This article was first published by Dr Jane Barker in January on To Medicine with Love.

This article is written in response to a recent report on Alcohol and Cancer published by the American Society of Clinical Oncology and asks whether we, as physicians, have difficulty talking honestly about alcohol with our patients, because of our own attitudes towards it.

It is not unimaginable that bottles of Château Mouton Rothschild, which once bore the artwork of Salvador Dali and Pablo Picasso, might one day be required to have plain packaging and images of oesophageal cancer or a cirrhotic liver. (1)

So concludes a lead article in a recent edition of the Lancet, reporting on a newly published statement on alcohol and cancer from the American Society of Clinical Oncologists or ASCO. (2)

Optimising patients for surgery is an essential part of good medicine and requires a team approach. In recent years there have been improvements in perioperative iron management as a result of the National Blood Collaborative, in which St Vincent's and Lismore Base took part. The improvement has occurred because of improved co-ordination and communication between the GP, surgeon and the pre-operative clinics.

A difficulty sometimes encountered by the pre-op clinic at LBH is getting current health information on their more frail patients. This information is usually sent to the surgeon by the GP but may not in turn reach the pre-op clinic.

Hospital in the Home

Dr Richard Lucas outlines the new Hospital in the Home (HITH) Service at Lismore Hospital

What is the HITH service?

HITH is an alternative, patient focused, easy to access, voluntary, cost-neutral model of care for acute and post-acute medical patients to be treated outside the hospital inpatient setting.

The model of service delivery is offered as either “in-centre treatment” where the patient returns to the Lismore Base daily or goes to the relevant community health service for treatment. Alternatively, where possible, the service provides treatment in the patient’s home or at the Residential Aged Care Facility (RACF).

Care is provided by appropriately trained registered nurses or a physiotherapist.

The HITH physician also operates clinics at Lismore Base Hospital three times weekly to review patients whose illness requires closer monitoring.

The HITH entry criteria dictate that the patient is an admitted inpatient to LBH.

SS Canberra, Docked in Sydney Harbour

by Richard Arnot*

During an interesting six-month internship at the West Cornwall hospital in Penzance, Cornwall I looked for a berth on a square-rigged sailing ship with the intention of sailing round the world.  Fortunately common sense prevailed, and instead I joined P&O as junior surgeon on the SS Canberra, and set off from Southampton in August 1966.

It was a great introduction to life at sea - romantic, wicked, and a wonderful experience in life affairs. I rubbed shoulders with the great and famous, including Cary Grant and his wife Dyan Cannon, with whom I was on first name terms.

During that voyage I had one day ashore in Sydney, one of the very few during the trip around the world, and fell in love with Australia, lying on starlit Bondi beach.

Medicine men pursue work-life balance

At the start of this year Dr Katherine Willis-Sullivan (DMS of the Lismore Base Hospital), and Dr Sue Veloski (local General Surgeon) advised me that a ‘Women in Medicine Night’ was being organized, and suggested it might be good to have a similar event for men.

Our task as clinicians, male and female, is demanding, both intellectually and emotionally, and at times physically. We must pass through numerous training barriers and overcome examination hurdles, all while seeking to provide excellent care to our patients.

Hopefully somewhere along the way we also look after ourselves. While the concept of ‘Clinician Wellbeing’ may not be new, recent reviews into the culture of medicine have brought this into stark relief. A further example was provided recently with the RACP Primary examinations, and the immense distress and disruption this debacle caused to candidates sitting exams.