An outback doctor's tales

The outback presents different medical challenges

By Georgina Kenyon

Trying to work while baking in heat of 45 degrees Celsius under a gum tree, in Western New South Wales, could make you wonder whether outback doctoring is a good career move.

Dr Alastair Duncan had just spent five years in a busy London hospital, and this was a completely different experience.

He had just finished stitching up a jackeroo - an Australian horse worker - who had a gash to the side of his head, having fallen from his horse that morning.

Ted, the jackeroo's best friend, had just radioed Duncan for help.

I was not used to feeling that it was my patients, not me, who were in control

It was a straightforward stitching but the man had surprisingly not lost much blood, which was strange for a head wound.

Duncan was further startled when he noticed there was thick green and pink string sewn into the man's head.

"It turned out that Ted had been there before me. He had just used some string and a needle to stitch his head up."

"Ted just said, 'Nothing to it, I've done it before, doc. We thought we better get you out here just in case you were bored.'"

Ice cream injury

It was not to be the first time that day that Duncan was to be feel that ten of years of training in city hospitals, prepared him for a different kind of medicine than that required by the bush.

His friends were giggling in the surgery and singing Greensleeves which I thought was peculiar

"I was not used to feeling that it was my patients, not me, who were in control," said Duncan.

Duncan's second patient for that day back at the surgery was a young Aboriginal man with a broken rib and what looked like tyre marks all down his back.

He was also covered in mud.

"His friends were giggling in the surgery and singing Greensleeves which I thought was peculiar."

Before referring the man to the closest base hospital Duncan asked the friends what had happened.

"Ice cream man very angry and drive over him in Mr Whippy van!" burst out one friend.

It appeared that the ice cream van jingle had been left running throughout the motorised assault.

A long-running feud between the young man and the ice cream vendor had come to a head in the early hours of the morning.

Fortunately there had been heavy rains the night before and the earth was wet. The van had just pushed him into the mud face down.

This probably saved him from dying as a result, although it was likely that he would be doing more than "watching for children" when he passed the next one.

Self-reliance

Duncan had been briefed before he arrived in the town of Broken Hill, on how bush doctors need to be prepared to see some brutal accidents.

"A large proportion of calls are emergencies," he said.

One of Duncan's colleagues had just flown back from Thursday Island, where he removed a javelin from a young boy's thigh, who had been injured in a school sports day carnival.

Many people do not want fancy treatments out here - they are self-reliant people

"Somehow inner city schools in London did not seem so dangerous," said Duncan.

It used to be said early last century that outback doctors only needed to carry two remedies in their doctor bags when visiting patients.

Iodine for the outside and whisky for the inside. All other treatments were simply superfluous.

"In some ways, little has changed. Many people do not want fancy treatments out here. They are self-reliant people."

The advent of "tele-surgery" could change that - allowing ordinary doctors to carry out more complex operations in the back of beyond with a video link to an experienced surgeon in a city hospital.

"The huge distances of the outback no longer seem so vast," said Duncan.

Dr Duncan's real name has been changed.