NO MATTER how many helicopters fly in with people on the brink of dying, or how bizarre the situation seems, for Echuca Regional Health emergency doctor Matthew Adamson, it's all in a day's work.
Whether it's listening to a drug-fuelled rant from a street straggler or treating a sprained finger, he has developed a quiet appreciation of the privilege that comes with helping people in all different situations.
Working in cities as well as Echuca, Dr Adamson has gained insight into the challenges and advantages of working regionally — especially during the initial anxiety-inducing stages of COVID-19 on the frontline.
“It’s rare that anyone comes in with something that really stops you in your tracks and you haven’t seen before,” he said.
“After two or three years working in emergency, you see enough to really raise your threshold for what’s surprising.
“As a patient, if you think you have an unusual, embarrassing or a particularly strange issue — chances are we’ve seen it before.”
Dr Adamson, 36, isn't local — something his accent gives away pretty quickly. He was born in Durham in north-east England and went to university in Edinburgh, Scotland.He went to Townsville in north Queensland to start work in a hospital while he decided on his career path. He didn't expect to fall in love with the land down under, or emergency medicine, but that's what happened.
Eventually, he made his way to Melbourne, where he finished his emergency training.
“I took a holiday in 2017 to go to South Africa for a year to work as a doctor, and that was great exposure to the high level of interpersonal violent trauma and those kind of injuries we occasionally deal with here.”
Aside from his aptitude for dealing with the extreme, Dr Adamson's passion for medicine began as mixture of interests in science and philosophy.
“Essentially I was always interested in human nature and equal parts biology, but also psychology and how to optimise life in a more philosophical sense.
“There's always more to learn about how to best deal with life.”
When he refers to the potential of COVID-19 to run rampant in the community, overwhelming hospital systems, Dr Adamson refers to it as "a mass casualty event" — a "code brown" — to be managed and prepared for accordingly.
It helps him deal with the fear associated with being a frontline worker facing up to a lethal and not well-understood virus.
“Yes we were anxious, but it would be wrong to say we were trembling and fearful, because we had really good plans and could see the worst case scenario, and it wasn’t long before it became likely the worst case scenario wouldn’t unfold.
“Echuca has run an extremely tight response to COVID-19.”
Dr Adamson works part-time at Echuca Regional Health.
“Echuca's hospital is essentially run by very skilled rural general practitioners, which makes it very different to working in a city hospital where the main hospital is run by sub-specialists,” he said.
“As an emergency specialist here at ERH, that presents challenges in some ways because you don’t have specialist colleagues down the corridor to call on for consultation for things that are complicated.
“But the advantages are there is a little bit of room to work a bit more flexibly with common sense, patient-based, holistic plans for patients.”
However, it's not all smooth sailing and not everything can be dealt with as easily as he would like.
One aspect of the job that regularly frustrates him is the emergency department's capacity to deal with mental health problems.
“We have a lot of patients present with mental health problems in ED.
“Despite our best efforts, I feel like we’re not able to address these problems in a meaningful way, because we’re helping them over a short time frame and there’s not enough time to build trust and provide the care we would like.”
Asked about highlights of his career, Dr Adamson found it difficult to answer.
“In emergency medicine we’re not really doing it for moments of triumph, or moments of success and reward; it’s just something we can quietly appreciate the privilege of being able to help everyone every day.
“No matter how many helicopters have been involved, or how sick the patients have been, it's no different than a mundane Wednesday afternoon when perhaps you and one of your nursing colleagues happens to turn someone around who's presenting with depression.
“The people who come in who’ve been on a methamphetamine binge for three days and the things they say that would be bizarre to normal people, it’s normal for us because we know what comes with that.”
In his spare time, Dr Adamson is an avid guitar player and fitness enthusiast.
But Australian rules football has him stumped.
“I’ve been in Australia for a long time and still haven’t learnt how to kick a footy, so I consider this the start of my AFL career,” he said.
“I would say I barrack for St Kilda because they seem pretty rubbish; you don't want too much success.”
