July 9, 2007

Hello family, friends, and possibly a few scattered enemies -

I have decided to resurrect the mass email idea while I am here in Darwin. For the first time since I lived in Malawi seven years ago, I have limited access to the internet. And, hopefully, there are people interested in what I have to say, who might want to read an occasional email from me. I suppose, this being 2007, I should just set up a blog. This is probably very easy to do for the motivated technophile. But I am not that motivated, or that philic, so it’s email [well, until now, when I am putting this up on a blog. Is that irony? Or just idiocy.]

I arrived in Darwin last week to begin a three month stay working at the Royal Darwin Hospital. Darwin itself is the largest town in the famed Northern Territory, better known abroad as the outback. The Northern Territory is very different than the rest of Australia - not even a state, just a “territory.” And it kind of has that frontier mentality. It’s the jumping off point for most of the bushwalking and adventure activities that are associated with Australia - “Australia in hyper drive”, as it’s described in the guidebooks, with the rugged terrain and very few people (the entire territory only has about 200,000 people, and half of those are in Darwin). But it’s also unique in that it’s home to most of the Aboriginal population, as well as a healthy number of Asian expats, given that it’s closer to Jakarta and Papua New Guinea than to Sydney or Melbourne. Most of the territory is desert, but in the Top End, where Darwin sits on the Timor Sea, it’s tropical, with a monsoon season and year-round heat. It’s actually almost exactly due east of Lilongwe, so the seasons are the same. Right now is the dry season, and technically winter, but really very comfortable with endless cloudless skies and temperatures in the 80s every day.

My job is to work as an infectious disease registrar (called a fellow in the US). It’s basically what I’ll be doing at Duke starting in mid-2008, so is another step above where I am right now in my training. I wanted to come here because I’m interested in tropical diseases - all that time in Central America and East Africa left its imprint - and the Royal Darwin Hospital is a very unique place to see tropical diseases. I can’t think of many places in the world where you can see lots of tropical disease, but English is spoken, and there is access to modern medical care such as CT and MRI scans, a full complement of medications and diagnostic tests, and specialists including ICU-level care. In fact, I can’t really think of anywhere else that meets all these criteria, except maybe South Africa, which isn’t quite tropical but does see patients flown in from the tropics. Essentially you see what is usually third-world disease, but in first-world conditions. So in my first day I saw leprosy and malaria and melioidosis, and suspected dengue fever, and several cases of tuberculosis.

It's hard to be away from the family. Josette took the boys to Maine the day after I left, which made it easier for Andrew, he's been to Maine without me before. Here is a snippet of the update I got from Josette:

"Andrew was in hog heaven with the July 4th parade that went by the house in Limestone. There were tons of tractors, fire trucks, ambulances, buggies, and clowns. At one point, Andrew left my sight, and I turned to the side and he was peeing on a bush near the house. All by himself. Just peeing. Shorts and underwear around his ankles, bare butt, no-hands, but his body was turned so that he wouldn't miss a minute of the parade. Pee was spraying everywhere. My cousins took a picture, and Andrew told everyone that his daddy taught him how to pee outside. 'It gives the earth a drink. Can't you hear the grass saying 'thank you'?"

So at least im my absence he has retained some of the important lessons I have instilled.

More to come later.