Clarke, Dr Graeme Edgar Interview

Today is the 5^th February 2015. This interview is about the Clarke family in medicine in Hawke’s Bay and Hastings. We’re talking now to Graeme who will carry on and give us all the details. Thank you Graeme.

My father Edgar Clarke was born in Balclutha, lived in Dunedin and attended Medical School in the height of the depression. In those days the majority of New Zealand doctors came from Otago and were educated at Otago Boys’ High School as he was. His father had emigrated from England as a young man and had worked in various occupations and farming before becoming a land agent in Dunedin. Land agent and business man – he had lots of investments.

Our medical family history in Hawke’s Bay started in 1950. This was started by my father Dr Edgar Clarke, who was at the time Medical Superintendent of Dannevirke Hospital when he decided to leave hospital practice and enter private practice in Hastings. He was an Otago graduate who had practised medicine in Dunedin, Wanganui, Nelson and for some years in England – London in particular – during the war obtaining specialist surgical training at a variety of London hospitals. Prior to his position in Dannevirke Hospital he’d been a surgeon on the New Zealand Hospital ship “Maunganui” during the latter part of World War 2.

He’d purchased a home in Hastings which was a fine old villa on the corner of Railway Road and Southampton Street which is now a country residence just out of Havelock North. In those days medical practice in Hastings was quite a closed shop and it required approval from the current medical practitioners before one could be accepted to practise in the town. He must have been given the right number of ticks or approval to start practise. Initially he started practice from a separated off area of the family home but later built a custom built surgery on the grounds of the home. These were the days when many doctors worked from their homes or in commercial terms ‘lived above the shop’. Hastings doctors were unique in New Zealand in that they still retained the refund system of payment in which the patient paid the full amount, was given a chit and went to a Health Department office and received a refund. This was a system they regarded jealously and it lasted for some years.

My father Edgar had an unfortunate start to practice in Hastings in that after a few weeks of starting practice he began to develop weakness in his legs which prevented him from working and the cause was a difficult and prolonged exercise to diagnose. However, it was eventually solved by referral to the new neurosurgical unit in Dunedin where an operation to remove a benign spinal tumour was totally successful. However, this had meant a whole year off work with no income – not a good thing when you are starting out in practice with a young family.

From 1952 he was back in active medical practice and slowly built up a large practice over the years consisting of general practice, surgical practice in which he had considerable experience. He was also the Hastings Police surgeon for many years which could be very busy at times. He remained in practice in Hastings until his sudden and unexpected death in 1976 at 66 years of age. His personal and community interests were wide and varied. He was a good pianist and organist and often relieved at St Andrew’s Church, Hastings, where he was a church elder. He was also involved with the High School Board of Governors, medical officer to the Hastings Harriers, the Boxing Club and the Wrestling Club. Outside medicine he was always active building a bach at Taupo and involved in caravanning and boating.

Yes he certainly had some community interests didn’t he?

He did. When my father Edgar commenced practise in Hastings it was before the days of specialisation and all doctors were expected to do general practice duties and cover after hours and at weekends. In fact it was essential in these provincial towns for doctors to survive financially to do this.

I’m Graeme Clarke and I’m also an Otago Medical graduate and I came back to Hawke’s Bay in 1969. I had grown up in this area and attended Central School, Hastings Boys’ High School and then went on to University. During my time at school I was very involved in sport and was in the Hastings Boys’ High School First XV for three years my last year as captain. I was also selected for the Hawke’s Bay Junior Representative rugby team for the last 2 years of my secondary schooling. I was very involved in athletics and won many athletic events at Hastings Boys’ High in the years that I attended there. I played tennis and I also was involved in boating through the interest of my father who had a launch in Napier. I was involved in a series of yachts starting with the P Class working up to ‘idle alongs’ and other large craft.

As I said I returned to Hawke’s Bay in 1969 after experience in various hospitals in Dunedin, Wellington, Palmerston North and National Women’s Hospital, Auckland and obtained specialist training in obstetrics and anaesthetics. I set up in solo practice – as was the way in those days – in a custom designed surgery in a flat on my property in Frederick Street but later had a custom built surgery away from the home. Subsequently I joined two other local practitioners, Dr Ritchie and Drysdale, in the first purpose-built group practice in Hawke’s Bay at Stortford Lodge. My range of practice was extensive and the practice grew very rapidly particularly with my special interest in obstetrics. I also had a hospital appointment in anaesthetics which involved sessions of general anaesthesia and epidural anaesthesia at the Hastings Hospital. I held this appointment for 17 years.

I was also involved in industrial medicine being the Medical Officer for J Wattie Canneries for 27 years. My other real interest was sports medicine and I was one of the medical officers for the Hawke’s Bay Rugby Union for a number of years.

In 1981 to 82 I arranged an exchange of my practice with a medical colleague in Hampshire, England, Dr Nick Silk, which was a huge success both medically and family wise and we made lifelong English friends who we still visit regularly and keep in contact with. Dr Nick Silk was an Oxford and England rugby representative who loved the outdoors and fishing in particular and he also enjoyed his year in New Zealand from the medical point of view. I subsequently returned to the UK on other occasions to work in the same English practice for shorter periods which required me to organise a locum cover for my practice while I was away.

At the time that I entered practice in Hawke’s Bay I had been preceded by the sons of other established doctors in the area and those that come to mind are Dr Alistair White, Dr John Cashmore, Dr Ian McPherson, myself and subsequently Dr Jay Tyler and Dr David Velvin. I remained in the group practice at Stortford Medical Centre until 2004 then with Dr Drysdale moved to the Hastings Health Centre. This is a large group of practitioners in one building where extra services are provided all under the one roof, e.g. x-ray, physiotherapy, pharmacy, accident and emergency department. In other words a ‘one stop shop’.

It’s interesting to go back and see how patient cover was arranged for after hours and weekends or if doctors were away. Initially when I started it was personal cover by a colleague which you had to arrange and early on in Hastings GP cover (which was 24/7) was expected and a roster system which lasted for one week and then one day per week was established which involved all doctors in the area. Then with the setup of groups they arranged their own roster for cover. Nowadays after 8pm all urgent calls are referred to a call centre in Auckland which is staffed by nurses. This is probably a good thing as it gives doctors a much better work/life balance and gives them time to do things that they have considerable interest in outside medicine.

There have been many changes that I have witnessed in my time in medicine in this district –

Firstly: increasing specialisation, doctors practising in their own area of expertise, e.g. orthopaedics, urology, physicians, surgeons, radiologists, pathologists.

2: GPs are now mainly only involved in family medicine care though some have particular interests within that sphere.

3: Group practices: These are almost the norm now and we are witnessing the death of the solo GP.

4: Health team within the group practices: This involves doctors, nurses, social workers – all sharing responsibility or care.

5: Nurse practitioners: This is a new development where nurses can do extra training and be certified to extend their range of care, e.g. writing prescriptions, and now we’re on the cusp of portal internet medicine of the digital age where the patient and doctor consult via internet for symptoms, results, appointments, etc. This really is the digital age.

So medicine like everything else these days shows increasing sophistication in all areas – testing e.g. gastroscopy, ultra sound, scanning, MRIs. This is a significant aid to the diagnosis and monitoring of conditions. New drugs and vaccines enable control and cure for many conditions previously a problem. Improved surgical techniques of coronary artery bypass surgery, joint surgery etc. Nuclear medicine and fertility medicine and neuroscience.

Each generation of medical practitioners probably think that their era in medicine was the best – the golden years – but like my father before me I must say that I thoroughly enjoyed my time in medicine in Hastings and feel privileged to have cared for the many patients who put their trust in me to provide them with their medical care.

That’s an interesting comment because I know speaking at it from a patient side, the doctor looked after all of you and all the family. Today when you go to the hospital to have something done, instead of one man dealing with you there’s a team and it certainly has changed.

This is a little bit of personal family history.

I met Margaret, my wife, in Dunedin where she was a graduate in arts. She had a BA in history, and we married in 1964 in Palmerston North. Her father was a well-known obstetrician/gynaecologist in Palmerston North who delivered many babies over his years of practice.

We had three children, a daughter Kathryn, son David and younger son Robert. They went to school in Hastings – Boys’ High and Karamu – and they have subsequently all been to University. Kathryn graduated BA in English Literature and art history but now works in finance in Auckland. David did a science degree and then an honours degree in law and is now the chairman of Russell McVeagh, a well-known New Zealand legal firm. Robert graduated in law in Canterbury and in Arts and subsequently went overseas, working initially in London and then spent 10 years in Paris where he qualified as a lawyer in Paris an avocat á Paris. He has now returned to New Zealand and works as a civil servant in the Ministry of Economic Development in Wellington where he specialises in international telecommunication law.

We now have 7 grandchildren – 3 with our daughter in Auckland Kate – Kathryn – who has a daughter Sophie, she goes to St Cuthbert’s College in Auckland; Gus who is at Ponsonby Intermediate and Maggie who is at Westmere Primary. David has 4 children, all girls, aged 10 – twins, a daughter of 7 and another of 5. They all attend local Khandallah Primary School.