Dr Charlotte Greer is presently making her mark as a researcher in cardiology, but she’d admit to not doing a lot of in-depth study on her New Zealand destination before she signed on as a junior doctor at Christchurch Hospital in 2013.
The Newcastle-born physician had completed a medical degree, and an accompanying ‘intercalated’ BMedSci research degree with first class honours before setting out from the United Kingdom on what she calls a ‘well-trodden’ path to the antipodes – a post-grad journey that benefits Australia’s and New Zealand’s hospital staffing, while also allowing those same doctors a chance to explore the wider world and decide their future. Dr Greer signed on for 6-12 months work.
"Oh yeah – off we go on adventure to New Zealand,” says Dr Greer now. “ I got here and it was a bit of a shock. Naively, I thought everything was sorted by the time I got there. It was a bomb site.”
After the M6.3 earthquake of February 22 2011, Christchurch was still a city of Red Zones and demolitions, of road cones, underground infrastructure repair, and a wrecked cathedral, but Dr Greer decided to stay on beyond her original 12-month contract and completed three years as a junior registrar, before choosing to train as a cardiologist. The city itself had become special by then. She’d met and married a Christchurch-born builder, Mark Kelly, he’d built a house for them at Hoon Hay, and she was pregnant.
She planned a maternal year off from the three-year cardiology training, but the maternal year of 2020 was an opportunity also to advance her research skills. Five months after the birth and after a visit by her UK parents to hold what Dr Greer calls “a very screamy little new-born baby” her parental leave payments ended and she applied to the A H Couch Trust for $40,000 to fund the first half of an MMedSci, a research degree intercalated this time with ongoing maternal care for her new daughter Chloe.
“My application was successful, and my daughter got into nursery in the mornings, which then gave me enough time to do the Master’s degree work.”
New Zealand’s Very Low Birth Weight Study – a longitudinal project begun in 1986 to catalogue the ongoing physiology of children who weighed 1.5 kg or less at birth – is well-known in natal care circles world-wide. Dr Greer’s degree subject was a sub-set of the wider study, examining and reporting from echocardiogram imaging, the participants’ adult heart structure and function. The degree work extended into 2021, alongside the last year of the three-year general cardiology course, and she completed that course in early 2022, along with the MMedSci work.
Cardiology course graduates usually then choose to specialise further in one of the three main branches of the discipline – as Intervention Cardiologists who relieve heart attacks or angina with angiograms and stents, as Imaging Cardiologists who diagnose using echocardiograms and CT scans, or as Electrophysiologists who deal with problems of arrhythmia, using pacemakers and other procedures to steady the heart’s electrical disturbances.
Dr Greer has yet to undertake the further years of specialist training to qualify as an interventional cardiologist, but is keeping up her catheter lab skills meantime. Her focus through 2022-23 remains research, for as the MMedSci year came to a close, her supervisors suggested she credit that work as the first year of a three-year PhD, centred on cardiac imaging. She won a Heart Foundation Fellowship for the PhD, and is now concentrated on assisting trials, and compiling and analyzing data. One example is a trial presently underway to track the advantages, before sending heart attack patients direct to the catheter lab, of a CT scan. If the scan can identify the statistical 40% of patients assessed as heart attack patients, who turn out not to need a stent at all, then there’d be far fewer invasive angiograms, with consequent savings in medical resources.
Interventional cardiology remains her further goal. It’s not the same as heart surgery, but it does venture in a less intrusive way into the aortic system, and it suits her practical style.
However delicate the work, it requires practical judgement, judgements that might be seen to accord at a micro level with the slick movements she first developed as a medical student at Sheffield University, rock climbing amongst the well-known boulder fields, crags and escarpments, on Sheffield’s outskirts. These days she keeps stretching for those handholds, but because of a busy schedule, it’s usually on climbing walls within the Christchurch City precincts.
“I don’t want to be a surgeon. As an interventionist I’ll be doing angiograms and stents and things like that, and they’re obviously very practical. There’s also a lot of procedures that interventionists do that immediately or fairly quickly result in a good outcome for someone.”
“For me, intervention cardiology is just the thing I’ve enjoyed the most.”