Throughout NSW's Emergency Departments, the number of patients walking in the door is not equal to the number of patients exiting out the door (either via admission to hospital or discharge to the community). The result is severe wait times, staff burnout and ultimately, poor outcomes for patients.

The real equation is layered and complex - a web of factors that interplay and influence both patients, healthcare workers and the system itself. Here, I've done my best to depict some of what I believe to be amongst the most significant factors at play, as well as how they interact with each other on the most superficial level. A lot of our system's inadequacies seem to link back to both insufficient funding and inadequate resources that properly address Australia's evolving population needs (i.e. an ageing population and increased prevalence of chronic disease).

I am twenty-five years old. I have spent a quarter of my life studying for a career that I hate.

I am a doctor.

But not a real doctor, demanding of society’s respect and admiration and gratitude. I am a junior doctor.  As a surgeon once told my class, “you will soon be below the level of shit that cakes the operating room floor…” Fortunately for his ego, he was right. Here I am now, below the shit.

The cryptic array of numbers that somehow translate to a “healthy” human-being is blurring on the screen in front of me. “Please don’t cry, please don’t cry,” I desperately urge my sub-conscious.

“How’s it going, Maddy?” my always positive and proactive nursing colleague politely enquires from the computer next to me, unaware of the oncoming emotional outburst.

My silence prompts him to turn his head in my direction. I don’t want to imagine the ugliness that he is met with. My fingertips have become stained by the cheap, evidently not waterproof mascara, that I don each morning in an attempt to distract from the dark rings below my eyes. Black tears trickle now down my cheeks. Just the slightest sense of interest in me as a person has suddenly prompted a uncontrollable release of emotion.

From the age of 18, I have had an affinity for travelling to developing countries. I love the authenticity of culture that is breathed into everyday life of places that remain largely untouched by the influence of the west. Selfishly, I also love the buzz of gratitude that I experience upon each return to Australia; the continuously renewed appreciation for the luck that allows me to enjoy the life that I do.

A few years ago, on a trip to Nepal, I met a woman three years my junior. She had fallen pregnant as a girl at the age of just 13 to a “husband” who soon left her for his other wife. She was grateful to be skilled in speaking English, as it allowed her to manage a small hostel in Pokora, and therefore, have a means of providing food and shelter (albeit, a small dormitory room) for her and her two children.

Dear Mr Minns,

You recently cited that Monday, 3rd August, 2026 was, “the biggest ever recorded winter’s day in history” for Sydney Emergency Departments (ED), with more than 10,000 presentations to hospitals in this city alone. However, instead of considering a sustainable and appropriate response that may reflect the root cause of this issue - the country's rapidly ageing population, the growing prevalence of chronic disease, the exponentially increasing cost-of-living crisis and subsequent inability of families to afford primary health care appointments, the ever-expanding void of general practitioners, the deteriorating mental health crisis, and most importantly, the physically dangerous and psychologically taxing working conditions of hospital workers - you simply advised the public to “avoid hospital” unless their life was in danger.