By Glynn Pritchard

When I first worked in Casualty (known as ‘Cas’, and referred to as Emergency), the only overnight staff consisted of a very good porter called Peter and myself. After some time, an excellent clerk called Jane was added, and finally a series of State Enrolled Nurses (SENs). Later we had a security guard who patrolled the hospital as well.

On one occasion, after I had been on the job only a few months, we were having quite a busy night. The Paediatric Doctor was treating one family for food poisoning and the Cas Intern was inserting a drip into another patient who was haemorrhaging. A man called Kenneth, whose face was a picture of deep sorrow, entered this scene and told me that he had killed his wife.

‘You mean you think you have killed your wife,’ I said.

‘No I have killed her,’ he said.

‘What made you do that?’ I asked.

‘The voices told me to,’ he replied.

I gave him a cup of coffee, and with trembling knees I went to a phone where he could not hear me. I rang 000 and told the police, I rang switch and asked for several porters to come and sit on the Cas chairs and I rang the Night Supervisor. I then continued to talk to Kenneth and to drink coffee with him. He seemed to have something bulging in his pocket. After further discussion he told me that he had shot his wife and that the gun was in a taxi outside.

'You don't mean to tell me that you have kept a taxi-driver waiting all this time?' I asked.

'No, I am the driver,' he said.

I asked if I could have the key to the taxi, but it was in the ignition. Peter and I went out to the taxi which I locked and pinned the key in my pocket. The taxi contained a gun, ammunition and a sheathed knife.

Those cups of coffee seemed to last a very long time as I talked to Kenneth, As well as the porters the Night Supervisor had come to Cas but they stood well back from Kenneth and me. From when I rang the Police until their arrival was exactly ten minutes. They put a guard on the taxi and searched Kenneth - the bulge in his pocket was a money machine that taxi drivers use. Subsequently I was required to go to court twice - once to the Coroner's Court, and once to the Supreme Court. Kenneth was judged guilty but of'Diminished Responsibility' and 'detained at the Governor's Pleasure'.

One night a man ran into Cas saying in broken English, 'Wife in Russell St. Baby half out.' This story had a happy ending – Dr Murnane arrived (in her car) on the scene outside 'Jessie Mac' and took this baby from the unorthodox delivery straight to the Special Care Nursery.

The ambulance cases were many and varied, including the one with the Ambulance Officers bringing me a patient as 'unknown male, unconscious with unequal pupils one of which was not reacting' After one glance I replied, 'He is not unknown, he is John X who has one glass eye.'

We saw a great number of patients who had been beaten up, often due to the prejudice of the attackers. One very nice man, who was known to us, was brought in badly beaten up with two black eyes which were completely closed and a badly dislocated shoulder. He required admission for the shoulder to be reduced under a general anaesthetic. Another example of this type of prejudice was when some transsexuals (known to us) came in following an attack on their faces with broken glass – their severe lacerations required extensive suturing.

I saw many victims of crime and worked with Dr Peter Bush and Dr Jim McLeod quite a lot and also many police women. One night there was a phone call from a familiar voice, which I thought was from a ward. 'This is Jill X,' she said. I asked her which ward she was working on that night. There was laughter and she said, 'This is Sergeant Jill X and I'm bringing in a victim of crime.'

On one occasion when a victim of multiple stab wounds was brought in, I carefully undressed her and placed her night-gown in a large brown paper bag which I presented to the young constable. He was not only wet behind the ears but had never read a detective story! He said, 'Throw it away.' Of course I didn't, and when the Sergeant arrived he was most grateful to have the evidence.

We did STD checks when requested and one interesting phenomenon was that amongst the brothel workers who requested these tests, quite a few said they were 'only receptionists'.

One evening a thirty-year old woman attended Cas with a champagne cork in an interesting place. She said she had been playing a foolish party game.

Sometimes a foreign girl would be brought in by male relatives for a virginity check. When questioned what would happen if the answer was negative they would say she would have to be killed usually by a brother. The 'diagnosis’ saved her life.

When new young doctors were doing a procedure for the first time, it often required great diplomacy to guide them whilst still keeping the patient's faith in the doctor, so I would say something like, 'Would you like this instrument next?'

We had our share of very difficult patients and one evening, an asthmatic woman was giving the good, conscientious young Registrar a dreadful time. When he came out to write his notes he commented on her behaviour. I said, 'Yes Philip, but you know asthmatics sometimes die.' That night she arrested in the ward but he was successful in resuscitating her.

Many of the Doctors were on rosters which required them to work for 24 hours or more at a stretch and occasionally lack of sleep impaired their judgement. I was able to prevent some mishaps because I had usually had a good sleep during the day. There were never any incident reports, except when one old man claimed we had stolen his wallet!

We occasionally took our turn working with the Commonwealth Police. On one such occasion a phone call informed us that they had a prisoner with 'heroin in his rectum'. When they arrived I asked the Policeman how he knew the anatomical situation of the heroin. He replied in a strong English accent that the patient had swallowed it. The patient was given a liquid aperients and Ipecac and the result was most dramatic. He vomited almost a bowl full of vomit and with it six condoms packed with a white powder which we could see because one package had burst. The Police finally took away their prisoner and a sample of the white powder for testing.

On more than one occasion migrant women were brought in by their husband because of severe depression. These women spoke no English but after questioning the husband the reason for their 'depression' was quite clear. The couple’s young baby had been sent 'home' (to their country of origin) to be brought up by the husband's parents so that the religion and culture would not be lost.

At times in Melbourne, men posed as doctors and in some hospitals actually went as far as the wards where they examined patients. Also there were some drug addicts who feigned illnesses such as Renal Colic in order to be given pethadine injections. Lists of both the above, with descriptions. were sent to us from the Medical Superintendent.

Security was most important in Cas and my precautions were usually adequate, as when a well-dressed man wearing a familiar tie arrived in Cas claiming to be the new Medical Superintendent Dr Dunning, and asking to come into the work area. I refused him entry, remarking that he had the right kind of tie but that it was not enough. At that moment one of the Interns peeped around the curtain and said, 'Glynn, it is Dr Dunning.' He congratulated me on my caution.

Among the many distressing injuries which patients suffer, burns are one of the worst. In the most severe case I saw a man with extensive burns run screaming into Cas with the skin peeling off his hands like a pair of black gloves. After treatment and stabilisation in Cas he was transferred to the Burns Unit at the RoyalMelbourneHospital. He was later found to be an arsonist.

Homeless people often found their way into Cas especially on cold winter nights. Many of the Resident Doctors called them 'Glynn's Private Patients'. They were not always sick, but usually in need of TLC. Also we often obtained accommodation for them at hostels like the Gill Memorial Centre, and for women at the Indian Nuns in Gore St. They always found room for another woman.

When we were not too busy we would give them tea or coffee (with the Matron's blessing). In some cases the Night Supervisor obtained food for them. Mostly men attended, but occasionally women. One lady did her clothes washing in the hand-basin at the toilet. Another, Joan, whose dialogue would make a bullocky blush, needed accommodation once and when I mentioned her name to the Catholic Nun at the hostel, she said she would take Joan only if she promised to go to bed without talking and left in the morning without talking!

There was an excellent painter called John, of no fixed address, and he was frequently beaten up and robbed of his paintings and materials. Thomas who suffered from Epilepsy sometimes faked a fit and when this was imminent I would say, 'If you sit up straight I'll give a cup of coffee.' This worked every time.

A homeless man, called Bill, at some stage in life had had his twolarge toenails removed and he habitually discarded most pairs of shoes because they hurt. He was always gentle in speech and actions – one police sergeant who knew him called him 'Gentleman Bill'. Whenever we were able to we gave Bill shoes or slippers. Amongst the many vagrant types there were only a few about whom I would need to contact the Security Guard.

There was a younger man in his thirties, called John, who wore a purple caftan and carried a banjo. He wanted to kiss everyone. Another tricky client was Julius, a six-foot man with an aggressive face and body language. Smaller but also vicious was Robert, red-haired and about sixty years old. He carried a walking-stick which, it was rumoured, he used as a weapon.

Rarely was there violence evident in Cas. On one occasion, however, a man punched out a row of windows in the ambulance room. Another aggressive young male whistled to Mike, a tall Intern, who went across and silenced the man with a few words. Later Mike told me what he had said. 'I'm not a dog to be whistled, but if I were your dog I'd piss on your leg!'

There is then a connection between what happened in the Casualty Department of a large city hospital all those years ago and the Church. When something really touched my heart I wrote their Christian or given names on the prayer list at Church, and then prayed for them too.