I have a men­tal image of hun­dreds of remote nurs­es and doc­tors criss-cross­ing the deserts and rain­forests of Aus­tralia in tee­ny Cess­nas and on jets; in bus­es, trains and 4x4s. 

And maybe on foot if you’re unlucky and bust both those Bridge­stones on your Land Cruis­er or put petrol in the diesel. Ouch $$. But like ​‘ships in the night’ we don’t often meet up.

If you’re like me and work in a num­ber of dif­fer­ent com­mu­ni­ties, then chance encoun­ters with col­leagues at air­ports and brief con­ver­sa­tions over hur­ried lunch breaks might be all you get as far as con­ver­sa­tion with like-mind­ed peo­ple. Every time I bump into a nurse or doc­tor who does remote work, we end up talk­ing about sim­i­lar things. Top of the list would be:

1. Lat­est news about com­mu­ni­ties we’ve worked on (who has retired/​retrained/​remarried/​adopted res­cue cats).
2. What’s going on in rela­tion to safe­ty in the town/​community and how to avoid get­ting into trouble.
3. Nifty gad­gets to pack and ways to make life more comfortable/​interesting/​fun.

Work­ing in remote areas – where life may be any­thing but com­fort­able and fun – has taught me about the best and worst in myself and oth­ers. When I least expect it, the stress and iso­la­tion and unavoid­able work­place fric­tions, as well as the lack of sleep and very real fears about safe­ty, mean the side of me that is grumbly, ungrate­ful, teary and demand­ing can pop up at any time.

It’s a side I keep under wraps even from myself. But our emo­tions and reac­tions, when they come out of the blue, are worth lis­ten­ing to.

Over the last 20 years, I’ve col­lect­ed lit­tle gems of pock­et wis­dom shared by nurs­es and doc­tors. Ways of think­ing and relat­ing that are nuggets of gold which help me nav­i­gate the dif­fi­cul­ties: the inter­nal and exter­nal deserts.

I don’t just want to sur­vive dif­fi­cul­ty – I want to find trea­sure in the midst of it – and have a whole lot of fun doing it. 

I like to think of these trea­sured gems and pre­cious tips as things I can pack in my ​‘cog­ni­tive suit­case’ to ​‘spark joy’ while I’m away.

Joy instead of cyn­i­cism. Joy instead of help­less­ness. Joy instead of burnout. No one has an emp­ty suit­case of beliefs and habits. Every­one car­ries bag­gage – that’s a good thing. But some­times it’s worth check­ing out what’s weigh­ing you down and replac­ing it with some­thing lighter and more functional.

Even if you’re liv­ing in a com­mu­ni­ty full time and call The Red House at Lot 104 Desert Track Road your home, then tak­ing the time to fos­ter heal­ing habits of mind is impor­tant. What is in our ​‘cog­ni­tive suit­case’ has an impact on our health.

Even if you’re a trav­eller like I have been in the past, with a swag or a camper van, then mak­ing your inner (and, there­fore, out­er) envi­ron­ment a com­fort­able and joy­ful place can be a calm­ing and cen­tring practice.

Here are a few mem­o­rable things – maybe even life-chang­ing things – that nurs­es and doc­tors have told me they pack when they trav­el. I’ve adapt­ed them to suit me – espe­cial­ly the first one because I’m a swim­mer. The idea came from a nurse who lived right in the cen­tre of Australia…

Remem­ber the tint­ed goggles

I pack a pair of blue gog­gles to remind me that how I see things habit­u­al­ly is just one way of view­ing the world around me. It’s easy for me to devel­op an out­look that cat­e­goris­es peo­ple and sit­u­a­tions based on my fears and past expe­ri­ences. The gog­gles remind me that I can be metacog­ni­tive – that even if I can’t change my per­spec­tive on life right now, I can acknowl­edge it exists.

Remem­ber the monofilament

I don’t actu­al­ly car­ry a Semmes-Wein­stein monofil­a­ment, although I know a stack of peo­ple who do. Dia­bet­ic foot dis­ease is sky­rock­et­ing. But when I use a mono-fil­a­ment, I remem­ber the say­ing that unless you’ve walked a mile in some­one else’s shoes you don’t real­ly under­stand them. The say­ing came from a poem called Judge Soft­ly, writ­ten in the 1890s by Mary Lath­rap. Even though the writ­ing is archa­ic, I sug­gest look­ing it up in full.

The first few vers­es go like this:

Pray, don’t find fault with the man that limps, Or stum­bles along the road.
Unless you have worn the moc­casins he wears, Or stum­bled beneath the same load.
There may be tears in his soles that hurt Though hid­den away from view.
The bur­den he bears placed on your back
May cause you to stum­ble and fall, too.
Don’t sneer at the man who is down today Unless you have felt the same blow
That caused his fall or felt the shame
That only the fall­en know.
You may be strong, but still the blows
That were his, unknown to you in the same way, May cause you to stag­ger and fall, too.

Most patients I see don’t have shoes. Most staff I see do. I find it easy to judge both. Espe­cial­ly if I’m tired and there are pre-exist­ing rifts and seem­ing­ly unfair dynam­ics. The imag­i­nary monofil­a­ment helps me nav­i­gate tricky per­son­al­i­ties with a bit more open­ness and empathy.

Pack a piece of coral

A few peo­ple I’ve met trav­el with a reminder of a favourite place. One nurse keeps a piece of coral in his pock­et from his favourite beach at home. When stressed, he puts his hand in his pock­et and is remind­ed that just a plane flight away is a place he loves. A place with soft breezes and palm trees. But he has – for impor­tant rea­sons – cho­sen to be else­where for a time. His spe­cial place will always be there. 

Maybe it’s a café with friends. Maybe it’s in front of the tel­ly with your part­ner and grand­kids. Wher­ev­er it is, pack some­thing to remind you that there are good things around the corner.

An achiev­able goal
There are a stack of things I can’t do when I work away.

On some of the remote islands and cen­tral desert places, I can’t go for long walks by myself; I can’t go to the shops in gym gear; I can’t even go to the gym because there isn’t one; I can’t get in the car and go for a dri­ve because despite hav­ing ​‘access to a vehi­cle’ writ­ten in my con­tract, there aren’t enough in work­ing order to go round.

Pon­der­ing all the things I can’t do doesn’t get me any­where good. So instead, I make a list of things I want to bring back. Not paint­ings and stat­ues. But things that no one can take away.

Last time I took a skip­ping rope and a goal to com­plete 100 skips with­out end­ing up in the emer­gency depart­ment. When­ev­er I walked past it, I made myself increase the num­ber I could skip. I went from 5 to 400 jumps (with just a few abra­sions). Some­one I know sets a goal to read a clas­sic nov­el every eight weeks away and so far he has read every­thing from War and Peace (Tol­stoy), Mid­dle­march (Eliot) and most of Shake­speare. So what? Well, this is a guy who grew up read­ing comics and failed Eng­lish Lit­er­a­ture at high school. Some­one else I know taught them­selves enough Japan­ese over a year of remote work to trav­el solo through Japan and be rea­son­ably well under­stood. There are many things you can’t do when you’re away, but a heck of a lot you can do if you receive the poten­tial iso­la­tion and ​‘lim­i­ta­tions’ as a gift.

A motor­bike (?!)

I wish I could real­ly pack one. Instead, I have a few old pho­tos on my phone and I sus­pect they’re lost some­where amongst pic­tures of our pets. I’ve had six motor­bikes in the past. The one that scared the day-lights out of me was a big red shiny VFR 800. Next to the bike I was knee high to a grasshop­per. As a novice rid­er years before, my bike instruc­tor told me I had to learn to ​“lean into the dis­com­fort”. He under­stood that rid­ing was a fright­en­ing expe­ri­ence. And that cor­ner­ing didn’t come naturally.

I had to learn to lean into the dis­com­fort of cor­ner­ing while keep­ing my head fixed on my goal. It’s a great way to think about life. Try­ing to make things per­fect, try­ing to avoid our fears and los­ing sight of where we’re going is a haz­ard. You only get where you want to go when: a) you have a vision for the future/​know where you want to go; and b) when you learn to accept that with all worth­while pur­suits there will be dis­com­fort. You mas­ter one cor­ner and there will be anoth­er and anoth­er. Safe rid­ing and wise liv­ing is about know­ing lim­i­ta­tions, hav­ing wise teach­ers, and some­times about being com­fort­able with being uncom­fort­able. As long as that is in ways that will in time see us and those around us thriving.

Whether we realise it or not, well before we pack our old boots, fly spray, flop­py hat and scrubs in our trav­el­ling bag, we have already tak­en up a huge amount of space with men­tal habits. It’s worth spend­ing time think­ing about what they are and decid­ing whether swap­ping them out for some­thing more use­ful might be a bet­ter idea. Pack things in your life that don’t weigh you down. Fun/​wise/​creative ways of look­ing at and doing life.

Dr Kirsten Due
FRACGP FACR­RM Dip Pal Med
BPsych Hons 1^st Class

Kirsten is a SMO who works between var­i­ous Abo­rig­i­nal and Tor­res Strait Island com­mu­ni­ties across Aus­tralia. She was born in Africa and spent her ear­ly years in Soma­lia and Christ­mas Island. Her involve­ment with remote Indige­nous com­mu­ni­ties start­ed in her teenage years and has con­tin­ued since then. Kirsten is espe­cial­ly pas­sion­ate about the cen­tral place of rur­al and remote nurs­es who she says are the heart­beat of remote med­i­cine. Her inspi­ra­tion comes from her hus­band and from two extra­or­di­nary women … Robyn Miller (The Sug­ar­bird Lady) a flight nurse and a pio­neer­ing avi­a­tor and Ida Scud­der, one of the first female doc­tors who was born in South India in 1870 and the founder of CMC Vellore.