0:00:06 > 0:00:09It's one of the most beautiful but dangerous places on earth.
0:00:09 > 0:00:14My name's Helen, I'm one of the doctors. Any pain in there? Any teeth loose or anything like that?
0:00:14 > 0:00:17And when Australians call out the flying doctor,
0:00:17 > 0:00:20they are likely to be British.
0:00:21 > 0:00:25And so is the pilot, paramedic and crewmen.
0:00:25 > 0:00:28We see lots of sharks 200 or 300 metres out.
0:00:28 > 0:00:31I think they get the idea when we go like that.
0:00:32 > 0:00:36They say they got the bends from coming up too quick.
0:00:36 > 0:00:39From shark attacks on surfing beaches
0:00:39 > 0:00:42to exploding barbecues in the Sydney suburbs,
0:00:42 > 0:00:47these are the Brits who can make the difference between life and death down under.
0:01:09 > 0:01:15James Milligan is an NHS consultant, working at Leeds General Infirmary.
0:01:15 > 0:01:19How is that tummy pain now? Now, like hundreds of medics every year,
0:01:19 > 0:01:24he's swapping rainy Britain for a life in the sun.
0:01:24 > 0:01:26We are living right by the ocean. It's a beautiful spot.
0:01:26 > 0:01:30Work is nice and relaxed. The atmosphere is great.
0:01:30 > 0:01:32Life probably couldn't be much better.
0:01:32 > 0:01:36But it's a place where the nearest hospital can be 200 miles away
0:01:36 > 0:01:40and the wildlife can kill you. Are you ready?
0:01:40 > 0:01:42Can I have a listen to your heart?
0:01:42 > 0:01:46Welcome to one of the world's most extreme health services.
0:01:47 > 0:01:52Today a baby's life could depend on a low-level flight through the mountains.
0:01:52 > 0:01:55The pilot is pretty happy to fly a little bit lower for us. That's good.
0:01:55 > 0:01:57We're not sure in these conditions.
0:01:57 > 0:02:01A flying doctor faces a dangerous descent into the bush.
0:02:01 > 0:02:04Lots of foliage, lots of trees and not very easy access.
0:02:04 > 0:02:07And a motorist is trapped after a head-on collision.
0:02:07 > 0:02:11The left foot is kind of wedged between the clutch and the front of the car.
0:02:16 > 0:02:20Australia is a nation built by the British
0:02:20 > 0:02:25and visitors from the UK often have a familiar feeling when they arrive.
0:02:27 > 0:02:32This is Newcastle, a city built on coal with suburbs called Gosford and Wickham.
0:02:32 > 0:02:36Only this is New South Wales, not Northumberland.
0:02:36 > 0:02:40It's home to former Royal Navy Officer, Mike De Winton,
0:02:40 > 0:02:43who is planning a rescue mission to a place called Tamworth
0:02:43 > 0:02:46that's certainly not in Staffordshire.
0:02:46 > 0:02:48So we will always look at a job
0:02:48 > 0:02:50and decide whether we as a crew can do it
0:02:50 > 0:02:54and whether the aircraft can safely do the actual mission
0:02:54 > 0:02:58and then we'll discuss and have a brief with the crews before we do it.
0:03:00 > 0:03:03They've been joined by a specialist neonatal team
0:03:03 > 0:03:06that's about to head to one of its youngest ever patients.
0:03:06 > 0:03:10It's a premature baby, 34 weeker,
0:03:10 > 0:03:13who is currently in Tamworth neonatal unit.
0:03:13 > 0:03:17This is quite normal for us to go out and do this, out to Tamworth.
0:03:17 > 0:03:20I have been up there by road before but that took about five hours
0:03:20 > 0:03:25so time is pretty crucial here. 'Medical Westpac One.'
0:03:27 > 0:03:32Dr Larissa Korostenski is bringing her skills to this job from Britain.
0:03:33 > 0:03:36I actually started doing paediatrics when I was in the UK.
0:03:36 > 0:03:39Started off in North Wales in Bangor as an intern
0:03:39 > 0:03:45and then my ending in London was in Great Ormond Street, which was a wonderful experience.
0:03:45 > 0:03:48The team is heading for a very different hospital,
0:03:48 > 0:03:53one where local doctors are caring for a newborn baby with a collapsed lung.
0:03:53 > 0:03:56We'll have to decide whether we put a chest drain in,
0:03:56 > 0:03:59to drain the little bit of air that is there.
0:03:59 > 0:04:02They have to consider, up in the air, whether the pneumothorax can re-accumulate,
0:04:02 > 0:04:05so that's the main decision we'll need to make now.
0:04:07 > 0:04:09BABY CRIES
0:04:09 > 0:04:12Because he was born at 36 weeks,
0:04:12 > 0:04:16his lungs at the moment are not making all the things
0:04:16 > 0:04:21they need to make to be able to expand the right way so he's having trouble breathing.
0:04:21 > 0:04:24So now this baby has to go to a bigger centre,
0:04:24 > 0:04:28where some more positive pressure can push the air into his lungs.
0:04:28 > 0:04:34So this is the latest one, there. It's pretty much the same, isn't it?
0:04:34 > 0:04:37BABY SNEEZES BOTH: Bless you.
0:04:37 > 0:04:40We're not specifically trained, I suppose, as retrieval doctors.
0:04:40 > 0:04:45We are trained as neonatal doctors and this comes as part of the job.
0:04:45 > 0:04:49We're still working really hard, when we get upset, up to 90 breaths per minute,
0:04:49 > 0:04:52but still maintained saturations in air.
0:04:52 > 0:04:55But we are flying, I suppose, is the thing I have.
0:04:55 > 0:05:01I can always have a butterfly needle ready if I need to, in-flight, and ask them to fly low.
0:05:03 > 0:05:05Although Laiylan is now 10 hours old,
0:05:05 > 0:05:08his mum Cynthia hasn't yet even been able to hold her son
0:05:08 > 0:05:11because he has been needing specialist care.
0:05:11 > 0:05:14When they phoned us, he was in 30% oxygen
0:05:14 > 0:05:16and now he is down to air, so he is improving.
0:05:16 > 0:05:19And we would expect him to carry on improving.
0:05:19 > 0:05:24The thing that I've been trying to work out is sometimes when you get up in the higher pressures,
0:05:24 > 0:05:28higher altitudes, it can cause pneumothorax, even in healthy people.
0:05:29 > 0:05:31And because he's got that lung disease,
0:05:31 > 0:05:34he's at increased risk and because he has had a bit of air leak as well.
0:05:34 > 0:05:36So I've been thinking whether to put a chest drain in
0:05:36 > 0:05:40but he's doing so well on the CPAP in air, so I think we'll be fine.
0:05:42 > 0:05:45Dr Larissa knows that if Laiylan's breathing worsens,
0:05:45 > 0:05:47she may need to operate in mid-air,
0:05:47 > 0:05:50using a needle to allow air out of his chest.
0:05:50 > 0:05:53And altitude could affect him.
0:05:53 > 0:05:56I don't know if it is a possibility we can fly lower? I don't know.
0:05:56 > 0:05:58Yeah, no. That's no problem. Good.
0:06:00 > 0:06:04It's not a problem. Daytime, the weather is fine.
0:06:04 > 0:06:09So we'll just go over the hills on the way back.
0:06:09 > 0:06:13The weather is fine so we will see it all.
0:06:13 > 0:06:16I'll put my party hat on.
0:06:16 > 0:06:19'Medical Westpac One.'
0:06:20 > 0:06:25But low-flying brings added risks, especially when there are big obstacles in the way.
0:06:25 > 0:06:28Between here and Tamworth, there are 5,500 foot mountains
0:06:28 > 0:06:30and there are a couple of tracks back from there
0:06:30 > 0:06:34where we can actually keep the height down to around 2,000 feet,
0:06:34 > 0:06:37if we pick a few of the valleys to fly down.
0:06:37 > 0:06:39These are areas that we fly regularly at height
0:06:39 > 0:06:42so we know what's in there and where the wires and masts are,
0:06:42 > 0:06:47so when we come back, we will, if the doctor's asked us to keep low,
0:06:47 > 0:06:50we'll fly down those valleys, which will minimise any risk to us
0:06:50 > 0:06:54and also minimise any altitude to the child.
0:06:55 > 0:06:57It was very good. No issues.
0:06:57 > 0:07:00We had a little bit of oxygen and travelled really well.
0:07:02 > 0:07:03Mum will come down tomorrow.
0:07:03 > 0:07:06We've got expressed breast milk so as soon as he settles down
0:07:06 > 0:07:09and his respiratory rate comes down, we'll be able to start feeding him.
0:07:09 > 0:07:13Anything else? No, that's it. Thank you so much, guys.
0:07:13 > 0:07:16Have a good day. Thank you, you too. See you next time.
0:07:25 > 0:07:29Laiylan.
0:07:29 > 0:07:33I got told that because he was born at 36 weeks, he had immature lungs.
0:07:33 > 0:07:38And he may have had a bit of fluid on his lungs.
0:07:38 > 0:07:40They just basically said that because he was a bit early,
0:07:40 > 0:07:45he didn't have that stuff to help him and it's a bit harder for him to blow up his lungs.
0:07:45 > 0:07:47He had a little bit of an air leak
0:07:47 > 0:07:51and one of my biggest decisions was, being in a helicopter,
0:07:51 > 0:07:53increased altitude can make more air leak
0:07:53 > 0:07:58and that air leaking can compress the lung and cause further respiratory compromise.
0:07:58 > 0:08:01So that was the decision I needed to make,
0:08:01 > 0:08:05whether I needed to put a chest drain in to drain that air before we got into the helicopter,
0:08:05 > 0:08:09but because his clinical condition had improved and the pilots could fly low,
0:08:09 > 0:08:12I decided we would be OK without a chest drain.
0:08:13 > 0:08:15He's doing really good.
0:08:15 > 0:08:19He is breathing on his own and he is not needing help
0:08:19 > 0:08:21but they said that hopefully, this afternoon,
0:08:21 > 0:08:25if he's really good, I can get is to hold him and stuff.
0:08:25 > 0:08:28So for Dr Larissa, it's been another successful outcome.
0:08:28 > 0:08:32Using the skills down under which she learned back home.
0:08:33 > 0:08:37Getting up and standing in the freezing cold for the train from East Sheen into London,
0:08:37 > 0:08:42it's nothing compared to having the beach 10 minutes away.
0:08:42 > 0:08:45So it's a much more relaxed lifestyle, I would say.
0:08:45 > 0:08:50Then again, there are times when I think about my bus trip across the bridge, you know,
0:08:50 > 0:08:54going to Great Ormond Street, that was also beautiful in its own way.
0:08:54 > 0:08:59I think certainly, because I have two children, it's a much better place to live here.
0:09:02 > 0:09:06But not all of Australia is child-friendly.
0:09:06 > 0:09:11This is Crocodile Dundee country, the Northern Territory,
0:09:11 > 0:09:13where the wildlife is as harsh as the climate.
0:09:15 > 0:09:17It's also home to another iconic Australian institution,
0:09:17 > 0:09:20the Outback flying doctor.
0:09:21 > 0:09:24Emergency medicine tends to be a little more autonomous
0:09:24 > 0:09:29and you can push the envelope just a little bit further over here,
0:09:29 > 0:09:32so you have ownership of your patients for a little bit longer,
0:09:32 > 0:09:36rather than just passing them on to other colleagues.
0:09:37 > 0:09:40Dr John Roe is from Liverpool.
0:09:41 > 0:09:44Today he's flying 250 miles from Darwin
0:09:44 > 0:09:48to the small town of Wadeye, home to an Aboriginal community.
0:09:48 > 0:09:51They've got many health issues,
0:09:51 > 0:09:55a lot of social disadvantages compared to other Australians, unfortunately.
0:09:55 > 0:09:58It's very common for these guys to have diabetes,
0:09:58 > 0:10:02which I think is a bit of a silent epidemic up here.
0:10:02 > 0:10:04Nurse Shona Laird runs the cottage hospital.
0:10:04 > 0:10:07She's been treating a young woman with sepsis,
0:10:07 > 0:10:11a lethal condition caused by her diabetes.
0:10:11 > 0:10:15She came up to the clinic yesterday and had some sutures removed from her ear.
0:10:16 > 0:10:22Dr John knows the average member of Australia's indigenous communities dies at just 47.
0:10:22 > 0:10:25The causes are complex.
0:10:25 > 0:10:28Drug and alcohol can be a problem in some communities
0:10:28 > 0:10:30and the way of life is perhaps changed
0:10:30 > 0:10:32from what things were traditionally,
0:10:32 > 0:10:35throw in European involvement and a lot of the strong community ties
0:10:35 > 0:10:38that would have existed have been eroded over time.
0:10:38 > 0:10:41So it makes it a pretty complicated picture,
0:10:41 > 0:10:47it's not just the medicine that's different here but there's a whole swathe of social issues
0:10:47 > 0:10:50to be mindful of in the background as well.
0:10:50 > 0:10:54Wadeye was founded by missionaries nearly 100 years ago
0:10:54 > 0:10:58but many of the population is suspicious about modern medicine.
0:10:58 > 0:11:02There are many communities that live close to the traditional way of life
0:11:02 > 0:11:05so they are still into hunting and fishing
0:11:05 > 0:11:07and doing a lot of things their ancestors would have done
0:11:07 > 0:11:09when the Europeans first got over to Australia
0:11:09 > 0:11:12and that is another barrier, really, to healthcare.
0:11:12 > 0:11:15Those guys don't want to leave where their ancestors are
0:11:15 > 0:11:17and come to Darwin for treatment
0:11:17 > 0:11:20and they can often perceive that as white man medicine
0:11:20 > 0:11:23and there are many stigmas attached to that as well.
0:11:24 > 0:11:28We've kind of semi stabilised patient for retrieval back to Darwin
0:11:28 > 0:11:32so the flight team have taken over her care
0:11:32 > 0:11:34and she's on her way to Darwin,
0:11:34 > 0:11:38hopefully she's going to get better very quickly.
0:11:43 > 0:11:45So John and the team are now flying back
0:11:45 > 0:11:48across the Northern Territory to Darwin,
0:11:48 > 0:11:53this area's major city and the only place their patient can get the life-saving treatment she needs.
0:11:55 > 0:11:59My previous experience in Australia is really metropolitan,
0:11:59 > 0:12:05out in Melbourne, and that really didn't give me any clue as to what I would face up here
0:12:05 > 0:12:08and it was a massive eye-opener coming and seeing the communities
0:12:08 > 0:12:11and some of the problems these guys have to face.
0:12:13 > 0:12:18At Darwin, their patient is taking the final stretch of her journey by road.
0:12:18 > 0:12:20She is kept in the hospital for further treatment.
0:12:22 > 0:12:26For John, it's a job that's typical of his workload Down Under
0:12:26 > 0:12:31and with the landscape and lifestyle, he has no plans to head back to the UK.
0:12:32 > 0:12:36I can just see a great future for my little baby, going to school
0:12:36 > 0:12:40and hopefully learning to surf and play footy and be outdoors.
0:12:40 > 0:12:43Even though he's two weeks old, he starts rugby training next week
0:12:43 > 0:12:47and will he play for Australia or will he play for England?
0:12:47 > 0:12:50There are issues to be ironed out with my wife
0:12:50 > 0:12:53as we move along the track a little bit.
0:13:00 > 0:13:03One thing that keeps the flying doctors down under,
0:13:03 > 0:13:06is the unpredictability of their jobs.
0:13:06 > 0:13:08MOBILE RINGS
0:13:08 > 0:13:11624. Yes, mate.
0:13:12 > 0:13:15Two people are trapped after a head-on car crash
0:13:15 > 0:13:19and Scottish doctor, David Anderson, is on the case.
0:13:19 > 0:13:21OK, we'll go back to the aircraft.
0:13:23 > 0:13:28A routine hospital transfer flight has changed to an urgent rescue.
0:13:28 > 0:13:31We've got a quick Latin Long John to Tomerong,
0:13:31 > 0:13:36but we'll get something more definite in a minute. OK.
0:13:36 > 0:13:40The crush has happened in a remote stress of the Princes Highway,
0:13:40 > 0:13:44which is a 1,200-mile road running down the coast, south of Sydney.
0:13:45 > 0:13:49HELICOPTER RADIO: We'll be overhead Tomerong in about five minutes.
0:13:49 > 0:13:52I have a long background working in pre-hospital care.
0:13:52 > 0:13:55I used to be a paramedic and that's what brought me
0:13:55 > 0:13:57to work with HEMS service here.
0:13:57 > 0:14:02It's a good mixture of my background as a doctor and my background as a paramedic.
0:14:02 > 0:14:06Too much bush between there and the road for the guys to go.
0:14:08 > 0:14:11The nearest landing site is a paddock next to the road.
0:14:15 > 0:14:17INDISTINCT TALKING ON THE RADIO
0:14:17 > 0:14:21Pilot, Ian Broome, known as 'Broomy', is relying on the skills
0:14:21 > 0:14:25of the paramedic and the crewmen to guide him in through the trees.
0:14:25 > 0:14:28We're in a bit of a hole, it's looking OK.
0:14:28 > 0:14:30Looking inside and underneath.
0:14:32 > 0:14:3471-year-old, Gloria Ardwin,
0:14:34 > 0:14:39is trapped after losing control of her car and crashing head-on into another vehicle.
0:14:39 > 0:14:43She's complaining of pain to the right side of the ribs and right side of the leg.
0:14:43 > 0:14:47There's a laceration as well. The feet aren't compressed at all. OK.
0:14:47 > 0:14:50She's got deep skin tears on this side and that side.
0:14:50 > 0:14:53Cannulated five of morphine and oxygen.
0:14:53 > 0:14:56I was driving north back home, back to Sydney and I noticed a car
0:14:56 > 0:14:59veering on the wrong side of the road, just missed me
0:14:59 > 0:15:03and I looked in my rear vision mirror and it collected the car behind me.
0:15:03 > 0:15:07After the impact, did a few barrel rolls.
0:15:07 > 0:15:10All I saw after that was a plume of dirt and it came to rest right there.
0:15:10 > 0:15:15Gloria was driving home after visiting her son in Sydney, when the accident happened.
0:15:15 > 0:15:17Do you know where you are at the moment?
0:15:17 > 0:15:20I'm going home. You're going home? I'm nearly home.
0:15:20 > 0:15:23Nearly home...do you remember what happened today?
0:15:23 > 0:15:26The first thing I knew I was spun around.
0:15:26 > 0:15:28What day is it today?
0:15:28 > 0:15:31I've no idea.
0:15:31 > 0:15:35Just going to look at your legs, then talk to these guys about how we can get you out, OK?
0:15:35 > 0:15:39The left foot is wedged in between the clutch and the front of the car.
0:15:39 > 0:15:44It looks like it'll come out but if we get snagged on it, we might just have to reassess.
0:15:44 > 0:15:45But I think it'll be all right.
0:15:45 > 0:15:49Dr David and the team managed to manoeuvre Gloria
0:15:49 > 0:15:52out of the car without using any cutting equipment.
0:15:52 > 0:15:53GLORIA: Argh.
0:15:53 > 0:15:58OK, pivot her round. Bring it over. Sorry guys.
0:15:58 > 0:16:02Can you straighten your left leg? No.
0:16:02 > 0:16:05Gloria has broken her knee and her leg.
0:16:05 > 0:16:07But because she hit the other car so hard,
0:16:07 > 0:16:11it's likely she also has more serious, internal injuries.
0:16:11 > 0:16:15So, we're just going to get the patient out of the car and do some more assessments.
0:16:15 > 0:16:20It's very difficult to assess her in her car, so we'll do it in the back of the ambulance.
0:16:20 > 0:16:24The couple who were in the other car have escaped with cuts and bruises.
0:16:24 > 0:16:30OK, on the count of three we'll lift and we'll go in stages so we'll probably do three stages, OK?
0:16:30 > 0:16:32Ready? One, two, three, lift.
0:16:33 > 0:16:36About 40 minutes St George Hospital which is the trauma centre
0:16:36 > 0:16:39that covers the southern part of Sydney.
0:16:39 > 0:16:41Gloria's pretty stable now,
0:16:41 > 0:16:43we're happy with her pulse and blood pressure.
0:16:43 > 0:16:47She's still a bit cool peripherally but we don't want to give her too much fluid
0:16:47 > 0:16:51because there's evidence now that people who're bleeding and giving them
0:16:51 > 0:16:53fluid that isn't blood isn't so good for them.
0:16:53 > 0:16:56She's got good blood pressure, we're happy with that.
0:16:56 > 0:17:01Managing her pain with a bit of morphine and we'll stay in touch with her during the flight.
0:17:01 > 0:17:05Good afternoon it's the air ambulance helicopter, how are you? Good, thank you.
0:17:05 > 0:17:08We're coming over the south coast where we've retrieved
0:17:08 > 0:17:13a 72-year-old lady from a car accident. Are you ready to take the medical details?
0:17:13 > 0:17:18This 40 minute journey in the helicopter would have taken at least three hours by road.
0:17:18 > 0:17:22And in Gloria's case, the time saved could prove critical.
0:17:22 > 0:17:25Trauma in the elderly is an increasing problem.
0:17:25 > 0:17:28People have less reserve to cope with things.
0:17:28 > 0:17:32They're often on blood-thinning medicines which makes any bleeding worse,
0:17:32 > 0:17:36and often on blood pressure medicines which affects their ability to cope with blood loss.
0:17:36 > 0:17:40She has an increased heart rate, it's going fast all the time anyway.
0:17:40 > 0:17:43She's probably on medicines to slow it down slightly so the fact
0:17:43 > 0:17:47she's going fast already does imply there is a degree of shock.
0:17:47 > 0:17:51But she's maintaining her blood pressure at the moment, so we're happy with that.
0:17:51 > 0:17:54But we're checking it every three minutes to make sure.
0:17:54 > 0:17:58Also, she is opening her eyes and looking around and she's breathing normally.
0:17:58 > 0:18:02If any of that changed that would get us alarmed.
0:18:02 > 0:18:04Gloria can't remember much about the accident.
0:18:04 > 0:18:08She thinks she may have fallen asleep at the wheel.
0:18:08 > 0:18:11We've taken Gloria into the resuscitation room at the hospital here.
0:18:11 > 0:18:15She's actually deteriorated a little bit since we got her into resuss.
0:18:15 > 0:18:18It's reassuring we've brought her to the trauma centre.
0:18:18 > 0:18:22Her blood pressure is decreasing and her heart rate has gone up a bit,
0:18:22 > 0:18:25and she's had a blood transfusion, but I think we got her here just in time,
0:18:25 > 0:18:29and it's good she came in the helicopter rather than an ambulance to another hospital.
0:18:29 > 0:18:33Given the speed she was travelling at when she had the other car head on,
0:18:33 > 0:18:36Gloria was lucky to escape with just a broken knee and leg.
0:18:36 > 0:18:39She spent several weeks recovering in hospital,
0:18:39 > 0:18:44but was still able to celebrate her 50th wedding anniversary with her husband, Harold.
0:18:51 > 0:18:56In places like Sydney, many of Australia's hospitals are state-of-the-art.
0:18:56 > 0:19:00British-born Dr, Toby Fogg works in one.
0:19:00 > 0:19:02We've got everything we need, pretty much.
0:19:02 > 0:19:05And that evolves as we see new technology coming out.
0:19:05 > 0:19:07We will evaluate it,
0:19:07 > 0:19:10think about it and maybe incorporate it in what we do carry.
0:19:10 > 0:19:16Now that technology is bringing big-city medicine to remote health centres via the internet.
0:19:20 > 0:19:2369-year-old cancer patient, John Laurent,
0:19:23 > 0:19:26is up about to be examined by a doctor 50 miles away.
0:19:27 > 0:19:32We've got a new web cam and this patient has leukaemia.
0:19:32 > 0:19:36His blood pressure dropped really, really quickly, so it's important
0:19:36 > 0:19:41we get urgent medical treatment to get him to a bigger referral hospital than us.
0:19:41 > 0:19:44We're a very small rural hospital and we have few resources.
0:19:44 > 0:19:48And our GPs have been to see him but they need extra support,
0:19:48 > 0:19:51so the web cam has provided us with that.
0:19:51 > 0:19:55At the other end of the camera is a consultant in Newcastle's John Hunter Hospital.
0:19:57 > 0:20:02And he's decided to send his emergency retrieval team to go and fetch John.
0:20:02 > 0:20:05Newcastle city helicopter, Westpac.
0:20:05 > 0:20:09Crew is airborne now, from the John Hunter Hospital for Dungog Hospital...
0:20:10 > 0:20:14Dr Simon McLaughlin will be responsible for John during the transfer,
0:20:14 > 0:20:19but first they need to get there and make sure he's stable enough to fly.
0:20:25 > 0:20:31I'm just after some lignocaine and a syringe and needles and stuff, where would I find that?
0:20:31 > 0:20:36At Dungog Medical Centre, the local GP has been treating John,
0:20:36 > 0:20:39but he knows there's only so much his team can do.
0:20:39 > 0:20:41John is actually a long-term patient of mine,
0:20:41 > 0:20:44so today he's come in with low blood pressure
0:20:44 > 0:20:46so we treated him with antibiotics and fluids
0:20:46 > 0:20:48and medication to increase his blood pressure.
0:20:48 > 0:20:52Just leave your hand there, we'll let that do its job, OK?
0:20:52 > 0:20:56Simon needs to be sure John is stable enough to fly.
0:20:56 > 0:20:59Carly, Simon here out at Dungog, is Martin around?
0:20:59 > 0:21:01But now he is able to share that decision.
0:21:01 > 0:21:04He looks unwell and septic.
0:21:04 > 0:21:09Not only can he describe John's conditioned to the consultant at John Hunter Hospital...
0:21:09 > 0:21:11He's only got a HB of 54.
0:21:11 > 0:21:15..that senior medic is also able to watch every development.
0:21:15 > 0:21:19Probably a central line and then bring him back, what's your thoughts?
0:21:19 > 0:21:22While I'm putting that line in we'll run another blood gas
0:21:22 > 0:21:24and then we'll reassess from there.
0:21:24 > 0:21:29It's not as good as being there, but the technology is good.
0:21:29 > 0:21:32So whether it's looking at an ECG or a heart tracing,
0:21:32 > 0:21:36or looking at a patient, you can get a sense of what's going on.
0:21:36 > 0:21:44You can tip the monitor to the screen to get constant readouts of their vital signs.
0:21:44 > 0:21:47We need to get you to a bigger hospital really quickly,
0:21:47 > 0:21:50because we need to get you some blood products, OK?
0:21:50 > 0:21:54If you've got any pain, or anything, just give me
0:21:54 > 0:21:58a thumbs down and point to what the problem is, OK?
0:21:58 > 0:22:03John's wife Pamela knows that deciding to take John as he is, is risky.
0:22:03 > 0:22:07If he deteriorates, there's little they can do in flight.
0:22:07 > 0:22:11But his need for a blood transfusion is too great to delay any more.
0:22:13 > 0:22:15RADIO CHATTER
0:22:17 > 0:22:21In Australian terms, this is a short flight, just 15 minutes.
0:22:21 > 0:22:23But during it, John's condition gets worse.
0:22:28 > 0:22:32His treatment continues here at John Hunter Hospital.
0:22:32 > 0:22:38But, despite all the team's efforts, his health slowly deteriorates as his leukaemia takes hold.
0:22:38 > 0:22:40And a week later, he dies.
0:22:42 > 0:22:45But, his family knows John's final hours were made more comfortable
0:22:45 > 0:22:48by the doctors who treated is illness and the technology
0:22:48 > 0:22:51that allowed them to manage his care from many miles away.
0:23:04 > 0:23:09Sydney has been voted one of the world's top ten best places to live, many times.
0:23:09 > 0:23:14But at the weekend, the four million people who call this place home like to do the same
0:23:14 > 0:23:19as city dwellers the world over, and that escape to the country.
0:23:19 > 0:23:24It means working weekends for flying doctor, Pete Sherren from London is rarely restful.
0:23:25 > 0:23:27On top of all of those things,
0:23:27 > 0:23:29the medical and clinical things we're doing,
0:23:29 > 0:23:32we're also having to function as a bit of
0:23:32 > 0:23:35a search and rescue aircraft as well.
0:23:35 > 0:23:38RADIO: Thank you, Rescue 23 has departed now...
0:23:43 > 0:23:50It looks like a mountain bike rider has come off his bike on a trail in the National Park.
0:23:50 > 0:23:54We're not really sure of his condition, but there's some pretty
0:23:54 > 0:23:58experienced guys on the ground who will let us know what's happening.
0:23:58 > 0:24:02Somewhere in the forest below, 58-year-old, Mark Stillwell, lies badly injured.
0:24:02 > 0:24:06Ground paramedics are trekking through the trees to find him.
0:24:06 > 0:24:08They're walking in, is that correct?
0:24:08 > 0:24:14Yeah, they should be in further than us right now...unless it's a different track.
0:24:14 > 0:24:19If they are walking in, the patient is not going to be coming out that way, either?
0:24:19 > 0:24:22It's not going to be easy to get the patient out.
0:24:22 > 0:24:26The crew of rescue 23 can only circle the area in the hope
0:24:26 > 0:24:30of catching a glimpse of the casualty through the tree canopy.
0:24:35 > 0:24:38Rescue 23, we've now located the patient.
0:24:40 > 0:24:46Went over the handlebars. Loss of consciousness for up to five minutes. Facial abrasions.
0:24:46 > 0:24:52Amnesia to the event when referred to questioning.
0:24:52 > 0:24:55It sounds like the patient may have the symptoms of a brain injury.
0:24:57 > 0:25:03Rescue 23 has a winch, but lowering Dr Pete into trees will be difficult and dangerous.
0:25:03 > 0:25:08We're going to set up and winch our medical team in and go from there.
0:25:10 > 0:25:14But, when Dr Pete gets to his patient, he finds his injuries
0:25:14 > 0:25:17aren't serious enough to justify the risk of winching him out.
0:25:17 > 0:25:20Instead he's driven out of the woods in a 4x4.
0:25:20 > 0:25:23Mark Stillwell's condition is now stable.
0:25:24 > 0:25:27Just four and half kilometres down a bush track,
0:25:27 > 0:25:31he was mountain biking this morning, which he does every week, apparently.
0:25:31 > 0:25:37Just came off over the handlebars when he hit a rock, but there's a lot of cyclists, a lot of horse riders
0:25:37 > 0:25:41and people out on nice days like this, so recreation activities are common
0:25:41 > 0:25:45and unfortunately often happen in remote areas with lots of foliage, lots of trees
0:25:45 > 0:25:50and not very easy access down dirt tracks. We'll be in North Shore, probably about
0:25:50 > 0:25:52five minutes, if that.
0:25:52 > 0:25:54Land on their new helipad.
0:25:54 > 0:25:58Mark's family has heard of the accident. It's his daughter's wedding tomorrow
0:25:58 > 0:26:01and it's looking like he may not be there.
0:26:01 > 0:26:05You look a mess. Oh, honey. Oh.
0:26:08 > 0:26:10I'll ruin the wedding photos.
0:26:10 > 0:26:12Oh, hey, there's an idea.
0:26:16 > 0:26:17RADIO CHATTER
0:26:25 > 0:26:30Mark is being flown direct to specialist at Sydney's most modern hospital,
0:26:30 > 0:26:32the Royal North Shore.
0:26:32 > 0:26:35OK, this is Mark, he's 58-years-old.
0:26:35 > 0:26:41And, just around 8:30 this morning he was mountain biking around Terry Hills.
0:26:41 > 0:26:44Came off his bike, an unknown speed, hit a rock,
0:26:44 > 0:26:49no presyncable or syncable episode at the time, was not feeling otherwise unwell.
0:26:49 > 0:26:53Came off the rock, hit his head on the right side of his body...
0:26:53 > 0:26:57Mark needs a full body scan to determine the extent of his injuries.
0:26:57 > 0:27:01It's down to the doctors at the Royal North Shore Hospital to get
0:27:01 > 0:27:05him patched up and back on his feet to walk his daughter down the aisle.
0:27:05 > 0:27:08OK, I'll leave you with the doctors and nurses here, all right.
0:27:08 > 0:27:10Thanks very much. No problem.
0:27:14 > 0:27:18Luckily, Mark's not quite as badly damaged as his bike
0:27:18 > 0:27:20and the following morning, he's home.
0:27:22 > 0:27:27It was mainly abrasions and cuts that I sustained by falling off.
0:27:27 > 0:27:31I also hit my head. I had a helmet on, which I normally ride with.
0:27:32 > 0:27:36I think the rock must have hit my right side here
0:27:36 > 0:27:39because the facial injuries seem to be more on the right side
0:27:39 > 0:27:44and it's not me unconscious and put a few dents in my helmet, and four cracked ribs.
0:27:46 > 0:27:52But it takes more than a few injuries to keep this dad from his daughter's big day.
0:27:52 > 0:27:56Less than 24 hours after he last flew into the centre of Sydney Mark is back,
0:27:56 > 0:28:01smiling through the pain to walk Kate, down a very spectacular aisle.
0:28:04 > 0:28:06I don't think I was supposed to find out, for starters,
0:28:06 > 0:28:09so I rang up wanting to speak to my brother
0:28:09 > 0:28:13and one of my cousins casually said, "He's at emergency with your dad".
0:28:13 > 0:28:15OK, step back...explain!
0:28:16 > 0:28:19I give you my love for eternity.
0:28:19 > 0:28:24It was nice seeing him walk in through the door, even though he's a bit scraped and banged up,
0:28:24 > 0:28:27but he's walking, he's fine.
0:28:27 > 0:28:31And having given away a daughter, Mark's determined to be
0:28:31 > 0:28:33back on his bike before the end of the honeymoon.
0:28:39 > 0:28:42Subtitles by Red Bee Media