The quintessential family doctor

A quiet, slight man with a powerful emotional aura, a calmness, he was never rushed

Ian Milne was a man of faith who inspired faith; an old-school specialist GP with new-school ideas; someone who was available, yet slightly remote.

The late Dr Milne’s long-time practice nurse, Ruth Cooke, calls him a man of great pauses and silences. His friend, University of Otago professor Peter Crampton, remembers a wise soul who offered guidance through questions.

Former Ministry of Health primary care advisor John Marwick says his old friend may not have possessed a personality that could fill a room, “but when he spoke, people listened”.

Irina Aksenova, a Wellington-based specialist GP, talks of a quiet, slight man with a “powerful emotional aura, a calmness”.

“He was never rushed,” says Dr Aksenova.

For each, Dr Milne was such a steadfast presence. They were shocked to hear of his death on 7 March at the age of 74.

The wider impact of his loss is illustrated by the many online comments, including those on the Facebook page of his home away from home for more than 30 years, Petone Medical Centre.

Born in Christchurch during the 1947 polio epidemic, Dr Milne was galvanised by his local evangelical Anglican church and decided medicine was his best means of serving the community.

He studied at the University of Otago, where he met his future wife and GP colleague Janet Scott. After marrying and enjoying a few years of travel, the couple purchased their Petone practice in 1978.

It is described as an “ancient little cottage”, a functional workplace, without bells and whistles, that reflected their modest lifestyle.

Dr Milne was also the sole foundation pupil of sorts for the Wellington stream of the Family Medicine Training Programme. John Marwick joined in its second year, the class having then doubled in size to two.

Dr Milne was awarded Fellowship of the RNZCGP in November 1991 and was made a Distinguished Fellow in July 2013.

Above all, though, he is remembered as a family man and a man of God, who took joy in delivering tens of thousands of Petone babies. Being of service was his ethos, says Professor Crampton. This was not only elemental to his practice, it also drove his enthusiasm for training GP registrars.

“I did my placement with him in 1989,” says Professor Crampton, “all I knew about him was that he had a reputation as a fine teacher, but he was quite an earnest character, which felt quite intimidating.

“But working for Ian meant getting to know his family. You slept at the family home, and we’d all sit around the table for dinner. On my first night there, one of his boys looked at me and asked: ‘Do you believe in God?’ I didn’t really know how to answer that one...”

Later that night, he was introduced to another Milne ritual, the evening mug of Milo, where everyone gathered in the lounge for some reflective time before the kids went to bed.

Which was just the kind of moment when Dr Milne could blindside you with a question.

“We were sitting at the table and he asked me where I wanted to work,” says Professor Crampton, whose family had settled in Nelson after immigrating from England. So he had assumed he would set up shop in Nelson.

But Dr Milne asked: “Have you thought about making your career decision based around where GPs are needed, rather than where they are not needed?”

The young Peter Crampton was floored, “because I hadn’t at all thought about that, and in that one moment he fundamentally altered my thinking”.

“So, that is such a crucial conversation for me, but that was how he was. He didn’t tell you what to do, he just asked the right questions and, to me, he was such a treasure. A man deeply grounded in his ethics and, it has to be said, a modest man who was a very fine teacher to so many and who watched our careers with genuine interest.”

While serving as chief advisor, Dr Marwick worked regular weekly shifts at the Petone practice to keep his hand in. “I used to say my patients only got sick on Thursday mornings.”

Dr Aksenova, one of Dr Milne’s registrars in 2008, confirms his “no work Thursday” approach. She says everyone understood it was the day he and Janet set aside for quality time together and with their grandchildren.

This balanced approach to work, says Dr Marwick, made his friend the “quintessential family doctor” with a modern take on traditional values when it came to his team.

Some old-school GPs, says Dr Marwick, saw nurses as “handmaidens or glorified receptionists…but he expected nurses to be professional”.

“He encouraged everyone to take full responsibility and was happy training people in how to do different things.”

If mistakes were made, he never failed to notice: “I wasn’t above that myself, once or twice he came in to make a comment about my record-keeping.”

This quiet, yet determined pursuit of excellence created great trust among his patients, says Dr Marwick. He says his own wife, a former midwife, attended home births with Dr Milne who, she says, patients just liked to see arrive. “He didn’t push his way in to take over, he was just this calming presence…he’d often end up being the one holding the camera.”

The two friends also joined the Balint Society, an international collective of practitioners discussing clinical practice. “Ian was very much into that, the psychosocial side of medicine, what is important to patients and the impact of the work on doctors as well.”

Ms Cooke became co-owner and director of Petone Medical Centre in 2009, after initially rejecting an offer to become Dr Milne’s practice nurse in 1996.

She had been pipped by an experienced Australian practice nurse who then decided she wasn’t up to it, so Ms Cooke was invited in for a two-hour grilling – making the prospect of working with him more intimidating.

After a night of prayer, she decided to withdraw her application unless she got a direct offer from the man himself. She did, she took up the job, and she stayed.

Ms Cooke remembers Dr Milne as someone who commanded respect, who listened carefully and took his time responding. She recalls being ushered into his office and the door being closed: “I thought, ‘I’m in so much trouble’, then he’d say: ‘I really liked the way you handled that patient’ or something…he was an old-school doctor.”

There were also occasions when nurse would call out doctor; he would think the situation through and, if he found himself in error, would admit to it.

“That’s why we had such a good relationship, he trusted me, and I trusted him, it made us a strong team.”

But he was never an over-sharer, so she has strong memories of the day some awful news left her crying. Dr Milne kneeled beside her chair and wrapped her in a hug. “I was, ‘oh my goodness, please stand up’. It wasn’t a normal thing for him, but it has always stuck with me. He wanted to be there for me.”

In 2009, he sold his practice to Ms Cooke, Dr Aksenova and practice manager Sally Stanley but continued on a part-time basis.

It was a timely offer as Ian and Janet Milne had formed a grand plan to do volunteer medical work for Green Cross in Asia. They’d give it six months and take things from there, and got as far as selling their old family home when Janet fell ill – and that was that.

Dr Aksenova says even in (quasi) retirement, he remained keen to learn and would pepper her with questions while she was taking a diploma in skin cancer medicine. “He would even come to see me with his patients, which was funny because it was like our roles had reversed.”

By his 70s, Dr Milne began tiring of the paperwork that came with the job and stepped away from medicine.

Ms Cooke didn’t expect him to give up work easily and wasn’t surprised when he rolled up wanting to take the vaccination course so he could vaccinate Petone locals against COVID-19.

“He gave me my vaccination, and then my husband, but it also meant he got to see some of his old patients because in a place like this, everyone still knew him...Which is why there was such shock when he died, people couldn’t believe it and the number of comments people have posted about him…they are just beautiful to read.

“But that’s Ian, really. He was a man of faith and he lived out those values his entire life.”

Ian Milne is survived by Janet, their children Jonathan, Kiri, Anita, Frances and Steuart, and nine grandchildren.