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Our Medicine Season 2 Episode 2
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00:00Aboriginal and Torres Strait Islander viewers are warned that the following program may contain images and voices of deceased persons.
00:25Previously on Our Medicine
00:27So yeah, Blanche.
00:28Med student Keisha kicked off her rural placement.
00:31She's come in with some itchy spots behind her ears.
00:34Like everything, there's risks.
00:36Oh, of course.
00:37Deadly visions prepared for surgery, and the Achillata team began an adventure.
00:47Indigenous Australians still suffer some of the highest rates of chronic illness and shortest life expectancies in the developed world.
00:55As mob coming into these medical spaces, we feel like everything's against us.
01:01But change is happening.
01:02Is it painful?
01:03No.
01:04I can't even feel it.
01:04Across the nation's senior Indigenous health professionals and traditional healers are joining forces with the next generation.
01:12I know my mob.
01:13I know my ancestors.
01:15That keeps me grounded.
01:16To create a future of better health for First Nations people and all Australians.
01:22There are people that care.
01:23A lot of people that care.
01:28A lot of people that care.
01:35A lot of mates having difficulty breathing.
01:38Yeah.
01:39And that's all we got.
01:40Like, no name, no nothing.
01:45In Cairns, veteran paramedic George Finnamore and trainee Rob Minicon are on their way to assist a distressed woman who
01:53approached another ambulance crew for help.
01:57My colleagues will look after you, okay?
01:59Get you out to hospital.
02:00Come and hop on the bed.
02:01Get out.
02:02Turn down.
02:04Bit of a step.
02:05Bit of a step.
02:06Yeah, just there.
02:09Okay.
02:10I'll pop your keys in here so they're safe.
02:12George and Rob's 73-year-old patient has been vomiting and has concerningly low levels of blood oxygen.
02:21Following a recent operation, her respiratory system is compromised.
02:28Rosalyn had a tumour in her throat and she has removed and has a tracheotomy in place.
02:35That's a hole in the neck to help breathing.
02:40Her trachea hasn't got a filter on her, so she can't talk.
02:45The open tracheotomy could be a source of infection.
02:49But the first priority is to stabilise her condition.
02:53Your oxygen drop in 1092.
02:57Put this on your arm there.
02:59She was having a very difficult time breathing.
03:01But obviously because she had a tracheotomy, we can't go over her mouth.
03:04We've got to sort of improvise.
03:06Hold it over your trachea, okay?
03:11She could go into respiratory arrest where she stops breathing and then her heart stops
03:16and then we have like a cardiac arrest as well.
03:19You alright, Rosie?
03:21With stable oxygen, Roz is out of immediate danger.
03:26But patients can be resistant to medical care even when they've made the call out themselves.
03:32Can I pop this in your ear, darling?
03:35Okay, thank you.
03:36I won't do it hard.
03:38It's alright.
03:39It's gonna sit in this.
03:41Edmonton 142, transporting.
03:43You're alright, darling.
03:46And despite her current challenges, patient Roz is no shrinking violet.
03:56Bumpy.
03:57Yeah.
03:58Just watch the bumps.
03:59No worries.
04:00Sorry, Roslyn.
04:01I'll take it easy.
04:02Roz is directing me here to tell you.
04:07That's okay, though.
04:08We try to please.
04:16Oh, sorry, though.
04:25I look at how my mentors deliver their care, how they interact with patients, how they joke
04:33with patients.
04:33I was telling her that Rob was a racing car or rally driver or something.
04:38You just have a joke with them, you know.
04:39It works for white fellas, it works for black fellas, you know.
04:42It's easy to build rapport with anyone.
04:47I think that's pretty much done now.
04:50Can I pop this on your nose?
04:52Just so you can breathe, darling.
04:55You don't want it?
04:56Okay.
04:58One, two, three.
05:00At Cairns Hospital, the acute response team is ready to provide Roz with full emergency
05:06care.
05:08She can't talk.
05:09Her trachea hasn't got a filter on it.
05:11There's a bit of secretion coming out of that as well.
05:14I'd say she'd be on a full treatment of antibiotics intravenously.
05:20They'd also put a new filter over that tracheotomy instead of it being exposed, so she can go
05:27back home.
05:28It's good exposure for Rob to see.
05:31It's showing him the different medical conditions we go to.
05:37This is the kind of job that makes me want to go back and read, so I have a better
05:40understanding
05:41of these things.
05:42Everything's a learning curve, so it's amazing.
05:55All right, so we're just getting everything set up.
05:56Yeah, yeah.
05:57That's fine.
05:58At Darwin Hospital, a group of First Nations patients are prepping for life-changing eye
06:04surgery.
06:05Yeah, a little bit anxious just to go through the process, but I'm excited for the end result.
06:14So right eye, and then it'll give me...
06:17First Nations ophthalmologist Dr Chris Roller-Baker has returned to Darwin to perform the delicate
06:23cataract surgeries.
06:24Why is it taking so long?
06:26And this time, he will be shadowed by first-year Indigenous medical student Aidan Wu.
06:32Aidan will see the anaesthetic go around the eye, and there'll be some sedation to make
06:39the patient feel a little more comfortable.
06:43Anaesthetist Dr Chris Bradshaw is providing some medicinal relief for the anxious patients.
06:50Well, some chilling out drugs coming from me now.
06:54There are medications mixed into that sedation that reduce anxiety.
06:58We've done that hard, hard Eileen. You can relax now. The eye's very numb.
07:02Dr Bradshaw is excellent with his sedation. It's just a whole approach.
07:05It's a really culturally safe approach that he takes.
07:09People feel very at ease by the time they get in here.
07:11Is your eye comfortable?
07:13Yeah.
07:15You're welcome.
07:18After successful surgery to remove a cataract from his left eye, Uncle Leonard has returned
07:24to have the other side done.
07:27I'm 73 years old and I'm getting my eyes back.
07:31Oh, my God, it's incredible.
07:32You know, these young folks don't know what they're handing out.
07:36But Leonard's operation has gone off plan.
07:40He ate this morning, so he won't actually have any sedation.
07:44He'll be fully awake.
07:45But he's very comfortable with that.
07:47And he's quite happy to go ahead with the surgery unsedated.
07:51And the most important thing is, is relax.
07:53And I'll talk him through things as we go.
07:57You're Chris, mate.
07:58I am.
07:59Yeah.
07:59How are you?
08:00Yeah.
08:00You might hear me talking to Aidan here.
08:02Is that junior?
08:04Yes, yes.
08:05He's here.
08:06Cool.
08:06Oh, that's perfect.
08:07I'm going to get started now.
08:12Aidan will be able to see the actual cataract being removed and the lens being injected.
08:16You let me know if you're uncomfortable or feel any pain.
08:19You shouldn't.
08:20It's a wonderful anaesthetic that Dr Bradshaw has done.
08:24Dr Chris is conducting the surgery through a 2mm incision, breaking up the cloudy old lens
08:31so he can insert a new one.
08:35Very tight.
08:37That's all I think.
08:39When you're operating, it's already a very big thing for these people to come up to the
08:43hospital and have something in their eye.
08:46If you have a bad outcome, it's very difficult to regain that trust.
08:53You've got to get it right, and you've got to get it right the first time.
09:00What's that pink thing?
09:03It's a heartbeat.
09:06His heart rate is dangerously low.
09:14A resting heart rate below 40 beats per minute can lead to brain damage or cardiac collapse.
09:21We've got adrenaline in the bags, do we, Peter?
09:24Yep.
09:29If the heart rate doesn't climb, the outcome could be fatal.
09:45Dr Chris's patient is in mortal danger.
09:48Heart rate 36.
09:51Okay.
09:5373-year-old Leonard is fully awake, and his pacemaker should be keeping his heartbeat stable.
10:00But anethetist Dr Bradshaw has discovered a problem.
10:05It's a technical issue with the pacemaker.
10:07The pacemaker does not actually really.
10:09Okay, give me the green, please.
10:11That's not my green.
10:12Don't worry about the panel.
10:13Yep.
10:14His heart rate was in the 30s, and his pacemaker should kick in at a heart rate of about 50.
10:21Chris, I've just got to put a magnet on.
10:24Can I talk to him?
10:25Yes.
10:25Can I talk back?
10:26Is that okay?
10:27Ah, give me two seconds.
10:29Yeah, I'll just wait till you're ready, Chris.
10:31Get above this iris.
10:32I don't want to catch it because you can engulf it.
10:38Before they can address Leonard's low heart rate, Dr Chris must carefully remove the tools
10:43from his eye, as any slight wrong movement could cause irreversible damage.
10:51You can talk to him now.
10:53Leonard, whereabouts is your pacemaker located?
10:56Left shoulder.
10:58Left shoulder.
11:00Over here?
11:01Yeah, good.
11:01There?
11:03You'll feel it.
11:04I called for a magnet.
11:06Is it there, Leonard?
11:07Yeah.
11:08Got to put a magnet on.
11:09Put the magnet over the pacemaker.
11:12Yeah, I can't, I can't.
11:13You're good.
11:14I wasn't quite sure what would happen, but I knew if it does work, it would restart his heart
11:21at a satisfactory rate.
11:29Uh, it's 50, 77, 88.
11:33Caught in.
11:34Yeah.
11:35Wonderful, thank you Chris.
11:38All part of the surgery.
11:39Yeah, thank you.
11:40Wonderful, thank you.
11:41He's made a worker now.
11:43Yes, working.
11:43At the moment, yes.
11:45I better put a magnet in my pocket.
11:47Yes.
11:48But you wouldn't have known.
11:51Michael's saying he said, everyone's different.
11:52Anyone who tells you, oh, cataract surgery's the same, they've got no idea what they're
11:55talking about.
11:56You're welcome.
11:57Ready for the, uh, my cold.
11:58You're ready there, Peter.
12:00Lovely.
12:01Lock it in.
12:02With Leonard's heart rate stabilised, Dr. Chris can finally relax and continue the operation.
12:11I've never had a pacemaker malfunction during surgery.
12:15Dr. Bradshaw was able to put a magnet on the pacemaker and reset it and the pulse came
12:20back up.
12:21So, a very difficult, complex case, but we got there safely and we'll have a good outcome.
12:28All right.
12:29You got there.
12:31Thank you so much.
12:32Pleasure.
12:32Very, very.
12:33You put us all through our paces.
12:36He was very, very lucky that he was in hospital having his cataract surgery done and being monitored.
12:42If he was at home and if he stood up with a heart rate of 36, he probably would have
12:47lost
12:47consciousness and it would have probably been a very bad outcome.
12:52All right.
12:53Well, it's as hard as it gets.
12:54Yeah.
12:54All right.
12:56Pretty wild.
12:59Things don't always go the way that you want them to go and eight out of nine cases seem
13:03like they're quite routine, but then you get the odd case where if something can go wrong,
13:07everything goes wrong.
13:09Both Chris and the anaesthetist that did a great job at not letting that affect the outcome
13:14and the safety of the patient.
13:16It's pretty exceptional how they can consider those variables, but still focus on the patient
13:20and make sure that they can do the best work.
13:32And it's just a very slow, slow, slow push.
13:39That okay for you?
13:40Yeah.
13:40Yeah.
13:41But you'll have to come back and see us next week and we'll check it again.
13:46On Palm Island, where 90% of the population is First Nations, colonisation has left a legacy
13:54of chronic illness like rheumatic heart disease.
13:58It was eradicated in the mainland long ago, but yet we still suffer in this day and age.
14:08Compounding the problem, there is widespread distrust of the mainstream health system, stemming
14:15from the island's traumatic history.
14:20Palm Island was the traditional home of the Munborough people, but from 1918, everything changed.
14:30That year, the Queensland Government began to forcibly relocate First Nations people from
14:36across the state onto the island.
14:41Today's Palm Islanders are descendants of those relocated peoples, plus the original inhabitants,
14:48a population that traces its origins to over 50 different tribal groups.
14:57My name's Stanley Palmer Izzard.
15:00I'm a proud descendant of the Warrungoo tribe here in North Queensland.
15:04My grandfather and his siblings were one of the ones that got sent from Mission Beach
15:09area all the way to Palmer Island.
15:14Under government policies which lasted for over five decades, people like Stanley's elders
15:20lived in harsh prison camp-like conditions and were systematically deprived of adequate food
15:27and proper medical treatment.
15:32It was a tough life.
15:35Being told what to do, where to go, every day by a superintendent,
15:41listening to a bell that was ringing, ringing, ringing.
15:44We are still living with a transgenerational trauma.
15:48Even though some of us didn't go through that.
15:54But our parents, our grandparents went through that.
16:01In response to the harsh conditions, the people created a new identity.
16:08The word Bulgaman means many tribe, one people.
16:13So back when people were brought here to live, you know, Stolen Generation days,
16:18people come together and created Bulgaman as one mob living on Palm Island.
16:27Although the dark days of forced relocation are over,
16:31the Bulgaman people now suffer from some of the poorest health outcomes in the country,
16:37and many are reluctant to use government-run health facilities.
16:45However, after decades of downward spiralling health trends,
16:50in 2021, the community took control of the local primary health care centre,
16:56renaming it the Bulgaman Healing Service,
16:59and things began to dramatically change.
17:04Just in the blue chair there.
17:06You can pop your bags here.
17:08Getting a flu vaccine today, yeah?
17:10Yes.
17:12Bulgaman Healing Service is an Aboriginal medical service.
17:15We're community-run.
17:17It's more welcoming for community to come in.
17:20And you say you're a bit nervous from needles, eh?
17:22Yes.
17:23Yeah.
17:23I have to look on that part.
17:24Yeah.
17:25I have to look at the needle.
17:26All right.
17:27Big deep breath in.
17:29And ready.
17:30Following a self-determined health care model,
17:32which began in Redfern in 1971,
17:35Bulgaman Healing Service is one of 146 Aboriginal community-controlled health services
17:42across the country,
17:43which follow the same model of comprehensive and culturally safe health care.
17:49Yep.
17:51All right.
17:53It's more of a friendly setting.
17:56It's more family-orientated.
17:58So we're just checking the haemoglobin.
18:01It can indicate the iron levels.
18:04Yeah.
18:06We have that holistic approach.
18:09We have night clinics here.
18:11Paediatricians, physiotherapists, dietitians, all making an impact together.
18:17We have our community members working in here as receptionists, health workers like myself.
18:23Do you want to come through things?
18:26Community trust is on the rise.
18:28All right.
18:29Ready.
18:30Since 2021, patient numbers have tripled from 1,000 per year to over 3,000.
18:36Well done.
18:39It's early days, but it looks like the trend of health outcomes on the island may be improving.
18:49That same information, knowledge that's been handed down to us needs to be passed on to the next generation.
18:56We can turn that transgenerational trauma to a transgenerational strength.
19:13With just six weeks before her exams, today, fourth-year medical student Keisha Kalyan will be facing one of her
19:21fears.
19:21And then you're like, I've done it once before, my friend.
19:25Like, technically, I have done it before.
19:28Today, I'm learning how to take bloods.
19:30And not this, but the...
19:32Patient Raymond needs regular tests to monitor his peripheral vascular disease.
19:38But in the past, getting a blood sample has not been easy.
19:43With his vein, he's got, like, jolly veins.
19:45So when you put the needle in, the vein just sunk.
19:48Sometimes it will move if you're too soft.
19:50Like, even if you come in sideways, it will just move the vein.
19:52You've actually got to turn it and, like, give it a little, like, this.
19:57Indigenous health worker Salel will assist.
20:00But Keisha is only allowed two attempts before she must hand off to someone else.
20:07Thanks for having me, Dara.
20:10So here, let's please the butterfly to take a look.
20:13I don't like needles, and I hate getting my bloods taken, so I'm really worried about missing.
20:21All right.
20:22You ready?
20:28Nothing.
20:30So just stop for a sec.
20:32Have a little feel.
20:34So you're just to the right of it.
20:37So, yeah.
20:38Turn it to your left a little bit.
20:40How could you really be a doctor?
20:42Yeah, yeah.
20:42I'm helping with her telling you what to do, eh, Ro?
20:45Yeah.
20:45Ah, she knows everything.
20:46I'm going to land a lot off of her.
20:50Raymond's jelly veins are very hard to locate.
20:54I'm like, ah, like, feel really, really, really bad for stabbing them with a needle.
21:03Any flashback?
21:04No?
21:05All good.
21:06All right.
21:06Let me just try and find it for you.
21:08That's how we help.
21:09All good.
21:11Down there.
21:12There we go.
21:12See?
21:12Do you want to anchor that for me?
21:14A little tape or what?
21:15Just hold it in your hand.
21:16And then you can keep that still.
21:19And you can swap that over.
21:21Keisha's stumbled at the first hurdle.
21:24But there's still technical work to be done if she can hold her nerve.
21:28Keep pushing.
21:29It's not a bush.
21:30I've got to get used to using this.
21:33And just be mindful of your needle not moving.
21:37Yep.
21:37If you're going to release the tube.
21:40And release the tourniquet.
21:43Yep.
21:44And then book your belly.
21:49Yeah.
21:51Thank you for me for that.
21:53That's it.
21:54Okay.
21:55All done.
21:55All right.
21:56Cheers.
21:57Good.
21:58See you.
21:59Bye.
22:02I thought I would be better at it.
22:07If she can't master this skill, it will be difficult for her to pass the year.
22:13You just get used to it.
22:14Okay.
22:15Just got to keep the one on.
22:16Yep.
22:17100%.
22:17I think I'm psyching myself out a bit.
22:20I need to get better.
22:28Hey April, do you want to come through?
22:30My name's Keisha.
22:31I'm one of the student doctors here.
22:34Nice to meet you.
22:36Happy to meet you.
22:37Having survived her earlier failed attempt to take a blood sample, medical student Keisha
22:43is not giving up.
22:44OK.
22:45I've got like massive empathy for if I take blood from someone and then I miss
22:50and I have to do it again I hate when it happens to me so I don't want to do
22:54that to someone else this time she'll be assisted by Aboriginal health worker
22:59Leon who's been taking bloods for over 12 months which side would you go Leon I
23:06find it more comfortable on this side all right let's go have a field can't
23:11feel anything swap over okay don't have a feel I don't know if I can even for a
23:20seasoned veteran like Leon finding a good vein can be a challenge there's one but
23:27we could have a little bit on this side yeah I might have a look on that side I
23:30mean you should just clean the whole area yeah and then if you want to tighten it
23:36like that hey no you just feel right here my fingers yeah all right let go a
23:45little sharp scratch oh yeah it's slowly coming now so I just hold it here hey
23:55yeah no we tried last time and I didn't get
24:04it but this time I did I was glad that I didn't have to poker more than once take
24:12the needle out mm-hmm solid thank you I'm really grateful to Leon for helping me
24:23today and teaching me with the blood that gives me strength and confidence for my
24:28practical exams yes thanks I have a good teacher yeah
24:40around 300 kilometers southwest of Alice Springs the Achillida Healing Center has
24:46brought workers and their families to collect and experience a different kind
24:50of medicine following traditional protocols bring spiritual health and
24:55safety and strengthens mental health when you're traveling or anywhere you're
25:02going like to other places doesn't matter where you're traveling or wherever
25:07you're going respect the land tell them where you're coming from manual introduce
25:13yourself to the country and to the ancestors are there have a look at the hills and towards the creek
25:23and you just sing out hi my name is Chris I'm just visiting your country I come from
25:31my
25:49after when you welcome yourself so you just come grab a little bit of water and just let them
25:59Let your ancestors know that you are here visiting.
26:02Yeah.
26:03My name is Liana.
26:06I come from Alice Springs.
26:09From Jay Creek.
26:17My name is Declan.
26:18I'm from town.
26:21From Jay Creek.
26:26Hello, Madden, Jaylen.
26:28And I'm from Alice Springs.
26:31Yeah, thanks.
26:53Next time, in Cairns...
26:55Oh.
27:00...a young child suffers a serious injury.
27:03You had a fall, did you?
27:04Yeah, it looks like a fracture.
27:06And George and Rob are on the case.
27:08So you've got two bones here,
27:10and I think you might have hurt one of them.
27:13While in Broome, Keisha is thrown into the deep end.
27:17Do you want to run the consult?
27:18I'm not really confident in myself,
27:21but I have to do it,
27:22because it's going to be my job one day.
27:24And on Palm Island,
27:26Dr. Rob Blackley deals with a painful infection.
27:29This is the worst part.
27:31Oh!
27:48Oh!
27:49With the
27:50fresh become 80 years old,
27:50let go there!
27:56Oh!
27:59Oh!
28:05We'llujurn more.
28:08We'llujurn more.
28:10We'llujurn Man milyam.
28:11I'm not really pretty good.
28:11The best we've got in the local level
28:12And thean emotional area.
28:12I mean,
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