Canadian bacon on the barbie: a locum experience in rural Australia
Eugene Leduc, MD, CCFP
Creston, BC
Can J Rural Med vol 2 (2):82
Correspondence to: Dr. Eugene Leduc, Box 2010, Creston BC, V0B 1G0
eleduc@kootenay.awinc.com
© 1997 Society of Rural Physicians of Canada
Doc, I'm crook in me gut!" comes the strained reply to my greeting.
Sitting in my surgery, the husky bloke wearing a grease-stained singlet, shorts and thongs is dramatic in his suffering. After a history and exam indicating viral gastroenteritis, he asks me, "Got the wog, you reckon?"
I confirm his diagnosis, advise him he may soon get the gastric and, if he doesn't drink enough, will certainly get the wobblies, especially if he continues on the grog. I tell him that if he follows my advice, he'll be fair dinkum by this avo and right into his tucker within a fortnight. No worries.
Reflecting on this encounter and many other colourful experiences my family and I have had during our 6-month locum in rural Australia, we feel very fortunate. This evening, as I sit by our kitchen window, tapping on my keyboard to the sounds of crickets and the warm breeze rustling the palm trees, Canada is very far away. It is hard to believe that exactly 1 year ago we were on the other side of the world, pondering whether to come here. There were many reasons for our decision to do so, chief among them the desire to travel and to educate our 3 children about the world outside our own small town in British Columbia.
After we decided to go, the first step was to find someone to replace me. Through an advertisement, I found a South African-trained GP/anesthetist from Manitoba who was available for a long-term locum and who was soon confirmed as my temporary replacement.
Once I could give the agency coordinating my own locum a tentative departure date, I filled in the application form and mailed copies of my CV, diplomas and references. The agency even did some background checks by telephone, but thankfully my colleagues, anxious to be rid of me, gave glowing reviews.
Because of restrictions on the registration of foreign-trained medical graduates in Australia, the only locum opportunities are in rural areas. Most placements involve moving every few weeks, but because we had our school-aged children with us, we preferred to stay in one place for most of our stay. This preference limited our choice, but we were very happy with our ultimate placement in Emerald, Queensland, on the Tropic of Capricorn.
Two months before we left, I started informing my patients about our plans. It was reassuring to many that I had personally selected my replacement. It was difficult saying goodbye to those who were seriously ill and unlikely to survive until my return. However, most were very encouraging about our venture and wished us the best. In fact, a few seemed a bit too happy to see me go.
We left Creston on a rainy day in early spring, driving through snow flurries to get to Vancouver. Just a few days later we arrived in Emerald, where the seasons were reversed. We were sweating in our shorts and T-shirts while the natives complained about the autumn chill in the air and donned their jumpers.
On the day of our arrival, our first social event was a traditional Aussie "barbie." We gathered in our host's backyard. The men chatted, each holding a "stubby" beer in one hand and barbecue tongs in the other. The women conversed while preparing the salads and desserts, and the children ran among everyone, shouting and playing. This scene has replayed itself many times during our stay.
The friendliness in this rural area is evident in the way strangers acknowledge each other on the walking path. I first noticed this when I went jogging one morning. As I passed people, they shook their heads. At first I thought they just couldn't believe that anyone would want to run on a "cold" winter morning, but then I realized that the Australian head shake was equivalent to the North American nod; I was actually being greeted!
We have frequently been surprised by the frank and unassuming nature of many Australians. On one occasion, we were passing through a dusty outback town on a hot day and stopped to buy ice cream at the general store. The elderly proprietor noticed our accent and asked where we were from. When he discovered that I was a physician, he exclaimed with pride, "I'm a paranoid schizophrenic! I reckon you couldn't tell 'cause I take me medication."
I have found the patients equally welcoming and genuinely interested in how I came to Emerald. As an assistant to a busy private GP, I have quickly become busy myself in this under-doctored and growing town of 10 000. The practice of medicine here is much the same as in rural Canada. The illnesses are the same, and there are no specialists for 300 km, so the local GPs must be skilled in procedures such as anesthesia and emergency surgery.
Emerald has four private GPs. Their patients pay the full Australian Medical Association suggested fee ($34 for a standard consultation) at the time of the visit, then apply to Medicare for the rebate ($21). This results in extra-billing of approximately $13 per visit. The only exceptions are pensioners (over 65 years of age) and those on social assistance, for whom the GPs here accept the Medicare payment of $21 directly from the government, a process called "bulk-billing" and one with which Canadian doctors are very familiar. Because there is more competition in the cities, most urban Australian GPs bulk-bill for all their patients.
Emerald Hospital is a public hospital staffed by 3 salaried GPs, 2 of whom are trainees. In addition to providing 24-hour medical coverage for the hospital, they run a free daytime outpatient clinic that is booked weeks in advance. Because of the wait, many "public" patients come to the private surgeries and pay the price of a prompt consultation. But if they need admission, they usually prefer to return to the care of the hospital doctor. Consequently, my hospital work has been limited to occasional anesthetic or inpatient care for those few who are privately insured.
The GP with whom I am working prefers to do most of his own on-call work, so I have plenty of time to get involved in the community. We attend educational meetings, as well as church, school and musical functions. The children have adapted well to their new primary school, wear their uniforms proudly and have made many new friends. My wife and I enjoy playing with the Emerald Town Band.
Without a doubt, though, the most popular pastime in this land of endless summer is sports, whether it be participating in, watching or betting on them. In Emerald, there are facilities for playing just about any sport, except those on ice. My wife is in the 10-pin bowling league and fitness club, I do a daily run in the morning, and our kids play cricket. Our oldest boy, Marc, attended a free cricket lesson given by Merv Hughes, a famous Australian cricket player. Merv, obviously not thrilled with Marc's technique, said, "Where are you from, mate? You're swinging that thing like a baseball bat!"
Around Emerald, there is much to discover in the way of flora and fauna. Along with the common gum tree, we see many different types of palm, beautiful flowering bushes, ferns and cacti native to this region. We often awaken in the morning to the mocking laughter of the kookaburra or the whistling of the magpies. In the evening, the brightly coloured green and orange lorikeets gather in the trees and chatter noisily.
Fortunately, the medical business has not kept us confined to town. During our weekend and holiday camping expeditions to places like the outback, Carnarvon Gorge, the Great Barrier Reef and the Daintree Rainforest, we have had close encounters with kangaroos, wallabies, dingoes and possums. Other animals, such as emus, cassowaries and crocodiles, are more elusive, but we have seen them from a distance. At the seaside we were able to view dolphins jumping and humpback whales breaching, and to swim among the coral with sea turtles, stingrays and schools of colourful fish.
As my term of service nears an end I reminisce with satisfaction on a very rewarding experience, both professionally and personally. We will miss the sunny days and starry nights, the beautiful orange sunsets and all the things I have mentioned here. But most of all we will miss our new friends in Australia. In a short time, we will be back in the Great White North. Until then, no worries, mate!
