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Desert Skies
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Entering into a different world,
So very dry and dusty, yet tropical and unfurled,
Skies as big as eyes,
And palm leaves that leave you curled,
Figuring it all out is just another quiz,
Bearing the answers of a why?,
There is peace here too,
Beyond the disturbance of a sigh,
And everything is once again anew,
As your eyes open to the colour and the hue.
30-1-12 A new locum emergency job, and new location. Today was my first day working in the Port Headland emergency department, a part of the world that I have never before been. I left Sydney in a rush as I tried to finish my PhD outline late the night before, leaving the house without my jacket – but where I was headed I wouldn’t be needing that. Jumping on the plane was as exciting as it was scary! Even from the moment I was boarding the plane I noticed things were different – such as the fact that more than 50% of the aircraft passengers were wearing uniforms with that were either orange or yellow with reflector patches!
The Port Headland hospital is a really nice place to work I sensed this from the first moment I was orientated (*being orientated formally in an emergency medicine job is a luxury, so today I felt very lucky!). The first day of any job is always a huge stress because in emergency medicine one of the key elements of practicing emergency medicine relies upon knowing how the local systems work, what to do by oneself, and when to call for help, and how to call! In other words it’s about knowing the culture of local practice in that department and that particular hospital. Learning cultures takes time and when you are in a high pressured environment it is natural to want to feel like “I wish I just knew how to do things faster”! What is comforting to know is that almost everyone faces this same learning curve when they start in a new place, so we are not alone!
Another other great challenge of first day on a new locum is to do with making diagnoses in populations that you don’t yet understand. This is something I learned from my supervisors in Toxicology, one of the key clues to the diagnosis lies in knowing what types of poisoning are prevalent in the particular community where you are working (eg a semi-conscious 28yo male coming in with pin-point pupils is opiate toxicity until proven otherwise if your hospital is next to Kings Cross, but in Rural Sri Lanka it’s more likely to be organophosphorus poisoning!).
Port Headland has a large aboriginal population and today I felt like I was in a different world – ie I encountered more aboriginal patients in one day that I have in my whole career put together. This is quite Ironic given that I have practiced medicine in Australia for over a year but this has been in Eastern Suburbs Sydney, and before that North Sydney. It was so challenging for me to treating the aboriginal people, as I there was a culture that I am still learning to understand and I’m looking forward to learning more by working in this region. I remember when I was in rural Sri Lanka, it was in learning the culture of the villagers who made up the majority of the patients that was the key to being able to deliver service.
Well I guess it’s time to sleep – I’ve got another shift tomorrow and got to do a teaching session on one of my favourite topics – organophosphorus poising!