Saturday 31 December 2011

Dream: a drug ring bust by Will

In this dream I have bought a sky blue Nissan Micra. In the dream I shudder at my own poor taste - I think Nissan Micras aren't exactly the essence of style and am lamenting why I spent $20,000 on that car!

Anyway I pull up at the Woolworth's petrol station outside Casuarina. It's raining as I get out of the car to fill up. When I unscrew the lid, I see that the petrol tank actually looks like a big plastic bottle inside the car and the petrol just splashes in. I shake my head at the poor design and start filling it up. I look up and it only costs 70c/L! After a while I wonder how a Nissan Micra could have such a big petrol tank and decide to stop.

I walk inside to pay. The total is $54.25 and I hand the man at the till $55. When I get the receipt back and my change, I realise that the receipt is actually printed in Chinese and the items on it are completely random, as if I had bought things in a supermarket. Nowhere does it even mention the word petrol. I ask the man why I've been given this type of receipt and he says, just take it and go.

Suddenly it comes to me that this must be some sort of tax scam! I threaten to call the police and the man presses a big button on the wall. All these people immediately appear in the store and start calling things out over the PA system such that all the other cars in the petrol station scoot off quickly. I start to feel scared that I am stuck in this place with a bunch of thugs, but try to keep calm.

Then Will the ED consultant opens the door and he is standing there with his 5 year old daughter wearing a pretty pink dress.

"What are you doing here, Will? It's dangerous, you have to leave immediately!" I said.

"That's all right, I just came to save the day." He strolls in and picks up a candy bar for his daughter, who is very sweet.

"How? These men are really dangerous and they have guns!"

He hands me a copy of the NT news and says "The answer is there, as always, in the NT News".

I look down at the cover and there's a huge picture of a bunch of men being led away in handcuffs, and the title is Major drug bust in petrol station.

My spine chills and I wake up.

Sunday 25 December 2011

Haw Par villa

I had heard about Haw Par villa from my previous boss Tsin, who regaled me with tales of when he was taken there by his parents as a child in the 70s, when the place was all the rage for scaring kids into shape. Particularly gross sounding was the ten levels of hell, I knew I had to check it out for myself!



Built by the Tiger balm brothers (yes, the folks who invented tiger balm), it is a strange sort of Buddhist / Chinese theme park, where there were no rollercoasters but ethical and moral dioramas taken from old Chinese stories. As Singapore became more developed, it became less and less of a tourist attraction, slowly crumbling away in the south western corner of Singapore.


I was surprised to find that the new MRT line actually had a Haw Par villa station - I think it was meant to be. Some effort had obviously gone into restoring the place in recent years, and there were a fair number of families with little kids wandering around on the Saturday morning that I visited.

Most of the park consists of story dioramas and a really random assortment of statues which are just dotted around the place. Some of the staircases are fashioned into waves or caves and it was sort of eerie to walk around amongst these plaster statues that were built almost a century ago.

I had a great deal of fun making up captions for some of these dioramas:


Yellow and red don't go together!

Life is more fun with three!


You never know what skimpily dressed woman you might find inside a giant clam shell
 
There was also the most bizarre animal park, where three giant gorillas (about twice my size) sat down one side on a fake log, and the rest of the park was dotted with scared looking animals including some real menacing looking kangaroos (!), a few kiwis pecking at the lawn and this tree of koalas.
A few monuments to the Aw (Tiger balm) family were scattered around the park, and the centre of attention was this lake filled with turtles.



Other surprise finds included the weirdest diorama of a badger hospital (this badger doctor is obviously a vampire)

And also this Tiger car, I guess it'd be hard to lose in a carpark!


But of course the real attraction was the Ten Levels of Hell, which was inside a dark building of its own. It was barely lit inside by a dim red glow, which made everything look extra bloody. I think the sign outside warning that the place is PG should probably be extended to adults, especially after I'd read that being stuck on a mountain of knives is punishment for tax evasion!



It's so oddball that it's almost not gory, but there sure was a lot of blood in hell...

The solution? Well, one could dance around some Tiger balm 


or alternatively just follow this helpful plaque at the exit (topped by a skull with daggers coming out of its eyes): The sea of suffering is endless, just turn around and the shore is there.


What a weird place. I loved it!

Monday 5 December 2011

An unique outreach

So there we were on a remote island, a couple of hours flight from Darwin. We had arrived on our own little charter plane, crossing a crescent of deep blue ocean onto a lushly wooded island. The clinic was practically closed as there was a death on the island the day before, and everything was in lock-down mode. It appeared as if we had fatefully chosen a bad day to come to the island (and we only visited three times a year!)

We spent most of the morning seeing just a handful of patients. As we were having a cup of tea and getting ready to pack up and call it a day, a nurse ran into the tea room and shouted "We need a doctor! Emergency!"

It was almost a little surreal, as the tearoom really felt like someone's lounge room, and it didn't seem like we could be called to attend an emergency in such a cosy relaxed place. But as we ran outside, reality sank in - there was a landcruiser with a handful of locals, shouting and gesturing frantically at the motionless figure sprawled across the backseat.

For a split second my brain froze as I thought it was the lady I had just seen in clinic, but as I got closer I realised it was someone else. She didn't appear to be moving at all. My boss started doing chest compressions and all of us together managed to get her onto the trolley to move her inside the clinic.

Inside we realised that she was in a terrible way, and that she was probably "gone" as convention would say. Her heart had gone into a seriously abnormal rhythm and was unlikely to recover. We carried on the resuscitation, knowing the grim prognosis at the back of our heads. We looked at one another sternly and decided on ten minutes as a cutoff point, thinking that everything would probably end there and then.

Ten minutes later we were surprised to find that she had started to show signs of life. So we kept going, and going, and eventually got to a point where we had to make a decision to evacuate her to Darwin. It was a bad day to fly - Darwin was a no-fly zone because Obama was in town, and we ourselves had even seen the giant US airforce planes parked across the runway at Darwin like alien spacecraft as we took off in the morning. Careflight took several hours to come, and things had taken a serious turn for the worse during that time, though she was still alive.

I have never been called upon to bag ventilate a patient for four hours. The repetitiveness of the muscle strain aside, my mind was adrift in a sea of thoughts, about what had happened during the resuscitation, about what would happen to the patient once she made it out of this place (or would she?), about all the things that we didn't have on hand at the clinic.. about all the ways things could have been better.

But there was nothing I could do, other than rhythmically squeeze that bag. It was almost hypnotic, watching the oxygen go in and out. Eventually when Careflight came it felt like there were so many people in the room it was almost like a circus. As we got ready to leave the clinic, I looked outside and it was completely dark. There were dozens of faces in the front yard peering anxiously inside the security fence, and beyond those faces were even more, spilling out onto the main road. We drove to the airport and there was a crowd there too, all lined up along the fence near the Careflight plane. It felt like half the community was there, and though everyone kept quiet, it felt like a potentially unrestful situation.

Later I heard that she passed away in intensive care, which was more or less the expected outcome. Though she'd fought the odds to come back, the time before she got to the clinic that her heart had not been working and the long time it took for her to be retrieved, meant that she didn't really have a chance at long term survival.

I had never done an out-of-hospital resuscitation before, and getting to grips with the difficulties of being in such a remote location was certainly an eye-opener. A lot of things we take for granted in the hospital setting simply do not exist out there, and we were having to "make do" with what we had. There was a lot of thinking on one's feet, and given the circumstances I thought everyone involved did extremely well. On one hand there was certainly the feel-good factor that even in the community there were competent doctors and nurses serving the community, but there was also the sombre undertone that this is the harsh reality of life - getting sick 1000km away from the nearest major hospital is tough, and it's really touch-and-go. And not every community is going to have such a wonderful clinic, though it really makes one appreciate the work that remote health workers do.

Friday 2 December 2011

A few favourite quotes

Patient with STEMI:  Doctor, I have this terrible pain in my chest, it's just like a buffalo is sitting on my chest!

Kirsty: Why would the surgeons even ask for an ECG? So they can fold it up and fan themselves?!

Dr Chacko (trying to explain to a patient going for a mitral valvuloplasty using a model of the heart): Guys, where is the mitral valve?

Patient with a stroke: my body was just swaying, like a tree in a cyclone

At handover, after 30 admissions: we need to marinate our brains in coconut liquor to continue

Dr McDonald: some patients are clearly obligate anaerobes

Monday 21 November 2011

Dream: Johanna and the LV store

In this dream Johanna and I are a bit older, perhaps about 40. We are at a party where there are about 20 people and I don't recognise any of them except her, so naturally we start talking. She is wearing a pink striped shirt, much like the one I have hanging in my wardrobe right now, black pants and red heels. We are talking pretty excitedly about how I recently got married, and she berates me for never having introduced him to her.

"So here he is!" I turn around in the dream and see this short obese man, basically a conical Christmas tree shape with arms sticking out of a circumferential ring of fat. And I feel slightly nauseous.

"This is Tim Flannagan." I say to Johanna and feel shocked at myself in the dream. Me and some fat Irish man? What in the world?

They exchange some pleasantries and Tim waddles away.

"So what do you do with yourself these days?" Johanna asks me.

"Well, nothing really. Tim is really rich so I'm just a housewife." I reply and feel horrified at myself.

"Let's go to the LV shop then!" She suggests.

So we go to the Louis Vuitton shop in the city and Johanna says she is looking for a red bag to match her mother's red shoes. As she is browsing the bags, I see the world's most hideous necklace. It is made out of several circles of stone, a fungal shade of black-green. I pick it up and can see some bile coloured swirl inside the stone.

As I am staring at the yellow swirls, my alarm goes off.

Tuesday 1 November 2011

Dream: a vomiting man and a water canal ride

In this dream, I am called to go to CCU to see a new patient. When I get there, there are hardly any nurses around and I walk all around looking for the patient. I find him in bed 1. A skinny old man, he is absolutely soaked in brown stuff that looks either like vomit or diarrhoea. More is coming out of his mouth in spurts and the gown and bedsheets are just totally covered in brown goop.

I turn away feeling nauseous, and find myself in a different scene. I am in Xiamen where I am meeting Marek and his friend Peter, who is a thin tall man with brown hair and brown eyes (no recognisable features to link him to anyone I know). They tell me that flights to Beijing are super cheap, only Y100 today. So we go to the airport and get on the next plane to Beijing.

On the flight I try to text star to tell him we are coming to Beijing but I find I have erased his phone number. I manage to find some pxt he sent me and send it to that number but the mobile doesn't tell me whether the message was sent properly. We take a taxi to star's place, which has warped back into his old place. Peter says he is exhausted and goes off to take a nap. So Marek and I are sitting outside in the living room when I suddenly realised that star is going to be absolutely furious if he came home and found that I'd let myself in and brought these strangers! So I tell Marek that we have to leave and go stay somewhere else, but he seems really non-chalant about it all.

Then the scene chops to a water canal town which looks like the region south of Shanghai. We are taking a small boat through the canal. The paddling is a little difficult at first because we keep striking things in the water, but we can't really see what the things are because the water is quite dark and murky. Then the canal broadens and we can see beautiful old whitewashed houses with grey slanting roofs on both sides of the canal. People are milling about doing their own thing. It seemed like the whole scene was in black and white with not much colour.

At some point we decide to go back and as we turn the boat around, gentle waves start to come down the canal. Our boat rocks a little, then the waves get bigger and water is splashing in. Marek says just keep calm and push on, so we paddle and paddle until we get back to the landing where we started. The stairs down to the water are completely flooded and we have to get out of the boat and swim to the top. We struggle to swim against the tide and whilst I can see the top of the stairs I can't quite make it there. Then I look up and there is a row of children standing on a balcony watching us.

Then the alarm clock  goes off and I have to go to work.

Sunday 30 October 2011

Maubisse

After a day in hot dusty Dili, I decided to head to the mountains for some cool air. The taxi driver left me on the side of some random road to wait for a bus going to Maubisse. After ten minutes no bus came along so I went to ask a random truck driver, who was quite enthusiastic and encouraged me to climb into the truck. Note to self, if climbing up the side of the truck into the back is rather difficult, it may be a sign from god that bumping down a pot hole track in a truck isn't the best idea.

But anyway I got in and ended up sitting on the floor next to a billie goat whose legs were tied up and it was forced to lie on its side. It bleated softly at first, but as the truck went around the mountains it got about as motion sick as me and started vomiting. Then it was screaming and gasping like it was having a stroke. It was just about how I was feeling too.

The truck was totally packed - the entire back cabin was taken up with women and children sitting on two wooden planks along the sides of the trucks, with men hanging off the sides and the back. Eventually I got upgraded to sitting on a bag of rice after a couple of vomiting girls got off, and about half an hour from Maubisse I even landed a seat on the planks, next to an old man holding his prized rooster like it was a baby.

The road was pretty rough, at some points leaving one wondering where the road actually was amongst the potholes. The steep winding around the hills made me want to vomit so I had to close my eyes. Intermittently when I opened them I would see lush green rice paddies, beautiful coconut and banana trees and the odd coffee tree. Children and animals played in the dirt, occasionally chasing the trucks down just for fun.

The main monument in Maubisse, next to a Fretilin flag

Four and a half hours later (depressingly, Maubisse is only 70km from Dili!), we arrived in a bustling market. But I felt so sick that I decided to go for a walk. The poussada (guesthouse in old Portugese building ) was set high up on a hill, overlooking Maubisse. The 10 minute walk up the hill was beautiful and one was rewarded with breathtaking views over the mountains. Halfway up there is a small memorial commemorating deaths in the local area, one of many I would see in Timor. The poussada is set amongst ruined walls of a Portugese era fort, and has a really abandoned feel to it.

 Steps up to the poussada

I went down to the market again but it was packing up for the day, everyone was getting into trucks to go back to their own villages, so I ended up having lunch with a bunch of UN police at one of the only eating joints in town. A strange old man who clearly wasn't part of the UN but was wearing some faux police jacket came up and started talking to me, then started shaking my hand vigorously whilst sporting a toothless grin. He insisted on buying me a bottle of water, which I guess was nice of him..




Man passing his chicken up the truck

There wasn't actually anything to do in Maubisse, which was just perfect. So I sat on my little verandah at the poussada, reading The World According to Garp, which reminded me of when I did anaesthetics last year and Dr Ferris was telling me about John Irving books. Dinner was served in the massive dining room (there's a lounge with old-school leather couches too) and I was the only guest. Rice, green beans and "Timorese steak", which was a steak marinated in tomato & onion salsa then grilled and served with the salsa reduced. It was pleasant enough though the steak was hard to chew.




 At the poussada



















I woke in the morning to the sun casting a lovely soft light on everything. Breakfast was the most wonderful chewy bread rolls, still slightly warm.

I was happy after breakfast, so I dawdled down to the town to get the bus back to Dili. I sat in front of the market waiting for the bus to come, and vowed that I wouldn't go back to Dili on the back of a truck again (especially since the people at the poussada were adamant that no-one goes on trucks, everyone goes on buses!) I waited and waited, and eventually saw the "policeman" from the day before, who clutched my hand and semi dragged me across the road to a toothless woman with stained gums from betel chewing. I couldn't understand anything she said, but eventually (after trying to put me in a refridgeration truck) she shoved me on the back of an ute, and despite my vows that I wouldn't go back to Dili on a truck... I went back on the back of an ute which was probably worse...

Because when we went through several towns, there were convoys of trucks carrying lots of men, and lots of them had guns. I felt pretty exposed, the only foreigner on the back of an ute. But luckily I didn't get shot and made it back to the mindbogglingly luxurious hotel in Dili where I was to meet Namiko and Jade.

Saturday 29 October 2011

East Timor: random first day in Dili

I flew to Dili early one Saturday morning. The flight was just one hour and ten minutes, and it felt like we hardly had time to scoff down our pastries before we were landing. We walked out onto the tarmac and into the single square building that is the airport, waited at the only conveyor belt, and pretty soon I was in the "waiting area" which was just a handful of plastic chairs out in the open air.

I had no idea where I was headed, but on the flight I decided I would try to get to Atauro Island on the ferry that morning. It was early so I took a taxi to the wharf, thinking I'd just wait for the ferry there. When I got there, hundreds of people were trying to push their way onto the wharf, frantically waving their pre-purchased tickets. I had no hope of getting a ferry ticket, so I gave up and went for a walk instead. I wasn't carrying much stuff, so it was nice to walk in the early morning (relative) coolness.


Some deserted blocks later, I made my way to the only backpackers place in East Timor - the East Timor backpackers, run by a Pom and his Timorese wife. As I walked in, they were trying to chop down a tree full of beautiful yellow flowers, a rather strange activity for Saturday morning, I thought. After a short nap I spent the whole morning talking to some random guy working as a volunteer for Arte Moris, a local organisation supporting young Timorese artists. He had finished university in Brisbane and decided to move to Dili - he seemed like the archetypal wanderer, so by the time I finished talking to him I felt like I was back on the road wandering too.

Eventually I went for a walk around town in the almost unbearable midday heat. Near the water it was not too bad, but everywhere else the air was so still that it was almost suffocating. Everything seemed to be closed, and there were not many people walking on the streets. I walked along the waterfront where people hid under huge banyan trees and drank coconuts, then I had lunch of fried fish and fish curry at a padang style joint.


Dili was strange to walk around - most of the time it was just hot, dusty and unpleasant, but one would come across some strange surprises. Sometimes, turning a corner, one would suddenly see the hills that surround Dili, and it was actually pretty picturesque.


Also there were a number of colourful murals around the place, a lot of them with a Tour de Timor theme. I guess the bike riders or organisers must have painted them.


And once in a while there would be pretty trees and flowers, such as this one near the cathedral.



The strangest surprise for me was when I went back to the hostel and sat drinking iced tea. The men who had chopped down the tree with yellow flowers earlier in the day were busy building a shelter-like structure out of palm leaves. After laying down the layers of palm, they had to trim the shelter, which they did with a machete and a mango stick! Sitting under the palm cover once it was done, it exuded a sweet smell which reminded me of rain in the wet season.



So I drank iced tea, gazed at the sky and unwound. At sundown I went for another walk, but I was uncertain about the safety situation so I stuck near the hostel and had a masala dosa for dinner.



I saw lots of UN vehicles that day, both standard ones (so easy to spot white Landcruisers) and UN police vehicles. I had my first taste of the demonstrations - there was a peaceful protest in the city centre, where lots of people old and young marched through the streets carrying signs. At this protest I did not feel uncomfortable to watch (unlike others later), so I stood on a corner near the National University and watched the hordes of UN police carrying heavy weapons direct the protest away from the city centre. How surreal it was..

Sunday 25 September 2011

Outreach to Nguiu clinic


One beautiful sunny day, I went to Nguiu for outreach clinic.

I sat on the ferry reading Joe Cinque's Consolation, which was an intriguing tale of love, death and psychosis. I kept reading till I felt like I was going to vomit from seasickness, then I went to sleep. When I woke up the ferry was perfectly still, and when I looked out the window there was a small boat speeding away from the ferry. We are sinking! was first my first thought. But no, a group of unhappy youths had burnt down the jetty on the island and the little boat was our only way to land.

Once on the beach, there seemed to be not much other than red sand and coconut trees. I was picked up by the clinic in a brand new white government-issued 4WD which looked really quite out of place, and drove a few hundred metres down the road to the dialysis centre.


My consulting room consisted of a bed, a desk with broken drawers and two broken chairs (everyone sat on the bed). The clinic assistant drove off in the 4WD to "round up" the patients from all their houses, and soon there was a queue outside my door.


It was much like any other clinic in the NT, but the Tiwi islanders are really quite sweet (always smiling, they are pretty much my favourite group of patients!). I always have the most hilarious conversations with patients in clinic, for example:

Patient: Doctor, doctor, I need you to help me.
Me: What can I do to help you?
Patient, opening mouth real wide: Can you take out this rotten tooth? It's really annoying me.
Me: I'm the kidney doctor, not the dentist.
Patient: That's ok, you look like a nice one, take it out anyway!

Patient: Doctor, now I'm on this dialysis thing, it's really affecting my life, you know.
Me: Yes, I understand it's hard to come to dialysis three times a week.
Patient: No, no, I like coming to dialysis, all my friends are here.
Me: What's bothering you then?
Patient: Well, I've got to wear shoes... I don't like wearing shoes.
Me: Well, you've got diabetes and the feeling in your feet is not so good.
Patient: Oh, but I like going walking in the mangroves without shoes.
Me: If you go walking without your shoes you might cut your feet and it might get infected.
Patient, reluctantly: Ok, I'll put my shoes on once wet season comes.
Me: What's the difference between dry and wet season for shoes??
Patient: Well I don't want to die from soil sickness (meliodosis)

(See, even patients have their priorities straight).

After we saw all the dialysis and transplant patients, we had lunch on the verandah, looking out to the sea. The dialysis centre is in a really beautiful spot, right on top of a cliff, looking out to Melville island.



In the afternoon we went to the local health clinic for our other clinic, but no-one knew we were coming so it was cancelled. We ended up roaming down the street to the art centre where I bought a Tiwi bird carved out of wood and painted using pigments from the earth. Then I went back on the ferry and read some more Joe Cinque.


It was such a relaxed day, if only I could go on outreach more often....




 The Indigenous food pyramid!

Sunday 18 September 2011

The end of the dry

A lot has happened in the last few months.

The weather has been just beautiful. Dry crisp nights, not too hot during the day, clear blue skies everyday (bar the occasional burning). Often I went to work thinking that no matter how awful things get, it's impossible to be in a bad mood in this sort of weather. It's just anti- seasonal affective disorder, and makes me wonder how I'll cope with the Sydney winter when I go home. When I was in Sydney in August it was almost unbearably cold, and I wondered how I'd lived there for so long.

Now the dry has sort of ended, and the days are starting to get muggy. The mango season has started though, so it's somewhat compensating for the lack of good weather. The nights are still tolerable but we've had a few afternoons that were a bit choking. But I get to eat a mango everyday (at least), which I'm enjoying immensely.

And from the end of my time in GM5, to relief, to 3 weeks of annual leave, I've now been in renal for 2 months. The last three months have just warped away from me and I have no idea where they went. Part of the reason time has gotten away from me was because of the uncertainty about next year. I had originally planned to take a year off to travel and work for MSF, and in fact had already applied to work for MSF and even got an interview. But somehow it was not to be. The college released a regulation update that mandated continuous uninterrupted training, and though I could apply for "special consideration", I ran the risk of being unemployed (or stuck somewhere horrible) if the special consideration was not approved.

Like the last time I faced an uncertain situation, I decided to leave it up to fate. I applied for two jobs only and decided that if I were not to get either, I would just go to Africa. One could call it a win-win situation - either I end up in a good ICU where I want to be, or in Africa where I want to be.... or one could call it a lose-lose situation - either I'm miserable back working in Sydney and actually want to be in Africa, or I drop out of the training program! True glass half-full or half-empty ness.

I felt almost nothing when I got those interview offers, and almost nothing while I was doing the RPA interview. I still felt nothing when RPA called and told me I had a job (shouldn't I have been ecstatic? bouncing off the walls? after all this is what I wanted all along..). It felt surreal, I felt detached from it all.
Even now it hasn't really sunken in. Though with the weather getting hotter (and more like the weather when I arrived in Darwin), the realisation that two thirds of my time in Darwin has gone has slightly indented in my mind. I can't imagine what will happen when I go back to Sydney, it will be the biggest culture shock!

The strange thing is, I've almost stopped dreaming. Once I dreamt I was in a patient's bladder watching the fungating tumour (with lots of flailing arms sticking out of the giant cauliflower like lesion), struggling to keep afloat in a sea of urine. Another time I dreamt I was being delivered a curry, one cube of meat at a time. But my dreams have faded somewhat and are not really very vivid. It's probably just sleep deprivation, or maybe it's too hot at night now. But I miss my dreams...

Monday 15 August 2011

七月

夏夜
狭窄的床
隐约的汗味
口中喃喃的絮语

无法言喻的心情
已经遗忘的约定
未曾实现的希望
走投无路的憧憬

Tuesday 7 June 2011

Dream: death by oestrogen

In this dream I'm sitting in a strange man's black convertible. I don't recognise who he is at all, but apparently in the dream we are on some sort of date.

So we are driving around up and down a few highways, just enjoying the feel of the wind in our hair. Then we decide to go to this shopping centre, which looks a lot like Casuarina. We take a left at the KFC, much like the real Casuarina, except as soon as we turn I see a huge boom gate which is not there in real life.

He is still speeding along so I tell him he'd better stop at the boom gate. He says "why should I stop? I don't have any money". I am somewhat horrified and tell him that I'll pay for the parking.

"All right then." He says grudgingly and pulls up at the boom gate, where there's a little hut with a man sitting inside.

"Wait here," he says to me and ducks into the hut.
The next thing I know I look up and the man is no longer there.
"What happened to the man?" I ask him.
"Don't worry about it, let's go." He says.

As we drive into the parking lot I am overwhelmed by this feeling that he somehow killed the ticket collecting man, so I start asking him again and again, somewhat hysterically "What did you do to him? What happened to him?"

Finally he sighs and says "well, if you must know.."

He pulls out a tab of pills from his pocket and shows it to me - it has the Mon-Tue-Wed etc pattern written on it like the oral contraceptive pill. He turns it around and most of the pills are missing.

He says, "I made him take all these pills, and he died of an oestrogen overdose."


Then I wake up.

Random Darwin, part two

Darwin's one of those places where one sees strange stuff all the time, and despite the fact my phone takes really crappy photos, I often have the urge to pull it out and snap a random photo. My interns will testify that I frequently announce "Kodak moment!" on the ward round, for example when we were trying to find a ward in the private hospital (the public frequently overflows into various corners of the private), and the nurses helpfully directed us to this sign on the wall:


One day I finally went up to this ward in the hospital called "Constant Care", which is actually really a nursing home because all the patients in it are waiting for nursing homes, and found this sign at the entrance next to the fish tank (yes, all this nursing home has to entertain its residents is a fish tank)


 Back to the good old private hospital, they got a bit tired of the public staff using their things all the time, and even their bench space they were very protective of. So on one ward, which was half public and half private, I found this sign, reminiscent of primary school days...


Of all the random things I've taken photos of from medication charts, I thought this was probably the most hilarious. Fleet enema TDS, only in Darwin...


And I couldn't resist taking a photo of my intern Olivia who was so tired on our massively long ward round that she sat down on the nearest piece of furniture (of course we don't have chairs).. the patient's wheelie walker.


And here on a random antique scale....

On a different ward, a patient complained that she couldn't get hold of the nurses because there were no call bells.. so she was given one of those old fashioned ringing bells (here is Olivia again demonstrating its use). And of course our patient was an adult, just the hospital was so full they stuck her in the children's ward.



Away from the hospital, one day I went for a walk and found a dead snake just outside the driveway of the hospital... what can one say but Normal For Darwin?



A handful of really  random things have happened since I moved to Darwin, and this has to come close to the top of the list. One night I was meant to go with a bunch of medical students to Lee Point for a bonfire, but I  ended up staying at home because I wanted to sell my microwave. Eventually I sold the microwave and made my way to Jacky's house for dinner. While bonfiring one of the boys, a 21yo French 1st year medical student, had burnt his foot trying to firewalk. So he sat in the bathtub sulking while running his foot under cold water, and Jacky went to look for his "special bag of medications" which he'd stashed in a cupboard somewhere.

It was actually two whole plastic bags full of medications, and it was the weirdest thing ever sorting through them! Aside from the obvious paracetamol, nurofen, antibiotics (half a dozen types, including ones I'd never heard of), anti-histamines and steroid creams, there was also clonazepam syrup (just in case one develops epilepsy, perhaps?), anti-fungals, a combination paracetamol-tramadol tablet (very bizarre), oxazepam (maybe to be taken if life in Oz got too stressful?) and an anti-depressant! All the medications laid out covered a whole side table, and I was simply amazed by what one's father would give an otherwise healthy 21yo to take to a developed country where medications are readily available!

Anyway.. I gave him some panadol and nurofen, and couldn't resist giving him half an oxazepam! Then we all crowded into the tiny bathroom to keep him company, eating kangaroo stir fry to the sound of running water.. Now if that's not random, I don't know what is.

Thursday 26 May 2011

Dream: the sun doesn't set at Dripstone anymore

In this dream, a whole bunch of us from the hospital are at Dripstone cliffs, sort of like the medical registrar welcoming party they threw us in January. We are standing around chatting and sipping drinks when I looked up and realised the sun was gone.

"Are we here to watch the sunset?" I ask the nearest person.
"Oh, no, the sun doesn't set at Dripstone anymore." They reply (I can't remember who they are at all!)
"Why not?" I ask, puzzled how the sun can choose where it sets.
"Well, the hospital ran out of money and stopped paying the subscription fee, so the sun has gone somewhere else now."

Disappointed, I look down at the sea to see if anything else has changed at the cliffs. Then someone says "We can get the sun back if only we win this competition."
"What competition?" murmurs the crowd.
"Actually it's more like a randomised controlled trial. We take these two types of laundry powder and if we can guess which is the more high powered one, we can get the sun back."

Someone else walks among the crowd with a large cane basket, distributing two identical packets of white powder to everyone. I'm just looking at my packets when someone shoves a trophy in my face and says "Congratulations! You've won the most enthusiastic participant award!"

I splutter, "What??" and look at the trophy. On it my name is all garbled, and I can't quite make out what it says. I put the packets of powder in the trophy. Then I wake up.

Tuesday 24 May 2011

Dream: the radioactive barramundi

In this dream I'm just about to embark on a long road trip with my dad, I think we were planning to drive from Darwin to Sydney but I can't remember the route we were going to take. I look out the window and our Honda is parked just outside, but it looks like the alleyway outside our house in Shanghai. I wonder how it's possible that our car seems to have made its way to Shanghai for a roadtrip starting in Darwin. Looking around, I seem to be sitting in my living room in Shanghai too.

I tell my dad that we are already running late, so we need to look at the map and check how far we can get that day. He tells me not to worry, then there is a knock at the door.

When I open the door a man comes in pushing in a catering-style trolley, covered in a cloth. This is the type of trolley that's used to serve food at meetings etc, with enough space for big platters to be stored on several tiers. He says he has a present for us and without delay starts telling us about how he caught a giant barramundi and wants to give it to us to take on the road trip.

Just as I'm wondering why there are giant barramundi in Shanghai, he lifts the cloth from the trolley and I see a whole row of giant jars like the ones used to preserve rice wine. He starts taking the jars down and naming the fillets "this one came from the front of the left side of the barra... this one's from near the tail" - fillets of barramundi seem to be swimming in some amber-coloured unidentified liquid inside the jars.

He finishes unloading the jars, probably about 20 of them in total. There are 3 jars left on the trolley and I ask the man "what's in those?" He picks up one and shows it to me, and it is the most hideous fish head I have ever seen.

"Hold on, you can keep those. I don't like fish heads." I say to the man.
He looks disappointed and points to the other two jars, "What will I do with these then?" he asks.
I look at the other two jars and each seems to contain a giant hideous fish head.
"Wait, if you only caught one barramundi, how come you have three heads?" I ask.

He stares at me like I've just asked a crazy question and finally says "Don't you know? This fish was raised in radioactive nuclear-contaminated water in Japan, it's full of genetic mutations!"

Then I wake up.

Tuesday 10 May 2011

A day in Singapore

On my way back from China, I decided to stop in Singapore for a day of food.


Yes yes, the Singapore river was very picturesque in the morning light, but where was all the food? Every store and stall seemed to be shut, and hardly anyone was on the street except a few confused looking tourists and some street cleaners. I walked in some random direction till I finally came across a shop full of people even at 8am on a Saturday morning.

I've never had bak kut teh before, but this was pretty good. Pork rib soup simmered till the stock is full of flavour, and the spices have really shown their true flavour. There is no greasiness at all, instead a pleasantly refreshing after taste. The pork falls off the bone, and makes for a delicious accompaniment to rice and pickles.


Feeling rather content, I walked down the road and somehow ended up in Chinatown. Walking down the side streets, I found myself first at the muslim mosque, where workers were painting the walls furiously. Then I came across the Sri Mariamman temple, where some serious procession was in progress. Around the corner I went into the Buddha's Tooth relic temple and even there, there was a crowd chanting prayers and lighting incense.

Out of luck with temples, I ended up in the Chinatown food court. Not really feeling hungry, I couldn't resist the sight of a super long queue heading to the glutinous rice stall. Here a man with funny chorea like movements was dishing up the glutinous rice along with a sprinkling of peanuts and salty fried shallot crisps. It was quite savoury, and would have been nicer if there was an element of sweetness to it.


Feeling truly too full, I headed to the Singapore Art Museum for a spot of air conditioning.


It just happens that the Biennale is on, and I happened to arrive at the SAM at the time of a guided tour with a very interesting and spirited lady. This was a fantastic exhibition (I didn't even make it to the other three sites) of modern art, with the theme being "My Home". The idea was to invite a group of artists from around the world to use the spaces within the exhibition centres to explore the concept of home. My absolute favourite exhibit was an artist who followed six Singaporean families on their usual shopping, and then set up a room with six fridges full of their purchases, inviting the viewer to think about what sort of lives they lead...

Coming out of the SAM, I set off in another random direction and ended up in Albert Centre near Bugis, where I actually stayed last time. I stopped for some more snacks.
Soy milk pudding with almonds.


Nasi lemak (coconut rice) with fried chicken.


Too much shopping in Bugis later, I headed back to the airport. At Tanah Merah interchange, I saw an amazing sunset over the top of a handful of apartment buildings.


Meanwhile, I munched on a curry puff from Old Chang Kee...

Feeling rather bored in the airport, I finished off my day of eating with a bowl of fish ball noodle soup. The fish balls weren't as good as the place that serves fish ball laksa in Terminal 3, a little bit too chewy for my liking. The soup was rather bland too, but it was pretty all right for an airport meal!



It did feel like half of Singapore was out on the day I was there, probably because it was a Saturday and plus it was election day too. There's food just about everywhere in Singapore... I'd love to live there for a bit and try everything out. And of course there's great shopping too, I couldn't resist this sign in a MRT station.