The afternoon sunlight creeps down the wall and as the day trades its heat for the intensity of evening’s deeper orange glow, the floodwaters, like the sun, start to sink. The golden light filtering through the palm fronds outside mirrors the lion emblazoned on the interior wall of the footy club. In front of that mural, a fat sixty-year-old woman sits puffing as we apply monitoring. I wonder if there are any fat lions or emphysematous ones. In the club fridge lies a dead body.
In this New South Wales town, the floods are at their nadir and starting to subside. A few of us were sent out before the waters rose and others are local volunteers. Thankfully, most of the residents here have been minimally affected and, although the town is cut off, the property damage will be limited.
This place is lucky, in large part because the bonds of community and belonging still exist here. As much as people condescend the area as being dirty and uneducated, at a time of crisis those living in a low socio-economic area show more moral fibre than most, and have come together to provide for each other.
Hauled up in the footy club is a doctor, one or two nurses, two ambos, the firemen (all are men, imagine that), and police officers. Local volunteers bring supplies across the river by boat, including food and medicines. Local people cook for us and we are provided with more and better meals than ever in the hospitals. Everyone is part of the community and I’m the only one who doesn’t live within half a kilometre of the footy-club.
The patient in front of me hasn’t taken particularly good care of herself. Her Cole’s bag of medicines attest to this. However, she is a tremendously courteous person and, although concerned, looks generally well – I suspect we will be sending her home. In these situations, we make decisions as best we can with limited resources and if something is non-emergent, we send people away – sometimes with a script for when the waters subside. Other times we have to arrange for a helicopter.
The man in the fridge had a cardiac arrest last night. As events unfold, there is only one ambo to attend the scene and she calls for help. The firies are dispatched to retrieve the patient, but by the time he arrives at the footy club he has been without a heartbeat for thirty minutes. Half the workers here know the patient. They call the second ambo from home as there aren’t enough staff – he is now in trouble for breaching his fatigue code.
The staff work for hours providing CPR as well as any intervention that can be managed to revive him. It doesn’t take that long to realise that even if the resuscitation is successful, there’s probably not the equipment here to transport the patient safely.
Such speculation is in vain. There is no return of spontaneous circulation, the patient doesn’t wake up and death is called two hours after arrival. The staff are shaken and sweaty. There is then three hours’ worth of paperwork, talking to the family, debriefs and preparing the body. Not having a morgue, bodies go in the fridge. It’s there or the toilet floor with ice packs in the body bag. The club only has one toilet – it’s not dignified. The time is two o’clock in the morning.
In the middle of talking to the patient’s wife – she in tears – the doctor leaves because another patient has arrived. Someone made the wife wear a mask to enter the centre. She struggles to keep it on as she gasps for breath over the tears. Many staff believe the masks are political theatre; how fortunate that those in large offices don’t have to wear them. Some wonder how big the offices of our health executive and government officials are. That was last night.
Now, as the sun sets, a seventeen-year-old woman arrives in labour. None of us have ever delivered a baby. Do we plan for her to deliver here, get flown to a hospital, or risk taking a boat across the flooded water at night? I imagine we will have to explain ourselves to someone if she goes by boat and drowns. The grimly comic image of myself in a court of law runs through my head, jousting with other images (similarly described) of me trying to deliver a baby. After discussions, the boat is the only option. Those images – once comic – become more concerning in my mind (and very vivid).
My thoughts drift to our base hospital across the river where a dozen patients who need transport to a tertiary centre are stuck, awaiting ambulances and helicopters grounded by the floods. They are not allowed visitors due to government restrictions. A lady I treated a couple of days ago will probably never walk again, she knows this, but still her daughter who lives with her is not allowed to visit. She has been there for four days. This is a consequence of government decisions on prohibiting visitors. Meanwhile, staff discuss the invasion of Ukraine. Let us hope the brave defenders at least have some masks – we could always send them some of ours.
In the footy club, we are brought back to the present after the labouring woman leaves. The explosions on the news echo the thunder in the distance. Both seem very far away. I drag myself away from reams of documentation to assess the woman in front of me. She is still very well, and that is for the best. We send her home after a brief examination, to walk back barefoot in the rain. Somewhere in the last hour, the storm returned with the unflinching inevitability of night.
We are all tired, several having been here for nearly a week, sleeping on the floor in the corner of the room. Fatigue bleeds through people’s eyes, as they are awake most of the nights as patients present. I am lucky to have only recently arrived. There is a huge amount of love, dedication and sacrifice amongst the people of this town, and I am lucky to be a part of it.
On the television behind, they are playing Biden’s state of the union address; none of them are wearing masks. Everything is well with the world; we all agree he is a president without fault; the standing ovations are mistaken for rain on our tin roof. There are a lot of ovations; there is a lot of rain.
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