John Murtagh on life
Emeritus Professor John Edward Murtagh AO
Just out of Coleraine in 1939, Dorothy Woolley caught a rainbow trout that weighed 6.6 kilograms. This catch made the world record books and put the Konong Wootong Reservoir on the map for growing the largest trout in the shortest span of time.
But Coleraine - a small picturesque town in the Western District of Victoria - is also famous for producing another great catch. Born into a farming family, John Murtagh spent his early childhood developing a passion for everything rural and Australian.
At 8 years of age he spent several months convalescing from poliomyelitis, and it was then he developed an appreciation for the healing art of doctors and the medicine they practised.
Murtagh completed secondary school at Hamilton High School. As fate had it, his future wife Jill Rosenblatt also lived in Hamilton with her family at the time. It was the beginning of a synchronicity that was to eventually draw them together, both romantically and professionally. But for now, they passed each other in the town, also known as 'the wool capital of the world', unaware their paths were to eventually merge.
Murtagh had wanted to be a doctor since he was a child, but during his high school years he became fascinated with mathematics. 'I thought I'd like to be a maths and physics teacher', he told Good Practice, 'so I took myself off to university to do that'. But, he added, 'I found that although I was qualified to teach these subjects, I didn't get the opportunity because I was sent to a very small school at Rainbow of 120 students'.
Murtagh found the experience frustrating as he was teaching only junior arithmetic and science. So after completing his government bond of 3 years, he reverted back to his original career choice to study medicine and applied to attend Monash University in Melbourne.
The Rainbow experience hadn't been a total disappointment, though, as Rosenblatt's family had, by happenstance, moved from Hamilton to Rainbow. 'It was all coincidence,' Murtagh said, referring to the way his path had crossed again with Rosenblatt's.
'I was lucky enough to be admitted to Monash', Murtagh said, and in 1961 he became part of the first group of medical students to study and eventually graduate from Monash. His association with the university was to continue for more than 50 years, and today, as an emeritus professor, he continues to give keynote lectures to its medical students.
Studying medicine, according to Murtagh, was 'demanding, fascinating and wonderful'. He provided some of his fellow students with free individual tuition in the basic sciences while he was studying medicine, and was also awarded the Robert Power surgical prize.
While Murtagh was studying at Monash, Rosenblatt had commenced a medical degree at the University of Melbourne. One day when Murtagh was visiting Melbourne uni he ran into her and 'something clicked', he said, 'and that was when it all started'.
But it was more than a meeting of hearts when the future doyen of general practice 'clicked' with a woman he described as 'very bright' and 'gifted', and 'one of those lucky people who never failed an exam'. At the time, only one in 10 medical students were women and Rosenblatt's academic achievements were indeed impressive. A relationship ensued that would provide the couple with a life partnership and the world with immeasurable contributions to general practice and medical education. Murtagh graduated in 1966, and Rosenblatt in 1968. They married soon after.
After graduating, Murtagh undertook an extensive postgraduate program that included a stint at Ashwood Medical Centre, working as a locum for Cyril Rosengarten and, in his third year, as surgical registrar at Bendigo Base Hospital. In order to gain real experience, Murtagh said, as a medical student, he used to hang around the emergency departments and 'lend a hand.' It was there, he added, that he saw 'life in its raw and all the critical stuff coming in' and where he 'really learnt'. In order to gain a comprehensive medical education, 'You have to learn by exposure,' he said.
By 1969, Murtagh and Rosenblatt were ready for the challenge of general practice, and together they took on a practice in Neerim South at the foothills of the Great Dividing Range in Victoria. Murtagh sees this time as the highlight of his professional life. 'Practicing with my wife, we had our own hospital and we were it,' he said. 'We were the only medical people in the community. It was fascinating, it was the best part of my career.'
Murtagh and Rosenblatt took great pride in providing a service for the people in Neerim South. They loved the small country town where they shopped, socialised, went to church with their patients, delivered their babies and cared for them in their dying days. 'You did everything,' he said. The couple also had babies of their own by now, and with their surgery attached to their house it was a lively home where patients would drop in for a cuppa and a chat. Rosenblatt conducted antenatal classes in their lounge room and the walls between the house and the surgery were, more often than not, welcomely blurred.
In those early years of general practice, Murtagh was able to reflect on his study of education and integrate aspects of it into practising medicine. He applied his knowledge of educational theory to develop his interviewing, history-taking and diagnostic skills. His legendary ability to connect with the person in the patient developed and so did his reputation as an outstanding GP.
Regarding the important skills of patient communication, Murtagh agrees they are often a gift, rather than an acquired skill. 'Some doctors I know', he said, 'have never been taught an educational method and they are just brilliant because of their interpersonal style and communication skills'.
The most important of the interpersonal skills, he said, 'is to listen'. He reflects on a favourite cartoon, 'How to housebreak your dog', which he still uses sometimes to demonstrate to medical students that teaching interpersonal skills can be futile if they lack the intuition to understand their applicability and context. 'I put this cartoon up', he said, 'and I say to them "look we can teach you how to do things, but quite often we don't get the message across and it's up to you to use your brain and work out how to do it properly".'
Murtagh is an exceptionally good listener and completely at ease with the small silences that punctuate conversation. It's easy to understand his enormous popularity, for he possesses a rare blend of genius and humility. It's obvious too that he is fond of people, and not surprising that he tries to answer all his fan mail personally, even prospective patients who write to him out of the blue asking for medical advice.
Lured back to Melbourne from rural practice in 1979, Murtagh took on a fulltime position at Monash University as a senior lecturer. Academia suited him as he was able to combine his two professional passions - medicine and teaching, although he truly missed the rural practice experience. He was appointed to a professorial chair at Box Hill Hospital and later as chairman of the extended department. He then became professor of general practice at Monash University.
In 2007, following Murtagh's retirement, he was offered the position of emeritus professor of general practice.
There were awards and honours along the way too such as the Francis Hardy Faulding Prize for Research in General Practice in 1980, Monash University's David de Kretser medal and he became a member of the Order of Australia in 1995. There is also a strew of literary awards for his books, many of which have been translated into 13 languages including Portuguese, Italian, Spanish, Mexican, Chinese, Greek, Polish and Russian. And at home, the RACGP honoured him by naming its library after him. But these prestigious awards don't appear to have defined Murtagh's view of the world, or his place in it. His Order of Australia medal is framed on his lounge room wall, but it's clear he considers it a gift rather than a prize.
As well as medicine and family, Murtagh and Rosenblatt share other mutual interests. They love music and opera, belong to the same bible study group and are committed to the same Christian values. They also love bushwalking and share a passion for the country. Somebody suggested to them they 'take the Captain's choice tour of Eastern Europe', Murtagh said, 'but no, we took the Outback spirit tour around Queensland'.
Murtagh transitioned into medical writing when he started providing content for check Program at the RACGP. He was invited to edit Australian Family Physician (AFP) parttime in 1983, at a time when the journal was rundown and suffering a diminishing readership. He had innovative ideas for the publication and 'there was a lot of opposition to them' he said. But he persevered and introduced a series of features into the journal such as Brain teaser, Practice tips, Patient education, In a lighter vein, Lumps and bumps, Focus and Cautionary tales (also the name of his latest book). These regular pages were overwhelmingly popular and the readership responded with enthusiasm. Murtagh built up a team of contributing doctors and had 'a sort of fellowship of doctors who were interested in expressing ideas'.
Some of his fondest memories are from the days he edited AFP, and it was 'always a buzz,' Murtagh said, to see the journal in print and successful. 'We built it up from nothing really to an outstanding journal.' He also developed an interest in photography and placed photographs on the pages to provide visual references for medical cases. These too were immensely popular and before long illustrators were also employed to provide artwork for AFP, which is still an intrinsic part of the journal today.
The regular series in AFP spawned Murtagh's writing career. His patient education pages are today universally synonymous with his name. At the time he introduced them drug companies were providing information for patients and it was a revolutionary concept that GPs could do it. 'We were educating the patients and giving them permission to look after themselves and understand their own diseases,' Murtagh said, but he emphasised they should always be 'one-pagers with a good diagram'.
During his time at AFP, Murtagh was approached by a publisher at McGraw-Hill who wanted to reproduce his regular series for a book. He agreed to do this and 'that's how it all started', he said. 'That's how the books really got going.'
Murtagh has completed seven projects over the past two years, including the anticipated second edition of Cautionary tales, which has just been published. Drawn from personal experience, the book contains authentic case histories from his vast experience practising and teaching in general practice. Murtagh said he had received many comments about the first chapter of Cautionary tales, which is named 'Embarrassing moments' . It shouldn't come as a surprise that the great Australian doctor is happy to share the less glorious aspects of his career in order to contribute to the education of other doctors. In the foreword of the book he writes 'Good judgement is based on experience. Experience is based on poor judgement. I trust our shared experiences promote a certain wisdom and better judgement.'
What comes to mind when reading this is the Benjamin Franklin aphorism that 'Humility makes great men twice honourable.'
By Sharon Lapkin - originally published in Good Practice May 2012.