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Catherine Crock heals with music
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Catherine Crock heals with music
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Catherine Crock heals with music
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"There's that saying, 'Treat others the way you want to be treated.' But I think it's going one more step. 'Treat others the way they want to be treated.'"
Conversations
20 January 2018

Catherine Crock heals with music

Interview by Nathan Scolaro
Photography by Lucy Spartalis

Nathan Scolaro on meeting Cath

I’m sitting down to write this introduction with the most exquisite, captivating orchestral music filling my ears. I don’t know a lot of the technical nuances going on, but there’s lightness in what I hear, and an element of intensity building to something epic, something wonderful. There are strings and trumpets and flutes in spirited conversation and I feel uplifted, like I do while watching a golden moment in a Disney movie.

The album playing is Hush Volume 13, a collaboration between the Tasmanian Symphony Orchestra and Hush, a foundation which produces powerful, stress-relieving music for hospitals.

Hush is the brainchild of Dr Catherine Crock, a physician at The Royal Children’s Hospital in Melbourne who for nearly 20 years has been paving the way for a paradigm shift in healthcare: one that puts kindness and empathy at the centre of the work, and seeks to minimise the anxiety felt by patients and their families.

In the mid-90s, Catherine notably introduced general anaesthesia to lumber puncture procedures for children with cancer, a need she saw as a young mum herself working with anxious patients—some of whom were just toddlers and babies. She found it increasingly difficult to cope, so she did something unheard of at the time: she brought parents together and asked them, “What’s it like for you? What do you and your children need to make this process easier?”

The ripple effects of Catherine listening to patients and families and then empowering others to help meet their needs have been deep and lasting. Not only has pain management in treatments improved, entire hospital environments have been transformed to make the experience of children’s surgery less stressful.

Hush sees some of the world’s most accomplished composers experience operating theatres and waiting rooms and then write beautiful, uplifting music to play in those spaces. The collection now encompasses 14 albums and is used across the world.

When we meet, Catherine has just returned from the UK where she watched the London Symphony Orchestra perform a piece written for Hush Volume 13. She is giddy with excitement, proud and jubilant for the composers and musicians, amazed at the reach of the humble idea.

She tells me about the plays she’s been working on: plays for hospital practitioners that explore some of the problems occurring in their environment—the idea being that they spark conversations afterwards about how everyone can work more effectively together.

Catherine sees enormous potential in the artistic world for changing behaviour. She also believes in the power of collaboration, and recently brought creatives, philosophers and heath practitioners together for the inaugural “Gathering of Kindness,” in which people re-imagined a more compassionate healthcare system.

Empowering others to shine is what Catherine loves most. She is a leader with heart and empathy, creating important systemic change by bringing others to the table and listening.

This story originally ran in issue #47 of Dumbo Feather

NATHAN SCOLARO: So I wanted to actually start with a conversation about music. And your personal interest in music. I’d love to know what music awakens in you.

CATHERINE CROCK: Music for me is just incredibly grounding. It’s good for the soul, it makes me calm—certain music does! My husband Rod and I have been doing jive and ballroom dancing since 1976 when we were at university. I guess for me this love started in childhood, because Mum really enjoyed music. She always talked about this nun who taught her piano, and she’d just light up. She was also an Australian-Irish dance champion, which we used to see and hear bits of. My auntie played the piano and the hornpipe, and Mum would dance.

How beautiful.

So I think there was always this love of the creative world. And then Mum had all five of us kids learn instruments. She said everybody should start on the piano and then we could branch out. We had a piano teacher who would come to the house to teach all of us in one afternoon, and we’d have dinner somewhere in the middle! Mum would be going, “Your turn next!”

[Laughs].

And later on I took up the oboe, as a fourth year medical student. I just think it’s the most beautiful sound. It’s quite hard to play. You need to practise a lot. So I guess the fall-down for me is that I don’t practise enough to keep it in tune and keep my reeds in good condition. But I play it at Christmas time.

This story originally ran in issue #47 of Dumbo Feather

This story originally ran in issue #47 of Dumbo Feather

You do a Christmas concert?

Yes, a Christmas carol gathering. But actually now what’s happened is my kids are better than me.

Oh, okay! They learned the oboe too? Or just with their respective instruments?

Michelle plays oboe and double bass and a bit of violin. Ben plays the cello. The next one, James, plays the bassoon and the pipe organ. Catherine, the cello and the French horn, and Richard the saxophone.

Goodness. So you encouraged music in your house, like your mother.

Yeah, ‘cause I can see there’s real benefit in getting kids to understand enough about music and do it while they’re young and get to a level of expertise. I think playing together builds a sense of love between one another. We’ve had some hilarious rehearsals. One night all of us are practicing, the concert’s on the Sunday. And it just sounds shocking. And we thought, This is really going to be embarrassing. Then we realised half the room’s playing one Christmas carol and the other half are playing another! And it’s going on and none of us have even noticed ‘cause we’re all so intent on the bit we’re trying to do! But it’s true:

music for me is about that joy and feeling of community, being connected in a deep way.

And it really opens us up, emotionally. It can create shifts in us. Which I imagine is the thinking behind Hush.

Yeah, well that’s right.

So tell me how that idea came about.

So, I’m a paediatrician and I started working with children with leukaemia and other cancers in 1998. The hospital asked me if I would set up a bone marrow service for the treatments. My own kids were all little at the time. Richie was just a baby and he would be in the crèche downstairs while I worked. My first day on the job was a real shock when I realised how much we had to restrain these children to do procedures on them. The senior nurse assisting me explained that the treatment room had just been soundproofed. So the children were having to have multiple bone marrow tests and lumbar punctures over the course of their cancer treatment, which lasts two or three years. And it was my job to do the procedures. We gave them a bit of a sedative, but it wasn’t sorting out the pain management and the kids were getting stressed in our arms. They were even stressed being out in the waiting room with their parents. And I was finding it really difficult. I thought, If this was one of my kids, frankly I wouldn’t be coping well. But we had to get on with what needed to be done, ‘cause this was a really important part of their treatment. The bone marrow tests are done to check how the leukaemia’s going, and how the chemo’s been working. The lumbar puncture is to make sure they don’t have disease in their spinal fluid, because we put chemotherapy into their spinal fluid. So technically it all needs to be done really well. But the whole experience made me think: What is the impact of this on the families?

The impact of that child’s stress?

Of the stressful situation. I was finding it hard to cope myself and then thinking of my own kids—wondering how I would deal with them going through something like this. So I decided to sit down with a group of parents whose children were going through these procedures, and talk it all out. It was unheard of at the time—to connect with the families of patients in that way. But

it just seemed natural to me that if you want to know how something’s going, ask the people that it’s happening to.

So I gathered this group of parents and we called ourselves, “Together We Achieve.” We’d have a plate of sandwiches and sit around and I would ask them, “What is it like when your children come in for these procedures?” And they’d say, “Actually it’s the hardest part of the cancer journey for us.” But no one had ever complained.

Why is that? Why wouldn’t they speak up?

Because they know they’ve got this huge journey to go through, and they have to get it done. So they put their faith in the process. And we as health professionals, with all good intentions, are doing the best we possibly can. But there’s this missing piece that is actually causing stress. Not only on that day, but stress when the patients and families go home, stress when they have to come back next time, long-term stress. Even when the kids are cured, there’s psychological damage that happens further down the track. So the parents were able to tell me about the impact it was having. Nobody was doing anything wrong and I would never criticise how it was being done.

The question just wasn’t being asked. And you were coming from a very empathetic place.

I was coming from a mother’s perspective thinking, What if it was my kid? You know, you feel like a bit of a lioness. You want to protect your kids and make sure nothing bad’s going to happen to them. It all looked too stressful to me. The background to this though is that when I started out, the long-term survival rate for children with leukaemia was 50 to 60 percent. Now it’s 90 percent. So more and more we can and have to think about the psychological impacts of this process. Now that they’re surviving, it’s really important that we do the least possible harm psychologically to these children and families. So the medical need is quite different. The need when you look at the whole family is different to what it was 20 years ago.

We’ve been talking a lot about this at Dumbo Feather, the need to move from a disease-centric to a patient-centric model of care. Recognising that it’s a whole person that’s going through this experience, not just the particular illness or disease they have.

I think people are realising this need. But if you’re just working on making sure these kids survive, whether or not the procedures are causing some distress is actually a minor issue. First thing’s first is the technical and the medical. But now we’re realising right throughout healthcare there is more to it than that. We’ve got to look after the whole child and the whole family. Once the families were able to tell us, “Actually it’s causing a lot of stress and anxiety that goes on for a long time,” then they started to help me come up with solutions. It’s like opening up the floodgates.

First was doing something about the pain management. Back in the early days, we weren’t doing enough in terms of pain management for young people. Parents were asking me if there was something I could do, and I’d been researching what was happening in other parts of the world. In 1978 in Nottingham in the UK, they decided that children needed to sleep for repeated painful procedures, because by keeping them sensitised to painful things, they develop long-term psychological effects. So I talked to the anaesthetic doctors, and brought something similar in. And that was really easy.

It’s that easy! When you have the conversation it can be that easy.

That’s the thing you see. It opened so many doors once we knew what the problem was. So part of this whole concept of “patient-centred care” is really about tapping into the expertise of the person it’s happening to.

So how does music and the artistic world come into this? When did it become clear to you that music could offer something powerful?

So the parents talked to me about the environment, they said: “Okay, now you’ve got the pain management under control, we’re really finding coming into a hospital environment challenging and threatening and hard. It doesn’t look homely. It’s not somewhere you feel at ease and comfortable.” And part of that’s unavoidable. You’ve got to have the drips and the machines and the beeping. But people weren’t thinking about the sound environment and the look—what it’s actually like for the people experiencing it. And the parents said, “Well, what about some music?” There was resistance from surgeons and ward staff at first. But I just started by bringing in some classical CDs to play in the operating theatre. And some of it was good. And some of it wasn’t. You’d put something on and then get to a dramatic part of a sonata and it’s all gone very dark and a little bit scary or there’s the feeling of impending doom! And in some music it’s there for a purpose, but it obviously wasn’t our purpose. And so I thought: I know a lot of musicians. I’ll talk to them about this. What I like is tapping into other people’s expertise. I don’t have the answers. But I know enough people who can really help with the next bit. So I talked to musicians. And they said, “Oh yeah, we can help with that.”

And these are musicians you knew from being immersed in music?

Yeah, they were teaching my kids at the time, and they were in the Melbourne Symphony Orchestra, they were involved in really good music-making. So they came in and helped make the first CD with me. All I wanted was one! There was no vision for a whole collection. We just had the one CD and would play it in the operating theatre. So what happens is the children come every week over a couple of weeks, and then monthly and then three-monthly over the three years. And we bring them into the operating theatre awake. And they sit up on the bed with their mum or dad, and the anaesthetic doctors put them to sleep. That’s the time when having the music in the room is fantastic.

You walk in and it’s just really chilled and beautiful. Not so hospital-y.

So what did you identify in this music that worked, that resonated, and what didn’t work?

It’s been an evolving process. Early on especially we created some music that didn’t work too well. But we’ve now come up with a Hush brief, just by talking to lots of the composers. When you get someone creative to come into that space and stand there and experience it, and then use their expertise about what’s needed to make it calmer, it’s really magical.

Wow, so the composers actually came into that space to get a sense of what that experience is like?

Yeah. They came in, talked to the staff, the patients, the families. And they’ve said, “This is actually really hard.” It’s the most challenging brief they’ve ever worked with. Because if you think about it, composers mostly do what they feel like, but this is a very specific feeling that they’re trying to invoke. So we’ve found that pieces in a major key are better, pieces that are moving along a bit so there’s a pace and interest building. At first we thought, Oh, it’s got to be lullaby music to put them off to sleep. It actually doesn’t. I mean it can be, but it doesn’t need to be. So if you listen to some of Hush it’s actually quite vibrant and fast-moving.

Really we’re trying to capture a sort of optimism in the music. We had long discussions about whether it matters if the music’s a little dark. I don’t think it’s our job to push people into that dark place.

We could, but these families are facing a child with a life-threatening illness and a really uncertain future, or whatever your healthcare challenge is. Hush’s role is to reduce stress and anxiety.

To pour some light into that experience.

Yeah, so all the composers get a copy of the Hush brief now. We’ve done orchestral, jazz, we’ve done vocal arrangements. There are many elements that work. But we know that some things don’t. Like if the music gets too fast or frantic it winds people up.

And what about you as healthcare practitioners being immersed in the music? What are you getting out of it?

Well, that’s been the other really interesting thing: the effect of this music on the staff has been profound. So at first I thought, This music is for the children. And then I realised, Actually it’s so good for the parents. Because if the parents are calm then the children are calm. And that must be good for the journey. Then I started noticing the effect on my team in the operating theatre. The music helped build respect between them. I think it’s about feeling cared for and looked after. We have musicians and composers and creative people who come and meet our staff and go, “You guys are doing an unbelievable job. I’m so grateful for what you do, and I’d like to help.” And then they go out and make this beautiful music for us to play in our workspace. It really does help the feel in the room, and the kindness between the people, and the teamwork. We already know that good teamwork is better for patients’ safety and care. So for me that’s been one of the biggest joys of it.

It’s phenomenal to think about the power of music in that sense.

It’s sort of simple. I mean, people talked about music having its roots in healing a long time ago. And now we’re trying to recapture that. Healthcare needs the input from the creative and the artistic world to really help soften the edges and to help us do our jobs even better.

That’s it, because this is hard, taxing, emotionally and physically tough work. And you raised a family while you were doing all of this work, and your husband is a paediatrician. You’ve both had lives dedicated to service. How did you manage a household of five children while doing all of this big work?

Well, Rod’s extraordinary. He’s really one out of the box. He’s an amazing person. He was my first year chemistry tutor when I was a medical student. He was tutoring medical students. He actually was finishing his PhD in chemistry tutoring medical students and thinking, Hang on, all the stuff they’re doing is really, really interesting, and then he got himself into medicine as a late entry. And then he went through medicine. And he’s gone on to do children’s skin disease. He believes in empowering the kids to be part of their healthcare, to be responsible for it.

Interesting. And important because doctors are always talking to the parents of the children.

Yes, but if you can start giving them health literacy from a young age and get them looking after themselves, they’ll be much more responsible for their health as adults. So Rod’s amazing, he’s like the wind beneath my wings, if that’s not too corny. He’s just encouraged me and helped me to get my ideas straight so that I could then talk about them once I got this passion for where I wanted to go. It was hard with the kids. And looking back on it we were both pretty tired. We both worked part time. He did a bit more than me in the early days. But there was a lot of packing everybody up in the morning and dropping them at crèche and then picking them up at six o’clock at night, they’re all crying in the car and there’s no food at home! And you do all these things when you’re young enough and you sort of don’t realise that you might be pushing yourself a bit far. But I think it was worth it. We were both immersed in bringing up the kids together. And making sure they had really good values, an outdoor lifestyle.

We haven’t ever bought a TV. Not that we’re real out-there greenies or anything, but the kids have always had guinea pigs and chickens and, like, all of this, in Camberwell. They just played all the time.

And they’ve all been really close because of that.

What drew you to the medical world initially?

It would have to be my really close relationship with my parents, who are both medical. Mum did general medicine and Dad did orthopaedic surgery. And Dad was very busy, he worked very long hours when we were little. I would go with Dad on ward rounds, and I would watch how he would sit on the bed and interact with the patient and the family in this extraordinary way—just connect with them on a really human level. And I saw this to be the norm—this level of care for the whole patient and the whole family. Dad’s brother was the same, Uncle Gerard. I remember he had a patient who said, “I’ve got to go, I’m going to miss my plane.” And Uncle Gerard said, “It’s really important we do this eye examination, I can’t let you go until we’ve done it.” And then when they finished, Uncle Gerard said, “Come with me, I’m taking you to the airport.” And he did. And I think that’s okay, we should be able to make those decisions. But it’s not always the way.

I wonder is it too much for some doctors to show that level of empathy, to take on what patients and families are going through.

Some people think that. They think they shouldn’t because they’ll burn out or whatever. Actually I think it could be the reverse. That when you make a really human connection with somebody, you’re getting  something out of that too. You’re helping them but it’s helping you. And if you’ve got good support around you, I think that it makes for a much more satisfying medical career. I certainly saw that with my parents. Dad’s fascinated by people. So he would want to know people’s stories, and he’d be really interested in them. And of course then you get it back when you show that interest in people. For Dad there’s no difference between the carpenter at the hospital and the overseas professor—all of these people would come to dinner at our house.

He sounds like an amazing man.

Absolutely, and I think that really showed us kids how we’re all the same in this world. Just treat each other with respect and kindness and you can’t go far wrong.

What’s your relationship with your parents like now?

Great. Mum is the more active one now. She does Argentinean tango, she studies Italian. She’s always keeping busy. Dad’s much frailer. He had a back injury early last year that’s really set him back. But the two of us have developed something that we’re loving doing together, which is mosaicking. It happened about three years ago. I’d been doing mosaics after some health problems of my own where I ended up with a pacemaker. It’s like, you have this concept of yourself as a busy person with lots of plans and everything, and suddenly you’re not. Nothing’s going to be happening except recovering for six weeks. So a friend of mine said, “Do some mosaics.” And I did. And then I got Dad helping out. And so now I’ll finish work and go over to their place, and Dad will be working on his mosaics. He does table tops, coasters. Being a surgeon I think it’s really good for him to be doing something with his hands. He was a very delicate, careful surgeon who always made sure he had the anatomy right and lined everything up perfectly. So mosaics are sort of the creative side of his surgical career.

I love that! Is that what you get out of it as well? Working with your hands?

Probably, yeah! I hadn’t really thought about it but I love doing creative things with my hands. Dad lines up all his mosaic tools there. He uses some of the orthopaedic tools to help clean the grout! And anybody who calls through the house cannot resist. Because he’d be sitting there working on it and you’d go, “Ooh!” And you’d put something into it. So many people have had input into his projects. It’s been really beautiful. And so both my parents have been real mentors to me, in terms of highlighting the importance of showing kindness to other people, be that at work or in your everyday, but particularly at work, because it can be uncommon in healthcare.

I want to talk about this word “kindness.” It’s a big part of your mission—reinjecting kindness into healthcare. I think in our society we have a very surface idea of kindness: that it’s about keeping the peace, just smiling at each other. I wanted to know what you see the potential of kindness being?

I didn’t think kindness was going to really resonate in healthcare. It’s been quite surprising that it has. I think kindness is wanting to know what kindness is for the other person.

There’s that saying, “Treat others the way you want to be treated.” But I think it’s going one more step. “Treat others the way they want to be treated.”

That’s what kindness is—finding out what you think kindness is for that person. For some people kindness is just, “Put an arm around me,” for others it’s, “Don’t hassle me at the moment, just give me some space.” So there has to be a conversation. Someone I’ve gotten to know is a philosopher from Monash University, and she wrote me a letter about dignity—another interesting word. She got a serious illness, went into hospital, and wrote that the medical care was superb, the nursing care outstanding, but day-by-day her dignity was stripped by small things from well-meaning people. And I think in healthcare we’re all well-meaning, we’re coming to work to do a really good job, but what if we’re forcing some sort of kindness on people that they don’t want? She’s a very private person, she was in this world where she was getting bad news and she needed time to process it, but people kept forcing themselves on her with their kindness. Eventually her husband had to step forward and say she’s a very private person, she needs time and space.

It’s interesting, because to be generous with someone in that way, to really connect deeply with another person and understand what kindness is for them, really requires you to have a strong inner world. Someone I talked to recently for the magazine, Pico Iyer, said the only way we can be of benefit to other people is when we take the time to slow down and gather our inner resources. But I imagine that can be difficult in healthcare where you have to be on all the time.

Right, people in healthcare are extremely busy, we’re pressed for time, there’s a lot to be done. People expect us to do more in less time, and so you might get caught up in thinking you haven’t got time for the interpersonal stuff, but actually if you chill a bit, and take the time to make a personal connection with the patients and families, and find out what it’s like for them, it can make a big difference to our work and to the lives of the people in care. It can actually speed up the whole process.

We had a family once and the nursing staff said to me, “Oh that lady is so irritating. She’s brought her toddler again and he’s causing trouble out in the waiting room.” And I thought, I can go out there with the assumption that she’s a problem, or I can go out there with the question, “What’s going on here?” Totally open mind. So this particular day I walked over and sat next to her, and quite quickly could take in the situation. She’s got a six-year-old who’s really sick. And he’s got a tube out of here and a drip and she just looks exhausted and she’s got this toddler who’s climbing all over her while I’m trying to talk to her. A really stressful situation. And I said to her, “It must be really hard.” And she just burst into tears and started sharing this story.

Her partner wasn’t understanding this whole journey the family was going through, he was upset with her because she wasn’t fully available to him, she’s totally focused on the sick child, she’s obviously not giving the toddler enough attention because he’s desperate as well, and here we are labelling her as difficult. One of the parents overheard and she came over and put her arm around this woman and said, “Why don’t I mind the toddler while you go into the theatre.” And I talked to the mum after the operation, and said, “It’s really hard for the partners, he’s not here, seeing what’s happening every day. Maybe he needs a turn to spend some time in here.” A week later I saw the whole family come into the theatre. So just this tiny interaction, of not judging her before but finding out why things were unravelling, meant we changed the course of that relationship. That’s it right there.

Suspend your judgement. Find out what’s really going on.

What are the challenges you face in the workplace that make it difficult to do that?

So, hospitals are very hierarchical. And we still work somewhat on a power and control model. A top-down thing. And it can make this task-focused experience even worse. So instead of thinking about how you’re interacting with everybody, you’re really focused on the policies and procedures and tasks at hand. I think too much of a focus on that can make scratchy relationships, less respect between people, and we can become really afraid of taking risks, of getting too close to people, because we might get into trouble. I started thinking about kindness in healthcare because there’s actually a lot of talk of the opposite: there’s bullying and harassment, and poor culture and behaviours in healthcare that are very negative and draining, and become topical and huge in the media. I became frustrated with the idea that

we’re going to have more policies and procedures on bullying and harassment, and we’re going to weed out the bad apples from the system, when actually—what if we thought about a kind health system? What if we envisage where we could be instead?

Because at the moment, good as parts of it are, it’s not a great place to work. It’s a hard place to work for the staff, and it’s a hard place for the patients and families when they’re at their most vulnerable.

And I guess it starts with colleagues demonstrating a level of kindness to each other and a level of care and recognition that this is bloody tough work, but I’m here for you and what we’re doing is really important.

It actually has to. And I found in my own operating sphere that you can get this going regardless of how small the space is. Start small. Then you can change a whole hospital, a whole whatever. Just start where you are. And start one-on-one. We’ve had issues with staff who were judgmental of each other and of the patients. Things just not flowing. Now we’re really getting to know each other, showing our vulnerabilities. You’ve got to put it on the table sometimes. In healthcare, the way we were trained was, “I put on my white coat or my lanyard, and I’m here in my professional role.”

“I’ve left the personal stuff at the door.”

Yeah, “The rest of my life’s got nothing to do with this.” Not true. No. I went into theatre one morning and I said to the team, “Look, this has happened at home and our son’s done this and I just don’t know where we’re at. And I’m feeling pretty wobbly.” And they go, “That’s okay. We’ve got your back. This is a team.” You see? If you haven’t disclosed it, how are they going to know? We’re checking drugs and chemo and trying to get all that right for patients. We’ve got to be 100 percent focused. We’ve got to feel safe to speak up in these spaces. I don’t know if you read about the plays that we’ve been creating?

Yeah! About problems in the healthcare system?

Right, so we’ve been collecting stories about everything we’ve been talking about. And I thought we could put them into a play. So I googled playwrights and got onto Alan Hopgood, who’d written a couple of plays about health-related things, and I put to him these ideas about relationships in healthcare, how we need to listen more to each other, and he said, “Bring it on.” What he came up with was a play called “Hear Me,” with real anecdotes from junior doctors who haven’t felt safe to speak up when their senior consultant is somewhat intimidating. So that brings up all this bullying in healthcare stuff. No one listening to the mother’s story when she knew there was something wrong. It’s a sort of an unravelling tragedy that you watch and go, “Oh my God, if anyone had felt safe to speak up!” At the end of the play, after people have emotionally connected with the drama of the situation, people in the audience then tell their own stories of working in healthcare. So one of us, often me, gets up and says, “Okay, has anybody experienced this? What do you reckon?” And the audience just launches into it. It’s getting people talking about some really hard stuff. How we treat each other and the impact.

There’s also a play about aged care called “Do you know me?” and it’s got a scene about racism. There’s an older man who’s been through the war, he doesn’t want anyone who looks Asian to look after him or touch him. And it’s a really challenging scene but we work through it, and he comes to an understanding with this young Asian doctor, and he talks about how he doesn’t want to die with hate in his guts. He’s pleased that he had an opportunity to talk it through with her and hear about what happened to her family during the war. And at the end, in the audience, a young Asian lass got up and said she now knows she needs to step up when she has to face that situation. She’d been avoiding people who have been rude to her about her race, and she said she now had the strength to address it.

Amazing. It seems like this has been key in your life’s work: to really use the artistic world and the emotional experience that it creates to explore these issues and create change.

And to get these conversations going. Hopefully keep them going. This is not about, “If they give us more money, if they give us more staff that’ll fix the problem.” This is about changing behaviour in the workplace, interacting with patients and interacting with your colleagues more thoughtfully. We’ve had nurses stand up and say, “We are so mean to each other on our ward. What are we going to do about that? C’mon!” And for me, I’ve learned a lot working with the musicians and creatives and actors because they’re part of a world where they do take risks and push boundaries and try different things, and some of it doesn’t take off, and some of it does—beautifully. But it’s all worthwhile. We can definitely afford to bring a little of that into healthcare, to soften the edges like I say.

You took a risk bringing Hush into the world. You knew it was going to be challenging getting all these heads of wards and surgeons to agree to play music in hospital waiting rooms and surgeries, but when you saw the potential, you couldn’t not do it.

Yeah, you know, I never thought I would speak in public, change anything, take a stand on anything. Because I was painfully shy at school and at medical school. But

I think sometimes you’ve got to get to almost a crisis point, or be so moved by a passion or an injustice that you speak up.

So I was just pottering along with no great career aspirations, and just thought I’m enjoying my medicine and that’s fine. I’ve got five young children and I’ll work a little part time. And then boom! I fall into this job where we’re holding children down to do things to them in a soundproof treatment room. I tapped into these extraordinary parents who had such knowledge of the healthcare system that none of us knew about.

That’s interesting what you said about being a shy person. I wonder how your shyness might have been an asset in your work. Because I think there is a lot that shy people have to contribute to the world.

I hadn’t really thought about that. But I think part of my shyness might have made me observant. Like, I would happily stand back and just be watching everything that’s going on. I still do that, actually. I don’t speak up a lot, but I watch things and I watch interactions and I think about the interactions. Maybe if I was more involved, I wouldn’t. So I’m listening the whole time and that helps me understand people’s needs, or the needs of a particular situation. It’s interesting.

Well, I’ve written something down about leadership here. When I was researching you, I really saw you as a leader. I don’t know if that’s how you see yourself?

Well, I never did. But now it appears that I might be.

You’ve been a real leader. And leaders typically are more extroverted, they’re louder, they’re comfortable in the spotlight. But you, and I think many other great leaders out there, are showing us that it can be done a little differently.

I do do it differently. ‘Cause I’d prefer to step out of the limelight and do my leading by actually getting other people to bring their expertise to something, by enabling them. That is also something I’ve got from Dad. ‘Cause when Dad retired they had some sort of an award from Melbourne Uni, years after he retired. And somebody got up and said, “Under Harry Crock, it was like a field of tall poppies.”It wasn’t about him being the head of the unit—they all felt they were as integral to being a tall poppy as he was. He had the casting vote. But I actually think you don’t want that, you don’t want one person standing up there and being denoted as the leader. The idea of bringing everybody up to be the best that they can be, well that is just fantastic. Because sometimes people need to see that in themselves. To recognise that they can do something with what they have. And given I’ve come from a place where I didn’t feel secure in my own abilities and questioned whether I really was useful, I think I can see in it other people.

Interesting! ‘Cause you’ve had an extreme level of self-doubt, you can recognise it in other people!

Exactly. And then say, “Have a crack at it. Take the risk. Get involved in this even though it’s a bit out of your comfort zone.”

If lots of people are shining, the quiet and the loud, I think we can achieve wonderful things!

Hush has just grown into this thing we never imagined because we’ve brought so many different people in and let them all shine their way. I think shy people and people with self-doubt get left out. Maybe people think they haven’t got much to contribute.

Sometimes it’s just really difficult to speak up, but we have to try I think.

It’s especially hard when you’re with people who find it easy to speak. I think I’ve gotten a lot better at it. And I think it’s about finding your thing. Once I was really passionate about this work, about patient-centred care, and didn’t feel nervous to say the wrong thing, I found it much easier to speak up. Also, I felt that this was just simple and straightforward and so it didn’t feel hard to talk about it. There’s nothing complex here. I can’t have got it wrong!

[Laughs] I think it takes a special person to be able to be open like that, to be questioning rather than thinking that they have the answers.

Maybe that’s not having huge confidence in myself. That I’m always thinking other people’s expertise is greater than mine. If you’re very firm in your own convictions and you know you’re right, you’re not going to need other people’s expertise. And I do think that’s opportunity lost.

Nathan Scolaro

Nathan enjoys getting elbow-deep in sentences, pressing and pricking them like a Chinese doctor until the blood is flowing just right. He hails from Western Australia, where he first experienced the joy of putting together a magazine, and now indulges his love of thoughtful, life-giving storytelling by bringing Dumbo Feather to life once a quarter.

Photography by Lucy Spartalis

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