“Let’s do it – I will write again after I battle through the seals to the gym and back!” Such was Meg McKeown’s response when first contacted about writing about her work with the Australian Antarctic Division (AAD) on Macquarie Island. A former veterinarian who has retrained as a medical doctor, McKeown is currently employed by the AAD as the doctor servicing Macquarie Island Station, known to the small number of inhabitants as ‘Macca’.
During winter, the human population of the island amounts to little more than a dozen, while in summer the island can accommodate as many as forty people. As McKeown’s comment suggests, however, the vast majority of the island’s other inhabitants include various types of seals, sea lions, petrels, albatross and penguins, many of which use Macquarie Island as a breeding ground.
Located in the Southern Ocean about halfway between New Zealand and Antarctica, Macquarie Island is about as remote as it gets. The island is 34 kilometres long and five kilometres wide, and its climatic conditions are moderated by the surrounding seas, with temperatures hovering between 5 and 8 degrees Celsius year round. Macquarie Island is renowned as one of Earth’s cloudiest places, with an average of only 856 hours of sunlight per year. In this respect it is similar to Tórshavn in the Faroe Islands (between Scotland and Iceland), which records an average of only 2.4 hours of sunshine per day. Snow is common on Macquarie Island from June to October, but can fall at any time of year, particularly on the two higher plateaus at the northern and southern ends of the island, which are approximately 150-200 metres above sea level, and on the island’s higher points, Mt Elder in the north (385 metres) and Mounts Hamilton and Fletcher (410 metres) in the south.
Macquarie Island Station, located on a narrow isthmus close to sea level at the foot of Wireless Hill on the northern end of the island, has been home for McKeown since the end of March 2014, when she took up her post as resident doctor.
Originally established by Sir Douglas Mawson in 1911, the Station was used from 1911 to 1914 as a base to relay radio messages from members of the Australasian Antarctic Expedition in Antarctica back to Hobart. Macquarie Island Station was taken over by Australian National Antarctic Research Expeditions for scientific purposes in 1948, and the base has been used as a research station ever since.
Now comprising roughly thirty buildings, Macquarie Island Station is currently operated by the AAD, and is one of four permanently manned AAD bases. The other three bases – Casey, Davis and Mawson – are all located within the two Australian federal territories on the Antarctic continent, and the AAD is responsible for administering the bases, the Australian Antarctic Territory, Heard Island and McDonald Islands on behalf of the Australian government. Macquarie Island Station and the island itself are not governed by the AAD, though. Quirkily, they are deemed part of Tasmania – despite the fact Tasmania is more than 1,500 kilometres away.
McKeown has first-hand knowledge of just how different living on Macquarie Island is, compared to living in Tasmania.
“I grew up in rural northwest Tasmania on a small farm where we raised our own beef cattle and had a few chooks,” she said. She recalled the town of Zeehan, where she spent her early years as “a long way from a hospital, and even getting dental care or routine child health checks required travelling”. Ironically, instead of infrastructure and services improving over time, McKeown said the area around Zeehan “is now more remote than it was then, because the population has diminished as the mines have closed and the work opportunities have gone”.
Although her family moved to an area of northwest Tasmania better serviced by a major hospital and an airport that could facilitate evacuation to larger and more specialised medical facilities in Hobart or Melbourne, McKeown’s early experiences have exerted an influence on some the decisions she has made, particularly in relation to her career path and where she has chosen to live and practise.
“I have a commitment to the more remote areas and a connection with the west coast of Tasmania that is difficult to shake,” she said.
Growing up in a rural community contributed to McKeown’s decision to become a veterinarian.
“My interactions with vets were always positive and I admired them,” she said, adding that representations of veterinarians in books and on television also helped: she read all of James Herriot’s books and loved the character of Vicki the vet on the 1980s Australian drama series A Country Practice.
Upon completing high school, McKeown was faced with a choice between veterinary science and medicine. “My sister was studying medicine, and I thought veterinary science would suit me better,” she said. “Medicine was my second choice, and although I was accepted from school to study medicine I turned it down to become a vet.”
After graduating from Sydney University in 1997, McKeown worked as a veterinarian in small animal practices for twelve years, primarily in Richmond and Penrith in western Sydney, but also as a locum in various other locations. As her career progressed she was faced with another choice: whether to choose an area in which to specialise or to open her own practice.
The decision proved more complicated than McKeown had first anticipated. “I wanted more from my career,” she said, “but the thought of specialising did not appeal to me as it would narrow my caseload and I knew I would become bored.” She went to TAFE and undertook a Certificate IV in Small Business Management, but upon completing the course came to the realisation that opening and running her own practice was not what she wanted either. Sensing she had reached a vocational crossroads, McKeown began to consider other options.
“I didn’t want to stay as an employed vet, so I started thinking more abstractly,” she said. “I had a friend who had completed the graduate medicine programme at Sydney University after a year of veterinary practice and she was very settled in her new career as a doctor, so I had that in the back of my mind too”.
In 2006, McKeown enrolled in the MBBS graduate medicine course at the University of Sydney, qualifying as a doctor in 2009. Rather than giving up on her veterinary background, she worked as a vet through her medical degree.
“I worked on weekends and after hours as a vet at Penrith Vet Hospital and attended my clinical day at Nepean Hospital one day a week in the first two years of the degree, and five days a week in the final two years,” she said.
Not unexpectedly, there were occasions when her practices would overlap. “I would quite commonly treat someone’s pet, then their mother in the same week. I loved that,” McKeown said. “I continued a little after hours work after graduating from medicine but have not had any paid veterinary work now since 2011.”
By this time, McKeown had also identified her desire to pursue her medical career in remote communities, particularly after gaining experience of working in far-flung locations around the country. Student medical placements conducted with the University of Sydney are allocated using a ballot system, and McKeown was selected to complete one placement in Lismore, in northern NSW, and two others in the Northern Territory at Groote Eylandt (an archipelago on the western side of the Gulf of Carpentaria) and Borroloola (about one thousand kilometres south-west of Darwin). While studying her medical degree, she also successfully applied to be one of the three hundred medical students in Australia chosen to join the John Flynn Placement Program with the Australian College of Rural and Remote Medicine (ACRRM), and after undertaking her first John Flynn placement in Geraldton, WA, she completed her remaining three placements with the program on Lord Howe Island, six hundred kilometres east of Port Macquarie, NSW.
On Lord Howe Island, in the absence of any other suitably qualified professionals, McKeown was again called upon from time to time to use her years of veterinary training and experience, performing minor surgery on small animals, attending to a sick horse, and even conducting a post-mortem on a goat. But for McKeown, what proved most invaluable about living and working on Lord Howe Island was that in addition to experiencing the life of a rural doctor first hand, she gained a mentor in her supervisor, Frank Reed.
“At graduation from medicine the keynote address was about finding mentors in our medical career,” McKeown said. “I have taken this to heart and listen to the experiences of other doctors as I meet them and make informed choices about my career taking these interactions into account. I have met several doctors working rurally and remotely in Australia and I can’t help but be inspired by them.”
McKeown said one such choice was to begin training with the ACRRM after completing her degree and gaining general registration following an internship in Sydney. Part of ACRRM training involves completing an Advanced Specialised Training (AST) component in areas such as surgery, anaesthetics, or emergency medicine, each with its own curriculum and research. Unsurprisingly, McKeown has elected to conduct her AST in Remote Medicine.
Being employed by the AAD for “a stint on Macquarie Island has enabled me to complete the curriculum of Remote Medicine,” McKeown said. “When I gain my Fellowship of ACRRM I will have an AST of Remote Medicine, ready to practise as a rural generalist anywhere in Australia and with opportunities to work overseas independently in locations that would be considered austere by many.”
While Macquarie Island is more remote than any other location she has worked in before, McKeown’s experiences on Lord Howe Island have prepared her for some of the challenges of being the resident doctor at Macquarie Island Station. “The first part of an emergency in either location is all about using resources at hand and performing the work without a lot of help, except by remote means such as telephone or video hook-up,” McKeown said. That said, Macquarie Island’s geographical position and peculiar weather conditions – which regularly include snow and winds in excess of 80 knots as well as its infamous cloud cover – can present a particularly difficult set of circumstances to navigate. “In good weather the NSW air ambulance can reach Lord Howe within a few hours,” McKeown said. “On Macquarie Island we would wait a minimum of three days for a ship if there was a serious incident.” Emergencies can be made even more challenging by the fact there are no vehicles on Macquarie Island, and all transport – even of an injured person – is on foot.
Although McKeown has not had to deal with a serious incident during her time on Macquarie Island, she is confident she has the necessary equipment, technology and training to deal with an emergency. Medical facilities at the base include a fully equipped surgical theatre and facilities which enable her to provide anaesthetics, X-rays, dentistry, pathology and emergency treatment. Video-conferencing is also available should McKeown need to make contact with specialists on the mainland. She points out that any X-rays and pathology tests she conducts on the island are digitally transmitted, noting that “same day reporting helps sort out cases more quickly”.
McKeown also has the capacity to have patients monitored remotely. “I can attach the monitors and the information is transmitted over the internet so an intensivist doctor or anaesthetist can help us monitor a critically ill or anaesthetised patient from Hobart,” she said. But she is equally comfortable working without such technological back up.
“I like having the challenge to use resources at hand,” McKeown said, crediting her years of veterinary experience with “providing the background that keeps me calm whether I am needed as a medical doctor, anaesthetist, surgeon, dentist, plaster technician, pathologist, radiographer or emergency doctor.”
Having well-equipped facilities means that on a typical day, when McKeown is not attending to the minor complaints and illnesses of patients (who present on a no-appointment, drop-in basis), part of her job involves maintaining the array of medical paraphernalia she has at her disposal – from ventilators to defibrillators to pathology machines. “All these items need calibrating and have quality assurance programmes so they can be put into use at any time,” McKeown said.
She also has to maintain the first aid kits at the Station and in the seven remote huts and caches located around the island, as well as keeping personal first aid kits current and replenished. With only one medico at the base there is always work to do on these tasks, but McKeown has also been using her time at Macquarie Island Station to undertake further studies, preparing for her ACRRM Fellowship examinations and completing a Diploma of Child Health.
In addition to her primary role as resident doctor on Macquarie Island, McKeown also has a secondary – and more quirky – role as Macquarie Island Station Postmistress. In this capacity, McKeown is responsible for receiving mail from the resupply ships when they come to the island and stamping and post marking outgoing mail.
“I open the post office for the tourists when they come on their voyages from New Zealand, too, so they can post items with the Macquarie Island post mark,” she said. One can only assume the Macquarie Island post mark is amongst the most rarely seen, worldwide.
When she has spare time, McKeown can most frequently be found in the gym, aiming to improve her personal best times over her two favourite distances (one mile and five kilometres), or taking photographs of the remarkable scenery and wildlife around Macquarie Island. The island was listed as a World Heritage Area in December 1987 and is recognised as having outstanding universal value for its unique geo-scientific features. Since Macquarie Island is an exposed portion of the Macquarie Ridge – where the Indo-Australian and Pacific tectonic plates meet – it is the only place in the Pacific Ocean where rocks from the Earth’s mantle (which usually lies some six kilometres below the ocean floor) are regularly and actively exposed above sea level.
Macquarie Island was also included on the UNESCO World Heritage list because of its spectacular natural beauty and its biodiversity, particularly in relation to the animal and bird populations whose vast colonies take over the island for part of each year to breed and begin raising their young. The world’s entire populations of royal penguins (Eudyptes schlegeli) and Macquarie shags (Phalacrocorax atriceps purpurascens) use Macquarie Island as their breeding ground, but the island also hosts king, southern rockhopper and gentoo penguins, four different species of albatross, southern giant petrels and white-headed petrels, three different species of fur seals, Hooker’s sea lions, and southern elephant seals. To put the enormous numbers of animals and birds using Macquarie Island as a breeding or nesting ground into perspective, the island hosts a population of more than 15,000 southern elephant seals (Mirounga leonine) alone, while nature conservation organisation BirdLife International estimates that Macquarie Island supports approximately 3.5 million breeding seabirds across thirteen different species.
Whenever her schedule permits, McKeown has welcomed the opportunity to participate in the various projects being undertaken on Macquarie Island. “I volunteer with the Tasmanian Parks and Wildlife Service (TASPAWS) as often as I can to clean up beach debris, count seals, count birds and, starting this weekend, to guide the tourists around the penguin colony at Sandy Bay,” she said.
Wildlife counts form an important part of conservation programs, with one of the most important elephant seal censuses taking place in mid-October, at the peak of breeding season. Two TASPAWS rangers are currently living at Macquarie Island Station, and McKeown and many of the other current base residents were happy to assist them with the massive effort of conducting an all-island count – not only because they were keen to see the seals, but also because doing so presented them with the opportunity to enter some of the Specially Managed Areas around the island to which access is usually restricted.
“There were two thousand seals here on station in peak season, so it was a huge job,” she said.
With the exception of treating a constipated dog that was part of the TASPAWS pest eradication team shortly after arriving on Macquarie Island, McKeown has not been specifically called upon to use her veterinary training.
“Although there are many injured wildlife, they are injured in the course of nature – and there are always other species waiting for these injured animals to die, or actually to kill them as their food source,” she said.
Stressing the importance of not interfering with nature unless it is absolutely necessary, McKeown said “we don’t intervene to euthanase or fix anything unless we injured it in the course of our activities here, or they are tangled up in rope. I did help to disentangle a royal penguin on the beach, but I was just the closest person”.
Observing the food chain in action has also provided McKeown with some memorable – though gory – moments, particularly when observing giant petrels, who take on the role of vultures on Macquarie Island.
“I watched them devour a dead male elephant seal over a period of a week or so and collected some great photos of their efforts. They will make holes in the hide and go right inside the carcase to eat the best bits; they come out covered in blood,” McKeown said, before adding that the elephant seals themselves provide an unforgettable spectacle during the mating season.
“Two males rucking almost to the death would be my most amazing experience so far,” she said, “There was blood everywhere as teeth were knocked out and the losing male shuffled into the water to have the ocean turn red around him”.
McKeown said she has appreciated seeing “the cute side of things” up close, such as watching baby king penguins, Gentoo penguins and elephant seals. She has also enjoyed seeing baby seals coming right up around the buildings in which she lives and works, but is realistic about the juveniles’ prospects once they leave the island.
“They will soon go and teach themselves to swim and leave the island,” she said, “but on their way out there is a chance a killer whale might eat them. We will be watching, as morbid as it sounds, to get some good shots of the orcas.”
Last December was time for McKeown, too, to leave Macquarie Island and return to the mainland with all its creature comforts – which, after consuming mostly frozen and processed food for nine months, she now counts as including freshly grown fruits and vegetables. She is looking forward to having a superfast internet connection and even plain old television services, but is grateful that not having such things has proved she can live without them.
It is hardly surprising, however, that after spending the better part of a year living in a land of snow, ice, wind and seemingly endless cloud cover, McKeown is taking a well-deserved holiday in January 2015 before heading north to sunny Queensland. There she intends to work for six months as a GP registrar in Childers, southwest of Bundaberg, and to sit her final exams to attain fellowship of the ACRRM.
When asked what she will miss most about Macquarie Island, the wildlife and the stunning scenery top McKeown’s list. “I have never lived anywhere before where I can watch albatross flying overhead out my bedroom window. It’s just awesome,” she said. “Also, you can’t beat the southern lights down here – when the Aurora Australis is blazing there are no words to describe what that is like”.
McKeown acknowledges that living at Macquarie Island Station has not been without its challenges.
“To have such a small group working well together requires a lot of tolerance of small annoyances and a lot of give and take,” she said, but added that she has been fortunate enough to form a relationship with a fellow expeditioner, Graeme, at the base.
She also said that one of the best things about life on the island has been “having a lot of time for self-reflection, mindfulness and personal improvements. I have never been fitter, and I have had the time to focus on what is important and what is superfluous to a genuinely fulfilled life”.
It seems clear McKeown will take more than memories with her when she departs from Macquarie Island, and equally obvious that wherever she chooses to live and work, many adventures are sure to lie ahead.