Dr Jessica Dean is a Senior Intensive Care Registrar. In 2022, Jess passed the CICM fellowship exam. She
is also a Lawyer, and a Director of Beyond Blue and the Federal Australian Medical Association, including Chair of their Audit and Risk Committee, previous State Finalist for Young Australian of the Year and mother of a gorgeous two year old and five month old.
Can you tell us about the pathway that led you to study medicine and intensive care?
I actually think I just wasn't sure. I was initially very torn between medicine and law and that's probably ultimately why I did the double degree. The complexity of medicine was very appealing, and the idea that we don't do a nine to five job at a desk. I was in a small regional centre as a resident, where I was running Code Blues and doing lots of procedures and that was really appealing to me at that point in my training, whereas now I think it's the family meeting and the interdisciplinary relationships that are the most rewarding. Ultimately, we meet patients and their families on the worst day of their lives and the way we interact can have a really significant, positive or negative impact on what is a really hard time in their lives. I think it's really special to intensive care, and on reflection, it's probably one of the things that drew me to medicine in the first place.
What sort of field in the future do you see yourself where you can utilise both your law degree and your role as an Intensivist?
I am not really sure. I think my dream is that part of my non-clinical portfolio as an Intensivist could be working as a lawyer. During COVID I was very fortunate to be able to complete my Graduate Diploma of Legal Practice by working in the legal department at St Vincent’s Hospital Melbourne. That was a pretty wonderful opportunity and could show a benefit having a conduit between the medical and the legal departments.
I think there is a role in promoting legal and ethics education within medicine. When intensive care doctors have a good, solid understanding of legal and ethical principles, they tend to be less likely to practice defensively, and know when to ask for external assistance, be it from the legal department or the Office of the Public Advocate… And so I think improving legal literacy within intensive care is something that would be of benefit and something I would like to pursue.
What drew you to work with Beyond Blue and what achievements are you proud of in this role?
I was president of the Australian Medical Students Association, and during my term Beyond Blue released a doctors’ survey that showed alarming rates of suicide and depression within medical students and the medical profession. We launched an Australia-wide Mental health campaign, which is actually still in force and much stronger than when we launched it almost 10 years ago. As part of that role, I was approached by Beyond Blue to be on their Advisory Committee for Doctor's Health, and while I was on that committee and I was approached by Jeff Kennett (founder of Beyond Blue) to join their board, which was, I think, very forward thinking of their board, to approach a young person. The Board is comprised of people with all different backgrounds and skills, and functions at a very high level.
As for the things that I'm proud of - being able to be part of some really innovative pilot programs. I was on the steering committee for a government initiative to tackle mental health in the medical profession. We developed a framework for good mental health in the medical profession that's actually been granted funding for an implementation phase, which is exciting. One example of the pilot programs is The Way Back, which is a post-suicide intervention program with good efficacy that Beyond Blue funded, tested and now universal aftercare is being funded by Government and rolled out to almost every health service in Australia.
Congratulations on your recent success in the fellowship exam! Could you could tell us about your experience of sitting the fellowship with a young child?
I made the decision to study over a longer period of time. So, I studied over 18 months rather than the short sprints that some people do. My husband was also studying for the Radiology fellowship exam, and we needed to somewhat take it in turns as to who was going to be the primary carer and who was going to be the primary studier.
I received some great advice from women who had sat before with kids. They suggested doing it as early as possible because as kids get older, being away can be harder - they ask for you more and are less distracted by shiny things and other people.
We're very fortunate to have lots of family support and increased childcare hours to support that process. I have a very supportive partner who was very equal. We sat down at the beginning and made some important decisions about things that were negotiable and things that were non-negotiable.
One of the things that was very important to us was that it wouldn't be a stressed or unhappy household. I guess that forced us, to some extent, to swallow our own stress and anxiety and put on a strong face and go play with the kid, which I guess might also be quite protective because you don't really have the opportunity to ruminate in your own stress. I think one of the things that I'm most proud of is the fact that I think we did manage to achieve that.
With all your roles and aside from the exam, how do you find balance in your life?
The best advice I received was from one of my earlier mentors, and it came during exams and was; you can do lots of things but you have to know when to ramp up and ramp down and that's the only way that you can actually succeed. So during the lead up to sitting the fellowship, I stood down from a bunch of committees, and I worked out what my minimum requirements would be - what are the things that I wouldn't be able to step away from. I think these decisions also informed my decision to study over a longer period also.
Everyone has things that they do and don’t enjoy doing. I don't enjoy cleaning, so that's something that I’m fortunate that I don't do. I'm very happy to work an extra shift to pay for a cleaner. I think it's about being really honest with yourself, what are the commitments that bring you fulfilment and that you should keep doing, and then what are the ones that don't? The one thing that never works is trying to do everything. I just don’t think you can.
You’ve worked with some incredible people across all of your roles, both in intensive care and in your work with Beyond Blue and AMA. Who has been a significant mentor in your life and what are some of the most significant takeaways you've had from that relationship?
Julia Gillard is my hero. She's the chair of the Beyond Blue Board and she's incredible. Her ability to articulate her purpose and drive is pretty amazing. A good example of this is she once told me she went into politics having a very clear sense of the outcome she wanted to see for the community, and that was her driving force through some of the hardest times. I think, having someone ask you, ‘Why do you do this? What's the point, and what drives you?’ was really helpful.
I think often in medicine we just make lots of little career decisions without considering it as a bigger decision. You know, people talk about the hamster on the wheel, or stepping onto the conveyor belt and stepping out the other end as a consultant. And so I thought that was really helpful, to sit back and ask, what actually drives you? What makes you happy? What in your career would make you content, and working backwards from that rather than the other way around.
I'd like to think that we have responsibility in receiving mentorship to also give it, and so I'd like to think that even if I don't have that much to offer yet, that you can continue to provide support and relationships that go both ways. Having been the recipient of incredible advice over the years, something that I look forward to is being able to help other women who want to get through training/exams with kids or have interests outside of medicine such as governance or Director interests.
What would you say to women who want to do intensive care as a career?
I think awesome! I've always found it really funny when people have thought that intensive care is not a good option for women, and I think for a lot of us we've had someone at some point along the way tell us that as a woman it's a terrible idea and I just don't think that's the case anymore.
There are elements of it that I find are more compatible with having a family, for instance, coming back from maternity leave, I was considering coming back part time, but that would have been 3 shifts a fortnight, so I decided to come back full time. The amount of care that I require is actually quite little. I get all this time with my kids because of the way that our rosters work.
There are definitely some challenges, like breastfeeding and pumping in a very busy unit. But I think we're getting better at creating those opportunities for women. And I think with more visibility and more discussion, I think that's probably something that will continue to improve.
How do you define success?
I don't know.
I don't know yet and that's something that I'm probably still working on.
I find lots of significance in what we do in ICU. I'm sure everyone has experienced how rewarding a really good family meeting can be. And I think the difference in bereavement if that’s done well versus if that's rushed or disjointed or ill-prepared for, is significant. There's not that many things in medicine where we're not completely uniform and replaceable. I think family meetings are something that can be done really well in our own personal style, and something that I strive to do really well.
But I don't really have an answer to what success looks like. I think being in a job that you find rewarding and doing it well is probably what I'm aiming for at the moment.