Wednesday, March 30, 2011

Inspirational: Dr Susan Downes

I came across Dr Susan Downes' story as I was browsing the net this evening, searching for some career inspirations (as you do). She is a GP-Obstetrician who delivers services across a huge expanse of land in Western Australia (extending as far out as Christmas and the Cocos-Keeling Islands in the Indian Ocean!!).

The following is an article that was featured in Medical Forum WA Magazine (April, 2006). I hope you enjoy reading about her story and find her work as inspiring as I do!

Multiskilled - Dr Susan Downes
Written by Mark Thornley
Saturday, 01 April 2006

They say the genes for multi-tasking, negotiating skills, spatial awareness and acceptance are carried on the X chromosome. Dr Susan Downes is living evidence of these inherent skills, plus more, having pursued a varied career in primary health care while raising three children. Her ability to thrive on diversity, adapt, and break down boundaries has positioned her as an every day pioneer in primary care. Susan was a wide-eyed epidemiology research assistant before she took up medicine at the age of 35. She has excelled since, undaunted by family trauma, and this year her remote GP work in the Pilbara and on Christmas and Cocos Islands earned her the General Practice Prize for Excellence in Population Health, conferred jointly by The Public Health Association of Australia and the RACGP.

Dr Susan Downes on her RFDS run

A self confessed travel junkie, Susan has always had a curiosity for new cultures.

"When in London I was working with many epidemiology doctors who inspired me with their stories of different countries and cultures. One in particular had worked in New Guinea and told me how he had to do a caesarean on a tribal chief's wife who had obstructed labour with twins."

"The tribe was cannibalistic and he was thinking, ?if this doesn't come off, I'm on the menu for dinner'. He'd never done it [a caesarean] before and was reading the medical book and was on the pedal radio trying to get instructions."

Flicking through an international medical journal and drooling over jobs for medicos in exotic locations, she decided to enrol in medicine as a mature age student.

Her actual medical career began as a family GP in Fremantle where her strong connection to people meant it was not long before she knew the names of her patients' budgerigars and was "burying their grandmothers".

The multicultural Fremantle mix of Greek, Italian and Portuguese provided a solid grounding for her transition to the Rural Women's Female GP Program that now sees her consulting Malay, Chinese and Muslim communities throughout Christmas and Cocos Islands.

"I felt I was becoming a bit narrow in the suburbs and just filling out forms and sending people off for blood tests. When you're out in the sticks you're doing everything yourself. You're reading your own x-rays, and doing your own bloods and ultrasounds."

She now incorporates Chinese medicine and Aboriginal bush medicine into her consulting, where she can. She thinks any GP who takes on a rural locum might regain some of their inspiration, especially away from bureaucratic hoops.

For example, she recalls one confronting incident on Christmas Island, which is so remote even the Royal Flying Doctor Service cannot attend patients unless they charter a special plane.

"We had a fracture-dislocation of the cervical spine. No plane could come and the paralysis was getting worse as we watched him. A community plane that used to go to Jakarta happened to be on the island so we took the seats out and a nurse and I got on with the patient and the pilots, and set out into the Never Never and flew to Perth via Learmouth in the dead of night. We really felt we weren't going to make it but eventually we got the patient there and he went into theatre straight away and is now walking."

Susan has been attending the health needs of adolescent Aboriginal women in the desert communities of the East Pilbara for five years. She visits these communities for 2-3 days every two months where she confronts sexually transmitted infections, unplanned teen pregnancies and cervical cancer.

To do this she must gain the trust and confidence of these shy groups of women, where she helps deliver education programs at medical centres, schools or even creek beds and swimming holes.

By preventing STIs, future infertility and its expensive solutions are greatly reduced. By encouraging pregnancy-free years, young Aboriginal women mature physically and mentally and attain higher levels of education.

Susan's involvement as Liaison GP at Woodside Maternity Hospital has ensured the hospital's status as the last inner suburban hospital to retain a thriving public obstetric service run by GP obstetricians. Deliveries have risen 12.5% and she assumes a senior role in a team delivering over 700 babies each year. Susan now performs her own caesareans and can offer the full obstetric service in remote locations such as Derby where she does obstetric locums.

Twenty-one years after entering medicine, she had recently completed an obstetrics research project and hopes this, plus her work with the WA Centre for Rural and Remote Medicine, will help others providing obstetrical services in remote communities.

Enjoying bush walking and bee keeping as hobbies, she has a long term goal to work for Medicine sans Frontiers or Oxfam - when she gets enough money in her super fund.

(, accessed 30 March 2011)

I'm trying to locate her contact details so as to send her an email and ask if I can do an elective with her at the end of the year! Would be amaaaazing!!

Tuesday, March 29, 2011

Full-time all the time

Random rant that I feel strongly about, so just put up with me for a few minutes here.

Dear Stay-at-Home Parents (who think that only they can exclusively call themselves "Full-time Parents" and feel that they have the hardest and most important job in the world),

I'm sorry to break it to you, but you don't. In fact, you only have half the job that some others do. Because - believe it or not - parents who participate full-time in the workplace, do not come home to part-time parenting. No, in fact, they come home to full-time parenting: the same job that you do all day, they do when they come home. So they essentially have two full-time jobs. It's called "Time Management".

I understand that you may be frustrated by the lack of recognition and financial reimbursement of full-time parenting, but here's the thing: it's even less valued and recognised as an occupation if you are a full-time participant in the workforce, because there is the assumption (by a select few) that you cannot be a full-time parent AND a full-time worker. So they take claim to the title of "Full-time Parent" and take it to define only those who do this exclusively.

Oh, and another thing, if full-time parenting was financially reimbursed - I bet you anything that parents who are also full-time participants in the workforce would be excluded from that payment. And you'd all be okay with that. So go figure.

Anyway, just putting it out there for the next time someone starts giving me their spiel about how exclusive full-time parenting is "the hardest and most important job in the world".

End rant/

Sunday, March 27, 2011

GAMSAT Version 2.0 and "meh" talk

Weekends always go so quickly. What's with that..?! I had a very bizarre experience this weekend. I did St John First Aid duty for the GAMSAT exam (Sydney Venue). It was so weird right. Last time I was there was four years ago when I was sitting the exam myself. It's funny how even the memory of a high-stress situation can provoke the same sympathetic response as the original event. I so vividly remember not being able to sleep the night before the GAMSAT - I kept dipping in and out of consciousness, checking the time on my mobile phone next to me every half an hour for fear of sleeping-in and missing the damn thing. Not to mention the drum-roll palpitations on entering the exam hall. It's such a b*tch of an exam and I honestly see no correlation between passing the exam and success in medical school. It really is just a high-attrition tactic to wipe out > half the med-school hopefuls so that the bureaucrats and admin people don't have to deal with the effort and paper-work of going through all the potential applications that would come through. Meh. Anyway, thing of the past, can comfortably put it behind me and was oh-so-very relieved to be there as a spectator at the Australian Technology Park in Redfern (venue where the exam is held) this time.

On the med-school front, I finished my rotation in Neurology last week. It was a really good rotation; made all the better by the team I was with and my supervisor. I definitely could have been more pro-active and involved, but I seemed to always find the temptation to go home after lunch too strong to resist. So basically I'd attend ward rounds in the morning; then tag along with the registrars on their consults (usually in ED); there would always be a meeting of some sort that was worth attending (especially the radiology ones where they go through scans of patients on the wards); some days there would be a clinic on in the morning or afternoon; and the rest of the time was spent seeing patients on my own or with another student. I tried to see at least one patient a day and do a long-case type assessment of them. Sometimes the interns would ask us to take bloods or put in cannulas which I'm a bit over doing now because the novelty has worn off, from doing so many last year. Anyway, there were four medical students on the team - one of whom was a bit annoying because she would always hang around until really late into the evening with the team. She's interested in pursuing Neurology as a speciality, so I understand that she wanted to get as much out of the placement as possible; but still, it made us all look unmotivated and less-than-keen. It was a bit frustrating too because she would never explicitly answer my questions on what she would get up to in the afternoon/evenings when we weren't there; so it was hard to gauge whether it was worthwhile staying behind or not. Of course we could've just stayed behind ourselves and found out, but I don't know that it would have really been useful as most of the activity seemed to happen during the day, and she would always slip off and do her own thing anyway. Meh. I'm sounding a bit like sour grapes now, so I'll stop. I am actually happy that she's thrown herself into Neurology. Two reasons: (1) every speciality and its patients deserves to have a keen-bean enthusiast who will throw themself into their work - these people turn out to be the movers and shakers of the specialy; (2) last year she was set on pursing O&G, so she would have made some very stiff competition if we were going for the same registrar-level training position. Okay, official freak of sour-grape I am today - will stop! So, um, yeah.. I always assumed I'd fall into a career Neurology myself, because I have a degree in neuroscience - so it seemed like a natural progression. I have to say though, the fascination and general awesomeness that drew me to the theory of neuroscience back in my undergrad days; is numbed by a sobering overtone of helplessness when it comes to the actual clinical practice of Neurology. There really isn't much that can be done for a lot of patients under the Neuro or Stroke-Unit teams, curatively - with the majority of management aimed at stopping disease progression or rehabilitating the body back to a functional state, post-event. The true hero(es) in my eyes, are the clinical research teams that are working on preventing and/or curing neurological diseases. I hope that I can see their effect of their studies in my life-time. It really would be an amazing contribution to society.

Tomorrow I start the last of my medical/surgical "selective" terms - Gynae Surgery. I had initially been timetabled for Haem Oncology, but I heard it was a fairly average term to do as a med student, so I swapped out of it. The person who was assigned to Gynae Surg has no interest in this area at all, so she was happy to take anything else. I'm thinking again about going into O&G, so I guess it was a win-win situation. I've heard the supervisor for this term is really nice, but he grills his students on their knowledge of the anatomy of female reproductive organs. So I spent like maybe half an hour (if that) trying to memorise the ligaments that hold various different things up and stop them from falling, if you get my drift. I think I'm okay getting grilled for the first week, and then getting the swing of things by the second week, because I'm honestly finding it too hard to just stare at diagrams of the uterus and ovaries without a clinical situation to slot things into context.

Anyway, it's now midnight and I'm wishing I had more weekend time to catch up on sleep, chillax, watch some DVDs and do some uni work. Meh.

Thursday, March 10, 2011

Long-lost friend

I haven't blogged in a long time. I haven't even read other people's blogs in the time being :-S Of late, I've had a bout of avolition where I've just found it hard to get on with the easiest and simplest of tasks. It hasn't helped that I've had deadlines to submit various forms coming at me left, right and centre. It's paper-warfare I tell ya! So, since November, here's what I've been up to (in a nut-shell):

- Sat and passed end of 3rd year exams (phew!). Actually did aright, I got an overall mark of 76% which is the highest I have ever gotten in med-school so far as an end of year grade.

- Travelled for 2 months to Jordan, Syria and England over the summer break (although it was actually winter in all of these destinations). I had an amazing time and definitely could've kept going with my continental drifting had I not had to come back to start 4th year in late January (I actually missed first week back, so go figure). I did some hospital placements while I was oversees (O&G in Jordan, ED in England) but have nothing remarkable to report on those execpt that they were pretty boring, uninvolved and student-unfriendly. This turned out to be a good thing as it meant that I was okay not being at the hospital and actually doing some travel.

- Returned in late January to commence my 4th and final year of medical school (*squeal!*). I'm so excited to be on the home-stretch run. This has been a long time acoming! I will have plenty more to write about this as the year progresses, so it's definitely going to be an overriding theme throughout my posts this year. As for what I have been up to rotations wise, I am half-way through my 2nd rotation (Neurology). My first rotation was Cardiothoracic Surgery (this is something I plan to write more about as well in the near future) - but suffice to say for now that it turned out to be the highlight rotation of my med school career so far. Bloody mind-blowing, complex, intensely emotional cases - the grand dame of surgical specialties did not fail to impress! Neurology has been quite cruisy but enjoyable as well. Kind of my niche area if I had to pick a medical speciality as I did my undergraduate degree in Neuroscience.

- What else? I was made redundant from my long-held (9 years!) job before going overseas. This is something that stressed me out a great deal, especially since I have a maasive loan (~ $20 000) that I took out to buy my car last year... and also because I was just about to go on holiday and the last thing I wanted was to do things on a shoe-string while travelling. Anyway, I dug deep into my savings and managed to budget what I had quite well while on holiday. As for my car, I lent it out to my parents (who sold their car at the end of last year and didn't yet get a new one), while I was o/seas and they paid my fortnightly loan repayments in return. So then when I returned from overseas for the first month I just made do with what I had and brought lunch from home and didn't go out at all, etc. Then I found a tutoring job which was advertised on Gumtree, basically just helping a mature-age "return to uni after having kids" student from a non-English speaking background with her assignments for a Bachelor in Early Childhood Teaching (very random, I know!). It's a few hours work so it's not too bad and it's cash-in-hand. But get this right, in a fortunate twist of fate, my ex-work contacted me last Sunday about getting my job back because they'd culled too many people and were in desperate need of staff that they wouldn't have to retrain. SO now I've got my old job back (on a Sunday too - so extra pay!) AND I have this random tutoring job, which means I've gone from just Youth Allowance income, to > double that every fortnight (and all is well with the world!). This is has been a big relief, especially since I would like to save up to travel at again the end of this year.

- Lastly, my sister is now about 21 weeks preggers and getting quite big. Her and her hubby want to keep the gender of Little Bambi (as I call It) a surprise. But I'm very much looking forward to meeting it and forming an awesome friendship with it later down the track!

So, that's it from me. I have a few things I want to reflect on, which I will do gradually. One thing I was thinking of doing is switching to a different blog as I feel like this blog was started in a time and place that I am far removed from now, and everytime I log in I think of all the crazy shit that was happening at the time, so it's not always a happy place to come back to. Still, it feels like a long-lost friend that knows all your secrets; but not in a snide way either. Anyway, I will give forwarning of a change if it does happen as I don't want to drop off the blogosphere and have people wondering if I got hit by a car or something :-S