Intense and rewarding: Being a GP at a mass event

As GPs, we never know just who will walk through our door.
 
But volunteering as a doctor at a mass event, caring for 10,000 people who have travelled from across Australia and the world to participate in 10 days of intense activities can bring the ‘context’ aspect of clinical general practice to a whole new level.
 
This is the exact situation I found myself in last week when I volunteered at Australia’s 26th Scout Jamboree (AJ25) in Maryborough, Queensland, signing myself up to be a part of its 160-strong healthcare team, offering pharmacy, nursing, dentistry, physiotherapy, and allied healthcare. 
 
One of the joys of my work as a GP has been the enormous versatility the job offers, so when an opportunity to join the health and wellbeing team presented itself, I knew I wanted to be involved.
 
Having worked as a rural generalist for my entire GP career, as well as previous overseas and disaster and emergency response experience, including in post-tsunami Sri Lanka, throughout the COVID-19 response, and in remote Vanuatu, I knew I was up to the task of grabbing my stethoscope, a pencil, and rolling up my sleeves to work alongside my team members to get the job done.
 
Starting about six days into the event, I knew others would have found their stride by the time I arrived, but I also knew they would be tired from the intensity of a full week of work, so whatever fresh eyes and new energy I could provide would have to make up for being the ‘new doc’ in the clinic.
 
The temporary medical facility was built from scratch in the days preceding the Jamboree and included a triage space, emergency clinic, consulting rooms, a pharmacy room, spaces for assessment and management of those needing urgent healthcare and even a short stay ward.
 
It was also equipped to provide isolation for dozens of people should infectious disease outbreaks of gastroenteritis or respiratory infections occur.
 
And so, a few minutes before 11 pm, on the same day I arrived, I fronted up for my first shift.
 
The clinic was crowded, and the team already working told me it was the most hectic evening so far, so I was immediately put to work.
 
Trench foot and leg rashes were the flavour of the day, a flow-on effect from torrential rains, but most of my work that evening was ensuring those admitted to the clinic’s overnight stay ward were settled, that their medications were charted, and that their medical and wellbeing needs were in hand.
 
Some participants were understandably pushed to their limits with around six requiring respite and care in our overnight facility to recharge their batteries in a quiet space.
 
There were also some young people needing extra healthcare enroute back to their units after short stay admissions in the local emergency department the previous day.
 
A bit like I once, as a GP registrar found and met my fellow GP registrars on the dancefloor of a conference, at Jamboree, I found the calm faces of my very capable health and wellbeing team colleagues above the bustle of scouts and leaders.  
 
Amidst the noisy fans, the exhaustion and the imposing Queensland heat and humidity, we slowly but surely got the required work done.
 
As the evening shift docs headed off to rest and recoup, I was handed a sparkling orange lanyard with its set of keys to the ‘drug room’ and a badge labelled ‘Duty Doctor’.
 
Some hours later between 2 am and 3 am when calm and quiet had slowly descended upon the clinic, I escaped to my bunk bed for a couple of hours of ‘on call’ sleep before attending handover the next morning at 6 am.
 
A few hours into another shift, someone yelled out ‘we need a doctor out here right now’, so without hesitation, but with an accompanying rise in my own heart rate, I rushed outside to find myself in the ‘resus bay’ where I began assessing a young person who had been brought in by the first aid team following ‘repeated loss of consciousness’.


Dr Torquil Duncan-Brown, Dr Tereza Rada, Dr Michael Rice, Dr Manisha Fernando, Dr Paul Grinzi, and Dr Kylie Stephan. 

Amongst the many expected minor presentations I encountered were some individuals with more complex and serious concerns including possible febrile neutropenia in an adult volunteer.
 
I saw a young adult with a history of myocarditis who presented with fever and a new chest infection, and a child with multiple infected skin lesions and possible infected abscesses in whom we had to consider more rare infective causes, such as melloidosis.
 
Some kids experienced falls with associated knocks to the head and changed behaviour so we had to tease out the young people with exhaustion, also known as ‘Jamboritis’, who required reassurance or observation and rest, from potentially more serious possibilities such as head injuries and seizures.
 
Dr Michael Rice is a GP and is the event’s Deputy Director of Health and Wellbeing, he told newsGP that it is essential to have a great healthcare team at such large-scale gatherings to keep participants from having to go off site for hours for medial assessments.
 
‘Jamboree is such a big event in the scouting life of the participants, and I wanted to be sure it ran smoothly,’ he said.
 
‘As the Queensland doctor with the most Jamboree experience it was a no-brainer that I’d be involved.’
 
For Dr Paul Grinzi, a Melbourne-based GP who was also on the medical team, it was an opportunity for him to give back to the community in a fun and novel way.
 
‘If you are looking for a way to contribute, the Jamboree medical team role will push those buttons for you,’ he told newsGP.
 
‘The medicine was as much as I had expected, a mixture of acute, minor and some serious concerns, the resourcing and teamwork were stand out factors for me.
 
‘For a team to work so well together in challenging circumstances, it was a testament to our combined goal of ensuring the Jamboree participants’ health and wellbeing was optimised throughout the event.’
 
Dr Kylie Stephan, a Brisbane-based GP, said she was stunned by the sheer scale of the event, telling newsGP it made her appreciate the truly generalist nature of a career as a GP.
 
‘It is work, but it is work that fills your cup,’ she said.
 
‘How well we worked together, how well we all recognised each other’s strengths and weaknesses and worked together as a team, specialists and GPs together.’
 
Would I go back again? Absolutely. Just tell me where I sign up for the next event.
 
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