Last days in Port

Our last two days in Port were uneventful. The weather was fabulous, which unfortunately meant I spent a good deal of time hiding from it. On the plus side, this has given me ample time to finish my book. After my disappointment with Richard Dawkins’ argument or lack thereof, I thought I would try Christopher Hitchens.

‘God is not Great’ is an amusing read- 350 pages of argument can essentially be condensed to 4 objections to religious faith: ‘that it wholly misrepresents the origins of man and the cosmos; that because of this original error it manages to combine the maximum of servility with the maximum of solipsism; that it is both the result and the cause of dangerous sexual repression; and that it is ultimately grounded on wish-thinking.’

He does have some good arguments against religion, but these are somewhat overshadowed by his pompous tone. I would be surprised if Hitchens liked anything in the world, religious or otherwise. He is flawed in the same way Dawkins is flawed: by suggesting that people of faith cannot and do not acknowledge the flaws in religious belief and behaviour. He assumes that all good acts stem from humanism rather than religion, but that all bad acts are a result of religious belief. I certainly enjoyed reading his work, but I don’t think it has swayed me from my Christian agnosticism yet.

Book reviews aside, we did have some great meals in Port. On our last night, we went to Nautilus, which is an outside dining restaurant. I began my night with a 5 spice pineapple daiquari, followed by a white pepper lamb starter and followed by ‘A Taste of the Sea’: seared scallops in Japanese pepper with lotus root, plum aioli & wakame; char grilled bay bug tail al vino bianco; pan seared tiger prawns with garlic & brandy cream; grilled Reef fish with mud crab butter & cucumber noodles. By far the biggest surprise of the night, however, was Graham, who ate two of his least favourite foods- a duck starter and an entire coral trout for his main.

My new love is the Cassowary

Wednesday saw us embark on the final ‘activity day’ of this trip, the Daintree Rainforest. We were picked up by a huge 4WD vehicle that looked like it might be more use in active combat than in a holiday resort, but it did prove useful for the roads of Northern Queensland.

Our guide, Kelvin, was brilliant at explaining features of the landscape to us en route to the Daintree River. He also explained something of his views on politicians making decisions about crocodile management from their offices in Canberra, which was interesting.

At the Daintree River, we were again given morning tea before boarding a river cruise to hunt for crocs and snakes. Our first croc sighting was a tiny baby sunbathing on a log. He/she shared my birthday, so I felt we had a mutual understanding already! We then saw a female swimming in the middle of the river, which was unusual as the weather was not really cold enough for a croc to want to cool down. Nothing quite compared to the sheer size of ‘Big Al’ who at 5.5m long was quite content to lie on a bank while hoards of tourists took photos of him!

After crossing the river, we rejoined the 4WD and wound our way through the rainforest of the Alexandra Range to the Alexandra lookout, which gives great views of the Daintree River estuary and out to the sea. Unfortunately, it was raining quite a bit, so the photos don’t do the view justice. We continued on our way to the Daintree Discovery Centre, which is a great place to visit – it was amazing to stand underneath the canopy of the oldest tropical rainforest in the world! The aerial walkway gives a great view of all the various climbers and ferns etc. They only had to cut down two ferns to make the walkway- it weaves its way through the trees- apparently it was constructed using helicopters and aerial imaging.

Lunch was in a canopy and was fabulous- a BBQ with steak, seabass and sausage, with mixed salads and fruit. And wine. It was bizarre because we were sitting in the middle of a torrential downpour, but it was still perfectly warm.

After lunch, we continued our journey north to Cape Tribulation, so named after Capt. Cook ran adrift on the Barrier Reef near there. The beach is stunning, although you can’t swim because of the crocs. There is no tarmaced road north of Cape Tribulation, which is a bit disconcerting! It is famous for being the point where rainforest and beach meet. We walked to the Kulki lookout in order to get a better view of the reef, beach and rainforest, but unfortunately the weather wasn’t playing ball!

On our way back to the Daintree River, we stopped at the Daintree Icecream Company. These people specialize in tropical fruit ice-cream. I had one of their ice-cream taster selections: yellow capote (weird, and not at all as I expected it to taste), whattleseed (like a cappuccino), black sapote (like chocolate pudding) and pineapple (bliss on a spoon). After indulging, we caught the Daintree cable ferry across the river (there are no bridges) and arrived at the south side.

Our final stop of the day was Mossman Gorge. Here, the rainforest borders the Mossman river. I was disappointed we only had half an hour- I would have loved to go swimming here. It was oddly reminiscent of the mountain rivers in Switzerland. They are rebuilding the walkway and trying to involve the local aboriginal community in this project. I would be interested to revisit when it is all finished.

A fabulous day.

Laura attempts to keep a straight face…

As part of the deal with our hotel, we were given a free dual treatment at the hotel spa. Those of you who know me well will know that I enjoy a good massage, but am not particularly beauty-minded. Graham, on the other hand, had no interest in spas or massages, so it was with great effort that I finally managed to bully him to the spa for our treatments.

All was going well until they recommended that we needed to be naked for this experience. After sharing identical looks of horror, we eventually acquiesced and hid under the plethora of towels. We were then told that we would be taken on a spiritual journey from head to toe to make sure all our energies were running in the right direction. Now, I may not have been paying attention, but I don’t remember being told about energy channels running through my body at med school. G looked frankly horrified and I promised myself I would nod and look serious and definitely not for any reason suggest that my energy channels did not exist.

The treatment was actually fabulous, not least because I fell asleep. I’m not sure I buy all the ‘energy channels’ and aromatherapy stuff that goes with it, but I certainly enjoyed myself. The rest of the day disappeared in a haze, but I think we wandered around Port and ordered curry for dinner.

Finding Nemo

Today I have visited a wonder of the world. And found Nemo! We went with Poseidon Tours and visited three different dive sites. The Agincourt Ribbon reefs are on the edge of the Outer Barrier Reef and take an hour and a half to get to by boat. Normally sea-sick, I maximized on the overpriced sea-sickness pills the boat was offering, but they worked, so I was hardly going to complain.

The day began in the glorious sunshine of Port Douglas Harbour, where we were asked to take our shoes off. I had no problem with this, although did wonder what was going to happen to them… there were quite a few pair of blue flip-flops that day! On the boat, we were offered ‘morning tea’ which was great, although the terminology still interests me- is there a different afternoon tea? The calmness of Port Douglas Harbour was a little deceptive, as once we cleared the headland, the winds picked up and I was very grateful for my travel pills.

We were given a tute into how to snorkel…I hadn’t realized it was particularly complicated, but as I hadn’t snorkeled before, the guide wanted me to used a foam cylinder as a buoyancy aide. Using flippers was something new and different, and it took me a while to get my head around the concept of not doing the breaststroke! And not breathing through my nose when under water!

The Agincourt Ribbon Reefs are long and narrow and are flushed out at every tide by water welling up from the Coral Sea Trench, which apparently provides an ideal environment for coral. The reef is greyer than anticipated, and the water uninvitingly cold for the first five minutes!

The first dive site was probably my favourite, just because it was my first time of seeing an underwater environment like that. I lost all concept of time and space, just floating with my weird buoyancy aid. I was thrilled to see angel fish and clams and sharks and so many weird and wonderful forms of coral. I ended up drifting off, so was chased down by one of the guides who pointed out just how far I had gone from the boat….oops.

The second dive site was fun because it was more spread out, and the tide had gone out, so I could get a really good impression of the layout of the reef. Again the view from the boat was oddly underwhelming, but once under the surface I was again enthralled. The water was definitely colder this time and I think I glared at the underwater photographer because he wanted me to stay still for too long. I didn’t buy the photo in the end anyway!

The lunch provided on the boat was good- cold meats and salads etc, and all-in-all the service provided by the crew was outstanding. We returned to Port via the Low Isles, where apparently they have turtles, but I think that might have to be left for another trip!

Laura goes from being the palest thing in Port Douglas to the reddest in one hour.

Port Douglas is not at all as I expected. It is smaller and somehow more touristy than anticipated. Our apartment is very nice-set in palm trees and surrounded by pools. Even in the bleak mid-winter, Port Douglas is 30°C, making me very grateful for air conditioning!

We spent our first day exploring the Sunday markets in Port. The market stalls are lovely. A condition of having a stall is that the produce has to be sourced locally and run by local people. It was a highly colourful affair- lots of fresh fruit and locally made clothes and jeweler. Afterwards, we wandered to the four mile beach, which actually isn’t four miles long. It is gloriously sandy with a good surf. I realized that jumping through the waves is fun whether you are five or fifty! Unfortunately, sunburn hurts just as much, and I was suitably annoyed that I had managed to burn wearing factor 30 suncream and only being exposed to the sun for an hour.

Dinner that night was at Fins, a restaurant just up the road from our hotel. I had the seafood linguine, which included ‘bugs’. Bugs are not rainforest creatures, but are a cross between a langoustine and a crayfish. They are yummy! G had the vegetarian laksa with chilli jam, which was also very good.

Saying Goodbye

Friday was a mixed day for me. It began with a lovely breakfast, followed by the most mammoth of ward rounds since I arrived! I will really miss the ICU and the people I have worked with. So much so that I will be back…might see if Newcastle will arrange an international transfer for me. Here’s hoping.

After loitering around the hospital for far longer than was totally warranted, I finally made it back to Coogee. G and I then wandered along the Eastern Costal Walk to Bronte and back. Dinner was at the Spanish Fly, which wins the award for most visited restaurant in Sydney on this visit. We had zucchini flowers, pork belly, halloumi, a dip plate and bread.

It seemed really strange to pack up my room- a bit like leaving at the end of the uni term, but worse because I have enjoyed this placement more than anything I have done before.

Manly, physiology and drinks

Thursday morning saw us catch the early ferry to Manly. This is a beautiful ferry journey and gives you stunning views of the harbour and the various bays around the CBD. Manly is famous for its beach, and we were lucky to be there on such a glorious day. We walked along the promenade, but didn’t have time to do the Manly to Spit walk. We did make it to Ocean World, however, which is quite possibly the biggest disappointment of my time in Sydney! It could have been quite good if the glass had been clean and there had been slightly more to see, but as it was even with taking my time I had covered the entire aquarium in 20 minutes. I had to be consoled with chocolate instead. We did manage to find Ugg boots, which should make me very popular with at least one of my sisters! I’m still struggling to understand the allure, but that is probably because I am old before my time and can’t bear people shuffling in their footwear!

As some of you know, Thursday afternoon is physiology viva practice, which I have been going to for the last five weeks. This week my topic was pressure-volume loops of the left ventricle, which I vaguely remembered from medical school. I’ve really improved my understanding of physiology through these sessions, even if sometimes I can’t quite articulate as clearly as I would like. Even better was going out for drinks with everyone afterwards. I have had the best time working in the ICU and it was lovely to know I have made some great friends in the process.

Non so pui cosa son...

Wednesday was a glorious day- beautiful blue sky, warm, stunning… Then we got on the bus. I had just finished explaining how much I liked the Sydney public transport system when our bus lady drove into an oncoming car at the roundabout. Not content with having produced language from me that would truly shock my mother, she then reversed into the traffic behind her. And then giggled. Having decided at this point that being alive was better than sticking to my schedule, we got off the bus and went for breakfast at the Sweet Spot, which, as its name suggests, is a good place for cake and strudel. Having given the buses an hour to return to normal, we finally made it into the city.

We were booked in for a behind the scenes tour of the Opera House at 10:30, so spent the time before the tour pottering in the Botanical Gardens. I had been before, but was still struck by how stunning the gardens are, and how close they are to the CBD. The Opera Tour was pretty good- I was a bit put off by the need to wear headsets, but other than that it was great to see behind the scenes. It was interesting seeing the original design that won the Opera House competition and to appreciate just how over-budget and delayed the project was. I still can’t quite believe that that same person who is responsible for the Opera House is the same person who designed Elvet Bridge. He must have been having an ‘off-day’. We were lucky enough to watch part of the Sydney Symphony Orchestra’s rehearsal, which was truly awesome. The seats in the Opera House were designed by a surgeon to be as comfortable as possible, and they really are.

After a wander around The Rocks, we returned home to shower before dinner and the Opera. Dinner was at Aria, a restaurant I had been to, and loved, before. The pre-theatre menu was good and the views were spectacular, but it all felt very rushed. We very nearly didn’t make it to the Opera House on time, which is bizarre considering they are only 300m apart. The Opera was stunning. I love Marriage anyway, but the performance was first-class. Suzanna and the Countess in particular were brilliant, and Figaro had the most beautiful voice. If this medicine thing doesn’t work out, I think I will spend my time reviewing operas. But only decent ones! I’m beginning to appreciate the advantage of knowing an opera as a singer- I really wished Sarah was there to appreciate the cat-fight between Marcellina and Suzanna with me!

And what became of the monkey, monkey, monkey, monkey...

Well, having spent Monday loitering around a very sunny hospital, I thought I would have no problem at all convincing G of just how lovely Sydney is. Then he got off the plane in a thunderstorm… Thank you Australia!

Things improved on the Tuesday, and despite him being very jet-lagged, and me being very sleepy, we finally made it for breakfast in the city followed by a boat ride to the zoo.

The zoo was stunning, not least because it gave exceptional views of the harbour. I don’t think you could find a spot anywhere else where you could see giraffes and the Harbour Bridge and the Opera House. The food, however, was vile- the second only example of rubbish food I have had since being here.

For dinner, however, we went to Mamak, which is a Malaysian restaurant, which was lovely, although I am still not entirely sure I know what I had to eat. The queues to get in were massive, so it is obviously very popular with the locals.

Graham assures me that nobody will understand the title of this entry… I am putting this down to the fact that he was not a Rainbow, Brownie or Guide, but shall explain anyway. The title is a line from the song ‘Animal Fair’ which you should all learn, even if only to get through very boring car journeys.

Leaving my comfort zone

You could argue that this whole trip has been an exercise in leaving my comfort zone, which is true. My slightly neurotic need to plan has been tempered by elements of the trip that have been totally beyond my control, such as the weather.

From a medical point of view, this week has been fabulous for procedures, but also an exercise in leaving my comfort zone and trying not to show how very nervous I was! I have put in an arterial line, which is a bit like putting a venous drip in a patient but is in the artery instead to allow regular blood gases to be taken and a beat-by-beat blood pressure recording to be made. I have also intubated a five year old and a three year old (with a lot of help). I can definitely see myself doing this sort of practical thing in the future. I have also done another viva practice this week, on lung compliance, which had been good for improving, at least in theory, my ability to communicate physiological principals.

I have been joined in ICU by two medical students from UNSW, which is good, although they are both cramming for finals, while I have at least 10 months to go so can’t really motivate myself in a similar way. We are, however, going out for tapas and sangria tomorrow, which should be fabulous

Abstraction and Aroma

Saturday was a lovely day, which began with a gym session at 8 followed by brunch with coffee. I then took the bus into the city. I first went for a wander through Hyde Park to the Archibald Fountain before arriving at St Mary’s Catholic Cathedral. The cathedral was oddly reminiscent of Durham, although very modern by comparison. It was really strange to be in a religious building where the history only began in the 1800s. I did not stay for Mass, but would like to on another occasion when time permits.

I made my way through the Botanical Gardens to the Art Gallery of New South Wales. The building itself is stunning. The current building was built in stages, and has a beautiful aspect out over the Botanical Gardens and the waterfront. It has free entry and lots of seating areas, so it is a good place to sit and read. I enjoyed the Aboriginal art gallery and the Degas statues. I even managed to find a painting of Diogenes in his barrel just for Sarah! The real reason I went, however, was to relive my year nine art days with the Abstraction exhibition, which involved quite a bit of Cubism. It was a collection of 150 paintings from around the world by Monet, Cezanne, Matisse, Picasso etc. It was a good exhibition, although very busy, so it was a bit difficult to really appreciate the art. After the exhibition, I had afternoon tea in tea museum café, with many pitying looks from the waitresses who didn’t seem to understand why I was so content to eat my scones and drink my tea alone.

After the gallery, I went on a shopping trip. The primary reason for this was that I need a scrapbook to put all my tickets and programs into, as I have a rather spectacular collection of tickets growing in my bedroom. Sydney, however seems bereft of such an item. I therefore gave up and instead searched for the second item on my list- mascara. This item proved far easier to find than the first, although prices in Australia are much higher. After an incredibly busy bus journey home, I taught my flatmate Matt how to make Delia’s Minestrone soup and had an early night.

On Sunday, Matt and I went to the Aroma coffee festival at The Rocks. I have never tasted such an amazing cappuccino, nor seen so many people queuing for coffees. There was a really lovely atmosphere, with live street entertainment and a bit of a party feel. The weather could have been slightly more festival like, but it was still a brilliant day.

This week in ICU should be very practical. I am looking forward to some hands-on work. I can’t believe how quickly the time has gone- I’m really going to miss it when I leave. I am looking forward to G being here and showing him why I think Sydney is amazing!

Thank God they didn't find the BeeGees...

This week I have learnt a very important lesson. It is not sensible to increase both the speed and incline on a treadmill and then become so distracted by your success that your ipod goes flying across the room never to be seen again. My initial hunt was unsuccessful and I was reluctant to ask for help from the gym guys on the grounds that the track that was playing when I dropped my ipod was ‘Staying Alive’ by the BeeGees. However, a full week later it has still not turned up which means I have been bereft of music for an entire week!

Life on ICU has been less depressing this week. It has been good for learning procedures. On Friday, I did a lumbar puncture, which was scary but really exciting. The patients have been an interesting lot this week. A couple have been readmitted either post-op or have bounced back from the ward. I am becoming more aware of the differences between the Australian health system and the British health system. For a start, there are far more ICU beds in Oz, so the admission guidelines are less stringent. In a way it is nice when the patients stay for a while because you get to know them and their families.

I also have been to see Inception, which is a brilliant film, but is one of those films that you need to see twice to full appreciate just how clever it is. I saw it with Matt, my flatmate, at Bondi Junction, where we also had dinner in the food court. Duck Laksa is gorgeous!

Lost: Blonde girl in search of a tower...

Flying to Melbourne was relatively straightforward. Apparently for domestic flights no-one cares about seeing your passport or how much fluid you take on board. The flight was 1 hour 15 mins, and they gave me drinks and a quiche on the aeroplane. Exciting!!

The commute from Melbourne airport to the city centre was not at all difficult- I went on the Skybus and they transferred me to the hostel. I then discovered that I was staying at a building site. After accidentally trespassing on the building site whilst trying to enter the building, I finally made it to the front desk. The hostel itself is not bad-when they have finished the building work it will be fabulous. I met one of my roommates, Tom, and went for a walk around the river with him. The Melbourne run was happening on the Sunday, so we had to avoid the various 10km signs. Melbourne is a beautiful city, very cosmopolitan and almost European. There are lots of little side streets with cafes spilling out into the street, which were great for coffees and breakfast.

I met Kat in Federation Square and we wandered into China Town for dinner. Our plan had been to follow the locals to find a good eatery, but the place they went to was packed so we chose a slightly less busy eatery for goyza and curry. We then met up with the people Kat had been on tour with and went to the cinema to see Toy Story 3 in 3D, which was great although did make me feel a little travel sick.

Saturday started with coffee and croissant in Federation Square while watching the sunrise, before a walk through the Royal Botannical Gardens. It was a lovely way to have a proper girly catch up before walking to the Victoria Markets. Here you could buy virtually anything you could want and quite a lot that you didn’t want. As with all Aussie shopping centres, there was a fabulous food court where we had souvlaki and Turkish bread. Turning back on ourselves, we went to the Tim Burton Exhibition in the Museum for Moving Arts. It was well worth a visit- I had no idea just how many films he had been involved with. In the afternoon, Kat went to a rugby match. As I still don’t really understand the rules of rugby league, I offered to be the scout and to find out how much a trip up the Eureka Tower would cost. This turned out to be slightly more difficult than anticipated, as the tower I had been shown was not the tower I needed to be at. Thus I spent a considerable amount of time standing in front of glass doors hoping they would let me in, before giving up and having a coffee and a cupcake.

Melbourne is famous for its shopping, and I did enjoy mooching around and looking at things that were well beyond my budget. I did balk at the idea of going into the Gucci shop in my hostel kit of jeans and a t-shirt…I thought it would be a bit too obvious that I had no intention of buying anything.

After the rugby, Kat and I met for dinner in a tapas bar that was recommended in the Rough Guide. Even at the relatively early time of 5:30pm, it was heaving, so we were lucky to get a table. The food was excellent- scallops, sea trout, croquettes, zucchini fries, oysters… The one down side was the cost of the alcohol, but we decided it was well worth the expense. We had managed to find cheap tickets to see Calendar Girls at the theatre, so enjoyed a great giggly night eating ice cream and watching slightly senior women take their clothes off.

Sunday began with breakfast in a gorgeous café tucked into one of the side streets. I had French toast with strawberries, while Kat had the Eggs Benedict. Even at 8:30am, the place was busy, so we knew we had found somewhere good. We then went up the Eureka Tower (88 floors in 30s) to get a true panorama of Melbourne. This view was particularly good because we could see people starting the Marathon down by the river. No, we weren’t tempted to join them!

My weekend in Melbourne went too quickly. I think I needed a couple of days extra to really relax into the city. It is well worth a visit for anyone who is fairly close by. Particular thanks to Kat who arranged her tour around me- it was lovely to see her.

The week of dinners

This week has been fairly depressing on ICU. People are sick and getting sicker, and I think I must have been shielded from this in my previous weeks because there was always someone on the ward who was getting better. However, in the words of Frank Sinatra, ‘That’s life’, so I had better get over it. I have put in quite a few NG tubes and cannulae and assisted in putting in a PICC line, so my practical skills are improving.

I have been out for dinner with the medical staff for a Fellow’s leaving do. This was my first thai meal, and while I don’t have a clue what I was eating, it did taste good! They also had amazing cocktails- the Naked Native was particularly good.

On Wednesday night I was taken out to Aria, a restaurant with amazing view of the Harbour Bridge and the Opera House. We had the degustation menu- seven courses of absolutely amazing food with equally great company. I think my favourite course was the goose; cured goose breast with chicken liver parfait, poached rhubarb, black pepper and gingerbread. Amazing.

This weekend, I am meeting Kat in Melbourne for the weekend. I fly out on Friday and come back Sunday lunch time.

I am now Dutch

Friday night was epic. It began with duck pansang in China town, which was amazing and not quite as hot as the thai green curry I had last time with my Dutch friends. Then we bought Roosters scarves and went to the rugby. Apart from the fact that I don’t really understand the rules of rubgy league, I really enjoyed the game. And we won!! After the game, I went back to the city with my friends for a night at the youth hostel bar. We got some odd looks in our Roosters garb and Dutch dancing is a revelation!

Saturday was a fairly quiet day. In the afternoon, I met Veronique and Michele in Bondi Junction shopping centre. I managed to find a few of the odds and ends I needed and then we went to the food court. Unable to make our minds up as to which of the many cuisines to go for, we decided upon seven courses between us all! Very full, we went to the cinema to watch ‘Grown Ups’, before heading home for an early night.

On Sunday, the Dutch trio (Michele, Veronique and myself) took the ferry to Manly. The views should have been stunning, but the weather didn’t quite want to play ball! Manly is a lovely little town with an amazing beach, where I will be taking a surfing lesson at some point. We then walked through the national park to Spit. It is a 10km walk, with quite a few stairs, although not as many as the Blue Mountains. It was another fabulous day.

A week of many parts

This week was my week on paediatric intensive care, and I was determined to make a good impression. This lasted all of forty minutes into the ward round, when I collapsed and a code blue was called. I spent a sizable chunk of time on a paediatric trolley in the ED before going home for the day. For the rest of my time on paeds, I was greeted with ‘Oh, you’re THAT medical student’. Fabulous!

Fainting spells aside, I have really enjoyed paeds. I have seen a lot of the conditions that we read about in textbooks- congenital heart defects, inborn errors of metabolism etc. There are a good mix of patients, those who are fairly fit and well who just come in for one night after major surgery and those who are born with suck complex medical problems that they have been in ICU their entire lives. It has certainly raised some interesting ethical issues, and I reminded me why I love this specialty.

And now we shall take the scenic route

Sunday morning involved a leisurely bus journey into the City to meet up with some friends and to go to the fish market. We started in Darling Harbour, which has been used as FIFA central, with big TV screens projecting the live matches. It was gloriously sunny, so we wandered around the harbour and crossed the footbridge, before popping into a café for coffee.

Our walk to the fish market was supposed to take 10 minutes, however we opted for the scenic route, which took considerably longer as it involved walking along the headland. It was well worth it! Even though it was nearing the close of play, the market was full of fresh fish, and restaurants where you could watch it being cooked for you. We tried oysters and then shared seafood platters, which were supposed to serve two but easily served four. We had grilled octopus, scallops, oysters with chorizo, battered cod… it was amazing! We then ordered salmon and tuna sashimi, which was a little strange, particularly when combined with a wasabi-eating contest.

We ended our day by buying a bottle of wine and sitting by the harbour watching the sunset. It gets dark fairly early here, but Australia is not limited by Sunday trading hours, so Veronique and I went shopping so I could buy a coat- my English stoicism has eventually given in to the 3 degree mornings! We also had pedicures, which are really popular over here and available in every shopping centre I have been in.

We agreed to go and watch a Rugby League game on Friday, which should be fun after my week of paediatric ICU. I don't think certain people (Vikki) will forgive me if I come back a League fan!

And then I ate a 1000-year-old egg

Week three in ICU has been a real mixture. Some of the really sick patients are getting better, which is fabulous. However, there are a couple of really sad cases where metastatic cancer and massive cerebral bleeds have put up a better fight than the combined forces of the patients and medics. I’m learning loads… the teaching sessions of the week have been: management of severe brain injury, non-invasive ventilation, airway management, renal physiology and a journal review about the use of certain antipsychotics for delirium in ICU. I’ve also felt surgical emphysema and stuck my finger through someone’s chest cavity to feel his lung (we were putting a chest drain in, I hadn’t just stabbed them!). I’ve also sat in on a family conference, where the consultant had to break bad news. This was interesting to see as it was done with great sensitivity and care. We also did a couple of simulated senarios. My role in each was ‘medical student’, which was great as I just did as I was told and did CPR and put fake cannulae in. In both cases the ‘patient’ survived, although this may have been due more to luck than anything else in the first senario, as none of us had realized that the oxygen was not turned on!


In addition, one of the Residents is Chinese and brought in a 1000 year old egg for us to try. I will now quote Wikipedia to give you an idea of what this entails:

Century egg, also known as preserved egg, hundred-year egg, thousand-year egg, thousand-year-old egg, and millennium egg (or Pidan in Mandarin), is a Chinese cuisine ingredient made by preserving duck, chicken or quail eggs in a mixture of clay, ash, salt, lime, and rice hulls for several weeks to several months, depending on the method of processing. Through the process, the yolk becomes a dark green, cream-like substance with a strong odor of sulphur and ammonia, while the white becomes a dark brown, transparent jelly with little flavor. The transforming agent in the century egg is its alkaline material, which gradually raises the pH of the egg to around 9, 12, or more.[1] This chemical process breaks down some of the complex, flavorless proteins and fats, which produces a variety of smaller flavorful compounds. Some eggs have patterns near the surface of the egg white that are likened to pine branches.


I definitely will not be trying one again- the aftertaste of mouldy egg will stay with me for a long time!


Thursday night was out with the girls for amazing tapas and Twilight. The tapas restaurant was fabulous- we has scallops and octopus and meatballs and several other things I can’t remember anymore! And sangria, which was another first for me. The cinema was lovely, a bit like Zefferelis in Ambleside. You can take a glass of wine in with you, which is very civilised.


Friday night was dinner in China town before the Dutch game. We ate in the food court, where there must have been at least a thousand different meals from various different outlets. Not good for someone as indecisive as me!! My seafood Thai curry was amazing, if hot enough to make me weep.


I shall write again soon, and will eventually get round to writing some postcards.

We're going on a koala hunt

On Friday, Hannah (Brit), Veronique (Dutch), Koen (Dutch) and Michel (Dutch) and I headed to the Blue Mountains in a little Hyundai Getz. The Blue Mountains lie 120km west of Sydney, although it took us some time to get there due to Friday night traffic.

We were staying at the YHA in Katoomba, one of the towns in the Blue Mountains. The hostel was clean and comfortable, and full of a variety of other travelers. On the first night I had kangaroo steak, which is best enjoyed medium-rare and tastes like a cross between venison and beef. The mountains are blue because of the eucalyptus oil evaporating from the trees, so we were on a hunt for a koala as this seemed like prime koala territory.

On Saturday we were blessed with fairly good weather and decided to walk through the rainforest to Echo Point and the Three Sisters. As you can see, the Three Sister are a rock formation of three outcrops, supposedly named for three sisters who were turned to stone by a witchdoctor to prevent them marrying men from a different tribe. We descended via the Giant’s staircase, a steep and slightly nerve-wracking experience for those of us who do not like heights. We then continued our trek to the Scenic Railway, which runs at 50 degrees, and was originally used to haul coal up the mountain, but now transports tourist up to the Scenic World at the top. We walked back along Prince Henry’s Walk to Echo Point, where we found an amazing chocolate shop. I can thoroughly recommend the macadamia cheesecake. No koalas.

On Sunday, we drove to the Jenolan caves, which are 400 million years old. They are extensive and you can choose a number of tours through the limestone. We went on a tour of the Lucas caves, named after an ex Prime Minister of Australia. There were some fabulous stalactites and stalagmites and columns, although our guide was on his first expedition, so the commentary was a little staged. Still no koalas


The drive back to Sydney was interrupted by the arrival of 20 kangaroos, which really do move very quickly, and a stop at McDonalds (yes, they do exist everywhere). I arrived back having had a wonderful weekend, even if my legs still haven’t forgiven me for making them walk up thousands of stairs! I’m a bit disappointed that we didn’t see a koala…maybe next time.

Bad things happen in threes, or fours in the case of AAA rupture

My second week has confirmed one thing: bad things happen in fours. I have found myself shocked by the shear number of patients who are in the ICU with ruptured abdominal aortic aneurysms. For those non-medics amongst you, ruptured aortas anywhere are a bad thing- you bleed out and make a mess! I’d never seen one that had ruptured before this week; my only previous experience had been planned AAA repairs, where the aneurysm had not yet ruptured. Each of the patients had a different presentation, which was strange.


I was with a different consultant this week, who is the head of the departments, which was a bit frightening, particularly when he asked me to present on ventilator-associated pneumonia. I think I was fairly lucky in so much as his cerebrum was working at a level so beyond mine that I don’t think he was expecting much!


This week has been quiet for practical procedures, but good for meeting other students on elective. I have been to steak night with both British and Dutch students, and we went to the Blue Mountains over the weekend. More to follow about that later…

Modern Art, Botanical Gardens, Bruch and Beethoven

Saturday proved to be an eventful day. After waking up disgustingly early to watch a pathetically poor football game, I decided that I needed more sleep before I was to do anything. I headed into the city centre to collect my opera ticket and book tickets for G and myself to see Marriage of Figaro in August. It was a stunning day, so I headed into the Botanical Gardens for a wander. The gardens are stunning- even for non-botanists like myself. It was bizarre to be surrounded by sleeping bats and cockatoos while in a garden not so dissimilar from the Botanical Gardens in Sheffield. There is a tropical centre in the gardens full of orchids and Venus flytraps, which again was stunning. I then meandered around Circular Quay to the Museum of Modern Art. I thought that if anything could persuade me to enjoy modern art more, then the gallery in Sydney would. Alas, I still could not persuade myself, although they do a very tasty lunch! The concert in the Opera House began with a talk about the four composers before the performance. It was a well-informed talk, although I was surprised by how few members of the audience were tourists. The concert itself was fabulous- the acoustic, the standard of the ensemble, the soloist. They played Haydn’s Symphony No. 45 in F sharp minor (leaving only two violinists on stage at the end), Bruch’s Violin Concerto No.1 in G minor, Schoenberg’s Chamber Symphony No. 1 in E and Beethoven’s Symphony No. 8 in F. It was a wonderful concert, and the building truly is fabulous. Sunday was a quiet day. I took the bus to Bondi Junction to try and find some jogging trousers. Bondi Junction is a great shopping centre, although the prices in most of the designer shops were far beyond me! There are lots of seating areas dotted around, and it is really spacious- British shopping centres could learn a lot.

First week of work...ish

Arriving at the UNSW campus on Tuesday reminded me acutely of my first day of clinical medicine. I was nervous, and beginning to think that applying for intensive care had been a really silly idea. I needn’t have worried- the department is fabulous. I am working in a private hospital, which has been a bit of a revelation. There is a neuro intensive care unit, intensive care unit, cardiac intensive care unit, and a high dependency unit.


The consultant of the week is frighteningly intelligent, but also an excellent teacher. I spent my first day on the ward round; we had 10 patients on the ward, ranging from spinal fractures to out-of-hospital MIs. I’m really looking forward to following the patients’ progress. We then had a clinical meeting about spinal injuries (with free lunch). In the afternoon, I watched a central line being put in, and began to get me head around the different monitors.


Junior doctors here work 12 hour shifts for 7 days, then have 7 days off, then work 7 nights, before another week off. I am doing 8 hour days, with weekends off. My time is fairly flexible- I can choose my days off. For example, next weekend I am heading to the Blue Mountains with a group of medics, so will tak the Friday off.


I arrive at the hospital at 8, for the handover and then there is a daily teaching session for an hour at half past. These are aimed at everybody from resident to fellow, and are really useful for me, even if some of it goes completely over my head! The ward round normally lasts for 2-3 hours, then there is time to grab lunch before jobs are done in the afternoon. I have been taken out for lunch by the consultant a few times this week. He has also organized for me to spend some time on the paediatric ITU, which is a particular interest of mine.


In terms of patients, I have seen a septic abdomen, carbon monoxide poisoning, post-MCA aneuysm, a post-partum haemorrhage in a Jehova’s Witness resulting a haemoglobin of 2.7, T10 spinal fracture, fluctuating consciousness and delerium. It’s been a really useful learning experience so far, although the team changes each week, so I will have to make friends again then!


I’m quite tired today and am looking forward to a good sleep before getting up stupidly early for the football, and then a concert at the Opera House- what an odd mix of culture!

Eastern Costal Route

Having been up since 4am to watch a lamentably poor football match, I felt a more sedate day was in order. Therefore, after lunch, I wandered from Coogee beach to Bronte beach, along the Eastern Costal route. This is a stunning walk that I would thoroughly recommend to anyone who has a few days in Sydney. I particularly enjoyed watching the surfers at Bronte beach… I am even tempted to give it a go.

Sometimes being a daft blonde helps...

On Saturday, I was due to meet my cousin, Denise, in Lilyfields, which is a district in Western Sydney. This involved two bus changes, which sounds easy, but proved to be anything but. The first bus to catch was 100m from the front door- so far things were going well. However, unlike London buses that announce the stop, Sydney buses do not. Thus to find my stop I had to ask the very kind Australian gentleman behind me, who was incredibly helpful. However, the next difficulty was locating the second bus stop I needed. Having wandered around for a good twenty minutes, I eventually gave up and went into the local YHA to ask for directions. Again playing the ‘daft blonde’ card, I was given directions that proved not to be as difficult as first anticipated. I eventually found the correct bus stop, and jumped onto the first bus that looked as though it might be going in the right direction. On the second bus, I suffered similar problems, though luckily managed to persuade the driver to give me directions. Walking on foot for the rest of the journey, I again needed to call on the good will of the Australian people to help me find my way. The Lilyfields market is a food market mainly, with lots of organic produce and continental food stalls. Denise works on a cheese stall, as Australian cheese is not good. I had a lovely time pottering around the different stalls and in the school grounds, where ibis birds were wandering about.
Denise and I then went to the University of Sydney where Denise is doing her PhD. It is very like an Oxbridge college, with big open quandrangles and stunning buildings. We then drove to Glebe, another suburb of Sydney and had lunch in a café called Badde Manors, sitting outside in the glorious sunshine. I then took the bus to Circular Quay and the Rocks. Here, I wandered around The Rocks, taking many, many photos of the Harbour Bridge and the Opera House. I was lucky that the light was good and that it was not too busy. I also managed to find a relatively cheap ticket to see a Bruch concert next weekend. I think, in this instance, I will let the photos speak for themselves...

And winter is setting in today with bitterly cold temperatures of 15°C…

Well, the journey was long. The first 12 hours to Singapore nearly killed me, but the final 7 were not bad at all. I’m staying in Coogee, which is a 15 minute drive from the airport, 5 minutes from the beach and 20 minutes ambling slowly to the hospital. My room is lovely- nice double room and the flat is really convenient for supermarkets etc. My flatmates are good fun. After a questionable night’s sleep (my body doesn’t quite seem to have adapted to the nine hour time difference), I woke at nine and ambled along to the beach (see attached photos). It was a glorious, warm day, despite my flat mates telling me it was freezing. Coogee beach is really sandy and appears to have good waves, so I may yet make it onto a surfboard… I pottered along the headland for a bit, before realising that I hadn’t eaten since 5pm the day before and needed feeding. I found the supermarket- Woolworths- and sorted myself out. In the afternoon, I found the medical school and began registration. It is a fabulous complex of university buildings, with lots of outside space for socializing. Registration involved lots of forms to sign agreeing that I was not a child molester and that I had a CRB check (4 actually). Enrolment was in a stunning new building by the library lawn, where you have to collect a ticket as though you were waiting at a supermarket delicatessen. I can’t quite see Newcastle adopting the same process. Finally, I met the Clinical Teaching Department and had my mug-shot taken for the security department. I start officially on Tuesday, as Monday is a bank holiday to celebrate the Queen’s birthday. No, I didn’t know that until I got here, either! Maybe we should institute it in the UK. On my way back to the flat I tried to buy a10-journey bus ticket, which involved the man in the shop asking me whether I wanted to get off before or after St Martin’s Place. I declared that I had not a clue, at which point he tutted, and I felt duty-bound to play the ‘daft blonde’ card. I think it worked as I certainly have a card that will take me to most places I might want to go in the city centre. I arrived back to find that the news was on and the weather forecast was telling us that this was the first day of the ski season, but that they might need fake snow… I love this country!

All my bags are packed...sort of

Well, there are now fewer than 24 hours before I leave on a jet plane. And my suitcase is still too heavy. It doesn’t help that the weight changes depending on where I put the scales in this house, so the result ranges between 19.7kg and 24.5kg. As the luggage limit is 20kg, I feel something should go…but what? Stethoscope and the Oxford Handbook of Medicine are a necessity rather than an indulgence, but what about a hair dryer? I’m living with 2 boys so it is unlikely I could borrow theirs… I have spent the morning slowly shifting all my reading material into my hand luggage, hoping that they don’t really want to weigh it at the airport tomorrow. We shall see.

This is my longest time away from home, so I’m excited but also a little nervous. In true Laura-style, this has manifested itself by re-packing three times. Passport? Check. Insurance documents? Check. Money? Check. What could possibly go wrong?

Introductions

For those of you who have stumbled across this blog, I’m Laura and I will be spending the next 12 weeks in Australia, on my medical student elective in Sydney and then in Cairns and Port Douglas. This is a self-indulgent record of my travels, but I hope you enjoy reading anyway.