Reflections from the Sky: The RFDS experience

Recently, I was interviewed by Gina aka Gezina Mosch, the Digital Content Writer Marketing, Future Students and Admissions Services and Resources Division James Cook University, Australia and it was about my experience with the Royal flying Doctor service (RFDS) And I thought, why don't I share it on here, since it was a written interview and I'd love to spread the word Re: my RFDS fundraiser. So here we go. What was a typical day like during your placement with the RFDS and can you describe one of the most memorable flights or clinics you joined? It really depended on the shift I was rostered to. On aeromedical shift days, I’d start with lots of telehealth calls from patients in incredibly remote and beautiful locations - places as far out as Hardy Reef (with complaints like barotrauma), to places inland as Mount Surprise, Kowanyama, all all the way out to Bamaga or the TI. Presentations ranged from acute urinary retention and geriatric falls to motorbike accidents. These telehealth consults would sometimes turn into roadside FaceTime calls, where we could assess patients in real-time and offer treatment advice based on whatever supplies they had on hand. Many patients living on properties and cattle stations had access to the RFDS medical chest, so we could prescribe things like antibiotics or analgesics for stable patients. For unstable cases, we’d make important logistical decisions: Was it best for RSQ to retrieve them? Could a local hospital ambulance reach them? Or were we the best team to fly out and retrieve them ourselves? When it was our mission, we’d land on airstrips, cattle stations, or tiny tarmacs, do a thorough assessment on the ground, stabilise the patient, then bring them onboard to transfer them to a tertiary hospital like Cairns Base or Townsville University Hospital - depending on the medical needs and geography. On primary health care clinic days, I’d fly out with senior doctors and flight nurses to remote communities like Croydon, Forsayth, or Georgetown. We’d either set up a morning clinic in a local town hall or staff a small outreach clinic for the day. These clinics often involved caring for entire intergenerational families - each with unique and diverse health needs. My most memorable RFDS flight actually happened on my very last day with them. I was part of an urgent retrieval from Normanton. When we arrived, we quickly realised the patient was far more critically ill than anticipated. He had a non-blanching purpuric rash - a telltale sign of sepsis. In the tight quarters of the RFDS aircraft, our team worked together to stabilise him mid-flight. At one point, the flight nurse and supervising doctor quietly said they wouldn’t be surprised if he didn’t make it. It was one of those full-circle moments - where I realised that everything we train for as clinicians can be called upon at a moment’s notice. It was raw, real, and deeply human. And it reminded me exactly why this service is so vital: to give people in geographically isolated communities the same chance at survival, the same standard of care, and the same dignity we promise every Australian - no matter their postcode. Was there a particular patient interaction or community visit that really stayed with you, and why? Some patient stories don’t fade - not because of what we did, but because of what we couldn’t undo. She was a two-year-old from a cattle station in the Torres Strait, transferred by the RFDS through 2 different rural hospitals before arriving at the Paediatric ICU at TUH, where I was placed. Her death from an entirely preventable illness continues to shape how I understand healthcare equity - and why I advocate for rural, remote, and Indigenous health. Although this happened about a year before my placement with the RFDS in Cairns, the patient was an RFDS case. She had been flown in, already intubated from a small rural hospital, after presenting with subtle seizures that weren’t responding to treatment. During the morning ward round, I assessed her under the supervision of the paediatric ICU specialist. I gently lifted her eyelids and shone light into her beautiful blue eyes, searching for any response. My heart sank when I saw how utterly unresponsive they were. I reported to my supervisor, “Pupils fixed and dilated,” holding back the lump in my throat, fully aware of what those words meant for this little girl and her family. She was already gone - far beyond the limits of what medical intervention could reverse. Later, it was confirmed that she had died of Primary Amoebic Meningoencephalitis (PAM), caused by an infection with Naegleria fowleri - a rare but devastating amoebic infection of the brain lining. It is entirely preventable, yet it continues to claim the lives of children in remote parts of Far North Queensland, where exposure to untreated warm water is more likely - in communities where most Australians would never swim, let alone live. Her eyes stayed with me - I couldn’t forget them. In the days that followed, they even appeared in my dreams. Eyes that should have been filled with life and mischief were utterly still. I didn’t know a person I’d just met could move me so deeply. But she did. And since then, I’ve carried her with me. She reminds me - quietly, insistently - why I care so deeply about healthcare justice for rural, remote, and Indigenous communities. Since then, I’ve had numerous conversations with people in positions of influence about bush children’s health. More often than not, whether it is a conversation about testing waters after the floods or doing more outreach, I hear things like, “You’re getting hung up on rare stuff, we need to allocate resources sensibly.” And while I respect the principles of resource allocation; I believe true justice isn’t about how often something happens - it’s about what’s at stake when it does. Preventable deaths can and should be prevented. That is the very purpose of a just and compassionate health system. Yet time and again, rural, remote, and Indigenous communities disproportionately suffer the consequences of preventable illness - whether due to under-resourcing, systemic neglect, or sheer indifference. Justice means allocating resources not based on the frequency of disease, but on the severity of need and a refusal to let geography, socioeconomic status, or race determine who gets to live. I believe we move closer to that kind of justice when we stop othering people. Othering is the root of so many forms of oppression - racism, sexism, white supremacy and, in this case, metropolitan supremacy and systemic indifference toward the healthcare needs of rural, remote, and Indigenous communities. It is the very opposite of compassion-driven, culturally competent, individualised care and it stands in the way of true health equity and integrity. How did this experience challenge or surprise you, either personally or professionally? I love medicine, and nearly every patient interaction feels precious to me. What surprised me most during this experience was witnessing the incredible dedication of the diverse team - doctors, nurses, pilots, engineers, and more -serving rural, remote, and Indigenous communities. One moment that simultaneously surprised and challenged me occurred during a tense flight when a patient’s condition became critical. The stress was palpable in the tight confines of the aircraft. Both the supervising doctor and flight nurse seemed deeply concerned. I felt flushed and realised in that moment that I was out of my depth, so I stepped back, knowing this was beyond my scope of practice as a medical student. Reconciling with feeling out of my depth and recognising that stepping back, rather than being too eager to help, is ultimately more helpful, was a crucial and humbling lesson in putting the patient’s needs first. The pilot then broke the tension with a perfectly timed, light-hearted joke. His emotional intelligence reminded me how vital teamwork, communication, and compassion are in high-pressure environments and just how amazing all the RFDS employees are! What did you learn about healthcare in rural and remote Queensland that you think more people should understand? Queensland is vast and so much of it is remote. Flying over rural and remote communities, I was struck by just how far everything is from everything else. What I came to understand is that healthcare here isn’t just about clinical skills - it requires creativity, cultural humility, logistical thinking, and a deep connection to community. Rural and remote healthcare isn’t fast-paced or transactional. It’s longitudinal, relationship-based, and anchored in trust. You don’t just treat illnesses - you care for whole multi-generational families, whole communities. You work with limited resources, cover huge distances, and often deliver care that would be highly specialised in a city, all while navigating cultural, logistical, and geographic complexity, in contexts where you may be the only healthcare provider around. And through it all, you are met with extraordinary strength and resilience - particularly from Aboriginal, Torres Strait Islander, and cattle/ farming communities, who live in places many Australians will never see. I was constantly moved by how willing patients were to share their stories and allow me into their lives and how open they were to help me learn. The doctors and nurses here don’t just tolerate students, they invest in us. They teach generously, model resourceful practice, and help build our capacity to serve so that, one day, we can return to these communities with confidence and commitment to serve and give back. And as a turban-wearing Sikh woman - likely the only one in a city like Townsville, let alone in some of the remote communities I visited, where most people had never seen anyone who looked like me - what stood out to me was not just the clinical richness of rural practice, but the incredible inclusivity and generosity I experienced. The warmth, curiosity, and welcome I received meant everything. Sure, I sometimes get a curious question or a funny assumption about my background, but nine times out of ten, I feel like I belong - or at the very least, that I have a role here. I feel like I can heal, empower, and support the communities here - give back to the communities that are helping shape me into the kind of doctor I hope to become. What would you say to fellow students who are considering a rural or remote placement but are unsure what to expect? To anyone considering a rural or remote placement but feeling unsure - take the leap. Truly. Whether it's through Rural Generalist training, GROW Rural, John Flynn, or a clinical school placement, these experiences will challenge and stretch you in the best possible ways. As senior students, especially in Years 5 and 6, we often get to function at a level closer to that of an intern and you won’t believe how much that prepares you for the job ahead. The learning curve is steep, but it makes you more capable, more confident, and more connected to your purpose as a future doctor. Medicine is a long road, and you’ll be learning forever - but rural placements fast-track your growth in ways city rotations just can’t replicate. You’ll learn to think on your feet, take initiative, and rely on your own reasoning. And you’ll be surrounded by clinicians who genuinely want to teach you, not just use you. And beyond the medicine - the people and the places you encounter are beautiful beyond words. I’ll never forget lying in the grass under the FNQ night sky, staring up at more stars than I ever thought existed, and seeing the Milky Way stretch across the sky, clear as anything. Or snorkeling for hours over the reef, mesmerised by the world’s most enchanting underwater natural wonder - following turtles into crystal-clear waters and spotting Nemo (Ocellaris clownfish) darting among anemones and unbelievable marine creatures, alongside an abundance of unique soft and hard corals- from the most intricate lace like structures to massive ancient brain motifs, showcasing fascinating morphological diversity. Hiking to endless waterfalls, swimming in hidden water holes on hot weekends - it’s all just unbelievably stunning. Rural medicine gives you more than just clinical growth; it gives you moments of joy, awe, and deep peace that stay with you for life. Why is it important to you to raise awareness and support for the RFDS, and how do you hope others, especially fellow students or graduates, might get involved or give back? Raising awareness and support for the Royal Flying Doctor Service is deeply important to me because it represents more than just emergency care- it’s a lifeline for people living in rural, remote, and Indigenous communities who often face immense barriers to accessing healthcare. The RFDS embodies equity, compassion, and resilience, bringing high-quality medical care to those who need it most, no matter how isolated they are. Having seen firsthand the dedication of the RFDS teams and the profound impact they have on individuals and families, I believe supporting this service is supporting the very foundation of healthcare justice in Australia. It’s about ensuring that geography, culture, or socioeconomic status don’t determine who gets timely, life-saving care. I hope fellow students and graduates will see the RFDS not just as an incredible healthcare provider but as a community to which they can contribute in many meaningful ways. Whether it’s through fundraising, advocacy, volunteering, or choosing to pursue rural and remote medicine, every bit helps to sustain and strengthen this vital service. Getting involved is also a chance to learn, grow, and develop skills that will shape compassionate, adaptable doctors ready to serve all Australians. Ultimately, giving back to the RFDS is about standing in solidarity with our most underserved communities, honoring their strength, and committing to health equity for all.