It rained last night in Katherine. Riding my bike to work shortly after sunrise along a dirt trail behind a pocket of suburban houses, I see fresh pram tracks. They must have been made before dawn, and a few hundred meters along they veer right onto a narrow path defined in the scrub by regular traffic. In the distance, under the thirsty trees and tall dry grass, a small tent sits silently in the morning stillness. The beating sun is already hot, and a few pots hang from a stump.

I've seen these tents pop up and disappear, and a few tarpaulins hanging between trees staying in place for months at a time with collections of cans, old chairs, shopping trolleys and blankets gradually accumulating. Occasionally, I see a figure stooped over a fire. The homeless population of Katherine – the "long-grassers" – form spontaneous bush-camps at the fringes I imagine not too dissimilar to how Bennelong spent his last days by Sydney Harbour.

I have never seen children in these camps, but sometimes wonder at the size of the footprints in the sand. With 15% of the town's Aboriginal population homeless – the highest rate in the country – this scene is an inherent part of contemporary life in Katherine rarely appreciated by the steady flow of tourists who come north over winter to escape the cold and take stories south.

My cycle to work continues, down the pock-marked old runway that once landed warplanes 60 years ago, and past the Katherine cemetery where more than a few of my patients have finally lain to rest – a lifetime under the beating sun finally rewarded beneath the cool mahogany-covered shady lawns beside the river. Finally, I turn into the frangipani-lined driveway of the hospital; the smell is so pungent that the air feels sticky.

The pram tracks and the cemetery come together in my mind. An Aboriginal man who was a patient of mine passed away a few weeks back. He wasn't old – in fact he was the same age as me, and I'm not quite middle-aged. But his body was old and worn, a consequence of a very hard childhood, crushing tragedy at every turn, an absence of opportunity regardless of education and a decision years ago to numb the pain with grog. He came to the hospital with few expectations, extremely unwell and with a handsomely sad face. I knew he had only a little life left to live and told him; he accepted his reality and asked me to do anything I could.

This man's sadness is a normal daily heaviness that I live with. The Katherine region has a brutal history of colonisation and every Aboriginal person I meet wears its scars. My friends who are survivors of authoritarian regimes overseas have survived and prosper. Their scars exist, but for the most part life is good. But for most Aboriginal people in this town, their grandparents were born into an ancient land, living lives that I guess were probably not dissimilar to the way my own ancestors lived many thousands of years ago. These survivors of colonisation did not end their journey in a land where they could find safety and prosperity at least. Instead, they were engulfed by a world so profoundly different that nothing at all was familiar – not a brick, not a spoon, not a thread of cloth. These are complex generational scars, and for some the wounds will never heal.

When I first met this man on the wards of Katherine Hospital, my initial reaction was frustration with a tinge of anger. How could a young person allow such profound pathologic processes to overwhelm his body? Why did he drink so much alcohol? It's hard to watch a young man die from a completely preventable death. Yet his story is not unusual; in fact it is normal. The life expectancy of an Aboriginal man in this region is 49, he was about 10 years shy, and there is a reasonable number of young men like him who drag down the average.

He was a really likeable bloke. Timid, but happy for a chat. My registrar spent more time with him than me, possibly with more hope and compassion than I could afford because she was leaving Katherine a few weeks later, and noticed that he would sit on the veranda of the hospital, always in the same spot looking out towards the cemetery, his eyes fixed on something distant and untouchable.

One afternoon I sat with him, ceiling fans whirring and warm moist air always prefaced with the faint smell of stale cigarette smoke. I asked him where he would like to "finish up". Many of the patients I meet have strong attachments to their country and want to die on their land. At first he was silent, his gaze on the cemetery. "My daughter in that cemetery" he said, eyes moist but without tears. "I wanna be buried next to her".

She had died when she was just nine – a car had run her over. I don't know if alcohol was a participant in the tragedy. It was 15 years ago and had broken his heart and his spirit, and I suspect also his will to live. His life disintegrated and he became itinerant, living in Darwin, Katherine, over to the west and down to the southeast, where his country was.

Plagued by alcohol and progressive poor health, he'd finally come back to Katherine because he felt close to the end and needed to be near his daughter. He told me that over previous years he'd found it hard to come back here, as the memories were too much. When he did visit, he would spend a few weeks drinking heavily down by the river and would retreat to the cemetery at night to sleep by her grave. Now he knew he was at the end, and he was torn between a desire to die on traditional country and his profound and unresolved grief.

Katherine cemetery is a peaceful place, sitting at the northern end of the old runway and from the practical realities of the time the town was planned, next to the hospital. The river runs silently past on the western boundary, and once every decade or so its ferocity overwhelms the banks and deposits another layer of fertility that keeps the grass green and the trees enormous. There are always flowers on the graves, and solar-powered multi-coloured lights are also popular adornments that leave an eerie night-time presence under the great African mahoganies.

A few weeks ago, I picked bagfuls of mangoes dripping from the trees that lie along the fence between the hospital and the graves. My two little daughters sat in the tray of the Hilux, sweating in the afternoon heat and carefully placing the mangoes in bags as I handed them down, excited to get home to eat the juicy fruits. They didn't see my tears as I was up in the tree giving my silent farewell to a father who loved his daughter as much as I do mine. It was a death that represents so much about the history of this land, a death shared down the line of fringe-dwellers all the way from Sydney Cove to Katherine river, the last ripples of colonisation.