Almost 12 months ago, I retired from my full-time FACEM position in Brisbane to take on a new challenge – farming in southern Tasmania. When I took on my first job in emergency medicine I knew very little about what it would entail, but I did enjoy watching ER and that seemed as good a reason as any to pick a career. I never did get to work with anyone like George Clooney, but I did have a lot of fun along the way, so the methodology regarding choice seemed sound. Now that adventure is complete, and I have chosen the next one based on little more than my enjoyment of TV shows about farming – what could possibly go wrong?
Farming seems very similar to my early career in emergency medicine. There are the old codgers in the background, happy to hand out occasional advice, but in the main it’s about taking a deep breath to bolster your self-belief and just cracking on with it. I do think my whole career has been guided by the philosophy of the Eleanor Roosevelt quote, “do one thing every day that scares you”. I started out doing anaesthesia and when that ceased to terrify me I switched to emergency medicine. After almost 20 years as a FACEM I was starting to relax just a little, so it was clearly time to switch to something else. Farming fills that requirement with a seemingly endless source of fear.
The decision to leave emergency medicine was not hard. The thing that was hard was leaving behind the people, the colleagues that over the years shared so many of the highs and lows of life in the ED. During the course of my career, the work environment in the ED has changed substantially, and like the constant drip of water on a rock, the ever-mounting pressures of patient volume and flow slowly and almost imperceptibly wore away the joy of going to work. It took a six-month break of long service leave spent on the farm to recognise this fact. There, I briefly enjoyed working to my own schedule rather than to a roster, although that short hiatus has now been replaced by working to the schedule of the chickens and the dogs, as well as the seasons, so no wins to be had there.
The break did provide an opportunity to ponder the deeper questions about what kind of life to live and for me the answers lay in the draw of the land and the possibilities that living on it opened up. The desire to leave our little patch of earth in a better state than when we bought it feels like a good thing to do in the context of the global environmental situation. The challenge of surviving without a fortnightly paycheck is not a small impediment to handing in a notice of resignation, and running out of money is another fear to add to the list but for us, the desire to be young enough and physically strong enough to embark on this venture were the deciding factors. In the short time since I have retired, two young colleagues I worked with when they were registrars have sadly passed away and this only reinforces the importance of living your own dreams.
The process of ceasing clinical practice has been interesting. Perhaps not surprisingly, the hospital hierarchy where I had worked as a specialist for more than two decades did not notice my absence. No exit interview there. Maintaining registration with its CPD requirements is not feasible without ongoing clinical work, so retiring as a Fellow is the only real option. It does feel a bit abrupt that one day you are considered an expert in your field and the next you're not eligible to offer an opinion. I do think this is an area that the College and AHPRA could reflect on as the number of Fellows approaching this career stage increases. There is a lot of expertise and talent that could have an input in alternative ways other than fronting up to run a shift in ED. My husband is an academic and on his retirement has transitioned to Professor Emeritus status with links maintained to his university and academic community. No such equivalent exists in emergency medicine. A retired FACEM benefits by paying no fees but little more is expected or received.
For me now, the fear of tractors and power tools, sick animals and electric fences is more than enough to keep me going. I relish the need to keep learning new things. The ability to identify sick/not sick in the ED does not translate well to animals I have found. I am hoping my intuition will improve with time. My experience in trauma and massive transfusion was of no help when I recently encountered our remaining guinea fowl dripping blood from the neck after an attack from a hawk. After looking close to death it rapidly recovered following the boisterous attention of our young Maremma guardian dog. Therapy dog indeed! Our initial plans of growing truffles has had to pivot due to water and soil issues and the latest plan is sheep breeding as well as orcharding. Perhaps I should have been a vet…but that’s another dream.