Professor David Kissane AC has returned to Parade to accept the Distinguished Old Paradian Award, 50 years after he completed his final year of schooling at the Bundoora Campus,

In accepting the award, Prof. Kissane delivered a keynote address to the more than 1900 students who had gathered for Term Two Assembly in College Hall.

Prof. Kissane's address, as follows, chronicles the career path he has taken in psycho-oncology and palliative medicine as an educator, researcher, author and clinician, and through executive roles with a range of national and international professional medical bodies.

Thank you so very much, Brother Denis Moore, for this Distinguished Old Paradian Award and for inviting me back to Parade College in this year of the fiftieth anniversary of its establishment on the Bundoora Campus. Thank you also, Mr Andy Kuppe, for your kind words of introduction.

I was fortunate to receive eight years of my education at Parade, which included some time at the Preparatory College in Alphington, time at the Old Bluestone Pile, and then my second year Matric at this campus in 1968. The year 1968 was also the anniversary of the first 100 years of Edmund Rice Education in Australia.

The historians among you may know that on November 11th 1850, Queen Victoria confirmed the separation of Victoria from New South Wales as an independent colony within Terra Australis, our great southern land. Within just 18 years, Archbishop Gould arranged for four Christian Brothers to come from Ireland to assist in the education of Catholic men. On 18^th September 1868, Brothers Treacy, Lynch, Bodkin, and Nolan arrived in the young colony of Victoria, initially teaching in St Francis’ Hall, beside St Francis’ Church in the city, before obtaining a site recorded in the memoirs of Brother Tracey as “Eastern Hill, overlooking the beautiful Fitzroy Gardens.” The foundations were laid there on November 22^nd, 1869, and classes began at the Victoria Parade property on 30^th January 1871.

In his annual report to Speech Night, 1967, the then Principal, Bro JS Nash, recorded the cost of building stage 1 of the new college at Bundoora at $1,008,000, with the Commonwealth Bank lending $750,000, and the sale of the Bluestone Pile site in East Melbourne raising $380,000. These prices would purchase a single house or unit today - the value of money has changed so much across 50 years!

Now many spectacular events occurred in 1968. John Gorton became Australia’s Prime Minister following the disappearance of Harold Holt at Cheviot Beach. The Vietnam War continued, The Russians invaded Prague, Senator Robert Kennedy and Martin Luther King were assassinated in the USA, Pope Paul VI released his encyclical Humanae Vitae, music was alive with the Beatles singing Hey Jude, and Simon and Garfunkel released Mrs Robinson. Change was happening everywhere. And in 1968, Parade College opened its Bundoora campus. Although this eighty acre site brought excitement and opportunity, with seemingly endless sporting grounds after the limited sporting facilities we had use of in East Melbourne, change was an inevitable experience for staff and students in 1968.

As I look back on the past fifty years, there can be no doubt that Parade equipped me beautifully for the many changes that unfold across one’s career, in my case in medicine and psychiatry. I completed my bachelor degrees at the University of Melbourne and attended the St Vincent’s Hospital Medical School, graduating in 1974. I initially trained in General Practice and Obstetrics, spending eight years of private family medicine in the outer suburb of Dandenong, where many young families lived, and where I delivered over 1000 babies and built breadth of experience in medical practice. Looking for more challenge, I then returned to further study and St Vincent’s to train in Psychiatry, obtaining masters and doctoral degrees in the process. As a new academic, I studied family grief and bereavement, and began trials of group therapy to help women with breast cancer. Doors opened and more change occurred, as I moved to Prince Henry’s Hospital, then Monash Medical Centre, and then eventually back to St Vincent’s in 1996 to become the Foundation Professor of Palliative Medicine for the University of Melbourne.

This was a colourful period of my career, involving debates with the euthanasia advocate, Dr Philip Nitschke, whom I talked into publishing, jointly, clinical accounts of his cases of euthanasia in Darwin in the medical journal, The Lancet. These accounts showed the poor standard of medical care that these patients had received in the Northern Territory. This taught me that although people think that legislation to control the time and choice of a person’s dying is straightforward, it is impossible to protect the vulnerable, who may be depressed, have received inadequate symptom control, or may have suffered from just poor medical care. Euthanasia legislation appeared to allow the suicidal to be medically helped to suicide.

My research in end-of-life care flourished across this decade when I led the Centre for Palliative Care at the University of Melbourne, and contributed much to the establishment of training and education for palliative medicine in Victoria. My research was noticed in the USA, culminating in an invitation in 2002 to become Chairman of the Department of Psychiatry and Behavioral Sciences at America’s largest comprehensive cancer center, Memorial Sloan-Kettering Cancer Center, in New York. With three of our four children established at university here in Melbourne, my wife agreed to move to New York, where our youngest child (at that stage, aged 15) attended UNIS, the United Nations International School. Although I had been at school with many migrants to our country, I would never have entertained in my time at Parade the thought of becoming a migrant to another country, but I had been taught to be ambitious, to lead and to adapt to change. That was what was called for, and so, that was what I did. Over the next decade, I was able to build the largest psychosocial care program at a cancer center in the USA, with a faculty of 36 members and over 170 staff engaged in a $45 million dollar research program enhancing cancer care. It was both thrilling and fulfilling to spend this decade in the USA, teach in more than 30 countries, and help to develop the disciplines of psycho-oncology and palliative care on the international stage.

I was privileged to become President of the International Psycho-Oncology Society, an association that brought together clinicians and researchers from across the world to share their research findings, and helped establish this discipline as a specialty in cancer care. It’s a great experience to build friendships with people from many other countries, to visit their universities and teach with them. However, after a decade of living in the USA, my parents had grown old, and my four children were living back in Melbourne – it became time for my wife and me to return to Australia. Fortunately, there was a position available at Monash University and Monash Medical Centre to head up their Department of Psychiatry.

I teach clinicians to provide psychological and psychiatric care to patients with cancer who become depressed, find it hard to cope with their diagnosis or treatment, and sometimes even think about giving up on life. I also work at Cabrini Hospital, where I see cancer and palliative care patients. In my research, I described a syndrome that we call the Demoralization Syndrome, wherein patients develop low morale, feel they can’t cope, and start to lose hope, to lose a sense of purpose and meaning in their remaining life. They despair their future and can begin to desire help to die. We have developed targeted interventions to correct such a state of mind. I developed a measure of Demoralization, a questionnaire that has been translated into more than 12 languages, and has shown that around 15% of patients with advanced cancer become demoralized. There is much work for palliative care physicians to do to help people live their lives out fully until they finally die.

Working in this setting of palliative care, and supporting people who are dying, has given me the privilege of seeing the courage and faith of many people as they die. Such an experience forces you to think about the meaning of life, to think about God, and to examine your own faith. Is there really life after death? Despite all the progress that science has made in understanding nature, it seems to me that with the vastness of the cosmos, science will never understand it all. There will always be some mystery, something about the universe that I call ‘unknowable’. And it is in this space that I believe there is room for God.I have come to more strongly believe in the Resurrection of Christ, to be a resurrection person, and to hold on to the Catholic beliefs that I was taught at Parade.

I have been helped in this journey, because it is never an easy one to hold on to your faith, I have been helped by becoming a member of the Order of Malta, a 900-year old institution sometimes known as the Hospitallers. They formed a hospice in Jerusalem at the time of the crusades, cared for pilgrims to the Holy Land who were sick or dying, and lived very much the principles taught in modern times by palliative care. Today, the Order of Malta distributes over $1 billion dollars per annum in aide to the poor, refugees, those affected by natural disasters, and those left homeless by war. Internationally, it has a staff of 25,000 medical personal and another 80,000 volunteers who help carry out its work. We run a medical clinic in Timor Leste, hospitals in many parts of the world, including a maternity hospital in Bethlehem, on the West Bank, and we run ambulance services in other countries. The Order of Malta has observer status at the United Nations. In Melbourne, we run the Eastern Palliative Care Service, which delivers community based palliative care to people that want to die at home in the eastern suburbs of Melbourne. Belonging to the Order of Malta for some 16 years now has helped me sustain my faith in very practical ways, as we work for the poor and sick.

In conclusion, I have been delighted to return to Parade 50 years after I last stood among your ranks, to tell you something of the gifts that Parade gave me, and of how I have acquitted myself since that time. I will leave you to judge whether I have upheld the traditions, but I have long had a sense of being blessed by God, and of having been fortunate to have received my secondary education in the Edmund Rice tradition from Parade College. Thank you for this award and for listening to me.

images courtesy Tony Teo