Critical Times

IT’S mid-afternoon and the emergency department at Sydney’s St Vincent’s Hospital is predictably frantic. A dead body has just been delivered – somebody has jumped or fallen from a block of flats – adding to the already onerous workload of dozens of routinely busy people.
Yet Gordian Fulde, the man in charge of this maelstrom, has spent more than a half-hour sitting on a park bench just outside the chaos, chatting to Inquirer.

Aren’t you busy? I venture. Shouldn’t you be inside taking charge?

“We’re always bloody busy,” Fulde grumbles. “But right now what we’re talking about is more important.”

What we’re talking about is crystal meth or ice, the party drug du jour creating mayhem around Australia. Just the previous night, Fulde, who has worked in emergency departments for more than 25 years, has seen the worst drug casualty he can remember.

The licence photo that arrived at hospital showed her to be a fresh-faced 18-year-old. Now, three years later, she’s upstairs clinging to life in intensive care after presenting, in Fulde’s words, as a “zombie”. The ice victim is the talk of the casualty section.

“It’s like Steven Spielberg’s got hold of her for one of his horror movies and used special effects to rip out her heart and soul. It’s just a sort of unique devastation,” Fulde says.

I’ve arranged a visit to St Vincent’s to discover whether the tumult forming around ice is justified. After a while in journalism you learn some of the things we encourage people to be terrified about aren’t really all that frightening.

Fulde, too, has seen drug scares come and go. The ice storm is no beat-up.

“It’s big, it’s big,” he exclaims. “It rots your brain and we really don’t know how to deal with it. The hype is completely justified. People – parents – should be very scared.”

The federal Government agrees. Late on Thursday night, Fulde’s emergency department entertained a couple of younger, more sharply dressed, and more influential visitors. Chris Pyne is the parliamentary secretary responsible for illicit drugs and mental health. Ryan Stokes is Kerry Stokes’s son and chairs Headspace, which advises the Government on youth mental health.

They saw for themselves the extra security guards deployed to cater for the ultra-aggressive ice victims and the lock-up cells used to placate patients lurching out of control.

Fulde has no idea how to dissuade people from destroying their lives experimenting with ice. “I leave that to the clever people,” he says. “I’m down at the end of the food chain dealing with the consequences.” Those consequences are becoming increasingly well documented. The delirious, glorious high followed by the steep, debilitating come-down. The nigh absurd acts of self-harm. “You can tell when the paddy wagon or ambulance is bringing in an ice victim by the way the back of the vehicle is shaking,” Fulde says.

The emergency boss has seen off numerous drug fads – ecstacy, special K, fantasy – but crystal meth is, he insists, different and by far the most disturbing. “It’s as if after all these years experimenting they’ve finally come up with the perfect drug, particularly suited to the Australian lifestyle. It’s cheap, it’s small, it’s easy to hide. It works instantly and is insanely powerful. You can smoke it or swallow it or inject it. You don’t rely on the Mujaheddin or sunlight or rain for supply, people can cook it up in their back yard. The dealers are making huge profits and, unlike heroin, you’re not going to die straight away.”

Where we’re sitting is a short walk from the notorious Kings Cross strip. Fulde waves his arms and grunts: “And don’t think this is confined to Darlinghurst and the so-called degenerative underclass. Ice users are across every level of society. That’s what’s really frightening; there are so many people using who we don’t see here, or haven’t yet. They’re in trouble and just barely coping.”

This theme is reinforced during a chat with Peter McGeorge, director of the hospital’s psychiatric emergency care centre. “This is really an epidemic now, all around the country,” McGeorge says. “And because ice is so cheap (often less than $50 a hit) it attracts all sorts. You’ve got the lawyers presenting with cases of paranoid psychosis, yet we’re seeing an unprecedented number of homeless people wrecked on ice.”

Josette Freeman runs St Vincent’s group therapy program from a poky old building a few hundred metres from the casualty ward. The sessions are open to all comers – drunks, potheads, junkies – but the spike in ice use has forced Freeman to introduce a separate crystal meth group. “They can be very aggressive and edgy and prone to too much sex talk, which can be distracting and uncomfortable for other people,” Freeman says.

Again, there are no lofty, unrealistic ambitions to “cure” addicts; success is judged on small things. “If we can get someone using four times a week to reduce it to three, then maybe two, that’s a win,” she says.

Typically, those who volunteer for therapy are high-earning, high-performance professionals. “They start out using because it’s very attractive to people in stressful jobs, but it’s so bloody addictive and, in the initial stages, pleasurable,” Freeman says. “So we’re seeing lawyers, bankers, chefs, advertising executives, university professors.”

Since most ice is consumed on the weekend, Freeman advises users to post their credit cards to themselves Friday morning and turn off their mobiles when not at work. “Reduce their easy access to money and dealers and there’s a chance you’ll change the behaviour,” she says, more out of hope than conviction. “A lot of this is just common sense.”

Tragically, common sense and crystal meth consumption seem incompatible. Beyond the immediate, shattering effects of the drug, experts worry about the long-term impact and side effects. Will the powerful sexual drive inspired by ice increase sexually transmissible diseases? Rampant ice use is a relatively young phenomena: how will the brain-rotting effects of crystal meth manifest themselves over five or 10 years?

Right now these are other people’s problems. Freeman’s group therapy program is impossibly stretched and has all but run out of money. McGeorge’s psychiatric department can’t cope under the extra, ice-induced strain. Fulde’s casualty ward keeps churning patients in and out.

“There’s not a single positive thing I can tell you about starting to get on top of this drug,” the emergency chief warns.

“I mean, look what it’s doing. This is Australia; 20-year-old girls don’t start car-jacking, sane, educated people don’t suddenly turn into monsters. I’ve no idea what we can do about it, but I do know parents who live in this casual drug-using society – who drink coffee and alcohol and smoke the odd joint – should be terrified. Get the message out, everything about ice is just stuffed. And go home and cuddle your children.”