Dr David Smart (BMedSci 1981, MBBS Hons1 1984, MD 2005) understands pressure. He is a world leader in diving and hyperbaric medicine, alongside his career in emergency medicine, having practiced, researched and taught across these fields.
When he graduated from Medicine in 1984, the top medical graduate in Tasmania that year, neither emergency medicine nor hyperbaric medicine were recognised specialties – something he has helped to change.
Six years later, Smart received the Buchanan Prize from the Australasian College for Emergency Medicine for being the top graduate in Australia in his Fellowship exams. In 2004, he was awarded an Order of the International Federation of Emergency Medicine for his international contributions to emergency medicine.
Smart went on to chair the Scientific Committee of the Australasian College for Emergency Medicine. He was also Director of Emergency Medicine at both Calvary Private Hospital and the Royal Hobart Hospital (RHH) – a role that saw him lead the medical response to the Port Arthur tragedy in 1996.
“RHH had a comprehensive disaster plan, which we had finalised only weeks preceding that event,” he said of the coordinated response that is widely regarded as having been world-class. Without such preparation, the event could have been even more tragic.
In the field of diving and hyperbaric medicine (DHM), Smart was Medical Director as well as Supervisor of Training at the RHH hyperbaric facility – used to treat divers suffering from ‘the bends’ (decompression sickness) and other patients requiring the healing benefits of hyperbaric oxygen, such as for wound treatment.
Pragmatic is how he describes his research interests, which have led to 130 published scientific papers and abstracts. “I am interested in research associated with trying to fix a problem,” he said.
“I’m proud of what we’ve been able to do for Tasmania’s aquaculture industry. Our field research led to safe diving tables that didn’t exist previously. These are now utilised worldwide.
“Another major achievement was leading the design and commissioning of the new world-class RHH hyperbaric facility, which also has hypobaric (lowpressure) functionality and unique capability for future research.”
Passing on knowledge is also important to Smart. For three decades, he has been teaching medical students at the University of Tasmania in an honorary role and was appointed Clinical Professor in 2015. “It has been a privilege throughout my whole career to teach. You touch the future with teaching,” he said.
And then there is his 25-year-long association with Fiji, leading emergency life-support training of remote doctors, a program developed by a team of Australian doctors that was rolled out in the Asia/Pacific region.
“We also teach management of serious illness in remote environments to nurses in Fiji,” Smart said.
“More than 200 doctors and nurses, many being sole nurse practitioners on distant islands or junior doctors on postings, have now completed the courses.”
He adds there are many Tasmanian medical connections with Fiji, including the late Emeritus Professor Ian Lewis AO, a previous professor of paediatrics at the University of Tasmania’s School of Medicine.
Smart is also lead DHM Examiner with the Australian and New Zealand College of Anaesthetists and past president of the South Pacific Underwater Medicine Society. In 2014, he was invited to provide medical supervision of the Australian Antarctic Diving Program at Casey Base.
“I feel incredibly fortunate to have trained and studied in Tasmania and to use it as a launching pad to work at national and international levels,” he said.
He challenges the way many people, including Tasmanians themselves, sometimes underrate Australia’s smallest State in terms of capacity and ability.
“I feel incredibly fortunate to have trained and studied in Tasmania and to use it as a launching pad to work at national and international levels.”
“It’s been an advantage to come from Tassie where you are not painted into a narrow, specialist corner,” Smart said.
“You have to see the bigger picture because there is a need to be across a broader range of skills and ideas here … I’ve really enjoyed the variety of medicine over my career. A degree from UTAS, working and training in Tasmanian hospitals, means you are able to mix it with anyone from the bigger centres.”
And then there is the place itself. “The opportunity to be able to access that amazing scenery and environment is a big advantage,” he said.
His advice to medical graduates is to choose your partner carefully, take your time when deciding on a specialty after finishing your initial degree, and find a medical field that stimulates you.
“You also need to know when to lift the drawbridge,” he said. “You can make a lot of difference to other people’s lives, but you have to make sure it is not at your own, or your family's, expense.”
“One of my resilience and survival techniques when there is too much in your portfolio is to intermittently rationalise and fine tune it.”
He describes experiencing burnout in 1998 after juggling a large workload with limited resources.
Personal experiences have also influenced his outlook on life. At just eighteen, his sister died suddenly from encephalitis. Then, several decades later, his eighteenyear-old daughter had a near-fatal anaphylaxis. Smart was the first doctor to attend to her, the worst case of anaphylaxis he had encountered, but his daughter survived, supported by excellent pre-hospital care.
Consequently, one of his mottos is, “Today is called to-day not one-day – don’t put off until one day what you can do today.”
Written by Katherine Johnson for Alumni Magazine Issue 54, 2023.
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Top of page: Dr David Smart diving in Fiji
Photo: Annette Smart