Sunnyside superintendent: always learning, developing

Press, 22 June 1989, Page 15

Sunnyside superintendent: always learning, developing

By

CHRISTOPHER MOORE

Medical ■ • ’• A.-. - , I ■’ ' '* '• • ‘ \ career I remained {personal ■ •'/ > goal in If ;• - A K childhood

DR LES DING recently stood in the middle of a medical no-man’s land.

Requested by the Canterbury Hospital Board to produce a report on the role and function of Christchurch Hospital’s Ward 24 — specifically its handling of recent child sexual abuse cases — the superintendent of Sunnyside Hospital was surrounded by an emotional and ethical minefield.

It was, Dr Ding concedes, one of the most difficult assignments he has been asked to undertake.

“The majority of my colleagues told me that it would be a most difficult task — one that I couldn’t win. To be honest, I never saw this as a win or lose situation. I had been asked by the board to prepare a report. Having agreed, my main concern was whether I could do it thoroughly enough" in the time available,” he says. “Having obtained information and facts, would I be able to sit down and make certain deductions? That was my preoccupation rather than any sense that this or that would be potentially damaging for myself or the board ...” He reacted to the demands of the situation by simply vanishing from the hospital environment, for several weeks during the interviews and the preparation of the final 49-page report.

“I felt that criticisms that a board employee could not produce a balanced report were something of a vote of noconfidence. But I was also aware that if I did not do a thorough job, it would lead to further criticism. If I had been asked by another board to do a similar job, I would go through the same process. "I think that the issue is still sensitive. I would hope that the report might have defused some of the anger. If I have succeeded in producing the findings that an outside investigator would produce, then logically it should defuse some of the public anxiety .. Later, in a moment of selfanalysis, Les Ding described himself as “a perpetual optimist and a basic pessimist. “I let myself become as pessimistic as I can before bottoming out and coming up again ...” His medical career spans two

turbulent decades in the devejopment of New Zealand’s psychiatric health services. It has, been accompanied by a broadening public interest and concern over the nature and quality of these facilities. For Les Ding and his team of health professionals, at Sunnyside Hospital, this process often means standing in the) firing line of public criticism. But Les Ding is a man who clearjy believes that every situation contains valuable lessons for the future. Born in Dunedin, he is the firsts generation of his family to be born in New Zealand. His grandfather arrived from Southern China in 1910, his father in 1920, and his mother and remainder of his family during the 19405. For Les Ding, a village 30 kilometres north of Canton is the ancestral home: a place of deep family associations. “My father had a classical education in China. His generation was acutely aware of what it could do and not do in a foreign country. They often had to turn their hands to something they knew about — selling or growing vegetables while possibly feeling that what they were doing was below their potential. For par-.; ents of this generation, the hope was that their , sons would do something which would get them right to the top.” ; ; / As a young child, Les Ding remembers being told that he . would become either a doctor or a lawyer. The notion never quite vanished. “I never questioned this until I graduated in 1963 from the , Otago Medical School and became a house surgeon,” he adds. . There are other memories of growing up in the closely-knit community at Outram — clear memories of going to school and not being able to speak more than six words of English — “and I’m still struggling to improve it,” he adds with a chuckle.

"I’ve never returned to the family village, but I have visited China. Returning was a very affirming experience. I realised that I had been to the place I came from a previous form,

where my older brothers had been. It somehow balanced things, placing my ..fpot on the soil I sprang -was raised with the pre-Comriiunist images of China, I lost interest for a while before realising that whatever political cultural or economic changes had taken place, it was the same China which had existed for thousands of years. . “I didn’t go to China with any idea that I was actually going home. It was a spiritual sojourn. I think that pakeha New Zealanders can share this feeling.” A medical career remained a personal goal throughout his

Dunedin childhood. . "I made it without any culty, but not to question that ’ decision was perhaps bad. I never questioned what medicine ..was about until becoming a house surgeon in Christchurch when I found that I was not receiving the satisfaction I had expected from a medical career. Ki During this time, 1964-65, I was forced to search in my mind ; A>. about what I wanted to do. “The 'decision to specialise in )•'. psychiatry came quickly ...” The move into a new area of ; medicine involved his skills as a y doctor with a need to understand /A people ’and their environment. At the same time, he was aware that he was giving up one medical identity and adopting a new one. Work as a psychiatric registrar at Princess Margaret Hospital was followed by a move to Sydney where he completed his examinations. He finally qualified in 1968, returned to Christchurch in 1971 to take up a consultant’s position at Princess Margaret and work in private practice. £. ■ In 1984 he joined the Sunnyside Hospital staff, hoping to apply eventually for the position ' of superintendent “My first 15 years as a psychiatrist were spent saying that I would never work in Sunnyside Hospital, the ‘Bin.’ I wasn’t going to have any superintendent countersigning my letters. But searching my soul I think that I had difficulties in®, facing the most severe forms of mental illness. I was a little fearful of losing my last foothold in general hospital work — perhaps losing a professional identity. “But after a year working as a . consultant psychiatrist at Sunny- ■ side, I had the satisfaction of knowing that I was working with people suffering from the: most difficult forms of mental illness. I didn’t expect to discover this ... as doctors perhaps we take time to come to terms with the seriousness of the illness we work with.” As a psychiatrist, he is acutely conscious of the image projected to the public. The “cult” of psychiatry which has periodic-

-■ ’’fß '' the Western World £ Mrice tlif •: w6Qs.;.aiso has to be . balanced (against Kpw levels of p J, / F ifeople in psy- ?■ tqi:adeliniate the ■..tbqimdjifias itoitei clearly, almost vl£W_l96ospsychiatry was in its' of being a formaj had to tea® rather than The mid to late 6Qi became -a turning psychiatric medicsfe ; ;has' been by media involveand bad article on Hospital cerviprogramme Was able tdWick-sthrt an examination of issues which had to be brought to the public attention. But it can aKo ( (harm. Television,for .example, can be an. informative medium in terms: of breadth.and comprehensivenessof the." information .’it presents.. But it can be a poof ’shadow;".of radio or newspapers. , “On the whole, media involvement in some issues has often had long-term benefits.* The trouble is that when you, read something exposing defects in? someone else’s departments ybui say thank God, about tinjb? But; when it deals with your own area l you get • He believes that' the public today is generally . better in-: formed about psychiatric: health" and treatment. He- feels also that the community is generally more accepting of psychiatric counselling, there will always be dark areas of misunderstanding surrounding psychiatric illness — areas which could only be illuminated through improved education. ; “There will be a constant need : for hospitals containing psychia-. trie wards, whether they are based in a psychiatric or general hospital. There will always be a need for those people with severe forms of mental illness to use a hospital-based treatment. But that requirement won’t be as great as it has been in the past. Staff have become increasingly pragmatic and flexible in terms of where they offer treatment.... day hospitals, out-patients, domiciliary services, consultations

with general practitioners,” Dr Ding says. There are the problems which show no signs of lessening. Solvent and alcohol abuse are jointly placing increasing stress on the services offered by psychiatric hospitals. “I’m especially concerned over alcohol abuse. In terms of numbers, it is a far, far greater problem. I’m not sure whether we’re going down the tubes yet but alcohol is our greatest form of drug abuse. The reasons? There is some evidence of some sort of bio-chemical disposition. Availability and accessibility plays a part. The question could be as simple as how alcohol is

sold. “I’m a conservative. I believe that increased accessibility increases the problem. We’re not talking about those individuals who can handle alcohol. If you take 100 people and rank them in terms of those who can or cannot handle alcohol, it would resemble a normal distribution curve. But it’s not the majority. It’s the number at the other end of the spectrum who cannot.” Meanwhile, he cannot envisage a move from the region in which he has spent the bulk of his career in psychiatric medicine, both as a practitioner and administrator. “During the past four years,

I’ve tended to work as hard as possible. I’ve constantly had to juggle the needs of the board and this hospital. It’s hard but never so difficult that I’ve thought of giving up. We’ve been able to balance things out.” In the absence of medicine, what would he have taken up as a career? Les Ding studies the classic lines of a Chinese brush painting on the opposite wall. “I think that I may have taken up law — if my English had been better. As it is I’ve had a deeply satisfying career in medicine. What has kept me going? Learning new things all the time and helping develop new areas of care