Maui in Hawai’i is a big island, with a benign climate when the Pacific storms stay away. Its waterfalls and sunsets are famous. Tough place to have to travel to, but somebody has to do it, right? For the last ten days, I have been attending the University of California (UCSF)’s “High Risk Emergency” training in Maui.
I enjoyed the company of the emergency medicine faculty, who are stimulating teachers and warm, good-humoured humans. I particularly like this course (which I’ve attended a couple of times before) because it highlights emergency medicine situations which are risky for the patient and may also be risky for the health worker. People come to a clinic or an emergency department when they are really suffering or frightened — often both. Taking care of them at such a time calls for special skills. At the training last week, I became better equipped to look after children in pain. I also learned to use ultrasound for diagnosing internal bleeding and for bathing a nerve in anaesthetic so that pain can be relieved without knocking the patient out.
One evening after class, my wife drove an Australian colleague, her young adult son and me up the side of the volcano at Maui’s centre. Our plan was to see the sunset. The road to the National Park passed rural pastures with cattle, goats, horses and sheep. We passed through a forest of eucalypts, their leaves bushy and effusive. I’ve heard that eucalyptus trees flourish far from the drought and endemic bacteria of the native Australia. “They need some koalas,” my friend suggested, “They’d eat some of those leaves.”
As we climbed higher we passed remote houses pitched to enjoy the superb view to the coast. The sea in the distance shimmered silver, the horizon blending into a bright spring sky.
Entering the Park the road began to climb steeply up the mountain-side, switching back via hair-pin bends. Claudia drove deftly as the edge of the road fell away below us. We pulled over at the entrance to the path to a look out. The elevation there at Leleiwi lookout is about 8,800 feet. A sign with cultural information described this as a place where the spirit left the bones of people who had passed. At first, the stony path was unremarkable except for a closer look at some of the bright flowers and a view over the cloud-filled plains. But cresting a rise at the end of the path revealed an immense and strange space — a panorama of desert dunes and volcanic cones. Great sweeping stretches of earth in tones of sierra, russet and ochre lay before me, rising to rugged volcanic cliffs and ridges. While we stood there watching, the trade winds pushed billowing clouds into the valley and across the volcanic basin. Within a few minutes the space bigger than Manhattan island was covered in white cloud.
We huffed back to the car, feeling the effects of the thinner air. As we continued our journey, the vegetation became sparser. Black volcanic rock and dust dominated the landscape as we approached the summit. The observatory — one of those unique places fully occupied by the study of the infinite space around us — was dwarfed by the surrounding landscape. It was cold when we got out of the car. Claudia set up her tripod purposefully while the rest of us ambled. A striking plant of the summit was the Ahinahina — the silver sword. A shrub of spiralled, spoon-shaped spikes, brilliantly silver in the twilight, its leaves had an astonishing velvety feel. Climbing up on the ridge to join Claudia we saw a world of clouds, as you do from a plane, with the orange ball of the sun dropping below. It got colder and colder, with all of us putting on every piece of fabric we could find. I got stuck in the dark on the ridge with Claudia because she had the only torch and I couldn’t climb down without one. My hands were so cold they hurt as the blood came back into them in the car later. Claudia went out for a few more shots of the magnificent northern Milky Way. I resolved to bring my own torch next time.
Winding down the road in the darkness later I felt grateful for the opportunity I’ve had to travel for my education. The legend of Haleakala tells that the demi-god Maui went to the peak to argue and struggle with the Sun. His purpose was to help his mother complete her craft — drying the tapa cloth that connects people to their family and clan history. Maui was able to slow down time. In an emergency department, time moves very fast. Pain and panic can do that. But by giving me the knowledge to look more deeply into a patient’s emergency and by filling my days with different colours and ideas, the island of Maui has slowed down time for me. I will return refreshed to my clinic in the desert.