As many of you are aware, Lori, Rachelle and Anthea have made it back to Canada and have left me here in Katherine to batch it for the last three weeks. As I write this (and hope to complete this) I will be in my last week here.
It has been a strange transition to being alone after being in each other’s back pockets for nine months. The unit seems strangely large, empty and quiet. It’s probably telling that I have heard barely two sentences from Rachelle and Anthea since they have been back with their friends. Anthea’s comments have mostly been limited to exhortations to shave off the beard that I have allowed to grow in their absence.
Working in Katherine has required its own degree of adaptation. To improve patient safety in the ER they have created a new position of ER Senior who is present in the ER during the day and then on call overnight. Due mostly to my grey hair I think, I have been doing many of these shifts and on-call as well as anesthesia on-call. Even though I initially trained in Australia I have not worked very much here and certainly not at all in the Top End. Thus, my level of “experience” is low in this environment. Adding to this is that the spectrum of disease here is quite different not only to Canada but to the rest of Australia. As I have been wont to say, “I know lots about frostbite but not so much about snakebite”. I thought I was intellectually prepared for many of the health challenges in the Northern Territory but the realities of diagnosing Rheumatic Fever and Post Streptococcal Glomerulonephritis and admitting so many children with dehydration from Rotavirus in a country as wealthy as Australia was nonetheless startling and disheartening.
Working here has tested my knowledge and skills, probably more so than working in Uganda and Zimbabwe. Part of the reason for that is that, in Uganda and Zimbabwe, I was very clearly the less experienced with a certain limited skill set that I was offering. In Katherine, the lines were less clear. I found it a significant challenge to be “supervisor” for many who have far more on the ground and local experience than me. Likely adding to this is 20 years of working in Rural Canada which means working predominantly solo and only having to be responsible for myself. While I have supervised Family Practice Residents the training and work structure is significantly different enough to make the supervision required different enough.
I have somewhat paradoxically found it less disquieting to be on call for and attend major life threatening anesthesia emergencies than to be the senior on call for the ER. I think this is in part because, in the anesthesia position, my role is very defined and I have a certain area of expertise for which I am responsible. In the ER position I am also responsible for a lot of other people and it’s not a role I have had a lot of experience with.
That being said, it has been an incredibly valuable experience for me working in an ER staffed with several doctors. Sometimes we would be tripping over each other as physical space is limited, but the opportunity to bounce ideas off colleagues and have someone else have a second look has been invaluable. I think the patients benefit from this as well.
As the gap year draws to a close there are many things to reflect on. It is hard to distill what I have learned into a few words. When setting up this final job in Katherine I did joke that, what working in Africa did teach me is that, as a family, we do need our separate time (especially Rachelle and Thea) and thus going to work in an even more remote community in the Northern Territory would not have been wise. As it was, they were probably not here in Katherine long enough to get their own space.
What this year did give me was an opportunity to work with Lori. In FSJ, while we would chat back and forth about work things, we were always working in our own work environment. In Zimbabwe and Uganda we had the opportunity to work on things together and to troubleshoot issues. It made it all the more worthwhile making small contributions to projects she was working on.
Outside from work we all very much benefited from Lori’s approachability and social awareness. It definitely helps that she is very good at remembering names and effortlessly covers for me when I don’t. Truth be told, as per these three weeks, I don’t really mind my own company and could easily be a hermit if given half the chance. However, Lori was always out there meeting people and finding out ways to engage, be that the Basket Weaving and Gorilla Mask Making in Uganda, the Dingo Lady in Tassie, or Aboriginal painting in Katherine. It was great to go to an art exhibition here in Katherine (OK so I did go out occasionally once she had left) and recognize one of the artists who had “taught” Lori and the girls and so we were able to have a chat.
A final solo highlight, and possibly the greatest highlight of the whole trip for me (big statement I know) was a visit to Purnululu National Park and the Bungle Bungles in Western Australia. I had thought that I would not ever get there but cousin David remarked to Lori, “Why doesn’t he just drive there from Katherine?” So I managed to link together 3 days off, drove the 500km to Kununurra, did a tour flight over, down to and a walk amongst the Bungle Bungles then drove the 500km back the next day (stopping about 30 times to take pictures of Boab trees). Breathtaking, remarkable, stunning. The words (and the photos) just can’t do it justice. It is one of those places that you read about and see pictures of but to stand there amongst them was overwhelming.
That’s about enough from me. Here are some thoughts Lori penned before heading home. We had hoped that Rachelle and Thea might also share some profound insights on what they had learned from the year….
I knew it was unrealistic but I had hoped the extended togetherness these past 10 months would knit the four of us closer together. I had imagined that our communication would improve and any irritating habits and mannerisms would wear away. Alas the travel and often extreme conditions just seemed to accentuate any pre-existing issues. Paul and I have completed enough flights to Australia and back with small children and their inconvenient luggage that travelling with two teenagers does not tax our teamwork. I gained even more appreciation for his organizational ability when all his hours of booking flights, visas, accommodation, and transport were realized. He invariably gets asked directions in a foreign city (in fact it’s sort of a badge of honour!). Even being confronted by immigration officials in Johannesburg demanding full birth certificates for Rachelle and Thea didn’t overly fluster him as he had scanned copies on our home computer that were available on the cloud.
It was enlightening to observe his respect for all patients and other healthcare professionals he came in contact with, regardless of their age, disability, social status, and language or cultural barriers. He managed to brainstorm ways to contribute, even if it was as simple as taking inventory in an OR, fixing an ECG machine, or playing ukulele for a group song. He took every opportunity to learn about the local medical concerns, operational systems, and history. There were days I was less motivated to be a tourist but his enthusiasm kept me going. He dealt with the irritation of whatever parasite he picked up in Europe and the pain from his vertebral disc injury stoically. I am so grateful I approached him in that hospital cafeteria so many years ago – it has made my life very interesting.
Understandably Rachelle and Thea did not get along better on the road than at home as they often had to share a bedroom and share the laptop for schoolwork. Probably their one uniting emotion was their frequent annoyances with Paul and me. OK the time I told the guy trying to sell skin products in an airport that I actually prefer if they are tested on animals probably did warrant some embarrassment on Rachelle’s part.
Rachelle was always willing to pose for a photo though and certainly expanded the range of foods she was willing to eat. Thea was a good sport about most things but it was clear that both girls desperately missed their friends and just hanging around others their own age. It was gratifying to see them both become a bit more outgoing and comfortable talking to people we met and wonderful to watch their interactions with the young children at the Redemption Song Foundation soup kitchen. Many of our friends also have teenage children and it was fun to get to know them a little one-on-one as individuals rather than the earlier random whirlwind toddlers or tweens. Our friends’ kids were uniformly welcoming to our girls and we are impressed with the maturity, keen sense of humour, and high emotional quotient of the current generation we met. The girls have been keeping in touch with several new acquaintances via snap chat and Instagram and I hope these connections can persist over time and they can get meet up in person again in the future. It was heartwarming to spend some extended time with the cousins and in-laws and to tour around the Margaret River area with Paul’s Dad and Sandra and for Paul to take the train with them.
For me personally I don’t think I became more attuned to issues of poverty, disease, and malnutrition, because I had a high level of awareness and concern. However, the scale of the problems in Zimbabwe and Uganda are certainly more real to me and I almost feel less optimistic than I was before. Obviously actually witnessing poverty and meeting numerous patients with chronic illnesses affects one deeply and at times I just felt overwhelmed and hence impotent. I did try to learn what I could about HIV, malaria, and TB and I also had time to read several books on the history of South Africa and Zimbabwe and about effective volunteering and aid programs. I do think I will buy even fewer clothes than I did before and have a higher threshold for discarding them. Despite ample time, I did not learn to operate our camera better but I did learn a few photo editing techniques and acquired a few more chords on the ukulele. I was pleased to have many CE lessons to review for CCCEP and some other editing work to do as well.
The first half of our trip certainly took me out of my comfort zone; I was often physically uncomfortable and emotionally stretched. I cried the first time I heard the nurses singing at Karanda, because it was so achingly beautiful in the midst of so much deprivation and disease.
I decided I feel ‘at home’ when I know where to get groceries and do laundry. We recently listened to an interview with a British writer Geoff Dyer and he had a great comment about how he likes to travel but he likes to be settled in one place for a while and have his own kettle and tea pot each morning (he said it more eloquently and humourously). I definitely prefer being based in a spot and doing trips from there versus constantly being on the move as we were in Europe. When we arrived in Katherine I was ridiculously pleased to unpack the coffee press and glasses and beach towels we had mailed from St Helens before we left Tasmania.
The experiences I enjoyed the most were not the ones that were strictly esthetic – looking at paintings or wildlife or taking in scenic vistas while hiking. The most enjoyable experiences had at least some element of interacting with another person, e.g. meeting an artist while at an art show in Harare, chatting to fellow hikers while hiking the Cape to Cape, visiting with friends while watching the sun set.
Can I work a full day again?
Why do my least favourite underwear not wear out?
Things I wish I hadn’t packed: jeans – too hot for Africa and Australia and too cold for Europe (could not fit another layer underneath), ready sarcasm, .
Things I was surprisingly happy I packed: Canada pins to give away, plastic toothbrush cover, Wizard card game.
[In case anyone was following along here are the final results of the 10 month long Wizard Tournament: Paul: 4740, Thea: 4640, Rachelle: 3510, Lori: 2910 (she would much rather play scrabble)]
Things I wish I had packed: nail brush (especially for after building the mud hut).
Things I did that I wouldn’t have thought I could: drive along the Great Ocean Road and in Melbourne without a crash; hike almost 60 km of the WA coast, carrying all my gear for 2 of the 4 days;
Things I thought I would be better at than I was: teaching pharmacology to nursing students; bouncing on giant inflatable water toys; helping with homework
Nonetheless the four of us will have many shared jokes and sayings and I’m sure the experiences will percolate through our consciousness and affect us positively over the years to come. A telling book end to the whole experience and an illustration of how imbalanced the world still is was our departure from Katherine to Darwin. On the Bhodi Bus Rachelle, Thea and I were very much the visible minority on board.