Settling in…..

There is art everywhere in Dunedin. Just across the street from my favorite wine store (Wine Freedom… in case there was ever any doubt…owned and run by long time friend Paul) is this thought provoking image. It’s these nooks and crannies that you begin to see once you start to settle into a place…once you begin to get your feet on the ground.

There are more of these, and I am sure I will be showing them to you over the next few weeks. But first…

I have started to settle into my newly rented house (tonight is my 7th night in this house…so it’s all still quite fresh). Having living in Dunedin previously, I had an idea of what I wanted in a domicile…several bedrooms, North facing (for sun), and fantastic views of the city and harbor…oh, and I only want to spend $1500 a month.

The view from my deck…the City of Dunedin and the Otago Harbor
Sunset and the Otago Harbor….and my one table in the house…

Fortune smiled upon me a couple of weeks ago when this home came up for rent. I recognized the potential, and quickly snapped it up. It came pretty much unfurnished (one bed and one table and several chairs), and I spent a week getting the kitchen stocked before moving in 6 days ago. After 5 weeks of living out of a suitcase, and meals consisting of just ‘heating things up’ I was finally ready to make myself a proper meal. Last Saturday I visited the Otago Farmer’s Market last, and that night and the following made my first two ‘real’ meals.

Fresh lemon peppered salmon and salad
Pear and avocado salad with citrus dressing.

It wasn’t Thomas Keller…but what a difference home cooked food is when you’ve been eating pre-prepared food for 5 weeks! I’ll be restocking the frig tomorrow, after another visit to the Farmer’s Market…

Toko Mouth…The small settlement (it’s not really a town) at the mouth of the Tokomairaro River, as it enters the Ocean.

I love the house…and the views!…but one can only appreciate those Otago Harbor views for just so long before lusting to explore this magnificent land. Last Saturday I ventured about an hour outside of Dunedin to fish (read..fishing, not catching)..and despite my admonition to not take my little rental Toyota Corolla on any more muddy roads, I found myself zigging and zagging along a wet dirt road to a small community called “Toko Mouth”. It was an in-coming tide (my plan all along) and the tidal estuary looked “very fishy” (a term used by fisherman when it looks like you should catch a lot of fish…but unexpectedly don’t get a bite). No fish, but you can’t argue with the view!

Not getting any bites here, I thought I might try the mouth of the Clutha River (New Zealand’s fastest flowing river…and a very big river at that!), and so I drove about 30 minutes along the South Coastal highway.. as the sun was reaching lower in the sky, I just happened to stumble into this majestic view.

The Clutha River..about 1km from it’s entrance into the Ocean on a cool winter late afternoon

It was late in the day, and this particular stretch of the river did not look very “fishy”…it was silted and murky from recent rains, so I opted to just enjoy the view rather than say I fished and didn’t get a bite.

This was also the week I had to return my rental car….which meant I had to find a car to buy. My biggest priority…a proper 4 wheel drive vehicle. Last thing I want is to be stuck on some road a hundred km from the nearest home or person. It’s like every Monday at work…Where’s Dave? Someone call out the search party! Where did he say he was going fishing??!! So, in addition to fishing for trout, last weekend I went fishing for cars (or trucks). It is a very interesting experience shopping for cars in another country (let alone another hemisphere). I looked at Subarus… (if you’re from the USA, they pronounce them different here…they say, “Sue-Bar-U” with heavy emphasis on the ‘Bar’. I also looked at the Nissan trucks (not ‘Knee-Sawn’…but rather…’Niss-Awn’). In the end, I found a very reliable Mitsubishi Pajero (pronounced Pa-Jer-O…no one here is accustomed to how Spanish words are pronounced).

Over the next week, I plan to test the limits of the true ‘4 Wheeler’, as they say. If you don’t hear from me for awhile…you’ll know why.

This is likely a crime…to have already been in New Zealand many weeks and not have posted any pictures of sheep. So, in the hopes of avoiding (more) jail time, I will leave you with a little taste of last week’s explore….

Sheep in New Zealand always get the best views!

Kia Ora,

Dave

A day in the life of a doctor, and a life’s end…

If you’re a physician, the CT scan above ought to get your attention….but more on that later.

A lot of people (well, doctors mostly, but they, too, are people…mostly) want to know what’s it like to practice medicine in a different country. So this week I thought I’d share a typical day of my work at the hospital.

I should first mention, we don’t have any COVID cases in the hospital. Actually, not even any COVID cases in Dunedin. And to be fully truthful, for two straight days none in the whole country. That’s just a little different than what I would be experiencing in California. Just a little…

No Covid Cases in New Zealand!

I’ll walk you through a typical ‘on call’ day…which means I’ll be accepting patients for admission to the hospital beginning at 8am and ending the following day at 8am. I arrive at the hospital a little after 7am. My office is on the 7th floor, but given that the ground floor is street level (what in the USA would be the first floor), I have 8 flights of stairs to ascend. It’s a good way to start the day.

The sign that greets me when I have just one more flight to climb!

It’s a good thing the cardiology department is also on the 7th floor, as I’m sure one day I will experience some chest pain during the ascent.

Did I mention there were no COVID cases in NZ?

When I arrive to my office, I’ll review the events of the last 24 hours, and then proceed to our 8am handoff meeting, where all the patients admitted over the last 24 hours are reviewed and assigned to the relevant teams. I then round (or go see patients) with my team…which consists of a registrar (kind of like a senior resident in the US, though my registrar has many years of training under his belt), a house officer (who is in her third year of postgraduate training), and a medical student.

My Registrar , Moses, and I on a Friday evening after a busy week. Ignore the words above my head..it’s all work and no play.

During the day, we will see the patients who need hospital admission to the internal medicine service. The variety on conditions we see is legion, and you never know when the operator calls to connect you to someone what you might encounter on the other line. Like, in the case of last Tuesday, when the operator connected me to a physician from a rural hospital about 150 km outside of Dunedin. A patient had come to the hospital with visual disturbances and new mild right sided weakness. The CT scan there looked similar to the one above (which I pulled from the internet to preserve patient confidentiality). I asked some pertinent clinical details, and since we have a neurosurgeon on staff here, agreed to have the patient transported here for further evaluation and possible intervention. The transport would be a helicopter, which is a common mode of transport to this hospital (I think helicopters transport patients here at least 4-5 times a day…we have a helicopter pad at the hospital I worked at in California…it is not used nearly as often…like 4-5 times a year).

Getting Ready To Land on the Top of the Dunedin Hospital
Minutes later, off to get the next patient…

It wasn’t a long a wait for the patient to arrive in Dunedin…maybe 2 hours since the phone call…and in that period the condition of the patient had worsened. We arranged another CT scan of the brain, which confirmed our clinical suspicion of further bleeding and worsening edema of the brain. We talked with the neurosurgeon, who felt there was already significant damage to the brain, and the surgeon was of the opinion that even with an operation there would still be significant functional impairment. To translate that, at best, the patient would be completely paralyzed on the right side. We then discussed this with his family (by phone, as they would be driving here and wouldn’t be here for an hour or two), and they informed us that if we felt the outcome was unlikely to be significantly better with surgery, since the patient had previously been very clear that any significant physical impairment would not be acceptable, to not proceed with any surgery.

My registrar diligently cared for the patient that night…and we all met together the next morning with the patient (who was not responsive…read- not awake-) and the patient’s whole family…the spouse, sons, daughters, and grandchildren.

I should reiterate, again, we don’t have any COVID patients in the hospital, in case you had forgotten.

Back to my patient now…

The patient’s condition had worsened mildly overnight; we had tried some medical therapies to decrease swelling in the brain, with only modest effect. We had lengthy discussions with his family throughout the day and the family was very clear the patient would not have wanted any life prolongation measures in this particular circumstances, and would just want to made comfortable. So that is what we did, and very quickly after that, the patient passed away.

I met with my team at the end of the day, because it was not clear to me they truly appreciated all that had happened that day. We gathered around, and reviewed the clinical events; a patient with long-standing high blood pressure presented with an acute intra-cerebral hemorrhage (bleeding in the brain), which was too severe and in a location which was not amenable to surgical therapy. He died of this acute event. That information we all understood, but what was so unique for me was that I have never experienced the kind of discussion with a family about an acute, devastating event that occurred that day. In fact, the words to my team were, ‘in the 34 years I’ve been practicing medicine, I have never had a family discussion like that…..ever’.

What made this discussion different for me (and keep in mind my registrar has been here in New Zealand for 4 years and he didn’t bat an eye during the discussion) was how sincerely nice every single member of the patient’s family was during this devastating event. I remember explaining to the family what had likely happened to cause the bleeding. They acknowledged the patient had high blood pressure, that these things (like bleeding) can happen, and that we all are going to pass away sometime. Those were the families’ words. They appreciated (and they said that several times) that we seriously considered trying to do surgery (the acute helicopter transport to Dunedin and a thorough review with the neurosurgeon) and they accepted the outcome with surgery would have likely been not what the patient had wanted. In these conversations, my accent (clearly not New Zealand) came up…they thought I was from Canada. We all laughed as I tried to distance myself from the fact I was from the land of the President who shall not be named. We talked about water polo, since one of the patient’s granddaughters had a water polo sweatshirt on…we talked about the life the patient had with his spouse of about 40 years. We cried at the sadness of a life’s end, and we were also thankful for the lack of prolonged suffering and disability. There were hugs all around, several times during the day. This was a brief illness, and a brief encounter in the scheme of things for me… less than 48 hours…but it was an encounter I will never, ever forget. And this was just my first full week working in the hospital, and I suspect there will be more encounters like this.

Oh yeah…there are no COVID cases in NZ.

There are struggles working here in New Zealand, just as there are struggles working in any hospital, anywhere. But if you wonder what’s different here…what’s truly different here…it’s the people.

The Otago Harbor and the lights of Dunedin.

Be well, remember that life is short. If there is someone in your life you love, tell them today.

Kia Ora,

Dave

Adjusting to life, with no mask!

It was an unusual sensation, my firsts breaths of fresh air without wearing a mask. Once I cleared the last health check in Auckland (after 2 negative COVID swabs, the first on my third day of quarantine, and the second on the 12th day), I was then ‘processed’ by immigration (making sure my passport and visa were in order), checked out of the hotel (no bill to me, though there are rumors of travels being charged in the future), and then I summoned an Uber to take me to the Auckland airport. Domestic terminal, please, I said with relief.

The flight from Auckland to Dunedin was just under two hours (it’s about 1000km, or if you prefer, about 660 miles by air), and it was a stunning and bright sunny day as the plane descended into the verdant valley and landed at the Dunedin Airport. The airport is about 20 minutes outside of the South Island’s second most populous city, though it’s interesting to note Dunedin is one of the largest (geographic size) cities in the world, with a territorial size of 1280 square miles (3314 sq km).

As in the UK, you drive on the left hand side of the road here. Fortunately, the car I rented had a reminder….

KEEP LEFT, has been my mantra all week!

One week in, and I’ve had no egregious driving errors… We don’t count the number of times I’ve turned on the windshield wipers, meaning to signal. Keep your fingers crossed (and perhaps stay off the Dunedin roads for another week or so…).

The Iconic Train Station in Dunedin

The First Church of Otago: stunning architecture!

It’s the middle of Winter here, but it hasn’t stopped the sun from shinning. The clear days bring brisk temperatures, usually hovering around 3-4C at night and 8-10C during the day. The wind, nearly always present, makes it feel colder. It’s great walking weather, though, so on Saturday I walked around the town..visiting some old haunts like the Train Station, the First Church..and the Farmer’s Market of Otago. So fun! When I left the Northern Hemisphere, I was enjoying the bounty of California summer fruits…so I’ve had to reset my taste buds for the fruit available here…which are local apples (I counted at least 10 different varieties) and pears (another half dozen varieties).

Bags and Bags of Fruit and Vegetables! (and frozen Boysenberries)
Even the organic Farmers get into it. Note the warm attire..

I have a relatively common name…but here…it seems I’m everywhere!

If this Doctor thing doesn’t work out….

I’ve spent a couple of days touring the Otago peninsula, which is just a magnificent, wild, and scenic location (and just a short drive from the hospital).

Sandly Beach (so named for the sand that flies in the wind, not an insect)
The Otago Peninsula, Otago Harbor, and the locale of MacAndrew Bay.
Making some new friends…always 10 meters away! The Mom (on the right) was very protective and watched me very closely.
Hooper Inlet, near Allan’s Beach, on the Otago Peninsula. About 15 seals were frolicking around in this calm little estuary.

So that’s a little taste of the scenery here…as I look at these photos some of them almost seem tropical. But, the winds are almost always howling (today at Allan’s Beach the wind was a constant 25 mph) and the temperature may have reached into double digits (C) only the late afternoon. It’s all about layers (though, I did wear shorts….you can take the boy out of California, but…).

Next week, hopefully a little more about the the job, people and culture. If I can keep my camera off, that is.

Kia Ora,

Dave

Quarantined!

My room, for the 14-day stay in Auckland.

Is there a way to be prepared for a quarantine? Empty airports and half-full flights should have helped.

A very empty San Francisco Terminal

Air New Zealand, with room to spare!

I didn’t know what to expect when I arrived in Auckland almost two weeks ago. I expected to be quarantined; I didn’t have any idea what that would mean on a day-to-day basis. But I had to get to New Zealand first… I wasn’t prepared for the empty airports and half-full airplanes. It was eerie. I encountered this novel way of traveling the minute I walked through security…wait, no lines! Then, walking in an empty San Francisco Terminal. Weird. The short flight to LAX, and then a long walk to the International Terminal, passing just a few a people instead of thousands. Crazy! And at the LAX International Terminal, where I had dreams of a nice dinner and Duty Free Shopping, I was instead met with…empty.

No one was more sad than I to see the caviar and champagne bar closed.
The Dinner of Champions! Notice just a solitary person in the background.

I kept expecting, as I peered around the corner, to see zombies heading my way; it was like I was in a movie set.

There are, fortunately, few airplanes arriving from overseas to New Zealand. I say fortunately since the several hours long process of customs and immigration at the airport would have been much longer if more jets had offloaded hundreds more people. But our half-full flight from LAX to Auckland was sufficient to test the limits of how long a line of weary travels can stretch in a hallway. I will go on record saying the entire process was incredibly well organized. When I cleared the last hurdle of a customs inspection, I was ushered onto a waiting bus, and then whisked off to a hotel in Auckland with about 40 other lucky travelers. We were let off the bus, one bubble at a time, and checked into the hotel. It was very efficient, and very organized. Suddenly it was easier to understand why the COVID19 virus didn’t fare well here. There are, on any given day, about 200-400 travelers being quarantined at this hotel. On alternate days I get either a phone call or a visit from health screener. I’m asked a litany of questions about possible symptoms, and by week 2 I was regaling the health care worker with my knowledge of the list by reciting it first. On those days when my room is visited, my symptoms are monitored (that list again…) and my temperature is checked. My meals are delivered to me three times a day in a little handled grocery bag…did someone say room service?! I was given an empty laundry bag, and told I had two ‘free’ bags of laundry that would be done during my stay. This will be better than college!, I thought.

For breakfast, I was having Bacon!
But for lunch, went for the Veggie alternative..

We are given a menu twice a week to fill out…there are 2 choices for each of the 3 meals a day. My liver has embraced the ‘no alcohol’ delivery policy. It’s not that Nz is against drinking…but rather I think someone, wisely, thought that giving a bunch of quarantined souls unrestricted access to alcohol might not be the healthiest thing. I think they were right. On day 3 of quarantine I was COVID tested (a nasal swab, which is brief, but low on the fun scale), and then again tested on day 11. Thankfully, I was negative on both days, else my luxurious stay might be extended. We are allowed to pick one 1-hour slot for ‘outside’ exercise. It’s actually not all outside, as this wonderful respite time is spent on level 13 of the hotel’s parking structure, and most of the space-but blissfully not all- is concrete covered. One lap of the circuit is about 150 yards, with six 90 degree turns for each lap (yep, I counted).

I thought the time would go by slowly, though in fact each day has a nice little routine and pace to it. Wake up, make some coffee, stretch, do some Headspace, have breakfast, read and write, go out for the 10am one-hour outside time, back to the room for inside exercises and stretching, do some more reading and writing, have lunch, read and write some more, do a little more exercise, have dinner, watch some Netflix and go to bed. Intermixed in all this are calls, texts, Skype and FaceTime with my family, who I miss very much.

The Auckland SkyTower, as seen from a corner of window

Very soon I will start work in Dunedin, and my little holiday will end. I look forward to the challenges, but I have grown quite accustomed to my little room and routine. Maybe…I’ll start coughing and see if I can get one more week here….


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Re-entry

When a space capsule returns to the Earth, it has a heat shield to protect it from burning up in the atmosphere.  As I walked into our newly renovated house in Los Gatos I wondered, where is my heat shield?

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Boxes and boxes everywhere!  I, like Dorothy in the Wizard of Oz, wanted to tap my heels and say, “There is no place like home (Dunedin)”.  Actually, I did, but when I opened my eyes I only saw more boxes, and I was still in our garage.

But, I’m ahead of myself (as usual).

I left Dunners on a beautiful sunny (16C, unseasonably warm) winter day.

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My heart was aching as I said goodbye to Dunedin, and the Otago Peninsula.

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Air New Zealand plies you will pretty good fare to eat and drink, and plenty of good movies, so the long trip home wasn’t too painful and I even managed a few hours sleep.

After I had my wits about me at home I ventured to our local grocery store.  Of course, when I left Nz it was winter and I returned to summer in the agricultural center of the US…so what did I expect?

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Beautiful stone fruit, plums…..

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Tomatoes, avocados……

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And fresh, wild King Salmon (a product of the USA!).

And from those still in Nz who are reading this (and who just paid $5 for a green pepper……)

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That really hurts.

It’s quite strange to be back here after a year away.  Things have changed (new neighbors, new streetlights….heck, our whole house was remodeled) but then it was eerily the same.  After only hours it felt like I had never left.  And this, coming from someone who in many ways didn’t want to come back to the hustle and bustle of Silicon Valley.  I was so conflicted.  Then, as the warm California sun lowered in sky, all the neighborhood kids came out of their homes after dinner (there are, seemingly,  dozens of new kids on our block), and then their parents came out, and we struck up conversation after conversation…everyone so curious to know how the year in Nz was.  It felt good to be back home…….and yet I still longed for my little Dunners.

And I think that’s how the next week will go.  I’ll reconnect with my many friends here, enjoying the warm sun, hiking, enjoying the amazing fresh produce and salmon.  I’m heading out to see my grandmother tomorrow, who turns 99 years young next month!  (Now THAT will remind my of Dunedin….since last week I had 8 people on my hospital service who were over the age of 90).   I don’t think I feel completely at home for awhile.  And it’s always good to know there’s an Air Nz flight leaving San Francisco each night….just in case.

Cheers,

dave

From the heart…

Today is my last full in Dunedin.  The words, so matter-of-factly written, belie a deep sadness in my heart.

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This is the store Wine Freedom; hands down the best wine store I know.  Yes, the wines there are outstanding, but more importantly it’s run by Paul Williams, who is just the most knowledgeable (wine) person I’ve every known, and to boot he is a gem of a guy.  Who was the first person to ensure I had a ride to the airport tomorrow?  Paul was, and tomorrow he (and his little daughter Serin) are the ones taking me there for my send off.  I went to Paul’s store twice this week (that’s a lot, even for me), looking for the perfect wines to take home with me.  It was like I was trying infuse a little of Nz into a bottle, to savour at a later date when I’m in California and missing my little Dunedin.  I know it won’t be the same, but next week I will be sitting outside on our patio in the warm California sun, and sipping a Central Otago Pinot……just trying to hold on to this slice of heaven just a little longer.

A little more about the heart; CS Lewis wrote this about love:

“To love at all is to be vulnerable.  Love anything and your heart will be wrung and possibly broken.  If you want to make sure of keeping it intact you must give your heart to no one, not even an animal.  Wrap it carefully round with hobbies and little luxuries; avoid all entanglements.  Lock it up safe in the casket or coffin of your selfishness.  But in that casket, safe, dark, motionless, airless it will change.  It will not be broken; it will become unbreakable, impenetrable, irredeemable.  To love at all is to be vulnerable.”

It was no secret I was leaving the hospital.  Nor was my favorite Friday afternoon haunt, Ombrellos, a secret.

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So my fellow consultant colleagues took me there for lunch on Thursday; a cool blustery day with intermittent hail, but there we were by the fire inside enjoying a warm lunch.

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From left to right, Tracey, Elizabeth, Shelley, Dion, and then some guy who forgot to shave.  You can tell whose on call, because they have their phone near by…

I struggled through Friday….so many goodbyes….so many “We don’t want you to leave” comments.   But I knew 5pm would roll around soon, which was good, because it meant I was going back to Umbrellos.  The registrars had organized a little goodbye party for Friday evening and as we arrived, one by one, we still had some work to do (here, we’re doing sign outs…)

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My kind of work environment!  After a few hours at Umbrellos, were sufficiently hydrated, and then we all went out for Indian food.  Reshma (front row, to my immediate left) did the ordering (she’s from India, after all).  And, I got invited to her wedding! (so did everyone).  She promised there would be an elephant.  She just needs a groom.

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What’s astounding is the diversity of the registrars.  Here are the countries where my registrars are from:  Ireland, New Zealand, England, Oman, India, Sri Lanka, and Saudi Arabia.  We talked and talked….it was an amazing evening.  But as big as those smiles are, the photo was taken at the end of our evening, and that meant more goodbyes.  It was so difficult to say goodbye.  So much pain.

Today, I woke to a beautiful sunrise.  It was like Dunedin was teasing me.

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Eion and I had a squash game early this morning (no, it wasn’t easy getting up this am); you gotta love a hospital with a squash court.  After squash, I had a quick coffee from the hospital coffee stand, ‘The Dispensary’ (one of the best in town).  Their pastries are pretty good too!
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Then Eion, his partner Sarah (who is my current registrar) and I went to the Good Oil (the BEST breakfast place in town) for a last breakfast together.

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It was a beautiful day in Dunedin; bright blue sky and 15C.  Yep, Dunners (what people here call Dunedin) was teasing me!

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And this all brings me around to matter of the heart.

Why does it hurt so much to leave?  It hurts because I opened my heart and I let Nz, and the people of Dunedin, in my heart. I loved the people here.  Like this week, I took care of a woman who came to the hospital for back pain; she was older (about 90) and brought in by her granddaughter.  It didn’t take us long, and we found she had widely spread cancer.  We explained what we had found to them; they listened and nodded.  And then they thanked us for letting them know what was wrong.  And they asked us if WE were Ok.  That it must be hard telling someone they have cancer.  Yes, that’s right, they were making sure we were OK (we said we were, and then focused back on them).

Its hurts to leave because the house officers and registrars truly appreciate teaching (as evidenced by the goodbye dinner last night)….that,  and they begged me not to leave.  And they don’t just say they appreciate the teaching; they stay late just to get extra teaching (this week several times staying at the hospital until after 7pm just to hear me lecture).

So, my heart was open, and I let all that is Nz and all that is Dunedin in.  It was wonderful while I was here, and it hurts like hell to leave.  Tonight it’s the worst.  I will leave this wonderful place tomorrow, but a big part of heart will be here in Dunedin.  I’ll take the pain, though, because the alternative is a heart locked safely away, and I never want that.

It’s like jumping off the bridge…you just have to let go of what seems safe….go all in….open yourself to something new.

For now, goodbye frm Dunedin.

Cheers,

Dave

 

 

 

 

 

 

 

 

 

 

Perspective….and more of the bucket list.

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This is a GT (if you fish, you are salivating right now).  A giant trevally.  30 kg of pure muscle.  This GT was photographed by my niece, Christine, on the Great Barrier Reef.  And if you dive, and if you dive and have a bucket list I would be bet the Great Barrier Reef is on it.  And here’s why.

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Truly some of the most beautiful coral I’ve every seen (and like the sunrises from my last post, I’ve seen a bit of coral in my life).  And the amazing thing is how much of Great Barrier Reef there is to explore.  Over a thousand km!  A lifetime of diving wouldn’t begin to cover it; I was very lucky to have had this chance, and I want to come back (again, and again).

And if the bucket list is the highlight reel of your life, what about the day-to-day living?  That’s where living in Dunedin has given me even more perspective on life that I could have hoped for.  Like last night.  I stayed at the hospital a little late to give the registrars a lecture, and then we all went out for dinner (Del Sol, one of the few Mexican restaurants in town).  After dinner it was late, by Dunedin standards for a Monday, and there was NO ONE driving in the streets.  (Dunedin, especially around the Octogon, on a Friday and Saturday night, with the Univ students, is a different kettle of fish).  Back in the Bay Area of California there are millions of people crammed into one lovely little part of the state.  It is beautiful, but it’s crowded.  I don’t think you realize how crowded it is until you are in a city which, literally, has no traffic.  Where it’s possible to walk everywhere in town (we walked from the hospital to dinner).  Where you can walk into your favorite wine store (which here in Dunedin is Wine Freedom, to be sure) and the owner manning the store shouts out, “Dave!”.  The same owner who offers you a ride to the airport in case I didn’t have one.  There is just something about this town, maybe the Southland (the South part of the Southern Island), where everyone is just so friendly.  Where some of my colleagues as work, knowing it’s my last week here, insist on giving me a hug goodbye and are genuinely sad that I am leaving.

And the patients I care for at the hospital…they are the salt of the Earth.  Just honest, hardworking folk, who are kind, understanding and gentle people.  Today I helped teach a registrar (similar to a resident back in the US) how to do a thoracentesis (take fluid out of the chest from around the lung).  The man having the procedure couldn’t have weighed more than 40 kg; yet he just sat right up in the bed, didn’t mind that I was teaching someone (with several medical students watching), and thanked us all, individually,  at the end of the procedure, saying it was the easiest thing he’s every gone through.  Practicing medicine is always rewarding….always…but here it just seems more so.  Because the overwhelming majority of the people are just extremely grateful you are here to help them, and are vocal about their gratitude, and appreciate everything little thing you can do for them (it’s like they don’t even expect they will get better, and when they do, they are so happy).  I truly hope I can retain some of their perspective on life (for my own life) and be grateful for what I have, and gracefully accept what life throws my way.

And I will end today with the image of driving to work this morning, in the near light of dawn, as the full moon hung low over the hills surrounding Dunedin, its glowing image reflecting off the still waters of the Otago Harbour. (or Harbor, if you want to spell it THAT way).  Yeah, I’ll miss that…

cheers,

dave

Reflecting, and a bucket list

This is it.  The countdown.  My last Sunday night here in Dunedin (for now…..).

I didn’t really know what to expect when I moved here a year ago.  I don’t think I tried very hard to imagine what it would be like….I have moved enough in my life (this is the 7th country I’ve lived in) I just assumed I’d figure it out (I did).  But, moving here was on my bucket list (one of two things, if you remember; the other was becoming a doctor).  And it was everything I had hoped it would be for me, but even more importantly for my family (this the first extended stay out of the US for all of them.  So, what was so special about being here?

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See the smiles?  We had so much family time (OK, maybe the boys might have said TOO much family time)..but nevertheless, as a parent, I know the boys will be under my wings for such a short time and it was just heartwarming to see them having so much fun (and to have a job here which allowed me the time to be with them as much as I was).  Life…work…in the US seems so, what’s the word?…consuming.  Here, Deb and I really got to be with the boys. We made it almost every single one of their sporting events, which would be a Herculean feat to attempt back in the US.

Another thing I hope I never forget is the drive into work each day.  We live out on the Otago Peninsula, on a meandering road which follows the Otago Harbor for about 10 km.  It’s just serene to drive along the water each morning, and just last week we were greeted by this sunrise.

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Probably the most spectacular sunrise I’ve ever seen….and I’ve seen many a sunrise.  And I’ll miss listening to Nz radio on the drive into work and home again in evening.  My favorite station is 91.8FM- the Edge Radio.  The disc jockeys are hilarious!  They say things and do things you could never say or do in the US (lots of four letter words).  They have this one segment called, “What it feels like.”  Here, the three disc jockeys spin a wheel, and the winner (loser) of the spin has to play the game, “What does it feel like?”

Because of this segment, here are some of the things I now know:

1.  I don’t want to pee on an electric fence.  (it hurts)

2. I don’t want to shoot my bare foot at point black range with a paintball gun.

3. I don’t want to walk through a wall.

4. I don’t want to be human pinata.

See what you learn by traveling abroad?

I’ll miss the weather reports.  Which tell you what the weather was like today.  So funny.  And, strangely enough, I’ll miss the weather.  Northern California, especially in the summer, is just one blue sky after another.  Nice, to be sure…but where is the drama?  Last Thursday my buddy Eion (pronounced Owen; he’s from Ireland) and I had a coffee outside in the after because the weather was SO nice.  Then, on Friday we were greeted with this:

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The coldest day of the year, and lots of snow (even at sea level).  Then, on Saturday it was back to sun (and about 50 F).

There is lots more coming, but I wanted to talk a bit more about the bucket list.

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This is Luwak Coffee, which my sister brought me from Borneo.  That’s a picture of a civet on the front.  I am, truly, a coffee hound and Nz has been good to me since they take their coffee seriously here.  Why, I’m considering investing in my own espresso machine when I get back to the US (that sound you just heard is Deb saying NO).  Anyway, the civets eat the coffee beans and then, how to say this delicately….they eliminate them.  The droppings are collected (now, THERE is a job!) and roasted and that is Luwak coffee.  For a coffee hound like me, it was a treat to taste this very rare (and delicious) coffee.

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And it would be impossible to talk about Nz and a bucket list with talking about jumping off a bridge.  Quite honestly, it was never on my bucket list.  But of all the things I’ve done here, it has been one of my favorites.  No just for the thrill of it…and it was stunningly thrilling…but because it really was metaphor for our decision to move here.  We didn’t know what it would be like, and no matter how long you stand there and look over the edge, you will never really know what it’s like until you jump.  So, just jump.

More posts this week (I

Tell me it isn’t so…..

First, my apologies for a whole month without a post.  Wow, things have been busy…In my defense, for two weeks we were in Australia (new tourist motto: great beaches, but not a lot of hotel internet) and then after our return to Nz, we are busy getting ready….to….leave…Please, say it isn’t so.

One of the great things about Nz (and this is NO secret to anyone who lives in Nz, and especially those who spend the winter here) is it’s just a 3 1/2 hour flight to Australia.  There is even a direct flight from Dunedin to Brisbane! So, here’s a little bit of our two weeks in Australia.  Enjoy being a tourist!

We spent two days in Sydney.  Wow, what a city!IMG_7725

I guess it’s human nature to compare and contrast, but the city reminded us a lot of San Francisco (in a good way).  We loved the vibe of the city, right there on the ocean, the hip back street markets, the great seafood.  We could have spend many days there.  IMG_7751

The iconic Sydney opera house!  How could we live in Nz and not go to Australia?  How could we visit Australia and not see the opera house?  Being right there, touching the tiled roof of that so photographed landmark gave me pause.  It had always been something I had wondered if I would ever see…..and then here I was.  Was this part of my bucket list?  Did I even have a bucket list? I’ll get to that at the end of the post… We had so much fun exploring the city (there was a lot of walking!, just ask the boys….)  Our second evening in the city was just spectacular. wandering around Darling Harbor.

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From Sydney we flew North, to the Whitsunday Islands (to Hamilton Island in particular).  There we met my sister Karen, her two daughters (Michelle and Christine) and their spouses (Dave and Sam, respectively).  So, nine of us in total.  We spent a week on Hamilton Island, and I’ll just say it was too short a time.  First of all, who wouldn’t want to stay longer on an island where everyone drives a golf cart?  We had rented apartments…and each apartment came with its own golf cart….sweet.  Then, there was the view.  Our west facing (meaning, we could watch the sunset every night) apartment was amazing.  Here’s our first night’s view.

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On Hamilton Island there are hundred of rainbow lorakeets (a beautiful bird!) and also wild sulfur cockatiels.  Those cockatiels are cheekly birds, very smart (said to have the intelligence of a three year old), and not at all intimidated by anyone.  They will get into your house and rummage through your belonging….and they love jewelery.  Fortunately, we kept our doors closed.

They are always hungry, and were serious considering stealing Deb’s beer.

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We also saw a cute little wallaby!

We went to probably the most beautiful beach I’ve ever been to… (7 kilometers of the finest sand you’ve ever seen.)  The sand was so fine, when you picked it up and let it fall on your hand, you couldn’t even feel it.  I’m talking, of course,  about Whitehaven Beach, which is frequently mentioned as one of the best beaches in the world.  There we playing cricket and beach volleyball and managed to get a group photoshot (from left to right…Dave-or Skip as we call him, Michelle, Karen, Sam, and Christine)

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We also visited a zoo, and those who wanted got to hold a koala (yes, they are as cute as they look).

From Hamilton Island we flew to Cairns, and the drove up to Port Douglas (way North) to one of the oldest rainforests in the world.  Lots of adventure here.  One day we went on a boat up a river to see those wild saltwater crocs we see so often on Animal Planet (and, When Animals Attack!).

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Crickey! That’s a big croc, Mate!  About 12-13 feet long.

But here we were on the coast, both in Port Douglas and also in Hamilton Island, and so we had to dive the Great Barrier Reef…

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Matt and I wanted to our hand as fishing one day, so we fished a reef about 10 miles offshore.  The bright orange fish is a coral trout, and we were told it was the tastiest fish around…and they were right.  It fed all nine of us!

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When we left Port Douglas, we sadly had to say goodbye to my family (I guess they all have jobs and stuff like that), but we continued on with our vacation and flew South to Brisbane and then drove to Mooloolaba (it’s pronounced just like it’s spelled, Mo Lou La Ba).  Boy, did we have fun there!  Just a half hour away is Steven Irwin’s Australia Zoo, and that was a destination for all of us.  It was really, really cool.  Lots of kangaroo’s, just hopping around and you could even feed them!

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We also went to a very hip little town called Noosa, where the surfing was outstanding.

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And I will never, ever forget the sunset that night as we walked along the beach, savoring every last moment of the warm (remember we were coming back to Dunedin in the winter) sun.

 

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So, that’s a very quick synopsis of 14 days in Australia.  And now back to bucket list idea.  I’ve had only two things that I absolutely wanted in my life.  One was to become a doctor, and the other was to take my family aboard for a year.  (check, check).  But, I’ve never really made up a bucket list on paper.  Instead, I try to live each day fully, have no regrets, and seize the opportunities which present themselves.  That being said, in the back of my mind I think there are things I want to do before I surf my last wave (so, maybe I do have a secret bucket list after all).   And as my time in Nz comes to and end, I thought it would be a good time for reflection, so I will do my best over the next 7 days to reflect my experience here, and what’s it meant to me and my family and we’ll see just how well I did on my list.  Stay tuned, I will try to post again tomorrow…..

Until then,

 

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Cheers,

dave

 

The Gift

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Five years ago this July, my dad was diagnosed with pancreatic cancer.  It was a terrible moment, and I remember so vividly sitting with my sister Karen in the waiting area outside the recovery room where my dad was laying, asleep in a drug induced slumber after his diagnostic procedure.  His doctor came out an told us what was found on the endoscopic procedure.  He didn’t need say much more….I knew the average survival of someone diagnosed with pancreatic cancer.  Months.  This was it, I thought.  My dad, who didn’t have any chronic illnesses, was not taking any medications, and someone I thought would live forever (just because I’m a doctor, doesn’t mean I’m immune to logic) was likely to die by the next Christmas.

So, with this new information, our family rallied.  We were determined to make every day count.  No matter what was going on in our busy lives, we would take family trips together, have a family dinners once a week.  We would squeeze every last drop of living out of the next few months.  IMG_0355

And we did just that: Las Vegas (above), Jackson Hole, Carmel, San Francisco, Paso Robles, salmon fishing in Alaska, salmon fishing in Oregon, Hawaii…we did it all.  So many great dinners, so many great moments.  We got together to watch Stanford footballs games, and cheered when they beat USC (sorry, Trojan fans).  And we got lucky, because dad’s cancer responded to chemo and radiation, and he had…no, we all had….almost five years of full on living.

In my last blog, about jumping off bridges, I talked about full on living.  Tim McGraw has a song, “Live life like you’re dying.”  A fan or his music or not, it’s a good message.  After all, in reality we are all dying just a bit every day.

And that brings me to this blog.  Cancer has been called The Gift.  Not because you would really want to be told you had cancer, but the diagnosis of cancer brings to the front that you are indeed mortal, and it’s a reminder that you had better (if you haven’t already) begin to live the life you want.  Say the things you want to say, be with the people you love, and do the things you want to do.  And that is what New Zealand has been to us.  A gift.  And here are some of the gifts of the last few weeks.

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On Wednesday, I drove to the Balcutha hospital, as I normally do about once a week.  It’s a small hospital (maybe, 12 hospital beds) in a small town about 100km from Dunedin. It was unseasonably warm for June (14C).  During lunch, I walked across the street and admired the mighty Clutha river (one the largest in Nz) reflecting the winter sky.  What a sight

Last week we went up to Timaru, a town about 200km North of Dunedin, to go to our former nanny’s (Mallory) and her husband0-to-be Nate’s engagement party.  You see, Mallory went to high school in Timaru, and she was back here for a party with all her high school friends.

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The party was fantastic, as was our time in Timaru.  There is a big park at the oceanfront, and on crisp clear Sunday morning we strolled through the beautiful park.

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The boys didn’t need to be told to have fun….

On the way home, we stopped in Moeraki, a small fishing village about 45 minutes North of Dunedin, and home to the famous Moeraki boulders (which I have pictures of in previous blogs).  Moeraki is also home to Fleurs Place, a famous Nz restaurant infamous for its fresh seafood.

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The food was amazing….truly one of our greatest lunches ever.  And Fleur herself was there, helping cook and serve….as she always is.

The drive to Timaru was beautiful, at sunset, with snow capped mountains in the distance.

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A couple of weeks ago the All Blacks were in town to play England.  If you’re not from Nz, you won’t understand the passion Kiwis have for rugby (in general) and for the All Blacks, New Zealand’s national rugby team (specifically).  It boarders on hysteria.  We got tickets to the game months ago (it’s a sold out event, in a stadium that seats about 1/4 of the population of the city of Dunedin.

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There we are in our All Blacks scarfs.  Mallory and Nate had just arrived in Nz the night before, and they HAD to make the trek down to Dunedin for the game.

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Matt never tires of tricking ophthalmologists into thinking he needs eye surgery.

The previous week we had organized a wine tasting of some California wines we had brought here, and it turns out we ousted all the Dunedin eonophiles and they, too, brought out some of their prized California wines.

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We even sampled a 1994 Ridge Montebello.  Wow!  In the lineup are wines from Justin, Belle Glos, Regusci, Cliff Lede, Ravenswood, and I’m sure I forgot something…  It was a great evening.

About two weeks ago, on a rare Saturday in Dunedin (we are often not here on the weekends) we went to the boy’s high school fundraising carnival.

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For a few dollars, you got a sledgehammer, a pair of safety goggles and got to whack the heck out of an old car.  It was fun.

It’s funny what happens every Monday when Deb and I return to work after a weekend off.  One of our colleagues never fails to ask where we’ve been.  And invariably, when we tell him, he just shakes his head and admits he’s never been there.  Now, with just weeks before we return to the US, we cherish our time here even more.  We know this will end.  We are bound and determined to squeeze every last drop of fun to be had, to relish each moment.  Why, just yesterday as we were leaving the grocery store I looked up at the clouds and saw this magnificent sky.

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Life is short.  Make every moment count.  If you love someone, tell them you love them.  If there is a bridge, and sufficient tethering equipment, just jump!

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Enjoy, and cheers,

Dave