Month: August 2017

In which a bit of Iceland comes to New Zealand, or…I knit another sweater

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Remember back in June, when my real excitement in Iceland was picking up some Plotulopi yarn? It’s found it’s way into a sweater!

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Look like you’re in love, the photographer said…I ended up simpering

It took me a while to find a good pattern. A lot of the traditional Icelandic sweater patterns look, well…old, and not particularly pretty or stylish. The other finalist was the pattern below, but I felt like it wasn’t as modern looking, and I loved the geometric shapes of this one and the details on the bottom and the sleeves.

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Grettir from Brooklyn Tweed, the rejected pattern

 

The yarn is untwisted roving, which means that it breaks apart very easily. Try to imagine using fluffy bolts of cotton candy to sew together a leather jerkin, and you’ll have a decent idea of what it’s like to knit with. As with many things involving knitting, I try to find a metaphor in this, and for this project it was learning exactly how much tension and pressure to hold the yarn with. Too little, and the yarn would loop and sag unattractively in the stitch. Too much and it would simply tear apart. A happy medium existed, though it took a while to find it. Extrapolate that to a life lesson as you will.

 

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Neckline close up

 

The other difficulty was that I the pattern I’d chosen called for this yarn to be held singly, though it’s usually knit double. I swatched both and greatly preferred the double thickness, creating as it did a lofty and cozy fabric. With a sigh, I pulled out a calculator as using a bigger yarn meant that I’d have to do math to figure out the new sizing. I figured out that if I just followed the instructions for the smallest size, it should work out okay.

It almost was, until the very end. While I’d been able to change the horizontal measurements of the sweater with fewer stitches and I could simply knit fewer rows to make the length correct, this didn’t translate with the neck of the pattern where you can’t just cut out rows. The first iteration of this did not work well, and I looked like I’d made a sweater for a thick-necked giraffe.

 

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The pic I sent to my phone a friend, thick necked giraffey sweater

After a telephonic and picture consultation with a knitting friend back home, I ripped back to the middle of the yellow diamonds, switched to a smaller needle and began decreases in the black areas between to hide them and maintain the pattern. It worked pretty well! I wish I could tell you that this sweater was 100% perfect to me, and it almost is. Trying to account for vertical gauge and burned by the extra fabric Eric’s sweater had in the shoulders with all the short rows, I knit fewer of them and I wish I hadn’t. I would have preferred the sweater come up a bit higher in the back, and I wish I’d knit the sleeves just a touch longer but overall I’m pretty happy with it! I especially love the shaping in the waist, which is key in such a big bulky sweater to avoid making one look like the Michelin Man.

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Next up, to finally finish all the socks for the kids I’ve promised them and have completely ignored. Of course, now that they run around barefoot like all the other Kiwi kids, I wonder if I should even bother.

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Sweater in action along West End, Ohope Beach

pattern: Telja by Jennifer Steingass

-s

In which I start my job as a doc in New Zealand

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I knew I’d have a lot to learn working as a doctor in a new country, but I didn’t think it would start before I entered the hospital.

I walked up to the hospital on my first day of work, held my badge up to the double doors and expectantly waited for them to open for me. They did not. I flashed my badge a few times, looking like a proper idiot, wondering if the doors weren’t working. I then realized that I had to manually open the doors here and walked on in. I had two days of a gentle orientation before beginning to see patients, where I got a tour of the hospital, filled out important paperwork and was introduced to nearly everyone and welcomed warmly.

On Wednesday, it was time to start the real doctoring.

Things run a lot differently here than I’ve been used to. Some of that is simply because I’m working in a small rural hospital instead of the large urban center I was at. Some of it is because I’m working with the New Zealand medical system, and some is because I’m taking care of New Zealanders and not Americans, who seem to approach their healthcare quite differently.

I came into morning report, a gathering of the doctors on for the day, the head nurse, physical and occupational therapists, pharmacists and other members of the care team. We listen to the new patients admitted overnight and then run through our list of patients to see what is needed from members of the care team. I picked up my list of five new patients to start seeing that day and met up with my house officer. The training system in New Zealand is beyond my capacity to understand – from what I can tell, the educational level of the H.O.’s is about that of a 3rd or 4th year medical student, but they function much as interns. It’s also not necessarily linear in a way that’s incomprehensible to me. My house officer, upon later conversation, casually mentioned that he was going to quit to go travel for 6 months and planned on returning. I’d like to find a residency in the States that would let that happen!

I went to see one of my first patients, a man who needed a procedure done to drain fluid out of his body. He was on a blood thinner, though, making it more dangerous. I approached this the way I do with my American patients, carefully explaining to him and his family the risks and benefits of the procedure, the possibility of increased bleeding, what we would do to prevent this from happening, and how we couldn’t do much if bleeding happened. I asked at the end if he would like to think about it and we could return later, which would be pretty typical at home. “Nah, I guess we’ll just go for it.” I blinked a few times, as it seemed a bit too easy. “You’re…sure you don’t have any other questions?” “Nah, if it’ll help me feel better let’s just do it.” We set up the procedure for the next day, and it went swimmingly.

I saw another patient who was in for a heart issue for which ultimate diagnosis would require an echocardiogram, or an ultrasound of the heart. The only problem was that it was Wednesday, and echoes are only done on Tuesdays and Fridays, and even then only four on a single day. If you’re the fifth patient, too bad, you’re going to have to wait. If you need a more urgent echo, you’ll have to be driven an hour away to Tauranga to a larger hospital. This is utterly unheard of in urban centers, where I would roll my eyes at an echo taking more than a few hours to obtain. Feeling sheepish, I went into discuss this with the patient, expecting anger and incredulity at the inefficiency of the system. “Oh, no problem,” was the reply, “If we can’t get it on Friday my daughters can just drive me up to Tauranga to get one.”  I was forced to use actual clinical skills to diagnose and treat her without the technological test, which ultimately did get done on Friday.

Another thing we don’t have available that I’m used to : consultants. There’s a surgical team and an orthopedic team, but other than that, there are no medical subspecialties here at all. If someone really needs to be seen by a cardiologist (heart) or a nephrologist (kidney) we ship them to Tauranga hospital for evaluation. Once the patient has been seen and recommendations given, they’ll be shipped back for us to continue the remainder of their hospital stay.

At home, I’m used to doing all the primary work of doctoring myself by which I mean writing notes, ordering medications and tests, following up, and taking calls from nurses if something goes wrong. Here, my house officer does all of that for me. I look up pertinent information before seeing the patient, and then we see the patient together, and then I just tell him what needs to be done and written and…it gets done. It leaves me feeling a little unmoored to be honest, and without me sitting down and looking through all the details of the chart as I write, I keep feeling like I’m missing something. Somewhere along the way I’m supposed to be teaching them something, but I’m okay with letting that slide for a couple weeks while I figure out the system myself.

Being in a nationalized health care system means that there are stricter limitations on what medications you can use in the hospital, especially antibiotics. A patient who comes in with pneumonia in the U.S. would reflexively be prescribed ceftriaxone and azithromycin or levofloxacin for treatment. There are infection nurses who look over more unusual antibiotic choices to regulate those, but no one would stop you from prescribing ceftriaxone. I had to call an Infectious Disease doctor to order it as part of a combination treatment for a patient of mine who came in with pneumonia and got worse with outpatient Augmentin pill therapy. The doctor paused for a second before she said, “I don’t think that’s necessary yet, let’s try IV Augmentin first.” I was denied. (The patient did, though, get better with the IV Augmentin, I must admit.)

There are at least a few patients daily who hear my accent and take the time to tell me what an unhinged lunatic Trump is. One guy, hardly able to breathe with a lung problem, still took time to squeak out that he thought Trump would be the last president of the United States as we know it. It’s a common feeling here, where the U.S. is currently regarded as something of a laughingstock.

All in all I’m enjoying the new gig, though I feel I’ve got a lot of learning to do before I get a handle on how things really work.

-s

In which we make our way to New Zealand for the year

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As most people reading this blog know, last year we decided to extend our time out of the US for another year and I took a job in New Zealand!

Packing for a year of settled life on an island where things are reputed to be quite pricy is a different story than last year, where we left with carryon backpacks and a minimalist attitude. This time, we asked ourselves how much we could cram into 300 pounds of luggage. Sports equipment and clothing are expensive here, so into the bags went our ski clothes, goggles, bike helmets and sleeping bags. Eric tossed in some basic tools, I brought my flatiron. The kids took along a box of legos and some card games, as well as favorite books and some art supplies. The tent didn’t make it, nor did our bikes, blender, printer, two burner griddle, waffle maker, kitchen scale, rock collection, entire library (for the boy) or guitars, though all of these were considered at some point and some people (cough the kids cough) tried to stuff them into the sacks when no one was looking. I didn’t check closely enough and the miniature amp made it, despite us not having a guitar to plug into it!

 

We initially flew to California to visit my parents, and got a few looks as we lumbered along the Southwest baggage check-in line, where despite their generous baggage allowance most people seem to travel with little more than a roller bag. “Going camping?” the check-in guy asked, fishing for an answer. “We’re moving to New Zealand,” we replied. “Oh, I didn’t know Southwest was running an international moving service now,” he said with a smile. In California we had a lovely time with family and running around the Park where I used to play as a kid.

The flight from SFO to Auckland takes 12 hours and 50 minutes, and normally I’d be too excited to sleep much at the prospect of being able to squeeze in 4, possibly 5 movies during that time. Alas, it was not to be as we were planning to drive directly to Whakatane on the day of arrival, and I’m more likely to sleep on a plane than Eric is. I ate the relatively tasty Hindu Vegetarian meal I always order (too much cumin this time) and slept somewhat fitfully for most of the ride.

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Even the currency exchange shows shade at Trump – make your USD great by making them NZ dollars!

Off we went on the 4 hour drive to Whakatane, stopping off for tasty fish and chips just outside Tauranga and rolling into our our beachfront apartment around 2 pm. By coincidence, my longtime friend Judy and her son had been traveling in New Zealand and drove over to Whakatane to see us for a few days before they flew home. We got in some fun beach walks, hot spring time and tasty food. 

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Sunrise from our window

The first few days here could be characterized by a jet lag fog. Barely able to stay awake after 7 pm and then awakening at 3 am, I was dysfunctional for a few days, not even noticing the beautiful beach sunrises through our windows. We managed to get the kids enrolled in school and had them start on Friday, with good reports from both! The boy is in middle school here, which is 6th and 7th grades.  Different from school at home, however, the classes are mixed 6th and 7th grades and most learning takes place in one classroom with the exception of specials. It’s a lot more low key than middle school in the States, which is like a pre-High school with lockers and different classrooms and the like. The boy is especially excited about the wood and sewing shop! The girl’s school is a more typical Elementary school, with the change that her class is combined with the one next door much of the time. One little quirk of Kiwi people everywhere is that they are often seen barefoot, and even on this rainy morning I spied a little boy scampering into school shoeless, splashing through puddles.

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Wood shop (sorry for the blurry pics)

 

After the jet lag improved, a feeling of panic set in. Where were we going to live for the year? An online search of listings yielded exactly NO properties. Perhaps people don’t list online? Eric and I then went to several realty offices to ask for long term furnished rentals, and as soon as we uttered the word “rental,” the realtors’ lower lips would stretch away and downwards with a sucking in of air, making the universal expression for “you are screwed, my friends.” Housing is always tight in New Zealand, and compounding matters is that a large flood earlier this year displaced many families who are now renting the houses that we might want to rent ourselves. The other problem is that many places are only rented long term during winter, and from December through April are rented short term for the holiday season (seasons are flipped here, so that’s summertime). Eric thought it was heee-larious to keep making jokes about perhaps renting a shipping container, or just living in tents, or getting two camper units. I failed to find this amusing. We went to visit one possible rental, only available through the end of November, which was split into two separate floors, both dingy and dark, with about two feet of aluminum countertop for a kitchen. Things seemed dim, and I bought a pack of Tums out of necessity.

It’s a different culture here in that you have a better shot at things if you actually go in person to meet people, rather than the internet focused world of the US. We began to stalk our real estate agent with this in mind. Eric went in one day to find out that the rental agent was on vacation but would be back on Monday. On Monday morning, we wondered if it would help or our hurt our chances if we simply waited in front of the doors, staring through the glass until opening time like curious kittens. We decided instead to visit in the early afternoon, only find that she had gone out. We tried our luck a few hours later, and still, she wasn’t in. We were beginning to doubt her existence at this point. Tuesday morning we popped on over again, and voila, there she was. We considered shackling her to a chair lest she scurry off again, but she sat us down and told us of two places that were coming up on the market just that morning. Perhaps she was being friendly and helpful, but I think that she’d heard of our frequent visits and decided that getting us a house was the most efficient way to get rid of us, else we would take to haunting her office like wayward ghosts.  We drove by one of the houses, another dismally dark rental with a tiny aluminum countered kitchen. Our spirits drooped yet again. I popped a few more Tums and wondered if it was acceptable to start drinking at noon in New Zealand, considering the circumstances.

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Central heating doesn’t exist here, so we hang out with sweaters, warm hats, and space heaters.

That afternoon, she took us out to the other house and were happily surprised!  It’s a 3 bedroom house with a wraparound porch, no yard to speak of, but that’s okay because the yard is the beach which is one street over. Most importantly, the kitchen is nice with good counter space, made from some variety of laminate and a good step up from prison decor.

We called a few people we know here to ask their opinion, and everyone told us that we should lunge at the opportunity and take the place, and so we did. We’ve also managed to find a good car to buy here, so all in all things are looking better for now, given that we’re up to step one on Maslow’s hierarchy of needs.

Next week, I start work, we move in, and I’ll post some pictures of the new house, our car, and the hospital!

-s