From Carolina to Kiwi

Thursday, July 28, 2011

Pictures?

View from Ponsonby Road back toward the needle on a winter night

Part two

Wow- I caught flak when I got home for both being too brief and being too boring at the same time so I will try to wrap it up.

I guess I am just doing my best to keep my mind open about the health system here- most importantly because I have to be able to function effectively within it but also because there is a lot to learn.

In clinic today, I saw three different people that had lesions in their mouths, probably benign, but all needing to be excised. For each of these patients I had to come up with a score based on a variety of criteria such as potential for malignant change, psychosocial consequences, risk of progression, etc. I don't really have any idea what the score means except that each of these individuals went on to some kind of list. The nurse told me that it would be several months. On the other hand, when cancers come in to clinic, they go on the operative schedule within 2-3 weeks- which is actually faster than they would in the US a lot of the time.

It's a bit of a facade however to think the system is truly an equitable one. There is actually a tiered system in place. Private insurance is available and relatively cheap (at least by our standards). For Jesse and I to get a basic plan, it would have been about $800 for the year. It basically provides access to the same physicians but much sooner. So the really really nervous guy from Bombay I saw today that is here studying for a year can pay the premium and then get the small spot on the inside of his cheek excised in the short term.

I won't be critical because I haven't seen any evidence yet that the system doesn't work. I don't have any personal anecdotes about people waiting months for much needed surgery- at least not yet.

That's it for now- I will save my thoughts on my malpractice insurance that cost about $400US for the year and would have been $25,000-$30,000 back in the States.

Apologies for the hiatus

It's been awhile for me since my last post. Our goal had been at least a couple of updates a week but work has really sped up for me and thus I haven't been keeping up my end of the bargain.

Fear not however as I have come up with a solution. Since most of what I have been doing is working, I thought it might be interesting to write a bit about working. Just as a tidbit, the news about what is happening in Washington with the US debt is HUGE news here. Obviously, American culture is pervasive- from the radio stations all essentially playing hiphop all the time to the fact that everyone in this country seems to have an iPad or iPhone or both. But one doesn't always remember how closely economies in the rest of the world are tied to us. Anyway, it's interesting but maybe I will save that for another post.

What ever name you put on this system (socialized, public, equitable health), it's quite different in a lot of ways. Maybe I should start by saying that I truly believe the US health care system is broken. Waste occurs at every turn for a multitude of reasons. In a fatalistic way, I was ready to give Obamacare a shot (even if he does think tonsillectomies are evil). The US health care system is simply not sustainable and I figure that something has to change.

More to come later on today . . . have to get my clinic going.

Wednesday, July 20, 2011

Where's the heat?

Hello! Raining today after 4 or so days of sweet sweet sunshine. Yesterday I even had the windows in our new place open letting a cool, dry breeze through. The apartment tends to stay a bit dank and dark so any sunshine = warmth and wind is welcome. In fact our space heater is my new bff! So to catch you up Paul and I had a really awesome weekend. We were invited out to Waiheke Island which is about a 35 minute ferry ride east of the city centre of Auckland. The ferry alone was exciting right?! Well it got exponentially better from there. We were greeted at the ferry by our hosts Mark, Ro and Mac the 4 month old puppy. Mac was beyond adorable, wriggling around with his gumby like lanky legs and just overjoyed with pretty much anything he encountered. The best part is he reminded me so much of Bitty since he is a black Poodle (Standard) mixed with Springer Spaniel – such a cutie with a sweet devilish temperament. From the ferry we drove out to their house which was an impressive modern open floor plan tucked into the hillside near the top of a beautiful ridge overlooking every shade of green, vineyards and the Hauraki Gulf peaking over the horizon. We drank and ate like kings and queens enjoying the company immensely. Sunday morning we woke up to a warm and cozy sunrise followed by a stroll on the beach with Mac and our new friends. After a snooze in the sunshine we headed out for a fishing expedition to the far end of the island. Only one fish was caught but it was a glorious day out in the fresh air. We can’t thank our hosts enough for their incredible hospitality and allowing us a brief encounter with their beautiful life on that island.
This week Paul has been hard at work while I make this new place something to call home. My job hunt is slow going but given our circumstances I want to find something that fits so we can enjoy this fabulous country!

Saturday, July 16, 2011

Brief update and couple of plugs

We spent a comfy first night in our flat!! after a great meal at a local Indian restaurant. Posts may be a little sparse for the next few days as we havent gotten our home internet set up. Broadband is quite expensive here (around 100NZ per month = roughly $80US) so we are looking at a couple of different options. Jesse did a wonderful job selecting a "Norwegian" duvet cover (not sure what that means but it looks very nice).

I found out late last week that I may be "required" to attend a conference in Singapore in early September. More to come later on that bit of excitement.

Big thanks to Skip! I am SO glad one of us is photogenic

Paul Farmer's new book on Haiti (Truly a great American)

Tonight we are headed out to Waiheke Island to attend a cocktail party at the home of one of my "bosses" as they call the attendings here.

Wednesday, July 13, 2011

Quite a Domain

Now that Paul and I have found a place to live in .... drumroll please .... Parnell! ... we can purge the shock & awe and pay closer attention to our surroundings. Parnell is the oldest suburb in Auckland. It is conveniently situated near the hospital, neighbors the city centre and is very close to the water. It also hugs the Auckland Domain featured here. We are scheduled to move in to our new pad on Friday so once the keys are handed over I will officially expose the location. Until then I can start scamming for jobs, scoping out the best cafes, where is the dry cleaners?, making our wish list of restaurants to try, testing out bar stools and engaging the locals. Everyone seems genuinely friendly and excited for Paul & I. So yesterday I walked from our hotel through the Domain. I inspected the Wintergardens, tended by the rather stiff caretakers pictured above and then walked up to find out what will await us inside the museum. Here is the view atop the hill where the museum sits. I am anxious to start settling into our new 'hood!!

Sunday, July 10, 2011

Tramping, anyone?

Nope, it's not something beer-swilling frat boys do on Friday nights in Athens. It's what one does on the weekend in New Zealand- or at least it's what we did today. We headed out to the Waitakere Ranges about 30-40 kilometers west of Auckland.

First stop- Fairy Falls.

Is that a hobbit?

Lion Rock

This is Lion Rock- the star feature of our journey today. As the guide book says, "with some imagination" you can see a lion looking out over the Tasman Sea.

I think she likes it here!

Lemon?

Well yesterday was my first experience with Paul driving the car....it is just so unnatural! He does a fine job though despite the car's efforts to thwart us. It's a 2003 Volvo station wagon (bright red!) and although we look totally rad in it, we've noticed some funny things with gear shifts. So yesterday we drove it over to Saint Heliers to take a look at the beachy suburb we've heard so many good things about. Well we parked the car to get out onto the beach to soak in some scenery and when we got back in the ignition would not go beyond the first notch. Unreal! AAA equivalent came out to our rescue and the result is the bottom cover for the steering shaft is now removed as if we've hotwired the thing! We'll sort it out... In the meantime - enjoy these shots we took on the beach in Saint Heliers yesterday afternoon. That peak beyond Paul across the water is Rangitoto Island. This is the most recent and largest of the dormant volcanos of the Auckland Volcanic Field. Rangitoto is Maori for 'Bloody Sky'.

Thursday, July 07, 2011

Join me in the loo

Most toilets here have 2 options- "big flush" or "little flush." This is a shot of the toilet in our room here at The Quadrant.

* I am slightly ashamed to admit how much entertainment this "water feature" has provided me. Jesse continues to wonder what the giggles in the bathroom are all about.

** note the toilet seat in its correct upright position

Can I get a White Wiiiiiiinnneee

Well it was only a matter of time before I commented on the extraordinary selection of white wines and snacks here in New Zealand. I find it ironic that I have landed myself near to what is arguably the finest Sauvignon Blanc growing region in the world. Oh the joy! These kiwis surely love to kick back and have a crisp glass of wine or perfectly frothed pint of beer after a long day at the office or walkabout. Check out the "box wine aisle" at the grocery store! But really, I've noticed how proud and community oriented this place really is. They prefer to consume homegrown before imports when it comes to food & beverage and are very proud of anything kiwi! The fruit is phenomenal and the bread - oh the bread!! Ciabatta is the specialty and it rocks our worlds each and every day. The coffee is a little harder to praise as there is an entire section of ... can I even utter the word ... Nescafe. BUT we've still managed to find some decent drip and there is no shortage of the corner cafe. Prost!

Tuesday, July 05, 2011

That's right- her headband is made of opossum

My wife is so beautiful she makes roadkill look good!

Devonport - yay or nay?

Same address different country

It came as a welcome surprise (although maybe it shouldn't have been a surprise at all) that the first place I would feel comfortable here would be "in theatre" (aka the operating room). Seeing the patients for the first time today made me feel like I was back at the Baptist! New Zealand neck incisions look the same as North Carolina neck incisions I guess . . . more to come . . .

Go America!

Happy LATE 4th of July USA! It's the 5th here and there are still no signs of American independence. Yesterday was just like any other day and the hills were just as steep. On the walk back to my hotel from getting my morning "flat white" there were people walking toe first down the hill! But I digress. So Paul seems to have enjoyed his first couple of days of work. I've walked him "to school" the past 2 mornings, it's been fun. We found a fabulous short cut through the city's oldest park, the Auckland Domain which is the crater of a very old volcano. It is now a huge beautiful green space containing gardens, trails, cricket fields and the Auckland War Memorial Museum which sits up on the rim overlooking the entire city. Still grinding the pavement finding out where the best spot is to place ourselves for the next year. This city has a lot to offer. Devonport seems to be really neato but it's across the harbor and might be a bit tricky for Paul to get back to the hospital on the rush. Will post a couple of pix - tell me what you think.

Sunday, July 03, 2011

First thoughts

Our hotel has flat screen TVs in all the elevators with techno music and wildlife movies playing (mostly penguins)
Coriolis was right! Coriolis effect
New Zealand has its own version of Netflix called Fatso

First day of work tomorrow- wish me luck!

The first days

Well we are into our 2nd day here in Auckland! This is such a neat town. It's very hilly which was a surprise and extremely lush even in the middle of winter. Everywhere you walk there is a beautiful flowering bush or a Lord of the Rings inspired wicked looking tree or an exotic tropical plant. The temp stayed in the 50's yesterday but with the humidity level the wind was bone chilling in the shade. Our hotel is fabulous and the best part is we're up on the 19th floor so the view is incredible. To the left the famous sky needle peers over the buildings and straight out ahead and to the right is the Waitemata Harbor dotted with sailboats and surrounded by hilly land covered by homes. Yesterday we strolled through the city centre which contained all kinds of shopping, cafes, banks etc then made our way over to the inner suburb called Parnell which has been a standout as a potential area for our permanent residence. It was up on a hill with amazing views of the water and a long (HILLY!) street filled with art galleries, super cute restaurants, bars, cafes and shopping. Today we need to fetch our new wheels after we summon the courage to drive it on the "wrong" side of the road. I hope to catch a ferry across the harbor over to Devonport which is another standout for permanent digs. More soon!! We miss and love you all so much!!