Fellow profile: Dr Sarah Wong

Dr Sarah Wong and Ms Diana Wong (Supplied by Australian Defence Force)

Keeping it in the family

The end of 2020 marked a significant sea change for anaesthetist Dr Sarah Wong and her mother Diana Wong, an emergency nurse and midwife with a PhD in disaster health. While Sarah not only received her fellowship papers for ANZCA, both were accepted into the Royal Australian Navy as reserve officers in the Maritime Operational Health Unit (MOHU) based out of HMAS Penguin.

A CONSULTANT AT Sydney’s Westmead Hospital’s surgery trauma referral centre, Lieutenant Commander Wong is one of a few Australian anaesthetists in MOHU. The fact that her first naval exercise on the flagship HMAS Canberra last year was alongside her mother Lieutenant Diana Wong isn’t lost on her. “You often see fathers and sons serving together as Reservists, but not mothers and daughters,” Sarah explains. “Joining the Naval Reserve was something that I had always wanted to do. I focused first on medical school and then when I started my fellowship year I started the application process to join the Royal Australian Navy. The process took almost a year as it involved interviews, fitness tests and a final board panel of review. Then there’s the Reserve Entry Officer Course which involves four separate phases. “I completed most of the process with my mother. She had started her recruitment process about six to 12 months before me but we managed to get on to the same Reserve Entry Officer Course together.” The pair served together on board HMAS Canberra for three weeks during Exercise Sea Explorer in mid-2021 which, in addition to simulating a series of mass casualty events, reaccredited the ship’s hospital facilities. Exercise Sea Explorer involved nearly 1400 soldiers, sailors and aviators practising amphibious landings of soldiers, battle tanks, helicopters and equipment in north Queensland. As the ship’s anaesthetist during the exercise Sarah participated in numerous drills as part of a trauma response unit to a raft of simulations and protocol tests for toxic hazards, flooding and

Dr Wong at Westmead Hospital.

on-board fires. The medical and surgical teams would handle the “casualties” in the ship’s hospital through triage, emergency and resuscitation and then “transfer” them to either theatre, intensive care or a medium-dependency unit depending on their needs.

Sarah worked with the ship’s surgeon to “treat” conditions ranging from fractures, amputations, airway trauma, abdominal trauma and head trauma that needed neurosurgery. “The hospital is a small place in a warship. There are two operating theatres, five ICU beds and three resuscitation beds,” she explains to the Bulletin. “We needed to make sure we could outfit the surgical table and prepare ourselves for surgery as required depending on the trauma involved. The theatre bed is fixed to the deck of the ship so we had to work out how to operate despite the limitations of the space. The scrub nurse is always on the patient’s right for instance, so you quickly learn how to work within certain limitations based on the resources and supplies you have. “While it’s about being innovative and resourceful it’s also recognising the chain of command is different to that of a civilian hospital. In our normal day-to-day hospital work it’s so easy to pick up your phone or run next door to check something with a colleague, whereas on board the ship there is one controller and that person needs to know everything so they can make decisions for you. Getting your mindset around that chain of command is quite challenging because you have less autonomy. As you step into that military environment, instructions become orders which are effectively commands. “At Westmead everything is electronic so you can see at a glance who your patients are and what’s coming next but that technology is not used on the ship. Paper is more reliable when you are on board, especially during operational activities.” When the ANZCABulletin caught up with Sarah she was in the middle of a three-week junior officer leadership and management course. She relishes the transition from her civilian life to her temporary role as a medical specialist reservist and embraces the challenges in both. She says many of the skills she applies in both settings are interchangeable. “I quite enjoy balancing my civilian work and bringing those skills into my defence work. I want to make sure I keep my critical and trauma management skills sharp so that I may best contribute to our Defence Force’s health capability. The Australian Defence Force is responding to a greater number of humanitarian and disaster relief (HADR) operations in our region and is building its capability as it monitors the situation in the Indo-Pacific (Plan Pelorus 2022).

“The self-challenge and the desire to learn is what drives me. The way I have approached anaesthesia and how I continue to, is the challenge for me to keep learning. I want to focus on becoming the best anaesthetist I can be for my patients. “For me personally, the Navy Reserve is a new and exciting environment that provides me an opportunity to build on my existing teamwork, leadership and critical thinking skills. These attributes translate across both my work places and are so important in both.” Sarah is adept at juggling her civilian commitments at Westmead Hospital and private practice with her reservist role and is grateful for the hospital’s support. “When you’re in the navy you’re first and foremost an officer and then a medical specialist so you do role model a certain type of behavior as a reservist when you’re on board. Teamwork is key in both my civilian work and in the navy. I’m applying my tradecraft skills outside of Westmead where I have access to everything, to the austere environment on board the ship. That said, the resources on the ship are phenomenal.” Sarah’s next challenge is to hopefully complete a submarine rescue course in Western Australia later this year. She would appreciate the opportunity to undertake further training with Diana, however, recognises this may not be possible. “It’s really like taking your best friend with you when you’re doing something outside your comfort zone and not being sure what to expect. It’s the perfect balance as you have responsibility but also the ability to have fun. “My great grandfather was in the Dutch Navy and served in World War II so it’s nice to know our military heritage is continuing with our naval service.” Carolyn Jones Media Manager, ANZCA