Maori war dances and busy A+E wards

Nisheeth Rajpal spends his elective in new Zealand

I set out for Auckland early last November. I was leaving the worst of the British winter behind without any regrets. No more gloomy sky, no more arctic winds, no more 3 00 pm nightfalls. I was off to a land where the summer of '99 had yet to begin. After months of preparation and a weekend of careful packing to ensure my backpack wasn't too heavy I was ready to embark on the adventure.

The jetlag I experienced on reaching Auckland was incredible; it left me in a constant state of fatigue for a week. The feeling wasn't entirely unfamiliar, as I had been through the preclinical years in much the same state. The UK had a 13 hour time gap with New Zealand, and it took my body a while to catch up.

Almost like ER

The emergency department at North Shore Hospital was considerably less busy than I had initially expected. I had been envisaging a hectic accident and emergency department of the type you see in fast paced American medical dramas. The surrounding North Auckland sleepy suburb with its well to do population was a stark contrast to the bustling overcrowded accident and emergency departments in South London that I have become accustomed to. The staff at North Shore were friendly and keen to let me partake. Most of my work involved attending to minor "touch" (an affectionate name for touch rugby, a much less hazardous version of rugger) injuries. After a fortnight of telling most patients to rest, ice, compress and elevate (or RICE) the routine began to show results, and I felt confident in the management of a sprain. I wanted to see more, and I asked Auckland University for a transfer to the more famous and reputedly more busy Auckland University Hospital (which also happened to be in the centre of town and just around the corner from the America's Cup Village).

Auckland University Hospital's emergency department, with its fully fledged trauma unit, was just the ticket. The department was always buzzing, and it was easy to find something to participate in. The departmental registrars made time to teach. I was working alongside a few Auckland trainee interns, who spend a year between finals and their house job, easing into the routine. I was able to assist in trauma calls and not feel as if I was in the way. I honed skills such as intubation and suturing. I assisted with chest drains, joint relocations, and diagnostic peritoneal lavage. The consultants were especially keen for students to gain "hands on" experience. The central location of the hospital meant that Friday and Saturday nights were the busiest times of the week, with victims of violence and road traffic accidents making up the bulk of patients admitted. I had my few harrowing experiences in the vicinity of the resuscitation room. The most memorable one was being asked to manually support the neck of a patients who had been in a traffic accident after the cervical collar had been removed, while kneeling (and slipping every few seconds) on a blood covered floor. I breathed a sigh of relief when the consultant declared the radiograph of the cervical spine as clear. After four weeks at Auckland University Hospital I felt the long flight over had been worth while.

On the tourist trail

Towards the end of the attachment I had just over two weeks to see the South Island, having taken ample opportunity to see the North Island on my weekend breaks. The North Island's highlights were the Bay of Islands and Rotorua. Rotorua, a town that smells (or rather reeks) of sulphur, takes some getting used to. The active Maori culture and mud spouting geysers draw tourists from Auckland by the busload. I witnessed the Maori war dance, the Haka, which the All Blacks made famous worldwide by intimidating their opponents (although they lost the World Cup!). Sitting before six bulky Maori men in grass skirts, watching their thigh slapping routine with the occasional grunt is scarier than one would imagine.

New Zealand's natural beauty is spectacular. The South Island is reputedly more scenic, but both islands are worth seeing. The vast number of terrains that are present in such a small land area make this small country unlike any other place on earth. From near tropical beaches to glaciers to fjord land, all within a few hundred kilometres of each other. My camera did some serious overtime, and I returned with over 600 photographs. New Zealand is custom designed for the independent traveller. Every town had a choice of "Backpackers" (youth hostels), each with its individual character and facilities. All had kitchen, bathing, and email facilities, which in this day and age are essential for survival. The kiwi summer diet consists of anything as long as it is cooked on a barbeque. You cannot spend a day in New Zealand without being invited to a barbie.

In search of the adrenaline high

Queenstown, in the centre of the southern part of the island, is every adrenaline junkie's Mecca. This is one place not to miss if you are planning an elective in New Zealand. A myriad of adventure activities are on offer, ranging from the conventional to the down-right bizarre. It seems Kiwis will do (and subsequently market) anything that gets them that sought after adrenaline rush.

One such activity is zorbing, which involves rolling down a big hill at high speed in a large plastic ball full of cold water, a bit like Gladiators. I did my fair share of screaming (sledging, skydiving, bungee jumping), and the rush is hopelessly addictive. Once you try one activity you get the urge to do another to top it, and so goes the endless budget draining cycle.

Queenstown is home to the world's second highest bungee (134 metres), but no thanks! White water rafting is nowadays shunned in favour of white water sledging. Indeed, why sit in the comparatively safe surroundings of a dinghy when you can really get into, and under, the wild rapids on a piece of flimsy polystyrene?

The fjords of Milford Sounds are a short scenic flight away from Queenstown. This is one of New Zealand's most beautiful and unspoiled locations. On a clear day the mountains reflect in the water, giving a perfect mirror effect. The fainthearted can stick to pony trekking or mountain biking. There is something for everyone. Queenstown's fame also means that it is one of New Zealand's most expensive resorts, but if you are converting from British pounds, you're laughing anyway.

Conclusion

When I left for New Zealand I had many hopes. To do some serious travelling and live out of a backpack... done! To jump out of an aeroplane... done! To meet lots of interesting people and learn about their different lives... done! To learn a fair bit of emergency medicine and hone those clinical skills to absolute perfection... erm, well, kind of. Maybe I'll reach perfection when I am appointed professor of medicine at a famous medical school in about 40 years, and then I can grill 20-somethings about cranial nerves. But for the time being I can say that I had an amazing elective, and I would thoroughly recommend New Zealand.

Nisheeth Rajpal, final year medical student, GKT, London
Email: email


studentBMJ 2000;08:89-130 April ISSN 0966-6494