ANZCA Bulletin June 2012 - final.pdf - Australian and New Zealand ...

Originally the mace was developed duringmedieval times as a weapon wielded byone arm from horseback. Therefore theshaft was long with a heavily studdedhead, and such maces developed afearsome reputation, which made theman excellent symbol for power.Following the introduction ofgunpowder the usefulness of the maceas a weapon declined but its symbolismfor power and authority survived.Ceremonial maces became larger withmore decoration and were made ofprecious metals such as silver and gold.The ANZCA mace was gifted to the geographical region and the domicile The Duke of Norfolk as Earl Marshall ofCollege by the Royal Australasian College of its headquarters; its derivation from Her Majesty’s College of Arms authorisedof Surgeons (RACS) at our College’s first the Faculty of Anaesthetists, Royal the armorial bearings on December 1,annual scientific meeting in 1994, when Australasian College of Surgeons, and 1992, and they were officially grantedtheir then president, Dr David Theile said, the links particularly in intensive care on May 10, 1994. The subcommittee“as a demonstration of our part in your with the Royal Australasian College of members were very pleased to behistory and a permanent expression of Physicians; its closeness to the basic notified that, because of the designour good wishes for your future”. The sciences of anatomy, physiology and and its detailed justification, thesedesign of the mace was greatly assisted pharmacology; and the relationships arms were granted in the minimum timeby Joan Sheales, the then College which exist between the new and old – an exceedingly rare occurrence.Registrar (now titled chief executive worlds.The armorial bearings consist of theofficer), and is based around a lily to The armorial bearings were“supporters”, which were chosen assymbolise the creation of the new college designed by a College’s Coat of Arms famous historical figures whose workof anaesthetists, as the lily in Greek lore Subcommittee, which met between was vitally important in changing not onlysymbolises birth.September 1991 and September 1992 medical knowledge, but the way in whichThe mace design also incorporates and consisted of Barry Baker (chair), people thought about that knowledge.much of the symbolism from thePeter Livingstone (dean/president), DavidCollege’s armorial bearings which were McConnel (councillor), Peter Jonesdesigned to represent the Australian and (RACS) and Joan Sheales (registrar/CEO),New Zealand origins of the College; its and later Michael Hodgson (president).2003Anaesthetists inManagement SpecialInterest Group establishedOnline journals availableto Fellows2004Curriculum 2004commencesMichael Cousins appointedANZCA PresidentOne Grand Chain(volume two) publishedJack Havill appointed Dean,Joint Faculty of IntensiveCare MedicineMilton Cohen appointedDean, Faculty of PainMedicineClinical Teacher CoursepilotedANZCA website createdANZCA Trainee Committeeestablished18 ANZCA Bulletin March 2012 ANZCA CELEBRATING 20 YEARS 1992-20122005Mike Richards appointedANZCA CEOAcute Pain Management:Scientific Evidence (secondedition) publishedANZCA Trials Group formedAndreas Vesalius is on the left. Hepublished his seminal work De HumaniCorporis Fabrica in 1543 from Padua,Italy. This publication changed anatomybecause it overthrew, after 1400years, Galen’s dogma (largely basedon the anatomy of apes and monkeys)with human cadaver dissection, andby instituting the scientific approachof challenging dogma with directexperience. Vesalius also was the firstto show that an animal that had ceasedto breathe could be resuscitated byusing artificial respiration through areed inserted into the windpipe – in thecoat of arms he is holding a bellows tosignify this act. The bellows also signifiesthe experimental scientific basis ofthe specialty following Vesalius’ lead.His view is outward looking to signifyhis broad academic outlook, and toindicate the widespread place of artificialventilation in anaesthesia and intensivecare.William Harvey, who lived in Englandbut who had studied in Padua, is theother supporter and is depicted holdinga book with a heart etched on thecover. The heart and book represent thecontribution made by Harvey in 1628when he published De Motu Cordis,which for the first time described thecirculation of blood through the lungsand around the body. The book alsosymbolises the College’s respect foracademic learning.Harvey looks towards Vesaliusto explain that the discovery of thecirculation depended on prior anatomicaldescription by Vesalius and others (thatis physiology followed anatomy), and alsobecause Harvey studied in the Italianmedical schools.These two supporters represent theheritage of the specialty based as it is onrespiratory and cardiovascular physiologytogether with anatomy.2006Walter Thompsonappointed ANZCA PresidentRoger Goucke appointedDean, Faculty of PainMedicineRichard Lee appointedDean, Joint Faculty ofIntensive Care MedicineRegional AnaesthesiaSpecial Interest GroupestablishedNew Fellow first electedto CouncilIn 2008, ANZCA commissioned the design of a contemporary corporate logo tocomplement the College coat of arms on ANZCA livery. The logo is now used,along with the crest, on all ANZCA hard-copy and electronic documents, andon our website. The two symbols presented together signify the historical andcontemporary values of ANZCA and the confidence of our organisation as wemove forward.The logo was inspired by the triangular board room table at ANZCA House inMelbourne, but the overall design is abstract and open to wide interpretation.The designers, Streamer, commented that the overall effect of the overlappinggeometrical shapes is one of precision and exactitude, reflecting the sciencesthat underpin the profession. The two sets of overlapping forms may reflect ourtwo countries and the three sets the foundations of our College - anaesthesia,intensive care medicine and pain medicine. The multiple and connecting triangularelements pointing in different directions allude to the multidisciplinary nature ofthe College.The “triangles” remind me of a high mountain range reflected in a deep ocean,requiring us to be courageous, intrepid and visionary in all the things we do. Theyevoke a journey where the summit will be reached through careful steps and bydogged persistence. The rich burgundy colour denotes quality, authority and a linkto the traditions of our past, but in essence the logo is modern and forward-lookingand that’s what I like about it!Professor Kate LesliePresident, ANZCAThe place of pharmacology, which isworld of Europe (and the not-so-old worldthe third scientific base for the specialty,of North America where anaesthesia wasis addressed by use of the botanicalfirst demonstrated and broadcast to thespecimens in the “charges of the shield”.world in the mid-19th century).The supporters stand on land separatedThe sea also indicates the significanceby water, which forms the “compartmentof sea travel in the transmission of theof the arms”.introductory news about anaesthesiaThese separate lands signify notfrom North America to Europe andonly the countries of Australia and Neweventually to Australia and finallyZealand, but also the separation of theNew Zealand.new world of Australasia from the old(continued next page)2007ANZCA Foundation officiallylaunchedAirway ManagementSpecial Interest GroupestablishedTrauma Special InterestGroup establishedANZCA Code of Conductintroduced2008Leona Wilson appointedANZCA PresidentPenelope Briscoeappointed Dean,Faculty of Pain MedicineVernon Van Heerdenappointed Dean, Joint Facultyof Intensive Care MedicineReview of the curriculumcommenced19The Cootamundra wattle (Acacia of Anaesthetists of the Royal Australasianbaileyana) illustrated on the land on College of Surgeons. The College ofwhich Vesalius stands representsSurgeons has the torch of glory in itsAustralia and the silver fern or ponga arms and has also the motto Fax mentis(Cyathea dealbata) on the land on which incendium gloriae – “The torch thatHarvey stands represents New Zealand. illuminates the mind is the fire thatThe shield contains two parts. The consumes vainglory”.“chief of the shield” contains theThe charges in the four quadrantsSouthern Cross indicating the College’s symbolise the plants that togethergeographical place in the Southern form the basis for the pharmacologyHemisphere because the constellation fundamental to anaesthesia. In theis at 600 S and therefore not visible upper left quadrant is the opiumfrom most of the Northern Hemisphere. poppy (Papaver somniferum) signifyingThe five stars are represented with the analgesia, and in the upper rightnumber of points representing their real quadrant is the mandrake plantbrightness in the night sky starting at (Mandragora officinarum) signifyingthe base of the cross with the brightest sedation and anaesthesia.star and moving clockwise: alpha – eight These charges also symbolise the oldpoints; beta – seven points; gamma – world plants. The new world plants areseven points; delta – six points; epsilon depicted in the lower charges. In the– five points.lower left quadrant is the curare vineThis representation is also that taken (Chondrodendron tomentosum) signifyingby the state of Victoria and is not taken neuromuscular paralysis, and in theby any other state or country using the lower right quadrant the cocaine leaf andSouthern Cross. Thus this representation fruit (Erythroxylum coca) signifying local into the wreath on the helmet andsymbolises the College’s founding and anaesthesia.its lambrequin (or cape). The risingheadquarters in Victoria.The crest consists of the helmet, sun behind the helmet indicates theThe lower part of the shield contains which is unusually affronté (or facing geographical place of the College in thethe Cross of St George indicating the forward) with a closed visor to indicate east next to the international date line;links between the College and itsalertness and readiness for any urgent and also symbolises links with the RoyalBritish counterpart, the Royal College of action. This type and position of helmet Australasian College of Surgeons and theAnaesthetists, as well as the Christian is similar to the Royal College ofRoyal Australasian College of Physiciansheritage of the College.Anaesthetists again linking the College to both of which have similar rising suns forThe “torch of glory” imprinted on the this fraternal organisation.the same symbolic reason.upright of the cross symbolises the direct The colours of the College gownderivation of the College from the Faculty (black and gold) are incorporated2008 (continued)Continuing ProfessionalDevelopment ProgramintroducedDr Ray Hader Trainee Awardfor Compassion establishedFirst ANZCA E-Newsletterdistributed2009Continuing ProfessionalDevelopment Programbecame mandatoryANZCA begins producingpodcasts20 ANZCA Bulletin March 2012 ANZCA CELEBRATING 20 YEARS 1992-20122010Independent College ofIntensive Care Medicine(CICM) formed replacingJFICM. Vernon VanHeerden inaugural CICMPresidentKate Leslie appointedANZCA PresidentDavid Jones appointedDean, Faculty of PainMedicineThe “hand of the carer” (physician) sterling silver when the RACS offered to lip is engraved “Presented by the Royalrising from the Lord’s cloud representing gift the mace to ANZCA. The aspects of Australasian College of Surgeons 1994”.Almighty guidance links the College back the armorial bearings that have been The mace is 960 millimetres long,to the Parisian medical influence and to translated into the design for theweighs approximately 2.75 kilograms,the foundations of the modern European mace are:and was cast in 19 separate piecesmedical tradition in 12th century Paris, The butt: This is now the larger end at Flynn Silver’s workshop in Kyneton,and symbolises the Fellow’s hand guided of the mace and is in the shape of a Victoria, using the lost wax technique.by the Lord caring for the patient’s life. half opened lily containing the motto Dan and John Flynn commented at theThe hand holds an ankh, the Egyptian “Corpus curare spiritumque” engraved on time (May 17, 1994) that “we considerhieroglyph for life, which links the major the inner lip. Within the open lily cusp, it to be the most significant commissionresponsibility of College Fellows – the like a stamen, the crest is reproduced in undertaken by ourselves to date”. Thepreservation of life – to the roots of full with the torch of glory placed below cost of the mace was $A34,500.western medicine in Egypt in the 5th the crest in a sense holding the crest Every council meeting is conductedto 3rd millennia BCE.aloft.with the mace on its jarrah rest in openThe snake of Asclepius (Aesculapius) This repositioning of the torch was display to symbolise the authority ofentwines the Ankh to symbolise the links deliberately designed to represent the gift council, and again at the College annualwith the heritage of Greek medicine and of the mace by the RACS to the College, general meeting.the ethics of doctor-patient relationships, and to symbolise the growth of theThe mace is also ceremonially carriedwhich derive from that time.College of Anaesthetists from the Faculty in the procession of the president andThe motto reads Corpus curare of Anaesthetists.council to the opening of each annualspiritumque which translates as “To care The shaft: Embossed on the shaft scientific meeting.for the body and its breath of life” and (stem of the lily) is a representationIf you have not looked closely at eitherwhich aptly summarises the main aim of the shield containing the fourthe coat of arms or the mace, you shouldfor Fellows of the College. There is an quadrants and with the chief containing do so, as they are each rich in a heritageintended pun in the motto, which uses the Victorian Southern Cross stars that you share with your colleagues,the Latin word curare (to care). This is represented by Argyle champagne-colour not only in anaesthesia but more widelyalso a word, derived differently from diamonds sized in proportion to the stars’ across the breadth of medicine andMacusi Indians in Guyana (wurari), used brightness (1x20pt, 2x16pt, 1x11pt, science.daily in the specialty for the drug curare and 1x6pt). The charges are representedor its analogues, which cause the state of more boldly and larger than in the arms Professor Barry Bakerneuromuscular paralysis or curarisation. to emphasise their differences, and for Dean of Education and Executive DirectorOriginally the College mace had been artistic relief on the shaft.of Professional Affairsdesigned to have a timber shaft made The head – Australia and New Zealandfrom Australian jarrah and an unspecified are represented in the head (anotherNew Zealand timber, but this timber half open but smaller lily) by a wattle inshaft was replaced with gold plated silver-gilt and a fern in silver. Around the2010Acute Pain Management:Scientific Evidence (thirdedition) publishedPerioperative MedicineSpecial Interest GroupestablishedOnline in-trainingassessments start2011Linda Sorrell appointedANZCA CEOOnline Clinical TeacherCourse piloted1992-20122012 (to March)Lindy Roberts announcedPresident-elect, ANZCABrendan Moore announcedDean-elect, Faculty of PainMedicineNumber of Fellows – 5300and 2000 traineesANZCA Curriculum Revision2013 learning outcomesapproved21The first honorary secretary’s reportof the WA State Committee includedthe following:“In a country the size of ours it isimpossible for the Board of Facultyto maintain satisfactory contact withFellows and Members in the variousstates of the Commonwealth and theDominion of New Zealand. The Boardtherefore exercised the powers given toit under additional Regulations (1955)and appointed State and DominionCommittees whose functions are tocarry out duties delegated by theBoard, to convene at least one scientificmeeting each year and to advise theBoard of any matters which may concernthe interests of the Faculty.“In July last year the Board appointedDrs G.R. Troup, Douglas Wilson andL.G.B. Cumpston to constitute theWestern Australian State Committee. On8th September 1955 this committee heldits first meeting at which Dr Troup wasappointed Chairman and Dr CumpstonHonorary Secretary. The committee hasmet on five subsequent occasions.” 2The inaugural meeting lasted 30minutes and took place at Dr Troup’srooms in Yorkshire House, 194 StGeorges Terrace, Perth. The first matterdiscussed was the Faculty scientificmeeting. Were these meetings to beexclusively for Fellows and members,or did the committee have the rightto invite the profession at large? Thecommittee was keen to involve Fellowsof the Faculty of Anaesthetists of theRoyal College of Surgeons in Englandand sought advice from the board as towhether these professionals would firstseek membership of the AustralasianFaculty or would be entitled tofellowship outright.With only nine members andFellows in WA there was insufficienttime and resources to organise ascientific meeting during 1955 and itwas suggested at the second committeemeeting in October that March or April1956 would be regarded as the earliestpossible date. In fact the committeedid not meet again until March 1,1956, and at this time planning for thescientific meeting began in earnest.It was decided to hold the meeting onan evening in June at approximatelythe same time as the College (RoyalAustralasian College of Surgeons –RACS) scientific meeting. The meetingwas to take the form of a symposiumentitled “Controlled respiration inanaesthesia and in medical conditionswith respiratory embarrassmentor paralysis” and anticipatedthe presentation of papers by ananaesthetist, a physiologist, a physicianand a surgeon. Three more meetingsof the WA committee were held beforethe annual scientific meeting on June 7,1956.The Faculty symposium commencedat 8pm and was now titled “Themanagement of respiratory paralysis inanaesthesia and disease”. The meetingopened with a short address by Dr LSouef, chair of the State Committee ofRACS. Dr Douglas Wilson presentedthe subject from the anaesthetic aspectand Dr Beech, also a foundation Fellowof the Faculty of Anaesthetists, RACS,from the medical angle. Discussion wasopened by Dr Thorburn (by invitation),from the physician’s point of view, andDr Peter Gibson discussed the thoracicsurgical approach. The meeting closedat 10.30pm.The honorary secretary’s reportof June 9, 1956, concluded with thefollowing: “College Meeting – Perth –1958. It is anticipated that the AnnualMeeting of the College will take placehere in 1958. This will undoubtedlyinclude the Faculty and will be afunction of great importance to us all.”Gilbert Troup was one of the outstandingfigures in anaesthesia practice inAustralia. He led a rich career inmedicine prior to his work during theearly 1950s in helping to establish theFaculty of Anaesthetists, RACS. 3Born in Christchurch, New Zealandin 1896, he was educated in Melbourneand graduated in medicine from theUniversity of Melbourne in 1922. Hesettled in Perth in the same year,working first at the Children’s Hospitaland then at the Perth Hospital, becominga junior honorary physician in 1924while maintaining a private practicein Subiaco.A long and distinguished career inanaesthesia began when Dr Troup wasappointed honorary anaesthetist to thePerth Hospital in 1927. He followed inthe footsteps of William Nelson (whoserved from 1918 to 1926) and BruceBurnside (served 1918 to 1923), whowere the first honorary anaesthetistsappointed to the hospital.Dr Troup was a member of theFaculty’s WA Committee from 1955 until1959, serving twice as chair, from 1955 toOctober 1956, and from November 1957until June 1959. He died in August 1962.Dr D R C Wilson(ASA) Executive Committee stateD R C “Bunny” Wilson was perhaps best representative for WA from 1947 to 1951.known for his contribution to paediatric Dr Wilson died in January 1970.and neonatal anaesthesia, particularlyDr Ernest Beechhis pioneering work in WA. 4Ernest Beech was born in AdelaideBorn in 1906 in Perth, he graduatedin 1908 and studied medicine at theMBBS at Melbourne University in 1931.University of Adelaide, gaining hisAfter a year as a resident medical officerMBBS there in 1932. He relocated toat Perth Hospital he entered generalWestern Australia in 1933 to becomepractice in Dowerin, which continueda resident medical officer at Perthuntil 1939. He served with distinction inHospital. Dr Beech was appointedWorld War II and was awarded an MBE,medical registrar in 1934. He then spentMilitary Division, for his service in Syriatwo years in postgraduate studies inin 1941.England at the Royal Chest HospitalDr Donald Stewart wrote in 2010and the Queen’s Square Hospital.that it was Gilbert Troup who nurturedDr Beech obtained his MRCP inBunny Wilson’s interest in anaesthesia1936 and, on his return to Perth,after the period of hostilities ended,was appointed honorary outpatientand he soon became the first full-timephysician and honorary anaesthetistanaesthetist in Western Australia,to the Perth Hospital in 1938. Hewith posts at Royal Perth Hospital,maintained this dual role until 1950, andHollywood Repatriation Hospital andwas also in general practice until 1946.Princess Margaret Hospital, where heDr Beech also served as anaesthetistwas director of anaesthesia from 1945to the neurosurgery unit at Perthuntil 1956. 5Hospital. He contributed to postgraduateDr Wilson served on the WAeducation in Western Australia as theCommittee of the Faculty ofsecretary of the ASA PostgraduateAnaesthestists, RACS, from 1955 to 1966.Committee for two years. 6He was chair twice, from November1956 to September 1957 and from June1960 to August 1961. He also served Above from left: Dr Gilbert Troup,as Australian Society of Anaesthetists Dr D R C Wilson, Dr Ernest Beech.70 ANZCA Bulletin December 2011ANZCA Bulletin December 2011 71Letters to the editorRich history ofanaesthesiadepicted“ The Duke of Norfolkas Earl Marshall of HerMajesty’s College of Armsauthorised the armorialbearings on December 1,1992.”Corporate logo – “the Triangles”“ Vesalius also was the firstto show that an animal...could be resuscitated byusing artificial respirationthrough a reed insertedinto the windpipe.”“ The motto reads Corpuscurare spiritumque whichtranslates as “To care forthe body and its breathof life”.”ANZCACELEBRATING20YEARSWestern Australia’s foundation Fellowsand the establishment of the WesternAustralian State CommitteeThe first annual businessmeeting of the WesternAustralian State Committeetook place at the BritishMedical Associationcouncil room on June 9,1956. Members of thecommittee could reviewthe achievements of thepast year with satisfaction.At this time the committeecomprised two foundationFellows of the Facultyof Anaesthetists, DrsGilbert Troup and D R C(Bunny) Wilson, and Dr LG B (Graham) Cumpston,a foundation member ofthe Faculty who had beenelevated to fellowship inJanuary 1956. 1Heading SampleThe men who made it happenDr Gilbert TroupCelebrating our Coat of ArmsIt is no exaggeration to say I was thrilledto see Professor Baker’s exposition of theCollege Coat of Arms (ANZCA Bulletin,March 2012). Every feature rich with historyand significance; their appearance, colour,position, shape, size, all telling the story ofthe College and our traditions of anaesthesiaand intensive care in a spectacularsymphony of colour and images. As thelogo for a learned college I believe our Coatof Arms stands head and shoulders aboveevery other Australian and Australasianprofessional college and is something ofwhich every Fellow can be proud.I turn to the article about the triangles.What contrived symbolism that is. Thetriangles have no soul and the many FellowsI have spoken to appear to have a similarview and are baffled by the supposedsymbolism of the triangles.Can I appeal to the new Council to reviewthe decision to adopt the triangle logo? Letus make the most of what we have, our trulymagnificent and inspiring Coat of Arms.Let us use the coloured version at everyopportunity. Trainees should be made awareof its nature and design so they can drawinspiration from it.Let us proudly display our inspirationalArms whenever and wherever possible.Dr John Paull MB BS, Dip Ed, FANZCAConsultant Anaesthetist (Retired)Honorary Research AssociateSchool of History and Classics,University of Tasmania,Launceston, Tasmania.Why does the College need two logos?I was intrigued to read the descriptionsof the armorial bearings or “crest”, andthe corporate logo, “the triangles”, in theMarch 2012 ANZCA Bulletin. Barry Baker’sexemplary article should be compulsoryreading for all current and aspiring Fellowsof the College.The description of the logo, however,leaves a number of questions unanswered.That the logo design is “abstract and opento wide interpretation” reminded me ofan occasion when I met with a senior staffmember at Melbourne University. Withoutprompting, she commented on a Collegebusiness card that depicted the corporatelogo, saying that it appeared to representan organisation that was unsure ofits direction!Why did the ANZCA Council feel theneed to commission a new logo in 2008 inaddition to one that was widely recognisedand had been developed through a rigorousand well established process? Contemporaryvalues are not obtained through theacquisition of a pretty design; they areobtained by action and achievements,thereby bestowing integrity on the nameand reputation of the organisation.We now have the confusion of twologos. The original armorial bearings, withso much embodied meaning, has beendeliberately downgraded by the impositionof an abstract design of uncertainfoundation.The “rich burgundy colour” of thecorporate logo supposedly denotes “quality,authority and a link to the traditions of thepast”. I find it difficult to ascribe such arange of attributes to a colour, more so asthe logo appears in a range of colours in thesame issue of the Bulletin.Other Australian and New Zealandmedical colleges use a single crest or shield,and display it proudly. It is timefor the council to reconsider the meritsof having two logos.Dr Rod Westhorpe OAM, FRCA, FANZCAHonorary Curator, Geoffrey Kaye Museum ofAnaesthetic HistoryPerth Hospital recordsThanks to Fraser Faithfull and ProfessorGarry Phillips for the article on the earlydays of the Faculty of Anaesthetistsin Western Australia (ANZCA Bulletin,December 2011).For the sake of the historical record I offersome minor corrections. The records of thePerth Hospital contradict the statement in theBulletin that Dr B Burnside and Dr WH Nelsonwere the first honorary anaesthetists appointedto the hospital, commencing in 1918.Although the record is incomplete,the minutes of the Perth Hospital Board 1as early as 1906 record the nominationof a Dr Thurston to the post of honoraryanaesthetist. In 1924 Gilbert Troup wasappointed as an honorary assistantphysician (not junior physician) to the PerthHospital, and he was first appointed as anhonorary anaesthetist in 1930 (not 1927) 2 .It is not clear when Dr Troup firstworked at the Perth Children’s Hospital;his own “personal information” held by theAustralian Society of Anaesthetists givesthe date as 1922 (the year of his graduationfrom Melbourne University), but accordingto the records of the hospital, his initialappointment there was in 1924 3 .Dr Toby NicholsDepartment of AnaesthesiaRoyal Perth HospitalReferences:1. Minutes of board meetings of the Perth Hospital(held by Royal Perth Hospital Museum).2. Annual reports of the Perth Hospital (held by RoyalPerth Hospital Medical Library).3. Jeanette Robertson, archives facilitator, PrincessMargaret Hospital (personal communication).8 ANZCA Bulletin June 2012