Reunion roundup

Reunions held in 2010: Class of 1985 reunion

By: Nicky Welsh

1985 class photo
Attendees:

Philip Allen, Jonathan Bailey, Andrew Baker, Shane Barker, Geoff Baron, Mark Black, Raymond Borcherds, Rod Butters, Alan Chesterton, Helen Cox, John Cur rie, Anne Davies, Lynette Dean, Andre Demblon, Duncan Douglas, Christopher Eedes, Amanda England, Alawooddin Firfiray, Geney Gunston, Edward Hillary, Brandon Hitchcock, Philippa Hugo, Shirley Jonathan, Walter Kammies, Neill Kling, Frans Korb, Dirk Lazarus, Kathy-Jo Lewis, Faizel Lorgat, Tim Matthews , Hassan Mahomed, Joy McInroy, Carol Metcalf, Ulli Meys, Sean Murray, Hitendra Narotam, Andrew Newham, Michael Pather, Mark Patrick, Basil Petersen, Fraser Pirie, Allan Puterman, David Roberts, Kenneth Shewell, Caro Sims, Clive Sperryn, Paul Spiller, Dan Stein, Douglas Stevens, Lesley Survela, James Te Water Naude, James Tunnicliffe, Ivan Watson, Greg Webb, Nicky Welsh, Douglas Wilkinson, Ian Wilson.

Amazing, awesome, wonderful, exciting, stunning, emotional, unbelievable, surprising, hilarious, happy, strange and weird overtook apprehensive and awkward - just a few words that de scribe our 25th medical school reunion. Wrinkles, crows' feet, spectacles, botox, weight, paunches, baldness, kojak, greying, weathered, foreign accents, same, different, better and worse are a few others that come to mind!

There was an excellent turn out with nearly 60 of us attending th is long overdue occasion. Incredible representation from Canada, America, United Kingdom, Australia and New Zealand. How can we ever thank you all for making such an enormous effort to be there?

Shrieking (some of us!), staring (others!) guffawing, gasping, head (and hand) shaking and hugging marked the opening registration process. Laughing (belly and cheek aching), talking, reminiscing. Our first reunion proved to be an unforgettable weekend and a highlight of 2010 - what a great way to end the year off.

Renewed friendships and acquaintances, reconnections, familiarity, close bonds, shared experiences, flashbacks, nostalgia and reminisces. At times though a sense of sadness that so many colleagues had left South Africa - but such a sense of pride realising they have done extremely well.

Being with some exceptional people from our class left one feeling uplifted and appreciative of knowing them. On that note, our hearts were heavy as we missed our dear friend, Kevin O Connell, who died suddenly in October 2009. He certainly would have loved the reunion too. Most fascinating was what choices our colleagues had made, and what career paths many had chosen, together with the turns their lives had taken. Seems the most popular speciality for the class of '85 was psychiatry, with at least 10 working in puzzle houses! Makes one wonder ...!

The activities were officially opened on the Friday evening with a cocktail party. We were welcomed by Prof Greg Hussey - the Deputy Dean for Research and an infectious diseases specialist.

The Academic programme provided a Saturday morning of mixed emotion with a spectrum of presentations ranging from serious, sobering and heart wrenching to amusing, light-hearted and fun. Ten of us had signed up for providing some entertainment for our colleagues. General consensus was that it was a most interesting morning and inspiring hearing what our colleagues have accomplished. We listened with respect and admiration.

Geney Gunston: Medical Education Then and Now

Geney is a lecturer in Basic Health Sciences at UCT. In undergraduate training a solution was needed for problem solving skills - the new curriculum was introduced at UCT in 2002 - and very different from our training in the '80's. She discussed how Problem Based Learning (PBL) is a system of learning that results towards the student working, understanding and solving a problem. It is also a rigorous, structured approach to learning with small group discussions of cases supported by a facilitator. PBL is a paradigm shift for teachers as students have to take responsibility for their learning.

Paul Spiller: Life as a Rural GP

Paul lives and works in Ashton, a small town near Robertson. ("If any town needed an enema it would be Ashton!") Anecdotes of rural practice involving patients, the mayor and "the fuzz shop" kept us amused. A mother was diagnosed with scabies, as was her child. After receiving the account for the two consultations, the mother laid a complaint as she felt that the same diagnosis should not be charged for twice! In 1995, Paul did a 2-year postgraduate course at UCT in homeopathy, wanting to pursue alternative therapy. He worked as a clinical homeopath (one who makes diagnoses by the normal means) as opposed to a classical homeopath (one who relies on observation and history taking). He was also interested in acupuncture and the use of Chinese herbs although the latter are difficult to obtain. After many years in private practice he now does state work at the Robertson Hospital. As the CEO of Langeberg Sub- District, he has his hands full with hospital administration.

Douglas Wilkinson: Primary Trauma Care

Douglas is an anaesthetist in Intensive Care in Oxford and had just returned from Afghanistan. Having joined the Royal Navy he was previously in Iraq. He is a major player in the Primary Trauma Care Foundation whose business is to design and present medical training courses for worldwide application. Primary Trauma Care (PTC) is a system for training surgeons, anaesthetists and other health professionals in hospital trauma management, aimed at preventing death and disability in seriously injured patients in remote areas. It is specifically geared towards the needs and logistics of front-line hospitals without the access to high-tech facilities, being based on straightforward clinical practice. Douglas helps to promote PTC through these courses - this trauma care is now being run in 48 developing countries. Another aim is to empower people to run these courses themselves. PTC is endorsed by WHO and supported by the ministries of health. He describes it as a charity with the head office in the Wilkinson's house in Oxford! He has written a PTC Manual outlying trauma management in district and remote locations and is also an author of a chapter for Guidelines for Essential Trauma Care.

Clive Sperryn: Imaging

Clive is a radiologist in private practice in Cape Town. He opened his presentation with "random radiology" showing amusing (and embarrassing!) photos of youthful classmates illustrating the point of facial recognition. He reminded us that CT imaging was invented in 1972 by British engineer Godfrey Hounsfield and by South Africa-born physicist Allan Cormack of Tufts University, Massachusetts. Hounsfield and Cormack were later awarded the Nobel Peace Prize for their contributions to medicine and science.

With the use of incredible videos he demonstrated how far imaging has come since the days of Marie Curie! Technology such as perfusion scans, virtual scanning and 3D imaging has made radiology an exciting and dynamic discipline. With respect to radiation dose limits, he mentioned that 50mSv is the lowest dose at which there is any evidence of cancer being caused in adults. Clive had many in the audience guessing what some of his pictures were about, in particular an MRI of coitus that appeared in the BMJ 2007 (Interestingly the subjects were volunteers from Italy and not from the pornographic industry!) Not surprising either is that this was the most read item on the BMJ website! There has been a CT revolution, MRI revolution, analogue versus digital revolution and more recently the nackt-scanner revolution. These are full body scanners that can depict weapons or explosives - amongst other items!

Mark Patrick: Quality of Care Children Receive in the South African Health System

Mark is a paediatrician at Grey's Hospital in Pietermaritzburg. He spoke about indifference and the devastating effect it has on health care. He presented his figures from a 6 year audit pertaining to perinatal mortality at Frontier Hospital in Queenstown. He explained how The Child Healthcare Problem Identification Programme (Child PIP) assesses the quality of care children receive in the SA health system, through the process of death auditing. The programme provides the structure and tools for careful review of in-hospital paediatric deaths by ensuring all deaths are identified, assigning a cause to each death, determining the social, nutritional and HIV context of each child who dies and determining modifiable factors in the caring process for each child who died. Through death auditing, quality of care improves and lives are saved. Child PIP includes all infants and children (up to 18 yrs), admitted into paediatric wards and is currently being used in more than 30 hospitals across South Africa. Through a network of provincial co-ordinators, health workers collect and enter data onto the Child PIP software programme. The data is then analysed at local level, but also sent to a national database. Using this information, interventions at local, provincial and national level, can lead to improvements in quality of care and ultimately to a reduced case mortality among children. A set of unified recommendations with specific actions for government officials and policymakers, health managers and healthcare providers are then formulated to save lives. Mark left us with another important reminder of being reflective at the end of each day - is this the best I can do?.

Kenneth Shewell: The business of Medicine / Surgery in Middle America

Kenneth is a general surgeon at the St Joseph Speciality Clinic PC in Missouri. He described his presentation as medical business in the USA or "scary stories to tell at night." In America medicine is now approached similarly to the hospitality industry - patients decide whether they are happy or not with their doctors, and rate them accordingly. ("Vitals" is the website "where doctors are examined"). Categories for patient rating of the doctor include ease of appointment, promptness, staff courtesy, accuracy of diagnosis, bedside manner, time the doctor spends with the patient and follow up. (I am delighted to report that on a scale of 1 - 4 Ken has a 4 star rating! Well done Ken!) The Physician Quality Reporting Initiative (PQRI) System was established in 2006 and includes an incentive payment for eligible professionals who satisfactorily report data on quality measures for covered professional services. Nearly every hospital in the USA gets grades for its performance in a variety of areas such as case volumes, mortality rates, complications, length of stay and rescue rate (the number of times a patient is rescued during a procedure or while in hospital care). Scores are considered reliable indicators of overall quality - by speciality. Hospitals as a result are highly competitive and doctors are highly pressurised to perform!

Dirk Lazarus: Facial Age - We're all getting Older

Dirk is a plastic surgeon doing cosmetic surgery in Cape Town. He also does cleft lip and palate surgery, heading up the Red Cross Hospital Cleft Lip and Palate Unit. The majority of his work includes liposuction, breast improvement surgery, tummy tucks, facial rejuvenation, rhinoplasties, ear re-shaping, botox and fillers. His particular interest is in facial aging (different from facial beauty) - a process that (unfortunately!) begins after the age of 25 years. "How old do you really look?" The age of one's appearance as we know, is often different from one's chronological age. He started this project in 2006 and by using the following four parameters: wrinkles, neck sag, lip height and jowl area, one can establish the computer or AEON (Africa Earth Observatory Network) age as opposed to chronological age or subjective human age. His website includes a free full facial analysis based on uploading a single photograph. Significantly more accurate than the free analysis, based on five photographs of one's face and looking at more parameters, a full facial age analysis will also give suggestions as to how one can appear more youthful. Bring it on!

Lesley Survela: How the Discovery of Factor V11a has Revolutionised the Care of Trauma Coagulopathy

Lesley is a haematologist working in a large teaching hospital in Sydney. She reports on haematopathology, and has a subspecialist interest in myelodysplasia diagnosis and Transfusion medicine. Lesley's talk was the most scientific of the academic programme and when she reminded us of the coagulation pathways the relief was enormous that firstly, we were finished with medical school, and secondly we had pursued the careers we had! Factor V11a is a new clotting product designed for haemophiliacs with antibodies to factor V111, and has been found to be extremely useful in acute traumatic bleeding. It promotes haemostasis by activating the extrinsic pathway of the coagulation cascade. It is indicated in severe coagulopathic bleeding due to traumatic injury (blunt and penetrating) when all conventional treatment modalities for haemorrhage control have failed. Due to its extreme cost, a careful assessment of the potential risks (such as thrombo-embolism) and benefits must be made.

Myself (Nicky Welsh): Of Yaks and Yetis - High Volume Cataract Surgery in Nepal

I am an ophthalmologist working full-time at the Charlotte Maxeke Johannesburg Academic Hospital - one of Wits University's teaching hospitals. In October 2006, during a short period of sabbatical leave, I went to Nepal for various reasons, one of which was wanting to establish how we could reduce our cataract backlog in South Africa as we are faced with similar challenges. Lahan is a small town in southeast Nepal, close to the Indian border. Here the Sagarmatha Choudhary Eye Hospital (SCEH), established in 1983, has gained a worldwide reputation not only for the high volume cataract surgery but also as a training centre for ophthalmologists and staff. (The SCEH, together with the Aravind Eye Hospital in Madurai, South India, are the busiest eye hospitals in the world). In the annual report for 2005, figures show that nearly 60 000 operations were performed, of which more than 51 000 were cataract procedures. At the SCEH surgery is performed six days a week, with five or six surgeons operating on a daily basis. Each operation takes less than 5 minutes to perform, resulting in 15 - 20 operations taking place in an hour. About 200 operations take place every day. The majority of the cataract surgery takes place through a "fishhook" technique known as SICS (small incision cataract surgery). This does not require expensive equipment, and is sutureless. Phacoemulsification with modern equipment is also routinely performed. Self sufficiency is obtained and maintained with low running costs and income generating activities. Dedicated, highly motivated capable and versatile staff, effective management and modern equipment provide this high volume treatment programme. The excellent eye services and their affordability in Lahan have a far-reaching impact on the improvement of the quality of life and economic situation of reversibly blind people.

Jim Te Water Naude: Asbestos Legacy in South Africa

Jim specialised in Occupational Medicine and Epidemiology. He became involved in pneumoconiosis, initially in silicosis and later in asbestos related diseases, both of which continue to be huge social problems in South Africa.

As medical manager of the Asbestos Relief Trust, Jim travels extensively throughout the country. The Trust compensates those who have contracted asbestos lung diseases as a result of asbestos mining in poor rural areas of our country, especially in the Kuruman, Penge and Swaziland areas Some 15 000 ex-asbestos miners have been screened over the past 6 years and the Trust has been able to compensate about 4 000 of them.

Jim talked about the three types of asbestos ores found in South Africa: blue (crocidolite), brown (amosite) and white (chrysotile). While mesothelioma seems to be almost exclusively caused by blue crocidolite in South Africa, there is serious scientific work to show that the current mesothelioma epidemic in Britain is ascribable to the exports of brown amosite, 100% of which was produced by South Africa.

Average compensation amounts for the asbestos diseases compensated by the Trust are: Asbestosis and/or asbestos related pleural disease R39 000 - R80 000, Asbestos related lung cancer R160 000 and Mesothelioma R350 000.

After a morning of concentration, light relief followed that evening. Smuts Hall, the venue for the Gala Dinner, brought back more memories of varsity life! Doug Stevens was master of ceremonies, with the guest of honour being Prof Maurice Kibel, Emeritus Professor of Child Health at UCT. He sang to the accompaniment of Steve Reid on the piano. Prof Kibel was in fine form and certainly could have pursued a vocation in singing and lyrics! "Bring back the old and the worn", "Making wee wee" and my personal favourite "Glory education" had a few revelers joining in the chorus. A special thank you to Prof Kibel for his marvelous performance and for very kindly sending me the words to the latter ditty - included at the end of this report.

Activities for the Sunday included a guided walk around Kirstenbosch Gardens and a family picnic which, unfortunately I was unable to attend.

Many thanks to Joan Tuff for all her hard work, tireless efforts, dogged determination and organisational abilities. In spite of today's technology. it is still difficult trying to track people down, continually update a database and keep the communications and correspondence going.

Thank you also to Geney Gunston and Carol Metcalf (UCT stalwarts) who worked with Joan in making the reunion such a huge success.

Here's to the next reunion - it's the BIG 4-0! Only 15 years away, so diairise December 2025 - an event not to be missed by anyone!

Glory, Glory Education

The flora of the colon were a mystery to me
I knew naught of carcinoma nor of physiology
But now I'm educated with the best MB degree
From Med School UCT.

Glory Glory education
Glory Glory cerebration
Glory Glory emigration, from Med School UCT.

How Professor Dall spends his time is not for us to guess
Orthopaedics was the specialty that once he did profess
If only he'd still do it we would not-be-in-such a mess
Down at Med School UCT.

Glory to administration
Glory glory hesitation
Glory glory vacillation etc.

The brightest and the youngest is Prof Solly Benatar
(bronchiectasis and asthma, emphysema and catarrh)
There's nothing that will turn him on like smoking a cigar
At Med School, UCT.

Glory, glory, auscultation,
Glory, glory, crepitation,
Glory Glory ventilation,
At Med School, UCT.

John Terblanche is quick to notice if he finds you're talking tripe
And he's not afraid to tell you in a voice both rich and ripe
He loves his trips to China and the Land of Stars and Stripe
NOT to Med School UCT.

Glory, glory, strangulation
Glory, glory, perforation
Glory to pontification etc.

On resistant staph'lococci Arderne Forder is a hit
Send him smelly faeces and he won't complain a bit
He's not averse to putting all his fingers in the -
Down at Med School UCT.

Glory, glory inflammation
Glory, glory desquamation
Glory, glory defaecation etc.

At morbid anatomy Professor Keen's the LORD
He's as good as any surgeon though he's not been in a ward
He can tell where your appendix and your pineal gland are stored
At Med School UCT

Glory, glory dissectation
Glory, formalinisation
Glory to evisceration etc.

Professor Bloch's the fellow who can tell you what to do
When the cervix is dilating and the vulva's turning blue
Thanks to him the births are rising in each ward and MOU
He's at Med School UCT.

Glory, glory, fornication
Glory, glory, ovulation
Glory, glory, tuballigation etc.

If your sex life is atrocious, and you're bad at parlour games
If you're prone to violent spasms and you can't remember names
It's time you had an interview with our own Francis Ames
Down at Med School UCT.

Glory to hallucination
Glory, fits and jactitation
Glory to women's liberation etc.

But-if-your dreams are pornographic and you're badly oversexed
If your dearest friends won't greet you and you're totally complexed
Borrow, beg or steal the Gillis 'Guide to the Perplexed'
From Med School UCT.

Glory, Glory meditation
Glory, Glory masturbation
Glory, Glory flagellation etc.

When your brain cells are atrophic and your hair is thin and grey
When there's osteoporosis, senile tremor and decay
You'll remember Peter Meiring as they carry you away
From Med School UCT.

Glory geriatrication
Glory to decerebration
Glory superannuation etc.