Extract from “Nine Minutes Past Midnight”
Here is a brief excerpt from ‘Nine Minutes Past Midnight.’ It tells of an experience that I had as a young doctor completing my specialist training. I was a rationalist as doctors must be yet I had heard that God heals today and had seen some evidence of this. This is what ensued.
‘The spectre I saw from the bedroom door filled me with dismay. The patient, a woman in her forties, lay motionless on the bed save for agonal heaving of her chest. This was medicine in its most confronting form, real white-knuckle stuff. I was just a hospital resident moonlighting to earn enough money for the deposit on a house. What could I do to save this woman’s life?
Examining her I could feel no pulse, and there were no audible heart sounds. Pulling her from the sagging bed, I began CPR by the light of a naked bulb dangling from the ceiling.
Ribs cracked under my hands. The patient’s stomach filled with air and its contents were regurgitated, making mouth-to-mouth resuscitation impossible. I resorted to ventilating through cupped hands.
About twenty-four hours earlier, I had faced a different kind of crisis. It was late, very late on a Sunday evening in July 1973. My wife, Lynne, and I were sitting in the lounge room of our Strathfield home deep in thought. Few words were exchanged. I needed an answer. I needed it now!
I had been a doctor for three years and had struggled to reconcile my understanding of modern medicine with the concept that God may supernaturally intervene in the healing process today. I needed to find a position that sat comfortably with my medical training and experience, and with my Christian faith. I had witnessed healing beyond my comprehension, but these observations were often not compatible with my background physician training and my prior medical research. I regarded myself as a rationalist.
Yes, I had seen migraines, backaches and ‘arthritis’ healed. I had seen people’s asthma symptoms eased and heard how infertile women had fallen pregnant after prayer. But there always seemed to be some psychosomatic aspect to the illness. I was aware of the powerful impact of the placebo effect and, for the believer, prayer seemed to be the ultimate placebo. Yet, to me, as a young man, keen to move on in my career, there was a real sense of urgency. The matter must be resolved.
I challenged God. ‘If you heal today, we need you to show us in the next seven days. If we don’t have an answer within the week, we will put the issue to rest and move on.’
The next morning I drove in to Royal Prince Alfred Hospital where I was a nuclear medicine registrar. There was the usual busy schedule: patients to see, rounds to attend, a research paper to complete. I had not planned to work that evening and was looking forward to a quiet night at home. Mid-afternoon, my friend Bill called. Together we had been managing an after-hours radio-doctor service in the inner western suburbs of Sydney. This was not a job for the faint-hearted. We provided an after-hours service for approximately fifty general practitioners over an area of 100 square kilometres, extending west to Burwood, east to Balmain, north to Drummoyne and south to Mascot. The pay was about $4.00 per patient! It was a tough business, often requiring us to visit doubtful areas of Sydney alone in the early hours. Any scenario might be expected, from a child with asthma to suicide. (Only once was I assaulted.)
Bill was scheduled to cover the service that evening, but for personal reasons was unable to do so. ‘Could you cover me?’ he asked.
By 6 p.m. there was a long list of patients all requiring home visits. It seemed that everyone in the inner west had a fever or a sore throat. But by midnight all of the calls had been attended. I made my way home and crashed in front of the TV with a cup of coffee, before turning in.
It was just after midnight when ‘Mrs Mac’ called.
‘Can you come quickly, doctor? I have pains in my chest.’
She sounded unwell – very unwell. I took her address, told her not to panic, to lie down, and that I would be there as soon as possible. Saying goodbye to Lynne, I grabbed my bag and was off. It was a twenty-minute drive to Hurlstone Park.
The door was ajar, and I let myself in to find a woman in her mid-forties sprawled across her bed in a dimly lit room. Though previously well, tonight she had experienced the sudden onset of severe chest pain which radiated into her left arm. She was nauseated and began to vomit. I examined her as best I could in the dim light. She was pale and sweaty, but her heart rate was regular – sinus rhythm I suspected – and her blood pressure was maintained.
I called the admitting officer at Royal Prince Alfred Hospital and asked him to accept this lady with a provisional diagnosis of acute myocardial infarction (heart attack) and then called the ambulance service, imploring them to ‘Please hurry!’ It was 1 a.m. I sat in the kitchen to write a note to the admitting officer.
Mrs Mac lived alone. As I wrote, there came a knock at the door. It was her son with his wife and young family. I asked them to sit quietly with her until the ambulance arrived. But within minutes the son appeared at the kitchen door, ashen-faced. ‘Doctor, come quickly, Mum’s gone all funny!’
And so there I was resuscitating a patient that I had never met before in my life, and who had called me at home just thirty minutes earlier. Despite CPR, her pupils became fixed and dilated. I searched for a vein to administer adrenaline. But there was no vein to be found. Finally in desperation I drew up an ampoule of adrenaline and injected it straight into her heart with a large spinal needle. Again, no response. By this stage I had been attempting to resuscitate the lady for about twenty minutes and was just about exhausted.
The son watched in despair. ‘What can we do?’
‘You can pray if you like,’ I said, ‘and call the ambulance again.’ I don’t know whether he prayed, but he did call the ambulance service. He discovered that the details of my call had been misplaced, but that they would now send an ambulance immediately! In my experience, this type of error was unprecedented.
I knelt beside the woman, exhausted and with no idea what to try next. But as I did so, a quiet voice within said, ‘Now’s the time, now’s the time.’ My hands were already on the patient’s chest and as they rested there I prayed for her under my breath. There was nothing to lose. She shuddered, as someone does when they are counter-shocked by the ‘crash’ team in hospital, but then . . . nothing. I suspected some kind of hypoxic seizure caused by lack of oxygen, and continued CPR.
Ten minutes later, the ambulance arrived with only a driver. He walked into the room, hands in pockets, summarily assessed the situation and told me in no uncertain terms that I was wasting my time.
‘The patient’s dead.’
But I was the doctor and I was adamant. We would continue resuscitation until we reached the hospital. Together we heaved the patient onto a stretcher and into the back of the ambulance.
With lights flashing and sirens screaming, the driver made record time to Royal Prince Alfred Hospital, ‘bells and whistles’ all the way! The ambulance was one of the older style low-profile vehicles, and there was very little space for me to access the patient. I straddled Mrs Mac and held on to a window rail with one hand to prevent being thrown around. Very occasionally I managed to compress the patient’s chest, but any kind of meaningful ventilation was out of the question.
We pulled into the old emergency room ambulance bay opposite the residents’ quarters, to be met by a team of residents and interns who had been alerted. They quietly made their clinical assessment in the back of the ambulance to emerge and pronounce the patient DOA (dead on arrival). She would not be accepted into the ER but would be ‘certified’ and could then be taken to the mortuary behind the hospital. But I was a medical registrar at that hospital and was able to bring some pressure to bear. Soon we had Mrs Mac transported into the emergency room and onto the arrest bed . . .’