This biography is based on an interview with Marion Carey-Smith in 2019 for the Early Medical Women of New Zealand Project. The interviewer was Lucy Goodman.
Contents
Early life: a natural curiosity & dreams of missionary work
Marion Dewar was born in New Plymouth in 1940 around the beginning of World War II. As the eldest of five children, Marion often helped her mother around the house and would sew clothes for the younger children, particularly her two sisters who were ten years her junior. Her father was an electrician who was also a skilled engineer, and his scientific mind helped prepare Marion for her future career.
“My father was always interested and curious about many things, and we grew up being curious. And that’s a good start, I think.”
Marion went to the Central Primary School in New Plymouth, and then later to New Plymouth Girls’ High School. Entering secondary school, Marion was convinced that she would go into nursing. Against the advice of her headmistress, she chose to enter the ‘standard’ rather than ‘advanced’ streams of study that included science and maths, only to change her mind at the age of about 15 when comments from a family friend drew her attention to medicine. Fifth form was the most difficult year for Marion, who had to catch up on the science education she had missed from her earlier years, including physics, which was taught by a male teacher from the neighbouring New Plymouth Boys’ high school. However, she soon rose to the challenge, graduating with high marks in 1958.
“I began to think, do I really want to do nursing? And by that time, I realised—because I’d been first in my class—that I could do it, academically, if I wanted to. I had to go on bended knees to Miss Allum and confess that I now wanted to do medicine. So, in the fifth year, I had to change over and start algebra and all the things that the others had been doing for two years.”
“Also, one of my ideas of doing nursing was that I had wondered about going overseas to work as a missionary in a third world country, or what were called ‘developing countries’ in those days. And so, medicine was the next … step, which would be very useful in that situation too if I did do that. So that was probably part of my thinking as well.”
Medical school: fraternising with friends & learning medicine without the pressures of responsibility
Marion completed her medical intermediate year at the University of Otago, after travelling via overnight boat across to Port Lyttleton and then down by train to Dunedin. As her family were not particularly well-off, she did not go home to visit very often during her studies and would instead visit her aunt or family friends around Dunedin for the holidays. Marion lived in St Margaret’s College where she made good friends, including two women she met during this very first year of university who she remains friendly with to this day.
Medical intermediate was a competitive year and Marion was awarded for her hard work, gaining entrance into medical school on her first attempt. She supported herself financially throughout university largely through her academic success, with funding from the Dr George Home Memorial Prize she had been awarded in her final year of secondary school, the Mckenzie Trust Fund, and philanthropic funds from her secondary school via her headmistress, who had taken a special interest in Marion and her career.
“I was looking in some of my diaries and I realised I spent a lot of time just fraternising with the girls in the college… So, I thought I worked really, really hard, but I think we must also have had some time off as well when we just had coffee or all went out and went to the cinema, or you know. And I was quite involved in one of the university clubs- the Christian Union Club. So, I had a lot of friends from places like Knox College, where they had the Divinity school…..”
About three weeks into their course, the women students from the year above invited the new women students to a lunch, welcoming them to medical school and introducing them to the lecturers. Marion soon learned that university life held some interesting social norms for women, who drew interest from the predominately male student population. However, she was not particularly bothered by these customs, recognising that her medical predecessors had faced larger challenges.
“We would always come in and sit in the front seat. Now I think we probably sat in the front seat not because we had to, but because it was better to sit down. My very first lecture I went into I discovered that the boys all sat up the back, and when the girls came in—… usually came in together or in dribs and drabs— they would boo and whistle and stamp. I don’t know if they booed, but they definitely stamped. It was not a “What are you doing here, get out?” type whistle. It was a “What are you doing here?”— You know, “It’s interesting to see you”. After the first few weeks
or so they wouldn’t have done it all the time. But if you came in late or if you did something that showed you up then they would stamp.”
“We had a separate common room, and we were not allowed in the men’s common room and they were not allowed in ours. That would have arisen from the beginning, wouldn’t it? When the first women doctors came into medical school, they would have needed a place where they could escape, yes. Because they did have a very difficult time, some of those women. But for us, we didn’t really think too much of it. I don’t think we were particularly worried.”
The medical students completed over eighteen months of basic science, including anatomy, biochemistry, and physiology, before their First Professional exams, followed by over a year of further studies before Second Professional. Marion enjoyed anatomy, where she recalls working on a cadaver amongst a group of six women.
“One man—a surgeon, he was—used to gravitate towards our six-girl group around our cadaver. Just to egg us on, I think. He was a really nice sort of chap. And I remember he gave us some really good advice at the end—about the way to look at medicine and the way to look at dealing with people.”
In their fourth and fifth years of study, the students were sent into Dunedin Hospital, where their curriculum expanded to include medicine, surgery, obstetrics and gynaecology, and pathology. The students were also sent to Wakari Hospital for some experience in psychiatry. These early clinical years were an enjoyable time for Marion, when the students were free to learn without the pressures of clinical responsibility.
“You weren’t being tested on it, you were just learning how to do it. And we practiced on ourselves. We had to learn how to take blood and we had to learn how to give an injection and that sort of thing. So you did all of that kind of in a practice way before you actually did it on a patient. I guess it must have been nerve-racking taking the very first blood, hoping that you were going to get into the vein and not make a mess.”
Working with patients during these early years had its own challenges. Marion did not feel that being a woman in medical school had any academic disadvantages, and although some patients balked at treatment from a female medical student, others were supportive of her efforts, particularly as her confidence grew.
“In the clinical times, sometimes you, as a woman, had it easy, I think. Sometimes, you know they were nicer to you.. But when you were actually in the orals or doing your exams and that, it was all the same. We did exactly the same as the men.”
“I remember going to a patient to take some blood off them, and the patient looked at me and she said, or he said— I can’t remember now. “You’re only a girl, you can’t do this”. I said, “No,” I said, “I’m nearly a doctor.” “You can’t be!”.”
“I was doing this case history, and when I finished the patient said, “Oh, Miss Dewar, that’s very very good”.
Marion went to Wellington for her sixth year of clinical studies, where she lived with the other students in the hospital. Marion had a natural inclination towards surgery, and at the end of the year she was awarded the prize for medicine and surgery. Around this time, she began to consider her options for the future. Obstetrics piqued her interest due to the surgical component, as well as for more pragmatic reasons.
“It was quite a busy year. We not only had to do house surgeon work (without responsibility), but we did have to learn how to take case histories and do things, and then also had to study for our finals. Because our finals were at the end of sixth year.”
“I really wasn’t interested in general practice. I think I had been thinking about maybe anaesthetics, or obstetrics and gynaecology. So I was looking ahead like that, and thinking anaesthetics might be a good job though I didn’t like it because there’s very little contact with the patient. You know, I like people. And I quite liked surgery, you know, doing things with my hands. So obstetrics and gynaecology, have both. There are good close relationships with women going through their pregnancies and having their babies. And then there’s also the surgery, but it’s a limited surgery in that it’s a surgery concerning women’s problems.”
Specialist training in obstetrics and gynaecology: living and training in the United Kingdom
After graduating from medical school in 1964, Marion returned to Wellington Hospital as a house surgeon. Over two years, she and the other students in Wellington rotated between different specialties, which included emergency medicine, anaesthetics, paediatrics, obstetrics and gynaecology, orthopaedics, surgery, and ophthalmology. With her sights firmly set on a specialist career in O&G, Marion was now able to plan her future.
“There weren’t that many women O&G specialists at that time, there were just a few of us.”
After completing the required six months of surgery training in Wellington, Marion moved to Auckland for the two and a half years of O&G training at National Women’s Hospital. She lived and worked at the hospital where she was on call a lot of the time, although she did enjoy some time outside of work.
“In Wellington, I used to go sailing with one of the guys quite often. I didn’t go sailing in Auckland, but yes we had time off. I remember going off to the hot pools and I went to church, I had a church connection as well there.”
Marion met her future husband Keith while working as an O&G registrar at National Women’s Hospital. A few years of medical training behind her, he worked as her house surgeon while studying for his Diploma in Obstetrics and preparing for a career in general practice. The couple married in a Baptist church in New Plymouth that Marion used to attend in her childhood.
“My family were a Christian family. My belief and my faith in God have always been there.”
Almost immediately after their wedding, the couple moved to England for postgraduate training. While Keith completed an anaesthetic diploma at St Thomas’ Hospital, Marion sat her O&G specialty exams. To qualify for registration as a New Zealand specialist, she then needed three years’ experience working under senior O&G consultants. For her first hospital appointment in the UK, Marion was fortunate to gain work at the Elizabeth Garrett Anderson’s Hospital for women, under the guidance of Dame Josephine Barnes, where she found the working environment different to what she had experienced in New Zealand.
“She (Miss Barnes) became the president of the Royal College of O&G, so she was a good person to work with, it was really lovely.”
“It’s a different sort of situation there. When you were training in England, you would maybe work with one specialist only, in your training. So you were rather narrow in the way you do things. So we were fortunate, I think, in our training.”
Working in Nepal’s mission hospital: a dream fulfilled
“So that was a real highlight in my life I think, too. Being able to go over and help out in those sorts of situations, in the government hospital or mission hospitals.”
Marion gave birth to her first child in the United Kingdom. With young son in tow, the couple then took the opportunity to travel to Nepal, fulfilling both their dreams of working in a developing country. While Keith worked in anaesthetics, Marion ran general medicine clinics at the mission hospital, which included some obstetrics and gynaecology under the guidance of an English-trained O&G specialist, allowing her to count some of this work towards her specialty training. Marion found she was able to balance work and family commitments with help from the friendly locals.
“We took him (our baby son) overland for three months, we were in a bus going overland, through all of the places that you can’t even go into now, like Iran and Pakistan, India. In Nepal, I had a wee Nepali lady that would come in and look after him when I was at the clinic. But we lived right in the hospital, so when I had to go and do something a lot of the time my husband was there, usually.”
Marion and Keith returned to Nepal about four or five times over the course of their careers. Usually, they would visit to provide additional support when services were lacking, or to allow doctors time off. On a few occasions, they visited remote hospitals where they would need to take all their equipment with them.
“The first one I just went with another Nepali gynaecologist, and we went for a week and saw six hundred women. There was also a couple of GPs, another doctor as well. And we did sixty operations. And nobody complains. I mean they want to come, they want the treatments. And then the other time we went we had a couple of other gynaecologists—one from Europe and one from England. And they advertised it, and the women came from two or three days walk away. And just came to be helped.”
“You couldn’t do it without the people who know the language and are there more long term and know the language and can talk to the patients.”
Stratford: another intergenerational family of doctors
After their first year in Nepal, Marion and Keith returned to New Zealand. Pregnant again, Marion was tempted not to complete the six months training still outstanding on her specialty training. However, her mother-in-law was particularly supportive, giving up her own work and moving to Auckland to look after Marion’s son. This enabled Marion to work for 6 months as a senior registrar at National Women’s Hospital under Professor Bonham—just long enough to gain her specialty registration before giving birth to her second child.
With a general shortage of O&G specialists in New Zealand during the 1970s, Marion was in the position to choose where to live and work. She turned down full-time work opportunities in Tauranga and Tokoroa, instead choosing to return to Stratford—Keith’s hometown—to work part-time at the hospital while raising her children. Here Marion worked in gynaecology alongside the famed Dr Doris Gordon’s son, Ross Gordon, covering his half-days and holidays. Careful to maintain competency by attending doctors’ meetings, this arrangement allowed Marion to retain her profession during her children’s early years, when the couple decided to have a third child.
Over time, Marion’s workload increased, and by the time her youngest child started school, Marion had taken over from Ross Gordon, working several clinics a week and covering most of the on-call work. Marion’s colleagues were supportive of her work and family arrangements, and she only recalls one particular incident of gender discrimination.
“There was only one colleague who had a ‘thing’ about women doctors. And although he was always very pleasant to my face, he used to say things. I knew he said things behind my back to patients, you know. I think it all washed off because after all it usually reflects on the person who’s saying it, not the person they’re talking about. So, I have had very few problems.”
Marion and Keith lived and worked in Stratford for forty years, where they were the third intergenerational family of doctors in the community. In their family, Dr Marion and Dr Keith were preceded by Keith’s father Dr Carey—a surgeon. Before that, several doctors from the Stevens family were popular in the town, in addition to the famed Dr Doris Gordon family consisting of Dr Doris, Dr Bill, Dr Ross, and Dr Graham.
While Marion’s O&G career blossomed, Keith set up his own general practice, while also working part-time as an anaesthetist in the hospital. With husband and wife working together, this sometimes created some minor scheduling complications, which were gracefully handled in this small, rural town where everyone knew each other.
“It’s quite nice when you’re working in a rural place because people know everybody. And so everyone works in together, and if I had to go in and do a delivery and it tured out to be a caesarean section then I would need an anaesthetist, and so if my husband happened to be on call there was three children sleeping. But because it was a smaller, rural place, everyone knew, and they would send one of their community nurses or someone like that to look after the children while I did the caesarean section and Keith did the anaesthetics.”
“And also I think one of the good things about it is that you knew your patients much better, because you might have delivered them and then you did some gynaecological procedures at a later date on them and you knew them. And also the nursing staff were from the town and people knew each other.”
La Leche League: educating the community about breastfeeding, childbirth, and women’s issues
Despite her medical training, Marion had received little education herself on breastfeeding, which was considered the domain of midwives, and she had previously found herself unprepared for her own breastfeeding journey. In 1970, she started her own antenatal group in Stratford to educate new and expectant mothers about breastfeeding.
“I did breastfeed, I knew I had too because we were going to Nepal. But when I came to about nine months, I thought you were supposed to wean them, you know, I didn’t know any different. And then he got very bad diarrhoea, and when I went to the German doctor who was at the the mission hospital, she said—“Oh, are you still feeding?” I said “No”, she said “Oh, why have you stopped breastfeeding you silly thing.””
“I began to learn more about breastfeeding, and so when I came to have my second one I was introduced to the La Leche League, the lady down the road from us had some experience and I quickly realised how much information there was about the scientific side of breastfeeding and how important it was for the baby and for the mother.”
Over time, Marion’s expertise in women’s issues grew, and she expanded her community education classes to include medical issues with having a baby and postnatal depression. She was involved on quite a number of occasions in talking to women’s groups about various health issues. She also served as the medical consultant for La Leche League in New Zealand for many years, where she talked at conferences and provided information for women struggling with breastfeeding due to an underlying health conditions.
Changing Stratford Hospital for the better: a new birthing unit & improving hospital policy
Marion was at the forefront of instrumenting change in childbirth and antenatal practices in Stratford. Early in her career, she set up a ‘perinatal morbidity’ meeting in Stratford where she would get together every couple of months with other obstetricians, GPs, and midwives to discuss recent cases of concern. This audit found that many childbirth and antenatal practices were outdated, and over time Marion worked to improve the standard of care, albeit with some resistance from midwives.
“They used to have enemas and shave the women, and put them in bed and keep them in bed all the time; they never got up when they were in labour, and all of these sorts of things. Sometimes they would ‘cot-treat’ the baby, they would put it away in a cot. And you couldn’t have it for twenty-four hours. I mean this was barbaric. And they would give the baby a bottle of cow’s milk, you know, of formula, which is not a good thing if they’ve got a history of allergy. You want to breastfeed your baby. So all of these sorts of things had to be overcome.”
With assistance from her father in law—the medical superintendent of the hospital—Marion introduced a new policy that allowed husbands to be present during their baby’s delivery, including during a Caesarian section. She introduced a new birthing unit into the hospital, with an associated lounge, where the mother could choose to give birth without needing to go to theatre. Unfortunately, the new unit was met with disparagement, and some time passed before it was accepted by midwives. Marion was also aware of the negative repercussions of leaving small children alone in an unfamiliar hospital. Together with her father-in-law and the Matron, Marion set up a ‘granny scheme’, which ensured that a roster of women were available to stay with a child who needed to remain in hospital without a parent. At the end of her time at Stratford, Marion and her colleagues also briefly started a ‘Know Your Midwife’ scheme, recognizing that women would prefer coming into the birthing unit with a midwife they already knew through their pregnancy.
In 1998, Stratford Hospital surgical services closed down, and Marion was no longer able to practice O&G surgery or abnormal obstetrics in the region. She moved her surgical services to nearby Hawera Hospital for a short period of time until that hospital’s surgical services were also discontinued. Marion then moved her focus towards gynaecology, which she could complete in her office rather than hospital.
“I did things like a menopause clinic. I set up a clinic for the whole of Taranaki for menopause, so I used to get patients from all over, who would come to see me because I was the only woman gynaecologist.”
Reflections: family & career
Marion retired from medical practice when she was 63. She found that she didn’t really miss her work, particularly as she kept in touch with the medical field through her husband’s extended career. Instead, Marion found time to join other activities, including walking, reading, folk art, and sewing, and in 2013, Marion and Keith moved to Havelock North.
Looking back on her career, Marion felt challenged balancing her time between family and work commitments.
“They didn’t always have their mum and dad there for everything. I used to try and get to school things,, because my hours were very flexible most of the time if I wasn’t doing a clinic or surgery. The other hours were flexible unless someone was having a baby. I can remember on one occasion my youngest son -I think it was a calf day or something like that – I said to him, ‘No, I’ll be there about ten o’clock’. And he just stopped and looked at me and said, “No you won’t, mum. You won’t be there until about eleven, probably”. And I suddenly realised that they had already decided that they can’t rely on me, really.”
Marion has some well-thought out advice for women considering a profession in medicine:
“I would say that if you want to be a woman doctor you really have to want take up medicine more than anything. Because there’s a lot of sacrifices that you end up making as a woman. You know, especially if you try to combine it with motherhood or marriage.”
“I think your reason for doing medicine has to be altruistic, and not materialistic. Because medicine is a profession, really, not a job. In other words, if you’re looking on it as a job you’re going to be worried about what money you’re getting and what hours you’re doing. But if you look on it as a profession to help people then it doesn’t bother you if things go wrong, if there’s stress and if there’s long hours, or if things are not quite what you thought.”
“And then I think also that if you marry, the fact that you’re a doctor might put a strain on your marriage, especially if you want to be a mother. Because there are a lot of things that happen being a doctor that are unexpected. Although, I’ve always found it wonderful because my husband’s a doctor too, so I don’t ever have to explain anything. You know, when you come back from a call, you know that he’s going to know what the experience has been like.”
“If you have children, you’ve probably already detected, that my feeling is that you will need to put them first especially in the early part of your career. And plan to care for them yourself if you want them to grow up with a mature rounded character. Because you’re the best mother for them, really.”
