The Royal Melbourne Hospital’s Director of Emergency Medicine, Professor George Braitberg, is in his usual element, in a medical bay full of tubes and wires and boxes of surgical gloves, bright lights and overhead X-ray machines, and all manner of devices that go bing.
But he’s not talking about any of that, the cutting edge of trauma technology. Having battled the medical aftermath of road trauma for almost three decades, he’s talking about people: the road victims that his team treats 800 or more times a year, and the impact of that trauma on the patients, their families and, yes, his staff.
This is a surprise of sorts, because when you spend time in the trauma bays, there is a conspicuous and deliberate lack of emotion. Sights and situations that would haunt non-medical folk are dealt with calmly and efficiently by teams of experts, who then move seamlessly to the next bay and deal with whatever new set of graphic injuries they find.
But of course, under the professional veneer they are human, with human emotions and empathy. And all have their pressure points. The doctor, for example, trying to save the life of a child who is the same age as his or her own, and maybe even physically resembles their child. That can rattle even the most experienced and rational professional.
George acknowledges this challenge of the job. “It’s not so much every trauma that we see, but if I was to ask my staff – medical, nursing, social workers – to think of a trauma that sticks in your mind over the last 12 months, they’ll each have a number that they’ll refer to, so some aspects of a trauma do actually leave an emotional stamp on us, and on a regular basis.”
That blink-of-an-eye moment
“It’s a human business and it’s a tragedy that plays out on a lot of different levels. At the end of it you have a person who, before the accident, had their life, their aspirations, often had a life that was well planned out for them and then in the blink-of-an-eye kind of moment things will change.
“Not everyone recovers 100 per cent from a trauma. In fact, the more significant the trauma, the less likely you are to get a full recovery, so then you’ve got to think about what’s the disability of that person? Is it affecting their spinal cord, is it affecting their brain? If they were a footballer, are they going to play football again? Because the effect of that trauma is individualised to that person. What is important for one person might not be as important for another, and we have to learn that along the way of the person’s recovery and rehabilitation.”
Of course, when the ambulance or air ambulance arrives and a trolley is first wheeled into Emergency, such concerns are secondary for the medical team that gathers. At the Royal Melbourne, and the city’s other major adult trauma hospital, The Alfred, there is a constant factor acknowledged by all senior medical personnel: pre-patient preparation is everything.
“I guess the first thing is hearing about it (an incoming trauma) and getting prepared and making sure we’ve got the right number of people in the room, knowing what job they’re supposed to be doing and focused on that particular part of their role,” George explains. ‘We really do need to get the right number of people. Every so often you get a lot of people who want to look in or get in the way, so everyone who is in that room has to have a specific role to play. Once we’ve set it up, we have a team leader who is like the conductor of an orchestra. He or she will oversee everything and make sure it’s working.