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Newsletter – July 2019

Below: Rone Empire Installation, Dining room, Burnham Beeches, Dandenong Ranges Photos by Gigi and Robin Williams.

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RCH AlumniThe Royal Children’s Hospital Melbourne5O Flemington RoadParkville Victoria 3052 AustraliaTELEPHONE +61 3 9345 5522www.rch.org.au/alumni

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Caroline Clarke

The 2019 RCH Alumni ExecutiveDr Hugo Gold, President

Ruth Wraith OAM, Vice-President

Professor Jim Wilkinson AM, Treasurer

Professor Garry Warne AM, Honorary Secretary (garry@warnefamily.net)

Dr Kevin Collins

Bronwyn Hewitt

Christine Unsworth AM

CreditsEditors – Profs. Garry Warne and Jim Wilkinson.

Graphic design – Dan Warne

Contents (Hyperlinks)

1. From the Hon Secretary Garry Warne

2. Rone Empire Installation, Burnam Beeches Gigi Williams

3. Antarctica as a ship’s doctor Peter Loughnan4. Masters Swimming and overcoming fear of the waves!

5. Walking in the footsteps of Robert Louis Stevenson Geo� Mullins

6. Memories of Kester Brown Peter Howe & Alan Duncan

7. “Our Connected World” Julian Clarke meeting (July 2)

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From the Honorary Secretary Meetings held 9 February 2019

Ruth Wraith OAM, “Children, trauma and recovery”

14 April 2019

Mr Mike O’Brien, “What health systems could learn from health professionals”

2 July 2019

Julian Clarke AM. “Our connected world”

Meetings to look forward to2 October 2019

The Vernon Collins Oration. The Hon Jennifer Coate AO QC

12 November 2019

Alumni Annual General Meeting and Gala Dinner (Kew Golf Club). Speaker: Professor Katherine North AC, Director of the MCRI

Dates yet to be confirmed

RCH Alumni and Children’s Rights International (Chair: the Hon Alastair Nicholson AO RFD QC) will co-host two medico-legal seminars.

Australian honours awarded to RCH Alumni in 2019Dr Bernie Jenner OAM

Professor Ruth Bishop AC

Dr David McCredie AM

Professor Jim Wilkinson AM

Mrs Patricia (Paddy) Keith AM

Dr Pat Phair OAM

DeathsDr Kester Brown AM, anaesthetist (14 Nov 2018)

Dr Fred Jensen, radiologist (16 Jan)

Dr Robert Kelly, dermatologist (21 Jan)

Dr Ian McDonald, anaesthetist (8 Feb)

Dr Ann Morgan OAM paediatrician and psychiatrist (14 Feb)

Garry Warne garry@warnefamily.net

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Rone Empire Installation at Burnham BeechesDandenong Ranges, Melbourne A photographic essay by Gigi Williams

Rone, or Tyrone Wright, as he was born, is an internationally famous street artist based in Melbourne. Born in Geelong, Rone started decorating skate boards and skate parks but soon his stencils became larger and more bold and he is now best known for his stylised images of women’s faces.

Beauty and decay is a common theme in his work and often he paints buildings that are to be torn down thereby giving a fleeting life to his paintings.

Robin and I were fortunate enough to get tickets to Rone’s latest and most ambitious project so far – ‘Empire’.

Featuring the images of Lily Sullivan, an Australian actress who stars in the remake of ‘Picnic at Hanging Rock’ and in collaboration with interior stylist Carly Spooner and a team of set, audio and lighting designers, Rone transforms this abandoned mansion into an immersive work of art.

It is beautiful, haunting and awe-inspiring.

The title ‘Empire’ hints obliquely at the rise and fall of the Nicholas empire, but in reality the installation allows each viewer, or participant, to create their own version of the stories they see depicted here.

It is not proscriptive: In each room one wonders ‘what happened here?’ Rone himself describes his paintings of Lily as depicting the universal woman – the girl next door.

Twelve months in the making, It is an emotional journey through all the rooms that have been painstakingly furnished and meticulously decorated – every leaf and cobweb deliberately placed, the peeled off wallpaper hung and the dust blown on.

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This is Rone’s largest scale installation. The photos that accompany these words show that truly an image is worth a thousand words but in this installation, the fully immersive experience with light, sound and smell is far in excess of a two dimensional image.

Readers would know that ‘Burnham Beeches’ was an art deco mansion built in 1933 for Alfred Nicholas of Aspro fame. In 1941 it served as a children’s hospital and has been a pharmaceutical research facility and then a luxury hotel till 1991.

It was largely left abandoned for 20 years until Shannon Bennett of Vue de Monde fame and his business partner Adam Garrison bought it in 2010 to develop a sustainable five-star resort. However their plans have been contentious and there have been many objections causing long delays in the re-development.

Robin and I stayed and dined at this magnificent property 30 years ago and so it was an enormous pleasure to step back in time and visit Burnham Beeches once again. We had the earliest time slot at 9am.

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Eighty of us were scheduled to explore upstairs and downstairs for an hour and a half. It didn’t seem crowded as the installation spanned 12 rooms and everyone was in awe of what they saw.

Silence interspersed with gasps of wonderment could be heard as people traversed the rooms. It was dark and difficult to photograph faithfully as no tripods were allowed but everybody was very respectful of each other and patiently waited whilst others enjoyed their experience.

If you would like to see more images please go to www.robinwilliamsphotography.com/back-to-burnham

Above: A guide holds up an iPad showing a room before the installation in front of the completed version. Even the wallpaper peeling away was all part of the work that was done.

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Antarctica as a ship’s doctor Peter Loughnan

I will tell you about some of my medical experiences in Antarctica. In all, I was fortunate enough to have eight trips to the amazingly beautiful Antarctic Peninsula.

Drake Passage, between the tip of South America and Antarctica, is the roughest bit of ocean in the world. So the commonest illness that I treated was motion sickness, and my wife Marg would always be my first patient.

On the first few voyages all that I saw was sea sickness, coughs, colds and the occasional minor injury.

However, on the last two trips I earned my money, which wasn’t difficult, because the ship’s doctor did not get paid, just a free passage.

Before I went to Antarctica I read up on motion sickness. I imagined that there would be an extensive literature: double blind randomised controlled trials, meta-analyses and so on. But no!! I had been told that motion sickness was a big problem for the NASA astronauts, so I went to the NASA website to see how they treated it. To my surprise they used only good old-fashioned promethazine (or Phenergan). The NASA physicians in the early days of manned space flight had done a randomised trial which showed that Phenergan was more effective than other anti-emetics. But of course, this was “classified”, so it was never published in the medical literature!!

So I decided to perform my own non-randomised, non-blinded, non-controlled trial.

The ship’s ‘hospital’ was poorly equipped with medical devices, but was well equipped with a wide range of medications. Most passengers brought their own antiemetics. Scopolamine patches, prochlorperazine and dramamine were the popular ones. However, I had many passengers come to me seriously seasick, despite taking one of those drugs. Most of these patients were greatly relieved, or cured, with single decent dose of Phenergan, 50 mg.

As I said before, it was on the last two voyages that my adult medical skills were seriously challenged. I will now give you an outline of what they served up to me.

My first patients were two English girls who had been trekking around South Africa for two months. They both developed a severe, protracted paroxysmal cough which had been present for about six weeks when I first saw them. Their coughing was typical of pertussis. Bilateral basal

crepitations were noted. I prescribed them both erythromycin. When seen two days later there had been dramatic improvement and they had only a mild sporadic cough. This would not happen with whooping cough, so the very rapid response to erythromycin made me think that they had mycoplasma pneumonia. But without chest X-rays and serology I could not confirm this.

The next patient was Lois from Israel. She had fallen on a slippery pier and injured her right wrist. She had an obvious posteriorly displaced Colles’ fracture, which was impacted and would need reduction under general anaesthetic. Lois was transferred back from the pier to our ship in an up-

market rubber dinghy called a Zodiac, and winched up onto the deck by the ship’s crane. The guy driving the Zodiac was David Wood. Before he started as an Antarctic expedition guide, Woodie had a much more conservative job. He worked in the Finance Department of The Royal Children’s Hospital!!

Getting back to Lois with the Colles’ fracture, definitive treatment of this injury was not possible on the ship. All that I could do was to immobilise it in a plaster back slab, and recommend that she get hospital treatment when she arrived back in civilisation, which would be in about three weeks time. Evacuation from Antarctica is not done for such injuries, only for life-threatening problems. This is in part because the cost of such an evacuation is between fifty and one hundred thousand dollars. As well, the ship may be 2 to 3 days sailing from the nearest feasible evacuation point.

The next patient was Glander who was from Holland. He presented with fever and rigors due to facial cellulitis. The pain had been present for about 48 hours. He was febrile, 40.5 degrees centigrade, and had an exquisitely tender lump on the left side of his nose. There was spreading cellulitis down the left side of his face, extending onto the neck. This was very likely to be caused by Staph aureus, which in this setting was likely to be sensitive to the antibiotic flucloxacillin. However he informed me that he was severely allergic to penicillin! We were en-route to Stanley in the Falkland Islands, so I radioed ahead to arrange an urgent consultation at Stanley Hospital for IV antibiotics. The only antibiotic available to me on the ship that was likely to be effective was oral ciprofloxacin. I gave him 500 mg three times a day. There was dramatic improvement when reviewed 24 hours later. Fever and pain were gone and the spreading cellulitis had retracted. I continued the cipro for ten days and was able to cancel the hospital admission. I had never used this antibiotic before, and I must admit that I was very impressed with it.

The next patient was Nobuo, a young Japanese university student.

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While dancing vigorously after a few glasses of wine, he collapsed in severe pain. He limped off to bed and saw me the following morning. There was extreme tenderness over the Achilles tendon in the ankle, with a palpable defect. I immobilised his ankle in a plaster back slab. He was nonetheless determined to see the rest of the wonders of Antarctica. He learned to walk on crutches on the ice (no mean feat) and was soon limping around, wearing heavy duty gum boots. He subsequently went on every excursion. If it was 50 years earlier I am sure he would have been a very good Kamikaze pilot!

One of the ship’s staff was Ray McMahon, a long-standing veteran of Antarctica. In fact, many years ago, he led the last expedition that used huskies to traverse the ice. Ray was picking up kayaks to bring back to the ship. We were watching from the deck and saw him overbalance and fall into the icy water. A young female staff member who was nearby pulled Ray up into her Zodiac. It’s a good thing she had spent a lot of time at the gym. He was in the water for about one minute. I ran to the medical centre and filled the bath with lukewarm water. But Ray is a tough cookie. Despite having a temperature of 33.8 degrees centigrade, and a pulse rate of 50, he just said “let me have a hot shower and then a sleep”.

One of the most challenging problems was with Yitzhak from Israel. He fell on a slippery deck while watching whales and sustained a mid-shaft fracture of the humerus. The bone ends were overlapping by about four inches. I enlisted the help of the only other doctor on board, but there was a problem. He was an ENT surgeon. So there was a neonatologist and an ENT surgeon trying to deal with a very difficult orthopaedic problem. And, as you might guess, orthopaedics is not my forte. Nor was it the ENT surgeon’s.

So I put in an IV and gave repeated doses of intravenous morphine while we put on a collar-and-cuff sling (which is quite a bit more difficult than it sounds). That night he slept sitting semi-upright, but woke up every few hours in pain requiring another dose of analgesia. Marg (my wife) and I took turns giving the morphine.

Despite all this Yitzhak was back on the deck two days later. However, I forbad him from whale watching if the deck was wet!

Greg was a 45 year old Melbourne man with no significant past history. I was called to see him when he collapsed while observing wildlife on the bridge. He reported severe crushing chest pain radiating down the arm which had occurred two hours earlier, lasting about 20 minutes. When seen he had a pulse rate of 40. An ECG showed sinus rhythm, not complete heart block, together with multiple ventricular ectopics. The ECG changes were consistent with an inferior myocardial infarct (I consulted a cardiologist in Seattle via satellite phone and email). Despite considerable and frustrating difficulties with bureaucrats, I arranged for Greg to be evacuated to the mainland from a Chilean Air Force base. But this was two days sailing away. So I hooked

him up to a little cathode ray oscilloscope (not a proper monitor), and Marg and I took turns watching the screen for 24 hours a day until we got to the Air Force base. Marg is not too hot on interpreting ECG’s so I just told her that if it suddenly looked very different to charge up the defibrillator and wake me up. Fortunately nothing bad happened, for which I am eternally grateful. I probably would have electrocuted myself!

Greg spent four days in coronary care in Punta Arenas on the Chilean west coast. He made a full recovery and remains quite healthy.

The next patient was even more difficult. He was a member of the expedition staff. Jack (not his real name) started to behave in a strange manner soon after we crossed Drake Passage. He told everyone he met that he was medically qualified, and that I was a hopeless doctor. He also told many of the passengers that the ship’s crew were all incompetent and that the ship would probably sink.

He knocked on our cabin door at 3 am next morning and insisted that Marg and I do some meditation with him. Now I don’t like meditation at the best of times and certainly not at 3 o’clock in the morning with a fruit loop. Later that morning, about 6 am, one of the Russian crew knocked on our door. He was holding onto Jack’s arm, and via an interpreter, informed us that they found him trying to climb over the ship’s rail and jump into the freezing ocean. Jack’s wife was with him and I told her that I should give him an injection to calm him down.

She said that they did not believe in Western Medicine and refused to let me sedate him. A short time later she came back and said: “Dr Peter, I think he needs that injection”. We went to his cabin and found Jack totally disoriented. He was punching the wall of his cabin, sustaining a fractured metacarpal. He then smashed a large mirror with a chair. I drew up an ampoule of the sedative Largactil. When I was an anaesthetic registrar at RCH, I had been taught that the dose of all drugs for an adult was one ampoule. The three of us dragged Jack onto his bunk and I gave him the Largactil through his jeans. Sterile technique was out the window. After he went to sleep I went to see the Captain to see if there was a secure room that we could lock him in. But there wasn’t! However the captain gave me a set of handcuffs that he kept in case someone was arrested and needed to be restrained. So I handcuffed poor Jack to his bunk. He was not very happy when he woke up. The next day he was also evacuated from the same Chilean Air Force base on the same plane as the Australian with the myocardial infarct. I found out later that Jack had worn two of the strongest scopolamine patches each day crossing Drake Passage. The Chilean doctors informed me later that within 24 hours Jack’s behaviour had returned to normal. I suspect all these events were due to scopolamine toxicity. Scopolamine, known also as “The Deadly Nightshade” was the drug that Hitler and the Nazis used to disorientate prisoners of war during interrogations.

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So, as you can see, many of these cases were quite serious, but I will tell you about another one that was rather humorous. I was called to the galley to see the ship’s cook who had a runny nose. Now I don’t normally have much sympathy for people with rhinorrhea. But the Argentinean cook said to me in broken English: “Jeez doc, I wouldn’t have worried you, but it was dripping into the food”. And that was the food that I was eating!

My final patient was a wonderful 35 year old woman from California. Her name was Anne, and she was suffering from terminal lympho-myosarcoma. She knew that she did not have long to live. Before you can go to Antarctica you must have a detailed medical examination and submit a medical report to the cruise ship company who can refuse to take you if their doctors judge that you may become seriously ill. But Anne was desperate to see Antarctica before she died. So she told lies in her medical report, saying that she was quite healthy.

When we got back to Argentina I was asked to see Anne who had become sick on the way back to Ushuaia. She told me that she was dying of cancer, but that she desperately wanted to get home to see her loved ones again before she died. Because of sea-sickness she was about 10% dehydrated and also wasted. She knew that if she was admitted to hospital in Argentina it would be ages before she would get back to the States. Have any of you ever told a ‘little white lie’? I did on this occasion. I put in an IV on the ship and gave her 1500 ml of normal saline over two hours.

Then I took her straight to the airport, and assured the airline authorities that she was healthy and quite fit to fly. Anne did get back to California and spent time with her loved ones. She died a week later. When we got back to Melbourne there was a letter from Anne’s daughter waiting for me.

It basically said: “Thank you so much for letting mum get home to die with all her family”. That really brought a tear to my eyes.

In conclusion, you can see that life as a polar doctor is never boring. And it’s great to have a wife who is a competent nurse. In fact, even her social work skills were also needed! She spent hours consoling and counselling the wife of Jack, the guy who tried to jump overboard.

The tour company had been visiting Antarctica for about 15 years and had never had to have a patient evacuated. It is probably a testament to my lack of competence in adult medicine that I had two patients evacuated from King George Island to Chile, on the same aircraft !

And finally, thank God, no-one came into labour!!!

We came home via Los Angeles. Unfortunately I got a piece of Kentucky fried chicken stuck in my immotile oesophagus and ended up in UCLA Medical Centre for an oesophagoscopy.

Thank God for travel Insurance!!!

Masters Swimming and overcoming fear of the waves!Caroline Clarke

Those who have known me for many years are aware that I’m a bit of a swim tragic – I have been since I was about 5 years old. People are often quite surprised that a “Pom” is such a keen and, even if I do say it myself, reasonably accomplished swimmer!

I learned my craft in a tired old pool in Oxford, which I revisited a few years ago on a visit to the homeland and found it has now been very effectively modernised.

My first swimming teacher was very adamant: “Learn your strokes properly, don’t compete until you are 9 or 10 otherwise you will just end up thrashing about…” – very wise words.

As a result of his wisdom, I ended up as a keen medley swimmer – proficient in all strokes – and this has stayed with me as I’ve moved through the ages and stages to Masters swimming.

I swam throughout my junior years in the UK, achieving representation at the equivalent of state level and enjoying lots of trips with my team. It was good “respite” from studying to get into medicine.

When I went to the University of Southampton in 1976 I did continue competing for Uni, but we didn’t have our own pool and once I entered clinical years it all got too difficult.

In those days it was very hard finding lane space in pools for lap swimming in the UK so my fitness and my passion were put on hold for a whilst I undertook house jobs and my neonatal and paediatric training in the south of England and London.

Fast forward to 1989, and I moved to Melbourne with my Australian husband, John, and our two sons, Ben and Matt, then aged 2 years and 4 months respectively.

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Within a year or so of settling into the eastern suburbs I discovered we had a very nice and recently refurbished and upgraded swimming pool literally 5 minutes walk from our house.

Even better, I then found Doncaster Dolphins Masters Swimming Club, and thought this was a great opportunity to get my swimming fitness back (at that stage swimming 400 metres seemed an effort) and meet a few new people. Once I’d joined I discovered that masters swimming was more than just following that black line up and down the training pool, there was the opportunity to compete. That had me hooked. Over the past 25 years since I became a “Dolphin” I have competed in interclubs, state meets, national championships, Pan Pacific games,

FINA world masters championships and World Masters Games.

I’ve swum in pretty much every capital city in Australia as well as some regional cities, plus overseas. I am fortunate to be part of a great club which has about 100 swimmers, and have some great friends made through the club which is also a very social group. In 2013 I swam at national championships in Sydney (the Olympic pool) and was thrilled to get my first individual national medals – a second in the 400m individual medley and a 3rd in the 200m individual medley. After that my expectations shifted a bit, although the competition remained stiff. One of the interesting things about Masters sport is that you actually look forward to moving into the next age group and becoming the youngest in that 5 year category. 2013 was one of those years for me, and I was delighted again earlier this year in Perth (again a new age group – I’ll let you guess which one) to get a bronze medal in the 200m butterfly. I do like the endurance events, I’m not a sprinter – no fast twitch I’m afraid.

Over the years whilst I was ploughing up and down the pool, I was aware that many of my swimming friends disappeared every weekend over summer to head to the beach for open water swims.

Above: Doncaster Dolphins in Hobart 2015

Left: With my teammates – national gold medallists in the 4 x 50m freestyle relay

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Having grown up in a country of largely pebble beaches and freezing water, I have to admit I was actually terrified of the sea.

Even after moving to Australia I rarely ventured into sea water where I couldn’t stand up. Sometime in the 1990s someone persuaded me to swim the Pier to Pub and it was one of the most ghastly experiences of my life – when we arrived and I registered the organisers noted “it was pretty rough” and they were considering cancelling the event (and I can assure you that doesn’t not happen often with the Pier to Pub).

They didn’t cancel it, but I was a bit overwhelmed with all the people, got clunked round the head numerous times, got Vaseline on my goggles instead of round my neck (to stop my wetsuit rubbing) and I think I swam breaststroke for most of it.

I came out wondering what people saw in open water swimming and vowed I would never do it again!

At the Sydney meet in 2013, one of my teammates said “you really should try open water swimming, you would be good at it because you are an endurance swimmer…”

I looked unconvinced but she suggested a couple of events towards the end of the season which she thought were pretty tame and why didn’t I try?

Never one to turn down a challenge for too long….off I went to get the wetsuit, and booked in some dates with the elements. I decided to do the Point Lonsdale Ripview Classic as my first swim – everyone said “it’s always as flat as a millpond, it’s an easy course, just a straight line….”.

Well, needless to say, it was no millpond, I overheard someone in the changing room afterwards saying she’d done it for 20 years and had never known it be so rough. I was starting to develop a complex! But at least I had finished it (even though again there was a fair bit of breaststroke).

As the other event I had entered wasn’t for some weeks I decided I’d better dispel my fears and entered the Danger 1000 at Torquay the next weekend.

There I discovered the hazards of trying to actually enter the water through fairly significant breakers – “go underneath them…” my experienced friends said: that’s fine when you’ve done it before but not really intuitive to a scaredy cat!

Anyway I survived that too, despite also getting my foot caught in the rope under one of the buoys.

I did two more swims that year, both of which were much more enjoyable in the bay at Mount Martha and then Dromana and that set me up for a new era of my swimming career.

Now I generally do about 6-8 open water swims per year over the summer, my favourites are probably Point Lonsdale (which generally is as flat as a mill pond), Sorrento, the Brighton Australia Day swim (which is a deep water start – I do these events to swim not run) and the Portsea Classic where I got my first podium finish. Over the most recent summer season I actually managed several placings (new age group)!

My most recent “change of direction” was in 2017 when I entered the pool lifesaving in the Australian Masters Games in Launceston. I hadn’t done it for some years – although I had achieved the highest level of the Royal Life Saving Society in the UK as a teenager.

Previously you had to find your most buoyant (human) friend and use them as a live “body”, now you have to rescue these plastic orange things with no arms which are like a bar of soap when you try to pluck them off the bottom of the pool.

It was actually terrific fun and as well as getting a few individual medals I also hooked up with some new and old friends and we romped away with a few gold medals in the relays.

Left: Medals in the lifesaving – note my plastic orange “friend” appearing on the right!

Above: On the podium!

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Swimming has certainly been a very important part of my life: I am fortunate that John has always supported me in pursuing this interest and on my travels – behind every good woman there is an even better “bag man”.

I’ve also been on the committee of our club for many years and recently was very proud to be honoured with Life membership in recognition of my contribution.

The next challenge? Teaching my granddaughter to swim. At 21 months she is already pretty confident in the water so it might not be such a big challenge!

Walking in the footsteps of Robert Louis StevensonGeoff Mullins

In September 1878 the young Scottish writer Robert Louis Stevenson, heartbroken following the return to the United States of Fanny Osbourne, a married woman with whom he had fallen deeply in love, set off on a walking journey accompanied by a donkey (named Modestine) on a 220 kilometre walk in remote south-central France. He travelled to recover from his separation from Fanny as well as a wish to explore the land of the Protestant Camisards.

His journey began in the village of Le Monastier-sur-Gazeille traversed the Velay and Cevennes regions and finished in the small town of Saint-Jean-du-Gard (right).

In the following year he published his celebrated book “Travels with a Donkey in the Cevennes“ based on a journal he kept on this walk and still published today.

The book is now considered a pioneering classic of outdoor literature and one of the earliest accounts presenting hiking as a recreational activity. He wrote:

“For my part I travel not to go anywhere; but to go; I travel for travel’s sake….But the great affair is to move; to feel the needs and hitches of life a little more early, to get down off the featherbed of civilisation and to find the globe granite underfoot and strewn with cutting flints”

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Because of his extensive journal notes of his journey, it is possible today to follow in his footsteps and to even complete the walk as Stevenson did with a donkey.

In June 2016 armed with his book, maps, compass and GPS my partner and I set off to follow in his footsteps without a donkey but at times regretting this decision especially when meeting walkers on the trail with donkeys.

The well-marked trail winds its way through the Mastiff Central – a sparsely populated region of south-central France which includes the high mountainous plateau of Velay, Gevaudan, Vivarais and the rugged forested mountains of the Cevennes. These regions have been progressively depopulated since WW1 from a loss of people both from the countryside and the small villages in the name of “progress”.

The remoteness the Cevennes made it a place of refuge for Protestants in the Religious Wars of the 18th century and of the site of the revolt of the Protestant Camisards against their Catholic rulers at that time. In the 20th century it also became a hideout for Spanish Republicans, Jews, French Resistance fighters and hippies.

The scenery along the trail is magnificent with lush green fields, vivid yellow and purple wild flowers on the high plateau and deep valleys and rivers in the first half of the walk.

Small almost deserted villages along the way with old stone houses, churches, monuments and occasional ruins of a once impressive castle are a reminder of what must have been a much more vibrant region in previous times.

Particularly poignant were the monuments in so many of these small villages to men killed in WW1 (pictured right).

These monuments often displayed three, four or even five members of the same family killed in action and a reminder of the tremendous loss of life the French suffered in that conflict.

Once into the Cevennes, the scenery changes to wild mountainous country of dark dense forests of oak, beech and chestnut trees and rushing streams before emerging onto high grassy plateaus.

In recent years bed and breakfast accommodation (pictured above) has become available in many of these villages some advertising to accommodate a donkey on site or nearby. A prominent sign of a painted donkey would indicate they were certified to provide the prerequisites of shelter, hay, water and a block of salt!

Stevenson wrote much about his donkey Modestine and indeed he could be cruel to her often goading her along with sharp implements. He finally realised that he had to negotiate with her rather than inflict pain and by the end of his journey when he was forced to sell her he wept and wrote – “For twelve days we have been fast companions; we had travelled upwards of 120 miles, crossed several respectable ridges and jogged along with our six legs by many a rocky and many a boggy road”.

We were told that many people today who take the journey with a donkey are equally sad and tearful on parting with their donkey at the end of their journey.

There is much information along the trail and in villages on signs, monuments, churches and ruined castles both on Robert Louis Stevenson and the history of the region dating back to Roman times, the one hundred years religious wars and the revolt of the Camisards in the 18th century.

We took 12 days to complete the trail, found it a wonderful experience and taking inspiration from Robert Louis Stevenson may next time undertake it with a donkey.

Despite chronic ill health Robert Louis Stevenson went on to travel extensively during his short life, particularly throughout England, Scotland, the US and the South Pacific. He suffered from severe respiratory infections throughout his childhood and his adult life, and at times

was severely incapacitated and leaving him extremely thin. He was thought to suffer from tuberculosis, but more recent views believe it to be bronchiectasis or sarcoidosis.

The year following his walk in the Cevennes he travelled to the US reuniting with Fanny Osbourne and following her divorce they married despite him being in his words “a mere complication of cough and bones, much fitter for an emblem of mortality than a bridegroom”. For the next eight years he travelled with Fanny and her son around England, Scotland and the US seeking a home suitable for his health. Finally, they travelled extensively in the South Pacific before settling for the last 4 years of his life in Samoa where he was much loved by the Samoan people. He died suddenly in 1894 aged 44 years of a probable cerebral haemorrhage. The Samoans insisted on surrounding his body with a watch-guard during the night of his death and on bearing him on their shoulders to nearby Mount Vaea where he was buried overlooking the sea.

The requiem inscribed on his tomb reads:

Under the wide and starry sky, Dig the grave and let me lie. Glad did I live and gladly die, And I laid me down with a will. This be the verse you grave for me: Here he lies where he longed to be; Home is the sailor, home from sea, And the hunter home from the hill.

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Memories of Kester BrownPeter Howe

My anaesthesia training was a bit all over the place. Although I’d been at RCH as an aspiring paediatrician several years before, I had ended up an anaesthesia trainee in Darwin. I had only a year to go in my training, and I was determined to spend at least some of it at RCH, so there was only one thing to do. I had to meet Kester.

I arranged to attend a meeting in Perth, where Kester was due to speak. At the welcome reception I scanned the room – I’d never met Kester, but from the size of his reputation I presumed he would look like an admiral – tall, waxed moustache, 3-piece suit – a little like Rod Westhorpe, in hindsight.

My scanning was interrupted by a genial chap who had shuffled my way, and seeing my ‘NT’ badge, asked me if I’d met a series of his former colleagues who had spent time in the Top End. He had a striped tie that didn’t match his checked shirt, shapeless trousers and a charming demeanour. Several minutes had passed before I paused my scanning and looked at his badge. Kester had found me!

Kester appointed me, taught me about anaesthetics and in particular taught me how to teach. Many things that I’ve heard in educational theory, from snowballing to getting students to write themselves a script before a discussion-based tutorial - were old news. Kester used to do that!

But the number one thing Kester taught me was to look after patients well. I have now inherited one of the lists he loved – surveillance of children with retinoblastoma, and eventually surveillance of the children of those children. Many current parents remember Kester from their childhood – if not by name, by description – ‘the lovely man who always told the same story about the chicken that thought it was a dog!’

Vale Kester. We miss you.

Dr Peter Howe MBBS, FANZCA, MClinEd Clinical Associate Professor (Department of Paediatrics, University of Melbourne) Staff anaesthetist, Supervisor of Training Department of Anaesthesia and Pain Management

And from Alan Duncan:

Wally Thompson, former President of ANZCA and the ASA, today advised the WA Retired Anaesthetists Group of Kester’s passing and I indicated my sadness. Kester made contributions nationally and internationally in so many ways. He influenced many careers including my own. He had a unique knack of knowing what he believed would be a good direction for others to follow - I would call it steering rather than manipulation!

Kester appointed me as a Senior Registrar in Anaesthesia at RCH in 1974. Bob Eyres was in a similar position as we had both completed our FFARCS diplomas that year. I had never met Kester and he knew nothing of me. I was working in the

Netherlands at the time and Geoff Mullins with whom I had worked at SCGH in 1970 apparently said that it was worth taking a chance on me. Kester engineered our futures. Bob followed the anaesthesia course and made a major contribution to PICU over many years, whereas I focussed on PICU and whilst maintaining an involvement in cardiac anaesthesia. It was the commencement of my career in paediatric anaesthesia and intensive care and there was to be no turning back.

Kester subsequently recommended that I join the Editorial Board of AIC to manage the intensive care component and this led to a 20 year involvement with the journal.

Kester also thought that it would be useful for me to link up with the late Struan Sutherland to undertake research into Funnel Web Spider envenomation (this was very topical at the time as there had been a number of highly publicised deaths). In association with James Tibballs, this relationship led to exciting research and productive outcomes. Jim, of course, went on to have his own stellar career in the field of venomology.

I am sure that many will have their own stories about how Kester helped them along the way.

Dr Alan Duncan AM MBBS FRCA FANZCA FCICM

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Our connected worldGarry Warne

Julian Clarke AM, the former CEO of News Corp and former chairman of the RCH Foundation, was the guest speaker at the Alumni luncheon on July 2nd.

As a newspaper man, he said, he had given careful thought to the title of his talk, as a good headline should reflect the content and entice the reader. Two memorable headlines, he recalled, were “Headless body in topless bar” and one which appeared in a farmers’ paper, “Time to root daisy”.

On the subject of connectedness, Julian spoke about the digital revolution of the last 20 years as one that was just as important as the agricultural and industrial revolutions that preceded it.

The information age has transformed, in both scale and weight, every profession and every industry. Of course, there have been winners and losers.

The impact on newspapers has been massive, life threatening. Viability has been threatened – in fact, 1000 U.S. newspapers have closed in the last decade.

As newspapers disappear, fundamental questions are being asked about what will happen to our democracy?

Newspapers are incredibly expensive to produce. Sixty percent of the costs are in printing and distribution. Seventy percent of the revenue to support a newspaper comes from advertising and 30% from sales of the paper.

Of the $17 billion spent on advertising, 50% now goes to the new electronic search and social media companies (Google, Facebook, Instagram, Twitter, etc).

So how do news organisations respond when threatened in this way?

The advent of television in 1956 was predicted to have the power to wreck sales of newspapers, but in fact newspaper sales peaked in 1973. The newspaper organizations successfully bid for TV stations and this ensured their survival.

The new digital companies, however, are different. They are world-wide and very smart – they don’t have to produce any of the content they publish.

Newspaper companies have realised that more and more readers will access the paper through electronic devices and so NewsCorp decided to build its digital platform and to employ a paid subscription model.

The Herald and Weekly Times now boasts 550,000 subscribers and they are able to read every word of the paper. The Australian newspaper has 150,000 digital subscribers, more than the number of subscribers to the printed edition. Journalists upload their articles directly to the internet and their articles can be published immediately.

Having a digital publication also gives certain powers to the people at the top. Julian recalled that while sitting at his desk in Sydney, he could see on his computer screen how many people were reading any particular article at any moment (in real time), where they were, and what kind of device they were reading it on.

In finishing Julian answered questions and inevitably, there was one about what Rupert Murdoch was like to work with. “He’s someone who is a Ph.D brain and a street fighter all in one”, he said, “but I always enjoyed working with him”.

Julian Clarke AM

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