The Complete Book of Australian Flying Doctor Stories (12 page)

I was already really, really tired after having just arrived home off night shift from another flight. Then the call came through. ‘We’ve got a Code One emergency out at Nyrippi,’ they said. ‘A guy’s unconscious with a GCS of three.’

Now a GCS, or Glasgow Coma Score, is the way that head injuries are rated and, among other things, is gauged on your best verbal response, eyes opening, and your best motor response. If there’s nothing wrong then your score is usually fifteen. If it’s under nine you’ve got a serious head injury. Having a three wasn’t a good sign really; more like a life and death situation, with the odds stacked towards death.

Mark, the doctor, Peter, the pilot, and I flew out on that trip to Nyrippi. A sixteen-year-old guy had been cracked over the back of the head by a person wielding a firestick. Apparently the week before the young kid had caused some sort of trouble. This was his ‘payback’.

We got out there in about an hour which was pretty good considering that we had to drive out to the airport and pack some special equipment into the plane. Peter also had to do all his flight checks and so forth before take-off. Anyway, when we landed at Nyrippi the community officer was waiting to pick us up. So I grabbed whatever gear I thought we’d need and threw it into the back of his ute on top of his welding gear and bits and pieces of cars and other scrap. Then we headed into the community.

John was the community nurse on duty that night. I think it was his first week at Nyrippi, if not the first night he’d spent by himself out at the community. And he’d done a fantastic job. When the young guy had first come in he’d put a plastic stiff-neck collar on him to keep his neck in alignment. He’d put a drip in, got the oxygen on him, checked his blood pressure, and then rang the Flying Doctor Service in Alice Springs.

By the time he got back from calling us, the young guy had stopped breathing, and that’s when John started bagging him. So he must have been bagging the patient for at least an hour. By ‘bagging’ I mean physically squeezing oxygen into his lungs through a mask, virtually breathing for him.

It was amazing. In a hospital, you bag someone for ten minutes and your hands are aching beyond belief. Ten minutes and, like I said, John had been at it for at least an hour. It’s heat of the moment stuff. It’s all full-on. And John was the only one bagging. There may have been a health worker somewhere but when it’s their own family they tend not to want to be hands-on.

What’s more, fifteen or so of the family were in the same room watching every move John made, which must’ve added to the pressure. There were also a few extra police there by that time. They’d driven over from another community because they knew there could be some serious trouble brewing.

So we got into the clinic and Mark said, ‘Okay, what’s going on?’

‘This is the situation,’ John said, then explained the medical details and what’d happened.

Then Mark took over which gave John the chance to stand back for a while and catch up with things.
Of course, the first thing that Mark requested was mannitol, which is a drug that releases the fluid off the brain. Silly me, of all things to leave back in the plane, I’d left the mannitol. But, luckily, just a few weeks beforehand I’d shown Peter, our pilot, where everything was packed, just in case. So he was able to go back out and grab the drug from the bottom of the cupboard. While Peter was doing that I was getting ready for Mark to intubate by checking the patient’s blood pressure and his pupils, and putting up another bag of fluid.

And so we got the young guy intubated, which is sticking a tube in his throat to clear the windpipe. We continued to bag him, though. He was still unconscious. While we were moving him onto a spinal board for the trip back out to the airstrip we got Peter, the jack-of-all-trades, to do the bagging. When that was done, Mark explained the situation to the family.

‘Look,’ he said, ‘he’s had a big head injury and he’ll probably have to go to the theatre and have an operation.’

After Mark had finished talking, a faint wailing started to rise up from among the women in the room. And as that gathered momentum everyone outside began joining in. This wailing, I don’t know if you’ve ever experienced it, but it’s the most haunting sound you’re ever likely to hear. It’s filled with such pain and sadness that the hairs on the back of your neck go stiff. And there they all were, watching everything that we were doing and wailing at the same time. Louder and louder, all around us.

So we loaded the young guy into the back of the Toyota four-wheel-drive ‘troopie’ and I hopped in with
him. The grandmother and the auntie also hopped in and the two of them kept up this wailing all the way out to the airstrip. Meantime this guy’s blood pressure was really low and I was thinking, ‘What sort of situation are we in? No one would ever believe this.’ And you think, ‘If only people could see what it’s like, to be out here in the middle of nowhere, with these poor women wailing and their young boy fighting for his life.’ It’s so scary. It’s weird. It’s surreal. People just don’t believe that you have those sorts of experiences.

By the time we reached the airstrip, about sixty people had gathered from the community. There they were, all just wanting to touch the young guy because they thought that it was probably the last time they’d see him alive. By then the wailing had built up to be a whirlwind. It was like a wall of sound. And it just went on and on and on, spinning around us.

Eventually, the police stepped in and gave us a hand to get the patient onto the plane. One of the family members, a cousin it was, came along to keep the guy company. By that stage Peter was quite distressed. He’d never seen or heard anything like it. It really got to him.

Anyway, we got the young guy onto the plane and as we were flying back to Alice Springs his heart suddenly faltered. It went into an odd sort of rhythm. And that’s when you realise that you’re all by yourself. There’s no one you can turn to and ask ‘What do you reckon about this?’ because you’re just up there in black vastness. You can’t even fax anything to anyone.

It makes you realise just how isolated you are in a situation like that, when you’re thousands of feet up in the sky. No one’s there to help you. Even when you’re
being trained in a hospital, they say that if a patient has a cardiac arrest then there’ll always be someone to do the airways, someone to do the chest compressions, someone to do the drugs, someone to write it all down and someone else will be there to do this, that and the other. But there we were, just Mark and I, a doctor and a nurse, doing everything we could, and there was this poor young guy, deteriorating further and further.

Still, we managed to get a request through for an anaesthetist to meet us at the airport. Then as soon as we’d landed and got the patient into the ambulance the anaesthetist came and took one look at him. ‘Go!’ he shouted to the driver. ‘This patient needs lots of people focusing on him.’

So the ambos and doctor drove into the hospital with lights and sirens blaring. By that time the young guy was having a cardiac arrest. In the plane I’d noticed that he had a big lump on his temple. It’d sort of swelled up. Like, there was no blood coming from his ears. There was no obvious bleeding from his head. It was all internal.

After the ambos had left, I went back out to clean up the plane. Though he hadn’t bled externally, he’d still lost a lot of bloody frothy sputum and there was a mess on the floor. So I cleaned that up. Then I cleaned the equipment. Then I restocked the plane so that it was ready to go again, just in case something else happened.

I must’ve spent an hour or so cleaning and checking things. By that time it was four in the morning. As I said at the beginning, I was already really tired from a night shift, before the call from Nyrippi came through. But in those sorts of situations your brain doesn’t
stop and you’re always thinking, ‘Could I have done something better? Is there something that I didn’t see?’ Always analysing things.

So on my way home I decided to go into the hospital and that’s when I was told that the young guy had passed away.

All the staff were good about it, reassuring me that I’d done everything I could. He’d had an autopsy and it was found that his skull was cracked right across, from one ear right through to the other.

‘There’s nothing more you could’ve done,’ I was told. ‘Even if he was in the neurology unit he still would’ve died because he’d had such huge internal bleeds.’

But it still upset me. I was also tired beyond belief. But I just wanted to go outside and sit by myself. Just to take my breath. I needed to be alone for a while. So I went outside and I was sitting there, about half-past four in the morning. Everything was quiet, dead quiet. I was tossing things around in my head when a wind blew up from a distance and I swear that it brought with it that haunting sound of people wailing.

Bush people are different, you know.

There’s two types in our area, out from Broken Hill. First, you’ve got the sheep people. They’re pretty urban sorts because they come to town a fair bit. Then there’s the other breed, that’s the cattle people. They live right out in the harsh country.

The cattle people don’t get to see civilisation too much, maybe once or twice a year, sometimes even less. They’re the ones you see around town with the big hats on. Slow movers they are, and they talk in single syllables. ‘Yeah. G’day. How, yer, goin’? All, right.’ That’s because, out there, there’s not many people for them to mix with, except for their own types. But that’s their lifestyle and they reckon it’s wonderful, and you can’t knock them for that. They probably think that our lifestyle’s pretty weird, and you couldn’t blame them for that either, especially with all the goings-on you read about in the paper and see on the box.

But it’s the isolation that makes the cattle people so unique.

There was an old bloke. His name was Joe. And old Joe was one of the cattle people types. He had been most of his life. He’s gone now, God rest his soul. And what you’ve got to understand here is that there’s a lot of these old fellers, just like Joe, who live out on these stations. They don’t own the stations, like. They don’t even manage the stations. Yet they’ve lived on the properties for most of their lives, helping out here and
there, doing odd jobs, mostly as jackaroos. And a lot of them never get married but they become like family so, when they retire, they just go on living on these stations in a caravan or something.

Anyway, old Joe was a real bushie, retired he was, and he developed a medical problem which we had to keep an eye on. But when we suggested that he move into Broken Hill he dug his heels in.

‘There’s no way I’m gonna live in a place with street lights,’ he complained, and you could tell by the steely look in his eye that he meant every word of it.

So the next best thing we could come up with was for him to move into Tilpa where we flew in regularly to do clinics. Tilpa was the ideal place. There definitely weren’t any traffic lights there. Dead quiet it was. It had a population of about eleven, if you can imagine that — just a pub, post office, petrol bowser, that sort of town. But Tilpa had a caravan park, in a manner of speaking. Pretty basic it was. Nothing like the ones you see in the tourist brochures. What’s more, it didn’t need to be too flash either because you’d be lucky to get one or two tourists coming through every month or so, and that was in peak season.

So old Joe agreed to come in off the station so we could keep an eye on him. Which he did, and he instantly laid claim to being the only permanent resident in the Tilpa caravan park.

As I said, having the problem that he did, whenever we were up there we’d go and visit him in his caravan.

‘How yer doing, Joe?’ we’d ask.

‘Yeah, okay,’ he’d say in that real slow bushie drawl of his which didn’t give us a ghost of an idea as to how he was really feeling.

Then one day we flew into Tilpa and we noticed that his caravan had gone. It wasn’t there any more. So we asked the nurse, ‘Where’s old Joe?’

‘Oh, he’s shifted,’ she said.

She told us that he’d moved out of town, down the road a bit. So we shanghaied a four-wheel drive and we drove out of town about 10 kilometres and there’s old Joe’s caravan, parked well off the road, away out in the scrub. So we knocked on the door of the caravan.

‘G’day, Joe. How yer doin’?’ we asked.

‘Oh, okay,’ he drawled.

Then we asked him how his health was, and about his problem, and all that sort of stuff.

‘Yeah, okay,’ he said, which was a fair bit for Joe, even at the best of times.

Then I asked, ‘Joe, how come you’ve moved out of the Tilpa caravan park? What’re you doing way out here, in the middle of nowhere?’

‘Ah, it was the bloody traffic,’ he grumbled. ‘The bloody traffic in Tilpa was drivin’ me bloody balmy.’

It’s a few years ago now but when I was a Flight Nurse there was one property in particular that we were never too keen on visiting. It was only a smallish place, an outstation, right on the edge of the Simpson Desert.

We didn’t drive out there of course, we flew. But on the mornings that we did, we had to be up at the crack of dawn, ready to take off at 6 am, to get to the outstation by 8 am and begin our clinic or whatever. And, as was the routine, when we reached any of these stations we’d circle the homestead a couple of times just to let the people know that we’d arrived and then they’d drive down to the airstrip to pick us up.

Anyhow, on this particular occasion we did just that. We circled the place a couple of times then we landed. The only trouble was — no one came to meet us. No one, that is, apart from the flies. And when I mean flies, I don’t mean just the odd couple of hundred. There were swarms of them. Sticky things they were, too.

So there we were, Llew, the doctor, and I, hanging around in the stinking heat, swamped by these flies, when finally an old EJ Holden station wagon drove up.

‘Jump in,’ the driver said.

‘Where?’ Llew asked.

Now this may have sounded like a silly question but for starters there was no back seat in the vehicle. And, what’s more, apart from the space where the driver sat, the rest of the station wagon was stacked to the hilt with big pats of cow dung, all at various stages of being
dried. Now, when these cow pats were thrown onto a camp fire they might have worked miracles in keeping the mosquitoes at bay, but to the flies they acted like a super magnet. If, as I said, we were swamped by flies when we stood beside the airstrip, we were drowned by the blessed things as we stood beside the vehicle.

With no help in the offing, Llew and I started reorganising these cow pats in an attempt to make some room for ourselves. When that proved to be impossible, we ended up having to perch ourselves on top of this dung the best we could manage. So there was Llew, hanging on for grim life to his doctor’s bag full of sterilised gear. There was me, squashed in next to him, dressed in my freshly washed and ironed atomic-blue nurse’s uniform. And not only was the inside of the station wagon a sea of flies but I could well imagine a dark cloud of the things trailing the vehicle as we drove through the dust and up to the homestead.

Then, lo and behold, when we got in the homestead we were tossed a piece of hessian to hang off the verandah for our shade. And so began our clinic, the full medicals, the lot, among the flies and the heat, and in the most basic of hygienic conditions.

While we were checking people over, I could smell kerosene and I remember saying to Llew, ‘God, Llew, can you smell that kero?’ He just screwed up his nose at the stench and went back to the job at hand.

Not long after that a woman came out and started to set up a fire to cook lunch just a few metres away from where Llew and I were working. I was going to say something to her but I thought better of it. I guess I must have been staring at the massive pieces of pepper
steak that were laid out on a plate because she turned around to me and said, ‘Would youse people like somethin’ ta eat?’

Now the strong smell of kerosene was getting to me so I didn’t have much of an appetite. But you have to be very careful not to offend some of these people so I said, ‘Yes, just a small piece, please. It looks like very nice pepper steak you’ve got there.’

‘Nothing for me,’ said Llew, who was a bit more forthright on the matter.

Anyway, the woman didn’t say anything so I continued helping Llew and she got up and disappeared into the homestead. When she came back she was carrying a tin can and in that tin can was some sickly greenish stuff which, to my horror, turned out to be fat. I couldn’t stand to look but when she threw the fat into the pan the smell of the bubbling, burning mixture, along with the strong stench of the kerosene, got my stomach in a spin.

‘Just a small piece,’ I called. ‘A very, very small piece.’

But again the woman didn’t say anything so I started to walk over to make sure that she’d heard what I’d said. That’s when she went to pick up the steak. And that’s when it struck me that the pepper bits on the steak weren’t pepper bits at all but, in actual fact, all this while the meat had been smothered in flies. Because, as she picked up the meat and threw it into the pan, the flies took to wing. In saying that, I must add that there were a good many who were a bit slow on the uptake and they ended up in the frying pan along with the meat and the bubbling greenish fat.

Llew must have seen my reaction because he came to my rescue like a shot and made the excuse that we
couldn’t stay for lunch because he just remembered we had an emergency to attend to. So we wrapped up the clinic quick smart and were taken back down to the airstrip in the station wagon which was still stacked to the hilt with cow pats. But we weren’t so concerned this time. It was just such a relief to be getting out of there. When Llew and I were dropped off, we said goodbye, loaded the plane and were out of there like a bolt of lightning. Just as well we did, too, because that wasn’t the end of the saga.

Later that night the news came through that there’d been a fire out at the homestead. As luck had it, there were no injuries. But, apparently, what I’d been smelling during the day was the kerosene fridge leaking. Then, after we’d left, the fridge blew up and the homestead was burnt down, leaving just the roof and the supports, and no doubt the flies.