Two minutes’ silence were observed on Tuesday to mark one week passing since the earthquake. I was in the hospital canteen and at the end of the silence a prayer was read by members of staff. In some ways it was hard to believe a whole week had flown by, at the same time it is already becoming difficult to imagine life here as it was before.

Although the hospital seems in some ways quieter than usual (orthopaedics excluded), it has been a difficult week to be at work for everyone. A huge proportion of the junor doctors have lost their homes and are being put up in nearby flats with no running water, or are staying with other staff members dotted around the city. The usual stresses of work are being magnified after sleepless nights broken by aftershocks.
 
Now that the inital rush of injuries has passed, it is expected that cardiac and respiratory admissions will increase. I don’t know the numbers but you certainly read many admissions that start “central chest pain developed following aftershock” and the dust in the air is so thick it makes you thirsty as soon as you step outside. The practicalities of getting outpatient services up and running are complex, with many buildings still without power or water. We are now starting to try and catch up with telephone clinics to triage future appointments to make sure those who need an urgent appointment are not overlooked. I spent the end of the week phoning patients who had left as soon as the quake had struck to see how they were managing after their premature discharge. One man who had been in with an exacerbation of COPD was glad he had left as his flatmate’s partner was still missing in the collapsed Canterbury TV building.
 
The aftermath of what has happened touches everything. With every discharge the first consideration is do they actually have a home to go to? The answer is often no. One lady I have been looking after lost the house she has lived in for the last 45 years. Though like many Cantabrians , she remains amazingly upbeat. The neuroradiology meeting this week was somewhat limited by the fact that the magnet has been “shaken out of line.”
 
Despite all of this the hospital is running almost as normal, helped by an incredibly dedicated workforce and help from all over New Zealand. The registrar I am working with on nights has travelled from Wellington for a week, nurses from Auckland are working on the general medical wards with a new cohort arriving from Dunedin today. A team of orthopaedic surgeons arrived to relieve those who had been working non-stop for days. Even baked goods have been sent from all over the country and are distributed regularly around the wards to at least keep sugar levels high when spirits get low. It has been a revelation to see first hand just how much difference can be made by the thoughts and actions of people so far away.

Monica Jackson is a house officer at Christchurch Public Hospital.