Almost two decades ago, Dr. Alf Smith was one orthopedic surgeon out of 145 in his city.
The residents in the metro area had their choice of 35 private and academic hospitals and to say the medical and communicative technology that the area’s doctors, nurses and surgeons used was sophisticated would probably be quite the understatement.
But this wasn’t in Canada. And it wasn’t the United States, or even Europe.
Dr. Smith was practicing in South Africa. Pretoria, to be exact — a northern city in the province of Gauteng and the executive capital of the country. Within it, Dr. Smith was far from lacking in his profession.
So when a fellow South African surgeon, Dr. Wiggins crossed paths with Dr. Smith in Pretoria and told him they were looking for orthopedic doctors in Prince Rupert, Dr. Smith’s curiosity was piqued.
The transition would be different; it would be jarring going from a busy metropolis area to a rural and isolated region, but Dr. Smith knew of Canada, though nothing could have prepared him for his inaugural visit to the North Coast.
“You come from a so-called third-world country and yet we had a lot of things that were first-world,” said Dr. Smith.
“Our medical system was first-world. We came from a very privileged society and coming to the north of Canada, this is in many ways more primitive than what we were used to. I was surprised to come to Prince Rupert and find that all of British Columbia only had one MRI, whereas the city where I lived, there were seven or eight MRIs. We had private hospitals that were like luxury hotels. [B.C.] was using analog cell phones and we had the latest Nokia digital cell phones. It was very odd. I found it strange that you have a first-world country, a so-called part of the G8 and we were supposedly coming from the third-world. It was a bit of a shock.”
Don’t get Dr. Smith wrong however, the physician, who was born in the province of Free State (“flat and like the breadbasket of South Africa,” he described it), has absolutely fallen in love with the region from the moment he arrived.
After growing up with a father who was a radiologist and a mother, who was the administrative head of the Pretoria Academic Hospital, Dr. Smith knew he wanted to work in medicine for as long as he can remember. He emerged from an all-boys’ 1,400-student school in Pretoria’s educational system that includes uniforms and inspections, to enter into the region’s system of conscription and mandatory military training for all young men.
“I saw active service in the Angolan War – three years ... it’s a war and it had different meaning to different people. I served in the special forces unit, so I got to see a lot of stuff and do a lot of stuff. It was a different time in my life,” he said.
Dr. Smith had to undergo rigorous training and his superiors saw him fit to be selected for a special long-range stint behind enemy lines.
“We seldom saw any of our colleagues in the unit because we operated in small teams ... I was in the bush with [my battalion] for five months. It was long periods of time away from home,” the physician said.
That was when Dr. Smith was 26. By that time, he was already a fully-practicing doctor, serving at a government hospital and working as a family practitioner. He then went into orthopedics.
The physician made the move to Prince Rupert 16 years ago and has fully embraced everything the unique region has to offer.
A hunter (both rifle and bow) and a fisherman (fly-fishing is his favourite), Dr. Smith used to be drawn to the city, but now he rarely travels to even Vancouver anymore.
“I love the people here. I hunt and I fish and [my wife and I] travel up-country. I like the people; I like the rural mindset. Every year I go hunting with a bunch of guys from town – none of them are physicans, they’re just ordinary [friends] and we hang out and we have a moose camp every year,” he said.
Dr. Smith has been and currently is a member of the Rod and Gun Club and the Eagle Eye Archers – bow and arrow was something he learned how to do before coming to Canada.
The doctor bought a piece of real estate along Lakelse Lake recently.
“Just a little piece of land there and I’ve got a cabin and we go there on weekends and hang out. We dig holes and do stuff. We bolt things – I make my own furniture and stuff like that,” he said.
Where did the physician come to be so handy?
“I don’t know – it comes with the territory, I guess. My work is basically that of a carpenter. I work with tools, nuts and bolts. I fix things that are broken,” he said.
Between himself and a fellow orthopedics colleague in Kitimat, the duo serve 80,000 northern residents and Dr. Smith has given lectures in the past about challenges facing rural-based surgeons, to help new doctors cope with some of the plights they may face.
“Our situation is unique. We’re far from the city and we’re far from specialist amenities ... I don’t have a peer backup because you’re a lone practitioner. My [Kitimat] colleague, Dr. Van Der Merwe is effectively 150 kilometres from me,” said the physician.
“It’s even tougher for our patients. I have great sympathy for [them]. My furthest patients travel 10 hours by road.”
Dr. Smith and his wife have a daughter currently attending Queen’s University in Kingston, Ontario, a northern city that can become a bit brisk in the winter.
“She’s coming home now for the summer ... she doesn’t want to live in Ontario, it’s too cold,” he said.
The doctor has rarely been back to South Africa since moving. The allure of the city is a young man’s game and he’s comfortable where he is.
“I came to Rupert 16 years ago and I only thought I’d stay for a year or two. And here I am 16 years later and I’m probably going to retire here ... I’m Canadian now. This is my home.”