Stethoscope

#14 Interview with Dr Mrin Nayagam

Member Dr Mrin Nayagam has recently become an author and published her first book Silver Linings: True Stories of Resilience from a General Practice. Visit www.silverliningscharitabletrust.com.au to find out more about the book or buy a copy. 

Dr Nayagam explained to AMA Victoria how a list of ‘interesting patients’ prompted her to write the book.

 

Over the years I have surprised myself when, time and again, a gut feeling about a diagnosis came true and the patients were saved many months of investigations and the cost of many specialist visits. 

As I had a part-time teaching appointment at the Department of General Practice at Monash University, a practical knowledge of real-life patients came in handy during teaching sessions. Whenever I used the de-identified patient’s notes to enhance the students’ knowledge of a subject I kept a note of the patient’s details in a list. I like keeping lists – it’s a relic from studying for exams. From these small beginnings, my list of patients with an interesting or even rare diagnosis grew. I transferred the names on the piece of paper to a book classifying the names under specific conditions or simply as interesting cases.  

Patients are intrigued and at times amused when I pull my notebook out and include their names in one of the lists. As I made more exotic diagnoses by following clinical principles rather than referring to specialists, my list grew. I referred the patients to specialist for fine-tuning. Most specialists were happy to send them back for continued follow-up and management as they knew I would re-refer, if I needed further guidance. One of the first such cases was myasthenia gravis I diagnosed in a 30-year-old female at her first presentation. I referred her to Prof Edward Byrne for further management and it was this interaction early in my life in general practice that led me to appreciate the rewards of investigations. 

One day a fourth-year medical student sitting with me at the practice leafed through my book of lists and suggested I could write a book. The seed was sown! I always wanted to be a published author, this being a consequence of extensive reading during my formative years, so I had given the subject much thought.

 

Read the full interview in the February/March 2018 edition of Vicdoc.

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