The Ski Bum and the Single Parent.

   "Daddy, I heard you say the F-word!"

    Mt. Ruapehu, an active volcano on the North Island last blew its top with a major eruption in 1995-1996.  Since then it has had a few smaller eruptions most recently in 2008.  It is also home to two of the major ski fields on the North Island, Turoa and the other one of which I am still working out the pronunciation.  Our neighbor, a mechanical engineer who has been relaxing between jobs (living on the money he made in Aussie) has a ski home there. He has piqued my interest (lucky bastard) with his reports of the ski trips he has taken over the winter months.  His complaints of feeling "shattered" after some hard days snowboarding and the seven hour drive back to Kerikeri have garnered my deepest sympathy (Please get a job).  Why didn't I get to go? Oh, yeah. This is a WORKING sabbatical.

    It is mid October, and I am still trying to wrap my head around this southern hemisphere living.  Usually this is the time of year where the changing leaves and mountain valley rainfall find me nursing my shin wounds from a recent backcountry bushwhack...no..fishing trip while watching the snow reports tally the snowfall at the higher altitudes.  This year the calendar reads the proper dates, but instead of snowfall, I am enjoying the fragrance of orange blossoms while checking the ocean and beach temps. 
    A couple of weeks ago while sharing a beer in our backyard with our neighbor as he pulled his recently caught Waipapa Inlet mullet out of his bait net (Yeah, between ski trips, relaxing mechanical engineers drink beer and fish.  Did I mention the two college female exchange students, one Chilean, one German, neither language hard on the eyes, who are staying with his family?) a ski plan was hatched.  He reminded me that October 23-25 is Labour Day weekend in New Zealand.  The ski fields at Ruapehu were currently getting fresh snow from a southerly storm and another southerly was expected the week before the holiday.   "The ski fields will stay open 'til mid-November with this snow base. Bro,you oughta go."

     Hmm... Saturday morning clinic then drive seven hours.  Ski Sunday.  Hmmm...  I have hiked for seven hours just to make a few ski turns.  Lots of ski gear shipped over here sitting around waiting to be used.  Hmmm.  Day to drive back on Monday.  See more of this beautiful country....I'm in!
      Did I mention that Kim was going to be back in the US during that time.  Due to her amazing (some of my in-laws are following this blog) family, that has bonded together through some very difficult circumstances that I will discuss in a future post, Kim needed to go back to the US for a visit.  I was signed up for two weeks of single parenthood, (As opposed to the life sentence of double parenthood?) from October 11-26.

     Convincing the kids to go was a no brainer.  I have been grooming them as co-conspirators in getting mom back up onto the ski mountain since they were old enough to enjoy the snow.  Yeah, Kim was getting to be a pretty good powder skier, and even headed towards the bumps.  But ever since one slipped past the goalie and became a Joel bump, her skiing days have never been the same.  I am still scarred by my one and only solo attempt to get her back up on the mountain postpartum.  Hence my reason for looking for help from the kids.  Their joy of skiing has been infectious and we have had mom out a few times the last couple of years.  So when I told McKeely that I would take her skiing the week after her birthday, she was all in.  So was Joel.

    Now the part that would take some brains and organization:  Getting through the two weeks before the ski trip.  With a good after school program that the kids loved, generous colleagues at work who volunteered to cover our late acute clinic, and a day off per week to reload the groceries, the majority of the two weeks cruised by without much problem.  I would say I was the king of the daddy domain (it's good to be king when the queen is gone).   As king, I even was able to host a birthday party that included five little princess friends of my princess McKeely.  Thank goodness for an associate queen mum who stood in to help.  No way could I have combed that much candy (pinata malfunction) out of one little princesses hair!



  
     But then there was the full moon Friday before we were to leave for skiing.  The morning was going great before work.  Had the dishwasher nearly loaded.  Ten minutes early too.  Kids lunches packed and homework checked.  I am the domestic king!  Then the largest glass of spilled milk and Milo I have ever seen occurred.  It was also the first time I properly pronounced the name of the other ski area on Mt. Ruapehu.  Somehow as Joel was picking it up to drink, the glass opted to hit the counter ledge, twist out of his hand and spray ,with a couple bounces, the entire volume of milk onto nearly every cabinet front in the kitchen, onto Joel's pants, and the front of the refrigerator.
   So now we were five minutes late heading up the driveway.  Pleasantly drop the kids at school (Bye, get out.  Now!), and race to clinic.  Back to a normal day until the call from school at noon.  Seems that the one holer loo per classroom was not enough for the number of kids with post lunch gastrocolic reflex.  Kid number three in line could not control number one and "needs a fresh pair, so would it be OK for a teacher to walk your child home for a change of undies?"  Bummer.  "Sure that is fine, I am a half hour away."  What was that ski area name?  Thank goodness for some wonderful teachers at the school.
   A little late getting out of work, so the kids were the last ones at the after school program.  No big deal, as it is a holiday weekend, and next week, Kim will be back home for the after school routine.  That is when the volcano blew.  It started with a simple small voice.  "Daddy what are nits?"  Clinically, I have known it was only a matter of time before this happened.  Seems the nice moist warm environment in this part of New Zealand is ideal for the spread of head lice among school children.  Clinic nursing staff have since entertained me with stories of the number of times they have had to treat their children over the years.  At this moment though, I was not being entertained.  "Daddy, my head has been itching for the the past three days too." says the older of my precious children.   A rapid search through each child's scalp, which revealed plenty of crawling parasites, and I suddenly found myself an expert in pronouncing that second ski area name.
    A load of bedding into the washer, a drive back to the clinic to pick up a bottle of malathion, a stop at the store for a nit comb and additional conditioner (works great to loosen the nits for combing) and the battle was on.  By 2pm the next day, thanks to additional help from our unbelievable find of a babysitter, (yes, she rewashed bedding and combed the kids hair, while I finished Broadway's Saturday clinic) we were still able to depart for the ski field.  Hair and scalp hygiene much improved.  I packed the two remaining parasites (the ones that could have only been removed with a preemptive vasectomy on my part) into the car and headed south.

  
     The ski trip was wonderful, as the pictures show.  Turoa ski field treated us well.  It was definitely spring skiing, but the beauty of a snow covered volcano surrounded by the lush greenery of New Zealand more than made up for the quality of snow.  Mt. Taranaki, another volcano near the west coast of the island, even made an appearance on the sunny horizon.   Smiles all around erased some of the difficulties of the preceding weeks.

      As I sit and write this in a Taupo hotel room, kids worn out from the day, already tucked in bed, I do have some remorse for erupting in front of them.  Daily stress can catch up to us, and sometimes blow up to cause damage.  Fortunately, our children are at an age where they are highly inquisitive about the handling of emotional situations.  We had some great talks about words, communication, joy, anger, sadness, and losing a loved one during our drive to the mountain.  As parents and children, we are each growing up a little more each day.  Maybe as a dad I didn't handle full moon Friday as well as I should.

    
     While the sun sets across Lake Taupo with Mt. Ruapehu on the far horizon there is one thing I do know for sure. When they ask to go skiing again, thanks to my outburst, they will at least know how to properly pronounce the name of the other ski area at Mt. Ruapehu.
    "Dad, when can we go skiing at Whakapapa?"
     That's the story of the F-word in our house.  (Read the June 27 post for proper Maori pronunciation help.)          
  
  
               

Cathedral and Train, The Coromandel Part II

   After leaving Hotwater Beach and enjoying a lunch, not spaghetti on toast, at Cook's Beach, we considered our options for additional sightseeing on our way to our overnight destination in Whitianga.  The kids were begging to head to the hotel, as they knew it had a swimming pool.  The weather was not the best, and for some reason the statement made by an Aussie travel mate years ago, while traveling in Europe on a Contiki Tour bus, ran through my mind.
   "Ah, Jeez**!  Not another !%$ D$#% Cathedral!"

   That Aussie bloke uttered his religious observance as our bus pulled up in front of another institution in central Europe.  After several days in a row that involved stopping at a cathedral for a look around, he had had his fill.  Despite the inspired architecture, I too had to admit that they all started looking the same after awhile.

      With Cathedral Cove only a few minutes drive from Cook's Beach, I was hopeful that our family would have a better tolerance before we headed off to the hotel.  We were not disappointed.  Nothing like God's own carving with the help of Mother Nature, to provide beauty and inspiration. I have put in the video, mainly for a feel of the ocean ambiance while you view the pictures.  

   Fortunately the lunch had rejuvenated us, and it was an easy hike along the coast to the Cove.  The heavy ceiling of rain clouds intensified the reverence we felt for this site.  As we hiked back to the car for our final drive of the day to Whitianga, visiting Cathedral Cove was a wonderful way to finish our day enjoying nature. 

    After our overnight in Whitianga, blessed by another ocean front sunrise, we drove across the peninsula to Coromandel Town.  Formerly a gold mining town and port city in which surrounding Kauri trees were harvested for use as ship masts, this town now thrives on the gold from tourists pockets.  It also is famous for its Coromandel Mussels which are farmed in the bays near town. 

     We opted to take on the Driving Creek Railway, a narrow gage railway on private property that travels up into the native bushland.  In 1975 Barry Brickell, a schoolteacher who decided he did not want to teach school anymore, started a pottery workshop on land he obtained fairly cheap after it had been harvested of all its native Kauri trees.  He also was a railway enthusiast and decided that a railway would be the best all-weather transport to bring clay from the surrounding hills on his property to his workshop.  In 1990 the train was safely upgraded to carry people to the top of the property.  



The Snake Train



The potter's work

     





     As we wound our way to the Eyefull Tower at the top of the hill, 465 meters higher than we started, I came to a realization.  It takes a whole lot of wine to build a railroad!  Even though the tunnels and some other major structures were built with pottery tiles, all of the corner terracing of the rail bed was done with empty wine bottles buried neck first in the ground.  Maybe the potter needed to get on the wagon and not on the train!

The view from the top.  Whanganui Island.

Organic Devil's Sugar with Mt. Spaghetti on Toast Lands Us in Hot Water.

    The "spring break" school holiday started off with an amazing health discovery.  We had friends over for dinner whose child has some food allergies.  For dessert we had purchased New Zealand Organic Chocolate Ice Cream, as our friends knew this as a safe food for their child.  So what makes it organic?  I see the herds of dairy cows happily munching on the beautiful green grass hills on my way to work each day, so I am certain the main ingredient in the ice cream is starting from a certified "organic" source.

    So I had to laugh the following morning as I added a healthy scoop of ice cream to my breakfast oatmeal (try it, you'll like it) and read the ingredients label. Fourth on the list after organic cream, organic sugar and organic chocolate was none other than Organic Maize Syrup!  The much maligned sweetener...none other than the Devil's Sugar.  Maker of free radicals and a possible cause of obesity (other than our over eating, lack of sleep, and sedentary life?)  Label that syrup with its Mesoamerican name, and wah lah...Organic!  Bothered me so much, that I added another scoop!  Hope my pre-breakfast, predawn 5K run balanced out the danger of the Maize.

       I did not realize another interesting breakfast choice would be the theme of our travel during the school holiday.  Once again, Kim as social organizer/connector on our travels came through with a real bummer of a place to stay and visit.  A friend Kim met had invited us to stay with her family at their family condo in Mt. Manganui.  (Another postcard picture, but it is the best one I could find.  The arrow points to the little "shack" we stayed in.)  Mt. Manganui is a two hour drive southeast of Auckland, and fortunately it is one of the few places in New Zealand where the coast is commercialized like the California coast.  It has taken on the name of Mt. Spaghetti on Toast after our visit there.
         

   Let me introduce you to Harry, the youngest son of the Hannan family.  He is credited with introducing Joel and McKeely to the morning delicacy of cold spaghetti (canned spaghetti no less) on toast.   Harry is the youngest of the three children in his family, and the picture shows his go get 'em attitude.   His mum is great about balancing nutrition for her family (they own the local supermarket) but sometimes with a strong willed five year old, a mum's gotta do what a mum's gotta do!  So when Harry made his morning demand for the same meal he had for dinner, the spaghetti on toast breakfast was introduced. 

     Being the naive Americans, Kim and I only realized a couple of days later when we stopped at a cafe for lunch, that lo and behold, there on the bottom right corner of the chalk board menu, was spaghetti on toast.  We have taken notice of it on most every cafe menu since then.  Seems we have found a new Kiwi delicacy.  At the end of our two day stay in Mt. Monganui, the children had consumed 6 cans of the Mattie's spaghetti and a loaf of bread.  Nutritional balance, no, but it did give them enough energy to make the climb up the mount.

   

     I showed my appreciation for Harry's introduction of spaghetti on toast to our children on our final day in Mt. Monganui by almost allowing the poor kid to drown!  Bad dad morning.  Both Joel and Harry were keen to get out boogie boarding on the final day.  Problem was, the swell and surf were a little larger than the preceeding day.  I had volunteered to take the boys to the water while Kim, Deanne and her daughter Emma prepared (drank their coffee) themselves for the day.  Joined by McKeely we walked down to the beach.  The boys being boys, headed directly to the water.  Directly at the point where the biggest waves were hitting the beach.  I did my best to guide them further down the beach to the more gentle surf (woke the neighborhood by yelling at them!). 

     They headed down the shore a slight distance.  I was distracted briefly talking to McKeely and unbeknownst to me, the boys had immediately headed back into the water.  Next thing, I look back, and there is poor Harry getting pummeled by big waves while moving further out into the ocean than Joel.  His sudden realization that he is only half Joel's height, and in danger, showing on his face.  His boogie board strapped to his wrist doing a good job of bashing his head with eevery pounding wave.  After each wave passed, as he resurfaced, I could see the tears and fear growing in his, and my own mind.

    Swim bag dumped, warm dry clothing that I hoped to wear home from the beach still on, I splashed out into the surf.  Time sometimes seems to stand still during moments of high anxiety, and this became one of them.  Seems like I could not get out beyond Joel and to Harry fast enough.  Harry's minimal life line of the boogie board strapped to his wrist then separated and floated away from him.  Three more waves crashed over his head before I was able to get to him.  I lost sight of him a couple of times as he went under.  Standing now chest deep in the water, I finally was able to grab him as a fourth wave foamed into both of us.  It was only then, as I turned back to shore, that I noticed the concerned surfer on his board, a few meters from us. A look of relief on both of us, as the surfer handed me Harry's boogie board that he collected shortly after I had grabbed Harry.   

     Fortunately Harry was warmed, dried, and tears resolved, ready for more action by the time his mum showed up.  Me, I was thankful for the extra energy of the morning breakfast of spaghetti on toast!

   The rest of our week took us back up the east coast of the North Island to the Coromandel Peninsula.  As it is still spring time here, activity on the Coromandel is not yet full on.  The Coromandel is a popular summer tourist area, due to its beauty, and its proximity to Auckland. Our first destination after leaving Mt. Monganui was Hot Water Beach (HWB) again on the east side of the peninsula. 

   HWB is a wonderful  geologic feature that exists due to the volcanic nature of the islands.  Hot springs exit the earth along the beach front, and become accessible at low tide.  We had departed Mt. Monganui trying to time our arrival at Hot Water Beach to be just before the nadir of the low tide.  Due to the winding road, and some car sickness experienced by McKeely, we were a bit late, which turned out to be a bonus.    

     As you can see, with a little sweat equity, you can have your own hot tub on the beach.  With our late arrival, some visitors already had turned to prunes with their soak, and were abandoning their tubs.  The nice lady in the picture above to Kim's left, who was hosting a birthday party for 8 year old boys on the beach, saw us wandering about, and pleasantly informed us that the tub next to hers had just been abandoned.  Bonus! I had to show us in the pictures with shovels in hand, just to prove that we were still willing to put in a little effort to be lazy!

   The serenity of the sound of the rolling waves, coupled with the warm soak in the pool was relaxing to say the least.  As the tide came in, Joel and McKeely enjoyed sprinting out to the ocean and back to the pool for warmth.   Once again while watching their joy, I was reminded of the beauty of our world, the friendliness of people, and the thankful heart we all need for being alive each day.    And even though some days I may end up in hot water, while other days, life can be a beach, when you put those experiences together, life does not get any better!

 

Right Now

    "The ambu(lance) is here, now, with the patient you were expecting from the aged care center!" a slight sense of urgency in one of the practice nurses voice as she pokes her head into my exam room.

     "I'll just sign a script for this kiddo and I'll be able to come now", is my reply, aware of the experienced concern conveyed by our nurse.

    Right now a busy day on the acute side of the clinic is going to become a whole lot busier.

    As we enter the resuscitation room I now recognize the patient as a gentle Maori soul from the aged care center whose stroke 2 years ago at age 65 left him with ambulatory deficits, tremor, and a seizure disorder.

    I saw him a week ago, after he had a break through seizure.  Now I wondered if his recent drug levels and urine culture were available.

   Right now his gentle soul is hidden in a combative world of delirium, fending off carers, calling out forcibly and sometimes acting out violently.

    He now has a fever with a temperature to 39.1 and a heart rate of 118, infection headed towards sepsis, the cause of his delirium.

    This man needs an IV started, blood cultures, IV fluids, foley catheter, oxygen, antibiotics....and now that I am in New Zealand, the IV start falls to me. 

    "This man needs and IV now....I need to start an IV now...right....now" thoughts run through.

    Thin spider veins hidden beneath his dark skin...right now I wish I had spent more time practicing my IV skills before leaving the US of A.

     This man would be better off if I had a central line kit and an ultrasound machine, as I am more experienced with those tools than this IV catheter...but right now, those tools are not funded in this health centre.

    Steady now as I give a go at a vein in his left arm...a moving target...I have always respected the skills of the EMT's and paramedics who have brought patients to the ER's in which I have worked...they have to start an IV in even more unfavorable conditions...I respect them even more now!

    A poke...a flash of blood, an attempted advance....Curses!  Blown vein.

    Curses? Right now it has been over seven years since a malpractice suit started in a small Pacific Northwest town...who else's mind is wandering now?  Should not have checked my email earlier today...communication from a lawyer as a source of delirium can be worse than sepsis.

     Now I need a new IV catheter, and begin a search for another vein.

     This man's delirious soul is being tormented by the person with the tourniquet and needle, from which he now tries to flee.   Help, restraint, extra assistance arrive. 

    The four year old boy in the cubicle next store, awaiting his immunisations, starts to cry. The disruptive level of noise, now starts to rise.

   Noise! Disruption!  Deception?  Much like expert witnesses deciding the value of a persons life.

   Right now, the US government pays $6000 USD to the family of an Afghani father killed as a result of collateral damage, a value given to a human life.
   In your malpractice case, the lawyers have started the bidding at $5 million USD, said the email that I received.

    Now, at a time like this, why is the Declaration of Independence running through my mind?  " ....We hold these truths to be self-evident, that all men are created equal, that they are endowed by their creator...."  

   Right now, as is customary in malpractice litigation in the US, those same lawyers doing the bidding, may receive a windfall equal to thirty percent of the settlement.  Not a bad income for seven years work.

     "endowed by their creator..."  In his delirium this man is now praying to his creator in a haunting voice.  "Take these needles away from me, dear God!"

     In my own mind I am silently praying to the same God to guide my hands and technique to be true, so that this man can receive the help he needs right now.

    Steady now, the IV is in, blood draws back, fluid goes in.  Hurry and secure it now.  Tape, dressing a moment of relief. 

    Why did the poor kid have to get his immunisation jab right now?  The scream and cry of the child occurs, further agitating this man.

    Now, from what medications do I have to choose, to help calm his soul?  Thank goodness for another nurse with the IV medication tray at the ready.

    It has been several months since the battle over health care reform took place in the US. The battle in which the general public and legislators were convinced that malpractice litigation does not add to the cost of health care.

    Right now, I wonder if the taxpayers in a small Pacific NW hospital taxing district know that they have already contributed nearly $300,000 USD to a the cost of a single malpractice case. 

     Choices of medication to help calm his soul.  Diazepam (Valium) too long lasting, and respiratory depression for this man while on a long ambulance ride to the hospital will be fatal.  Right now the paramedic that can intubate is not on with the ambulance crew that has arrived.

     Ghosts in my head reminding me of the last time I ever ordered IV Valium.  Again, whose mind is wandering now?

    Haloperidol.  We have that.  Ah, now I remember that 3am discussion I had with an ICU nurse way back in my internship..."Do you like to use benzodiazepines or haloperidol to sedate your ICU patients, doctor?"  Doctor (DOK TUR) said with a hazing tone at the hands of an experienced nurse to create humility. 

     The medication is drawn up now.  Let's get it into this patient so he can settle.  The medication is flowing.

     Humility and a sense of calm.  The lessons that served me well.   Helped me survive through two days of being twisted and hazed by lawyers in a deposition.  

     Right now I need all my fingers and most of my toes to count the colleagues who have been put through... no hazed? Maybe ...Tortured? by the same malpractice process.  All of them are people to whom I would entrust my life for their medical care.

    Is anyone else wondering right now what purpose medical malpractice has in our health care system?

    The medication is working.  IV fluids, antibiotics.  Heart rate improving, blood pressure improving.   He is ready to be moved on to the hospital for additional care.

    The delirious voices are quieted....for now......