Sunday 27 January 2008

To love, honour and bubble bath.

Harold Thistlethwaite, known as Cec, was one of G5’s frequent flyers. I lost count of the times I saw him wheeled into the ward with his cardboard port tucked between his knees. What could one do but wave and smile?

“G’day Cec. Be with you in a tick.”

The problem was Cec’s breathing. After a life time of smoking, his lungs, or what remained of them, were a mess. We suspected oxygen reached his brain only by diffusion through the scalp. His ongoing survival through bouts of respiratory failure was a source of unexpected delight and wonderment for his family and amongst the medical staff, a matter for hospital wide speculation and general head scratching.

Over the years I knew Cec, he never seemed to change. Tufts of snowy white hair protruded from beneath his black and white Magpies supporter's beanie. He had a fondness for “Breathrite Nasal Strips” which he applied each morning. The narrow plasters were supposed to open the nasal passages but on Cec’s broad nose, they lifted and curled at the edges as though trying to form new nostrils.

The nurses always gave Cec a bed on the solarium. The large fifth floor windows gave a good view of the railway tracks and the Boggo Road jail as well as a glimpse of the pretty city lights and the freeway.

One day, there was a breakout from the jail. Seven inmates had skipped. The morning paper was full of pictures of police scouring nearby Dutton Park. Cec quietly told us he had seen the whole thing. The escapees had timed their scaling of the barbed wire to the minute. As the 1am goods train passed, heading west, the men strolled down a grassy slope, hopped on a car and were away.

For Cec, the prison escape was a mere diversion. Of far greater importance was his lack of oomph. He couldn’t walk to the phone at the end of the ward. It was way too far. Every evening at around 6.30, he would try to get to the phone, wobbling on matchstick legs, lips turning a deep Prussian blue. Homeless George, known as ‘Jacko’, in the next bed, would alert the nurses by calling out, “Cec’s up! Cec’s up!”

It wasn’t that Cec was senile or silly. He just wanted to talk to his wife and he really didn’t want to bother anyone. Mrs T was the light of Cec’s life. In the evenings, she would sit in her lounge room watching the tail end of the news, awaiting Cec’s call with the phone pulled close beside her. I never saw Mrs T but Cec told me all about her. A stroke had left her all but paralysed down her left side. She had as much difficulty reaching the phone at home as Cec did in the ward.

Cec’s time in hospital (and therefore separation from Mrs T) became slightly easier for him when his RSL mates got him a set of army surplus CB radio walkie talkies. You have to remember this was in the days before mobile telephones. As we approached Cec on ward round, he would heave the brick sized transmitter to his ear and wheeze into it, “The docs are coming, Love. Over and out.”

“10-4, over and out,” came Mrs T’s stroke slurred reply.

When Cec wasn’t on the air, he was drawing on a dinner tray serviette, with all the concentration of a great master. One day I interrupted and asked what all the lines and circles meant. Cec explained that Mrs. T loved bubble baths. Since her stroke, she hadn’t been able to safely lower herself into the bath and then get herself out again.

In his own inimitable way, Cec was going to make it happen by having an electric winch and pulley system installed. There was a strong girder in the roof straight above the bathroom.

Cec planned to sit on a stool in the corner of the bathroom holding a lever, which, according to the diagram, looked a bit like a tiller on a boat. With it, he would swing Mrs T over and down into the bath. Rescuing Mrs T would take a simple push downward on the lever to set the winch into reverse gear. When he talked about it, a tear came to his eye.

Tuesday 22 January 2008

Ringing in the New Year.

The New Year is traditionally the time to make resolutions, turn over a new leaf (or several branches if necessary) and gird the loins for the year ahead. Without dissolving into melancholy, it can also be a time for zimbles to look back at the year just gone and consider the lessons learnt.

Some concepts should be obvious from the get go. Take tinsel for instance. One can never have too much tinsel. Red, green, silver or gold, boa-esque or threadbare; it is all good. When you think there might be enough tinsel, by definition, there is not. Find that spare nubbin of Blu-Tack, twirl that banister and loop that lintel. Slide on the sunnies and accept nothing less than a supernova of sparkle! Holly and mistletoe be damned!

Other revelations arrive unexpectedly like coconuts on a tin roof. Stella Artois is not a benevolent society lady who organises charity tennis matches. “A stitch in time saves nine” does not refer to quantum physics and the space time continuum. The Zimble-Mobile, the Nissan Pulsar, is the post-millennium equivalent of the 1979 Datsun 120Y. (Now that hurts.)

The ideas that are most important don’t come suddenly though. They percolate ever so gradually through the thick zimble skull. This year’s idea, when it finally arrived, was a doozy.

Burnout is bad.

Such an obvious concept and yet one so difficult for zimbles.

When you can no longer see it coming, when you think you are fine but you’re not, it is too late. At the 'too late' stage, the only cure is to stop and learn how to say “no”. "No, I won't be able to do that today. Would tomorrow morning be okay?" "No, I can't work that weekend, it's my nephew's birthday party and I want to see the rocket cake," and so on.

By learning that simple word you are doing yourself and everyone around you a big favour. In my own zimbly fashion, that’s what I did this New Year. I also bought some more gold tinsel, which helped enormously.

Tuesday 1 January 2008

Air - Speed - Indicator.

Early morning, Charleville.

If one lives on an isolated antipodean island, it is well accepted, that world travel will involve a twenty-plus hour siege in a QANTAS economy class cabin where the effects of prolonged hypoxia and jet lag are enough to try the patience of a saint. Hence, most of this zimble's plane travel has been domestic and, as it happens, work related. This is not to say it has all been in the plush comfort of airbuses and 737s.

After the fifth year of a six year medical degree, each student of the class of 1990 was asked to organise for themselves an elective overseas hospital posting, of four to six weeks duration, based on a pre-determined list of possible destinations.

Many of my friends chose elegant European towns for their elective (a wonderful chance to practice high school French and German and spend much time between study commitments browsing in quaint shops for the ultimate shoes and matching handbag). The brave and admirably altruistic Medicins Sans Frontieres wannabes headed for remote third world stations.

That left me a December choice of Shanghai or the Royal Flying Doctor Service. The RFDS posting, whilst not overseas, was considered suitably remote and as Shanghai in December sounded untenably cold, my decision was easy: Charleville it is!

The distances involved in flying around South West Queensland are huge. For example, Charleville to Birdsville, a normal flight for the RFDS, is about 700 km. To the newcomer, the vast landscape of the outback can be quite unnerving. Flying over it in a small aeroplane is a good way to start to understand it.

As it happened, the Flying Doctor, Bob, had just purchased a brand-spanking-new portable antenatal ultrasound machine. It, naturally, took pride of place in the cabin seat that I would normally have taken. There was nothing for it but to ensconce myself in the cockpit beside our pilot, George.

George was a great guy. He had been a naval airman flying jet aeroplanes on and off aircraft carriers in the Indian Ocean. He had retired from that to become a commercial pilot for Ansett and with the demise of that airline, he had become a bush pilot based in Gove, in Arnhem Land. From there he had come to the RFDS.

With hours in the air, we chatted about many things but over the time, he started to teach me about flying, about the instruments, about take-offs and landings and navigation and so on and so forth. One of things he drilled into to me was that in take-offs, something called the "air speed indicator" was of vital importance. The aeroplane had to be at a certain speed or it would not fly.

Well, one day, towards the end of my posting, we were doing a clinic at a place called Carnarvon Station, a 60 000 hectare grazing property immediately west of Carnarvon Gorge National Park. (It is now owned by the Australian Bush Heritage Trust and the general area is a current focus of debate about land clearing.) The outback stations employ many people and they need regular GP style medical care as well as access to emergency care.

We had just finished and I noticed George was looking very worried. He told us (Bob, Kerry (the flight nurse) and me) to 'hurry up' as we had to get off the strip. It had been raining the night before and in this late afternoon, dew was already starting to settle. To make matters worse, the strip had been graded with a dip in its middle so that from the side on, it looked a bit like a wide angled "v".

So, we hurried. Even then, with all the gear and all of us safely stowed, there was a further but necessary delay. After taxiing to the end of a strip, the station manager (or someone) must get in his ute or truck and drive up and down the strip to clear it of livestock (in this case cattle), other animals (kangaroos, wild boar etc) and birds (including emus).

Finally, with the strip clear, our Beechcraft Kingair started to roll. I looked at the air speed indicator. Going down hill, we made good progress over the rough strip but then we hit the middle and the upsloping leg. The air speed indicator started to fall. I looked ahead and saw a small herd of about 20 cattle sheltering under the tall eucalypt trees that defined the end of the strip. We were coming up to them very quickly and I thought to myself, something in this equation has to change very soon or it's going to be hamburger time! (A bad state of affairs for cows and even worse for zimbles.)

Suddenly, George shoved the throttle forwards, pulled the stick back and the aeroplane swooped up. I remember feeling the canopy of the gum trees scraping along the undercarriage. When we were up, George said to me, "Saw a few white knuckles over your side, Doc!" to which I replied, "I have three words, George: air, speed, indicator!" He explained that it was a better option to stall above the trees than to plough into their trunks and the cattle. I just think that with all his experience and skill, George knew the engineering limitations of the aeroplane and simply made the thing fly.