The following article by Dr Jared Watts is shared with permission from the Rural Doctors Association of Western Australia (RDAWA) Quarterly Newsletter August 2019. Visit the RDAWA website here.
‘Actually doctor, umm, there is just one more thing.’ Often the consultation has just finished. The patient is hesitantly about to get out of their seat or at other times I have opened the door and they are about to walk out. They look nervous and worried, not sure if they should ask the question or not. My medical student often looks quite complexed. We have just been talking about bladders, bowels, bleeding, babies and other very personal topics and the student wonders after all that, ‘what other topic or question could the patient now be so hesitant to ask?’ I smile, slightly grinning, often knowing what the next question will be.
‘So, why did you become a gynaecologist?’ Sometimes it is ‘why are you a women’s doc, doc?’ At other times ‘why did you specialise in pregnancies?’ It used to be ‘why did a young guy like you become a women’s doctor’ but sadly the emerging grey hairs seem to have slowed that line of questioning!
I often laugh, hopefully allaying the patients fear that she has asked too personal a question. And then comes the second question, ‘and why here in the Kimberley?’ So why am I an obstetrician gynaecologist in the Kimberley? Or as I like to describe it ‘how did I get to have the best job in the world, working in the best part of the world, with the best patients and absolutely the best colleagues?’
As I tell my medical students, I actually started training as a rural GP, but decided that was way too hard, having to know everything and anything, and therefore decided to become a ‘partialist.’ I had returned to Perth from Broome for family reasons, and while there decided to further my skills in paediatrics and obstetrics. Initially, I really disliked O+G. They had their own language that no one else seemed to understand, such as there were all these patients with ‘PE’ and yet not one of them was on a heparin infusion? There were these nurses called ‘midwives’ who I was petrified of (and still am!) and patients in labour, well they were just something else. But with time, and under the mentorship of obstetric legends such as Dr Anne Karczub, I discovered the absolute joys of obstetrics and that midwives were not as scary as they seemed but passionate and enthusiastic about their jobs.
I still remember the patient that really cemented my decision. She was in her early 60s and due to embarrassment with a severe uterine prolapse and incontinence, had not left the house for 6 years. She was an amazing person, looking after her family and working for many charities from home. Finally convincing her to have surgery, I still have tears in my eyes thinking about her 6-week post op check-up. I did not recognise her as I went to call her from the waiting room. She was a new person, with a new life and a new haircut and wardrobe to match. We were both in tears as she told me about leaving the house to go shopping for the first time in years and it was then I knew O+G was for me. I wanted to stand up and advocate for women who often put themselves second in life to family responsibilities or were too embarrassed or did not want to bother the doctor with their ‘minor’ problems, which often severely affected their quality of life.
Fast forward 6 years and I was lucky enough to see my ultimate job, as a Kimberley Regional Obstetrician and Gynaecologist, advertised just as I graduated. I received some negative opinions about taking on such a job, with some people even worried about my gender. But with the guidance and learning from Dr Wendy Hughes, this job has given me amazing opportunities to serve the women of the Kimberly and their families, and they have given me so much more in return.
A huge attraction for working in the Kimberley is that no day is ever the same. Often when I get out of bed, I have no idea how the day is going to go, and at times even where I’ll end up going to bed that night! Often, I am the only obstetrician gynaecologist in the region, but when I run into a difficult case or situation, I know that other doctors are available and more than willing to come and help. The teamwork is incredible, and people are willing to step out of their comfort zones and routine jobs to help each other out.
Another attraction and challenge in the Kimberley is the variety of pathology, from infectious diseases to many lifestyle conditions such as alcohol and type 2 diabetes. It is quite challenging as you can’t simply fix a lot of the social aspects of our patients’ lives. Clinics are therefore often incredibly varied. I can be seeing an infertility patient one minute, someone with ovarian cancer the next, and then two minutes later a pregnant lady with twins. At any time, you can be called to the ED to see a gynaecological patient, or there may be a complication with an obstetric patient, and I am call urgently to theatre or labour ward to assist. In between I can be taking phone calls from right across the Kimberley, to even being called into a video conferences where a pregnant woman has gone into labour in a remote community where I help talk them through the delivery.
Some of my favourite weeks during the year are outreach trips to remote clinics. It is a privileged to be welcomed by these women into their lives and communities. Often I am asked if being a male limits patients coming to see me. I think that most remote women are wary of newcomers but if you demonstrate care, compassion and respect you will be soon welcomed and trusted. After three years now, I love that I am affectionately called, ‘Lady Doctor Jared’ and past patients are bringing in their daughters or mothers to see the Lady Doctor with our remote clinics overflowing. I was taught well by my mentors that no woman should get out of a consultation without being asked about their bladder, bowels and pain, and for many Indigenous and remote women, they have being hiding or putting up with these conditions for many years. Rural and Indigenous women face so many challenges and yet are a ‘tough mob’ who have also taught me so much.
Often as I fly over the amazing Kimberley landscape to see these incredible women who put their families first, I realise it is a privileged to do this job and I wonder if I really should be paid! Hopefully my boss does not read this, as house loans need to be paid, but I do realise each day how lucky I am, and all the doctors who get to work in remote and rural areas of Australia.
Dr Jared Watts
Shared with permission from the Rural Doctors Association of Western Australia (RDAWA) Quarterly Newsletter August 2019. Visit the RDAWA website here.