...to Esperance

Injecting multiple trigger points in fibromyalgia, taking a punch biopsy of a suspected basal cell carcinoma, cryotherapy to solar keratosis, prescribing 5-fluorouracil for squqmous cell carcinoma in situ, managing a patient with septicaemia in hospital, all part of an average day's work for a rural GP in Australia.
Every single day that I've been here I've learned a new skill or taken on management of a condition that would have been in the hands of a consultant in the UK.

Dempster Street, looking towards the centre of town. The surgery is on Dempster Street, the main road into Esperance town centre.

Looking down to the sea from the surgery. The seafront is currently closed for repair

From EC1...

After ten years working in City Road Medical Centre, it felt like a good idea to take some time out to re-energise myself as a GP. Soon after our sabbatical trip at the end of 2011, I was approached by people from Perth who were looking for GPs to work in rural and remote locations in Western Australia. They put me in touch with Dr Graham Jacobs, GP Principal at Banksia Medical Centre in Esperance. My colleagues at City Road Medical Centre kindly gave me a one-year leave-of-absence. The paperwork to get registered and obtain a visa took much longer than anticipated  but we got here in the end.

For my first entry I'm posting some pictures I took in the practice area on my last working day before leaving London.

This is City Road, taken just outside the practice. City Road Medical Centre occupies the ground floor of the building on the right. You might just manage to get an unobstructed view of the Medical Centre at dawn on the school holidays. Then again you might not. City Road is best known from the nursery rhyme Pop Goes the Weasel: the Eagle is just behind the buildings on the left. 100 metres down the road, obscured by the bus, is Moorfields, the world's oldest and largest eye hospital. 

City Road Medical Centre is on the corner of City Road and Bath Street. Bath Street's claim to medical fame is that it is the site of the pits where the dead were dumped during the Great Plague of 1665. 

St Lukes, the area covered by the practice, has a long association with literature and nonconformism, being just outside the boundaries of the City of London. Milton wrote Paradise Lost here and Bunhill Fields contains the graves of John Bunyan, Daniel Defoe and William Blake.

Across the road from Bunhill Fields is Wesley's Chapel, the Leysian Mission and the Museum of Methodism.

St Lukes was part of the Metropolitan Borough of Finsbury. Often called the People's Republic of Finsbury, the council had a long tradition of progressive radicalism. Good quality social housing, public baths and a pioneering health centre were built in the early part of the twentieth century. Today, over two-thirds of City Road Medical Centre's patients live in social housing, the highest proportion in Islington and one of the highest in London.

Whitecross Street market, in the heart of the practice area, goes back to the 17th century. The market has had its up and downs, as has the local community. By the mid-19th century St Lukes had become one of the most notorious rookeries in London with appalling levels of poverty and deprivation. Today the practice area of 70 hectares has a population of 7,000. The area is thriving once again. Silicon roundabout, where City Road meets Old Street is the epicentre of Britain's technology industry. 

After just a few weeks away from City Road I'm struck by the crowded streets, the soaring buildings, the non-stop movement in the photographs

I've a feeling we're not in London anymore...