After a weekend of exploration and recuperation I was excited come Monday morning to join the general medicine team. The day started off with the morning meeting where we discussed the patients on the ward. After a busy weekend we had thirty patients to visit on our ward round.

Having spent the last six months in small hospitals, and having not been on an official ward round in that time, thinking about a thirty patient ward round was intimidating. The general medicine team was a multicultural mix of consultants, registrars and interns. All of whom were welcoming and keen to teach and let me practice my clinical skills. Despite my reservations I was able to survive the ward round and started to get an idea of the different patients and presentations we were looking after.

The first thing that struck me from that morning was the prevalence of lifestyle related illness. Many patients were obese and many had illnesses related to smoking, alcohol and diet. I have always struggled with these illnesses knowing that they are preventable by healthy diet and exercise. But I am also aware that these choices are only possible with education and by living in an environment that facilitates a healthy lifestyle.

One patient that I remember from the week was a forty year old indigenous man who came in needing his ascites drained. The man was morbidly obese, had cirrhotic liver disease, diabetes, and sleep apnoea.  We drained 20 litres of fluid from the man’s abdomen, a procedure that had been performed three times previously. We asked him about his alcohol consumption and whether he was compliant to his CPAP machine. He told us that he had been drinking lately and his machine had been broken for the last three months. Both of which were contributing to his current state. I felt frustrated talking to this friendly man knowing that he could make, what to me seem like simple choices, to improve his health and quality of life. But in reality those choices are not simple and his poor health reflects the health of many Australian indigenous people.

Later on in the week I spent some time in the emergency department.  The department was busy with a wide variety of patient presentations. In one afternoon I helped decompress a pneumothorax, relocate a shoulder, drain an abscess, take a history from a woman with Addison’s disease, and help manage a woman having a pulmonary embolus.

This one afternoon in ED highlighted why I love rural medicine. Unlike in large teaching hospitals, where there is competition to see patients from many other students and junior doctors, in rural hospitals it is often just one student having one on one teaching from a senior doctor. The doctors are also often happy to teach and let you learn procedures and practice history and examination skills. All of this resulting in expansion of knowledge and skills without having to be three rows back at a patient’s bed.

I’m grateful to the Pat Farry Trust for their support of rural medicine and allowing me a vastly different experience of rural medicine then I am used to in New Zealand. I know that my time in Kalgoorlie has been valuable for both exposing me to a wide spectrum of disease and to people of a different culture, and for this I am very thankful.