Missionaries, mercenaries, and misfits

It’s hard not to give away my age, but suffice to say, my first day on the job was when ACEM was only two years old. American rock band Bowling for Soup sang a song about the year.

I’d graduated in the bottom 20 percent of my medical school year so missed out on an intern position at my alma mater hospital, Prince Henry’s Hospital. Western General Hospital (WGH) had offered me a position, but my first three months were to be on rotation to the emergency department at Mildura Base Hospital (MBH) in Victoria, Australia.

“I arrived, on that mid-January Sunday in 44-degree Celsius heat, to that magnificent art deco building on Thirteenth Street. ”

I arrived, on that mid-January Sunday in 44-degree Celsius heat, to that magnificent art deco building on Thirteenth Street.

Me and my five fellow WGH interns were accommodated in new apartments next door at the unprincely sum of $3.70 per week. I was told they assumed we were all paying rent back in Melbourne during our three-month sojourn, but they had to charge us something.

Monday was forecast to be 46 degrees. Thankfully MBH and our apartments had good air conditioning and I found a six-pack of beer in the fridge, courtesy of our employer.

Mildura Base Hospital Emergency Department

Staffing in the ED was minimal. Two interns, two second-year residents and one third-year. No registrars, no consultants, and certainly no director. Night duty was covered by the interns and second-years, but we didn’t need to stay on-site overnight. We could sleep in our beds and only come to the ED if the nursing staff were unable to manage a patient. We’d split the night in half with the second-year on shift. The intern would cover the second half of the night, which tended to be less busy.

On-boarding was simple. As there were no computers, everything was paper based. All you needed was a pen, a stethoscope, and a name badge.

I remember my first patient, a simple case of thrush that required a prescription of Canesten. I also remember my first occupational violence incident: a mental health worker had his nose knocked sideways by an agitated patient.

Missionaries, mercenaries, and misfits

Other than us interns, much of the medical staffing was made up of missionaries, mercenaries, and misfits. One of the hospital medical officers was known for going missing during shifts, only to be found later in some back room sucking on the nitrous.

One weekend I was left in charge of a colleague’s marijuana seedlings. My watering skills were clearly inadequate as they all died.

An orthopaedic surgeon taught me that you can only apply a quality plaster cast by getting it all over your clothes, the walls, the floor and your eyebrows.

Another surgeon was known to be somewhat of a cowboy and wore short-sleeved safari suits, a fashion item made popular in the 1970s.

The St Patrick’s Day green party. Dr Walby is third from left.

Despite the long hours we were rostered we made the most of our time off. Swimming at Apex Park, day trips to the Walls of China in the Mungo National Park, drinks at the Workers and the Setts, falling in love, bands at the Bridge Hotel in Buronga – Mental As Anything, Dragon, and the Dynamic Hepnotics all visited during my time there. The town even laid on a free bus to take you to the pub from the Mildura Post Office and back again at the end of the night. I even managed to swap a few shifts around to make the pilgrimage to the Melbourne Showgrounds to see Springsteen’s first Australian tour.

““One should approach each day with the mindset that this place provides the best healthcare available anywhere, and work with the resources you currently have to deliver that care.””

There were plenty of parties too. Most notably an orange party in Orange Avenue where we all wore dyed theatre boiler-suits. Similarly, after the St Patrick’s Day green party, a memo went out warning staff to stop taking hospital linen as it was disappearing and getting dyed green!

One day, one of the interns complained that MBH didn’t have the services he was used to where he’d been a student (at the Royal Ivory Tower Hospital). A local surgeon explained a better way to view your workplace. He said, “One should approach each day with the mindset that this place provides the best healthcare available anywhere, and work with the resources you currently have to deliver that care.”

Sage advice, regardless of where or when one works.

At the end of my three months, I returned to work in the ED at WGH, where I met the director, not realising he would later become my mentor and friend in emergency medicine. Joe Epstein ran a fantastic department which was one of Australasia’s key training sites in those early years of the College. Despite working in this cradle of emergency medicine, it took me seven years to realise that surgery was not for me and that I should pursue a career in emergency medicine.