iSimulate Advanced Life Support Resuscitation Simulation Application for iPad

www.iSimulate.com.au

This amazing software was demonstrated at a recent Australian Resuscitation Council meeting and was developed by one of the ACT members of the ARC. It has a variable monitor display including an ECG trace, arterial line, etCO2, BP, SaO2 etc, and an inbuilt defibrillator function. The instructor can alter the ECG trace and students can then respond in real time e.g. to deliver a shock (without risk of harm to anyone) or commence CPR. Heavy manikins are not required so training can be delivered in any location.

There is a licence fee of $2,000 in first year and then $500 a year thereafter. It uses a wireless router for a LAN. They can also supply the iPads already set up (for an additional fee). There is additional information downloadable from the website and an email newsletter that you can subscribe to.

It is certainly an exciting development in resuscitation simulation training and apparently has been taken up enthusiastically by healthcare agencies around Australia.

Los Amates Mexican Restaurant

Spreets vouchers (http://spreets.com.au) recently offered a deal on a local Mexican restaurant, Los Amates, including margaritas, nachos and mixed enchiladas. The decor and the staff were genuinely Hispanic, and the food was excellent. For starters, both the lime and tamarind with chilli margaritas were flavoursome and refreshing. Although small, the nachos was delicious, with a tangy fresh tomato sauce, crunchy round corn chips and a beautiful guacamole with a refreshing taste of coriander. The melted cheese on top was a little sparse, but the black bean paste (a variation on the oft-used refried beans) was outstanding.

The final course was a mixed platter of chicken enchiladas with three different sauces - a light tomato and green chilli sauce, a thicker more spicy sauce and a chilli and dark chocolate mole sauce. This was accompanied by side servings of beans, a carrot-coloured rice dish with chunks of fresh tomatoes, and a lettuce and tomato salad with balsamic dressing. All in all, tasty, fresh and satisfying, but the main dish could have been heated up a little more as the cheese on top would have been better melted . It was just as well dessert was not included!

The service was attentive and quick, but this was in part due to needing to move customers through to make room for the later second sitting. The food and ambience seemed more authentically Mexican than chain restaurants like Taco Bill, and the overall experience can be recommended.

Scandinavian Crime Fiction

Most of my reading unfortunately is to do with medical journals and work materials, but I have developed quite an interest in Scandinavian crime fiction after watching the television series "The Eagle" and many episodes of both the Swedish and English adaptations of Swede Henning Mankell's "Wallander" in addition to the trilogy of movies based on Steig Larsson's novels, beginning with "The Girl with the Dragon Tattoo".

Prior to travelling to Nepal late last year, I purchased a copy of the final Wallander book, "The Troubled Man", which I am sad to say I found rather disappointing. After ploughing through hundreds of pages, it was all concluded speedily and unsatisfactorily in the equivalent of the last five minutes, and I regret that I cannot recommend it. It almost seemed as if the author had become bored with the Wallander character and was merely 'going through the motions' to bring the series to an end. This speedy resolution of the storyline also tends to happen with the episodes of the television series, with varying dramatic success.

I did however enjoy "The Snowman" by Norwegian Jo Nesbø. This is cleverly crafted, and for the observant (who do not read in memory-challenging opportunistic and halting instalments as I must do) the clues to the resolution of the mystery are given at the beginning of the book. This one I can recommend, but it is rather gory in places and is not for the faint-hearted. I

I have also just seen the Norwegian movie "Headhunters", based on one of Jo Nesbø's other novels. This was entertaining and well done, with many unexpected twists and turns, including an unexpected final denouement. At times it did 'push the envelope' in terms of the willing suspension of disbelief, including several implausible escapes from certain death, and once again there was a significant amount of gore. Also not for the faint- hearted but nonetheless enjoyable! It would be interesting to know whether the gruesomeness is a common theme with Nesbø's works.

Having seen all three of the Swedish film adaptations of Larsson's Millenium novels, I was curious to see the Hollywood version of "The Girl with the Dragon Tattoo". This was surprisingly good. However, both films have variances from the original novel which in my view detract from the storyline. Which one do I prefer? This is hard to say, but perhaps the Swedish version. Why? Well, it is Swedish, and I particularly like the 'ordinariness' of the appearance of the actors, which makes it more believable. It will be interesting to see if Hollywood proceeds with adaptations of the other two novels. The third movie was by far the best, and convincingly pulled together all the threads woven through the three books into a suspenseful and exciting conclusion.

The Power of One

Much has happened since I last wrote anything of substance, and I am still struggling to make sense of some of it. Sometimes we do not express what is in our heart as we do not know what to say.

I did travel to Nepal in late October last year with the intent of visiting Everest Base Camp, a lifelong desire, but through collusion of circumstances I was prevented from achieving this, and fell ill with altitude sickness and three simultaneous viral infections, including likely influenza. As a result, I was ill for some time after returning to Australia, and developed post-viral fatigue, which still lingers and hinders my activities some months later. I still do not know when I can expect to make a full recovery but feel that things are gradually heading in that direction. I still try to do as much as I can, but some days pay a heavy price for this.

Prior to travelling to Nepal I attended a series of meditation workshops presented by the Sri Chimoy Centre (www.srichimoycentre.org/au, http://au.srichinmoycentre.org/, http://www.melbournemeditation.org/). These were sensitively and thoughtfully presented, but my participation was cut short due to my trip. There is ample scientific proof of the benefits of meditation, but like all disciplines it requires commitment; something which I have not been able to provide. I find it ‘hard going’ as at present I have too much of a ‘monkey mind’ and too many intrusive thoughts. I wish that I were better at it, but of course that would only come with time and effort!

I have been able to resume my tutoring at Melbourne University Medical School, which is both challenging and enjoyable. I am also looking into various other options for part-time work in a mixture of clinical and educational areas. The legal case against my ex-business partner (for which I have suspended my full-time medical career for two years now) has failed to make any progress over the past twelve months, and indeed I have not even heard from my own lawyers since November last year. I have concerns about both the level and method of representation and their commitment to my cause.

I feel scarred by my experience last year serving as a member of a national ski patrol committee (due to the intensity of commitment and the level of bullying and harassment), and in common with 'aversion therapy', in truth do not know if I will be able to return to ski patrolling. This (in part) led me to withdraw from attendance at the FIPS Congress in France this year as an Australian ski patrol delegate.

Those of you who have seen the movie "Excalibur" or the final instalment of "The Lord of the Rings - The Return of the King" will recall quotes about how the age of magic has come to an end and the age of men has overtaken it. This is how it feels - that the time of those who fought for a better way is over and that we have not won. Furthermore, we are redundant and have no place in the future. We are like ghosts in the machine, but I have no desire for haunting.

However, I haven't lost my interest in undertaking some overseas research to benchmark best practice in pre-hospital care in alpine areas, but unsuccessfully applied this year to both the Churchill Fellowship and the Emergency Services Foundation Scholarship fund for a scholarship to conduct research in Scandinavia.

Having relocated from the country to fight the court case, I have been enjoying singing with my church choir on a regular basis, and enjoyed attending the ACCET Conducting Summer School in January (www.choralconductors.org.au). There are many studies to suggest that choral singing is good both for the soul and the immune system! We recently had a gruelling full-day rehearsal in preparation for Easter, but will be singing a lot of wonderful music.

ACCET Melbourne participants - January 2012

'Continuing Professional Development' is an ongoing part of life as a doctor, and out of the courses I have attended so far this year I can highly recommend:

• Paediatric Advanced Life Support (Critical Care Education Services: www.criticalcare.edu.au)
• St Vincent's Hospital Melbourne Annual Department of Anaesthesia Workshop
• Monash Disaster Resilience Initiative Forum - Learning lessons from recent disaster reviews (Monash Injury Research Institute: www.monash.edu.au/miri/research/research-areas/disaster-resilience/monash-disaster-resilience.html)
• The Australia Doctor Mental Health Seminar (http://www.australiandoctor.com.au/events) 

I am still trying to spend some time (with varying success) on improving my Swedish language skills to work towards eventually taking the TISUS test required for work purposes. I suppose it is still a dream to spend some time working as a doctor in Scandinavia (Norway or Sweden), but the pragmatist in me realizes that it is rather a ‘long shot’ to achieve this in practice. However, I will not entirely give up hope just yet!