Fear and Despondency in Punta Arenas

Hello and greetings! Many apologies for not writing in such a long time. The truth of it is that on our way back from the Weddell Sea I really didn’t have anything particularly exciting to say- there were just a lot of grey and glowering waves- and then after our sojourn in Punta Arenas it felt like I had too much to say! So I kept putting it off as a bad job. I feel shame. I’m like Cersei Lannister- apart from, you know, the weird stuff.

The only excitement on our way into Punta Arenas- a huge flock of seabirds shadowed us!

I had a fantastic time in Punta Arenas. I took delivery of a huge cargo of chocolate and many books. The purser is now charged with rationing me to a bar a week lest my Christmas podge re-appear. And I had letters from my lovely other half and from a friend of my parents which was amazing! I sat and opened my mail whilst drinking a coffee and gazed out over the Atlantic. I felt so cool; it hurt. Martha Gelhorn totally did stuff like this!

Once chocolate supplies were assured however, my main priority was going for a swim. As I’m not quite stoical enough to go for a dip in the Southern Atlantic, I booked into a hotel. I donned my bikini and shot into the pool and wallowed for hours. Apparently my presence dismayed the other pool users; they promptly fled the scene after I began swimming laps and created my own little bow wave that washed them into the shallow part of the pool. I then spread further fear and despondency in the hotel by wandering back up to my room clad in my towel and bikini. Judging from the looks of dismay that I received, I’ve suddenly realised that behaviour that is charming and amusing when you are 5, lacks a certain something when you’re 32.

I ate out almost every evening in Punta- including in a French restaurant which was very agreeable. I had pate and hare in the Magellan style if you’re interested. Followed by a trio of chocolate pudding-y goodness. The waiter had clearly taken my measure by this point because afterwards he brought me out a coffee with a little chocolatey thing sat next to it. Pisco sours then ensued. This is an utterly lethal beverage containing egg whites, syrup, Pisco, bitters and lemon juice. After a number of months of drinking only on special occasions, it hit me like hand grenade. Wow. Apparently I insisted on making friends with every single dog in Punta Arenas. There are a lot of dogs in Punta. It took me hours to get back to my hotel.

I was not defeated by this minor hiccup however and the next day I sallied forth- blinking fitfully at the bright sunshine- to book a trip to Torres del Paine. This is a rather lovely national park that sits in the Patagonian part of Chile. The Paine massif- an outcropping of the Andes mountains- looms over the park which is heaving with the kind of flora and fauna that simply doesn’t exist anywhere else.

Approaching the national park

 Confused by Chile’s draconian laws about bringing in fruit or nuts? This unique environment is the reason why. Amongst the very exciting beasts that bound through the park are pumas, guanacos, rheas, condors and grey foxes! There’s a cave where prehistoric human remains have been found and there are three granite towers named Cleopatra’s Needles by a woman who gloried in the unlikely name of Lady Florence Dixie. What more could you possibly want in a park?

Bird of prey (any help guys?)

The guanaco

Cleopatra's Needles/ Torres del Paine

 I had imagined that it was too far to get to from Punta Arenas- but we found a tour company that were doing day trips. It did mean getting up at 5am to catch the minibus but it was well worth it.

My 5am face. I NEED that coffee

 We were exceedingly lucky; the weather is fairly unpredictable in Torres del Paine and we had a whole day of glorious sunshine. The joke goes “So, you don’t like the weather in Torres? Wait a minute.” Ho ho ho. Something of a dad-joke there. Our guide, Francesco, told us that the previous week he had taken a group to the park, waved at a wall of roiling clouds and said, “Well, the mountains are behind those clouds there. I can show you a picture if you'd like?” Our day was beauteous however and provided me with many an opportunity to take intrepid explorer photos. Such things are not to be sneezed at. I was enraged to see my buddy’s photos though. The little devil was taking photos on an i-phone and they looked far better than what I was taking on my cool, multi-lens camera. Only after stringing me along for several hours did he disclose that an I-phone lets you edit photos as you go along. Ah...

I'm an explorer! Just like Lady Florence Dixie!

We returned back to the ship at 10pm and exhausted by my dissipation; I crawled into bed. And that was it; the next day we were off! Back out to sea again. We’re in good company though; there are two science cruises aboard and most importantly, Boaty McBoat Face (the autosub) sails with us!

 

Cleopatra's Needles/ Torres del Paine

Neck Pain and Ice

I taught my first aid team how to take a history the other day and as I did so a little shockwave of warmth and contentment ran through me. You see, history taking is a game that patients like to play with doctors where we try to garner enough information to establish a diagnosis and patients do their best to obstruct that process.

Me: So, Mr X, how long have you had this pain in the neck?

MR X: Oh, a while.

Me: I see. Erm...any idea how long “a while” is? Are we talking weeks, months, years?

Mr X: Well, it started after I bought the new playstation.

Me: Riiiiiiight....I’m not quite sure when that was, Mr X.

Mr X: Well, you know, just after the TV.

Me giving up: OK, fine, fine. So what does the pain feel like, Mr X?

Mr X: Well, you know, it’s bad. Really sore.

Me: OK, yes, but you know how a burning pain is different to say, a stabbing pain? Which is different to an ache? Well, what does the pain feel like? Because that might help me to differentiate what the problem is.

Mr X: Well, it’s just bad really.

Me getting slightly high pitched: So I get that the pain is severe, but what I’m really trying to get at Mr X, is what the sensation feels like.

Mr X: Oh I see. Well it’s like a burning, stabbing, achey kind of pain really.

Mr X, this last in a helpful voice: But it’s really bad. Very sore.

Me: So, Mr X, do you have any previous medical complaints?

Mr X: No, none.

Me, nearly crying now: Are you quite, quite sure Mr X? Any idea why you might be on this cornucopia of medication then?

Now, I don’t want you to get the impression that doctors are impatient and intolerant individuals who bark questions at their patients and are never satisfied with the answers. No, indeed. We’re all lovely people. I, in fact, have a certificate of niceness! But the above conversation is one that will definitely be familiar to all of my colleagues so it was with a sweet sense of recognition that I saw very similar interactions being played out by my first aid team.

I had split the team in half and given one set of first aiders the scenarios and the others were to try and take a history from them using the SAMPLE (symptoms, allergies, medications, past medical history, last oral intake, events leading up to illness)  framework. It was so satisfying. I watched my first aiders struggling to gain the correct information from patients who decided entirely without prompting to be obstructive and withhold key nuggets of information. Perhaps my favourite moment was when I took on the role of the consultant on a post-take wardround (the consultant who reviews patients after admission and clerking by a junior doctor) and had various angry first aiders squawk, “Hey, you told me you had a pain in the neck, not in the buttock!” Welcome to hospital medicine lads. Welcome.

Joking aside, my first aid team are doing brilliantly. We’ve covered using splints, taking X-rays, history taking, wound and burn management, major trauma, managing severe allergies, and hypothermia and cold related injuries. I couldn’t be more pleased with them. But I wouldn’t be human if I hadn’t experienced a flicker of schadenfreude during the history taking...

That rather bold interlude aside, let’s talk about ice. As, I’m sure you’re aware, ice is the solid form of water. And as anyone who has ever had an iced drink will know, ice floats on top of water.

 Now this happens because ice is rather less dense than water and so it’s able to float. Think of water molecules as square dancers interacting with each other. In liquid water the music is playing and the dancers are gliding past each other, swinging their partners round and stripping the willow with glee. In ice, the music hasn’t started just yet so the dancers remain at a fixed distance from each other and they don’t move.

So what makes our icy square dancers so stand-offish? Well, water molecules have something called hydrogen bonds holding them together. In liquid water the hydrogen bonds are constantly breaking up and reforming, rather like our square dancers taking new partners. As water gets warmer, the particles within it have more energy so they move about more and break and remake the hydrogen bonds more frequently. The reverse happens as water gets colder. As water turns to ice, the water molecules stop moving about and stay still. The hydrogen bonds within the ice stop breaking and reforming and instead are fixed- just like the dancers when the music stops. Because the hydrogen bonds aren’t continually breaking and reforming, the water molecules are forced away from each other by the fixed and outstretched hydrogen bonds and thus the liquid water is denser than the ice because the molecules in liquid water can get closer together.

Now this is quite handy. If ice was denser than water it would sink to the bottom of our oceans and seas and these bodies of water would freeze from the bottom up. This would be rather a shame for all of the organisms that dwell at the bottom of our seas but it wouldn’t just be those organisms that suffered. Some scientists hypothesise that were the seas and oceans to freeze, they would reflect solar heat back out into space and in very little time our lovely home would turn into a massive ice ball.

The other rather nifty trait of ice is that it’s transparent. Light passes through ice to illuminate the water beneath. This enables photosynthesising organisms to make their home under the sea ice down here in the Southern Ocean whilst being protected from the wrath of the elements by the carapace of ice. The algae and young krill that live under the sea ice are a vital part of the food web of the Southern Ocean- without the sea ice these food webs could start to come apart and the cute little weddell seals and penguins might start to struggle.

Emperor Penguins

Emperor Penguins in the water

Now, you may wonder why the fate of a weddell seal is even remotely important to you. After all, that seal is a long, long way away. It never calls on your birthday and it certainly never sends you a Christmas card. All it does, in fact, is help to trap carbon that was in the atmosphere in its own body. Our friend the seal eats the krill, which feeds on the algae which strips carbon dioxide from the atmosphere. The southern ocean is a carbon sink of incredible importance and without the ice it might not do its job as well as it does. So if you’re opening a bottle of wine tonight, or perhaps enjoying a gin and tonic, I’d like you to raise your glass to the ice. Saving our planet, one cube at a time!