Dr Ruth Stewart is a Senior Medical Officer for the Torres Strait community of Thursday Island. She is also the recently appointed president of The Australian College of Rural and Remote Medicine (ACRRM), taking up the post at last week’s Rural Medicine Australia conference in Canberra.
Below, Ruth takes some time to reflect on the nature of rural and remote practice, and some of the personal and professional issues that will inform her term as president.
Dr Ruth Stewart writes
An old man sat in the dust under a tree and watched the whitefellas climb out of the four-wheel drive vehicle. One of them waved. He made no response.
A month later when the same health team returned to that remote community he was there again. They waved again, no response. This happened again and again, they came, they waved, they left with no response.
Then finally, one day he waved back, as if he always had. Intrigued a team member went over to him. “Hello Uncle, if you don’t mind, can you tell me why you waved to us today and not the other times?” He answered, “I just wanted to see if you’d come back”.
I have recently become president of the Australian College of Rural and Remote Medicine (ACRRM). I have been a member of this college for seventeen years.
I joined ACRRM in 1999 because I wanted to be part of an organisation that was tackling the issue of the sudden dearth of new rural and remote doctors.
In my work as a rural doctor I knew that we didn’t have enough doctors out bush. I knew that the stories I told about my practice were very different to those told by my friends who chose to work in cities. I joined the college that was struggling to articulate what this meant for training future rural and remote doctors and supporting the existing ones.
The story about the old man under the tree brings together some of the themes that I intend to work with during my presidency of ACRRM. It’s a story about remoteness, about culture, about connection and disconnection and the impact that these have on health care and closing the gap.
Changes in people’s lives and health are not wrought by the accurate transfer of information; change happens when a person understands what that information means in their life.
As a doctor I have had the incredible privilege of knowing my patients and their families, their motivations and their frailties. And they know quite a lot about me. It is the relationship built between a patient and their doctor that enables the information to be adapted for the patient to get what it means for them.
This cannot happen when a medical service is delivered by a string of locums. It cannot happen until the patient learns that they can trust the doctor; until the old mans sees you come back again and again and again.
If you are an Aboriginal or Torres Strait Islander Australian, you have generations of experience that tells you not to take what these whitefellas say at face value.
Of course if the health professional is not a whitefella that helps get the message across. That’s another reason to support Aboriginal and Torres Strait Islander people to become doctors and health professionals.
Through the ACRRM pathway to fellowship, doctors can gather the competence and the confidence to take up permanent roles in rural and remote communities that will change lives; close the gap.
I bring some other things to the role of president as well. I’m female and I am currently having telehealth chemotherapy for lymphoma on Thursday Island in the Torres Strait where I live and work.
Having my chemotherapy close to home has made a huge difference to me. At a time when I am easily exhausted and can be emotionally fragile, having treatment from people who know me, and whom I know helps. It also helps that I do not need to undertake a long trip for treatment.
The bus, ferry, bus plane and taxi ride can take a lot out of you and your pocket, even when Patient Travel subsidy supports the costs. I hope to see the model of care from which I am benefitting available to rural and remote Australians right across the country.
As a young doctor I looked around for role models. I found many great rural doctors, but most of them had a wife who did the home stuff.
I found a group within ACRRM, the Women in Rural Practice. I also knew Dr Mary Grace Whyte who was an awesome GP anaesthetist, wife and mother of seven amazing people. I could see that whilst it was unlikely that I would do it all at once, it was possible for me as a woman to be the kind of rural doctor, woman, wife and mother I admired.
I hope in my presidency to demonstrate to our 619 registrars (274 or 44% of whom are female) what a great career they have chosen, how the sky is broad and the horizons wide and that the only limits on what you achieve are the ones you allow.
Dr Ruth Stewart is a Senior Medical Officer on Thursday Island, Torres Strait, Associate Professor of Rural Medicine at James Cook University, and President of the Australian College of Rural and Remote Medicine.