‘What a bloody privilege’: Dr O’Kane’s tale of rural medicine

Nobody gave Donna O’Kane much of a chance when she told them she was going to be a rural GP.
 
Growing up by the bends of the Murray River in north-east Victoria, she came from three generations of farmers. Her dad left school at 14, her mum at 16.
 
Nobody in the family had been to university, let alone studied medicine.
 
It was a similar story for her high school in Cobram at the time. It might have been the right place if you wanted to become a mechanic, but no one had ever gone on to be a doctor.
 
‘Just watch me,’ Donna would think to herself – and fortunately, a few others also entertained her dream. Her mum encouraged it, and while her dad thought she would end up on the farm he also told her she should give it a go.
 
Donna can also reel off the names of a bunch of ‘wonderful, wonderful’ teachers who pulled out all the stops to help: Mr Currie, Mr Langford, Miss Luxamborg, Mr Meehan and Mr Smith all get mentioned almost three decades on.
 
With their guidance, she did ‘okay’ in her results, she recalls – but still didn’t think it was enough.
 
That was when her neighbour, Margaret Dick, a local councillor and community stalwart who was perhaps Donna’s biggest mentor, suggested she write directly to the university decision-makers.

When the first-round offer arrived, Donna couldn’t quite believe it. Nonetheless, a few months later, there she was.
 
But that didn’t stop the doubts.
 
University professors openly told her parents they shouldn’t be surprised if she was back in Moira Shire in a few months.
 
However, far from a crestfallen return home, Donna left more than half the cohort behind in her final results. She also stood out with her passion for rural medicine.
 
Where others tried to avoid getting sent out to the regions, she went towards it, actively picking placements away from the city.
 
Fast forward a quarter of a century, and Dr O’Kane remains about as far from the crowds as you can imagine with a career in rural general practice she views with pride.
 
Currently, she is a live-in doctor for NT Health working at Papunya, a small, dry community a little more than 200 km west of Alice Springs.
 
While she acknowledges the difficult social determinants of health that she has to work with, the enthusiasm for rural medicine that fired her teenage years is still driving her on.

A crossroads in the Papunya area, which lies about 200 km to the west of Alice Springs in the Northern Territory.
 
One post to the RACGP’s Rural Faculty Facebook page is typical.

‘It is such an honour to be part of the community and to work alongside the local Warumpi mob,’ she recently wrote above a series of pictures showing the beautiful outback surroundings.
 
‘Twenty-five years living and working in remote Indigenous communities, extremely challenging, but what a bloody privilege!’
 
In that time, Dr O’Kane has worked in enough places to have a strong sense of where she stands after a little more than half a year in this job.
 
Anyone met with seemingly overwhelming barriers and obstacles faces disillusion, she understands – but with the right approach she knows she can make a difference.
 
Having been in the NT on and off since heading to Darwin to train in 1998, Dr O’Kane has experience that is already standing her in good stead with the Papunya community, with songlines from previous postings in Groote Eylandt and Borroloola crossing over to her current location.
 
‘A couple of the families go that way, so it’s a little bit quicker to be accepted,’ she said.
 
‘It takes about 18 months to really get the trust of people – that they don’t think you’re a blow-in or a flyby.’
 
Working in a community that has largely been without a doctor for two years, Dr O’Kane says her focus is on foundation work: cervical screening, for example, along with diabetic management, rheumatic heart disease screening, contraception and sexual health.
 
‘You have got to have that long-term approach,’ she said. ‘I’ve got mini goals working with the community that we want to achieve.’
 
She attributes learning obstetric, emergency and anaesthetic skills early on in her career as an important confidence booster to the work she does now.
 
‘I just feel comfortable that I can deal with anything that walks through the door to the best of my ability at the highest standard that would be expected,’ she said.
 
‘I work really hard at upskilling.’
 
For all that, she urges younger medics considering a career in the country not to be intimidated.
 
‘It’s just being amazed at how simple life is, and how simple the medicine is in some ways,’ she said.
 
‘Being curious and having a connection to country and community are the most important qualities for a rural generalist.
 
‘It doesn’t have to be complex or scary and you always have someone to call for backup and advice. I think it’s so rewarding.’
 
Dr O’Kane is also a strong believer in self-care.
 
She indulges her love of the outdoors whenever possible, trekking the West MacDonnell Ranges on free days, or cycling the unpaved streets, as well as tuning in to free online yoga supported by the Rural Doctors Association.
 
She also credits her husband, a physio she met on the Karakoram Highway while backpacking along the Old Silk Road during a break from junior doctor duties, for supporting a career with more logistical obstacles than most.
 
‘I couldn’t do it without him,’ she said. ‘It’s absolutely crucial to have a supportive partner.’ 
 
As well as coming a long way from Monash professionally, Dr O’Kane has been on quite a journey personally, having balanced the parenting of twin sons with her clinical duties.
 
Far from cramping their style, life in the outback has brought freedoms and possibilities that would not exist in the city, she says.
 
They have taken gap years off to travel, lived for a stint in Tonga and most recently Dr O’Kane put her job on hold to support her boys through Year 12. 
 
‘We see our whole life as an adventure, travelling and moving every five years,’ she said.
 
‘As long as you’re happy to be there and immerse yourself, stay positive and have a good time, I think you can slowly achieve good results and make a connection.’
 
And what of her sons? How have they coped with the moves, the bouts of extreme weather, the lack of food choices, and the challenges of having a mum trying to juggle parenthood with rural GP commitments?
 
Now they are out of school, are they planning to retreat to the comforts of the city?
 
Not for a moment. Both are medical undergraduates chasing their own dream of rural doctor life.
 
For Dr O’Kane, this tells its own story.
 
‘It was such a privilege for the boys to grow up and school in some of the most remote communities in Australia,’ she said.
 
‘It encouraged resilience, independence and a unique connection to country.
 
‘Their experience has been so rewarding and nourishing that they want to live that life.’
 
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