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The People’s Hospital Tales from the surgeon's table

Trevor Jones

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Trevor Jones

General surgeon and former clinical services director at Footscray Hospital 1976–2015

Trevor Jones was born in 1943, in Manchester, England and later emigrated to Australia with his family. Mr Jones was educated at Melbourne High School and completed his surgical training at the Royal Melbourne Hospital. He worked in Britain for several years before returning to Melbourne. Associate Professor Jones held senior surgical leadership and teaching roles at Footscray for more than 37 years before his retirement in 2015.

The move to Footscray

“In 1976 I’d been working in the department of surgery at the Royal Melbourne Hospital as a lecturer. I was quite unhappy there because there wasn’t enough to do. I’d just come from very busy surgical work in the UK in a big provincial hospital and also at a London hospital so I found it a bit boring at the Royal Melbourne.

I heard from one of my senior colleagues at the Royal Melbourne that there was a job coming up at Footscray and I should apply.

The job became available because Paul Large, one of the senior surgeons at Footscray, retired. In those days there were five general surgery units with a senior surgeon and a surgeon in each unit, as well as a registrar and an intern.

The general surgery units did everything, which was what I liked, including neurosurgery in an emergency. The first operation I did at Footscray was a compound fractured leg, my second operation was a fractured nose.

I was appointed to Kendall Francis’ unit. I’d never met Kendall but I knew him by repute – as a surgeon at Prince Henry’s hospital and at Footscray. So I went to meet him in his rooms at Parliament Place.

He was very friendly, down to earth.

I then worked with Kendall for 25 years.

He’s the sort of chap, the longer you know him, the more highly you regard him.”

First impressions

“I’d been at Footscray a couple of times as a medical student. I remember coming out with the Professor at the Royal Melbourne, Professor Maurice Ewing, and Bob Thomas, one afternoon because the senior gynaecologist at Footscray, George Thoms, had got hold of a laser machine for cutting, a dissection device. (believed to be the first demonstration of laser surgery in Australia)

We watched George, who was one of the great characters, cut a piece of steak in the operating theatre, with this great big, unwieldy laser machine. It was pretty useless, not as sharp as a knife. It got some publicity for the hospital.

The thing that struck me about the hospital was just how friendly everyone was. The hospital didn’t have this incredible opinion of itself as the Royal Melbourne Hospital, for example, does.

The people who came here didn’t come here for the money because there was very little private practice here at the time. You came here for the work, for the friendship and for the teaching.

When I got the job, the appointments committee was Vernon Marshall and the senior anaesthetist, George Robinson. They made the appointments. That was it. There was no interview. It was informal.”

A social era

“It was a much more social hospital in those days. The senior medical staff organisation was a real social club, and that has largely disappeared as medical care has fragmented.

There were three interns for the entire hospital in the 60s and 70s during Jo Epstein’s early years here. One was probably a surgical intern, one was a medical intern and there was probably one for the emergency department.

They did everything. They had no time off and probably earned $50 a week. This is why it was such a social place. Everyone knew everyone, whereas now we have about 50 interns. There were two urologists then and now there are about 16 urologists.”

The last days of general surgery unit structure

“The convenience in those days of having five surgical units meant there was one unit on for each day of the week and one weekend in five.

The other units, like the orthopaedics unit, which was just Kevin King and Jonathon Rush, used to do a month on and a month off. Orthopaedics is terribly busy so they were here all the time. Nowadays there are about 16 or 18 orthopaedic surgeons.

We used to do a lot of orthopaedic work, broken legs and arms, to take a bit of the load off Kevin and Jonathon. We did the same with plastic surgery whereas nowadays everyone guards their own patch very jealously.”

Searching for staff

“In the late 70s and early 80s our main concern surgically, was to maintain an anaesthetics department. Sometimes Bob Smith, our anaesthetist, was the only full time anaesthetist, and perhaps a couple of registrars.

The department was supported by a number of visiting anaesthetists who did regular operating lists. But we couldn’t recruit full time anaesthetists because they preferred to work in the eastern suburbs.

We now have a glut of anaesthetists, they’re all getting a bit hungry, so that’s good.

Also it was difficult to recruit radiologists and some of the surgical specialties such as urology, orthopaedics. That was the culture of the time, people preferred to go the big city hospitals where there was seemingly more kudos.

We now have about 16 urologists but about 10 years ago we couldn’t get a urologist to come out here. It was the same with anaesthetists and specialist surgeons, there was always a dearth of them, they wouldn’t come out this way.

It was even the same in private practice. Trying to get an anaesthetist during the weekend was very difficult. They didn’t have to do it, so why bother. This happened until relatively recently. But now supply more than matches demand so they’re willing to go anywhere.”

Hospital status: moving up

“The status of the hospital went up enormously with the establishment of the chair in surgery and with Bob Thomas as the first Professor of Surgery.

When I first came here, we taught Melbourne University medical students, who came on rotations. Then for a while we were attached to Monash University and we had a lot of interns here from Prince Henry’s, (a Monash teaching hospital) and that was mainly because of the influence of people like Vernon Marshall, Kendall Francis and Graeme Peck.

But graduate (post-intern) training was very limited. Graduates did their intern year here, and maybe a second year here and then they had to find somewhere else to go if they wanted to do surgery.

For example if a registrar wanted to do obstetrics and gynaecology they had to find a spot at the Royal Women’s, they couldn’t do it here.

We used to get our registrars from elsewhere – our regular suppliers were the Royal Melbourne, Monash Medical Centre and the Alfred and others we could pick up along the way.”

Becoming clinical services director

“Bob Thomas was the clinical services director for general surgery and Liz Edmunds was the manager. When Bob was leaving to go to the Peter MacCallum Hospital, no one put up their hand to take over the job.

So Bob called me to his office one day and said, ‘Look, the hospital would love you to take on this job. There’s only one meeting a week and Liz Edmunds does all the work’. I fell for that and I’ve been in meetings ever since. But it was lovely working with Liz Edmonds. She was a gem.

That job has now evolved into general surgery, specialist surgery, anaesthetics, coronary care - it’s now Peri Operative and Critical Care Services. It kept getting things added to it and it’s now a vast job.”

Being a mentor, seeing the person not just the patient

“My own former mentor likened surgical teaching to a relay race – ‘someone hands the baton to you and it is your obligation to develop it and hand it on to the next generation’.

I always impressed upon junior surgeons the impact of understanding the story of the patient. The patients are people, not a ‘gall bladder in Bed 12’. I tell medical students to talk to their patients, not just about their illness, but about their experiences. Some patients are refugees and they have had horrendous experiences.”

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