Martinborough wines, Old Friends and musings on work

A bit of time has passed since the last blog and we put that down on our work schedule. When we are here and short staffed and on for the weekend, work pretty much occupies our time. And for you Northern hemisphere folks, remember our days are quite short in Mid autumn, so no after work bike ride or hike. But to complain about my hours is silly, I see men and women at the fish processing plant work 70 hours a week and the people up at the Mine work tough 7 days on and 7 off schedules. We have it good, though our recent visit to see Duncan, a friend from our freshman dorm at Stanford, raised the work issue as well. And not just because David Beckham

I

is retiring at age 38 but because Duncan has now a nifty lifestyle farm in the Greytown Carterton area north of Wellington with his partner Jan

SO Duncan has now traded his academic hat for a pick and shovel and an infinite number for projects around the farm. And though I am tempted to post a picture of Meatloaf here as that is one of the cows name, the fat Meatloaf's drunken support embarrassed Romney and totally eliminated the 1.3% chance that Nate Silver predicted he had of winning the election, and I do not want to popularize him again to the 4 readers of the blog.
Actually I was thinking of Kurt Vonnegut and Cat's Cradle and the tenet of the fictional religion ( is there a non-fictional one/) Bokononism called Karass.  A karass is a group of people who lack the common socially acknowledged ties like Cheeseheads, Rotarians, meadows club members, Boy Scouts, Boulderites, etc but actually seem to have an undefinable close tie. That's how it felt visit Duncan and Jan, though we have  only visited Duncan now three times in thirty 34 years or so, it was immediately familiar and warm. And that was not just the Wine talking

Though the Pinot Noir at Ata Rangi was excellent. I hope we can get together more often in the next 30 years, though I do not know if retiring to a lifestyle farm is really retiring or not.
And speaking of close friends, our returning flight to Westport was cancelled due to a giant storm that shut down the Wellington airport and Mark and Linda Baxter came to the rescue with  their hospitality and provided us with an excellent dinner, bed to sleep in and great company. All the more reinforcing the Karass tenent.

Hokitika

We left the Baxters and drove with the Girls back to Westport where we wanted to show then where we lived and worked. They were quite impressed with how friendly our coworkers are! We did not have but one night here so of course we dined at the Dennison Dog and enjoyed the local fish. The next day we were of on our adventures, including a stop at our favorite walk Cape Foulwind Because, after all, how can you pass up the opportunity to watch fur seal pups! They are already so much larger than our first visit when we had just arrived. From there we continued south and enjoyed again the Pancake rocks and the blow holes at Punakaiki and Truman Track through the rainforest down to a pebble beach. Our goal was to drive part way to the glaciers and Kayak the next day at OKarito lagoon to see the White Herons. Hokitika made for a perfect stop We stayed right by the beach with a sweet little drift wood art sculpture display. But one of the most amazing travel coincidences of our lives, in the Hokitika grocery store , Carolyn ran into friends of ours from Boulder, Kay and Jack Fellows. We had no idea they were traveling in New Zealand. The odds of running into a neighbor in a little off the beaten track town 8000 miles from home is quite Low, we could not believe it. We enjoyed evening tea, actually take out fish and chips and wine, and then caught a beautiful sunset from Hokitika beach. Then we checked out the glow worms. You will just have to take my word for it, but imagine a star filled night sky stuck under some heavy rainforest canopy.

Actually at Work

Well, here's a post for those medical readers who have been wanting some info on actually working here.

Carolyn and I alternate our time between having scheduled appointments and being on the Duty Team. The scheduled appointments are what you might expect, people are given a 15 minute appointment slot to discuss their acute or chronic conditions. The duty rooster involves seeing acute patients but also patients who are not able to get to see a provider with appointments. At our clinic there are two MDs and usually 2 Nurses who are seeing duty patients.

We have found that our average daily visit numbers are very similar to what I have seen at Clinica and Carolyn at Indian Peaks. The differences reflect the support staff. Here, the front desk will check in the patient but I personally call the patient to my exam room, personally take whatever vital signs I deem important ( vital signs are vital, PSSHAW, not for knee pain!), personally review their medications, etc. So much of what we rely on in the States before we see the patient is up to us.

Overall though, the mix of patients has been great, the people have been friendly, We have seen traumatic amputations, sore throats, chronic mental illness,and gyn problems. The medicine is much the same as what we are used to in our Colorado practices, though I personally have yet to see the problems presented by the chronically homeless that we see at home. Also, though I keep ordering A1cs here expecting the typical diabetic or prediabetic result that I see at home, apparently the New Zealanders have not succeeded in matching our soda and sugar intake to make those tests so consistently abnormal.

We wanted to write this entry before our impressions were colored by our first weekend call experience. You might know, unlike the states, when we are on call here we get not only the on-call beeper but the on-call car, complete with a hard hat, flashing lights, emergency cape and all sorts of things to respond to emergencies. We cover the only ED within 100 KMs, cover the hospital ward, and cover the long term care wards. Transfers out of here have to go by helicopter. Obviously, this is not exactly how it works in Boulder Colorado when you can not have dinner at Mateos without bumping into three other MDs, every major intersection has a hospital with an MRI. So wish us well. I hope our post call post is as enthusiastic.

Westport

After a sunny morning stroll along the Island Bay waterfront with Linda we caught a flight from Wellington to Westport. Unfortunately we got nailed with a huge fee for our second bags, be really careful if you fly domestic flights here. We had a smooth flight and had our first view of the South Island West coast from

Westport was one of the smallest airports we have flown into though the welcome was great and the staff from the clinic who met us were wonderful. They gave us a brief tour of the town and then took us to our home, a second unit on a property on the banks of the estuary in town.

We had a wonderful meal at a local pub last night where we were overwhelmed by the hospitality of the local folks. We greatly look forward to getting to know them. Today we will do some more settling into our home and perhaps check out the rec center. Still a bit to get done before we start work tomorrow.

Our previous visit, 26 years ago!

We are returning to New Zealand after a 26 year hiatus. After Carolyn and I finished our residency in Family Medicine in 1986, we took a 6 week trip to Hawaii, Australia and New Zealand. We had a wonderful whirlwind trip with one week on the North Island and one week on the South. The trip was outstanding and we always meant to go back, never expecting it would take so long. Just last week I was able to get some of our old slides from our trip transferred to digital and it has been fun looking at the highlights of that trip. We had no slide projector so we had not seen these photos in probably 20 years.

For those of you who know us, you can see how we have aged from these photos! You can also see why we were so determined to make it back to visit again! We are now in the final couple of weeks of preparation and I am rapidly reviewing the ACLS algorithms, crossing my fingers that I will have no need for them. At my going away Party at Clinica Campesina last night, Mary gave me some flies to use when stalking those New Zealand Browns and my hope is that they will be muhc more useful than the ACLS algorithms.