MEDICUS MARCH 2016

B O O K S H E L F

On the wings of change The Leading Edge is a modern history of a medical icon, says Robert Reid

T he Royal Flying Doctor Service is a quintessentially Australian icon. A vital part of our history as a nation that reflects our ingenuity, our ability to use technology and a willingness to work together to solve a problem, in this case getting medical care to isolated areas of our huge country. Established by the Reverend John Flynn in Queensland in the late 1920s, the RFDS had moved westward within a few years of its beginnings, with a radio base established in Port Hedland in 1934 and Wyndham in 1936. Thanks to the current RFDS Medical Director in WA, Dr Stephen Langford, the history of the RFDS since the 1970s is now available in an incredibly detailed but very readable new book, The Leading Edge . Subtitled Innovation, technology and people in Australia’s Royal Flying Doctor Service , this is an obvious labour of love by Dr Langford, who joined the RFDS in 1983, originally for a year and who was a National Finalist for the 2016 Local Hero Awards, a category of the Australian of the Year Awards. The early history of the RFDS and the life of its founder have been well documented in the past but there has never been a study like this! The degree of detail is a gift for those readers with a working background in medicine, but there are enough short anecdotes and examples of care provided in each section to keep even the non-medical reader interested. The RFDS was born from a combination of two technologies – radio and aircraft – and one of the

fascinating things about Dr Langford’s history is the detailed examination of new technologies over the last 40 years. Dealing with haemorrhage and blood loss while in the air, neonatal transport, ultrasound and flying clinics, even teaching Australian slang to doctors recruited from the UK, Canada, the US, South Africa or elsewhere are all recounted, invariably using an example or an amusing story as illustration. Other issues include how to deal and transport morbidly obese patients, the introduction of computers, training, what stretchers to use or adapt, what equipment to use for in-flight births, even how to “go” in the air. “If we have a big spill, we have to notify our aircraft engineers. The aircraft is taken offline and while wearing appropriate protective equipment, they need to remove the floor panels and clean out blood or other liquids that have seeped below them. Not a pleasant task and one we try to avoid,” he writes. Further indicating the amount of terrific detail, Dr Langford writes that the key breakthrough was in the early 1980s with the arrival of the wonderfully named Spil-Pruf urinal. “The risk of urinals splashing around in turbulence or during landing was solved!” The Leading Edge is a serious record of the growth of the RFDS with an excellent index, a very helpful timeline of significant RFDS events in WA, a

detailed list of aircraft types, fascinating photographs and even a glossary of medical terms and acronyms. Innumerable lives have been saved by the RFDS events in WA and throughout Australia. It is appropriate that the history of the service be recorded and that we appreciate what has come before us even as we look at the next steps in the development of the RFDS. Dr Langford is to be thanked for this detailed and fascinating history. A great read that is highly

recommended. ■ The Leading Edge

Innovation, technology and people in Australia’s Royal Flying Doctor Service UWA Publishing, RRP $29.99

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