The many faces of Dr Ros
Nelson surgeon Ros Pochin knows all about dealing with cancer, mentally as well as physically. She is also a busy wife and mother, community advocate, fashion model and musician. Tracy Neal reports:
Within Ros Pochin's extensive and learned vocabulary, there are three words the Nelson surgeon will never quite get used to delivering: "You have cancer".
She has cultured the art of when to lace the bad news with hope, or to tell the truth when the person in front of her is dying.
What is clear after talking to a number of women, whom circumstance has placed before her, is that Nelson is lucky to have Mrs Pochin, a woman who knows women and the intensely deep fear a cancer diagnosis brings, particularly breast cancer, a field she specialises in.
Her compassion is also her burden. It is not unusual for Mrs Pochin to take the journey alongside her patients.
It would be easy to think that this would not leave room for much else in her life, but alongside her surgeon and consultant's role, she is also a wife and mother, a lecturer, a community enthusiast, a conference organiser, a musician and a fashion model.
She insists that this is why she is able to connect with her patients, most of whom are also busy women with families.
"I'm the mother with the dog and the cat with three legs, and I'm running around always late because I'm trying to do 50 things at once - and, actually, my patients are just like me," says the British-born Nelson Hospital general surgeon, who is also one of the team of surgeons in the private practice, Nelson Surgical Associates in Collingwood St.
Mrs Pochin performs common general surgical procedures each week, as well as focusing on her specialist interest of breast and endocrine surgery and treatment.
The fact that you are reading this is proof of her accessibility in her adopted city, which she and photographer husband John-Paul (J P) Pochin have become fully involved in during the four years since they settled here.
Their Kiwi daughters arrived during the couple's formative years as immigrants, which began in Hamilton and took them on a zig-zag journey between Britain and New Zealand.
The genesis of Mrs Pochin's career might well have been the days she spent as a child, listening to the tales of the elderly residents of the Sussex nursing home run by her mother, a nurse.
"I'd have to go to Mum's work after school because there was no-one at home. I'd do my homework, but I used to get really bored, and after a while I started helping out.
"I'd sit with them and they told amazing stories. There was an old guy called Bill - his first job was lighting the street lamps in London. I thought it was really cool that there was somebody alive who had seen things I thought were out of a Sherlock Holmes story."
Mrs Pochin also credits her mother with being a huge influence on her, despite early attempts to dissuade the young Rosalynd from a career in medicine.
Mrs Pochin was born in London, and returned there at the age of 17 to attend London University, from which she graduated with a degree in psychology in 1992 and a medical degree in 1994. It was also where she met J P, who was studying physics. They have been together for 20 years.
Mrs Pochin obtained a fellowship in general surgery and underwent post-fellowship sub-specialty training in breast, reconstructive and endocrine surgery. In that time, she worked closely with plastic surgeons, enabling her to improve her skills at breast preservation and remodelling.
She is a fellow of the Royal Australasian College of Surgeons, a member of the breast section of the College of Surgeons and a member of the New Zealand Association of General Surgeons.
Her husband adopted her surname when they married. "J P took my name as I was the last of the line, only having a sister, so wanted to carry the name on." It is also common for doctors to retain the name they qualified with.
New Zealand appeared on the couple's horizon when the young trainee doctor was at medical school.
Her choice of destination for elective study was partly governed by her aunt in Whakatane. J P, who was a "newish" boyfriend, decided to accompany her.
"I came over for six weeks, and J P for four weeks, so I did about two weeks of medicine and about four weeks of bunking off and touring around New Zealand.
"We just fell in love with the place, and Nelson was our favourite."
J P is keen on the outdoors, and now their two daughters are as well, which has forced Mrs Pochin to succumb, but walking remains her primary outdoors interest.
"We went backpacking, which was cool. We loved places with shared kitchens and a country where you could buy this huge piece of steak and cream was almost free. We couldn't believe we could have steak with cream and mushrooms in a backpackers'!"
They returned to England, where Mrs Pochin spent a year as a house surgeon, all the time determined that they would come back to New Zealand, which they did in 1996.
"We went to Hamilton initially, on a scheme where a spouse's air fare is covered, but it was for a ‘wife', so I argued the case that I had a husband."
They then ended up in Auckland for five years, before a return to England sealed the deal on where they wanted to be.
"It took me going back to realise home is where you decide it's going to be. Then I was very happy to come back to New Zealand."
After working in Christchurch and Auckland, the Pochins came to Nelson, where Mrs Pochin initially worked as a registrar.
"It never occurred to me I'd end up in a small place. Sometimes you come to a town and you feel like you fit. We just fitted straight away."
While Nelson lacks the buzz of a major metropolitan centre, its smallness forces her to consciously maintain her professional levels more actively.
She teaches on three college of surgeons courses for trauma and sits on the executive committee of two.
"I teach so that I can retain my skills and be challenged. If I stayed in Nelson and didn't do these things, it would be easy to become less and less good."
Her specialty fields evolved by natural progression rather than particular ambition.
"When I was training to be a surgeon, I seemed to get given all the breast runs because I was the only female surgeon at the time. It was like, ‘Oh, there's a girl - we'll put her on the breast run'.
"When I got to advanced surgical training, I actively requested no breast runs for the first two years."
Plastic surgery interested her because it was a good mix of psychology and surgery, and ultimately, breast treatment emerged as a good combination of the two.
Mrs Pochin believes doctors have become "more sensible" about dealing with the territory of human emotions. They understand that they see people in the most intimate and difficult situations and that communication is paramount.
"You can be the best technical surgeon in the world but if you can't communicate with your patients, you're blimmin' useless at your job.
"They have to trust you implicitly. They have to feel you're there for them."
If the tables were turned, it's what she would want. The downside is that it is difficult to separate work from her personal life.
"My patients are like my family, particularly those I see who I deal with in bad situations - which, unfortunately, is quite a lot of them."
Sadly, it's often December when she is more likely to end up sobbing at home on the couch.
"We get a lot of breast cancer then because of awareness month in October."
In December 2011, she handled eight breast-cancer diagnoses in the week before Christmas.
"You cannot leave a woman sitting, waiting, over that time. It's fine from a cancer point of view, but useless from a psychological point of view."
However hard it is to tell people bad news and watch them cry, she has to be the grown-up, but wants to cry too.
"Part of my job is to be there and make them really know I'm fighting for them every step of the way."
In most cases, she gets to see patients emerge on the other side.
"They start to get their life back, their hair grows, then they get their job back. They start doing some activities and taking up a new hobby.
"They rejig their lives and their priorities.
"It's a bit like having an adolescent - they need you a lot when they're a toddler, then they come through and go, ‘Oh, I don't need you so much any more'."
There is never a right way to break terrible news, but there are an "awful lot of wrong ways" to do it, Mrs Pochin says.
Her psychology degree and a year of psychotherapy training helped her learn the subtle art of saying it honestly, along with the time she spent working in intensive care in Auckland, where she saw an "awful lot of bad news".
Mrs Pochin says the week between patients being told they have cancer and seeing her as a specialist is one of the worst times.
Men and women deal with the news differently.
"Most patients are women, but most of the partners are men, and they really struggle.
"Men are used to fixing things, so I always give the man a job, because they need one.
"The key thing is they feel helpless and they're not used to that. That's also true of men when I tell them they have cancer - they want to fix stuff."
Mrs Pochin says women tend to be "sorters".
"Tell a woman she has cancer and she worries about the children, her job, her husband and about number four - she worries about herself."
After the intense shock of a diagnosis, formulating a plan is the first step.
Helping people confront death is an area that is lacking in medical training, she believes, and she wishes that death was a subject people talked more openly about.
"You can't not tell the truth."
A lot of patients, particularly those with a terminal diagnosis, tell her that people suddenly begin to avoid them, because they don't know what to say.
"People avoid dying people because they don't know what to say. It doesn't matter what you say - say anything. What matters is that you go and see them."
Children need to be exposed to it as well, to help allay their fears, she says.
"We do a birth plan - why not do a death plan? Westerners aren't good at embracing death and dying. It's almost like we treat cancer as if it's contagious."
The stages patients go through upon diagnosis are the same as when the condition they face is terminal: anger, denial, bargaining, guilt, then acceptance, Mrs Pochin says.
"One of my jobs is to get people to the state of acceptance before we do surgery. If they're not there, they get stuck."
The fear cancer brings stems from a fundamental fear of death. The over-riding fear of the gruelling treatment is that it's not going to work.
"Most of us are control freaks, but you can't control when something goes wrong with your body.
"It's OK to feel scared - you need to fall apart. In fact, if you don't, I'm going to worry about you."
She says it's only once someone hits the ground that the upswings can occur.
"Once you drop, you can bounce, but you have to drop first. Part of that is giving someone permission to take over."
Mrs Pochin's spare time is spent with family, picnics and walks along the Maitai River, and music.
Her husky, jazzy voice and rapid-fire London accent hint at a good singing voice, along with her "slightly famous" sister, sultry brunette mezzo-soprano opera singer, composer, arranger and record producer Juliette Pochin.
She is quite possibly the key influence on the stylish surgeon's dress sense.
"She's very glamorous, to the point my daughter will say, ‘Oh, Mummy, that's a bit of a Juliette-type top - a bit too glamorous for you'."
Mrs Pochin did music at school and is continuing piano lessons, prompted by her daughters, who also play. She's also part of a "mad medics" trio of guitar, piano and vocals, but they do strictly backroom performances. Melancholy "slow stuff" helps her calm down.
Mrs Pochin's community interests have extended to her having a say at a public hearing on the Nelson City Council dog control bylaw and modelling clothes as part of a charity fundraiser, which placed her "completely out of her comfort zone".
"I arrived at the dressing room and there were all these 20-year-olds in their underwear, and I started thinking, ‘Can I have a private changing room, please?'
"It was good to do, because it was different and it raised $27,000 for the hospice."
Her last word of advice to anyone stricken with fear over what may or may not be: try not to google your symptoms.
People like Mrs Pochin have spent 20 years learning how to do their job, and no two cancers and no two people are ever going to be the same.
CANCER FACT FILE
Cancer might be becoming more common, but people are also surviving it much better. "We're much better at diagnosing it earlier, which is probably why it's more common," says Nelson surgeon Ros Pochin.
"We never used to see a lot of pre-cancerous stuff, but we do now because the technology is much better." The specialist breast and endocrine surgeon and consultant says other reasons are not so clear, but research is continuing all the time.
"With something like breast cancer, the thinking is that women are having children much later in their lives, when pregnancy and lactation is for the development of the breast, and if you don't let it finish development, then maybe that causes an issue with it. "It makes sense, but no-one really knows."
We're also living a lot longer. "We were programmed to live to about 40, but we're living twice that long, so something has got to give. "Our expectations keep growing too, in that we should be living better, longer, higher and wider, and sometimes that's not obtainable."
The increase in cancer cases isn't restricted to the older population – it's young people as well, the 42-year-old says. "I see a lot of younger women, and I'm seeing more women my age coming in. "The ones who really upset me are women in their 30s and the occasional one in their 20s. It shouldn't be happening to them. You can't help but compare yourself with women with young kids. It's truly awful. "It helps me to prioritise my life too."