Its been so busy "settling in", and we've only had very slow dial up the last two weeks, so I'm only going to catch up the news this week, and will blog later on about Broome and Derby..

In a nutshell, we spent last week in Derby, moving into the house, getting unpacked, and orienting to the community and the Derby Aboriginal Health Service, (DAHS). Then we flew here to Kalgoorlie (2300 km south of Derby) last Saturday.

This week, I've been helping (and participating in) Student Orientation for the Rural Clinical School, the other 1/2 of my job in Derby.

Sunday was Site Coordinator's meeting. I am the RCS Site Coordinator for Derby, which means I am responsible for supervising the education of three 5th-year medical students who will live and study in Derby for the next year. In the Australian system, students start at age 17-19 usually at University, in this case, the University of Western Australia in Perth. Completion of the MBBS (Bachelors of Medicine and Bachelors of Surgery) degree takes 6 years. They begin clinical experiences in the hospital in the 4th year, with basic skills on the medical and surgical wards, and in the 5th year, they are expected to obtain proficiency as well-rounded
doctors, with an emphasis on outpatient and inpatient GP, Internal Medicine, Paediatrics, and Obstetrics and Gynecology.

Our students have just returned from summer break and are beginning their 5th year. We have 62 students in the RCS; 3 will come to Derby, other sites have from 3 to 10. All students are provided furnished housing, a living stipend, mobile phone and transportation of themselves, their car and personal belongings to the site.

This week we began Monday with a curriculum review and general instructions on how to be an RCS learner. The students are responsible for their own learning and are to obtain it from many clinical sources such as hospital physicians, office nurses, Aboriginal Health Workers, midwives, and community allied health persons. They log their cases online and learn medicine case by case. There is an overall list of topics they need to cover, monthly learning focuses,
and didactics every week. However, the RCS models the way mature physicians learn and keep up in practice from the get go. Monday night was a dressy Cocktail party at the racetrack to meet everyone.

Tuesday was devoted to 6 skill sessions: Adult and Pediatric Resuscitation, Airway Management, C-Spine care, Suturing, and Casting. I was out in the 40 degree C. heat all day- good thing I brought my hat, sunscreen and water bottle. We were on the lawn in the shade, and there was a nice HOT breeze. (This is just good for physiological acclimation for me to the hot weather.) In the evening there was a picnic in the park, with Aboriginal dancers and orientation to cross-cultural medicine. Several of us left a bit early to go comet-watching (see photo). Comet McNaught is absolutely spectacular here in the dry, desert climate.

Today we had a Disaster Drill at the RFDS base, followed by a swim, and an afternoon of discussion of doctor-patient relationships. And this evening, supper was out in the open air at the student housing, followed by charades and games (a la "Who's Line Is It Anyway?").

Tomorrow we have a 1/2 day of student performances, then they get back on the train to Perth. I plan to get a haircut here (havn't found a barber in Derby so
far), and poke around town a bit. We fly back home to Derby on Friday, Australia Day.

This has been a great week. The other Site Coordinators are committed, bright, interesting people from a wide variety of backgrounds. And the students are as eager as puppies to explore their new learning sites. I have made a lot of new friends and everyone has been helpful and concerned about us. Vicki has had a nice break too after a hot week of house organization. She's enjoyed the museum, shopped a bit, and got her hair done. But best of all she's been able to meet the people I work with and experience the students along with me.

You can see the Kalgoorie Album here:

A lot has happened this week, so much I can't really tell all of it. I'll just give you glimpses and a lot of pictures..

Saturday: We FINALLY get off the plane. Vicki goes to the Ladies and I go to buy a phone card. My brain is not working well, I just pick the $10 card off the reader board in the airport newstand. Once I open my mouth to tell the nice lady what I want, she wants to know where I'm from and launches into a careful and long explanation of which phone card is cheapest and best for calling the U.S (its only 1.5 cents a minute!) and how to use it and by the way, don't use the Australian 800 number they take minutes off your card and the local numbers are best and is this my first time in Australia, and welcome, you'll love it here, etc, etc. Very chatty!

Driving to the hotel from the airport: Its about 4 pm in Perth and we are dog tired after a 40 hour trip. The cabbie asks why we have come to Australia- I tell him I'm going to work as a doctor in Derby.. "OH" he says. "Awful up there. Hot and full of flies. And the people... well, I reckon they diverged from the human race a long time ago, you know?.....". I am so tired I just don't know how to respond to this blatant racism. He goes on to tell me he doesn't believe in global warming either.

Sunday: We sleep till 8 am. 12 hours almost. Still jet lagged. Take a morning walk in Kings Park. We go shopping to get some food. Take a nap. Later, the traffic is very sparse, I suggest we go out on a drive so I can practice driving the the left side. I pick out a course due West. See the pictures: Hello Indian Ocean...

Monday: First day of orientation. We arise at 0600 and walk for an hour in Kings Park. On my way back I take a picture of a sign in the apartment building next door. (See the picture below.) A lady comes up to me and I explain I have never seen an apartment advertised with "good feng shui" before. She turns out to be the owner. She is a retired doctor. Her family fled China to Malaysia, then she went to England when she was 15 and attended medical school there. She emigrated here and has retired. Real estate prices have shot up in Perth and she would like to take her capital gains exclusion. And the apartment has great feng shui in that it faces South, where the healthy winds come from. She is very nice and talks a mile a minute and also extracts my story from me. She would have taken me up and showed me the whole place also, but I have to beg off so I can make my appointment. But if I have any friends who would be interested.... ( you can call the number in the picture yourself, Dr Lu is very nice!)
Medical Board at 9 AM. LOTS of paperwork. Then rest of the morning at the Western Australa AMA for beginning orientation. Back to the grocery and a bit of shopping then home to rest.

Tuesday: Another early morning walk in Kings Park. More orientation today, this morning from the WA Rural and Remote Medicinne Center. They have wonderful support here for rural medicine. A network for spouses, conferences and CME, even a counseling line staffed by a woman who just became an Anglican priest for any kind of problem or just to talk. Vicki and I agree that if the U.S. had this I might still be in Quincy, Washington.
A nasal swab for MRSA at the local hospital. A drop into the Rural Clinical School offices to pick up a laptop to use in Derby.
And we spend the afternoon at the the Art Gallery of Western Australia and also at Western Australia Museum. The latter has a very detailed exhibit on the origins and history of the First Australians. More on that later on I think.

Click on this picture to see the Photo Album!

Have arrived safely in Perth STOP Total 40 hours in transit from Ft Myers airport STOP Ambien CR helped with 5 good and 2 so-so hours of sleep STOP Slept 11 hours after arrival but still Jet lagged STOP Today walked around Kings Park and drove to say hello to Indian Ocean STOP start Orientation tomorrow STOP Perth is beautiful STOP more later END

We said goodbye to our daughters this morning, for a year. They are already off the plane and back in Long Island where they will spend another week together. We miss their laughter already.

And... we've been traveling now for about 9 hours and so far have only completed the first hop, to Miami. Here is the itinerary...

AMERICAN EAGLE/EXECUTIVE
Flight 5012 Booking Code:H Date: 04 January 2007
From: Regional Southwest Arpt, Fort Myers FL - U.S.
To: Miami Intl, Miami FL - U.S.
Departs: 13:20 Arrives: 14:15

Qantas Airways , Operated By: AMERICAN AIRLINES
Flight 3024 Booking Code:H Date: 04 January 2007
From: Miami Intl, Miami FL - U.S.
To: Los Angeles Intl, Los Angeles CA - U.S.
Departs: 18:10 Arrives: 20:55

Qantas Airways Flight 108 Booking Code:H Date: 04 January 2007
From: Los Angeles Intl, Los Angeles CA - U.S.
To: Sydney Kingsford Smith Arpt, Sydney Australia

Qantas Airways Flight 577 Booking Code:H Date: 06 January 2007
From: Sydney Kingsford Smith Arpt, Sydney Australia
To: Perth Arpt, Perth Australia
Departs: 12:20 Arrives: 15:15

Of course, this assumes no delays. And the times are local. One printout said 29 hours, but I wonder if it won't be longer than that. Or at least SEEM longer. We'll see.

Neither of us slept well last night, so as Liz says, "we'll either be so exhausted we'll have to sleep on the plane, or we'll just be exhausted...".
My plan is to adjust the itinerary as so..
1) Fly to LAX
2) TAKE DRUGS (Ambien CR- Yummy! as Dr. House would say...)
3) Wake up in Sydney and fly to Perth.
We'll let you know how it works.

We've been talkin' about pelicans
Whether there are patterns-
Do they only fly in fives?
And if so, why?

No mortal place
This magic coastline
I walked it 40 years ago
And return in times of change

A place to visit family
To prepare for discontinuity

I walk this beach wondering
The same questions:
What is it all about?
What does the future hold?

Best to simply wheel and dive
Fold wings and fall
Like a pelican from a height
Hoping to catch a fish