Dr Richard Mayes was spiralling into depression and knew he had to change his mindset about the way he was practising medicine
DR Richard Mayes – variously known to his local community in Castlemaine, Victoria, as “the Dancing Doctor” and “the Mullet Man” – was born to be a doctor. He came from a long line of doctors and always knew that medicine, general practice in particular, was his vocation.
His wife, Lucy, a leadership consultant and facilitator, says they met as students – him medicine, her law – at Monash University, playing water polo.
“That's put me in an interesting position to have watched his journey through medicine. It’s a very deep calling for him. There was never any question in his mind that was going to be his path. He always wanted to do cradle-to-grave, community-based medicine’."
A country boy by birth, and co-founder of the Rural Medical Students Association at Monash University, Richard’s first GP training job was part of the rural/regional training program and he was expected to move every 6 months to fulfil the program requirements.
“I was like, ‘oh well, that's not very helpful for my career so I may as well just try and get pregnant and have a baby’,” Lucy tells the MJA.
Lucy and Richard’s son was born 2 weeks after they arrived in Castlemaine, a small town in the Victorian goldfields, south of Bendigo.
“It all went crashing downhill very quickly because we had this new baby who never slept, we had a new community and Rich threw himself into the work, trying to be all things to all people,” says Lucy.
“We never saw each other, and he barely slept. It was a combination of challenging life circumstances alongside that fairly tenuous time when you're at the start of your career anyway.”
It was a bad time, for both of them. Lucy was struggling with post-natal depression, and neither of them recognised that Richard was sliding into depression and burnout.
“It was a bit messy for a few years,” Lucy says.
The turning point came when they realised their marriage was in danger. A friend recommended a personal development course.
“That’s when Rich had his ‘a-ha’ moment. He said, ‘oh my god, I was so passionate about medicine, what happened? I realised what I had become, what I had let go of, and the dream was reignited. I remember the first time seeing patients again after that experience. I felt I was able to actually see people again, for the first time in years. I got back to what it was all about’.”
The family moved to Queensland’s Sunshine Coast, where Richard set up as a solo GP in an integrative clinic. But, as Lucy says, the practice was not as “integrative” as it promised to be, there was quite a bit of patch protection and it was also hard to sustain financially. Richard was also struggling following the death of his father.
“I was at home with young children and I was watching him spiral out of control,” says Lucy. “I was reading his medical magazines, and I was reading all the reports about doctors’ burnout and suicidality. I was thinking, I'm living with a potential statistic here.
“It was really scary for a while there. I was thinking, ‘you were born to this work, it is the essence of who you are; surely we can learn to do this in a way that is sustainable for you’.”
He soon realised that the very thing that had burnt him out was the very thing that he loves about medicine, which is deeper connection with his patients, continuity of care, cross-generational relationships and community. He was going to have to learn to balance the two.”
A return to Castlemaine followed this realisation.
But why return to the same clinic that had burned him out in the first place?
“He said, ‘the clinic didn't burn me out; it was my mindset that burnt me out’," says Lucy.
So, Richard set out to change the way he had been practising.
“He took one clinic day off a week. His work life broadened. He's four days in the clinic and one day he devotes to medical education and his own self-care. He has a personal coach/therapist who he sees weekly on that day. He also does his sports – kayaking, running, and dancing,” says Lucy.
“The shift in my thinking which I brought back was that working towards a health partnership approach with patients was more sustainable in the long run because I was facilitating them to be their own healers, rather than setting up a co-dependent relationship,” says Richard. “It took an enormous burden off me – and when that was lifted off, it gave me my compassion back, and my patients were getting better because they became more empowered to take more responsibility.”
One of Richard’s patients ran a youth hip-hop dance school. “We had joked for a few years about my lame dance moves and that I might need some schooling in the hip-hop arts.”
One day the patient announced that she was starting an adult 80’s style hip-hop soul funk dance class, just for fun, and Richard was the first to sign up. The group performed a “flash mob” dance routine in a local supermarket as part of a local arts festival. An ABC journalist just happened to be in the store and captured it on her smartphone, and the rest is history.
“Of course, Rich was the only bloke in the line-up,” says Lucy. He was wearing his mullet wig, the journalist posted the video online and the big thing became, ‘who's the mystery mullet man? who's the bloke with the cool dance moves?’
“Then, of course, it became even more newsworthy when it emerged that he was the local doctor.”
The ABC had Richard recreate his routine solo, complete with mullet.
Has the dancing, and his other self-care activities made Richard a happier man and a better doctor?
“Very much so,” says Lucy. “He thinks it's the most powerful public health intervention he's ever done. You know, he can sit there in his clinic until the cows come home and tell people to stop smoking and take up exercise, but actually doing it himself and doing it in such an exuberant, fun way has been attractive to people and people are really inspired. He has also now joined his dance teacher in setting up a dance class for older people who have compromised mobility, called ‘Silver-tops’. A number of his patients have signed up and its been transformative for some.”
Lucy was inspired as well. She found Richard’s story so compelling that she decided to do something tangible.
The result is Beyond the stethoscope, a collection of first-person stories from Richard, and other doctors from around Australia and New Zealand, representing multiple specialties, all willing to talk about their own experiences with mental health, well-being, self-care and reconnecting with meaning and purpose as doctors.
“I thought there must be other doctors out there who are finding ways to practise medicine which is both good for them and for their patients, figuring it out and making it work. I decided I wanted to meet them, and hear how they were making it work,” says Lucy. “I was interested in how those people were integrating, you know, bigger picture thinking into mainstream medical practice.”
“People seem to think that doctors can't actually have a personality outside of being a professional. Collecting the stories and creating the book has been profoundly inspiring. These are really stories of people being humans first and professionals second, who see their patients as humans first and sick people second. The wisdom that speaks from these doctors is a special kind of wisdom that is the by-product of sitting with people in all states of the human condition, day in and day out, and seeking to make their lives a little easier. These are doctors who have fought to reclaim care at the centre of their work, in order to sustain themselves as much as their patients. I was so moved by the stories that I felt I had to share them with the world. If it helps save one career, or even perhaps a life, I’ll be happy,” says Lucy.
Other doctors who have contributed to Beyond the stethoscope include Dr Catherine Crock AM, Dr Glenn Colquhoun, Dr Peter Howe, Associate Professor Vicki Kotsirilos AM, Professor Vikram Patel, Dr Geoffrey Toogood, and Dr Mark Wenitong.