”…………………..……………….…..read more

News from the Archives Department

An introduction to the Archives Department and its services ……...........................................read more

News from the Clinical School………………………………………………………………….………………….……..read more

News from St Vincent’s Hospital ........................................................................................read more

News from the St Vincent’s Foundation.............................................................................read more

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New website for the association

Our new website was launched in October 2013 and can be visited at http://stvincentsmedicalalumni.org.au/ The Association is very grateful to alumnus Dr Rowan Thomas for designing and building the website for us on an honorary basis. At the website you will find notices of forthcoming events by clicking on “News”.

Annual General Meeting

The Annual General Meeting of the Association will be held on Monday, February 24, 2014 at 6.00 pm. The meeting will be held on the ground floor of the Aikenhead Wing. The agenda will be placed on the Association web site two weeks before the meeting.

The 2014 Association Annual Golf Day

The Alumni Association Annual Golf Day for 2014 will again be held at Green Acres Golf Club in Kew. The date for 2014 is Friday 14th March.

Players with official handicaps compete as individuals for a silver cup that has inscribed on it the winners over the last 70 plus years. In addition there will be prizes for the best group, the longest drive and nearest-the-pin. Players without current handicaps are most welcome to participate.

Contact Ms Sue Mabilia, Secretary to the SVH Senior Medical Staff on 9288 2304 or by email Susan.MABILIA@svhm.org.au for more information and to make a booking.

Historical Talk and Cocktail Party

For 2014, the topic of the historical talk will be the history of neurology at St Vincent’s and will be delivered by Professor Mark Cook. The date is Sunday 27 July 2014. Welcome drinks will commence at 4.30 pm with the presentation to start at 5.15 pm. The venue will be the Chamberlin Lecture Theatre on the ground floor of the Aikenhead Wing (use the entrance in Victoria Parade closest to Nicholson St).The cocktail party will follow the lecture and will end at 8.00 pm.

Obituary: Dr Gerald Little

14/3/1924-24/10/2013

Gerald Little was born in Werribee, the middle child in a family of three boys, and soon after his birth the family moved to Essendon. Gerald attended local schools in the area before being sent to boarding school with his brothers at St Patrick's College, Ballarat, a school where his father and his uncles had all attended with great distinction. He graduated from St Patrick's in 1940 and won, by examination, a Newman College Exhibition Scholarship.

In 1940, at the tender age of 16, Gerald entered Melbourne University and Newman to study Engineering. At 18 he volunteered for the AIF. Following the medical examination, he was declared unfit to serve overseas because of a chronic ear infection that left him profoundly deaf in his diseased right ear and unable to localise sounds. He subsequently graduated with a Bachelor of Civil Engineering and during that time, he also completed a 4-year course for the qualification of Land

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Surveyor. Gerald was articled to a surveyor attached to his father’s prominent Civil Engineering & Surveying firm.

Gerald worked as an engineer and surveyor for a number of years before a personal and spiritual epiphany saw him return to Melbourne University as a mature age student to study Medicine. He attended St Vincent's as a clinical student and graduated in 1955. He completed his residency at Prince Henry's Hospital before spending a year at the Royal Victorian Eye and Ear Hospital. Thereafter, he travelled to the UK to study ENT surgery and obtained his Fellowship in Surgery, while working at the Royal Infirmary in Edinburgh and later at The Royal National Ear, Nose and Throat hospital at Grays Inn Road, London.

On returning to Melbourne in 1961, Gerald held appointments at three public hospital ENT units: St Vincent's, the Royal Children's and the Austin, working on an honorary basis in all three. He was on-call for emergencies at all these hospitals (there were no ENT registrars then) and each week he operated and attended an outpatient clinic in all three.

Gerald established his private practice at 2 Collins St and maintained his appointment at St Vincent's as a consultant surgeon attached to the ENT department. The position involved a weekly operating session and attending a weekly outpatient clinic. He retired from St Vincent's in 1986, but continued to practice for a further 18 years. On ceasing to operate, he was engaged with medico-legal work and was appointed by the State Government to the position of Panel member making final assessments on the claims presented. He retired from practice at the age of 80 in 2004.

Gerald contributed to the training of a generation of ENT surgeons and he also served as President of the Victorian division of the OLSA (now ASOHNS) for a number of years. Gerald also initiated ENT consultancy sessions at several institutions on an honorary basis. One was at the RVIB boarding school in Burwood. For 10 years, he brought his own equipment to the regular clinics he conducted. For recognition, he was awarded Life Governorship of the RVIB. He also provided similar honorary services to the Aboriginal Health Service for many years, which then operated out of Gertrude St, Fitzroy, and also to Pentridge Jail.

Outside of work, Gerald was a keen sportsman. He represented Newman in athletics and rowing and was a member of the Melbourne University Athletics team. He was a keen alpine skier, at a time when there was no human habitation on the Victorian Alps. He owned a keelboat with his good

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friend, Dr John Brenan (also a St Vincent's graduate). The pair won the inaugural and now highly prestigious BYS Round the bay night race, The Pinto Trophy. In his 50's, Gerald took up golf with a passion and brought an engineer's attention to detail and a late convert's zeal to the sport. After retirement, he was an active member of the Stonington Probus Club, he rekindled his love of learning German and volunteered 1 day a week for 7 years to Vision Australia where he worked as a reader to blind clients.

Gerald Little loved St Vincent's. His family had a close connection to the Hospital with his uncle, Jack, being one of the Hospital's administrators in the 1920's; his brother Frank, being initially Chaplain to the Hospital in the 1950's before being associated again when serving as Archbishop of Melbourne; his wife, Margaret being a nursing graduate of St Vincent's and his son, Andrew, a medical graduate of St Vincent's. Gerald was a proud alumnus of the Hospital and always felt privileged to work with colleagues who constantly inspired him.

Contributed by Assoc. Professor Andrew Little, Gerald's eldest son, also a St Vincent’s graduate and a visiting staff radiologist at St Vincent's.

Obituary: Dr Peter Julian Johnston

15/7/1939 – 3/8/2013

Peter Julian Johnston (‘PJ’ to most) was a man of broad interests, with a big and generous heart, such that any tribute to this mighty man must of necessity be limited by one's individual experience, and can only reflect a small impression of his extraordinary talent and wonderful career as a doctor and universal good bloke.

Those of us who were privileged to be his medical colleagues through our undergraduate years and intern year at Footscray (now Western General) Hospital and SRMO year at St Vincent's in 1965 and 1966, remember an enviously handsome man, with a lovely crop of swarthy curls, a broad and amiable smile, with boundless vitality, and a very dedicated doctor, proud of the badge he wore. But he was no swashbuckler, and everything he undertook, he took seriously, except himself. He was a man of great warmth, one of those people who really did give a damn about you, and all around him. When you spoke with PJ, it was as if nothing else was more important than that conversation, right then and there. He had an innate sense of others' worth, which made it such a privilege to be counted as one of his friends.

Not everything came to PJ as easily as his handling a ball or swinging a club, for which he had an exquisite natural talent and agility, together with a winner's appetite. Those goals which were harder for him to kick than his legendary spiralling six pointer punts from centre-half forward, he worked on

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doggedly, till they were as close to the mark as he could possibly make them. He wasn't perfect at everything, but he always strove to achieve the best result possible. This applied to work and play, golf and painting, life and love. These qualities did not pass unnoticed by others, but it was the graceful and gazelle-like Denise, a staff physiotherapist, who denied other admirers, and PJ and Cookie became an unassailable item, whose subsequent 46 years together, with five children and seventeen grandchildren attest to their compatibility and love.

PJ explored a career in surgery and general practice before settling on radiology, returning to St Vincent’s for some of his training. His career commenced before the widespread use of endoscopy so that referring clinicians were very dependent on the attention to detail that radiologists needed to apply in both performing and interpreting barium contrast studies. Here PJ excelled and was described by one of his referring gastroenterologists as meticulous in his approach and generous in giving his time to review xray films with the referring doctor. He rounded off his medical career by returning to an early interest in surgery, proudly assisting his son Michael, a colorectal surgeon, for a number of years.

All of us who knew PJ were aware of his fondness, and talent, for singing (in that order). Although his vocal skills had reached legendary status in boarding school shower cubicles, it was not until much later that his youthful thready tenor gradually morphed in to a rich mahogany baritone. By the time he was on the stage at St Vincent's residents' nights, he was punching out such memorable tunes as "Rosie's Cantina", and "The Streets of Laredo" to thunderous applause from his envious less talented colleagues. A few years ago, at a St V's golf day dinner, his choice was 'The Impossible Dream', and it was not long after that the prophetic significance of those words he sang so trenchantly became apparent.

To dream the impossible dreamTo fight the unbeatable foeTo bear with unbearable sorrowTo run where the brave dare not go

To right the unrightable wrongTo love pure and chaste from afarTo try when your arms are too wearyTo reach the unreachable star.

How true it was that he fought the unbeatable foe, and even when his arms were too weary, he reached the unreachable star. Vale PJJ, a fine friend, a wonderful doctor, a much loved man, and a loyal St Vincent's colleague.

Contributed by Dr James King, a close friend and fellow St Vincent’s Hospital graduate (1964). Peter’s son, Michael Johnston, colorectal surgeon at St Vincent’s, assisted Dr King in compiling this tribute.

Book review: recently published book

“The crisis in contemporary medicine and the rise of the reflective physician” by Ian McDonald.

Published by Nova Science Publishers, Inc. New York. 2013. ISBN. 978-1-62618-827-3. The book may be purchased on line at https://www.novapublishers.com/catalog/product_info.php?products_id=41839 for $157.50.

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Reviewed by Dr Peter Greenberg

This book is a tribute to Ian McDonald’s extraordinarily broad professional interests and to his established capacity for reflection, learning from history, lateral thinking, creative innovation and leadership. It reflects his background in sociology, anthropology and clinical epidemiology, his experience as consultant physician, cardiologist, researcher and teacher, his long-standing roles as Director of the Cardiac Investigation Unit and founding Director of the Centre for the Study of Clinical Practice at St Vincent’s Hospital, Melbourne, and his associations with the University of Melbourne.

McDonald’s stated objective is to highlight the contribution of the prevailing major health care paradigm to the “crisis” he perceives in contemporary health care. Approximately 200 years ago, this paradigm, which is rooted in scientific evidence, replaced the previous key paradigm, which had been paramount since the time of Hippocrates. McDonald argues that a new order of “reflective physicians” would lead to resolution of this crisis. By incorporating techniques learned from continuous quality improvement, such physicians would catalyse the emergence of a new and more inclusive major health care paradigm, which would still retain the strengths of the existing one.

Several chapters discuss in depth the meaning of the term paradigm. McDonald uses it to include the attitudes, shared-beliefs, practices and objectives of a group of like-minded individuals. He details the two major competing intellectual paradigms arising from the time of the ancient Greeks, reductionism versus holism. He shows how the current scientific paradigm evolved through reductionism following the Renaissance and the subsequent Enlightenment. The next step was the development of quantitative medical sciences, including empirical studies, in the teaching hospitals in France after the French Revolution.

Holism, the basis for the former long-established and prevalent health care paradigm, with its associated interpretive explanations of phenomena, while absolutely acceptable to many non-medical disciplines, sometimes clashes with the reductionism of health care evidence. Another reason for conflict is that in contrast to reductionism, holistic evidence is usually expressed in qualitative terms through a process of reasoned hypotheses. McDonald emphasises Kuhn’s opinion that the gradual evolution of knowledge appears to have been punctuated by short periods of rapid philosophical transformation called paradigm shifts, including the shift away from holism to reductionism, which permitted the heath care and other sciences to flourish.

McDonald argues that the prevailing reductionism of our medical science paradigm is only appropriate for some, but not all, kinds of health care evidence. It is valid, for example, for establishing drug-efficacy, with randomised controlled trials as the “gold standard”. It is not valid, however, for addressing other questions arising in health care, for example evaluating the subtle clinical interactions between doctors and patients, as such questions necessitate interpretive and hence qualitative approaches. As a consequence, in spite of this prevailing reductionist paradigm, a new paradigm is required which includes these approaches as well.

Subsequent chapters elaborate on the perceived crisis, in terms of the various components of “Clinical Inefficiency” and of “Consultation Failure”. He then discusses the history and evolution of health care evaluation, clinical epidemiology, evidence-based medicine and quality improvement

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and is even brave enough to define and detail “Postmodern Medicine”. His final chapter deals with the qualities required of reflective physicians and an account of a model for their potential catalytic role in paradigm shift.

Although the text in this well-written 258-page tome is clearly presented, it is not recommended for exclusive bedside reading, because of the depth of its contents. On the other hand, an overview of content is easy, as each chapter includes brief introductory summaries of previous text as well as concise conclusions. The text, including chapter sub-headings, is indexed. Other strengths include the author’s admirably broad knowledge and his detailed analytical approach, the inclusion of relevant history drawn from the last 2000 years and his engaging and almost conversational writing-style. The book’s final paragraph explains the otherwise possibly occult meaning of the Chinese letters on the front cover which illustrate McDonald’s view of danger followed by opportunity!

How might this book have been even better? Getting to the source of the broad and interesting references is difficult at times, as some quotations do not appear to be referenced. In addition, references at the end of chapters do not always include all references referred to in that chapter’s text, although some can be found in other chapters’ references. Referencing at the end of the book, as well as or instead of at the end of chapters, would have made this task easier. There also seem to be several sentences in which one word is missing and some minor typographical errors, although the meaning is usually clear, in spite of this. Furthermore, there are relatively few references to publications within the last 10-15 years.

This book will appeal to many, including those who know and admire Ian McDonald, to reflective physicians of all ages and to those, including students, from various health care and other academic disciplines who are interested in the evolution of intellectual and medical thinking. It will also appeal to those who share McDonald’s concerns about the current status of health care and how this might be improved.

Ian McDonald MD FRACP was the Director of the Cardiac Investigation Unit at St Vincent’s Hospital from 1967 until 1994. He established, and was the Director of, the Centre for the Study of Clinical Practice at St Vincent’s until he retired in 2000.

Peter Greenberg MD PhD FRACP is a consultant physician in general internal medicine with long-standing interests in the teaching of clinical medicine and evidence-based practice. He has appointments to the Departments of General Medicine and to the Melbourne EpiCentre at the Royal Melbourne Hospital. as Honorary Principal Fellow in the Schools of Medicine and Population Health at the University of Melbourne and Adjunct Associate Professor in the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine at Monash University.

Suggestions for book reviews: If you have a suggestion for a book review, please email your suggestion to book reviews editor, Dr Katrina Watson, at katrinajrwatson@gmail.com

News from the Archives Department

An introduction to the Archives Department and its services was provided in the Alumni newsletter of Summer 2011-2012 (see http://us2.campaign-archive1.com/?u=c5ad0c53dc32e84edaa5eae82&id=02dc0f258d#ARCHIVES). Since then, the Department and its

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collection have been relocated from the Daly Wing to a new purpose built facility in the Aikenhead Wing, an area which offers dedicated space for display, reference services, desk work and storage. Some recent photos can be seen on the architect’s blog at http://www.gardinerarchitects.com.au/news/

As well as being the year of relocation, this year has also been a busy one for exhibitions and displays and a bountiful one for new acquisitions. The Archives loaned material and provided information for the University of Melbourne’s exhibitions “A body of knowledge” and “Strength of Mind: 125 Years of Women in Medicine” and worked with Artist-in-Residence Pam Bain in development of the “Mapology” exhibition. (The latter exhibition explored the evolution and expansion of the Fitzroy campus in exhibitions held in the St Vincent’s Daly Gallery and in the Brunswick Gallery). The Archives also worked with the hospital’s Communications team to prepare a display for the Open House Melbourne Weekend. Smaller displays were also prepared for Anzac Day, nursing reunions, Mission Week, St George’s Hospital, and the 120th Anniversary of St Vincent’s Melbourne.

New acquisitions included a wonderful series of oral histories commissioned in celebration of the 75th anniversary of Caritas Christi Hospice; the Order of Australia medals of St Vincent’s researcher Anne Raymond; a scrapbook of clippings, photos and illustrations compiled by a nurse during her training at St Vincent’s in the early 1940s; a brass plaque commemorating early physician Alexander Lewers; MBBS certificates and correspondence of surgeon Brendan Dooley; papers published and unpublished by Dr Joseph Santamaria concerning addiction medicine and medicine and ethics; material related to the foundation and development of the Aboriginal Health Program; and a silver cup surgeon Hugh Devine provided for a fundraising golf tournament in 1933.

The Archives are open by appointment to St Vincent’s staff, bonafide researchers and interested members of the public and we are delighted to receive alumni as visitors. To arrange a visit email Archivist Barbara.Cytowicz@svhm.org.au or phone her on (03) 9288 3040, letting her know any particular topics or years of interest to you so she can tailor material brought out for you accordingly.

The Archives is on summer break till late January but is usually open Wednesday – Friday.

News from the Clinical School

(The following news has kindly been provided by Dr Justin Tse and Dr Jacinta Mogg)

In December 2013 we saw our last group of students graduate with an MBBS. The Graduation Mass is a tradition that continues at St Vincent’s and was well attended by the students and their families. It was an historic moment in time, and we were all sad to say goodbye to a generation of students who were a mix of school leavers, postgraduates and international students in equal proportions. We farewelled some lovely and very capable students back to their home countries, including Singapore and Botswana, knowing that they will always have a connection to St Vincent’s and that the education they received will stand them in good stead for their future careers.

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St Vincent’s Clinical School, Final Year 2013

Our students performed exceptionally well, as in past years. Fittingly the two top students comprised one school leaver and one graduate. Jayne Moxey achieved the top aggregate score for the whole year and she gave the Valedictory speech on behalf of the Class of 2013 at Graduation. Anna Proietto was the top final year student and a close second in the whole cohort. Anna has a PhD and she is the daughter of Joe Proietto, a St Vincent’s alumnus.

The Stephen Rosen Teacher of the Year as voted by the students was awarded to Antony Tobin for his series of Organ Failure presentations and bedside teaching in ICU. The Paul Kitchen Award for young teacher of the year was awarded to Veena Roberts who has tutored throughout the year as a Clinical Skills Coach.

The first cohort of students in the new course completed Women’s and Children’s Health and Specialty Health rotations in 2013. Their final year commences in February with a Scholarly Selective research term, and is followed by a return to the hospitals in July for the final semester

The second cohort of graduate students in the new MD course completed their first clinical year in 2013. In their orientation week students met with staff in various non-clinical areas of the hospital including kitchens, archives, art curator, volunteers, pastoral care, aboriginal liaison, the Cottage, addiction medicine and cultural diversity. They then put together a set of very entertaining presentations (no powerpoints!) to teach their colleagues about these departments. This widened students’ perspectives and forged valuable connections within the hospital. It also provided us with a lot of laughs as the students’ creative talents were unleashed! Andrew Smith achieved the top

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score for the whole year. We were very proud of the students’ progress and academic achievements, thanks to the dedicated teaching of all staff and the strong culture of teaching at St Vincent’s.

News from St Vincent’s Hospital

In past editions, we have arbitrarily extracted some news items from the St Vincent’s Hospital monthly newsletter known as The Font. To give the reader complete access to this news source, the Hospital has provided the following link: http://www.svhm.org.au/aboutus/newspublications/pages/theFont.aspx. Just click on the link and you will be taken to recent issues of The Font.

News from the St Vincent’s Foundation

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