Marika Azzopardi meets Dr Alfred Grech for an insight on the daily work of a GP and the life of miniature trees.

TS: What can you tell me about your career as a doctor?


I graduated in 1985. Over the years I experienced several different aspects of being a GP and family doctor. For instance, I was, for a substantial amount of time, one of the doctors responsible for the Malta Drydock employees in the south of Malta, visiting them at home when they were on sick leave. I also had my private clinic, serving families in Kirkop which is my hometown, as well as Safi and Luqa. Eventually, two years ago, after several years working also at the Paola Health Centre, I opted for Contract A. In order to conform with the conditions of this contract, similarly to other doctors working in health centres around Malta, I had to terminate my private practice and now work solely at the Paola Health Centre. It was very difficult letting go of my private practice because I miss the aspect of patient continuation. I actually felt bad telling my patients I was closing my clinic. Many of my patients knew me on a first name basis since I had taken care of their health and that of their family for many years. On another note however, this change in work schedule has also changed my work rhythms and given me a new lease of life with so much more free time to spend with my family and doing what I love best ….


TS: What can you tell me about your present role?


I am presently Principal General Practitioner (PGP), sharing the workload with another PGP here. At times, duties are mostly management-oriented. A case in point is the allocation of all the doctors in the centre, when the other PGP is on leave, creating a daily roster to fit around the needs of this busy health centre. We are all preparing for the eventual new Paola Health Centre which will be a state-of-the-art health hub at the site of the former Schreiber ground.


TS: Speaking of doctors, especially young doctors, what changes have you witnessed over the years, regarding their formation?


In my case, after emerging from university I had three months’ experience in dermatology, three months’ experience in surgery, three months in medicine and another three in psychiatry. That was it. After that, I was allocated to Paola Health Centre. I still remember my perplexity with skin rashes. For example, prior to my commencent at the health cantre, I had never seen chickenpox manifested on anybody. I quickly learnt after observing a seasoned doctor diagnose spots on a child as being chickenpox. Before that, I had absolutely no clue what the spots indicated. Today things are so much different and much better for new doctors who can consult their assigned mentors for guidance when in doubt.


TS: Can you identify some cases which touched you over the years?


Personally speaking, the most impressive cases which left me considerably distressed were suicide cases and stories of gross neglect as in the case of the very elderly. As a young doctor, you receive a call and you have to go in and deal with horrendously difficult human stories which touch you to the core. We never had counselling to help us overcome such experiences. I very much doubt whether new doctors are given any such psychological assistance even today.


TS: Were you ever tempted to train further and specialise?


No. I was content with becoming a family doctor and GP. But today, in hindsight, I know that, given a second chance, I would have gone in for research in molecular biology, specifically into epigenetics. I love to read mostly about molecular biology, but also on quantum physics, and cosmology. I have an innately inquisitive nature. My first interests were nature and magic. I was always curious to know what lies behind the facts, and unravel the hidden processes of that which is not visible and not evident. It was one of the main reasons why I chose medicine.


TS: I know that you find great solace and pleasure in a special kind of gardening. Can you amplify?


Indeed, and it all started thanks to my curiosity. I came across a book about bonsai trees and was instantly enthralled, because as I read, ‘how can a tree which in the wild is so big and majestic, be grown on a much smaller scale in such a small pot, surely there are hidden secrets involved!’ After reading this book, I was hooked for life. The Bonsai Culture Group-Malta already existed and I joined immediately. It was the best thing I could have done. Whoever becomes interested in bonsai generally makes a rudimentary mistake of doing it alone. This only results in catastrophes. A group will guide you about the bonsai’s growth process, techniques, etc. Eventually, I became the Bonsai Culture Group’s General Secretary and have been so for the past 16 years. The fact that I like to organise events and bring people together has helped me immensely.


TS: Can you tell me something more about bonsai?


Well the culture was born in China but the Japanese took it to a much higher level, by establishing styles and strict rules. I personally prefer classical bonsai styles although there are now several schools of thought which prefer ‘modern’ style bonsai. Whichever the style, the basic horticultural techniques remain the same and must be fully mastered for success. Some bonsai trees can be grown from seed. Others grow from cuttings. Nonetheless, on average, a bonsai will take anything between five and eight years to reach an accepted level of maturity from such humble beginnings.


Also one needs to point out that bonsai is a living art form with four dimensions, where time is of utmost importance, since certain aspects need time to be achieved and also, no true bonsai is ever actually ready. Bonsai cultivation can serve as a de-stressor especially if you go into its philosophical connotations. Indeed, as a famous bonsai artist John Naka once said, ‘Bonsai must have philosophy, botany, artistry and human quality behind it to be a bonsai’ and ‘The bonsai is not you working on the tree; you have to have the tree work on you.’


For more information about the art of making bonsai, please visit


I read The Synapse because….


There is always something that interests me and intrigues me to further it by doing some research. Also I like the editorial which is so nudging and suggestive and at times entertaining but always with subtle useful messages.