first emergency

Today was exciting! Charlie let me scrub in on a shunt surgery and I got to do the abdomal part under his supervision! That was awesome! I got to do the skin incision, incise further down to the muscle through the fat.... then put the end of the catheter in the abdominal cavity and then help him withe closure - some facscia suturing and the skin! I also got to intubate patients and I had to say goodbye to a wounderful team in the theater!!!! I have really enjoyed working with them and spending time outside theater as well. I don't know if it has made a good impression that I have not spend that much time in the public hospital even though I was assigned to a surgeon who is mainly operating there, but I have had so much more fun in the other theater and watching a great surgeon operate is just so much more exciting than watching someone who is just learning themselves without much explanation. Maybe I would have had a few more oportunities to scrub in on cases in the public theater, but the social part of the experience and the teaching would not have been quite as good... In the private I have certainly seen a lot more brian sugeries that I would have in the public and it is all just so much more organized. Today I went to the public, because I needed to get a signature from my supervisor, who I have been trying to get a hold of for the past days of this week and it was just so much different...nurses weren't as nice, surgeon didn't talk as much, no teaching from the anethesiologist..... But if my supervisors did have a problem with me being in the private so much, they could have told me, but they never did.... Anyway I have had a great time there!

After I left today I went to get some dinner and when I was waiting for my food to get ready someone had an epileptic attack! Not good for the guy, but great for me! I was the only person in the room with medical background.... I went to the guy made sure he didn't hurt himself, made sure he was breathing all the time, tried to talk to him.... I may not have done things in the right order, but I was amazed at how little the whole situation freaked me out. There are definetely worse emergencies, but I was a little proud of myself that I felt confident enough that I could handle it. I was glad that someone was there as well to help me figure out which leg to put where when turning him on the side, cause I always get that mixed up.... But it was great to have experienced my first Emergency on the street, because I have always wondered if I could stay calm and what I would do and what it would be. Now I know it was a young guy who had a seizure at KFC and it didn't freak me out. 

last Sunday...

The last Sunday in Sydney (at least for this time) is over.... We started out having breakfast at Coogee-Beach! With some people from the hospital and the other Germans we went to a restaurant overlooking the water. I had blueberry pancakes. The view was stunning and the pancakes were ok, not like Deb's Sonday Morning pancakes - but it at least made me think of them. After breakfast I went to La Perouse which is at the nothern End of Botany Bay. There isn't much to see and I just walked around Henry Head and enjoyed some more of the typical countryside. I saw tons of little lizzards. There were three different kinds that I could actually see and two that I also got a picture of. They were so quick... and most of the time I could hear them, but not see them. The same was true for most of the birds. I really enjoyed walking a tour that wasn't crowded, because that way I got to see some animals! Mammoth had tried to get close to the lizzards, but that never really worked.... ;)
Later in the afternoon some clouds came up and I decided I head back towards the city and not stay on the beach. I only went back to Maroubra, got off and did some shopping at a German supermarket, to be able to bake a cake on my last day... Now I just have to find an oven! Appearently ovens don't necessarily belong to an Australian kitchen! We got a stove, but no oven and I asked Morgan and he's only got a stove as well... So I need to find someone living close by with an oven.... I never thought that would be a problem! ;)
Then I walked down to Maroubra beach and back along the coast to Coogee. As you may recall on the first Friday I was here I did go down to Maroubra as well (without a camera back then) and sort of lost the costal walk at some point. This time I found it! And I am glad that I went back there again. It didn't look that much different from the other costal walks that I have done - cliffs, touquois water, amazing waves... But it is always so nice to look at and walk along! And the sea was really rough in the later afternoon today. So the waves were really really great!
Now the last weekend is over, my legs are tired from walking around so much and they might actually enjoy a weekend of just sitting around... ;) So I have prepared them well for next weekends journy (or at least I have tried to do so...) Now I have to start thinking about packing and getting things organized, because so far I have been putting that off... I wanted to enjoy the last weekend and then start thinking about organizing everything.... I will do that with very mixed feelings. I am looking forward to many things, but I am also a little bit sad, that I will leave quite a few nice things behind and mostly of all that the adventure that I have been planning for so long and that I have been hoping for to happen even longer will be over soon...
Tonight when we were out for a glas of wine someone asked me what I get out of this: It is really hard to say while you're still enjoying the experience....

the Blue Mountains' Grand Canyon Tour

At first I have to give a short update on what has happened during the second half of the week... Since I have been too busy (and then to tired) to write up to now, even though some really exciting things did happen....

On Wednesday surgeries were over by 9pm, so that could be considered a short day...;) I once again was allowed to intubate most of the patients (not the first one, because I was still rounding with the other team, while that happened) and it is getting easier each time... I am so glad Sudeep is letting me do that! During the day an appearently very important Australian celebrety showed up to watch Charlie operate, because she is one of the public spokespeople of his foundation and wanted to have a closer look at what happenes in theater....
During rounds in the morning it came in handy that I am German! We have a patient with a very German name and someone noticed that and since she was not responding when they spoke to her in English, my registrar asked me to examen her in German... And it worked, she opened her eyes when spoken to in German!!!! She had suffered from a head bleed and was just waking up... For the next two days they had me examen her in German every morning even though she already responded to English, just to watch me I guess....

On Thursday I scrubbed in on a spine case. That was really cool. My registrar had a great day and let me do the skin incission and open the surgical wound all the way down to the muscle.... Really amazing. Since there was no other doctor scrubbed I was his assistant for the entire surgery and really got involved! Very cool!!!! Once the sugeries of the day were over I went back up on the ward and was allowed to take an extra ventricular drainage out (it is basically a tube stuck into the ventricles - the fluid filled spaces in the brain - to drain fluid that would otherwise build up and cause severe damage). I felt like I had really done something by the end of the day. In the afternoon Jörg, Katja and I then went to the AMP Tower to have enjoy the stunning view across Sydney. And it was stunning. I just can't get enough of that, I could have stayed there much longer than the other two and just keep walking around and soaking it all in..... For dinner we had initially planned to go out to the oldes Pub in Sydney, but Aneela (the American Fellow) had suggested to go to a brasilian Barbecue instead. That was amazing. I don't think I have ever eaten that much meat in my entire life during one meal! It was all you can eat and they kept comming up to the table with all kinds of different meats that had been grilled... There was so much to try and I wasn't hungry again until lunchtime on Friday!

Friday was again a little bit frustrating. The clinic I was supposed to go to didn't happen, but when I went up to the ward none of the doctors was there yet to start rounds - I had once again showed up way too early... (for Australian standards at least!) I took the oportunity to take care of my paper works and get all that organized... Later I wanted to go into surgery, but that one got canceled because the child had had some really strange EKG.... so they decided to wake him back up, instead of risking rescucitation with the skull open.
Back on the ward, rounds were finished, but there was nothing for me to do and in clinic they already had two other students, so I decided after having spend so many nights in the hospital over the past weeks, that I would just take the rest of the day off and enjoy some sunshine and the beach... I had a great afternoon on the beach. It wasn't too hot, the water was great.... and I finally got to just be lazy and enjoy doing nothing, but reading a book.....

And then today. I got up early and went on my last daytour...:*( It was wounderful. It was a group of only 11people and a guide. We went to the Mountains in a minivan and our first stop was in an area where one can usually see the grey kangaroos, but unfortunately not today.... It was still a nice tea break. The guide was a real nature person, he told us all kinds of really interesting things about plant and animals all throughout the day! If I had done the tour on my own, I would have missed so much! It was awesome! The next stop was a non touristy look out to see the three sisters. The guide wanted to make sure that we don't end up in the areas where all the tourist go, but actually get to enjoy the scenerie far away from the crowds. We had lunch on the bus - not a 1hour lunch break in a place with nothing to do but eat, like most of the day tours offer... I loved it! That was exactly what I wanted - get off the bus to do thing and see stuff and not eat. After lunch we got to the start of the grand canyon tour. There is just no way I can describe all of it satisfyingly. The track was narrow with lots of stone steps, steep parts, sand, wooden steps, some flat parts and extremely interesting. It was so much fun. We walked about 250m down into the canyon through bushland and rainforest land. It was amazing how the plants changed from one meter to the next. The guide described it as stepping through doors and that's what it was like. Absolutely great. He also took us to a termite hill, pointed out spide webs, showed us a special lizzard, a flesh eating plant and explained so much that it would take a few more hours to write it all down... As already said, I would not have been able to enjoy the stone formations, the different colors of the stones, the burned and newly growing trees and the animals and plants as much as I did without our guide. It was a wounderful tour, even though I did slip once and landed on my budd. It was kind of funny, because I was not the only one that slipped when we were walking along the river down in the Canyon. Falling wasn't funny (I admit that), but the other girl and me, we were the only ones to wear real hiking boots, everybody else just had normal sneakers and the two of us ended up falling.... (maybe the shoes are only made for European hiking.... - she was from the neatherland!) At the end we had to climb up again, it was a lot steeper than going down and there were hardly any flat parts along that part of the way, but the view up top across the seemingly never ending green bushland was stunning! It almost didn't feel real.... At the end of the day our guide took us to a tourist spot, just to be able to take a quick look at the three sisters from the post card point of view.... Then we headed back to Sydney with tons of great memories and things to tell. It was just like the kind of tour I had hoped it to be, except that I did not see any Koala (exstinct in that area) and not Kangaroos....
The group of people was also really nice. Mostly people my age and most of them were in Australia for work and travel. So they all enjoyed life and were a pretty easy going bunch of people. Just one girl from Germany was different... She had been in Brisbane for 6 month with EF for a language study year abroad (don't recall what that is really called), but it is similar to the three week summer courses except that the students stay for 10month just like au pairs and exchange students. She was really unhappy with how things had been going and was on her way back to Germany. And talking to her made me realize how much I really enjoy being here and having the opotrunity to see and do all the things that I have been doing and seeing.... Even though some things have not been running smoothly in the past and I have had quite a few frustrating moments as well, I still got so annoyed by her negative attitude after a while that I just couldn't talk to her any longer, because it felt as if it took away some of the excitement I felt about this whole trip.... And on the way back into Sydney I got a little bit sad.... It was the last big adventure, now I will still try to spend as much time as I can in the city to soak up some more of the Sydney feeling before going back, but coming back today made me realize that my adventure is almost over....

Monday, monday - and tuesday

Monday morning.... after an exciting long weekend work just did not seem extremely appealing, but there was one surgery to look forward to, one that I could hopefully assist with and do some cutting and closing, some real surgeon's work.... and there is also a need for all kinds of tubes before starting surgery.... The meeting in the morning was very boring, there are just some people in this world, who like to hear themselfes talk.... Very, very annoying! Once I was headed to the theater with 6 surgeries coming up Monday didn't seem to be all that bad anymore... I got to practice intubating patients again and was excited every single time I managed to do it and especially, becuase it has become a lot easier over the past weeks - it's all a matter of practice! Unfortunately the surgery that I had been looking forward to for almost a week (before I had let other students assist, who did only spend a few weeks here knowing that I would stay longer and hopefully get my turn....) didn't turn out to be quite as exciting for me as I was hoping. The shunt equipment hadn't been set up properly, which aggrivated the surgeon a little and teaching was then not the main priority anymore.... I was quite upset afterwards, because I had been hoping for a similar experience to what the other students had had in the past.... Oh well. The last surgery of the day (for me at least) was a very interesting surgery, the anatomy was that I got to see was amazing, and it just once again proved to me why I am loving this so much... I could have watched them forever find their way between nerves, vessels, important brain structures.... The skull base is just so very fascinating! But shortly after 12 I decided to leave and not stay for the last surgery. I knew I was going to be tired the next day if I stayed too long and I was still a little bit uphappy about the shunt surgery and the fact that I don't actually get to do quite as much as some other students in the past....
On the ward we don't have very many patients and there isn't much work I can help with (and appearently they don't really expect students to be there quite as much as I am...), so I sometimes get a feeling of being kind of useless up there and then going to theater is sometimes a little bit frustrating as well, because even though most of the surgeries are very fascinating and interesting and the teaching is usually really good, I sometimes wish I could get to do a little more.... but that's just what students have to deal with (unless you are in switzerland, you are usually only no 3 at the table with nothing much to do....

Today I went to clinic again and we saw patients pre- and postoperatively. Some are really impressive... and it is great to once in a while see a few patients, who are actually talking to you and are not asleep most of the time.... So today I felt a lot better than yesterday and not quite as frustrated.... Tomorrow will probably be another long day in theater again, but I love the team Charlie is working with, so it will be as lot of fun as well!

Trip to Jervis Bay

Today was amazing! Even though I had to be ready for pick up at 6.45 I really enjoyed every minute I was out today. They day started with a tour around Sydney to pick up other people and I could watch the city slowly waking up and the sun rise.... It was a nice extra city tour!Today's bus driver was much more pleasant und the group of people traveling was much smaller (only 15people), but we still had a big coach! The sky was bright blue all day long and sun was shining all the way down to Jervis Bay and back to Sydney and the scenerie was amazing. Since traffic was pretty good the bus driver altered the tour and took us down to the coast and drove along cliff rather than up on top. We drove across a C-shaped bride, that was going along the cliffs (it was actually featured in a Ferrari commercial once...) We stopped in Kiama, where there is a rock formation right on the water and if the tide and wind is right water comes out of one hole just like out of a wale's blowhole.... We had a baby wale today... All the way down the coast I just could not believe how incredebly beautiful the weather was. I had checked the forecast and it had talked about thunder storms by mid day, but the sky stayed bright blue. In Illawhara (that's the part of the country we drove through) they do get a lot of rain though and everything was still very green, not like in other parts of the country and driving a long the coast it reminded me a little of pictures I had seen of Ireland. The next stop was Jervis Bay where we got on a Boat to cruise the bay for about 2,5hours and look out for Dolfins! And we got lucky, again not quite as many as they sometimes get to see, but still quite a few. But they were really hard to capture on a picture..... But it was fun to watch them and cruise around the bay. The group of people I was traveling with was really nice. One woman was from Zurich (we spent quite some time talking) and during lunch time we chatted with a couple from Texas and a Lady from L.A. It was really a nice group of people. The wharf in Jervis Bay looked like right out of paradis - white sand, clear turquois water and bright blue sky. I could barely believe that I saw all of that!!!! It was amazing (had I mentioned that yet...;))
Then we headed to Kangaroo Valley in Kangaroo Valley (the town got the same name as the valley - not confusing at all;)) On the way I did see one Kangaroo hopping through the bushes! Pretty cool, but again too quick for a picture, so you just got to believe me! Kangaroo Valley was another really green area.... we had to drive up a very windy road, but the view from the top into the valley was (guess what) really, really great..... Kangaroo Valley (the town now) was a cute little country side town with little wooden houses on the either side of the one main road... And that had really good ice cream! Driving through Kangaroo Valley (the actually valley now) we passed a lot of other very similar towns. We appearently also drove by an intersection where one could get to the town where "Babe" was made.... The last stop of the day was Fitzroy falls. A very impressive and high waterfall (61m). Fortunately it had rained a little bit over the past days so that we did get so see some water going down.... Most of the stops today where quick stops, but they all were great and the countryside we drove through was wounderful. I am afraid the pictures will only represent little of what is actually there.....
I had a wounderful even day, even though I was dressed a little inappropriate since I had expected rain to come in at some point during the day.....

where it all began

Today I slept in.... What a pleasure!!! No noise, no cars, no work..... It was great. Then I took the train for the first time today and went to Cronulla, which is a small peninsula south of Sydney (still sort of part of Sydney). I walked along the coast around the pensinsula and went swimming for the first time. At first I just wanted to walk along the beach at one of the bays, but then the water was so nice and warm that I just couldn't stop myself. I had wanted to wait till I had someone to go to the beach with, because leaving my stuff unattended is not really great, but since that hasn't worked out so far, I decided to just take the chance. It was wounderful. The water was warm and really soft.... I didn't stay in too long, because there was noone to watch my bag....
Once I had finished my trip around Cronulla (which wasn't much different from the rest of the coast, still very beautiful, but again cliffs and the bluest water I have seen so far - which I still can't get enough of....) I took a bus to Kurnell. Kurnell is where the Botany Bay National park is and that is where Captain Cook first landed in 1770. They got all kinds of memorials set up alongside the water to remember people that came with him and the first European to die on Australien ground is also burried there. I did not walk around too much, because I was worried I might miss the last bus going back to Cronulla.... So I sat down and read a book right behind Captain Cook's memorial. From there I could overlook Botany Bay and watch planes coming in and landing on the other side of the bay (very busy!). I also got to wittnes how a thunderstorm slowly formed. The clouds were amazing, but the rain in the end wasn't.... ;) It was still a really nice relaxed day (even with the rain at the end). I got to see free flying parrots for the first time. Their colors are amazingly bright, but unfortunately they were too quick for the camera.

Canberra - Trip to the Capital

All of a sudden week Number 6 is over..... That happened really fast! Wednesday and Thursday I was in surgery, but it wasn't all that spectacular and a little bit frustrating on Thrusday, because I had to stand next to two scrubbed surgeons for almost 7hours to suture the skin.... Even though I was promised before that I would get to do a little more than just be Number three at the table..... But I took the time to make it look pretty and I am proud of it! I think it looks very even, I was even tempted to take a picture, but didn't have a camera.....
On Wednesday the surgeries were finished early and Charlie took the team out for lunch. That was a lot of fun, even though things were revealed that should have just stayed in the dark.... After lunch I went downtown and used my bridgeclimb certificate to visit the Pylon lookout. One of the four stone pylons of the bridge hosts a museum about the bridge and you can go up there and enjoy the really great view. It is exciting every single time, I have spent so much time now overlooking the city, just looking at the bridge, the opera house, the skyline.... and I still love it. I just can't get enough of it!

Today was another hospital off day and I had booked a day tour to go and visit Canberra. Canberra is about 280km south of Sydney, so I got to see a lot of country side today! That was pretty cool. I even saw a kangaroo, but since we passed by so quickly I couldn't tell if it was relaxing or dead.... We stopped a in a small town on the way down, which was supposed to become a tourist town when the railway was built, but then they took a different route and all the inns that had been opened there gradually closed again, but it still claims to have the oldest continuously running Inn! There was also a court and a jail and lots of really pretty small houses. It was meant to be a morning tea stop and many of the older folks walked right into the suggested restaurant, but I decided to look around the town.... Much better!
Around noon we got to Canberra. The town just doesn't feel right (even though that might sound weird). I think one can feel that it was designed on a map and didn't just develop like other big towns in the world or Sydney.... There is a hight restriction on Buildings and they also wanted to preserve a lot of the plant and therefore the town is extremely green, but I could barely see any houses.... It seemed to be empty and not filled with life.... The line from the War Memorial to the parliament house is a little bit like the Mall in DC, but there are hardly any people..... It was just really, really strange. We went to the National Museum, which was really interesting and very well equipped. I wish I'd had more time to look around.... Then we went to the Parliament House. That is a fun building. It was build on a hill - sort of. The actually took down the hill, then build the house and then put the soil on top of the house, so that the building is now part of the hill - very funny idea and very unique. The architects gave a lot of thought to the building. It is a very bright building, lot of light everywhere and many meaningful details that one would not recognize without a tourguide - really interesting. Today I found out that in Australia everybody has to vote once they turn 18 and if you don't show up without a good reason you have to pay a fine! I haver never heard of another country making their people show up for election (except for communist states maybe...). The next stop of the tour was the War Memorial. On our way there we drove through the embassy quater. I was impressed by the fact that some had hardly any fences and seemed to be on property that was very little secured. Especially the asian Embassys looked really great. The America Embassy was the largest one and bigger than the parliament building.... I was sitting on the wrong side of the bus, so I could not take a picture of it and for the same reason I couldn't take a picture of the German Embassy.... It wasn't all that spectacular anyway, but it would have been nice. The War Memorial was build to honor all the soldiers that had fought for their country. It is a big museum, but since I am not a history freak it didn't excit me all that much, even though the exhibits were really neat. There was also a remberence hall and thought it was quite impressive that they did not just have pictures of a navy, an army and an airforce soldier, but also of a woman!
The last stop in Canberra was on top of the highest Mountain. From there we had a pretty nice view over the city and there again I couldn't see much city.... Some of the buildings were really impressive, but very well thought through, but it just seems to be too perfect, too well planned, not spontanous - I just did not have the same feeling that I get when I am wandering around Sydney, especially downtown, Circular Quai, the rocks.....
On the way back to Sydney we stopped in another small town for dinner. It was another country town and because sheep are very important, this town has a huge and I mean HUGE sheep standing at the town entrance...... Very impressive.
The sunset was pretty spectacular, because there were some thunder storms, so some of the sky was really dark and other parts looked like they had cought on fire.... and we got to see a big, bright, full rainbow!