Only Human – Episode 5 – Dinesh

Henry Goldstein: 0:00 Welcome to Only Human, a podcast from Don’t Forget the Bubbles. This is Henry Goldstein with Becky Platt. And these the stories that reflect the diversity of our community, and the multitude of life events that come our way that shape us as professionals, and as humans. Dinesh’s story is both brutal and inspiring. Halfway through medical school, Dinesh was involved in a car accident, suffering a spinal cord injury, and quadriplegia. Despite this challenge, Dinesh’s passion and perseverance made history when he qualify as Queensland’s first ever quadriplegic doctor. His achievement caught the attention of the media and featured on ABC News’ Australian story. Our story picks up here, we find out how Dinesh has been able to progress his career since.

Dinesh: 0:48 Yeah, they spent about six months putting that story together and filming bits and pieces. So they put a lot of effort into it. So they covered a fair bit, but since then, it’s it’s still been a roller coaster ride. I’ve progressed in my career. I was a JHO then and now I’m a PHO in the ED. I’ve been chipping away at a spinal cord injury research project. So I split my time between the ED and that now. We started from very, very humble beginnings. Just me and a colleague and really tiny bits of equipment and our own time. Now we’ve been funded by the Motor Accident Insurance Commission, who gave us $2 million in funding just over a year ago. So now I have a team of people. So I work half time in our lab and half time clinically. And I work at the Disability Royal Commission as a senior advisor, as well. So I get to do a lot of fun and interesting things which I feel very fortunate for.

Henry Goldstein: 1:59 Dinesh found that despite the limitations of his injuries, colleagues of his were prepared to support him on his career path.

Dinesh: 2:07 I think just around that time, when Australian story was filmed, I was working in the ED one night. And it was the kids ED, probably about 10pm. And there’s a paediatric emergency physician, Christabel who some people listening to this might have come across. But Christa was sitting with me in the ED, and we’re talking about what I want to do with my career. And she said, ‘you know, what, what, what do you what do you like, what do you like doing? Where do you see yourself?’ And I said, ‘you know, I really, I really enjoy working here. I enjoy what we’re doing right now’. And so she said, ‘you know, if that’s what you want to do, I think we as a department will make it happen for you. And I’ll go and advocate and, we’ll explore this possibility’. You know, that was a really exciting thing for me, because I didn’t think that I could work in an ED after the injury. And at that point in time, I was thinking about what I would do for the next couple of years and where I’d work. And for someone to actually just say that, was a pretty exciting thing after the journey that was. So that that was, that was a really, that was really cool moment in the career. But here we are now on PGY5 and so much has happened. I often can’t believe that I woke up in an ICU just over 11 years ago now, but I am super grateful for everything that I get to do today.

Henry Goldstein: 3:48 Despite Christa’s support, not everyone shared her view that Dinesh could meet the challenges of working in an emergency department.

Dinesh: 3:55 The journey up to that point, I mean, I had a lot of people that were supportive, but it was also peppered with challenges. And some of them are big, big challenges. And all along that road, I think people said, ‘you need to pick a career that’s sensible for you with your physical capacity. You need to think about your injury and where you can fit into medicine’. So it was very, very conservative. But for someone to come out and say there, ‘there are big possibilities in what you can do’ was a really good thing. You know, interestingly, there was another doctor in the department who was a registrar at the time, who overheard the conversation between me and Christa. And she waited until I finished my shift. She waited back. And just as I was leaving, she pulled me up and said, ‘I know Christa said what she said, but I think that’s a terrible idea’. So there have been conversations like that around the road. And even though it I was a bit taken aback it was, it was still the reason why I thought what Christa said was a really profound and awesome thing.

Henry Goldstein: 5:11 Even though Dinesh’s achievements have been remarkable, there have inevitably been some very dark times,

Dinesh: 5:18 Going through depression was an incredibly lonely thing, because, and I see some of our colleagues going through this all the time. But I think it’s it’s also this cycle, where you are struggling with yourself, and you are trying to figure out why you’re not happy and you’re feeling low all the time. But you can’t really interact with people around you as well. And then I think people around you can get frustrated through that process. And it can become this really, really bad spiral, where you become more and more isolated, and more and more alone. And really, like not many people can understand what it’s like unless you have been through it. Depression is just a horrible thing. Like you just feel flat. And you feel disconnected and you feel just low.

Henry Goldstein: 6:11 I’ve heard this description of depression that is something that is upon you and as drives away, and you’re just looking at watching it disappear in the rearview mirror, as you drive as fast as you can away from it. And just as your eyes go back to the road, there it is. You say ‘Hello, friend’. And that’s a worry for a lot of people.

Dinesh: 6:32 Yeah, it is. It’s so dark. I mean, even your sensory interactions are impaired. So I actually remember the day that I realised that the depression had resolved. The very day. And it obviously didn’t happen overnight. But I just remember coming to the realisation that, ‘whoa, I think I’ve come through this’. It’s when I drove out of my garage one day, and I just had the music going, and I could just see the sunlight and see the trees and smell things and hear the music outside. ‘Whoa, this is amazing’.

Henry Goldstein: 7:18 Dinesh now gets to sit on panels with extremely influential people in Australia. But even at a higher level, his experiences are hard for people to grasp.

Dinesh: 7:27 Last year, we had some roundtables at the federal government level about disability and the pandemic. There’s being some on the vaccination and disability on the pandemic. There aren’t many people with lived experiences, who are working in health or whatever is relevant at some of those tables. It does take a bit of courage, because it’s, it’s not really professionally encouraged for us, particularly in medicine, to go and speak about these sometimes for the risk of your career and progression and employers.

Henry Goldstein: 8:07 I was reflecting, as you said that, I am looking at one quote to talk with you about and it was from George Engel, who’s the originator of the biopsychosocial approach to healthcare and medicine. He says, to be able to think of the disease as an entity, separate from men, and caused by an identifiable substance apparently has great appeal to the human mind. Perhaps the persistence of such views and medicine reflect the operation of psychological processes to protect the physician from the emotional implications of the material with which they deal.

Dinesh: 8:45Oh, that’s heavy. I went to conference a little while ago, and there was, they did a really interesting exercise where they had a workshop with a group of patients and a group of doctors. And they wanted the patients to tell the doctors what they wanted from them. And between an endocrinologist and a patient, this really heated argument started because the patient was saying, ‘I really want you to enable me to live my life the way I want’. And then the Endocrinologist was like, ‘what are you talking about? I can tell you, I can tell you how to manage your diabetes. And that’s that’s what I do professionally’. He’s like, ‘you don’t get it. Like I want to time these things. So I could go and do things and I want to live my life to the fullest’. And the Endocrinologist just didn’t understand it. So I think I think there’s a…we need to enable people to live a life and we need to see people as human being. I think the most significant and memorable interactions that I’ve had with patients is not about a diagnosis or a treatment or anything like that. It’s been about a cup of coffee that I’ve bought them, or it’s been about a conversation around their life or family.

Henry Goldstein: 10:26 What has amazed and shocked Dinesh the most in his journey, is the reaction of the patients he treats.

Dinesh: 10:31 So this is my fifth year as a doctor, and I spent two years as a student wandering around the hospital. And I’ve put cannulas in patients for the first time, and they’ve been they’ve been, they’ve had the knowledge that is probably the first time that’s ever been done in the world. Someone’s let me suture them up with my boss. So you know, of course, in a safe and controlled manner, but not a single patient has ever said, ‘Hey, how come you’re a doctor? How do you do this?’ And it’s all been so positive. But it’s, it’s come from the medical side of it, which has been really interesting. And, yeah, there are people that have said that there, there are doctors that have had conversations like that with me. And how also reflect that Christabel an Emergency Physician, and in fact many other EM doctors in our department have been so supportive. But then some doctors who have been in the least physical of specialties, who essentially operate from a desk have said that I wouldn’t be suited for that specialty.

Henry Goldstein: 11:52 Dinesh’s innate instinct to set goals and use techniques to help him achieve them. have helped him get where he is today.

Dinesh: 12:00 When I was practising for my interview for medical school, I have a really good friend, we went to school together, he trained as an actor. So he’s got all these techniques of visualisation. When we were doing it, he gave me this visualisation, which we did over and over and over again. And it was….you picture this idea of you in medical school, and you becoming a doctor and whatever else, and you put it in a balloon, and then you cut the string, and the balloon floats away. So the idea is there, you’ve seen it, but you’re not attached to the outcome. So now it’s time for you to do the work. And when I came back to medical school from the accident, it was like that, too. I knew that I wanted to graduate. And I knew that I wanted to do well. I identified that then I put it aside. And then I just ended up doing the little things every day to get to that, because it’s 1000 different steps, right? So I think you have a goal, and then you just start taking small, incremental steps to get there. I think eventually you do get that because everything is made with tiny little steps.

Henry Goldstein: 13:16 And I think as well as doing the work and putting in the time and effort, occasionally coming up for air. Dinesh reflects on why he continues to do what he does, and strive in his career.

Dinesh: 13:29 I think it was Nietzsche or someone who said ‘he who has a why can bear to live with anyhow’. So I think having a why is really important. Because why is what gets us out of bed every morning. And why is how you can keep going. It’s why is how you can get through the hard times. So I think having a why is super, super important, whatever that why might be. Because I think you see the colleagues that don’t have a why in the job anymore. And it’s just a job. But if you’re going to spend eight to 12 hours a day doing something, I think you really need a why, yeah, always gonna get to the end of life and go ‘I don’t know how I felt about that’.

Henry Goldstein: 14:18 Yeah. And I think that that process of redefining your why at the appropriate moments is important too. Why is this for me and my personal self? Or why is this for greater humanity? Or why is this for a particular patient cohort or why? And it’s okay, when that changes, and you can reconsider it, so long as you challenge yourself to define whenever you’re not sure. And you’ve got to do that in a sort of cognitively and emotionally neutral time.

Dinesh: 14:49 Agree, but I think if you’re struggling to find a why some days, I often think about what a privilege it is to have the job that we do, particularly in the last year. People celebrated healthcare workers. Often I think, you can ask a patient, their sexual history, or their illicit drug use, and they won’t think twice. They’re saying, ‘yep, I cheated on my wife’, or whatever. Well, level of trust is phenomenal. That human connection and the ability to do something. So yeah, if you’re struggling to find a way that at least thinking of that helps, I think.

Henry Goldstein: 15:33 Dinesh, I’m so grateful for our chance to talk today. Thanks for being here.

Dinesh: 15:37 Thanks for having me. It’s been fun. And thank you for what you guys do at Don’t Forget the Bubbles.

Henry Goldstein: 15:43 Thanks for listening. You can find more episodes of Only Human as well as details for events, courses and articles at DontForgetTheBubbles.com. Until next time,