Our cover this month is the painting “Love 2019” by local artist Katka Adams. Katka has explored the refugee experience in her recent exhibition “Coming Home”. She describes her inspiration and motivations below and on Page 15 editor, Robin Osborne details her journey of  escaping the Soviet crushing of the Prague Spring in 1968 and the start of a new life in Australia as “that Czech girl”.

Dislocation from one’s cultural roots is a common experience for many Australians from European, African and even Aboriginal backgrounds. For some art gives voice to their experience, for others it is the written word.

I believe - That the Lord God created the universe
I believe - That he sent his only son to die for my sins
And I believe - That ancient Jews built boats and sailed to America
I am a Mormon! And a Mormon just believes
I Believe, from The Book of Mormon, by Trey Parker, Matt Stone and Robert Lopez

The Book of Mormon, the No. 1 hit musical in Australia, follows the journey of two devout young men as they set off on their mandatory two years of missionary work far from their home in Salt Lake City, Utah where the church is headquartered..

The Book of Mormon is the work of South Park creators, Matt Stone and Trey Parker, which as be expected given this pedigree is irreverent, scatalogical and confronting. In short, not the normal fare of religion, making its success with mainstream audiences seem highly improbable, even though its central theme touches a cord for the religious and irreligious alike.

An iceberg analogy of the interactions between lifestyle/environmental determinants

In clinical practice it is very easy when looking at the causes of chronic disease to focus on risk factors and markers by performing measurements and blood tests on a patient. It is well known that abnormalities in these indices can lead to low grade chronic and systemic inflammation called meta-flammation, which in turn leads to chronic disease.

In this process it is easy to blame the patient for ‘letting themselves go’ with unhealthy lifestyles such as poor nutritional choices, inactivity, smoking and alcohol dependence etc. However behind these lifestyle behaviours there are more subtle causes of chronic disease that should not be ignored. These are often referred to as the social determinants of health.

Professor Bruce Robinson

“Half the money I spend on advertising is wasted; the trouble is I don't know which half”. This aphorism is attributed to the founder of the first major American department store, John Wanamaker. It might be argued that the same can be said of medical care.

The Medical Benefits Review Taskforce (the Robinson Review) is drawing to a close. Set up in 2015 by then Health Minister, Sussan Ley, at the suggestion of the Dean of The University of Sydney Medical School, Professor Bruce Robinson, the review has aimed to modernise and rationalise the 5700 odd items on the Australian Medical Benefits Scheme (MBS).

Many of the item numbers had not been reviewed in over 30 years, were outdated or redundant, or just sufficiently vague as to being open to “innovative” interpretation.

Dr Richard Freihaut

We all know the Achilles tendon. Most of us will also know the tendon is named after the ancient Greek mythological figure Achilles because it lies at the only part of his body that was still vulnerable after his mother had dipped him (holding him by the heel) into the River Styx.

Even for mere mortals the tendon remains a vulnerable part of our body, especially as we get older, and its chronic conditions can be difficult to treat. Understanding each particular condition can make our job easier and allow us to give informed advice to our patients, ensuring they recover faster and avoid unnecessary treatment and expense.