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Serendipity becomes identity for many a career person. This would apply to me, born in 1942, and internal medicine. At Westbourne Park primary school in about 1950, with my Ukrainian refugee friend, we reckoned being a doctor might be the thing. Many ups and downs intervened, but Ludomyr Mykyta and I both did Adelaide medicine, became physicians and continue shared interests. A Korean from war's end in about 1953, Choung Soon Kim, whose medical father had a small hospital near the North-South border, and I became correspondents and shaped each other's destinies, she an agricultural scientist and me in medicine, much of it in Asia. Ludomyr and Choung Soon became my two longest friendships. They prepared me, along with my inter-cultural family, for a career with my fellow medical student, Huang Soo Sien, a Singaporean, who became my wife and a GP with interests in family psychiatry.
I might have had a renal career with the brilliant Dr Reg Pak-Poy, but he suffered a stroke at that time. Instead, I became engaged in inflammatory and metabolic cardiovascular disease as a medical science student in Adelaide, and pursuing my doctorate in medicine in Melbourne; in both places exposed to the visits of Howard Florey as an expositor of 'the inflammatory basis of disease'. My MD provided early evidence that atherogenesis was inflammatory. From the University of Melbourne I resumed my Swedish family connectedness, went to the Karolinska Hospital in Stockholm, then to the Geriatriska Institutionen at Uppsala University. There, another MD by thesis redefined the nutritional, metabolic and endocrine regulation of human myocardial metabolism. Erstwhile seniors like physiologist Bob Whelan, physician Hugh (Norrie) Robson, and academic extraordinaire RD ('Panzee') Wright gave me support.
I returned to Australia to Clinical Science at the Australian National University, at a time of biomedical science vibrancy, and health care reform during 1972 to 1975. The clinical enthusiasm and exceptionalism of Dr Kerry Goulston at the Canberra Hospital inspired me to gain RACP credentials and pursue a clinical academic career. Colin Johnston, the second head of Medicine at Monash University, arranged for me to join him at Prince Henry's Hospital in Melbourne in 1976. While keeping my Monash associations, and mentored by Bryan Hudson, who had been the Foundation Chair of Medicine at Monash and the Chair of the National Nutrition Committee, I accepted the Foundation Chair of Human Nutrition, Australia's first, at Deakin University in Geelong. Studenthood links with Basil Hetzel became a collaboration with him now Head of CSIRO's Division of Human Nutrition.
From Deakin it was back to Monash, and Monash Medical Centre as the third Professor and Head of Medicine (from 1989 to 2001), ultimately with the Monash Asia Institute and in an Emeritus capacity. Presidency of the International Union of Nutrition Sciences (from 2001 to 2005), Foundation Editorship of APJCN for some 26 years, Foundation Directorship of the Fuli Institute at China's Zhejiang University, senior academic appointments in Indonesia, China and Taiwan; and recognition by national and international nutrition societies characterise the later, less formal phase of professional life.
Best practice depends not only on conventional evidence, but on instructive environments, not least patients themselves. In the wake of several pointers, insulin deficiency was shown in 1921, to be a cause of diabetes and used as treatment. In 1922, a young Australian girl was first treated with insulin. By 1923, the Commonwealth Serum Laboratories (CSL) in Australia manufactured it. One of the earliest Australian insulin recipients was Mrs LO. It was my good fortune to become her endocrinologist in the late 1970s, she one of some 400 or so globally known to have had insulin dependent diabetes (IDD) for more than 50 years. She was remarkably free of diabetes complications into her 9th decade, with only minimal background retinopathy. I wondered why. In her early years, she had tested her urine with Benedict's solution, but now was not overly fastidious about blood glucose monitoring. Strikingly, she had a generous, reflective and appreciative demeanour, dressed as if younger, a keen dancer, claiming to 'dance every day', not overweight and with no significant cardiovascular risk. She was an inspiration to others with diabetes, ever ready to engage with medical students. She enabled me to be a more effective carer and teacher. Ultimately, after a short illness, she succumbed to ischaemic heart disease. She lived and died, thankful for the medical progress which saved her life to share with others. To look forward to working with such patients and recognise that they extend our role through their lives and story-telling is salutary.
Basil Stuart Hetzel AC, FRACP (1922 – 2017) profoundly influenced my life, from when I was a clinical student at the University of Adelaide, and he was the second Professor of Medicine, the first being Hugh Robson. Both were life-long role models. I moved to the University of Melbourne Medical School in 1967, and Basil to Monash University as its foundation Professor of Social and Preventive Medicine (from 1968 to 1975). We developed a fruitful multidisciplinary discourse in Melbourne. We encouraged Tony McMichael, later a distinguished environmental epidemiologist and author of Planetary Overload, to undertake a PhD with Basil.
Human nutrition science surged in Australia in the 1970s, Basil becoming the first Chief of CSIRO's Human Nutrition Division (interested in iodine deficiency disorders) (from 1976 to 1985), me the first Chair of Human Nutrition in Australia at Deakin University (from 1978 to 1987) and Stewart Truswell at the University of Sydney. We joined forces. Sir Richard Doll, Regius Professor of Medicine at Oxford, on Australian tour in 1978, about diet and cancer, was to appear on ABC TV's Monday conference; Basil could not appear with him because of his wife's terminal cancer. He recommended me, and considerable interest was generated. Now, me as Professor/Head of Medicine at Monash, we convened a review of indigenous Australian health and nutrition (APJCN 2000; 9:157-63).
In 2003 and 2004, my medical wife was stricken with haemorrhagic stroke. Notwithstanding his gubernatorial and academic roles, Basil would call with wisdom and support. Not long before he died, he sent a photo of us both with Tony McMichael. He was a remarkable physician, mentor and friend.
The RACP has been a catalyst and moderator of my venture into clinical and public health nutrition, and a more ecological approach to medicine. Nutritional biochemistry, physiology and pathophysiology attracted my attention as an undergraduate, in early research projects, and teaching. Its advocacy in education and practice was formatted in the 1980s with publications relevant to the College: