 Why did you want to study Medicine?
My family was not well off. I wanted
to ensure that I was better off. I wanted material comforts for my children and my family,
which unfortunately I did not have. My father was from a poor family. He had to leave the
town because there was no work. He had to take whatever jobs he could get at that time. It
was a struggle all the time. I did not want to struggle like that. Getting into medicine
was a way out. Of course, It meant getting better grades and working hard.
In your family there
were no doctors, so why did you want to particularly take up medicine?
I used to admire those few general
practitioners who attended on me and my family when I was young. They had strength,
kindness and were down to earth. They looked different. They had rich, fruity, deep
voices. Like them, I wanted to drive a nice car and carry a big black bag.
Why did you join
Psychiatry?
 Upto 1970, people thought that those who were
not good in anything else took up psychiatry. It is really true in my case. I was not good
at anything. I could not do surgery. I was not good with my hands.
I went for psychiatry as I was always
interested in English literature, history, drama, philosophy and psychiatry was the only
field where these interests could be partly accommodated. Psychiatry in Australia is full
of failed writers, musicians, dramatists, actors and artists. Psychological theories,
psychoanalytical theories and existential philosophy are all relevant to psychiatry.
Why did you leave
Adelaide?
I left the country as I could not stay in
Adelaide. It was inward looking and parochial. It was important to move out and meet
challenges elsewhere. I was not content having a triple fronted house with a double
garage, 2.2 children, an unhappy wife and staying smug under the wings of a consultant.
For the past twenty-five
years what have you been trying to achieve in Psychiatry?
I am trying to get it right. I am trying to
get a broad understanding of the nature of psychiatric problems rather than look at them
from a narrow point of view and understand psychiatric problems from the biological,
social and historical perspective. For me, fundamentally, the nature of psychological
misery is the same worldwide.
I am trying to understand what
schizophrenia is all about. I am trying to develop medical education programmes for the
graduates and the post-graduates. I am trying to develop a mental health service that is
effective and innovative. Generally speaking, the service needs to be more accessible and
responsive to the general practice. Service personnel need to adopt more evidence based
practices, which means that the treatment given is based on the sound evidence of its
effectiveness. They need to ensure that they provide care in a manner that is humane and
compassionate.
How are you making it
possible?
We are trying to do it in Newcastle by
evolving responsibilities so that everyone knows the policies. We are trying it through
vision and focus on improving streams of mental health services with the leadership of
several clinical education and training to those who are responsible for delivering
services. I am also trying to do it by providing leadership and by setting an example by
my own behaviour.
What are the
difficulties you are facing in implementing a responsive and innovative service?
We are facing normal inertia and resistance to change what
exists in all long established systems. To get over it, we are communicating and
consulting with all our staff and other interested parties. We are trying to provide
supportive and positive environment in which the staff can achieve these changes. We are
educating and training the staff by having consultation and communication with the GPs and
patient groups. We are aiming at better mental health outcome for the patients and a
congenial clinical environment in which to teach and do research.
In Newcastle, you seem
to be working with several psychiatrists from India, any comments on that?
We had shortage of staff in Newcastle and
we had to recruit people from many parts of the world like UK, Yugoslavia, Fiji, New
Zealand and also from India. On the whole I can say Indian psychiatrists in Newcastle are
outstanding. They have very good clinical skills and they have been trained extremely well
in India.
What is your impression
about the service delivery by the NGO and the government run mental health facilities in
Chennai and Bangalore, which you visited?
I have been very impressed by the work, the
quality of clinical assessment and the treatment provided. I found the staff of the
Schizophrenia Care and Research Foundation (SCARF) in Chennai, to be very committed and
dedicated. It is a very effective organisation to provide care, advocacy, treatment and
research for the people affected with schizophrenia.
On the other hand, I found NIMHANS
(National Institute of Mental Health) at Bangalore to be a very impressive organisation. I
was impressed by everyone there. Their quality of work is very high. The people are all of
very high caliber. Their public work and the published work and consultancies they do with
WHO etc. show how well they are regarded. Both in the Institute of Mental Health in
Chennai and NIMHANS, I was impressed by the fact that they do qualitative work with such
few resources compared to what we have in Australia.
What are your plans to
establish linkages between India and Australia in future?
I would like to explore the possibility
of sending registrars to India for three to six months to expose them to quite a different
treatment environment and problems of health care delivery in countries like India.
I would like to have exchange of trainees
and medical students and develop bonds that should benefit both sides. I would like to set
up an elective programme of four weeks to three months at NIMHANS and St. John’s
Hospital in Bangalore and at SCARF INDIA and the Madras Medical College in Chennai. I
would also like to start collaborative research between Australia and India, with SCARF
and other groups. Lastly, I would like to come to India for a few months and not for a few
days as there is so much to learn, share and take back.
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