Resilience is a difficult quality to cultivate, however, it is an important quality for junior and senior doctors attempting to balance a stressful job with any setbacks they may experience. It is something that is developed through life experience rather than being innately present.
Dr James Muecke is a senior Ophthalmologist and an entrepreneur with Sight For All, a charity that is dedicated to providing eye health care to those in need. He was recognised for his efforts in the medical and public health fields and received the 2020 Australian of the Year Award.
A career in Ophthalmology was borne out of a natural desire to help people as well as work with his hands, something Dr Muecke had unknowingly been training for with his interest in intricate model construction. Stemming from this was an interest in microsurgery, leading him down an Ophthalmology training pathway. However, after graduating from medical school, we almost lost him from his medical career before it had even begun. He was quickly confronted with the challenges of internship including long 34-hour shifts and a predominant focus on temporising treatment of chronic conditions. This became so frustrating that Dr Muecke seriously considered swapping management of COPD for building furniture!
Being caught between the ‘treadmill’ of further specialty training and being unfulfilled in the workplace can be a difficult challenge. On this point Dr Muecke sought to broaden his horizons by volunteering for a year in a Kenyan hospital, encouraged by the Director of Ophthalmology who ‘would choose you (for a training position)…because you’ve done something different, you challenged yourself.’
The Kenyan medical landscape was vastly different. Dr Muecke explains that ‘we didn’t see a single case of heart disease…the ECG machine didn’t actually have any paper in it,’ and he felt he was able to ‘cure people’ for the first time since being a doctor. Along the way he experienced further challenges, ranging from being captured at gunpoint by Ugandan rebels to falling victim to malaria twice. Although on further reflection there is a traumatic element to his time in Kenya, Dr Muecke managed to draw lessons from the experiences, and credits it with reinvigorating his love for medicine. Further, it encouraged him to concurrently pursue a career in public health to increase his scope of practice.
Dr Muecke has also been confronted with his own insidious health challenges. In 2012 he was diagnosed with focal dystonia, a genetic progressive neurological disorder that impairs the relaxation of antagonist muscles when using the agonists. It particularly affects his dominant hand and slowly began to affect his ability to hold things in his right hand as it required more intense contraction to overcome the antagonist muscles. Simply put, ‘if I held a champagne glass now, I’d smash it,’ such is the force required to grip objects.
In between the onset of the condition and his formal diagnosis, Dr Muecke applied a similar thought process as in Africa when being confronted with a stressful situation. Before becoming aware of the issue, he began to adapt to maintain his functionality, using acronyms for documentation to shorten his time writing and eventually using his left hand for writing and shaving. His ability to operate was undisturbed, however, he did fatigue much faster and overcame this by taking more breaks between cases.
A common theme to Dr Muecke’s life has been facing adversity – whether it be in Africa fearing for his life, or for his career after his diagnosis with focal dystonia. He credits his mindset and ability to ‘keep a cool head’ and allow the rational thought process to evolve and formulate solutions. His capture at the hands of rebels was a prominent example of this, whilst his companion had been overwhelmed with thoughts of despair, Dr Muecke ‘controlled the emotional brain and (gave) time for the thinking part of the brain to take control of the situation.’
Rather than being born with these skills they developed in response to challenging situations and he credits time in Africa for embodying him with this mental resilience. This mindset later applied to his personal health challenges, which allowed him to come up with ‘strategies to get around the problem (using) micro-innovations,’ to achieve goals. The progressive nature of focal dystonia led to him retiring from surgical work, however, he continues to medically treat people in clinic as well as from a public health perspective with Sight For All.
Since being award the Australian of the Year, he has used his platform to advocate for increased awareness of Type 2 Diabetes as a ‘blinding disease,’ that over half of those people who have been diagnosed are not having regular eye follow-up. Furthermore, he has also advised a ‘Sugar Tax’ as a potential public health measure to improve glucose control in the general population, largely because the blindness associated with diabetes is very preventable.
Healthcare professional resilience is being particularly tested now with the global COVID-19 pandemic creating a great deal of anxiety. Dr Muecke acknowledges that his medical practice does not deal directly with COVID-19, however, keeping a cool head applies to all doctors working currently to prevent from being overwhelmed. He further advocates for the ability for the brain to undergo neuroplastic change. ‘Good habits, good deeds…exercising,’ as well as taking stock of the positive goals and actions at the beginning and end of the day can cultivate a positive mindset and resilience which can be used in times of stress.
Dr James Muecke has experienced hardships, however, he developed resilience and has been able to respond in a positive way. He found a rewarding career in performing eye surgery and even when this was taken away from him, his passion for helping others led to him innovating and discovering ways to still achieve this in the public health sphere. This has taken the form of advocation for the health complications of Type 2 Diabetes, particularly blindness, which are becoming increasingly common and endemic in some regions of Australia despite the universal healthcare model that we possess.
This blog is based on the interview with Dr James Muecke by Sophie Scott, for Avant Mutual. To view the video interview visit Dr James Muecke: Ophthalmologist and 2020 Australian of the Year.
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