The flying doctor saved my brother

In a place where the ‘no fuel for 200km’ signs are almost as common as the kangaroos, finding a doctor within cooee can be a tough ask. When you need one fast it can be a matter of life and death. But in western Queensland, the locals have been looking to the sky for help for almost 80 years. In 2007, Rick spent a day with the Royal Flying Doctor Service, which runs its practice in the world’s largest waiting room.

THE first sign of help might be a low drone far off on the horizon. It’s the same story everywhere. Curious ears on cattle stations or in tiny towns buried in the red, dry plains prick up. Coffees are left cold, work stops and locals wander outside and cast a cautious eye to the sky. It might be the same doubtful glance cast when looking, hopelessly, for rain, but this time things are different. A speck appears in the distant deep blue sky and the buzzing gets louder.

The flying doctors are coming.

Like a scene reminiscent of a Superman movie, the Royal Flying Doctor Service plane sweeps past in the sky. Everyone’s eyes are glued to the spectacle. The shadow of the plane briefly blocks out the baking sun and then, the plane lands, whipping up a cloud of red dust. Visitors are rare out this way, and none arrive in such an exciting way.

But then again, none are quite as important as the flying doctors. Charleville, the largest town in southwest Queensland and 740km from Brisbane, is one of eight bases for the service in Queensland. It’s the heart of mulga country, a bush that oozes a sweet scent when it rains, and also forms the centre of a 622,000sq km waiting room.

Big? Certainly. Unreachable? Never. All you need are wings.

The Royal Flying Doctor Service has been around for almost 80 years. It started when planes were slow, cumbersome and not that safe. But, the Reverend John Flynn decided that the vast distances of his Australian Inland Mission needed a so-called ‘mantle of safety’. Today, the planes are faster, stronger and a lot safer but distances in the Outback, one of the harshest and cruelest places in Australia, remain vast.

Residents out here know that, at the first sign of trouble, the sweetest sound they will hear is the far-off whine of a plane engine. Out here, where ground-based ambulances can be as far as 300km away, that whine is the sound of help. Danielle Weise is a flight nurse with the RFDS. Originally from Brisbane, she’s relatively ‘green’ in terms of the RFDS, having started just eight months ago. Her skills as a nurse, however, are unquestioned.

Newer still is doctor Graham MacFadyen, a likeable chap from Britain with a wicked sense of humour and an amazing knowledge of medicine. Joining them on the roster today is pilot, Captain Roger Ruddock. He strikes an imposing figure as he towers over everybody else. Six years he has been with the service, four in Charleville.
He’s the most experienced of the crew on duty when I arrive at the dusty hangar at the airstrip. It’s not really an airport.

Today, the crew are carrying out the most important function of the service – bringing their medical expertise to the isolated residents of small country towns. It’s their version of a house call. Although it would take three hours to drive from Charleville to Thargomindah, a town of about 230 people, the five-year-old $5.2 million Pilatus PC-12 aircraft at the base will do the trip in 48 minutes.

Danielle, flight nurse and, for this flight, the safety instructor, shows me inside the plane to make sure I know my emergency exits and how to do up my seat belt. Despite their easy going nature, nothing is done by halves. It’s a strict routine that has kept the service almost crash-free for more than 78 years.

The plane is shining under the early morning sun. It’s a single-engine beast with 1200 horsepower under the bonnet. Roger would later tell me the Swiss-made planes are built like the proverbial outhouse. They would want to be, conditions are unforgiving out here. On board it feels smaller than it looks, but that could be because there are two patient stretcher beds head to tail along one wall of the fuselage.

Danielle gets excited when she tells me what the plane could handle. “When I first started I was worried that the plane wouldn’t be that well-equipped,” she says. “But I soon discovered it has everything. It is a flying miniature intensive care unit. I’ve never been in a situation where I have thought, ‘geez, I wish I had one of those’. And we can pack the patients in, too.

“On an evacuation flight near Mt Isa, we had three patients in a car crash. One could sit up, so we placed him on a seat and we put the other two on the beds. There’s not an inch of space wasted. We have drugs, medical equipment, syringes and everything all stacked up.”

I catch up with the pilot Roger before he starts getting the plane ready for our flight. He knows all too well the importance of the jobs they carry out. “Today we’re just going to do a clinic run,” he says. “It’s like a usual GP visit for anyone in the city but it’s even more important for people out here because they don’t have doctors
close by. This is our daily routine, but we know that things can turn to an emergency situation in a hurry.”

Accidents are common in rural areas because of the nature of work done by residents. This is where the flying doctors’ crews come into their own. Station fires, car accidents in the middle of nowhere and workmen getting gored by bulls, or falling from horses on isolated properties, are just some of the situations to which the service has been called. Airstrips, at least a kilometre long and made of dirt, are common for that reason.

Almost every station has one. Those who live on the stations hope and pray they never have to use it.

My family had to.

My brother Toby and I grew up on a cattle station two hours from the nearest town, Eromanga, which had a population of nine. There were no emergency medical facilities there – in fact, no medical facilities at all. The closest hospital was a four-hour drive away.

Because of this, and my brother’s adventurous nature, he had become well-known among the flying doctor crews by the time he was nine years old. They had been called in twice already. Once they had to stitch a wound, performing the treatment under the wing of the plane on the airstrip at Mt Howitt.

On the other occasion, they came to the rescue of my brother after a wayward bounce on an extra springy trampoline gave him concussion.

But on the afternoon of September 4, 1994 – Father’s Day – there were no more minor emergencies. This was the big one.

My family came to know all too well just how great it was to hear that plane fly overhead. Toby had been helping a jackaroo fix a bike in the shed when a fireball exploded in the car-servicing pit. He was engulfed, suffering full thickness burns to some 45 per cent of his body.

The flying doctors got the call just as they had landed back at their Charleville base after returning from the Birdsville races, the biggest day of the year for them. They had time enough to refuel and repack equipment before taking to the skies again. It was real count-the-minutes stuff.

It was a two-hour flight to the station, but through radio communication and an ingenious medical system devised by the service, the crew were able to direct my parents what to do. Decades earlier, every station was fitted with a ‘medical chest’ with essential drugs, numbered so they could be found with ease by the remote guidance of a flight doctor.

My father injected painkillers into my brother, who was in shock from his injuries, and we waited for the aircraft to arrive. The plane buzzed in the distance. It was soon on the ground. The medical crew stabilised him and inserted a drip before take-off, but by this stage the sun had set and the runway was dark.

We filled jam jars with kerosene and lit them up and down the runway as a crude lighting system.
My mother, together with my then four-week-old sister, boarded the plane for the flight to the Royal Brisbane Children’s Hospital burns ward. It would be another few hours before he was admitted but by this stage it didn’t matter – he was in the hands of the best-equipped medical service the bush has seen.

Without the flying doctors, he would have died.

Toby spent two months in hospital and has today almost two decades later made a full recovery. Ordinarily you might call it a miracle, but the flying doctors put it all down to being prepared. “Every time we get called out, we have to think of the worst-case scenario,” said Roger. “Inevitably, Mr Murphy will pay us a visit.”

Mr Murphy, of Murphy’s law, that is.

In the tense moments that follow the doctor getting the emergency phone call, several more calls are made.
“We need to find out what the condition of the patient is like and just as importantly the nearest runway and what condition it is in,” said Roger. “Safety is paramount – for them and us. Our motto is ‘can do’, but ‘can do safely’. We need independent reports of the runway condition because often the person on the end of the line is a relative of the patient and they just want us to land, regardless.

“It can be dangerous. But we won’t leave our clinics unless we really have to. They are our priority.”
More than 80,000 patient consultations were carried out by the RFDS in Queensland in 2007. The most common treatments were routine injections, blood tests and check-ups.

As we board the plane ready for Thargomindah, Danielle announces they have 12 patients waiting to see them in ‘Thargo’. Flying high above Charleville, heading southwest, the landscape below is featureless but mesmerising.
A patchwork of dull green mulga scrub is laid out like artwork on the red dirt far below.

Despite the view, Danielle reads.

First, a newspaper and then an updated manual on infant nursing care. Dr MacFadyen is staring out of the window in between talking to Roger. The discussion ranges from how much rain everyone got last week to Roger’s impending visit to the ‘fang fairy’ during his upcoming holidays.

Four-and-a-half-month-old Ashlee Anderson is due for three vaccinations when we land. We are greeted at Thargomindah by a nursing assistant in a white four-wheel-drive vehicle. She takes us to the clinic ‘down town’. The clinic is really a long building clad in sheet metal and sitting in the middle of an unusually green lawn.
Inside, clinic staff member and baby Ashlee’s mother Mardie has cooked a breakfast of bacon, eggs and sausages for the crew.

They will need it before they get to work.

Patients start to trickle through the doors. On the agenda today are baby Ashlee’s injections, a few blood tests and general check-ups. And there is a shearer who has come in complaining of an abscess on the inside of his leg.
He got it while shearing after a burr from a sheep infected his leg.

Doctor Graham will have to lance it and hope the abscess goes away. And then there is baby Ashlee.
Three injections is a lot for anyone, let alone a tiny baby. Her mother Mardie doesn’t want to be there when it all happens so pilot Roger, ever the handyman, steps in to help.

Danielle needs him to hold little Ashlee while she gives the shots. It’s a humbling scene.
The pilot of a multi-million dollar plane who could be sleeping right now coos over Ashlee before holding her gently while the needles are given. She cries a lot and Roger tries to comfort her.
He’s later very modest about the whole thing.

“I’ve got eight grandchildren,” he said. “I’ve been through it all before- you’ve just got to get in and do it.”

After almost an entire working day at the clinic, we are back on the runway and preparing for take-off. Roger has placed me in the cockpit alongside him so I can see what he sees – and why he loves his job so much.
Before we take off, Graham announces that this is the ‘silly hour’ – a period when staff at the base know the crew should be finished and might forward any emergencies their way.

If something is going to happen, it will happen now.

Although they are prepared, everyone hopes the big one isn’t today. While in the air, Roger explains the aircraft could fly anywhere within their district – almost the size of the United Kingdom – within
two hours. It’s a ‘long legs’ plane, which means in most locations they could make it there and straight back to Brisbane where the patient can have emergency surgery should it be needed.

“After a while you learn to change your flight plan in mid-air,” he said. “In one case, we were flying from Ballera to Brisbane and we were just short of St George when we got a call to a woman having a heart attack in the Carnarvon Ranges. We turned around and were on the ground in 45 minutes. We took her on to Brisbane with our other patient and were back in Charleville in time for knock-off.”

For today, at least, there have been no emergencies.

For the vast majority of Outback residents they will never require the emergency capabilities of the RFDS. But on the off chance they do – when they look to the sky – it might just be the greatest sight on earth.

The RoyalFlying Doctor Service is a charity with operating costs of more than $30 million a year. If you would like to donate to it, visit the service’s website.

This article was first published in the Gold Coast Bulletin in 2007.