Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
Between the land and the sea
Between the land and the sea

Back in winter, Dunedin provided a warm welcome on a freezing weekend as host city for the RNZCGP Conference for General Practice, which proved something of a homecoming for many delegates who went to medical school in the city. New Zealand Doctor deputy editor Cliff Taylor returned there recently for a spring break to explore the harbour and Otago Peninsula
Tuesday night in George Street. The town is quiet, with a forecast of 4degC, which doesn’t bother the boys in shorts and T-shirts piling into a hatchback with boxes of beer from the Bottle-O.
Moray Place is a bastion of southern hipness. A man works alone in a shop roasting coffee while across the street The Dog With Two Tails is full of diners, watching the toy train chug endlessly around its elevated track near the ceiling. The place is always full after being named New Zealand’s best café last year by Hospitality New Zealand.
Posters in windows above the street call for the Government – or someone - to Rebuild Our Hospital.
The Leviathan Hotel house bar is full of big-bellied truck drivers – in shorts and T-shirts.
Dunedin in bright spring sunshine is glorious. Coffee and eggs at Modaks. There is an article in the Otago Daily Times with a photograph of a man who appeared in court the previous day. Later, I pass the same man in the street. It’s that kind of town.
It’s a good place for walking too, with small surprises around every corner; the literary trail around the Octagon, a few lines of a poem on a rock face, small circular holes drilled with coins into a wall by idle boys in decades past, now preserved behind Perspex.
The road to the car hire place in Great King Street runs north past the student flats, named The Greasy Beaver Lodge. The Jolly Roger. Signs pinned to doors – “Flats let 2018”.
The road to Port Chalmers is like a journey back in time, running beside the railway track out past Sawyers Bay, past the weather-roughened timber houses and wooden power poles.
Port Chalmers is drenched in sunshine. Chick’s Hotel is closed, it’s now a recording studio. But there is a feeling of permanence which the endless rumbling cavalcade of trucks from the container port cannot shake. The owner of the Union Co café is a former Aucklander. He runs guided walks for tourists and is helping organise a seafood festival at the harbour. The old town is in resurgent mode.
“I used to look up the street and see one car,” he says. “Now you can’t get a park.”
A man is sitting on the floor at the Box of Birds vintage shop. He says he’s looking for really bad folk records. He doesn’t say why.
Cold waves are piling onto the beach at Aramoana. Despite the wild beauty, its dark past still weighs on the place. A sealion basks on the sand.
A tourist train winds through the hills above Purakaunui. Snow-capped peaks inland are visible from the road above the inlet. Winter is not so far behind. Down in the settlement, there is no sign of life among the cribs. Just the sea rushing in and the sound of bellbirds and wind in the pines.
Surfers with wetsuits thick as seal skins are riding big Southern Ocean waves at St Clair.
The high road along the spine of Otago Peninsula is ravaged by slips from the recent destructive rains and is closed completely just past Larnach Castle, so it’s down to Portobello, then up again on a different route which eventually runs out at The Pyramids, two conical rock outcrops guarding Victory Beach, a long curve of white sand pummelled by barrel waves.
The track winds through wetlands of bracken and flax, past signs warning you are entering the habitat of sealions. Lizards and butterflies skitter and flit in the hot sun. It all feels remote and pristine.
Dark clouds are gathering over the hills but Papanui Inlet is flooded with warm sunshine igniting the water around a flotilla of black swans. The road becomes vertiginous, rising up and up until it runs out at Cape Saunders. The trees here are flayed and bent parallel to the earth. Rays of light angle down through the rain clouds out at sea.
Hooper’s Inlet is a shimmering version of the Robin White landscape on the wall of my friend’s house in Mornington.
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