The Long Road

Thousands are injured on our roads each year. Emergency services, medical staff, patients and families confront the horror. Here, road trauma victims share their stories in the hope that others don't have to suffer.

It’s all in the faces

The blood crusted around the nostrils and brow of the kid artificially breathing on life support. The pale countenance of a wife who has made the dazed, horrified journey of dread; from the formal phone call of a police officer to the clinical, fluoro-lit emergency ward where her husband lies, attached to tubes and machines.

The drained but sharp gaze of the trauma doctor, watching a road crash victim being wheeled off to Intensive Care and surgery, even as two paramedics round the corner with yet another bed on wheels; another patient, another mess of blood and trauma and pain.

There is a portal to this other world, and it is only a split second away from us every time we get in our car or van, SUV or truck. Every time we climb onto a motorbike or hop on a bicycle. It’s not a portal you ever want to pass through, yet thousands of Victorians will do so every year, and may never be the same.

All you need to do is lose concentration while driving, or go too fast, desperate not to be a minute late. Or maybe you make that decision to run a yellow light, knowing in your heart that it’s more red than yellow. Perhaps you try to weave fast between lanes, or you glance at the screen of your phone – it’s just one text after all. Or you kid yourself that the fact you had a light beer to finish means you’re not over the limit. Or you make any of the other misjudgments that take a fraction of a moment to physically destroy you. Your life just changed forever. To be clear, this is not a story about death. It is a story of survival, told by road trauma patients in the hope that others won’t suffer or die.

RoyalAuto spent the first half of 2016 flying with Ambulance Victoria to road crashes across Melbourne and its surrounds. We flew to motorbike crashes, head-on collisions, vans wrapped around poles. We watched road trauma victims, almost always men, being cut out of their vehicles, or having cycling leathers sliced from swollen, shattered limbs. We flew to the Royal Melbourne Hospital or the Alfred – Melbourne’s two adult trauma centres – and followed along as doctors and nurses battled to save lives, repair bodies, check for brain damage and stop bleeding. We watched distraught relatives arrive numbly in Emergency, trying to be brave and composed, listening to the doctors’ calm explanations, even as their minds reeled, trying to catch up with the new reality of what had only that morning been their husband or daughter or boyfriend, heading off for work as usual.

We watched the victims enduring CAT scans and invasive surgery and months of recovery. We watched them move through Emergency to intensive care units, to wards, to rehabilitation centres. Groggy with pain-killers, bowels blocked due to side effects, endlessly interrupted for blood tests or to fill in hospital menus, or for who knows what. Frustrated at having to remain horizontal, bored stupid, grateful to be alive. We watched it all.

And it was not pretty. Teenage motorcyclist Trent McGaffin’s muted groans of agony, his left leg a shattered mess and his right lung collapsed by shards of ribs, among a host of other injuries. Footy coach Greg Kelly’s leg hanging below the knee, where it had been jammed between the engine of his van and a pole. Father of three Carl Lewis trying to be wise-cracking brave through the pain of a crumpled pelvis, cuts to the bone and leg fractures, as well as deep lacerations to his eye. Worst of all, 29-year-old Cameron Caldwell in an induced coma, his father Alec affable, unflappable and brave as he wondered if his son would ever wake.

All arriving in emergency trauma bays, having been ferried by the MICA flight paramedics from Ambulance Victoria. The pilots are often ex-military or police, and perform astonishing feats of flying and paramedics deliver urgent medical attention on the sides of roads or in fields or wherever they can land, all while dogs bark, citizens gawk, and patients hang between life and death. They work with fire officers and police, CFA and regular ambulances – the entire gaggle of emergency services for whom a crumpled body in a crumpled wreck is a depressingly common day’s work.

We asked MICA paramedic Anna Sutton what she would say to drivers, if she could. Slow down, she replied immediately. Don’t drive angry. Stop worrying about arriving one minute late.

We asked Alfred Hospital trauma doctor Helen Stergiou the same question. “We don’t take as much care as we should,” she said. “We don’t demonstrate as much patience as we should. We don’t demonstrate as much respect for each other as we should. We don’t know what’s going on in the head of the driver in front of us, so the fact that they’re stalled for a moment at the lights, we can potentially sit back for a moment in the seat, not hit the car horn directly, and just wait.

“I think just demonstrating some patience and some mutual respect would go a long way to mitigating some of the events that we see.”

Professor George Braitberg, from the Royal Melbourne, said drugs were an ongoing problem, both recreational and prescribed, with users perhaps not realising how medications slow reflexes or alertness as they take to the road. He said people also made the mistake of thinking that because they got away with texting while driving before, they will again. “But it’s an all-or-none phenomenon,” he said. “Just because you got away with it on Tuesday, you’ve got the same chance of having a disaster every single day you do that sort of thing. For us, as people working in emergency who deal with trauma, seeing people’s lives change as a result of silly decisions or choices is something that is hard to watch.”

Yet watch they must. The Alfred and Royal Melbourne face wave after wave of crash victims arriving in their bays. Trent McGaffin was even assigned the same trauma bay he’d been in a year earlier after another off-road motorbike crash. Cam Caldwell’s brother James talks of losing two friends to road crashes since Christmas, one of them a Mount Evelyn crash where nine people were jammed in a car, one in the boot, driven erratically before it clipped another car and hit a pole. A teenage girl died.

None of the victims we spoke to remembered the crash. Carl Lewis has a subliminal flash of seeing a grille right there, yet didn’t know until afterwards that his collision was with a truck. Others remembered a few minutes before the crash, and then paramedics working. Or what they think is a recollection doesn’t fit the reality.

Our brains, and strong immediate painkillers, protect us from horrible memories and road trauma becomes a blur. But not the aftermath. That reality remains.

Victoria’s road toll has dropped over the past four decades. In 1970, more than 1000 people died on our roads. In 2015, 252 people died on Victoria’s roads (179 males, 73 females), slightly up on 2014. At the time of writing, police were projecting more than 300 deaths for 2016.

New technology in cars, ambulances and hospitals keeps people alive, but what the official road toll doesn’t record is the number of people who don’t die, but suffer significant injuries.

In the Transport Accident Commission figures for 2015, 6277 people were hospitalised after crashes on Victoria’s roads (up 5.1 per cent from the previous year), well above the five-year average of 5706 a year. In 2015, the number of those categorised by the TAC as seriously injured (hospitalised for more than 14 days) was 970 (up 9.9 per cent).

00 active financial claims on its books. In the last financial year, there were 22,138 new TAC claims for road trauma, up from 22,012 the previous year and well above the previous three years, which sat around 19,000.

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It’s no wonder Dr Helen Stergiou adds, “Human beings surprise me. They are incredibly resilient in terms of the experiences that they have, the traumas to which they are subjected. Their humour surprises me, and I will say that their less-than-ideal choices surprise me. That’s what keeps it interesting.”

But the cost goes far beyond dollars. RoyalAuto saw the human ripples flowing from each crash. The kid who has to move back home for more than a year of rehabilitation, affecting family dynamics and his single mother’s ability to work and look after him. The family man whose wife turns up in Emergency, torn between sheer gratitude he’s alive and fear at what lies ahead, the sole breadwinner bedridden for the foreseeable future. The small business owner who is missing from work for months, learning to walk on a prosthetic limb. And the victims who don’t return home at all, that ominous phone call from a police officer tossing everybody through the dreaded portal to an awful new reality.

We are incredibly lucky in this state. Victoria’s two trauma hospitals are world leaders. Deaths have decreased with the highly effective systems and teams of inter-skilled experts available for every road trauma victim. Sometimes the air ambulance will land on the hospital helipad to find 20 or more medicos waiting, doctors scrubbed for immediate surgery.

In Emergency, it is striking to watch the team leader doctor stand back, arms folded or behind his or her back, quietly asking for this test to be performed or that procedure to be done, watching vitals on one of many screens, answering questions from the chief nurse. He or she is an orchestra conductor and the team is skilled and intent. There is no panic – calmness is a vital element of the work. From a registrar furiously working to stem blood loss from a massive open wound to the nurse at the Royal Melbourne who continually closed the curtain to the bay because, “He is unconscious, he has very little privacy at this moment, so I speak for his dignity.” There is a remarkable mix of humanity and extreme problem solving, blended with incredible technology and skills. Witness the video-guided intercostal catheter (VICC) tube inserted into Trent McGaffin’s chest cavity to gently suck away life-threatening air gathering outside the collapsed lung. A brand-new procedure performed within six minutes of his arrival at the Alfred, saving his life.

Our system, developed by leading experts in the state, including Professor Mark Fitzgerald, has been exported. He estimates that for every life saved in Victoria, another 10 are saved overseas. Every advance in preparation, teamwork, technology or theory of medical intervention ripples across the globe.

Yet for Fitzgerald, and the other medicos, the joy is in the people.

“The best thing is when someone wakes up,” Fitzgerald smiles. “You see someone who is really, really sick and you don’t think they’re going to make it and you suddenly walk around the corner one morning and they’re sitting up having a cup of tea. That’s inspiring.”

Written by Nick Place, Photos by Meredith O'Shea
October 01, 2016