Thursday, 31 March 2011

New Zealand foodstuffs Part I

So far this week I have consumed four New Zealand foodstuffs:

1) The Flat White
This was the first NZ product I tried. This is a coffee similar to a latte, which has a shot of espresso topped up with milk 'microfoam'. Microfoam is found at the bottom of a jug of steamed milk, and has a very smooth texture. In this way it differs from a latte, which isn't as smooth and is a bit more like plain milk, and a cappuccino, which is dryer and much more foamy.

I had actually already had a flat white, in Starbucks in Manchester. I can safely say a NZ flat white is much better.

2) The Feijoa
Otherwise known as Acca sellowiana, the feijoa is a small green fruit that looks like a cross between a lime and a kiwifruit. You eat it by cutting it in half and scooping out the pulp with a spoon - you can't eat the skin at all.

It has a very...distinctive...taste, shall we say. It has the texture of a slightly gritty kiwifruit, and tastes a bit like a perfumed apple. It's quite odd. Not unpleasant, but more 'I'd rather have something else.'

3) The L&P
Lemon & Paeroa, or L&P, is a fizzy soft drink described as 'World Famous In New Zealand', which is an odd claim. Especially because you can't buy it anywhere else in the world. It is made by combining lemon with water from the town of Paeroa, and tastes pretty much how you would imagine. Quite refreshing.

4) The NZ Cadbury's
I thought I was imagining it when I said it tasted different this side of the world, but my consultant assured me I was not. Cadbury's chocolate manufactured in the UK contains palm oil, which I'm sure we all know is Bad Stuff. However, Cadbury's in NZ bowed to media pressure and boycotts and removed palm oil from it's recipe. So it tastes different, but not in a way I can describe.

They have pretty much the same chocolate bars though, with a few additions. However, there's much more exciting chocolate to be had instead, so I can't imagine I'll be eating much of it!

As a side note, New Zealanders aren't buying much Cadbury's, as they disagree with the takeover by Kraft.

Medical post: Foetal Surgery

Today I learnt about something I had never come across before: EXIT procedures, aka 'ex utero intrapartum treatment' procedure.

This can be performed when a congenital condition (picked up on prenatal scanning) is threatening the airway of a foetus, and it is believed the baby will be unable to be intubated upon delivery, for example: large tumours (teratomas or blastomas) obstructing the airway, or severe bronchopulmonary sequestration where the lungs are not attached to the main airways.

In this procedure a standard C-section is performed by the obstetricians, and the baby is partially delivered but remains attached to the placenta by the umbilical cord. This means the baby continues to receive oxygen via the placental circulation. An ENT surgeon can then secure the baby's airway, i.e. tracheostomy, and the umbilical cord can then be clamped and the delivery proceeds as normal.

This is obviously a major procedure for mother, baby, and clinical team: the risk of bleeding to the mother is high; the risk of not maintaining the placental circulation adequately and causing low oxygen levels in the baby is very high (and the consequences can be catastrophic); and the cost and manpower needed to actually perform one is extremely high. After all, you need two operating theatres, two anaesthetic teams, an obstetrics team, a paediatric ENT team, and who knows how many nursing and allied professionals.

Learning about this got me to thinking about other types of foetal surgery, of which I don't know much. A swift googling upon returning to my hostel threw up a handful of articles, discussing both open and laparoscopic procedures that can be performed in utero. I had heard of laser ablation of vessels in twin-to-twin transfusion syndrome, but had not realised you could actually take a foetus out, correct neural tube defects or congenital heart malformations, and then return the foetus to the womb to continue gestation! (although how much longer the baby will remain in the womb is tricky - the rates of preterm birth and miscarriage are very high)

The big issue surrounding foetal surgery is, as I'm sure you can imagine, the impact on the mother vs. the impact on the foetus. I'm no ethicolegal whizzkid (unlike H!), so my writing on this will be very brief. It is my understanding, and indeed opinion, that the rights of the mother come before the rights of the foetus; i.e. the potential risks to the mother are of more importance than the potential benefits for the foetus. Especially because there are no benefits of the surgery for the mother, apart from the obvious 'having a child' business.

As foetal surgery becomes more prevalent and more high profile I'm sure all sorts of parties will have their say on the appropriateness of mother vs. foetus rights. For now it's just nice to be able to go 'wooooaah that's really cool!'.

Wednesday, 30 March 2011

Maori creationism

Today I skipped out of clinic early and went back to Auckland Domain to visit the museum and the wintergardens.

The museum contains exhibitions about Māori culture and history, so I would like to share my two favourite legends:

The legend of Māui:
Māui was born premature to Taranga and Makeatutara, the guardian of the underworld. Because he was premature, Taranga wrapped him in her hair and threw him in the river, where he was brought up by sea spirits. When he was an adult he went back to his parent's house and was welcomed with open arms.

Shortly after, he decides the days are too short for humans to get their work done. He and his brothers throw a noose around the sun, and Māui severely beats him with a jaw bone until he promises to move slower. This is why days last 24 hours.

He then uses the same jaw bone as a fish hook and, from the ocean, hauls up a fish made of land - the North Island of New Zealand (Aotearoa). He gives the fish to his brothers to look after while he goes to find a priest to give the approprite blessings, but they are impatient and start to cut up the fish to get their own share. The fish doesn't like this and begins to struggle, causing it to break apart into mountains, cliffs and valleys. If they had waited for Māui the land would have been a level plain. And so the North Island is known as Te Ika-a-Māui (The Fish of Māui).

When he was hauling up the North Island, he needed to use a canoe to steady himself. His canoe became the South Island, which is known as Te Waka a Māui (The Canoe of Māui).

The legend of Ngātoro-i-rangi:
Ngātoro-i-rangi, a high priest, was very important to the Māori during the settlement on Aotearoa. During one voyage he got caught in a blizzard while scaling Mount Tongariro (literally means 'looking south') with his slave, Ngāuruhoe. He called to his sisters, who were elsewhere, to send him sacred fire to warm him up. The fire they sent came up through holes in the ground, and so Ngātoro-i-rangi is credited for bringing volcanoes to Aotearoa. The fire arrived in time to save Ngātoro-i-rangi from freezing to death, but when he turned to pass the fire on to Ngāuruhoe, he found he had succumbed to the cold. So the hole through which the fire ascended, the active cone of Tongariro, is called Ngāuruhoe.

To finish up, here are a few pictures of things I've seen the last few days, selected from my Flickr account (click on the sidebar for all of them!).

Māori representations of my cousins, in Auckland Museum:

Yellow aubergines, in the Wintergarden:

Boats, in the Auckland Viaduct:

Sunday, 27 March 2011

Starship Children's Hospital

Today was my first day at the hospital. The main hospitals in Auckland are a nice 40min walk across the city - fortunately most of the way is covered by shop awnings so I didn't start the day with sunburn! We had our induction, went to get ID badges (was glad to see that admin is always a palaver, even on the other side of the world), and then I went for lunch.

Next to the hospital is a massive park, called Auckland Domain, which has in it the Auckland museum and a Wintergarden with fernery, tropical house and cool house. The park was built around an extinct volcano, so it has an amphitheatre-style look because of the rings of rock produced thousands of years ago when the volcano was active. There are duck ponds which apparently are made by the natural springs in the park. It was here that I ate my lunch, so I got to look at scenes like this:

...and this:

After that I went back to the hospital. Starship Children's Hospital is massive, and is the only tertiary and quaternary paediatric service in the entire country. In the words of one of the other students, it is 'very bling' - indeed, there are botanical gardens and stuff inside. I wanted to take pictures, but obviously that is not the done thing when children are involved, so instead here is one I stole from the internet:

When I went onto the ward I was left with the house officer called DrL, who is from the UK. After graduating from Birmingham medical school she did her foundation training (the first two years of training) then came out to Auckland to work for a year. During this time she applied for specialty training back in the UK, so is going back in a few months to start that. She could not recommend this career break more; better pay, better perks, better weather, better standard of living, and you can wear shorts to work! Apparently there is a big deficit of doctors here, so it is relatively easy to get a job.

The placement I am doing is paediatric neurology, and because it is the only tertiary centre it is full of weird and wonderful conditions - acute disseminated encephalomyelitis, paraneoplastic NMDA receptor encephalitis, all sorts of tumours and complicated AVM's. I then clerked in a couple of patients, including one little guy who told me his name was Tyrannosaurus Rex and kept trying to eat me.

One thing I have noticed about Auckland folk is that they are extremely unobservant: they keep apologising about the 'rubbish' weather, and don't seem to notice that I'm a horrible sweaty mess in shorts and a vest, covered in heat rash and starting to burn! Apparently the 'cold weather' is on its way, but this needs to be taken with a pinch of salt, as winters in Auckland have temperatures of 10-15 degrees, average of about 13 degrees. However will I cope?!

Saturday, 26 March 2011

Envy-inducing photos

As requested, here are some pictures of the hostel I took today to make you all jealous.

View from the street - most of the houses in this neighbourhood are made of wood.

Bedroom. Standard hostel size.

View from my pillow.

View from the computer room.

TV room with Sky (we found a UKTV channel, but in the end watched the Home and Away omnibus to help us adjust to this foreign land).

Stepping out into the garden.

Outside seating area 1.

Outside seating area 2.

Covered outside seating area 3.

View as I ate my cereal this morning.

I would also like to let you know that it is true that on the other side of the world everything is upside down. I turned the above photos of the hostel the right way round, to make it easier for everyone.

Friday, 25 March 2011

I've arrived!

Well, I have arrived in Auckland safe and sound, and am writing this from the hostel as we speak. However, instead of a blog about my journey, I have decided to do a film review. After watching nine films in the last 36 hours I feel I am somewhat of an expert now. I shall even have a star rating.

1) Harry Potter and the Deathly Hallows: ***
Young wizard and his two friends try to destroy some jewellery so a man with no nose will stop killing people. Half a film, and most of it is shot in a tent. It is a magic tent though, which makes it a bit more exciting.

Morals of the story:
  • Jewellery is evil.
  • Magic swords solve all woes.

2) Never Let Me Go: ****
Children are modeled on less desirable members of society so they can donate parts of their body to more desirable members of society. Ethical implications. Romance. Baffling bit where someone seems to have donated a part of their body they needed for locomotor skills.

Morals of the story:
  • Try not to breed humans if you can help it.
  • If you do get bred, don't fall in love.

3) Tangled: ***(*)
Lady with long hair uses it to fight evil. Meets a thief who has an epiphany and becomes a nice guy. Get the sneaking suspicion not aimed at my age group. The extra star in brackets is because H really liked it and disagreed with my rating.

Morals of the story:
  • Look after your hair.

4) Sword in the Stone: *****
Another magic sword saves the day. One of my favourite childhood films, and the first I watched when I found the 'Disney Classics' folder on my entertainment hub thingy.

Morals of the story:
  • Name your children after viral skin infections if you want them to grow up and become a monarch.
  • Magic swords solve all woes.

5) Fantasia 2000: ****
I think I'm one of the few people that actually like this. Was brilliant for dozing in and out of very light sleep. Managed to miss the sorcerers apprentice bit though as I think it coincided with the only 20 minutes of proper sleep I got the entire journey.

Morals of the story:
  • Don't put spells on brooms.

6) Aristocats: ****
Posh French woman leaves fortune to cats, so evil butler gets rid of cats. But they come back, with the help of a sleazy, smarmy alley cat who is only after one thing, really (eskimo kisses).

Morals of the story:
  • Don't have a butler. They are evil.
  • Don't have a fortune. It causes strife to your cats.

7) Red: ****
Ex-CIA agents get targetted because they helped the Vice-President of the USA do mean things in the 1980's. Lots of explosions, cool gadgets, and old people kicking young people's behinds. And Helen Mirren, who always looks amazing, even when wearing massive biker boots with a white ball gown.

Morals of the story:
  • Don't topple Guatamalan governments.

8) Chronicles of Narnia - Voyage of the Dawn Treader: *****
My favourite Narnia book. Kings and Queens of Narnia sail to the end of the world while defeating evil. If you ignore the blatent rip off of the less well-known book 'The Bible', the blatent sexism, and the blatent modelling of the bad guys on the Middle East, it's brilliant. And there's a grand total of SEVEN magic swords.

Morals of the story:
  • Jesus is actually a lion.
  • Magic swords solve all woes.

9) Finding Nemo: ****
Fish misplaces his physically disabled son (foolish) and sets off to find him with the help of a fish with memory loss and the voice of a lesbian. On the way he meets three chronically confused sharks, some seabirds with echolalia, and a turtle who I suspect has abused marijuana in the past. There is some mild peril, but in the end everyone lives happily ever after.

Morals of the story:
  • Never trust a dentist.
  • Try not to lose your offspring.

So, there you have it. Am going to try to beat my personal best of nine films on the way back home.

I did learn a few things on the journey that may interest you:
  • Everyone who works for Emirates is really goodlooking.
  • Crossing time zones means you have meals in an odd order. I had lunch-lunch-breakfast-breakfast.
  • You can buy a gold mobile phone for about US $40k.
  • NZ motorways have palm trees in the central reservations.

There were a few things we did not learn, however:
  • What country Dubai is in.
  • What the currency is in Dubai.
  • The conversion rate between Dubai money and GBP. We had to measure everything based on the price of a stuffed camel we saw in the gift shop. For example, miniature ornamental tea set = 3 camels. One coffee = 1.125 camels.

Right, signing off now as I smell and need a shower. And potentially slightly delirious, but I lack insight into my condition.

Wednesday, 23 March 2011

Testing again

Just testing to see if the automatic email notification function is working.

But to jazz up an otherwise boring post, here is a picture of a monkey I met in Derby the other weekend:

Tuesday, 1 March 2011


Just checking this thing is working!

And it is. Excellent.

So, my plan with this blog is to post rambling descriptions of things I have got up to while I'm in NZ, so all those crazy types without Facebook can see my exploits. These will probably end up being 50% medical and 50% OMG-I-JUST-SAW-A-DOLPHIN type posts.

I will also be uploading my photos to Flickr. If you notice on the right hand side of the page there are a load of thumbnails. Currently they are of sheep and stuff that I uploaded years ago to my Flickr account, but they will be replaced by NZ pics. If you just click on the first picture it takes you to my Flickr account!

I'm not sure if you can comment on the posts without having an account, but I will be contactable by Facebook and email my entire trip. My UK phone will be off the majority of the time, but I will have a NZ phone for emergencies.

So, watch this space :)