Sunday 27 February 2011

The end of nights

Life is always like this - when it's happening everything seems to be in slow motion, yet when it's over it seems to have gone too quickly. Finally, I've finished my six weeks of nights, and will have no more nights for the rest of the year!

Most of my nights were long and painful, and I struggled with not only hunger and fatigue, but with unfamiliar diseases, cultural and language barriers, and the sheer volume of work to be done. I did feel desperate a few times, and it wasn't pretty. Sometimes I wanted to scream "There's five of you (ED doctors) and one of me! Can't you do a better job so I can have an easier time?". Often I was given a completely useless story by a completely clueless person, and have to start from square one, which drove me to the brink of exasperation.

Morning handover was also unpleasant at times. Though most consultants tried to make it a neutral environment, I often felt like I was on trial. I called it the solo standup show of Nancy, and it really was like that, facing a whole room of up to 30 people. One time I started giggling uncontrollably when I relayed that the patient had been hit on the head by his wife wielding a mango stick, and not a single other soul laughed along. All I could hear in the big quiet room was my own loud giggles rising like sobs out of me, fraught with such physical and mental exhaustion. I was so frustrated when I felt like I was being criticised, and sometimes it was just the last thing I needed to make me slouch home like a walking corpse and collapse into bed, unconscious for the next 10 hours.

So in conclusion, it was tough. This job is so different from my last that I am still learning the ropes, and six weeks of nights was the worst way to start. But I have to put that behind me now, see all the positives (all the amazing stories I heard and crazy cases I saw), and look forward to my next job, starting tomorrow.

Saturday 19 February 2011

Three mini-dreams

These three dreams arose quickly in succession after I finally got to sleep in my own bed after a two hour restless snooze on the Bali - Darwin flight.

One

I was in a multi-storey carpark, on the bottom level which appeared to be below ground as it was very dark and illuminated only by a few odd lightbulbs dangling from the ceiling. It's not a carpark that I recognise as having been to before.

I'm looking everywhere for the exit when I suddenly see Eric (as in Nowra ICU nurse) and another girl across the carpark. I walk over to them with the thought to ask Eric how to leave, when I realise he had her draped and prepped for a spinal anaesthetic, sitting over the edge of a little plastic stool.

He's holding a 2mL syringe and about to inject when I ask him (incredulously), why in the world are you doing this in the carpark?

He says "she's made a grave mistake and must be punished". As he injects she screams and I start running away as quickly as I can, and soon I see a lift. Breathlessly I jump into the lift and press a random bunch of buttons.

When the lift door opens I'm in the handover room at Darwin, and everyone's sitting there waiting for me. I grab the first consultant I see (James) and tell him "There's someone trying to murder a girl in the basement, we have to help them!"

He groans and rolls his eyes, "Oh, all right",and gets up reluctantly.

He retrieves a motorbike from behind the lockers in the handover room and we set off into the carpark. When we get there the girl is gone, but Eric is still standing here, and as we approach he chuckles evilly "You'll never get me!"

James says quietly, I'll drive by as closely as possible and you try to kick his head...
but when he does I totally miss and almost fall off the bike.

We try again and again, I try to punch and kick and pull at Eric, every time we are nearby, but he yields a little tiny knife which he keeps cutting my feet and legs with.

Just as I start to feel despair, James runs the bike up a straight part and up onto the ceiling of the carpark. As we are driving along upside down I look down and catch the shining gleam of Eric's knife in the dark.. and that's how I wake up.


Two

I'm sitting at my desk in ED when someone comes up to me and says "Excuse me, I'm just needing a bit of help with the inotropes, could you possibly come and help me?" I don't recognise the girl, who looks about 18, but I assume she's another ICU registrar I haven't met.

I say "Sure, I'll be over as soon as I'm finished here." On the screen I'm reading some food blog about how to make chicken satay sticks; I close the browser and stand up.

Suddenly the alarm goes off and there are flashing red lights everywhere. I wonder briefly if it's my vision going funny as the world flashes bright red.

I walk over to the patient and see that she is completely grey. A nurse stands by staring at the monitor, which is showing a row of flat traces including an arterial BP of 50 / 01. I shout "start CPR", then "get the arrest trolley!" "prepare adrenaline!"

The girl comes rushing up to me and says, I wasn't sure how to make up the noradrenaline and dobutamine infusions, so I started all of them at 1mg/min, is that ok?

The blood rushes to my head as I think about the ramifications of this bizarre situation, then I hear the patient groaning and realise she' s come back to life.

Then I realise she is one of the patients that I lost last year.. and wake up in a sudden fright.


Three

In this dream I am in my own kitchen back at home, and there are lots of plates full of food all around me, as if there had just been a party.

The plate in front of me has a large turkey breast, stuffed with pesto and crushed nuts, rolled and then roasted. It looks and smells delicious, though it has clearly gone cold. I'm wondering whether to heat it up or put it away, when my friend star walks through the doorway.

"I was wondering what happened to the turkeys! Now I know, you've eaten them all!" He says accusingly.

"I didn't have anything to do with this." I protest, "I just walked in and all this food was already here."

He starts shoving plates into the fridge angrily and says "I thought you were vegetarian, but obviously I'm wrong. There's the other turkey breast here, do you want to eat that too?"

Then my grandma shuffles into the kitchen and says "kids, kids, stop arguing, the turkey is already dead." She smiles at us, "I'm going to sleep now, you'd better clean all this up."

I make a cup of tea and sit at the table, wondering which pile to clean up next. There's no more room in the fridge and despite looking through all the cupboards the only containers I can find are a carved wooden box I bought in India (previously containing spiced tea) and an old mobile phone cardboard box, with an old sim card in it.

I'm just wondering which bits of food I can put into these random boxes, then my dad comes into the kitchen and says "What are you doing? It's 6am now! Have you been up all night eating?"

"No, no, I've been trying to clean up, but.." I protest weakly but my dad loses interest and instead drags my friend off into the living room. I overhear him asking "What city are you from? What do your parents do? Where do you work? How much money do you earn?"

I groan in my head and wake up.


(Even for me, this many vivid dreams in a night is too many, my head felt like it was going to explode at the end..)

Monday 7 February 2011

Dream: crocodile drystroke

So I start this dream standing outside some sort of tourist office advertising "New crocodile tours!". Soon this ranger looking like Steve Irwin (in khaki shorts and sunnies) comes out and takes a group of us into a white van.

We drive out of Darwin on a beautiful sunny day, down the Stuart highway heading towards Katherine. Suddenly the guide brakes and pulls over, parking the van in a clump of grass.

We get out and stand by the side of the road. There's no water around for miles, and I start to wonder where the crocodiles would be.

"Are we supposed to cross the road now?" I asked the guide.
"No, just wait and the crocodiles will come."

I stand there watching sceptically while cars, 4WDs, trucks and road trains hurtle down the Stuart highway, sending little clouds of gravel into our midst.

Just as I was about to laugh at the ridiculousness of this all, I saw a huge looming grey shadow on the horizon, slowly coming towards us. As it gets closer I see that it is about 10 times the size of a normal crocodile, about 50m long with a humongous tail. It looks like some sort of reptilian dinosaur, steadily trudging towards us. Its feet make thunderous plops as they land on the road, like something out of a horror movie.

One of the girls in the group starts screaming, and the guide says "shhh... these are non vegetarian crocodiles, they'll eat you if you make too much noise!" The adrenaline starts to run in me and I shout at the guide "shouldn't we run away? this looks too dangerous!"

But the guide calmly says "These crocodiles have evolved to incorporate a new style of swimming on land, called the drystroke. Please don't be afraid of them because they are Olympic champions in drystroke and would be very upset if you ran away from such a master performance of this art".

So I stand there wide eyed as the crocodile comes closer and closer, when it passes by us I see that it is indeed swinging its arms & legs in a strange awkward fashion like a flapping drowning duck. It gets so close that I can see all its scales..

Then I smell that distinct smell of blood, my heart is filled with horror and I wake up.

Sunday 6 February 2011

Sydney to Darwin: day seven

Day seven: Tennant Creek to Darwin, 989km

Our last day started early once again, and as we packed up the car the sky burst into the most magnificent colours. It was to be the prettiest thing I saw in Tennant Creek.

Sunrise, Tennant Creek


I've never been a real fan of the GPS, but we amused ourselves on so many occasions by the GPS telling us some ridiculous instruction like "turn right after 500km". This was captured shortly after we left Tennant Creek.


We were restless with excitement this last day, and the kilometres seemed to pass faster than on other days. Before we knew it we pulled into Daly River for petrol, where the roadhouse had a rusting aeroplane right next to it.

At the roadhouse, Daly River

We passed Mataranka and soon enough drove into Katherine. Excited by the impending approach to Darwin, we decided to push on and eat at the first rest area after Katherine. By then it started drizzling and we ended up stopping in Pine Creek instead. This visit to Pine Creek was much like our last - the town was almost completely deserted, and there were neither visitors nor locals on the streets.
The last couple of hours to Darwin passed in a flash. Darwin in the wet season has a distinctly different feel to it than my last visit at the beginning of the dry. The air is far more dense and humid, and there's a heavy tropical smell in the air. I particularly love the frangipani trees everywhere, with their subtle scent drifting past lazily.
We drove through a few suburbs, and then came the moment when we arrived at the hospital, my new home to be for the next 12 months. As I walked into emergency (the waiting room filled with dozens of Indigenous patients) I thought, this is it, my life is changing right here before my eyes.
So I come to the end of my tale of how we drove from Sydney to Darwin, clocking up 4700km. I knew before we started that it would be special, and it was - not everyday does one have the opportunity to drive halfway across a country, encountering all the different landscapes, people and towns in between. It was also special to me because I knew my dad had wanted to go on a long roadtrip in Australia for ages, and I was happy to fulfill his dream.

And for the drive back next year? I'd love to go through Queensland!

Friday 4 February 2011

Sydney to Darwin: day six

Day six: Uluru to Tennant Creek, 953km

When I planned the whole roadtrip, I decided that we would do two long days after our break in Uluru, gambling that the 130km/h speed limit that I'd seen near Darwin would be the same near Alice. I was right, and the two almost-1000km days were just fine, as insane as that sounds.

We left really early from Uluru, just as the sun was rising. We saw less than 10 vehicles on our way to Stuart Highway, and didn’t really think we were in civilisation until we got to Alice Springs. Just out of Yulara, we came across a pack of wild camels just on the side of the road. What majestic creatures they are! They stood tall and proud, with such muscular bodies, staring at us with heads held high as we drove past.

Alice Springs was a huge shock to the system after so much time in the desert. There were so many people that I felt like I had landed back in a major city. We left after picking up some food, and returned to the flat, featureless road.

After we drove out of Alice, we started to plan our lunch break. At one rest area where we tried to stop, there was a gang of youths lying across all the tables staring at us as we pulled in, so we drove off again. At the next town, there was nothing but a shop and a police station, something which I'd never seen before (no other one-shop towns I have ever been to in my life have been accompanied by a police station!). I felt afraid, as if I had passed into a danger zone. Everywhere we looked, there were people idling by the roadside, in groups under the trees, at the rest areas.. I felt annoyed at myself, that I had become frustrated by their presence, and that I was inexplicably affected by my own prejudices. Somewhere at the back of my mind I remembered Maddie telling me "don't stop in the middle of nowhere or when people wave you down, no matter what happens" and then I was truly paranoid, probably the only time I've ever felt that way during daylight hours in Australia. So we kept driving, and the kilometres passed by.

We stopped by Devil’s marbles, which are incredible round fragments of rocks that have broken off solid sandstone chunks under the ground. Here it was so hot that we felt dehydrated just walking for 10 minutes around the rocks. It would have been an amazing place to visit when it’s cool, or to rock climb, except a huge Contiki bus pulled in and so we left.

Devil's marbles

The last 100km to Tennant Creek from there were totally unexciting and we were happy to pull up. The town itself looked run down and our motel was pretty decrepit too, but I did discover a little garden of relics from the gold mining era in our motel. I love stuff like this (others would call it junk)...

Old stuff

Thursday 3 February 2011

Sydney to Darwin: day five

Day five: Uluru

Sunset at Uluru (1)

At the end of our fourth day, we went to Uluru to watch the sunset. The cloud was thick on the wrong side (ie. the side of the sun) and there was almost no light cast onto the rock. The only glimpse of magic we had lasted about 10 seconds and somehow I managed to capture it just as a beam of light escaped from the thick cloud cover and flitted across one corner of the rock.

While sitting in the carpark, I realised that I had already seen more than 10,000 sunsets in my life, and it made me wonder how many of them are actually imprinted on my mind.

The hidden sun


The next day we got up in the dark to go to Uluru for sunrise. The sky brightened as we drove into the park, and it was almost a race against the sun. Unlike the previous day where buses & cars are segregated (the poor and the rich, perhaps?), this was all congregated in one spot and there were hundreds of people all vying for the best spot. We tried out several viewing spots, finally settling for a small hut at the edge of the viewing zone, away from the crowds.

As the sun rose, the rock became progressively redder, though the cloud cover made the sun’s powerful rays wax and wane in its effect on the rock. At its reddest, the rock looked like it was a giant loaf of bread covered in tandoori paste.

Sunrise at Uluru


We had breakfast in a little hut near the cultural centre, which was blissfully quiet; I think most bus groups were off somewhere having breakfast. The centre has a sorry book where people wrote letters in about how taking bits of the rock away have brought them bad luck. It’s funny how people have a conscience about these things, almost like they would attribute their bad luck to the one thing they feel guilty about. Lots of people climb the rock too, which is specifically not advised by the Park and by the Aboriginal owners.

We spent the rest of the morning on a guided walk up close to the rock. The ranger was an interesting character, quite informed of the ways of the Indigenous people. He painted vivid images of how the Aboriginal people had lived in this land for the last 22,000 years before the White people came – they have always hunted, fished, foraged for seeds, berries and fruit, lit fires and told stories from generation to generation. It is an entire culture and lifestyle which has now mostly disappeared, which is just incredible if one thinks about the enormity of the loss to that culture.

Touching Uluru

I always thought Uluru was perfectly round and really red, but actually it's quite irregular on its surface and has multiple layers of rock squashed all together from its time under the sea. There were many caves where people used to seek shelter, some of which had some amazing rock formations.

In an Uluru cave

After an afternoon nap, we decided to give sunset one more go, and this time were rewarded with a spectacular postcard-perfect Uluru sunset. Every time I looked up I thought the colour was changing again! I was mesmerised by the evolving and deepening colour, and must have taken at least 50 photos in the same spot!

Sunset at Uluru (2)

Wednesday 2 February 2011

Sydney to Darwin: day four

Day four: Coober Pedy to Uluru, 734km

By the time we set out on day four, it was almost a practised routine of packing up, putting everything into the car and settling in for the drive.

Coming out of Coober Pedy, the landscape was scattered with piles of rubble from the opal mining. These formed little hills dotting the landscape, quite like the piles of salt I saw on the salt plains in Bolivia. I think tourists actually drive all the way up to Coober Pedy just to see these, and the fancy name for them is the "Moon Plain". I guess the moon probably does look a bit like the landscape of Coober Pedy, flat and rocky with a few random piles of stones.

The most pleasant part of the drive up from Coober Pedy was watching for animals, and we had a few (too) close encounters with wild cows and wild horses. We were sad to see bodies of animals in various stages of decomposition near the road, including one little kangaroo skeleton that was all too intact. Eventually we got bored and started taking photos of the road signs which included things like “Be aware of the cows” in German and Japanese.

Mother and baby by the roadside

Just before lunch, we passed into Northern Territory at a roadside rest area where we stopped for a peach. As we were stretching our legs, a Greyhound bus travelling south stopped and a group of tourists jumped out, complaining loudly about the heat and the flies while snapping photos of the border. One girl ran screaming out of the toilet because she saw some bugs, and another gestured to us while complaining to her boyfriend: was machen diese Leute hier? es gibt uberall nichts! (What are these people doing here? There's nothing here!) They were gone in a flash and after a while I began to wonder if I'd dreamt them because we encountered almost no-one else on this day's drive except at the roadhouses.

Outback prices!

As we drove closer to Uluru, we were filled with a strange adrenaline at the anticipation of the upcoming R&R. We passed by a lookout to Mt Connor, which is like a flat topped version of Uluru. I The sand there was immensely red, and so hot that it felt like sitting on a stove when I tried to sit down. The temperature was extreme in the midday heat, and climbing a small sand dune made me want to drink a litre of water.

Hot red sand

Eventually we got to Yulara, the only resort complex next to Uluru national park. I'm a bit against giant corporations dominating a particular site just coz "they got there first", and usually when I travel alone avoid staying at those places altogether. On this trip though, I thought my dad and the car both needed some well earned rest, and with the alternative being bush camping 80km away at the nearest settlement, well.. there was no real alternative.

The accommodation here was pricey, close to $200 a night for a budget cabin room with shared bathroom, so we shelled out $300 for a self catered apartment. I was momentarily frustrated when we got there though - there were no marked directions to the apartments, and check in was at another branch of the resort. Then we found the front entrance locked, and I walked all the way around in the blazing heat only to find the actual entrance was concealed behind some trees, mere metres from where I started.

Those complaints aside, we had a nice stay in the apartments and had the opportunity to visit one of the most amazing places I've ever been...

Tuesday 1 February 2011

Sydney to Darwin: day three

Day three: Port Augusta to Coober Pedy, 560km

Day three was our shortest driving day, partly because there weren't really any other big towns to stop in between Port Augusta and Uluru, but mostly because I really wanted to see Coober Pedy after reading about it in Mark Dapin's book of travels around weird spots in Australia. The drive was really easy, all along 110km/h roads which were well maintained.

The only thing that had really changed was that we drove into the road train zone, and they became an increasingly frequent sight as we drove north. At one point we came across an oversized road train with a disassembled house on its back which was so wide it didn't fit in one lane. It drove along with a police car in front of it, going the wrong way in the opposite direction. By the time I realised what was happening I had to slow down very quickly and pull off the road, or I would have had a head on collision with the police car!

As we drove further north, the desert became more barren and the sand more intensely red. We passed several salt lakes which glistened a shiny white in the distance. At the first lake we thought it was freshwater that was just illuminated by the sun, but at the second lake it was quite obvious it was all salt. It must be so frustrating to those lost and thirsty that the only water they can see is undrinkable!

Random salt lake by the side of the highway


It was really too early for a stop but since we had such a cruisy day we decided to make the detour to Woomera, about 200km north of Port Augusta. There we went to the most amazing missile park right in the centre of town, a collection of missiles, rockets and planes from the era when there was very active testing and military exercises in the Woomera region. The collaboration between the Australian and British armies saw a busy period in Woomera, which quietened down in the 70s and eventually the town was open to the public in the 80s. Now the area is still occupied by the military, which has a huge “Prohibited Area” to do whatever it wants in, but there is little testing or military activity in the region. The relics from the bygone era stand in a park like forgotten toys, but they were pretty impressive.

Missile park, Woomera

We stopped in a place called Bon Bon for lunch, complete with a huge shelter, rainwater tank, enviro toilet and a solar powered emergency phone. I was very impressed by the whole set out in the middle of nowhere. Here we saw a psychedelic cloud which I thought looked like a man on fire running away somewhere.

Cloud at Bon Bon

It was pretty remote road from Bon Bon to Coober Pedy, and we stopped for petrol at the Glendambo roadhouse, which was a "town" consisting of pretty much just the roadhouse.

Sign outside Glendambo


Before we knew it, we were in Coober Pedy, a mining town famous for producing 90% of the world's opals. Coober Pedy is full of dugout buildings, and about 2000 of the 3500 residents live underground. Apparently dugout buildings keep cool in summer and warm in winter, an ideal setting in the desert. It was rather surreal walking into our underground motel room, coz the walls literally look like they’ve been dug out like a cave. It had a slightly musty but not unpleasant smell of being underground, but the temperature was just right - neither the artificial cold of air conditioning nor the roasting 40 degrees outside.

Underground church

This is one of the underground churches we went to. It was very simple, with a few wooden benches and a slightly wonky cross made from tree branches. Sitting in the cool, deserted church, I thought perhaps once upon a time, all churches were like this, just a simple place for worship without the sophisticated sculptures and stained glass and all the other things we associate with churches.

The highlight of our day was a huge sandstorm, which strangely reminded me of the sandstorm we had in Sydney in 2009 when everything was coated in red dust. The wind was so strong it felt like it was lifting us away, and the sand swirled into everything. I knew you shouldn't take photos in this sort of weather, but I couldn't resist - even as the lens came out of the camera, it was grinding with the sand getting in between the layers of the lens!

The sandstorm was followed by our first huge downpour, perhaps a premonition of what was to come in the territory. We were the only people at the kangaroo orphanage, where I fed a 6 month old joey whose mother had been killed in a road accident. Holding the joey in my arms was just like holding a baby – it had such a soft warm body and huge doeful eyes that looked at me intensely. I'll never forget that almost human-like expression which was so simple and innocent. It was about 2kg and just starting to hop around, still quite wonky on its feet and occasionally almost falling over. I was amazed by its natural instincts to dive into a pouch too, and as soon as a soft bag is provided it jumps straight in headfirst then turns around and looks out, just as if it was in its mother's pouch. The kangaroo orphanage was run by a couple who also ran an art gallery, and they took turns getting up at night to feed the joeys. They aim to get all the joeys back into the wild, though they had a few that became too domesticated and had to stay. They even had an incubator donated by the local hospital when they bought a more up-to-date one, with which they were hoping to keep more joeys alive in the future! It was an incredible place to visit.