Indigenous doctor’s Cape ENT surgery dream

Torres Strait Islander doctor Lisa Waia first glimpsed herself as an ear, nose and throat surgeon during a James Cook University medical placement on Cape York Peninsula.

After seeing an ENT surgeon and his registrar in action on a Deadly Ears outreach to Cooktown and Hope Vale, she returned full of dreams of becoming a surgeon who could make an impact on chronic ear disease in far northern Aboriginal and Torres Strait Islander communities.

The dream has crumpled many times under the weight of stereotypes and self-doubt, but it’s becoming a reality for the Townsville University Hospital principal house officer and 2016 JCU graduate.

“My cousin brother and I both graduated from high school in the same year. We were the first out of our family to finish high school,” Dr Waia says. “I went on to university and was the first of my family to finish up with a bachelor's degree, which was really exciting.”

Dr Waia says it was a struggle to find her place during her junior doctor years. “I don't come from medicine. I don't come from a line of doctors. I don't even come from a line of professionals,” she says. “Boys and men in my family are labourers and the women are usually stay-at-home mums or work casual jobs here and there. Coming into a profession like medicine was daunting.

“I've had my fair share of having imposter syndrome as my baseline and then having snide comments come my way that medical students who are Indigenous don't have to pass their exams or they have a really low pass mark or they let anyone into med school, which is not true.

“We've done the degree; it's definitely not easy. But it just compounds that imposter syndrome, which is really upsetting. Then, getting into the workforce, you come across systematic barriers and challenges that our people face. It gets a bit exhausting after a while being someone who's trying to be the voice of our people, which is in no way my responsibility, every time someone makes a negative comment or voices a stereotype.

“When I come across someone who's got a negative mindset or stereotype about my people or my culture, I go back to the basics and talk through it because I don't think they understand quite how many horrific things have happened, and the intergenerational cycles of trauma that are in place.”

Heroes, mentors and allies

Dr Waia completed her general surgery rotation last month and began working towards her goal to specialise as an ear, nose and throat surgeon.

She is a mentor for the Indigenous Interns Pathway Townsville Hospital and Health Service (THHS) recently implemented to attract more Aboriginal and Torres Strait Islander doctors. Just nine of Townsville Hospital and Health Service’s 850 doctors have Aboriginal or Torres Strait Islander heritage.

The nation’s first Indigenous surgeon, Newcastle-based Professor Kelvin Kong, whom Dr Waia met at an Australian Indigenous Doctors’ Association (AIDA) conference, has helped her forge a path towards ENT surgery. “Professor Kong is one of the most incredible human beings I've ever met, and he just happens to be an ENT surgeon – literally goals,” she says.

“Having him as one of my mentors has just been absolutely phenomenal. He's been able to say, ‘This is how we're going to do things.’ There have been times where I'm like, ‘I can't do this, I'm just not smart enough or I don't have what it takes.’ Just having someone to say, ‘Yeah, look, I feel you, it's tough some days but you do have this and you can do this if it's what you want,’ and having someone to look up to in the medical community, despite having a background that is non-medical, makes a hell of a difference.”

She’s also been fortunate to have non-Indigenous allies in her corner: “My dad's a concreter. He's not a surgeon. So for me to become a surgeon, I had to hunt down a surgeon and say, ‘Hey, how do I do this?’ and I've been so lucky. I've got the most incredible ENT bosses who have sat me down and said, ‘Okay, let's go through your resume. This is what we get to do, this is how we get to do this.’

“They're extremely supportive and they have worked alongside me for the last couple of years to get me where I am today. They have been phenomenal and they're just as passionate about Indigenous health as I am. Shane Anderson was the director of ENT when I came through as a junior and I really did just basically annoy him continuously until he gave me a job. Dan Carroll is a paediatric surgeon who was my supervisor during my internship. He basically took me under his wing because he's quite passionate about Indigenous doctors and Indigenous doctors becoming surgeons.”

‘I've done things the hard way earlier in my career’

Dr Waia is hoping the newly established Indigenous Interns Pathway increases the number of Indigenous doctors in communities, in turn giving Aboriginal and Torres Strait Islander peoples to look up to and strive to be.

“I've learned a lot and grown a lot as an Indigenous doctor,” she says. “As the young ones come through, it's important to be able to understand what they're going through, where they're coming from, point them in the right direction or shine a light on the path of least resistance.

“I've definitely done things the hard way earlier in my career. If I had an Indigenous doctor who was either keen on what I was keen on or even just there to have a chat, I think it would have been a lot easier, especially in my junior days when I was just going with the flow and trying to figure things out on my own, which is pretty tricky.

“Having Indigenous doctors around, especially ones who are more senior, is quite nice because you've got someone to bounce ideas off if you do have issues and you don't feel comfortable talking to other doctors about it.”

Indigenous Pathways Coordinator Amy King says THHS looks after a sizeable proportion of the state's Aboriginal and Torres Strait Islander population.

“Within our region alone, we account for 8 per cent of the total Indigenous population of Queensland, and yet only 1 per cent of our doctors identify as Indigenous,” Ms King says.

“A big motivator for me when building this pathway was how can we adequately look after our Indigenous population if our own health service isn’t representative of it?

“My biggest hope for what we can achieve with this pathway is to see our junior doctors supported through their formative years, to encourage and embrace them to follow their dreams and reach those goals while providing them with amazing support along the way.

“Given how few Aboriginal and Torres Strait Islander doctors we have, the struggle to find someone who understands what they are going through on both a professional but also cultural level is very real. With this pathway we are helping our doctors build those networks and find that cultural support and collegiality with other Indigenous doctors in our region.

“I hope that with the support networks we are building, and continually improving the cultural competency of our health service, we can encourage more Indigenous doctors to join us.”

Family and the future

Dr Waia’s family is originally from Saibai Island in the Torres Strait. She grew up at Alau Beach and Seisia near the tip of Cape York, moving to the Atherton Tablelands at age 11. In Year 12, she successfully applied for entry into JCU and transferred into medicine after a year of a Bachelor of Medical Laboratory Science.

Dr Waia says the amount of chronic ear disease plaguing communities in the far north drives her career aspirations.

“My game plan would be to become an ENT surgeon then I'd hopefully come back north, as north as I can go. At the moment, that would be Cairns, but if I can get any further north as time goes on, then I'll probably take that, with the goal of servicing Indigenous communities within Cape York. Being able to bring surgery to rural and remote communities would be ideal.”

Dr Waia and her partner have an 18-month-old son. “Last year I had an ENT reg who is also a mum, with two young kids,” she says. “It was really nice to be able to have another female working alongside me who's been there done that, had the sleepless nights and still rocked up to work after three or four hours of sleep and tried to soldier on through a double consultant clinic."

Townsville University Hospital is the only hospital in north Queensland that offers ENT training positions, something she hopes will change soon.

“We've put down roots in Townsville. We will have to move at some stage for part of my training, but I've made really good networks here with the ENT surgeons, who I absolutely adore, and I've come across incredible ENT registrars who have taught me heaps and guided me along."

“Ever since being in ENT, I’ve just loved it more and more. I love that it's a specialty that delves both into medicine and surgery."

"I love the procedural aspects. I’m a very hands-on person so that's always been an upside for me. The surgeons in ENT are just amazing and they all have personalities that I clicked with. I think that's one of the driving factors that has pushed me further towards the end.”