I came here 20 years ago as a jaded trainee doctor, disillusioned after a few years being a cog in the hospital system.
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I came here sick of writing drug charts for, and poking needles into, very ill patients who I didn't have time to talk to and would never get to see again.
I came here wishing I knew the people behind my patients, and how their stories turned out. I came here wondering if there was a different way to be a doctor.
I found out there was.
In general practice, my patients stepped out of the textbooks and off their hospital gurneys, and settled into the chair opposite me in full, messy glory. Strange. Tender. Hilarious. Scary. Dignified. Falling apart. Cranky. Familiar. Human.
In general practice, I had time to listen. I heard what was behind symptoms and illnesses; the longings and fears and secrets. I got to know the bigger picture, the whole family, the next chapter.
My patients were not theoretical specimens who had read the medical textbooks; nor were they obedient objects lying passive under the umbrella of their hospital diagnoses.
My patients were singular and opinionated, bringing their own agenda and personality to dance with mine.
Consultations were conversations; I quickly discovered the art of negotiation, of mutual trust and respect. I learned to live with uncertainty and wait and see, no longer testing for everything on the hospital lab list. I learned how to listen to all a person was telling me, what was said, unsaid, and spoken by their body. I learned when to push and when to give.
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In general practice I had the privilege of walking with people through the long arc of their lives, through growth and grief, babies born and loved ones lost, slings and arrows and good fortune, illness and recovery.
The refugee child who ran from New Year's Eve fireworks which sounded too similar to gunshots, who grew up to top of his class and became a leader for his community. The teenager neglected by parents struggling with addiction who found her way through abusive relationships into a respectful partnership.
The elderly widow who went on to thrive after a long wilderness of grief. The milestone of 10 years after the cancer. First cuddles with a newborn whose older sibling was stillborn. Daring young and old people coming out to me as queer, as survivors of abuse ... even as fans of midday TV.
General practice was not boring.
One patient brought in a jam jar containing the offending (still live, giant, and angry) spider who'd bitten him. Another brought the worm she'd found in her toilet bowl which she thought was the cause of her gut pain (we sent it off to pathology who reported back that it was "an earthworm"). A young woman showed me a new mole which was growing bigger every day - on closer inspection there were tiny legs and I yanked out an engorged tick!
A young man who turned up with an unusual superficial burn on his lower abdomen confessed it was from stealing a hot chook from Woolies by shoving it down his tracksuit pants.
Another brought us an African ornament "shoplifted especially for you". Our waiting room was often loud and colourful, with occasional biffo and covert drug deals at one end, a mob of sticky preschoolers wrestling over toys at the other, and elegant, hijab-wearing refugees, besuited public servants, queer academics, diplomats, and pierced students waiting patiently in the middle.
People were good about how late we were running, because they knew when it was their turn, they would get the time they needed with their doctor. They knew whatever language they spoke, wherever they had come from, whether they were well-off or homeless, clean or using drugs, HIV or Hep-C positive, working girl/working poor/working at Parliament House, they would be treated with dignity and respect.
They had found a place which offered non-judgemental, quality care to the whole community. Those who could pay, paid; those who could not were bulk-billed, even though over the years this made the practice increasingly unviable and eventually led to its closure.
Interchange General Practice, and its successor Hobart Place General Practice, became my medical home. I worked through my pregnancies there (lumbering out through the full waiting room just before going into labour, to be gifted free, high-volume advice from one of my patients across the room "remember what I said Dr Chew - push with your BOTTOM not your FACE!"). I brought my kids there to be jabbed and lollipopped by the magical nurses. I was teaching a medical student there when I got the news my father had died.
When I returned raw after the funeral, kindness and understanding from workmates and patients kept me going.
Listening deeply to people, engaging with suffering and how liberally and unfairly it is distributed, takes a toll. I burned out a few times from the intensity of the work, but I recovered and returned.
The best medicine for me has been witnessing the resilience and irrepressibility of the people I work with. How they hurt and heal, how they lie down and then get up again, how they love and let go, how they surprise and fascinate me. How they know best.
Thank you to my colleagues for 20 incredible years. You taught me how to be a better doctor.
Thank you to all my patients - it is from you I learned how to be a better human.
- Dr Joo-Inn Chew is a GP who has worked in general practice and refugee health in Canberra for 20 years.
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