I wanted to be a doctor ever since my final year in primary school when I first learned about the human body. I was blown away by its intricacies and complexities, and wanted to learn more. I was extremely lucky to receive a good education, which enabled me to become a doctor. I believe health is a basic human right and I see myself as an unashamed ‘do-gooder’. I have always wanted to assist disadvantaged people who find themselves in difficult circumstances through no fault of their own. This renewed commitment to my medical work was spurred on by the death of our teenage son, after a long and difficult illness. My husband, a vascular surgeon, and I are now more motivated than ever to spend the remainder of our careers helping to alleviate suffering. I still derive lots of joy from my work as a GP, and I am enjoying the patient contact more than ever. For 10 years, I worked at a clinic that embodies my philosophy, at the Kirketon Road Centre in Kings Cross, Sydney. This multidisciplinary clinic, with its dedicated staff and the motto ‘Health For All’, focuses on marginalised people in inner city Sydney — the sex workers, homeless, injecting drug users, and the mentally ill. But now with our three adult daughters travelling far and wide, and my husband often away overseas volunteering with MSF (Medicins Sans Frontiers), I am able to fully commit to my work at an Aboriginal Medical Service in central Australia. I find myself encountering a whole new spectrum of diseases and disadvantage in this setting. It saddens me that my husband sees the similarities with his MSF work overseas and my work in rural Australia. While I now work in a completely different setting from inner-city Sydney, there are many similarities with my outback work. The presentation of disadvantaged patients is the same; the only difference is that here I see babies and children as well. Managing patients presents the same challenges too — homelessness makes follow-up and the continuity of care difficult. My approach is to chip away at the problems and in doing so hopefully make small gradual improvements to patients’ health. In this work, I can see how basic tenets of public health need addressing and also how the social determinants of health are far more important than our medical interventions. I now find myself treating the consequences of overcrowding combined with poor housing, sanitation and nutrition, and how this has led to a range of social problems and a society damaged by alcohol.

Dr Ruth Carter