Normandie 70 ans plus tard

As we commemorate the 70th anniversary of the D-Day landings in Normandy (6 June 1944), I’ve been reflecting on my visit to the region in 2012 and the continuing legacy of that fateful day. It was indeed an eerie experience walking on ground where thousands of soldiers had given their lives.

Gold Beach, near Arromanches-les-Bains, was one of the British landing zones. These days it seems to be a popular recreational beach, however reminders of its wartime role are ever-present. Remnants of the Mulberry Harbour built by the British to offload matériel lie scattered around Gold Beach.

Gold BeachMulberry Harbour, Gold BeachOmaha Beach, to the west, was one of the American landing zones. The terrain is steeper and more rugged, and it’s not hard to imagine how difficult it must’ve been for US forces landing here under enemy fire.

Omaha Beach

Omaha Beach fortificationCimetière américain de Colleville-sur-Mer (Normandy American Cemetery and Memorial) looks over the beach and is a sombre reminder of the costs of war.

Normandy American Cemetery and MemorialReflecting Pool, Normandy American Cemetery and Memorial The photos above are also on my Flickr photostream.

Environmental Mobility Check

When I booked an ICE3 train from Munich to Frankfurt earlier this year, I was impressed by German railway operator DB Bahn‘s website which shows the comparative travel time and environmental impact of travelling by train, car and aeroplane. All you have to do is click on “Environmental Mobility Check”, which I’m sure must be a direct translation from German.

DB Bahn environmental mobility checkDB Bahn Environmental Mobility Check sample (click to see full-size)

I tried a few different origins/destinations for curiosity and, needless to say, travelling by train was always the most environmentally-friendly option. Catching high-speed rail with direct connections was no slower than travelling by car (even with Autobahns) or aeroplane for journeys up to 3–4 hours. Now if only we had a high-speed rail connection between Sydney and Melbourne…

Amour fou

During my travels aboard RATP trains (Métro/RER) in Paris recently, I spotted the quaint notice below aboard a few of the trains. Somehow, I have a feeling that the poetry (and meaning) may be lost on the target audience… (And yes, the walls of the 1970s-designed MI 79 rolling stock are actually orange.)

RATP - Amour fou

Amour fou

Les chewing-gums sont de grands romantiques,
Ces coeurs d’artichauts s’attachment très vite.
Mais les pauvres, rarement aimés en retour,
Cherchent désespérément le grand amour
Alors que la promesse d’un amour fusionnel
Est là dans tous les couloirs: c’est la poubelle!

—–
My translation:

Foolish love

Chewing gums are great romantics,
These fickle lovers attach themselves very quickly.
But the poor things, rarely loved in return,
They search desperately for true love
Yet the promise of a love that binds
Is there in all the passageways: it’s in the bin!

My colonial medical elective

Now that I’ve finally completed the Sydney Medical Program, it’s about time that I finally post some long-overdue reflections on my elective terms in London and Hong Kong at the start of the year.

The Royal London Hospital (Barts and The London, QMUL)

The Royal London Hospital

My first elective term was spent at The Royal London Hospital under Barts and The London School of Medicine and Dentistry (Queen Mary, University of London). The Royal London Hospital is a 650-bed tertiary hospital and the principal facility of the Barts and The London NHS Trust. It is particularly known as one of London’s major (level one) trauma centres and the home of the London Air Ambulance (Helicopter Emergency Medical Service), however a full range of medical and surgical specialties are represented.

Drs Po and Preston

I was assigned to the gastroenterology team under consultant gastroenterologist Dr Sean Preston. He was an excellent supervisor and I was lucky to have spent quite a lot of time under his guidance during my elective. Dr Roocroft (the F1 house officer) was also a great mentor, teaching me the ins and outs of being a house officer in the NHS.

Work casual

Work attire in NHS hospitals is very appropriately guided by infection control considerations. In summary:

  • no tie
  • sleeves rolled-up to elbows
  • no watch (most male doctors wear their watch on their belt)

The Royal London Hospital

The logic (and comfort) of this policy was such that I continued with this after returning to Sydney, where it was still convention for male doctors to wear ties.

Speaking English

There were a few differences in the medical vocabulary used in the UK, which took a little while for me to get used to. The most prominent ones during my elective were:

bleeper – pager
phlebotomy – venepuncture
OGD (oesophageogastroduodenoscopy) – endoscopy
TTA (to take away) – discharge summary

EastEnders

I alluded in a previous post that I lived in hospital accommodation. Indeed I found myself living in John Harrison House, The Royal London Hospital, Whitechapel E1 2DR for the duration of my stay in London. Whilst relatively cheap (approx. £100/week), it was rather spartan. One of the other JHH residents described living there as punishment for his sins, whilst more colourful language was employed by one of the senior registrars.

One of the unexpected consequences of living in Whitechapel, with its majority non-white population, was the difficulty I had in trying to find a decent full English breakfast. Despite there being half a dozen (halal) fried chicken shops on Whitechapel Rd alone, there were very few decent cafés in the area. Spotting a modern-looking café on New Rd advertising that they served “English breakfast”, I stepped into Zaza’s Café (E1 1HJ)… only to realise that they served a halal version of English breakfast: smoked turkey, beef sausage, egg, baked beans, mushroom & toast. It wasn’t bad, but it’s just not the same! Thereafter I quickly learnt the Arabic characters for halal (حلا).

Queen Mary Hospital (HKU)

My second elective term was spent at Queen Mary Hospital under the Faculty of Medicine, The University of Hong Kong. Queen Mary Hospital (est. 1937) is a 1400-bed tertiary hospital and the principal facility of the Hong Kong West Cluster, with a catchment area population of over 500,000 people.

Queen Mary Hospital, Hong Kong

I was attached to a final-year group undertaking their Specialty Clerkship rotation. This works rather differently from the way our attachments work during clinical years – instead of being attached to a specific medical/surgical specialty team for the duration of a clinical attachment, each group of HKU students is allocated to one general medical ward where they’re expected to clerk patients (with seemingly little direct role in patient care). They take part in case discussions, PBL tutorials, and clinics with consultants from different specialties over the course of the term. Often ward-based tutorials were quite crowded, particularly with the confined spaces inside most hospital wards in Hong Kong (see pic below – I wasn’t standing at the back).

Ward tutorial, QMH

Masquerade

I was in Hong Kong during the 2009 influenza H1N1 “swine flu” pandemic. Following their experience during the SARS epidemic, all Hong Kong hospitals had activated what they termed “pandemic emergency response level E2”. One of the E2 requirements was that a surgical face mask was required in all clinical areas – effectively meaning that staff/students had to wear surgical masks all day!

Emergency E2 clinical attire

White coat syndrome

In total contrast to NHS policy, Hong Kong clinical attire convention was still very conservative and included the wearing of a “clean, white laboratory coat”. I’d never previously worn a lab coat in the clinical setting, but noticed two advantages: (i) it was handy having large pockets in which to put my stuff (e.g. Oxford Handbook of Clinical Medicine), and (ii) I got my student/staff discount at the hospital cafeteria and Starbucks without having to show any ID. Nevertheless, once I returned to Sydney I greatly appreciated not having to wear a lab coat.

HKU Specialty Clerkship group a/b, 2010 rotation 1

Finally, I’d like to take this opportunity to acknowledge and thank the Specialty Clerkship group to which I was attached – Fifian, Jimi, James, Vincent, Rosemary, Edgar and Sha Sha – for helping me to fit-in and manage the language barrier.

London: First City of the Empire

London: capital of the United Kingdom and once the heart of the greatest empire the world has seen. I think English literary figure Dr Samuel Johnson said it best when he declared that, “When a man is tired of London, he is tired of life…” These are a few thoughts from my time living in (East) London, whilst completing my medical elective at The Royal London Hospital (Dec 2009 – Jan 2010). As usual, photo highlights are available on my Flickr photostream.

Old, new, borrowed, blue

I took quite a few photos whilst in London. Inspired by one of the memes from the final episode of Doctor Who this year (The Big Bang), I present here a small selection (with more available on my Flickr “Britannia” set).

Something old – Tower Bridge

Tower Bridge, London

Something new – City Hall, SE1

City Hall, London

Something borrowed – King’s Library, The British Museum, WC1

King's Library, The British Museum

Something blue – police box, Earl’s Court SW5

Police box, Earl's Court

Getting around London

One of the first things to get to grips with when you spend a decent amount of time in London is the arcane British postcode system. Whilst the postcodes may look like bizarre jumbles of letters and numbers (e.g. my address E1 2DR), they’re actually derived systematically – the first half of the postcode (“outward code”) is composed of a letter sequence for the locality and a district number, e.g. OX1 for central Oxford and L4 for Anfield, Liverpool; and is helpfully marked on street signs. Central London is divided into EC (East Central) and WC (West Central), and the rest of Greater London is divided into the eight compass directions relative to the city centre. The “inward code” localises to a specific street/block/building.

Great Ormond St sign

The actual process of getting around London is quite an efficient (albeit sometimes painfully slow) process, thanks to city’s comprehensive public transport network (Transport for London). Perhaps the most essential item for the intrepid traveller is an Oyster Card, a stored-value smartcard that can be used on all Transport for London services and most National Rail services within Greater London.

Oyster Card

London’s red double-decker buses are one of the city’s icons. Travelling by bus is a great way of absorbing the cityscape. It can also sometimes be a rather frustrating experience, thanks to the notorious traffic congestion in the city centre – it once took me almost an hour to travel 9 km from Whitechapel to Euston aboard the 205. Some routes are operated using “bendy buses” (articulated buses) where, unlike Sydney, passengers are allowed to board through any door – one of my cousins jokingly refers to them as “free buses” since many passengers don’t validate their Oyster Cards when entering through the rear doors.

Routemaster bus, Charing Cross

Routemaster bus, Charing Cross WC2

The other iconic mode of public transport is the London Underground, referred to as “the tube” by locals. The tube was the world’s first metro system and it shows… you very quickly become familiar with the multitude of stairs and tortuous tunnels within the stations. Also, many stations have narrow platforms that aren’t able to accommodate crowds – I did NOT appreciate being caught in stampede on an overcrowded platform at Bond Street Station (initially away from a fight that had broken out between two chavs, then subsequently onto the train once it arrived). Living in Whitechapel, I was often forced to contend with the Hammersmith & City Line, perhaps the worst line in the network for service frequency and reliability – so much so that one of the other medical students at my hospital preferred to commute from Euston on the painfully slow 205 bus (see above). Another other major issue with the tube is that there seems to be no mobile phone reception in underground stations and lines. Nevertheless, the network generally works quite well with mostly frequent and reliable services. I found the deep-level underground lines rather amusing because of the diminutive size of the rolling stock made necessary by the small tunnel diameter (e.g. 1996 Stock in the photo below). It can get quite claustrophobic inside the tiny deep-level tube trains!

Bond Street tube station

Jubilee Line 1996 Stock train approaching Bond Street tube station

Engineering work on the tube network means that train drivers sometimes have to override the digital voice announcement system and make passenger announcements themselves. One time, as I was travelling on a District Line train, the driver decided to employ British dry wit to entertaining effect (much to the confusion of several tourists aboard). A selection of quotes:

“Due to planned engineering work, there is no DLR service from Tower Gateway today. There is a special replacement magical mystery bus service operating.”

“This train will attempt to stop all stations, taking the scenic route to Richmond.”

“Trains do not stop at Cannon Street on Sunday, due to a complete lack of interest. The next station will be Mansion House.”

Life in Whitechapel

Whitechapel in London’s East End has an interesting history. It is associated with such diverse people as Jack the Ripper and Joseph Merrick (the “Elephant Man”). The Salvation Army was founded there. The bells for Big Ben, the Liberty Bell, and closer to home the University of Sydney Carillon were forged at the Whitechapel Bell Foundry. In recent decades the area has become known for its large Muslim population (predominately Bengali), with East London Mosque being one of the largest in Britain. It is an area of historical and continuing socioeconomic disadvantage, and it’s not without reason that Whitechapel Road is the cheapest property on the Monopoly board (see my previous Monopoly photos).

Whitechapel Rd, Whitechapel

Whitechapel Road, Whitechapel E1

I lived in Whitechapel for over a month and, despite my reservations, gradually became accustomed to the character of the area: traversing through the slum-like Whitechapel Road Street Market to buy my groceries at Sainsbury’s supermarket, the halal adaptation of English breakfast served in the local cafés (turkey bacon, beef/chicken sausages, &c.), the ubiquitous fried chicken stores, the old Bengali man who ran the newspaper stand at Whitechapel tube station from whom I bought my copy of The Guardian every day, the sight of the Gherkin looming to the west, etc.

Catching up with friends/family

During my time in the UK, a few of my medical friends were also completing their electives elsewhere in London and/or dropping by. I variously managed to catch-up with Athina (St George’s Hospital), Martina (Eastman Dental Hospital), Owen (Israel) and Aileen (Germany). It was hilarious sharing our experiences with adapting to the freezing weather conditions (one unnamed friend slipped-over multiple times on the ice outside her hospital), inquisition by the UK Border Agency, jet lag, terrible coffee, language barriers (even in the UK) and just being on the opposite side of the planet in general.

Jamie's Italian

I also caught-up with my English cousins on a few occasions. On the final occasion we had dinner at the London branch of Jamie’s Italian (as in Jamie Oliver) in Canary Wharf E14. The restaurant doesn’t take bookings, but it was well worth the hour-long wait. I still find the British concept of eating spaghetti with knife and fork quite amusing – as with coffee, the Brits clearly don’t have the Italian influence that we have in Australia – but then Jamie’s spaghetti bolognese was actually the best I’ve ever had!

Coffee – rewarding disloyalty

The general standard of coffee served in the UK is rather poor. I should’ve known it was a sign of things to come when my first cup of coffee on English soil was burnt to the point of being undrinkable. The second warning sign was when I discovered that the Brits consider the “flat white”, an ordinary Australian variant of café latte, to be a novel and highly regarded espresso drink. The first part of my salvation came when I discovered a café named “Flat White” (17 Berwick St, Soho W1) . As the name suggests, it’s actually run by an Antipodean partnership – who would’ve thought that we in the “colonies” would be the ones to rescue the Brits from coffee hell.

Coffee disloyalty card

The second part of my salvation came when I discovered the Prufrock Disloyalty Card, the brainchild of Gwilym Davies (World Barista Champion 2009). Gwilym’s idea was to promote the emerging East London coffee scene with the offer of a free coffee from him for visiting each of the places listed. Most of the places were a bit out of the way for me, however the places I managed to get to (The Espresso Room, Nude Espresso and the Whitecross Coffee Cart) were excellent.

Whitecross Coffee Cart

Whitecross Coffee Cart – Pitch 42, Whitecross St, Barbican EC1

The sun never sets…

While the British Empire may be no more, there are certain benefits from once being the centre of the greatest empire the world has seen. One of these is the vast collections of antiquities from across the world that are housed in Britain’s museums. Furthermore, in a rather enlightened public policy decision, entry to all national museums in Britain is free! I managed to spend several full days just at the stalwart British Museum. I also particularly enjoyed exploring the V&A Museum (art & design), the Wellcome Trust collections (history of medicine) at the Wellcome Collection and Science Museum, and the Natural History Museum’s Darwin Centre.

Natural History Museum

Central Hall, Natural History Museum

V&A Museum

Paul & Jill Ruddock Gallery (room 50a), V&A Museum

The Rosetta Stone

The Rosetta Stone, British Museum

Photo Monopoly

Whilst I was in London (Dec 2009 – Jan 2010) I met-up with my friend (and fellow Sydney Medical School student) Owen, who’d dropped by en route to his elective attachment in Tel Aviv. Over a drink in a Hammersmith pub, we made a bet about whether I’d be able to take a photo at each place on the Monopoly board during the rest of my time in London. It became clear, as I was hunting for all the places on the board, that some of the properties were chosen completely arbitrarily (e.g. Vine St, which has no significance whatsoever). And whilst it wasn’t entirely straightforward – Mayfair and The Angel aren’t streets, and Old Kent Rd was out of the way in Southwark, SE1 – I did eventually manage to get the photos and win the bet! So, without any further ado… (Photos are available at higher resolution on my Flickr photo monopoly set).

Railways set

Whilst Kings Cross and Liverpool Street are major National Rail stations, I found the choice of Marylebone and Fenchurch Street stations a little puzzling as they are two of the smallest stations in London. I think Paddington and Euston stations would’ve been better choices (even in the 1930s).

King's Cross, Marylebone, Fenchurch St and Liverpool St railway stations

Brown set

The photo here was taken on Whitechapel Rd, Whitechapel, E1, just outside The Royal London Hospital facing towards the City (“The Gherkin” building at 30 St Mary Axe is clearly visible). This is an area of historical and continuing socioeconomic disadvantage, reflected in its selection as the cheapest property on the board. I lived here for over a month and will reserve my thoughts for another post. In contrast, A2 Old Kent Road, Southwark, SE1, was quite typical of the A-roads leading out of central London.

Whitechapel Rd, Whitechapel

Getting there
Whitechapel Rd: Whitechapel tube station
Old Kent Rd: Elephant & Castle tube station then bus or ~2 km walk

Sky blue set

The Angel is a building on the northwest corner of Pentonville Rd and Islington High St, Islington, N1. Originally a coaching inn near the start of the Great North Rd (A1), the historical building lends its name to the surrounding area in Islington (e.g. Angel tube station). Pentonville Rd and Euston Rd, part of A501, are major roads in N1 and NW1 heading west from The Angel.

The Angel, Islington

Getting there
The Angel, Islington: Angel tube station
Euston Rd: Kings Cross St Pancras, Euston, Euston Square or Warren Street tube stations
Pentonville Rd: Angel or Kings Cross St Pancras tube stations

Purple set

The three streets in this group radiate outwards from Charing Cross, the historical centre of London. Whitehall and Northumberland Ave are home to many British government offices, whilst Pall Mall is home to St James’s Palace and various traditional gentlemen’s clubs.

Whitehall

Getting there
Pall Mall: Charing Cross, Piccadilly Circus or Green Park tube stations
Whitehall: Westminster, Embankment or Charing Cross tube stations
Northumberland Ave: Embankment or Charing Cross tube stations

Orange set

This group appears to be the most arbitrarily selected on the board. Bow St is a street in the Covent Garden district, WC2, and the location of the Royal Opera House. Great Marlborough St (presumably the “Great” was dropped for formatting reasons) in the Soho district, W1, is the location of the Tudor wing of the historical Liberty & Co. department store. Vine St is in the Piccadilly Circus district, W1, and is of no apparent significance.

Great Marlborough St, Soho

Getting there
Bow St: Covent Garden tube station
Great Marlborough St: Oxford Circus tube station
Vine St: Piccadilly Circus tube station

Red set

Trafalgar Square, WC2, is a famous public square adjacent to Charing Cross in the heart of London. It is the location of Nelson’s Column and the National Gallery. Strand and Fleet St, part of A4, are major streets heading east from Trafalgar Square. Important buildings on Strand include Australia House, King’s College London and the Royal Courts of Justice. Fleet St continues to be synonymous with the British press, although all major news agencies have since moved their offices elsewhere.

Fleet Street

Getting there
Strand: Charing Cross, Leicester Square, Embankment or Temple tube stations
Fleet St: Temple or St Pauls tube station
Trafalgar Square: Charing Cross tube station

Yellow set

Coventry St is the main thoroughfare between Piccadilly Circus and Leicester Square. Leicester Square is at the centre of London’s cinema and theatre district. Piccadilly, part of A4, is the home of the Fortnum & Mason department store, Ritz Hotel, Royal Academy of Arts, and Hatchard’s bookshop.

Piccadilly

Getting there
Leicester Square: Leicester Square tube station
Coventry St: Leicester Square or Piccadilly Circus tube stations
Piccadilly: Piccadilly Circus or Green Park tube stations

Green set

This group is the heart of London’s shopping district. Regent and Oxford Streets are the major shopping streets of London, intersecting at Oxford Circus. Of note, the flagship stores of Selfridges & Co. and John Lewis on Oxford St are the second and third largest department stores in the UK respectively. New/Old Bond Street (the two streets are contiguous) is another major shopping street in the upmarket Mayfair district.

Regent St, Mayfair

Getting there
Regent St: Oxford Circus or Piccadilly Circus tube stations
Oxford St: Marble Arch, Bond Street, Oxford Circus or Tottenham Court Road tube stations
New/Old Bond St: Bond Street, Oxford Circus or Green Park tube stations

Navy set

The upmarket Mayfair district is the home of many luxury shops and hotels. Although Park Lane no longer enjoys the prestige it had in the 1930s, as it has since become a major road on A4202, it nonetheless still features several 5-star hotels and luxury car showrooms. Marble Arch is located at the northern end of Park Lane. In choosing a landmark to represent Mayfair, I decided that The May Fair Hotel would serve as a fitting metaphor for the board game.

May Fair Hotel, Mayfair

Getting there
Park Ln: Marble Arch or Hyde Park Corner tube stations
Mayfair: Bond Street, Green Park, Hyde Park Corner, Marble Arch or Oxford Circus tube stations