A lot of the time, being the doctor for 14 fit and well people can be a rather quiet job. Most of my consults are for aches and pains - pulled knees and rolled ankles (pretty much nowhere except inside is flat on this island), although I do get a smattering of other medical problems, and a bit of dentistry on the side too.
Despite my rather civilised working day, it's always in the back of my mind that any moment someone could have a major injury, or become seriously unwell. I think this is one of the few medical jobs in the world where you are the solo doctor on call 24 hours a day for 365 days straight.
In addition to this, we are over 1500km from Hobart, and only accessible by ship, so if a medical evacuation was needed, it could take a week or longer depending on weather.
Fortunately our medical facility here is extremely well equipped, with an emergency room, a ward, an operating theatre, a dental room, laboratory and radiology equipment. We could theoretically provide ICU level care with the equipment and medications on hand, but you can only do so much with one doctor.
However I'm not quite alone, as I have 4 minions - more formally known as lay surgical assistants (LSAs) ready to help me.
Back in Australia a few months before we leave, 4 tradies are selected to undergo 2-weeks training at the Royal Hobart Hospital. They usually have no experience in the medical field at all, but they quickly learn the basics of how to assist in a surgery - both with the anaesthetics, and with the surgery itself.
Introducing:
Angus - usually a meteorological technician, one of my anaesthetic LSAs
Pete - usually an electrician, the second anaesthetic LSA
Greg - usually a plumber, my scout nurse
Chris - usually a diesel mechanic, my scrub nurse
During the year here I build on their base knowledge with monthly training sessions to keep their skills up, and teach them how to help in other medical situations such as someone being severely injured, having a medical emergency, or even just needing a filling.
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| What better way to learn how to suture and staple then on a lamb we are planning to spit-roast that night. From left: Pete, Angus and Chris |
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| Chris does a lovely running stitch while Pete masters a vertical mattress suture. In a live situation I'd get them to change out of their high vis first... |
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| Angus has a go at using one of the tiniest needles we have (usually for eye surgery). It doesn't go terribly well. |
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| In another session we set up the theatre from scratch ready for a surgery. Greg and Chris work out how to test the diathermy machine. |
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| Pete and Angus run the (rather vintage) ventilator through its paces. They definitely look more authentic in scrubs. |
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| Nurse Pete attaches monitoring to our patient Danielle in the pre-op room (actually the emergency room/lab/my office - space is at a premium here) |
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| Greg checks off the instrument count list as Chris makes sure everything is ready to go. |
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| Our patient (with faux-appendicitis) is wheeled through into the operating theatre. Manoeuvring the trolley around the corners was probably the hardest bit of the exercise. |
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| And in a more recent session we try out plaster casting. Pete tries out a below elbow cast while Angus is on standby with the scissors (I'm not sure why) |
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| Having been the patient Greg now tries out his skills on my leg - and a rather nice job too |
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| Angus and Pete posing with plaster. As you can tell our sessions are very formal. |
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| And the most nerve racking bit of the session for me - Angus wielding the plaster saw. Fortunately I remain intact. |
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