creating collegiality - Australian Medical Association NSW

President’s word
Dr Saxon Smith
President, AMA (NSW)
Creating collegiality
It is through the support of peers that we
become better doctors and deliver better
care to patients and the community.
The image of a doctor emotionally
breaking down outside a hospital in
America after the death of a 19-yearold patient has captured widespread
mainstream and social media attention.
This is a scenario that is repeated daily
around the world as doctors try to help
their patients when they are at their
greatest need. But usually it is not
captured or shared in such a public way;
rather it is our colleagues, friends and
loved ones who see the impact of one
of those days. It is a poignant reminder
of the importance of those social
foundations that keep us together even
on the toughest of days.
It has been 20 years since I started
my journey through medical school,
internship and specialist training; and 10
years since I began my involvement with
the AMA. In fact, some of the problems
splashed across recent media are the
same reasons why I decided to get
involved with the AMA in the first place. I
wanted to champion a culture change in
the profession – one that supported you
when you were sick; allowed part-time
training and work when your personal
circumstances needed it; looked after
its junior doctors to develop the future
healers and leaders; and, accepted its
own human frailties.
My career has been interrupted,
turned upside down and inside out due
to health problems. I was diagnosed with
[email protected]
ulcerative colitis (the other inflammatory
bowel disease to Crohn’s disease) in
the last year of medical school. This
began a rollercoaster ride with chronic
illness, which at the time robbed me
of my passion, confidence, fitness and
even my image of self. I was obsessively
diligent with my medications in an
attempt to control this disease – at one
point taking 16 tablets a day, as well as
using embarrassing topical therapies.
Despite all of this, at its worst I still
needed to visit the bathroom 20 times
in a morning due to severe abdominal
pain. After my weight dropped to 60kg
(from 75kg prior to being diagnosed),
I then ballooned to nearly 100kg as a
complication of long term high dose oral
steroids. As an intern, every morning was
a struggle to get to work – trying to time
the 10-minute drive between episodes of
urgent painful need to visit the bathroom.
All my sick leave and holiday leave
was taken up by hospital admissions,
investigations and simply being sick.
This was not the life I had dreamed for
myself nor a way for anyone to live and
work. I subsequently had long periods
not working and three major surgeries
to remove my entire large bowel (colon)
over a 12-month period, which were
associated with significant complications,
and subsequent years of piecing my life
and health back together.
During this incredibly hard time I was
lucky that I had family and friends around
me to pull me up when I was at rock
bottom. I also had amazing support from
colleagues and hospital administration. I
even had a random visit in hospital from a
cousin of a family friend who lived in rural
Queensland, but had been through the
same thing. I was also aware that I was
one of the lucky ones, as I know other
people with whom I worked were not as
supported by the system around them.
They felt isolated by colleges, hospital
administration and, at times, even by
colleagues. This left them trapped, lost or
pigeon-holed in their careers due to the
limitations of their health. This inequity
is what drove me to join the AMA and
turn up to my first doctors-in-training
Collegiality is a living thing that is fed
or starved by our actions and interactions
with each other. It is important to stand
with and stand up for our colleagues. It
is through this support of peers that we
become better doctors and deliver better
care to patients and the community. dr.