Alice Springs: a land shaped by caterpillars, wandering boys, wild dogs, rivers with no water, and a dental experience as inimitable as the landscape.
Sam Osborn is a recent dental graduate. In this article he provides a brief insight into his time as a locum Dental Officer in Alice Springs, in an attempt to illustrate the professional, cultural, and social opportunities that exist in remote areas of Australia.
It was during one of my frequent procrastination efforts, when I was meant to be studying for my final semester dental exams, that I asked myself the all-important question "What was I going to do with my holidays in between graduating and commencing full-time practice at the end of January the following year?"
Some friends had bandied around the idea of visiting Goa, some had urged a Contiki Tour around Europe, and lecturers highly recommended enjoying my last months of "freedom" somewhere warm, easy-going, and near a beach.
Now, I love to travel, but swapping the sunshine of Australia for the frigid winter of Europe did not hold much appeal after five years in freezing Central West NSW. On the other hand, the idea of nonchalantly floating in warm waters off the coast of a tropical beach did sound attractive, but with my thirtieth birthday approaching, thoughts of sharing these waters with inebriated revelers in their early twenties did not sound as alluring as perhaps it once had.
So with no decision made I determinedly returned to my studies, only to find myself procrastinating again twenty minutes later. This time I was thinking of visiting places with a difference and I recalled that my cousin had recently moved to Darwin. I started looking at websites for the Northern Territory, when all of a sudden I noticed the Northern Territory Government, Department of Health's website advertising 'Dentistry with a Difference' I had wanted to holiday somewhere different, but I asked myself why give up my remaining months of 'freedom' to work? I read a little further and the website appeared to answer this question for me: ˜if you want your career to go places then join us in the Northern Territory. The challenges and opportunities in oral health care in the Territory are like no other in Australia".
Now I must admit, as someone who had grown up in Melbourne and loved the fast pace of the city, I had never really given the Northern Territory a second thought until this point. However, I had wanted to do something different with my holidays, and remembered my lecturers' advice to visit somewhere warm, easy-going, and near a beach.
I started making some calls and managed to contact the Clinical Manager of the dental centre in Alice Springs. Luckily, there was a position available for the exact period for which I was interested, and pending positive feedback from my referees, I would be considered for the position. My referees were called and I was subsequently telephoned with an offer to work as a locum dentist in Alice Springs.
I was ecstatic! Not only would I be paid for this position (something that sounded very nice after eleven years at university), I would be able to improve my clinical skills and also further my professional development as a newly graduated dentist. In addition, I would be visiting a place with a difference, it would be (extremely) warm, easy-going, unfortunately no beach - but three out of four ain't bad!
Arrangements were made, Saturday flights booked, and before I knew it I was greeted by a searing heat, the sweet dulcet tones of German backpackers, and a warm welcome to Mparntwe (Arrernte for Alice Springs). I caught a taxi to my accommodation and set out to do some grocery shopping, find a gym, and watch England play an Australian select cricket team. While at the cricket I met the English cricket team, made some new local and international friends, ventured out for a drink and was invited to play for the Barmy Army in the inaugural KFC Beach Desert Cricket Competition. I played the next day for seven hours in 45-degree heat against an Australian team wearing beanies, posed for pictures for the local paper, and returned home burnt and exhausted. I readied myself for an early bedtime in preparation for my first day of work as a dentist, happy that any fears that my time in Alice Springs would be dull had been safely quashed!
The next morning I arrived at the Flynn Drive Dental Centre, was given a very warm, albeit brief, introduction to my colleagues, taken through cultural awareness training, introduced to the dental facilities and computer software, and had my first patient seated in the chair at a time earlier than my usual awakening time when a university student. My first appointments were reserved for relief of pain patients; extracting symptomatic wisdom teeth, virgin teeth ravaged by periodontal disease, long grossly carious root stumps encased in dense bone, extirpations, repairing fractured restorations, and performing caries control. The remainder of the day was filled with restorative appointments, removable prosthodontics, fixed prosthodontics with the approval of the Clinical Manager, oral surgery, and endodontic cases as clinically indicated.
Within a week I found myself growing in confidence, continuously aiming to develop my clinical knowledge, skills and competence in treating cases of acute and primary oral health care. Every attempt was made to engage clients in treatment planning and the promotion of effective self-care. In addition, I also took comfort in the fact that if any difficulties were to present, or I had any burning questions, one of the more senior dentists would always be on hand to advise or assist if the circumstance required - the staff at Alice Springs truly are amazing!
Moreover, Alice Springs provided me with educational opportunities and experiences that I never had in the classroom and, I doubt, will ever be replicated in my general practice. I cannot adequately describe my initial apprehension at treating prisoners from the local gaol, or my trepidation at extracting teeth affected by early childhood caries under GA in paediatric patients, for the first time, at Alice Springs Hospital. Furthermore, I simultaneously experienced excitement and anxiety at the prospect of being telephoned while on call as the hospital's emergency department duty dentist over the Christmas and New Year holidays.
As well as the clinical experiences, I will never forget watching Indigenous children from remote communities inquisitively examine the automated hand-wash basin tap seemingly for the first time, appear startled and retreat momentarily upon being splashed by water, before bursting into laughter and filling the surgery with their infectious smiles. Also, I will never forget the shock at seeing so many patients with chronic disease; especially those on dialysis, being treated for stage 5 CKD.
However, just as my clinical experiences were many and varied, so too were my experiences outside the clinic. As I previously mentioned, I played desert cricket for the Barmy Army in a waterless river, scaled Spencer Hill in time to see the sunset over the jagged MacDonnell Ranges, but never in time to catch a glimpse of the giant Dreamtime caterpillars that created them. I saw dingoes chasing wallabies and many backpacking didgeridoo playing wannabes. I swam in the pristine crocodile-free water holes, traversed hundreds of kilometres of red sand desert in 40+ degree heat in a car with no air conditioning to visit Indigenous communities, gladly shared my backyard with goannas (they keep the snakes away), and ventured to the iconic natural features of Uluá'Ÿu (Ayers Rock) and Kata Tjuáa National Park. I made long-lasting friendships and spent many evenings at the local watering holes (not to be confused with the natural water holes) giving my best at Trivia Night, or finding myself engrossed in conversation with some of the most interesting people I have ever met.
When reflecting on my time in Alice Springs I will often reminisce about the awe-inspiring landscapes of this vast ancient Red Centre. I will also fondly remember the motley crew of colourful characters whom I was fortunate enough to call my friends. I will remember the quality mentoring I received from experienced dentists, and the staff who made Flynn Drive Dental Centre a place I looked forward to working at each day. But most of all I will remember how they took a chance on a recent dental graduate.
The professional opportunities are extremely varied, with the patient demographic arguably very different to what can be found in the cities; Sydney, Brisbane and Melbourne. Alice Springs allows and encourages dentists to practise in areas of dentistry that would be seldom available to city practitioners. In addition, practising in Alice Springs encourages a greater understanding of the cultural and health (more specifically dental) issues facing Indigenous Australians. The disparity between dental health outcomes of Indigenous and non-Indigenous Australians has been widely publicised and garnered much discussion and calls for action among the allied health professions. Further, Alice Springs allows for a great social experience once work is done for the day.
In summary, I believe for any dentist looking to further themselves professionally, develop a greater understanding and appreciation for Indigenous culture, and concurrently have a great time - Alice Springs provides all these opportunities. It is for this reason that I had an (dental) experience as inimitable as the landscape!
Sam Osborn