Medicine on ice

Dr John Cadden discusses the unique challenges and rewards of working with the Australian Antarctic Division’s Polar Medicine Unit.

1975 Alumnus Dr John Cadden has a longstanding association with the Australian Antarctic Division (AAD). He first joined the RV Aurora Australis as the ship’s doctor on a winter research voyage to the Mertz GlacierPolynya in East Antarctica in 1999.

Dr John Cadden

Dr John Cadden

Nearly two decades later, Dr Cadden’s love affair with the ice continent is still going strong. The intrepid physician reflects fondly on that first voyage.

“It was a truly life-changing experience,” recounts Dr Cadden. “It incorporated all the aspects of medicine and adventure, with the challenge of applying my skills in an isolated situation. All while surrounded by world-leading scientists and support personnel.

“I’ve now completed seven engagements with the AAD, including two winters.

“This extended time away from home has been magnificently supported by my wonderful family and partner, Dr Shar Edmunds, who graduated in the same year."

Dr John Cadden

Dr Cadden’s interest in Antarctica started early, and may be attributed to the 1950s Queensland School Reader, with its accounts of Scott and the ‘Heroic Era of Antarctic Exploration’.

“In the late 1990s, the AAD’s Polar Medicine Unit still had personnel who touched upon this early exploration and development,” says Dr Cadden. “I found their stories enthralling – the need for improvisation using basic equipment.”

The strength of the icebreaker Aurora Australis is often put to test with seas varying from millpond (rare) to ten plus meters.

The strength of the icebreaker Aurora Australis is often put to test with seas varying from millpond (rare) to ten plus meters.

Australia supports three stations in Antarctica – Mawson, Davis and Casey – and another on the subantarctic Macquarie Island, or Macca, which is about halfway between New Zealand and Antarctica.

“Once you reach Antarctica, all the Australian stations have medical facilities of the highest standard,” explains Dr Cadden. “They provide all medical, surgical, dental, pathology and investigative ability.

“The Australian ethos is to supply doctors trained to provide the necessary care. Evacuation can be a complicated and lengthy process, and impossible in winter. Other national stations aim to evacuate patients. The limitations of their facilities and transport in the winter can have serious or even fatal consequences.

“Our medical personnel and equipment often provide a referral hub for other countries during emergencies. To achieve these standards, the Polar Medicine Unit goes to great effort during the training period to provide the necessary skills.”

The Australian stations have medical facilities of the highest standard.

The Australian stations have medical facilities of the highest standard.

All Australian National Antarctic Research Expedition participants are carefully medically screened prior to deployment. Doctors who are wintering at Australian Antarctic stations are required to have their appendix removed.

“On a day-to-day basis, all the normal general practice problems present,” says Dr Cadden. “In addition, falls on the ice, fractures and musculoskeletal strains are common. Dental work is more common than you would expect – think minus 30, a deep breath and amalgam fillings!”

Participating in Search and Rescue exercises, mountain and crevasse rescue, whilst not mandatory, gives extra confidence to those on station.

Participating in Search and Rescue exercises, mountain and crevasse rescue, whilst not mandatory, gives extra confidence to those on station.

As Dr Cadden explains, the isolation of a winter expedition presents unique psychological challenges.

“Summers are filled with enthusiastic, happy, often first-time expeditioners. In the winter, isolation depletes immune factors and latent viruses can present without a new virus being introduced into the station. Now that expeditioners can travel more frequently by plane, viruses can present within the incubation period.”

"Each trip maintains my enthusiasm for general medicine and drives my desire to stay up-to-date.”

Dr John Cadden

Dr Cadden says station doctors must broaden their knowledge and skills to work in the extremely well-equipped facility. Being an integral member of the base community is also vital.

“Reading the community, catalysing interpersonal relationships, negotiating and counselling so that the community functions to achieve its work and scientific goals are an important part of the position.

“Since you are living in close quarters with your patients, medical and relationship issues are very important. Any breakdown in relationship may remove an expeditioner’s access to the only doctor. In the past, this has had disastrous consequences, so you are never off duty.

While the hours are long and the environment can be unforgiving, Dr Cadden is quick to recognise how fortunate he is to have experienced life on our southern polar continent.

There is no shortage of exciting, visually stunning activities.

There is no shortage of exciting, visually stunning activities.

“As long as we maintain radio contact and can return to station quickly, we’re allowed to be off-station to enjoy the extraordinary environment. This can mean visiting the safety huts dotted around the immediate area, travelling on stable sea ice, visiting the grounded iceberg galleries, hiking on Macca, camping out or visiting penguin rookeries. There is no shortage of exciting, visually stunning activities.

A truly life changing experience.

A truly life changing experience.

“Life on the station is as good as you make it. All stations have hobby huts with appropriate tools. There is no shortage of coaching from experienced tradespeople. Maintaining fitness and agility is important and supported by well-equipped gymnasiums, volleyball courts and cross-countryskiing in the summer. And, of course, photography is captivating.

For more information on the Australian Antarctic Division, and to get involved, see: www.antarctica.gov.au

“For me, there is no medical position in the world which gives such a broad and life-changing experience in the most exquisite and challenging environment."

Dr John Cadden