Tribute

The first time I met Dr. FM was in my first year during the elective summer surgical program. He has a small stature and is very reserved, speaking when he absolutely had to. This was when I realised that English was not his strongpoint. Back in the surgical program, getting my head around the "layers of surgical principles" was a challenge. It still is a major challenge; the only difference is I'm a more competent surgical assistant now (self comparison to when I was in first year).

One afternoon I was eating lunch in the staff cafeteria and it was quiet that particular day. It was early January and many people were vacationing. I was about half-way through my meal when I noticed Dr. FM looking around for somewhere to sit. He noticed me waving and smiled, then joined me. Simply nodding, he started to eat slowly and didn't speak very much at all.

It's not very hard for me to talk myself silly, but I was doing what I could to stop myself. I decided to ask broad questions.

Where are you from? 


Iran. 


So you were trained there? 


Yes. I went to the University of Tehran. 

Are you married?


Yes. My wife is a doctor in Pathology in Tehran. 


Oh so you're out here alone?


Yes. 

Any children?


Not yet. 


He didn't seem to be getting any more comfortable from my attempts to break the ice. Sometimes awkward silences are less awkward than awkward conversations. But it still didn't sit well with me. I wanted to break the ice. This guy looked like a nice person. He was much too polite to be a surgeon.

So was it difficult to get a training position here in Australia?


Very difficult. The requirements are unbelievable. 


I can imagine. My father believes that some of the Australian-trained doctors couldn't pass the exams you've written!


He raised his eyebrows. Where are you from?


Turkey.


And then he started asking questions about my ethnicity and immigration. The ice was finally breaking!

I always struggled to understand why Australia is so strict with accepting overseas applicants.

He obviously didn't know about the catastrophe of the Bundaberg Base Hospital in Queensland and of Dr. Jayant Patel, infamously known as Dr. Death. It is a horrible story and after reading a book about it, I appreciated the gravity of what had happened and why overseas doctors were scrutinised heavily and examined extensively before admission.

I spent the next ten minutes explaining some of the things Dr. Patel had done to patients.

After a few minutes of absolute silence, he said I can understand why now. It wasn't such a bad conversation after all and I was happy to help clarify the reasons behind the strict admissions process. It should've always been so stringent.

Lunchtime was finally over and I was off to theatres.

Fastforwarding to second year medicine, like in first year, we were only at the hospital one day a week. What I soon found out through gossip was the work of Dr. FM. At the time he was the Upper Gastrointestinal Registrar (General Surgical rotations are 6-monthly) and given that one of our Professors of Surgery was an Upper GI surgeon, Dr. FM was under very close observation.

Rumour grew that the Professor and other consultants allowed Dr. FM to operate unsupervised. Apparently the scrub nurses noticed that his techniques were very unique and not practiced by the Professor or other consultants.

One of the nurses then told me his background:

After Dr. FM finished a morning list in theatres, the rostered scrub nurse approached him while he was writing up the peri-operative notes.

I'm sorry to interrupt you Dr. FM, but I just had a burning question.


Yes?


Well the nursing staff have noticed that you operate unsupervised and that your techniques are very different from those used by the consultants. Could you shed some light on this?


Everyone had obviously been eager to hear his answer. He was shocked and cornered. Silence.

Yes, I do have different techniques to the other doctors and they have been letting me operate unsupervised. I was a Specialist in Transplantation Surgery, so I finished all my general surgical training before my fellowship years in Iran. 


The response was silence. Nobody knew what to say.

This guy had been operating as a 'surgical registrar' for 2 years and not once did he openly declare himself as a specialist. Never was he rude to staff or arrogant. He held the patient's hand, never made people wait and his phone was always on. He apologised readily when appropriate and was always happy to teach medical students.

I remember when I was in Colorectal Surgery this year. We were on rounds and he was the Registrar for one week when the other Registrars were at a national conference in Adelaide. After seeing the second patient on rounds, he asked us (i.e. resident, intern and medical students) what we knew about enterocutaneous fistula. All of us looked at each other and shrugged. We continued rounds and after seeing the last patient, Dr. FM took us to a room and said let's talk about fistula. He was kind enough to discuss the theories, principles and management of surgical fistula for 90 minutes; something no other Registrar did.

The Riddler

So this is a tribute to one Dr. FM. The man who kept to himself, never declared his brilliance and is always there for the patients, medical students and staff. The one guy who is an example to all Surgical Registrars... a reminder that humility, modesty, courtesy and respect are not lost. They live on in surgeons. He carries a flame that must spread and I hope one day, I can follow in his footsteps.