Managing Director, Investment Banking, Bank of America Merrill Lynch
BCom, LLB (UNSW)
David Currow addressed graduates from the Faculty of Health in the Great Hall, University of Technology, Sydney on Thursday 2 May 2013, 5.30pm.
Our speaker today is Professor David Currow.
David is a Professor of Palliative and Supportive Services at Flinders University, Adelaide. He is also the Chief Cancer Officer and the Chief Executive Officer of the Cancer Institute, New South Wales. His previous roles include national presidencies of two peak bodies, Palliative Care Australia and the Clinical Oncological Society of Australia.
David has researched, published and presented widely about the evidence base in hospice and palliative care, population-based approaches to understanding service provision and planning, Phase III and IV clinical trials in hospice/palliative care and the research of dyspnea. He is the author of several books and is a senior associate editor of the Journal of Palliative Medicine. David is on the editorial advisory boards of the Journal of Pain and Symptom Management, British Medical Journal Supportive and Palliative Care and Current Opinions in Support and Palliative Care.
David received his medical degree from the University of Newcastle, and his Master of Public Health from the University of Sydney. He is an internal medicine physician and was admitted to the Royal Australasian College of Physicians as a Fellow in 1995. He received the University of Newcastle Annual Alumni Medal for Professional Excellence in 2012 and was also a member of the team that received an award from Australian Awards for University Teaching – Office of Learning and Teaching for programs that enhance learning – post graduate education.
It gives me great pleasure to invite Professor David Currow to deliver the occasional address.
Speech
I acknowledge the traditional custodians of the land the Gadigal and Gur-ing-gai people of the Eora Nation and pay my respects to the Elders both past and present.
I would like to thank the university for inviting me to be part of the graduation ceremony today. I would like to acknowledge the Presiding Chancellor Dr Ron Sandland, Presiding Vice Chancellor Professor William Purcell, Presiding Registrar Mr Brendan Nelson, Presiding Dean Professor John Daly, faculty Dean, staff, distinguished guests, graduates, ladies and gentleman.
You are lucky to be at a university that achieves spectacularly at celebrating student and staff diversity, promoting equality, social and environmental responsibility, community leadership and community service
So, how do you and I combine the art of clinical practice, listening to and being genuinely excited by a dying women’s life insights, with rapidly burgeoning science that demands continuing education which will accelerate as science takes its next huge steps forward?
People talk about work/life balance. I have an American colleague who, when asked to talk on this topic, dismissed it summarily, pointing out that, in her view, a work/life balance was only necessary if you didn’t like your work. I disagree. No matter how much you and I love the work that we do, and are inspired by the people whom we serve, the real question is how do we keep coming back every Monday morning with renewed energy and vigour, renewed passion and genuine interest in the people that we will see that day?
If we are to celebrate people’s humanity in all it’s facets, we must engage with our own lives to the full. Indeed, it has been said that the greatest tribute we can offer to the infirm is that we continue to engage in every aspect of life, even as some of our patients can’t. I was always troubled by this thought, but patient after patient has reinforced this truth.
We will continue to learn from our patients. They want to teach us to be better health professionals. We will adopt professional standards where we commit to stretching ourselves to higher and higher levels of performance, and greater accountability. We will strive to help generate new knowledge and share our skills for the good of the whole community.
But if we are to achieve all of this, we each have one challenge; how do we maintain our personal humanity? The essence of who we are because it is that essence that will drive our clinical excellence more than any other force.
What are the characteristics of professional? Peter Wright, a Justice of the Ontario High Court 60 years ago pronounced his definition, which has stood the test time. It has been slightly modified by others over the years, but the essence is still there.
A professional is a Self-disciplined group of individuals who hold themselves as having special skills from education and training, which they exercise primarily in the interest of others.
This definition has direct implications for each of us, let’s pick it apart.
Firstly, we have a responsibility for education, to ourselves as professionals, to other aspiring professionals and, I would suggest, to the community more broadly. This asks each of us to be life-long learners, forever seeking out better ways of improving health of our community. This process never stops, and to do it well requires a great deal of commitment on the part each of us.
We have a responsibility to refine knowledge. Whenever I say this, some colleagues plead that they are not researchers, but I have not talked of research yet, only that we improve the knowledge base in order to deliver better health outcomes. Such a process can include audits of our practice, or a focus on better synthesising new knowledge as it becomes available.
And the central game, delivering patient-centred clinical care. Ever been sick? Did you manage to have your illness between the hours of 9 and 5, between Monday and Friday, with an appointment already serendipitously in the general practitioners diary? The odds are few of us are quite that organised. Illness chooses more perverse times and provides less warning. Our current rhetoric around patient-centred care takes too little account of when people become acutely unwell.
For chronic conditions, the pressure and challenges are different again; I am not sure the woman about whom we spoke a few moments ago would live long enough to get cancer if she had been born half a century earlier. We are experiencing new variations on well-known illnesses as we push the frontiers of improved acute care. It will continue to challenge us as the health system adapts to these changing nature of illness as we know them, especially those that lead to death.
Ultimately, being a health professional is about people, with all of their joys and the frustrations, the highs and the lows, the privations and the plenty. Each of us is the sum of our life’s events.
Picture this. An Autumn afternoon not unlike today. A busy outpatient clinic that was in so many ways, like any other busy outpatient clinic. Anxious people hanging on every word as information is shared, discussed, digested. It is almost 20 years later, but one person stands out from the clinic.
A rich bronchitic laugh, a new sparkle in her eyes, a new spring in her step. I had seen this woman with advancing cancer in her larynx several times before. Nothing was going to change the course of her illness, and we had discussed her prognosis, and all that this meant. But today, something had changed for the better.
She triumphantly announced she had ‘beaten the bastards!’ Who were ‘the bastards’? Pretty much every authority. ‘They can’t get me for speeding, for parking in a no parking zone, for not paying her electricity bill. They just can’t touch me.’
She used her few savings instead to fly in the family for a wake while she was still alive to enjoy it, and while she was alive to tell each and every one of them what they meant to her. I saw her a couple of weeks after the event, and she was still glowing from the opportunity to spend money in bringing together her four kids and their families in a way she could never have contemplated at any other time of her life.
The next time I saw her was on a Sunday afternoon a few weeks later, now a shadow of her former self; emancipated, weak and exhausted. She had come to the hospital to die so that, in her words, her family could just be themselves.
What can this amazing woman teach us? Lots, but there are two things that stand out. Firstly, when you are facing death, for almost everyone, the only thing that matters is life’s relationships, the people who are near and dear to us. Secondly, no matter how clever our technology, each professional is here to ensure that care is offered, and that includes care when people are frightened, alone, upset and threatened. No technology can replace the person-to-person interaction at such times.
As the University of Technology, Sydney celebrates its silver anniversary and as each of us celebrate your achievement in graduating and embarking on the next exciting steps of your career, what is going to make the most difference?
The bottom line is to embrace every part of life; work, art, music, sport, gardening. Identify the things that give you energy, things from which each of us derive a net benefit, from which can recharge out batteries so that every Monday morning we can come to work ready to be ourselves, revitalised for the week ahead, keen to be human and share the humanity while serving others to improve the health community.
Congratulations to each and every one of you. Thank you again to the university for inviting me here this evening.