Bula Vinaka

After another week with Jeff and Sheila it seems appropriate to open this blog with one of their stories.  I do wish Sheila would write a blog as I’m sure this is only the tip of the iceberg...

During Jeff and Sheila’s six weeks in New Zealand there were only two nights which they had pre booked, (months in advance before leaving the UK.)  These were the nights at Milford Sound. There is only one place to stay here; a hostel.  Jeff had studiously booked a double en suite room; a very clever move ensuring privacy and relaxation.  Two days before their ‘expected’ arrival at the hostel Sheila checked the booking confirmation and realised they were booked in for March not February!  Already on their way and not wanting to miss Milford they rang ahead and were relieved to hear the hostel was not fully booked for the actual required dates.   However there were no double rooms left so needless to say Jeff and Sheila ended up in a mixed shared dorm in bunk beds!  I am so pleased that Sheila particularly embraced this experience telling us how she brought home her spare pizza to her ‘roomy’.  Amazing ...

We travelled to Nadi (in Fiji) and then on to Musket Cove, a resort on a small Fijian island called Malolo Lailai, the following morning.  Jeff had booked the trip through an Australian company who turned out to be a nightmare and so he wasn’t surprised when our transfer from the airport was the only broken rusty bus and the hotel in Nadi was tired and quite damaged with tape cordoning off many of the rooms. We all wondered what lay ahead. After some confusion about the boat times we managed to get the correct bus and then boarded the ferry.  It was a beautiful journey and as we dropped people off at the first resort they were greeted with singing and shell necklaces.  I think we were all slightly anxious about what we would find around the corner at Musket Cove....  It was beautiful!  Being a marina meant that there were beautiful yachts lining the resort.  It was so tranquil.  As we exited the boat there were no singers but a golf buggy ready to take us for a tour of the resort, as we set off a van pulled up and a chap jumped out with glasses of tropical juice for us.  We exchanged glances, paradise!  The next few days were filled with swimming, snorkelling, sailing and lots and lots of eating.

As Jeff’s treat we all went out on a twenty two foot sailing boat called Merlin 1.  I loved the idea of sailing; wind in my hair, sun on my face, dolphin spotting as I glide over the pacific ocean.... Bliss....  My actual experience does not quite echo my optimistic hypothetical sailing imagery.  As the wind filled the sails (the wind was quite strong) I felt certain we were on the brink of catastrophe!  The boat leaned at a very unflattering angle and I braced myself with silent anticipation wondering what would happen next.  As Jeff practically squealed with delight all I could think about was the massive gin and tonic I was going to need as soon as I hit shore, to get over this experience (and I don’t usually drink gin).   I did survive the experience and am currently contemplating where I stand with regard to future sailing trips.  Likely with my feet firmly on the ground I feel!

I initially thought Greymouth was small but I never thought I would meet people we had links with in Fiji!  On the third day Jeff and Sheila got chatting to the guys in the next banda.  It turned out that one of the guys had family in Greymouth, a loose link but still quite incredible.  Then something really amazing happened.  As the conversation deepened we realised his mum had recently been in hospital.  Then it clicked.  I had seen is mum during my first set of nights at 7.30 in the morning just before I clocked off.  She had been the sickest person I had ever seen conscious and within seconds of coming through the door her heart rate dropped from 150-30 and she lost output.  I started CPR and as the rest of the team began to arrive she regained output.  For the medically orientated out there the gas I then performed had a pH of 6.8, for those who need a little context this pH isn’t compatible with life.  However she defied the laws and did really well with the treatments that followed and looking back I think she is one person whose life I genuinely saved.  And there I was talking to her son in Fiji.  It was like a little nudge from God saying “that’s why I sent you”.  Suddenly five years of medical school and the move to NZ all seemed to have new value.  I saved a life.

We left Musket Cove on quite a windy day and the journey back was described by Jeff as a “a little choppy” however the Sheila-ometer graded but the greeness to Sheila’s face and level of conversation would suggest that it was a little more than choppy.  We said goodbye and Dan and I spent our last night in Nadi before travelling to see Anna and Andrew in Tauranga.  I intend to write another blog about our adventures with Span (Anna) and Andrew so here are just a couple of other interesting moments during our journey home...

On our way to Tauranga from Hot Water Beach I text a national radio station to request a song.  Ten minutes later we pulled into a petrol station and nipped inside for a comfort stop.  Dan then walked in completely bewildered.  It turned out that as I left the car my phone rang and Dan had a lovely chat with the lady from The Breeze- Tanya.  As he hung up the phone it occurred to him that he had been live on the radio.  Unfortunately we had lost signal for the station and despite frantic tuning we didn’t manage to hear our song.

There are a few golden rules in NZ.  One I will now never forget is-

Fill up with petrol before long journeys.

 After flying back from Auckland to Christchurch we had a three hour drive over Arthurs Pass through the mountain range which separates the two coasts.  It was very late when we set off, perhaps ten pm and I suggested we fill up with petrol in Christchurch, but we had half a tank and Dan doesn’t believe filling up until you have less than half a tank, plus we got distracted by food during the petrol conversation and forgot to revisit it before we left Christchurch . Over the next hour we passed six petrol stations all of which were closed.  I didn’t feel too worried but Dan did and his concern infected me.   Now we were at the point where it would take us two hours to drive back to Christchurch and return to the point we were currently at.  Logic would say “we made it one way on half a tank so we should make it back”, but as the rain hammered down, the thunder and lightning flashed and Dan dodged fallen rocks the voice of logic was not very reassuring.  Dan tried to be optimistic listing off our potential options, his favourite being driving until we ran out of petrol and then sleeping in the car.  It was past midnight, cold, wet and I was due at work at 7.30am, I did not want to hear options like that!  Apparently I was being negative.  Isn’t it amazing how being told you are being negative when you are actually quite scared can turn fear into anger.  That’s a golden rule Dan won’t forget!  I’m being slightly dramatic, Dan and I worked fabulously as a team to solve the problem- he told me to sleep and I told him to get us home alive- sorted!  We made it to the village at the pass, the only stretch with signal, and text a friend to say where we were and if we didn’t turn up to work it was because we were stuck on the Pass with no petrol.  Her response was that she had driven half the journey with the petrol light on and had been fine, this was a hugely calming message and we made the final stretch of the journey in a relatively relaxed manner (mainly because I was asleep!)

We had a great week with Jeff and Sheila.  After another week of work we were blessed to have a second weekend with Anna and Andew- another blog to follow shortly!

Much love

S x 

There's no place like home

So I haven’t blogged recently, this is mainly due to the fact that I have worked manically for the last 3 weeks, as has Dan.  It’s been an interesting time.  We changed rotations last week which for me meant saying goodbye to my surgeons.  They have become a bit like pets to me, or perhaps children.  Over the last three months I’ve learnt what they like and don’t like, how to calm them down when they are frustrated and throwing their toys out the pram and how to calm myself down and implement  self preservation strategies which have stopped me from losing my cool with them on many an occasion.  I summed up my rotation with a card to say thank you, on the front of which was Dorothy (me), the lion, the tin man and the scarecrow all skipping along- just like our morning ward rounds.  These rounds generally involved calming down Mr E who gets very wound up about- well anything, checking all Mr A’s patients are on his very specific, and slightly odd, pain relief regime, encouraging Mr C to make decisions and (praise God for small mercies) basking in the knowledge of Mr S who is always thorough, always calm and just generally quite wonderful!   Mr S worked as a trauma surgeon in the British army and used to operate in a theatre with an unexploded bomb lodged in the ceiling; unsurprisingly those operations were swift and efficient.  What a hero (quote Dan).   As an RMO (resident medical officer) my job is to look after the patients on the ward, I oversee their care, advocate for them and am generally the person who actually knows what’s going on with their care.  Yet sometimes I reach points of frustration where I need someone else’s expertise, I can diagnoses the surgical problem but trust me you don’t want me operating on you!  Our knowledge is always being tested, our patience often stretched and our skills challenged.  

During night shifts there is one doctor in the hospital, covering A&E, the wards and being a point of reference for nurses at satellite centres as far away as three hours drive north and south of Greymouth.  On my first night one of the first patients who came in was someone with a dislocated shoulder. They were quite drunk which is these situations can be quite handy as alcohol is a good pain killer!  I diagnosed the dislocation, confirmed it with x-ray and checked the neurological and vascular supply to the arm.  I then called the orthopaedic registrar in Christchurch three hours away, who provide our orthopaedic support, to confirm the plan.  Relocate the shoulder.  Simple.  Well yes, and no.  It can be a simple procedure there are many techniques which can be used to try and pop the shoulder back in place, however if the patient isn’t relaxed or the first attempt is unsuccessful the muscles around the shoulder tighten and the procedure gets more difficult.  I put it out there to the orthopaedic Registrar “I haven’t actually relocated a shoulder before”.  In theory there should be someone on back up I can call in, but guess what, there was no one on the rota.  Meanwhile the ambulance crew bought in another patient who was drunk and had a fluctuating conscious level.  Great.   I checked the second drunk person was safe and went back to my shoulder.  I called the registrar again “there’s no one on back up, what do you want me to do”.  The shoulder needed to go in that night so I resorted to my trusted and faithful backup – Dan.  Having done A&E for six months Dan has performed relocation procedures and I quote “if you get stuck just call me”.  So I did, it was half twelve and the phone rang and rang and rang...  Up until this point I had felt quite calm but now my heart started to thud, I really was on my own.  I had a frank discussion with the patient and explained why I hadn’t relocated the shoulder, I had never done it before and I wanted to get someone to help me, this however seemed not to be possible.  My only option was to use gravity and a little manipulation to get the shoulder in, this and a lot of prayer.  There was only one technique I felt safe to use as it didn’t require harsh manipulation so no chance of damaging structures.  The patient sucked on gas and air and I lay them on their tummy, the dislocated arm flopped over the side of the couch.  I gently manipulated their arm (as per the internet diagram I had seen).... clunk.... the shoulder popped back in- praise God!  This was my first two hours of 70 that week- I will say no more on the matter.

Dan organised an end of rotation meal to which over twenty of the medical ward staff signed up to attend.  All the nurses love Dan.  I know what you are all thinking- it’s his Dashing good looks and warm smile which produces these warm fond feelings.... actually I think it is he constant singing and his hyperactivity which make him an amusing and endearing work colleague.   We turned up to the restaurant and although we didn’t fill it, we quadrupled its numbers.  It was a wonderful meal, food was eaten, wine was drunk (not by me as I drove), and there was much laughter and jokes and then........ the unexpected Sri Lankan dancing!  The consultant who came to the meal was the wonderful Dr U who is slightly mature and very well known in Greymouth.  At the end of the evening I think he had consumed a moderate amount of alcohol, enough to dis-inhibit his dancing gene, and boy did he dance!  There we were in a little restaurant with our consultant pushing back the tables and for want of a better phrase “dancing his butt off”.  I’m pleased to say we have video evidence...

Life is always eventful and there are many many more stories, particularly about work, that I could share.   What I will say is that doctors are human.  We live, breath, cry and make mistakes like everyone else.  Our mistakes have the potential to cost lives and that is why a safe doctor isn’t the doctor who “knows” everything, because trust me they don’t exist; a safe doctor is someone who knows what they don’t know and seeks advice from other professionals to make sure they are giving the best care.   I didn’t want to relocate that shoulder by myself and I set a limit on what I was happy to do.  If I hadn’t relocated it the patient could have had nerve damage and complications so did what I could and was lucky it worked.  So next time your GP says “I’m not sure about that, I will look it up”, don’t sit and think “what an idiot” be thankful that he is looking it up and being honest about his knowledge and expertise. 

Happy Mother’s Day

Sarah xxx