The first week continues ...

Okay ... just letting you know that I am eating well, really ... that's a picture of my lunch. Food here is fresh, not a great variety, but I buy what I need every couple of days. I was told that the best food in town was either at the Thai restaurant in town (Fri-Mon), or the Bowls Club on Friday nights. I indulged and tried some of the Thai as takeaway .. the usual test of Tom Yum and Chicken green curry ... if this is the best in town then it truely is a sad state of affairs. Yes, I am spoiled rotten with having found a few very good Thai food places near home in Melbourne - the Thai food here was of good wholesome home-cooking style, but nothing that could reasonably be called restaurant quality food.

Tuesday - hot weather with no cloud cover, but the humidity felt less so more like the Melbourne hot summer day I am familiar with. The airconditioning in the hospital and accommodation is crucial though. Interestingly the hotter, drier weather brought out the ants. Some at work, tiny ... smaller than I have ever seen,

and these "green ants" around the lower structure of the house I am staying in. I found this interesting website while editing this post.


The cane mill "railway line" near the house that runs across the main street is used frequently. The narrow gauge line is for the sugar cane being moved from one section in the cane mill to another ... the engines pull out a very long line of cane "trucks" out of the mill until the line is clear of the redirection point and then the engines push the cane back again. A photo of this.

I am still completing the medication reviews at the "acute stay" end of the hospital - reducing a number of excess medications and rationalising others. Particularly ceasing some of the ones like cholesterol lowering agents in some of the older patients with liver dysfunction. Neither needed for the "long term risk reduction" as what it would have been for them twenty years younger nor as safe with the unhappy livers.

Today had a Melbourne man who was at the end of a ten day fishing trip who came in with a "boat propeller injury" ... I dreaded what I might see on arrival, but fortunately the propeller was in fact stationary at the time of the injury. Still a significant laceration though - didn't know propeller blades were so sharp.

Another thing I am beginning to see as a common pattern is the sun damaged skin, in almost everyone local ... young adults who work in the plantations are very tanned, and the older adults all have multiple patches of sun damage, and the elderly who have live local for the whole of their lives have skin that has an appearance somewhat less than human-like.

Wednesday - a little overcast. Ward rounds are starting to come easier with getting to know the patients and their individual needs. Today also introduces the administrative paperwork of the ward - signing off on discharge diagnoses and treatments for the coding that will be used to determine some of the funding for the hospital. Of the 22 beds, 15.3 are funded as acute care beds ... interesting, as it really is defacto nursing home care for the majority of the occupancy. We have 20 patients in at the moment ( yes the other two currently empty beds are for my genuine short stay, acute care patients - and I have used these as such a number of times already ) and a category review of all of those 20 patients this morning with our ANUM ( yeah .. you can look that up too - hint : it's a role descriptor abbreviation ) revealed, as I expected, that only two of those are classified as acute care patients, and even then they are the longer end of the acute care, eg. one with COPD recovering from pneumonia - thats a two week acute care episode if all goes well.

Did my second clothes wash today ... have 5 days work clothes supply, and two days casual clothes, so need to keep ahead - twice a week seems to work nicely. There is a good set and forget washing machine, and a hanging line under the house for drying - even with the humidity anything out of the washing machine dries in a few hours.

Today I started planning what I might do on my weekend off ... found a good website with local road tour maps here ... will do the Reef to Rainforest - about 260kms round trip Gordonvale, Etherton, Mereeba Wetlands, Mt Molloy, Port Douglas and back along the coast to Cairns, probably Friday. Haven't decided about Saturday yet.

Oh by the way, in case if you haven't found it already, just at the bottom of each of my blog posts there is a "Comments" .. click on that link and you can make a comment or leave me a message ... I have this blog set up to email me when a comment is posted and a copy of your comment gets sent to my mobile phone, so even if I don't have easy net access I get your message fairly promptly. You can choose to post anonymously so you don't have to set up a gmail account, and there is a security number you need to copy from a distorted picture - this is implemented to discourage random automated spam for the usual unpleasantries.

Will probably post next on Friday after my first day off ... see you all then.