Life is a rollercoaster - Dr. Sarah Koffman

When I was first asked to write a piece for Canberra doctor about what I’ve done since graduating, I felt dismay that I didn’t have a long list of achievements or exotic destinations I had travelled and worked in. I’m “Just a GP Registrar” came to mind.

As I started the process of writing however, I realised I have in fact done quite a bit since graduating and am very happy with how my career and life in general is progressing.

Winning the AMA leadership award at our grad dinner in 2006 took me completely by surprise.

I had contemplated not even going as my father was very sick having just started chemo for terminal stomach cancer. He lived with me, my husband and our 2 year old daughter during this time and caring for him whilst studying fourth year med was quite consuming to say the least. In the end we did go and my dad came too – in a wheelchair with his chemo infusion running. Winning the award with dad there was a very proud and special moment.

I commenced my intern year the following January at TCH. Dad was going OK for a while but only made it to August that year. He died, as my mother had 18 months earlier, at Clare Holland house here in Canberra. I was 18 weeks pregnant with my second daughter when he died. So intern year was a challenge for all the usual reasons plus a few more. After maternity leave, I completed my intern year part time.

I did the usual resident year at TCH and landed myself an SRMO job in O&G. I had always been interested in GP, O&G and emergency medicine as possible career options. I went in to that SRMO job with an open mind and open eyes. It was a chance to “try before you buy”. I loved it. The excitement, the emotion, the ethics, the surgery. It is a fascinating and rewarding job. But it also comes at a great cost. Not so much to the doctor I believe, but to their family.

Being a doctor is a very special and privileged job. But in my opinion, it is ultimately still just a job. During my oncology term as a medical student I met a man who was dying of his cancer. He was a career man. He held my hand crying and said “Sarah, I have 300 days of sick leave owing. I don’t think I have that many days left to live. I spent too much time at the office”. He didn’t survive the week. His words have always stuck in my mind.

I guess losing both my parents during my medical training changed my perspective on many things- including medicine- and has ultimately influenced how I approach my own life and my patients.

For me, my husband and my children are the priority and I didn’t think I could put them first if I pursued obstetrics- at least at this stage in my life. A side issue to this decision was the fact we were now living on 40 acres, 40 minutes outside Canberra and we hope to always live on rural property. Being on call for obstetrics meant either moving closer to the hospital or staying “in town” during those times.

So with O&G on hold for now, I left the hospital that had been my training ground for 9 years and entered general practice. I am pursuing both the RACGP and ACRRM pathways. I’ve spent the past year working in general practice two days per week, 1-2 shifts per week in the Queanbeyan hospital emergency department as a CMO, one day a week as an O&G surgical assistant in the private sector and am also involved with teaching clinical skills to ANU medical students. We have three daughters (the third being born during my second SRMO O&G year) and our fourth (and final) child is due in March (another girl no doubt!!).

General practice is very satisfying. I am constantly amazed and humbled by my patients and what they bring before me. It is a relentless and exhausting job at times and I’m not sure I will ever work full time in it. Having worked in the Canberra region since graduation has meant that I have developed quite a good professional network and have an understanding of local services. This helps a great deal when managing and advising my patients. Being able to call and speak directly with local specialists whom I know and have worked with to ask for advice is wonderful. I feel I have a good understanding of both the tertiary and the primary level of care and can therefore help my patients to get the best out of the system as they deal with their individual health needs.

I recently attended the ACRRM Conference in Fremantle WA (as exotic as it gets for me) which was as close to a religious epiphany as I’ve ever had. The doctors were inspiring. They are hardworking, dedicated, enthusiastic, resourceful yet very human, everyday people who are passionate about what they do. Some of them were very seasoned yet not in the least jaded or cynical. They were still excited about their work- even after all those years. They seemed to have the balance right and it confirmed for me that I am doing the right thing for me.

I love my job(s). Every day as I drive home through the countryside, dodging kangaroos, I think about how lucky I am. The mix of general practice, surgical assisting, teaching and ED work (any of which would be draining on a full-time basis) provides a great balance. Outside of work we manage the farm complete with angora goats, alpacas, horses, too many kangaroos, too many weeds and 3 and 3/4 “pet humans”.

People often ask me when I’ll be “finished” training. I’m in no hurry. Given that I hope to be working part time in general practice, surgically assisting, teaching medical students and working in the ED when I’m “finished”, I kind of feel like I’m already living the life! Between drenching and shearing goats, trimming alpaca teeth and toenails, taking the girls to pony club, gymnastics and swimming lessons, I imagine I’ll finish my GP training…eventually.

My dad always said that you’d know you were in the right job if you’d get out of bed in the morning and go to work, even if you wouldn’t be paid for it. He was right. Getting paid is icing on the cake.