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Day 1 on the Bus. We got picked up at 0830 from the hostel and first headed off to Mt Eden, one of the several dormant volcanoes that are around Auckland. The highest natural point in the city, it offered spectacular views over the City of Sails - through breaks in the rain (yes, it was still raining!).



We then headed on towards Mercury Bay on the Coromandel Peninsula, stopping in Thames en route to grab some lunch (and also a frisbee as I’d neglected to bring this vital piece of travel gear). The torrential rain became more sporadic as we crossed over the Coromandel range of mountains, and began to clear as we approached Whitianga. Mercury Bay is so called because Captain Cook moored here to observe the transit of Mercury in order to work out the longitude and latitude of New Zealand - pretty important info so that other ships could find the Island of the Long White Cloud.

As the weather had brightened up, some of us on the bus went sea kayaking from Hahei beach round to Cathedral Cove, accessible only on foot or by sea. One of Cathedral Cove’s claims to fame is as a location in the Narnia film, although it’s beauty in its own right is reason enough to visit it.

After a quick cappuccino on the beach (yep, we even brought chocolate sprinkles with us) we headed out to two of the islands in the Bay - the Bay itself is formed out of a huge volcano that has since been submerged as sea levels have risen over millennia. We paddled round the islands before heading back to shore and onto to our evening’s accommodation: Turtle Cove hostel, with good beds, good food, cheap beer and an evening of shooting the breeze with fellow travellers.

The rain hasn’t stopped.

First mission of the day (and arguably the most important) was to find breakfast. After wandering along the Auckland sea front near Viaduct Bay in squally rain, I came across the fine establishment that is Ronnie’s Cafe & Bakery which did a good full english for a good price - well worth it if you’re ever over here.

Given the weather, the Auckland Museum seemed like our best bet, and myself and Bev (fellow travelling companion, met yesterday) headed off there, walking via the Auckland Domain. “Domains” seem to be the Antipodean equivalent of commonland, basically either open grass, wooded/bush areas with freedom to roam.

We spent a good couple of hours looking around the museum - it provides a good introduction to Maori culture and heritage, plus we also saw the “Maori Cultural Experience” - essentially the PC way of saying “song and dance” - which was (surprisingly) actually really good. In addition to the Haka, amongst others they performed included Paikea - the Maori whale riding song made famous by the indie film Whale Rider - and the stick throwing song E Papā Waiari. I was initial skeptical that the NZ$15 I coughed up would be worth it, but I would happily see it again - I’m now trying to find an CD that gives justice to both those songs!

Tomorrow I head South to Mercury Bay on the KiwiExpress on the well beaten tourist trail. Due South.

I’m beginning to rapidly appreciate why the latitudes between 40° and 50° South are known as the Roaring Forties - our final approach into Auckland was buffeted by big gusts of wind, and the sea below was a foaming Westerly windswept mass.

Torrential rain greeted us as we disembarked and on the bus ride into central Auckland (and it’s still going as I write this). I’m staying at Base Auckland hostel on Fort Street which is a nice, open, well-lit affair. As usual, there’s the usual British crowd here - 2 Scots, 1 fellow Englishman and a couple of Irish for good measure.

Tomorrow I’m planinng on getting to the top of Mt Eden, a nearby extinct volcano which is meant to offer good views over the city, and also take a look around the harbour - this is the City of Sails after all. If the rain sticks with us, then the Auckland Museum or Maritime Museum may be more promising (and drier) alternatives!

I’m nearly at the end of my time in Australia - it’s gone quick. However, NZ beckons and I’m flying out this Saturday (26th July).

Partly out of laziness/convenience, instead of proper roughing/backpacking it, I’ve got a Kiwi Experience bus pass on their Sheep Dog route. I’ve posted my intended itinary below, so if you’re in the vicinity let me know (I’ll have my UK mobile on me so an SMS is probably your best bet).

Seen by a nurses station in an Australian hospital - pure genius.

Last week saw my first introduction to multitrauma: patients with multiple traumatic injuries. Monday is my team’s day ‘on-take’: any trauma patient admitted between 0800 Monday and 0800 Tuesday comes under our care. The following account hopefully provides a flavour of what happens to a multiply-injured patient once they reach the hospital.

Case 1

Early on Tuesday morning, a 35 year-old women was hit by a car whilst crossing a road in central Sydney (pedestrian vs. car). The cars here in Sydney are slightly larger on average than those in Britain, and the drivers tend to be a little crazier too.

She arrived in the resus bay of the Emergency Department (ED) shortly after 0730. When I got into resus after the trauma call had gone out, she’d been intubated, a chest drain placed on the left after a chest x-ray showed a whiteout on the left, suggesting massive haemothorax. The secondary survey revealed a fracture of the left femur, distal radial fracture on the left, and proximal fractures of the radius and ulna on the right. She also had a scalp laceration, so was being treated as a head injury (i.e. hyperventilated). The left leg was put into traction, whilst both arms were immobilised with cardboard splints and bandages. Fortunately, all the fractures were closed (open fractures are a Bad Thing) - about the only piece of good luck she’d had today.

After some vigorous fluid resuscitation, she was stable enough for a transfer to CT, and then onto theatres. Theatre turned out to be a bit of a circus, as because her radial fracture on the left was distal, the Hand team wanted in, as it could potentially affect articulation at the wrist. So, whilst our team worked on her right arm, the hand team worked on her left arm - there was almost an edge of competition about which team could finish first, but professionalism prevailed. Following on from the arms, the femoral fracture needed fixing. This was achieved by open reduction and internal fixation (ORIF), medic-speak for opening it up and fixing it with some metal. In her case, we used a plate screwed into the femur, which was then wired axially around the femur for additional security - pretty much bombproof.

She was transferred to intensive care after the operation, where she remained intubated for a few days post-op. The head-injury turned out to be cerebral contusion on CT, and the ‘massive haemothorax’ on the left side was later shown to be pulmonary contusion (the chest drain never really drained anything). She has subsequently been extubated, and is now making good progress - a testament to the teamwork and professionalism of the paramedics, nurses, doctors, and surgeons who were involved.

Case 2 from last weeks rush of multitrauma patients will be posted shortly once it’s been written up.

Despite the sparcity of recent posts, Kenrick is still alive and kicking.

After a slow start to the elective due to some unfortunate paperwork issues, he’s been doing the long days of a surgical start and late finish. Somewhere along the way he’s also acquired the tendancy to refer to himself in the third-person.

In theatre, he’s been cutting the sutures too long, too short or too slow, forgetting to laugh at the boss’ jokes, standing in the wrong place at the wrong time, and occasionaly desterilising himself for good measure. Still, he’s loving every minute of it (well, mostly), and learning stackloads: learning by doing, and along the way, there’s been a couple of instances of true old-school see one, do one, teach one. It’s a mini-adventure.

His team’s on-take tonight, hence the brevity and slightly unusual style of this post, but hopefully when he get’s a moment he’ll be posting updates on events thus far.

Imagine the scenario: you travel 10,600 miles to the other side of the globe and whilst sitting on a bench in central Sydney at lunchtime, two vaguely familiar people approach: Naomi and Gabi - fellow medics from Cambridge.

The situation was comical - seriously, what are the chances?! Gabi and Naomi are in Sydney for a few days en route out to NZ where they’re doing their electives. They’d flown in this morning and were just wandering through town when they’d done a double-take on seeing me sitting on a bench. My conclusion is that the world is either:

1. Small
2. Incredibly random

Take your pick, but it was definitely one of those moments you’re going to remember.

We’ve since just been wandering around The Rocks area of Sydney, and are now doing the whole check-email thing in a cafe as path results are due out soon - too soon.

As another random aside, they flew in on a BA/Qantas codeshare flight this morning, that just may have been piloted by a fellow member of the Turner/Sims tribe. More to follow after confirmation!

Arguably the biggest highlight of a medical students career is the elective: that mystical 2 month period spent overseas saving lives whilst exploring uncharted territories and finding a cure for HIV, all before heading back to Blighty for tea and medals. The elective is for all intents and purposes the last big adventure before life as a junior doctor begins.

I’m spending my elective in Sydney, Australia, working in a busy Trauma department. I’m flying out tonight and starting work on Monday morning, where I suspect my body-clock will still be somewhere over the Indian Ocean.

As I write this, I’m sitting in the departures lounge at Heathrow, waiting for the flight to be called. Outside, it’s a pleasant June evening, with a fiery orange glow on the horizon for a sunset, and pinpoint dots of light leading up into the sky mark out the planes on the Heathrow glideslope. There’s something about sitting waiting for a flight that’s calming: a period of time to sit and reflect on the work done over the past year. Exams are done, bad or good, and there’s nothing else to do other than sit and drink a coffee til the flight’s called.

Over the next two months I’ll be keeping a photojournal of the adventures Down-Under, so if you’re interested in what I’m up to, swing by every couple of days for updates.

It’s time to leave the country.