Dr Ken Gudmundsen has been the region's dermatologist since he settled here in 2000. We heard from Ken recently when he spoke up about the need for medical practitioners to be seen as essential services and to be adequately supported after a disaster, along with many others at the emergency summit. You can read more about that here Medical professionals gather for Emergency Health Summit, and find out more about the man behind the Dr, below.

Image: Dr Ken Gudmundsen in his new (for now) Dermatology Rooms at St Vincents

"I was born in North Sydney, in Crows Nest. I went to Marist Brothers High, and had a brother, unfortunately, he and my parents have passed away now. My brother and I were in a rock band called Wench growing up, it was hard not to be able to connect during Covid, the isolation had a big impact on him, he died last year."

"I also have a 22-year-old son who lives up here with me".

"I came up to Lismore when his mother was pregnant, we came together and he was born in Lismore Base Hospital, which was where I did my internship and residency years before".

"After I graduated from UNSW, I came up to do my training and really enjoyed the area, I lived in Armstrong House across from the hospital".

"There were no additional opportunities for training so I left, and actually went over to Ireland then England, to become a Dermatologist over 4 years. Unfortunately, the UK year didn't count, so when I got back, I did another term at St Vincents Hospital in Sydney, and then did some locums as a practising dermatologist".

Image: Ken and his Brother Alan, with Mum and Dad

"I had been travelling to Lismore once a month for a while and decided to take the opportunity to move up here and when Dr Walter retired, I took on his patients and practice team, and we grew."

"Two of the doctors who worked with me have now gone on to start their own practices in the region, one in Coffs Harbour, and another in Byron Bay. Until then, I had solely covered a vast region, from Coffs Harbour to Inverell to Tweed Heads, so it's good to see this process working. However, a lot of medical practitioners in the area, just can't afford to take on Locum staff. This creates a break in the chain of Rural Doctor and Specialist Recruitment, something I see particularly in the important area of General Practice."

"I always thought I might probably leave the city because I just got sick of that traffic and the travelling and I enjoyed my time up here"

Image: Ken and Brother Alan exploring their world in the early years

"I did enjoy travelling the world for a while, and did a fair bit even recently, taking time off each year to go somewhere completely new for a month. It's something I really miss since Covid happened. I was with this lady for a while and we used to go on our annual trips, we went to Norway and we've been to Spain and every year so that you try and get a bit of real-life balance".

"I was lucky enough to have a locum doctor from New Zealand come over".

"He lived in my house and he would allow us to go away for 4 weeks, just leave the computers and go.."

"After I completed my training, I did some locums for 3-4 years in Sydney and a little bit in Maitland, it was a kind of a wandering around time, where you could transition from being like a student doctor dermatologist to a real doctor dermatologist, under the under the umbrella of someone else who takes you in and you don't have to worry about setting up a practice".

"The biggest thing that has changed in the field is immune therapies like the biologic medications. You have to start with that because of psoriasis, bad eczema. That's been very hard to treat for many years and while we've had drugs which will take the edge of it and help a little bit, it's always a battle".

Image: Brothers with a Cheeky bond- Ken and Alan

"Now we can effectively treat these things, and that's wonderful".

"My life as the dermatologist is a lot easier now, because of these medications. Something which works like 90%-100%. Whereas when I first started, we couldn't do that. And I also say that if these medications were found to have some terrible side effects, and they took them away, I'd probably quit."

"Because, as I said, I have so much trouble dealing with all these people who have been used to a good treatment and ended up needing, you know, just regressing and not doing very well".

"We had light treatment as well. That's not advanced but it's a special treatment that we had to beat skin conditions, where patients would come in and get controlled light shone on them. Psoriasis, eczema, vitiligo, each in lots of different things and that's like a non-drug treatment, which is really good. Unfortunately, the machine was destroyed in the floods".

When we came up and I started to practice, I set-up in what was the AMP building in town, on the corner of Magellan Street and Molesworth street, which was made above the flood height. We ended up having to leave there and then I bought the place that I'm at now, Molesworth House.

We had 9 rooms in the end, and a number of staff, who luckily I've been able to retain, despite having to work from St Vincents, which I am very grateful to be able to do, though I really feel it's so important for the medical practitioners of Lismore to have a plan and support in situations like these, so that they can continue to see patients. I had to find this solution alone, and really haven't felt supported in the way I feel is necessary for a community to truly recover.

Image: Ken rocking out in his band "Wench" with brother Alan

"I do a bit of photography, and play the guitar, I like to take my car out to Casino to drag race it. I don't engage as much as I'd like, it just seems to take a lot of time to be a medical practitioner."

"Prior to the floods, the practice was busy, with 9 rooms in total, including a couple of biopsy rooms, a light treatment room, kitchen and consulting spaces, we were open 5 days a week and often 6 rooms would be in use on these days."

"So the main thing about practices like us going under and not having adequate government support or insurance coverage, is that you aren't just losing the doctor, you know, when the doctors gone, you actually lose a team. So you lose the secretaries and the nurses and all the other people who help make it a whole team. So if the practice closes, it's a huge thing that you're losing, you're not just losing a couple of doctors, you're actually losing an institution".

"We went through the 2017 flood, it came in just enough to be a nuisance. It came in 30 centimetres but still put us out of business for three months. Luckily, we had insurance for that one, so they paid us out and we're able to not have to go to the government and ask for help. And not have to whinge and carry on".

Image: Ken and Alan in their teen glory

We kind of took the money rebuilt and just started back up and running.

"You can't look into the future. You just deal with it day by day. But looking back, you can say what happened. We just started cleaning and throwing things out and thinking oh, well, we might get back here in a little while. But eventually, with time, I've kind of realised how bad it was and that we actually wouldn't get back in. It's still not fixed now, you know, over six months later."

"So, of course, as I said before, it's all our money, savings and loans that got us to where we are. So you weren't insured because you had a payout in 2017 and once paid out then they're not going to insure me anymore."

"It's terrible, lots of people, you know, this time had no insurance and there was so much more damage, so much. Yeah. So after three months, some of the group practices were able to get a few people working back together, they've got probably a bigger sort of organization. They came straight to St. Vincent's. They gave them rooms. But I'm smaller. And as a single practice, it's probably harder, but it was also not just physically/practically, but mentally.

We lost all our computers, you have to recreate everything. You can't just sit down and start seeing people. Rooms, printers, faxes.

Image: Dr Ken in his medical garb

Every day, I'd go for a long walk, which was helpful, good mental health.

But I spent a lot of time on, the internet, buying computers and printers and equipment.

So we had to buy everything. We took the backup drive for the practice on the night, that was lucky. And I took my own computer, which I have in the practice. Thank goodness. Yeah, so I was still able to deal with a few issues with patients. And we had most of our data, though we did lose some initially as one part of the server, which we lost because I thought it was being backed up and a bit of a misunderstanding with my IT person. So we had to send it up the coast to get it retrieved, at great cost.

Luckily, though, all our computers were Macs, as they have a dust seal around their hard drives, which turned out to be sealed against water too, so I was able to get specialists to retrieve the patient files and information, but as I say, this again was at great cost.

We started out like seeing one patient an hour and then build it up to two an hour, now we're kind of about three now.

The next challenge is deciding if we should stay in the danger zone, or go.

A lot of patients have said that it's not just whether we are safe or at risk, it's important for mental health to know you are safely out of the flood zone. It's another reason why I have put a sign on the front desk, asking people to please not talk about the floods unless necessary, as I'm trying to protect my staff and myself, from the effects of vicarious trauma exposure. It takes a lot to be able to be in the right space to treat someone, so this is important.

I truly feel private and the public should be part of the essential services so there is someone who says, right, you need this help, you need this money in support. We're coming and they're in there. Absolutely. It's just been atrocious that this hasn't been already regarded and actioned. Business people don't want to be begging all the time.

Coming back to where we are now though, we're lucky to be where we are, we've got a view of Girards Hill which is quite beautiful, it almost looks like the hills of Italy.