the second half starts

so i can't believe i have passed the half way mark of my stay in australia. once in a while i find myself talking with a slight australian accent. it's not so much the accent though as it is the inflection of the sentences.

it's been a good week. today i even got to suture a boy's knee. it took forever, but the final outcome looked decent, so i was happy about that.

tomorrow, Rebekah and I leave for Brisbane and start our 10 day vacation up the east coast. we have people we will be staying with thankfully, so hopefully that'll cut on some cost. i hope i remember how to scuba dive. it seems like ages ago since i learned to dive even though it's only been 4 weeks. it seems like ages ago since i've been home too.

although i miss home tremendously, i also am already starting to feel sad about leaving this place.

weekend event

There was a conference held this weekend called "Are you remotely interested?" that was a forum to share, discuss, challenge and educate the delegates on the various projects, ideas, and happenings around remote and rural health care in Australia. As I attended the various sessions and listened to the speakers, I realized again that much of the issues surrounding health care in the remote areas are embedded in a much larger issue of improving the quality of life for the indigenous population.

I was helping Rebekah suture a cut of the left knee of a 10 year old Aboriginal boy a couple of weeks ago. At first, he would not let her touch his leg with the syringe as he kicked and cried. With as much convincing words as we could find, he finally let her put the first shot of local anaesthetics near the cut while his father and I held his arms and legs. We told him the first one would hurt a little, but the second one shouldn't hurt as much. With every shot and every suture, we made a bit of progress in gaining his trust. By the time the last suture was in, he was almost smiling saying that "he's being strong and will take the pain." He also mentioned that maybe he can grow up and do what we are doing. I told him that I think he would make a great doctor. Since he knows what it's like to be a patient, I said that he would make a very compassionate doctor and encouraged him to read a lot. But as I was telling him that he should read lots of books, I was wondering if he has any books at home to read. The father was very quiet throughout the whole procedure rarely saying a word. While I was hoping to encourage this boy to have big dreams, I was wondering if maybe I was giving him false hope. I wasn't even sure if he went to school. This boy will have a knee that is sutured with hopefully minimal scars after the ED visit, but that really is the least of his problems. What about his education, his future? What can we do to help that?

The conference was a place to communicate and connect hopefully to help coordinate and share ideas that will ease the health care burden. It was encouraging to hear about all the projects and research that is being done to help improve the health care system. The challenges seem almost impossible both practically and politically, but it's still nice to know that strong efforts are being made to make life better for all, especially the Indigenous.

full week

well it's been a full week. i worked one night shift in the middle too, so that kind of threw my sleeping pattern of a bit.

i did get to go out for dinner a couple of times this week. Once to Dom's, which is an Italian restaurant that is supposed to be the "best" restaurant in town. It was very tasty, and good atmosphere too. Our Dean from Dallas flew here for a conference, so he took us out to dinner there. Then my roommates and I went to an Ethiopian restaurant last night. That was good too.

The "Are you remotely interested?" health conference starts today which focuses on health for the remote and rural communities. So, big name people in health are here from Queenland Health, and as they are trying to promote Physician Assistants, we were invited and sponored to go to the conference as well. It'll be interesting I think. At least we'll get free meals. I'm looking forward to the discussions.

I just returned from a nice walk up the mountain again. I'm going to miss these walks for sure once I'm back in the States.

sunday

Rebekah and I decided to work the night shift yesterday so we got home at 3:30 am. i couldn't get up for church and slept in a bit. My other roommate Anne and I visited the Underground Hospital and did a little stroll around the city. The Underground Hospital was built in anticipation of a possible attack by the Japanese during WWII in mt. isa. It never came about, but they preserved the underground hospital which was created by the same method that they use to blast in a mine. Pictures to come later I hope.

We then did a little shopping and went to Buff's Club for tea. I had what's called a Spider. It's strawberry sprite with vanilla ice cream. YUMMMY! I took a picture of that too.

Then we walked up a place called the Lookout where there is a pole with a arrow pointing to various big cities in the world and the distance to that place from mt. isa. It's on the top of a hill and you can see the whole city of mt. isa. Picture to come of that too. It's a neat little pole.

We then came home to rest, read, and relax. My other roommate Glenda prepared a very good dinner of kangaroo roast and veggies. To top it off, we had a dessert called Pavalone, which is sort of a fruit merangue pie. Yummo!

The weather is now back to what I got used to. A bit warmer during the day and cool at night.

in search for a kangaroo

so we went to lake moondara that's just about 20 km from our place this afternoon. one of the doctors was able to check out a car for 2 hours, so he drove us there. he apparently has never driven a car with an automatic transmission, so every time he pressed on the brakes, it was a very abrupt, harsh stop as if he was pushing the clutch. the first couple of times it startled us, but then it became quite funny. i have seen people having trouble driving a manual shift, but never a person driving an automatic.

but safely, we did get to the lake. and we were told that the kangaroos come to the lake about twight time to get a drink. unfortunately we didn't see any at the lake. the others saw one on the road, but i missed it as it quickly hopped into the bush. i hope to see one in their natural environment soon...

the lake was beautiful. i didn't realize how much of a "cabin fever" i had until we got out there. the water and the sunset was so refreshing.

i also went into work for just a little bit. i had told one of my patients to come back today so we can make sure he's doing okay after he was diagnosed with pneumonia. i thought maybe he might not come back, but as i walked into work, i saw his mom and him waiting in the the waiting room. i quickly called them back, and was so very happy to see that he's improved quict remarkably. even though i didn't want to go into work just to check up on him, i'm so glad that i did.

change in weather!

I couldn't believe it. It actually rained here today! It was even cold during the day like real winter. Rebekah and I went to workout this morning and walked in the misty rain. It was actually a nice change. We then had a big burger at Chief's Burger. The owner asked us where we were from, and we told him Texas. He like many others responded... "The Bush state...that's a terrible place." I was afraid he was going to poison our burgers, but he actually ended up being a nice man. Everyone here just has some very strong feelings towards George Bush.

The burger was yummy. They like to use sweet chili sauce here and also beets in their burgers. It was very tasty.

I'm starting to itch for some big city life though. 2 more weeks of Mt. Isa, then we go on a little vacation on the east coast. Then one more week of Mt. Isa, then another week of vacation. Then HOME!

busy week

It's been a very busy week at the ED this week. There are people waiting all the time it seems. With the flu outbreak, and the news of a couple of kids dying from it, everyone is on the edge it seems. I thought I had escaped the flu season this year, but I guess this year, I'll have the joy of experiencing the flu season twice. Hopefully this time I won't catch it myself.

Pretty much it's been work, and home this week. I managed to work out on Monday which felt good and even go for a walk up a nearby by hill/mountain. It was a nice walk in the morning to catch some fresh air and spend some time praying and reading. Maybe I'll try to catch the sunrise one of these mornings. The sun rises on the side where it's pretty barren and sets on the side with the city. What a dramatic difference.

I'm continuing to enjoy the ED. Learning more each day, and honing my skills and learning new ones. I am looking forward to a day off tomorrow and maybe work again on Saturday. It's nice because we are starting to get invitations to dinners and such now. We're half way through with our stay already. I have a feeling just when we start to feel like we know a bit of what we are doing, we will be saying good bye to this outback city. Oh, how peaceful it is to be out here. I'm definitely getting a bit spoiled by this place with its simplicity. I hope I can maintain this simple lifestyle when I get home. I'm realizing how little I need of stuff to be happy. Or maybe it's that "stuff" actually makes life too complicated and is much more burdensome than helpful.

rodeo weekend

Well, it's the biggest weekend of mt. isa with the rodeo. I went to my first rodeo ever last night on Friday. Before that was the annual mardi gras parade which was in the evening. But it was nice to see the celebration and the fireworks. The show started afterwards and i saw cowboys by the dozens. It was quite remarkable to watch these men try to stay on the bull or the horse for 8 seconds. It seemed a bit odd to me, but i guess with any sport, there is a bit of oddity to it. I took lots of pictures and even a video of a couple of rides that I wish I can post.

We walked home under the beautiful starry skies. One thing about being out here in the middle of nowhere is that the sky does truly sparkle at night. I saw the southern cross again which brought back memories of the first time i saw it in South Africa. I'm really enjoying this small town. Walking to the groceries, walking to work, walking to the fitness center...walking everywhere. I'm afraid i may have forgotten how to drive. I still have not gotten use to the cars driving on the left hand side of the road and have to be extra careful when i cross the streets.

No cell phone, no personal computer, no car. The things that I feel sometimes a slave to in the States. it's been nice to be away from those things. A simple life seems easier to attain here, but i know it's temporary and perhaps that's why it's easier.

My roommates and I went to a restaurant called Dom's this morning for breakfast. It's suppose to be the best restaurant in town. And the breakfast was truly delightful. I had eggs florentine and it was wonderful. I went into work afterwards. It wasn't to busy, but i got to see a few patients. As I was leaving, a rodeo cowboy came in with lots of bleeding to his face. Apparently, a horse had stepped on his face. Put a bit of a damper to this weekend. The rodeo was fun, but I don't think I'll be going back.

introduction to the Aborigines

As I get more comfortable in this new setting, I'm starting to see things as they are a bit more rather than through the eyes of someone who has just come off the plane. "Starting" is the key word. I think it may take a few months at least to really understand the culture and history that makes Mt. Isa what it is.

The days in the Emergency Department (aka Accident and Emergency) are as unpredictable as most EDs are. There are very busy times, and times when we can all just sit down and chat about anything and everything. As patients come and go, it's not long before one notices that many of the Aborigines come in with no shoes. They are either living near by, or have been flown in by the Royal Flying Doctor Service from a more remote site. It's not long before curiosity and concern stir up questions of why's and how's regarding the living standards of the Aborigines. This week we had a day session on Cultural Awareness that focused on the Indigenous population of Australia which answered lot of questions. It also brought up many more questions. It was designed I think to help us see things from the Aboriginie perspective, which I think is key to understanding why things are the way they are now. How would I feel if everything dear to me was taken from me?

So I checked out a book from the library titled "Australia's Rural and Remote Health" by Janie Dade Smith. Although I've only read through chapter 2, it has already enlightened me some on the history of Australia. I understand and agree with the author that it is impossible to gain any clear insight into the present state without knowing a bit of history and to gain even a small understanding of how the Aborigines lived before anyone else had set foot on this land. Certainly the theories of terra nullius, the Great Chain of Being, and Social Darwinism had an immediate and profound impact on the lives of the Aborigines. There is an obvious clash between the cultural value systems of the Europeans and the Aborigines. And as I was introduced to the Kinship system of the Aborigines, I realized all the more how big the clash was. I look forward to meeting more Aborigines and learning more about their lives. I think only then will I be able to make them feel comfortable when I see them in the A&E. I've been told that avoiding eye contact is a sign of respect and that body language is very important to them. Many Aborigines seem to fear coming to the hospital as they may never have been in one before or even seen one. One doctor mentioned that they come in intoxicated even during the day because that is what will give them the courage to even enter the hospital doors. Indeed, the smell of alcohol is quite apparent when some of the Aborigines come to the A&E. Trying to understand the Aborigines perspective seems critical to being able to gain their trust and interact with them in the hospital setting. As with any provider/ patient relationship, mutual respect and understanding seems a critical component to effective management of any health concern.

not a good day

so i started this morning off badly. i lost my stethoscope. i'm hoping it'll turn up somewhere and sometime soon. all day i felt a little distracted because of my lost steth. i didn't know that i had come to treasure that thing so much, but i suppose it was sort of a security blanket. i felt empty all day. i was trying to examine a CHF patient, and i so missed my own steth. i looked all over the ER numerous times and others too, but it was no where to be found. i guess what's worse is that now i feel i have to be extra careful with my stuff.

today was a much slower day. in fact, i only saw 2 patients the whole day. but i learned a lot. one was a fellow who had hurt his left eye while cleaning his tools that had some cement on it. it was badly infected and wasn't properly washed. the second person had signficant heart disease history and was waiting for a heart transplant. he was very sick.

we also had an hour of teaching from Dr. T and that was good. Now i'm getting ready to go to the 2nd week of trivia. i think when anything is required, i don't feel like going. must be the rebel in me. hopefully it'll be a good time had by all.

another day in the ED

you know, i'm really starting to enjoy my work here. everyone is really so nice. in terms of work culture and atmosphere, i don't think i've been anywhere that i feel quite so welcomed. scott and white was quite welcoming, but mt. isa even tops that. i've had quite a few people say that i look like "that Asian doctor on Grey's anatomy." all the nurses, the doctors and even the patients are so warm and funny. patient and willing to teach. no one is above another, and everyone treats each other with much respect and we all call each other by first names. that's not so easy to find anywhere, especially in a medical setting where doctors and nurses are not always on equal ground.

today was a very busy day in the emergency department. it started out slow, but a lady came in cardiac arrest, and somehow with that came a flood of sick patients. i'm learning more and more about how to get around in the ED and learning where things are.

11 hours went by fast and furiously. it was a might fine day.

Church and Mt. Isa Mines

We were suppose to go camping to a beautiful oasis called Lawn Hills, but plans fell through. So we stayed in town this weekend. Yesterday, we went grocery shopping and joined a little party downstairs that the med students were having. It was a Tapas party, and the food was quite extraordinary. If they don't make it as doctors, I'm sure they could make it as chefs.

Today, Rebekah(my classsmate) and I went to church in the morning. Mt. Isa Baptist Church. I'm always surprised to find faithful people of God and feel so much part of the family the moment we start singing the praises. It's a small church, but they worshiped in spirit and in truth for sure. One member shared a verse that hit home with me.
"But I have prayed for you, Simon, that your faith may not fail. And when you have turned back, strengthen your brothers." Luke 22: 31-32

I know that Jesus has and is praying for me. And even when I fail Him, he expects me back and encourages me to keep the faith and encourage my fellow believers. That was such an encouragement to me this morning.

After church, we went on a tour of the Mt. Isa Mines. Not the actual one, but something they set up for tourism. Still it was interesting. We dressed up as the miners do and went down the elevator. They showed us how they used to mine 40 years ago, and how they do things now. I'm happy to say that mining is much safer these days than it used to me. Still mining is not what you call a "fun" job. Mt. Isa Mines is the largest mine in Australia and perhaps the southern hemisphere. They mine copper, zinc, lead and silver. A miner's salary in Mt. Isa ranges from 85,000 dollars to 130,000 depending on years of experience and job safety too. Typically they work 4 days 12 hour shifts and then get 4 days off. So essentially they work half the year, but still I'm not sure I would do it or even could do it.

I was going to try to post some pictures, but I couldn't figure out how to do it on this computer. So those will have to wait til i get back to the states.

another trivia question

What country has the most official languages...

Update on Mom:
Her procedures went well. She said she felt no pain through it. The results will be coming in 3-4 days. My brother was able to fly in for it, so I think that helped a lot. Thank you for your prayers...

Answer to ?: South Africa. I believe it has 18 official languages.

feeling a bit more comfortable

today was a much slower day in the ER. and perhaps since everything wasn't so new, i didn't feel as overwhelmed. there's quite a bit of orthopedic cases, so i wish i knew how to handle back pain and such better. but i guess maybe after this rotation, I might feel more comfortable. I really like the work environment at the ER. The doctors make it real fun and relaxed. Many are willing to teach and interested in getting to know us. The nurses are all very nice as well. They are all very thorough with their work and kind to the patients.

i learned a bit more thoroughly how to use the slit lamp which was good. quite a bit of eye cases that come in as well.

a pharamcy rep came today to give a talk on metalyase which was very interesting. as always the extra pens and snacks they bring always makes it a bit better.

FOOD note: so i've tried the vegemite and the kebab and the tim tam's which are distintly Australian. Two i liked, one I'm still learning to like. The two i liked are kebab and Tim Tam's. Kebab is actually not the kind with the small wooden stick, but more like a wrap sandwich and it's very good with sweet chili sauce. Tim Tams are 2-layered chocolate wafer like cookies that have been dipped in chocolate sauce. VERY GOOD! I must bring some of this back home to Texas. Vegemite is the staple spread of Australia. some sort of yeast like spread that is very strong in taste and salty. One normally puts it on toast with with some butter. I tried it once and i'm working on trying to get myself to try it again before I quit all together.

WEATHER note: it is so very predictable. every day has been the same. warm to hot during the day, and cool to cold in the night time. no rain, a few clouds, and sunny. i have no complaints on the weather.

1st day in Mt. Isa ER

so the 1st day anywhere is usually a bit rough. meeting new people, learning the computer systems, learning all the various processes, and things like that. here, we have to learn new medicine names and symbols since they use the British system, but all in all, things went smoothly.

mt isa ER sees about 110-120 pts a day and there are about 30 total beds. all the doctors were very kind and also new to the concept of PAs. but they were so fun and so good with the patients. very international group of doctors from Nigeria, from Iraq, from India, from Australia, from England.

the pts were mostly locals or aborigines and some passing through travelers. i was impressed with the very up to date resources they have available.

after work, my classmate and i went for a walk and treated ourselves to some ice cream. yummm...

so here's another plea for prayer for my mom...her biopsy is scheduled for 10 am on Thursday. and please pray for me as well...that i might make the most of this opportunity to learn and get to know the people and culture here and study when i can. i do miss home anytime i have time to think.