Dr James Sartain is Director of Anaesthesia & Perioperative Medicine, Cairns & Hinterland Hospital and Health Service. His clinical and research interests include acute pain management, perioperative medicine and obstetric anaesthesia. Over his 23 years in Cairns, he has seen the care of obstetric patients with rheumatic heart disease continue to improve, as a result of better documentation, enhanced clinical awareness and greater interdisciplinary collaboration.