Former prostitute Lauren Roche took a long and difficult path to becoming a doctor. She tells Ruth Little how she overcame abuse, drugs, and alcohol and is now a general practitioner and author

"I finished medical school in November 1991. Only ten years earlier I was working as a prostitute," writes Lauren Roche in part two of her autobiography: this New Zealander has overcome incredible obstacles to achieve her dream of becoming a doctor.

Lauren had an abusive childhood and lost her mother to suicide at 14. She left school then, and she stowed away to the United States a year later. She was the victim of a gang rape while hitchhiking and was later imprisoned for three weeks for immigration violation at age 16. After returning to New Zealand, Lauren became pregnant for the first time at the age of 17. For the next few years she held a variety of jobs, including stripper and prostitute, and she worked at Kentucky Fried Chicken. Lauren misused alcohol and drugs during this period and had depression. Aged 20, she chose to leave this life behind, return to school, and go on to study medicine. Before medical school, she had her second child, who has learning disabilities.

Although Lauren had no long term physical consequences from her traumatic past, she carries many psychological scars. In an attempt to exorcise her demons, she began writing a diary which became her autobiography.

"It was a kind of therapy for me... things were looking really bleak and I realised that although I had overcome a hell of a lot to become a doctor, I had not focused on the underlying problems that I had from my childhood, and they came back to bite me."

The audience of her book is "people who have really stuffed up in their lives, to tell them that it doesn't matter what you've done, that you can pick yourself up and become whatever you're capable."

The question remaining is how did Lauren manage to overcome such adversity, and have the self belief and motivation to finish high school and become a doctor? Lauren's change began with a diagnosis.

"What happened for me was that finally someone recognised that I was depressed and put me on antidepressant medication, and as my depression lifted, so did the lethargy and the lack of self esteem and the lack of self belief... once I was no longer depressed I had the energy and the self belief to move ahead."

She went on to choose the profession of medicine partly because "being a doctor was such a lofty goal for me," and also in an attempt to neutralise her past. "If I became a doctor I believed that all the stuff that I'd done before would be kind of forgiven or negated... and because doctors are such good people--I believed. Also because I've always had a really deep love of people... and I like sciences and was good at them... I feel really privileged to be a doctor."

The choice of medicine was a leap of faith as nobody in her family had ever attended university. Although a few friends supported Lauren's goal, several discouraged her--often with the best of intentions. Lauren proved her dedication to medicine over the subsequent years. Unlike the average medical student, she had to complete medical school with the added responsibility of two children and little support: "I got around it by getting up at four o'clock every morning to study, by being very single minded."

Despite Lauren's abilities, her experiences as a student and later as a doctor were often shadowed by her sense of insecurity that she was an impostor, "I felt very very different to the other doctors... as a child my family had revered doctors... they were these kind of God-like things and here I was one of them and I didn't feel the least bit God-like."

Despite the challenges she faced, Lauren graduated from Otago Medical School in 1991 aged 30. She currently works as a general practitioner and sexual medical health officer. Her practice serves a population that includes many young people and sex workers: "I'm seeing people who remind me of the way I was. I really like to be able to educate people and to help people make responsible decisions and there's a very big role for that in sexual health." Apart from because of her background, Lauren was interested in sexual health because she was treated with memorable kindness as a teenager by a doctor at a sexual health clinic. This lady was true role model "that inspired me to look to do some kind of venereology... I just love the work."

Lauren also talks to and conducts group sessions for female prisoners. She has spoken to several groups in New Zealand and visited five prisons in the United Kingdom including Holloway and Low Newton. She will also begin speaking to male prisoners in New Zealand in the near future. She does this work "to give back some of the hope I've found along the way. To help women believe that it is possible to change for the better, whatever the past has been. My belief is that although some of the women I speak to will write me off as naive or just another do gooder, my story will help maybe one in each prison. To give one person hope that they can have another chance makes the grief of the past worthwhile."

Part of Lauren's success is also her ability to confront and deal with her depression. She found it difficult to seek help for her depression and take medication, particularly as student where she believed that, "You don't say anything. If you do seek help you'd better make damn sure that it stays secret."

Lauren now has a common sense approach to depression. She advises other doctors and students suffering from depression to "start to see is as a chronic illness... you should be no more ashamed of having depression than you would of having diabetes or high blood pressure... "

In her books, Lauren documents her vulnerabilities and mistakes as well as her successes. Most people have reacted positively, but some negatively.

The catharsis of her autobiography has helped her to come to terms with her past: "Going back through the past, I've forgiven other people for the nastiness that's happened to me [and] forgiven myself for stuffing up too... forgiveness has helped me to achieve a kind of a peace I've never felt before."

"I found that ruminating on nasty things that had happened allowed people to continue hurting me, many years after I'd last seen them."

Lauren asks her colleagues to think about their tendency to put patients into rigid boxes, "It's sometimes too easy to classify someone as once a 'something,' always that something. We often see people who have made big mistakes, we see people who have had addiction problems, all sorts of problems and we do tend to assume that they are going to be stuck in that model forever. People can make very big changes." You can read a review of part 1 of Lauren Roche's autobiography, Bent not Broken, on p127.