The good DOCTOR
Dr Peter Borzi is the longest serving paediatric surgeon at the Queensland Children’s Hospital, known by thousands of children and their grateful parents for his enormous skill and kind and gentle nature
He came here by way of Sicily. By way of his grandfather Alfio stepping on a boat in Sicily and stepping off again at the port at Innisfail in northern Queensland, and knowing just two words of English: “bread” and “milk”. “Guess what he lived off for the next three months,” Alfio’s grandson Dr Peter Borzi, chuckles.
Borzi, 63, has an easy laugh, one which tens of thousands of children he has treated in his decades as a paediatric surgeon, know well. One that has soothed them – and calmed their anxious parents. “Now, what colour would you like me to do your nails?” he might say to a child when first ushered into his rooms.
Such is the gentle and humorous manner of Borzi, who is the longest-serving paediatric surgeon practising at the Queensland Children’s Hospital.
Appointed in 1993 (and also at the Mater Mothers’ Hospital in 1994, working across both), for 33 years Borzi has been operating on the smallest and most vulnerable members of our population, specialising in surgeries of the abdomen, urinary tract, thorax and chest.
But before that, there was Alfio Borzi stepping off the boat at Innisfail in the 1920s, like so many Italian immigrants chasing a better life in the cane fields of Queensland’s far north. Alfio would eventually marry Concetta, and become a father to Guiseppe (known as Joe), Michaelo, Nell and Ross, setting in motion a medical dynasty that continues today in his grandson’s careful hands.
“I was born in Atherton, and we lived in Mareeba,” Borzi recalls. “My father Joe (the aforementioned Guiseppe) married my mother, Dawn, Dad became a GP and we moved to Brisbane when I was about 10.”
Two years later, Joe Borzi would die of renal disease, leaving Dawn Borzi to raise her boy alone, with a young Peter travelling back to Innisfail in the school holidays to help out in Alfio’s cane fields in the absence of his father. All this would leave its mark on the future paediatrician – from his choice of profession to his understanding of experiencing grief at a young age, to an appreciation of the rewards of hard work.
Borzi smiles. “When my father died, my mother found work at the local school as a print technician, and she also went back to school attending adult education at the same time I was in high school. That was thanks to good old Austudy (the long departed and lamented educational assistance scheme that once provided funds to anyone between the ages of 16 and 64 studying).
“She finished Grade 12 the same time I did, and then we both sat our university exams on the same day at Cloudland (the also long departed and lamented Brisbane landmark). I was doing medicine, and Mum was doing social work. It was pretty special.” Borzi pauses.
“I am not entirely sure why I chose medicine, but I did quite well at school, and I think probably watching my father, and just having a feeling that it was the right thing to do.”
Borzi would begin, in 1976, the long and gruelling path to becoming a paediatric surgeon, including six years of medicine at the University of Queensland, two years of prevocational training, two years of general
surgery training, and three years of paediatric surgery training, finally qualifying as a paediatric surgeon at the age of 31 in 1990.
Along the way, Borzi’s reputation was steadily growing, not only for his technical prowess, but for his kindness.
“When I was an intern, you do a number of rotations where you experience different specialties, and in my second year I spent time in paediatric surgery at the Royal Children’s.
“There was this wonderful nurse there, in charge of the children’s ward, her name was Sandy Miller, and she ran that unit like it was her own home. She was a real life Florence Nightingale, she really cared for those children. I’d watch the way she worked, the way she spoke to the children, I learnt a lot from her.”
Those who work with Borzi say exactly the same thing about him.
Any parent who has a child who has to undergo surgery, simple, or complex, knows the anxiety that comes with it.
Borzi knows it too.
“I don’t take it lightly,” he says.
“I have always thought that for someone to meet you for a short period of time and then say, ‘I’m happy for you to operate on my child’ is an incredible leap of faith.
“I have enormous respect for that trust, and I think that unless you have that respect and realise that’s actually a privilege to be allowed to do that, then I don’t think you really should be doing surgery.”
In his time as a paediatric surgeon (Borzi has worked in hospitals in Melbourne, Darwin, Bristol, Leeds, Canberra, Hobart, Adelaide, Kuala Lumpur and London) he has performed between 1500 to 1800 surgeries a year. And every time he feels the weight of it.
“I think the first time (Borzi performed surgery on a child) was very confronting, and I do remember it, that feeling of “oh my goodness, the responsibility I’m taking on here really is immense. But, of course, you are also trained, and you know like any job you do, if you do it often enough it becomes routine, and remember many of us (surgeons) are OCD,” he smiles. “You have to be, you have to have that attention to detail. But, as time goes by, you do have an innate ability to do it, and also know potentially what could happen and what you might need to say to communicate all of that to the family.”
And most times, the person that Borzi is communicating that information to is not the parent, but the child.
“Unless the child is very young, or not able to understand, I think the most important thing is to establish a relationship with them, that the child has that confidence in you.
“To help ease the initial tension I might say, ‘Why have you come to see me today, do you need a haircut?’ They might laugh and we’re away. The next thing is showing them respect by talking to them about what’s going to happen, by asking the child for permission as well as the parent, for example, in examining them. I will say what I am doing and why and then ask ‘Are you happy for me to examine you?’”
To the parents, Borzi will ask, ‘What do you do?’, ‘Where do you live?’, ‘How has this been for you?’ It is a singularly inclusive way of calming everyone down.
“Teenage boys are always terrified they are going to die – I don’t know why,” he says, “but they are, they have this morbid fascination, and all kids are very honest, which I love.
“I remember one little boy saying to me after I’d explained what was going to happen, taking the family through the procedure, “Well, I hope you know what you’re doing.”
Borzi does know what he’s doing, from basic procedures treating mild cases, to highly complicated, intricate surgeries often lasting for hours and as part of a multidisciplinary team. In August, he was part of the 25-member strong team performing a marathon six-hour operation to remove a 2kg tumour growing on a premature baby – Saylor Thomson’s – tailbone. Borzi led the operation, performed just moments after the little girl’s birth (at 28 weeks).
“I very much see my role as a surgeon as a cog in the wheel, part of a team, and I think my most memorable surgery was quite recently, because it was such a team effort. There were five of us operating on a child of three and a half. The child had a tumour in the left kidney, it had invaded the blood vessels, gone up the back of the liver and into the heart. I was working with a cardiac surgeon, a hepato biliary (liver, bile ducts, gall bladder) surgeon, and my role was to remove the kidney, and also help remove the tumour from the vein to the kidney.
“We had a really good result, it was a huge effort, a huge technical challenge, but everyone did their bit, everyone helped and just worked together. I was really happy with that.”
Something else that makes Borzi happy (and it makes him really, really happy) is seeing children he has operated on grow up to live happy and healthy lives, or to live lives that are, at least, far better than what their parents ever imagined. Sometimes, these children grow up to be colleagues, having entered the field that once helped them.
“Many years ago there was a young child who was born with a constellation of abnormalities, including no oesophagus, and an abnormality of the lower genital and urinary tract. I operated on this child as a newborn, they had to have a reconstruction, and over the next few years this child had to have multiple surgeries. That child was never happy to see me, I can tell you,” he smiles.
“They would see me and go spare because they knew what it meant, more surgeries. But as that child grew, they became more understanding of what I needed to do. Now that person is a nurse, looking after children with the same condition. So I see them, and we chat and they are happy and that makes me very, very happy.”
Of course, not all endings are happy ones. Some are unspeakably brutal and unfair. Some end, despite everyone’s best efforts – every surgery undergone, every treatment explored, every avenue taken – with the death of a child. “Yes, well, that is, of course, the toughest. That’s just so very tough when you see that this child is not doing well, that this child is heading towards dying and to introduce that subject, of dying. I try to be very open, I try to be kind, I try to give all the information I can, the reasons why we are now entering, well, we call it, redirection of care.
“And that is a conversation you have with a social worker present, an ethicist, the treating paediatrician, everyone there to support, but it’s always just very tough for families to hear that information.” Tough too, one imagines, on Borzi to deliver it.
“It isn’t easy, I feel like sometimes we have a run of those cases. About three to four weeks ago it seemed to me that every second child was not having a good outcome. There was a baby with an infection in its belly that I knew was not survivable, and at the same time I had a child who had a near drowning, and there was talk about doing an operation but I had to tell the parents it was not going to help.” What does he do when these tough talks take their toll on the man who delivers them?
“I take myself away for some quiet time. I’ll say to the registrars, ‘just give me 10 minutes’ and I’ll just sit really quietly and shut out the world, and” – Borzi smiles – “I also have a terrific wife who is there for me, always. That helps immensely.”
Borzi is married to his wife of 34 years, Therese, a former nurse he met while he was working at the Toowoomba Hospital. They have four children, Sam, 32, Sophie, 28, Izzy, 26, and Liv, 22, and if he had his time over, Borzi candidly admits he would do his parenting differently. “Things have changed now, thank goodness, but when I was starting out, surgery was your life, and everyone else had to fit around it. The commitment I had to make to be a surgeon and to establish myself as a surgeon meant I was missing in action at home a lot, and there was much more responsibility placed on Therese than there should have been.
“It is a generational thing and these days there is more consideration for a work life balance. I try to keep an eye on my young surgeons and make sure they are seeing their families and taking care of themselves.”
Borzi is very involved with training the next generation of paediatric surgeons, and he says he has an succession plan in the works. One day he will hang up the (very sharp) tools of his trade but not for some time yet. In the meantime, he says, he remains in admiration of, and grateful for, the people he calls “diamonds”.
“I graduated in 1989, and I’ve had 33 years of meeting the most extraordinary families, the parents and carers who are out there every single day caring for a child who is severely impaired. These people give over their whole lives to their child, and love them unconditionally. They don’t complain, they don’t say to you, “Well I’ve been up all night because he’s been screaming”, they just carry on. These are the people who don’t get the accolades, there are so many of them outside of this hospital door, who do so much for their children, living a life of service.”
Borzi pauses for what seems like a long time.
“There are diamonds out there everywhere.”
And while he would never say – or think – it, there’s one on this side of the hospital door also.
For someone to meet you … and then say, ‘I’m happy for you to operate on my child’ is an incredible leap of faith