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'This baby needs to come out now'

LONDON-born, Scottish-raised Doctor Maureen Hepburn was in the early stages of her medical career as she was thrust into the war zone that was Cowper.

The advertisement responsible for taking her half way around the world to the quiet regional centre of Grafton seemed like the perfect opportunity and place to gain more hands on experience before completing her GP training.

But never could the junior doctor have imagined the magnitude of experience she was about to encounter weeks of her arrival. A learning curve the doctor has carried her whole career.

Dr Hepburn said she had no medical "calling" when she was young, she did very well at school "always in the top two or three in my class in most subjects". The bright student, along with her siblings, were all adopted in infancy forming the kind of close, loving family most aspire to.

At age 13 she was encouraged to do medicine or law by her high school careers guidance teacher "on the basis of my grades" and studied her way into a place at Glasgow University medical school.

"Medicine sounded more attractive. I chose science subjects, worked hard and earned my place."

After graduating in 1986 she held two junior house jobs, six months surgical and medical and another six in accident and emergency (A+E) followed by a year in obstetrics and gynaecology and a final year in infectious disease.

"I initially thought about a career in obstetrics and gynaecology - I loved spending time with women in labour and delivered a number of babies and cried with the emotions of the deliveries on every occasion."

Dr Hepburn however changed her career plan on two accounts.

"I was more envious of the midwife role in normal deliveries than drawn to the drama and trauma of difficult births, forceps, c-sections and the like. I also had a drive for a good work-life balance. Even back then, I liked my sleep, and was not attracted to a 'one in two nights on-call' rotation for the next five or more years."

She decided general practice was the path to proceed down completing the necessary training before making the decision to literally expand her horizons.

Maureen Hepburn during Jacaranda season in Grafton 1989.
Maureen Hepburn during Jacaranda season in Grafton 1989. Contributed

"I've always had a lust for life and travelling, so when I saw an advertisement in the British Medical Journal (BMJ) for a 12 month job as a junior doctor at Grafton Base Hospital in NSW, I delayed the final part of my GP training (a year in a GP training practice) to spend a year in the Clarence Valley."

Dr Hepburn remembers leaving Glasgow early in the morning on August 1, 1989 as she'd practically come straight from working at the hospital to get on the plane for Australia.

"I had been on call on the last night of my six months in the Infectious Disease Unit at Ruchill Hospital Glasgow. This was during the AIDS epidemic and that was a fascinating part of my role there. All junior doctor jobs were for six months and everyone stopped on the last day of July or January and took up their new post the following morning."

Despite leaving for Australia, she was unable to swap her final on-call night "as no one wanted to work overnight" before starting their new job in the morning.

"I was getting on a plane to the other side of the world, so I guess it was easier for me. My parents picked me up at 8am and drove me and my luggage directly from the hospital to Glasgow airport to start my new adventure."

Dr Hepburn flew into Sydney and then onto Grafton "on the smallest plane I'd ever been on". "The Grafton airport was just a shack back then."

She stayed in the residents block in the hospital grounds with three of the four other doctors from the UK (one from Northern Ireland and three from England). "One chap was married and had a young baby - and he rented a place in town."

Dr Hepburn said it was quite a different set up from back in Scotland, a largely GP-run hospital at the time with a few attached consultants.

"During the day the work was similar to at home - very much ward clerk work, some minor A+E work and assisting in surgical theatre and the likes."

However from 6pm each night Dr Hepburn said they were "pretty much left to it unsupervised".

"When I think back we were probably way out of our depths dealing with patients with Chronic Renal Failure and horribly abnormal bloods. If I knew then what I know now I would have been horrified."

Dr Hepburn said she found Grafton to be a strange place which grew on her.

"I remember thinking it was a bit like a caravan park - lots of even rows of relatively modern well-spaced wooden houses on stilts. Glasgow on the other hand was old and built-up with Victorian houses and terraces as well as high-rise flats."

Socially, the resident "Brits hung out together a fair bit, though we made friends with some of the nurses and the ambulance crew and went out some evenings to bars and to Susan's Restaurant if we wanted a posh meal."

"We got dressed up in purple at Jacaranda and enjoyed all the celebrations. We travelled when we got the chance - down to the nearest beach and to Coffs Harbour where the only (and sadly very average) Indian Restaurant in the vicinity existed at that time. We Brits like our curries."

Maureen Hepburn with husband Stephen
Maureen Hepburn with husband Stephen Contributed

The visiting doctors also enjoyed exploring their new environment, venturing into the bush to make campfire and bread, they spent weekends in Brisbane, Byron Bay, Sydney, Cairns and The Whitsundays.

"It was a great experience to see a new country, and we were paid almost three times as much as junior doctors in Australia as back home so we were rich. I always planned to go home after the year and had my next job lined up back in Glasgow."

Dr Hepburn was on-call the night of the Cowper tragedy.

"The phone went off in the middle of the night some time before 4am. I was sound asleep at the time and someone informed me that there had been a bus crash north of Grafton near Maclean - and that there was an ambulance waiting outside A+E to take me to the site. It took a moment to sink in but I pulled on a cardigan on top of my theatre blues and headed out."

She doesn't really remember the journey to the site or the time it took "a good 20-30 minutes away I think."

Dawn was just breaking when Dr Hepburn arrived at the site.

"I remember getting out of the ambulance and being taken over to someone on the ground. I was the first medic on site but various other people had arrived before me and already started lining up the significantly injured in one row, and the dead in another, and there were also some walking wounded."

"I remember getting down on my knees beside patients and asking some questions, and before I had time to make an assessment, being asked to come quickly elsewhere. I tried to decide who I could best help, and remember putting some IV lines in a couple of people and taking some blood to cross-match someone that was bleeding.

"I particularly remember being completely out of my depth in a major event situation, without the skills to make quick assessments and delegate to others and have always berated myself for this."

Relief for the junior doctor came in what would have seemed like the longest 15 minutes she can remember when the additional medical support arrived and "someone took proper charge of the situation".

Dr Hepburn stayed on site for several hours not really remembering the ins and outs of the day except for one woman who became her focus.

"She was pregnant - third trimester I'm sure, and was very anxious about her unborn child. I spent time trying to reassure her and keep the mum positive. I stayed with this lady for a while at the crash site before escorting her back to Grafton Base Hospital by ambulance."

Video footage captures Dr Maureen Hepburn (black cardigan) and Dr Ray Jones (teal jumper) provide medical treatment to an injured passenger at the Cowper crash site.
Video footage captures Dr Maureen Hepburn (black cardigan) and Dr Ray Jones (teal jumper) provide medical treatment to an injured passenger at the Cowper crash site. Jenna Thompson

She recalls communicating either during the road journey or upon arrival at the hospital that the patient needed a c-section. "This baby needs to come out now."

She said there were concerns whether the patient might have had a head or neck injury from the crash however and the obstetrician/anaesthetist wanted further checks before considering intubation and c-section which understandably resulted in delay. "The baby was stillborn. I know there was a lot going on in the hospital with other injured patients, but I was just devastated for this lady."

Dr Hepburn remembers someone telling her to go home in the early afternoon to get some rest but she felt there was little chance of that happening.

"I remember being distraught. I spoke a little to my colleagues at the residents' block, and after 5.30pm when they finished, a group of us went to Pizza Hut in Grafton for food, drink and what turned out to be the only debrief I/we ever got. I remember talking and, crying, drinking alcohol, talking more. I got so much out of my system and my colleagues were so supportive.

"As far as I remember I had no time off after this - but I could be wrong - a lot is a blur now."

Dr Hepburn said she remembered being really disappointed later on that no-one from the hospital came to ask her about the experience. "No one thanked me for my input, (not that she was looking for thanks) and pretty much everything just petered out after that."

She said back then there was no debriefing nor interest in my or my colleagues' experience or mental health. "There were obviously media reports - TV and newspapers and we kept an eye on these. I think there was a church service at some point in memorial before we all left Australia but again my memory is a blur here too."

Dr Hepburn didn't keep in touch with anyone from the crash though remained in contact with some of her British colleagues after she came home.

"We still have some (infrequent) contact even now. They saved me that night. By just listening and being supportive and letting me cry. I still do that now if something bad happens - I can get most things all out of my system, rather than holding it in."

Dr Hepburn said it was hard for her to remember what she was like in stressful situations before Cowper. "Maybe I was better at staying calm and clear headed, but I do know since then, I am aware that I can struggle in stressful situations. I get very anxious if I don't feel fully in control. If several people need my input at the same time. I have got better with time, and I have had to work hard to manage myself, but I do wonder how much of this stemmed from that morning of being completely shocked and out of my depth in such an event."

Maureen Hepburn started her 12-month position as a junior doctor at Grafton Base Hospital in August 1989.
Maureen Hepburn started her 12-month position as a junior doctor at Grafton Base Hospital in August 1989. Contributed

While finding a positive in the horror of that day or the aftermath was not possible passing time has helped lessen the burden.

"I used to think about it a lot but less so as time has gone by. Every now and then something will trigger the memory - usually another crash or a stillborn baby. I usually end up (particularly with a few glasses of wine in me) bubbling to my husband and re-telling the story.

"I remember googling a few years ago and realising there was information online. The crash was before the web. I read a number of articles and remember thinking all these people are talking about an event that was huge in my life, some people were being thanked, some recognised for the part they played, memorials being placed, and family members talking about their experiences and loss - but no-one has ever talked to me..."

Dr Hepburn said her husband encouraged her a few times to write to someone. "To reach out, to tell my story. I kept stalling." (It was her husband who found The Daily Examiner's recent article about the podcast and wrote to us).

Dr Hepburn said she was glad that the Pacific Highway has improved over the past 30 years. "I was terrible back then - we drove up and down it many times."

She was also well aware of the other crash that occurred further south a couple of months later. "It attracted a lot of attention too with regards to the poor state of the highway."

And while the crash left its own scar with the young doctor from Scotland she said she did have an amazing year while living in Australia, more life-changing moments than could ever have anticipated.

"Apart from the wonderful travel experience, there is of course, my souvenir. I have the most wonderful daughter Jennifer who was the best thing to come out of my year in Grafton. I met a man at Jacaranda and we dated for eight/nine months. It was a bit of a stormy relationship and I broke it off shortly before leaving Grafton."

On her final sojourn to central Australia before leaving the country Dr Hepburn discovered she was pregnant.

Maureen Hepburn now lives in Scotland with husband Stephen.
Maureen Hepburn now lives in Scotland with husband Stephen. Contributed

Unwell with morning sickness her ex partner helped her to get back to Sydney where talk of marriage and moving to Scotland to raise the baby ensued.

"I gave it due consideration, but in the end that wasn't right for me and I brought my daughter up on my own (with lots of help from her doting parents)."

Dr Hepburn continued her GP training while pregnant obtaining her qualifications when daughter Jennifer was about five months old.

While Cowper may have been an overwhelming, negative experience for the junior doctor, there were other aspects of her life that were enriched by her time in the Clarence.

Aside from the arrival of her daughter when she returned to Scotland she also had a new facet of family life added into the mix.

"I also met my full biological family a few months after I returned from Australia, when I was pregnant. A mum, a dad and two full siblings, I didn't know I had. But that's another story."