It has just gone 6pm when the barefoot man stumbles into the brightly lit hospital.
asserted
man → go → hospital
He is erratic, groaning and dishevelled with a wild, dark beard.
asserted
He → groan → beard
Police have escorted the man into St Vincent’s Hospital’s emergency department after he violently attacked a stranger, a woman walking down a nearby street in Fitzroy.
asserted
he → escort → Fitzroy
A doctor and team of nurses calmly assess the man, who is dressed in torn, grey tracksuit pants and chequered flannel shirt, and in the grips of psychosis.
asserted
who → assess → psychosis
They reassure him gently before giving him a mix of antianxiety and anti-psychotic medications.
asserted
They → reassure → antianxiety
To their relief, he swallows the medication without much resistance.
asserted
he → swallow → resistance
Minutes later, he is attached to a drip and quietly snoring, surrounded by a sea of patients in various states of consciousness.
asserted
he → attach → consciousness
It is just another night inside the busy emergency department in the hospital on the edge of Melbourne’s CBD, where staff are caring for a record number of acutely unwell and injured Victorians every day.
asserted
staff → care → Victorians
Another young man is wheeled in on stretcher by two paramedics.
asserted
man → wheel → paramedics
He has taken methylamphetamine – commonly known as ice – and the liquid party drug GHB.
asserted
He → take → ice
He was found shirtless on the side of the road.
asserted
He → find → road
The combination of drugs has triggered a life-threatening spike in blood toxicity known as metabolic acidosis.
asserted
combination → trigger → acidosis
He is coming back to consciousness, as if he were waking from a bad dream, thrashing about and screaming incoherently.
asserted
he → come → dream
“Just try and relax, mate,” Dr Rex Gavan reassures him.
asserted
Gavan → try → him
“It’s OK.
asserted
It → ’ → ?
You’re all right, mate.
asserted
You → ’re → ?
You’re in the emergency department.”
asserted
You → ’re → department
In the stretcher next to him, a woman in her 80s, with grey, clammy skin and lips that are tinged blue is sitting upright and struggling to breathe.
asserted
that → ting → skin
She is being given oxygen and showing all the grim hallmarks of heart failure.
asserted
She → give → failure
A team of nurses and doctors is working tirelessly to stabilise her before she can be taken to the intensive care unit.
asserted
she → work → unit
A growing number of patients flooding to emergency departments across the state are gravely ill older Victorians.
asserted
number → grow → state
Director of emergency services at St Vincent’s Hospital Dr Jonty Karro says some older patients are coming in with catastrophic injuries, akin to being in a high-speed car crash, following falls at home or on the street.
asserted
patients → say → street
Others have several co-existing chronic conditions, making diagnosis and treatment more complex and time consuming than ever before.
asserted
diagnosis → have → conditions
“We’ve got an increasingly ageing population,” Karro says.
asserted
Karro → get → population
“They’ve got diabetes, high blood pressure, heart failure, they may have cancer, or kidney failure.
uncertain
they → get → cancer
They come in with shortness of breath or delirium so we have to work out what is going on, what’s causing the symptoms and then what is the best treatment.”
asserted
what → come → symptoms
Between January and October this year the hospital’s emergency department treated 43,171 patients, an increase of more than 1400 patients when compared to same period for 2024.
asserted
department → treat → 2024
Earlier this month, the Australasian College of Emergency Medicine warned this exponential rise in frail, elderly patients meant patients were being left in hospital corridors to deteriorate as they waited for a bed.
asserted
they → warn → bed
The college’s Victorian branch chair Associate Professor Mark Putland warns the state’s health system is at tipping point and unless urgent action is taken now, the worst is yet to come.
asserted
worst → warn → point
New data from the Victorian Agency for Health Information shows more that half of patients are waiting more than four hours to be treated in emergency departments across the state.
asserted
half → show → state
On any night, acting secretary of the Victorian Ambulance Union Olga Bartasek says paramedics face a dire situation where there are at least 10 to 15 ambulances ramped outside hospitals.
asserted
paramedics → act → hospitals
“Paramedics are being told they’re not going to be able to get their patient off the stretcher for anywhere between two and eight hours,” she says.
asserted
she → tell → hours
On Sunday, the state government will unveil an ambitious $1.5 billion plan to slash emergency department wait times by up to 20 per cent.
asserted
government → unveil → cent
The government said if it was re-elected it would expand 12 hospital emergency departments by 25 per cent, including the state’s major trauma centre, Melbourne’s Alfred Hospital.
asserted
it → say → centre
It plans to hire 1500 health workers, including 750 more nurses, and delivering 250 more beds over the next four years.
asserted
It → plan → years
But Karro believes much of the pressure on the hospital system comes not only from a lack of staffing and ED beds, but also from delays in being able to discharge people.
asserted
much → believe → people
“The problem is manifesting at the other end of the system,” he says.
asserted
he → manifest → system
“It’s getting people out of hospital beds and into residential aged care or getting them NDIS [National Disability Insurance Scheme] supports.”
“You can’t get people out of the hospital until they have somewhere to go.”
To deal with this, St Vincent’s and the Austin hospitals both have dedicated teams of geriatricians working alongside emergency department clinicians to assess older patients and safely divert them to their homes, aged care facilities or rehabilitation services.
asserted
Vincent → get → homes
Health, including overcrowded emergency departments, has emerged as political flashpoint in the upcoming state election.
asserted
Health → include → election
In September, there was public outrage after The Age revealed 20 new emergency beds at the Royal Children’s Hospital would be left empty even after a long-awaited multimillion-dollar redevelopment is completed in November because the health service lacks the staff to use them.
asserted
service → be → them
…and 77 more, not listed.
The Aporia
