by Pitt, Turia
Dr Weidmann made them all coffee, apologising for the quality – hospital blend after all – and asking who took milk, sugar. Célestine thought, ‘This can’t be right, she’s the doctor’, and offered to take over the coffee-making. Gabby Weidmann waved her off. It was her job to give these people the bad news and she fully understood the shock they were all in; making coffee was the least she could do besides offering comfort.
Next she explained what the escharatomies were for; Turia would need these before her transfer to Sydney. However, she would only be allowed to fly if her blood pressure was stable. Dr Weidmann assured them that Turia would be in good hands; the procedure would be performed by the best surgeons available – this was a hospital with highly experienced burns staff.
‘Don’t worry about the anaesthetist either – he’s my husband,’ she said, adding. ‘He’s also Swiss and very precise.’
Michael tried to take in what he was being told. He looked at Dr Weidmann a look that seemed to say: ‘Is she really saying what I think she is saying?’
He had never heard Belinda’s use of the term ‘Michelin Man’ before and didn’t know what it meant, nevertheless he decided he wouldn’t see Turia anyway; if she died, he wanted to remember her as the pretty, smiling Turia in trendy gear, long dark hair flowing as she ran to board the bus in Bomaderry. Not lying in hospital with tubes everywhere, unconscious, unresponsive and unrecognisably puffed up.
He recommended that Célestine not see Turia either. Célestine did choose not to see her, but for reasons that were different from Michael’s. She did not want to make this the last time she saw her precious daughter. She was determined that Turia would live. Genji also chose not to see her; although a toughened military man, he could not bring himself to see his pretty, vibrant sister like that. And Angela hardly knew her young sister-in-law.
But Gary said he would like to see her. He came out after about five minutes and Michael, waiting outside with Célestine, was alarmed at how solemn his father looked. Gary gave Célestine a big hug and Célestine, sensing he must have seen something bad, returned to the family room. After Célestine was out of earshot, Michael asked Gary how she really was.
‘I don’t think she’s going to make it,’ Gary told him with tears in his eyes.
This was too much for Michael; he found a quiet spot well away from everyone else and broke down. She’s dead, he told himself, still not quite believing it. How did this happen? He thought of all the happy times they had shared. How perfect things had been for them.
On the other hand, he reminded himself that his father hadn’t been in many hospital situations so maybe he was over-reacting, whereas Michael had seen dead and dying people when he was a police officer. So it might not be as bad as Gary imagined. Michael hung on to that hope.
Later they all headed back to the airport to pick up Michael Pitt. ‘Hello, the mother of my children,’ he said embracing Célestine. They sat together tearfully in the back of the Tarago holding hands tightly for mutual support as they returned to the hospital to be with their daughter.
At the hospital Michael was introduced to Dr Weidmann, who told him what the others already knew and the prognosis. It was also explained that if he wanted to see his daughter, she was so full of fluid she might be unrecognisable.
Michael wanted to see her regardless and went straight into intensive care, where he looked down at his little girl. Her body was bloated – her face had swollen to twice its normal size, but Michael was surprised; he expected to see a black burnt face; instead she just looked round and pink.
Back in the family room, Michael could see how seriously his son was traumatised. He and Turia were close in age and close as siblings, but Genji had always been Mr Action Man, catching the big waves, taking the risks, joining the Army, becoming a Navy diver.
‘How could this happen, Dad? I always thought it would be me that’d end up in hospital from doing something dangerous. Not Turia; she was always so smart; so careful.’
Michael had no answer. Bad things can happen to good people. He could not say why one person was chosen and not another.
Steven Hudson, a New Zealander who was Darwin Hospital’s Rural and Trauma Fellow in 2011, was off-duty on the day Turia and Kate were admitted. He came home from the gym early on 3 September to find his pager had gone off, which he thought was odd because he was not on call. He phoned and was told about a couple of patients with severe burns and how Dr Weidmann had been looking for extra people to help; but things were now under control and he wasn’t needed. Nevertheless, as Dr Hudson lived near the hospital, he thought he’d go in and see what was happening.
Mr Ninin had his hands full with two such badly burnt patients and was pleased when the young Kiwi surgeon turned up. Performing escharotomies is time-consuming at the best of times: patients have to first be positioned and cleaned with antiseptic fluid. In this case, applying the drapes was in itself a major task, as it involved all four limbs on both patients. After extending the escharotomies, dressings had to be applied and each limb bandaged. With Dr Hudson assisting, two limbs could be done simultaneously, each surgeon working with a scrub nurse and Mr Ninin overseeing Dr Hudson.
The surgeons were worried that the hands and feet of the two young women may have to be amputated later because the blood supply to them had been severely compromised due to the length of time before being treated. The surgery took several hours and it was late evening before the surgical team emerged.
Dr Weidmann informed the waiting group that the surgery had gone well: the extended escharotomies on Turia’s arms had helped release the claw-like contractions of her hands, and her blood pressure remained stable so Care Flight was organising her transfer to Sydney.
Michael Hoskin, detecting slightly more optimism in the doctor’s voice, asked if Turia would live. Gabby Weidmann looked at this nice-looking young man desperately hoping for better news. She told him that with medical advances, people in Turia’s situation did live these days; she would most probably live but it would be a rocky road to recovery, with skin grafting, scarring, multiple operations and ongoing health issues, her rehabilitation would be extensive and long.
‘How long – weeks, months?’ he asked.
‘Years.’
Years! Michael was aghast. But then, years was better than dead, which was forever. They could get their lives back. He had something to hang on to and felt optimistic for the first time in twenty-four hours.
When it was time to leave, Gabby Weidmann accompanied Turia and her family down the long ICU corridor to the lift; downstairs an ambulance and Care Flight doctor waited to transport Turia to the airport for the journey to Sydney. Dr Weidmann has a lasting memory of those few minutes: Turia’s father walking alongside the gurney saying, ‘We are here, you can do it, stay strong, don’t give up’, as if cheering her on to pull her through for a marathon. At that moment Dr Weidmann knew she would pull through.
After seeing Turia off, Michael felt emotionally and physically exhausted; he had flown backwards and forwards between Darwin and Sydney three times in thirty-six hours with only two hours sleep before he received the devastating news. He and Gary decided to book into the airport hotel and get a few hours’ sleep before flying back to Sydney because Michael knew he wouldn’t be able to see Turia immediately anyway.
The others booked the first flight to Sydney at 1 am; unfortunately it went via Brisbane, which meant additional delay. When they got into a taxi to take them to the airport, the cheery driver, having no idea of the ordeal that his passengers were enduring, was playing Stevie’s Wonder’s happy hit ‘Isn’t She Lovely’ – a song written to celebrate the birth of his daughter.
Célestine, who normally loved music, could not stand the sound of it right then: ‘Turn it off.’ It would be a long time before she was able to listen to music again.
TEN
INTENSIVE CARE
AT ABOUT MIDDAY ON SATURDAY 3 SEPTEMBER, PROFESSOR David Milliss, head of the Intensive C
are Unit at Concord Hospital, received a call from Dr Gabriele Weidmann at Darwin Hospital informing him about a serious burns patient – Turia – and asking if the hospital would accept transfer. Acceptance would have to be approved by either the head of the surgical burns team, Professor Peter Maitz, or his associate, Professor Peter Haertsch.
After discussing the case with Professor Maitz’s registrar, Professor Milliss rang Professor Maitz. Although Intensive Care and the Burns Unit are nearly always at capacity, and that day was no exception, no one is turned away even if beds are in short supply and Professor Maitz agreed the hospital should take her. So transfer was accepted with Professor Maitz as Turia’s admitting medical officer (AMO).
Turia was admitted to Concord Hospital’s ICU at 5.31 am on Sunday 4 September in an induced coma; the principal diagnosis from Darwin Hospital was full thickness burns to sixty-four per cent of her body – face, neck, right scapula (shoulder), upper and lower limbs. The Concord ICU team were pleased to note that the team in Darwin had ticked all the boxes before transferring her so that although Turia’s condition was critical – in other words still life-threatening – her vital signs, such as heart rate and blood pressure, were relatively stable.
During her flight to Sydney Turia’s sedation, administered by automated pumps, had been increased to keep her completely still and she arrived sedated, intubated and ventilated. During the day her sedation was slowly decreased to enable her to start breathing for herself.
The immediate issue facing the intensive care team was keeping her alive. While Turia was young and fit and therefore more likely to survive than someone twice her age who might have sustained such a massive amount of burns, her lean athlete’s body actually worked against her. She had a body-fat mass of about ten per cent and body fat is helpful in burns victims because it is a thermal insulator.
Without the fat as an insulator the burns go deeper into the tissues, where it is difficult to treat; burnt tissue releases factors called cytokines into the bloodstream to counter the injuries. This action has profound effects on all organ systems: brain metabolism is altered; so is heart rate, liver and kidney function; and the gastrointestinal tract shuts down. The body in crisis mode starts taking blood from other organs and directing it to the two most important organ systems – the brain and the heart – to help it survive.
The average heart rate of a normal person is 60–80 beats per minute (bpm); the average heart rate of a burns’ patient can be anywhere between 120 and 150 bpm. The immune system is racing to try to stop infection and, as a result, burns patients need a three-to-four times higher kilojoule intake than normal; in Turia’s case, while she may have been fit, she didn’t have a lot of kilojoule reserves to draw on.
By now the story of the runners being burnt in a fire in the remote Kimberley region of Western Australia had become international news. Turia’s name was out, and the news spread like wildfire among her friends and the Ulladulla community, where she’d grown up and was a popular figure.
Briggs was on a plane, returning to Sydney after a work-related trip to Thailand, when the news hit the headlines; she went straight home to bed without turning on her mobile. Nicola was skiing in Perisher when someone called her with the news; she immediately packed up and caught a plane home. Her calls to Briggs’s mobile went to message bank.
When Briggs woke on Sunday morning she found she had twenty missed calls. The first was from Nicola, who knew by then that Turia was going to Concord Hospital. Briggs collected Nicola and they drove straight there. When they arrived at ICU at 8.30 am, Turia had been there for three hours. They were told she might not live and, to their surprise, were allowed to see her. Horrified, they stared at their unconscious friend; her as yet unbandaged face the size of a football, and undressed arms showing the long incisions of her escharotomies. It was an image that neither will ever forget. Tearfully they both talked to her even though they knew she couldn’t see or hear them.
A little later, Michael Pitt, Célestine, Genji and Angela arrived and were ushered into the room where the shattered Briggs and Nicola were waiting. The ICU registrar, Dr James Allen, came out to talk to them and told them Turia was stable and they could see her. Michael encouraged Célestine, saying she didn’t have to look at Turia, just be in the room; she could even keep her eyes closed. But if Briggs and Nicola had seen Turia then Célestine knew she had the strength to see her as well.
Célestine, Michael and Genji stood at Turia’s bedside; her face was now bandaged and she was wrapped from head to toe. Turia’s eyes were swollen shut and Célestine could just see Turia’s little teeth peeking out through swollen lips. The sight of her like that rendered Célestine speechless; she wanted to find words that were empowering but they wouldn’t come. Instead she broke into a favourite Tahitian hymn:
E te varua maitai, e a pau mai io matou nei, haapii mai te pure, ia au matou te tetei.
(Holy Spirit descend amongst us, teach us to pray so we can praise the Lord.)
Over and over, Célestine sang these words, praying they would seep into her unconscious daughter; that this call to God would summon an invisible force to empower her on the journey ahead. Turia’s breathing seemed to deepen.
‘Keep singing, Mama,’ Michael told Célestine.
Michael spoke to his daughter, telling her that he loved her; he knew she was very strong and she would pull through. Aware that Turia was a worrier, he wanted to put her mind at rest: ‘Everyone is here who loves you; your mum is here; your brother is here. Michael is on his way. Your little brothers are at home – John is looking after them so you don’t have to worry. You don’t have to worry about work. Don’t worry about anything. You will pull through.’
He held the railing on the side of her intensive-care bed, repeating the message again and again, figuring that even if she was unconscious, some part of her deep subconscious must be registering the words. Words he would repeat to the unconscious Turia many times over the coming days.
Dr Allen explained that the next step for Turia was another operation – this time to debride her skin further and remove all the dead tissue. She would be assessed by her surgeon the following morning; he asked her father to sign a consent form.
When Michael and Gary arrived at the hospital later that morning, they went straight to ICU, where they met the others before talking to Dr Allen, who outlined what was happening. They were introduced to the two intensive-care nurses on duty. One of the nurses, Sue, explained she would be looking after Turia and doing all her wound dressings while she was in ICU and said Michael would be able to see her soon. Michael felt relieved and reassured that she was in the hands of professionals.
Sue came out a short time later and asked Michael if he would like to see Turia as she was responsive. Michael walked in and was confronted by an image he will never forget: his girl bandaged from head to foot like a mummy. Only the tip of her nose and her swollen-shut eyes and mouth were visible; she had tubes up her nose, in her mouth, in her arms and monitors everywhere. The bed was elevated and both her arms were raised in a sling. She also had a sheet of aluminium foil draped over her. The sight of his beautiful girl like this was almost too much for him to bear. He felt quite numb.
Sue told him he could talk to her; she would be able to hear him. Michael found this hard to believe.
‘Turia, Turia. Michael’s here,’ Sue said loudly. Turia move her head slightly.
Shit, she can hear me, Michael thought.
‘Go on, say hello,’ Sue encouraged. Michael went over to the bed.
‘Hey, Turia, it’s Michael.’
Turia rolled her head over towards him and opened her eyes and rolled her head back again. Michael was thrilled – she could hear him! He could see her big beautiful eyes. She could see him.
‘Oh, great. She can hear me,’ he said to Sue.
‘Yes. Tell her again you’re here.’
‘Turia. It’s Michael. I’m here.’ Again she rolled her head over, opened her eyes and looked
him; once more she rolled her head back. Michael didn’t know if she really understood but was happy to have had eye contact. This was his Turia; she was wrapped up but maybe it wasn’t as bad as he’d thought.
Sue talked to Michael about the next step of debriding, adding that the surgeons would also remove some unburnt areas of skin, which would go to the laboratory to be processed for grafting.
‘What about her fingers?’ he asked.
Sue said she would let Turia’s surgeon explain that to him.
She told him the next few weeks would be like a roller-coaster ride. It was an expression Michael would hear many times in the coming weeks and each time he thought, I’ve heard that once; I understand. I don’t need to hear it again.
He was about to leave the room when Turia started swinging her arms wildly in the slings and he looked at her. Michael’s thoughts were again positive, ‘She’s moving.’ He didn’t know why she was moving in such an agitated way, but she was moving. As he left, the nurses were trying to settle her down; her sedation was increased and Turia was returned to an induced coma.
Michael joined everyone in the hospital gardens and they sat together, quietly processing the events of the last twenty-four hours. Then Michael Pitt went back to his in-laws’ and everyone else went back to Genji and Angela’s apartment in North Sydney, where they had a few beers and continued to talk about Turia and tried to gather more information about the fire.
Célestine said she’d cook dinner and went to change her clothes; she found the crumpled ChildCare T-shirt and put it on. The sight of it prompted Briggs to burst into tears, remembering the great time she and Turia had raising money and cycling around Cambodia.
Early next morning, Monday 5 September, Hal Benson turned up at the hospital to see Turia. On Sunday he had flown to Melbourne with Kate’s friend Andrew Baker to meet Kate’s parents at the hospital when she arrived from Darwin. He had never met Kate’s family before but saw how much they seemed to appreciate speaking with someone who had been on the scene and knew what had happened; with this in mind he thought he might be able to help Turia’s family. But it was too early and they were not yet at the hospital. He managed to see Turia, bandaged and in a coma. He left a message for her family and contact details with the hospital but they somehow got lost in the paperwork. It was many months before he saw Turia again.