|Best of both worlds|
|Monday, 21 May 2012|
Julian Speight came to New Zealand in search of a healthy work-life balance, but also found the perfect setting for a consultant with his clinical interests, writes Mark Baillie
The website for the Invercargill tourist board boasts of the city’s friendliness, warmth and hospitality. Mr Julian Speight, Consultant General Surgeon at Kew Hospital, knows this is no exaggeration. “Living in a small community has its advantages,” he says. “The people of Southland are incredibly welcoming and generous. It's not uncommon for patients to show their appreciation with a crayfish or a kilo of blue cod, or a wild venison steak!”
Originally from Dorset, Mr Speight moved to New Zealand from the UK on a permanent basis in 1999 and progressed through registrar and advanced training, including posts at Dunedin and Christchurch. He was appointed Consultant at Kew Hospital in 2008 following a year back in the UK as Colorectal Clinical Fellow at Bath’s Royal United Hospital.
As an undergraduate at the University of London, he had an affinity for anatomy, taking an intercollated degree in his third year. In 1993, he graduated with Distinction in Surgery MBBS from the United Medical and Dental Schools Guys’ and St Thomas’ Hospitals.
However, it was while on an elective in Kenya that he realised the full value of surgery: “I was humbled by the stoicism and kindness of the Kenyan people in the face of adversity,” he says. “I realised how fortunate we are in the West, and how people take their health (and health service) for granted. I also realised that there was an opportunity to do so much good in the developing world. Lives could be saved with such simple interventions.”
To illustrate this point, he describes treating a young boy whose family didn’t expect him to survive. After successful treatment, the patient’s family showed their gratitude by presenting Mr Speight with a gift: their only chicken. He remarks, “I tried to decline, but they'd already killed it for me! In real terms the chicken represented the most valuable commodity the family owned. It was like someone in the West giving me their car!”
As one of the RCSEd’s most southerly-based Fellows, it may be wondered why he still chooses to maintain his Fellowship when he lives so far away and also holds the RACS Fellowship. This comes down to family roots and an attraction to the RCSEd’s global profile: “There is Scottish heritage on my mother’s side, but I’m also drawn by the global spread of the RCSEd Fellowship.”
One of his motives for the move to New Zealand was to gain a better work-life balance, but was it easy to make the transition from a professional perspective? “At first glance the systems seem very similar. Certainly it is very easy for junior doctors and seniors alike to make the transition.” He remarks that the New Zealand healthcare system is efficient and innovative, and despite a relatively low GDP spend on healthcare the level of care is excellent and reflects what he calls the “Kiwi can-do” attitude.
“The relatively sparse population and large distances between population centres lends itself to being a ‘generalist’”
Southland’s Kew Hospital covers the largest catchment area (in square kilometres) in New Zealand, but with one of the smaller populations. The nearest referral centre is a two-and-a-half-hour car journey away in Dunedin.
For Mr Speight, it is these challenges that make the job enjoyable; “Because we are relatively isolated, and transfer to our nearest referral centre can be difficult, we have to be prepared to deal with most eventualities. It can be quite taxing if you're dealing with a problem well outside of your area of expertise. We have no neurosurgery, paediatric surgery, cardiothoracic surgery, ENT or opthalmology resident in Southland.”
Explaining further, he adds, “I came here in search of true ‘general surgery’. The relatively sparse population and large distances between population centres lends itself to being a ‘generalist’. That having been said, our hospital is still affiliated with the University of Otago, and we have both medical students and surgical trainees. So I feel that we have the best of both worlds: a small, friendly hospital with the opportunity to practice general surgery, and yet the opportunity to train students and trainee surgeons.”
Perhaps it is the country’s wide open spaces and natural beauty that makes Mr Speight so passionate about outdoor pursuits. Current and past hobbies include skiing, paragliding, flying and mountaineering. However, such pastimes aren’t without risk, as he knows too well; “I've been paragliding since 1986, and have seen a few accidents during that time. It was clear to me that managing severe trauma in an austere environment was very different to coping with trauma in the relative security of a hospital.” In fact, he has also been the patient on a few occasions, injuring his back and braking ribs while paragliding in the Drakensberg Mountains of South Africa. He also crashed and sustained a foot injury in the Himalayas.
However, it was while working as the medic on a climbing trip in Nepal in 1999 that Mr Speight decided he’d like to know more about wilderness and expedition medicine. Since becoming an AWLS instructor, he’s now developed an interest in Disaster Medicine.
His passion for an outdoor life extends to enjoying it with his young family. He proudly states that his eldest – seven-year-old Matthew – has just finished his third ski season, four-year-old Ollie has had his second season, while two-year-old Isabelle is desperate to join her brothers on the snow.
“While in Wanaka over the Christmas holidays, I was canoeing on the lake with the kids one day, and flying over the lake in a friend's Tigermoth the next day. We have some of the most beautiful wilderness all around us: the Fiordland National Park to the west, the Catlins to the east, Stewart Island to the south and Queenstown/central Otago to the North.”
He has reduced some of his more adventurous activities since becoming a father; he flies planes less often and certainly refrains from aerobatics; he still enjoys hill-walking but is holding off backcountry skiing and mountaineering until his children are older. But, displaying some of his adopted Kiwi can-do attitude, he points out, “The great thing is there is still a multitude of cool things to do with the kids, and when they get older I'm hoping to get back into the other stuff with them!”