When Dr Terry Hannan agreed to this interview, I went prepared with a long list of questions, most of them poised around his book Bedtime Stories, or the interconnected voluntary assisted dying legislation. However, what I walked away with was not so much the answers to the questions asked but an insight into some of the stories he has been privy to over the years, and his knowledge and concerns surrounding the medical field.
Dr Hannan’s book Bedtime Stories, though published in 2018, is more timely now than ever with the discussions on voluntary assisted dying happening in Tasmania.
The book consists of short, human documentations of encounters between Dr Hannan and his patients over a period of 45 years, of which the conversation often centred on “death” or “dying”.
“That’s how the stories of 45 years were kept, because they had significance for me. They were just beautiful stories,” he said.
During that period of time, Dr Hannan worked as a physician in internal medicine and did 12 years as a palliative care physician. One could say that he has seen the worst times in people’s lives. Yet, his demeanor never faulted from happy and easy going when we had our interview.
In other news:
National Book Council Tasmania met on Wednesday for a discussion by Dr Hannan about the journeys of three patients and their case stories in his book. The discussion highlighted A mother’s journey of the cross, Robyn the daughter who listened, and I’m allergic to Catholics and Morphine.
In his introduction, Dr Hannan said he was not aiming to tell a story of himself and is life experiences, but deliver a message that would make people reflect on their journey through life and the encounters they have had with the Australian healthcare system.
Dr Hannan started his anecdotes by outlining the treatment presented to patients. He said when he worked in a chronic pain centre and looked after those in palliative care, day after day all he saw was inadequate teaching and unnecessary treatment.
“If you go towards the end of life, how much of the treatment is necessary or unnecessary. Is the treatment that was unnecessary causing more harm and poorer quality? The answer is yes, and it’s very costly,” he said.
“I’d see day after day while I was teaching the inadequate, inappropriate education and training of junior doctors in the management of pain.”
One story he shared that highlighted the importance of training in pain management was of a healthy woman in her 60s who presented to him at a chronic pain clinic after stubbing her toe and enduring regional pain syndrome. Dr Hannan said to provide her with a plan, he would need to know her as a person. Her husband told her she should share her story with the doctor.
“She told me this story of how she had run over a relative and killed them. And all that was hidden because they lived in a small town, couldn’t share it with anybody. She told the story and I said, come back in two weeks and I’ll give you the protocol,” he said.
When the woman returned, she had no pain and was back to her healthy normal self after having the guilt, stress, and worry lifted off her shoulders. Dr Hannan outlined the difference between stress that is normal and stress that is not, with inappropriate stress often leading to other health complications as was seen in this story. The tale of this woman begs the question: are patients listened to enough?
VOLUNTARY ASSISTED DYING:
When Dr Hannan was asked about the legislation on voluntary assisted dying he said that he can’t change the minds of those behind the bill, but he can present an alternative to it that’s not that far out, and has been practiced for decades. The approach centres on listening to patients first and looking at the grieving process of those left behind.
“I can’t stop the legislation going through but I can tell you there will be decades of mentally, emotionally ill people because of this process, because they haven’t been able to say goodbye,” he said.
Dr Hannan said there are up to eight different kinds of pain in the early stages of a palliative patient but only one in three patients experience that pain. He said dying is presented to the public as intractable pain, instead of what is found in the statistics.
Dr Hannan said we have very effective pain medicine and in his time in palliative care he can only remember two or three who they could not make pain free but were pain free at rest.
QUESTIONING THE FIELD:
During the interview Dr Hannan often questioned the medical field. One such instance was when we discussed the topic of opioid addiction and he asked the question: had anyone considered whether doctors were the problem?
“How did the opioid dependency and crisis develop? Who prescribes it? In the conversations, has anyone raised the issue that doctors might be the problem?,” he said.
It was strange listening to a man talk about his profession with such warmth but still question some of the harder issues. He also discussed the expectation in our society of tests and computers providing answers to patients, when those in the medical profession should be talking to their patients to better understand how to help them.
“Who has created that expectation? Again the profession. We have done marvelous things but there is this danger, I talk about the seduction of technology,” he said.
He also touched on the complications surrounding the language used when someone dies. More specifically, Dr Hannan talked about the issue with the use of the term “passed on”.
“I believe a lot of this has to do with the way North America presents the world. So everybody passes on. So it’s now become part of the lingo. If you take the word passing it implies going somewhere. Death is a final end point, dying is a progress to death,” he said.
THE WRAP UP:
Bedtime stories only took two weeks for Dr Hannan to write, with his passion and interest in other people and their stories fuelling him to finish the book.
“All I am trying to say is, I’m no one special but somehow I have acquired this gift of listening,” he said.
Dr Hannan is a physician who listens to his patients and in their hardest times, cares enough to ask. He acts as a voice for those who feel unheard. The interview with him opens up a new world of looking at the bigger picture in life.
Dr Hannan is currently writing his next book which he says will be more intense.
National Book Council Tasmania highlights Tasmanian publications, writers, and publishers. It is the last remaining council in Australia and has survived the pandemic times. Dr Hannan’s book signing and discussion was the first event after the pandemic.
The next event will be on Wednesday October 21 and will feature Lucinda Sharpe from 40°Publishing.
Bookings are essential. Contact Rocelyn Ives at [email protected] to secure your spot.