Dr. Wallace Back to Work

Sorry its been a while, but we just got internet hooked up to our house. It has been an eventful 10 days. I have been settling into my work in Timaru. Here I am on my first day at work.

I am just starting to understand something of the health system here. There is a nationalized system of health care to cover in-patients with significant subsidies for primary care, so it is a bit of a public/private system. Primary care GP’s practice outside of the hospital, and are considered a lower strata from hospital-based physician consultants (which is my position here). I work with a house physician or house surgeon, roughly the equivalent of an intern or first or second year resident. Some are better than others, some have more experience, and some may be here only months and others years. As a consulting physician, my job entails directing the medical care for hospitalized patients, doing consults on in-patients and out-patients, mentoring the house officers and students that come through, and communicating with other consultant physicians (cardiology, pulmonary, ID, etc.). There is a lot less paper-work as most of it is to be done by the house physicians or registrars.
The system is far from perfect. There is a significant “brain-drain” here because medical students accrue large debts, and Australia and other countries pay significantly more (thus the on-going need for well-trained foreign locums). The system is under-funded, with a smaller slice of the GNP going to health care compared with comparable developed countries, so there can be very long waits for non-emergent problems, such as a 9-12 month wait (or longer) for joint replacements, specialty consultations, MRI’s, if they are done at all. Some specialists such as neurologists are particularly in short supply.
Malpractice is practically a non-issue because years ago New Zealanders passed a national accident insurance plan. There is one large fund to which they all contribute which covers care and compensation from accidents, whether they be vehicular, industrial, or medical.
I feel well-prepared to do this work, having a broad background and have maintained in-patient and out-patient skills. I can see there will be times where I will get swamped with sick patients and would like to have more back-up than I will, but my commitment is just for six months. The country is beautiful, its easy to get around, and the people are friendly. Some of the doctors get together for dinner on Tuesday nights, a nice social and bonding event. I can take night call from my home across the street from the hospital and most things can be handled by phone.
The doctors offices are on the 5th floor of an old nurses school dorm.

I have my own small room, very cozy.There is a kitchen and bathroom with large bathtub across the hall.

It brings back warm memories of the call rooms at Mt. Zion Hospital in my residency days.
The weekend was clear and sunny, so we took the opportunity to see more of the countryside. First we went to Lake Tekapo. The small lakeside church the Church of the Good Shepherd is a famous sight in NZ, and we happened upon its 75th birthday party. HRH Prince Richard, the Duke of Gloucester, was there to help celebrate. Look carefully and you can see Dick on the steps.
His father laid the cornerstone back in the day.
Mt. John observatory overlooks the lake and has a nighttime star-gazing program that we will definately go back to do, but I wanted to push on to get to Aoraki/Mt. Cook National Park before the winter weather really sets in. It was the perfect day to visit. Many days the highest peak in Australasia (3755 m.) is enveloped in clouds but not for us.

(The Maori name Aoraki means "cloud piercer".) We spent the night at the venerable Hermitage Hotel ("arguably the most famous hotel  in NZ" according to The Lonely Planet). The view from the room was spectacular. There is also Sir Edmund Hillary Alpine Centre (Ed to his friends)

and a planetarium. The visitor center has a wood carving depicting the native myth of creation of the South Island and Aoraki (overturned canoe, four brothers turned to stone, if you are interested). We drove back on a southern route Sunday though beautiful hills and rivers and fall foliage.
Monday the rains started, and there has been some flooding. Old-timers are a bit nervous because there was some quite serious floods about 30 years ago. Winter is coming.

Back to Timaru

Saturday, May 15, 2010-So two weeks to the day after arriving to Timaru from Wellington for very brief stay, it is time to return to the place that we will call home for the next six months. I decided in order to see more of the landscape we should return via a scenic highway. Highway 1 is the most direct route up and down the East Coast of the South Island and that is the way we traveled up to Christchurch. On the way home, we initially headed west and then south along the western edge of the expansive Canterbury plain, just where it starts to meet the foothills of the mountain. It was a beautiful fall day, and we had an unhurried drive through the countryside. The highlights included crossing the Rakaia River just at the exit of the Rakaia Gorge.

We did not have time to participate in the jet-boating, salmon fishing, or trekking up the gorge walkway, but I suspect we will return later to do one of those activities. Just inland from there is the nearest ski area, Mt.Hutt. The Canterbury plain was originally heavily forested before the arrival of man, but subsequently most of the area has been cleared and converted to farmland. The traditional sheep-based economy is now being replaced by fewer sheep and more dairy cattle. This is causing some concern and controversy due to the effects on the environment and lifestyles. Dairy products are one of New Zealand’s biggest exports, and because the price they get for these goods overseas is so favorable, the New Zealanders have to pay more than you might expect for these items. There are few such stands of trees left, such as the Alford Forest and the Peel Forest, and these are favorite spots for walks and picnics and fishing. There are multiple streams which cross this plain, and I’m told they are excellent places for rainbow trout (imported from California) and the salmon fishing. Alford Forest is where we encountered four of the most pleasant words in the English language (at least according to Fayne), “Breakfast Served All Day”. We shared the big breakfast, pictured below.

 As you can see, it was a good venue for meat lovers, lacking only a healthy portion of Spam.
Next stop was Geraldine, a lovely little village about 40 minutes away from Timaru. There were many oddities that we discovered, including the world’s biggest woolen jersey and a mind-bending recreation of a medieval mosaic (not pictured). There were also interesting local cheeses and fruit products including unusual jams and chutneys. We took a walk along the river bank,

and then continued back to our house in Timaru. It was very much as we left it, and it did feel a bit like a home. After some shopping, we were eager to try the local cinema, taking in Iron Man 2, which I would recommend if you liked Iron Man 1.
Sunday we will regroup, try to find the Preakness Stakes on the horse racing channel, go to the library to use the Internet (we still don’t have it at home), and I will need to get ready what awaits me at Timaru Hospital. More on that later.

A Fortnight in Christchurch

By the end of my second week at Christchurch Hospital I was beginning to feel acclimated to the hospital, the town, and the system. The physical plant is intimidating enough by itself. The main complex consists of seven separate buildings stuck together in a haphazard fashion with no obvious evidence of a higher intelligence at work. They only connect on the ground floor, and the path from one ward to the clinic or cafeteria can be quite a maze. Also, there was no formal approach to my “orientation”. Dr. Lutz Beckert

did his best, but even he wasn’t sure what to do with me. When I was introduced to people, I got the distinct impression that while doctors from other areas had been sent to Christchurch for orientation, it was not routine. It did not seem clear to anyone whether I was there as a colleague or someone who was supposed to either observe or be observed. The overall impression I got was “nice to meet you; I’ve got work to do“. Don’t get me wrong, people were polite enough, but my role was ill-defined, and I sensed it made everyone just a little bit uncomfortable (perhaps I’m over-reading that). It may not have helped me to realize my age was about equal to three of my junior associates combined.

What did I learn that will help me with my work in Timaru? That’s a difficult question to answer because “you don’t know what you don’t know“. However, I was able to observe the social structure of the medical system. It is more complex In Christchurch because they have more levels of doctors. The system is quite hierarchical. There are medical students (who seem to be similar around the world), house physicians (roughly the equivalent of an Intern or junior resident), registrars (approximately senior residents or young doctors-one can hold this position for several years), and attending physicians (my rank). Professors or emeritus positions would be above that. Timaru only has house physicians and attending physicians. When you make rounds on patients, the most senior doctor will talk with the patient and examine them, and the doctor immediately below them in rank will transcribe the events. The system has some interesting consequences. I saw cases where the night-coverage physician described the patient briefly to the registrar, and shortly thereafter the registrar described the patient to the attending physician using recall of the verbal check-out as well as reading from the written notes. The attending will then go in and briefly talked to and examine the patient, and then announce a plan of action. It seems to me that there’s a fair amount of “performance” in these bedside rounds and it encourages one to “shoot from the hip”. Overall, the system seems to work fairly well, especially since some of the time none of the physicians in charge has really done a complete history and physical.
The patients seem quite familiar to me, with the same types of medical problems I’m used to dealing with a daily basis. They also seem to be “salt of the earth” type people, straightforward and down-to-earth, like the folks around Fort Bragg. Some of the medical terms are different, as are some of the “vocal tics” or shortcuts the doctors use. For instance in describing heart sounds, I am used to routinely saying something like “S1 S2 within normal limits”, whereas here they are always described as “dual”. A notation “2/12” or “15/52” is used to mean 2 out of 12 months or 15 weeks in the last year. I believe it is meant to imply the most recent period of time consecutively, i.e. the last two months, but I’m not completely sure. With the health system here, they do try to get the patient in and out of the hospital as efficiently as possible, but I am a very used to that from my work at MCDH especially with the critical access designation. In fact even a hospital the size of Christchurch seems to have skeleton services available over the weekend, so if you’re not discharged by Friday you will be in until Monday at least. Senior physicians such as myself seem to have to do much less documentation that I’m used to. The admitting and discharge notes are done by the house officer, as are the daily progress notes. I believe I will be expected to enter notes primarily for consultations in the hospital and clinic. Like in the states, coordinating care with the primary care doctor is an important part of the job, and a place where it is easy to drop the ball.
Doctors and students are here from all over the world; any place you can imagine in the old British Empire and Europe and throughout Asia, in particular China. Most people talk rapidly, and I am impressed how the medical personnel and the patients seem to have no trouble with the various accents, which are at times quite thick. Almost all of the doctors here have trained and/or worked outside of the country, although not too many in the United States. Many people both foreign and domestic have decided to live and work here in large part because of lifestyle choices. In particular, parents have chosen to raise their families in the environment that appears simpler, safer, and perhaps with a better educational system. The doctors I’ve met have been bright and well-trained. They seem to value and possess a good sense of humor, and have interests outside of the hospital. For example, Dr. Beckert missed one 8 AM session of lung cancer rounds because his son’s school was having an ethnic heritage day, and he spent the morning preparing the tray of sausage, cheese, and German bread in the shape of the German flag. (I wish I had a photo of that). People are very interested in the outdoors here, and pretty much everyone seems to “tramp” (hike) regularly and many bicycle to work. One nice thing about the hospitals in Christchurch and in Timaru is that both abut Botanical Gardens; many rooms in the hospital have lovely views, and the patients are encouraged to get outside when possible to enjoy the flora and fauna.

Overall, I think it’s been a useful two weeks here, a time to allow me to see a different way of doing things. I also met physicians with whom I will be dealing on a consultative or referral basis, and have a better idea of how the system handles things like strokes, MRI’s, cancer screening, and sleep disorders. We were also made to feel very welcome by Michelle Dhanak and her family.

She is the ex-patriot East Bay physician now working as an elder care physician at The Princess Margaret Hospital, a rehab hospital here in Christchurch, as I mentioned in a previous post. I was fortunate enough to run into her a few times this week at educational rounds. And we had two lovely meals with David and Susan Cohen (also previously mentioned in a post), including a wonderful meal at their house Thursday night. David has become quite the oenophile, we had some wonderful wine to accompany fine food and conversation. Thank you David and Susan, and to Paula for putting us in touch with them.

Fayne and I also had time to enjoy more of Christchurch over the last week. The location of our apartment could not have been better, rightl in the center of what is considered the Cultural Precinct. We were able to visit some of the less obvious sites. There is a small but creative dyslexia discovery exhibit.(http://www.cmct.org.nz/dde/exhibit.html)

The COCA (Centre Of Contemporary Art) had some provocative exhibits, we saw more films, and a very entertaining play entitled “Glorious”. It is contemporary play, but written in the style of the screwball comedies of the 1930s, quite witty and fast-paced and well-performed. On Friday night we capped off our visit to Christchurch with an excellent dinner and nighttime tour at Willowbank Wildlife Reserve on the outskirts of town. we got to see several natives New Zealand creatures, including a swarm of freshwater eels

(which can grow to be over 3 m long), the kea mountain parrot, the kereru pigeon, an ugly kunekune pig, and the highlight: the brown kiwis. Unfortunately for my blog fans the kiwi is a nocturnal animal and we were not allowed to use flash photography as it could frighten the animal and damage his eyesight. If you can see a bird in this photograph, your eyesight is better than mine.

Mothers Day in a Blizzard in Christchurch

Sunday May 9, 2010- What a beautiful bright sunny day! In the morning we took a spectacular walk through the near-by Botanical Gardens. People here like to walk and be outside, even the children. The trees and flowers were on full dazzling display. Here are just a few examples.
After the walk, we visited the weekend market at the Arts Center, packed with local arts and crafts, street performers, and food stalls. Also on the site is a small interactive museum dedicated to Sir Earnest Rutherford, the kiwi Nobel prize winning nuclear physicist of the late 19th and early 20th centuries. He studied here when it was Canterbury College, and his lecture rooms and lab space has been re-created. He did a lot to discover the structure of the atom and how to split it. My favorite quote from the exhibit was something to the effect (and I paraphrase) "If you can't explain your theory to a char-woman, you don't really understand it".
We then drove out to near the airport to enjoy the Antarctic Centre, which calls itself "The World's Best Antarctic Attraction". I cannot confirm or deny that claim. The Centre is associated with the campus for both the US and NZ Antarctic endeavors. The flights into their base camps on the continent begin here. It is part Disneyland, part science. This is where the blizzard comes in. They have a special room that simulates an arctic storm with temperatures with wind chill down to -18' C, an experience they describe as "exchillerating" (something Fayne might disagree with). Of course there were also more blue penguins (rescue birds all), an aquarium with antarctic sea life, and a spectacular 17 minute film. It was worth the visit.
The day was capped off by meeting Paula Cohen's brother David and his wife Susan. They have lived here for ten years, and it was wonderful to get to know them a bit. We had dinner at a very nice restaurant where their son Avi works before going off soon to study in Europe for a while. Paula had tipped off David that I had referred to him in a previous post, but he took it in stride. Overall, a fitting end to Mothers Day in New Zealand, and Happy M D to all you mothers at home.

To the Banks Peninsula and Akaroa

Saturday May 8, 2010- Today was a bit drizzly, but we decided it was time to get out of the city for a bit of a field trip. Our destination was about a 90 minute drive away across mostly country roads. This New Zealand driving on the left side is still new to me, so I am trying to be extra careful. It went well.
The Banks peninsula was formed from the collapsed crater of an ancient volcano, hence the round shape and the multiple isolated towns and bays (there is a fairly popular tramping trail through these hamlets in the summertime). Akaroa is the main town on the main harbor, and was first settled by the French in 1840, a very brief time after the British signed the Treaty of Waitangi with the Maori giving them the right to buy land in exchange for privileges of British citizens (the exact deal is still being litigated, in part because there are several different versions of this agreement). Anyway, the French settlers stayed, but decided not to fight with the British over New Zealand. The town still maintains French influences (street names, crepes, etc.), perhaps mostly for the benefit of visitors. The permanent population is about 600, swelling to 3,000 in the summer, with many kiwis having vacation homes here. It is quite charming, and has a lovely waterfront and small beach.We wandered some, had a bite to eat, and by then the weather let up a bit. We went on a two-hour nature cruise of the bay and were rewarded with up-close views of the blue penguin (the smallest one), the Hector's dolphin (also the smallest of dolphins), fur seals, and the Buller's albatross. It was really great. I got a few pictures (not great) before my battery went dead. I asked another photographer on the cruise if he could e-mail me some photos. If he does, I will post them.

Timaru is to Christchurch as Visalia is to????

The title comes from an e-mail comment from Paula Cohen's brother David to us. The correct answer according to him is "Fresno". We are hoping to meet up with him soon, but just keep missing. His official title is "David A. Cohen, Ph.D., Senior Lecturer in Marketing, Chair and Dogsbody, Postgraduate Committee, Faculty of Commerce, Lincoln University". (We may perhaps be unworthy.)
I haven't really seen the Fresno side of things in Christchurch yet; it reminds me more of Ashland, OR. Remember, it is often described as more English than any current English town. Walking by the tree-lined banks of the river, past black swans, the statues of Queen Victoria and Captain Cook, and the blocks of stately neo-gothic buildings is evidence of this.I am trying to balance some work with touring. The "work" is mostly trying to get the hang of the nomenclature and social structure of medical practice while not impeding those actually working. Being here in particular I believe the medical establishment is more formal and hierarchical than in the rest of the country. There are more suits and ties than elsewhere. I have learned that in general they have less respect for American-trained doctors (too many multiple-choice exams and not enough grueling oral exam humiliations, I'm told).In fact, a large percentage of NZ medical students (over 50% I think) never pass the medical boards, and never end up "physicians", but end up as GP's, considered a lower life form. They do have respect for experience, so that helps. I have gone to some interesting rounds and clinics, but it is all very low key so far. It is giving me time to work through the large amount of orientation material I received in Timaru.
As to the touring, we visited the cathedral today, and I could not pass up the chance to climb the 134 steps up the spire. Near-by are the Art Center, the Botanical Gardens, the Art Museum, and 4 theaters (we saw a very good program of international short films tonight, and will catch up with Colin Firth and "A Single Man" tomorrow). Good work if you can get it.

To Cristchurch By Order of NZMC

We barely had time to unpack our trunk in Timaru before being dispatched to Christchurch Hospital on the orders of the New Zealand Medical Council. I have been assigned to orientation with Dr. Lutz Beckert, a pleasant German Pulmonologist who has been in NZ for 10 years. He also works in Timaru, although he seems to think I am a certain "Allen Walsh" who is used to seeing "100 patients a day". Everyone feels this orientation is a good idea, especially those locums who had none, but no one is quite sure what I am supposed to do. I try to stay out of the way, meet a few of the principal doctors I will be using as consultants, and get the gist of the British-style system. I would just like to get to work, but that is not to be for now, so I am taking advantage of the time to visit this lovely city. This is considered the most English of all the major NZ cities, and you soon see why as you watch the punts poled down the Avon River past weeping willows and Tudoresque colleges and public buildings. The central square is dominated by the cathedral. Outside of town you can take a Swiss gondola up a hill for a commanding view of the city and its main harbor, Lyttelton.
The weather has been quite mild, even a bit warm. Last night we were treated to a lovely dinner at the home of Michelle Dhanak and her partner. She is an Indian-English doctor from the East Bay whom I contacted as a friend of a friend of my sister Athena. Michelle is a Gerontologist who three years ago went to Timaru to do the same job I was recruited to do. They were marvelous company, and obviously well-informed. There are so many good, gracious people in this world; we are truly blessed.

Getting To Know New Zealand a Bit

Sorry its been a few days. Will try to catch up with photos and commentary.
April 26- The day started ominously; I awoke from a dream about home. In the dream, I returned home to Fort Bragg briefly, and the longer I was around (the post office?) the more people surrounded me with questions and concerns (Anne from home Health was there, and I was told our cat Saturday had gone AWOL, and I kept trying to give people my cell phone number, but for the life of me I could not remember it, just a cascade of old numbers ran through my head). So I awoke in a troubled state, and when I turned on my global cell phone, there was a voicemail from Jasper, our house sitter, that he couldn’t get the home phone line to work (but the cat was fine, thankfully). So a fair chunk of the morning was spent contacting ATT from NZ (on our dime, of course), but I think we straightened it out, but I guess lost our FB home phone number of 26 years. At the end of the day, I did some shopping, and had 2 different credit cards denied, so that led to more calls to “customer service” in the US. One company was just interested to hear we were in New Zealand, so that was no problem, but the other wanted to verify some purchases last week at a Wal-Mart in Michigan. Not cool. So that card gets canceled, and we have to hope the Public Storage locker in Richmond doesn’t auction off our stuff because the automatic MasterCard payment won’t work. I guess the optimist might note it is actually possible to work these things out around the globe with the Internet. Thank you, Al Gore!
It wasn’t all bad. We went mid-day to Kelly Tarlton’s Underwater World and Antarctic Encounter. You see, Kelly was a more commercial disciple of J. Cousteau, and was a man with a dream, a visionary. 25 years ago, he acquired a section of abandoned Auckland sewage system and turned into a walk-through shark encounter, later adding King and Gentoo penguins that you visit by riding in an Autotopia-style Sno-Cat. Did I mention the re-creation of Sir Robert Scott’s Antarctic hut, or the ubiquitous sting rays?
Sound hokey? You betcha, but fun and educational.
On the way back, got caught in a downpour and rode a free downtown shuttle with a large group of wet schoolchildren. All-in-all, we had a good introduction to the largest city in NZ, and look forward to returning to re-visit the museum and visit some of the islands in the Hauraki Gulf, maybe a little wine tasting. Now, off to Wellington!
Windy Wellington, The Capital
Wed April 28. We arrive in Wellington primarily so I can take care of some business and secondarily to see some things. I am scheduled to meet at the Medical Council of New Zealand Office to finalize my license requirements tomorrow. We are met at the airport by Kate VanEchten, the point-person for NZMedics, the firm I worked with to get a placement here. We have exchanged so many e-mails and phone conversations since August I am eager to finally meet her. She is younger and 6 months more pregnant than I expected, but very pleasant and helpful. We first go to the hotel, then I am taken to a lab to swab my nares and nether regions for MRSA screen (they just told me about this). Then off to the Post Office to apply for a tax ID, and to the NZMedics office for a spot of tea. Everything goes smoothly. Time for a little walk around exploring, dinner, then off to bed.
Thurs. April 29- Wellington is nice. Did I mention it is windy? We took the cable car up the hill past the university up to the botanical garden and observatory. Lovely view.Then took a nice walk around the harbor to the national museum, alongside bustling shops and restaurants. Since we arrived in NZ April 25, ANZAC Day, I have been searching for ANZAC biscuits, the traditional way to celebrate this joint Kiwi/Aussie Veteran's Day. Finally found them in the upscale "New World market" here.In the pm, had the appointment with the NZ Medical Council for final approval of my license; a mere formality as it turned out. A handsome young civil servant took a cursory look at my hand-carried, original diplomas and documents, had me fill out a form I already filled out, and said he will mail the final certificate to me.
That night, we had a lovely dinner by the harbor, and went to a play, “Dead Man’s Cell Phone”. An interesting premise, lost its way at the end, but fun to support the local arts.
Friday April 30- Theoretically, a day at leisure. Spent much of the morning on the phone and internet with “me mum”. Friday here is Thursday there, the day I usually call her, and while we were on the phone, her tech support person came in. I thought it would be a good opportunity to get her up and running on Skype. Not such a good idea, limited success; we’ll see if it ever gets done. (Skyping with Sofia and Kimarra has been a real joy- HIGHLY recommended for those far away- get on-line, we may Skype you too!).
Did I mention the wind? Today was possibly the third or fourth windiest day I have experienced, along with the Falkland Islands, Cape Horn, and a sand storm on the pass between El Paso and Carlsbad Caverns. Finally went in the national museum, Te papa Tongarewa, a tourist must. Actually, we liked the Auckland Museum more, but lots of interesting exhibits, Maori stuff, extinct animals (the giant moa bird and eagle), colossal squids, Phar Lap’s skeleton, and a certain Fab Four with local jewelry. Went to the cinema, saw a really good NZ film “Boy”. Highly recommended, see it if you have the chance. Among other things, some interesting twists on Michael Jackson choreography. A walk by the Capitol and parliament, then a quiet night. On to Timaru in AM.

Timaru, At Last

Saturday, May Day, 2010- Today was a day literally circled on my calendar for six months, the day I arrive where we will be living and working for the next six months. It was a bright, partly-cloudy day, fairly calm, really beautiful. There was a rainbow out the window of our two-engine prop plane for the one-hour flight to the South Island. And there was no security to strip down for at the airport! It was clear enough to see the glacier-bound peaks and Mt. Cook, over 12,000 feet, the highest spot in Australasia. The air was fresh and clean as we alit in Timaru, at the seaward edge of a fertile plain. A cab was sent to pick us up. We went to the hospital to pick up keys, then were driven ½ block to our new home across the street from the Botanical Gardens. I was expecting a flat, but instead we found a 3-bedroom home, washer/drier, our two trunks sent from the US, and a Toyota for our use.
After a bit of unpacking, we walked the two miles or so into town, very quiet for a Saturday, and had brunch at a café over-looking the park stretching down to the beach on Caroline Bay. Unbelievably lovely; Fort Bragg could really use something like this. A long walk home, a bit of shopping and orientation at the I-Site for tourist information, and more un-packing and settling in. later on we found an unassuming restaurant in front of a motel 2 blocks away for a really good dinner of scallops and rack of lamb (what else?).
The slogan so far of our trip has been “exceeding expectations”. At every stop, things have been nicer and more beautiful that anticipated. And in particular, the food, wine, and coffee have been exceptional. And we currently have plenty of room for those interested in a visit.
Sunday, May 2- Slept in a bit, then found the Kentucky Derby live on the 24 hr horse-racing channel. (Horse racing very big here, and the KD is a yearly milestone for this native of Louisville). Also big here: newspapers. Literally. the page sheet size is bigger here than in the US. I have been enjoying being informed and entertained in Auckland, Wellington, now Timaru by the local papers. I guess they haven’t heard print media is dead yet.
Then, met up with two different doctors for the beginning of orientation here. The Medical Council has decreed I will go to Christchurch tomorrow for two weeks of orientation to the NZ system before starting work in Timaru May 17.
We are now in the local library using the free internet. Quite full for a Sunday. People do read here.
We have to pack for Christchurch. More from there.