Dr Bianca Leigh Edwards, The Children's GP

What do you do when the plan you’re committed to doesn’t work out the way you’d hoped, but your sense of purpose stays the same? 

Dr Bianca Leigh Edwards - or Dr B, as she’s affectionately known by her patients -  had her heart set on becoming a paediatric oncologist even in her teens. Life, however, had other plans. 

In this episode of Awakening Doctor, we reflect on the early childhood influences that catalysed her passion and learn about her challenging personal journey with medicine. One marked by repeated rejections, years of perseverance, and the courage to keep pivoting in the midst of thwarted ambitions. 

Together, we explore her postgraduate medical school experience and reflect on the harsh realities she faced as a young COVID intern. Bianca speaks candidly about signing multiple death certificates on her first day as a doctor, the fear of bringing the virus home, the difficult decision to postpone her wedding, and the wise friends and small rituals that helped carry her through that time.

We also reflect on how motherhood has changed the way she practices medicine, and the grief and frustration of having to let go her dream of specialising due to a lack of registrar posts. An unforeseen obstacle that eventually forced her to formulate a Plan B.

Today, Bianca runs a thriving GP practice for children in Cape Town, allowing her to reframe her vocation and honour her passion in ways she didn't anticipate. 

If you’ve ever wondered whether being “just a GP” can serve a calling, or how to rebuild a dream when doors are closed and posts are frozen, this episode is for you. Join us for a thought-provoking reflection on the complex interplay between vocation, ambition, individual agency and systemic realities.

Chapters

• 0:00 Meet Dr B: The Kids GP
• 3:45 Childhood Calling And Early Loss
• 7:20 Six Years Of Med School Rejections
• 12:40 Med School As A Postgrad
• 17:20 Seeing Beyond The Illness
• 22:30 Processing Grief And Finding Purpose
• 27:00 Internship Begins In A COVID Ward
• 33:40 Breaking Bad News And Holding Hands
• 39:10 Fear, PPE, And Small Wins
• 43:30 Postponed Wedding And Cost Of Duty
• 48:00 Community Service And Pregnancy
• 53:00 Neonates, Complications, And Empathy
• 58:30 Motherhood Reshapes The Doctor
• 1:04:20 Posts Frozen: Rethinking The Path
• 1:09:00 Choosing GP With A Paediatric Focus
• 1:13:30 Prevention, Community, And Continuity
• 1:17:20 Private Practice Reality Check
• 1:21:40 Leaving Public Sector, Staying Connected
• 1:26:20 Valuing General Practice And Impact
• 1:31:10 Perseverance, Patience, And Growth

Transcript

Meet Dr B: The Kids GP

Dr Maria Christodoulou 0:00

Welcome. I'm Dr. Maria Christodoulou, and this is the Awakening Doctor Podcast, a space where we discover the personal stories of those who work in the medical and health professions. Join me as I explore the hopes, the fears, the aspirations, and the real life challenges of those who carry the title, responsibility, and privilege of being a doctor. Joining me today is Dr. Bianca Leigh Edwards, or Dr. B as she's affectionately known by her patients. Bianca has a BSc in Human Life Sciences with psychology and an Honours in Human Genetics, both of which she completed before entering medical school. With a deep-seated love for children and a passion for paediatric medicine, she has established an innovative GP practice in Cape Town, Dr. B, the Kids GP, that is committed to nurturing and protecting every child's potential through dedicated, compassionate, and comprehensive care. Welcome, Bianca. It's lovely to have you with me today.

Dr Bianca Leigh Edwards 1:05

Thank you so much, Maria. So lovely to be here.

Dr Maria Christodoulou 1:07

Yeah, absolutely. We've been trying to make this happen for a while. So I'm happy that the day has finally arrived.

Dr Bianca Leigh Edwards 1:13

Me too. I'm so glad we finally got to align the calendar.

Dr Maria Christodoulou 1:17

Yes. So perhaps I can ask you, where would be a good place for us to begin telling your story?

Dr Bianca Leigh Edwards 1:24

Sjoe, probably in the very beginning of what made me want to be a doctor, I guess.

Dr Maria Christodoulou 1:28

Okay, that's a good place to start.

Dr Bianca Leigh Edwards 1:30

So I always wanted to be a doctor. Since four or five, my mom found me literally looking after all my animals and teasing people and making everyone sit down for a full examination. I was always one of those people that was wanting to care for people if anyone was hurt, would be going off the playground, going to check that they're okay. And when I became a teenager, my passion just kind of grew even more. I used to teach in Sunday school. Actually, as a teenager, I used to assist. And I had little boys and little girls in my class who were just toddlers. I used to babysit on the side. And when I babysat, I had a little boy that I used to babysit for a very long time until he was three. And he was diagnosed with leukaemia just after his third birthday. And I found that incredibly challenging because he was practically a little brother to me because I'd been there for all his journey.

Dr Maria Christodoulou 2:28

Right.

Childhood Calling And Early Loss

Dr Bianca Leigh Edwards 2:28

And that family was very, very close to me. And at that time, my parents were splitting, and this family was literally my second home. And it was very, very special to be able to be a part of everything. I was there when he took his first steps with his mom and swimming in the pool, you know, all the things that are such important milestones. And so it really affected me. I was always interested in children. But what became more prominent was caring for children through chronic diseases and caring for children through cancer. And so it was one of the driving factors of me going into medicine and being so passionate. Actually, why I did my honours in human cancer genetics as well. It was something that I was very passionate about. My dad also had cancer, my stepdad had cancer. And so cancer and research has always been a part of my life. And I couldn't get into medicine. So the truth was that this journey was actually part of not being into medicine and applying every single year. I literally applied to medicine every single year, including matrick, then first year of varsity, second year of varsity, including my final year, my honours year. I then actually started my master's in human cancer genetics, and then I eventually got the phone call to say that I got into medicine. And I remember that day being the best day of my life.

Dr Maria Christodoulou 3:55

I'm impressed by your perseverance. What makes you keep applying year upon year? I mean, it was six years, I think you told me in total that you kept reapplying for med school. Other people may have given up along the way. What made you keep going?

Dr Bianca Leigh Edwards 4:10

I think the thing for me was that although I loved my BSc and I loved doing research and I loved being behind the scenes, I always had this tugging in my heart that clinical medicine was for me. Working with the patients, even my supervisor will tell you from my honours, I got so excited when I got to go into the hospital and do the clinical side of it. And I think making a difference for me and just seeing people get well is something I really, really intuitively love seeing and helping people. And so that was very much a driver for me. And anything that I normally put my mind to, I make sure I achieve. My parents brought me up with this persevering spirit, and I've definitely always had it. And I knew that that puzzle piece was missing, something was missing. I needed to both have the research, but also have what I really wanted to do, which was become a doctor. And so I didn't want to let the system not let me get in. I was like, I'm gonna beat the system and just keep applying until you guys accept me. And I phoned the lady every single week and I'd be like, Do you have my application? Is there anything missing? And she got to phone me that day when I was in the lab, sitting in the lab, the day I got in, and I remember I just burst into tears. And it was a very special day for me to know that I had made it. I hadn't been rejected again. They could never tell you where you are on the waiting list. And that year the lady had said to me, You were actually number one, and I'm so glad I can call you. And I cried, I actually didn't answer her. She phoned me back. She said, I'm gonna phone you back when you can speak. And she phoned me back and she's like, I'm taking it, you're taking it. And I'm like, Yes, of course, of course.

Dr Maria Christodoulou 5:57

I imagine that after all those rejections, some part of you was expecting another rejection. It must have been quite a shock to be told that you were in.

Dr Bianca Leigh Edwards 6:04

I was like, Wait, did I hear that properly? Maybe I didn't hear it. So when she phoned back, I was like, Yes, of course, I'll take it. So the hardest part was going to tell my supervisor, but he knew. He knew that if I got in, I had always told him I was applying, and he just knew that that was where I was meant to be. And they always joked, I was the receptionist of the lab. I was just so excited to see someone walk through the door. I'm like, hi, hi.

Dr Maria Christodoulou 6:32

Yeah. So you were clearly meant to work with people, not in a laboratory.

Dr Bianca Leigh Edwards 6:36

Yeah, I know.

Dr Maria Christodoulou 6:37

And you were busy with your masters when you got accepted, and then you weren't allowed to finish your master's if you accepted the place at medical school.

Dr Bianca Leigh Edwards 6:46

Unfortunately, some universities have policies where you can't graduate from another university while being with them. And that was just the case of me. It was a bit sad because I'd done a lot of the lab work already. But it's not a waste, and someone took over the project. That's what happens. It was part of the journey. It was very sad. I would have loved to have finished because I only had one subject in my whole first year of medicine. But it wasn't meant to be.

Six Years Of Med School Rejections

Dr Maria Christodoulou 7:11

And med school, what was it like? This build-up, this anticipation, six years of trying to get in. What was your experience as a medical student like?

Dr Bianca Leigh Edwards 7:21

Wow, it was interesting. It was when I arrived, I think the most interesting part of it is that you enter as a postgrad. And so you're a little bit older than all your peers. And it's always overwhelming starting a first year and not knowing, the unknowning. And also I was kind of a little bit disjointed because I was only attending for one subject. So it wasn't like I was fully embedded in the university for that first year, but I really enjoyed it. The older colleagues of the med school, all of us postgrads, kind of gravitated towards each other, which was lovely. My clinical partner and I are still super close and it was so lovely to form such great relationships. It was a trying time at varsity because we had the Fees Must Fall and quite a lot of disruptions during our university experience. But just being in the clinical space from fourth to sixth year, I just knew that I was in the right place. Studying was easy, although it's a challenging degree. It just felt like it was meant to be. And I loved my courses, I loved all my lecturers and teachers. They really were phenomenal. I was learning from the best of the best, you know, Groote Schuur, Red Cross. I really was learning from incredible mentors. And a lot of people would ask me the question, why would you do medicine? And a lot of the consultants would be like, what made you decide to carry on? And I said, Because I wanted to do clinical medicine. So the actual medicine time was really special learning, and I really grew a lot. I think my background with research also helped a lot. I always tell people that nothing was wasted because I learned technical skills and analytical things, and the way I looked at things was slightly different, and especially even cases, I used to find that I used to unpack them. My husband, so he was actually just a boyfriend at the time, but he would laugh at me because the whole table was full of mind maps and all the stuff that I needed to know. And I would unpack cases a bit deeper than I didn't really need to, but just because I wanted to understand the physiology.

Dr Maria Christodoulou 9:27

Yeah, I'm sure it was a very valuable additional knowledge to bring to the table because I think the first year of med school is often so overwhelming that you don't really have time to digest those basic sciences. So I imagine that having an undergrad degree was very helpful in making sense of some of the cases. Are there any stories about med school that stand out? Maybe patients you remember or things that happened as a student. You spoke about the political turmoil that was happening. How did that impact your time?

Med School As A Postgrad

Dr Bianca Leigh Edwards 9:57

So the story that really stood out is I absolutely loved my rotation at Red Cross. Obviously, given my background and what I was really interested in, I had the cutest little patients. There was one little boy in particular. And I remember he was there for most of my duration of my clinical rotations. And I just got to know this family so well. There was a chronic condition in the background. And I think the passion of mine and caring for patients through things really came through there because I got to know the mom, I got to know the family, we got to unpack a lot of things. And I remember that little bond I formed with this little kid. And I was so sad. I remember when I got home, I was so upset that this kid had been discharged. I was excited that he had been discharged, but upset that I wasn't gonna see this smiley face every morning. And then funnily enough, when I went as sixth year again, I saw them in the clinic queue, and this kid came running to me and still remembered me. And that just stuck in me to realise that just seeing that family, the mom said something pertinent to me. She said, You saw beyond the illness. And I think for me, that's what really sticks out. The little boy that passed away, Matthew. I think it's very important that one sees past the illness. They're a family, they're a child, they're part of a system. And what I try and bring in my practice is caring for that system. Because behind every child is a mom and a dad, someone who's balancing it. I always find when my moms sit here, I do the longer consults because I want them to understand what's wrong with the patient. What do you have to do when you get home? How do you give the medicine? What do you do when they spit it out? How do you nebulise a kid? You know, all those little things. It's very quick to write a script and four or five things, but you've got to think about that person going home and how do they do it and how do they execute that medicine? So that was a very pertinent thing because it just made me realise that I didn't want to lose that, you know, no matter how far I went in medicine and how far I got in the system, I wanted to make sure that I always took that time to get to know my patients and form that little bond. Because if you form a trust with a child, you can do anything with that child. But if you don't have the trust of a child, you don't have that bond, and it's very difficult to break down that barrier. So that honestly was such a special journey to walk with that patient, and then ironically, that patient was in the exam.

Dr Maria Christodoulou 12:44

The exam that you were assessed on, so you knew the case. Oh my word. That's amazing.

Dr Bianca Leigh Edwards 12:51

The case I was assessed on, yes. So yeah, it was one of those things where you walk a full circle, and the child was relaxed and super fine and it went super well. And I was like, wow, it was nice because when I got into the management, I could get into the nitty-gritty, the clinical, the psychosocial, all of that kind of stuff. And I'd walked this journey, and I find that a lot of the times because of the special kid, I don't even think they realise the impact they had on me. But I was able to realise that the biopsychosocial model that we get taught in first-year medicine is actually so, so pertinent to every condition, be it a mild flu or be it a chronic condition where a child's going to be facing difficulties for the rest of their life.

Dr Maria Christodoulou 13:40

I'm struck by your sharing about the little boy that you babysat at a young age. And I'm wondering how you made sense of all of that as a teenager. What was it like to be with this child as he was going through this difficult illness?

Dr Bianca Leigh Edwards 13:56

So I was unfortunate that I didn't get to see the last little bit of his illness. My parents got divorced and I moved back to Cape Town and they were in Durban. But I kept contact with them. And I think not being there to see all the turmoil was very hard for me because I was so close to him and I wanted to be there in the time of need. But we would phone him and video call. And I remember I got a few pictures from mom. Quite a few pictures from Mom. Going through his chemo. And it was hard. Hard to see that he was struggling. I pictured this blue-eyed boy who had this glistening eyes, and there I could see he was struggling. And I was so excited because I was going to Durban for the September holidays to go and see him. My mom had planned a holiday. She said, let's go to the Drakensberg first, and you're gonna come back and see him. And I'd spoken to his mom, and I was like, I'm coming to see him, and it was all planned. And we got onto the mountain, and I got the dreadful phone call to say that he had passed away. And instead of going to see him on the day that I was supposed to see him, I went to his funeral.

Dr Maria Christodoulou 15:14

Gosh.

Seeing Beyond The Illness

Dr Bianca Leigh Edwards 15:17

The time I walked with him, the joy I saw in him, the fact that he never let anything get him down. The fact that he wanted to go home and wants to play with his toys, something so simple. But it's a constant reminder for me. And every year when his birthday comes and his death day comes, there's not a year, I don't think about him. And when I see patients and when I opened my practice, I remember the first day I opened my practice, and I sat in this chair and I thought, Matthew, I wish you could see. Because this is all because of you and your passion. He used to sing a lovely song because we used to go to church together and he used to sing a song called One Way Jesus. You're the only reason. And he just used to sing it so beautifully. And he really is a little boy looking down on us. But it was a very special time. It was a lot for me to process, but in the same time, I learned so much, and I became so much stronger. And just after that, you know, it was my dad's cancer and then my stepdad's cancer. And so it just gave me the kind of tools and the passion to learn more about palliative care, more about chemo, more about radiation. I mean, I was reading things probably way before I even needed to go to the med school. And I remember I volunteered at Friends of the Family at Red Cross Children's Hospital. And this was while I was still at high school. And I used to go and take books and read to the oncology unit there. And I felt like that was my way of giving back, but also processing everything. I mean, I needed community service hours, but it was easier because I could spend time there and the hours didn't count, it just went so quickly. And so I loved my time giving back. And I've been there at Christmas and gotten dressed and given presents. I even dragged my husband to read stories, and he's not a very good hospital person. And it's just me, and it's all given me the ability to do what I do today, and everything that I've gone through and the process I went through, even not getting into medicine straight away. Everything's built me, and even my internship was very rough. Everything's kind of shaped me to where I am today.

Dr Maria Christodoulou 17:46

I'm really touched by your story. I felt quite emotional when you were talking about Matthew, and I, I could see how emotional you were or are still about it. I'm struck by your capacity to stay open, to stay present to your own feelings, to risk building more relationships with young children who are going through difficult times. So often I've spoken to doctors who go through medical training and find themselves shutting down emotionally and blunting themselves to the experiences of their patients. What do you think it is that helps you to keep your heart open and to be in your emotions about what the kids are dealing with?

Dr Bianca Leigh Edwards 18:25

I think what always keeps me alive is the passion for my job. I always knew when I chose this career, I knew I was going to see some hard things. I knew, especially now choosing children, it's always hard to see children get sick. But I think what I always hold on to, even when I do a bit of palliative care is, you're either changing their last moments or you're giving them their life back. And that's how I saw it when I was in Red Cross working in G1 because there were weeks that I'd come in and be like, Where's... and they would be like, sorry, they passed away. And it would be hard. I remember being like, but I've read to them for so many weeks, you know. And you do form that relationship in that ward. I did my elective as well in that ward, believe it or not, my sixth year elective I spent there. And luckily, my elective was the beginning of the year. It was the biggest blessing because it was COVID, and COVID only hit in March, so I got to finish my elective. But if my elective was anything later in the year, I wouldn't have been allowed because they stopped letting people in and out of those wards. So yeah, I think I wear my heart on my sleeve. Anyone who knows me knows that I am emotional and I will tell people that it's okay to feel and it's okay to be upset and it's okay to process. And I often sit here with moms in my rooms. And when they're overwhelmed, then I say to them, it's okay. The feelings are all there. And I think I try my best. I'm not always very good at it, but try my best to allow myself to feel, but also to remember that my feelings make me a much better doctor. I feel like it's very important to be relatable, and it's okay to make mistakes, and it's okay to be sad and to be broken. I remember in COVID, I had started my internship. In fact, I started internship earlier. It was really rough and my first day of internship, I signed more death certificates than I would have liked to.

Dr Maria Christodoulou 20:36

First day of internship. So for people who don't fully understand our system, first day officially of being a doctor, right? Day before that, you're a student, and then on the first day of your internship, now you're the doctor and you're responsible for making big decisions.

Dr Bianca Leigh Edwards 20:53

Literally, yeah. And the worst part was is that it wasn't actually even my first day. It was my first day legally being the doctor and being able to sign and stuff. But the hospital CEO and intern curator had actually emailed us at Christmas time and said, we can't pay you. But if any of you would like to come and volunteer at the hospital, we need help. You will be acting like a bit of a student, you will still be under people, which obviously is different, but on the first, you'll take over. And I remember I said to my husband, I looked at him and I said, I need to go. I know we had planned this time chilling together and relaxing, but I, I need to go.

Dr Maria Christodoulou 21:29

That was at the height of the first wave, right?

Dr Bianca Leigh Edwards 21:32

Second wave.

Dr Maria Christodoulou 21:33

Oh, second wave. Okay. So end of 2020.

Processing Grief And Finding Purpose

Dr Bianca Leigh Edwards 21:36

Yeah. It was hectic. I mean, I started with the most incredible second-year interns. So they were obviously still first-year, about to become second-year interns, and they had me under their wing because they had to sign for certain things. And the one said to me, So come and learn the death certificate, I know you've only done one fake one in med school, we do one. But he said, Unfortunately, there's going to be lots of these you're going to need to fill in. And I remember thinking, okay, cool, that's not going to be like that. And then my first day, I was like, never mind. I was called constantly. There's a new patient who's passed away. There's a new patient who's passed away. It was a very rough beginning. And I was going home to my husband and saying, I give them oxygen. They're still dying. I said, We don't give them oxygen, they die. I said, everything we doing, you just can't save them. And it was hard. It was hard because here I envisioned this going into medicine and starting as a doctor and gonna be pleasant and happy. And it my first, it was like COVID ward, full suit, literally masked like this, visor over. I had a proper suit over. It was like covers over my shoes. I remember sweating because it's the heat of summer. And it was hard. And we as a hospital had an amazing policy of phoning the families every day because they couldn't come visit. And we'd give them an update and we'd sit with all the folders. And it was hard. It was hard to tell them how their family members were doing and when they weren't doing well. And I remember when I used to do oxygen stat checks, it was one of the things we had to do. And I would see someone lose oxygenation and they become a bit confused. And the moment I saw that confusion, I'd be like, I need to phone the family to say goodbye. And phoning a family member and telling them their loved ones going to die is not easy in any circumstance. But now telling them they're going to die, but you can't come and visit and say goodbye is... I mean, I'm literally got goose bumps because it gives me the grils every time. But I was those patient's family. I was holding the hand. I was holding the patient's hand, and I'd have to comfort them after the phone call. I had to comfort both the family and keep a very strong face. And every day I'd go home crying. Even in February, about a month and a half in, my husband could see I was really not doing okay. Called my best friend, because I hadn't seen anyone, because everyone was scared to be with me. They were like, You've got COVID. You can't touch me, you can't do anything. So I was very much in isolation. And she came over for dinner. And I remember saying to her, What am I doing? I've done all of this to be in this position. I studied medicine to be a doctor, and I can't help people. What's happening? And I remember she said, just you know, hold on to your passion, hold on to what you are, and what you're doing now and how you're feeling now is what makes you a better doctor.

Dr Maria Christodoulou 25:09

Wise friend.

Dr Bianca Leigh Edwards 25:10

A very wise friend. And she said to me, Let's do something, let's try exercise together in the morning. Let's get you out and about. And we did, and we ran together every morning. We'd meet super early. Obviously, not when I'm post-call, but we'd meet, and we'd go for a lovely run. And it was so uplifting and something I needed. I just needed someone. Because all of us in the hospital didn't have time to process it. We couldn't be there for each other. After being on a 30-hour shift or 24-hour shift, you just needed to get home. And so it was very uplifting to have something. And she'll never, I mean, she knows how much it meant to me, but I mean, it just gave me that ability to remind me of my passion.

Dr Maria Christodoulou 25:59

So, what was it like to be dealing with all of that in the hospital, to have people around you afraid of being close to you because they might risk getting infected? What made you get up and go to work every day, knowing that potentially you were putting yourself at risk, potentially putting your family at risk? How do you do that?

Internship Begins In A COVID Ward

Dr Bianca Leigh Edwards 26:19

I think when I knew I became a doctor, you know you're going to put yourself in these situations. I mean, even as a student, you're going into TB wards, you're going into places where you're constantly being exposed. And I chose this career knowing full and well that I'm going to put myself in things. And you know, when they messaged to say, can I come? There wasn't an ounce of my being that said, no. I had to be there, I had to be part of the change, I had to represent my country. And I don't know if you remember, but they used to clap at night because that kept us going. That clapping sounded amazing. That cheering, the dropping of meals at the hospitals. You know, even though the community couldn't be there, that getting from a distance and recognizing us really made a difference. And I remember the one night I was in the ward with lots of patients near death. And at eight o'clock, the clapping started. And I was like, Bianca, gotta just keep going for those ones that are gonna survive, and even the ones that are gonna die. You're here, you're the family, you're gonna hold hands, and they will remember this, and it kept me going, but it wasn't easy.

Dr Maria Christodoulou 27:49

I'm sure. Were you ever afraid? I was. I was very scared I was going to get COVID and die. I remember thinking, what happens if I'm not here to do everything that I've been studying for and done. My husband and I were just engaged at the time. And there was a lot of fear. I remember coming home every day. I was like, should I be coming home? You know, I would strip at the door and run to the shower. I didn't touch or do anything before I came. You do get afraid. You get afraid that you're gonna get sick. And I was hyper pedantic. I mean, it was like visor, goggles, everything. I'll actually send you a photo if you want to post of the what I looked like when I was covered and just the eyes. You get scared, and I always tell people I wasn't immune to it. You know, I didn't have my vaccine. There was no vaccines yet. So we were fighting, and there was no protection for doctors besides your PPE, and you were really relying on this PPE. And at some stage we were reusing PPE because we didn't have any. And you know, I bought a lot of PPE for myself because we were not having supplies all the time. It wasn't easy, but I think even that process has built me up. I mean, it made me learn to deal with a lot of emotions. It also really helped, I know it sounds weird, but breaking bad news a thousand times a day was rough, but you learn how to do it and you learn how to have that emotion and feeling without being too involved, but still not letting yourself not be human because people want to see the human being, they don't want this bold-faced doctor, they want to know that you feel it. And there was a lovely woman, and every morning at four o'clock, her SATS would drop, and I would walk into that ward and I'd be like, Mrs.... Can't tell her name, but you've gotta hold on. And I'd hold her hand and I'd turn her prone, which was one of the positions we used, and every time she was okay, and as a hospital, I think she held the record for being there the longest, and we clapped her out of the hospital. And I'll never forget that day of clapping her out. She did it, and she could see all our faces cheering her on, and it was a feeling of sometimes there was positivity, you know what I mean? Clapping people out was positive. So amongst all the trauma that we were going through, there were those moments. There weren't as many, unfortunately, but there were those moments, and that made it so worth it, so worth it. Every call, everything, it made it worth it. Emotionally, it really took a toll on me, but but I wouldn't change it for the world. It taught me so many things. I definitely would love to have no COVID, but in terms of my growth in that time, and in terms of dealing with the crisis. I think it's like most doctors that also were in the HIV and AIDS era where it was really hard. You know, it just builds you as a doctor, and it's hard to get through a pandemic and get through everything. And also knowing the world was going through it also made you realize it's it's okay, you know, everyone's going through it and they're all suffering. Yeah, it wasn't easy. No, and somewhere in the middle of all of that, you were supposed to have a wedding day.

Dr Bianca Leigh Edwards 31:48

I was. I was, and I was on call on my wedding day. It was so hard. I went up to the tea room at the time I was supposed to get married, and I remember thinking, I'm supposed to be getting married right now and I'm on call working this long shift. And I bawled my eyes, as I did many times at COVID. And I'm sure the patients after that could see my eyes were very wilted, and I even went into the EC. It was actually one of my most hectic calls, which was probably positive because it pushed me through the day and night. But it was hard, it was hard, but then I knew I had a duty to serve my country, to serve my people.

Dr Maria Christodoulou 32:35

How long had you been planning the wedding?

Dr Bianca Leigh Edwards 32:38

Over a year, a year and a half, just before COVID.

Dr Maria Christodoulou 32:41

Oh my word. What was it like to get to that point of going, okay, we're gonna have to call it off?

Breaking Bad News And Holding Hands

Dr Bianca Leigh Edwards 32:48

I struggled. But it was lockdown. I can't remember the exact stage, but we were needing to be indoors by nine or ten. There was no alcohol, there was no thing, and I married a Greek, and dancing and a party is a big thing. So there's no ways you can end a Greek wedding at nine. So I knew it wasn't gonna be possible. And about a month or two before the wedding, it was bad. I mean, it was where I was literally at breaking point, and I remember saying to my husband, we have to just postpone this because for the safety of our guests. My dad wasn't gonna be able to fly from Australia. There were so many factors that it just wasn't the right thing. And I said to him, it'll be stupid to have an event that's a super spreader, and then I lose loved ones. I'd watched so many people die, and I was just petrified of my family. I didn't even visit them for a long time because I didn't want to be that person that came in. I was constantly on high alert, runny nose, headache. Sometimes my headache was just lack of drinking because us doctors, to be honest, in COVID, were very dehydrated and not eating enough because it was such a mission to get out of your suit that we would just sit. I mean, I remember the one day I sat for probably around 16 hours and I hadn't gone to the toilet once, because we were just sitting in those wards working the whole day. And it was such a mission, I won't lie, to take everything off, decontaminate, redo it. I mean, you were just like, Do I really need to pee?

Dr Maria Christodoulou 34:29

Yeah, I can understand. So when did the wedding actually happen? Because you talked about your husband, so clearly you two did get married.

Dr Bianca Leigh Edwards 34:40

It happened about just over two years later. The vaccine had come out, we were all vaccinated. My dad could travel again. So we had to wait until it was the right time. So we just, yeah, waited, but it was still special. It was just as special with everything I'd imagined and more. It was at the venue I wanted. Everything was exactly how we had planned it in 2020.

Dr Maria Christodoulou 35:10

Lovely.

Dr Bianca Leigh Edwards 35:11

So it wasn't anything different, and I was very glad. And I had to kick my guests out because at three o'clock, they were still dancing. So six hours post lockdowns cut off, they would have still been dancing. So...

Dr Maria Christodoulou 35:24

Did they break plates?

Dr Bianca Leigh Edwards 35:26

They did break plates. It was very, very special. It was so special. We did a Christian and Greek Orthodox wedding together. So we did the English ceremony, the Greek ceremony, we did all the dances and the traditional dancing, and it was so special. It's really, very special.

Dr Maria Christodoulou 35:44

So that would have been post-your internship, right? By then you probably were in community service years.

Dr Bianca Leigh Edwards 35:50

Yeah, the end of the second year.

Dr Maria Christodoulou 35:52

What was Comserve like for you? Lots of young doctors have not such great stories about that time.

Dr Bianca Leigh Edwards 35:59

I was very blessed. Obviously, I was married. I'm a little bit older, so I had social compacted to stay in the Western Cape. And I was very blessed that it had worked and I was able to stay with my family. I was pregnant. Because of being the post grad, I had always wanted to be a doctor, but I equally wanted to be a mum. We had always planned to have our baby that year, but because of our wedding being postponed, we were like, we're not going to postpone our family because we are both a little bit older. So yeah, I was pregnant. And I then placed at Mowbray Maternity, and I absolutely loved it.

Dr Maria Christodoulou 36:39

Was that by choice?

Dr Bianca Leigh Edwards 36:40

It was my first choice. Because I was interested in children, you need to get neonates time to be able to specialize in paediatrics. I'd been at Mowbray as a student, and I'd always loved Mowbray. I knew that I could try, I would at best maybe get six months obs & gynae and six months neonates, but I knew I could try and ask and request for a year of neonates. And I was very, very blessed. I got a year of neonates with the team, and I learned an immense amount. I mean, the neonatal ICU there is state of the art. The high care, the sisters. I was very, very blessed, and I loved it. I was heavily waddling at the end of my pregnancy. They had to kick me out because I had quite a terrible high-risk pregnancy in the sense that... The pregnancy was lovely and I loved being pregnant, but I had a few complications along the way. Mowbray was lovely. I would have loved to have stayed on. If there was a position I would have stayed on. When I left, I was in the unfortunate event again of post-COVID. And post-COVID, there were no posts. Not a single post. They'd actually just frozen the posts. I can't remember exactly the date, but they'd frozen the posts the previous year. And so I literally was stuck in Jan in the dumps without knowing what's gonna happen. I'm not employed. I kept saying the government doesn't want us despite us doing all this studying. So yeah, it was another really hard process. But also, it was a blessing in disguise because it gave me time with this little baby that I had to leave at just over three months to go back. And I'd only spent like 16 days fully at home, at home with him since the four-month mark till the end of the year, because we worked every second weekend. So it gave me some special time with him.

Dr Maria Christodoulou 38:44

I'm trying to imagine being heavily pregnant, working in a maternity hospital, seeing babies being born all the time, neonates, complications, risks, and then having a complicated pregnancy yourself. I mean, that must have been scary.

Fear, PPE, And Small Wins

Dr Bianca Leigh Edwards 39:03

Yoh, it was very scary. People at Mowbray used to call me literally, I had the worst of luck. It used to be chaos, resuscitations, and babies battling it, hectic intervention. They'd always be like, Why, Bianca, do you get all these complicated cases? And then I remember the one consultant said to me one day, they're like, they just know you love kids. But it was really hard to deliver a baby that's the same age as what's inside of you. And what was harder, I remember the one baby I resussed for a long time. And I had to go tell the mum that the baby didn't... Sorry. And she turned around to me and she said, How far are you? And I said to her, I had to tell her the truth, I was exactly the duration of her baby. And she could see I couldn't hold back the emotions. I was pregnant, so it was, yeah, much harder in Mowbray to hold back my emotions, and I remember my eyes just becoming more and more like and I said to her I'm the exact same duration, and I said, It feels even more immense for me to tell you this, and she said, Thank you, Doctor, for everything, because I saw you in the corner of her eye. It was a caesar. And then again, it was my passion, and it was me just being me with this mum. And I remember I went to go and see her. Unfortunately, they still have to stay at the hospital, they're still a postpartum mum, there's still a risk of bleeding, so they can't go home and they have to sit in the ward. And I remember going to her afterwards, which was in the middle hours of the morning, because that's the time I had to go see the ward before I finished my call. And I sat with her and I said to her, I'm so so sorry for your loss. And she said to me, Doctor, I know these things happen. And she says, I really appreciate you coming through. And I felt sorry for her because it was after hours and her family weren't there, and we called them in, but you know, becoming a mom makes you feel so much. I remember when I became pregnant, I thought to myself, my inner being's changed. I always tell people becoming a mum was my biggest life lesson. It's made me who I am today. It really has. My little boy is the reason that I am who I am. He's the reason I feel the way I feel, as well. And um, becoming a mum and understanding motherhood and how it all shapes you. I mean, motherhood really changes one. Yeah, it was really hard to see those babies, but I had a lot of cases where the babies did super well, and I would see these, you know, 900 grammers go home. It's never easy to lose a child. I always tell people it's the hardest thing. Even if it's a miscarriage, it's hard because that person, it's a person, it's got a heartbeat. You can't really comprehend loss until you've lost. And I realized I couldn't ever get into those shoes because I hadn't lost my baby. But at 11 weeks, I almost lost my baby, and I had a threatened miscarriage. And I kept not holding on to that time, but I kept remembering what I felt in that moment when I thought I lost him, and yeah, I couldn't get in their shoes fully. But I tried my best to get to the emotional level to help them and to talk through it and to not just ignore it because often it's very easy to just write, baby passed away, da da da, tell the news and leave. But that follow-up for me was so important to be done by me, the person who was there. And post-call, I'd try my best to go and nip my way through just to check that they were okay. Often they were very surprised I was still there. They'd be like, Are you still in the same outfit? I'm like, Yes, I'm going home now.

Dr Maria Christodoulou 43:41

How has being a mom changed you as a doctor?

Dr Bianca Leigh Edwards 43:46

I think it's made me realize how challenging it is to give children care. Number one. And it's not as easy as it looks until you do your first antibiotic to your child, you really learn what it's like. I think it's also made me understand that feeling because as a mom, you're scared, you don't know what's coming. You know, that first fever. I mean, I had medical knowledge behind me, and that first fever still freaked me out. The time that he had his first croup and he could barely breathe. I knew exactly what to do, but I still freaked out.

Dr Maria Christodoulou 44:22

I don't know if I've told this story before, but I remember a night where I was very worried about my baby's health, and I called the Red Cross hospital anonymously and asked for advice because I didn't want anyone to know that I didn't know what to do, that even my medical knowledge, I was helpless in the face of what she was struggling with.

Dr Bianca Leigh Edwards 44:45

Yeah, I felt like that with my breastfeeding journey, and I always share this with my patients. I'm a doctor, I worked in Mowbray Maternity, I helped moms, lots of moms with breastfeeding. I had the knowledge, but do you think it was easy? No, I had the most challenging breastfeeding journey. I needed laser, I needed help. I had a child that I had to then go on to a formula for his condition, and then I had to express, and it was it was, yeah, it was hard. It just makes you feel more deeply, but also not really the challenges, and you know, I think it's very quick. A lot of the times we'll be like this symptom, this medicine, this symptom, this medicine, this symptom, this medicine. What I've learned in my practice is how do we get the medicines in, as less traumatic as possible? What is necessity? So I always tell my moms, this is important. This one, if you win, great. But this is not a necessity, you know what I mean, just so that they understand. And then I tell them there are lots of other medicines, but I know that these two or three are already enough. And you know, you start realizing like little things like not completing antibiotic courses. I mean, it grates me because of my whole microbiology teaching and everything. But you realize that sometimes you do miss a dose, you know, as motherhood is busy, or lack of sleep, or you can't remember if you've given it. And so I've learned a few tricks to try and help them with those things because it's important.

Community Service And Pregnancy

Dr Maria Christodoulou 47:46

So your path took a slightly different direction than you anticipated once again when you finished your internship and ComServ because you had always thought you were going to specialize in paediatrics. And then with this limitation of posts and things, you couldn't get a post to specialize. What was it like to have that door close?

Dr Bianca Leigh Edwards 48:05

I mourned it. I won't lie. It was very hard. I kind of blamed the system. I was like, how can the system generate these doctors and not have jobs? I want to help. I was frustrated. I was like, I'm ready to help. I'm seeing colleagues drown because there's not enough doctors. And I get frustrated seeing them work so hard. And I remember locuming and thinking, this shouldn't be this way. These people are struggling. It's not fair. So yeah, it was very difficult. But my husband had told me in the January, he said to me, He said, Listen here, we need to have a plan. He's like, I know there was the freeze of posts, and there's still freezing of posts. I understand you want to apply everywhere, but what's your plan? And I said to him, Well, I guess I'm gonna have to go and be a GP because that's what you can do after you've done medicine. There's not much, I mean, there is other things, but that was one of the main things for clinical. Yeah, in terms of clinical practice. And then he was like, Well, how are you feeling? So I said, Well, if I do it, I'm going to do it under my terms. And I remember him saying, Oh, yeah, here we go again. And I said to him, I will be a GP, but I will only do it if I see children only. And I remember him looking at me and being like, Okay, is that around? And I said, Yeah, there's quite a few paediatric GPs around, but it's not like a paediatric GP because you're not specialized in it, it's just that you only see children. So it's very important I always explain this to patients . I'm a normal GP, but I just see children. You know, there's nothing extra special about it. And the reason I do that and I tell them, is once they've seen me with the child and playing on the floor, I tell them I'm a child too.

Dr Maria Christodoulou 49:59

What's the benefit to your patients of you doing that, of choosing to focus only on children?

Dr Bianca Leigh Edwards 50:06

I think everyone has their strengths and everyone has what they're good at. And you know, it's really important that you always play to your strengths. If you are strong in a certain area and you can offer skills in that area, then do it because it's where you're comfortable. I always say, I know my limitations. So if there's something that I cannot deal with, I refer up. And I would rather have a lovely network, which I've started forming in private practice. I have ENTs that I refer to, paediatricians I refer to, OTs, physios, lactation consultants, because we're a team, and ultimately a body part can't act alone, and we're all parts of the body. So yeah, I just thought it was an area that really needed, and I think I've gained because I'm still doing what I love and I'm still doing what I'm passionate about, and I think my patients have gained because also I'm seeing a lot of the childhood conditions. Because I see children all day, I know what's going around the creches, you know, I know what's going around the schools, and you kind of gain that confidence with dealing with the childhood conditions. I always try to do some health promotion, be it de-worming or regular checkups or going for eye screening or hearing screening. I always tell my parents I want to pick up things early if something's going to go wrong, because if we intervene earlier, there's less steps. And so, yeah, I hope that I get to make a difference in my little community. And I grew up, my last little bits of teen years were in this area. And so servicing my own community is special. Nothing beats servicing your own community. And when I'm in the shops and these little hands come running behind, Dr. B, Dr. B. It's just so special. So my son's still learning to share me.

Dr Maria Christodoulou 52:10

Right, I can imagine.

Dr Bianca Leigh Edwards 52:12

Yeah, yeah, it's very special. I see these patients as kids, they're just yeah, so special.

Dr Maria Christodoulou 52:19

Did medical school prepare you for the reality of private practice?

Dr Bianca Leigh Edwards 52:23

No.

Dr Maria Christodoulou 52:24

Say more about that.

Neonates, Complications, And Empathy

Dr Bianca Leigh Edwards 52:27

Yoh, no. Business sport in med school. They teach you how to be, but there's no running a business. Being your own boss and running a business is a lot. Definitely was doing doggy paddle slash drowning in the beginning. But I had amazing people that I would network with and ask. I'm one of those people that's never scared to ask. So I think that's also a really important thing to have in life. And yeah, I learned along the way. You learn and navigating everything, medical aids and running a practice, insurance and consumables. I've still got lots more to learn. Luckily with medicine, when I committed to medicine, I committed to lifelong learning. So lifelong learning both in medicine and in practice management. But yeah, it's one of the things I really wish, especially in the current thing of not having jobs. It's really important one has those skills and learns. It's a lot. It's a burden. I mean, it took me over six months to put up my practice in terms of paperwork and registering with medical aids and independent numbers and you know all those kind of things. Registrations. It's not easy.

Dr Maria Christodoulou 53:47

Yeah. You told me when we first met that your heart was always in public sector medicine. You always imagined yourself working in the public sector and helping public sector patients. And I've had a couple of conversations where we've talked about the reality that only 15% of our doctors are retained in the public sector. Private practice in some ways always being made to sound as though it's the more attractive option. But this other side of the reality where younger doctors are now having to really think about private practice as an alternative option because there are no posts in the public sector. What was it like for you to have to decide, okay, I'm going to shift my focus, I'm going to prioritize private sector patients, start my own private practice, and not be this public sector doctor I'd always imagined I was going to be?

Dr Bianca Leigh Edwards 54:36

It was very hard. And um, I had always envisioned myself being at Red Cross because I'd been there growing up and did some studying there and my rotations. And so it was really hard. But what I did do that really gave me a little bit of it's okay, was I had a lovely locum consultant at Mowbray who just embraced me and taught me so much. And she honestly is such a blessing. And she said to me, I got this job researching at Red Cross when I finished. And I said, I'd love to do that because I'd love to still be in the public sector and giving back and making a difference. And she was like, perfect. I'll sign you up. And so I was. I only worked half-day on a T uesday in the practice, and we're still busy doing the long-term study. But that every week going there just gave me that fulfilment and knew that I was still giving back. And so it did fill a little bit of that empty void, you know, of having to leave public medicine. I mean, my friends have been nagging me to go to private practice, but I tell people private practice chose me. Because it really was that. There was no jobs, there was nothing. And it's something I never regret. I love my patients, I love my job, I love how I've evolved with my job. I love that I get to give back to my community, the one that I literally live in. And that I also get to make an impact in a different way. And because I'm not on call every third or fourth night, you know, I sleep in my bed, which is weird. It's an unknown, you know.

Dr Maria Christodoulou 56:37

Isn't it crazy that it's an unknown, like it's something that so many people take for granted?

Dr Bianca Leigh Edwards 56:42

No, I mean, every third or fourth night I wasn't in my bed, and there were some weeks where I was doing all nights and no days. And also, I see my son, and that's been the best thing ever. I get to spend more time with him every day, and that's just although if you ask my husband, he'll tell you I'm working much harder in private because of the admin and the referral letters and staying up late and all the messages and checking results and scans and notes. But when I get to go home, I get to see my little boy and I get to do bedtime routine more than I did. So everything has a silver lining. I'm one of those people that looks at the glass half full.

Dr Maria Christodoulou 57:26

I've heard that a number of times in this conversation.

Motherhood Reshapes The Doctor

Dr Bianca Leigh Edwards 57:30

So, yeah, there was a silver lining and it worked. And who knows what the future holds, but I really am enjoying this season and the relationships I'm forming and the moms and the dads that trust me with their little ones. And I honestly form a relationship with the families. Some of these little ones now. I mean, I've been in this practice now for over a year and a half. I've watched literally walkers coming from their six-week checkup, or even at a few days old. I've seen siblings. So I've seen moms getting pregnant, and then they're bringing their second one for their first consult. So it's just so special. It's really special. You know, GPing is not appreciated and spoken about. Medicine is constantly about specializing. Medicine, it's always about getting on this rat race. You need to get on this hamster wheel, you need to do the next step. What, where, now? What are you doing? And I'm so grateful that I have a phenomenal GP. And he actually inspired me. He doesn't really know this, but he inspired me. Just the way he's got his practice. And I remember when I started with him, he was also fairly new and um phenomenal GP. Really cares. Yeah, I just changed my whole mindset. And I wish... This is kind of one of the reasons also I wanted to chat to you, was just because people need to know it's okay. Lots of people call it just a GP, but there's so much. You're holding a family, you see a lot of the day-to-day things, which are the mundane things, but they're the foundation. You pick up the problems in a routine screening, you intervene. I get to see kids I send to the specialists, and then they come back and they do so much better. I've had instances where I've picked up heart murmurs and they've had surgery and come back. So, you know, there's so many impacts that one can have. And now I just feel so honoured to be their community GP because it really is an honour to serve the community at this level.

Dr Maria Christodoulou 59:45

Sounds like they're lucky to have you.

Dr Bianca Leigh Edwards 59:47

I'm lucky to have them. I'm constantly learning from my little patients.

Dr Maria Christodoulou 59:52

You raise a very important point that I think we don't talk about enough is this idea of just a GP, because there is so much emphasis and focus on the career path that includes specialization. And it's almost like it's taken as a given. You finish school, you're going to go and study medicine, you're then going to specialize, et cetera, et cetera. And it almost feels like a sidestep or almost like a what's the word? No, I don't want to say failure, although that's the word that's popping into mind. That somehow you've not pursued the path correctly if you don't go and specialize.

Dr Bianca Leigh Edwards 1:00:28

Well, someone said that you didn't make it. And I'm like, no. No, I didn't not make it. They didn't want me. But I think because I've received a lot of rejection, just even getting into medicine, I try not let it get me down. And I think that's my biggest thing to my junior colleagues. Just don't let it get you down. Even if it's a season, even if it's a thing, you will grow. You will grow so much. And I'm actually so thankful for my journey and my son, because by being in a position of wanting to be more present as a mom and being in the position of no jobs in the public sector and no hope of really specializing at the moment at that time when there just was no posts. It all got me to where I am today. And I'm so grateful. And I've learned so much being here. I feel like I'm constantly specializing, to be honest, because you're constantly learning. You know, it doesn't matter what you do, whether you specialize or whether you stay as a GP, you are constantly learning on the job. There's always new things to learn. I'm always attending a conference or an online meeting. You're always growing. And that's so powerful. And that is medicine. You know, medicine's about growing and about continual learning and continually staying up to date. And you can do that in any field. But I think you need to make sure you're doing your passion. And I think that's why when I chat to someone and tell people why I just see kids. I am a GP, just like all the other GPs, but I just see children because I'm a child at heart. And I literally love it.

Dr Maria Christodoulou 1:02:16

What do you wish you had known when you started your practice that you didn't know at the time?

Dr Bianca Leigh Edwards 1:02:22

I wish I'd known it was going to be hard and very hard. And that means just pushing. So when you start, you know, you get maybe one a week. But I remember thinking it's okay, I need to just keep pushing. My husband was loving. He said to me, it's going to take you 18 months, or maybe even three years, whatever. And I was very blessed because at about eight, nine months in I was getting fully booked. I just like to encourage people to not give up. It takes time. Medicine took time. You literally take six years of studying, two years of internship, one year community service at the moment. So that's nine years. You've almost done 10 years before you leave, and then you're jobless. You have to trust the process. And so I saw this process as hard as it was. I worked really hard, but I also locumed in the time and I would work on the weekends in the hospitals. I went back to the old hospitals I worked at and locumed for them. And I just continually learned and continued to stay on the field and worked in the ECs and in the NICUs, still learning. And then once it picked up, then I stopped my calls. And then I still, like I said, I worked at Red Cross and I'm still currently involved with this, just in the transition period now from short term to long term. But yeah, you gotta keep yourself busy and keep yourself motivated. And I always say keep your eyes on the prize. There is a rainbow. So there's a rainbow at the end.

Dr Maria Christodoulou 1:03:58

So you've kind of answered it already, but maybe something else will come out if I ask the question. What advice would you have for a young colleague who's about to finish and anticipating that there isn't going to be a post for them to specialize next year and contemplating the possibility that private practice might be the way to go? What advice would you have?

Posts Frozen: Rethinking The Path

Dr Bianca Leigh Edwards 1:04:19

Don't lose hope. Keep the passion. Persevere, because it's not going to be easy. Anyone who tells you it's easy is lying. And then the other thing I would tell them is when it gets tough, hold on to your passion because you really do need to hold on to that. And find a mentor if you can. It's very difficult in private because private everyone works for themselves. And it's one of the things I'm trying to change. But everyone works in isolation and silo. One of the first things I did was actually drop my information sheet at every paed. I went and said, in this area, obviously I didn't do the whole Cape Town. But I would drop a little thing and say, Hi, I'm Dr. B. I'm new. Please give me feedback, positive or negative. Just want to know. And I did it to all the sisters, messaged physios, and speech therapists. And I'd say to them, What protocol? How would you like me to do a referral? And yeah, I just got to know the team. And slowly actually, I mean, I still got lots of those to do. There's still so much that I need to do. And there's still so much I'm learning on a daily basis. I definitely have so much to learn. I mean, but if you can create your own little network and you've got people, and your mentor doesn't necessarily have to be, I struggled to find a GP willing to take me under their wing. It needs to just be someone that can encourage you through the time and keep you going and give you advice. And don't be afraid to ask because you're not gonna know until you've asked. So there's a lot of things you've got to learn, and lovely WhatsApp groups with other GPs and support, and it's okay to ask, even if it seems trivial and small, and you feel like you just want to check something, check it. You know, we've got people's lives in our hands. It's yes, it's okay to make mistakes, but it's also okay to just, you know, ask to try and avoid some of the mistakes.

Dr Maria Christodoulou 1:06:32

Yeah. I remember it's a big adjustment going from the public sector hospital environment where there's a team of people responsible for patient care, and there's almost like checks and balances because there's different levels in the hierarchy that are all responsible for the same patient. And then you go into your own private practice, and then if the buck stops with you. There's no one to bounce the sort of diagnostic decision making with, there's no one to check in about the treatment options, and it's hard to build that network, and it's hard to develop that trust in yourself and your own clinical reasoning and to not have a fall back system. So developing that is often the biggest challenge. What are some of the practical resources that have been most helpful as you've gone about setting up your business?

Choosing GP With A Paediatric Focus

Dr Bianca Leigh Edwards 1:07:17

One of the big things I did was read the HPCSA, like long pages of what's needed in that six-month period, you know, while I was prepping, just so that I knew what I needed, because it's so difficult. What do you need? The other resource that I found really helpful is, you know, basically literally calculators, because obviously I'm doing children, so everything's calculated. They have so many amazing resources like EM guidance, you know, these online things where they tell you the national protocols and stuff. And you know, the basics count. People often think when they come into private that they need to be describing the 20,000 other medications. But as I go through, I realize what's needed, what's not, what's just the noise. And I think the other thing that's a very important resource is your people. Is your people really because they're the most important resource. I can't do what I do without my receptionist. She's such a pivotal role in terms of admin and in terms of making everything possible. I always say she's the powerhouse of the system. And I embraced online. It was very difficult for me. I'm such an old school person. I loved writing notes. And so I had to learn to type. And I realized that my community needed to make the appointment... because most mums make them between 10 p.m. and 6 a.m. Because that's the time your kid gets sick. So I made sure my platform was all online and the mums could book online in the middle of the night and know they have an appointment and not have to wait till 8-8:30 in the morning to call. Because chances are at 8-8:30 they're taking another child to school or they're busy, and then by the time they eventually call, you're fully booked. So I made that platform and I just asked around to be honest, what worked and what didn't work with other people and what I needed. I just did a lot of research to be honest, it was six months before I opened. And I actively did the process because my husband was very much like, you need to actively do this plan B. And he was right. I did need to actively do my plan B. And so when I was ready to open, I felt like I had done my... in amongst the calls and locuming, I had done my due diligence. Every day I would do my little bit of homework. And I mean, like I said, I'm still learning. I'm definitely by no means got the perfect practice at all. I keep learning as you go along.

Dr Maria Christodoulou 1:09:46

I'm almost scared to ask this question, but if you got a call tomorrow saying there was a post for you to specialize in January, what would you do?

Dr Bianca Leigh Edwards 1:10:00

I would probably say no.

Dr Maria Christodoulou 1:10:02

Yeah?

Dr Bianca Leigh Edwards 1:10:03

I think the emotional side of me would say yes. But the practical side of me with my little one and what I'm going through and what my colleagues are going through currently in the specializing posts, being so short-staffed, not spending time with their children, and telling me all the things that they're struggling with. Like my struggles are there.. Their struggles are immense at the moment because of the system and the failure and the brokenness of the world. And as hard as it is to say, I would love to say yes, because it's always been my dream and passion. But it's not the time. My time at the moment is to continue to build this practice. My time at the moment is to be the best mom I could be to my little boy. He is literally, like I told you, being a doctor was my one passion, being a mom was the other. The story time I get in the morning and the lighting of his face. And when I get home, he's generally running up and mommy, mommy, mommy, mommy. And the heartbreak I feel when you leave for work. And no mommy, don't go to work. I mean, he's even gone as far as saying, Mommy, I'm sick, I need a doctor. So yeah, you can't put a price tag on life. And I feel like I'm a little bit better balanced, although I am working really hard and I am working after hours. I'm a little bit better balanced. And I've gone to family weddings, and I've gone to birthday functions, and people take that lightly, but I didn't get to do that. I had to turn away so many things. I had to turn away best friend's weddings. I had to turn away being there when people had kids. I had to miss functions, I had to miss a few birthdays, I had to miss Christmas, New Year's, Easter's. And now I get to be, although I do work after hours and I do have the call-outs and you know, all those things, but it's different. If it's two or three hours away, it's not 50 hours or 24 hours.

Prevention, Community, And Continuity

Dr Maria Christodoulou 1:12:18

Well, last month's guest was Professor Lydia Cairncross, and she described an event where she was quite heavily pregnant, I think, with her second child, and she was on call, and she, I think at the time was already working in an academic role, but was volunteering at other hospitals because she'd always had this dream of being one of those sort of surgeons on the front line, trauma surgeon, you know, in the thick of the action, and her child was sick and she got called out and she left and she came back at like 3 a.m. The operation had gone well, but she came back at 3 a.m. And the screaming child, an overwhelmed, stressed-out husband, and she just stopped and went, What am I doing? And she really had to accept that she was not going to be that on the frontline surgeon that she had imagined, and that she was now an academic and a researcher and a specialist surgeon in an academic institution, which meant sacrificing the other, but also brought certain benefits. Amongst them, the greater predictability in terms of her time and her availability for her children. And I think it's that thing of we have this idea of who we're going to be and who we're going to become. And often it's a romanticized idea, and then the reality kicks in, and we have to make some very difficult decisions. But what I'm hearing is that your identity now is able to embrace much more of who you are than just the doctor role. You're a mom, you're a wife, you're a family member, you have a community of friends and family that you want to be a part of. And I think that's really healthy.

Dr Bianca Leigh Edwards 1:13:57

I think if I look at myself where I am now, I'm more whole.

Dr Maria Christodoulou 1:14:02

Hmm. Lovely.

Dr Bianca Leigh Edwards 1:14:05

I have a better balance. It's still, if you customize what Emparius said, not perfect, but I'm definitely more balanced, I'm more present, and I'm happy.

Dr Maria Christodoulou 1:14:19

Yeah.

Dr Bianca Leigh Edwards 1:14:20

Not to negate the other years, and they were also great, and I learned so much. But I was very driven. I needed to do it, I needed a type A personality, everything's perfect. I had to accomplish this. I used to get upset when I was a plan B and not a plan A. Um, I was going to specialize in paediatrics, I was then gonna do oncology. It was all planned. And I had to just realize that I can still do those things in a different way. So one of the things I've been doing is a perinatal palliative care course. My plan is still to do my palliative care diploma, and so I want to incorporate what I was in the new role. Everything's just a different perspective, but still what I love, and actually almost maybe more in line because as the super specialist, you're busy, and I can't do all that emotional work and work with families. And I realized actually while doing this course, how the GP is the one that carries the family when they go home because the specialists are in the hospitals, they stuck in hospitals and they don't have the capacity, and it's not that it's not their role, but they don't have the time. They're running and they have their short consults because that's what they have to do. They've got a certain load that they need to get through, and that's why they get these teams like Paeds Pal and all these teams to step in. So I haven't really said goodbye to my specializing as per se, but at the moment, where I am, the reg program and specializing like in that way...

Dr Maria Christodoulou 1:16:11

Well, maybe it's about redefining what it means to be a specialist. I sometimes think that being a generalist specialist is much more complex than choosing one discipline, one field, and going very in-depth in that one arena. Because you have to be prepared for all different kinds of eventualities. And I've often thought about that as family medicine, but you're niching even within the generalization into paediatrics and paediatric palliative medicine. So yeah, I think it's a beautiful new way of looking at it, that one can be a generalist and still have a niche, still have a particular passion or focus or direction. Because I think the world's going to be needing that.

Private Practice Reality Check

Dr Bianca Leigh Edwards 1:16:51

Yeah. And I think that's what's so powerful about seeing people that had done it before me. The GPs who had just done paediatrics. Even the women's health GPs that I've been seeing, um, seen some mental health GPs. And I think it's really empowering. Yes, we do need generalist GPs as well. There's no divide or anything. We all work together. But I think it is so nice to see that these can occur. Just to make it that community and realize that you can still do exactly what you're passionate about and focus on what you love.

Dr Maria Christodoulou 1:17:32

You've described yourself as being a more whole person now. So, what does the rest of your life include that we haven't talked about? What are the fun things that you like to do? What are some of your hobbies? What brings you joy?

Dr Bianca Leigh Edwards 1:17:45

Sjoe, there's lots of things that bring me joy. I am quite an outdoorsy person. My husband and I love the outdoors. In fact, most of our holidays are spent on the mountains, Drakensberg mountains. We used to do a lot of that before my little one. So just being outdoors and nature is the greatest medicine, to be honest, for one's soul. I also love singing. I used to be in the worship team, and the only reason I've taken a little break was because of my little one. But the aim is to be back on the worship team. I absolutely love singing worship. In fact, my son loved worship in my stomach. When he was in my tummy and I used to sing in the worship team, he used to dance around. So I literally was on the worship team until the weekend before I gave birth. And then other things I love doing is, I love... At the moment all my activities are mainly with my little one. Um it goes walking around the neighborhood or doing little activities with him. So, you know, I do dance school with him and a little thing called Poppy Tots. Yeah, does activities with him. And so, yeah, for me, this chapter has been slightly different, but he's really taught me so many creative things, you know, and how to just enjoy life. And when we dance together, it's just to sweet. And I love reading, and I'm so glad that now I'm getting to read non-medical books. With my son, I'm getting to actually enjoy reading again. I read to him every morning and evening, which is just such a special time. To me, the most important thing is family and spending time with my family, be it over a meal or a braai, or going for a walk, or going for ice-cream, or you know, just spending time with family. I think over those 10 years, they sacrificed a lot. And um, it's so nice to just be and attend things and try my best to attend functions. And my little boys got the cutest little massage group of friends. We're in a massage class together. And we are tight as thieves as mums, and it's so nice. I always encourage moms to have a network because no one's in the trenches unless they're with you in the trench. And we were all in the trench together. So yeah, I know that's my kind of outdoorsy things. But if you'll see me in traffic, you'll see me singing on the top of my lines with my son.

Dr Maria Christodoulou 1:20:21

I used to do that too. In fact, I remember one year my daughter was still quite young and we went away and I had to leave her with my mom. And my mom recalls driving in the car with her, and a song came on, and my mom started singing. And my daughter was like, No, she's not allowed to sing that song because that's mommy's song.

Dr Bianca Leigh Edwards 1:20:38

No, exactly. No, we've got our own playlist. My heart beams with pride when I see him. He really is my little joy.

Dr Maria Christodoulou 1:20:45

Our listeners can't see you, but your face lights up when you talk about him. There's a big smile from ear to ear, and your eyes are sparkly.

Dr Bianca Leigh Edwards 1:20:53

Yeah, he's my world.

Dr Maria Christodoulou 1:20:56

Maybe a bit too early to ask this because your practice is only a year and a bit old. But like if we projected a little bit into the future, what's the dream? What's your hope? What's next for you?

Leaving Public Sector, Staying Connected

Dr Bianca Leigh Edwards 1:21:09

So I'll tell you what my dream was before and I'll tell you what my dream is now. So before, when I was going to specialize, I wanted to open Matthew's Memorial Hospital, where it was going to be a paediatric oncology unit. As a paediatric oncologist, as obviously my brain had wanted. But now I see myself, especially as a paediatric GP, one day having a team. Physios, other GPs, as a team, looking after and networking, and hopefully one day being in the same building actually, to be able to just nip next door and give feedback. It is quite lonely being by myself. And then I want to have that specific focus because of obviously still wanting to do some palliative care. One of my big passions is home care as well. Not many are doing it, but something very important for those last chapters. You know, walking that journey with families. So, that's my dream. Slightly... Similar to what was planned, but different, if that makes sense. I wanted to open Matthews Memorial Hospital, where it was going to be a paediatric oncology unit. But now I see myself, especially as a paediatric GP, one day having a team. Physios, maybe as a team looking after and networking, and hopefully one day being in the same building and to be able to just live next door and give feedback. It is quite lonely being by myself. And then I want to have that specific focus because I'm obviously still wanting to do some palliative care and incorporate it and allow that part of it. One of my big passions is brain care as well. And it's very old for it. It's something that's slowly, you know, not meaning doing it. It's something very important for those last chapters. You know, walking that journey with that is so that's my dream. Similar to what I was planning, but different if that makes sense.

Valuing General Practice And Impact

Dr Maria Christodoulou 1:22:30

I .. If there was one thing that you wanted people who listen to this conversation to take from it, what would that be?

Dr Bianca Leigh Edwards 1:26:31

I hope it's inspired you. And passion, perseverance will get you where you need to be. But remember who you are, and don't let who you are be shadowed out because I try to still be me in what I've learned. And that's I think really important. Don't lose sight of who you are in your career.

Dr Maria Christodoulou 1:27:00

Yeah.

Dr Bianca Leigh Edwards 1:27:01

Because you're still a person with emotions.

Dr Maria Christodoulou 1:27:04

Yeah, I think the thing that stays with me after listening to you is how sometimes the idea that we have of how things are going to pan out and what we're going to do with our passions often doesn't pan out. And at the time that that's happening, we feel like that's somehow bad or wrong. And yet life takes us in a different direction that still includes those passions, that still includes those threads. They just weave into a different kind of future. And perhaps the one that we were imagining may have limited us. It's so easy to think, oh, that would have been the ideal. So now I've got to make a plan B. But what if plan B is actually the better plan? David Whyte talks about how you know you're on the right path when it keeps disappearing in front of you.

Dr Bianca Leigh Edwards 1:27:52

That's excellent.

Dr Maria Christodoulou 1:27:53

So there's something of that in your story that really stands out for me. That kind of each time there was this idea, and yes, of course, there was some perseverance, there was something in your stubbornness in a way, your ability to keep at it and keep fighting and not give up on the dream that would open the door. But then beyond that point, it looked very different. And we don't know today what that background in biology and in genetics and you know the research you did there, what role that may play in the future. We can't see how these threads that you've pulled along with you since you were four years old are weaving into something magical that maybe you couldn't have dreamt of.

Dr Bianca Leigh Edwards 1:28:38

Yeah. And I think it's also important to remember, like you were saying there's plan A, plan B. I mean, I think I was on plan Z. And it's okay. Sometimes it's actually a plan. I think we did chat about this when we were prepping. Sometimes it's a plan that you didn't have. And it evolved, like you said to me, it evolves as you become. And you know, I've evolved as I've become. I've evolved as I've become a doctor, I've evolved as I've become a mother, I've evolved as I've become a wife, and I'm constantly evolving. As a businesswoman, that's another one that I had to suddenly pick up.

Dr Maria Christodoulou 1:29:18

I think the other thing that stays with me is your very early encounters with death and how they have shaped you, and how your journey has been one of repeatedly coming back to this theme of end of life, end of life, end of life, for even in your childhood, and then your first day as a doctor, signing 12 death certificates. I mean, yeah, I'm sure there are many other doctors who did that too, but I've not had a chance to speak to one of them yet. And it feels like there's something really profound in your initiation, actually. It feels like an initiation of sorts. And in many of the shamanic traditions, and I've spoken about this before in other conversations, but in many of the shamanic traditions, becoming a healer required a confrontation with death. And it was often a rite of passage that marked the completion of your training. And it feels like in many ways you've been initiated and that there is a deeper, bigger, greater destiny with this capacity to sit in that darkness, but also to be able to find the joy and to bring light and to bring grace and to bring your big, beautiful, emotional, passionate heart. Yeah, I think that there's something. It's weird. I don't have words for it, but I feel like there is something that is still forming, growing, emerging in you that is very powerful and that it is about this capacity to hold both birth and death and everything in between in your hands. So I'm very eager to see where life will take you.

Perseverance, Patience, And Growth

Dr Bianca Leigh Edwards 1:31:05

Thank you. And thank you for giving me this option to share, Maria. I think it's such an amazing powerful tool. It just gives us doctors, you know, healthcare workers and professionals, just a space to kind of also process everything and share the story and talk. I mean, I know as much as it's helped you, it's been phenomenal for me and just allowed me to kind of walk through everything. So thank you.

Dr Maria Christodoulou 1:31:35

Lovely. What's gonna stay with you at the end of our conversation?

Dr Bianca Leigh Edwards 1:31:40

Oh, there's so many things. I think the biggest thing that's gonna stay with me is like you were saying how we evolve over time. And I remember when we chatted informally that evolving and how you've come into your role and how as life throws your burdens and throws things, you evolve. And something that you start with doesn't have to be something you end with. And I think that was so powerful to me, especially when you asked me that question about what have happened in that, you know. And just because it's now not the time, but who knows? You know, one day maybe it will be the time, maybe it will be part of my story. But at the moment, my story is my family and enjoying the chapter I'm in now.

Dr Maria Christodoulou 1:32:31

And that's a beautiful story, and it's well worth being present for because it goes by very quickly.

Dr Bianca Leigh Edwards 1:32:37

I know. I know.

Dr Maria Christodoulou 1:32:39

Thank you, Bianca. It's been a joy to have this conversation, and I'm very grateful that you made the time and thank you for sharing so honestly and so passionately about what you've been through.

Dr Bianca Leigh Edwards 1:32:52

Thank you, Maria. It's honestly been such a wonderful chat. It's been so wonderful to just go through all the reflections and go through all the process that's got me here. And it's also quite enlightening because some of the things I hadn't really spoken or thought about, and I've never shared my story. The first time I'm sharing my story on any platform.

Dr Maria Christodoulou 1:33:16

Yes, I must say I tried to do some research before our conversation, and there was virtually nothing. There was very little social media, there's no social media profiles other than your practice profile.

Dr Bianca Leigh Edwards 1:33:28

I'm not very good at technology.

Dr Maria Christodoulou 1:33:30

Right. Well, so there's not an online presence. I know that doesn't mean that you don't have a life outside of what you do, but I feel very honoured that you were willing to share your story with me. So thank you.

Dr Bianca Leigh Edwards 1:33:43

Thank you.

Dr Maria Christodoulou 1:33:46

I'm Dr. Maria Christodoulou, and you've been listening to the Awakening Doctor podcast. If you enjoyed this conversation, please share it with your friends, follow Awakening Doctor on Instagram, Facebook, and Spotify, and go to Apple Podcasts to subscribe, rate, and give us a good review. Thank you so much for listening.