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Dr Mrin Nayagam and stories of patient resilience in general practice


Morgan Liotta


17/01/2018 11:58:43 AM

Dr Mrin Nayagam’s lifelong bonds with many of her patients is evident in her recently published book.

Dr Mrin Nayagam’s book, ‘Silver linings: True stories of resilience from a general practice’, details some of her most memorable patient journeys.
Dr Mrin Nayagam’s book, ‘Silver linings: True stories of resilience from a general practice’, details some of her most memorable patient journeys.

Born in Sri Lanka, Dr Mrin Nayagam studied medicine and qualified as a doctor in Colombo, after which she and her husband, also a doctor, decided to leave their homeland to complete their postgraduate studies in England.
 
It was then, as a stay-at-home mother with a working husband, that Dr Nayagam managed to find the time to study and pass her exams, earning first postgraduate medical degree (Member of the Royal College of Physicians [MRCP]). She began working in hospital paediatrics in London and later in Brighton when, in 1990, her husband was offered a post in Victoria. The family (now with two sons) packed up and embarked on a new life in Australia.
 
With the desire to broaden her medical career, Dr Nayagam joined the general practice training program and soon gained her Fellowship of the RACGP (FRACGP).
 
A few years later Dr Nayagam found herself running a local practice in Mt Eliza, on the Mornington Peninsula, after the existing partners moved on. She has remained at the Village Clinic, Mt Eliza since and has forged many strong bonds with her patients over the years.
 
She feels the clinic’s holistic approach to care is what keeps the patients, as well as the general practice registrars, coming through the door.
 
‘Our patients are very loyal and our registrars want to return to work with us,’ Dr Nayagam told newsGP. ‘This indicates my belief that we are a good practice, because they want to come back.’
 
Dr Nayagam’s steadfast devotion to her patients and registrars has always been very fulfilling and helped to form the foundation of her role as a community doctor. It was around 2005 that she had an idea to spread her philanthropic efforts across the community.
 
‘I was thinking how blessed I was, coming from Sri Lanka, where one lives beside poverty,’ she recalls. ‘And there was still poverty outside [in Australia], so I decided that I would do something about it.’
 
It was from this idea that the 15 Tubs Full initiative was born – a collaborative appeal between the Village Clinic and Community Support Frankston that collects food hampers to donate to those in need in surrounding communities.
 
Now in its 13th year, 15 Tubs Full has helped hundreds of people and fills Dr Nayagam with pride, knowing that the Village Clinic has made a significant contribution to her community.
 
‘We went beyond the square to help people,’ she said.
 
Work commitments and restructures within the practice eventually meant that Dr Nayagam had to take a step back from her charity, but she never stopped contemplating ways to keep this support flowing through the years. 

‘Every time I make a good patient diagnosis it goes into my little book diagnoses,’ she said. ‘One day, one of my medical students asked, “Why don’t you write a book, you have so many interesting patients?” and that’s when the penny dropped.
 
‘I thought about a book. I had all the material at my fingertips because I keep lists, so I went back to my list and selected [the] patients.’
 
The idea was to gather a series of case studies of various patient journeys – from diagnosis, treatment and outcomes, revealing each one’s unique story of resilience through the eyes of their GP. This process resulted in Dr Nayagam’s book, Silver linings: True stories of resilience from a general practice.
 
All profits from the book go to the Silver Linings Charitable Trust, which was always the backbone of the idea behind the publication. Rather than making money from the sales, Dr Nayagam wanted to have her book published to share patients’ stories and put GPs on the map for helping their patients.
 
When it comes to the GP’s role in patient resilience, Dr Nayagam believes that continuous support is the key.
 
‘We walk beside them, hold their hand, support them,’ she said. ‘It’s almost as if they are in a stormy sea and we are the navigators of the ship.
 
‘We have to help navigate through the troubled waters until we reach a safe harbour.’
 
With this analogy, Dr Nayagam relived each of her patients’ journeys when preparing her book.
 
‘It was a very emotive experience because most of them I have known my whole career,’ she said. ‘They all have something special. Every one of them has a take-home message of resilience to inspire people: there is always a silver lining despite the problem.’
 
And Dr Nayagam’s take-home message for GPs and future doctors?
 
‘Make your lists and be proud of your diagnoses,’ she said. ‘If you can keep those lists, then you can later look back on your life and know it was worth it and that you have helped people. We are GPs for all seasons, in good times as well as bad.
 
‘This is what our brief is as a family doctor, to help those under our care.’



Mrin-Nayagam patient-resilience silver-linings


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Dr Jagannath Mudaliar   21/01/2018 11:10:38 AM

Good work. Hard but it is very rewarding service. That makes us appreciate how fortunate we are to be " able to give" and "not to get and forget".

Thanks


Mai Maddisson   5/02/2018 7:45:13 PM

[‘Make your lists and be proud of your diagnoses,’ she said. ‘If you can keep those lists, then you can later look back on your life and know it was worth it and that you have helped people. We are GPs for all seasons, in good times as well as bad.]
That statement worries me: It's a bit like 'I have not broken any road rules and have driven on the right side of the road'! That is most people's mission in life. I can't see anything to pat oneself on the back for there. Maybe the young GP who has the guts to say to the patient: I have excluded all that I know to be sinister, I would like to reflect on the matter a little to ensure I haven't missed anything would be more enticing.
As for in good times and bad. Should I live within a stone's throw of the author and be feeling truly and atypically distressed, do I have her permission to call her at 2 am. Anything elective I would not abuse a colleague's time for. But me thinks I would find a stranger (called locum service) knocking on the door should I make such a call. I'll give' thatie' a miss!


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