30 April 2022

Difficult times ... and an escape hatch!

Fish bone, bowel blockage by adhesions, retirement and closure of clinic after 38 years.  

Dear colleagues, 

In October 2021 at a siblings reunion dinner I swallowed one or possibly two fishbones with my first excited mouthful.  After long Covid lock-down and with family I suddenly developed the dreaded sensation of a sharp foreign body in my throat.  And when it did not go away I booked myself in for a gastroscopy three days at Bowral Private Hospital.  However, to my surprise, nothing was found.  Subsequent examination at St Vincent's in Sydney was equally unremarkable.  CT scan, MRI scan (a punishing experience) and subsequent oesophagoscopy under anaesthetic were also all normal yet I knew there was still a bone (or two) there in the lower gullet or upper chest region.  Eventually, by the middle of January this year, the foreign body seemed to have either dissolved or moved on.  But I had more to worry about.  

The 'normal' rigours of running a solo medical practice were added to by the pandemic.  Apart from the daily threat to staff and patients, I was obliged to enter every patient's details on Service NSW Covid-safe web site by the close of trading, even on my 'days off'.  Getting 95% of our patients vaccinated was a challenge which we were also equal to.  Yet the enjoyment of running the practice was considerably impacted by all of these contingencies as well as the requirements of registration, accreditation, fire compliance, pest report, safety drills, etc.  So I decided to pull the plug and tell my staff it was a very sad day but we would be closing down.  Telling the patients was also tough.  Prior to that I had an assurance from the owner of a nearby large addiction clinic that they could manage to take most or all of our 165 opiate maintenance patients.  

An old adage is that people often develop illness, injury or other misadventure straight after retiring.  So it happened that just 8 weeks later I developed a bowel obstruction requiring urgent laparotomy with two weeks recuperation, somewhat cramping my style and confidence.  I thank the staff of Bowral District Hospital for magnificent care from the Emergency Ward to the operating theatres, intensive care and general wards.  Night staff especially were caring and prepared to go the extra distance in customised advice and support.  It must be especially exacting looking after fellow health workers and I was not an 'easy' patient by any means.