Vale Tony - My reminiscences of a most remarkable man and doctor by Warwick Ruscoe
It was my privilege to have been Tony Buhagiar's first partner - a partnership which spanned ten years. In all of my thirty eight years in various fields of medical practice, no other colleague has made such an enduring impression and earned such deep admiration as Tony Buhagiar. As one of his greatest admirers, I vividly remember a library of 'Tony stories' and whilst I am deeply saddened by his passing and will always miss him, I am delighted to commit some of my memories of Tony to writing at this time in order to allow others to understand the reasons why particularly those of us who knew him in the early days of general practice held him in such regard.
My partnership with Tony covered the sixties and early seventies when general practice was very different. You could drive around the Wentworthville area with ease and we made large numbers of home visits, particularly during the fairly frequent measles epidemics. We did appendectomies and tonsillectomies, the latter probably too often, and we did confinements. We were short of GPs and we worked hard - it was not uncommon to do our last home call at midnight and then cover the rest of the night on call.
My first Tony story relates to the workload problem. Tony had an extraordinary ability to work both fast and well - he could see incredible numbers of patients in a day. He would probably be accused of over-servicing today but nothing could be further from the truth - he was simply exercising his skills to meet the demands for his services. There was never any doubt about the quality of his medicine. I recall a young man who was sitting for his University finals and we had to put off badly needed nasal surgery to correct sinus troubles. In the meantime I was tiding him over with medication. I was going away for a week and suggested that he see Tony if he was in trouble. On my return I commented that he had seen Dr Buhagiar. He said that he had come in through one door, someone pushed a prescription into his hand and showed him out the other door and he didn't get a good look at him. I hasten to add that the young man had a delightful sense of humour and I was in no doubt that the story was somewhat exaggerated.
The second story, and I can vouch for its accuracy, relates to one of the measles epidemics during which we did large numbers of house calls. On one day I was aware that Tony did something like fifty house calls - a day that started at 6am and ended at 1am the next.
My third Tony story is that I had been his equal partner for some three years during which time he took the odd week off, but without leaving the area so that he continued to do his own obstetrics and the other things of which I was completely unaware. After three years, he presumably decided he could trust me and he took a whole two weeks away from the area and only then did I learn of the other things. The first surprise came when the Brother in charge of the St Vincent's Home asked me to do Tony's sick parade at the Home the next morning at six. Of course I agreed and was surprised to firstly find to thirty or so boys lined up in the morning and secondly to learn that Tony did this regularly. The second chapter to this story came the next day when I was asked to visit a priest at Richmond where I learnt how grateful large numbers of priests and nuns for twenty miles around were for Tony's visits. Needless to say, in those preMedicare days, all of this was without fee and therefore when I asked why I hadn't been asked to help, his reply was that this was his private work and that was why he always did it outside practice times.
My fourth Tony story relates to the way that I and the practice staff learnt to cope when the wind was blowing hard from Malta. Like tall trees we bent with it in the knowledge that it would blow out before long when, like the trees, we would spring back the other way without opposition.
My fifth Tony story concerns Parramatta Hospital which in those pre-Westmead days ' had a medical superintendent who was well known for his anti-GP views and his burning ambition to see Parramatta Hospital with a totally specialist HMO staff. At that time Tony secured the post of Assistant Honorary Physician. Not long after that I was called urgently to see a lady who had been found by her daughter delirious and with a high fever. The lady was indeed in a serious condition and I didn't waste time trying to make an exquisite bedside diagnosis at home. I called for an ambulance and telephoned the medical superintendent to tell him that I was sending the patient in - there was no question of pleading for a bed as usual. He asked me whom I would like the patient admitted under, to which I replied that I didn't care so long as she was in hospital and that I thought the physician of the day would be most appropriate. I was astonished when he said "Why not under Tony Buhagiar?" The next morning I called at the ICU to see how the lady was going and was taken aback firstly to notice that of the four beds in the ICU, Tony's name was over three of them, and secondly I noted two residents and Tony gathered around the bed with the residents clearly hanging on Tony's every word. It turned out that Tony had in fact been there all night. I subsequently talked to one of these RMOs who came to practice nearby. He said that Tony was universally agreed amongst the resident staff to be the best of the VMOs for that sort of thing.
My sixth Tony story concerns his obstetric practice. I think I am right in saying that he used to do 150-200 deliveries a year. In those days there was a shortage of specialist obstetricians in the area and Tony's advice was frequently sought by other GP obstetricians with me at the top of the list. Tony retained the services of an eminent specialist for Caesarian sections and after some years of this, the specialist said to Tony one day, "You know, Tony, I am sick of this and for, the next few Caesars I am going to assist you." I think it was after about 10 further specialist-assisted Caesarians that I found myself assisting Tony from then on. The only problem was that we had to get another anaesthetist because that had been my role.
My last Tony story concerns the AMA and the College. During my time with Tony, I served on the AMA's Branch and Federal Councils, having been pushed there by Tony who took the view that both our practice and his style of practice should be represented at that level. When I told him that I was moving on, he decided that he would take over, and that he did. About that time, he also discovered the College and I clearly remember him saying one day that he thought he should "get on top of this College business". I didn't realise at the time the truth of what he was saying.
I could go on at much greater length about Tony Buhagiar, not to mention the fact that whilst he was doing all of this, he was also playing grade soccer every Saturday and he was unbeatable by most of us at squash and at chess. I trust that readers will appreciate from these stories the reasons why those of us who knew him admired Tony as a most remarkable man and a truly great doctor. I doubt that the changed nature of medicine will allow us to see his like again.
By Dr Warwick Ruscoe, Macarthur and Southern Highlands Divisions of General Practice – originally published in Western Sydney Division of General Practice (WSDGP) news 1999 pp3-4.