I Feel GoodEaster on the North Coast - rain, washed out sporting events and the BluesFest. It’s a tradition - drugs and mud, booze and blues. Previous issues of GPSpeak have championed Dr David Caldicott’s advocacy of voluntary drug testing for festival goers. In April the first tests were run at the Groovin’ the Moo festival in Canberra. The results showed that 50% of the illicit drugs tested contained substances such as lactose, sweetener and paint, while 50% were pure MDMA.

Two of the 85 samples contained ephylone, a potentially fatal stimulant. Further testing is planned at other locations but the North Coast’s Splendour in the Grass is unlikely to participate for the foreseeable future.

I Feel Good

I feel good. I knew that I would now.
I feel good, I knew that I would now.
So good, so good, I got you.
- James Brown, I feel good (1964)

On a more sobering note, we report the recent study of voluntary blood alcohol testing at North Coast music events (page 29) by local researchers from the UCRH and Western Sydney University. The study showed that if a subject’s blood alcohol concentration (BAC) was high, they were more likely to delay their time of departure from the concert venue. Knowing your status and sharing that knowledge with others led to making better decisions and safer behaviour.

BluesFest now has a global reputation and regularly headlines international stars and legends of the various genres. On page 35, Rachel Guest reflects on the difference between BluesFest and other music festivals around the world. BluesFest attendees are older but probably more hard core. Hard core about the music, not the booze and partying, that is. They never knew the sixties, so it’s time to catch up.

Our cover story features “Soul Sister”, Sheli Nagas, a local singer and guitarist whose music gives a glimpse into her family’s life and history. Sheli is descended from the indentured South Sea Islanders who were brought to Australia in the late 1800s to work in the cane fields of eastern Australia. In addition to her music, Sheli has been key in promoting the Australian South Sea Islander (ASSI) group that lobbies and advocates for her community.

Australians have a long history and an international reputation for heavy drinking. This is considered uncouth in many cultures. On page 30 Chris Ingall discusses how fine dining is an art, with the cultured restricting their alcohol consumption to meal times. They probably make their last drink of the night a dry sherry at the end of the meal.

Not all of us are that self controlled. On page 17 Jane Barker reminds us that there is a linear relationship between alcohol and cancer, with the safest level of alcohol consumption being zero. However its deleterious effects extend far beyond cancer and every medical specialty will be aware of the effect alcohol has played in many of their patients’ pathology.

Many Americans have used medicinal marijuana for some time for the control of pain, nausea and anxiety and limited clinical trials are underway in Australia. Editor Robin Osborne (page 9) looks at the current interest in Australia for the clinical use of cannabis and other psychotropic drugs. He also touches on the economic opportunities that sanctioned marijuana cultivation creates for the North Coast community.

On 1 January 2018 California legalised marijuana for recreational use and big business has moved in. Drop in at a Green Dot or visit MedMen and receive the full concierge service. You might be interested in a tub of Mary Jane Relieving Cream or perhaps some Marley Natural Hemp Seed Body Salve. While there you can pick up a “CBD treat” for the dog. On page 13 we get a peek at the current scene in Los Angeles and what the future could look like here.

“If exercise could be purchased in a pill, it would be the single most widely prescribed and beneficial medicine in the nation” is the oft quoted statement by American geriatrician, Robert Butler. Combine that with a diet low in sodium and high in potassium, restricted alcohol intake, decreased consumption of saturated fats but increased fruit, vegetables and grains and there would be a radical change in the diseases presenting to Australian GPs.

These recommendations are part of the recent American guidelines for borderline hypertension management as reported on page 7. The NCPHN is supporting this approach by looking for effective ways to increase exercise levels in the community. It mirrors the more general approach to non-drug therapy being promoted by the RACGP.  

The College’s Handbook of Non-Drug Intervention is compiling the list of non-drug treatments that work. Professor Paul Glasziou of Bond University is using his expertise in Evidence Based Medicine to help sort the wheat from the chaff.

Practices and procedures are constantly evolving in general practice due to changes in government regulations and legislation. Sam Green gives an update to the Certification of Death at Home on page 19 and in the age of the Notifiable Data Breaches we also review the GP’s ability to share clinical data with all members of the patient’s treating team (page 21).

Looking after ourselves and our young colleagues is now recognised as an important duty for the profession. Young doctors Marissa Baker and David Glendenning give their reports (page 27) on the new Women and Men in Medicine groups that met for the first time earlier this year.

The NoRDocs Facebook group is another new medical organisation on the North Coast. It was formed late last year and is holding its inaugural face-to-face meeting on 30 June. The group comprises medical practitioners living and working in the Northern NSW LHD footprint and has grown to over 140 members in six months. It is open to general practitioners, specialists and and doctors in training. It provides a forum to discuss any matters of concern but has a particular focus on North Coast health problems and solutions.

The meeting on 30 June follows the same philosophy as the Facebook group. As such it is experimenting with the “Unconference” format where the floor is open to anyone who wishes to speak. However, there are only a limited number of slots available on the Saturday afternoon and these are assigned ahead of time. The outline for the day (page 22) gives further details. It will be interesting to see if this format is useful for furthering health solutions on the North Coast.

It feels good to feel good. That’s true irrespective of whether it comes from alcohol or drugs, music or art, religion organised or disorganised, exercise or simply by trying to make a difference in your community. However, as medical practitioners it is incumbent upon us to help our patients consider the consequences and choose wisely. Good now may not be good tomorrow.