Hello on the wards readers!
I have been kindly asked to give you an insight into the wonderful and sometimes crazy world of medicine in the Northern Territory.
By way of introduction, I am now in my 5th year of work, 3 of which I have completed in various jobs in the Territory. I am what you call a veteran now, as one thing you quickly realise about working up here is that your colleagues are a largely transient bunch. People leave because they have training that needs to completed elsewhere or they get fatigued from the work, which is completely understandable. I originally hail from Adelaide, where I grew up and trained, then following my internship, I headed north for some adventure. I quickly fell in love with the scope of practice and the people up in the NT and decided to start my specialty training in Emergency Medicine here 2 years ago.
So why did I stay and why are so many others temporary visitors? I think I can explain this to you by describing my three favourite aspects of working in the Territory.
Number 1 – It’s an adventure
Adventure was certainly one of the reasons I came north in my residency. I wanted to be able to start practicing my skills in a remote and resource challenged setting. Given Darwin is one of Australia’s major cities, this seems like any statement, but we are a one-hospital town, with no cardiothoracics, neurosurgery or spinal surgery and we see our fair share of trauma. We have only recently begun to offer PCI for acute myocardial infarction to some select patients. Unbelievable hey?!
I feel like every day is an adventure at work, finding new illnesses or complications of illness in our incredibly disadvantaged Indigenous population and trying to manage them in this complex context of their cultural world. Furthermore, I drive home at the moment, with a broody skyline and lightning storms off in the distance. I then take my dog for a walk, along the cliff tops looking for crocs down below and come home to a dinner of fresh fish caught in the local rivers (if its been a productive weekend!). What I’m saying is the lifestyle is also a constant adventure. We are literally surrounded by national parks and river ways full of Australia’s iconic creatures. Equipped with a 4WD, this place is a massive playground.
Number 2 – Indigenous health and the variety of illnesses we see
I touched on this briefly above, but we do see a great variety of things in Darwin. In Darwin, during our wet season, our antibiotics protocol for undifferentiated sepsis is Meropenem and Vancomycin (the big guns), because we need to cover for Meliodosis… ever heard of that? I hadn’t until I got here. It’s a rare, but devastating tropical bacterial infection, unique to the Top End. Furthermore, our patients are often non-compliant with treatment of their chronic illnesses. Therefore, we see many of the complications of illness for example, acute heart failure from decompensated rheumatic heart disease and diabetic foot infections, so bad that maggots are coming out of them.
Number 3 – Attitudes
Darwin is a place where people come to work with our Indigenous population and it is not an easy job, hence staff retention can be poor. It is under resourced, communication is always challenging and the cultural context of health for Aboriginal people is completely foreign to our mainstream Western ideals. But nonetheless, Darwin is a place full of enthusiastic, resilient and generally happy people who want to offer whatever they can to improve the lives of our native Australians. I think this underpins a hospital culture of acceptance and team-work that I have not experience elsewhere. I genuinely enjoy coming to work everyday to work with my peers, who approach their jobs with enthusiasm and a healthy dose of laughter.
I’m still here 3 years on, because I’m lucky enough to have a flexible training program that means I can complete a large portion of work here. But even if you are not in Emergency Medicine, many other specialties offer placements in the Territory and I would highly recommend you look into it as an opportunity. Adventure, Indigenous health and a real medical and cultural challenge is what makes Darwin unique and amazing.