A dreamer from the Darling Downs

It was a privilege to come across this book. Most of us go through our lives and affect the world around us in small ways, hopefully positive, in our immediate surrounds. It is only a small percentage of humanity whose work and vision change the world…for the better…for the benefit of the remainder of us. Dr John Frawley is one of that few.

John Frawley's mother described him as a dreamer, and the story of how his early years growing up on the Darling Downs of Queensland shaped him for the practise of surgery, is the stuff of a different book. Autobiographical writing is a difficult art, particularly without appearing pretentious or sententious. John Frawley is neither. This is an honest, powerful and often passionate account of the life of a pioneer transplant surgeon from the time of his graduation from medical school.

The introduction foreshadows the story to follow. At the very beginning of his internship he witnessed a fatal misjudgement end in the suicide of a nurse. This provided the most intense of lessons about the danger of casual assumptions which he never forgot throughout all his years in medicine.

Despite being promised employment in Brisbane, his initial bonded period was served in hardship conditions on Thursday Island in the Torres Straits. His graphic stories of working with indigenous people, with frequently indifferent or jaded colleagues bring home the reality of bush medicine with conditions and attitudes that still persist to a large degree today. Humour under these circumstances was frequently underlain by tragedy. In this remote setting, he met his wife Elizabeth who remained his constant companion and support for the remainder of his career and who travelled with him to his next position (after a major disagreement with the Qld Director General of Health) under the surgical registrar at the St Charles Gairdner hospital in Perth.

It was in Perth that he found the inspiration that determined the whole course of his future in the person of Alexis Carrel, who was to surgery much as Louis Pasteur was to microbiology. Frawley assiduously studied the surgical techniques developed by Carrel and began to practise and refine them in his own work.

It was no easy path that he followed and the world, in which he lived, even so few years ago, was entirely different from what we take for granted today. It's hard to imagine, but where our social divide today is sometimes regrettably determined by ethnicity, the greatest bar to advancement then could equally well be determined by whether you were Protestant or Catholic. Within the medical profession itself there were massive divides created by internal jealousies and matters of prestige. To a degree these still exist, but the barriers are not as insuperable.

He goes on to tell both his personal and professional story and readers will recognise many of the names of characters he encountered. With him and his growing family, we are taken from Perth to the UK, Sydney and back to Queensland as he develops and teaches his skills; in particular in the world of kidney transplants where he is without doubt a major pioneer of techniques that have saved countless lives.

I found myself very much at odds with his politics as he discussed the reaction of the medical world to the introduction of Medicare, and the Australian approximation of "socialised medicine", but he makes his points very forcibly. On this issue, he reflected the reaction of the AMA, but at no stage did he let career considerations override his personal ethics, or step back from locking horns with the establishment.

Every reader will enjoy this book. It is a very well written and fascinating behind the scenes look at the development of surgery in Australia as well as an intimate adventure story combining all the elements of romance, drama and personal tragedy with frequent glimpses of a wry humour and great compassion. Would that we could all dream to such effect. Strongly recommended!