The below story may be confronting to some readers. Discretion is advised. Images are not from an actual trauma.
The phone rings with that unmistakable ringtone. The chaos in the room somehow slows down just enough to make space for the triage nurse to answer and listen intently.
It's the Queensland Ambulance comms team, letting the triage nurse know about the incoming trauma.
The patient has been in a serious road crash, and things don't look good. They're on their way - it's time to prepare. The triage nurse hangs up the phone and the trauma team assembles.
As the ambulance pulls into the bay, the emergency department staff are already there, conducting their harried orchestra as they have done a thousand times before.
"When that phone rings you know that something bad has happened and you're going to get challenged in the next few minutes," says consultant emergency physician Doctor Peter Logan, from Retrieval Services Queensland.
"The moment it rings, there's always a little skipped heartbeat, a surge of adrenaline, a slight feeling of anxiety as to what's going to happen with this patient.
"A thousand things are spinning around your mind and you start to get everything ready to assess the patient.
"If it's a road traffic crash, you're preparing to deal with serious traumatic injuries; head injuries, chest injuries, abdominal injuries, long limb injuries."
DOCTOR PETER LOGAN, QUEENSLAND HEALTH
As an aeromedical physician, Doctor Logan travels by helicopter or light aircraft to remote and regional crash scenes to rescue injured patients. He calmly expresses his frustration at the choices people make on the road that lead them to the emergency department.
"I've been doing this job for 20 years and in that time I have seen huge improvements in the safety features of cars," he says.
"We've seen the introduction of mandatory seatbelt wearing, we've seen automated braking systems, stability control, all a range of safety features added to vehicles to make motorists safe.
"The thing that hasn't changed in all that time is human behaviour. And we continue to see the same crashes happening again, and again, and again.
"I think that's the big frustration for me - the human factor has not changed."
In the case of a crash with seriously injured casualties, Doctor Logan and his team work together to provide rapid but sometimes aggressive medical interventions.
"If the call makes it sound like the patient is really seriously injured, we'll usually go meet them in the ambulance bay, because seconds matter in that context.
"We start with the patient's immediate life threats and treat those, but often what we do in the emergency department is just a procedure to stabilise the patient."
While television shows set in hospitals may show a glamorous version of medicine, Doctor Logan stresses that real life is far more confronting.
"It doesn't look like it looks on the television. Trauma medicine is really battlefield medicine. It's not elegant, it's not subtle, it's brutal, it's unpleasant. It's unpleasant both for the patient and the staff looking after them."
Doctor Logan stresses the often-uncounted number of people who are affected by road trauma, including police, paramedics, firefighters, witnesses and hospital staff.
"There is a huge amount of human misery and a huge amount of human suffering and a not insignificant amount of psychological injury in the carers. It's not just a life pointlessly lost, it's the injury that happens and the angst that happens to the emergency workers and the family.
"For me, it usually hits when I get home. I'll reflect on what's happened during my shift, and often it'll be hard to sleep because I question myself. All health care staff go through that because they genuinely want to do right by their patients, and we tend to be quite introspective and self-critical."
Beyond the ongoing trauma to those who have made a career of managing serious crashes, Doctor Logan raises a sombre note on behalf of those patients who never quite recover.
"You could argue that the worst-case scenario is not actually that you die."
"We may manage to save your life, but perhaps you don't return to any kind of meaningful existence. You may be looking at spending the rest of your life in a coma or facing really tough disabilities that will be hard to overcome.
"People end up in wheelchairs, they can end up missing limbs, they can end up with serious head injuries that mean they can't intellectually function as they did previously, or they may just be a completely different person.
"I think you could make a strong case that some things are actually almost worse than dying."
When asked what he wants to see change, Doctor Logan places the emphasis squarely on the behaviour of motorists.
"I'd like people to change their behaviour. It's not worth risking your life just to get somewhere two minutes earlier. It's not worth risking your life just to impress somebody. It's not worth risking your life because you want a little adrenaline surge. There are better ways of doing that than doing it in a car, because you'll end up being cut out of it by the fire service and brought to us."
"There is a cascade of consequence from what they do, and the consequences can be utterly lifechanging for both the patient, their loved ones and their families. Life for that individual and the people around them who matter, may never be the same again from that moment on."
Police are urging all motorists to do everything they can to avoid meeting Doctor Logan at work. Road safety is everyone's responsibility, but that starts with you.
