In which I battle the Lord of the Flies, and lose.

It’s summertime in New Zealand, and apparently this means that it is the beginning of war. War of the flies, that is. For some unknown reason, New Zealand does not believe in having screens on windows, which means that you must choose between getting baked alive in your house or dealing with swarms of flies in it.

We  have tried swatting at them individually, both with towels and with rolled up newspapers. This has the effect of being immediately gratifying as well as giving the kids something to do over summer break. Eventually, though, the flies land on me and the kids would attack me with the towels and newspapers, making this method significantly less attractive.

Then came the boy who insisted that burning kawakawa leaves is an effective deterrent for the flies. Kawakawa is a plant that grows in New Zealand and has been used as a traditional medicinal by the Maori people for years. It can be used as a balm, a tonic and a tea for pain relief. We burned a few of the leaves on a plate, and the toxic smoke seemed to clear out the flies for a bit, but the leaves burned quickly and the relief short-lasting.

Then came a series of experiments where we tried to create homemade oil lamps from a kawakawa infusion to keep the flies at bay. Putting a wick of cotton in a shallow bowl to mimic the Indian oil lamps I grew up with seemed to be the most effective, but the boy underwent elaborate experiments with glass jars, drilling through the lids, creating a wick with cotton twine pretreated with wax, then lighting them on fire. None of them worked. The flies continued to descend.

I looked up more non-toxic ways to get rid of flies. I tried making a flytrap out of a glass of wine and a paper funnel. Other than wasting half a glass of perfectly decent pinot, this was a failure. We hung up flypaper and waited for them to fill up with flies, but they’re too smart for flypaper in this country, and the gross sticky strips remained largely untouched except for some unlucky moths. I made a homemade flyspray with dishsoap and water in a spray bottle, and we chased the flies around. Some we did get with this, but the larger effect was to enrage Eric when the kids sprayed the flies sitting on windows, as he had just finished cleaning them and they were now coated in a soapy film.

We tried keeping all the doors and windows open to let the flies roam in and out freely. They roam in but do not roam out.

Sitting on the couch one day I looked over to the arm where I heard a frantic buzzing and saw two flies mating not a foot away from me. For shame flies, for shame. I should have realized the futility at that point, but alas, my foolhardiness continued.

At the grocery store last week I came upon the household goods aisle and saw person after person walking away with a canister of aerosol fly spray. Enough of this non-toxic nonsense, I decided, and grabbed a can.

At home, I attacked the flies with the spray. “90% natural” advertises the can. “Citronella scent” it touts. Our house was soon filled with a cloud of unbreathably thick vaguely citrus scent. We ate dinner outside that night, in the cooling evening air. When we returned, the flies lined up and stared at us, with one especially large one in front. He raised a front leg and curled it in a “come and get me” maneuver. 

We admitted defeat. I for one welcome our new fly overlords. And the first cold snap of winter that will hopefully kill them all.

-s

In which I return to America, and find that I still quite like it.

New Zealand is in full on summer mode down here in the southern hemisphere. This means that we may have a few days of lovely, warm sunny summer weather and then a few days of pouring rain and cyclonic winds. There’s a skylight in our bedroom so the crashing rainfall at night keeps Eric and I up quite a bit, until the clouds dissipate and the sunshine returns again.

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From a recent seaside hike…

 

With bright, long, warm days it was hard to get into the Christmas spirit down here. We were graciously lent a tree by a fellow doctor,  complete with ornaments of a summer christmas such as a surfing santa and a kiwi in a convertible on his way to the beach. We hastily wrapped presents with yesterday’s newspaper, but it felt ridiculous to listen to songs about the weather being frightful or a white Christmas when it was 80 degrees outside. Last year, Barcelona for Christmas felt like a special travel event, and was festive in its own right. Here, we were in our house, doing our usual thing, only it was the middle of summer and it felt ill-fitting to celebrate Christmas the way we do at home.

 

I got to get a little bit of cold weather Christmastime though, on a short trip I took to the States. The government of New Zealand gives its docs a very reasonable amount of money for continuing education, and I used some of these funds to take a jaunt to New York in December for a conference and also to get some baby snuggle time with my newish nephew, Zian!

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Failed Selfie. I look I’m the witch from Hansel&Gretel and am excited about my tasty snack.

I was nervous about going back to the States. We’ve been away for almost six months. Would it feel strange to be back? Would it feel uncomfortable? We’re living in a rural town which doesn’t even have any traffic lights or a single Starbucks – would I have culture shock on being in Manhattan, a slightly larger city? And what would the environment be like overall?  Watching the news from back home reads like a horror show from so far away. Most importantly, would I look the wrong way while crossing the street and get squashed by an errant truck?

While 24 hours of straight travel might seem rough, it felt like a luxury to be traveling on my own without having to manage kids and I upgraded on the long haul flights so had a pleasant journey indeed. I finally got to watch Logan on the way over, which is now one of my favorite movies of the year.  (On the way back I rewatched Episode II of Star Wars, and I hated it only slightly less than I have on previous watchings. What a terrible film, shame on you, George Lucas. That moment when Shmi dies and her head flops over…gah.) Once I exited, I quickly opened my bag and pulled out the pouch of winter outerwear I’d prepared, pulling on a sweater, scarf, gloves, hat and coat in short order and waited for my car to pick me up.

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I hadn’t worn this many layers in months

The cold weather felt cozy to me for the time I was there, and being with family and friends felt warming and like Christmastime was right again.  More than that though, it felt really, really nice to be back in the States. You might argue that New York City isn’t exactly representative of the US at large, and you’d be right. However, it felt comfortable to be back home. It was nice to be somewhere where I understood what everyone was saying to me the first time around, and where I was understood as well. Where  you can crack a joke and have a shared background that makes it funny. And in all honesty, it was nice to be back in a large city again. The crowds were annoying in a way, but never overwhelming. And the sheer variety of food and shops available to me was something we haven’t had out here at all, and something I was happy to have back.

 

In a nutshell, it felt good to be home, and it made me realize that New Zealand isn’t where we’d want to stay permanently. I love our casual lifestyle here, the fact that I’m done with my job by early afternoon most days, that the kids are learning all sorts of watersports, that Eric gets to be the surfer dude he always was in his heart, the friends we’ve made and the adventures we’ve had here. I’m nervous about losing all of that and going back to our higher stress life back home, but despite all of it, the U.S. is still where I feel like I belong and where we’ll come back to.

At least for now.

-s

In which we get to the tippy top, and head back again

(This is the second blog of our trip to Northland, New Zealand. For part 1 check out this link: blog post part 1)

After Russell we had an epically long driving day – 3 1/2 hours up the East side of the long spit of land to Cape Reinga at the very tip of New Zealand, and then 3 hours back. We’d considered skipping it because, well, it is a bit out of the way but I’m so happy we didn’t.

Cape Reinga is majestical, to use a Kiwi word, and just stunning. All you can see for miles around you is blue water. At the Cape is also the point where two oceans meet, which you can see in the pictures with the variation in water colors.

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Where Oceans Collide

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The Famous Lighthouse

We spent a lot of time just sitting on one of the bluffs and admiring the view.

On the way back down the Cape, we stopped in for some sandboarding atop the famous Te Paki Dunes! Amazing to go from the ocean to the desert in just a few minutes. You rent “sandboards” in the parking lot, climb up, and go down on your belly. Pro tip: use your feet to brake, not your hands in front of you else sand flies up into your eyes, nose, teeth, shirt…everywhere. I mean everywhere.

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The other big draw up here on the Cape is 90 Mile Beach which I feel compelled to point out is closer to 66 miles. The big draw on 90 Mile Beach is to drive your car along the beach or pack into a large tourist bus that drives along the beach. Honestly, I don’t get this either. Why spoil a perfectly nice beach with fume spewing machinery?

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There’s a car. On a beach. Woo hoo.

After this came my favorite part of the trip – visiting the big Kauri groves. Kauri are large, ancient trees only second in age to the Sequoia. They grow in girth, not height, making for massive squat trees. They have declined considerably as they grow straight and as they grow the lower limbs fall off, making them into long logs perfect for lumber, and were used for years in the logging industry here. They are now seen as a taonga (treasure) and protected, but still under various threats.

Our first stop before going into the forests was a quirky little puzzle shop I’d read about in the delightful “New Zealand Frenzy” guidebook, which gives you all sorts of off the beaten path trips and tricks.

 

After this was a hike through a muddy but quiet little Kauri grove. One thing I love about hiking here is that if you’re not on one of the major tourist hikes, you may see no one else on your hike, just enjoy a peaceful stroll through the forest.

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Waterfall along the hike

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Kauri bark close up. It sheds this rough layer as it grows to become entirely smooth

 

Then came the tourist Kauri, or Tane Mahuta. Touristy or not, he is a sight to behold.

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The largest living Kauri tree known alive today, Tane Mahuta is estimated to be between 1500 and 2500 years old. I can’t even wrap my brain around that! Something that was just beginning life around the time of Ancient Greece and is still alive today.

A little ways down the road is another hike to a few other large Kauri. We took the road less traveled by and found ourselves on another solitary hike up to Yakas, a huggable Kauri.

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Trying to hug the massive, massive tree

 

We checked into a fun Top 10 Holiday Park for a glamping night. These places are great – they have clean facilities and a fun playground for the kids (and intrepid adults)!

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Wheee! The prettiest flying fox ride ever

That night, we went for a kiwi walk in the dark kauri forest, guided by a ranger with a red flashlight. While we saw eel, weta (large cockroachy insects) and gloworms in the forest, we did not spot any kiwi! Shy little critters.

Our last stop before heading home was a visit to the quirky Kauri Museum. It goes through the life of the Kauri forests, when logging industry and later Kauri Gum (amber) was big business.

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Showing the age and rings of an Ancient Kauri

 

After this, was a long ride home, back to our little house near the beach, until our next adventure in Aotearoa (Maori word for New Zealand).

-S

 

 

 

 

In which we head to the tippy top of New Zealand

A couple months ago, I took a week off of work for the kids’ Spring break and we headed up north on a road trip.

Driving in New Zealand is not really a fun experience. It’s often quite lovely, as you are threading your way by deep gorges covered in subtropical foliage, or along a rugged coastline, but it is almost entirely two lane roads that wend their way precariously along them. Much of the time, the maximum speed is 40 mph. So even though distances look short on a map, like 2 inches, it can take HOURS to get anywhere.

We drove to Auckland, excited to find a real sushi place, as we were going to the big city. In this, we were entirely disappointed. I have yet to find sushi here that even matches with the average roll you’d find at Whole Foods back home, sadly. It’s all futomaki and filled with traditional Japanese meats such as fried chicken. We were kindly hosted by our friend Chris’ parents there, and headed out early in the morning.

Our first stop was to the Waipu caves, tucked off road on a gravel path. New Zealand is well known for glowworm caves, where you walk in and after giving your eyes a minute to adjust, look as if you’re outside under the stars because of the thousands of tiny little glowing creatures covering the roof and walls of the caves.  It’s so beautiful, and we first saw this at the heavily trafficked tourist haven of Waitomo last year where you are sheperded in a line and sit in a tiny canoe on a track for five minutes to see the magic. These caves, however, are entirely free.  You pull up, walk across a grassy field of muck and down you go, open to explore to your heart’s content.

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The unassuming entrance to the caves

As we pulled up, a group of French tourists got out, completely bedecked in spelunking gear. Waterproof pants, jackets, headlamps, hiking boots with covers, they were PREPARED. As we are trying to be more culturally sensitive here, we decided to do it the Kiwi way – barefoot and using our phone flashlight to navigate. The kids and I scampered forth and may have left Eric behind, which he may have been a bit upset about given that he is not fond of caves in the first place.

Sadly, because I didn’t bring a camera and tripod to take long exposure pictures, you can’t see the glowworms the way we did, so you’ll just have to trust me on it. But it was incredibly cool to scramble around in the quiet underground with the Milky Way seemingly overhead, and feel the mud squelching between your toes.

After that it was onward to Tutukaka, where I had been hoping for a snorkelling trip to the Poor Knights Islands, alas, the weather did not allow for this. Instead we spent a few pleasant days kayaking around the harbor and hiking the beautiful walks to be found around before heading to Russell.

 

Further up north, our first stop was the Waitangi Treaty grounds. The Treaty of Waitangi (Te Tiriti o Waitangi in Maori) is a document signed in 1840 that theoretically establishes a governance of New Zealand by the British Commonwealth under the Crown, recognizes Maori land ownership and gives them the rights of British citizens. In practice, this is much more controversial. The English and Maori versions of the documents vary considerably in word and intent, and it cannot be argued that the two peoples have had a peaceful and equal existence since the signing of the Treaty. Today, the Treaty seems to be looked at still as a guiding document and one that is used to attempt to redress Colonial wrongs.

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Marae (meeting house) with traditional Maori powhiri (pronounced “pofiri” welcoming ceremony)

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Ceremonial Waka (war canoes)

 

One of the big tourist draws in the Bay of Islands on the Northland East Coast is to take a boat tour that takes you out to Hole in the Rock. This is a large Rock in the middle of the Bay with a hole in it. I…don’t see the interest and whoever is responsible for the marketing is a genius. We had still hoped to take a boat out to one of the smaller islands for a trek around, but it was still winter season and we hadn’t planned very well, so instead ended up taking a small boat to go around a bit to one of the largely uninhabited islands. The boat had stand up paddleboards, and we enjoyed a pleasant hour floating about the isolated bay.

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Little waterways among the islands

 

-S

In which I realize my dream of becoming a Quizmaster

Things have been going along fairly smoothly for us the last weeks. I’ve emerged from the immigrant doldrums into really appreciating our life here and how lucky we are.

The kids started their second semester of school and ironically are now involved in multiple afterschool activities in a way that typifies modern childhood in the U.S. We’ve generally really guarded against this at home, because with two working parents it gets too overwhelming to be shuttling kids to activities all week, homework takes up quite a bit of time, and I also value having dinner together as a family every night.  (Though I question that value on a regular basis when dinner seems to be an excuse for the kids to snipe at each other or for me to tell them for the millionth time that an entire quarter of a quesadilla isn’t an acceptable “bite.” Sigh.)  Here though, we have one slightly-employed parent, one full time working parent who’s largely home by 4pm every day, little to no homework, and a bunch of activities that are pretty special. So our schedule: Sunday mornings: Surf lifesaving (both). Monday afternoon swimming (both). Tuesday afternoon Drama (girl) Guitar (boy). Wednesday afternoon Violin (girl) then Surfing (both). The girl currently also has orchestra practice on Fridays. Phew. She wanted to pick up Rugby or Cricket as well, but those are scheduled on Wednesdays so it wasn’t possible.

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Coming out of the water at surf lifesaving

That said, it doesn’t feel terribly hectic because we still have a lot of free time around all those, and therein lies the major difference between life at home and life here. The stress level here is simply a lot lower. There’s no traffic to battle – in fact our town doesn’t even have a single traffic light! – and people everywhere are generally pleasant. I drive past the beach every day on my way home from work. Most days I can work out at the hospital gym and still make it home by four. When you want to meet up with friends, no one pulls out their phone to check their schedules to find a date in two months that works. You’ll say “hey, want to have drinks tonight?” and the answer is pretty much always “yes.” Our social life here is so much fuller than it is at home, and it’s really lovely.

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Impromptu drinks on a weekend afternoon, or my harem. (Joke people, I have women friends, they’re just not in the pic!)

We are scheduled in that Wednesday night is pub quiz night at the Ohope Chartered Club. Quiz is a different animal here than it is at home. For those of you who attend pub quiz in the states, the usual format is a quizmaster asking clues out, you write them down and turn them in. There’s audio rounds as well, where you have to identify movie quotes or songs. Because trivia is the domain of nerdlings at home, there are usually no more than 3 or 4 sports questions because they know their audience and want to be kind.

Here, there’s a quizmaster but the questions are shown on screens and there’s usually an accompanying graphic that may or may not be of any help to foreigners like ourselves. Example: “What was the name of the lost painting featured in ‘Allo! Allo!’?” Answer: “The Fallen Madonna of the Big Boobies.” Me: ????!

In addition, Kiwis find it incomprehensible that people would know nothing about sports so there are usually a LOT of questions about sports. You might think you’d have an advantage if you know sports trivia, and I regret to inform you that you’d be sadly mistaken. Because no matter how many baseball or football stats you know, they don’t care here. It’s all about Rugby and Cricket and Sailing and Netball. Now, there will often be a question that is ridiculously easy for an American like “What’s the smallest state in the USA” but Kiwis have no clue about, and we get to feel special.

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We are still in the British Commonwealth you know…

We’ve managed to cobble together a group of eclectic people to play trivia with every Wednesday, with people from the hospital and other friends. Among the group are people from India, Canada, Ireland, and of course we Americans. With this Voltron like supergroup, you’d think we couldn’t lose, and you’d be almost wrong – we generally get second or third most nights. The first place trophy as yet proves elusive, as we find ourselves beaten by a group of Kiwis every week.

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quiz night panorama, intently discussing a tricky question

As generally happens with quiz, the fun is partly from answering questions but more from making fun of people who get questions wrong. Last week there was a geography round about countries and they showed a picture of a ziggurat. For some  unknown reason (cough two glasses of wine cough) I went into Tourette’s mode and just kept chirping “It’s Chichen Itza! It’s Chichen Itza!” over and over. People would try to change the topic but I was undeterred, hell bent on pointing out that it was Chichen Itza until someone acknowledged how incredible it was that I knew that. Eric, however, couldn’t take it anymore and finally looked at me and flatly said, “You have GOT to stop saying Chichen Itza. We GET IT.” “But…but it’s…” “Chichen Itza!” chorused the other players.  We wrote down Mexico and moved on. No one else seemed to notice that when the answer round came through, it was actually Teotihuacan, and I didn’t advertise the fact. Now, when I get too excited about an answer, people just yell Chichen Itza at me and I shut up.

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CHICHEN ITZA, OF COURSE

As the title hints, I’ve also realized one of my lifelong dreams. Becoming a doctor? Meh. World travel? Whatever. But I’ve always wanted to be a QUIZMASTER and now I can say that I am! I’ve signed up to be a backup quizmaster, and had my first run at it this week! I think it went pretty well, with only minor technical difficulties. Some of my jokes didn’t go over as well as I’d hoped, as when I teased one person about thinking that a photo of Jennifer Lawrence was actually one of Viola Davis, because Viola Davis is black and Jennifer Lawrence is about as far away from that as you can get. My loving husband offered me a pity laugh, but from the Kiwis, crickets.

It’s my favorite night of the week, hands down.

-S

In which I feature someone else who knits, and it leads to a healing connection

A short story about medicine in a small town, or how small communities and their connectedness can be healing. As a side note, when I share any patient stories I will usually change significant details to avoid breaking confidentiality but maintain the essence of the problem. If I feel like a story needs more real details to share, I’ve asked permission of the patient to share first, as in this case.

In the hospital is currently a woman who I’ll call Mary who’s been in a healthcare facility for over three months. She initially came in with near total paralysis from Guillain Barre syndrome, an immune disorder that attacks your nerves, can leave you unable to walk, use your hands, and in rare cases, even breathe. Our hospital here functions as an acute care hospital as well as an inpatient rehab unit, so once the initial part of her hospitalization was over, she transitioned to acute rehab where she’s remained as she gets stronger, with her goal of walking freely again. During her time here, her husband had brought her a knitting loom, which she took to with aplomb and began churning out hats. She’s made hats for other patients, the children’s unit, and hospital staff. Once I walked in on another patient of mine wearing a sprightly red and black hat, and asked if Mary had made it, and of course she had. Over the course of the last week, she’d had a few features written up about her, one in the hospital newsletter, and then one in the local paper, focusing on her rehab and how her love of craft and knitting had helped her to heal.

Over the last week, however, she had been getting quite despondent with what she felt was the slowness of her progress, and wanting things to get back to her normal, which I think anyone in her situation would feel.  An elderly patient in the hospital in a different ward happened to read one of the newspaper articles and remembered that her husband had been afflicted with the same disease many years ago, and told him that he had to find Mary and go talk to her. And he did – coming into the ward, he asked for her room and walked in tentatively calling her name. She answered and he came in and sat at the side of her bed for over an hour, talking about his journey with Guillain Barre, how his recovery took six months, how he had even cried many times at his low moments wondering if he would fully recover, but how he eventually had.

I spoke with her the next day, and she felt entirely validated by the experience. Her tears and worry were not unusual, nor was she recovering too slowly. Someone else had struggled the same way she had, and had lived and thrived afterwards.

It was a healing conversation for Mary, and though it can’t take away all of the worries she has, was wonderful for her to have a connection with someone else. This is an aspect of rural small town medicine that I think is wonderful. The interconnectedness of the community and the openness of it make interactions like this possible, to the benefit of all.

-s

In which I learn the price of wool from one of my patients, and the kids footwear budget drops considerably

It is perhaps unsurprising that we would find ourselves in a bit of the doldrums over the last few weeks.

It’s pretty normal in the world of expat psychology, where at some point you start to miss all that you had at home, like your friends at home, or your kitchen, or having a goddamn garbage disposal. It’s part of the usual adjustment process, but it can leave you with questions about whether or not you did the right thing by moving halfway around the world. Eventually this is followed by another up, then downs, until you reach a homeostasis of expatriation, or just another middle ground.

Even New Zealand seemed to have it out for some of us. One day it was a “mufti day” which meant that the boy could wear whatever he wanted instead of his uniform. Deciding that he loved his uniform, he decided to accessorize only with his Stitch hat with the big flappy ears. He left the house to walk to the bus stop. Eric was drinking a cup of coffee on the balcony overlooking the street.  Suddenly, he noticed a commotion below him. The seagulls had left their usual post on top of the street lights to dive towards our son. The boy was being bombarded by a flock of seagulls who apparently thought that he, in his hat, was some kind of tasty large worm. The boy ran down the sidewalk, frantically waving his hands over his head to ward off the gulls, who squawked in frustration at being blocked from their breakfast. An older man walking along the beach stopped and stared at the scene, while we howled with laughter.

As if to troll us, our new place is decorated with all sorts of seagull paraphernalia that seems to have been put up with a permanent sticking charm. The boy doesn’t wear his hat indoors here, for fear of calling out the avian demons. They’d probably leave their paintings to attack in the middle of the night.

The girl has melted into school, and is having a ball. While she hasn’t made a lot of friends yet, she bounces out of bed every morning so excited about going to class. She loves her teacher, and one thing we’ve seen is that creativity is far more valued here than it is at home. Her homework, or “home learning” as it’s called here, is entirely open. Every two weeks she gets a sheet of paper with a variety of options for home learning – you can choose artistic options, math options, writing – so that every kid can find something to interest them at home, but without the rote tasks that homework seems to be back home.

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Homework for two weeks! You are expected to pick as many as you want to do and share at the end.

The boy is likewise enjoying school, and has a first playdate set up for this weekend. He was initially feeling a bit down about it, as NZ kids are quite sporty, and he’s…not. But he’s found his own little group of nerdlings as he does, playing chess in the school library at lunch and just this week has started introducing Dungeons and Dragons to his crew. His highlight of the last week was when he “accidentally” locked his shoes in the house when he left for the bus (we’d all already left for other destinations) and “had” to go to school barefoot. Upon arrival at school he was given the option of wearing a pair of the extra shoes they have at the office, but he declined.

As for me, the hospital work keeps on. Despite my years of experience back home, learning new medications and new systems leads me to feel like a new resident much of the time, which brings back all the traumatic PTSD I have related to that time and leaves me feeling unconfident.

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These signs are all over the hospital. What sort of zombie apocalype are they expecting?!

So many times I’ll casually ask for something that Americans would see as completely normal, only to have it thrown back at me. I had a patient who had fallen and had a nasty scrape where he’d lost a fair amount of skin. Unthinkingly, I said, “let’s put some polysporin on it and cover it with a nonadhesive bandage.” The resident I was working with looked shocked. Absolutely SHOCKED. “We…shouldn’t do that. It’ll lead to antibiotic resistance.” I paused, knitting my brows, and replied, “so…you can’t just get an antibacterial ointment over the counter here? What do people put on cuts?” “We just tell them to put hydrogen peroxide on,” he replied. He then proceeded to look up antibiotic ointments that were available in the hospital, and after a search of five minutes finally came up with one that they had that used a different mechanism of action less likely to result in resistance.  WHEW. I was kind of left feeling like, “Who’s the attending here?” and wanting to say indignantly “I AM! I’m the attending!”

Sometimes people think I’m a blinking idiot because it seems I can’t grasp a basic idea they’re talking about, when it’s just that I can’t understand their accent. They then go into details of whatever they were describing like I’m a moron, at which point I’m too embarrassed to correct them and say that it was their accent I couldn’t understand since of course, I’m the one with the accent. I had a patient who was telling me that he had “hot tack” a few years ago. Thinking that this was some Kiwi traditional therapy or something, I asked what “hot tack” was, only to get a quizzical look from my resident as she described “Hot tack? Well, it’s when the heart doesn’t get enough blood and then doesn’t work as well, and they get chest pain?” Oh.  A heart attack.  Great, now both patient and my resident think that I don’t know what a heart attack is. There goes any credibility I might have had.

That said, I continue to be amazed by the relative reasonableness of patients regarding their medical conditions. I’ve had far more conversations with ill people about their potential for death, and all of the elderly people I’ve talked with have expressed to me that they don’t want any aggressive measures to be taken and that they understand that this could lead to their death.  These are different than conversations like this I have at home, where usually the question is asked to someone who is not in extremis, and even then limits to “what can be done” is not typically discussed. People will talk about not wanting to be resuscitated, or be put onto a breathing machine, but smaller discussions don’t often take place, and there is a different attitude towards end of life.

I do feel like I can be more relaxed overall with the patients here, chatting with them and able to bring more humor into our interactions. I’ll leave you with a story from last week.

I performed a procedure to remove excess fluid from someone’s belly, and it takes a while to get the fluid out slowly as we don’t have the handy vacuum sealed flasks here that whoosh it out in a matter of minutes.  Over the 30 minutes I sat in the room, I chatted with the patient, a Maori person, and his daughter in the room. They live out in farming country, and I asked what type. “Cows, ship, pigs. All sohts of animuls.”

“Do you raise the sheep for meat or for their wool?”

“Wull. You can do it foh both…but listen to this. Theh was a farmah who hed his whole flock stolen! And thin two wiks latah, the entiah flock was returned to him, but they’d all bin sheahed! I said to myself, ‘theyah’s a man who knows the price of wul!’”

“Wait,” I said, “They brought the sheep back and no one noticed?”

“Oh yeah!” the daughter said, “And that’s when I said you know thet wasn’t no Mowri pehson stealin’ the ship because we would have kept those ship and fed them to our families!”

 

-s