It’s been a whirlwind, not-quite-over-yet, first week in Kalgoorlie. I arrived on Saturday night, expecting that I would have a day to check out what the town had to offer. Little did I know that in Australia, everything is shut down on Sunday, so I was forced to appreciate some buildings from outside instead.

Kalgoorlie is a beautiful place in many ways. The dirt is a vaguely preposterous shade of red that makes me feel like I am in a Dr Seuss picture book. The hospital itself is also red brick and obviously built to be airy and shaded in the summer. At the moment though, in the depths of winter, its actually, dare I say it, a bit cold. But before I give up my southern credentials I have to stress that it’s only cold at night. I continue to tell Australians that is really hot though.

The hospital itself is quite similar to my experience of hospitals in fourth year. This is probably helped by the fact that a lot of the patients and quite a few of the doctors are actually kiwis! I spent the first day this week getting orientated, then we were lucky enough to be given a bit of an impromptu neonatal resuscitation tutorial with the paediatrics team. The general medical ward experience since then has generally consisted of the gen med meeting, the ward round, then jobs, much the same as in NZ.

I have seen some extremely interesting patients though, who highlight a few of the difficulties of rural medicine. One of these is a man who presented to the ED a few days before I arrived with bilateral leg pain. This turned out to be metastatic prostate cancer. He went through 8-10 weeks of excruciating pain before deciding that he needed to go to hospital. Because he lives a good 4 hours away and has no ready transport home he is remaining on the ward, waiting until Monday when he can have a bone scan, after which he will have an appointment with the urologist in Perth.

He is a very forthright ‘true blue Aussie’ and has the sort of pragmatic outlook that you might expect from the type of person stoic enough to endure 8-10 weeks of metastatic cancer pain without presenting to hospital. I have found it a bit difficult that he seems philosophical about being ‘at the end of his life’ when actually he is only in his late 60s.

Another interesting thing I have seen is some of the aboriginal Australian patients on the ward, one of whom only spoke a dialect for whom a translator was not available. Another patient who I was able to talk to was in hospital because he had missed 2 dialysis sessions because he was spending all his time walking. He would get up in the morning and walk, and continue until it was too dark. He has some family here, but more back home in Leonora, a few hours’ drive away.

Sadly for him, dialysis facilities are only available in Kalgoorlie, so he is forced to live here. Distance is always a problem in rural medicine, but in rural Australia, distances are particularly cruel.

I have also done some hanging out on the maternity ward. So far nothing has gone as expected. I got to assist with the delivery of a baby with intra-uterine growth restriction, who despite being over 36 weeks gestation, weighed only 2060g. Another I met was being induced because she has insulin dependent diabetes and the baby was very big already even though she wasn’t yet at term. The baby’s head failed to descend so first vacuum extraction, then forceps were tried, without success, so an emergency c-section was done. I got to follow the whole way through, finally scrubbing in for the c-section late at night. The best bit was being able to go and meet the baby with his exhausted, but elated mother the next day.

All in all, it has so far been an amazing experience. The health system is similar in a lot of ways in Australia, but more is privatised, and there are some confusing quirks to who funds medications that I haven’t figured out yet. This weekend we are hoping to head off somewhere and find some Australian activities! Thanks so much to the Pat Farry trust for enabling this fantastic experience.

Read Meaghan’s next blog