Nostalgia Out of New Zealand

I have deleted all the political stuff here, 48 hours before the election.

This Nostalgia is relevant to my two year stay in New Zealand.

I have no regret leaving New Zealand.

25 doctor guys from Ceylon were there in Singapore to sit for the recruitment / screening examination.

I was the only guy who passed the screening examination.

On entry there was another English Examination and a Pre-clinical and Clinical Examination.

Out of all the Foreign graduates who sat with me, I was the only guy who passed the Pre-Clinical Examination (on the particular session). I had to revise Anatomy, Physiology and Biochemistry.

I had no problem with para clinical subjects which include Pathology.

Anatomy was the most difficult and I figured out a few important clinical setting and lower limb particularly and that saved me from failing.

This was enough for me to work for two years in a clinical set up.

I had already decided to come back home (to Ceylon) since, the retirement age in New Zealand was 50 and I was only 45 years. 

I wish not to retire at 50.

I had been eyeing for a University career in Ceylon.

My target was to retire at 65 and to do some research work of my liking during that period.

Linux became part of my life during this period.

Coming from English background, new Zealand English was alien to me.

Good Morning was Good Day and I heard it as Kodday (Umbrella in Sinhala).

My little daughter told me it is Good Day.

It does not matter where I work, I did my work to the best of my abilities.

In one occasion, saving a woman "chair bound" for three months from certain death, an account of the case appeared in the local paper. 

They spelt my name wrong and I was very happy about it. 

Advertisements are not allowed for doctors and I could deny, if any objections were raised.

My children were already telling me, they see me at 7AM in the morning and then late at 12PM to 1AM.

I had already decided to terminate clinical work at 55. 

I quit clinical work at 55 and continued to teach Pathology, till I retired.

I was given the worst hospital there and New Zealand Graduates did come there to work. 

The one who came was a German graduate, who was hopeless.

He did not have a clue, what to write on the clinical notes.

I deliberately wrote cryptic notes which he could not decipher.

One day, he asked me why not right legibly.

I said those notes are for (legal and forensic) me and not for you.

He never asked me any questions.

There was a Czechoslovakian guy who was working as a cardiologist / consultant.

He did not know where the heart is located in the human body.

In a case of haemothorax and a large pericardial effusion he did not know where to put the needle. We sucked out two or more liters and saved him. 

The patient was a fabulously rich guy and I had a cordial relationship with him until his full recovery. 

He was from a different city.

This  Czechoslovakian guy wanted CXR, ECG and all the tests before making a diagnosis.

He lacked all diagnostic sense / skills and was clueless with children.

Guys from the X-ray Unit were good.

I said we can save lot of money using Ultrasound scanner. I said when I was working in private sector in Ceylon we had good scanner.

New Zealand did not have a Medical Defence Union. I covered myself using UK M.D.U.

Additionally, I had to do 72 hours a week when their regulation allowed only 40 plus 4 hours.

I told them I am going to take legal action or else hire another guy. They refuse to pay me and I decided to quit.

I would relate two incidents. 

There were many more.

Only case I missed was a Chicken Pox case in an adult. I kept him in instead of discharging him.

I had not seen chicken pox in an adult white man but had a seen many in children (in UK).

One kid went into Coma and we kept him alive and used Immuno-therapy as a last resort and he survived with disabilities.

 

Case 1

One Maori guy was anaemic.

We knew he had a peptic ulcer.

This Czechoslovakian guy put an endoscope down his gullet.

I told him not to do that but he did not listen.

At 1.30 AM, I got a call that the guy was choking with blood.

I called the consultant on call (New Zealand guy, very nice), come soon, this guy is choking of his own blood (to death) and broncoscopy was the only way to save him.

Yes, we saved him.

Probing with the endoscopy had dislodged the blood clot sitting on the ulcer.

  

Case 2

There was a case with long  standing atrial fibrillation on anticoagulant treatment with a big thrombus in the atrium.

This patient had an ASD, too.

This guy decided to defibrillate.

I said do not, the thrombus would shoot to the lung and brain.

Sure enough, he did defibrillate and it did shoot to the brain.

We put him (there was another Ceylonese consultant) on heparin and saved him.

Unfortunately he had to have Lumbar Puncture on top of the near death syndrome.

 

My Case 1

On a  Sunday taking leave, I made a note on a young girl's (19) clinical notes DO NOT Give Aspirin for pain and underlined it.

She was given Aspirin and she almost bled to death. 

She had a splenectomy. 

Platelet surge after injury was absent without the spleen

With nearly 20 pints of blood, she survived and her blood group was also was rare to add to the problem. 

I had reserved two pints of cross matched blood in advance.

My Case 2

Young mother brought a kid for Tonsillectomy.

S/he was from Christchurch.

That was unusual.

I took a long history.

Decided to do all (I had done extensive haematology in Ceylon) the coagulation tests and we found a rare disorder similar to hemophilia.

We gave him blood with related coagulation factors, before and after the surgery and he had a perfect recovery.

The mother was very thankful, to say the least.

My case 3

I diagnosed a case of Red Cell Leukemia.

My consultant who was in service for over 40 years, had not seen one.

She said you are a lucky guy.

In UK most of my consultants were females and one was very nasty and I left her after 6 months, and I told her I will leave no sooner I get the next job but kept my contract of six months, less my leave quota. 

To make her realize my intentions, I came home for two week holiday, after 3 months.

Of course, I fixed one of my female batch mates in the job and she also left UK soon after, to pursue a career in General Practice in Ceylon.

Working as a medical guy has its own idiosyncrasies.

One who does not have a firm conviction should not take up this profession.

There was no regret leaving New Zealand.

A guy at the age 81 was persecuted for missing a carcinoma in situ.

He had seen the patient 30 years ago. 

In situ period is generally accepted as 25 years.

The case was legally flawed but I do not know what happened to him.

I had already left New Zealand, never to return even on a holiday.