During the early 1950s, I completed 2 years of hospital resident training in general and obstetric hospitals in Sydney, which in those days allowed for very little sleep! As a young graduate I had a desire to experience the responsibilities of patient care firsthand before attempting an extensive program of postgraduate training in orthopaedic surgery in the United States and United Kingdom.

There was time, however, to get married before starting out as a solo general practitioner in Wellington, in central-western New South Wales. Clinical demands were arduous: the patients had high expectations and, at the same time, seemed to have great confidence in the practical judgement of their doctors. As a young graduate, this caused me to feel a degree of “professional anxiety”.

As time moved on, my wife and I settled into the busy routine of general practice, with help and advice from the older, more experienced local practitioners. My obstetric work quickly increased, which meant blood work, cross matching and Rh typing — all part of our antenatal routine.

One particular experience shows how the circumstances of 50 years ago influenced one’s actions. An “elderly” primipara (in those days, 32 years old was considered elderly) was easily delivered of a beautiful boy — her pride and joy. Initially all seemed well, but after the first few days, no meconium had been passed and the baby appeared to be distressed, with abdominal discomfort.

I became concerned and phoned the paediatric surgeon at the Children’s Hospital in Camperdown, Sydney, for his advice. Feeling that there was clinical evidence of a developmental bowel obstruction, he too was anxious about the baby’s condition.

At that time, no air-ambulance or helicopter rescue services were available in the area. The road ambulance could not be arranged and would take too long anyway. I thought of trying to charter a light aircraft from Dubbo, and phoned Dubbo airport. But the weather was most unsettled, and no charter flights were operating. The airport official explained how a Royal Australian Air Force training squadron had been grounded by the bad weather over the state.

Was there any other option? The baby’s parents were so very anxious — they would agree to any suggestion to expedite the transfer of their child to the Children’s Hospital.

While I pondered the situation, suddenly a new voice came on the phone line — he announced he was an ex-Royal Air Force (RAF) World War II fighter pilot, and, being an emergency, he offered to fly us to Sydney despite the weather. The flight would be in a De Havilland Chipmunk — an open-cockpit, two-seat RAF light training aircraft — if I was game!

I agreed to be at Dubbo airport with the baby as soon as possible. We wrapped the small baby warmly, safely protected in a cane basket. The plane’s second control column was removed, enabling me to carefully place this important bundle away from the wind, set snugly between my legs in the instructor’s seat.

In no time, we took off in the drizzly afternoon weather, passing through the overcast gloom and flying above full cloud cover. I found the experience exciting, and when comparing this with my later years of instrument flying in similar meteorological conditions, it’s clear that our pilot certainly demonstrated his expertise.

Flying into Sydney airport was a relatively simple exercise in those days, compared with the hectic jet traffic, radar and intense air traffic control that are the norm today. While flying over the Blue Mountains on the approach into Sydney, above partly broken cloud, our pilot asked me through the intercom, “How far past the hills do you think? My dead reckoning indicates a further 10 minutes before commencing descent to Sydney.” I got a fleeting view of a long line of Katoomba street lights, confirming our pre-descent position. An ambulance was awaiting our medical emergency at the airport and raced us to the Children’s Hospital. I found this ambulance ride even more hectic than the air trip! Sadly, despite expert urgent surgery, multiple developmental bowel obstructions proved too much for the infant’s survival.

The return flight holding this sad little bundle was not easy. Before take-off, interested kind folk kept asking to see the small baby in the basket.

Happily, later, while I was studying overseas, news came that the bereaved mother had given birth to a healthy, bonny boy.

Now in my retirement years, I constantly worry about young country mothers experiencing the return of isolation, the deterioration of country hospitals and the lack of medical expertise. Despite modern road transport and air travel facilities, political priorities continue to result in few improvements being made to these serious problems in the country.

In the past, limitations to rural services were accepted as a fact of life. Every effort was made to compensate. Rural medical services must not now deteriorate because of political neglect.