Richard Crookes's memory of the day his life shattered remains blurry — one moment he was brushing his teeth, the next the entire right side of his body stopped working and his speech became muddled.
He didn't know why his razor clattered to the floor or why he couldn't grasp his phone.
"In the next moment all hell broke loose. I was rushed off somewhere and they injected snake venom into me," he said.
Mr Crookes had experienced a lenticulostriate stroke, a restriction of blood flow to the brain that can be fatal.
He was already in hospital when it happened. It was the day before he was due to be discharged after back surgery in May 2021.
When a nurse came to check on him, the warning symptoms were there — trouble speaking, loss of vision, weak hands.
To Mr Crookes, who spent his life wrangling crocodiles, running a successful fishing charter business and raising kids, a stroke was the last thing on his mind.
What followed was a five-month stay in hospital and a race to regain movement on the right side of his body, to re-learn how to walk and use his hand.
But in the Northern Territory, where access to neurologists and trained physiotherapists are limited, that race was a daily fight and one that Mr Crookes said he was lucky to survive.
"If you can get on a plane, get on a plane to a hospital down south because they've got everything down there: stroke ward, stroke personnel," he said.
"We used to have a saying in the Territory many years ago, 'in pain get on a plane', and we're still saying it today.
"It's sad, but it's true … we are limited."
Mr Crookes said he needed hours of rehabilitation each day, but would only have had access to a handful of minutes of physiotherapy if he had not sought his own.
Even two years later, his recovery journey continues.
Every eight weeks he makes the arduous trip to Adelaide for intense rehabilitation and Botox treatments to minimise the severity of tremors in his hand.
"Overnight, everything you thought you had you don't have any more. Not just for me, but for my wife, family, friends … everything changes," he said.
"I was a charter boat operator here and I can't do that anymore.
"I don't have the strength or control of my hand, and fatigue is the other [challenging] thing as well.
"I can't just go out and go mow the lawn or go fishing or go out to dinner because when the tremors come it gets embarrassing, and family members have to cut your food up for you."
A new tele-stroke service could help ease pressure
Dr Timothy Kleinig is the head of South Australia's sole comprehensive Stroke Centre and for the past few years has been trying to get a virtual stroke service set up at the Royal Darwin Hospital.
Every year, an average of ten people suffering from a stroke are transferred from the Northern Territory to his clinic to receive a thrombectomy, a procedure to remove a blood clot from inside an artery or vein.
"That's 2,500 kilometres people have to travel as an absolute medical emergency to get the clot removed from their brain," he said.
At a basic level, Dr Kleinig said hospitals should have a CT scanner, the ability to assess and see if a someone is eligible for clot-busting medication – which dissolves blood clots and restores flow to the brain — and a fully staffed stroke unit.
As it stands, there is a stroke unit at the Royal Darwin Hospital and CT scanners are available in Gove and Katherine, and Alice Springs is working towards being classified as one of Australia's first stroke capable regional general hospitals, Dr Kleinig said.
But a lack of expert stroke specialists in Darwin means critical clot busting services are not available in Darwin 24/7.
"If you've only got sufficient staff in the unit from 9am-5pm Monday to Friday, then patients who have their strokes at other times will miss out on that treatment," Dr Kleinig said.
He said his team is about to get a tele-stroke service — already provided at Alice Springs — up and running at the Royal Darwin Hospital overnight and on weekends.
"That has a high-quality camera that can zoom in on the patient and pan, then that can allow us to have proper secure encrypted communication with the patient and assessment of them as if we're in the room when we're not actually there," he said.
NT Chief Minister and Health Minister Natasha Fyles said the 2023 budget will allocate $2 billion to health services throughout the Territory, and said work was being done to improve the quality of stroke rehabilitation services at the Royal Darwin and Palmerston Hospitals.
"Outpatient rehabilitation services based at Palmerston Regional Hospital [provide] a multidisciplinary allied health therapy program, which includes physiotherapy, including neuro-physiotherapy, occupational therapy, speech pathology, social work and dietitian services," she said.
"Community Allied Health Services will also accept referrals for people who can't access funded allied health or assistive technology services via NDIS and MyAgedCare for example."
Dr Kleinig said that while the risk factors of strokes — smoking, high blood pressure and high cholesterol – are being addressed better than ever, rates of the disease are increasing as Australia's population ages.
Since his stroke, Richard Crookes has dedicated his life to bringing attention to the growing health crisis he said not nearly enough people know about.
He said 16 of his friends and acquaintances have been struck by a stroke in the last five months. Two didn't survive.
He is worried the government is not acting urgently.
"Are we going to have to wait for a politician or someone like that to have a stroke before something gets changed?".
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