Thursday, December 28, 2006

Jo's Go

I (JO) has begun to really enjoy the medicine here, just as I am finishing up. I have got to know the system, and a few recent challenges have gone O.K.! Two Caesarean section anaesthetics in the last week and even some people getting better under my care on the ward; very rewarding! However, there was no a/c in theatre yesterday afternoon and that was appalling!
A couple of funny remarks from Emily and Charlotte; on pushing them up the hill in the buggy to the unit, I often pant and groan a bit under the load, and their favourite two comments are: "Hard work, is it?" and "Tired, are you?" At that point I often say "Right, get out, you are both walking the rest of the way!!"
Emily also said to Charlotte today as the latter was trying to climb onto the former's bit of play equipment " Don't you ever, ever, ever, EVER do that!".
Charlotte said to me today as I was cooking the turkey risotto with them on the kitchen counter and listening to Pulp rather loudly, "Mummy, I don't actually like this noise!". I had to turn it down.

I know Tim mentioned it, but Imi can now really truly swim; no snorkel, no aids, nothing. Fantastic!
I shall miss this place; especially some of the lovely people we have met. It is a real meeting point for doctors who care about issues such as climate change, logging in the Amazon, raisning their children without too much stuff or tele or junk food, etc. However, I must say that my children have gorged somewhat on chocolate and jelly-beans during this adventure!
Anyway, we are off down the the breezy courtyard now to drink Cointreau and eat chocolates with our neighbours!

Wednesday, December 27, 2006

That Slideshow...

You know after Christmas where you invite all your friends and family to look at the pictures you took? Well this is That Slideshow. Except you can skip this instead because you're your hair. Or dying the cat purple. Or... well, any old excuse, really. And I'd never know you hadn't come. Isn't Web 2.0 great?
So, the first photo is from a few days ago, when we sang on the wards, and here you see us in all our glory!
The next few photos show our Christmas. The more observant of you will notice that we are not on an island somewhere, but still at home. As it was, Emily and Charlotte (and therefore all of us) had disturbed nights and were a bit grumpy. It was windy onChristmas, so the sea would have been rough and we just didn't feel up to that sort of trip, so we stayed at home, and had a lovely day. E & C ended up sleeping for most of the morning, which was a bit odd! We decorated our table and ate the turkey sandwiches we were going to have anyway, together with a delicious pasta salad.

Imogen, Emily and Charlotte can be seen exhibiting their new clothes, badges, stick on Christmas tattoos and big friendly dogs in these photos, not to mention dressing up. I don't know who that man is, but doesn't he look ridiculous?

On boxing day, we went to breakfast at one of the other doctors houses, and went swimming at the pool in the afternoon. Imogen spent the morning over at Reuben, Gracie and Mimi's house, seen here today in the final photo, and when we arrived to meet them at the pool, she was swimming under her own steam in the deep end!

Today was a quiet day, though Jo is on call, and it hasn't been quiet for her yet. It did become louder when the Arnold-Knotts came over, and we had a home-made milk-shake and a quick game of football.

We're all starting to think about going home now and looking forward to seeing everyone again.

Sunday, December 24, 2006

Christmas Eve

I shall hopefully remember this Christmas Eve for a long time. All the churches in town held a joint Christmas Eve service at the hospital. Against the backdrop of a stunning sunset, the children danced in sillhouette, Imogen lost in her own world, as the congregation made up of locals and patients sang Christmas carols. Wonderful.
I hope it will be this that sticks in my memory. There were other moments that might: Imogen wandering out from behind the minister just as he started talking, holding her dress in her hand to reveal to the whole congregation her lack of underwear. Or perhaps Imogen asking during the rather tub-thumping sermon "Why is he shouting? Is he cross?"
The girls fell straight asleep on getting back home, which meant they miss putting the stockings up, and we'll save putting out the presents under the tree until tomorrow.

It's been a family day, just as Christmas should be. We were at the pool this afternoon and came back here, having a picnic at both places. Jo prepared turkey, salads, little mince pin-wheels and I made Damper with Imogen, which turned out very well. We were a bit surprised, after all this preparation to discover everyone else was ordering pizza! Still, we got kudos points for cooking above and beyond the call of duty.

So, as I believe you're supposed to say on "The night before Christmas," Merry Christmas to all, and to all a good night.

Saturday, December 23, 2006

Christmas is coming...

You may remember in my last post I said:
"Tomorrow there's a doctors breakfast, carols on the ward (as opposed to Carol's on the ward - I'm sure tomorrow is her day off), a Primary Health Care party serving up Dugong and Turtle and a little bit of work in between."

As it happened it was even stranger than that! Unfortunately, Imogen was unwell, up vomiting in the night and through the day. (She's better today.) Jo was called in to do an anaesthetic first thing in the morning, so I took the girls, all 3 in the buggy, to the doctors breakfast at a local Motel. Emily and Charlotte had a lovely time eating croissants and fruit. Charlotte is very fond of men, and is unable to resist John Vaughan, the Director of medical services here. Every time she sees him, she asks to cuddle him, and yesterday was no exception. Imogen, meanwhile, was feeling pretty ropey, but did ever so well, spending most of the time wishing she could go in the small pool. ("When can we go here? You have to promise").

I didn't let the junior doctors off teaching, though - we looked at the evidence on injecting steroid into people (mainly, joints, tendons, etc, and not sports-people, which is a different and illegal activity), and I used it to sneak in some EBM teaching!

That afternoon, was a short 2 hour stint at PHC, which wasn't busy - everyone wanted to finish early for the party that evening. I spent much of the time opening work e-mails rom people I'd never heard of sending powerpoint Christmas messages. Hands up now if you'd like one. We didn't get to the party because of Imogen being unwell. However, we did manage carols at the hospital.

The carols were great fun. We stood around on the ward, all the children wearing cardbaord wings, singing. Jo sang wonderfully, I croaked loudly. The children all sprinted to the other end of the ward when they heard a helicopter landing. The patients all thought it was great.

Today was much quieter, the main event being a football (ie proper English-style football aka soccer) game for whoever wanted to come. Whoever wanted to come turned out to be the same people (mainly) who were at carols. Interesting... The children joined in again, distracted not by helicopters, but by a passing Santa Claus throwing lollies out of the back of a ute! Emily and Charlotte cried again, but still think he's a very friendly man.

For an Englishman like myself, I'll never quite get used to the heat at Christmas time. I keep having to pinch myself, look at our home-made tree, put Christmas music on, look at Imi's advent calendar to remind myself that it's Christmas. (And I'm looking out for TV, radio or internet broadcasts of the King's College 9 lessons and carols!) And then I worry about poor Santa in his Ute - will he get heat exhaustion? And this year will be a most unusual Christmas, as we're going for a picnic on Goodes Island nearby, with stockings beforehand and present opening afterwards.

But unusual experiences? That's why we're here.

I'll hopefully post again before Christmas, but if you're reading this and you haven't heard anything more personal from us, rest assured we have been thinking about all our friends and family and colleagues. Happy Christmas to you all.

Thursday, December 21, 2006

Today, Imogen's issues were...

Imogen, the philosopher-scientist, asked today: "Where did the very first people come from?" And also "If the world is round, why do people not fall off when they are in Antartica?"

These may be common questions from a nearly 5 year old, but everyone should try explaining evolution and gravity to this age group. And if you can't do it, then the loss of respect could well manifest in a comment somewhat similar to this at teatime today:

Me: "Charlotte, I can't understand what you're saying when your mouth is full of food. Tell me when you've finished that mouthful."
Imogen: "She'll learn from you, daddy. You're talking to her with your mouth full." She then exhibited a perfect demonstration of a proud, slightly cheeky victorious look.

Yesterday, Jo and I went out for a meal, just the two of us. As there's really only one decent restaurant here (Gab Titui, the cultural centre) a romantic meal for two, becomes a meal for 4, no, 5 or 6, as you always turn out to know several other people there. A midwife babysat for us, and the children were delightful to her, but are now telling us "Jeanette did this last night. Can you...?"

This morning, Emily and Charlotte were awake fairly early again, but it always seems so much better when you try to find the birds screeching outside your balcony and discover they are a flock of beautiful red-green-yellow-blue parrots. That kept Emily and Charlotte interested - more so than their weetabix did, anyway.

Emily is very fond of telling me that Santa is "a friendly man" but this doesn't stop here screaming when she meets him. They were at the library yesterday, and the photograph of me sat smiling next to Santa with Emily and Charlotte on my knee hiding from Santa and the camera will be one to cherish, I'm sure. Imogen, on the other hand, was sat smiling with Santa and his wife (Mary Christmas, I think) while I was still calling out "Imi, where are you?"

Tomorrow there's a doctors breakfast, carols on the ward (as opposed to Carol's on the ward - I'm sure tomorrow is her day off), a Primary Health Care party serving up Dugong and Turtle and a little bit of work in between.

Tuesday, December 19, 2006

Pool Party

Sunday was Reuben's 5th birthday, and he had a party at the newly opened swimming pool. Imogen's swimming has come on in leaps and bounds - she can now swim along with her face in the water. Emily's and Charlotte's swimming is also coming along in leaps - big leaps into the pool, prefaced by "Move back, daddy," and followed by a big splash and lots of laughing.

There were lots of children at the party, mostly from Reuben's preschool, and the lots of children ate lots of food. The pool probably has bits of cake in it now.

Yesterday we were late for morning tea at Jess, Innes and Ziggy's, where lots of the play group families were meeting, and being Monday we brought home our big vegie box. I know I keep mentioning the vegie box, but I've realised it's one the the activities that gives structure to the week. "It's Vegie day - it must be Monday." Those of you worried for my mental health will be pleased to know there are no vegies next week, what with it being Christmas day. I don't think it'll be too hard to find something to write about, though.

9 children

When we've met various women who's shown an interest in our children, it usually turns out that they have 9 or 10 of their own. We even met one woman who has had 3 sets of twins. Just close your eyes and imagine....

So today I had a go myself! Catroniona's baby sitter was unwell, so me and Jess, the mother of Innes, Ziggy and Felix had them for the day - 9 children between the 2 adults. (All you teachers and professional child carers can start laughing now. "Nine children? If I had to look after nine children, that would be counted as annual leave.") How did we tackle it? Boredom was our enemy! We painted on several thousand sheets of paper (and the floor and table, and, rather surprisingly, not each other), we made christmas bells, we played with lego, we played in the paddling pool, we ate about 20,000 jam sandwiches. For lunch there was home made bread (not made by me) home made dips, cheese and ham available, so all the children went for peanut butter on crackers. The afternoon had Thomas the Tank engine on DVD and in a layout across the floor, several stories being read in loud voices at once, and the day ended with Play School on TV.

So now all the children are asleep with no fuss, everyone had a good day with minimal upset, and it has t be called a success. It was just one day, though.

Saturday, December 16, 2006

Going on an explursion

Listening to 5 year olds chat is fascinating. Imogen and Innes (a boy from the house opposite) were talking about their trip to the nearby beach, which Imogen later called "Going on an explursion." I think explursions will catch on. They seem to be a combination of exploring and an excursion, which is a very good description of what they were doing. (The hint of explosion must also make it even more exciting.)
"Even Ziggy could rock climb" says Imogen, referring to Innes' 2 year old brother.
"No. My daddy carried him" said Innes
"Yes," said Imogen. "If Emily and Charlotte wanted to come, then both my mummy AND daddy would have to come to carry them."
"We'll have to fix up a date when we can go rock climbing again" says Innes.
"Yes and we can take ropes, so if people are better climbers than us they can tie ropes to the top and pull us up"
"Except, we're very good climbers. so we could pull mummy and daddy to the top with the ropes"
"Yes. They'd have to be very thick ropes."
"Yes. Very thick ropes"
"Yes. Let's play kicking a ball to each other"
All of this was a very serious discussion, taking time to listen to what the other had to say. Watch and learn all you adults!

Thursday, December 14, 2006

Kubin and St Pauls

We returned today from a fascinating clinic visit to Kubin and St Pauls. These are 2 villages on the opposite ends of Moa island, North of Thursday. Kubin was the original settlement. They generously allowed St Pauls to be set up on their land, apparently (though I don't know if this is generous as in "we'll let you live on it" or as in "we've been conned out of it by the whitefellas" which has certainly happened elsewhere in Oz). Anyway, apparently Moa Island was the holding island for Pacific Islanders after being taken from their homes and taken to farm sugar cane in Queensland. When the war (perhaps WWI?) broke out, the sugar cane farming collapsed and all effort was turned to the war. The pacific islanders went back to Moa and St Pauls was set up by the London Missionary Association to house them. The two communities are very different, therefore.

The flight over was beautiful. It's only a short trip, so we flew low and could see schools of turtles swimming over the coral. (Imogen insists she saw a couple of whales on the way back, too!)

Kubin clinic is a fabulous primary health care centre - if the doctors reading this could see it, they might be quite jealous! Very well designed, very well equipped. We stayed in a flat above the clinic. We would have stayed at St Pauls, which has an even bigger house attached, but the power was off for 2 days - no fans, no computers, no lights, no air conditioning. Whcih meant no doctor! I did the doctors clinic as planned today.

The clinics were interesting, though not too busy. There was a community meeting on in Kubin (I think to announce a recent death) and everyone was preparing for a tombstone opening ceremony in St Pauls. This is the grand finale to a funeral, where the whole community celebrates by opening the tomb. Deaths here are real community events (unfortunately, the high mortality rate means they happen much more frequently than they should.)

I did the clinics, and Jo had the children, who were befriended by the local island children. There was a beautiful secluded beach by the jetty, and from the jetty you could see schools of small sardines and large fish chansing them.
We also went to the local art gallery. It was opened especially for us by one of the local artists called Billy Missy, and we bought some of his artwork, because it's beautiful. (He also sold Jo some Crayfish he bought the day before, but then forgot to give it to us! Never mind. We were also given some home-made mango pickle by the nurse at St Pauls.)
And now we're back on TI, and the wind is blowing and it's raining. Rather lovely, actually.

Monday, December 11, 2006

Pearl Divers

Today we were back at Gab Titui, the cultural centre. They have an exhibition on about the pearling history on Thursday Island and the girls were fascinated. They were really disappointed to have to play on the playround, until I was able to finish my coffee and come into the exhibition with them. They watched a video from the 1960s called "Pearlers of the Coral Sea" and tried on a heavy diving helmet. For the rest of the day, they have been pearl divers. Their noght time story was about "the three bravest pearl diving sisters that ever there was" who found a magic oyster containing a huge pearl with black spots that looked just like Dimple, Imogen's favourite toy puppy!

If you think life is all pearl diving, I did manage to make a teddy bears picnic with Imogen this afternoon, and drew the best picture of a barbecue I've ever done (and that's not a sentence I write very often).

Tomorrow we're off to Moa Island to do clinics at the two communities there, Kubin and St. Pauls. Moa is one of the biggest Islands in the Torres strait. So no blogging for the next couple of days, though rumour has it that the health worker likes to take visitors out spear fishing - that'll be right up Charlotte's street.

Sunday, December 10, 2006

Swimming Pool

This morning Jo took the girls to church, and planned something to do for Sunday School as well. She doesn't normally run Sunday School, but no-one else does either. Usually Catriona (of Climate Change and Vegetable Orderign fame) will do it, but they are away camping this weekend, so Jo took it on. I didn't go today, but the children came back very happy and loving and have been offering hugs to all and sundry, so it must have got the "Love your Neighbour" message across extraordinarily well.

The pool opened this afternoon for the first time in months, and the girls demonstrated their increasing lack of fear of the water - which is interesting, because it is accompanied by an increasing fear in the parents!

Saturday, December 09, 2006

Ilan Life

Today was a lovely day. We were all together all day, and it feels like a while since we've done that. This morning we walked into town to do some Christmas shopping. (For those of you in England, imagine Christmas shopping in shorts and T-shirts and sweating. For those of you in Australia, imagine wishing you too could don the furry red and white hat, big thick coat and enormous beard just to keep warm.)

We walked down the sea front, and stopped first of all at a new shop called Ilan Life. Now I've been pronouncing it "Eelan Life" which makes no sense. Then I realised (or probably was told by someone less stupid than me - Jo perhaps) that it's "I-lan Life" as in "Island Life." Of course. Seems sort of obvious now. It's the most imaginative shop I've ever seen as it's a cafe that is also a dressmakers! If any of you have ever been to a cafe-dressmaker before, I would love to hear about it.

Their coffee and muffins are good, their dresses are the typical Islander bright floral patterns with a frill around the shoulders and plenty of room in the dress. "I'd only wear it for dress-ups" said Jo! (There was an alternative style called Fiji which was even bigger.)

We then continued with some Christmas shopping in the newsagent. Except that it's not just a newsagent. It's a newsagent, cum clothes shop, cum toy shop cum kitchen shop. (I suppose that means it's a department store! But a small one.)

This afternoon we built a Christmas tree out of some dowelling sticks, and decorated it with tinsel and bells we made out of egg cartons. "Does it look like a Christmas tree?" Imogen asked. "Er, well, it's representative of a Christmas tree" I answered.

"What does that mean?" asked Imogen, quite correctly detecting rubbish when she hears it.

"It means that if you ask someone what it is, they'll know it's a Christmas tree. But if you ask them if they've ever seen a Christmas tree like that one before, they'll have to say no."

It does look a bit wonky! But it's a fabulous tree. Here's a photo - slightly premature, as it's not fully decorated yet, but I can't resist.

This evening we went for a picnic by the beach. We chose the wrong beach, though, and nearly got blown away by the wind. We had a table cloth held down with big rocks. We nearly had to hold Emily down with big rocks too. Ziggy, Innes, baby Felix and their mum, Jess joined us too. Nathan, their dad, was on call and joined us later at the less gale-force Bach Beach (pronounced Back Beach) where there's a play ground. We ate food with too much salt, fat and colouring in. There were no tantrums at all!

Friday, December 08, 2006

And was Friday!

I've noticed myself how slack I'm getting with the posts recently. And that's mainly because of extreme tiredness. Well, it feels extreme to me.

Friday means more Primary Health Centre, more teaching and more grumbling about the computer system! I phoned the help desk twice today, both times experiencing the rather strnage phenomenon of having someone control your computer on Thursday Island from their call centre in Brisbane. (The second time, though, the computer was truly broken and someone will have to physically come up from Brisbane to hit it with a very large hammer.)

One of the other doctors (who shall remain nameless for now, and has not been mentioned in these blogs before) had this converstion with me today:
"Where do you go at 11am? DO you have a very long lunch break?"
"No, I go to teach the registrars {ie junior doctors}"
"What do you teach them?"
"General Practice" I said.
"Oh. What is there to teach?"
"Lots and lots" said I, starting to think more defensively now. "There's the whole of medicine!"
"But they're going to get bored, really, really bored for the whole of their career."
"Er...No they're not. I don't get bored."
"Don't you?" said with a look of amazement.
"Er...No. Maybe I'm just young and very naive."
Cue short reminiscence of General Practice in Toowoomba.

I suppose it's possible to get bored in General Practice, but I don't know how. You can get a lot of other things - frustrated, upset, angry, elated, warm and fuzzy, chicken pox - but not usually bored. The key, though, is to find out about the person, not the sore throat. Sore throats are very dull, but the people who have them are usually not dull at all. However, I know some doctors who call this "Social Work" or even "Priesting" - no, that should be "being a priest" - though I've never met a social worker who discusses the relative merits of COX-II inhibitors with their clients, and "Evidence Based Priesting" would rather defeat the nature of faith.

(By the way, if you're interested in how medicine has replaced religion read Foucault, who writes in impenetrable French, can only be translated into more impenetrable English and will very quickly persuade you not to keep on reading.)

Meanwhile at home, Emily and Charlotte are getting in plenty of practiced at their new skill: Having tantrums. They are naturals at it and I don't beleive they need any more practice. However, once they're over it, they were telling us that "Santa Claus is a very friendly man." Which is nice to know. Especially after they got pretty frightened by him at playgroup ("cay-boop" as Emily calls it) yesterday.

And so, to the weekend. The highlight may well be the Grand Re-Opening of the Thursday Island Swimming Pool. It's all everyone is talking about here.

Tuesday, December 05, 2006


The other day, while we were at the jetty attempting to catch another fish, we saw a group of lots of little tiny silver fish swimming around under us. "Look," says Imogen, "it's a pre-school of fish!" They were small.

We caught a tiny little rock cod, while Imogen, Emily and Charlotte danced in the outgoing tide on the bottom platform of the jetty. The fish, like us, went back to its home.

Regular readers will know that yesterday was Monday, and that this means comments about the pre-school bus and the box of vegetables. The bus has been very reliable recently. (So have the vegetables, actually!) After Imi got on the bus, I ran (well, walked very quickly) to preschool myself (with the buggy) to chat to the teacher about Imi's progress. We're very proud about how well she's done settling in there in such a short space of time. She has made a particular effort to try to get to know different children in the class, choosing someone different each time they are asked to "choose a friend to go to the bathroom with." (Insert your own joke here.)

Today Imogen came home from pre-school with a home-made robot (though I'm not sure it can do the washing up or put Emily and Charlotte in the bath, as the cardboard boxes would go all soggy) and the biggest piece of artwork I've ever seen outside a major art gallery.

If I seem distracted while writing this, it's because I'm trying to prepare a teaching session on otitis media, tonsillitis, sinusitis and other respiratory tract kind of illnesses. In my mind I'm trying to sift the evidence around diagnosis (which symptoms and signs are most significant) and which treatments are most effective, and does it matter whether your patient is indigenous or not? You might find all this quite boring. Strangely enough I don't (that's why I'm a GP!) For something that we blithely call "minor illness" it's not minor for the patient, because it makes you feel like you're about to die and, as it turns out, it's not minor for the doctor trying to navigate your way through a maze of evidence and uncertainty about the best thing to do.

What? You'd rather hear about those small fish again? Well, because they were very small, Imogen said it was a pre-school of fish. I wonder where she gets her sense of humour from?

Sunday, December 03, 2006

Goodes Island

Friday was another busy day at PHC, and I taught at lunch time on "Neurology".

On Saturday (yesterday as I write this) we went with the Arnold-Notts on their boat again to a nearby Island. Emily and Charlotte came this time.

We swam (what else would you do?) and did some spectacularly unsucessful fishing for squid. Imogen snorkelled and just floated around. We had a picnic. In the photos it looks like quite a grotty little place, but it was very nice. However, there was a boat wreck, and an ancient rusted engine, some collapsed huts, an old collapsing jetty and even some old gun turrets.

We came home in the afternoon, briefly rested, and then had an outdoor party with an influx of children all 5 and under.

A new doctor has arrived for 1 month in December. And it's someone Jo knew at Medical School! He has 3 children - Innes, nearly 5, Ziggy, 2-and-a-half, and a 5 week old baby. They had been here for 5 years in the past, so they know everyone. Caitlin came and all the Arnold-Nott children came, and another of the doctor's nieces came (Emily and Anna, nearly another Bronte pair). Childcare is so much easier when they are all playign nicely. However, the mess it creates is enormous, so traditional roles reasserted themselves, as I went to church with the girls this morning while Jo cleaned!


On we went to Warraber Island.

The first view you get shows the airstrip bisecting the island. After landing we aited to be collected. And waited. And waited more. We would have started walking then, but we had no idea which way or how far to go. So we went to a nearby house and asked. They were very helpful and gave us a lift to the "Warraber Guest House" where we were staying, next door to the clinic.

The guest house is where all official (ish) visitors stay when they're on the island. It's large with a kitchen, large living room, and 3 bedrooms. We were all in one together and borrowed linen from the clinic next door. Apparently they weren't expecting a whole family to turn up.

We'd been given an Esky of food for the trip by the hospital which consisted mainly of 2kg of frozen chicken! We discovered there was no way of lighting the gas hob. (I asked someone who stays regularly how they lit it: "Oh, I light the grill, then set fire to some paper and light the hob". "Ah," I said and bought some matches.) The whole island knew how naive I was when I asked if we could buy some beer, before being told it was a dry island.

The clinic next day was busy busy busy. They'd booked enough patients for both of us. They all needed seeing - I think it's the highest average HbA1cs I've ever come across.

(Note for non-medics - HbA1c is a measure of diabetes control - it gives a guide about the average blood sugars over the last 3 months. If you don't have diabetes it's under 6, if you're diabetes is well controlled you're around 7, if your poorly controlled you're over 8. These were all about 12)

So I developed my superquick "Tell me what you know about diabetes" consultation to get through all the patients without missing our plane. I was exhausted at the end. I didn't get to see much of the island. Jo and the girls did some more swimming, until seeing a stingray (not supposed to be dangerous, but that was what did for Steve Irwin, and was also in the news again that morning!) Here, again, the town looked well cared for, and, surprisingly, everyone was driving around in 4WDs. Maybe that's why the diabetes is so badly controlled...

We flew back that evening, and all fell asleep pretty quickly.



Well, we're back from our Island hopping and a really busy few days, hence lack of posts. I'll make up for that now with a splurge!

Our first clinic was on Wednesday on Coconut Island, also called Poruma. It's about a 30 minute flight on a small aeroplane - here you see the girls sitting in. It took Imogen some convincing that there would be no toilet on the plane (though she didn't seem to miss the cabin service). While Jo and myself were admiring the views of the islands below and even saw a big (thanfully old) shipwreck, the girls were more fascinated by the ear plugs. They looked a bit like sweeties.

Shortly after we landed we were met by the nurse at the clinic, Michael, on his quad bike. The bike took our luggage, while we walked the 50cm (perhaps a bit more) to the clinic.

This picture isn't Coconut, by the way, it's another island we saw on the way in the plane, but it does look a bit similar!

There we shared the workload. Actually it wasn't very busy as the community had organised what I'm told was a "whinge at the council" meeting. The whole community turned up, so no-one was at the clinic. I did some face painting on Imogen, Emily and Charlotte. Despite my offers, none of the patients wanted the same treatment. Jo saw a few people labelled as "women's health".

For the first time in my medical career, I had a swim in the sea during my lunch break.

That afternoon, the girls (all four of them) played in the sea with some very friendly locals. I did some home visits. Michael took me around, offering friendly abuse to everyone he met.

The island itself is long, thin and sandy. Great care has been taken by people with their gardens and the were the most perfect frangipanis I've ever seen. There is also this ruined church, built out of concrete, but made to look like stone. There's no roof, and huge cracks in the walls - a really unexpected find!

When the clinic was finished we caught our onward flight to Warraber. As Michael said, comparing it to Coconut: "What it lacks in length, it makes up for in width."

Monday, November 27, 2006

Jo's negotiations

Jo stitched up someone's wound in the middle of last night.
Seeing him today she said "You should give me a big fish for sewing you up last night."
"No I won't," he said. "You catch a fish, and I'll give you a recipe!"

On Wednesday we are off to a place called Coconut Island tomorrow. It has an exclusive resort there where people like Russel Crowe stay (probably when they're slumming it). I don't think we'll be allowed in. They'll take one look at our mess and lack of designer clothes and lock the gates. However, they will let us treat any of their sick guests; the health centre gets a mention on their website - and I'd be very surprised if there was more than one health centre. We're there to work at the clinic, by the way, not doing sight seeing. Well, I'll probably be doing the clinic while the rest swim and snorkel. I shall tell Jo she should catch me a fish. She'll probably just get me a nice recipe instead, though.

Then on Wednesday we go to Warraber Island and do a clinic there on Thursday before coming back here. I don't think they have an exclusive resort, just a local council. For these pair of clinics we'll fly in a teeny weeny (maybe even a toy) aeroplane, hopefully with beautiful views. It should be an amazing experience.

It does mean there are unlikely to be any blog posts for Wednesday or Thursday, so as you've been very good, you can all have a couple of days off. But be warned - I might try and write something tomorrow...

Readers' Requests

We've had our first Comment! You can find it here. Thank you to our friends in Picton, the Gough Family, and hello to you all.

They ask some rather specific questions, so I'll answer them here!

If you imagine sailing in to Thursday Island from the East as the first European sailors would have done, they come across quite a few islands.

I have a feeling that Captain Cook (for I think it was he) would have sailed in, seen these rather beautiful islands and rested on a small island just north east of Horn on this map. I suspect this happened on a Tuesday, so they called it Tuesday Island. Imogen and I went there, it's beautiful and deserted. From there you can see the next island to the West, and they would have travelled there on the next day. Therefore, they would have called it Wednesday Island. It's slightly larger, just north of Horn Island. We've not been there.

On the next day, They would have sailed to the next group of islands, and landed at the one most sheltered from the wind - it's much smaller than Horn and Prince of Wales nearby. This they called Thursday Island, and is where we are now, obviously. This shelter is why it took off as the administrative base for the area.

Just West of here is another Island which they would have gone to the next day, and called Friday Island. We've not been there either.

After this, they probably had a comment on their blog from someone suggesting they came up with more imaginative names. So they landed on a small island south of here and claimed it for England, probably with a nice little flag, and called it Posession Island. There's another one closer to the mainland called Entrance Island, where 2 people live, I'm told.

I've had a few requests for tie-dye T-shirts too. And one request to darn their jam (thanks mum!) I'm still thinking about it.

Maybe I should have a daily poll!
If you think I should put your hands up now.
And if you think I shouldn't put your hands up now.

Hmmm. That's interesting...


Last night I was on call for Jo again, and it's really making me relearn my Emergency, acute general practice and ward stuff - very good for me. We've realised how much Jo's skills and my skills complement each other - Jo is very good on procedural, anaesthetic type things, where as I'm much more comfortable with the broad general practice stuff. It means that we both think we look like complete dingbats on the ward for different reasons!

I've found it interesting being in a hospital environment again. I don't feel at home there, and I've realised how the context changes your consultation skills - it's very easy to be much more doctor centred interviewing someone on a bed. I've taken to using one particular room in the Emergency ward as it looks more like a GP room, and I know how to use that environment effectively.

(This may sound weird, but there's a whole literature on consulting skills which we teach doctors training to be GPs which definitely makes them more effective (as well as popular with patients). And consulting skills overlap with, but are separate to, communication skills. Consulting skills are about managing what we grandly term "The Consultation" which encompasses using the room, the roles of the people involved, using the computer, using the time....etc.....etc. Communication skills is the part which involves talking with, and much more importantly listening to, the other person. I'm glad that's cleared up, then.)

It was a busy weekend on call. There was a big football tournament (football=rugby league here) this weekend, so we saw all sorts of twisted knees and injured shoulders. Apparently the winning team get $10,000 each! That's more than Jo gets paid for me being on call.

Sunday, November 26, 2006

Music and Money

Last night (Saturday) Imogen and I went to a performance of Summer from the Four Seasons by Vivaldi. This was part of a documentary filming each season with a different soloist in a different location: Summer was here on Thursday Island, Autumn was in New York, Winter was in Finland and Spring was in Japan. They've been filming for 2 years now. The orchestra was a very photogenic group of young Australian player, and they played very very well. Hearing the fast sections played so tightly together, yet quite ferocious in attack was extraordinarily exciting. Imogen was very good indeed, sitting quietly throughout. They played 4 takes, but we only stayed for the first, as it was getting late and could have gone on for hours.

Jo was on call at the hospital and it was a really really busy day. She was so tired when we got back, so I covered for her in the hospital seeing the A+E patients. Again, today, Jo did the morning shift and I did the afternoon shift. Jo's favourite thing about this is that she is getting paid for the work - so all the overtime that I do will go into her bank account. Some say I should get a better negotiator.

Friday, November 24, 2006

Comments on previous posts

Well, how many of you have noticed the gems from these previous posts:

This picture was taken while walking through the cemetery where I asked: "Does this path stop in a dead end?"

Don't all paths in cemeteries stop in dead ends?

(And some of you will be pleased to see I've spelt cemetery differently this time - I'll let you work out which is right!)

"The afternoon is taken up with collecting our box of vegetables from Cairns - it sounds like it takes a long time"
It has come to my attention that that sentence may perhaps be a little misleading. I didn't actually walk to Cairns. I just walked around the corner!

This is Jo in the process of typing the previous post where she wrote:

"Tim has had a tie-dying session with Imogen, Emily and Charlotte today with three gorgeuos T-shirts the result. (see future pictures, no doubt). " Here is a future picture!

"He will be darning socks and making jam tomorrow."

I tried, but I ended up darning jam.

Wednesday, November 22, 2006

Dr Jo

Hello! Miracles do happen. No.1, the man with the severe head injury Jo "choppered" in to T.I. two weeks ago is walking and talking now. Just four days ago he was not expected to live. A very happy day for his family. No. 2, Tim has had a tie-dying session with Imogen, Emily and Charlotte today with three gorgeuos T-shirts the result. (see future pictures, no doubt). Yesterday he baked shortbread with them and an extra little three year old girl (no he didn't bake the little girl, just the biscuits), also named Mimi. He will be darning socks and making jam tomorrow. Jo continues to learn more and more about renal failure, diabetes and abscesses. Who would you rather have dinner with, the chef or the girl who spends her day with pus?
Anyway, what's the weather on T.I. tomorrow? 25-33degrees, windy and about 85% humidity, at a guess. And what does climate change therefore have in store for these low-lying isles? Tomorrow night there is a meeting on the island about just that; organised by one of the other doctors here (Mimi's mum, in fact) so I will be very interested to attend.
Then Friday night we have Christmas Carols by candlelight.
V. tired now.
Love to all who read

Tuesday, November 21, 2006


Mondays have developed their own routine. It starts with waiting for Imogen's pre-school bus not to turn up. Then we all walk up to Imi's preschool. There's a bit of variation then - I have to choose which long way round to walk back home with Daddy's pretend bus. Yesterday, I walked through the cemetary and stopped half-way up the hill to talk to a woman. She looked quite surprised to see us there.
"Does this path stop in a dead end?" I asked.
"No. But it's a long way."
"Everything's a long way from here" I said.
"That's true"
"Last week I walked around that hill there. That was a long way, too"
"It is," she said, backing away slightly.
"Must keep on climbing" I said, leting her relax.
It wasn't that far, but it was pretty steep.
("Does it get any easier?" Jo asked me later.
"No." I said.)

The afternoon is taken up with collecting our box of vegetables from Cairns - it sounds like it takes a long time, but it's the chatting, playing, drinking cups of tea that takes a while. Pushing the pretend bus up a steep hill with a box of vegetables on it takes a while too.

Monday, November 20, 2006

Children's Playgrounds

One of the main markers of health status internationally is the age distribution of a population. Countries in the majority world tend to have a young population with lots of childfren and not many elderly people - you can imagine it as a pyramid if you want. (They always call it a pyramid, but when anyone draws it, it looks much more like a triangle to me, but who am I to quibble with some of the most eminent epidemiologsts the world has ever known!) In the rich nations, there are more elderly people and fewer children - hence we worry our politicians and economists about superannuation/pensions in the future.

Here, I suspect there are a lot of children. Partly because I think I know most (?all?) of the families with preschool children now, and there seem to be a lot of them. But partly because there seem to be an awful lot of children's playgrounds around on this very small island.

Anyone care to research health status and its correlation with number of playgrounds per head of population? No? Ah well.

Sunday, November 19, 2006

Going to Horn Island

This morning we skipped church. (You'll remember the pastor has a slight issue with this!) We went on the ferry to Horn Island, which is just across the Ellis Channel. We met someone Jo works with (who took this photo) who was doing what Jo called "Church Hopping" in preference to "Church Crawling". She was going over to one of the HI churches. The pastor (not ours) was on the same boat.

We were given bad directions which meant that we had to walk about four times as far to our destination- the Gateway resort for a tour of the Island. The resort was a funny place run by a Chinese family who have lived in the Torres Strait for decades. The parents run the hotel, one son runs the tour and another son runs a shop on TI. They have notices forbidding almost anything that could happen dotted around the hotel, and an interesting, old fashioned museum about Horn Islands (including a sign which seemed to be saying in essence "prepare to be invaded by hoardes of people from PNG or Indonesia...")

The tour itself was mainly about the Islands in the first and second world wars. A very active history this, told my a man my age with obvious relish. He loved showing us bits of crashed plane, the places where they used to hide planes in the scrub, narrow trenches, even broken beer bottles from 1943 still in the place where they were broken (assuming I'm not being naive in thinking he hadn't gone out and placed them there the night before). I'm not really into military history, but told by an enthusiast, it's very interesting. It actually reminded me of Catch 22, about US air force soldiers going mad on a hot Island in wartime.

Imogen really enjoyed it, but it's pretty hard to explain war to a four year old: "Were those men being naughty, having guns here?"
"Err...umm, yes and no" was the best I could manage.

The morning ended with a quick dip in the hotel pool - our first chlorinated water since arriving here.

Saturday, November 18, 2006

A New Book

Today we went to a book launch! I've never been to a book launch before. It was a children's book called Triggerfish and Trevally, which is a traditional tale from Murray Island, and the text has been "endorsed by Priests of the Anglican Church of Australia in the Torres Strait Region." I've never seen that before either!

The launch was held at Gab Titui, the cuktural centre here, and they had a Bouncy Castle (which collapsed twice (another thing I've never seen before!)). There was face painting and some (not very exciting) speeches and very nice coffee and fruit. There was also somebody else's birthday party going on at the same time. Nturally we bought a book, and got it signed by the author. Imogen listened to someone else reading it to their grandchildren. We haven't read it yet, but Imi tells us it's good.

We went swimming this afternoon, with Jo keeping a close eye out for crocodiles, but there weren't any (luckily). And we ended the day with a barbecue by the beach - just us, no big party.

It's been really, really windy today, so the sea has waves on it and walking along with the double buggy is like walking with a big sail.

Tomorrow we're on a boat to Horn Island for a look around.

Friday, November 17, 2006

Talking Nonsense!

Imogen has discovered a love of talking nonsense. (Some of you will say it runs in the family!) This evening Imi, Jo and I were lying on the bed playing a game of making up sentences which go something like: "I'm going to the flim flomple grap because that's where you paint cows purple." The best one came from Imogen about going somewhere "because that's where you buy a new shadow!" Profound. She went somewhere else where you "sell God."

Anyway, tonight we ate fish and chips while watching a touch football tournament. Next week there's a Rugby League tournament with Mathew Bowen coming to visit. I've never heard of him, but if you follow NRL apparently he's very famous indeed. Next week's tournament is called "Island of Origin" apparently.

I've had another day in the clinic - today I've been ranting at the Queensland Health Computer System - if you sat down to try and build a geeky computer system with lots of theoretical bells and whistles but absolutley useless at the pointy-end of clinical care it would look something like the Queensland Health Network. It's a huge state-wide network which greets you with a message from the Chief Exec or someone as if to say "Hello. I'm watching you" in corporate speak. They should just put a webcam on each computer and have done with it. Then the e-mail is clogged up with changes to policy: "If you are plugging in a laptop or other movable item somewhere other than where it is now you will need to speak to us first and register it, so we can make sure the right software is available otherwise we will not be able to provide adeqate support" Surely the point of laptops is that they move? I got my passwords today, only 3-4 months after applying for them and because I phoned up 3 separate departments (well 2, the other was only available on e-mail). Everyone was very polite and nice on the phone, so I suppose that's something.

I could go on and on and on and on - again some would say I do. But computers should be like ducks - serenely doing just what they're supposed to on the surface and any effort required happening away from sight underwater.

It's only because I have to handwrite prescriptions - timeconsuming, illegible, error-prone prescriptions on someone else's pad...

....and on and on.... {fades into silence as everyone goes and visits a more interesting blog......}

Thursday, November 16, 2006

Imogen, Emily and Charlotte

Well, it's late morning (any normal people might consider it early, but we've been up hours and hours by now!) and the three girls are playing very nicely together. Emily just turned to me and said "No, don't look for us daddy!" so I always do what I'm told. They play all sorts of games, from squirting water in syringes over the balcony, to climbing up the fence with next door's balcony, to doing jigsaws, to putting a baby in hospital. When you listen in, you hear comments like Emily saying to Charlotte "You're taking the paper off, are you?".

Yesterday we built a bus in the front room - as you know Imogen goes to pre-school in a bus, and so Emily and Charlotte have developed a bus fixation. Today we will be going to play group because we get to go on a bus. (It sounds like they don't enjoy playgroup - they do, but they get more excited about the bus journey.

As Imogen has taken to snorkelling so well, we bought her her own snorkel yesterday. She calls it a snorgal and I think it may well catch on. She hasn't tried it out yet, but was walking around the front room wearing it. (I hoped she would watch play school wearing it, but she took it off. It will haved to remain an enduring mental image...) We might try it out today in real water. It's encouraged her to swim herself with no holding hands or floats.

Tuesday, November 14, 2006

Mangoes and lemons

"You didn't buy mangoes, did you?" somone asked me 2 weeks ago at playgroup. I must admit, I had, but they were nowhere near as nice as the mangoes I picked up off the floor! As you walk around the island here you can't help but come across mangoes dripping off the trees, usually with lots of windfall (roadkill?) mangoes lying around. If they've dropped off recently, the birds or the ants haven't got to them and you can take them home and let them ripen.
(Mind you, I did try to climb a mango tree outside church on Sunday - perhaps I should have been singing "Closer my lord to thee" - but had to give up in embarrassment!)

The mangoes themselves are very tasty, but not quite as good as those which hang off the trees in Darwin, which are the best mangoes I've ever had - a Platonic Ideal of a mango, if you ask me.

Still on a fruity note, I made proper home-made lemonade today, and that too is delicious. Imogen couldn't get enough of it. I call it lemonade, but there were rather too many oranges and grapefruit in the fridge, so I put some of their juice in too.I shall have to patent the recipe. Except I can't remember it - er, juice, water, sugar and drink it.

Where is all this fruit coming from? Well, we've been very fortunate to join in with some friends of ours who order in bulk fruit and veg from Cairns for about 10 families, because it's much better than the expensive F&V in the shops here. (By the way, don't tell anyone else about this, as the people who run it can't take any more families on - so their identity shall remain a secret for now... You never thought this blog would be full of such suspense did you?)

We ate the fish tonight (see yesterday's post), and it was very nice. And my head is getting better!

Monday, November 13, 2006

All that fish and no chips

The big news today (and I'm hovering around the phone waiting for CNN to call) is that I have caught my first ever fish! I think it was Imogen's help that did it. We actually caught 3 - one probably a baby snapper, the second a rock cod that was nearly as big as this (in just the same way that I look like this!) and something called a ling. Or not. We don't really know. The first and last went back in the sea, as they were too small too eat. ("Why?" as Imogen asked, about this and almost everything else.)
Our plan was to get chips just in case we caught anything, but the chip shop was shut.

The funniest moment, however (unless you're me, of course) was swinging the line around my head to cast it and hitting myself very hard on the forehead with the weight. I may be the only person ever to get a black eye from fishing. No, don't laugh. I said don't...

This morning Imogen's bus to preschool forgot to pick her up (not an unusual occurence around these parts, apparently) so we had to walk. It's a scenic walk, and not too far, but it added about an hour and a half to my morning.

Sunday, November 12, 2006

Yes, Jo has signed in. Its cool tonight, the breeze has picked up again and its lovely. I have the energy to add my bit to the blog tonight, instead of collapsing in a sweaty heap!
Where do I beign? Firstly, Imogen has learnt to snorkel, well and truly. We are very proud parents. She has seen a sea worm, something neither of her parents have ever seen!
Yep, we have all swum in the crocodile-infested seas and only lost a few digits, ha, ha. The water is like a massive warm bath. Emily relishes it very little but Charlotte is quite keen. The paddling pool feels a little safer for both of them though, I reckon!
I am back at work tomorrow, and I feel ready for another week of learning! The patients make the ward-work very rewarding, though. They are a funny, sarcastic, optimistic people here, I think. There is a real sense of these islands being their place, more of a feeling of culture, ownership and community than I have sensed on mainland Australia in aboriginal communities.
Church was good, this morning. The "Minister's Wife" gave the sermon; we never learnt her actual name. My favourite bits were her thanking God for the cooling breeze, and the assenting Hmmms and Yes Lords of the mainly Papua New Guinean congregation. And singing "Sweet Honey in the Rock" (six times!). No I'm not being sarcastic; I enjoyed it. I hope to have a sing-a-long Messiah organised before Christmas, but failing that, carols on the wards would suffice.
Enough from the "Wife of the Blogger". Stay well all who read, and in the words of the "Minister's Wife", "wake up happy in the morning". (I shall try, although it is likely to be a five o'clock start!)

Saturday, November 11, 2006

Tim and Im go boating

Here's a trivia question for you: Where does Tuesday come after Wednesday? Well, we found out today - if you sail from Thursday Island, past Wednesday Island you come to Tuesday Island. And that's what Imogen and I have done today with some friends here. We sailed off the North of Thursday Island, round anticlockwise past Hammond Island, Goodes Island, Friday Island and Horn Island and out beyond Wednesday Island to Tuesday Island.

And it looked like one of those tropical paradises you see on postcards. And it was deserted (until we got there). No houses, no buildings, just native trees and a sand dune. Just off the island is a coral reef with beautiful fish - Imogen had her first go at snorkelling, and was thrilled to see fish swimming around.

She's not a confident swimmer, so I held her around her tummy, while she looked under water. I knew she'd seen something when I heard "oooh" noises coming up her snorkel tube! (I had a go, but without my glasses, all I could see was grey fish-like shadows flitting around - not as impressive as Finding Nemo!)

She played with Mimi (3), Reuben (4 - 1 month older than Imogen) and Gracie (6 (I think)) and had a wonderful time. We saw a sea eagle and something big and grey that could have been a dugong, but was probably a turtle (which I am reliably informed tastes like gamey beef - which sounds to me like kangaroo!)

It seems that a boat is essential for people here long term, as it's the only way off the island - you can feel quite cooped up here otherwise. And then I got to imagining the first Europeans here - after months and months on a boat, seein gnothing but sea, and then you see land - and it's not just one land, but these small islands, with beaches, trees, wildlife, virtually untouched - what an amazing feeling that must be. (I don't wish to glorify what the original European colonisers did here, as some of it amounts to genocide, but equally, I can't help admiring their sense of adventure in actually achieving sailing halfway around the world in uncharted (to them) waters with no means of communication)

All the children had a sleep on the way back, before meeting up for a sunset barbecue with the same family and other doctors from the hospital for a sunset barbecue by the beach. This was the view.

So today was one of those days that was the reason we came up here in the first place. I feel enormously priveleged to have a job that allows me to come to places like this that most people just would never get the opportunity to visit.

Friday, November 10, 2006

A day in PHC

Today I worked for money for a living at the PHC (Primary Health Centre) doing General Practice. There are two things of note (well, maybe more than 2, but 2 is all I'm going to mention now) about this. One is how I've been trained in General Practice in inner city UK, and still what I learnt is applicable here far far away from anywhere, and still what I do here feels familiar. (I am acutely aware, though, that I don't know enough about Torres Straight Islander culture and how this influences health - I'm learning from my patients - "Do you speak creole?" one asked me today - "No. Do you speak any Islander languages?" "No".) There is a need for generalists, and if ever you find anyone speaking about being "just a GP" have a wry giggle and point out the error of their ways - in partiular all the good evidence that good quality primary health is essential for a functioning health service.
My second eye opener, though, is having to hand write all my medical notes, my request forms and my prescriptions. It has slowed me down tremendously, which has the knock on effect of making my handwriting worse. (If you're wondering, they do handwriting classes at medical school, to make it look more and more unreadable. It's just before the class on how to swear a hippocratic oath.)

I've been teaching the more junior doctors today on Chronic Disease Management (Wentwest readers would recognise the session!) and part of the message is how much easier computers can make chronic disease management (if used properly by all the team...) while I'm busy dusting off my quill and ink bottle.

A paddling pool and a tent

We have a blue paddling pool out on our balcony, which the children go in to cool off in the afternoons.
We have put a tent up in our living room (though without tent pegs, you'll be pleased to know) which the children play in.
One day they might both go outside!
If you know anyone else who does this, do let me know.

Thursday, November 09, 2006

What's on TI?

I've been walking everywhere, pushing that big double buggy (now christened "Daddy's pretend bus") and my calves are aching. If you look here, you'll see a map of TI - just imagine me walking along the bottom of the island, from the hospital in the far south-west corner to the area inland from that first jetty. It doesn't look far, does it? And actually, it's not, but on an island this small everyone's perspective changes. "You can't walk to playgroup, it's over the other side of the island!" It's not even that far. But today I got the playgroup bus. My excuse was that it would be fun for the girls to go on the bus - especially as Imogen has been going to preschool on a bus on her own - but actually I was just tired! Ahh, poor me.

The weather is hot and the wind has dropped leaving the humidity high, and the sea as smooth as glass. Even Imogen seemed to understand my explanation of humidity.

So, on a usual day, I walk through the little town (called Port Kennedy, I learned yesterday) which has a supermarket, a chemist, a newsagent (which sells lots of other stuff, too, icluding having a Retravision inside!) a computer shop, a Christian book shop (with some very strange signs in the window, including an ode in praise of the military). More interesting, though are the other random shops who seem to sell anything they can get their hands on - fishing tackle, ham, plastic cups. I'm going to try and find a trombone in one of them, just as a challenge to myself. (My favourite shop name is "Migi clos shop" which looks like it sells clothes for children, and then you realise the name must be in the local creole. I haven't been in as the buggy won't fit.) There's also a nice little library.
The cultural centre which, like most proper art galleries serves the best coffee in town. It also has a fabulous little playground - I think we'll be going there regularly. (Looking at the picture, it looks like you can't see the sea from here - but actually it's just behind Jo taking the photograph!)

Tomorrow I'm back at work, and after last week (which I've come to think of as being on call for family duties!) I should be able to complete a whole day. This will include registrar teaching for 2 hours, something I'm quite capable of getting excited about.

That's all for now. I'm sure Emily said lots of amusing things today, but I can't remember any of them. She is developing into a little Imogen, though. And Jo pointed out today that Imogen is a little Jo. So Charlotte must be me, but I don't see it myself.

Wednesday, November 08, 2006

A little blue church

On Sunday we went to the local Uniting Church. We are members of our local Uniting Church in Picton (hello to all of you!) which is one of the most friendly and welcoming churches we've ever been to. I feel a particular affinity, as my family were Methodists in the UK going back generations and were lay preachers. The Methodist church, for those who don't know, has a tradition of being very socially aware, which is what Christians should be, it would seem to me. I've been pleased to see this seems to be the case wherever you go in the world.

Anyway, the Uniting Church here is a lovely blue building, as you can see from the picture. (Those of you who know anything about the history or beliefs of Methodists will be amused to find it next to this pub on one side - and another pub on the other!)

In common with rural medicine, they seem to find it difficult to recruit ministers to areas as far away from cities as this. Their solution is to borrow a minister from Papua New Guinea! They rotate through for 2 years from the PNG Uniting Church.

Chatting to the minister before the service, he was experiencing his own culture shock, I guess, as he had been very surprised to learn that, unlike in PNG, many members of the community, including members of his own congregation, would go out fishing, visiting other islands, those sort of recreational activities instead of going to church. This would be ub heard of in PNG, and I hadn't really thought about it.

The sermon was quite fun - ostensibly about being humble, but ranging all around about true and false visions, messages from God, going to hell - quite tub-thumping really (and not my sort of thing!) What struck me most though was the singing - everyone really sang as if they were really enjoying it, harmonising to very simple choruses - and it shows how when people really put themselves into their singing, the results can be quite moving. It reminded me of my time in Zimbabwe, where the same thing happened - people were singing these familiar tunes in the local N'dabele language.

I learnt after from another friend here, that the Uniting Church here is where Papua New Guineans themselves go when they're on the Island - and apparently there's a lot of prejudice here against people from PNG. It sounds like some Australian attitudes in microcosm. However, I only have this second hand, I haven't knowingly seen it myself yet, so don't quote me yet.

By the way, I felt less threatened than I often am at a fairly fundamentalist sermon, and one of the main reasons for that is that I'm reading "God - A Guide for the perplexed" by Keith Ward, and it's brilliant. It describes the history of philospohical thinking about God, but is also quite opinionated, and funny without being flippant.

If you thought today's post is dull, then you'd better hope Emily says something funny tomorrow!

Tuesday, November 07, 2006

Why is it called Thursday Island?

"Can we have a barbecue by the beach, mummy?" asked Imogen last night.

"Not tonight," says Jo.

"When then?"

"Thursday," says Jo.

There's a slight pause.

"Do you know why it's called Thursday Island?" asks Imogen.

"No, why?" says Jo

"Because every day is Thursday." Pause. "So can we have a barbecue tonight?"

Imogen is 4 going on 28.

Monday, November 06, 2006


This is us on the Jetty at the wharf on TI on Sunday evening. We were going fishing! We caught nothing (as expected!) but knew some medical students who caught a rock cod (yummy) and an old piece of trolley (only yummy if you're iron deficient.) Imogen enjoyed holding the reel, while Emily and Charlotte rubbed the eyes of the cod. No really, they love doing that!

This, believe it or not, is the view from our balcony. I think that's Prince of Wales Island you can see across the water. Anyone jealous yet?

More of us - this is Tim's walk to work on Fridays or our walk to town on other days. It's not really any busier in rush hour, either. There's a lovely sea breeze (or you might call it a wind or a gale, depending) which takes the edge off the humidity.

Have Murphy!

Our next door neighbours in Picton have 2 big dogs, Chopper and Murphy. Before we left they lent us a large toy dog, just like Murphy. Emily and Charlotte cannot get enough of him, and walk around the house shouting "Have Murphy!" How long before the neighbours here on TI intervene?

Friday, November 03, 2006


We are here! And it's beautiful. Everywhere we look has sea. The island is small, so it's impossible to get away from the sea. And it's hot, but with a lovely, cooling sea breeze. I (Tim) have been exploring part of the Island with the girls, while Jo has been working at the hospital, revising her general medicine - a real variety of pathologies - interesting for a doctr, perhaps less interesting if you're the patient. She's off on an emergency helicopter trip to retrive a sick man off another island now, so I've been called back from the clinic!

Everyone here is very friendly - people just saying hello on the street. (Mind you we've experenced the same thing in Sheffield and in Picton, though without the heat!) And shopping is very very expensive - so if you feel like sending us a luxury (without violating quarantine laws) then please do!

Friday, October 13, 2006

Long Time No See

I've just come back from the RACGP conference in Brisbane. (That's why I've not posted for a while, obviously!) I'm usually a bit sceptical about "networking," and I think that's because I don't know anybody. This is what I was telling my colleague, when I realised I was stopping more often to greet old friends from Alice, from Darwin, from Campbelltown. Oooh, I like this networking thing!

At 2 conferences this year I have met GP heroes of mine. The first was Roger Neighbour, who is the president of the RCGP in the UK (about to retire) and has been one of the most influential GP teachers in the UK, probably in the world with his book "The Inner Consultation". The second was Chris del Mar the Dean of the new medical school at Bond University.

Both of these professors have an ability to explain complex ideas that we all think in a way that makes you say "Of course, that's exactly it!" They are also very nice people with nothing to prove, so helpful to mere mortals like me at the start of my career.

Enough about my secondary Queensland travels - the main event gets closer and closer. If we end up bankrupting ourselves (we are a bit worried) then you'll find ads on the site and you'll all have to click on them - both of you...

Friday, September 22, 2006

Aboriginal and Torres Strait Islander health

Do you intend to retire? I do, one day. Not yet, though. When I get to about 60, which is probably about the same as most people reading this. And we expect one of those nice lives full of leisure - you know, golf, travel, nice red wines, all of that.

Except if you're an Aboriginal Australian. If you're a man, you're life expectancy is 20 years less than mine. You can expect to live until you're about 56. Not much retirement there then. Imagine that being you, and your friends. No retirement, not much fun with the grandchildren.

In health there are measurements made to measure the health of a whole population which reliably reflect how healthy that population is. These are thing like life expectancy, mortality at a given age, the infant death rate. These are all higher for Aboriginal Australians - similar in fact to the developing world. Imagine the number of times you have to go to a child's funeral and multiply that by four. Imagine the number of days off to go to funerals.

Both within countries and across the world, populations with the biggest health needs have the least access. And working in Aboriginal health you can make a difference to people and communities. Why wouldn't you want to do that?

Friday, September 08, 2006

And who might you be?

Dear mysterious and perhaps non-existent reader, who might you be?
Well, you might be a member of my family or Jo's family finding out what we're up to on TI (as we don't write or phone often enough. And the pictutres are prettier on a blog). Or you might be friends in the UK. Or in Australia. Or in another country, perhaps.
Alternatively, you might be an Australian GP interested in finding out what it must be like to go to remote Australia. Or you might be a rural Australian GP thinking that I'm a Johnny-come -lately not really committed like you all are to rural medicine. (And you'd be half right. But only half...) Or you might be a GP registrar, perhaps even one of my registrars from Wentwest. Or perhaps you're an anaestheitc colleague of Jo's looking on with curiosity - do they use ether, alcohol or just a great big stick to bite on?
Some of you may be players or audience members of the Penrith Symphony Orchestra, wondering if my viola will warp in the humdity.
Or you may have hit upon the site randomly. That would be quite exciting, wouldn't it!

Tuesday, September 05, 2006

Thursday what?

As you may have gathered from what I've written so far, we're off to Thursday Island in November for 2 months. What is Thursday Island? Well, have a look here for some photos. It's just north of the Far north of Far north Queensland, which as the description suggests is high up in Australia. Apparently there is a population of about 3500, the same as Picton where we live in New South Wales. That's probably the only similarity, though. If you can find other similarites (or even if you've visited both places!) please let me know.

That's all for now. It'll get more entertaining, I'm sure.... For now we're getting bogged down in paperwork, and I haven't yet heard a good joke about doing paperwork...

Monday, August 28, 2006

Welcome! It's the first post.
I thought that if you's come across this blog thinking "I wonder if it's that Senior family..." then you might want to see a photo of all of us. Well, there we are. Obviously not on Thursday Island (or TI as I will eventually call it to prevent myself from getting repetitive strain injury) as we have too many layers of clothing on.

If it's not the Senior family you were expecting, then there must be many other Senior families going to TI later this year, and I look forward to meeting you all.

The posts will be a bit occasional for now, as I'm new to blogging, so I'll just be testing things out a bit. If you feel like giving me feedback or advice or have any questions, then do please post a comment.

More soon........