Retirement
I had decided a number of years before that I would retire at the age of 65. Trevor Pickering, the youngest of our three partners, decided to pull up stumps at an earlier age, when he was about 62, as I remember. He had been troubled with ill-health for several years which turned out to be cardiac in origin. After he retired, he had a triple bypass and his health improved dramatically. I think he may have regretted his decision to retire when he did.
When I discussed retiring with Colin Paull, the remaining partner, he was shocked that I should consider doing so at 65. He was nearly 70 at that stage and questioned my decision: “Why on earth would you want to retire at your age – what will you do with yourself?”
I had plenty of plans for retirement and had no desire for anyone to tap me on the shoulder and suggest my operating was falling off.
In fact, I was not planning to cut myself off completely from surgery. From the very start of my private practice in 1968, I had encouraged medico-legal referrals from lawyers and this steadily built up over the years to the extent that I had to devote a half day to seeing legal referrals and preparing reports for the legal profession. I enjoyed the challenge – it contrasted completely with surgical practice. It involved court appearances and jousting with lawyers. I tried to keep a balance between representing the plaintiff and representing the defence. If I appeared 50 per cent of the time for the plaintiff and 50 per cent of the time for the defence, then I knew my reports were at least reasonably fair and balanced.
A number of medicos around town had the reputation of being ‘hired guns’. This term inferred that they would base their opinion on whatever the lawyer required, rather than assessing the client purely objectively on their merits. Being honest was the only way one could defend an opinion under cross examination in court.
Surgery was the serious part of my profession – medico-legal work was the fun part. It was surprisingly lucrative as well, although my charges were always at the lower end of the scale.
Somewhere around 1990, the Australasian College of Surgeons decided to formally recognise medico-legal work and created a Medico-Legal sub-section within the college. Following on from this, they created a membership examination but those who were considered as already specialising and well-experienced were accepted under a grandfather clause without examination. And so I was awarded an honorary MACLM – Member of the Australasian College of Legal Medicine.
The presentation of the original memberships in the Legislative Council Chambers in Canberra was quite a big deal. I was appointed to the College Committee of the Section of Legal Medicine and then nominated to be the Convenor of the Section for the Australian Scientific Meeting in Adelaide in 2002.
Our small committee got together what we thought was a pretty good program. I had managed to persuade Allan Fels, then Chairman of the Australian Competition and Consumer Commission (ACCC), and ranked at the time, in 2002, Australia’s third most powerful figure by the Australian Financial Review to be our guest presenter. He was a controversial choice, campaigning at the time against what he believed to be a habit of surgeons to overcharge.
He proved to be an excellent presenter, familiar as he was with handling issues in the Australian setting, and exceedingly diplomatic. He attracted large audiences at the meeting and Sadie and I found him and his wife a charming couple, both completely down to earth.
He made his points at the meeting and the College bloodhounds were no match for his skill. He was ranked as Australia’s third most powerful figure by the Australian Financial Review that year, in 2002.
When I announced my impending retirement in 1998, the Colorectal Unit asked if I would like to stay on for a further six months as Nick Rieger, who had been appointed to replace me, was unable to immediately take up the position.
I carefully considered this but decided my time had come and the unit would do better to invite one of the many young bloods around who were only too keen to get a toe hold. Besides which, it would give the unit an opportunity to assess future applicants.
Come the end of 1998, there were farewells at various hospitals. I found these uncomfortable occasions – far better to slip quietly into the sunset.
My last session at Murray Bridge sticks in my mind. The clinic and hospital had arranged a small function which was delayed beyond its designated time of 6.00pm. Yes, Bob Thompson found the inevitable appendix which required removal at 6.00pm and so delayed the function. The clinic put on a dinner, speeches were made and a certificate presented by the CEO of the hospital together with an inscribed clock. Bob Cowham was designated to speak on behalf of the Murray Bridge Clinic.
Apart from my best friend, Frank Altmann, Bob was the closest to me of all the Murray Bridge Clinic and so it was an emotional occasion. Poor Bob developed a melanoma of the scalp a year or two later and died at home soon after from secondaries. I visited him and his dear wife Di at his home where he was being nursed in what turned out to be his final days and we all enjoyed a glass of red.
I was not sorry to finish at Murray Bridge. I found the final few months exhausting – flogging up the freeway at 6.30am for an operating list starting at 8.00am, after checking in the wards for all the patients listed. A quick lunch and then down to the clinic to consult for the afternoon and maybe finishing the day with an emergency that may have cropped up. I was always happy to get in the car to return down the freeway. In the early years, there was no freeway, the route following the old Germantown Hill, Kanmantoo and so forth – dodging semis on a narrow road all the way.
In latter years, Sadie accompanied me and that made life considerably easier as she established good rapport with the patients and other nursing staff at the clinic and generally smoothed the path.
At this time, my best friend, Frank Altmann, had retired from the Clinic and was doing a locum at his place of birth in his beloved Barossa Valley at Tanunda. He did, however, send me a letter which made me feel the 30 years at Murray Bridge had all been worthwhile. Part of it is reproduced here:
Self-indulgent perhaps but appreciation does not flow readily among surgeons. At times, the profession can be ruthless and jealous surgeons guard their patch with vigour, being very reluctant to concede that someone might be as good as, or, spare us – better than – themselves.
At Calvary, where I had operated for more than 30 years, CEO Peter Altree and Sister Thora representing the Little Company of Mary put on a morning tea and presented me with glasses.
I remember the last case I did that morning. It was a laparoscopic cholecystectomy and it turned out to be a mucocoele of the gall bladder – that is, a grossly distended gall bladder full of mucous, probably associated with obstruction of the cystic duct. Laparoscopically, it was a bit tricky, as the gall bladder had to be first emptied with a trocar and canula. Fortunately, everything went smoothly. Calvary Hospital had always been my favourite private hospital.
Another farewell was held at Western Community Hospital. I had operated there on a weekly or fortnightly basis for three decades and had spent a number of years on the Medical Committee as the College representative. In the late 1960s, when I started in private practice, it was a house on the seafront on Seaview Road at Henley Beach. The operating theatre, like Karoonda, was the original dining room.
In those days, the clientele of the hospital were mainly the local general practitioners. One entered the hospital at the front door of the house and did not change into theatre garb but rather took off one’s coat and tie and placed them on the hooks in the hall, covering the rest of one’s street clothes with a plastic apron. Plastic overshoes over one’s shoes and into the dining room/operating theatre, ready to go. Notwithstanding, it all worked very well and the infection rate was close to zero, and the nursing staff were excellent and efficient.
A brand new hospital was eventually built in Cudmore Terrace, just off Grange Road, in 1974 and that, too ,was a pleasure to work in, with excellent theatres and staff.
The farewell at Western was quite small but generous, with a dozen very expensive reds given as a farewell gift, together with an inscribed plaque, chosen and presented by the Chairman of the Staff Society, Gordon Ormandy. Wayne Singh was the CEO and he ran the hospital like clockwork.
And, finally, goodbye to The Queen Elizabeth Hospital, my Alma Mater. This farewell was held at the end of 1998 and the function was a bow tie affair at – the Adelaide Club of course. It was a farewell for six staff in all, including cardiologist Michael Robinson, nephrologist Bruce Higgins, anaesthetist Allan McLean, surgeon Tony Slavotinek and Graham Burrows, psychiatrist.
There were other hospitals that I had used intermittently over the years. At one stage I was doing all the surgery for the Torrens Clinic before my fellow surgeon and good friend Doug Allen joined them.
To manage this, I started a regular list at the Hindmarsh Community Hospital, an outstanding little hospital across the road from the soccer stadium. John Turnbull and Brian Sando were excellent GP anaesthetists and that list was a very friendly, homely affair. The Matron, Matron Smith, was a large, motherly soul who on one occasion asked me to fix her ingrowing toenails. I naturally offered her a general anaesthetic but she firmly declined and, on the appointed day, made herself comfortable on the operating table with a large bottle of whisky for pain relief and solace! She ran an excellent establishment with very happy patients.
In earlier years, I also did a regular list at the Northern Community Hospital, another exceptional little hospital on the Main North Road at Prospect. This was convenient for the Florey Clinic, whose surgery I was asked to do and whose clinic was close by. On one occasion, I was asked to do a vasectomy on one of the partners. He also insisted on having it done under local anaesthetic, which was a mistake, as it quickly became apparent that his pain threshold was low – and the whole procedure degenerated into a shambles!
This hospital is now a Nursing Home, which seems a pity.
At other stages, I did regular lists at Ashford and even for a brief time a list at North-East Community Hospital, both of which were enjoyable but totally impractical. I also had a fleeting association with the Glenelg Community Hospital when Peter Heysen was a referring doctor but, again, this was unrealistic and did not last long.
The annual College Scientific Congress was held in Adelaide in 2010 and I was approached to have a stand in the Trade Display area to assist retiring surgeons in their retirement options. I was happy to oblige and enjoyed the experience especially as it enabled me to attend any of the presentations free of charge and also catch up with many of my colleagues whom I had not seen since retiring. The other bonus was it was an opportunity to sell a number of books I had published.
I arranged the stand to include most of the passions I had enjoyed over the ten years since retirement – writing, cabinet-making, stringed instrument-making and water-colour painting. At the time I was halfway through constructing a Spanish Guitar and so continued working on it in the booth using my portable vice.
Later in the day, two musically-inclined surgeons from interstate asked if they could play a duet with the violin and steel-stringed guitar on display. Fortuitously, one of the participants was carrying his computer and so they downloaded the music and I held the computer in front of them as a small crowd of surgeons gathered to listen. I forget what they played but it was inspiring and enjoyable. A marvellous thing.
RG Johnson 