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 tell RoyalAuto's Impact series 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.
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.
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).
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.
The best thing is when someone wakes up. 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.
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.”
Back from the brink
Tanya Disher remembers the date instantly. “December 21,” she says. “The day my grandson, Tyler, was born.”
As if that wasn’t a date worth celebrating already, it was the same day that Tanya heard that her brother, Cameron, had opened his mouth and spoken.
This was no small thing. RoyalAuto has followed Cam’s story, and his family’s efforts to support him, from the moment he was involved in a horrific car crash on 22 June 2016. When we met Cam, he was a ragdoll being cut out of his car, which had apparently lost control and careened into oncoming traffic on Swansea Road, Montrose.
There were suggestions he’d been speeding. There was confusion over whether he’d hit a pole or an oncoming car or even two cars. It wasn’t his first car crash. As his family admitted, he had some form for driving hard and fast and sometimes coming unstuck.
He won’t make it through.
All his father Alec knew when he got the call from Royal Melbourne Hospital was that Cam was “very, very unwell” (which is hospital speak for: “quite possibly not going to live”) and he admits now, 11 months later, that when he walked in on that first horrible night and saw Cam’s lifeless body, full of tubes and hooked up to machines, a part of him said, “He’s gone. He won’t make it through.”
Cam’s sister, Tanya, went the other way. Having made the most dreaded of phone calls, to Chloe, the mother of Cam’s son, Blake, she approached her brother’s intensive care bed and felt the heaviness lift. Somehow, despite all the medical evidence, she knew he was going to come back.
Fast forward to May 2017, and Cam is carefully trying to sip coffee, some of which spills down his chin and onto a bib. He’s in a wheelchair at the Caulfield Hospital’s shiny rehabilitation centre, off Kooyong Road. Cam is kind of hunched, and moves slowly. He’s gradually regaining the use of his limbs, his speech is slurry and his memory is all over the place. Mostly, his family notices that he seems to think it’s five years ago. He’s still not all there but he’s definitely coming back to them, and Alec and Tanya are lighter, even if they’re only halfway along this long and difficult road.
The lights are on
For Alec, who is by Cam’s bedside at every turn, the last almost-year has been full of legalistic TAC paperwork that makes his head spin, arguments with police about unrelated speeding charges Cam had racked up pre-crash, fights with Cam’s then girlfriend, and ongoing concern about other members of the family who have been struggling with the accident and other issues in their lives. “I’m buggered,” Alec admits, as he sits to eat a sandwich and drink coffee in the hospital cafe. “We got dealt a really, really bad hand.”
But Alec and Tanya remind each other often that it could have been worse. Cam is alive, and awake and “the lights are on”, which is more than a lot of the medical staff who have nursed him since last June dared to hope for.
Always the prankster
Cam has a cheeky nature and an earthy sense of humour. He was always the prankster, from doing donuts on the perfect back lawn of his mother’s house on a motorbike, to carving her name into the grass while mowing the lawn, to pulling off perfect backflips from a standing start. Even now, he surprises his father with a sneaky head-butt while having his pyjamas straightened and he’s forever looking for other ways to cause trouble. It’s how his family knows the old Cam is still in there somewhere.
His eyes light up as he looks at the birthday card he got earlier in the week from Tiger star Dusty Martin and he happily indulges in “You’re a dickhead!” banter with his dad. His biggest dream, he says, and it’s noted on a list of goals drawn up with Liz, the social worker, is to see Blake, his now 10-year-old, play basketball one day.
Be careful about driving. Don’t be an idiot.
But that’s a while away. Blake has found the change to his father’s health confronting, and apparently was sure his dad was dead when he first saw him connected to all those tubes. Cam, for his part, struggling to recapture his brain, looks me in the eye, his face serious, and says yes, he understands he’s being interviewed. What he wants to say is that he never wants his son to go through what he’s going through. Struggling with the words, Cam slurs, “Be careful about driving. Don’t be an idiot.”
Alec says Cam took longer than usual to come out of the post-crash coma. He still appeared unconscious when he started to answer doctor questions with a wave or thumbs up, back in December, and memorably a middle-finger salute. When he finally opened his eyes and then talked, Alec’s long vigil was rewarded and he enthuses that Cam’s progress has been ahead of doctors’ expectations over the past few months. Cam is already trying to walk, half an hour of exhausting struggle along parallel bars with physiotherapists, while also having therapy on his arms and hands, and communication sessions, where he tries to interact with other acquired brain injury patients.
A new reality
This is his world now, after a greasy road and a heavy foot on the accelerator. Alec is rearranging his life to be Cam’s full-time carer. Tanya is juggling a bunch of kids and hospital visits. Chloe and Blake are travelling an hour or more twice a week to keep the connection with this broken, struggling man. It is one year after a car crash. This is Cameron Caldwell’s new reality.
Asked what she’s learned, Tanya chooses her words carefully. “When you drive,” she says, “you need to realise you are getting behind the wheel of a loaded gun”.