How did you become involved in working with the military?
The recruiters' answer is that anyone would choose 'the easy life' of working with young, fit patients who have rapid access to physiotherapy and mental healthcare, and call you 'sir'.
The real answer is, only the sick need doctors. Seeing 19-year-olds with shrapnel wounds, deafness and mild head injuries from IEDs (improvised explosive devices) is interesting enough.
Mix this with appointments with 21-year-old snipers, a driver, a chef, a couple of mechanics and then a meeting with the chain of command about how they are all doing, and that's a typical army GP morning.
I work as a GP locum with 1 Rifles, the infantry brigade in Chepstow, Monmouthshire, the Royal Navy's 40 Commando in Taunton, Somerset, and the RAF at Brize Norton, Oxfordshire.
Dr Nimenko's novel, charting the psychological journey of a traumatised serviceman, is available from Amazon on Kindle and in paperback.
Some 40% of marines go on to become officers and 40% go into special forces, so a morning's surgery with the Royal Navy is usually only minor physical problems. But you're always on the lookout for the odd case of 'slow burning' post-traumatic stress disorder.
When did you start working as a trauma psychotherapist?
I started seeing very traumatised patients when I began studying psychiatry. I realised that I was interested in trying to help them so they could get on with their lives, like my parents tried to when they came to the UK.
My mother was brought up in a workhouse in the west of Ireland and my father was orphaned during the famine in eastern Ukraine before World War II. Coming from a traumatised family makes it easier to sit with trauma, but also makes you want to do something about it.
Why did you decide to switch to general practice?
I like the terrestrial as well as the celestial, so I found myself drawn to general practice.
I like the more immediate satisfaction of being able to correct something physically wrong quickly and I've always liked being a physician. But throughout, I've carried on working as a psychotherapist.
Working as a GP in the military has given me the opportunity to come up with two new psychological ideas.
One, soon to be published, was the first research into the use of archaeological digs as psychological decompression for soldiers who return early from active service.
The other is the recognition of post-repatriation stress disorder and the need for training, monitoring and support in the armed forces and emergency services.
What about your work with human rights organisations and the NYPD after 9/11?
In the 1980s I was one of the first GPs in the UK to work with survivors of torture. I worked with Amnesty International and as a trustee of the Medical Foundation for the Care of Victims of Torture, now known as Freedom from Torture.
I worked with victims of torture for nine years but I've also worked with the homeless, who are a mixture of ex-military, asylum seekers and victims of domestic violence, childhood abuse and torture.
I find it difficult to see how you can be a GP and not be passionate about human rights for your patients.
I worked with the New York Police Department eight months after 9/11, at the invitation of a support group, Police Organization Providing Peer Assistance. It was no different from working with the police here, except they are not so conservative about getting help as the British.
Tell us about the plot of your recently published novel
Invisible Bullets is about the delayed and unseen damage that occurs after some events. It is about the suffering and recovery of Robby, a loadmaster on a C17 transport plane, who has done too many RAF repatriations.
Robby is haunted by nightmares and flashbacks after killing an 8-year-old girl suicide bomber in Afghanistan. Homeless after leaving the forces, a failed suicide attempt brings him to therapy and then a priest, but it is only the instructions given by a dying woman that show him the way to forgiveness and acceptance.
What made you decide to write the book?
My wife kept on at me to write a self-help book, but I don't read them because like most GPs, I don't like being told what to do. I thought, rather than 'tell', it would be better to 'show' what works, hence the novel.
It is fiction, but it draws on my experience. It is my understanding of how we see ourselves and the world.
The book also describes the armed forces' problem with repatriations and the need for research into post-repatriation stress disorder, which is a sensitive topic. It shows what works and how those who suffer trauma may have a greater capacity for inner happiness. It should be of interest to anyone who has experienced psychological trauma.
- Dr Nimenko also blogs at www.invisibledoc.org