Dr Larissa Trease - Chief Medical Officer, Australian Paralympics Committee, Beijing 2008

Dr Larissa Trease
'My job is to coordinate the health and wellbeing of the team. But it's much more about facilitating an elite performance than it's about helping someone with a disability.'

At the age of just 30 Larissa is leading the Australian Paralympic medical team in Beijing. She has been working for the Australian Paralympic Committee for the past 18 months.





Why did you first decide to get into medicine?

I wanted to work in sports medicine. During high school I was involved in cross-country skiing, and unfortunately had a lot of injuries and spent a fair bit of time seeing sports doctors. I thought it was a pretty cool job, so I went into medicine wanting to do sports medicine and was lucky enough to end up here.

How many people work in the Australian Paralympic medical team?

There are 26 of us for 170 athletes.

What do you do in your job as Chief Medical Officer?

My job is to coordinate the health and wellbeing of the team. I've divided the role into staff, screening and supplies. So the first part is to put together an amazing team of clinicians, physio, massage therapists, a nurse, sports scientists and psychologists to support our team and get them ready for the games.

The next step is screening all team members and identifying anything that might place them at increased risk during the Games, and then come up with management plans to help them prevent anything from going awry. That involves travelling from all of our sport camps, training camps and staging camps and educating our athletes about some of the things that might be medical risks to their performance, and putting in plans to try and prevent them from happening.

Then there is coordinating the supplies that we need in order to look after our team while we're in China, and working with our Medical Program Coordinator to get all of the supplies over there.

Can you tell us some of the issues that you've had to look at before going to Beijing?

Most of the things we've shared with our Olympic colleagues, such as the temperature and humidity, the quality of the air, and also the difference in food and water to what we have in Australia. They're really the main things we've been focusing on.

We've also been educating our athletes about the Chinese way of life; Chinese culture is quite different to Australian culture, and sometimes an adjustment is required.

There are also massive crowds anticipated for the Paralympic Games so we've been talking to our athletes about noise and focus and those sorts of things.

It's interesting that it's not just medical issues that the medical team deals with, but also helping the athletes feel comfortable.

Yes, we've got a plan in place so that our athletes are familiar with the environment, and are able to perform to their best. We try to encourage the athletes to investigate the place they're going, and what's unique about it, so that they are really forearmed with that knowledge. Just as they need to acclimatise to the heat or the humidity, they also need to prepare for the environment of the Paralympic Village, comprising 6000 athletes and much staff on top of that. It's a pretty unique environment and is something that we try to get the athletes ready for.

What will your day-to-day role be like in Beijing?

My day will probably start relatively early, hopefully with a bit of time for myself! Then breakfast in the dining hall. I'll help our recovery experts in the recovery centre   looking at athlete hydration first so we're in a position to change anything that needs to be looked at before competition. Then coordinating all of the medical service providers, touching base with our physios and massage therapists who are attached to specific sports and also having a short meeting in our Central Clinic where we have a lot of our allied support; recovery, nutrition, psychology and where we look after a lot of our smaller sports that don't have their own practitioners. Then probably going out and providing some on-the-field coverage for one of the sports which is my excuse to do what I love – to watch sport. I share the clinical role with two other doctors so another task is coordinating to make sure there's always one of us at the clinic and that the others are around and available for anything that might need to be done.

I'm also part of the team executive so I report to the Chef de Mission and the assistant Chefs de Missions on any medical issues that have come up during the day. And at the end of the day I touch base with all of the sports specific practitioners to make sure nothing has come up during the day, have a review with our Central Clinic staff and then off to bed. They're nice, long, busy days.

How much more complex and challenging is your job due to the fact that you're working with disabled athletes, as opposed to able-bodied athletes?

I've just come back from a conference in China where the keynote sports medicine lecture was 'Paralympic Athletes: The Greatest Sports Medicine Challenge'. The Paralympic athletes tend to have more medical complications as a result of their disability when compared with their able-bodied Olympic colleagues. In particular each of the disability groups has their well-known specific issues that we try to address in advance.

We're actually hoping to conduct some research where we compare the presentations in our clinic with those in the Olympic clinic. And I think we'll find that they're actually very similar, especially comparing sports, but that we'll occasionally have something that's quite disability-specific pop up. So most of it is to do with the fact that we're dealing with elite athletes and they're training to the best of their ability and really pushing their bodies, but there are still specific medical issues that we need to be aware of and address. I think our athletes also have the potential to become more unwell than their Olympic colleagues on the basis of some of their disability-specific issues.

Do you think the image of the Paralympics has changed over the past 10 years or so?

Certainly. I've come to it from a sports medicine background from an elite environment, and I think it's moved quite significantly from having a disability focus over the last say 20 years, to an elite sporting focus. Today it is recognised that these people are elite athletes who train and take all the preparation that they can to allow them to perform at their best, and as part of that they have a disability. But it's much more about facilitating an elite performance than it's about helping someone with a disability.

It's quite exciting, because a lot of the things where we have athletes pushing the boundaries of their disability can then be applied back to people within the community who have a disability. It actually improves their functioning and their quality of life as well.

What's your background?

I did a medical degree at Monash and worked in the hospitals for a couple of years. I'm still doing my specialty training in sports medicine, that's another four years on top of my medicine degree   I'm now a sports registrar. While I was at university I also did a research degree in sports medicine.

When did you first work with disabled athletes?

In 2006 I went to the Asian Games for the Disabled, which is like a warm up event for the Paralympics. That was in Kuala Lumpur. I've been involved ever since.

What advice would you give to Australians considering pursuing into a career in medicine?

I think it's a fantastic career. There are so many different fields that you can go into that you have the opportunity to pursue whatever it is that takes your fancy in medicine. We always used to laugh that finishing medicine was like finishing Year 12 because you have so many choices, and I do think that there is something for everyone. There are always jobs available.

You have to work hard and you have to study really hard in Year 12 or to sit the GAMSAT. That's only a warm up for the rest of medical school. And when you finish medical school you're only just beginning. You're looking at a minimum of another four years of training after that.

You're quite young to be in this position ...

I'm very fortunate to have been given the opportunity to do the job. There's certainly a preconception that you might be older to be doing the job I'm doing. I'm lucky to have an amazingly experienced team, some of whom have been practising their particular field of sports medicine as long as I've been alive. We've got a lovely mix in our team of experience and enthusiasm.

What's next after Beijing?

I'm having a very big holiday! I'll go back to working in private practice in sports medicine, full time. I hope to continue my Paralympic affiliations. I also work with the Gems   the baby Opals (able-bodied junior women's basketball).

Quirky question: what is the strangest job you've had?

My parents owned a poultry shop, so I can take all the bones out of the chicken and roll it up to make a roast. My dad used to tell me this was very good training for being a surgeon!

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