THE CONFAB WITH MICHAEL G IN CONVERSATION WITH DR PHILIP ROME

Philip attended The University of Sydney where he was awarded First Class Honours in his Bachelor of Medicine and Surgery in 1999. He is currently practicing plastic surgery in Canberra. 

Dr Rome has a strong sense of social justice and has visited Nepal to lead a volunteer surgical mission (burns reconstruction) ten times over the past 13 years.

Join me on the ConFab with Michael G to gain an understanding of his life journey and passions.

Transcript

SPEAKER_00 0:00

Welcome to the Confab with Michael G on the People Powered Radio 2XFM 98.3. We're streaming online and on demand on 2xfm.org.au. Tonight our guest is Philip. He's a plastic surgeon and has spent time in the pool. Tonight we're going to learn a little bit about his life journey and passions. Welcome to the Confab with Michael G.

SPEAKER_03 0:27

Sometimes when this place gets kind empty.

SPEAKER_00 5:05

Very well, thanks, Michael. Well it's a pleasure to have you in the studio tonight. But uh before we kick off the program, would you introduce the track that we've just played? Who is the performer and why did you select it?

SPEAKER_01 5:18

Uh the track is Under the Milky Way by the church. Um it's been a favourite song of mine for a long time, uh probably since my um university days through to now. It's always nice to hear on the radio and I was lucky enough to catch the band, uh which is a Sydney actor perform here in Canberra a couple of weeks ago that played live. So I got to hear that song live.

SPEAKER_00 5:44

Now, before we kicked off the programme tonight, you mentioned something about Mexico. Yes. Now, why did you talk about Mexico?

SPEAKER_01 5:52

Um, I was actually born there, Michael, so um on my password it says born in Mexico City. Um the way I was born there, well the reason I was born there is uh my father was working as a junior diplomat in the Australian Embassy there at the time. Uh where he and mother conceived me, uh apparently on an overnight train to Chihuahua, according to my parents. Uh I was subsequently born there nine months later. I was naturalized on birth to Australian and I spent the first couple of years of my life there.

SPEAKER_00 6:26

So your father was in D FAT for foreign affairs in those days. Correct. Um how long did he uh work in that organization?

SPEAKER_01 6:33

Oh, it was only a few years. I d I don't think it was more than three years or so. He um he tells me of his time there as a uh a problem solver. So after um Australian diplomats or Australian politicians came to Mexico City, some of them fairly colourful, can I say one in particular? Bob Hawk, for example, came when he was leader of one of the the unions and um had a colourful time when he was there, and Dad had to go around afterwards um I guess uh apologizing or making right to the right people, uh, that he may or may not have offended when he was there. Um but he was he was uh entertaining and on the flight back to Australia, uh which mum and I were on, Bob Hawke was uh apparently on this flight. This is what I'm told by my parents, and he was in the p pointy end of the plane. My mum and I as a baby were at the back. Mum had to use the bathroom and Bob saw Mum holding me as a child and offered to look after me for the few minutes and mum had to use the bathroom, so I was in Bob Hawk's arms for a few minutes when she went to do that.

SPEAKER_00 7:39

So how long so your father was in D FAT, uh how long and so he was there for a while.

SPEAKER_01 7:43

Did he then move up move away from D Fat or Yeah, so Mexico City was uh a a big city back in the seventh, it's still big now. Um didn't have the same sort of crime issues that it does now, but it was polluted, it was hard to get around, and I think dad being fairly conservative and new to having a uh a young child thought life back in Australia would be better, so uh he came back to Australia, came out of um foreign affairs and moved into public service.

SPEAKER_00 8:11

Was that based in Canberra or elsewhere?

SPEAKER_01 8:13

Yeah, it was based in Canberra. Um mum my mum is Thai, so she came out to Australia as part of the Colombo Plan. Met my father in um Western Australia. She was a mother um not working at the time, but she has a background in architecture. So she was um when she was raising me, she was back at uh CCE or can community uh college at the time, getting a a further degree or a degree in um material restoration, paper conservation, which she ended up pursuing a career in, but back when dad was a junior public servant, mum was not employed and we were growing up in Canberra um with her going to uh C C E classes at the time.

SPEAKER_00 8:55

So you were a Canberra lad? Yes. And you said to me that you could remember way back in in your childhood as and in the early schooling time. Which school did you go to in uh in Canberra? First off.

SPEAKER_01 9:06

First off was uh a primary school, Urambi Primary School, which is out in Canberra. Uh don't think it exists anymore. I think it's all been demolished, but uh that's where I went from kindergarten or preschool through to year three. And then I went to Morrison Primary School and Torrance Primary School.

SPEAKER_00 9:26

So what was Canberra like in those early days?

SPEAKER_01 9:28

Oh, it was terrific, Michael. It was Canberra in the seventies and eighties. Our neighbours in Canberra were Vietnamese refugees that had just come over. Uh pretty uh horrible to times back where they were. I remember the one of their sons telling me about pirates that came on board and raided their boat on the way over. Um the smell of cooking from their house was amazing. Um we played on the streets till sort of sunset, uh rode around on our bikes. Uh it was just an innocent good time. I just I I can't think of a a happier childhood, you know. I compare it with kids growing up today and the stresses they must have with technology, social media, and the the stress the parents must have, and uh I just I think I I I grew up probably at the best time, you know?

SPEAKER_00 10:16

So you went to preschool in Urambi. What about high school was that also primary school?

SPEAKER_01 10:21

Uh so yeah, um primary school was till obviously end of year six, and then I went to uh Canberra Grammar School.

SPEAKER_00 10:27

Well we'll we'll we'll focus on the primary school. Yep. Was that a uh a mixed school in a sense you had Vietnamese neighbours? Was this a school with a multicultural background?

SPEAKER_01 10:38

Yeah, it was the the Urambi primary school was uh local government primary school that took kids from all over the neighbourhood. I left there when we moved house at sort of end of year three. So I I can remember it was it was mixed. Um the next school I went to in Mawson was another local government school, um, and that just took in the local kids. It was a bit smaller, uh it had mixed classes and the classes were combined, and it was suggested to me after one year that I should go to the bigger catchment school of Tyrants, but all of them were just local government primary schools, um mixed backgrounds, you know. My best friend in one of those schools, his dad was a a bus driver. He was it was all you know, just a local suburban school.

SPEAKER_00 11:26

And what what were the teachers like? Did you find any of the teachers inspiring or or were they just you know came to school, came to work?

SPEAKER_01 11:35

Absolutely. My second grade primary school teacher, I'm gonna say her name, Mrs. Wright. I'll I won't mention her first name. Uh she's still alive and well, and I still have the privilege of seeing her when I take my dog for a walk. And she was recently uh my guest of honour at my 50th birthday last year, so uh my second grade primary school teacher is truly inspirational. She has done a lot of things outside of teaching, um, and to this day is still very whenever I talk with her, even if I'm just walking the dogs, I'll learn something new. So um she's got a very strong history in science and science illustration and music. She taught me recorder. Uh she still runs recorder teaching classes around Canberra. Some of my patients go to her classes so they know if they're listening, they know who I'm talking about. Uh yeah, so very much uh on the forefront of my existence still.

SPEAKER_00 12:27

She was inspiring and did she go beyond the norm that you would expect of a teacher?

SPEAKER_01 12:31

I I didn't know at the time. I was only seven when she taught me, but looking back definitely, um you know, I think uh just her approach she says to me now that that was her first year of teaching, was our year. She didn't know what she was doing, and she got even better after us uh because she knew her way. But um yeah, I I met her now and I can see just how dedicated she is to everything and teaching in general and acquisition of knowledge, curiosity, all those sort of things. She fostered that in in the kids.

SPEAKER_00 13:02

Were there any other teachers in primary school that were of a similar ilk?

SPEAKER_01 13:06

Yes, so um my my principal at Torrens Primary School, I can't remember his name, which is terrible. I I left Mawson Primary School, went to Torrens. He took the time to take a few kids for chemistry lessons at lunch breaks. Uh there were some of us I think were a bit under stimulated and would have got into trouble otherwise. Uh he could see that we needed something else, so he held fairly rudimentary chemistry lessons at lunchtime once a week. Um and I think we covered most of the year seven, eight curricula, uh just in year six, and uh I thought that was very good of him. There were four or five of us that were clearly interested in science at that age, and he uh made the time and uh I'll I'll always thank him for that because when I hit high school, the first couple of years of high school, you're distracted by being at the bottom of the heap in a potentially intimidating environment. Uh and to go into something that was sort of familiar educational-wise, uh help with confidence, that sort of thing. Philip, why were you interested in science? Well, Dad uh Dad, despite uh his um being in the uh uh foreign affairs and and public services, his background was uh organic chemistry, so he he is a true scientist within him innately. Innately um Mum had an architecture background, both of them science. Uh it was I guess it was just something that I was brought up with and found interesting. You could see things, phenomena around you even as a child, like a rainbow, uh, and wonder where they came from. There's a scientific explanation for that, so uh and dad would help me with that.

SPEAKER_00 14:43

Well, some families when they h go home at night and sit down at the dinner table or or sit around for lunch. They'll talk about sport and they'll talk about other just social activities. What was the narrative like around the dinner table with your mum and dad?

SPEAKER_01 14:59

My uh my dinner table had an extra addition which we haven't talked about, but my Thai grandmother lived with us for most of my childhood, so uh she spent increasing parts of the year uh in Australia and she became a resident of Australia. Um she and mum would converse in Thai. I would learn Thai just listening to them. So it would be a combination of listening to Mum and my grandmother gossiping, talking about food, and then dad coming home and we'd then talk about work and mum was uh she you know the first first conversations, first few years of my childhood uh growing up, mum wasn't working and then she was working. My sister came along, she's four years younger, so just typical conversations around the dinner table but interrupted with uh conversations in Thai about, you know, what my grandmother had cooked that day and what mum was uh gonna make the next day, that sort of stuff. Uh we didn't focus too much on asked it to be the usual conversations, how was your day, what did you learn today, that sort of thing. But uh if there was any questions about anything, uh Dad and it was usually dad was the academic out of the two who would spend the time to you know, sometimes to his frustration, try and teach me things like algebra. I was never particularly good at maths but science I was pretty good at.

SPEAKER_00 16:20

So you've got a a mixed cultural family with your grandmother being there. Yes. Was there any opportunity or did your grandmother or mum talk about the cultural Thai cultural issues or cultures in a sense?

SPEAKER_01 16:34

We didn't talk about it formally, but um I think intrinsic anyone growing up in an Asian household um learns the values. I and I I d I p I know when other p people my age talk about looking after their parents in their old age, particularly as the oldest son. Um that's not even something that I even have to conceptualize. It's just a given. It's intrinsic within me and it's not even an issue. And I wonder how did you learn that? Is that something that your family brought up with you, or did you just learn it? This is what I'm thinking to myself when I'm talking to them. And I suspect it's just uh a a a uh a part of being in an Asian culture. I was lucky to go to Thailand, I met my grandparents and observed how Thai's treat each other. So even though we didn't formally talk about it, um I think there was an increasing awareness about how to behave, how to treat your elders, your senior uh family members, how to treat others. Thais uh Buddhists in general, and there's a philosophy about how to live your life, how to treat others, um reincarnation until you reach the highest level and are released from it, all that sort of stuff. Uh so I think uh that that was important in in in how I grew up was just observing that.

SPEAKER_00 17:56

Well coming from a a mixed family and being in Canberra, was there any sense of people seeing you differently from people from uh uh a family from perhaps not culturally diverse?

SPEAKER_01 18:12

I don't remember any situations where that troubled me or got in the way of my existence. Um I think it may have been only in the very early years. I don't look particularly uh Asian, I guess. Uh most people look at me and they they if they had to have a guess they might say Middle Eastern or European or something. I could just disappear into anonymity. But uh I don't think there was ever I never felt any sensitivity about any racism or cultural prejudice or anything like that. I c I could speak Thai, but it was really only with my my family that hurt it. It wasn't like there were other kids I could speak with at school. There weren't many there were no other Thai kids in the school other than my sister as I grew up, so I I never it was never it was never something that was an impedance or hassle to me or anything that I was embarrassed about as a child. And it was only something that as I grew up it was a something to be proud of, you know. So once you get to about thirteen or so, you're you're proud of having that diversity in your upbringing, that awareness. And it's not it's it's more like you feel privileged that you you have an insight into something different that n that not everyone uh gets that gets that insight. If it's just a straight Anglo Saxon, white Anglo-Saxon upbringing in a middle class school here in Canberra, you c you can you can e you can possibly uh not not see that there's more out there.

SPEAKER_00 19:43

So now you've you've you said you're keen on science and you have you were privileged to have a couple of teachers and one in particular that was enable was enabling your knowledge to to be gained in that area. Was there any activities or any interests outside of school at that time?

SPEAKER_01 19:58

I was never sporty, let's just get that out there. So it wasn't like I played a lot of cricket or anything like that. Um I I did scouts, but it was more because my friends at primary school did that. We just got up to the usual stuff, um shooting things with slingshots, uh having contained small campfires, you know, pretending we're explorers in the bush. Um I guess uh I I used to make things, uh I still do, um, but uh rudimentary stuff out of wood and timber, things that I collected uh from there, you know, when I went on a walk with the the scout group, um drawing, that sort of stuff. Um it was it was a very physical, tangible life. You know, I look at kids growing up now and there's a lot of screen time. When I grew up that w that wasn't around. It was uh you either sat inside and watched daytime TV, of which there were two channels or you got outside and you did stuff, you you went and did things with friends, or you made things, or you created things, you you drew things or blew things up, you know. It's just that's the kind of kid childhood I had.

SPEAKER_00 21:03

So now you've left primary school, you're going into high school. Now you're saying that you went to a private school?

SPEAKER_01 21:08

Yeah, so my parents gave me the decision at age twelve at the end of year six, you know, do you want to go to local high school, which was Melrose? And um or or do you want to go to the private school? I I was I was happy to go to the local um government school. It was a fine school, I had a tour of it, and I'm sure I would have done well there or or done okay there. But I think my parents being uh as they were just wanted to provide for me the best they thought they could at the time, so they sacrificed a lot and they sent me to the the private school of the of the time, which was Canberra Grammar School, which has since then has become a beast of a school. But back then it was um not as uh intimidating as it is now. But it was still a sacrifice for my parents to send me there.

SPEAKER_00 21:51

And that was a a all bo a all boys' school.

SPEAKER_01 21:55

And what was that like? Oh, look, uh you know, I I my hallman's a And particularly kicked in by end of year six, so uh to go to an all-boys school and not have girls around was not a big deal. I think when the hormones kick in around puberty, you know, I b it was okay. I mean w the boys behaved. I was in a uh combined orchestra or or a band setting, so occasionally we did things with the um the the local private girls' school. So it's not like you didn't see girls as a species. Um there wasn't much interacting with them. Uh I didn't see it as um as as as uh too detrimental to my existence for the six years that I was there.

SPEAKER_00 22:39

And from an academic perspective, were you able to take your your interest in science and other areas of of knowledge forward?

SPEAKER_01 22:47

At that high school, yeah, definitely. Um I I studied the most science units I could. I had a very good chemistry teacher at that high school, Mr. Gilmore was his name. But the education at at grammar back then, I'm sure it is now too, uh, was very good. Um science was was um was well taught and I enjoyed it. So why was that teacher special? He he was just entertaining. Uh he took me for I think it was year twelve was my HSC year, and he was very laid back. He was sort of had a I think he was Scottish was his was his background, but he just sort of had a very laid back sort of sense of humour about him. Um and wasn't like he enjoyed watching you fail, but when you got something wrong, he'd let you go into it a bit and then reveal, you know, the right answer, I I guess. But Mr. Gilmore just uh clear cut, um not too stressful, never angry, sense of humour. Yeah. As fun as you could make a year twelve chemistry class, he he was able to do that.

SPEAKER_00 23:47

Were there any other teachers at all in that in that group of of of educators that also were of of had a positive impact?

SPEAKER_01 23:55

Yes. So the my physics teacher, uh Mr. Werner was his name, he was he was entertaining as well, um in a different sort of way. I I I occasionally mucked up in the in the physics class and I would stack power bank transformers together, and uh I think I had about five or six of them connected in parallel, so it was a huge amount of current, not high voltage, but I I set it across a pencil lead and it was essentially a arc lamp at the back of the classroom. The back of the classroom lit up like the sun and he just closed the divider in the classroom and just shut me in the back of the room, didn't say a word. I thought that was very calm of him to do that. Um I had a few other teachers. Mrs. Haynes was my welcoming year seven teacher. She was an English teacher, she never taught me, but she was the I guess the uh the when you start at a school you have a a mentor class or a um oh what do they call it? Um I think it's just a personal well-being. It's like a a home group. And she she was she was very gentle, very kind, um, English teacher. And uh I remember her fondly. She's no longer alive, but just very respectful and um could sense that we were all a bit scared and we didn't know how we fit in in this sort of prestigious school. So Mrs. Haynes, yeah.

SPEAKER_00 25:17

So you mentioned that you were involved with the m we in a music environment with a band. What was your instrument?

SPEAKER_01 25:25

Uh so I I wanted saxophone and of course I didn't get that. My next choice was trombone and I didn't get that. So I ended up on trumpet for six years, but later on I played bass guitar, so that's that's what I w enjoyed playing as well.

SPEAKER_00 25:40

So was that a an a an escape from the academic side of that part of your life?

SPEAKER_01 25:45

Yeah, look, it was it was in the early years it was part of part of what the school offered you. You had to do a music I think music was one of the options or drama was one of the extracurricular activities you had to do. Uh I chose music and I enjoyed it. I'd I'd already had been learning piano as a kid, uh so playing the trumpet was interesting, it was a bit different, and then the bass guitar is something I actually really enjoyed playing, so that was that was uh an additional thing and I played in a a band of a few other students and we we played locally at a at a at a pub actually in Marnica.

SPEAKER_00 26:19

So you're you're getting towards the end of your high school in in year twelve, I'm assuming at that stage. U what if a career counsellor came along and said, Philip, what do you want to be when you leave school and what what are you what are the marks you're aiming to achieve? Yep. What was in your mind at that stage?

SPEAKER_01 26:37

So I I was lucky um going into high school. I knew I wanted to do medicine. That was something I had I had realized when I was a primary school kid, and I I saw the the origins to this. People say, Oh, when did you decide you wanted to do medicine? I c I remember the day, and uh the day was uh in the middle of a summer holiday when cricket was on and dad was watching that, and in between the cricket or sort of as part of the program filler for the holiday periods, there was a British documentary show called Your Life in Their Hands, and it was filmed in a cancer hospital in the UK, and it was all camera on the ceiling of an operating theatre looking down, and it was women with gynaecological cancers like ovarian cancer, um, uterine cancer, and they filmed the surgery from above, and you could you could watch the surgeons doing their surgery and talking, and uh it wasn't glamorous back in the 80s when this show was on, and a lot of the patients died, uh, so it wasn't like the modern medical shows where which are a bit glam. Uh, but I remember watching that, and it was only four episodes, I think, and it was narrated. And I finished the last one and I said to dad, Oh, that's that's what I want to do, and he goes, What's that? I said, I want to do this sort of work, you know, doing operations and surgery and stuff. And Dad said, Oh, you're fair way off that. There's a bit of work you need to do before then. He said, You've got to go to school, you've got to come first in your year out of a hundred, and then you've got to go do a degree, and it was all laid out. So I hit year seven knowing that that's ultimately what I wanted to do. Um, and uh it gave me a it gave me the motivation. So there was always the motivation, knowing through my six years of high school that I had to get a certain mark at the end of it to then go on to university. So, you know, it it sort of uh it was it was I wouldn't say it was a guiding light, but it was something to aim for for the whole time.

SPEAKER_00 28:25

Well, on that note, we're going to pause, we're gonna play your second track, and then we're gonna talk about university and where your professional life took you. But would you like to introduce your second track? Who is the performer and why did you select it?

SPEAKER_01 28:39

So the performer is a band called the Sneaker Pimps, and they came up with this song or released it in 1996. Uh it's just a nice sounding song, and uh reminds me of my university days. It's a trip hop beat, and uh whenever patients hear it in the operating room, they all all comment on what a great song it is and how they haven't heard it in such a long time to enjoy.

SPEAKER_00 32:34

This is the Confeder with Michael G, and tonight we have Philip, who is a s plastic surgeon who has spent some time in Nepal. We're gonna talk a little bit about that as we progress in part two. But Phil, which university did you go to?

SPEAKER_01 32:50

So, Michael, back in my days here in Canberra, the options uh for a medical degree were undergraduate and they were all out of Canberra, so uh I ended up at Sydney University uh uh for my undergraduate medical degree.

SPEAKER_00 33:05

And at that stage were you looking at a specific discipline in the medical sphere, or were you just open to any areas of uh of uh medicine?

SPEAKER_01 33:16

I was completely open at that time. I hit medical school and the first couple of years were very dry, they were sort of almost science degree subjects. Uh but as we transitioned into the more clinical stuff, I really enjoyed neurosciences. I thought of doing neurology. Um I liked ophthalmology and psychiatry, but I almost failed those exams, so that discouraged me. Um and then as I became when I became an intern, I thought gastroenterology, which is a mixture of medicine and some interventional work, you can do the endoscopy, that sort of stuff, that really appealed to me. Uh, it was not until I hit my rotation in plastic surgery, which was not something I'd ever really thought I would do, that I realized I saw one particular operation late in the evening. I was the intern on the ward and I got called down by my registrars to help out in theatre, and they were doing a uh head and neck reconstruction for a tongue cancer, and they'd taken a bit of forearm skin and had connected it microvascularly to the vessels in the neck, and they were releasing the clamps off that, and this little patch of skin in the mouth became pink and alive, and I just thought that was the coolest thing I'd ever seen. So that was my eureka moment.

SPEAKER_00 34:30

So, Philip, we let's go lap back a little bit. In part one, we talked about the the spark or the the thought in your mind about being a doctor. You then go into university. Uh did you w when you were studying the first couple of years, did you think you made the right decision?

SPEAKER_01 34:47

Uh the first couple of years of studying uh it's just rolling chaos at university. Michael, this is back in the nineties. It was just uh it was I was away from home, living on campus, it was just uh a blurry haze of beer cans and headaches. I I I I really enjoyed my entire university time. I mean the the first the whole thing, I look back, it was great. Yeah, I I was I was in a big cohort of students. I think there were 240 of us in my undergraduate year at university. I lived on campus at uh Wesley College, one of the residential colleges that was a um um not overly religious co-educational college at the at the campus was pretty balanced uh group of people, mostly from out of town country people or out of area. Uh it was it was really good. And as the uh as as we progressed through our degree, we um we moved sort of groups, we we got hospital rotations and um I made some very good friends.

SPEAKER_00 35:48

So you and and in that period of time you've got people within the university that can leave an impression. Yeah. And as you said, you went into some rotations at hospitals. Yes. Looking at the university, was there any group or person or ind individual in that sphere that really had an impression on you personally or professionally?

SPEAKER_01 36:09

There w there were some people that um that were students, uh so there there were there were there were eccentric professors that uh had catch cries and they were very um well known, they're legendary, and they you know uh what they would have a catchphrase that we all knew and were true. But uh probably probably some of the more interesting things that had an effect were other students. There was one guy who had cystic fibrosis and um he was gonna be lucky to even finish his medical degree. I mean, cystic fibrosis uh even now is not something l people live a long time with. Um and here he was uh getting through his university degree um without even knowing if he was gonna finish it. But to see his sort of resilience as he got through it, and he did finish his medical degree, um I I found that very powerful because I I could see him every year. I mean our professors and teachers changed every six months or semester. Um but to see him turning up and getting into things and living the life, I thought that was that was pretty inspiring. Um there was another there were there were guys that, or guys and girls that did exceptionally well and just their academic prowess was impressive. Going through the hospitals in my clinical years, just meeting surgeons who are now legends. So uh, you know, as a student I stood in an operating theatre where the surgeon was Chris O'Brien, who is now past, but went on to was doing a lot of great work at the time. Um I'd go to meetings as an intern, and someone presenting was a guy called Richard Scollier, who later on uh went on to greatness. Uh, but I got to see these guys when they were at the peaks of the well, Richard was still, I think, a registrar when I saw him, um, and Chris O'Brien was probably in his forties and at the peak of his career. Um, so seeing people like that, I I was based at RPA in Sydney, which was the hospital I was a student at, and I uh a lot of the people there were working at just such a high standard, which I didn't appreciate back then. But looking now with some experience behind me, I can see that they were luminaries in their particular areas. So as a student, look, yeah, they were entertaining professors, but deep inspiration more from the the other students that were uh, you know, had another life. Um and um I guess later on, yeah, working at RPA, uh seeing some of the the the big names at the at uh doing their thing, you know. It's uh I I had a great, great university time and was exposed to a lot of things, so it was very privileged.

SPEAKER_00 38:47

Part of a job of of a medical practitioner in in all disciplines and some perhaps not in others, is what they call the bedside manner. Engaging with people and understanding half the problem is not necessarily medical but it's perhaps psychological. Did you get the right grounding and was there opportunities to get the grounding in those m in those hospitals that you were being a early days of your career?

SPEAKER_01 39:16

It's not something that's ever formally taught. You might be surprised there's no classes on uh bedside manner, though there probably should be. I mean we we we have uh back when I went through there was uh behavioural sciences, there were theories of you know empathy and sympathy and uh but communication was never taught. Um I think I think a lot of how your bedside manner is is uh obviously there's a uh there's components to it. So the ability to articulate and communicate, uh the ability to um simplify or uh condense information that you want the patient to know. Um you need to have uh uh an empathic feeling with your patient as well. Uh and that has to be genuine. And you have to have an interest in your patient too. So every patient I see I genuinely have an interest in. Um and I think if you can square away those things, your bedside manner is going to be pretty good. So um I don't know, how's my bedside manner, Michael?

SPEAKER_00 40:15

I I say it's quite good, sir, unless you're giving someone a needle in their ankle, then it's probably it is wonderful good, sir. And part of the part of being a medical practitioner is that ability to communicate. Now, you said you wanted to follow into plastic surgery. Yes. What was how did how did you get how did what was your journey like to become a plastic surgeon?

SPEAKER_01 40:38

So um I think I think for me it was it was it was again, I was lucky, so I had a um uh a target to aim for. I saw that operation, I thought this is amazing. Uh the operation I saw was a a reconstructive operation after cancer. Uh it was not cosmetic surgery. Um I later became uh part of the selection committee for younger pip young people wanting to get onto plastic surgery training program, and I was dismayed that a lot of them never had a eureka moment. You could say to them, what was you why do you want to do this specialty? And it's like, oh, I like the lifestyle, or you know, it's something like that. But maybe one in ten said, Oh, I saw this operation, it was a finger that would have been cut off, and the guys reattached it and it was alive. And you know, for those people that had a Eureka moment like that, um they were always going to get on. It was always so back back when I was applying, it's it was like with any specialty program, the number of people that want to do it usually exceed the number of positions, and each year there are a fixed number of positions, and it's usually probably about a a one in six to one in ten ratio of applicants to positions, maybe even more. Um I was lucky, I I I applied from outside of the New South Wales uh training program or the New South Wales selection committee. I was I was relatively unknown, and I was very fortunate to get on in my first application. Uh, and then it was four years of training um and then a year overseas as a as of um doing an extra six months. I went to Barcelona for my six months. But some people apply many times to get on. Uh they may spend uh a few years building up their experience or or moving around. I think I was advantaged because no one knew me, so I hadn't offended anyone yet that was to come.

SPEAKER_00 42:35

Um so Philip, were you going straight to private practice or were you working in the public uh domain?

SPEAKER_01 42:41

The f the first all throughout your training is is mostly in the public domain. So uh big teaching hospitals around Sydney and then when I finished my training, uh I worked at uh RPA in Sydney and Concord Hospitals, they're both public hospitals. I was uh a VMO at both of those for sort of fifteen years.

SPEAKER_00 43:01

In plastic surgery, you can focus down on perhaps reconstruction and following an accident or body enhancement. Yes. In your practice I've noticed that it is focused more on the medical side, not necessarily on the cosmetic side.

SPEAKER_01 43:20

Correct. Yes, why was that decision? I always found the reconstructive side of plastic surgery um appealing. It was what I what attracted me in that operation I saw that that motivated me to do plastic surgery. Um the idea of the cosmetic stuff just never appealed to me. The work itself, um you know, you go to conferences and and the people presenting make a big deal about what they're doing to refine the nasal tip or you know, m sculpt the perfect shaped whatever, but technically it's it's not that interesting. You look at the people that have a big cancerous section. For breast cancer or head and neck cancer. And the reconstruction for that is three-dimensional. It's using different components, a body type. You might be using a bit of bone for the jaw bone. Then you need some skin for the inside lining of the mouth. And then microsurgically attach it. I mean, the it's it's Formula One car racing builds versus, you know, a high secondhand high undo. You know, it's sort of uh completely different uh levels of um challenge, I think, in the reconstructive stuff. You know, the stuff I do, skin cancer stuff nowadays, it's not that hard, it's just skin deep. The I think the patients are also different. I mean, the people that are coming in for I'm just being very general here, not wanting to offend anyone, but the people who are looking just for cosmetic enhancements, um, I don't know, it's it's it's hard to be always empathic with people who are pointing at something on their nose that I can't see. Uh genuinely, they look fine to me and trying to generate empathy uh and connect with them. I they they can be hard work sometimes. If you can't see the patient's problem, it's hard to treat them seriously, you know, and effectively. There are people that make a lot of money off uh I guess not insecurities but things that are not that serious and foster that. Uh I find it hard to do that.

SPEAKER_00 45:20

Now, Phil, in in your uh CV and on your webpage, it makes reference to Nepal. Yes. Was there a length of time but in your professional career before that work started, or was it a gradual exercise?

SPEAKER_01 45:36

So when I when I was uh when I was a registrate up here, so I was almost finishing my training at Royal Prince Alfred Hospital in Sydney, uh one of my senior members of department, senior colleagues, he had been going to Nepal for volunteer work every year, and he was presenting slideshows upon his return, and it wasn't with a big well-known charity like Interplast or something like that, and he was just going on a very low budget, pay your costs yourself. Pretty gritty, pretty basic. And he was doing surgery that was not particularly glamorous, so it was Burns reconstruction. And uh, you know, with the clef lip and palette, um you see the kids with their clef lip and then they get a photo afterwards and they're smiling, and it makes for great PR and it's great work that a lot of people are doing, but the Burns stuff's not glamorous. Uh Burns, even after they've been um surgically corrected, still don't look pretty, but functionally that um there's a good result. So I was seeing him come back uh with his presentations, and one year I worked up the courage to say, Can I come along? Do you think I'm good enough to contribute rather than just be a dead weight? And he said, Oh, that'd be great. So I went as a registrar uh with him, and later on um when I was a consultant, we were sort of at the same level, he didn't have to supervise me. And then um he eventually wound down and no longer did that trip, so I went and I took other people with me. So there were other surgeons from around Australia and I took a registrar with me as well, or registrars. So it kind of it sort of got passed on to me for a while. I probably went about ten times over twelve years.

SPEAKER_00 47:18

And what was the journey like over there? You would have you you know, your experience of medicine here in Australia, first world country. Yep. What was your first impressions when you started to work professionally in Nepal?

SPEAKER_01 47:32

Oh look, it was it was interesting. The hospital we worked at was a seventh day adventist hospital outside of Kathmandu. So uh it wasn't in downtown crowded Kathmandu at a big public hospital. It was in a facility facility where the charity organization could donate to hire an inverted commas a award and a operating theatre. So the people there are extraordinary. That's the thing that I always remember about Nepal is the Nepalese people. Uh I got to know them over my time there, and I have friends there who work at the hospital or supported our our missions there. Really basic stuff like the anesthetic machines in the operating theatre are donated by the Japanese, so all of the writing on them is is in Japanese, so you it's uh stuff like that. Uh we use metal pins for pinning bones, and in Australia you just open up a packet and it's specifies length and quality. In the pool you actually cut a piece of stainless steel yourself and you take it to the bench grinder at the workshop at the back and you grind the point onto it. They then flash sterilize it. To drive those pins in in Australia you've got a hundred thousand dollar K-wire driver. In the pool we have a cordless drill from Bunnings that gets dropped into a sterilised cloth bag. So you can get the job done and you can get it done very effectively, uh, but you're running at you know one fiftieth of the cost here. It it relies a bit on innovation and uh I guess a bit of uh innovation as well.

SPEAKER_00 49:02

You know, so not all operations are successful. What sort of pressure did that put on you, you know, knowing that you're going to be there for a short period of time and you couldn't just stay?

SPEAKER_01 49:16

That was very much a issue that I I identified for myself. So um we we would see the complicated patients first that we anticipated may require revisional stuff, and then towards the end of our time we were doing very simple things that we knew had a very high success rate. So just um there are ways of treating burns. Sometimes you can just cut the burn in a certain way and restitch it slightly differently, uh, and that that's called a Z plasty, there's no grafts involved. Other times you need to take bits of skin from one part of the body and transplant that to another, and there's five days for that process to take. If the graft doesn't work at day five, you then might need to do it again or clean up the wound. So all the complicated flaps and graft procedures we scheduled early. Uh, the first day of the trip is always seeing all the patients that were potentially going to be treated by us. So we didn't operate on everyone. Um in the weeks leading up to our time there, uh people would go out and recruit patients or find patients, and they'd catch buses to different parts of Nepal and put out the word that we were coming to do burn surgery, and these patients, some of them would catch a bus for five days to get into Kathmandu, and they were assessed by us on the first day. We might look at 200 people. Of that 200 people, 50 might be appropriate for surgery by us, and then we would uh triage them uh in order of complexity from highest to lowest over the next preceding or then for the following five days.

SPEAKER_00 50:49

Now, working in another country and in particular a country that area, and some people might say a less developed country, did you have any issues with the government, the politics, the administration systems?

SPEAKER_01 51:04

Definitely. What were they? Uh Nepal is uh uh generally it's a it's a it's it is a developing country and uh it's right next door to India. I noticed over the time I was there over the twelve years, um it seemed to me that each subsequent trip, sadly, it just was getting a bit dirtier and a bit more polluted each time. And you hear stories over the border with India's generally improving economic situation, Nepal just seems stalled. Um I think that if you look uh objectively at it, there's corruption in a lot of developing countries and uh corruption I think was this is what my Nepalese friends were telling me was very rife at the time, and I think that came to a head last year with some riots. Uh but Nepal was in a sort of a funny place. Uh the king had been murdered by his son t ten years ago or before we started. Uh a government was in place, but there was a a lot of corruption, so uh investment from outside Nepal. Um there was reluctance if there's a corrupt government you're not inclined to invest. Uh China was starting to make inroads. I used to it was interesting to see the the trip it took us, the time it took us to get from Kathmandu to our hospital, the first time I went there was two hours, and it was a single-lane winding road up a mountain in the back of a bus. Uh by the time my I went last time the Chinese had funded a a dual-lane high, you know, highway, and the trip was 25 minutes, 30 minutes. So you could see over that time the investment changing and the uh the hopefully, you know, some of the basic infrastructure was improving, but corruption was always a problem. And towards the last of my trips, they were trying to make money off uh medical teams coming in by charging import duty on the materials, the uh sutures and the dressings we were going to use on patients there. So they'd say you're bringing medical goods in even though they're di consumables, and there was attempts made to pay import duty uh on these materials at the airport, you know, and it's like, oh, that's ten thousand dollars, and it's like, well, we've only got a thousand, it's like, well that'll do. In you go, kind of thing, you know.

SPEAKER_00 53:17

So Philip, you mentioned before we kicked off the program tonight that you had involvement in the public system. Yes. A a number of medical practitioners that have been guests on the program have balanced their private and their public activity. Is that the sort of balance that you're happy with?

SPEAKER_01 53:38

I I I was doing that in Sydney um uh up until my move back to Canberra a few years ago. Um and probably seventy percent of my work was in the public up in Sydney and thirty percent was uh private. I didn't do that much cosmetic stuff in Sydney. Uh coming to Canberra, um, you know, I I guess I had a midlife crisis, I guess you could say, and um I it was sort of around the time of COVID, and I I my parents are still alive here. My sisters here, my family's here. I'm not married, I don't have kids. So it was where do I want to spend the rest of my life uh professionally? So coming back to Canberra was a chance to be closer to my spiritual home, which is here. And uh the kind of work I do now is very different. It's still I think it's still good work, it's still cancer work, but um, you know, it's it's mostly eight to five, it's no on-call, I don't have to go in in the middle of the night for something major. Um the things I miss about the public is is I guess the scope of work is uh, you know, I choose the work I do now, but it's certainly not as exotic as some of the stuff that used to roll through the door up there. The other thing I miss here, uh not being in the public system, and this would be a reason I would go into it, but there's more to it, um, is the teaching you get to do. So I used to enjoy having registrars and trainees come through, and it's not like I could ever teach them something knowledge or fact-based, you know, they can learn all this stuff, but I guess it's more just uh that mentoring and the approach. So a lot of my registrars in Sydney w had young families, you know, they were married and they had young kids and it was balancing the demands of you know, on call and the stress of that with having a family life. Um I was supervisor of training at one of the hospitals for a long time and that was my job was to make sure these guys got through and it wasn't always about their marks or their grades, it was about how you're balancing this shitty on-call. You know, your hundred hours a week, you're working twice more than I am with you know, having your new kid you just brought into this world last week. So um, you know, I I I have a very comfortable life now. I don't have to worry about on call. Um most of my work is uh it's very enjoyable and love the patients I meet, Michael. Um and I find that very rewarding, but I do I do miss the you know, the meeting up with my registrars and you know, teaching that sort of thing.

SPEAKER_00 56:00

Well Philip, given that you're not at this stage planning to go back to poor or you might be.

SPEAKER_01 56:06

Uh I'm I'm looking for something, uh but yeah.

SPEAKER_00 56:08

What what what areas of work would you like to do in the sort of voluntary side?

SPEAKER_01 56:12

Uh look, this I had an interesting proposition from a dermatologist. I won't say who they are, but they've been approached by uh the uh correctional facility here in Canberra to run a clinic because there's people there and it costs a lot of money to transport these people to the hospital. And a lot of the stuff I do I can do just under local anesthetic, and if it's a skin cancer or something simple, it doesn't take me long to get that done. And she wants a wingman to go in with her to run a clinic, and it's something I'm just floating the idea of. Uh you know, they've been approaching her, but she said, Oh, would you be interested? So anyway, that's an option that's local, it's meaningful, it's simple. You know, twenty minutes of my time can save the government potentially a lot of money transporting someone and it helps someone out at the end of the day.

SPEAKER_00 56:59

So we talk a lot about people where they would like to be in, say, ten, fifteen years' time. Do you still want to be practicing plastic surgery till you retire? What what's what perhaps are your future directions?

SPEAKER_01 57:15

I I'll definitely do this. I had a line in the sand which was sixty-five and I'm out. But as I get closer to that, I might revise that. Um the skin cancer stuff I really enjoy. I find it it's it's not difficult, it's not stressful, it's not always predictable. Uh but you genuinely usually your your your satisfaction rate, mine is pretty high with it. You're m you know, most patients with a diagnosis of cancer, if you can help them out, even if it's a skin cancer, it's a good feeling. So uh as I get close to 65, maybe I'll just do a day or two a week, you know, for a little while longer, but I it'll be it'll be plastic surgery until then.

SPEAKER_00 57:52

Well Philip, as this program is um pulled down around the world, amongst many, many countries where they've had issues with skin cancer. Yep. As a practitioner in that field, are we finding more people being aware and being uh earnest about having their skin checked, or are we ambivalent?

SPEAKER_01 58:12

I think in uh in our uh privileged society here in Canberra, most patients are aware. Uh we live in Australia, we have very high rates of skin cancer. We have a traditionally a Anglo-Saxon background, a lot of white people here, Celtic background, so they're susceptible. But I I worry a little bit about social media trends with people throwing themselves into the sun to get tan lines and things like that. So who knows what this will herald in thirty years' time. I mean, people the problem is these people doing it now for social media, they know the dangers, so they're aware it's just what are the consequences of this behaviour down the track. I'll be well and truly retired by then.

SPEAKER_00 58:55

And Philip, from a non-medical perspective, you said you were a really keen bass guitarist.

SPEAKER_01 59:00

Have you been able to put that away or are you still strumming the guitar? I'm actually getting guitar lessons now, Michael, which is why the church which we played earlier was a favourite song of mine. So it's taken me about nine months, but I can play four chords out of that now.

SPEAKER_00 59:13

Excellent, good sir. On that note, would you like to introduce your last track?

SPEAKER_01 59:17

So this song is a bit different. Uh this is uh Deep South by Leo and Bush Leo and Bushwhacker. It was a uh song just before the 2000 Olympics, which in Sydney at the time was a marvellous time.

SPEAKER_00 59:30

And why did you select it?

SPEAKER_01 59:31

It just sounds it's just uh it's uh it's just got a nice um sample, a gospel hook at the start. It goes over and over again, and I was able to buy this song on vinyl in I think it was Soho a year later, and I carried it back on my lap in economy class all the way back to Australia.

SPEAKER_00 59:49

And Philip, thank you for being a guest on the Confact with Michael G.

SPEAKER_01 59:52

Thank you.