I was privileged to interview the 2020 Australian of the Year, Dr James Muecke, for the Australian Private Hospitals Association earlier this year.
In a medical career spanning three decades, Dr James Muecke has performed some of the most complex surgeries on the planet, stared down guerilla soldiers in Uganda and helped teach doctors in Myanmar how to save a child’s sight.
But he said one of the most “surreal” events ever to happen to him was to be named the 2020 Australian of the Year.
“It was pretty overwhelming, to be honest,” Dr Muecke said.
“I really thought I wouldn’t receive it – the Australian of the Year the previous year had also been a doctor from Adelaide, so I thought what are the chances of two South Australian doctors being given the honour two years in a row?”
Dr Richard Harris, from South Australia, and Dr Craig Challen, from Western Australia, were the joint winners of the 2019 Australian of the Year, for their role in rescuing a schoolboy soccer team from flooded caves in Thailand.
Dr Muecke said the announcement of the award in January this year was almost indescribable.
“I’d had about two hours sleep the night before,” he said.
“It was exciting and terrifying, and of course at the same time, it was very special.”
Dr Muecke has worked in both the public and private systems and has a long-standing relationship with the Cura Day Hospitals Group.
“In the public sector, being able to teach your colleagues is very integral to what I do, so that’s important to me,” Dr Muecke said.
“But also, working in the private sector over the years has allowed me to fund my passion projects.
“The private sector has given me the time and the freedom to do the things I really love, like medical volunteering.”
Dr Muecke’s first overseas adventure in medicine came in 1989, after finishing his intern year.
“During that year, my first year of real medicine, I had been managing diseases that were predominantly chronic and self-inflicted, such as heart attack, lung disease – diseases that were entirely preventable,” he said.
“I needed something different, so I packed my bags and volunteered as a general doctor in a little rural hospital in Kenya.”
It was while living and working in Africa that he and a travelling companion ran across a party of Ugandan guerilla soldiers.
“They pulled apart our packs looking for weapons; they found our binoculars and accused us of being spies,” Dr Muecke said.
“They marched us away at gunpoint and locked us up in a ramshackle hut at the edge of a village.
“We were convinced that if we stayed in that hut, we were done for, so we broke out through the back of the hut and escaped into the jungle.”
Dr Muecke later continued to combine his love of adventure and medicine, by practicing at the St John Eye Hospital in Arab East Jerusalem.
“The outreach visits to the refugee camps of the Gaza Strip and the West Bank were a highlight,” he said.
“Despite the machine gun battles that erupted outside the clinic, those weekly trips cemented in me a passion for fighting blindness in poorer countries.”
In 2007, Dr Muecke was part of a research team in Myanmar which found the leading cause of childhood blindness in that country was measles.
“Measles, especially in malnourished children, can permanently destroy the cornea,” he said.
“This trip made me acutely aware that there’s so much more to blindness than cataracts – and to finally understand that prevention is more powerful than cure.”
Dr Muecke helped train Myanmar’s first ever children’s eye surgeon, Dr Than Htun Aung, who is now providing nearly 30,000 treatments to children in his own country each year. He has also started to train his own colleagues.
As an eye specialist, Dr Muecke has conducted some of the most exacting surgical procedures.
“The cataract surgeon must insert a fine probe into the eye, through a slit in the cornea, through the dilated pupil, through an opening that’s made in the capsule that surrounds the lens, and into the lens itself, where it delivers high frequency ultrasound to break up the clouded lens matter, and then suck it out of the eye,” he said.
“The capsule of the lens is 10 per cent of the thickness of the finest cellophane.
“And it’s suspended from the inner wall of the eye by delicate fibrils that are 1 per cent as thick as a human hair.
“And the surgeon must clear all the lens matter, one quarter of one millilitre, without rupturing the capsule or dislodging it from its location. Surgery doesn’t get much more precise than this. Or exciting.”
However in 2013, Dr Muecke was forced to stop performing the surgery he had trained so hard for, due to a genetic condition called Focal Dystonia.
Focal Dystonia interferes with the brain’s ability to tell a muscle how hard to contract, which impacts on hand and finger movements – devastating news for a surgeon.
“I began to use my left hand for one-handed tasks,” he said.
“These days I’d smash a champagne flute if I were to hold it with my right hand and I can’t hold a plate any longer, as the whole hand involuntarily and, disturbingly, flexes inwardly on itself at the wrist joint.”
There is no cure for Focal Dystonia.
“I’ve tried occupational therapy, physiotherapy, hypnotherapy, kinesiology, cerebellar stimulation, sensorimotor re-training and anti-cholinergic medication, all to no avail,” he said.
“I’ve also tried three courses of acupuncture but even this ancient eastern therapy was unable to curb the steady progress of the condition.”
Despite this blow to his career, Dr Muecke is determined to stay positive and is focussing on his work with Sight For All, a social impact organisation he co-founded in 2008 aimed at creating a world where everyone can see.
“Our projects are now impacting on the lives of more than one million people every year in some of the poorest countries of the world,” he said,
Closer to home, Dr Muecke says he plans to use his platform as Australian of the Year to raise awareness of Type 2 diabetes and the devastating impact it is having on communities across the country.
“Type 2 diabetes is the leading cause of blindness in working age people in Australia and it’s entirely preventable,” he said.
“More than half of adult Australians are not having regular sight-saving eye checks and in Aboriginal communities, that figure is probably two thirds of the population.”
He added that eyecare services were readily available in Australia and he was determined to promote them.
“The services are there for all Aussies, both in the public and private sectors. It’s really about raising awareness,” Dr Muecke said.
“People often lead busy lives and perhaps don’t realise that by not getting regular eye checks, they could end up blind.
“Such outcomes are more prevalent in lower socioeconomic areas where people are not prioritising their health.
“There is free care available in the public system, but if people have to wait for a year or more, they might choose to pay out of their own pocket.
“The private sector is often more efficient, and the safety net may help soften the financial blow.”
Dr Muecke said there was one thing everyone could do to reduce their chances of developing Type 2 diabetes – cut back on the sweet stuff.
“We, as a society, need to reduce our sugar consumption,” he said.
“Sugar is a highly addictive substance, and it’s not just the teaspoon of sugar in your morning coffee, it’s all the added sugar that’s in so much of what we eat and drink.”
Dr Muecke added he personally had struggled to cut back on sugar.
“For me, giving up biscuits, chocolate and ice cream – well, not altogether – but just not eating it every day, has been one step and it’s something we can all do,” he said.
“We also need to address the predatory marketing aimed at children. You often see it at the checkout and the servo with ‘two for the price of one’ chocolates.
“I’ve written to supermarkets and other businesses about this issue and that’s one of the many things I’ll be using my platform for this year.”
Despite his adventurous life so far, Dr Muecke laughed when asked if Hollywood had come to call.
“Oh no, not yet anyway,” he said.
He added he would most likely be forced to retire from his clinical practice in the coming year, but that he was embracing the change.
“Looking back, I’ve learnt that preventing disease is always better than treatment,” Dr Muecke said.
“And that when a treatment is not possible, we must call on our own personal resilience.
“If you make the most of everything that life has to offer, when the time comes for you to draw on your own resilience, you’ll have plenty of weapons to take into that battle.”