FROM the first inhalation of air awakening a newborn, to watching as the last breath is exhaled from a soul departing its body - Dr David Rolla Cooke knows one thing for certain, life is precious.
Dr Cooke is the recipient of a 2020 Medal of the Order of Australia (OAM) for service to medicine and aviation.
It is a combination of passions that has defined the 78-year-old doctor's career even before he had the realisation that would be his path in life.
Dr Cooke comes from a line of aviators. His grandfather was a pilot in World War I and his father, who died one month before he was born in 1941, a fighter pilot in World War II.
While he never knew his father, Dr Cooke says for as long as he could remember, his head was in the clouds and dreams of flying at the forefront of his ambitions.
"I always said as a kid I was going to be a flying doctor, even before I knew what that meant," Dr Cooke said.
"Flying is in the blood."
He studied medicine at the University of Sydney, graduating in 1966 and heading straight out to the Northern Territory and North Queensland to work with the Royal Flying Doctors in remote communities.
People in the outback appreciate what you do. They are comforted in the fact there is someone who will come to them if they are in trouble. I put on 15 kilos the first year I was out there. Everyone thanks you with cake.Dr David Rolla Cooke
"I loved it. They weren't supposed to let the doctors fly - but they let me do it a bit," he said with a wry smile.
"I worked in Mt Isa in North Queensland for four years covering an area the size of Texas by myself.
"In the early 70s, there were no blood tests, cardiographs or x-rays when you were 300 miles from the nearest town. You had to make decisions on your own.
"I had a pilot and a nurse to throw ideas off - that was it!
"I was operating one evening when the town lights went out. I finished that appendectomy by torch light.
"People in the outback appreciate what you do. They are comforted in the fact there is someone who will come to them if they are in trouble.
"I put on 15 kilos the first year I was out there. Everyone thanks you with cake."
And just to make sure he was prepared for any situation, Dr Cooke did two practice parachute jumps from a plane fully kitted out with his medical gear.
"I wanted to know I could do that, you know, just in case," he said.
Dr Cooke has been a GP at the Lighthouse Medical Centre in Port Macquarie since 1998 after relocating from Gunnedah.
He flies his own aircraft to outlying areas including South West Rocks, to provide general practitioner services and has been an Air Crew Medical Examiner for 50 years.
"I've been told I'm the oldest doctor in town. People ask me why I haven't retired yet. Why would I give it up?
"I can sit in my surgery at Lighthouse Beach, watch the whales go by and talk to people all day."
Until two years ago, Dr Cooke taught final year medical students.
"I reminded them they can have fun being a doctor," he said.
"It's all about connecting with human beings. You need to listen to them and hear what they're really trying to tell you. And you need to love them.
"I always said a man will tell what's really wrong with him as he's getting up to leave.
"That's why I didn't specialise. I started studying as a neurosurgeon in 1967, but it was the people I really wanted to be with.
"You can learn about disease - you either fix it or refer someone on. It's the people who make it different."
Dr Cooke has two sons he taught to fly and is proud of that achievement. He now has his sights set on any one of his five grand-daughters.
Both sons perform aero-medical evacuations around the world. Dr Cooke co-founded, with his son, Avcair Pty Ltd and has been an occasional pilot with his sons since 2001.
He is the former vice-president and member of the Aircraft Owners and Pilots Association, has written for numerous aviation magazines and was a member of the Advisory Board for CASA from the late 1990s to the early 2000s.
His wife Liz, a former teacher he dearly loves, has summed him up in the title of a book she is writing - he's a pilot that practices medicine.
Dr Cooke owns his own 1950s antique aircraft and flies every week with his beloved Bobcats formation group.
"There's five of us. We fly in formation every Saturday morning over Port Macquarie and then retire to a local cafe where we spend the next two hours talking about how good we all were up there," he chuckled.
I lay awake at night sometimes thinking about them - how am I going to make them better. You've got to let them know you care.Dr David Rolla Cooke
So what does he think of his new honorary achievement?
"When I heard, I shed a tear that somebody even thought to nominate me," Dr Cooke said.
"I told my wife Liz that it's half hers. We've been married for 31 years and much of my ability to be a doctor is because of her.
"You tend to grow old with your patients. If I lose a patient, I am still devastated.
"Liz will sit quietly with me until I feel better."
It's all about making sick people better - that's doctoring.
But there's so much more of a reward when there's a connection, he says.
"I lay awake at night sometimes thinking about them - how am I going to make them better," he said.
"You've got to let them know you care.
"I've delivered babies and they always seem to arrive in the middle of the night and I grumble about it. But when you pull this crumpled, wizened up grey body out and it takes that big first breath in and cries - that's really special.
"You look up at dad and he has a grin from ear to ear, and mum has a look of relief on her face - that's what it's all about.
"And then you see the other end of life when they die. That's when I try and spend as much time as I can with the relatives.
"You might have a woman who has lost her husband of 55 years. Everyone is there for the funeral but they all eventually go home and back to their own lives and they are left with this emptiness no-one prepares them for.
"I look at the body of someone who has died and I think to myself - they've loved and they've laughed ... and now they're gone. It's all left in the memories.
"You never get over losing someone. You just have to find space for it.
"I didn't know my dad. He died a month before I was born. I never knew him, but I never got over it."
Dr David Rolla Cooke is one of four people in Port Macquarie-Hastings who are the recipients of Queen's Birthday Honours.
Eric Claussen has received a meritorious public service honour for his lifetime work with the National Parks and Wildlife Service.