This week I spoke with Dr Frank Brennan from Calvary Hospital in Sydney, Australia. What an incredible person. What an incredible conversation. We spoke about how his passion for Palliative Care stemmed from his Brother passing away at a young age. We spoke about his time in South Africa. We spoke about how to discover yourself as a doctor and his journey in medicine. He shared with us an incredible poem and a short story about the struggle of the dying process, not sure as the patient but also as the loved ones. We also discussed how working with people who are dying make us reflect on our own mortality as doctors.
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This week I spoke with Dr Frank Brennan from Calvary Hospital in Sydney, Australia. What an incredible person. What an incredible conversation. We spoke about how his passion for Palliative Care stemmed from his Brother passing away at a young age. We spoke about his time in South Africa. We spoke about how to discover yourself as a doctor and his journey in medicine. He shared with us an incredible poem and a short story about the struggle of the dying process, not sure as the patient but also as the loved ones. We also discussed how working with people who are dying make us reflect on our own mortality as doctors.
Support Doctors Getting Coffee:
Shout the next Coffee: buymeacoffee.com/DrSyl.AU
Become a Member: youtube.com/channel/UCiOBkubL46VQT9mPqrnJlrQ/join
Become a Patron: patreon.com/DrSyl
hello and welcome to another episode of uh doctors getting coffee dr sil here junior doctor from sydney australia
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today i'm very excited to uh be having a discussion with dr frank brennan the
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palliative care physician from calvary hospital but also working with saint george hospital
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in with multiple teams but also with the renal team now i'm really excited for today because
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i was here as a medical student i'm sure you don't remember but uh yeah i had a really
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um a special time i i you know it's not something that's covered
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a lot during medicine it's often referred to a lot of people talk about palliative care but
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the depth you don't get much depth until you come into into the hospital and and hear about just how multidisciplinary it
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is how um it's not just medical but also spiritual and and it was just it felt like a
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really wholesome time of medicine where you know medical medicine can feel like a very
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medical engineer like kind of sciencey kind of discipline but then you it really brings
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back the human element of it so i'm excited to speak to you about your life and your journey through this
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thing called medicine so thank you for taking the time well sylvian thank you for this initiative this global
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initiative and in speaking to to the group of us or collective of us um i can see great value in that and
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it's it's a wonderful initiative and thank you for inviting me to be part of this as well absolutely
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so i i was thinking maybe we'll just take it chronologically did you study in sydney or where did you
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always want to do medicine what was your journey into medicine so i suppose the journey started i can date it back from
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the time i was about 13 years old when i was 13 out of the blue my brother
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tom got a very serious illness a bone cancer osteogenic sarcoma
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between diagnosis and death was about three months so it was a very short intense period
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part of that time tom was away from we were living in canberra i was born and raised in canberra and there was at that
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stage very little in the way of radiation therapy or much chemotherapy
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available so tom went down to melbourne um and spent part of his time away and then
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came back and then eventually died at home so as a 13 year old i was witnessing all of that
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i was very conscious of how tragic that was and also looking at my own parents how they were
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responding to the loss of my brother i think um one of the things that sort of struck
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me was as a 13 year old okay of my naive sense well doctors are meant to
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cure people but tom's not going to be cured so what does that mean for a doctor does a doctor even have a role
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here and bit by bit starting to hear from particularly my mother how the doctors were speaking to my mother the
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communications which was wonderful compassionate caring um
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statements that were made and the way they were they were um discussing things with my parents i
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thought no that's that's that struck me after tom's death
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the i guess the seeing of how how my parents coped in their bereavement my mother was really safe because she had a
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a very close friend who would come and sit in the backyard our backyard with her and she would allow mum to cry and
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talk through things so this was in an era where there was there wouldn't have been too much sort of form or bereavement service at all
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and certainly when there was no palliative care that that concept had yet to be to be um talked about
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so i suppose that started getting me to think about the idea of being a doctor that the role of a doctor
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and so i did well enough in high school then to at that stage there was no medical school in canberra so i came to the
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university of new south wales here i'm sorry to slow it down but just because you're saying that your mom
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had a really good uh support network with that friend that came over how did your dad go with with tougher yeah
4:20
tougher at a different time back then it was a different time back then and i think you know i perhaps i can't speak for dad
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but it was more the sense of okay you you you've had your time at home now now
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you're back at work now you're back into the the run of things though i'm also aware
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that dad had some very close work friends colleagues who came to tom's funeral who were
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around for him so i think that that that would have been a great support to him but really nothing taking away the great
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tragedy of the loss of his son yeah yeah and has tom's
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passing influenced you like throughout your career or was it just that key point do you often you
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think it did i think it did well certainly the idea of being a doctor and then perhaps
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the germination of the idea that really didn't come to the surface for some years later
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the idea of potentially working in an area where where i'm going to be caring for people
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who are dying as i said there was no palliative care talked about or that expression really
5:24
didn't come into play for some years and at medical school there was no palliative care so it was only
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after some years that i started to hear about this new discipline that was coming through
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adapting the wisdom of the ages it wasn't that you know suddenly doctors discovered that their patients would die
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that that had always been present um but but this sort of sense of a discipline working through and working out what
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what is the role of doctors and my multidisciplinary team and that's came later for me so when you started medicine as you said
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there's no there was no palliative care um special there was no college for sure
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um what was your journey at the start of medicine were you interested in being a physician or were you thinking of oh
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look i was trying to get through my course it's like yeah trying to survive you know you know what it's like it's you know it's it's a it's a tough uh
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course and there's lots and lots of i mean it's very enjoyable working with you know starting with lots of good friends but yeah it was you know trying
6:21
to get through that and um and then you know as an 18 or 19 or 20 year old of course
6:28
you're trying to find your own way and who you are and what what other interests you might have outside of
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medicine so that was a whole story in itself just trying to think through that i'll tell you about that story well a
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couple of things one i'd always been interested in storytelling and writing so i think uh now
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hsc exams all engrossing and certainly medicine was all engrossing but i did try and start to do some short story
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writing and some other things like that um and then and then of course other things i they happen to be a
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couple of fellows and my one particular fellow in my year was very very keen on on music
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uh live music and so i started to for the first time started to listen to a bit of golden era really in terms of
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live music in this city so to go to that and then poetry and and other things starting to cultivate a little bit of
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that which was perhaps uh a fresh sort of way of looking at things
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compared to simply simply the medicine though i think i intuited any of all of that was going to be useful at some
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point in terms of life experience and having a breadth about me
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um more than the technical yeah yeah i was always wondering if may like it was
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after you did started palliative care medicine that you discovered poetry as a not a defense mechanism but as a
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processing mechanism but it sounds like actually the writing it preceded it not
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present oh wow that's very interesting so then you started as a as an intern how was your junior medical officer oh
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well that was very interesting because it was um i
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i was a medical student here at st george wow yeah the city university of new south wales then i had a myself and
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whole group had a complete change we went over to concord hospital so sydney university a very different style
8:17
and then getting to know that place now that was an interesting era because that was the return soldiers time so there
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were a lot of return or what used to be called the veterans right from from there
8:28
from welf it was set up during world war ii so it had um it was used there was a
8:34
system called the repatriation hospital system set up around about the end of the war where there was a lot of mainly
8:40
men but also women returning from the war who needed to be cared for so the commonwealth set up this series of
8:45
hospitals around the country in all the cities for return soldiers this is similar to the veterans affairs
8:53
story or administration through the united states so so i'm now then with a lot of very interesting men and women
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many of whom had gone through world war ii and then korea and then of course vietnam
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people are veterans as well all the the dynamics that that was
9:13
um great storytelling there was sort of quite a tradition of of you know how things came to pass for them and then
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eventually of course concord is now a general hospital so it's no longer at one point it was a repatriation
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general and now specifically general but it was very good working with some very good
9:31
doctors um discovering yourself as a doctor because of course all up until that time you're a student where you are
9:38
assuming what's going to unfold but you don't really know until you are in it and then
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seeing getting a feel of what that's like and the demands of that and and the hours i mean you know the working hours
9:50
and all of those sort of things but but also um you know enjoying that that greater i
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suppose accumulation of skills or maturing of skills yeah it's an interesting thing to go on isn't it it's an interesting concept this discovering
10:03
yourself as a doctor because identity is complicated and you know we are you know like part of our identities is
10:10
being a doctor it's not just a job really is it the patients you work with live with you in your in your mind and uh yeah haven't
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thought about what would be some tips you have to that worked for you to discover who you were as a doctor like what to discover what's
10:25
is it just trial and error or i think it's a bit i think it's a bit of trial and error because you can't ever
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come in with a sort of a highly sort of set sense of it you know the day you graduate you need to work into it
10:38
two i think um having people around you particularly your own peers is really helpful because you have a sense of how
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you're going three hoping for good kind seniors who are going to guide you and
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mentor you that's that's important but that doesn't always occur but when it does occur it's a fantastic element
10:58
fourthly i suppose maintaining a sense of humility because what can happen of course is society's or you're the doctor
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and there can be there is already an intrinsic sense of of of admiration of
11:12
even acquiescence to doctors and thinking well no i you know six years ago i was not a doctor i was
11:19
you know a year ago i was a medical student so now i'm a doctor and i don't necessarily feel or able to
11:26
endow great wisdom here so it's that sense of being humble in what you're doing and having a sense of that
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awesome that's why i introduced myself as a junior doctor yeah yeah yeah it's it's an interesting phase isn't it when
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people go through that and i think that that's that's a good sense of things
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but also also what i realized was this extraordinary privilege of
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repeatedly over and over again sitting with people talking with people and yes there's the highly technical
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aspects of what we do but also we have the opportunity of of seeing what what
12:02
how people tick and what's on people's minds what troubles people most now there's strong echoes of course of
12:09
as a 13 year old seeing my own parents and and what suffering was and the sense of great sadness and tragedy so so there
12:16
were echoes there at that time but also a sense that i i think this is a privilege i don't want
12:23
to i don't want to miss this or put this aside and see it only as a technical
12:29
exercise i need to see this that i'm here with people now and what people are going through
12:35
and you know the classic thing in a history taking trying to not rush people realizing people are going to sort of
12:42
talk in circles a little bit rather than going directly we want the direct answer but people will come come to the answer
12:49
people's fears and vulnerabilities even though they may appear entirely fine
12:55
that they're they're very vulnerable in their illness and certainly husbands and wives and families seeing what's going
13:00
on i mean that and also the power of our our presence our communication all of
13:06
those things became more and more evident as time went on and so you did your terms as a junior doctor uh
13:14
did you start on a physician's training pathway or go to example i didn't now it
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was really interesting because after about two or three years at concord um people seem to be choosing two paths one
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was uh training and specialty and the other was going to england this was the second thing so a lot of my colleagues
13:32
well started in physicians searching and training and then others went to england
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partly to work but to holiday or to to have a look around the place and you know do long locums and things okay so
13:45
there was quite quite a story there i feel it's the reverse at the moment we get a lot of
13:50
uk doctors traveling in australia indeed that's right so um but i thought they must i'm sure there's other other paths
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here as well so i happened to meet uh some south african doctors doctors who'd come out of south africa
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and i started talking to them and i was just struck by well i was curious about south africa but also by the remarkable
14:12
um just experience they had even as as junior well you probably know that's still the case when you hear from the
14:18
epa doctors who have worked in south africa yeah but just quickly what was your connection with south africa before
14:23
there's no particular connection right just i suppose interest in the politics and the history but no no particular
14:30
connection so what i did is i i rode across to some south african hospital saying look i'm a junior doctor i'm i'm
14:36
i don't i won't have the skills of your own junior doctors but but look i'd love to come and do
14:42
things and i was i was having done a lot of internal medicine i was quite keen to do some pediatrics and ong thinking i'd
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eventually become a general practitioner so i went across there and did a year of pediatrics in the year
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obstetrics in an incredibly busy hospital tumultuous really it was very
15:01
very busy but huge levels of experience and i was blessed also with some very good bosses
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mind you it was a tumultuous time politically as well but this is pre mandela's release oh so apartheid's
15:15
still present this hospital was mandela was in jail at this time that's right exactly he
15:20
his name was spoken about but he was he was effectively silenced and um and we
15:27
could perhaps turn a little bit to mandela later but i then um uh you know so this this was a hospital in
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a uh what they call a non-white hospital where the vast majority of those patients were poor and struggling and
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there was a lot of the socio-economic dimensions of medicine became very very evident to me like in the pediatrics
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within a week i'm arriving they said look we're running a malnutrition clinic would you like to i said well i know
15:55
nothing about that but if you and and i was brought into that um into that
16:00
sphere by a a remarkable um and quite historic doctor a woman called memphile
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renpelle who had when i first met her she was much older but she was doing a
16:11
junior term in pediatrics and i said fellow where are you from and she said well i've been under house arrest for
16:17
the last five years i thought oh god there's a history here and so she'd been a
16:22
a disciple of steve biko who was a medical student a major political figure through the 70s and and so all that that
16:30
history was sort of swirling around as well as the medicine wow
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um yeah wow it's a lot to process and how long how many years did you spend in
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two years two years longer than i expected but i was getting so much from it and i thought this is a
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fan this is a fascinating place to be um what because you know speaking about burnout
16:54
these days it's an issue that's at the front of a lot of um you know media likes to talk about it
17:00
and doctors experience it but it's kind of not as bad as it used to be i i would
17:05
think did you have some periods in your career that were like you're feeling burnt out
17:11
yeah it may not have been expressed in that way but yes the the sense of exhaustion and trying to you know not
17:17
wanting never wanting to get to a point of making a mistake or just trying to hold sleep together and and trying to
17:24
pace yourself as much as as possible um and and trying to have breaks but but
17:29
also realizing i absolutely needed to have my mind in addition to on the medicine which was terribly engrossing
17:35
on other things so that's where reading and a bit of writing but but in in that context i guess it was because i was in
17:42
that country starting to read south african literature speak you know i mean every conversation was fascinating
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really because i'm i'm dealing with people's lives in in a way that's completely
17:52
different to my own so all of that was was very very good did you learn the language for khan's
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sorry south africa has multiple different languages as you know um and so uh
18:07
the the in addition to english in this i was in a city called port elizabeth uh there
18:13
was a lot of afrikaans smoking but also there was the all the african language of that city
18:18
with a language was clicks so x-h-o-s-a so
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um becko was a classic speaker and mandela is a classic speaker so that's one of
18:30
the the many uh um uh african languages spoken there so
18:35
coming to that and and realizing i'd i'd never heard anyone speak that way because it's for it's it's lots of
18:42
clicks i thought um what's going on here this is something i've i've never heard a language where there's clicking
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um and i remember one person saying to me oh but white people can't click and i thought well this white person might try
18:54
because clearly there was very little in the way of of uh people attempt
19:00
um certain white south africans attempting they occasionally come across a striking example usually someone had
19:06
been raised in the country and they were speaking so i started to learn that and was incredibly encouraged by the nursing
19:13
staff there and being able to take a basic history and and and get a sense of things and it was um it was it was
19:19
interesting it was a good thing what was your relationship like with black south africans during this time in the past
19:25
side yeah so where well i suppose you're a doctor i was in a remarkably sort of privileged
19:31
position because i'm a doctor who's a foreigner who could step away out of that country compared to someone who is
19:37
in there so i was very interested to hear what was going on in people's lives
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the incredible [Music] structures that were placed on people for the color but because of the color
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of their skin and the historical um injustices there so so i that that's
19:54
something that i was i was very much aware of uh but also at a personal level just being able to get to know people
20:00
like for instance one of the few african pediatricians in the country was was one of my bosses so gordon de lima
20:07
remarkable fellow how he was able to work his way through high school into medical school and then to become a
20:12
pediatrician and and like rampelle i mean she had actually known ron palace so so that sort of sense of that was
20:19
fascinating and then because you didn't need to scratch below the surface say with pediatrics that you're immediately
20:25
into the uh deprivation poverty injustice you know it sort of sits there
20:31
because you know you know for instance you know or malnutrition why is that happening um and also um within a fairly
20:39
short space of time there was a lot of um police activity army activity in what they call the township so
20:45
you know nightswear will be on call whether it'd be like a bus would pull up full of children with tear gas
20:52
bringing the kids in and dealing with that so that all of that was sort of part of that work it
20:58
from a from what i was told being a fairly quiet place port elizabeth in terms of that became a a quite a um
21:06
a hotbed that there was there was a lot of political quasi-political activity and things and when you think of your
21:12
time as a doctor there is a single patients that stick with you or um was it more just the general like uh
21:19
whole experience that uh that stays yeah the whole i think the whole experience
21:24
there were times which really does strict strike to me or stick with me and that is a um
21:31
in the middle of this tumult there'd be uh people shot there'd be a funeral and
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the funerals were sometimes banned so this particular um just on the outskirts of elizabeth a
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little town called utenhag had um they'd there was a
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there was a funeral occurring there was large numbers of people coming to it um [Music]
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at a very very late moment i i think there was an official saying that the funeral can't occur so the police lined
22:00
up basically said you have to go and then there was um and there were shootings and there was a lot of there
22:05
was mass casualty and i remember how the hospital just was up ended really
22:10
with huge numbers of people there so that was a very tragic time and i thought um gee this is just really
22:18
awful for this country cry the beloved country as the famous novel says
22:24
and um and at that stage it was probably one of the nadir times in that country and i
22:30
was thinking in my lifetime i wonder if anything will change and of course not realizing within a couple of years
22:36
big changes mandela's released the negotiations in new south africa and then i went back a couple of years later
22:41
to a very very different situation met gordon de lima you know suddenly people can live anywhere they wish they could
22:48
marry whoever they wish their their so-called rainbow parliament and all with multi-colored of course so the the
22:55
sense of what is possible and and every language being given an official status
23:01
that that would have been a remarkable before and after and so then you came back to australia
23:07
between and you're working as a registrar at that time also okay so when i okay another thing that did occur to
23:13
me in south africa was that i'm um surrounded by lots and lots of nursing staff
23:19
african um nursing staff who were who were doing um
23:24
adult education at night and i found this really intriguing they were nurses but they were also doing
23:30
an arts degree they were doing all the accountancy they were doing this and this and i thought what's going on here
23:36
and of course i realized if you're an african person there you you
23:42
one of the few passages through to doing other things was further education so i started to think about that and i
23:48
thought look i'm not a south african but i'm interested in law so i might i might enroll and i will so
23:53
i did i enrolled in a a south african law degree by correspondence so i started doing some subjects there
23:59
knowing that i wouldn't complete it because i wasn't going to be a south african person uh but
24:04
and of course the the law much of the law was dominated by the apartheid stories so i thought um but it it was it
24:11
was very interesting to so once i finished there in south africa i came back to do law so i came back to my
24:17
hometown canberra and went to the anu to do the graduate law course and in the holidays
24:23
i would do um general practice locums or working casualty at the local hospital
24:29
right so i'm also from canberra uh yeah yeah so i'm born here but grew up it's
24:34
in yeah ninety percent of my life in canberra um but out of curiosity how do you find uh living in sydney compared to
24:40
canberra oh because i'm trying to make i'm at that decision point in my life now where i could go either way it's a
24:46
great question um but i do remember as a 17 year old coming out of canberra into sydney you're thinking oh this place is
24:53
so big so it's seemingly chaotic and of course
24:59
you're so used to in canberra um a lot of natural beauty a lot of natural beauty in the hills and and all of that
25:06
so it was it was it's a different place isn't it a different place here but canberra is a very well i mean a very
25:12
historic place of course the the national capital but a a good place a good place to live yeah
25:18
might try a locum year or something like that so um after you completed your law
25:25
degree and your weekends in a e what did you start in palliative care
25:30
straight away did it exist yet or how did you it was starting to be talked about and i was starting to be
25:36
aware of it um i at the end of my law degree i had a bit
25:41
of a choices to make here because i've now got the two stories unfolding i look i was keen to
25:48
mature a little bit in the law so what i did is i did the legal intern year in melbourne and then i did uh worked for
25:54
two years for mary gordon who was the first woman appointed to the high court so this sort of legal genius really um
26:01
and worked with her as her associate so that was a brilliant time in terms of really getting to know the law in a very
26:09
good way did you do law because it was so interesting or were there also
26:14
reservations with medicine was there problems that medicine that made you want to go towards or was it just no reservations about medicine
26:20
because i i loved i adored myths and being a doctor and working in that area and the skills of course but it was um
26:27
more i guess an interest i suppose that in the last year of my high school i was thinking is it laurel medicine so i was
26:34
always thinking about that i was very intrigued by the by the um the structure of what was
26:41
happening within south africa how could the law be part of this story so that got me interested and then also by that
26:48
stage i started to read more and i was getting more and more interested in the law so it was a logical progression then
26:53
to to do that so working with the judge was was wonderful and at that stage at the end
26:58
of that i started to think what am i going to do and i applied to the aboriginal medical
27:04
service and the aboriginal legal service to work part-time for both both said look
27:10
you could come and do this but you're these are very very demanding positions you can have to choose and i was missing
27:17
seeing patients a lot so i started working at the aboriginal medical service at redfern so i worked there for
27:23
three years as a gp and then during that time um tutored in law and you know just
27:28
tried to keep the law up as much as possible and do you still use law to this day or well there was long long
27:34
periods when i didn't and then um a pivotal moment came some years ago
27:39
when i was by that stage well advanced in my pal care training looking around for doing a project and it was a single
27:45
phrase in a single article and it was written by a man called michael cousins michael cousins is a or was a professor
27:53
of pain medicine anesthesia at north shore hospital and one of the leading dorians of pain medicine in this country
28:01
and he'd given a speech in the united states where he had said now he said he was speaking as a doctor
28:06
he said i put it to you that pain relief should be seen as a basic human
28:12
right now i read i read that phrase and i thought now this is really interesting this is a non-lawyer saying
28:19
this i agree with the statement but i thought something flashed in my mind as a lawyer
28:24
thinking okay justify that how can you possibly what is the justification what's the
28:30
what would be a lawyer's sense human right you know he's talking about human rights law it's a right okay what does
28:36
that actually mean and does would pain relief even come in under that so i started to write a lot about that and
28:41
over the years and then eventually met michael cousins and we started to to to write together and then have kept up and
28:48
then as years went on wrote not only about pain role management as a human right but palliative care is a human
28:53
right working in uh palliative care seeing a lot of death i was curious to know how it makes you feel about
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you know your own mortality and uh do you have any particular insights you can
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share about what working in palliative care has done for your view on life and yeah i think so and i guess that's come
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with um you know some years of experience and seeing and seeing uh patients
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i think one of the a couple of things one is the sense of how precious life is
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um and that can be as evident in a you know a 27 year old who's dying versus a 97 year old
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who's dying the sense of how precious this this particularly from the time of where it's clear that the
29:38
person is now incurable now where to be who to be with
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the sense of love and engagement and all of that i think that that repeatedly
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comes to mind because to an outsider they can look at this period as an unadulterated
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suffering or or there's an empty period waiting for that person to die but yet there's a lot of living that's occurring
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there as well and so now none of us really can live at that
30:07
intensity all the time but i guess it it's it's a just a general sense of the of how precious life is
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i guess the other aspect is the um uh
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this the importance of the importance of dignity the the
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dignity of the human person being very conscious that even in the most abject
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stories that are unfolding there or abject uh situations people still are human and
30:38
maintaining that sense of dignity is extremely important and people say to me i've lost all my dignity i'm no longer
30:45
able to bath or toilet myself look at me you know 12 months ago i was perfectly independent this is all gone
30:52
and trying to work out okay that that's all those statements are true but where is there any aspect of
30:59
dignity that's preserved here and i guess the inherent dignity the dignity of you as a human being
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this and i say to patients this disease has taken away many things from you and will continue to do that do so but it
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cannot take away who you are your your history your your the sense of who you deep down are
31:18
before this disease came on and indeed now and your legacy uh later
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so trying to reach into that is um can be seen as a bit counterintuitive
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but i think it's a very real and a very good thing to do particularly when people are in a sense of despair
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love absolutely the sense of what love can do and what what how precious that is i think that that's a very powerful
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and a a seamless sense i've had from from the time i've worked in this
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i guess the other thing that i was as a doctor fortunately being in an era where we're
31:56
quite sophisticated in symptom management being able to deal with that um now not perfect but but better
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i get but i guess your question is is a broader one about mortality isn't it well i think i think that was um very
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interesting in how patients can uh kind of what to focus on when
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you know life-limiting illnesses present but i guess more personally for you what have you changed in your life now you've
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seen good deaths and bad debts so i think echoing what i've said um how precious
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so for me holding the preciousness of life and doing my best to enjoy what's possible
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or be around a situation which is going to be affirming and good so i think that that that's given me that big lesson
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what's an example of something like that like is it just having a conversation and a glass of wine with someone you love and yeah just being present is that
32:50
the kind of thing you're talking about absolutely in ways that are uh quite remarkable when you you know you sort of
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step back and say but i'm going to have millions of that of those um interactions yes but each this this one
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i'm going to like a lot i'm going to get the most out of this one and continue to do that and i think it
33:09
one of the other aspects that is a lesson i've learned is to slow things down not to race ahead i think we're
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both of us and people on the end of hearing this would be we're blessed with very very quick
33:21
minds so i think to slow everything down it was also a good lesson for me just to think okay what's
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unfolding around here what what is important here so that that's a good thing
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and also i suppose the other aspect of that is you know with people like who are around me um you know
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um respecting them and having the having the best sense that they who they are to me i think that that's really important
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as well never taking for granted anyone and slowing things down do you think writing and reflecting is a way of
33:55
slowing time i mean that's uh something i've heard but uh has that helped you kind of slow time down in a sense yes
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absolutely absolutely yes i think i think the the role of a writer or sorry the the the act of writing or directive
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storytelling requires you to slow down because you need to think okay i can't i mean i could say it in a haiku
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you know well yes but that's barely saying anything i need to slow things down to reflect the truth of
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what's unfolded so the slowing down is a very good um
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part of writing i think yeah and it's and it gets you to think okay well at that particular point what were you
34:34
thinking or okay you're now shifting or that particular person saying a medical narrative they're shifting so where is
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this going here and i don't mean to catch you off guard or anything but do you have a poem that you have that you
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know that resonates uh deeply with you that you'd like to share or well no thank you for that this
34:52
opportunity so i'm going to read two pieces the first is a poem written by bruce dorr a very prominent queensland
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writer and it's a very interesting poem because it contains my discipline in its title
35:06
the poem is called white water rafting and palliative care for my late wife
35:11
gloria if i'd understood when down the river you and i went swirling in that boat
35:16
that there were those who knew the ways of water and how to use the oars to keep afloat i might have been less deafened
35:23
by the worry less stunned by thoughts of what lay up ahead the rocks the darkness
35:29
threatening to capsize daily if i'd only realized instead that help was all around me for the asking i never
35:36
asked and therefore never knew that such additional comfort could have helped me in turn to be more help in comforting
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you i'd had found it easier then to simply hold you instead of bobbing to and fro so much
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for it was you who seemed to be more tranquil and i whom death was reaching out to touch
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if i'd only had sufficient knowledge in that white water rafting i'd have learned that there are those around us
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with life jackets to whom i might have in that turmoil turned instead because i had not thought of
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rivers or rocks or rapids and gave way to fears that seeking help might make a
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man less manly and liable to portray himself with tears i was less useful then as twilight
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deepened than i might well have been had i but known however while the waves
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are all around us no one needs to live or die alone it's wonderful language isn't it
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it's an analogy yes and it's a great i think it's a great wonderful energy of of
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sudden you know losing you your normal life and your control with an illness your serious illness now
36:44
you're on the cascade of this river i love the fact that in that boat it's not just the patient but her husband i guess the sense of a family how death is
36:51
reaching out not only to her but to him as well that's right and also it's it's a problem of great regret because had i
36:58
about known we had no idea about palliative care until later and um
37:03
as he told me i actually contacted him to get permission to write a a sort of a pricy on that poem and he said no no we
37:10
didn't we're in he was in rural queensland they didn't know about that until later and also
37:16
the recognition that palliative care wouldn't be was not he wasn't the aim wasn't to get
37:21
them off the river was just to give them some modicum of control it's interesting but that remarkable phrase those who
37:27
know the ways of water we do as doctors hopefully we have a sense of this and so
37:33
that's a very powerful sense of trust in us isn't it yeah um okay so this now is my uh one of my um
37:41
one of my short medical narratives and the background of this is um i spent
37:46
about a year in ireland once i finished great once i uh finished my training i went over to island for a
37:52
year and now i'm entering a land of storytellers this is a very very strong
37:58
sense of uh of uh storytelling poetry and music and death and dying and a very
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deep way of looking at things so so it was fascinating to have every patient irish of course and all or i was there
38:11
in a um it was very very good so the story is
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the story is called the woman from county meath the warmth of the dublin day caught everyone by surprise through the window
38:24
i could see children playing in the garden we had walked into the visitors room the family was waiting they were
38:30
from county meath he was a farmer only 54 years she a teacher they had seven
38:37
children it was clear that he was dying he had battled seemingly intractable pain but
38:42
now over the past few days was much more settled i spoke about these days and what to
38:48
expect from this point onwards i then concentrated on the family themselves and recommended as we do the
38:54
usual things that they each take turns with being in being with him that they try to eat
39:01
and sleep that they talk to each other in short to look after themselves through this vigil
39:07
i turned to the patient's wife and said i know you've been here all the time it might be good to go and have a rest
39:13
even just for a little while there was a long silence she looked at me as though down a
39:19
passage she turned ahead to one side looked out the window then towards me again and
39:24
said no i will not be leaving him she spoke tenderly of their first meeting at
39:30
age 17 of their courting and their wedding day of their marriage and the birth of their children
39:36
she spoke in soft beautiful phrases then sentences that began plainly but
39:42
became brilliant each seemingly more evocative than the last and with every memory of their life
39:47
together each reflection she would end by saying no i will not be leaving him until that
39:54
phrase repeated became the tolling of a distant bell and then she said something that i've
39:59
never heard expressed in the same way before she said that from their wedding day they were united
40:05
that they were as the prayer states one body and that as he had fallen ill so would she
40:11
that as he was suffering so was she and that is he lay dying so was she
40:16
no james joyce no oscar wilde no samuel beckett could have put it so powerfully
40:21
as angela murphy the palliative care nurse with me in the room that day said later she was saying what he was feeling
40:30
in many ways of course she wasn't talking to us she was speaking across the vast sea of
40:35
their lives i had spoken at a practical level about rest the response i received was from a
40:42
person adrift on that sea not wanting to leave or soften the fate
40:48
too often as doctors we speak practically and are heard emotionally
40:54
and perhaps that is our role andrew and i left the room and walked
40:59
back onto the ward we were both too moved to say much later that that day angela rang me and
41:05
said frank we may never hear the like of that again when i returned to australia i was asked
41:11
to present some memories from ireland i contacted angela without prompting she said of course you'll talk about the
41:17
woman from me and in distant years if i ever were to encounter angela murphy again walking
41:24
down o'connell street in dublin or perhaps george street in sydney we would
41:30
stop and no doubt remember the woman from meath who spoke to us of a love that was boundless a union that was
41:37
indissolvable and who gave us a momentary glimpse into the mystery at
41:42
the heart of it all thank you so much for sharing that and
41:49
uh yeah many patients came to my mind's eye when i hear that uh
41:54
that story mm-hmm yeah well i think that's a beautiful place to leave it thank you for sharing your time
42:02
thank you for for the invitation to to to be part of this series and thank you for your questions it's been very good
42:08
thank you all right thanks everyone have an absolutely wonderful day bye for now