Michele Hewitson Interview: Des Gorman

Des Gorman has gone from naval attack swimmer to neurologist, head of Auckland University's School of Medicine and health bureaucrat. Photo / Brett Phibbs

Professor Des Gorman is a health bureaucrat, one of the country's top health bods, and so, according to me, a very powerful man, but ... Would I like to interview a health bureaucrat?

I'm sure health bureaucrats are very important people and the one who is head of the University of Auckland's School of Medicine and the head of a thing called Health Workforce New Zealand, a very important thing, no doubt, more important than most.

But another reform of the health system? That makes you, or me, at least, sigh in equal measures of tedium and frustration. The offer to interview him wasn't posed in quite that way, obviously.

So we're standing in the tidy office of the bureaucrat in his smart suit and reluctantly shown, rather surprisingly blingy gold Rolex - "you have to have one if you dive" - looking at a picture on his office wall of, "my other life". This picture was taken in Oman and shows a group of tough-looking blokes dressed in camo pants and assorted grungy looking T-shirts. "Can you pick me?" he says.

The chances of picking the top health bureaucrat from this line-up is made impossible by the incongruity of the contrast between the man in this office and the man in that picture. It is like looking at a picture of him playing dress-ups, which in a way, but a very serious way, is exactly what he was doing in his other life: with the Royal Australian Navy (he moved to South Australia after he graduated.) He was the medic for the Navy's special water operations, sometimes called a naval SAS. This, he says, is a euphemism. I tried to talk him into talking up his other, macho, life but his bedside manner, if I can put it that way, is mostly very calm and measured, not at all blokey and he is far too clever to be taken in by that obvious ploy.

Still, his CV should include the following: two PhDs, former submariner, deep sea diver, trained "attack swimmer", neurologist, philosopher. His specialties are the bends and brain injuries. Is the study of brain injuries philosophy? "Of course. Philosophy is the study of thinking." Was that an unbrainy question? "No, a very reasonable question." He doesn't have a degree in psychology, and I don't believe there is one in bedside manners, but he could get either standing on his, well, head. He is very good at both.

I knew from the sales pitch that he is also the owner of an " FU Porsche". "How do you know about that? I'm a car nut, that's true. No, it's a very quiet, conservative one." It's a turbo one. I have no idea what that means, but it sounds pretty macho. "That's the one you buy if you know anything about Porsches. It's a Jekyll and Hyde car. You can drive it conservatively and it does very well, but it also has a Hyde to it as well."

He said, after his appointment to the medical school, that "what you are seeing is my views expressed as moderately as possible". This suggested that there is another side to him, kept tightly reined in. He once told a dirty joke, about Monica Lewinsky, so you can guess the content, to a journalist (in a medical mag, admittedly.) He wouldn't do that now. "I probably would. Yeah." To a journalist? "Probably not."

He does get irate about a few things: seeing well-dressed women on Queen St, sucking on plastic water bottles "like babies on a teat", about vitamin supplements which give you "expensive pee", and the "worried well" of the middle classes who want to live forever, and the doctors who cater to these expectations.

So he is moderate to a point, in an interview at least. I wondered whether he knew he'd been offered for interview? "No." Does he think the fact that he was might indicate that he needs a higher profile? "Ha, ha. I think it's true." That might have been a rude thing to ask, but he thinks it makes a serious point about how health issues are communicated. "We are notoriously bad at front-footing anything we do. It comes back to an intrinsic, not arrogance, but to an assumption that, if that's a good idea according to me, that must be a good idea and you must realise it to be a good idea." Which does sound like arrogance. "Yeah, I was frightened of using the word too often."

He is a reformer, then, who has been described as a maverick. I think this means he has strong opinions, which is what you imagine he has been employed for.

Does his profile matter? "Yes, it does matter because ... you see, we need people to start doing things quite differently ... which means we need to recruit them."

Which means he has to be the marketer of the reforms. I'd say he's pretty adept at that. He is urbane, charming and clever, but he doesn't dress things up with marketing gobbledygook. He can whack hard. He talks a lot about how the health system is unwilling or unable to change; about the underlying arrogance of health workers.

This assumes that he doesn't share the trait. Why doesn't he? "I think we all do. With time and experience comes a realisation that, in fact, arrogance is the key thing. Also, my time in the Navy helped a great deal. I've had another life."

This other life involved that "attack swimming" which really ought to be on his CV. What it involves is using swimmers to attack ships. Goodness. With bombs? "Yes. Certainly." Has he blown things up? "No, no, no. I certainly trained to do that, but I haven't." He has never killed anyone, which is an odd but irresistible question to ask of a doctor. "No. Not that I'm aware of!"

This is slightly disappointing - although perhaps not if he is your doctor - but still fascinating. The Navy wanted medical support for its special operations team, "so they figured the only way a doctor could begin to understand what the needs were, was to have that doctor walk in their shoes for a while. So the logic behind me doing all that training wasn't so that I could wreak havoc on a, ha, unsuspecting enemy, but so that I could actually understand these people ... and it was hugely valuable for credibility".

Understanding the psychology of the team meant behaving and looking just like them. "Absolutely." So he was a pretty tough guy? "No. I was marshmallow." I'm not sure I believe him.

He said, "Well, that credibility issue, and understanding other people and how they think and behave, is of course at the core of what we're doing here. The way you lead clinical reform is by using clinicians because they have that same credibility issue. I can have conversations with other clinicians that non-clinicians cannot have ..."

That is a nice segue and is the interviewee's equivalent of strategic attack swimming: He dived under my questions and emerged, right where he intended to be, after having cleverly and covertly blown those questions to smithereens.

He says his job is political only in that it is "healthcare politics" but he's as good at staying on message as any politician. I asked him what it was like being in a submarine.

That counted as a good question, which he turned into an analogy about how the sense of camaraderie and collegiality on a submarine, are "what we need to reinstall back into the health service". He will readily admit that his time in the Navy has made him a good tactician.

The other thing he is remarkably good at, although he would say I'm over-emphasising this, is at being the outsider who becomes the most successful insider.

He is an Otahuhu boy, whose father was a meat worker originally from Queensland and whose mother, who is half Ngapuhi, was a nurse. He was - there is another photo of him with his maternal grandmother - a little boy with white curls and blue eyes who went on to become dux of Otahuhu College. When he arrived at med school, he had never been inside a library.

He likes to tell a story about being asked, at his interview: "Which New Zealand artist has made the greatest contribution to New Zealand society?"

He thought, "New Zealand's got artists? I know that sounds ridiculous and puerile, but that's what I thought." He also thought, and still thinks, that the question was "classist". He insists he mentions this not because of "any perverse pride or ongoing distress ... but because other people picked up on that distress and saw it and managed that and supported me and I have carried that not with any sense of grief, but with a sense beyond gratitude". What he has carried from the experience of arriving, unhappily, at a place where he looked at all the King's College boys, the Auckland Grammar boys and St Cuthbert's girls and thought, 'These people are from another planet' is his belief in pastoral care. He, on the brink of chucking it in, "was on the receiving end of fabulous pastoral care".

You'd easily forgive a little private crowing about now heading that medical school, but he isn't made like that.

Somebody once wrote, condescendingly, perhaps, about the many anomalies of his life, including that he is a working class son who loves opera. "I do like opera." Is that an anomaly? "No. Why would it be? Opera has its roots in the working classes. Who doesn't like inspiring music? It moves us all. The only possible anomaly might be a matter of exposure or opportunity."

He never had a sense of "being bright" at school. He was dux, he must have had some inkling he was clever. "In the land of the blind, the one-eyed man is king, Michele."

That is absurdly modest. I tried it another way: When did he realise how ambitious he was? "Ha, ha. I'm not sure I agree with your premise." He had already mildly ticked me off for calling him a very powerful bloke. "This is a position of enormous responsibility."

He believes in responsibility then, in God (but not organised religion) and duty and citizenship. "But that sort of stuff is very hard to express without feeling like some sort of dill."

Some dill. He's very clever, which you'd expect, and engaging, which you might not. And I would say he's above all decent - except that might make him sound like the dull bureaucrat he's far from being.