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Dear Winston

I am writing to you from Australia. We may not have met before!  I have heard a lot about you from Alex and Tony, whom I recently met in Sydney.

Let me give you a short introduction of myself.  I graduated from St Louis in 1967, matriculated in 1969, finished HK medical school in 1974, and migrated to Australia in 1975. Since 1977 I have engaged in full-time general practice.

My association with Fr Deane went back a long while. He first introduced my wife-to-be to me in 1969, married us in HK St Margaret's Church in 1i974 and then baptised my baby girl in 1991 here in Sydney.

Since then I have met Father Deane on a number of occasions serving as the Local Medical Officer of Father when he has been under the care of Theresa Lee as well as Dr  Teychenne in RPAH.

The following points relate to his conditions and its management.  I hope that these would become useful in the course of negotiation between you and the Salesians.

• Tension has the effect of delaying the response to drug.
• Peace and tranquillity are important in facilitating a better drug regimen.
• Being transplanted into an alien environment without social, psychological and emotional support would be traumatic in the extreme.
• The rigidity of hospital/nursing home routine is a fearsome experience to PD sufferers.
• Mental and physical exercise are of great benefit.
• A restricting environment is disastrous.
• A variety of behavioural changes vary considerably from patient to patient.
• Some PD sufferer may be frightened easily.
• Depression is a common feature of Parkinson's Disease.
• Patients should be encouraged to remain as active as possible and to continue with social and leisure activities to avoid boredom and apathy.
• Some may even develop clinical depression with sadness, lack of interest, lethargy and even suicidal tendencies.
• It is imperative to balance drug therapy with emotional and psychotherapy.
• Confusional state often can be reduced or reversible by adjustment of drug and emotional support from love ones.
• Careful, sympathetic management is necessary from carers and friends, Counselling and respite care is vital.
• Lack of body language and verbal signs can cause the patient to become isolated.  Plenty of stimulation and encouragement are needed.  Ignoring such factor is very  demoralising for the patient. It is important to keep alive the patient's desire to communicate.
• Apart from the visible mobility problem PD patients are especially prone to behavioural and affective disorder.
• Nursing care is important but in addition, constant reassurance is necessary to minimise the distress and agitation to be felt by PD patients when they have difficulty communicating  and find themselves in unfamiliar surroundings.
• In the past people tend to concentrate only on the administration of medication but in recent times the medical profession is paying equal attention to the patient's psychological and  emotional well being.  In fact the mind can control how we feel.

This is my small contribution to the whole team effort to relocate Fr Deane to a more suitable place for the reminder of his life.

hank you for giving yourself so generously to this most essential task!  Hopefully things will work out in an amicable way under your expert management.

And may the force be with us all the way!!

From

Bernard Yim

PS This year is the 40^th anniversary of Father's ordination.