Canberra paediatrician's great toil on behalf of tiny lives

Like paediatricians everywhere she has what is ironically referred to as ''the wall of shame'', a montage of drawings, clumsily written letters and cards and photographs of happy and smiling faces. Each represents a small life she has touched in her work as director of the neonatal department.

While all doctors save lives, the work of a paediatrics specialist is particularly important. If you pull an ailing infant back from the brink you may be giving somebody another 80 or 90 years of life.

Dr Kecskes, a mother of two, says it is a given she loves children and working with families. ''Of course I love children, [of course] I like working with families,'' she said. ''I wouldn't be much good at my job if I didn't, would I?''

One of the attractions is working with young people: babies, infants and children with their whole lives in front of them, and young parents who want to do the very best they can for the lives they are responsible for.

''I used to be younger than them [the parents] but now I am older,'' Dr Kecskes said.

That comes in handy given her job is treating families, not just the individual patient. Babies are the greatest challenge.

''We know so little about them; we have to be so careful. They are so small and so vulnerable; everything has to be safe. You have to ask yourself, 'do I need to do this procedure?' You need to treat them differently [than an older patient]. You can't do a thing without the support of the family.''

Then there is the problem, shared with vets, that you have a patient who can't verbalise what they are feeling or what their symptoms are. On the plus side, most children are born fighters.

''Babies are resilient; they are capable of dramatic turnarounds [in health]. I remember one who I was so sure we were going to lose. That child is six now,'' she said.

Time and technology have been on the doctors' side in recent decades. While children still die as a result of trauma or disease, their odds of survival once they reach hospital are continually improving.

''Some babies always stick in your mind. One was very, very sick. It was, of course, the middle of the night. We were at the end of our tether; we had tried everything. [Then] the parents allowed me to use a drug that was little known here but in common use in Scandinavia.

''I just looked at this baby and I wanted to see her run around. I desperately did not want her to die. I was going to do everything I could to turn it around. We work very hard; sometimes you are at the bedside of a baby for 36 hours straight.

''People think you are nuts. There are so many babies here and you are spending all that time with this one. This is the one that really needs you (that's why). It is not about your knock-off time or going home.

''Losing a child patient can be terribly hard - but it is manageable so long as the doctor knows, and the parents know, that everything that could have been done was done and was done properly.

''Sometimes babies die. When babies die you need to be with the family. You have to let them be sure you couldn't have done anything better. You have to be satisfied [that that is true]. You want to be able to look at yourself in the mirror; you want to know, when you see the parents at Woolies that we [the hospital] did everything that was known to baby science.''

For the past five years Dr Kecskes' life has been dominated by the planning and construction of the new Centenary Hospital for Women and Children adjacent to the existing hospital's site. It incorporates a Ronald McDonald House, much improved ward and patient facilities, and the best medical technology available.

Dr Kecskes worked hard to make sure that what was built gave patients what they wanted and needed, not just a bigger and better version of what had been there before.

One innovation, which she picked up during a conference in Europe, is the installation of webcams over beds so that parents and family members unable to come to the hospital can log on and see how their child is doing.

''Forty per cent of our patients come from outside the ACT,'' she said. ''Often only one parent can stay here with the child. Other family members don't get the chance to make a connection with the child or infant. This gives them that.''

Other hospitals around Australia are now interested in adopting the technology.

Dr Kecskes has never worked a 40-hour week and, in turn, expects others to provide what is necessary to do the best for her patients.

''We need to throw all the resources we can at paediatrics,'' she said. ''That is the future; these babies are the ones who are going to pay taxes for my pension and look after me when I get old.

''Yes, it is a lot of hard work. We follow them up until they are three years old. When you see a three-year-old laughing and smiling you know it is worth it.

''It's great [my job]. I love it. It is the bloody best.''

It is also a job she intends to keep doing in Australia, despite having her roots in Europe.

''I fell in love with the [Australian] people first and then the countryside. It was after that I met my husband,'' she said. ''Even though I had straight As in English [from school] I had to learn Australian. At first when people asked 'how are you?' I used to start to tell them. But nobody cared. It was a figure of speech, not a question. I loved the multiculturalism

of Sydney; on the street you see every type of person from all over the world. It's fabulous.''

Dr Kecskes said that compared with Europeans, Australians are less judgmental and take pride in their people and communities. She witnessed that first hand during the Canberra bushfires when the community rallied around with donations of clothes and other items for the people who had lost everything.

Her first visit to the Australian War Memorial was challenging. She had feared it would be a place that would focus on the evil of the Germans and how bad they were. ''But it wasn't. I was so happy to see how objectively history is represented; the AWM respects the courage of people from other nations, including Germany.

''As a German I was raised to be guilty. The war is still on Germany's mind but not in a positive way.''

In addition to her work as an administrator, supervisor and trainer, Dr Kecskes also handles a full clinical caseload. ''Clinical work keeps me balanced,'' she said.