Indigenous health: why role models matter

Indigenous doctors contribute in far bigger ways than just providing clinical expertise, says pioneer Dr Louis Peachey

---

Dr Louis Peachey has lost track of the number of committees, forums and consulting groups where he has acted as a link between the medical establishment and indigenous Australia.  In both worlds, he casts a big shadow.

In this year of special milestones, however, he’s giving a speech to colleagues that touches first on the blindness of race laws and turns pretty quickly to the not-strictly-medical hysteria over AFL legend Adam Goodes’ famous “war dance”. 

“As an Aboriginal child in my predominantly white school, I wasn’t allowed to hold a football, I wasn’t allowed to hold a cricket bat, I wasn’t allowed to hold a cricket ball unless I happened to be standing in its way far out in the field, in which case I was meant to throw it back at the lovely white kids,” Dr Peachey says. 

“I wasn’t too good at sport, which is not the only reason I am fat.” 

It’s a packed house in the auditorium at the Rural Medicine Australia conference in Melbourne. Some people are chuckling. 

After Goodes, a two-time Brownlow Medal winner, was named 2014 Australian of the Year, Dr Peachey says, he thought the Sydney Swans captain “had done what he needed to do”. Instead, after the 2014 award there came booing; then the uproar.

“During the indigenous round in which all 18 AFL teams don special-themed jerseys in honour of the sports’ indigenous heroes, Goodes did a dance,” Dr Peachey explains.  

“(Conservative commentator) Andrew Bolt described it as a war dance and said he’d upset people by throwing an imaginary spear at them. I understand how frightening that could be.”  More laughter.

“This dance was a dance taught to him by the indigenous youth arm of the AFL, called the Flying Boomerangs.  I know this will come as a surprise, but the implement thrown during the dance of the flying boomerangs … it’s a boomerang. Number two, a boomerang is for hunting, not warfare. 

“It was not a war dance. This man was celebrating what men have celebrated since the beginning of time.  Bringing home the bacon. Bringing home the protein part of the diet. 

“He was celebrating these wonderful young men. This was a man who had never been taught an Aboriginal dance because of how much culture had been taken from him as a child.  He was so overwhelmed with love for these young men that, on a national stage, he wanted to pay homage to them. 

“And this country had the audacity to turn this thing of love and thanks into violence.  Not long after that, Prince Harry came and went to New Zealand and did a war dance, and this country thought it was lovely.” 

It’s 50 years since the 1967 referendum in which Australians voted to include indigenous people in the national census.  

Dr Peachey is using the occasion to remind us that we have shared a history, even though it may be unrecognised by “an ahistorical people”. On the Goodes affair, he says commentator Walid Ali “nailed it” by saying Australia was a generally tolerant society until a member of a minority appeared not to know their place. 

At the time of the referendum, Dr Peachey was just one year and four months old, the son of a mother of the Djirrbila nation in northern Queensland, and a third-generation white settler who managed banana farms. He grew up understanding much of the language his nanna used, but did not speak it. 

“These were the days when speaking the language could get you taken away. 

“Nanna always spoke language. Pop always spoke English.  He was an Aboriginal man who worked on a cattle property where speaking language could get you flogged with a whip,” Dr Peachey tells The Medical Republic. 

With a head for numbers and skills in technical drawing, young Louis Peachey ended up enrolling in engineering at James Cook University in 1983.  “It had been my hope on entering a seat of learning that there would be a higher-quality yobbo there, but there wasn’t,” he says. “I just couldn’t stand engineers.” 

After a brief stint at a desk in Cairns at the Aboriginal Development Commission, a forerunner of ATSIC, he resigned to go back to his tribal country. He was walking out the door when he was called back and told Newcastle University was offering four scholarships in medicine for indigenous students.  

“If I had walked any faster, I would have missed it,” Dr Peachey says.  “Medicine had never crossed my mind. An Aboriginal doing medicine – and flying to the moon?” 

 Up until then, only one Aboriginal person had graduated in medicine. (Dr Helen Milroy took her degree at the University of Western Australia in 1983, became a GP and went into paediatric forensic psychiatry.)

In another milestone, it’s 20 years since Dr Peachey and other graduates of Newcastle’s program formed the nucleus of the Australian Indigenous Doctors Association, at a meeting of 50-plus people at Salamander Bay, in NSW, in 1997.  

“What became apparent was this dream of mine for an alumni association of Newcastle graduates just wasn’t big enough. It needed to be a national association. 

“A letter I’d written a year before came out of the cupboard, and we transposed the aims and objectives.  

“We were tossing up what to call ourselves and the opera Aida was touring in Sydney at the time.  We thought that might catch attention. 

“That’s why we pronounce it eye-ee-da.”

At 51, Dr Peachey is a rural generalist and anaesthetist living back on his traditional country and working as a senior medical officer at the small Atherton District Memorial Hospital, on the Darling Downs. 

If he and other pioneering Aboriginal doctors remain largely invisible to the public, he says, it’s because there are still only a few indigenous people whose opinion is sought by the media.  

But the visibility of indigenous doctors matters in far bigger ways than their contribution to clinical capacity in the community.

“Among the younger members of AIDA, you will hear, over and over again, what inspired them to go to medical school was a radio interview or an article or a bit on the telly, in which a more senior Aboriginal person inspired them to become a doctor.”

Of course, the role model does not have to be an indigenous person. 

“I’ve been fairly successful, and there were no Aboriginal men who graduated in medicine before me. The only people I had as role models were white people, and they were fine.” 

He admits there was a significant period of time when he felt like something of a “mascot” at his college, ACRRM.  Surely, doctors were only being nice to him because he was a black man.  

Then it slowly dawned; they wanted his opinion, he belonged. 

“No one in this college ever did a thing to me. This was informed by my childhood, by a lifetime before I started this gig, of knowing that I didn’t belong and could never be part of the successful world.”

In the early days of AIDA, Dr Peachey drew on lessons learned at the feet of eminent ACRRM leaders Dr Col Owen, Dr Jack Shepherd and Dr Bruce Chater. 

“They said, go in with equanimity and be the last to leave the table. You never show you are flustered.  No matter how much they get up your nose, never demonstrate it. Never raise your voice, never show you are flustered.” 

The substantive step in closing the gap in indigenous health will be education, he says. 

“Indigenous doctors will help with the health of some people.  The thing they will help with much more than that is giving a child hope. The original sin of this country was the theft of land; the greatest sin of this country was the theft of hope from children,” Dr Peachey says.

“So, my two daughters, they grew up in a world where half of the Aborigines they call uncle and auntie have medical degrees. In their world, medical school is like the fallback position.”  

Dr Peachey wants to get the story out about education so that indigenous kids who follow him will not be fooled into thinking, as he once was, that it would not be possible for him to take a place in the “successful world”. 

“I hope these kids can learn, as soon as possible, that all those doubts in their head, that ‘imposter syndrome’, it’s just a syndrome.  It’s complete bullshit,” he says. “I think I’ve just about got it.” 

As a doctor, he’s a believer in the well-known saying of Rudolf Virchow: “Medicine is a social science and politics is nothing but medicine at a larger scale.”

“I would maintain that all doctors have a responsibility to be socially engaged. I don’t care what party or what politicians you are engaged with, but I think you need to be engaged.  

“As rural doctors, we hold positions in our communities.  And if someone comes in spewing nonsense about Muslim refugees, I think we have a responsibility to say: ‘Oh Harry, you know, that’s not true. Would you like me to fill you in?’ By its nature, what we do is political.” 

In the same spirit, with humour and not a trace of rancor, he spells out some home truths for his “homies” at ACRRM, which he calls “gentle instruction on whether or not you know your history”. 

In the auditorium, he winds up the speech explaining the background of the seven-pronged star that adorns the flag (the seventh prong representing colonial New Guinea) and WEH Stanner’s Boyer Lecture of 1968 in which the ex-soldier and anthropologist coined the phrase “the great Australian silence”. 

“To be honest it hasn’t changed an awful lot,” he says.

He goes on to marvel at Prime Minister Malcolm Turnbull’s response to the call for an explanatory plaque on the statue of Captain James Cook in Sydney’s Hyde Park as “Stalinist”; the fuss over the City of Yarra’s stand on Australia Day; and Henry Parkes’ remark on being asked how indigenous people would be included in national day celebrations: “What, and remind them of how we robbed them?”

He wraps up with a call for the college to foster more Aboriginal women doctors.  

Of ACRRM’s six indigenous fellows, five are men.