A sheep station in the middle of nowhere, many hours’ drive from the nearest large town, even further from the closest city. Not somewhere you want to have a major medical emergency on your hands...
The tiny fixed wing plane flying doctor Patrick Buxton has been travelling in has been jostled by turbulence, and attempts to land hampered by an invasion of kangeroos who refuse to budge from the bumpy landing strip. On board the small plane is emergency equipment, morphine, drugs like antibiotics, intubation equipment, machinery to jolt hearts in cardiac arrest back into life.
There are few jobs in the world that really fit the “life or death” category... but as an advanced skills practitioner with the Royal Flying Doctor Service in Queensland, Patrick’s is one of them.
For this is ER on the wing, a role that involves massive distances, a cool head, medical expertise and a stomach for a turbulent flight.
“It gets pretty bumpy up there,” laughs Patrick, 46, his Edinburgh accent now featuring a definite Aussie lilt. “Some flights can be fairly short – we can fly from 30 minutes to two hours – but often we don’t get the chance to get out of the turbulence. When you’ve got an emergency, a couple of patients on a stretcher, you don’t notice it too much.”
Outback emergencies can range from anything from a farm accident on a sheep station to snake or spider bites and tropical diseases. And, just like people in the heart of busy towns, rural Aussie communities too have their fair share of medical dramas – heart attack, stroke, for example – each requiring urgent assistance from above.
It’s not all high flying drama, though. Part of the flying doctor’s role involves delivering everyday health services to communities which don’t even have the luxury of a local GP. And that, explains the dad of two, can often mean setting up a makeshift doctor’s surgery in school halls and even the local pub.
“We’ll fly somewhere for a day and run a GP primary health care clinic for the local population from wherever we can. The nurse, pilot and medical officer take all our gear and set up in a school or pub.
“That’s why I love this job so much,” he adds, “your office is the great outdoors, you see the most amazing scenery and meet the most amazing people. I work with a fantastic, dedicated team whose objective is the same, to support and help communities in rural Australia.”
The RFDS flies 26.5 million km a year – the equivalent of 788 return trips between Edinburgh and Sydney – and provides care to 80 per cent of the land mass of Australia, an area that’s around 90 times the size of Scotland.
Patrick is based at Mount Isa in the north west of the sunshine state, more than 1000 miles away from Brisbane but perfect for reaching the farflung farm stations and indigenous communities which have a raft of health issues that pose their own particular difficulties.
“The country is so massive – 75 per cent of the country is classified as remote and almost all the population lives in a little thin strip around the coast. For those who don’t live on the coast, the challenge is to provide healthcare.”
Statistics speak for themselves – the average life expectancy for someone living on Australia’s more populated coastline is 81, for those living in rural areas, it drops to 74 but for the rural indigenous Australian it’s only 64.
“There are a lot of health difficulties among the indigenous population, some are hereditary, some are lifestyle caused, there is a lot of diabetes, cardio vascular, kidney disease, blood pressure,” adds Patrick.
“And there are rarer issues like tropical infections, syphilis, even leprosy.
“Suicide rates are 30 per cent higher in remote areas, smoking, alcohol and farm injuries are all 35 per cent higher, so there are a lot of risk factors at the same time as people don’t have full access to healthcare, so when people present with an illness, it’s often quite advanced.”
Like his brother Alan, Patrick went to Stewart’s Melville, finishing in 1985 to go to Aberdeen University’s Medical School. He worked in the Highlands as a trainee GP before moving to Australia to work in a coastal town emergency department.
He was preparing to return to Scotland when the chance to join the air medical service cropped up. “I never did quite make it back home,” he laughs.
Now his role involves round-the-clock telecare consultations – sometimes over the phone, sometimes using Skype to talk to patients and nurses, as well as the clinics and sudden emergencies, day and night.
There have been dramatic call outs in his time with the RFDS both inland where he’s now based and on the scenic Queensland coast around Cairns where he used to work. One involved a patient who suffered a cardiac arrest on a boat, sadly the distance and difficulties of reaching the patient were overwhelming, and a horrific head-on car crash, caused when a car swerved to avoid running over a goanna, a kind large lizard, with fatal consequences.
While it can be stressful, it’s certainly never dull. “Of course I love Scotland and I often think I’ll come back at some point,” he adds. “But right now I can’t think of another job I would rather be doing.”