Dr Geoff Hittmann opens the door of his Wollongong apartment and scares the hell out of me. It’s not just that he’s barefoot and in his pyjama pants, it’s that he looks like a big, hairy mountain man.
I’m early. He’s gracious and welcoming. One warm smile and the wild man is tamed.
Hittmann and his long, greying beard settle back into the lounge and he continues his morning routine. Three pieces of tape are stuck to the side of his TV cabinet and there’s a birds’ nest of bandages at his feet. He rests his grossly swollen left leg on top of a green Tupperware container and continues his strapping.
On 2 June, the 58-year-old GP was diagnosed with a brain tumour and given three months to live without treatment or a year if he opted for surgery, radiotherapy and chemotherapy. He chose treatment and has endured two and a half months of hell. But this morning, as he struggles into one shoe and one Velcro-strapped sandal, it is cellulitis, not the brain tumour, that’s giving him grief.
If you’re a regular reader of this newspaper’s letters page, Hittmann’s name is likely to ring a bell. He’s the proudly non-VR GP from Mt Kembla, NSW, who told the RACGP to “stick your VR where the sun don’t shine”, refused two chances to be grandfathered and thereby sacrificed an estimated $500,000 in potential earnings.
Whether you can make sense of his stance or not, it says something of his passion that he has raged against the RACGP since 1977 – when he says his concerns about hospital registrars being exploited and poorly trained were ignored by his college representatives.
Hittmann’s conscience won’t let him join the vocational register because he would see it as condoning the college. But, having shunned the register, he’s indignant non-VR rebates have remained stagnant, not even keeping up with inflation when even “pensions are indexed”. His letters to the editor rage about this “kick in the guts” and being terminally ill hasn’t distracted him from his theme.
“Before I fall off the perch, I want to bring some kind of justice and fairness to how general practice is run,” he says. “I’m not going to turn my back on it now and say stiff shit.”
In a shocking piece of timing, just before he discovered he was going to die, Hittmann had turned his life upside down so he could finally access the higher rebates. In May this year, Australian Doctor reported he was leaving the Wollongong suburb of Mt Kembla, where he’d lived for 29 years, and heading for Bourke, an area in need in outback NSW. He’d been there two weeks when he experienced a blank spot in his vision and ended up in hospital.
“Next thing I heard the ambos talking to the air ambulance,” he says. “They said I’d had a convulsion and they flew me to St Vincent’s [in Sydney]. Did an MRI and showed a brain tumour.”
Hittmann lights a cigarette and heads out to the balcony of the modern apartment where he lives with his partner of two years, Margaret Flynn. The son of a pharmacist from Sydney’s North Shore starting smoking “roll-your-owns” as a medical student, but swapped to “ready-rolls” when he got a job driving cabs.
He and Margaret have only been here a week and are still soaking up the mountain and ocean views. Margaret confides that it’s something of a miracle they have the place at all. She left her new teaching job in Bourke when Hittmann got sick and feared an unemployed school teacher and a dying doctor would not be considered desirable tenants.
But Hittmann has long been a legend in Wollongong. He called Lord Mayor Alex Darling and, within a week, a real estate agent was giving them a tour of the place. Mr Darling, who met Hittmann 15 years ago, says the doctor is widely loved and respected, particularly in Mt Kembla, where he’s known simply as “the Doc”.
“He’s a very natural person. There’s no airs and graces with the Doc. He’s a very good man. If you went to visit the Doc and you couldn’t pay, it wouldn’t worry him one bit. He’s a person you couldn’t help but like.”
Hittmann practised from his home, Bedside Manor, located directly opposite the Mt Kembla Hotel, and kept a prescription pad in both places. “If it was someone who had something they needed urgently and it was someone I knew, [having the pad at the pub] would save me a walk home,” he says.
Dr Greg Mason, a general surgeon who used to work in Wollongong, says it is camaraderie, not drinking, that pulls Hittmann there. The GP regularly referred patients to him and would always start his introduction with “this patient’s a good mate of mine”. Dr Mason admires his clinical acuity and thorough approach to the job.
“If you get a letter that says, ‘Dear Dr Mason, please treat so and so for bleeding piles’ and I stick my finger in his backside and feel a big cancer, I know the GP hasn’t even looked,” he says. “That’s never happened with Geoff.”
Another of Hittmann’s closest friends is 40-year-old local radio announcer Phebe Irwin. They met – at the Mt Kembla pub, of course – after she moved to Wollongong 10 years ago.
She and other locals timed their visits to the pub around his routine. “The very first thing I do when I walk into the pub is look for Doc’s spot at the bar to see if he’s there,” she says. “It’s like when you wake up in the morning and look to see if the sun’s in the sky.”
She’s never succeeded in buying him a drink, though. He always shouts and, although he always has a beer in his hand, she’s never seen him drunk. Laughing, she recalls the time Hittmann hid near the finish line of the annual Mt Kembla foot race. When the first runners came into view, he burst out of nowhere and beat them all to the line.
When Ms Irwin’s boyfriend, Fish, died two years ago, Hittmann was the first person she called.
“I drove to the pub and he had a drink waiting for me,” she says.
“He said let Fish’s memory live on with you, so you can take the best things about him and make them part of your life.
“You can be feeling you want to kill yourself because your boyfriend is not around and he shows you reasons to keep on keeping on.”
Hittmann understands the pain of losing somebody you love. He remembers the exact time, 12 years ago, when police knocked at his door to tell him his son, Garth, was dead. Garth had been celebrating his 23rd birthday and gone for a spin on a motorbike with a mate. They’d been drinking and Hittmann suspects the bike had no headlight. They drove through a park, straight into a slippery dip.
“When my son was killed in that bike accident, I thought, nothing worse is ever going to happen to me now,” he says. “The coppers knocked on the door at 4.22am.”
In some ways, Garth’s death has helped Hittmann deal with his own grim prognosis.
“When my son was killed, I thought, I can’t do anything about it,” he says. “It’s happened. You’ve just got to get on with it.”
Although he has bawled as he thinks about dying, he’s found some solace in knowing there’s not much he can do about that either.
“I’ve always been a believer in, if it happens, it happens. If it’s good, it’s good. If it’s bad, it’s bad. You’ve just got to cop it.”
Being a doctor hasn’t eased the challenges posed by his treatment. He woke after his surgery at St Vincent’s Hospital with a 30cm scar across his head, when he’d expected something the width of his fist, and he was shocked by the memory loss that followed. Later, when his head was strapped tightly to the table for one of his first radiotherapy treatments, he had a panic attack.
His 29-year-old daughter, Bonnie Hittmann, took time off work to care for him and saw him at his lowest.
“Straight after the surgery he got easily agitated and upset and frustrated. He didn’t expect to have such memory loss and confusion, particularly with short-term memory and finding appropriate words,” she says.
He’d get one word stuck in his head for a day – usually something to do with his treatment – and he’d use it over and over. One day it was “X-ray”, Bonnie says.
“He might say, ‘What’s for X-ray tonight?’ instead of, ‘What’s for dinner?’.”
More recently he has had difficulty remembering names, so he can lack confidence about personal interactions, such as taking phone calls.
“With being such an independent and intelligent person, to becoming someone at the other end of the spectrum, needing help with his communication – that was very difficult for him,” Bonnie says.
Any problems with memory and speech are not obvious the day I meet Hittmann, apart from his constant apologies for his short-term memory loss. He certainly has vivid memories of the worst parts of his hospital treatment.
“They put a lumbar puncture in me. They gave me three goes in the ward and couldn’t get it through, so we went down to the X-ray department and they got it the fourth time,” he says.
He felt so miserable in intensive care after his surgery that he threatened to sign himself out.
“It was a waste of time,” he says. “No one was doing anything. They sent me in there with a nightie tied up at the back, a tube of toothpaste and toothbrush and that was it. There were no windows. You’re not allowed out of bed. It was two days of absolute hell. The lights were on all the time. I had a drip on both sides so couldn’t roll over to sleep.”
Strangely, after this tirade, he adds: “It’s the first time I’ve ever been a patient and most of the time it was good.”
Hittmann says he’ll never practise medicine again and there’s no point planning what he wants to do with his remaining days because he wouldn’t remember anyway. For now, he is more concerned with the recent past, questioning whether he made the right decision in opting for medical treatment and a prognosis of 12 months, rather than no treatment and three months of peace.
“It’s been over two months now and that’s been spent seeing doctors – two and a half months of hell,” he says.
“That’s not a life, mate. That’s not a life.”
He shows me the kitchen cupboard devoted to his medication.
“I woke up feeling good,” he says. “The sun was shining. I took 12 tablets and half an hour later felt like throwing up. Welcome to good health.”
Bonnie says her father has always been matter of fact about where medical intervention should start and stop.
“His belief has always been it’s better to live a quality life for a short time, rather than live a longer life at the mercy of doctors’ treatment.”
On top of weighing the balance between quality of life and quantity, a sense of injustice haunts him.
“There are so many layers to his disappointment,” Bonnie says. “He thinks, ‘I’ve spent my whole life looking after other people, and now this happens’. And it happened after he made all of these really drastic lifestyle changes.”
The old injustice of non-VR rebates being so low continues to eat away at him.
“He’s always thought, if he keeps fighting it, some changes will occur and it will be worth it,” Bonnie says.
“Now, since he’s been diagnosed with the brain tumour, he feels as though he doesn’t have the time left to keep fighting.
“He’ll fight it to his death bed. But he’s extremely disappointed. He’s disadvantaged himself by fighting this, his whole life, and nothing’s come of it.
“He’s upset by that.”