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!

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 just..er..washing 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.

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.

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.

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.

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.

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"
"Yes"
"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!

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.

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.

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!

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!

And suddenly....it 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.

Pre-Scool

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?

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!

Warraber

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.

ZZZZZZZZZZZZZZZzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

Coconut

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."