A year in Canberra

Moving to Canberra for work is a rite of passage for many young professionals in Australia. And so it was that I moved to there in early 2015 to undertake 12 months of neurology advanced training. Putting aside my ingrained bias about the national capital – a product of growing up in Sydney – it’s actually a very nice place. There are many differences and quirks, though, and I thought I’d share my Sydneysider perspective…

The bush capital

Firstly, to understand Canberra in general, it’s helpful to think of it as a large country town that happens to be the national capital. This is a city where there actually are kangaroos on the streets. If you manage to get here (Canberra International Airport has no international flights), you’ll discover the population of only 380,000 is sprawled out across an area about 40km north-south and 15km east-west. The planned city is organised into districts, the urban ones being: North Canberra, South Canberra, Woden, Belconnen, Tuggeranong, Weston Creek, Gunghalin and Molonglo.

Canberra land axis, view from Mt Ainslie

Parliamentary Triangle land axis (Mt Ainslie, Capital Hill, Red Hill), view from Mt Ainslie

Being in the Australian Capital Territory (ACT) means that there are many acronyms featuring ACT, some better than others, including:

  • ACTION – ACT Integrated Omnibus Network – public bus service
  • IntACT – Information technology ACT – ACT Government IST service
  • TransACT – internet service provider
  • GastrotrACT – private gastroenterology practice

Winter is coming

The first thing many Canberrans tell you about on arrival is the winter. By Australian standards, this city gets cold – a product of location (150km inland) and altitude (600m). Negative temperatures on winter mornings are the norm. Even in late September, during Floriade Nightfest, the effective temperature (with wind chill) was 0°C! Despite this, the dryness means that it rarely snows (less than 1 day this year).

Typical car thermometer reading whilst driving to work

Canberra state of mind

No-one working in the public sector here tells you what they actually do, only the ambiguous statement that “I’m a public servant”. It’s an almost meaningless statement in a city where the Australian Public Service is the largest employer. I’m a public servant too, but clearly what I do as a medical doctor is very different from my public servant neighbour does in the Australian Defence Force.

Speaking of my neighbours, there are very few people living in my inner-south neighbourhood who are actually from Canberra. The large proportion of people from interstate temporarily makes for a unique melting pot, with a very different vibe from any NSW town/city despite the geographical location.

The over-representation of young educated professionals also has other consequences. More people attend major events than one might expect for a city this size, such as Enlighten, Floriade Nightfest, Nara Candle Festival, etc.; and bumping into friends and colleagues is a near-certainty.

Enlighten festival 2015

Enlighten festival 2015

There also seem to be a lot of Volkswagen Golf GTIs…

Lots of GTIs in Canberra

Another reflection of the city’s demographics are the progressive tendencies of the ACT Government (at least in comparison to other Australian jurisdictions). Amongst other things:

  • Single-use plastic bags are banned, causing quite some confusion the first time I went to the supermarket (and some very contrived “reusable” plastic bags)
  • Major investment in wind and solar power, such that the ACT appears to be on-track to meet its 90% renewable energy target by 2020
  • A program to purchase all private homes contaminated by “Mr Fluffy” loose-fill asbestos (at huge expense)

The slow lane

Capital works in the ACT proceed much more slowly than equivalent work in Sydney or Melbourne. Construction on major projects such as Majura Parkway, Constitution Avenue, and Bowen Place; appear to stand still for extended periods and are subject to (repeated) delays. The Acton Tunnel was damaged a few months ago by an over-height truck and was closed for almost 3 days for temporary repairs.

Speaking of roads, everyone knows that Canberra has a lot of large roundabouts. What is less well-known is that the majority of Canberra’s roads have a chip seal surface (aka spray seal or coarse chip), a form of surfacing usually only found on rural roads, resulting in a harsh and noisy ride compared with asphalt. The ACT Government justifies the use of chip seal this by citing the much lower cost, which is probably a financial necessity considering the extensive road network for the small population. It is mystifying, however, when the ride/noise is worse after a road undergoes resurfacing; for example the recent works on Hindmarsh Drive and Tuggeranong Parkway.

Chip seal road surface

Normal for Canberra…

Overall, though, this place has grown on me over the year and I’m actually quite sad to be returning to Sydney in 2016. I’ll definitely miss the inner-south lifestyle, the lack of traffic, the politician-spotting (I live within 500m of PM Malcolm Turnbull), the national institutions, the cultural quirks, the many friends I’ve made, and yes even the weather.

Australia to adopt INNs

The Therapeutic Goods Administration (TGA) has announced that it will proceed with international harmonisation of drug names used in Australia from April 2016. For the past decade or so, since the United Kingdom moved to the World Health Organization’s International Nonproprietary Names (INNs), we’ve been in the anomalous situation of using former British Approved Names despite these no longer being used in the UK (nor listed in the British Pharmacopoeia). The TGA website has a list of affected drugs.

Some changes are trivial:

  • Substitution of “ph” with “f” (e.g. cefalexin, guaifenesin)
  • Substitution of “y” with “i” (e.g. amoxicillin, ciclosporin)
  • Substitution of “th” with “t” (e.g. indometacin)

Others are more significant (and will require dual-labelling for 3 years), for example:

  • Dosulepin (dothiepin)
  • Formoterol (eformoterol)
  • Furosemide (frusemide)
  • Glycopyrronium bromide (glycopyrrolate)
  • Hydroxycarbamide (hydroxyurea)
  • Lidocaine (lignocaine)

On the contentious subject of adrenaline vs epinephrine, the TGA has followed the UK practice where dual-labelling “adrenaline (epinephrine)” will be used indefinitely.

HbA1c now funded for diagnosis

From 1 November 2014, glycated haemoglobin (HbA1c) testing is now funded on the Medicare Benefits Schedule for the diagnosis of diabetes mellitus – MBS item 66841 (up to once every 12 months).

MBS item 66841

The Australian Diabetes Society and other international organisations have recommended since 2011 that an HbA1c ≥48 mmol/mol (≥6.5%) can be used to establish a diagnosis of diabetes.1 Until now this has been impracticable in Australia as it was only Medicare-funded for patients with established diabetes, however this new listing on the MBS provides clinicians with a more practical and efficient way to make the diagnosis.

1. d’Emden M, et al. The role of HbA1c in the diagnosis of diabetes mellitus in Australia. Med J Aust 2012;197:220–1. (full text)

Normandie 70 ans plus tard

As we commemorate the 70th anniversary of the D-Day landings in Normandy (6 June 1944), I’ve been reflecting on my visit to the region in 2012 and the continuing legacy of that fateful day. It was indeed an eerie experience walking on ground where thousands of soldiers had given their lives.

Gold Beach, near Arromanches-les-Bains, was one of the British landing zones. These days it seems to be a popular recreational beach, however reminders of its wartime role are ever-present. Remnants of the Mulberry Harbour built by the British to offload matériel lie scattered around Gold Beach.

Gold BeachMulberry Harbour, Gold BeachOmaha Beach, to the west, was one of the American landing zones. The terrain is steeper and more rugged, and it’s not hard to imagine how difficult it must’ve been for US forces landing here under enemy fire.

Omaha Beach

Omaha Beach fortificationCimetière américain de Colleville-sur-Mer (Normandy American Cemetery and Memorial) looks over the beach and is a sombre reminder of the costs of war.

Normandy American Cemetery and MemorialReflecting Pool, Normandy American Cemetery and Memorial The photos above are also on my Flickr photostream.

The Saturday Paper

It seems irrational to launch a print newspaper in the current milieu of newspaper-industry upheaval, and yet on 1 March this is exactly what happened. Imaginatively named The Saturday Paper, this weekly is published by Morry Schwartz (already known for The Monthly and the Quarterly Essay).

The Saturday Paper

Printed on high-quality stock (for a newspaper) in compact format, The Saturday Paper is all about long-form journalism and writing in its 32 pages each week. The first two editions contain only 17 articles each and none of the trivial/populist ephemera that dominates the mainstream “news” media. Full-page adverts offer a clue to their target demographic: Mercedes-Benz, Harrolds, Rolex, National Gallery of Victoria, Art Gallery of NSW, etc.

I’ve been concerned about the decline in the quality of journalism in Australia for some years now. The “broadsheets” (no longer printed in broadsheet format) have become almost as unreadable as the tabloids. Many of their best writers and senior journalists have left or been made redundant (with quite a few now writing for Guardian Australia and The Saturday Paper). This publication is a welcome addition to the Australian media landscape. Any new voice is crucial when we have the most concentrated newspaper ownership in the world (dominated by News Corp).

Winter is coming… to Sydney Uni

Studying for the physicians exams in Fisher Library a few weeks ago, I was delighted to hear the Game of Thrones theme being played on the University of Sydney Carillon (pronounced /kəˈrɪljən/). Honorary carillonist Isaac Wong was the one responsible, as seen in the clip below. Hearing it in person amongst the neogothic grandeur of the Quadrangle is quite epic.