Saviours in our skies
The Royal Flying Doctor Service turns 90 this year. To celebrate, The Weekly’s Michele Mossop joins flying midwife and intensive care nurse Derani Burns for a life-saving day in the skies above regional South Australia.
The call comes at 05.20: Code Two, cardiac arrest, female, 54. “That’s very young, and she doesn’t have any preconditions.” Flight nurse Derani Burns, of the Royal Flying Doctor Service, had just spoken to the medics at the small hospital at Tumby Bay, just north of Port Lincoln in South Australia. Rain blows across the tarmac in flurries at the RFDS base in Adelaide as we set out in the crisp early darkness. Above the clouds the sky is still a blanket of stars as Derani busies herself, logging the mission, thinking ahead about the patient and prepping me for what to expect.
Derani, 41, was born and raised in Adelaide. She has been a nurse and midwife for nearly 20 years – the last nine of them with the RFDS.
The hours are long (today we’re on the 5am to 4pm shift), she never knows what the day will bring and she has the trust and autonomy to make serious decisions with all the back-up she needs.
“I love my job,” she says with a smile as the eastern sky glows a faint pink through steel grey clouds on the horizon.
Derani works with arguably the most loved and iconic Australian institution: the RFDS, best known as the Flying Doctors. Founded by outback pioneer, the Rev John Flynn (or “Flynn of the Inland”), it first took to the air in May 1928 and celebrates its 90th anniversary this year. In the ’80s, the RFDS inspired a TV drama which can still be seen all over the world. Who could forget Rebecca Gibney in a red gingham shirt and denim overalls, spanner in hand, repairing a light aircraft in a tin shed? It was a far cry from today’s sophisticated fleet of 69 flying intensive care units, which provide around-the-clock emergency medical and primary health care services to rural and remote Australia.
It’s light when we land in Tumby Bay to pick up Jan Battye. Michelle Parker, a volunteer ambo, drives us to the hospital where Jan is being comforted by her husband, James. Jan was taken ill in the middle of the night and James drove her to the hospital, where she collapsed, banging her forehead badly. She only returned to consciousness after 10 minutes of CPR. On top of the cardiac arrest, she is in a lot of pain, with very sore ribs from the CPR and a huge shiner from the fall.
In the plane, Jan is calm, comfortable and linked up to a monitor. Derani doesn’t leave her side. She carries on a quiet, reassuring conversation. “You know, I used to spend my summer holidays at Tumby Bay. I was a kid and we used to stay at the caravan park,” she says, all the while keeping an eye on the monitor.
The flight is uneventful but Jan’s condition changes rapidly once we land in Adelaide. The ECG indicates that she is arresting again. Derani’s response is swift, quiet and very, very calm. The rescue paramedic arrives in a shot and Jan is quickly on her way to the Royal Adelaide Hospital.
Nine years ago Derani decided she wanted a change from nursing in a private hospital. A girlfriend suggested she try the RFDS. She says it was fate. With her background in critical care and midwifery, it was a perfect fit. She’d also had experience working in remote locations. In her twenties, she had helped to set up a healthcare centre in an isolated corner of Cambodia. When she’d first arrived, there was
no running water or electricity, but now women can give birth there safely. It was as though Derani had been moving towards her role at RFDS all along.
“Foxtrot X-Ray Whisky, we have doors shut at 10:50.” We’re off to Wyalla to pick up Elsie Phillis. She’s 96 and needs a lift home to Wudinna after a hip replacement. It’s very blowy as she is wheeled onto the tarmac on a stretcher, but Elsie is clutching her handbag and couldn’t be happier to be heading home. “She reminds me of my grandma,” says Derani as Elsie smiles up at her with blue, blue eyes. At Wudinna, Elsie recognises one of the volunteer ambos: “I know you! You were at school with my daughter.” She’s home.
In the nine years Derani has been with the RFDS, she has married her husband, Adam, and had two babies, Mason, now five, and Jett, two.
She has also had a medical emergency of her own: a brain tumour removed. Jett was only four months old when Derani lost hearing in one ear. It turned out to be a benign tumour but there were months of intense rehab after the surgery.
“I just knew it was all going to be okay – I wasn’t worried but it was terrible for Adam and my parents,” she recalls quietly. “My mum was wonderful and held it all together, cooking and looking after us.” And her RFDS family were the same – every few days a food parcel would land, as if by magic, on her front doorstep. “They were so amazing. They even organised a food roster.”
With two boisterous boys under six, Derani has a full and busy life away from nursing. “I go to work for a break,” she laughs. Recently Adam moved from regular office hours to a more flexible position that will fit better around Derani’s shifts – though he also has a busy schedule with the Army Reserve. They’ve managed to pull off the
juggling of hours (one day Derani might begin work at 5am; the next it could be a 9pm start and an all-nighter) because Derani’s parents, Margaret and Geoff, still play a big part in their family life – especially Margaret, who does much of the cooking.
Wudinna isn’t far from Kadina, where we’ve been asked to stop for a non-urgent pick-up, but the weather in the area is deteriorating. High winds and horizontal rain with varying visibility are not ideal conditions for an instrument landing on a small airstrip. The pilot, Gerritt Koldenhoff, makes the call to proceed to Ceduna, on the Great Australian Bight, instead. The clouds are clearing as we approach the town and sandy beaches line the vast sapphire blue Southern Ocean.
No two days at work are the same. Derani has seen farmers run down by rams and bulls and a patient legging it because of a fear of flying. She has helped countless babies into the world and offered reassurance to new mothers. Mental health care is also a big component of her work and, perhaps because the landscape nurtures a special kind of independence, there are many stoic patients: “Oh, she’ll be right, mate!” People can be critically ill but they don’t want to make a fuss.
Norm Bennet, 76, is a big, tall, friendly bloke with a shock of white hair and a small gold earring that features an Egyptian love amulet. The wind cuts sharply up from the coast as he stands to one side of the ambulance on the runway. He’s there to support his wife, Bobbie, who needs urgent treatment for an abdominal condition. She’s in a lot of pain. Derani keeps us out of the cabin until Bobbie is comfortable. During the flight, she speaks to her softly and reassuringly. She touches her gently.
Norm and Bobbie have been together for 47 years. They moved to Ceduna in the early ’70s but as Norm says laughingly, “you’re not a local until your grandmother’s in the cemetery”. They were supposed to head off to Bali later in the week to visit one of their sons but they’ll get there later, no rush. As we land in Adelaide, Bobbie seems to be progressing well.
It’s the end of the shift. “Let’s call and see how Jan is,” Derani says. Through the day, we had both wondered out loud how she was going. All is well, perhaps a stent for her heart, the bruise on her forehead is serious
(she has a small bleed in her brain as a result of the fall) but with age on her side, the outlook is good: much relief and big smiles.
It’s been a long day and Derani is looking forward to getting home to her family. She makes a quick call and smiles. “My mum is so good, she’s got dinner ready for us”.