Thomas Swinburn: student doctor's winning human touch

Honours student Thomas Swinburn taps the air in time with his carefully considered words.
At 25, he displays great wisdom, giving the impression he would be a safe pair of hands. He has already proven he can be trusted as a leader and has all the qualities needed to be a reassuring doctor.

Thomas is president of the New Zealand Medical Students’ Association, following a year as president of the Auckland University Medical Students’ Association.

When he has a bigger idea to communicate, both hands bloom into a circle shape. And he has some grand ideas.

Channelling these into creative writing won Thomas the Ascona Prize, an international award for essays by students on the patient-doctor relationship. This included a trip to Brussels in late 2022 and publication in a book that has just been presented to the University’s Philson Library.

Thomas’s winning essay, ‘An Unexpected Journey’, opens with his meeting an (anonymised) Māori cancer patient he calls Ereuti on day one of his first fourth-year hospital placement.

“The medical team bowled into 14B as the sunlight streamed into that whitewashed room. Ereuti was a gaunt, pale man with sunken eyes, in a hospital gown, sprouting various lines leading to various whirring devices. He asked whether he could go home. The oncologist was sympathetic but didn’t mince his words. He could, but without the constant intravenous infusion, he would be making the choice to go home to die. Ereuti looked at his hands and said nothing.”

As he goes about the wards, Thomas keeps thinking about Ereuti, left alone to contemplate matters of life and death, after the patient’s fleeting encounter with a medical team.

“Later that day, I was asked to take a medical history from Ereuti. Intuition spurred me to ask what mattered most to him now. He replied, ‘What matters is regaining health, eating without this tube in my throat and moving my bowels naturally. Relationships. Relationships where I can be myself. Relationships like the one we’re building’.”

Thomas realises he is learning valuable life lessons from this patient.

“Over the next few days, I asked myself the same question I had asked Ereuti. He wished simply for a healthy body and meaningful relationships. Meanwhile, the value I placed on academic and career pursuits, often at the expense of spending time with family and friends, seemed short-sighted. As confronting and refreshing as it was, I couldn’t help but question my values, and what matters most.”

It was an important early insight into the way that doctors learn from their patients.
Medicine has always been both an art and a science, Thomas says.

“We get robust scientific training but, in a way, that essay was about my discovering the art of medicine, the art of human connection, and that those things are just as healing as the science.”
Fittingly, Thomas is enthusiastic about his favourite pastimes of travel, photography and tramping, often all in one trip, and badminton.

Among his various roles, Thomas is co-chair of the Koi Tū Rangatahi Advisory group. He is also a Kupe Leadership scholar, which entails workshops and mentoring.

For most mortals, a medical degree is more than enough to cope with. So how does he do it?
“I’ve found that, often, just putting in that little bit of extra effort, really goes a long way,” he says. “But as I talked about in the essay, I am constantly re-evaluating that balance between personal and professional commitments – spending time with friends and family, and switching off as well.”

Thomas is also researching Rainbow-friendly healthcare and how best to achieve it.

His Kupe mentor is Professor Sir Ashley Bloomfield, whom he says is an exception to the rule you should never meet your heroes.

Sir Ashley, in turn, has enjoyed meeting Thomas and mentoring him. “I’m always impressed by his thoughtfulness and insight. He brings curiosity to our discussions, and we’ve had great conversations about the centrality of values and behaviours to good leadership.”

When Sir Ashley brought up the topic of values-based leadership, Thomas realised he had to dig deep to arrive at his research topic.

“One of the values Ashley spoke about was courage. It wasn’t necessarily one that I would have placed at the top of my list when thinking about my own values. But when I think back over these five years, I’m proud of myself for having the courage to step into that space, which is still quite stigmatised. It has been an important step in finding my own voice; towards being a leader and an advocate in a way that feels authentic.”

Advocacy is critical to advancing equity within healthcare, he says, and likely to be a part of his future career, something he is still figuring out.

“Every interaction is an opportunity for the clinician to reflect on what parts of that patient’s journey have brought them to this moment, whether it be the social determinants of health, or whether their pathway to and through care may have been suboptimal.

“For me, writing has been a way to express that. As doctors, we’re trained to be clinicians and to act at the individual level, but we can be compelling advocates if we take these stories and observations and use them as a force for good, and a force for change.”

Thomas’s empathy and interest in writing may well be linked to his younger years as the only child of estranged parents.

“Combined with boarding school, I think it taught me to be independent from a young age but also to grow comfortable putting myself out there and meeting people of all ages and backgrounds.”

He says attending Dilworth School, where he became dux, was a positive experience. His 2016 School Leaver award was “for the most optimistic, positive, outgoing, supportive, loyal, hard-working school leaver”.

Thomas has a Pākehā father, who was originally from Taranaki before moving to West Auckland. His Malay-Chinese mother was born in Singapore, but moved to Aotearoa New Zealand when she was eight. Boyd Swinburn, Professor of Population Nutrition and Global Health, is Thomas’s father’s cousin.

Population health calls to Thomas, although he has clinical interests, too. He’s still figuring it out, but, wherever he ends up, he is sure to be making a difference in people’s lives. Perhaps his essay says it best: “When I set out on the very first day of our very first clinical year, I thought medicine was about diagnosing and treating disease … But Ereuti showed me that sometimes it is the humanity we all possess that is the most powerful medicine.”

By Jodi Yeats

Read the full essay: auckland.ac.nz/thomas-swinburn-essay