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The Quarterly

Making History Count Print E-mail
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"So in this our 50th anniversary year, it comes back to the importance of history and what I have recently learned from the interviews of Presidents of the past and a founding college member. Without these interviews, important facts about the college would not be known to many and it has made me advocate even more strongly for a RACMA history, before we no longer have access to some of our early foundations"
 
  

None of us is “just here”. We always came from somewhere and it is where we came from that has a significant impact on not only the here and now but the future. That impact can be something that just happens or we can use our history to enrich our here and now and our future direction. For people, our history is our background, our ethnicity, our upbringing, our schooling but there are similarities with organisations too. Organisations also have histories and they need to be acknowledged, celebrated and consciously remembered to enrich our organisational futures.

In this, the 50th year of RACMA, the thoughts of the college have turned to history, with the project to interview all former presidents and some Fellows who were there at the inception. Recent interviews that I have been involved in, have caused me to reflect on the importance of history in organisations that I have worked in and what this has taught me about its importance.

My early medical management years were in the Repatriation System, at Heidelberg Repatriation Hospital in Victoria. It was during that time that the Commonwealth still directly managed hospitals and all the Repat hospitals in all the jurisdictions responded to the Department of Veterans Affairs in each capital city and this department in turn was responsible to head office of DVA in Canberra. When the decision was made by the Commonwealth to divest itself of its direct hospital input, all of these hospitals gradually became either state or private hospitals, with Victoria being the last to go. The reason for this probably related to the strength of character of the then President of the Returned and Services League, Bruce Ruxton, a Victorian who saw himself as singlehandedly holding back the inevitable tide.

During the time that negotiations had started to occur, one of my administrative colleagues began to agitate for a history of Heidelberg Repat to be written as he (and all of us) could see the writing on the wall. Bruce was not supportive, the Deputy Commissioner was luke-warm on the idea and the executive of the hospital neutral, so it was going nowhere. My colleague was very enthusiastic as was I and a small group of others. We knew that if we didn’t do this now, the opportunity would be lost. It was at a time when there were still a few WW1 veterans, some elderly staff from the WW2, WW2 veterans were in their early 70s and able to contribute oral history and the hospital was still stand-alone.

My colleague asked me to exert some influence on the key people with whom I had good relationships. So I set up separate interviews with Bruce (who had a lot of respect for doctors) and the Deputy Commissioner who had been an invaluable support to me over many years. And the rest was indeed history…

We engaged a historian who had been a speech pathologist and just had competed her PhD in history. This was her first book and what she discovered, was of incredible value. It showed quite clearly how the history of Heidelberg Repat had determined its future and its reputation in the hospital environment.

I had always wondered at the Repat’s reputation in the wider health world. It was regarded dismissively as not doing anything much and so staff felt almost embarrassed to say they were working there. I was never able to fathom why this was so. Our equipment was state of the art, our medical staff leaders in their field and asked to present at national and international conferences. Many went on to high office when they left. There was amazing innovation in medicine and allied health. However, outside our hospital (except for the research world), no-one knew about the achievements. It was our historian who discovered why and put it all into perspective.

She identified that it was the history of the inception of the hospital that had kept the reputation for outstanding and innovative medical care hidden. This hospital that had pioneered numerous techniques during and after WW2, including plastic surgery, had been unable to discuss any of its advances due to being a war hospital. It was forced to keep silent during war years and even after as it was dealing with WW2 veterans. This culture had continued to permeate the hospital over the intervening years and had never changed. By the time we became aware of this it was too late to take any definitive action for change. However, the power and influence of history struck me then and has continued to be a recurring theme.

When I moved out of the Repat to a private hospital, I came up against the influence of history again. I had moved to a hospital that everyone said provided the highest quality psychiatric care.  However, despite the pride in this care, it was delivered in the most run down and bleak surroundings. The rooms were drab, the carpets threadbare, there were few en-suite facilities and the hospital “front door” was depressing. It was my intention to find funds for renovation and to begin at the front door. The foyer was typical 70’s: dark quarry tiles on the floor and brown exposed brick walls. In addition, there was dilapidated and mismatched furniture. However, on one of the walls there was a truly beautiful and huge tapestry- the only bright thing in the whole foyer.

I managed to convince the Managing Director to provide funds and we plastered and painted and carpeted and put in new furniture so that the foyer was bright and modern and welcoming. The tapestry which had been carefully rolled up and put away was put up on a wall again and I was very pleased with the outcome.

The day after the tapestry was replaced on the wall, I received an angry visit from one of the older psychiatrists. He told me that the tapestry had been placed on the wrong wall. I looked at him in bemusement. I had been very considered I thought. I had looked at all the walls and where we had placed the furniture and put the tapestry up where it looked most appropriate. “You have no idea about the history!” he complained. “Do you know who designed that tapestry and designed it for the particular wall it used to be on!”  “ Do you have any idea how our patients will feel that you have had the temerity to move it from a place that they have always been used to?” He glared at me. “ Move it back” he demanded. I had listened to him and heard with interest his thoughts on patient impact.

“Before we move it” I said, “Why don’t we ask the patients if they mind?” He looked at me very suspiciously but had no answer to this although he grumbled that I could swing the vote if I wanted to. However, we agreed that a nurse he recommended would run the survey and collate the results with no input from either of us and the outcome would be the end of the matter. It was interesting that patients overwhelmingly liked the tapestry in its new place.  The tapestry had an eye that seemed to be all seeing and a number of patients said that where it was previously it seemed to follow them about and was threatening. The psychiatrist was very consumer focussed and so the tapestry stayed in its new spot with no more complaints.

My lesson was learnt however. History was of key importance particularly to the psychiatrists who had founded the hospital and any change in the future was couched in historical foundation terms. The history of the hospital was always acknowledged and celebrated and respected to ensure that organisational foundations were not forgotten.

So in this our 50th anniversary year, it comes back to the importance of history and what I have recently learned from the interviews of Presidents of the past and a founding college member. Without these interviews, important facts about the college would not be known to many and it has made me advocate even more strongly for a RACMA history, before we no longer have access to some of our early foundations. Although there is some information on our website about the first 30 years, this does not describe how the college came about and the importance of the public health stream in its genesis. I certainly did not know about the genesis of epidemiology, the public health medical fraternity in New Guinea after WW2, the involvement of our early Fellows in the NHMRC and the coming together of the two strands of medical superintendents in Victoria and public health physicians to form the college. It saddened me to realise that one of these strands was lost when the public health physicians left to become part of RACP. I think if we had known the history of RACMA at the time there might have been more effort to continue the relationship.

It became clear to me during these interviews how it was that epidemiology was a mandatory unit before Masters degrees were introduced and why we studied Advances in Healthcare. These units were a legacy of our public health roots and kept us in touch with aspects of medicine and research that impacted on medical management. It is likely that our reputation as high quality medical managers would have been easier to come by if the two strands had continued and supported each other. That however, is simply supposition and a professional historian expert in documentation and oral history may be able to come up with something based on real evidence.

I would like to think that all of us are prepared to support and advocate for the commissioning of a documented history so that we can better understand and celebrate our past and in doing so build an even  more exciting future.

 

Dr Lee Gruner
FRACMA

Last Updated on Friday, 15 September 2017 11:54