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.