CARING, CURING, CRYING
ABC’s Keeping Australia Alive offers a fascinating snapshot of the healthcare system over a 24-hour period
new mum Shay-Lee holds baby Monique for the first time, inset; bariatric surgeon Justin Greenslades, below
For most of us, our contact with health services usually involves little more than a visit to the local doctor or pharmacist, but as a complex new sevenhour ABC documentary series reveals, these services are part of a much broader and intricate network that’s as hard to visualise as anything the creators of Utopia could dream up. Think “governance and support mechanisms that enable the policy, legislation, co-ordination, regulation and funding aspects of delivering quality services”, a description that might have been written by Rob Sitch.
ITV Studios Australia executive producer Karen Dewey, with the help of 100 cameras and her crew, gives us an extraordinary snapshot of what happens over a single day in this medical ecosystem, stretching across the continent. “Filming over a 24-hour period — one single, random day — allowed us to highlight the incredible breadth and depth of our health system,” she says. “This was an irresistible opportunity to examine something so vital to all Australians, and to present a vivid and human portrait of a complex and sprawling system.”
In that single day — Dewey gives us an attractively insistent digital countdown graphic — more than 800 babies were born, 400 Australians died and more than 1000 people were treated across the country in hospital trauma departments. There was a lot to cover and, as always, the theatricality of surgeons in white gowns in the heat of the operating theatre fighting for someone’s life offers seductive viewing.
Dewey is no stranger to factual medical shows: she produced Medical Emergency (filmed at the Alfred Hospital in Melbourne) and Making Babies (creator), an observational documentary series for the Seven Network that followed 12 couples from pregnancy to birth; she was also responsible for RPA (filmed at Sydney’s Royal Prince Alfred Hospital) and Young Doctors, an observational documentary following residents at the John Hunter Hospital in Newcastle, both for Nine.
But Keeping Australia Alive is altogether different. Her production notes reveal seven frantic months of pre-production for the one-day shoot, including negotiating access to all the hospitals and clinics — more than 80 in all — and more than 1000 consent forms. (“How do you eat an elephant?” she says. Bite by bite.”)
Then there were four months of post-production. The footage was filmed, she says, using a multitude of cameras, with no opportunity for second takes, resulting in 550 hours of raw footage. Units were deployed in 10 different emergency wards, some surgeries required covering two separate patients (“There was a risk that if a patient had a temperature or was not well they wouldn’t go ahead with surgery and we would miss the story”), and film crews were on standby in maternity wards in two states.
“The story development list was extensive — we wanted to ensure we had all angles covered,” Dewey says. “We had to create a balance of stories: metropolitan to rural to regional to remote, public to private, from birth to death, from far north Queensland to southern Tasmania, from east to west, from surgical to clinic to home care.”
Allowance was made for seven stories per episode, plus emergency room sequences, and then another 10 to 15 reserve stories were allocated, in case some dropped off on the day.
“We wanted every story to hit at least three of our key themes: love and sacrifice, quality of life, tyranny of distance, compare and contrast, the indigenous health gap, private versus public, the future of medicine, ageing population, cost of healthcare, pressure points in the system,” Dewey says. Her intention is to confront and surprise us with the real stories of what makes up Australia’s extensive system of care and services — which, as her extraordinary production reveals, we often take for granted.
It’s a show premised on life’s big questions, and there are many to which she attempts to find answers in the very human stories of joy, fear, terrible uncertainty and hope on the part of patients and staff.
What are the inequities between public and private systems, between east and west, between country and city? What specific challenges do we face with a structure that needs to cater for everything from the most remote indigenous community to the busiest city hospital? What human dramas unfold every day within it, and what do they tell us about ourselves?
The first episode takes us from cradle to grave. On the day, 35 babies are expected to be born with fertility assistance. In Sydney’s Westmead Hospital we find Chrissie and Rob, who have been trying to have a baby for many years. They have completed another expensive invitro fertilisation cycle and now desperately hope for a positive result to a pregnancy test. It’s a big day and it may be heartbreaking. Meanwhile, Vanessa, who has three children, is donating her eggs to a childless couple who sought out a donor on Facebook. “I’m happy to help,” she says. “It’s a real honour.”
On Bribie Island, 79-year-old Rita Kok is a home carer, one of thousands of “unpaid soldiers of the health system”, as her doctor calls them. Rita’s husband Elbert has advanced dementia.
“He hasn’t forgotten me, he’s forgotten the relationship,” she says. The person she fell in love with is no longer there. More than a million of us care for someone with dementia.
Forty-one-year-old mother-of-four Lisa Clark collapsed at home near Ballarat. She’s been rushed to the Royal Melbourne Hospital with a ruptured brain aneurysm. As the trauma team works urgently, every minute counts. Then another emergency aneurysm patient arrives: a farmer sadly given little hope of survival. In Australia someone suffers a stroke every 10 minutes; one in six of us will suffer one. The speed of treatment is critical to the outcome.
Rural medical generalist John Douyere works in the small community of Longreach in Queensland. He describes his patients as his friends and his friends as his patients. Today he has a difficult consultation with an old mate who has skin cancer. “We’ll just have to see how we go here; this could be a bit emotional for me,” Douyere says to camera. The patient and his wife are stoic, brave and funny.
It’s a beautiful-looking and sounding production under the guidance of director of photography Ian Peterson and head of sound Tony Clunes, who briefed more than 130 producers, camera operators and sound recordists across the country at “boot camps” for crews in Melbourne, Sydney, Perth and Brisbane.
“The vital part of boot camp was to ensure everyone was aware of the shooting style and series mission,” Dewey says. “We wanted to ensure they captured the human stories, the heart — we encouraged them to ask questions of contributors about how they feel, what they’re afraid of, what their future holds.”
The series is visually gripping, the images sliding back and forth between high photographic stylisations and visceral handheld camera immediacy, shifting attractively between film modes and styles in coverage, not only between sequences but within them.
There’s a fast cutting rhythm in the edit, montages of fast and slow motion between the main stories, bespeaking a frantic medical universe, each sequence preceded by the rhythmical click and crunch of a camera shutter that adds to the feeling of being hurtled through this extraordinary day.
We’ll have to wait until the day is up to know how many questions this redoubtable team is able to answer, but there’s no doubting its probing and compassionate engagement with the realities of healthcare, and the joy, sadness and the occasional moments of wry humour are affecting.
There are wonderful, often inspiring moments of character in the show that really capture the essence of human drama by showing modest, unassuming heroes who work hard to bring peace of mind to people with perplexing medical problems.
from Tuesday, March 15,
A scene from Keeping Australia Alive;