27 September 2019

Shattered screens and broken faces

Grumpy Old Doctor RedHerring

Dear Julia,

The Top End is now our “Hotel California”.

Like the Eagles’ classic song and the locals, we seem to be able to check out any time we like, but we may have trouble leaving.

A big mistake was made upon our arrival. I failed to put Annie’s luggage in the ute sent to pick us up from the airstrip and it was promptly run over by another, larger ute driven by a miner wearing a dusty hi-viz vest.

Annie was left with a battered, dusty, sad-looking yet functional case; which has proved to be an apt metaphor for the lives of the local women and their mobile phones.

What do mobiles and women have in common?

Frighteningly, up here, they both have smashed screens/faces and countless other scars of abuse. I have yet to see a locally-owned phone that doesn’t have a fractured, scratched screen yet still works perfectly well.

Despite appearances, these phones must feel much loved because they NEVER go unanswered. The owner may be vomiting, being sutured or X-rayed, unconscious or in labor, but the call will always be taken and a long and animated conversation is likely to ensue.

Working evenings in ED it soon becomes apparent that many women are also used, abused, bashed and broken – yet still somehow manage to keep going. Unlike the phones, they do not appear to be much listened to nor loved.

Infatuation with the small screen and the keypad spans all ages and is incorporated in the assessment of early childhood development.

Sometimes it feels we have entered another world. In addition to the conventionally accepted milestones taught in medical schools – rolling over, first words, first steps and so on –  normal development up here appears to be assessed by consideration of seven local rules:

  1. All infants should be able to text before they can either walk or talk.
  2. Immediately after taking their first steps a toddler will know that, once empty, a plastic bottle should be dropped on the road or footpath, never in the bin.
  3. By two years a child should be able to walk barefoot on any surface of any temperature without flinching.
  4. By the age of three a child will be able to consistently lob a decent sized stone onto the roof of a house from a distance of up to nine meters. (Advanced individuals can do this with the non-dominant arm).
  5. First drainage of pus, from any body part, should occur before the second birthday.
  6. Once able to stand independently, a child will also know how to kick an Aussie Rules football. (No prior instruction needed).
  7. A child of five will be able to change a SIM card and video a medical procedure.

The mobile phone obsession does have an upside, it provides an infallible diagnostic sign in sick children.

The child who does not play, demand or engage with a mobile is likely to be VERY sick. This is known as the VERYSINIIM – “Very Sick If Not Interested In Mobile” – sign, validation of which is currently the subject of a large double-blind trial.

Life in the Top End would not be possible without the mobile. It’s strange what components of modern life have secured a permanent position in day-to-day  life here.

For instance, aeroplanes appear to have become a fundamental component of funerals, particularly in the more remote areas.

I ended this locum with a two-week stint on one of the local islands and found that there was always a funeral in progress, one per week with each lasting six days.

The mournful dirge of the didgeridoo was the soundtrack of island life and the sky abuzz with planes ferrying the deceased to and fro from dawn to dusk.

It was explained to me that in the old days bodies were buried, or the bones placed in a hollow log, the day immediately following death. Traditional law decreed that everyone then leave the burial area and not return for five years.

However, with the incorporation of Christian elements into the funeral services introduced by the missionaries, these farewells have become more elaborate affairs. And deaths are frequent, and funerals are never held concurrently.

In addition, it gets very hot and there is no local mortuary, so the deceased must be flown to the mainland to wait their turn in the morgue there before being flown back for burial.

As a consequence, fly-in, fly-out funerals with prolonged ceremonies have evolved.

Shorter funerals and a local holding facility might seem pragmatic, but the prevailing system is a major source of employment and the business and the ceremony of death can lend structure to otherwise directionless lives.

It is an industry that here could not exist without planes. But planes are mortal; they do breakdown and, unlike the local mobile phones and women, will not continue to function when damaged.

I learned that the hard way one night when a RFDS flight was grounded with engine failure en route to pick up a lady 26 weeks pregnant with ruptured membranes and threatened premature labor. The 12-hour wait for a replacement aircraft was character building.

Don’t leave home without a charger and plenty of credit.

Love, Dad

 Dr Max Higgs is a former country GP, a current rural and remote locum, and a collector of stories