One of the pioneers of palliative care in the Hunter, haematologist Dr Pamela Harrison OAM has also written a number of authoritative and illuminating history publications.

Pam Harrison remembers a time in the mid-1970s when, driving from one demanding job at Newcastle Blood Bank to another at the Mater Hospital at Waratah, she found herself contemplating an upcoming break from work. “I didn’t want to go on holiday,” she laughed. “I loved my work so much!” Talking to Pam about her career it becomes clear just how much she truly loved her work. She found a myriad ways to contribute and the public health system was an ideal environment for a dedicated person interested in limitless challenges.

Born in 1937 at Newcastle’s Fettercairn private hospital, Pam was an unexpected twin, arriving half an hour after her sister Pat (Patricia) to join a family that ultimately was to number five children, with birth-dates spanning the years from 1928 to 1944. The twins skipped the worst of the Great Depression but arrived in time for World War 2. Although she was only five at the time, Pam clearly recalls the night in 1942 when a Japanese submarine shelled Newcastle. “We were living in Hebburn Street, Hamilton, and my parents had bought a big heavy table to act as a shelter in case of an air raid,” she said. “Our mother got us out of bed and we huddled under the table. I heard the gunfire but Mother told me it was fireworks. My father was working night-shift as an electrician at Zaara Street power station, so our mother was very worried about him”. Shortly afterwards her father built an underground shelter in the backyard.

Pam’s uncle, Stanley Newton, was hit in the head by shrapnel in Parnell Place. He was probably the raid’s only casualty. “He was in the artillery and was rushing to the fort in a taxi. The cab driver wouldn’t take him all the way, so he was running across Parnell Place when the shell exploded. He kept going, but he had nerve damage as a result of the injury. It was never mentioned in the press,” Pam said.

In August 1945 Pam was getting ready for school when an announcement came over the wireless that the war was over. She felt sorry for the boy next-door who was an ink monitor and had to go to school early on what was obviously going to be a day off. Pat and Pam went out to the backyard and blew whistles and made as much noise as they could – as were all the neighbours. Ships were sounding their sirens and train engines whistling.

Then their older brother took them into town, where the crush of the crowds was immense. “At Scott’s Corner there were people on the awnings throwing buckets of water on the people below,” she said. The general singing and dancing paused while a radio broadcast confirmed the momentous news. “We went to the beach, which was fenced off with barbed wire, looked across the ocean from the pavilion and thought of our Uncle Ken who had been killed at the fall of Singapore.”

When it came to school and study, Pam conceded that Pat was slightly ahead of her. “Pat was the classic Victorian-style schoolgirl and I was the tomboy,” she laughed. At the end of high school Pat got a scholarship to study occupational therapy in Sydney. “I had to wait for my scholarship as other applicants turned down their offers and it moved down the line to me.”

Pam’s parents believed in the principle that girls ought to have the chance at education and careers. Not sure what she wanted to do, Pam recalled the encouragement she had received from her biology teacher who, admiring an essay Pam wrote, advised her to consider a career in research. “There was no university in Newcastle then, and my family couldn’t afford to support two children studying in Sydney, so I had to decline the scholarship.” One possibility was pathology, but only science graduates were being accepted at Royal Newcastle Hospital. So Pam took a job with the Kodak photographic processing firm in Newcastle, then located near “the Sandy Paddock” – the site of the present-day state office block in Cooks Hill. That was in 1954, at the time of the Royal Visit, and the Kodak outlet bosses gave staff prints of some of the better snapshots taken by customers. Pam still has some of these in her photo album.

The Kodak job only lasted a few weeks because Pam’s application for a pathology traineeship at the Mater Misericordiae Hospital at Waratah was successful. She was the sixth person employed in pathology at the Mater since 1937 – when it was sited above the morgue – and she recalls the newly opened laboratory in the North Wing as being very big. The Mater was a Catholic hospital, run in those days by the Sisters of Mercy religious order. In those years antagonism between Catholics and Protestants was intense and could at times be ferocious, but Pam’s Presbyterian religious status never caused any problems. “They never asked,” she said. The medical technologists’ award was one of the few that paid males and females equal wages, which was much appreciated. Pam was paid four pounds and ten shillings a week and she paid ten shillings board to her parents. “The sisters were strict but very good. They worked as hard as anybody. And at Christmas they gave every staff member a gift and that continued until the sisters were no longer in charge,” Pam recalled. There was an element of sexism in the gift-giving, however, with males receiving pens and females usually getting some item of crockery or china. “I’d have much preferred a pen,” Pam said.

For a trainee the job in the first year was mostly washing up and sterilizing laboratory equipment. In those days there were no single-use plastic items. Most of the items were glass, and were washed, sterilised if needed, and reused. Needles were also reused after being sharpened on a sharpening stone. All the blood tests were done by hand, there was no automation, and most of the chemical solutions were made up by the staff.

At night Pam was studying for a laboratory assistant certificate. This was a three-year course and very heavily targeted at the BHP steelworks’ male lab workers, with physics, chemistry, geology and other non-biological subjects. Catching the bus from the technical college at Tighes Hill to her home in Hebburn Street, Pam had to walk alone after 9 or 10pm past the warehouses in National Park Street, with nothing but a ruler for defence. And although the ruler was never needed, she decided to buy a Lambretta motor scooter – one of the first ridden by a woman to be seen in Newcastle. This course was followed by a two-year medical technician technology course – all at night, again. The subjects covered the pathology tests being performed in the laboratory for haematology, biochemistry, bacteriology and histopathology.

After Pam qualified there were no posts available at the Mater so she took a position as principal chief medical technologist at Taree’s Manning River District Hospital. “There was me, an assistant and a part-time secretary, in a lovely new lab. I lived in the nurses’ home,” she said. The work was taking blood samples from patients and doing pathology tests as required by doctors. At that time if a person required a blood transfusion the ambulance would collect a donor and bring him (they were usually males) to the laboratory where Pam would take a blood sample and check his blood group and compatibility, and the GP would collect the pint of blood from the donor. At Taree she enjoyed the contact with patients and with nurses.

By this time vaccines had already been introduced and although only five antibiotics were available, they changed the nature of medical treatment. Pam remembers the time before these advances. “The boy next-door caught polio. The girl on the other side died from measles. The boy down the road had TB in his hip. We used to see a lot of TB.”

Pam and Pat went on a long “working holiday” between 1960 and 1962, visiting “home”, as her parents called England. Pam worked for a time at Guy’s Hospital, then the sisters bought an old car (Pam did a motor maintenance course in London) and toured Europe with a friend, driving around France, Germany, Greece, Italy and Yugoslavia. The sisters toured Scandinavia, sleeping in a tent and driving on roads with walls of ice on either side.

On her way back to Australia by ship, Pam read a book about the emerging medical speciality of haematology, which focuses on blood-related diseases. Much of what she read was familiar to her and she decided to try to become a haematologist. This, of course, meant more study, so she applied for a mature-age scholarship – just at a time when university eligibility requirements were beginning to tighten. She was awarded the scholarship to study medicine at Sydney University, a six year course at that time. It paid seven pounds a week, plus university fees, and she shared accommodation with Pat, who was working as an occupational therapist at Prince of Wales Hospital.

Needless to say Pam qualified and after working as a Resident Medical Officer at Sydney Hospital for two years, studied for her Fellowship in Haematology with the Royal College of Pathologists of Australasia at Royal Prince Alfred Hospital. In 1975 she moved back to Newcastle to take a job as Director of the city’s blood bank, then based at Royal Newcastle Hospital. When she arrived the blood bank had just started to produce cryoprecipitate for the treatment of haemophiliacs. RPA had pioneered the concept of a centre for haemophilia treatment. Pam transplanted some of the practices and procedures from RPA to the blood bank, training the nurses to provide treatment under her direction. Pam headed up a haematology clinic at the hospital, also treating patients at the blood bank. Word spread quickly and soon haemophilia patients were being referred from all over the Hunter Region. As a result of this centralisation of treatment, haemophiliacs and their parents formed the Newcastle branch of the Haemophilia Society and raised funds for more equipment to meet the demand.

Meanwhile Pam was working two or three afternoons a week at the Mater Hospital, and in 1979 she had to choose between a job in private practice and a haematology staff specialist role at the Mater. She took the Mater job and as the haemophiliacs followed her there, a Religious Sister of Mercy and trained nurse, Sr Kay Sheridan, was appointed to help her haemophilia treatment service.

At this time the Mater hospital, with community support, was campaigning for oncology and radiotherapy services to be funded for the Hunter region, and sited at the Mater. The Mater formed the Oncology Working Group at the hospital to work towards this goal. Pam was a member of this group but her role was also to join the Hunter Valley Cancer Appeal Committee and the Hospice for the Hunter Feasibility Committee (later the Hunter Palliative Care Association), at Newcastle University, and liaise between the three. As a result Pam attended a weekend seminar on Palliative Care held at Leura in August 1983. At that time there was little awareness of palliative care in the Hunter region and its concepts of pain control were not part of medical training. On her return “I decided that the next time I had a patient who wanted to die at home I would make it happen,” she said. A few days later one of her patients asked for this, so she approached Sister Mary Tarcissius, the Sister Administrator, with her plan. By a great stroke of good fortune a Religious Sister of Mercy and Registered Nurse had just returned from missions in the Northern Territory and PNG, and she agreed to help with Pam’s palliative care service. This was Sister Mary Brendan O’Connor, a remarkable and deeply compassionate person who took to palliative care with extraordinary dedication. “Patients loved her,” Pam said. “She met their needs and she always gave them options.” So with no funding, but with determination to succeed, the palliative care service was created 10 days after Pam attended the seminar.

Pam had to liaise with the GPs and gain their acceptance for her involvement in home care of their patients, as usually they were sent to hospital to die. She introduced oral morphine for pain-control for her palliative care patients, and, as this was not generally available at that time, the hospital pharmacy made it up for the patients. This was highly successful and the idea soon spread. Pam was in demand for talks and seminars to share her rapidly expanding knowledge. She also gave lectures to medical students at the University of Newcastle on
Palliative Care.

The work of this palliative care service was extremely demanding. “I had thought that district nurses would be available to help, but it turned out they were only available for long-term chronic care,” she said. So Pam saw the patients in hospital and Brendan looked after them outside hospital, with Pam available for advice and home visits as needed. “Brendan did the lot,” Pam said. “We both worked pretty hard, with referrals from oncologists and GPs.” All of this work was entirely voluntary and, as there was no funding, they relied initially on improvisation, but as time went by, donations came from the Hunter Valley Cancer Appeal, service groups and others, for equipment, including a car. The first full-time funded nurse was made available only after nearly three years of practice. “I had no social life,” Pam conceded. “I was on call 24/7 most of my working life.” Staff specialists don’t get paid overtime, so the hospital did not incur any extra costs for this.

When funding arrived for the palliative care unit at the end of 1986, Pam’s contribution was no longer needed and barely acknowledged. Not only had she been doing a huge amount of work in palliative care; she was also running the lab and continuing with her clinical haematology. Largely frozen out of the palliative care unit she and Sister Brendan had built from scratch, Pam devoted herself to haematology. When the Mater’s palliative care hospice was officially opened in 1993, Pam was invited to attend. Her massive contribution was acknowledged – by the Sisters of Mercy. They, at least, did not forget.

When retiring from haematology in 1995, the Director of Palliative Care, Professor Peter Ravenscroft, invited Pam to work as a locum in Palliative Care, which she did, until finally retiring in 1996. Professor Ravenscroft also nominated her as a Foundation Fellow of the Australasian Chapter of Palliative Medicine when it was formed in 2000, in recognition of her voluntary contribution to palliative care.

In retirement Pam has set up and maintained a small museum of pathology and medical equipment at the Mater. Her most treasured personal memento of her long and distinguished medical career is a bronze medallion, presented to her by the Newcastle Branch of the Haemophilia Society of NSW in recognition of her hard work, care and devotion over many years.

After she retired Pam also threw herself into family history research with her customary dedication. She learnt black and white photography so she could copy documents and photos in-situ, and built a darkroom in her backyard. Tracking down relatives from the many branches of her family tree, she soon produced five family histories, all bearing the stamp of her self-acknowledged obsession with detail and accuracy. As well as the family histories, Pam has written six books and two booklets of historical research, including her biography of Captain Henry Newton and her history of the Newcastle Lifeboat Service – both of which represent, among other things, an invaluable body of information about shipping and shipwrecks. In recent times she has focused her research on Maitland’s historic gaol, producing one ground-breaking book about the prison’s 19th century female staff and another book on its first 20 years (1849-1869).

Pam has – not surprisingly – been awarded an Order of Australia Medal for her contribution to palliative care and to history. Her full list of qualifications looks like this: Pamela B. Harrison, OAM, MB BS (Syd), Dip MT, FRCPA, FAChPM

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August 15, 1945: the war is over!

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