Talofa Lava

Cockle Bay, NZ

Greetings, in Samoan. or "Fakaalofa lahi atu", in Niuean.  Both of these greetings, translated literally mean "lots of love from me to you."  In many Pacific Island countries, the greetings are about the person being greeted.  In Tongan, the greeting is "Malo e lelei" or "Thank you for being well."

My first week of work included several cultural opportunities that I will not likely forget.  On Monday, our week started with a Powhiri.  This Maori honoring ceremony welcomed Stethanie and I to the marae, or sacred place and meeting house, on hospital grounds.  We were greeted by elders of the iwi (tribe/family) that have inhabited the land around Middlemore Hospital for centuries.  It was a lovely ceremony that left me feeling quite honored.  One of the elder women came up to me later and exclaimed at how I was so small in every way except one... "you have long feet!"  We had a good laugh.  Perhaps my little duck feet make good paddles for swimming.

Marae on University of Auckland campus

Beyond the gates... University of Auckland

Another day, we met with a Samoan on the Middlemore staff who talked to us about some of the cultural differences of the Pacific Island people.  In Auckland, there are more Pacific Islanders (non Kiwi) than in the Pacific Islands!  Indeed, the area around the hospital where I work has the largest population in Auckland.  Unfortunately, poverty rates are higher in this group as well.  They have such a lovely sense of community and support, however.  If a Samoan shows up on another's doorstep, they will find a place for them to live.  Many garages have been converted into living spaces for family, friends, and fellow countrymen.  For them, the most important things in life center on family and connections with others.  Middlemore employs a group dedicated to cultural diversity and a specific mental health unit for Pacific Islanders and Maori.

 Alongside the cultural education has come a medical-cultural education.  The medical system here has a few different twists, many of which I am still sorting out.  I have arrived when the lab techs, rad techs, and interns have been in various stages of strikes.  I have also found it interesting here that in order to get a CT scan or MRI, a person has to review the case with the radiology liaison for approval.  Indeed, although sometimes the information may have been helpful, the  therapy has not varied.  Medical costs are certainly regulated yet the care is excellent.

Wednesday evening marks the official "over the hump" in my first work week.  I think I have run the gamut of emotions from excitement to being overwhelmed and wondering why I have chosen to come to NZ at all.  If there is one constant, it is that this work will be different.  My work will be a specialty position, where I have been working in a more generalist internal medicine position.  I will again switch from outpatient to inpatient care.  This time I will also  learn a new health care system, and introduce of the role of Physician Assistant. New protocols, new drugs, old drugs with different doses and schedules,  new abbreviations, conventions, and terms to describe the same illnesses all contribute to my need for further education.  I vacillate between being rabidly protective of my workout and private time and earnestly studying swearing that I will not be training for any events this summer!

As I write this, I am falling asleep.  The other consequence of all the unfamiliarity, is that I have been waking at 3 in the morning.  When I can't get back to sleep, I get up read and then run.

I have found a place to live in Herne Bay, Auckland.   I hope that it will provide that much desired sense of home.  A place where I can relax, enjoy the denoument of the day. Watch the sunset.  Where I can walk to the shore and swim, watch birds, enjoy the contrast of quiet after a busy hospital day.   I hope that I will meet and get to know more folks, my neighbors and coworkers.

My apartment faces NW on the ground floor of this house

The physician assistant pilot in New Zealand has hired (in addition to myself), Stethanie Jacobs, a delightful young woman from Guyana who has been living in the States for the past 10 years, most recently working in NYC.  I am lucky to have her as my comrade in arms.  Tomorrow we hope to head for Matakana, north of Auckland.

Good night, Kiwi.

Former TV sign off cartoon, Goodnight, Kiwi