After 28 years practicing medicine in Australia’s backcountry, it’s safe to say that Dr. Paul Carter has pretty much seen it all. Yet each day is studded with memorable moments. Carter remembers treating a 4-year-old boy who had been brought in because of severe constipation. A week later, on a follow-up visit, when Carter was asking the boy’s mother about his progress, he felt a tug at his shirt sleeve. “The child interrupted, looked at me with large brown eyes and said, ‘Doctor Carter, I have never seen so much shit in all my life.’ So I guess the treatment worked,” Carter says. Carter’s wry sense of humor is on full display in his debut memoir, Tales of a Country Doctor, which is peppered with similar anecdotes.
Years ago, Carter moved to Melbourne from England with his first wife after the loss of their infant daughter. The change was not enough to put the tragedy in the rearview mirror; Carter’s marriage dissolved in short order. Life in Melbourne ran on autopilot until a sign Carter saw outside a “rundown weatherboard church” really hit home: “Unless you change direction,” it said, “you will end up where you are going.” Taking that message to heart, Carter decided it was time for a reboot. A move to the country seemed like the perfect prescription. Enter Woongarra, a rural community just an hour’s drive from Melbourne, where Carter decided to make a new home. It’s a decision he has never regretted.
After decades of practice in a town where everybody knows your name, Carter decided to write about his experiences as a rural general practitioner. He says that while the memoir is “about real people with real conditions,” names and timelines have been changed. “We went to a lot of trouble to make sure that this didn’t turn into an exercise where people got upset. It’s about having fun, not upsetting people,” Carter says, adding that when he published the sequel, Further Tales of a Country Doctor, many of his patients requested that he use their real names. “In the first book, everyone was a little nervous about where this was going. Then when they realized it’s a nice thing to do, everyone got a lot more confident, saying ‘OK, if there’s a story about me in the second book, I’ll just be who I am.’ ”
Carter decided to self-publish as a way of making his work more readily accessible to the public. His publisher, Xlibris, priced the book reasonably, he says, and promoted it heavily through social media. On the downside, “you get presented with a large number of people in slightly different roles, and there’s a confusion of names, and not everybody understands boundaries,” Carter points out, adding that much of this can be eliminated if just one or two people had their fingers in the pie.
Carter acknowledges that the book makes small-town life seem a little too id yllic. In Further Tales, he displays more courage writing about the town, “warts and all.” Nevertheless, Carter is quick to defend Woongarra. “I have to say that the community is almost overwhelmingly idyllic; it’s about an hour’s drive away from Melbourne, it’s self-contained without being too isolated, and it’s where everybody likes to work hard and to help everybody else, so to me, I have written about a community as I have found it,” Carter says. “I think communities such as this one are under threat because they’re less self-contained than they were. I am worried that small rural communities will lose their special nature, and I wanted to record that before it was lost.”
Since attracting qualified doctors to the countryside is a problem, Carter serves as a stellar role model for younger doctors to emulate. He has been asked to lecture medical undergraduates “because they want people like myself who are very passionate about doing primary care to attract young doctors to follow in our footsteps,” he says. “I am hoping that my books might be just one step in that journey,” Carter adds. One of the many striking aspects of the memoir is just how many house calls Carter has made. “The insight it gives you is invaluable,” he says. “You see people as people rather than just as patients in your clinic. It gives you a much more holistic approach, and that helps enormously in clinical management.”
Shortly after his first book was published, Carter remembers being accosted by a woman in Woongarra who said she had a bone to pick with him. “She said ‘My sister is in your book but I’m not,’ ” Carter remembers. When the doctor promised he would make it up by featuring her in the second volume, she was only somewhat pacified. “Yeah, OK,” she grumbled, “but my sister will always have been in the first one.”
Carter admits that life as a doctor in a small town can be intrusive at times, but it doesn’t bother him anymore. “It is very much like living in a fishbowl, and your every movement is well-known. That does take some getting used to,” he says. “When my wife first moved up here she found that quite disconcerting, but you just learn that 99 percent of it is pretty harmless.”
Yet it is in this small town that Carter has learned many valuable life lessons. Featuring a teenager named Isobel in Tales of a Country Doctor—she’s both a patient and a friend—affected him deeply, he says. “She was unbelievably crippled but never once uttered a negative thought or complaint. I felt ashamed for grumbling about something minor. I learned hugely from her,” he says. Another gratifying experience? Performing a prenatal check on a woman whom he had delivered as a baby years ago. “That kind of a thing really makes it all come full circle,” Carter says.
Poornima Apte is a Boston-based freelance writer and editor and can be found at wordcumulus.wordpress.com.