Greetings again from the other side of the world!
The land of million shades of green and almost as many in blue has welcomed me. New Zealand is full of wonders, natural beauty. It is untouched in many parts, but also very much shaped by humans in extremely short time as first humans, the maori, came here only 700 years ago. I came here to work, to learn, but also to feed my never-ending curiosity for nature and human beings. I am lucky that my husband said yes as soon as I said my wish out loud. Sure, let’s go get this adventure, show this incredible earth to the kids!
Life is settling to a kind of a new normal after the first almost eight months. We have a house that is cold and poorly insulated in Finnish standards, but well in NZ standards. Did you know that a significant number of NZ houses drop temperatures way below the WHO recommendation for a healthy home in the winter? No wonder the market for electric blankets and oversized fleece hoodies is blooming currently. Personally I have fallen in love with merino clothing. When mornings are cold (well, a bit cool) but daytime mildly warm, layering is the way to go. I had no idea merino wool and -blends are so versatile. Not too hot even in summer temperatures and warm in colder temperatures. There are several local, sustainable merino outdoor clothing brands as well. Overall, it seems there is more local production of goods here than in Finland. Isolation will do that to you, I guess. Imagination and entrepreneurship have had and have room to bloom.
Work in the hospital is finding its form. With reduced hours, but still several shifts per week, I feel more at ease than with the original full registrar roster. I actually see my family and am awake enough to explore the nature and be a mum. I have starting to know people, their accents, their habbits. I admire ti kōuka (cabbage tree), the singing of local magpies and seek to hear the tui which sound like C3PO. I love walking uphill on a track.
I am a trainee in emergency medicine in Finland, University of Helsinki. We have planned to be here in Christchurch for 15 months. I am close to getting the training wrapped up, so the pull back to Finland to complete the training is strong. My exams are done, but I still need to collect specific rotations, like trauma, to complete the many-year path to the important milestone in a doctor’s career, becoming a specialist. Christchurch hospital is tertiary in almost all fields of medicine and offers a well grounded education scheme. It is the big trauma center for the whole Southisland of New Zealand, treats neurosurgical patients and children, is a major cardiac center and even has a hyperbaric chamber. I am honored to get this experience.
The Christchurch hospital emergency department sees approximately 320 patients daily. However, just few of shifts ago the number was 418! In reality the catchment area is bigger than Christchruch city alone given the role of this hospital for the entity of Southisland. This large part of New Zealand is mountainous, has plenty of fresh waters and is hugged by the Pacific Ocean. Remote areas are vaste and some very hard to access at all. Still people injure themselves out there and fall ill. We see them after rescue- and pre-hospital crews have completed the inital, sometimes complicated, steps. Interesting cases, stories behind them. The emergency department itself has over 70 beds and six resuscitation rooms. The beds are divided into two pods (named north and south), acute care, orthopedic ”bone shop” and children’s emergency care. We ED doctors rotate shift by shift between them, although the bine shop is run by orthopedics oriented folks. Almost all patients come to the ED under emergency medicine, surgigal and medical alike. Few come directly under another speciality (like oncology or respiratory) after a consultation between doctors prior to arrival. Naturally, ED doctors are the ones to stabilise, resuscitate and firstly assess all patients to the extent needed. We intubate, we start blood transfusion protocols where necessary, we call in the troops from other specialities to continue care. Back home there is still some ways to reach this trust, but getting there, getting there. I am optimistic.
As a registrar, my role is different here than in Finland. It has been an interesting route to go back to my ”junior” doc feelings. Verifying my decisions by another (senior) doctor and being constantly supervised is both confusing and reassuring – but how it should be. It has become clear how independent and responsible we doctors are in Finland from the first steps after we graduate. Here I have embraced the fact that there are at least two doctors (myself and a senior) going through a patient’s case before locking decisions. The resident doctor presents the case and the preliminary decisions and suggestions for treatment or conditions for discharge. The senior backs them up or poses new questions, challenges your thinking. All this, in the end, is reassuring and advantageous for the patient, very educative for me. I hear of similar culture evolving in the Finnish ED’s. There is an increasing number of seniors, specialists in emergency medicine, present and available for face-to-face consultations and on-site education in emergency departments. Within a branch of medicine that is constantly active, an urgency brewing every moment, the leadership and education by seniors must be at hand.
On ti kouka, cabbage tree. It is a signature sight in the Southisland and NZ. To a Finn the tree is exotic, to the maori a tree of many uses from fishing tools to baskets. My son named one of them ”a woman” with a spiky bunch of hair and a skirt. Here is a link for the interested: https://www.doc.govt.nz/nature/native-plants/cabbage-tree-ti-kouka/
Ngā mihi,
Reetta
Thank you for this insightful blog post. What an adventure not only in the world of medical but as a human in this hugely different part of the planet (from the European perspective). Thank you sis!!