• Freja Holmer told her boss she’d be late for work after stacking it on a scooter; it turned out she’d suffered one of the most deadly brain injuries and it was only the frantic efforts of two surgeons who were prepared to buck the system that saved her life.
FSH needs neurology unit
MY name is Freja Holmer. I am 20 years old and from Walyalup (Fremantle).
I wanted to share my recent experience in the WA healthcare system, as it illuminates the structural flaws and bureaucratic obstacles which nearly resulted in my death.
Six weeks ago, I sustained a brain injury from falling off a kids’ scooter.
My mother rushed me to the Emergency Department at Fiona Stanley Hospital where the identification of a bleed on my brain was severely delayed, followed by attempts to transfer me to another hospital for the surgery I needed right then and there. FSH is not equipped for neurosurgery.
Patient safety is being compromised every day in our understaffed public healthcare facilities where overworked and underpaid staff cannot provide the care our communities need.
My survival and continuing recovery are entirely attributed to the heroic actions of certain individuals who fought against the red tape to provide me with the urgent and necessary surgical care that all patients in my position should be routinely and efficiently receiving.
Unfortunately, my experience is not unique or the last of its kind, rather the direct product of a system ill-equipped to provide the necessary and timely healthcare required of our growing population.
It is our government’s responsibility to address this issue, though despite years of advocacy from healthcare specialists it appears little change has ensued.
As such, I am sharing my narrative in hopes of generating pressure on our governmental agencies to provide immediate and targeted actions to address the inadequacy of our public health sector and support the establishment of neurosurgery at FSH.
• Freja Holmer before her accident.
They couldn’t save my life according to policy
ON March 29, I fell off a non-motorised kid’s scooter without a helmet in my neighbourhood while heading to work and crushed my skull on the curb, which ruptured an artery and created a bleed in the narrow space between my brain and skull.
I rushed to FSH and had life-saving surgery for which my loved ones and I are eternally grateful.
In the hospital’s ED began losing the ability to walk or talk coherently, after already getting drowsy which the staff did not seem concerned about.
Pulse dropped
My pulse dropped to 40 while the nurse recorded 80 instead and one of my pupils dilated to 6mm on the 1-6 scale. It was not until then that they conducted the standard CT-scan to even identify the type and severity of my injury.
However, FSH have taken this case very seriously and an internal investigation is under way as well as numerous systemic changes.
I was to be sent to Royal Perth Hospital for surgery – a journey I did not stand a chance of surviving.
This is because FSH is not staffed or equipped for the procedure and as per policy, patients are sent to RPH or Sir Charles Gairdner Hospital to be treated, as they are the designated state trauma centre and head injury unit respectively.
FSH receives head injury patients who do not come by ambulance such as myself.
As the only major public emergency department in the area it is critical that it is able to fully meet the needs of the Perth metropolitan area south of the river, instead of putting additional pressure on RPH and Charlie’s as well as countless future patients’ lives and livelihoods at risk when every second could mean the difference between life or death.
Neurosurgeon Sharon Lee and general surgeon Anand Trivedi saved my life, but to do so they had fight to make an exception and improvise.
As I was being put on the stretcher for transfer Dr Trivedi remained adamant that I was to undergo surgery there at FSH – without his persistence and cooperative anaesthetic team I would not be writing this.
The bleeding continued, compressing my brain and increasing the pressure inside my skull leaving me with little more than 30 minutes left to live, while Dr Lee rushed from Sir Charles Gairdner in an Uber to avoid wasting time on parking and Dr Trivedi sprinted across the road through the red light, nearly getting run over himself.
• Surgeons had to remove this much of Freja’s skull to relieve the pressure on her brain. After enduring weeks with nothing but a layer of skin to protect her brain, she waited in hospital for six hours for the operation to put the skull back, only to be told there were no beds available and she’d have to go home and wait another two weeks. Fortunately she again found medical and nursing staff willing to buck the system and she was on her way to what she describes as a “miracle” recovery.
He ran to St John of God Murdoch Hospital to borrow the instruments that FSH did not have, begging the staff who were organising the tools to hurry up because “she is dying”.
Due to the craniectomy taking place on site as well as nothing but a miracle, my recovery has been astounding.
I’ve been wearing a helmet 24/7 because they removed a quarter of my skull to release the pressure on my brain, until last week when I had surgery to put the piece back into place.
Many patients with the same injury either die within a few hours or experience drastic personality changes, amnesia and spend months in rehabilitation.
After only 16 days in rehab and zero major impairments, part of the recovery for me is ensuring this does not happen to anybody else.
The government needs to listen to the long-standing pleas and guidance of the professionals and experts who are on the front lines and address the broader social issues in the equation.
The healthcare industry deserves a lot more than gratitude.
Gratitude will not make their workloads or working hours reasonable.
Gratitude will not raise wages to reflect the crucial value of the work they do.
Gratitude will not free up the beds occupied by people who have nowhere else to go.
It’s not like I requested brain surgery at my local GP – you would think a massive, newly-built, beautiful public hospital like FSH with such an established ED would be prepared for all emergency services, especially procedures that are required after accidents that are particularly likely and common among children.
As an institution, Perth public healthcare failed me that day – it was thanks to the persistence and desperation of Dr Trivedi and Dr Lee who advocated for my survival with the support of the FSH executives and staff, that made it possible to improvise and save my life.
The Perth neurosurgery community has been fighting this inadequate resource allocation for years – how many lives need to be lost until we see structural change?
Change that my case illustrates does not need to be overly complicated or expensive.
In the time it took you to read this a person may die or have their injuries significantly worsened because of the current system – Fiona Stanley Hospital needs to be fully trained and equipped for all emergency neurosurgery immediately.
by FREJA HOLMER