A locum could easily become a “Field of Dreams” for codeine. Prescribe it and they will come, tell their friends, and keep coming back forever
Dear Julia,
They know their world leaders in Opaltown. My first patient here was a youngish woman with a longish list. My heart sank.
I was anticipating an extended consultation, but she had just become bored while waiting and decided to pass the time jotting down the names of all the presidents of the US on the back of a supermarket receipt. She had got as far as number 37, Tricky Dicky Nixon, before I called her in.
Impressive.
Later that morning a multilingual Czech miner with a doctorate of philosophy, (“But I don’t use the title here”), told me that he was close friends with the past two presidents of the Czech Republic. He also added (I don’t know why) that he had once spent four months on remand for murder, but was ultimately found not guilty. This was followed by: “Only ever killed people in Vietnam, and that’s a different story.”
Opaltown is a place of many stories told in many tongues.
“Novak Djokovic will never win another major. His wife is making him sick. You cannot play tennis if you eat grass and vitamins,” according to an unasked for and inaccurate prediction delivered in a thick Serbian accent.
A French lady with rainbow hair explained that “There is no shortage of water in Opaltown because we use artistic water.” Hmmmm. Artistic water is no doubt more colourful than the stuff that comes out of the artesian bore.
A cheerful and cherubic Scottish miner known as Rabbit gave us a guided tour of his subterranean workplace and home. Rabbit was given his nickname not in reference to his occupation but his name, Peter.
Fragments of the human genome from every corner of the earth, and possibly beyond, have coalesced in the desert here and the results mirror the local geology; the odd stunning gem hidden in tonnes of ordinary clay and dust.
It is difficult to tell if evolution or devolution is at work. The Hungarians, Czechs, Slovenians, Greeks, Macedonians, Serbs and Poles responsible for the Snowy hydro scheme have tunnelled on, chasing opals and now form the backbone of local society, along with remnant 10-pound Poms and home-grown refugees from east coast suburbia.
The most recent contributors to the gene pool are the Sri Lankans (457 visas, strictly above ground housing, no mining) and the elegantly erect Africans. First Australians constitute one third of the population and always live on, not in, the earth.
I was, probably reliably, told that the southern Italians “do a bit of business with the drugs”. An imposing, shifty eyed Ukrainian gave his address as “Government Road, The Jungle” and, thankfully, did not request a home visit.
Opaltown can be as dangerous as it is multicultural.
Rock festivals, of the throwing, not the musical, kind are popular among sections of the community here. And self-harm is not an uncommon consequence.
The local nurse recalled one night, 20 years ago when the police presented her with a heavy, lumpy plastic package for safe keeping in the hospital morgue. A Russian miner’s heart had been so broken by a local prostitute that he blew himself up with dynamite.
But there is money to be made in opals. A certificate four in lapidary from the local TAFE enables you to earn $75 an hour cutting opals, which the miners will then sell to the Indian buyer for $1 to $10,000 an ounce. Hence the tale of the romantic Italian who married on Wednesday, honeymooned until Sunday, and returned home with his bride to find his claim “moonlighted”. What was once an opal mine had turned into a very big and empty hole.
It’s a wild, weird and wonderous town; I can understand why Mad Max movies have been made here.
Not only are there big skies and a starkly rugged landscape; there is an inexhaustible supply of ready-made “extras” who, with a little cash, can be induced to pop out of their burrows, in character and at short notice.
A mixture of dystopia and Mardi Gras, with darker corners of violence and despair, Opaltown is not conducive to good health outcomes.
Those who suffer most are, inevitably, the local Aboriginals. Working in the ED on a Friday night is like stepping into Dante’s Inferno – a case of “Abandon hope all ye who enter here”.
Untreated scabies can kill a malnourished indigenous toddler: itch, scratch, skin sores, infection, septicemia.
Common colds morph into rampant pneumonia within hours, and even the most trivial chest pain is likely to be a harbinger of myocardial infarction and death.
A 30-week pregnant lady arrived in premature labor. With a history of syphilis, alcohol and nicotine abuse, domestic violence and no previous antenatal care, she was obviously in big trouble … and right handed. I had to dodge multiple scars of self-harm when cannulating her left arm.
Alcohol, marijuana and valium are all used to escape the challenging reality here, but the most popular drug of all is codeine.
Every second consultation ends with a polite, but hopeful, request for Panadeine Forte.
A locum could easily become a “Field of Dreams” for codeine. Prescribe it and they will come, tell their friends, and keep coming back forever.
Cat Stevens was right baby; it’s a wild world.
Love, Dad
Dr Max Higgs is a former country GP, a current rural and remote locum and a collector of stories
