My Working Life, as at 7.11.03
It’s surreal standing here. I can close my eyes and imagine metamorphosing into Sir Lance or Big Red. Dreadful thought. I am a little uneasy about exposing myself in public, but Hamish is a persuasive man, and it seemed churlish to refuse.
I peaked early, was a star in secondary school, and my career has been relentlessly downhill since then. The decline began to get serious in 4th year medicine, when my dear friend Martin Haskett and I took a year off together
Hamish’ dad arranged for us to do a term at Guy’s Hospital, and after that it was a year of adventures on the road, and the start of an at times life-threatening addiction to motorcycles. We had a fabulous ride around Europe and then back across Asia. At Guys we became sort of honorary British medical students – I can remember my registrar, just returned from a term in America, berating us for our slackarsed approach – compared to US students who were up at 6am listening to their dogs’ heart sounds for practice.
Clearly I had the generalist personality beforehand, but there was no way I could seriously consider focussing on specialist studies after discovering the wide world. So in part I blame Martin, who regained his senses enough to become a fine dermatologist, for my subsequent decline. Take a bow, Martin, if you are here. In our early final undergraduate year we teamed up again to take junior houseman jobs in New Zealand, along with Dave Webb, Chris Martin and others. All I can deduce from that scheme is that NZ must have been really desperately short of HMOs. My first job was in a paediatric oncology unit in Wellington, and I initially felt quite anxious at the prospect of giving intrathecal cytotoxics to young children with leukaemia. But the mountain hiking around Queenstown was wonderful.
After graduation, I marked time with 2 years of the Rotating Residency Program, then got married and went to Kerema, an isolated outpost in PNG, for 2 years, where I ran a one-doctor 95 bed hospital. Another very interesting set of experiences, much of it not readily translatable into life in Australia, either personally or professionally – I can remember boasting that I had rapidly eradicated all the TB and Leprosy from my next practice, in South Gippsland. There was a lot of fairly extreme medicine, at times heroic obstetrics and surgery, a few disasters, too much work, too many migraines, and probably not an ideal way to begin a marriage.
I was often out of my depth, with a radio phone in one hand getting instructions from the great Ken Clezy in Port Moresby, and a scalpel in the other. There was lots of Leprosy and TB in its many and dreadful guises, and other more exotic diseases. Fournier’s testicular gangrene comes to mind, I’m not sure why. I kept a diary and now quite honestly find many of the entries hard to believe.
Kerema is on the south coast – the fever swamps – and had hyperendemic malaria and severe malnutrition, but was a place where even fit young people died from black magic – a kind of PNG pointing of the bone – but I guess that was less challenging for me than practice in the highlands, where an axe in the head was a more common diagnosis. I had proudly learned pidgin, but found myself in the one part of PNG where it wasn’t the lingua franca. Motu was too hard to learn, as were the many tribal languages.
We had the first of our 3 kids in PNG, and decided that as it wasn’t our culture and because personal security was an issue, it was less attractive to raise a family there than at home. So back to Oz.
Then 8 years with my own practice in Mirboo North in South Gippsland, built a 39 square mud brick house on 20 acres of mature forest, as did my neighbour that well-known Gippsland physician Brett Forge. Brett’s muddie was even more grand, a beautiful thing built on a series on octagons. It’s good to see Brett here today.
I was also heavily involved with the Peace Movement – stood as a peace candidate for the seat of Gippsland in the 87 Federal Election, and didn’t get my deposit back. But as the man on the radio said, “Lots of people in Mirboo North are voting for Dr Anderson.” Fortunately, I guess, nobody else did. I was also an active member of the Medical Association for the Prevention of War for a year or two.
? What do I remember from 8 years practice in Mirboo North, other than the occasional weird genetic syndrome or two caused by hillbilly consanguinity – it was Deliverance country, if you can recall that wonderful film. I can remember the local midwives going on strike because I thought that my mids should have the option of rooming in. So I did a few home deliveries, hung in for the principle – the matron was sacked and we got our rooming in. Which showed that although Mirboo North was only 2 hours distant from Melbourne by road it was a good deal further away in thinking and in values.
In those Mirboo years I got a melanoma – a bit of a scare, particularly as at the time I was looking after a farmer younger than me who was dying of melanoma, poor fellow. However in optimism decided to make baby #3 – just as well, he’s a great bloke.
I was increasingly drawn to Melbourne, to meetings of the Rainbow Alliance – a red-green political movement now defunct, but which gave both Labor and Liberals a bit of grief in its heyday. I coordinated and largely wrote its Health Policy – that involved some interesting readings in the socialist analysis of western health, which says basically that western health care is just a bandaid for many of the ills caused by capitalism. An example comes to mind from Respiratory Medicine, with academia only now beginning to acknowledge that much respiratory disease is related to motor vehicle pollution – something that seems self-evident. It’s hard to accept that through our dependence on cars and trucks we are killing our children.
We recognized that we were city pinko greenies at heart, and the district around Mirboo was ultra-conservative, a powerhouse of the League of Rights, which in pre – One Nation days was a sort of Australian branch of the Klu Klux Klan. Patients of mine were running anti-land rights campaigns. In PNG we had clearly been outsiders, so it was poignant to feel even more of an outsider in my own country a few K from Melbourne. So after 8 years we moved back to the edge of Melbourne and built a home on a steep bush block at Upper Beaconsfield, with practices in Berwick and Upper Beaconsfield, where I shared a clinic with an old Naturopath friend. If anything that hardened my attitude towards naturopathy.
After rural general practice I found some things about urban practice discouraging – the demands for instant referrals, the lack of patient loyalty, the local turf wars and backstabbing from some other GPs. Also noticed that aging full-time male GPs often seemed rather grumpy old men – hardly surprising really – and made a decision to move away from full time general practice and to give up GP obstetrics after 17 years of that rather exhausting trade.
As a pathway to conservation work, I moved into Medical Admin training and got a job as deputy medical director at Maroondah. After 9 months my boss was sacked in one of those blood-on-the-floor hospital assassinations that make GP office politics seem quite innocuous. My marriage also collapsed at that stage – not a good time, and I remember being pulled up for some driving offence one night with tears in my eyes and being comforted by a rather embarrassed young copper who reassured me that my offence wasn’t really that serious.
So I was made Acting Medical Director (and at times felt that I was truly acting) in those years when Kennett was cutting the hearts out of public hospitals, by one means or another. What sticks in my mind from those years is a throwaway line by my mentor in medical admin Mick Coghlan, who said “All CEOs are bastards”. I think he was probably right, given the political nature of those difficult jobs. Anyway Mick should have known; he had been sacked by one or two CEOs and reinstated at least once with a big compensation payment. I stuck it out for 2 years, kept my clincal skills alive with casualty sessions, then got a job as Forest Campaign Director for Environment Victoria, the old Conservation Council of Victoria.
After many years as a voluntary part-time activist I wanted to try the real thing. Also changed my MBA studies over to a Master of Environmental Science, with a great sense of relief at escaping the world of neoclassical economics. Forest campaigning was a lot harder than medicine. For one thing there’s virtually no government funding for conservation work, and so you live on a low wage – but even that had to be justified as anyone that I was lucky enough to ‘direct’ was a volunteer. So thank goodness for continuing GP sessions at Brunswick in Edelsten’s old clinic- you know, the one that had a white grand piano, or was it a pink helicopter??
I lasted nearly 4 years as a paid forest campaigner – the average is said to be about 2 – until burnout set in. I hadn’t really believed in burnout and felt a little embarrassed that it happened to me. It was a kind of depression, a feeling that nothing you can do will have an impact – which may of course be close to the reality of forest conservation work much of the time. I guess this taught me that mid-life career change is quite tricky. There are no reflexes as good as the ones you develop early in your first career.
Got married again (doh!!!) a few years ago to my Italian love Rochi, and we have been renovating a little house and warring with developers in Prahran. The kids, after some rough years, are doing well with their lives and I am proud to report that we all get on very well and value each other. So I am back in part-time general practice in Prahran and Clayton, and collating a history of Victorian forest campaigning, and relatively happy with my lot.
This sort of talk is about career, or lack of, and is necessarily a bit one-dimensional. Life for all of us has become a fairly rich, complicated brew, once we start to reflect on it, and especially as we reach the age of 50+. Mine sounds like a dog’s breakfast, or a madman’s shit as I once heard a warrant officer describe our platoon’s efforts at marching in time. But it’s my life, as the song goes, and I guess if I hadn’t tried these things I wouldn’t have learned the sometimes painful lessons, or had the opportunity to let it all hang out here today.